bluuebunny/crossref_metadata_2025 huggingface dataset:
Ciprofloxacin-loaded alginate/poly (vinyl alcohol)/gelatin electrospun nanofiber mats as antibacterial wound dressings
Authors: Thairin Tittaya , Wutticharoenmongkol Patcharaporn
Published: February 2021

Herein, ciprofloxacin (CIP)-loaded alginate/poly (vinyl alcohol)/gelatin (SPG) (CIP–SPG) nanofiber mats were successfully fabricated by electrospinning. The average fiber diameters of the mats before and after crosslinking were in the range of 190–260 and 385–484 nm, respectively. The chemical integrity of CIP remained intact after encapsulation into the mats. The degree of weight loss and water swelling decreased with an increase in the gelatin content of the electrospun nanofiber mats. A release study was carried out by total immersion and diffusion methods using phosphate buffer as a release medium. Burst release of CIP was observed in case of the total immersion method, while a more sustained release was observed in case of the diffusion method. The maximum amounts of CIP released during total immersion and diffusion were in the range of 70–90% and 72–85%, respectively. For both the total immersion and diffusion methods, the released amounts of CIP decreased and the release slowed down with an increase in the gelatin content; this result is consistent with the weight loss and water swelling values. The Young’s modulus increased, while the tensile strength and strain at break decreased with an increase in the gelatin content. The CIP–SPG nanofiber mats were slightly toxic to L929 mouse fibroblasts as evaluated by indirect cytotoxicity assay. The electrospun CIP–SPG nanofiber mats exhibited excellent antimicrobial activity against Staphylococcus aureus and Escherichia coli. These results reveal that the electrospun CIP–SPG nanofiber mats are potentially promising materials for wound healing applications.
Anti-Proliferative Activity of Glucagon-Like Peptide-1 Receptor Agonist on Obesity-Associated Breast Cancer: The Impact on Modulating Adipokines’ Expression in Adipocytes and Cancer Cells
Authors: Alanteet Alaa A. , Attia Hala A. , Shaheen Sameerah , Alfayez Musaed , Alshanawani Bisher
Published: February 2021

Obesity is associated with high risk and poor prognosis of breast cancer (BC). Obesity promotes BC cells proliferation via modulating the production of adipokines, including adiponectin (anti-neoplastic adipokine), leptin (carcinogenic adipokine) and inflammatory mediators. In the present study we investigated the anti-proliferative effects of liraglutide (LG; anti-diabetic and weight reducing drug) on MCF-7 human BC cells cultured in obese adipose tissue-derived stem cells-conditioned medium (ADSCs-CM) and whether this effect is mediated via modulating the adipokines in ADSCs and cancer cells. Proliferation was investigated using AlamarBlue viability test, colony forming assay and cell cycle analysis. Levels and expression of adipokines and their receptors were assayed using ELISA and RT-PCR. LG caused 48% inhibition of MCF-7 proliferation in obese ADSCs-CM, reduced the colony formation and induced G0/G1 phase arrest. LG also decreased the levels of inflammatory mediators, suppressed the expression of leptin, while increased mRNA levels of adiponectin and their receptors in obese ADSCs and cancer cells cultured in obese ADCSs-CM. In conclusion, LG could mitigate BC cell growth in obese subjects; therefore it could be used for clinical prevention and/or treatment of BC in obese subjects. It may assist to improve treatment outcomes and, reduce the mortality rate in obese patients with BC.
The relationship between flourishing, injury status, and resilience in collegiate athletes
Authors: Martin Chelsea L , Shanley Ellen , Harnish Chris , Knab Amy , Christopher Shefali , Vallabhajosula Srikant , Bullock Garrett
Published: February 2021

Background

Flourishing is a multi-dimensional construct that encompasses physical, psychological and social well-being. A proposed positive attribute of flourishing is resilience, which is the ability to bounce back despite the presence of stressors. A common stressor among athletes is overuse injuries, which may negatively affect well-being.

Objective

To examine the relationships of resilience and overuse injury with flourishing in collegiate athletes.

Materials and methods

253 college athletes participated. The Flourishing Scale, Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC), and Brief Resilience Scale (BRS) were administered via online questionnaire. For OSTRC scores, athletes were classified into injury and participation status groups. For BRS scores, athletes were classified into low resilience (LR), normal resilience (NR), and high resilience (HR) groups.

Results

Median flourishing score was 50.0 (46.5–53.5); mean BRS score was 21.6 (SD 4.3). Overuse injury and substantial overuse injury incidence proportion (IP) were 25.4 (95% CI: 20.3, 30.5) and 9.1 (95% CI: 7.0, 11.2). The IP for participants unable to play was 15.1 (95% CI: 12.9, 17.2). Significant differences were found in flourishing among resilience groups (p = 0.002) but not among overuse injury groups (p = 0.140) or participation variables (p = 0.205).

Conclusion

College athletes demonstrated high flourishing scores. Flourishing demonstrated a significant relationship with resilience across all groups but not among overuse injury or participation status. This finding indicates that college athlete well-being is strongly associated with resilience. Future longitudinal studies are needed to determine if resilience can be modified to positively influence athlete well-being.
Different mechanisms, same result: Remembering the liberation war in Mozambique
Authors: Bueno Natália
Published: February 2021

Even though scholars have made substantial contributions in connecting the fields of transitional justice and memory studies, important questions remain unanswered. The question of sequencing is one of them. How does a certain TJ mechanism condition the implementation of subsequent mechanisms and how together they shape memory narratives in a given society? This article builds on the case of Mozambique. Soon after the signing of the General Peace Agreement in 1992, the Frelimo-led government approved Amnesty Law 15/92 and with it, the past was to be left in the past. Such a choice was different from the one taken by Samora Machel—Mozambique’s first president—between 1975 and 1982. By promoting a quasi-truth commission, Machel revisited Mozambique’s colonial past and brought comprometidos’ actions into the open. This article finds that whether the government opened up about the past or sought to leave it behind, the result has been the same: the celebratory reproduction of the liberation war narrative. Resorting to path dependence and critical junctures, this study explains the ways in which such a narrative has become hegemonic throughout the last four decades.
Reliability of bilateral and shear components in a two-legged counter-movement jump
Authors: Gordon David , Hayward Steven , van Lopik Katherine , Philpott Lydia , West Andrew
Published: February 2021

Strength asymmetry can be detrimental to athlete performance and may lead to injury. The countermovement jump (CMJ) can be used to measure strength asymmetry via shear force production. The reliability of parameters and effects of asymmetry and shear force production on vertical CMJ performance were evaluated in a study with 15 university-level sprint and high jump athletes ( m = 11, f = 4). The athletes performed three CMJs on two occasions, separated by 1 week. Tri-axial ground reaction force (GRF) was recorded using two force platforms embedded within a bespoke weight training area. Key performance metrics were calculated in real-time describing total CMJ performance, asymmetry and shear force production. Changes in the means and coefficients of variation (CV) were used to express reliability. Twenty-six parameters from the Total analysis and 21 Asymmetry analysis parameters showed a CV lower than 10%. Temporal and kinetic variables describing Asymmetry analysis highlight a lower CV compared with equivalent parameters derived from Total analysis. Shear parameters show high levels of CV compared with Total analysis and Asymmetry analysis. The measures of asymmetry calculated using methods described in this work were shown to be reliable for monitoring CMJ performance. No significant negative relationships were found between measures of asymmetry or shear force and traditional performance metrics in the CMJ (e.g. jump height, specific peak power and peak force). Further work is required to identify the potential of reducing asymmetry on CMJ performance.
Time in Range Does Not Associate With Carotid Artery Wall Thickness and Endothelial Function in Type 1 Diabetes
Authors: Cutruzzolà Antonio , Parise Martina , Scavelli Faustina B , Barone Milena , Gnasso Agostino , Irace Concetta
Published: February 2021

Background:

Patients with Type 1 diabetes (T1D) have an increased risk of developing atherosclerosis and complications as myocardial infarction and peripheral artery disease. The thickening of the carotid wall and the brachial artery dysfunction are early and preclinical manifestations of atherosclerosis. The standard marker of care for assessment of glycemic control, glycated hemoglobin, does not associate with early atherosclerosis. We have hypothesized that the emerging metric of glycemic control, as the time spent in the target range (TIR), might be associated with carotid thickening and endothelial dysfunction. According to the hypothesis, we have designed the present research with the aim to evaluate the association between TIR collected in the short and long term and the measures of arterial morphology and function in patients with T1D.

Methods:

In our study, 70 patients and 35 healthy controls underwent ultrasound vascular study to measure carotid artery intima-media thickness (IMT) and brachial artery endothelial function by the flow-mediated dilation (FMD) technique. TIR was collected by a continuous glucose monitoring system for 2 weeks, 3 months, and 6 months before the vascular study.

Results:

Patients with T1D showed a significantly higher carotid IMT (mean±SE, 644±19 vs. 568±29 µ; p= 0.04) and a significantly lower FMD (mean±SE, 7.6±0.4 vs. 9.8±0.6%; p=0.01) compared with control subjects. No significant relationship between IMT, FMD, and TIR collected in the short and long term emerged.

Conclusions:

Young patients with T1D have early vascular abnormalities. The percent of TIR does not correlate with preclinical atherosclerosis. This finding underlines the complexity of the interplay between diabetes and atherosclerosis.
Contemplating Framing: Unpacking the Possibilities of Printmaking in Narrative Inquiry
Authors: Lavoie Michelle , Caine Vera
Published: February 2021

In this paper, we explore, name, and unpack the possibilities that printmaking, as an art form, holds in visual narrative inquiry. We also explore the relationship between visual narrative inquiry and narrative inquiry, a relational qualitative research methodology that attends to experiences. Drawing on two different ongoing narrative inquiry studies, where we engage with either trans young adults or refugee families from Syria with pre-school children, we explore how printmaking practices facilitate processes of inquiry. The etymology of the word “frame” helps us understand framing as a process that is future oriented and reflects a sense of doing, making, or preforming. In this way, framing allows us to see otherwise, to respond to and with participants, and to engage with experiences in ways that open new possibilities of inquiry.
Clinical Anatomy of the Posterior Meniscofemoral Ligament of Wrisberg: An Original MRI Study, Meta-analysis, and Systematic Review
Authors: Pękala Przemysław A. , Łazarz Dominik P. , Rosa Mateusz A. , Pękala Jakub R. , Baginski Adam , Gobbi Alberto , Wojciechowski Wadim , Tomaszewski Krzysztof A. , LaPrade Robert F.
Published: February 2021

Background:

The posterior meniscofemoral ligament (pMFL) of Wrisberg attaches to the posterior horn of the lateral meniscus and the lateral intercondylar aspect of the medial femoral condyle and passes posteriorly to the posterior cruciate ligament (PCL). The pMFL plays a role in recovery after PCL injuries and offers stability to the lateral meniscus, promoting normal knee function.

Purpose/Hypothesis:

The aim of the magnetic resonance imaging (MRI) arm of this study was to evaluate the prevalence of the pMFL in Polish patients. The purpose of the systematic review and meta-analysis was to evaluate the clinical relevance of the pMFL in knee surgery. It was hypothesized that extensive variability exists in reports on the prevalence, function, and clinical significance of the pMFL.

Study Design:

Cross-sectional study and systematic review; Level of evidence, 3.

Methods:

A retrospective MRI investigation was conducted on 100 randomly selected lower limbs of Polish patients (56 male, 44 female) performed in 2019 to determine the prevalence of the pMFL. Additionally, an extensive literature search of major online databases was performed to evaluate all reported data on the pMFL. Assessments of article eligibility and data extraction were completed independently by 2 reviewers, and all disagreements were resolved via a consensus. A quality assessment of the included articles was performed using the Anatomical Quality Assessment tool.

Results:

In the MRI arm of this study, the pMFL was observed in 73 of the 100 limbs. In the meta-analysis, 47 studies were included, totaling 4940 lower limbs. The pooled prevalence of the pMFL was found to be 70.4% (95% CI, 63.4%-76.9%); the mean length was 27.7 mm (95% CI, 24.8-30.5 mm) and the mean widths were 4.5, 6.1, and 4.1 mm for the meniscal and femoral attachments and midportion, respectively. The mean pMFL thickness was 2.3 mm (95% CI, 1.8-2.7 mm).

Conclusion:

Despite the variability in the literature, the pMFL was found to be a prevalent and large anatomic structure in the knee joint. The shared features of this ligament with the PCL necessitate the consideration of its value in planning and performing arthroscopic procedures of the knee.
Seizing a Window of Opportunity? The Causes and Consequences of the 2020 Sino-Indian Border Stand-off
Authors: Westcott Stephen P.
Published: February 2021

In 2020, the Sino-Indian Line of Actual Control (LAC) witnessed several violent clashes between the People’s Liberation Army (PLA) and the Indian military that resulted in a tense stand-off between the two highly mobilised armies and plunged Sino-Indian bilateral relations to its lowest point since the 1962 border war. Whilst confrontations between Chinese and Indian border forces are relatively commonplace, this recent crisis has proven remarkable due to the ferocity of the clashes and the alarming pace and degree to which established rules of engagement on the LAC have broken down. With both sides seemingly locked in a stalemate, it is prudent to reflect on the causes and significance of the current stand-off. This article argues that the crisis was largely precipitated by China’s calculation that India’s recent border infrastructure building activities and assertive domestic and foreign policy in the erstwhile state of Jammu and Kashmir could threaten the PLA’s tactical advantage along the border, and eventually undermine China’s hold over the disputed Aksai Chin region. Acting on these perceptions and sensing that a ‘window of opportunity’ could be rapidly closing, the Chinese government authorised the PLA to initiate actions to consolidate its advantageous position on the LAC. Although both militaries are fully mobilised and in close proximity across the LAC, both sides clearly recognise the decision to go to war would not benefit either side. Hence, both sides will need to engage in some deft diplomacy going forward to resolve the current crisis and to reset bilateral ties.
India, Taiwan and the Indo-Pacific: Economic–Security Strategic Partnership and Expected Utility Theory
Authors: Vanvari Neel , Tan Alexander C.
Published: February 2021

The China–India border dispute has witnessed escalations recently with China making fresh claims along the disputed border and deaths of Indian military personnel. This study examines the likelihood of a strategic partnership between India and Taiwan. We begin by assessing India’s ‘Act East Policy’ and Taiwan’s ‘New Southbound Policy’ for any points of congruence between these two policies. We then propose an expected utility model of India’s decision calculus. Using the theoretical implication of the model, we then examine the likelihood of a strategic partnership along two dimensions—an economic and a defence–security partnership. This study argues that the value added by an economic strategic partnership between the two countries may be substantial, and the likelihood of such a partnership may be significant. However, the likelihood of a defence–security partnership is substantially less in the bilateral sphere, although at the multilateral level there are areas where defence cooperation can occur.
Pragmatism as Problem Solving
Authors: Prasad Monica
Published: February 2021

At the level of sociological practice a three-sided debate occurs in American sociology between the rationalist tradition, in which the goal is the better understanding of society; the emancipatory tradition, in which the goal is improvement of society; and the skeptical tradition, which argues that we cannot know if either our knowledge or our norms are correct, and therefore it is not possible to expect progress in either. Each of these strands runs into difficulties: for the rationalist tradition, an inability to cumulate knowledge; for the emancipatory tradition, a difficulty in grounding the norms that would determine what counts as emancipation if norms are socially constructed; and for the skeptical tradition, inability to accept the logical conclusion of the argument, which is inaction even in the face of extreme injustice. The author shows that when pressed on these points, each tradition moves in the direction of pragmatism understood as problem solving, and that the practice of problem solving offers resolutions to these dilemmas.
Rethinking the biopolitical: Borders, refugees, mobilities…
Authors: Minca Claudio , Rijke Alexandra , Pallister-Wilkins Polly , Tazzioli Martina , Vigneswaran Darshan , van Houtum Henk , van Uden Annelies
Published: February 2021

This Symposium reflects on the growing relevance of biopolitical perspectives in camps studies, border studies, refugee studies, and in particular in research at the intersection between mobility studies and political geography. The five interventions accordingly engage with questions regarding the use of biopolitics as an analytical framework, but also as a pervasive strategy and governmental tool in Western societies. Through an analysis of several empirical cases – most notably hotspots on the Greek Aegean Island, refugee’s forced hyper mobility in Europe, speech acts connected to the ethnic cleansing of the Rohingya people in Myanmar and the ‘voluntary return’ policies in Europe, and the paper borders created by visa systems – the authors indicate new possible fields of enquiry related to the biopolitical critically inspired by the work of authors such as Giorgio Agamben and Jasbir Puar, while also clearly restating the fundamental importance of Foucault’s original contribution to any biopolitical analytical framework today.
Telemedicine Foot and Ankle Visits in the COVID-19 Era
Authors: Labib Sameh A. , Goel Rahul , Manz Wesley , Bariteau Jason
Published: February 2021

Background:

The COVID-19 pandemic created a difficult environment to provide musculoskeletal care to patients with foot and ankle pathology given the limitations placed on in-office visits. Telemedicine offered a unique avenue to reach these patients; however, the efficacy of telemedicine visits in patients with foot and ankle pathology is not well studied. We propose a telemedicine protocol that has allowed us to effectively see and treat patients with foot and ankle pathology.

Methods:

A 12-step standardized telemedicine protocol was created within the Foot and Ankle division that was used for seeing patients through telemedicine. Also included in this is previsit preparation and follow-up recommendations. Press Ganey surveys were retrospectively reviewed to understand patient experience with telemedicine.

Results:

85.2% of patients surveyed responded with scores indicating excellent care. When comparing patients who were seen in-office and through telemedicine, 89.2% and 83.4% responded with scores indicating excellent care, respectively ( P = .37).

Conclusion:

Telemedicine offers an effective and convenient way to provide excellent musculoskeletal care to patients affected with foot and ankle pathology. This is the first study that evaluated a comprehensive protocol for telemedicine encounters and can be used to implement telemedicine by others using this approach.

Level of Evidence:

Level V, expert opinion.
Treatment Intensity of Psoriasis Decreases With Age
Authors: Muddasani Suraj , Fleischer Alan B.
Published: February 2021

Background:

Elderly patients have worse skin related quality of life regardless of psoriasis severity. Despite this, there may be risks to starting systemic immunosuppressant therapy, a mainstay for moderate to severe psoriasis, in elderly patients.

Objective:

We assessed how age relates to treatment intensity for psoriasis. We defined treatment intensity as a continuous scale with a value of 0 indicating no treatment, 1 indicating topical treatment only, and 2 through 4 indicating progressive degrees of systemic treatment.

Methods:

We assessed the National Ambulatory Medical Care Survey from 1997 to 2016 to determine if treatment intensity for psoriasis was related to a patient’s age.

Results:

Between 1997 to 2006, a 1-year increase in age was not associated with a change in treatment intensity score for the younger ( p = .4) and older ( p = .8) age groups. Between 2007 to 2016, a 1-year increase in age was associated with a .01 (95% confidence interval .005, .02) decrease in the treatment intensity score ( p = .003) for patients aged 52 or older. When controlling for sex and race, a 1-year increase in age was associated with a decrease of .01 (.02, .005) in the treatment intensity score ( p = .005). There was no association with those who were younger than 52 ( p = .5).

Discussion:

Physicians provide less intense treatments for elderly patients with psoriasis. This effect has appeared in the last decade. It remains unknown if physicians are being cautious with more intense treatments in elderly patients or if they are unintentionally undertreating this population.
Addition of lenalidomide to intensive treatment in younger and middle-aged adults with newly diagnosed AML: the HOVON-SAKK-132 trial
Authors: Löwenberg Bob , Pabst Thomas , Maertens Johan , Gradowska Patrycja , Biemond Bart J. , Spertini Olivier , Vellenga Edo , Griskevicius Laimonas , Tick Lidwine W. , Jongen-Lavrencic Mojca , van Marwijk Kooy Marinus , Vekemans Marie-Christiane , van der Velden Walter J. F. M. , Beverloo Berna , Michaux Lucienne , Graux Carlos , Deeren Dries , de Weerdt Okke , van Esser Joost W. J. , Bargetzi Mario , Klein Saskia K. , Gadisseur Alain , Westerweel Peter E. , Veelken Hendrik , Gregor Michael , Silzle Tobias , van Lammeren-Venema Daniëlle , Moors Ine , Breems Dimitri A. , Hoogendoorn Mels , Legdeur Marie-Cecile J. C. , Fischer Thomas , Kuball Juergen , Cornelissen Jan , Porkka Kimmo , Juliusson Gunnar , Meyer Peter , Höglund Martin , Gjertsen Bjorn T. , Janssen Jeroen J. W. M. , Huls Gerwin , Passweg Jakob , Cloos Jacqueline , Valk Peter J. M. , van Elssen Catharina H. M. J. , Manz Markus G. , Floisand Yngvar , Ossenkoppele Gert J.
Published: February 2021

Lenalidomide, an antineoplastic and immunomodulatory drug, has therapeutic activity in acute myeloid leukemia (AML), but definitive studies about its therapeutic utility have been lacking. In a phase 3 study, we compared 2 induction regimens in newly diagnosed patients age 18 to 65 years with AML: idarubicine-cytarabine (cycle 1) and daunorubicin and intermediate-dose cytarabine (cycle 2) without or with lenalidomide (15 mg orally on days 1-21). One final consolidation cycle of chemotherapy or autologous stem cell transplantation (auto-SCT) or allogeneic SCT (allo-SCT) was provided according to a prognostic risk and minimal residual disease (MRD)–adapted approach. Event-free survival (EFS; primary end point) and other clinical end points were assessed. A second random assignment in patients in complete response or in complete response with incomplete hematologic recovery after cycle 3 or auto-SCT involved 6 cycles of maintenance with lenalidomide (10 mg on days 1-21) or observation. In all, 392 patients were randomly assigned to the control group, and 388 patients were randomly assigned to lenalidomide induction. At a median follow-up of 41 months, the study revealed no differences in outcome between the treatments (EFS, 44% ± 2% standard error and overall survival, 54% ± 2% at 4 years for both arms) although in an exploratory post hoc analysis, a lenalidomide benefit was suggested in SRSF2-mutant AML. In relation to the previous Dutch-Belgian Hemato-Oncology Cooperative Group and Swiss Group for Clinical Cancer Research (HOVON-SAKK) studies that used a similar 3-cycle regimen but did not pursue an MRD-guided approach, these survival estimates compare markedly more favorably. MRD status after cycle 2 lost prognostic value in intermediate-risk AML in the risk-adjusted treatment context. Maintenance with lenalidomide showed no apparent effect on relapse probability in 88 patients randomly assigned for this part of the study.
What pulmonologists need to know about extrapulmonary tuberculosis
Authors: Natali Delphine , Cloatre Georges , Brosset Christian , Verdalle Pierre , Fauvy Alain , Massart Jean-Pierre , Vo Van Quy , Gerard Nelly , Dobler Claudia C. , Hovette Philippe
Published: February 2021

Extrapulmonary tuberculosis (EPT) can affect all organs. Its diagnosis is often challenging, especially when the lung is not involved. Some EPT locations, such as when the central nervous system is involved, are a medical emergency, and some have implications for treatment options and length. This review describes clinical features of EPT, diagnostic tests and treatment regimens.
Contact Stress Distribution of a Pear Cam Profile with Roller Follower Mechanism
Authors: Yousuf Louay S. , Hadi Nabil Hassan
Published: February 2021

The problem of this paper is the high contact stress at the point of contact between the cam and the follower. A pear cam and roller follower mechanism were studied and analyzed for different position of the follower and different contact compression load. The objective of this paper is to study the effect of contact compression load on the contact stress distribution of the cam profile at the point of contact. Four different positions of the follower with the cam was considered (0°, 90°, 180°, and 270°). The theory of circular plate was applied to derive the analytic solution of the contact stress. The numerical simulation had been done using ANSYS Ver. 19.2 package to determine the contact stress, while SolidWorks software was used to investigate follower displacement, velocity, and acceleration. Four distinct values of the compression contact load, such as 3.121 N, 6.242 N, 9.364 N, and 12.485 N, were used in the numerical simulation. In the experiment setup, a photo-elastic technique was carried out in the field of polarized light to exhibit the stress distribution on the cam specimen. The annealed PSM-4 backalate material was used in the experiment setup. The experimental value of contact stress was checked and verified analytically and numerically at the point of contact. The innovation in this paper the use of spring-damper system which reduce the value of contact stress at the point of contact. The contact stress was maximum 2.136 MPa when the follower located at 270° with the cam, while the contact stress was minimum 1.802 MPa when the follower located at 180° at compression load 12.485 N.
Secondary analysis of change in physical function after exercise intervention in older adults with hyperkyphosis and low physical function
Authors: Gladin Amy , Katzman Wendy B. , Fukuoka Yoshimi , Parimi Neeta , Wong Shirley , Lane Nancy E.
Published: February 2021

Background

Hyperkyphosis is common in older adults and associated with low physical function and reduced health related quality of life (HrQol). Improved kyphosis has been previously established in kyphosis-targeted interventions in randomized controlled trials in older adults with hyperkyphosis; however, evidence for improved physical function is conflicting. Few studies have investigated change in physical function after a targeted kyphosis intervention in older adults with low physical function. The primary aim in this descriptive study was to explore change in physical function after a progressive high-intensity 3-month targeted kyphosis exercise and posture training intervention in older adults with low physical function and hyperkyphosis. Secondary aims were to explore change in HrQol, spinal strength and spinal curvature, and adherence and safety of the intervention.

Methods

In this secondary analysis of the Specialized Center of Research (SCOR) Kyphosis randomized trial, 101 community dwelling older men and women with hyperkyphosis who completed the intervention were divided into a low function group (LFG) and high function group (HFG). Baseline characteristics were compared between LFG and HFG. Physical function, HrQol, spinal strength and spinal curvature (kyphosis and lordosis) pre/post intervention change scores were explored within and between groups. Adherence and adverse events were examined in the LFG and HFG.

Results

Twenty-six (26%) older adults were LFG, mean Short Phyiscal Performance Battery (SPPB) 9.62 (SD = 1.17) points. At baseline, the LFG was older than HFG (p = 0.005), experienced more pain, (p = 0.060), had worse physical function and HrQol (p ≤ 0.001), and comparable kyphosis (p = 0.640). SPPB changed 0.62 (95% CI: − 0.20 to 1.44) points in the LFG and - 0.04 (95%CI: − 0.28 to 0.19) points in the HFG,p = 0.020. Gait speed changed 0.04 (95% CI: − 0.02 to 0.10) m/s in the LFG. Kyphosis improved equally in both groups. Adherence to the intervention was 83% in the LFG and 79% in the HFG. There were no adverse events in either group.

Conclusions

Older adults with low physical function and hyperkyphosis may improve physical function after a kyphosis targeted intervention. Older adults with low physical function may safely participate in targeted high-intensity kyphosis exercise and posture training. This observation needs to be confirmed in larger adequately powered studies.

Trial registration

Clinicaltrials.gov identifier:NCT01766674.
Community-acquired bacteraemia in COVID-19 in comparison to influenza A and influenza B: a retrospective cohort study
Authors: Thelen Julinha M. , Buenen A. G. ( Noud) , van Apeldoorn Marjan , Wertheim Heiman F. , Hermans Mirjam H. A. , Wever Peter C.
Published: February 2021

Background

During the coronavirus disease 2019 (COVID-19) pandemic in the Netherlands it was noticed that very few blood cultures from COVID-19 patients turned positive with clinically relevant bacteria. This was particularly evident in comparison to the number of positive blood cultures during previous seasonal epidemics of influenza. This observation raised questions about the occurrence and causative microorganisms of bacteraemia in COVID-19 patients, especially in the perspective of the widely reported overuse of antibiotics and the rising rate of antibiotic resistance.

Methods

We conducted a retrospective cohort study on blood culture results in influenza A, influenza B and COVID-19 patients presenting to two hospitals in the Netherlands. Our main outcome consisted of the percentage of positive blood cultures. The percentage of clinically relevant blood cultures, isolated bacteria and 30-day all-cause mortality served as our secondary outcomes.

Results

A total of 1331 viral episodes were analysed in 1324 patients. There was no statistically significant difference (p = 0.47) in overall occurrence of blood culture positivity in COVID-19 patients (9.0, 95% CI 6.8–11.1) in comparison to influenza A (11.4, 95% CI 7.9–14.8) and influenza B patients (10.4, 95% CI 7.1–13.7,). After correcting for the high rate of contamination, the occurrence of clinically relevant bacteraemia in COVID-19 patients amounted to 1.0% (95% CI 0.3–1.8), which was statistically significantly lower (p = 0.04) compared to influenza A patients (4.0, 95% CI 1.9–6.1) and influenza B patients (3.0, 95% CI 1.2–4.9). The most frequently identified bacterial isolates in COVID-19 patients were Escherichia coli (n = 2) and Streptococcus pneumoniae (n = 2). The overall 30-day all-cause mortality for COVID-19 patients was 28.3% (95% CI 24.9–31.7), which was statistically significantly higher (p = <.001) when compared to patients with influenza A (7.1, 95% CI 4.3–9.9) and patients with influenza B (6.4, 95% CI 3.8–9.1).

Conclusions

We report a very low occurrence of community-acquired bacteraemia amongst COVID-19 patients in comparison to influenza patients. These results reinforce current clinical guidelines on antibiotic management in COVID-19, which only advise utilization of antibiotics when a bacterial co-infection is suspected.
Significance of anger suppression and preoccupied attachment in social anxiety disorder: a cross-sectional study
Authors: Conrad Rupert , Forstner Andreas J. , Chung Man-Long , Mücke Martin , Geiser Franziska , Schumacher Johannes , Carnehl Friederike
Published: February 2021

Background

There is evidence for the relevance of attachment style and anger expression for the manifestation of social anxiety disorder (SAD).

Method

In a cross-sectional study 321 individuals with social anxiety disorder (41% men, age 38.8 ± 13.9) were compared with 94 healthy controls (37% men, age 35.8 ± 15.1) on several questionnaires (Attachment Styles Questionnaire, State Trait Anger Inventory, Social Phobia Inventory, Beck Depression Inventory).

Results

Individuals with SAD showed moderate-sized reduced levels of secure and large-sized increased levels of fearful and preoccupied attachment style compared to healthy controls (all p < 0.001) as well as small-sized increased levels of trait anger (p = 0.03) and moderate-sized increased levels of anger-in (p < 0.001). Attachment style and anger regulation could predict 21% (R2 = 0.21, p < 0.001) of the extent of social anxiety (SPIN) in SAD; secure (β = − 0.196, p < 0.01) and preoccupied attachment style (β = 0.117, p < 0.05), as well as anger-in (β = 0.199, p < 0.01) were significant cross-sectional predictors. Further analysis revealed that the relationship between preoccupied attachment and social anxiety is partially mediated by anger-in.

Conclusion

Study findings confirm the relevance of preoccupied attachment style and anger suppression for social anxiety. Disentangling the role of anger regulation in early attachment patterns has significant therapeutic implications in SAD.
Gene expression in tonsils in swine following infection with porcine reproductive and respiratory syndrome virus
Authors: Dong Qian , Lunney Joan K. , Lim Kyu-Sang , Nguyen Yet , Hess Andrew S. , Beiki Hamid , Rowland Raymond R. R. , Walker Kristen , Reecy James M. , Tuggle Christopher K. , Dekkers Jack C. M.
Published: February 2021

Background

Porcine reproductive and respiratory syndrome (PRRS) is a threat to pig production worldwide. Our objective was to understand mechanisms of persistence of PRRS virus (PRRSV) in tonsil. Transcriptome data from tonsil samples collected at 42 days post infection (dpi) were generated by RNA-seq and NanoString on 51 pigs that were selected to contrast the two PRRSV isolates used, NVSL and KS06, high and low tonsil viral level at 42 dpi, and the favorable and unfavorable genotypes at a genetic marker (WUR) for the putative PRRSV resistance geneGBP5.

Results

The number of differentially expressed genes (DEGs) differed markedly between models with and without accounting for cell-type enrichments (CE) in the samples that were predicted from the RNA-seq data. This indicates that differences in cell composition in tissues that consist of multiple cell types, such as tonsil, can have a large impact on observed differences in gene expression. Based on both the NanoString and the RNA-seq data, KS06-infected pigs showed greater activation, or less inhibition, of immune response in tonsils at 42 dpi than NVSL-infected pigs, with and without accounting for CE. This suggests that the NVSL virus may be better than the KS06 virus at evading host immune response and persists in tonsils by weakening, or preventing, host immune responses. Pigs with high viral levels showed larger CE of immune cells than low viral level pigs, potentially to trigger stronger immune responses. Presence of high tonsil virus was associated with a stronger immune response, especially innate immune response through interferon signaling, but these differences were not significant when accounting for CE. Genotype at WUR was associated with different effects on immune response in tonsils of pigs during the persistence stage, depending on viral isolate and tonsil viral level.

Conclusions

Results of this study provide insights into the effects of PRRSV isolate, tonsil viral level, and WUR genotype on host immune response and into potential mechanisms of PRRSV persistence in tonsils that could be targeted to improve strategies to reduce viral rebreaks. Finally, to understand transcriptome responses in tissues that consist of multiple cell types, it is important to consider differences in cell composition.
Activation of the cardiac non-neuronal cholinergic system prevents the development of diabetes-associated cardiovascular complications
Authors: Saw Eng Leng , Pearson James T. , Schwenke Daryl O. , Munasinghe Pujika Emani , Tsuchimochi Hirotsugu , Rawal Shruti , Coffey Sean , Davis Philip , Bunton Richard , Van Hout Isabelle , Kai Yuko , Williams Michael J. A. , Kakinuma Yoshihiko , Fronius Martin , Katare Rajesh
Published: February 2021

Background

Acetylcholine (ACh) plays a crucial role in the function of the heart. Recent evidence suggests that cardiomyocytes possess a non-neuronal cholinergic system (NNCS) that comprises of choline acetyltransferase (ChAT), choline transporter 1 (CHT1), vesicular acetylcholine transporter (VAChT), acetylcholinesterase (AChE) and type-2 muscarinic ACh receptors (M2AChR) to synthesize, release, degrade ACh as well as for ACh to transduce a signal. NNCS is linked to cardiac cell survival, angiogenesis and glucose metabolism. Impairment of these functions are hallmarks of diabetic heart disease (DHD). The role of the NNCS in DHD is unknown. The aim of this study was to examine the effect of diabetes on cardiac NNCS and determine if activation of cardiac NNCS is beneficial to the diabetic heart.

Methods

Ventricular samples from type-2 diabetic humans and db/db mice were used to measure the expression pattern of NNCS components (ChAT, CHT1, VAChT, AChE and M2AChR) and glucose transporter-4 (GLUT-4) by western blot analysis. To determine the function of the cardiac NNCS in the diabetic heart, a db/db mouse model with cardiac-specific overexpression of ChAT gene was generated (db/db-ChAT-tg). Animals were followed up serially and samples collected at different time points for molecular and histological analysis of cardiac NNCS components and prosurvival and proangiogenic signaling pathways.

Results

Immunoblot analysis revealed alterations in the components of cardiac NNCS and GLUT-4 in the type-2 diabetic human and db/db mouse hearts. Interestingly, the dysregulation of cardiac NNCS was followed by the downregulation of GLUT-4 in the db/db mouse heart. Db/db-ChAT-tg mice exhibited preserved cardiac and vascular function in comparison to db/db mice. The improved function was associated with increased cardiac ACh and glucose content, sustained angiogenesis and reduced fibrosis. These beneficial effects were associated with upregulation of the PI3K/Akt/HIF1α signaling pathway, and increased expression of its downstream targets—GLUT-4 and VEGF-A.

Conclusion

We provide the first evidence for dysregulation of the cardiac NNCS in DHD. Increased cardiac ACh is beneficial and a potential new therapeutic strategy to prevent or delay the development of DHD.
Correction to: Early impairment of coronary microvascular perfusion capacity in rats on a high fat diet
Authors: van Haare Judith , Kooi M. Eline , Vink Hans , Post Mark J. , van Teeffelen Jurgen W. G. E. , Slenter Jos , Munts Chantal , Cobelens Hanneke , Strijkers Gustav J. , Koehn Dennis , van Bilsen Marc
Published: February 2021

An amendment to this paper has been published and can be accessed via the original article.
Production of bio-xylitol from d-xylose by an engineered Pichia pastoris expressing a recombinant xylose reductase did not require any auxiliary substrate as electron donor
Authors: Louie Tai Man , Louie Kailin , DenHartog Samuel , Gopishetty Sridhar , Subramanian Mani , Arnold Mark , Das Shuvendu
Published: February 2021

Background

Xylitol is a five-carbon sugar alcohol that has numerous beneficial health properties. It has almost the same sweetness as sucrose but has lower energy value compared to the sucrose. Metabolism of xylitol is insulin independent and thus it is an ideal sweetener for diabetics. It is widely used in food products, oral and personal care, and animal nutrition as well. Here we present a two-stage strategy to produce bio-xylitol from d-xylose using a recombinant Pichia pastoris expressing a heterologous xylose reductase gene. The recombinant P. pastoris cells were first generated by a low-cost, standard procedure. The cells were then used as a catalyst to make the bio-xylitol from d-xylose.

Results

Pichia pastoris expressing XYL1 from P. stipitis and gdh from B. subtilis demonstrated that the biotransformation was very efficient with as high as 80% (w/w) conversion within two hours. The whole cells could be re-used for multiple rounds of catalysis without loss of activity. Also, the cells could directly transform d-xylose in a non-detoxified hemicelluloses hydrolysate to xylitol at 70% (w/w) yield.

Conclusions

We demonstrated here that the recombinant P. pastoris expressing xylose reductase could transform d-xylose, either in pure form or in crude hemicelluloses hydrolysate, to bio-xylitol very efficiently. This biocatalytic reaction happened without the external addition of any NAD(P)H, NAD(P)+, and auxiliary substrate as an electron donor. Our experimental design & findings reported here are not limited to the conversion of d-xylose to xylitol only but can be used with other many oxidoreductase reactions also, such as ketone reductases/alcohol dehydrogenases and amino acid dehydrogenases, which are widely used for the synthesis of high-value chemicals and pharmaceutical intermediates.
Eliminating Plasmodium falciparum malaria: results from tailoring active case detection approaches to remote populations in forested border areas in north-eastern Cambodia
Authors: Stratil Ann-Sophie , Vernaeve Lieven , Lopes Sergio , Bourny Yves , Mannion Kylie , Hamade Prudence , Roca-Feltrer Arantxa , Tibenderana James K. , Sovannaroth Siv , Debackere Mark
Published: February 2021

Background

Remaining Plasmodium falciparum cases in Cambodia are concentrated in forested border areas and in remote populations who are hard to reach through passive case detection. A key approach to reach these populations is active case detection by mobile malaria workers (MMWs). However, this is operationally challenging because of changing movement patterns of the target population moving into less accessible areas. From January 2018 to December 2020, a tailored package of active case detection approaches was implemented in forested border areas of three provinces in north-eastern Cambodia to reach remote populations and support the elimination of falciparum malaria.

Methods

Key elements of this project were to tailor approaches to local populations, use responsive monitoring systems, maintain operational flexibility, build strong relationships with local communities, and implement close supervision practices. MMWs were recruited from local communities. Proactive case detection approaches included mobile malaria posts positioned at frequented locations around and within forests, and locally informed outreach activities targeting more remote locations. Reactive case detection was conducted among co-travellers of confirmed cases. Testing for malaria was conducted independent of fever symptoms. Routine monitoring of programmatic data informed tactical adaptations, while supervision exercises ensured service quality.

Results

Despite operational challenges, service delivery sites were able to maintain consistently high testing rates throughout the implementation period, with each of 45 sites testing a monthly average of 64 (SD 6) people in 2020. In 2020, project MMWs detected only 32 P. falciparum cases. Over the project period, the P. falciparum/P. vivax ratio steadily inversed. Including data from neighbouring health centres and village malaria workers, 45% (80,988/180,732) of all people tested and 39% (1280/3243) of P. falciparum cases detected in the area can be attributed to project MMWs. Remaining challenges of the last elimination phase include maintaining intensified elimination efforts, addressing the issue of detecting low parasitaemia cases and shifting focus to P. vivax malaria.

Conclusions

Reaching remote populations through active case detection should remain a key strategy to eliminate P. falciparum malaria. This case study presented a successful approach combining tailored proactive and reactive strategies that could be transferred to similar settings in other areas of the Greater Mekong Subregion.
A cohort study on risk factors of high-density lipoprotein cholesterol hypolipidemia among urban Chinese adults
Authors: Tang Fang , Wang Jian , Nicholas Stephen , Qian Dongfu , Liu Rugang
Published: February 2021

Background

High-density lipoprotein cholesterol (HDL-C) hypolipidemia, a major type of dyslipidemia, has been associated with many kinds of diseases, such as stroke, coronary heart disease, obesity and diabetes, and has displayed an increasing prevalence in China. This study explores the risk factors of HDL-C hypolipidemia and makes recommendations for controlling and preventing HDL-C hypolipidemia and the diseases caused by it.

Methods

Using a retrospective cohort study design, 26,863 urban adults without dyslipidemia, diabetes, cardiovascular and cerebrovascular diseases, hepatosis, renal insufficiency and thyroid diseases were enrolled in the study between 2010 and 2015. Data on each individual were collected at the 2010 baseline year and at a follow-up medical check. A Cox regression model was constructed to evaluate the influence of potential risk factors on the outcome event- HDL-C hypolipidemia.

Results

The incidence of HDL-C hypolipidemia was 5.7% (1531/26863). Sex, age, body mass index (BMI), HDL-C, triglyceride (TG) and urea nitrogen (UN) were significant risk factors of HDL-C hypolipidemia. Men were more likely to develop HDL-C hypolipidemia than women during follow-up medical checks (HR = 1.258, P = 0.014). The incidence of HDL-C hypolipidemia in the over 65 years old group was higher than that of the ≤65 age group (HR = 1.276, P = 0.009). The incidence of HDL-C hypolipidemia increased with increasing BMI (HR = 1.030, P = 0.002), TG (HR = 1.321, P = 0.001) and UN (HR = 1.054, P = 0.019), while falling with increasing HDL-C in the baseline year (HR = 0.002, P < 0.001).

Conclusions

Men, aged over 65, with high BMI were at the highest risk of developing HDL-C hypolipidemia. Measures should be taken to prevent HDL-C hypolipidemia even for healthy urban adults whose blood biochemical indicators were in the normal range when their level of TG, UN and HDL-C are closed to the border of the normal value range.