bluuebunny/crossref_metadata_2025 huggingface dataset:
Case Report: Allergic Reactivity to Mahaleb (Prunus mahaleb) Spice in a Subject With Almond and Other Tree Nut Allergies
Authors: Benoit Lora , Masiri Jongkit , Janagama Harish , Gendel Steven M. , Samadpour Mansour
Published: October 2020

Background

Mahaleb is an aromatic spice prepared from the fruit stone of the St. Lucie Cherry that is used as a flavoring agent in traditional Turkish and Middle Eastern baking. Immunodiagnostic kits for almond, which are based on polyclonal almond-specific IgG antibodies, have been shown to demonstrate considerable cross-reactivity with mahaleb as was incidentally discovered during a cluster of allergen-related food recalls in 2015.

Objective

Though acute allergy to almond is somewhat common, allergies to mahaleb have not been previously documented. However, based on antigenic similarity observed with almond-specific IgG, it is predicted that mahaleb nut proteins would exhibit some level of cross-reactivity with almond-specific IgE and may therefore potentiate acute allergic symptoms in individuals with food allergy to almond. Case Presentation: Herein, we report on a 40-year old Caucasian female with longitudinal history of multiple tree nut allergies including allergy to almond, presenting with moderate pruritus and oropharyngeal swelling shortly following ingestion of mahaleb seed kernels.

Methods and Results

Skin-prick testing using extracts compounded from pistachio, almond, and mahaleb revealed positive wheals measuring 8, 3, and 7 mm respectfully. Indirect enzyme-linked immunosorbent assay (ELISA) using plate-bound antigens prepared from pistachio, almond, and mahaleb revealed IgG positive responses to all three targets. ELISA and Western blot analysis performed using goat anti-almond polyclonal IgG demonstrated significant cross-reactivity between almond and mahaleb, but not to pistachio.

Conclusion

This is the first documented case of acute allergy to mahaleb, co-occurring in the context of plural tree nut allergies, providing novel evidence that mahaleb may pose a risk to nut-allergic individuals and indicating a need for awareness of spice contamination with nut and mahaleb residues.
Use of 1-bromopropane (N-propyl bromide) in dry cleaning is rare and rapidly declining toward obsolescence
Authors: Smith Carr J , Perfetti Thomas A , Morford Richard G
Published: October 2020

Ten years ago, the Halogenated Solvents Industry Alliance (HSIA) and the New York State Department of Environmental Conservation petitioned the US Environmental Protection Agency (USEPA) to classify 1-bromopropane (1-BP) as a hazardous air pollutant (HAP), the first such classification of a chemical since 1990. The USEPA plans to classify 1-BP as a HAP. One of the putative exposures supporting HAP classification is 1-BP-based dry cleaning solvents. Only two 1-BP-based dry cleaning solvents have ever been marketed domestically, i.e. the dominant market share product DrySolv® (DrySolv) and less commonly used FabrisolvTM XL (Fabrisolv). The use of 1-BP-based dry cleaning solvents has been declining for several years. Fabrisolv is no longer marketed as a dry cleaning agent. In the first half of 2020, less than 1,600 pounds of DrySolv have been sold for the remaining six dedicated dry cleaning machines still in operation in the United States. It is expected that the number of dedicated DrySolv dry cleaning machines in operation will be reduced to three by the end of 2020. In addition, no 1-BP-based spot cleaner has ever been marketed in the United States. USEPA currently classifies 187 chemicals as HAPs, with a subset of 30 HAPS classified as urban air toxics. Dry cleaning is considered to be one of the 68 “area sources” that contribute to sub-classification of 1-BP as an urban air toxic. In the near future, 1-BP-based products will not be employed in the dry cleaning industry.
Investigating the influence of WEDM process parameters in machining of hybrid aluminum composites
Authors: Kumar Amresh , Grover Neelkant , Manna Alakesh , Chohan Jasgurpreet Singh , Kumar Raman , Singh Sunpreet , Prakash Chander , Pruncu Catalin Iulian
Published: October 2020

This article presents an experimental investigation to assess the influence of input process parameters of machinability of wire electrical discharge machining (WEDM) process for machining of triple-reinforced silicon carbide, graphite, and iron oxide hybrid aluminum (Al-6061) metal matrix composites. The composite work specimens, developed using stir casting process, have been processed through WEDM process by adopting a statistically controlled design of experimentation approach. Furthermore, analysis of variance and regression analysis have been performed to understand the influence of the input process parameters on material removal rate (MRR) and spark gap (SG) width. The statistical analysis highlighted the improvements in MRR and SG by 33.72% and −27.28%, respectively, upon adopting the suggested optimized range of input process parameters. Further, the morphology of the machined composite surfaces has also been studied using scanning electron microscopy and energy dispersive spectroscopy to report the phenomenon of formation of recast layer.
Interproject Conflict Management Through Cooperation in an Enterprise System Implementation Program
Authors: Cheng Fei-Fei , Wu Chin-Shan , Chang Jamie Y. T.
Published: October 2020

To achieve desired business benefits from the implementation of an enterprise system (ES), current practitioners often adopt a multiple-project (program) approach instead of a conventional single-project strategy. Unfortunately, during such an implementation, issues arising from task-related conflicts among different teams within the ES program are frequently observed; to successfully resolve these task-conflict issues, the adoption of a collaborative problem-solving strategy is essential. Collaborative conflict management theory encourages parties to develop solutions for the problems they encounter. However, less explanation has been provided about how collaborative problem-solving strategy influences the relationship between interteam conflicts and the final ES implementation program outcome. In this study, based on conflict management theory, we propose that interteam cooperation effectiveness serves as a critical partial mediator between the interteam task conflict and final ES program implementation performance, whereas interteam dialectical problem solving provides a direct positive influence on interteam cooperation effectiveness. Furthermore, the negative impact of interteam task conflict on ES implementation performance is moderated by interteam cooperation effectiveness. For this study, a survey examines the relationships among the aforementioned factors in ES program implementation. The results confirm that both interteam dialectical problem solving and interteam trust serve as antecedents of interteam cooperation effectiveness.
Bleeding severity in patients with rare bleeding disorders: real-life data from the RBiN study
Authors: Saes Joline L. , Verhagen Marieke J. A. , Meijer Karina , Cnossen Marjon H. , Schutgens Roger E. G. , Peters Marjolein , Nieuwenhuizen Laurens , van der Meer Felix J. M. , Kruis Ilmar C. , van Heerde Waander L. , Schols Saskia E. M.
Published: October 2020

Patients with hereditary rare bleeding disorders (RBDs) present with diverse hemorrhagic symptoms. Correlation between factor activity levels and clinical bleeding severity is poor for most RBDs. Threshold factor activity levels have been previously described in relation to bleeding severity but have not yet been validated. The Rare Bleeding Disorders in the Netherlands (RBiN) study is a nationwide cross-sectional study of patients registered in all 6 Dutch Haemophilia Treatment Centers with a known RBD and who are age 1 to 99 years. Bleeding scores were determined, and laboratory and clinical data were extracted from patient files. In all, 263 patients were included, of whom 202 (77%) attended the scheduled study visit. The median International Society of Thrombosis and Haemostasis (ISTH) bleeding assessment tool (BAT) score was 9. Correlations between baseline factor activity levels and ISTH BAT scores were strong for deficiencies in factor II (FII) (r = –0.792) and FX (r = –0.838) and were moderate for deficiencies of fibrinogen (r = –0.683), FV (r = –0.623), FVII (r = –0.516), FXIII (r = –0.516), and α2-antiplasmin (r = –0.594). There was no correlation for FXI deficiency (r = –0.218). The RBD BAT identified more women (94% vs 83%) and children (100% vs 71%) with an RBD than the ISTH BAT did. Importantly, 48% of patients had more severe bleeding than predicted for their baseline factor activity level. In addition, 34% of patients were predicted to be asymptomatic, but they actually had grade 2 (31%) or 3 (3%) bleeding. Bleeding severity in patients with RBDs is more pronounced than previously anticipated. The previously determined threshold factor activity levels to ensure no (spontaneous) bleeding in patients with an RBD are inaccurate. This trial was registered at www.clinicaltrials.gov as #NCT03347591.
Integrated analysis of co-expression, conserved genes and gene families reveal core regulatory network of heat stress response in Cleistogenes songorica, a xerophyte perennial desert plant
Authors: Yan Qi , Zong Xifang , Wu Fan , Li Jie , Ma Tiantian , Zhao Yufeng , Ma Qian , Wang Penglei , Wang Yanrong , Zhang Jiyu
Published: October 2020

Background

As global warming continues, heat stress (HS) is becoming an increasingly significant factor limiting plant growth and reproduction, especially for cool-season grass species. The objective of this study was to determine the transcriptional regulatory network of Cleistogenes songorica under HS via transcriptome profiling, identify of gene families and comparative analysis across major Poaceae species.

Results

Physiological analysis revealed significantly decreased leaf relative water content (RWC) but increased proline (Pro) content in C. songorica under 24 h of HS. Transcriptome profiling indicated that 16,028 and 14,645 genes were differentially expressed in the shoots and roots of C. songorica under HS, respectively. Two subgenomes of C. songorica provide equal contribution under HS on the basis of the distribution and expression of differentially expressed genes (DEGs). Furthermore, 216 DEGs were identified as key evolutionarily conserved genes involved in the response to HS in C. songorica via comparative analysis with genes of four Poaceae species; these genes were involved in the ‘response to heat’ and ‘heat acclimation’. Notably, most of the conserved DEGs belonged to the heat-shock protein (HSP) superfamily. Similar results were also obtained from co-expression analysis. Interestingly, hub-genes of co-expression analysis were found to overlap with conserved genes, especially heat-shock protein (HSP). In C. songorica, 84 HSP and 32 heat-shock transcription factor (HSF) genes were identified in the allotetraploid C. songorica genome, and might have undergone purifying selection during evolutionary history based on syntenic and phylogenetic analysis. By analysing the expression patterns of the CsHSPs and CsHSFs, we found that the transcript abundance of 72.7% of the CsHSP genes and of 62.5% of the CsHSF genes changed under heat stress in both the shoots and roots. Finally, a core regulatory network of HS was constructed on the basis of the CsHSP, CsHSF and other responsive genes in C. songorica.

Conclusions

Regulatory network and key genes were comprehensively analysed and identified in C. songorica under HS. This study improves our knowledge of thermotolerance mechanisms in native grasses, and also provides candidate genes for potential applications in the genetic improvement of grasses.
Older age and frailty are the chief predictors of mortality in COVID-19 patients admitted to an acute medical unit in a secondary care setting- a cohort study
Authors: Chinnadurai Rajkumar , Ogedengbe Onesi , Agarwal Priya , Money-Coomes Sally , Abdurrahman Ahmad Z. , Mohammed Sajeel , Kalra Philip A. , Rothwell Nicola , Pradhan Sweta
Published: October 2020

Background

There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations.

Methods

We describe the clinical characteristics of all consecutive COVID-19 positive patients (n = 215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (group 1: alive or group 2: deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) curves were generated by following the outcome in all patients until 12 May 2020.

Results

The median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (group 2: 63 vs group 1: 37%, p < 0.001), with a higher prevalence of cardiovascular disease (group 2: 58 vs group 1: 33%, p < 0.001) and respiratory diseases (group 2: 38 vs group 1: 25%, p = 0.03). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p = 0.03), frailty (OR 5.1; p < 0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p = 0.01) were significant predictors of inpatient mortality. KM curves showed a significantly shorter survival time in the frail older patients.

Conclusion

Older age and frailty are chief risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.
Iron stores in pregnant women with sickle cell disease: a systematic review
Authors: Aroke Desmond , Kadia Benjamin Momo , Njim Tsi
Published: October 2020

Background

Gradual improvements in the management of sickle cell disease (SCD), have led to an increase in the number of women with SCD who reach the age of procreation. However, evidence on the iron status of pregnant women with sickle cell disease (PWSCD) remains inconclusive. We conducted the first systematic review on the prevalence, determinants and maternal/foetal outcomes of iron deficiency anaemia among PWSCD.

Methods

We searched MEDLINE, EMBASE, Global Health, Africa Index Medicus, the Cochrane library databases and reference lists of retrieved publications for studies describing the iron status of PWSCD. The literature search was done over a period of 1 month, with no language or date restrictions applied. Data were extracted on a Microsoft excel sheet. Two authors assessed all included studies for methodological quality and risk of bias.

Results

A total of 710 reports were identified for title and article screening. Five retained studies were conducted before or during the 90s and included 67 participants. After quality assessment, the observational studies were designated to have a “fair” quality assessment while the randomised control trial had an “unclear” quality assessment. The prevalence of iron deficiency anaemia among PWSCD varied by study design and diagnostic method. The overall prevalence ranged from 6.67–83.33%. None of the studies provided evidence on factors associated with iron deficiency anaemia and the randomized trial reported no difference in outcomes between PWSCD who had iron supplementation and those who did not.

Conclusion

Evidence on factors associated with iron deficiency anaemia among PWSCD and maternal/foetal outcomes in PWSCD who have iron deficiency anaemia is poor. The studies included in this review suggests that iron deficiency anaemia may be highly prevalent in PWSCD but due to the very small sample sizes and varied study designs, this evidence is inconclusive. The review shows that there is a need for more studies with robust designs and adequate sample sizes to assess the disease burden of iron deficiency anaemia in PWSCD.
Whipple’s disease scleral nodules: a novel presentation in 2 consecutive patients
Authors: Alsarhani Waleed K. , Alkhalifah Muhannad I. , Alkatan Hind M. , Alsolami Afaf L. , Maktabi Azza M. Y. , Alsuhaibani Adel H.
Published: October 2020

Background

Whipple’s disease (WD) is a rare, chronic, infection caused by gram-positive filamentous aerobic actinobacterium Tropheryma whipplei occurs classically in the gastrointestinal tract and shows histopathologically foamy macrophages with typical numerous PAS-positive, non-acid fast particles. Ocular WD in the form of uveitis may occur in the absence of systemic disease but has not been reported to present with scleral manifestation. We describe for the first time to the best of our knowledge 2 cases of scleral nodules with typical histopathological morphology of WD and without systemic involvement.

Case presentation

The first was a 53-year old diabetic male farmer who presented with 2 nontender right eye scleral nodules for 3 months, had a negative systemic workup, and surgical excision showed Periodic acid Schiff (PAS)-positive eosinophilic structures inside macrophages. Grocott’s methenamine silver (GMS) stain and acid-fast bacilli (AFB) stain of the tissue itself were negative. The second case was a 60-year old male who presented with an asymptomatic superior scleral nodule for 4 months, which showed similar appearance and negative GMS and AFB stains.

Conclusion

WD should be included in the differential diagnosis of scleral nodules even in the absence of systemic symptoms. Surgical excision without systemic treatment resulted in successful outcome without recurrence.
Anxiety disorders and PTSD in Palestine: a literature review
Authors: Marie Mohammad , SaadAdeen Sana , Battat Maher
Published: October 2020

Background

The WHO reports that anxiety disorders are the most common mental disorders worldwide. Most people who experience such events recover from it; however, people with post-traumatic stress disorder (PTSD) continue to be severely depressed and anxious for several months or even years following the event. Palestinians are particularly at a higher risk for developing anxiety disorders and PTSD due to the continuous exposure to political violence, prolonged displacement, and other limitation on professional, educational, financial opportunities, and mental health services. This paper aims to provide a systematic review of the literature and established studies concerning Anxiety disorders besides PTSD in Palestine.

Methods

PubMed, Science Direct, Google Scholar was used to search for materials for the critical analysis of empirical articles. The following aspects were taken into consideration: study type, sample, and key findings.

Results

In this review, we included about twenty-four studies from Palestine (West Bank and Gaza). Five studies relate to children, five relate to adolescents, three relate to women, three relate to physical diseases, and four relate to gender and age differences. Results show that anxiety disorders and PTSD are one of the most common mental disorders in Palestine. Anxiety and PTSD develop from a complex set of risk factors, including genetics, personality, and life events. They are mostly associated with low quality of life and disability. The results indicate that a significant proportion of Palestinian experiencing serious issues that deal with several challenges, distinct barriers including; inconsistent availability of medications, absence of multidisciplinary teamwork, insufficient specialists, fragmented mental health system, and occupation.

Conclusion

As primary prevention, the occupation has to have considered as the main source of anxiety and other mental health disorders in Palestine. Besides, there is a need to implement a mental health care system through multidisciplinary work and raising awareness regarding the prevalence of mental disorders.
Development and validation of the body shape scale (BOSHAS) for assessing body shape perception in African populations
Authors: Cohen Emmanuel , Ndao Amadou , Bernard Jonathan Y. , Gueye Amadoune , Duboz Priscilla , Macia Enguerran , Boëtsch Gilles , Pasquet Patrick , Holdsworth Michelle , Gradidge Philippe Jean-Luc
Published: October 2020

Background

As a consequence of ‘Western’ acculturation, eating disorders and body image disturbances, such as fatness phobia and body dysmorphic disorders towards musculature and body shape, are emerging in Africa, with young people the most affected. It is therefore important to accurately assess perceptions of body shape. However, the existing body image assessment scales lack sufficient accuracy and validity testing to compare body shape perception across different African populations. The purpose of this study was to develop and validate the Body Shape Scale (BOSHAS) to evaluate body shape perceptions related body image disorders in African populations.

Methods

To develop the BOSHAS, anthropometric measures of 80 Cameroonians and 81 Senegalese (both sexes included; 40.1% females overall) were taken for three body shape criteria: somatotype components, body mass index (BMI) and waist-to-hip ratio. Subjects were selected to cover a wide variability in body shape and were photographed in full face and profile positions. To validate the BOSHAS, the scale was administered twice (2 weeks apart) to 106 participants (aged 31.2 ± 12.6 years) to assess its reliability. In addition, a questionnaire measuring different aspects of body shape (e.g. musculature) was also administered (n = 597; aged 36.7 ± 15.6 years) to assess its convergent validity.

Results

The BOSHAS includes two sex-specific subscales of 10 photographs each. Most participants were able to repeat their BOSHAS preference order. Test-retest reliability was also consistent in estimating Current Body Shape (CBS), Desired Body Shape and Ideal Body Shape for participants and their partners. CBS was correlated with BMI, and different BOSHAS indices were consistent with declarations obtained by questionnaire.

Conclusions

The BOSHAS is the first sex-specific scale of real African models photographed in face and profile, including large body shape variability. The validation protocol showed good validity and reliability for evaluating body shape perceptions and dissatisfaction of Africans.
Silent hypoxia: higher NO in red blood cells of COVID-19 patients
Authors: Mortaz Esmaeil , Malkmohammad Majid , Jamaati Hamidreza , Naghan Parisa Adimi , Hashemian Seyed MohamadReza , Tabarsi Payam , Varahram Maohammad , Zaheri Hamidreza , Chousein Efsun Gonca Uğur , Folkerts Gert , Adcock Ian M.
Published: October 2020

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has spread to almost 100 countries, infected over 31 M patients and resulted in 961 K deaths worldwide as of 21st September 2020. The major clinical feature of severe COVID-19 requiring ventilation is acute respiratory distress syndrome (ARDS) with multi-functional failure as a result of a cytokine storm with increased serum levels of cytokines. The pathogenesis of the respiratory failure in COVID-19 is yet unknown, but diffuse alveolar damage with interstitial thickening leading to compromised gas exchange is a plausible mechanism. Hypoxia is seen in the COVID-19 patients, however, patients present with a distinct phenotype. Intracellular levels of nitric oxide (NO) play an important role in the vasodilation of small vessels. To elucidate the intracellular levels of NO inside of RBCs in COVID-19 patients compared with that of healthy control subjects.

Methods

We recruited 14 COVID-19 infected cases who had pulmonary involvement of their disease, 4 non-COVID-19 healthy controls (without pulmonary involvement and were not hypoxic) and 2 hypoxic non-COVID-19 patients subjects who presented at the Masih Daneshvari Hospital of Tehran, Iran between March–May 2020. Whole blood samples were harvested from patients and intracellular NO levels in 1 × 106red blood cells (RBC) was measured by DAF staining using flow cytometry (FACS Calibour, BD, CA, USA).

Results

The Mean florescent of intensity for NO was significantly enhanced in COVID-19 patients compared with healthy control subjects (P ≤ 0.05). As a further control for whether hypoxia induced this higher intracellular NO, we evaluated the levels of NO inside RBC of hypoxic patients. No significant differences in NO levels were seen between the hypoxic and non-hypoxic control group.

Conclusions

This pilot study demonstrates increased levels of intracellular NO in RBCs from COVID-19 patients. Future multi-centre studies should examine whether this is seen in a larger number of COVID-19 patients and whether NO therapy may be of use in these severe COVID-19 patients.
Associations of cardiac stress biomarkers with incident type 2 diabetes and changes in glucose metabolism: KORA F4/FF4 study
Authors: Sujana Chaterina , Seissler Jochen , Jordan Jens , Rathmann Wolfgang , Koenig Wolfgang , Roden Michael , Mansmann Ulrich , Herder Christian , Peters Annette , Thorand Barbara , Then Cornelia
Published: October 2020

Background

High N-terminal pro-brain-type natriuretic peptide levels have been associated with a lower risk of type 2 diabetes mellitus (T2D). However, less is known about other cardiac stress biomarkers in this context. Here we evaluated the association of mid-regional pro-atrial natriuretic peptide (MR-proANP), C-terminal pro-arginine vasopressin (copeptin), C-terminal pro-endothelin-1 (CT-proET-1) and mid-regional pro-adrenomedullin (MR-proADM) with incident T2D and changes in glucose metabolism.

Methods

We performed a prospective cohort study using data from the population-based KORA F4/FF4 study. 1773 participants (52.3% women) with MR-proANP measurements and 960 (52.7% women) with copeptin, CT-proET-1 and MR-proADM measurements were included. We examined associations of circulating plasma levels of MR-proANP, copeptin, CT-proET-1 and MR-proADM with incident T2D, the combined endpoint of incident prediabetes/T2D and with fasting and 2 h-glucose, fasting insulin, HOMA-IR, HOMA-B and HbA1c at follow-up. Logistic and linear regression models adjusted for age, sex, waist circumference, height, hypertension, total/HDL cholesterol ratio, triglycerides, smoking, physical activity and parental history of diabetes were used to compute effect estimates.

Results

During a median follow-up time of 6.4 years (25th and 75th percentiles: 6.0 and 6.6, respectively), 119 out of the 1773 participants and 72 out of the 960 participants developed T2D. MR-proANP was inversely associated with incident T2D (odds ratio [95% confidence interval]: 0.75 [0.58; 0.96] per 1-SD increase of log MR-proANP). Copeptin was positively associated with incident prediabetes/T2D (1.29 [1.02; 1.63] per 1-SD increase of log copeptin). Elevated levels of CT-proET-1 were associated with increased HOMA-B at follow-up, while elevated MR-proADM levels were associated with increased fasting insulin, HOMA-IR and HOMA-B at follow-up. These associations were independent of previously described diabetes risk factors.

Conclusions

High plasma concentrations of MR-proANP contributed to a lower risk of incident T2D, whereas high plasma concentrations of copeptin were associated with an increased risk of incident prediabetes/T2D. Furthermore, high plasma concentrations of CT-proET-1 and MR-proADM were associated with increased insulin resistance. Our study provides evidence that biomarkers implicated in cardiac stress are associated with incident T2D and changes in glucose metabolism.
Utilitarian redundancy in local medical systems - theoretical and methodological contributions
Authors: de Medeiros Patrícia Muniz , Ferreira Júnior Washington Soares , Queiroz Fabiane da Silva
Published: October 2020

The utilitarian redundancy model (URM) is one of the recent contributions to ethnobiology. We argue that URM can be applied to access use-pressure on plant species, the resilience of socioecological systems (e.g., local medical systems), cultural keystone species, and the role of exotic species in social-ecological systems. Based on previous URM studies, we also emphasize the need to differ practical (considering plants and uses that are currently employed) and theoretical (considering both currently employed and potentially employed plants and uses) redundancy. Based on the main applications of the URM, we propose a new index to access redundancy of a therapeutic indication: the Uredit, so that Uredit = NSp + CR, were Uredit is the Utilitarian Redundancy Index for the therapeutic indication; NSp is the total number of species mentioned for the indication, and CR is the species’ contribution to redundancy (in terms of knowledge sharing). The maximum value that the Uredit could reach is twice the number of species employed for the therapeutic indication. We believe that this theoretical and methodological improvement in the model can improve comparisons of redundancy in different social-ecological systems. We also highlight some limitations of the URM (and our Uredit), and we believe that conscious reasons behind people’s decisions should be incorporated into future studies on the subject.
Medium-term outcomes of total hip arthroplasty in juvenile patients
Authors: Luceri Francesco , Morelli Ilaria , Sinicato Carlo Maria , Della Grazia Alberto , Verdoni Fabio , Maffulli Nicola , Peretti Giuseppe M. , Curci Domenico
Published: October 2020

Background

Juvenile hip osteoarthritis is often the end result of congenital conditions or acquired hip ailments occurred during the paediatric age. This study evaluated the middle term results of total hip arthroplasty for end-stage juvenile hip osteoarthritis.

Materials and methods

This is a retrospective analysis of prospectively collected data on a cohort of 10 consecutive patients (12 hips), aged between 14 and 20 at operation, who underwent cementless total hip arthroplasty for end-stage juvenile secondary hip osteoarthritis in two orthopaedic tertiary referral centres between 2009 and 2018.

Results

Juvenile hip osteoarthritis occurred as a consequence of developmental dysplasia of the hip, Legg-Calvé-Perthes disease, femoral head necrosis or slipped capital femoral epiphysis. All patients showed a significant improvement in Harris Hip Score (p< 0.01) at 3.3 years average follow-up (range 0.7–10.1 years).

Conclusion

The management of juvenile hip osteoarthritis following developmental dysplasia of the hip, Legg-Calvé-Perthes disease, femoral head necrosis or slipped capital femoral epiphysis is still challenging. Careful preoperative planning is essential to achieve good outcomes and improve the Harris Hip Score in these young patients. Total hip arthroplasty is a suitable option for end-stage secondary juvenile hip osteoarthritis, when proximal femoral osteotomies and conservative treatments fail to improve patients’ symptoms and quality of life.

Level of evidence

IV
Biomechanical study of the C5–C8 cervical extraforaminal ligaments
Authors: Zhao Qinghao , Yang Yemei , Wu Penghuan , Huang Chengyan , Zhang Rusen , Li Qingchu , Shi Benchao
Published: October 2020

Background

The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. However, detailed descriptions of the biomechanical characteristics of these ligaments are lacking.

Methods

The paravertebral muscles were dissected, and the extraforaminal ligaments and nerve roots were identified. The C5 and C7 or C6 and C8 cervical nerve roots on both sides were randomly selected, and a window was opened on the vertebral lamina to expose the posterior spinal nerve root segments. Five needles were placed on the nerve root and the bone structure around the intervertebral foramen; the distal end of the nerve root was then tied with silk thread, and the weights were connected across the pulley. A weight load was gradually applied to the nerve root (50 g/time, 60 times in total). At the end of the experiment, segments of the extraforaminal ligaments were selectively cut off to compare the changes in nerve root displacement.

Results

The displacement of the C5, C6, C7, and C8 nerve roots increases with an increasing traction load, and the rate of change of nerve root displacement in the intervertebral foramen is smaller than that in the nerve root on the outside area (p < 0.05). Extraforaminal ligaments can absorb part of the pulling load of the nerve root; the C5 nerve root has the largest load range.

Conclusions

Cervical extraforaminal ligaments can disperse the tension load on the nerve root and play a role in protecting the nerve root. The protective effect of the C5 nerve root was the strongest, and this may anatomically explain why the C5 nerve roots are less prone to simple avulsion.
COVID-19 and iron dysregulation: distant sequence similarity between hepcidin and the novel coronavirus spike glycoprotein
Authors: Ehsani Sepehr
Published: October 2020

The spike glycoprotein of the SARS-CoV-2 virus, which causes COVID-19, has attracted attention for its vaccine potential and binding capacity to host cell surface receptors. Much of this research focus has centered on the ectodomain of the spike protein. The ectodomain is anchored to a transmembrane region, followed by a cytoplasmic tail. Here we report a distant sequence similarity between the cysteine-rich cytoplasmic tail of the coronavirus spike protein and the hepcidin protein that is found in humans and other vertebrates. Hepcidin is thought to be the key regulator of iron metabolism in humans through its inhibition of the iron-exporting protein ferroportin. An implication of this preliminary observation is to suggest a potential route of investigation in the coronavirus research field making use of an already-established literature on the interplay of local and systemic iron regulation, cytokine-mediated inflammatory processes, respiratory infections and the hepcidin protein. The question of possible homology and an evolutionary connection between the viral spike protein and hepcidin is not assessed in this report, but some scenarios for its study are discussed.
Epidemiology, clinical characteristics, and outcome of candidemia in critically ill patients in Germany: a single-center retrospective 10-year analysis
Authors: Schroeder Maria , Weber Theresa , Denker Timme , Winterland Sarah , Wichmann Dominic , Rohde Holger , Ozga Ann-Kathrin , Fischer Marlene , Kluge Stefan
Published: October 2020

Background

Despite advances in the management of bloodstream infections (BSI) caused by Candida spp., the mortality still remains high in critically ill patients. The worldwide epidemiology of yeast-related BSI is subject to changing species distribution and resistance patterns, challenging antifungal treatment strategies. The aim of this single-center study was to identify predictors of mortality after 28 and 180 days in a cohort of mixed surgical and medical critically ill patients with candidemia.

Methods

Patients, who had been treated for laboratory-confirmed BSI caused by Candida spp. in one of 12 intensive care units (ICU) at a University hospital between 2008 and 2017, were retrospectively identified. We retrieved data including clinical characteristics, Candida species distribution, and antifungal management from electronic health records to identify risk factors for mortality at 28 and 180 days using a Cox regression model.

Results

A total of 391 patients had blood cultures positive for Candida spp. (incidence 4.8/1000 ICU admissions). The mortality rate after 28 days was 47% (n = 185) and increased to 60% (n = 234) after 180 days. Age (HR 1.02 [95% CI 1.01–1.03]), a history of liver cirrhosis (HR 1.54 [95% CI 1.07–2.20]), septic shock (HR 2.41 [95% CI 1.73–3.37]), the Sepsis-related Organ Failure Assessment score (HR 1.12 [95% CI 1.07–1.17]), Candida score (HR 1.25 [95% CI 1.11–1.40]), and the length of ICU stay at culture positivity (HR 1.01 [95% CI 1.00–1.01]) were significant risk factors for death at 180 days. Patients, who had abdominal surgery (HR 0.66 [95% CI 0.48–0.91]) and patients, who received adequate (HR 0.36 [95% CI 0.24–0.52]) or non-adequate (HR 0.31 [95% CI 0.16–0.62]) antifungal treatment, had a reduced mortality risk compared to medical admission and no antifungal treatment, respectively.

Conclusions

The mortality of critically ill patients with Candida BSI is high and is mainly determined by disease severity, multiorgan dysfunction, and antifungal management rather than species distribution and susceptibility. Our results underline the importance of timely treatment of candidemia. However, controversies remain on the optimal definition of adequate antifungal management.
Vertical handover algorithm based on multi-attribute and neural network in heterogeneous integrated network
Authors: Tan Xiaonan , Chen Geng , Sun Hongyu
Published: October 2020

A novel vertical handover algorithm based on multi-attribute and neural network for heterogeneous integrated network is proposed in this paper. The whole frame of the algorithm is constructed by setting the network environment in which we use the network resources by switching between UMTS, GPRS, WLAN, 4G, and 5G. Each network build their own three-layer BP (Back Propagation, BP) neural network model and then the maximum transmission rate, minimum delay, SINR (signal to interference and noise ratio, SINR), bit error rate, user moving speed, and packet loss rate which can affect the overall performance of the wireless network are employed as reference objects to participate in the setting of BP neural network input layer neurons and the training and learning process of subsequent neural network data. Finally, the network download rate is adopted as prediction target to evaluate performance on the five wireless networks and then the vertical handover algorithm will select the right wireless network to perform vertical handover decision. The simulation results on MATLAB platform show that the vertical handover algorithm designed in this paper has a handover success rate up to 90% and realizes efficient handover and seamless connectivity between multi-heterogeneous networks.
Eating quickly is associated with a low aspartate aminotransferase to alanine aminotransferase ratio in middle-aged adults: a large-scale cross-sectional survey in Japan
Authors: Ozaki Eri , Ochiai Hirotaka , Shirasawa Takako , Yoshimoto Takahiko , Nagahama Satsue , Muramatsu Jun , Chono Takahiko , Ito Takayoshi , Inoue Haruhiro , Kokaze Akatsuki
Published: October 2020

Background

An elevated alanine aminotransferase (ALT) and a low aspartate aminotransferase (AST) to ALT ratio (AST/ALT ratio) suggest nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, increasing the risk of liver cirrhosis and hepatocellular carcinoma. In addition, eating quickly has been found to be associated with outcomes such as obesity. This study sought to investigate the relationship between eating quickly and an elevated ALT or a low AST/ALT ratio in Japanese middle-aged adults.

Methods

The present study included 283,073 adults aged 40–64 years who had annual health checkups in Japan from April 2013 to March 2014. The data of serum parameters and lifestyle factors, including eating speed, were analyzed. An elevated ALT was defined as > 40 U/L, and a low AST/ALT ratio was defined as < 1. Logistic regression analysis was performed to calculate the odds ratios (ORs) and the 95% confidence intervals (CIs) for an elevated ALT and a low AST/ALT ratio.

Results

Significantly increased ORs for an elevated ALT were observed in men (OR: 1.45, 95% CI: 1.41–1.49) and women (OR: 1.34, 95% CI: 1.25–1.43). Moreover, eating quickly significantly increased the ORs for a low AST/ALT ratio in men (OR: 1.53, 95% CI: 1.50–1.56) and women (OR: 1.36, 95% CI: 1.31–1.41). When the analysis was limited to those with ALT ≤40 U/L, eating quickly had significantly increased ORs for a low AST/ ALT ratio, regardless of sex.

Conclusions

Eating quickly was significantly associated with an elevated ALT and a low AST/ALT ratio. In addition, eating quickly was significantly associated with a low AST/ALT ratio even for those without ALT elevation. This study suggested that modification of eating speed may contribute to reducing the risk for an elevated ALT and a low AST/ALT ratio.
Network-level functional connectivity alterations in chemotherapy treated breast cancer patients: a longitudinal resting state functional MRI study
Authors: Feng Yun , Wang Yun Fei , Zheng Li Juan , Shi Zhao , Huang Wei , Zhang Long Jiang
Published: October 2020

Background

Previous studies have found abnormal structural and functional brain alterations in breast cancer survivors undergoing chemotherapy. However, the network-level brain changes following chemotherapy remain unknown. The purpose of this study was to investigate the dynamic changes of large-scale within- and between-network functional connectivity in chemotherapy-treated breast cancer patients.

Methods

Seventeen breast cancer patients were evaluated with resting state functional MRI (rs-fMRI), neuropsychological tests and blood examination before postoperative chemotherapy (t0), one week after completing chemotherapy (t1) and six months after completing chemotherapy (t2). Nineteen age- and education level-matched healthy controls (HC) were also recruited. Independent components analysis (ICA) was performed to assess network component using rs-fMRI data. The functional network changes were then correlated with cognitive assessment scores and blood biochemical indexes.

Results

One-way repeated measures ANOVA revealed significantly changed within-network functional connectivity in the anterior and posterior default mode network (ADMN and PDMN), left and right frontoparietal network (LFPN and RFPN), visual network and self-referential network. Post-hoc test showed that decreased within-network functional connectivity in ADMN, PDMN, LFPN, RFPN, SRN and central network one week after chemotherapy and increased six months after chemotherapy (all P < 0.05). As for the between-network functional connectivity, the PDMN- sensorimotor network connectivity showed the same tendency. Most of these within- and between-network functional connectivity changes were negatively associated with blood biochemical indexes and cognitive assessment scores (all P < 0.05).

Conclusions

These results indicated that chemotherapy may induce widespread abnormalities in resting state networks, which may serve as a potential biomarker of chemotherapy related cognitive impairment, providing insights for further functional recovery treatment.
Transcriptional regulation of MGE progenitor proliferation by PRDM16 controls cortical GABAergic interneuron production
Authors: Turrero García Miguel , Baizabal José-Manuel , Tran Diana N. , Peixoto Rui , Wang Wengang , Xie Yajun , Adam Manal A. , English Lauren A. , Reid Christopher M. , Brito Salvador I. , Booker Matthew A. , Tolstorukov Michael Y. , Harwell Corey C.
Published: October 2020

The mammalian cortex is populated by neurons derived from neural progenitors located throughout the embryonic telencephalon. Excitatory neurons are derived from the dorsal telencephalon, while inhibitory interneurons are generated in its ventral portion. The transcriptional regulator PRDM16 is expressed by radial glia, neural progenitors present in both regions; however, its mechanisms of action are still not fully understood. It is unclear if PRDM16 plays a similar role in neurogenesis in both dorsal and ventral progenitor lineages, and if so, whether it regulates common or unique networks of genes. Here, we show that Prdm16 expression in medial ganglionic eminence (MGE) progenitors is required for maintaining their proliferative capacity and for the production of proper numbers of forebrain GABAergic interneurons. PRDM16 binds to cis-regulatory elements and represses the expression of region-specific neuronal differentiation genes, thereby controlling the timing of neuronal maturation. PRDM16 regulates convergent developmental gene expression programs in the cortex and MGE, which utilize both common and region-specific sets of genes to control the proliferative capacity of neural progenitors, ensuring the generation of correct numbers of cortical neurons.
The conserved molting/circadian rhythm regulator NHR-23/NR1F1 serves as an essential co-regulator ofC. elegansspermatogenesis
Authors: Ragle James Matthew , Aita Abigail L. , Morrison Kayleigh N. , Martinez-Mendez Raquel , Saeger Hannah N. , Ashley Guinevere A. , Johnson Londen C. , Schubert Katherine A. , Shakes Diane C. , Ward Jordan D.
Published: October 2020

In sexually reproducing metazoans, spermatogenesis is the process by which uncommitted germ cells give rise to haploid sperm. Work in model systems has revealed mechanisms controlling commitment to the sperm fate, but how this fate is subsequently executed remains less clear. While studying the well-established role of the conserved nuclear hormone receptor transcription factor, NHR-23/NR1F1, in regulating C. elegans molting, we discovered NHR-23/NR1F1 is also constitutively expressed in developing 1° spermatocytes and is a critical regulator of spermatogenesis. In this novel role, NHR-23/NR1F1 functions downstream of the canonical sex determination pathway. Degron-mediated depletion of NHR-23/NR1F1 within hermaphrodite or male germlines causes sterility due to an absence of functional sperm as depleted animals produce arrested primary spermatocytes rather than haploid sperm. These spermatocytes arrest in prometaphase I and fail to either progress to anaphase or attempt spermatid-residual body partitioning. They make sperm-specific membranous organelles (MOs) but fail to assemble their major sperm protein into fibrous bodies. NHR-23/NR1F1 appears to function independently of the known SPE-44 gene regulatory network, revealing the existence of an NHR-23/NR1F1-mediated module that regulates the spermatogenesis program.
YAP and TAZ maintain PROX1 expression in the developing lymphatic and lymphovenous valves in response to VEGF-C signaling
Authors: Cha Boksik , Ho Yen-Chun , Geng Xin , Mahamud Md. Riaj , Chen Lijuan , Kim Yeunhee , Choi Dongwon , Kim Tae Hoon , Randolph Gwendalyn J. , Cao Xinwei , Chen Hong , Srinivasan R. Sathish
Published: October 2020

Lymphatic vasculature is an integral part of digestive, immune and circulatory systems. The homeobox transcription factor PROX1 is necessary for the development of lymphatic vessels, lymphatic valves (LVs) and lymphovenous valves (LVVs). We and others previously reported a feedback loop between PROX1 and Vascular Endothelial Growth Factor-C (VEGF-C) signaling. PROX1 promotes the expression of the VEGF-C receptor VEGFR3 in lymphatic endothelial cells (LECs). In turn, VEGF-C signaling maintains PROX1 expression in LECs. However, the mechanisms of PROX1/VEGF-C feedback loop remain poorly understood. Whether VEGF-C signaling is necessary for LV and LVV development is also unknown. Here, we report for the first time that VEGF-C signaling is necessary for valve morphogenesis. We have also discovered that the transcriptional co-activators YAP and TAZ are required to maintain PROX1 expression in LVs and LVVs in response to VEGF-C signaling. Deletion of Yap and Taz in the lymphatic vasculature of mouse embryos did not affect the formation of LVs or LVVs, but resulted in the degeneration of these structures. Our results have identified VEGF-C/YAP/TAZ as a critical molecular pathway in valve development.