bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Orbital Floor Reconstruction with Split Corticocancellous Rib Graft
Authors: Niklinska Eva , Pontell Matthew E. , Jaeger Nolan , Golinko Michael , Kelly Kevin
Published: May 2021

Background: Orbital floor fractures constitute roughly 20% of all pediatric facial fractures. Reconstructive techniques are broadly subdivided into alloplastic and autologous. While pediatric literature exists for alloplastic orbital reconstruction, autologous orbital reconstruction studies are limited. Here we present several cases of posttraumatic pediatric orbital reconstruction utilizing autologous split rib graft. Methods: After IRB approval, a retrospective chart review was conducted at Monroe Carell Jr. Children’s Hospital at Vanderbilt from 2003 to 2019. A review of relevant published literature was also performed. Results: From 2003 to 2019, 5 pediatric patients underwent orbital reconstruction with split rib graft. Of the 5 patients, 3 were female and 2 were male with an age range of 4 to 8 years old (mean 4.8). Two patients had isolated orbital blow-out fractures while 3 presented with concurrent midfacial fractures. In each patient, the orbit was reconstructed by contoured split rib corticocancellous graft. Average length of stay was 5.2 days. There were no postoperative pneumothoraces. Mean follow-up length was 18.7 months, with no rib donor site complications. Each patient had adequate orbital volume restoration with no postoperative globe malposition or persistent diplopia. Conclusion: Pediatric orbital fractures are complex and challenging injuries. While alloplastic reconstruction is common and reliable, the risks of foreign body implantation and fixation must be carefully considered in patients who have not yet reached skeletal maturity. This is especially pertinent in younger patients as orbital growth continues until approximately 9 years of age. Rib graft use for adult orbital reconstruction has been explored. Data in the pediatric literature has not been identified. Corticocancellous rib graft harvest mandates a second surgical site; however, it is relatively inconspicuous with low postoperative morbidity. Corticocancellous rib grafting is a safe and durable option for orbital reconstruction and should be considered for use in the pediatric patient with a growing facial skeleton.
An MRI Case Study: The Anatomic Cleft Restoration Concept Utilizing Buccal Flaps in a Primary Palatoplasty
Authors: Haenssler Abigail E. , Perry Jamie L. , Mann Samuel A. , Mann Robert J.
Published: May 2021

Purpose: Primary palatoplasties using the Anatomic Cleft Restoration Philosophy uses the buccinator myomucosal flap (buccal flap) as the major tissue replacement flap to correct the tissue deficiency within the cleft palate malformation. The surgical approach aims to close the palate without tension, lengthen the palate, reconstruct the levator muscular sling, not inhibit craniofacial growth and achieve proper resonance for speech. The purpose of this study is to present preliminary data on velopharyngeal variables to demonstrate the muscle and tissue morphology in adults with cleft palate who have not received a secondary surgery for speech or orthognathic surgery. Methods: Magnetic resonance imaging was used to analyze velopharyngeal variables for 2 individuals with the buccal flap approach and 2 individuals who received a traditional cleft palate repair. Linear measurements were obtained and 2 velopharyngeal ratios were calculated. Results: All variables were compared to previously published normative data of velopharyngeal variables for individuals with non-cleft anatomy who are of the same race, sex, and of similar age. The individuals with the buccal flap approach presented with a similar velar length and levator length in comparison to individuals with non-cleft anatomy. The individuals with the buccal flap approach presented with a longer effective velar length and velar length in comparison to individuals with a traditional cleft palate repair. Visually, the individual with the buccal flap presents with a thicker tissue mass between the hard and soft palate junction. Conclusions: In this case study, individuals who received a primary palatoplasty with the buccal flap approach presented with a longer velum and effective velar length in comparison to individuals with a traditional cleft palate repair and those with non-cleft anatomy. This study highlights the utility of using magnetic resonance imaging to quantify the changes that occur to the velopharyngeal anatomy following the buccal flap surgical approach.
The CAT-SIR is out of the bag: tumors prefer host rather than dietary nutrients
Authors: Abbott Keene L. , Vander Heiden Matthew G.
Published: May 2021

The extent to which tumors acquire nutrients from dietary sources as opposed to from the breakdown of host tissues is not known. In this issue of BMC Biology, Holland et al. report an approach where food sources with different isotope labeled carbon ratios can be used to answer this question, and find that tumors arising in Drosophila melanogaster procure most of their nutrients from the host.
DIA proteomics analysis through serum profiles reveals the significant proteins as candidate biomarkers in women with PCOS
Authors: Yu Ying , Tan Panli , Zhuang Zhenchao , Wang Zhejiong , Zhu Linchao , Qiu Ruyi , Xu Huaxi
Published: May 2021

Background

The aim of this study was to apply proteomic methodology for the analysis of proteome changes in women with polycystic ovary syndrome (PCOS).

Material and methods

All the participators including 31 PCOS patients and 31 healthy female as controls were recruited, the clinical characteristics data was recorded at the time of recruitment, the laboratory biochemical data was detected. Then, a data-independent acquisition (DIA)-based proteomics method was performed to compare the serum protein changes between PCOS patients and controls. In addition, Western blotting was used to validate the expression of identified proteomic biomarkers.

Results

There were 80 proteins differentially expressed between PCOS patients and controls significantly, including 54 downregulated and 26 upregulated proteins. Gene ontology and Kyoto Encyclopedia of Genes and Genomes analysis showed that downregulated proteins were enriched in platelet degranulation, cell adhesion, cell activation, blood coagulation, hemostasis, defense response and inflammatory response terms; upregulated proteins were enriched in cofactor catabolic process, hydrogen peroxide catabolic process, antioxidant activity, cellular oxidant detoxification, cellular detoxification, antibiotic catabolic process and hydrogen peroxide metabolic process. Receiver operating characteristic curves analysis showed that the area under curve of Histone H4 (H4), Histone H2A (H2A), Trem-like transcript 1 protein (TLT-1) were all over than 0.9, indicated promising diagnosis values of these proteins. Western blotting results proved that the detected significant proteins, including H4, H2A, TLT-1, Peroxiredoxin-1, Band 3 anion transport protein were all differently expressed in PCOS and control groups significantly.

Conclusion

These proteomic biomarkers provided the potentiality to help us understand PCOS better, but future studies comparing systemic expression and exact role of these candidate biomarkers in PCOS are essential for confirmation of this hypothesis.
HDAC4 degradation during senescence unleashes an epigenetic program driven by AP-1/p300 at selected enhancers and super-enhancers
Authors: Di Giorgio Eros , Paluvai Harikrishnareddy , Dalla Emiliano , Ranzino Liliana , Renzini Alessandra , Moresi Viviana , Minisini Martina , Picco Raffaella , Brancolini Claudio
Published: May 2021

Background

Cellular senescence is a permanent state of replicative arrest defined by a specific pattern of gene expression. The epigenome in senescent cells is sculptured in order to sustain the new transcriptional requirements, particularly at enhancers and super-enhancers. How these distal regulatory elements are dynamically modulated is not completely defined.

Results

Enhancer regions are defined by the presence of H3K27 acetylation marks, which can be modulated by class IIa HDACs, as part of multi-protein complexes. Here, we explore the regulation of class IIa HDACs in different models of senescence. We find that HDAC4 is polyubiquitylated and degraded during all types of senescence and it selectively binds and monitors H3K27ac levels at specific enhancers and super-enhancers that supervise the senescent transcriptome. Frequently, these HDAC4-modulated elements are also monitored by AP-1/p300. The deletion of HDAC4 in transformed cells which have bypassed oncogene-induced senescence is coupled to the re-appearance of senescence and the execution of the AP-1/p300 epigenetic program.

Conclusions

Overall, our manuscript highlights a role of HDAC4 as an epigenetic reader and controller of enhancers and super-enhancers that supervise the senescence program. More generally, we unveil an epigenetic checkpoint that has important consequences in aging and cancer.
Alpha-1 antitrypsin deficiency in the elderly: a case report
Authors: Annunziata Anna , Lanza Maurizia , Coppola Antonietta , Fiorentino Giuseppe
Published: May 2021

Background

Generally, alpha-1 antitrypsin deficiency (AATD) is suspected in young patients with pulmonary emphysema or chronic obstructive pulmonary disease (COPD). Patients often suffer from diagnostic gaps and are misdiagnosed with chronic obstructive pulmonary disease (COPD), asthma, and airway hyperresponsiveness (AHR), as AATD may present with nonspecific respiratory symptoms. It is never too late to suspect AATD, especially in a patient with an unusual medical history. In recent years, evidence is beginning to emerge that there may be value in identifying and treating patients who do not already have deterioration of functional parameters.

Case presentation

We describe a case of a 69-year-old Caucasian female patient, late diagnosis of AATD, with both severe bronchial hyperreactivity and numerous exacerbations due to the peculiar clinical history and the presence of a rare mutation; although not presenting forced expiratory volume in 1 second (FEV1) between 30 and 65%, the patient was treated with alpha-1 antitrypsin (AAT) augmentation therapy and achieved clinical and functional improvement.

Conclusion

AATD should always be suspected. The Alpha-1 Foundation recommendations for the diagnosis and management of AATD in adult patients indicate that treatment should be provided for patients with FEV1 between 30 and 65%. It may be useful to evaluate and treat patients based on clinical symptoms, even outside the established parameters, in particular cases.
The association between somatotype and nutritional status: a cross-sectional study among the adult Sabar males of Purulia, West Bengal, India
Authors: Das Kaustav , Mukherjee Koel , Ganguli Sayak , Pal Somosree , Bagchi Subrata Sankar
Published: May 2021

Somatotype is the parameter used to determine the body composition, which is influenced by several factors and nutrition is the crucial one. This study aimed to determine somatotype and nutritional status as well as investigate the somatotype variations in relation to the age and nutritional status among the adult males of Sabar community living in Purulia district of West Bengal, India. The present cross-sectional study included 334 Sabar males aged between 18 to 60 years. Anthropometric measurements including height, weight, 2 breadths, 2 circumferences and 4 skinfolds were taken following standard protocol. Somatotype was determined following the Heath-Carter method and Body Mass Index (BMI) was used to access the level of nutrition. Descriptive statistics, Kruskal-Wallis H test, Pearson correlation, Spearman correlation and Chi-square test were performed to find out variation, correlation and association of the somatype components with age and nutritional categories. Prior ethical clearance had been obtained. As a result, the trend of undernutrition was gradually increasing with age and found highest among aged people (50–60 years) with an overall prevalence of 49.7%. Eleven different somatotype subgroups were identified. The mean somatotype of the participants was 2.3–3.6-3.9 which indicates mesomorph-ectomorph body type. Kruskal-Wallis H test revealed significant differences among somatotype components in different nutritional categories. Undernutrition was found highest among the mesomorphic ectomorph (62.7%) type. Chi-square test stated significant association between somatotype categories and nutritional statuses (Chi-square = 283.160,p < 0.01). This is the first reporting on the somatotype study among the Sabar community, where the dominant body type was found mesomorph-ectomorph. A highly significant correlation was found between somatotype and BMI. At the same time, this study expressed the need for immediate nutritional intervention.
18F-FDG PETCT and 68Ga-DOTA PETCT mismatch with in vivo histopathological characterization of low-grade neuroendocrine pancreatic tumor
Authors: Queiroz Marcello Moro , Lopes Carlos Diego Holanda , Salgues Alessandra Corte Real , Barbosa Felipe de Galiza , Abe Emerson Shigueaki , Silveira Thales Parenti , Machado Marcel Cerqueira Cesar , Capareli Fernanda Cunha
Published: May 2021

Background

Pancreatic neuroendocrine tumor (PNET) is a subgroup of neuroendocrine tumor (NET) that has unique biology and natural history. The histological classification has a major role in the management of this pathology, but in recent years Gallium 68 dotatate (68Ga-DOTA) scanning is at the center of a discussion about how these imaging technologies can modify clinical management of neuroendocrine tumors and how their results are correlated to Ki67 index.

Method

We hereby describe a case of a patient that investigated an unspecific stable pancreatic nodule suspected of high-grade NET after evaluation with 68Ga-DOTATOC positron emission tomography—computed tomography (PETCT) and 18F-Fluorodeoxyglucose (18F-FDG) PETCT.

Results

The images corroborate the hypothesis of high-grade NET based on the standard uptake value (SUV) described in both image exams (16.4 in 18FDG PETCT and 9.2 in 68Ga-DOTATOC PETCT). After surgery, the histopathological analyses revealed a localized grade 2 well-differentiated NET, Ki-67 of 4.7, glucose transport proteins 1 (GLUT1) negative by immunohistochemistry, evidencing a rare case of mismatch between the functional image and the in vivo characterization of the neoplasm.

Conclusion

Functional imaging of neuroendocrine tumors with different modalities of PETCT is a well-described strategy for evaluating PNET and can dictate conducts in some cases. However, histopathological analysis is crucial to confirm the grade and prognosis related to this disease.
Inadvertent internal carotid artery (ICA) injury during transsphenoidal surgery: review of literature
Authors: Al-Shami Hieder , Alnemare Ahmad K.
Published: May 2021

Background

Internal carotid artery (ICA) injury is a hazardous catastrophe for the skull base surgery team. We aimed to illustrate the vital joints in this hazardous event during endoscopic surgery.

Main text

The condition is rare (1.1%) but fatal per se. Working in the field of endoscopic surgery is not free of charges. It demands a thorough knowledge of anatomy, variations, and pathoanatomy to expect what can be seen thereafter. Once the injury occurs, one must have a quite clear plan to proceed. Marvelous bleeding is confusing not only in the field but also in the mind process.

Conclusion

Endoscope teams when expose to this event should think in a stepwise manner. In our review, we explained the pathoanatomy of the field after an injury, pre-conditions of injury, and how to avoid certain drawbacks during management.
Treatment of progressive multiple sclerosis with high-dose all-trans retinoic acid – no clear evidence of positive disease modifying effects
Authors: Ruschil Christoph , Dubois Evelyn , Stefanou Maria-Ioanna , Kowarik Markus Christian , Ziemann Ulf , Schittenhelm Marcus , Krumbholz Markus , Bischof Felix
Published: May 2021

Background

All-trans retinoic acid (ATRA) is an acid derivative of vitamin A which is discussed as a promising candidate to ameliorate the disease course of multiple sclerosis (MS) by immunomodulation or even by promoting regeneration in progressive MS. Here we report a patient who significantly improved for MS related disability following administration of chemotherapy including ATRA for mitoxantrone-related acute promyelocytic leukemia and assess the effect of high-dose ATRA in three additional patients with progressive MS.

Methods

Patients with progressive MS who had failed previous therapies were treated with high-dose ATRA. Patients underwent clinical and routine laboratory monitoring. Additionally, PBMCs were analyzed by flow cytometry for lymphocyte subsets.

Results

ATRA was well tolerated and no pathological laboratory abnormalities were observed. After initial mild (not statistically significant) improvement of EDSS and mean MSFC z-score, ongoing disease progression was observed. One patient subacutely experienced severe cognitive and motor worsening. Cerebral MRI revealed persistent gadolinium-enhancing lesions. Flow cytometric alterations of peripheral blood naïve, central memory and effector memory CD4 and CD8 T cells, B lymphocytes, plasma cells, memory B cells, plasmablasts and natural killer (NK) cells did not reach statistical significance.

Conclusions

Stand-alone therapy with ATRA did not ameliorate progressive MS in our limited cohort and we did not observe consistent alterations of T and B cell subsets. Intriguingly, application of ATRA may have caused marked disease exacerbation in one patient.
Autistic traits in offspring of schizophrenic patients in comparison to those of normal population: a case-control study
Authors: Amin Shimaa Ibrahim , Salah EL-Deen Ghada Mohamed
Published: May 2021

Background

Autism is not a discreet condition and those families members with autistic propend are more likely to display autistic symptoms with a wide range of severity, even below the threshold for diagnosis of autism spectrum disorders. Even with a parental history of schizophrenia, the likelihood of autistic spectrum disorder was found to be 3-fold greater. The aim of this study is to assess autistic traits among offspring of schizophrenic patients in the age group from 4 to 11 years and compare it in the offspring of normal individuals, and its association with the sociodemographic data. To determine whether schizophrenic parents are a risk factor to autistic traits in their children.

Results

There was a statistically significant (P < 0.05*) increase in Autism Quotient Child scores of the case group where 47.2% had a score equal or more than the cutoff point (76), while only 17 19.4% of the control group had the same score with odds = 3.71 indicating that children of schizophrenic parents 18 were three times likely to have Autism Quotient-Child score greater than or equal to the cutoff point (76) than 19 children of healthy parents. No statistically significant association (P ≥ 0.05) was found between all 20 sociodemographic characteristics and Autism Quotient-Child scores among the case group except for family 21 income and social class where there was a statistically significant association (P < 0.05) between insufficient income 22 and low social class and higher Autism Quotient-Child score (≥ 76).

Conclusions

Children of schizophrenic parents are at high risk to have autistic traits than children of normal parents.
GMPPB-congenital disorders of glycosylation associate with decreased enzymatic activity of GMPPB
Authors: Liu Zhe , Wang Yan , Yang Fan , Yang Qin , Mo Xianming , Burstein Ezra , Jia Da , Cai Xiao-tang , Tu Yingfeng
Published: May 2021

The congenital disorders of glycosylation (CDG) are a family of metabolic diseases in which glycosylation of proteins or lipids is deficient. GDP-mannose pyrophosphorylase B (GMPPB) mutations lead to CDG, characterized by neurological and muscular defects. However, the genotype-phenotype correlation remains elusive, limiting our understanding of the underlying mechanism and development of therapeutic strategy. Here, we report a case of an individual presenting congenital muscular dystrophy with cerebellar involvement, who presents two heterozygous GMPPB mutations (V111G and G214S). The V111G mutation significantly decreases GMPPB’s enzymatic activity. By measuring enzymatic activities of 17 reported GMPPB mutants identified in patients diagnosed with GMPPB-CDG, we discover that all tested GMPPB variants exhibit significantly decreased enzymatic activity. Using a zebrafish model, we find that Gmppb is required for neuronal and muscle development, and further demonstrate that enzymatic activity of GMPPB mutants correlates with muscular and neuronal phenotypes in zebrafish. Taken together, our findings discover the importance of GMPPB enzymatic activity for the pathogenesis of GMPPB-CDG, and shed light for the development of additional indicators and therapeutic strategy.
Next-Generation Sequencing–Based Decision Support for Intensivists in Difficult-to-Diagnose Disease States: A Case Report of Invasive Cerebral Aspergillosis
Authors: Kattner Simone , Herbstreit Frank , Schmidt Karsten , Stevens Philip , Grumaz Silke , Dubler Simon , Rath Peter-Michael , Brenner Thorsten
Published: May 2021

Aspergillus spp. are widespread environmental pathogens that can induce invasive aspergillosis, especially in immunocompromised patients. An 86-year-old female patient presented with a rare case of invasive cerebral aspergillosis. The aspergilloma invaded the intracranial region originating from the ethmoidal sinus and the orbital apex. In contrast to routine diagnostic procedures, next-generation sequencing (NGS) was able to identify the fungal pathogen in the cerebrospinal fluid as well as in plasma samples, supporting the biopsy-based diagnosis of invasive cerebral aspergillosis. Therefore, NGS-based diagnostics may be of particular importance for difficult-to-diagnose disease states, when conventional diagnostic procedures fail.
The ENJOY Project: Usage and Factors to Support Adherence and Physical Activity Participation
Authors: Levinger Pazit , Dunn Jeremy , Panisset Maya , Haines Terry , Dow Briony , Batchelor Frances , Biddle Stuart J.H. , Duque Gustavo , Hill Keith D.
Published: May 2021

Objectives

Long-term engagement and participation in physical activity by older adults in the general population is poor. The Exercise interveNtion outdoor proJect in the cOmmunitY for older people (the ENJOY project) is a community-based research project utilizing an outdoor Seniors Exercise Park that demonstrated increased physical activity level as well as physical and mental health benefits. This study aims to explore participants’ perceptions about barriers and facilitators to ongoing participation as well as the usage pattern of the Seniors Exercise Park.

Method

People aged ≥60 yr underwent a 12-wk structured supervised physical activity program using outdoor exercise park equipment followed by a 6-month maintenance phase. Participants completed two surveys: at the completion of the 12-wk structured supervised program and at the completion of the 6-month maintenance phase. Access to the Seniors Exercise Park was also electronically monitored during the maintenance phase.

Results

The social aspect (60%), health benefits/improvement (41.5%), and supervision (36.9%) were the most cited factors in positively supporting participation, with 60.8% continued using the Exercise Park regularly during the maintenance phase. The main barriers to continued usage for both regular users and nonusers included other commitments (71.4%), the weather (60.7%), and medical/health problems (42.8%).

Conclusions

The Seniors Exercise Park can be utilized to promote sustainable engagement in physical activity for older people. However, future implementation strategies should consider approaches to overcome barriers for participation.

Trial registration number: ACTRN12618001727235.
Money transfers within caring dyads: some open research questions
Authors: Lep Žan
Published: May 2021

By its definition, care is not (financially) reimbursed. However, care recipients often provide material and/or financial support to their carers, which may be related to a range of psychological and social outcomes, such as the financial fragility of care recipients, changes in the quality of relationships and care, or psychological burden. In this article, I provide a brief overview of the extant knowledge on the topic and discuss some of the research questions that should be addressed in the future, both through analyses of longitudinal data and through focused research projects, linking them to the aforementioned outcomes and overall well-being of the carers.
High electro-optic coefficient lead zirconate titanate films toward low-power and compact modulators
Authors: Ban Dasai , Liu Guolei , Yu Hongyan , Sun Xinyu , Deng Niping , Qiu Feng
Published: May 2021

Developing strong electro-optic (EO) effect materials and devices is vital for high-speed optical communications and integrated photonics. In this work, we explored a chemical solution deposition technique to grow pure perovskite lead zirconate titanate (PZT) films on sapphire substrates. The grown PZT films demonstrated a preferential orientation and a broadband optical transmission window ranging from 600 to 2500 nm. Based on the high-quality film, we subsequently designed and fabricated a PZT Mach-Zehnder interference waveguide EO modulator. The measured half-wave voltage Vπ is 3.6 V at the wavelength of 1550 nm, corresponding to an in-device EO coefficient as high as ∼133 pm/V. The response of the PZT modulator from 6 to 12 GHz has been measured. We foresee that our work may pave the way towards power-efﬁcient, ultra-compact integrated devices, including modulators, switches and sensors.
Ledipasvir/Sofosbuvir for 8, 12, or 24 Weeks in Hepatitis C Patients Undergoing Dialysis for End-Stage Renal Disease
Authors: Chuang Wan-Long , Hu Tsung-Hui , Buggisch Peter , Moreno Christophe , Su Wei-Wen , Biancone Luigi , Camargo Marianne , Hyland Robert , Lu Sophia , Kirby Brian J. , Dvory-Sobol Hadas , Osinusi Anu , Gaggar Anuj , Peng Cheng-Yuan , Liu Chen-Hua , Sise Meghan E. , Mangia Alessandra
Published: May 2021

INTRODUCTION:

We evaluated 8, 12, or 24 weeks of ledipasvir/sofosbuvir in patients with hepatitis C virus and end-stage renal disease undergoing dialysis.

METHODS:

Primary efficacy end point was sustained virologic response 12 weeks after treatment. Primary safety end point was treatment discontinuation because of adverse events (AEs).

RESULTS:

Ninety-four percent (89/95) achieved sustained virologic response 12 weeks after treatment. Six patients died during treatment (n = 4) or before study completion (n = 2); no deaths were related to treatment. No patients discontinued treatment because of AEs. Thirteen percent had serious AEs; none were related to treatment.

DISCUSSION:

Treatment with ledipasvir/sofosbuvir was safe and effective in patients with end-stage renal disease undergoing dialysis.
Spontaneous Internal Pancreatic Fistulae Complicating Acute Pancreatitis
Authors: Singh Amandeep , Aggarwal Manik , Garg Rajat , Walsh Matthew , Stevens Tyler , Chahal Prabhleen
Published: May 2021

Spontaneous pancreatic fistula (PF) is a rare but challenging complication of acute pancreatitis (AP). The fistulae could be internal (draining into another viscera or cavity, e.g., pancreaticocolonic, gastric, duodenal, jejunal, ileal, pleural, or bronchial) or external (draining to skin, i.e., pancreaticocutaneous). Internal fistulae constitute the majority of PF and will be discussed in this review. Male sex, alcohol abuse, severe AP, and infected necrosis are the major risk factors for development of internal PF. A high index of suspicion is required to diagnose PF. Broad availability of computed tomography makes it the initial test of choice. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography have higher sensitivity compared with computed tomography scan and also allow for assessment of pancreatic duct for leak or disconnection, which affects treatment approaches. Certain complications of PF including hemorrhage and sepsis could be life-threatening and require urgent intervention. In nonurgent/chronic cases, management of internal PF involves control of sepsis, which requires effective drainage of any residual pancreatic collection/necrosis, sometimes by enlarging the fistula. Decreasing fistula output with somatostatin analogs (in pancreaticopleural fistula) and decreasing intraductal pressure with endoscopic retrograde cholangiopancreatography or endoscopic ultrasound/interventional radiology–guided interventions or surgery are commonly used strategies for management of PF. More than 60% of the internal PF close with medical and nonsurgical interventions. Colonic fistula, medical refractory-PF, or PF associated with disconnected pancreatic duct can require surgical intervention including bowel resection or distal pancreatectomy. In conclusion, AP-induced spontaneous internal PF is a complex complication requiring multidisciplinary care for successful management.
Association Between Diarrhea Duration and Severity and Probiotic Efficacy in Children With Acute Gastroenteritis
Authors: Schnadower David , O'Connell Karen J. , VanBuren John M. , Vance Cheryl , Tarr Phillip I. , Schuh Suzanne , Hurley Katrina , Rogers Alexander J. , Poonai Naveen , Roskind Cindy G. , Bhatt Seema R. , Gouin Serge , Mahajan Prashant , Olsen Cody S. , Powell Elizabeth C. , Farion Ken , Sapien Robert E. , Chun Thomas H. , Freedman Stephen B. ,   on Behalf of the Pediatric Emergency Care Applied Research Network and Pediatric Emergency Research Canada
Published: May 2021

INTRODUCTION:

It is unclear whether the alleged efficacy of probiotics in childhood acute gastroenteritis depends on the duration and severity of symptoms before treatment.

METHODS:

Preplanned secondary analysis of 2 randomized placebo-controlled trials in children 3–48 months of age was conducted in 16 emergency departments in North America evaluating the efficacy of 2 probiotic products (Lactobacillus rhamnosus GG and a combination probiotic: L. rhamnosus and L. helveticus). Participants were categorized in severity groups according to the duration (<24, 24–<72, and ≥72 hours) and the frequency of diarrhea episodes in the 24 hours (≤3, 4–5, and ≥6) before presentation. We used regression models to assess the interaction between pretreatment diarrhea severity groups and treatment arm (probiotic or placebo) in the presence of moderate-to-severe gastroenteritis (Modified Vesikari Scale score ≥9). Secondary outcomes included diarrhea frequency and duration, unscheduled healthcare provider visits, and hospitalization.

RESULTS:

A total of 1,770 children were included, and 882 (50%) received a probiotic. The development of moderate-to-severe gastroenteritis symptoms after the initiation of treatment did not differ between groups (probiotic—18.4% [162/882] vs placebo—18.3% [162/888]; risk ratio 1.00; 95% confidence interval 0.87, 1.16; P = 0.95). There was no evidence of interaction between baseline severity and treatment (P = 0.61) for the primary or any of the secondary outcomes: diarrhea duration (P = 0.88), maximum diarrheal episodes in a 24-hour period (P = 0.87), unscheduled healthcare visits (P = 0.21), and hospitalization (P = 0.87).

DISCUSSION:

In children 3–48 months with acute gastroenteritis, the lack of effect of probiotics is not explained by the duration of symptoms or frequency of diarrheal episodes before presentation.
Effects of Screenings in Reducing Colorectal Cancer Incidence and Mortality Differ by Polygenic Risk Scores
Authors: Choi Jungyoon , Jia Guochong , Wen Wanqing , Long Jirong , Shu Xiao-Ou , Zheng Wei
Published: May 2021

INTRODUCTION:

Colorectal cancer (CRC) screening reduces CRC incidence and mortality. However, it is unclear whether the reduction in CRC risk may differ by genetic susceptibility.

METHODS:

We evaluated this question in a cohort of 304,740 participants of European descent aged 50 years and older. Genetic susceptibility was measured using a polygenic risk score (PRS) constructed with risk variants identified in genomewide association studies. Cox models were used to estimate hazard ratios and 95% confidence intervals of CRC risk.

RESULTS:

Over a median follow-up of 7.0 years, 2,261 incident CRC cases and 528 CRC deaths were identified. CRC screening was associated with a significantly reduced CRC incidence among individuals with a high (hazard ratio, 0.80; 95% confidence interval, 0.71–0.92) and intermediate PRS (0.84, 0.71–0.98) but not among those with a low PRS (1.03, 0.86–1.25; P
interaction, 0.005). A similar but more evident difference was observed for mortality (P
interaction, 0.046), with more than 30% reduced mortality observed in the high PRS group (0.69, 0.52–0.91). Among the younger group (age 50–60 years), CRC screenings were associated with a slightly (but nonsignificantly) elevated incidence and mortality in the low PRS group but a reduced risk in the high PRS group (P
interaction, 0.043 [incidence]; 0.092 [mortality]). No significant interaction was observed in the older group (age > 60 years).

DISCUSSION:

Individuals with a higher genetic risk benefited more substantially from CRC screenings than those with a lower risk. Our findings suggest that PRS may be used to develop personalized CRC screening to maximize its effect on CRC prevention.
Preparation of Cross-Linked Cellulase Aggregate and Application to Cool Finishing of Cotton Fabric
Authors: Bai Gang , Feng Bingbing , Liu Yanchun , Dai Shujiao
Published: May 2021

Cellulase was immobilized by cross-linked enzyme aggregation to improve the stability of cellulase. The prepared cross-linked cellulase aggregates (CLCAs) and ice silicone oil were used for the cool finishing of cotton fabric. The results showed that the CLCAs extended the cellulase stability compared to free cellulase. The surface softness, smoothness, moisture permeability, and air permeability of the cotton fabric increased after CLCAs and ice silicone oil treatment. Shearing rigidity of the treated sample was 0.44 cN/(cm·deg), bending rigidity was 0.0069 cN cm, and the drape coefficient was 29.3%. Coefficient of kinetic friction of the treated sample was 0.186. The capillary effect of the treated fabric was 12.1 cm/(30 min). Air permeability was 354.3 L/(m2·s). Moisture penetrability was 3.912 g/(m2·d). The thermal and water-vapor resistance were 0.0194 m2·°C/W and 4.691 Pa·m2/ W, respectively.
Bio-Antifelting Treatment of Wool-Fiber Based on Ficin: Improvement and Effect on Dyeing with the Reseda luteola Plant
Authors: Chemchame Younes , Zahra Mourid Fatim , Bouchti Mehdi El , Kharchaf Aboubakr
Published: May 2021

The objective of this study was to assess the effect of ficin enzyme as a new antifelting agent acting on wool yarn and fabric. The treatment effect on the dyeing efficiency of luteoline colorant that was extracted from weld ( Reseda luteola) was also evaluated. The structural properties of antifelted and non-antifelted fibers were evaluated by scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) spectroscopy. An optimal enzymatic process for antifelting and shrink proofing was achieved at 40 °C for 3 h in alkaline medium at pH 10. The treatment increased the dye absorbance and fixation of luteoline colorant on the wool yarn and fabric. It also improved the fastness proprieties, particularly when a mixed mordant of natural alum and tannin from Acacia meransii were used.
Cerebrospinal fluid hemoglobin levels as markers of blood contamination: relevance for α-synuclein measurement
Authors: Paciotti Silvia , Stoops Erik , François Cindy , Bellomo Giovanni , Eusebi Paolo , Vanderstichele Hugo , Chiasserini Davide , Parnetti Lucilla
Published: May 2021

Objectives

Cerebrospinal fluid α-synuclein (CSF α-syn) represents a possible biomarker in Parkinson’s disease (PD) diagnosis. CSF blood contamination can introduce a bias in α-syn measurement. To date, CSF samples with a red blood cells (RBC) count >50 RBC × 106/L or haemoglobin (Hb) concentration >200 μg/L are excluded from biomarker studies. However, investigations for defining reliable cut-off values are missing.

Methods

We evaluated the effect of blood contamination on CSF α-syn measurement by a systematic approach in a cohort of 42 patients with different neurological conditions who underwent lumbar puncture (LP) for diagnostic reasons. CSF samples were spiked with whole blood and serially diluted to 800, 400, 200, 100, 75, 50, 25, 5, 0 RBC × 106/L. CSF α-syn and Hb levels were measured by ELISA.

Results

In neat CSF, the average concentration of α-syn was 1,936 ± 636 ng/L. This value increased gradually in spiked CSF samples, up to 4,817 ± 1,456 ng/L (+149% α-syn variation) in samples with 800 RBC × 106/L.

We established different cut-offs for discriminating samples with α-syn level above 5, 10, and 20% variation, corresponding to a Hb (RBC) concentration of 1,569 μg/L (37 RBC × 106/L), 2,082 μg/L (62 RBC × 106/L), and 3,118 μg/L (87 RBC × 106/L), respectively.

Conclusions

Our data show the high impact of CSF blood contamination on CSF α-syn levels, highlighting the measurement of Hb concentration as mandatory when assessing CSF α-syn. The thresholds we calculated are useful to classify CSF samples for blood contamination, considering as reliable only those showing a Hb concentration <1,569 μg/L.
The UK’s shifting diasporic landscape: negotiating ethnolinguistic heterogeneity in Greek complementary schools post-2010
Authors: Karatsareas Petros
Published: May 2021

An estimated 65,000 Greek citizens migrated to the UK in 2010–2016, many of whom with the prospects of long-term settlement and with a view to provide better socioeconomic and educational opportunities to their children. Their arrival was felt across many sections of life both within and beyond the country’s pre-existing Greek-speaking communities. In this article, I present findings on how the arrival of Greek pupils, parents and qualified teachers diversified Greek complementary schools, which were previously run primarily by and for the Greek Cypriot community, and on the critical role language played in the process. Drawing on data from a set of semi-structured interviews with teachers and placing my investigation against the historical backdrop of migration from Greece and Cyprus to the UK, I show how teachers portrayed post-2010 migration as a much needed, albeit not always welcome, boost in ethnocultural vitality; how it helped to perpetuate the hierarchisation of standardised and non-standardised varieties of Greek and the stigmatisation of the multilingual and multidialectal repertoires of people with a Greek Cypriot background; and, how it put a strain on the ties that have historically brought the Greek and Greek Cypriot communities together in the context of the UK diaspora.
“Pride” and “profit”: a sociolinguistic profile of the Chinese communities in Britain
Authors: Curdt-Christiansen Xiao Lan , Huang Jing
Published: May 2021

In this study we explore the ongoing social changes and internal differences within the Chinese communities in Britain with regard to language practices, ethnic and cultural affiliations, and intra-community communications. Drawing on the notions of “pride” and “profit”, we report on how migratory experiences influence the linguistic practices of the Chinese communities. We argue that “pride” and “profit”, as manifested in language practices, are rooted in “prejudice”, a consequence of linguistic hierarchies related to broader socio-historical and socio-political systems. Data sources include ethnographic interviews with 15 stakeholders from three community pillars. The data analysis shows three major differences and changes within the communities: the multi-layered make-up of the Chinese communities whose members come from different countries and regions; the replacement of Cantonese with Putonghua as the communities’ lingua franca; and the increasing visibility of the Chinese communities in mainstream society. The findings suggest that social changes and language practices are associated with the social meanings of belonging, affiliation and reality, involving a form of symbolic struggle filled with “prejudice”. The study emphasises that “pride” and “profit” can make visible and explicit the sources of social inequality that tend to be concealed by neoliberal ideologies and discourses.
A disavowed community: the case of new Italian migrants in London
Authors: Pepe Giulia
Published: May 2021

This paper reports on a study of the language ideologies and practices of the post-2008 crisis Italian migrants in London. It explores how the traditional idea of a national migrant community is challenged by these practices. While the Italian post-2008 crisis migration continues a long tradition and has captured the attention of the media, it is understudied from a sociolinguistic point of view. Using a qualitative research approach, two sets of data were collected: recordings of social interactions in spontaneously organised gatherings, and interviews with 15 post-crisis migrants. The data show the multilingual practices of post-2008 migrants and their attitudes towards these practices. Participants recognise translanguaging as the main practice defining the community language. This seems to contrast with the disavowal of their national migrant community. They refuse to engage with traditional community sociocultural practices, challenge their membership of the Italian community in London and, in some cases, even deny the existence of the community by highlighting the internal diversity that characterises this group. Nevertheless, although the participants refuse to be seen as members of a national community, they describe their engagement with translanguaging as a community practice that determines their belonging to a migratory group. The paper argues that, through the practice of translanguaging, migrants negotiate and shape their migratory identities, and reflect on the concept of the community and its dynamics.
Language attitudes and language practices of the Lebanese community in the UK
Authors: Eid Zeina , Sallabank Julia
Published: May 2021

The number of Lebanese immigrants in the UK has dramatically increased in recent years, motivated by socio-political and economic pressures and in pursuit of academic excellence. This is one of the first studies to explore the attitudes of Lebanese parents and British-Lebanese children towards Arabic (Lebanese Arabic [LA] and Modern Standard Arabic [MSA]) in the UK. The data were collected from semi-structured interviews with 24 parents and 15 children, participant observation and field notes. Results indicate that Lebanese parents and children believe that HL maintenance can foster a sense of Lebaneseness, and help children access the highly valued socio-cultural significance of LA. MSA is regarded in high esteem, but Muslim children appreciate MSA more for its “pride” value than for instrumental “profit” purposes. This illustrates that the notions of “pride” and “profit” are not clear-cut in a linguistic market where multilingualism is undervalued and European foreign languages outweigh Arabic varieties, even MSA despite its global significance. For HL speakers, the “pride” value of the HL in family, culture and religion may outweigh both profit incentives and hegemonic language ideologies.
The intracellular fluid compartment is smaller than commonly believed when measured by whole-body bioimpedance
Authors: Hahn Robert G. , Giménez-Milà Marc
Published: May 2021

Objectives

To report our data on the total body water (TBW), intracellular volume (ICV), extracellular volume (ECV), and fat-free mass (FFM) from studies using whole-body bioimpedance (BIA) with the aim of contrasting them to commonly cited reference values.

Methods

Data were retrospectively retrieved from three single-center studies of adult healthy male volunteers and one study of women scheduled for abdominal hysterectomy where multifrequency BIA had been applied to obtain measurements of TBW, ICV, ECV, and FFM.

Results

Based on measurements performed in 44 males, the TBW, ICV, ECV, and FFM represented 49.1 (4.9)%, 23.32 (3.1)%, 25.8 (2.2)%, and 67.4 (7.4)% of the BW, respectively (mean, SD). In 15 females, these volumes were 40.4 (4.5)%, 18.0 (2.1)%, 22.4 (2.6)%, and 55.6 (6.1)% per kg BW, respectively. The deviation of these measurements from the reference values increased linearly with body weight and age.

Conclusions

Body fluid volumes indicated by BIA showed that TBW amounted to 80% of the reference volume, which is 60% per kg BW in adult males. The ratio between the ICV and the ECV was approximately 1:1, while this ratio is traditionally reported to be 2:1.
Time to say good-bye? Homeopathy, skeptics and thoughts on how to proceed
Authors: Pannek Jürgen , Pannek-Rademacher Susanne
Published: May 2021

Background

Although homeopathy is frequently used by many health professionals, there are ongoing debates concerning its effectiveness. Currently no unifying explanation how homeopathy works exists. Homeopaths are frequently challenged by skeptics, and in public opinion, the swan song for homeopathy is frequently sung.

Content

Regarding the efficacy of homeopathy, several well-designed RCTs, observational studies, case studies, and case reports, have been published, demonstrating its clinical efficacy. Regarding its mode of action, the discovery of the working principle of homeopathy would be a major advance towards a thorough scientific recognition of homeopathy. Basic research has already discovered some milestones, e.g., significant and reproducible effects of homeopathic preparations in plants.

To overcome the distrust of skeptics and public opinion, the support of basic research is indispensable. Second, homeopaths should continue to design prospective randomized clinical studies in order to create robust clinical evidence for the efficacy of homeopathy. Third, they should continue to publish their treatment outcomes, as these publications document clinical effectiveness beyond doubts about its mode of action.

Outlook

These measures will not only support homeopaths in continuing their clinical work, but may lead to a better recognition of this treatment in both the scientific world and the public.
Effects of 12 sessions of steam bath intervention on spirometry parameters among healthy adult volunteers
Authors: Pandiaraja M. , Vanitha A. , Maheshkumar K. , Manavalan N. , Venugopal V.
Published: May 2021

Objectives

Steam bath is extensively used around the world. However, its physiological influence is not understood in detail. Objective of the current study is to examine the effects of 12 sessions of steam bath on spirometric parameters among healthy participants.

Methods

Forty healthy adult volunteers of both sex (14 male and 26 female) aged 26.38 ± 8 years participated in the study. A steam bath session (10–15 min) was given once a week for 12 weeks. The spirometric parameters [forced expiratory volume in the 1st second (FEV1, L), forced vital capacity (FVC, L), FEV1/FVC ratio (absolute value), maximal mid-expiratory flow (MMEF, L/s) and peak expiratory flow (PEF, L/s)] were measured by Helios 401 spirometer.

Results

Compared to baseline, post-intervention spirometric parameters showed significant (p<0.05) improvement in the FVC (82.40 ± 11.24 to 96.91 ± 18.76), FEV1 (86.13 ± 14.39 to 91.17 ± 12.48), FEV1/FVC ratio (86.96 ± 3.64 to 93.75 ± 4.80), MMEF 25–75% (86.96 ± 3.64 to 94.16 ± 11.57), peak expiratory flow rate (79.82 ± 14.90 to 92.18 ± 18.96).

Conclusions

Taking steam bath improves the spirometric parameters of healthy adult participants. However, future randomized controlled trials with on a large scale have to done to validate our findings.