bluuebunny/crossref_metadata_2025 huggingface dataset:
Antidermatophytic activity of synthetic peptides: Action mechanisms and clinical application as adjuvants to enhance the activity and decrease the toxicity of Griseofulvin
Authors: Souza Pedro F. N. , Lima Patrícia G. , Freitas Cleverson D. T. , Sousa Daniele O. B. , Neto Nilton A. S. , Dias Lucas P. , Vasconcelos Ilka M. , Freitas Larissa B. N. , Silva Rafael G. G. , Sousa Jeanlex S. , Silva Ayrles F. B. , Oliveira Jose T. A.
Published: July 2020

Background

Dermatophytes belonging to the Trichophyton genus are important human pathogens, but they have developed resistance to griseofulvin, the most common antifungal drug used to treat dermatophytosis.

Objective

This study was aimed to evaluate the antidermatophytic activity of synthetic peptides, as well as mechanisms of action and synergistic effect with griseofulvin.

Methods

Scanning electron microscopy (SEM), atomic force microscopy (AFM) and fluorescence microscopy (FM) were employed to understand the activity and the mechanism of action of peptides.

Results

Here we report that synthetic peptides at 50 μg/mL, a concentration 20‐fold lower than griseofulvin, reduced the microconidia viability of T. mentagrophytes and T. rubrum by 100%, whereas griseofulvin decreased their viability by only 50% and 0%, respectively. The action mechanism of peptides involved cell wall damage, membrane pore formation and loss of cytoplasmic content. Peptides also induced overproduction of reactive oxygen species (ROS) and enhanced the activity of griseofulvin 10‐fold against both fungi, suggesting synergistic effects, and eliminated the toxicity of this drug to human erythrocytes. Docking analysis revealed ionic and hydrophobic interactions between peptides and griseofulvin, which may explain the decline of griseofulvin toxicity when mixed with peptides.

Conclusion

Therefore, our results strongly suggest six peptides with high potential to be employed alone as new drugs or as adjuvants to enhance the activity and decrease the toxicity of griseofulvin.
Endothelin‐1 in the pathophysiology of obesity and insulin resistance
Authors: Jenkins Haley N. , Rivera‐Gonzalez Osvaldo , Gibert Yann , Speed Joshua S.
Published: July 2020

The association between plasma endothelin‐1 (ET‐1) and obesity has been documented for decades, yet the contribution of ET‐1 to risk factors associated with obesity is not fully understood. In 1994, one of first papers to document this association also noted a positive correlation between plasma insulin and ET‐1, suggesting a potential contribution of ET‐1 to the development of insulin resistance. Both endogenous receptors for ET‐1, ETA and ETB are present in all insulin‐sensitive tissues including adipose, liver and muscle, and ET‐1 actions within these tissues suggest that ET‐1 may be playing a role in the pathogenesis of insulin resistance. Further, antagonists for ET‐1 receptors are clinically approved making these sites attractive therapeutic targets. This review focuses on known mechanisms through which ET‐1 affects plasma lipid profiles and insulin signalling in these metabolically important tissues and also identifies gaps in our understanding of ET‐1 in obesity‐related pathophysiology.
Preparing for sperm‐targeted contraception: College students’ perceptions and intentions related to non‐hormonal intravas injectable gel
Authors: Buck Kirstin A. , Stadick Jessica L. , Frazier Marian L.
Published: July 2020

Objective

The objective of the study was to evaluate college students’ perceptions and behavioral intentions related to a new long‐acting reversible contraceptive (LARC) for people with penises: non‐hormonal intravas injectable gel (NH‐IVIG).

Design and Sample

Data collection utilized predictive constructs from the theory of planned behavior. An online questionnaire surveyed undergraduates (ages 18–24 years) at a Midwestern, liberal arts college (N = 460).

Results

Of potential NH‐IVIG users, 28.6% of males and 51.4% of females reported being overall likely to use or encourage its usage. The top three hypothetical NH‐IVIG promoters were low cost, reversibility, and infrequent administration. High cost, new product uncertainties, plus administration via injection for the males, were the most frequently cited NH‐IVIG deterrents. A majority of potential users indicated intentions to use protective barriers or other contraceptives simultaneously with NH‐IVIG; females were more likely overall. Most respondents (males, 90.4%; females, 98.5%) agreed all sexual partners should be equally responsible for contraception. Over half trusted both males and females to use contraception, but females were significantly more trusted and trusting.

Conclusion

Understanding factors influencing NH‐IVIG usage can direct initiatives for sperm‐targeted LARCs to mitigate risk behaviors and optimize public health promotion.
From Accountants to Detectives: How Nuclear Safeguards Inspectors Make Knowledge at the International Atomic Energy Agency
Authors: Weichselbraun Anna
Published: July 2020

The International Atomic Energy Agency (IAEA) verifies state compliance with the Nuclear Nonproliferation Treaty through nuclear safeguards. The agency's legitimacy derives from the convincing display of technical authority. The politics of nuclear things, however, constantly threaten to undermine this authority. Nuclear safeguards are made legibly authoritative and credibly technical through bureaucratic objectivity. This epistemic logic and practice is widely shared by projects of technocratic governance in the liberal international order. After the discovery of Iraq's secret nuclear weapons program, the IAEA transformed its accounting‐based knowledge practices. However, these transformations into more detective‐like ways of knowing call into question the presumed technical purity of safeguards reports. This article unearths the historical origins of safeguards as bureaucratically objective knowledge and demonstrates its enduring legacy at the IAEA, as its bureaucrats and diplomats attempt to manage the tension between effectiveness and credibility.
Improving and standardizing protocols for alkaline protease quantification in fish
Authors: Nolasco‐Soria Héctor
Published: July 2020

Assessing the activity of alkaline protease is a common procedure in many biological, physiological and nutritional studies, including the maturation and digestive capacity of the digestive tract, in gastric and non‐gastric fish species. After reviewing the available literature on fish digestive alkaline proteases published during a time span of ten years (2008–2018), it has been detected some possible methodological and/or interpretative inconsistencies in this kind of studies when quantifying alkaline protease activity and concluded that special attention should be paid on: (i) the proper preparation of intestine and pyloric caeca extracts, (ii) the use of the proper reaction conditions at the normal range of physiological pH values and temperature and (iii) the proper quantification of the number of peptide bonds hydrolysed for alkaline protease unit calculation. The implementation of these recommendations and the proposal of more suitable (previously tested) methodological steps will promote the standardization of feasible alkaline protease analytical procedures, as well as improve the reliability of comparative studies between different fish species of aquacultural importance, dealing with the alkaline proteolytic enzymes.
Is backing grounding?
Authors: Sjölin Wirling Ylwa
Published: July 2020

Separatists are grounding theorists who hold that grounding relations and metaphysical explanations are distinct, yet intimately connected in the sense that grounding relations back metaphysical explanations, just as causal relations back causal explanations. But Separatists have not elaborated on the nature of the ‘backing’ relation. In this paper, I argue that backing is a form of (partial) grounding. In particular, backing has many of the properties commonly attributed to grounding, and taking backing to be partial grounding allows Separatists to make the most of their position vis‐à‐vis their Unionist opponents.
Role of plant diversity on arthropod communities in a restored tallgrass prairie of the U.S. Midwest
Authors: Kelleher Eric M. , Choi Young D.
Published: July 2020

We investigated the effects of enhanced plant species diversity on prairie restoration on arthropod community assembly in a restored tallgrass prairie of the U.S. Midwest. Despite weak correlation with the arthropod taxon, enhanced plant species diversity in the restored prairie (RP) promoted the evenness and diversity of arthropod functional groups and led to a divergence of arthropod assemblage in comparison to the ones in old field (OF) and monospecific stand (reed canary grass [RCG]) of exotic reed canary grass (Phalaris arundinacia). Pollinators were most and least abundant in RP and RCG, respectively, and exhibited a positive correlation to plant species diversity. Herbivore abundance, highest in RP, also increased with plant species diversity. The diversity of arthropod functional groups was likely facilitated by structural complexity of the RP vegetation that resulted from the enhanced plant species diversity, particularly flowering and nectar‐producing forbs. Predator abundance, highest in RCG, decreased with plant species diversity and increased with C3 grass cover. The presence of small‐body sized herbivores seemed to attract predators in the RCG site, which has a monospecific vegetation structure of C3 reed canary grass. Our results demonstrate a positive effect of prairie restoration on the diversity of arthropod functional groups. We recommend increasing the diversity of native plant species and reduction (or eradication if possible) of exotic plants in the OF and RCG sites.
Births and the City: Urban Cycles and Increasing Socio‐Spatial Heterogeneity in a Low‐Fertility Context
Authors: Salvati Luca
Published: July 2020

Analysis of fertility trends along urban gradients contributes to assess socio‐demographic change at larger scales and the new geography of metropolitan growth at smaller scales. At larger scales, urban fertility was systematically lower than rural fertility; at smaller scales, suburbs were found to have higher fertility than central districts and the neighbouring rural areas. However, fertility divides have rarely been re‐contextualised in a long‐term perspective, considering the influence of exogenous factors that change over time with urban cycles. Assuming that spatial fertility variations are contextual to the development stage of a given region, the present study goes beyond the traditional ‘urban‐suburban‐rural’ divide and provides a long‐term vision that integrates small‐scale fertility variations and city life cycles. The study investigates spatial trends in a fertility index along a cycle from urbanisation to re‐urbanisation in a low‐fertility European context (Athens, Greece) using a multi‐scale analysis framework. The empirical findings of this study demonstrate that rural fertility was systematically lower than urban fertility apart from a short time interval (1950s). Fertility in urban locations was the highest during earlier stages of urbanisation. In suburban locations, fertility increased during late suburbanisation, stabilising (or declining slightly) with counter‐urbanisation. Re‐urbanisation was associated with a greater spatial heterogeneity in fertility rates. By documenting a differential response of fertility to urban cycles, our study re‐frames the relationship between natural population dynamics and metropolitan transitions, concluding that regional fertility divides are temporary outcomes of a specific ensemble of socio‐economic forces underlying a given urban model.
Severe COVID‐19 in a patient with chronic graft‐versus‐host disease after hematopoietic stem cell transplant successfully treated with ruxolitinib
Authors: Saraceni Francesco , Scortechini Ilaria , Mancini Giorgia , Mariani Marianna , Federici Irene , Gaetani Mariana , Barbatelli Paolo , Minnucci Maria Luisa , Bagnarelli Patrizia , Olivieri Attilio
Published: July 2020

Graft‐versus‐host disease (GVHD) is a common complication of hematopoietic stem cell transplant, which is known to be mediated by cytotoxic T‐cell effectors and dysregulated inflammatory cytokines. Similarly, the lung injury observed in severe COVID‐19 cases appears to be related to a massive production of pro‐inflammatory cytokines. The selective JAK1/2 inhibitor ruxolitinib has shown promising results in the context of GVHD, and different trials are currently underway in patients with severe COVID‐19; nevertheless, no clinical observation of safety or efficacy of treatment with ruxolitinib in this context has been published yet. We describe a first case of severe COVID‐19 developed after hematopoietic stem cell transplantation in a patient with a concomitant chronic GVHD (cGVHD), in which a treatment with ruxolitinib was administered with good tolerance and positive outcome.
Characteristics and serological patterns of COVID‐19 convalescent plasma donors: optimal donors and timing of donation
Authors: Li Ling , Tong Xunliang , Chen Hanwei , He Rui , Lv Qilu , Yang Ru , Zhao Lei , Wang Jue , Xu Haixia , Liu Chuanqiao , Chen Guoan , Chen Sitian , Li Chenyue , Qiao Jiajia , Yang Juntao , Wu Yanyun , Liu Zhong
Published: July 2020

BACKGROUND

The lack of effective treatments against the 2019 coronavirus disease (COVID‐19) has led to the exploratory use of convalescent plasma for treating COVID‐19. Case reports and case series have shown encouraging results. This study investigated SARS‐CoV‐2 antibodies and epidemiological characteristics in convalescent plasma donors, to identify criteria for donor selection.

METHODS

Recovered COVID‐19 patients, aged 18‐55 years, who had experienced no symptoms for more than 2 weeks, were recruited. Donor characteristics such as disease presentations were collected and SARS‐CoV‐2 N‐specific IgM, IgG, and S‐RBD‐specific IgG levels were measured by enzyme‐linked immunosorbent assay (ELISA).

RESULTS

Whereas levels of N‐specific IgM antibody declined after recovery, S‐RBD‐specific and N‐specific IgG antibodies increased after 4 weeks from the onset of symptoms, with no significant correlation to age, sex, or ABO blood type. Donors with the disease presentation of fever exceeding 38.5°C or lasting longer than 3 days exhibited higher levels of S‐RBD‐specific IgG antibodies at the time of donation. Of the 49 convalescent plasma donors, 90% had an S‐RBD‐specific IgG titer of ≥1:160 and 78% had a titer of ≥1:640 at the time of plasma donation. Of the 30 convalescent plasma donors, who had donated plasma later than 28 days after the onset of symptoms and had a disease presentation of fever lasting longer than 3 days or a body temperature exceeding 38.5°C, 100% had an S‐RBD‐specific IgG titer of ≥1:160 and 93% had a titer of ≥1:640.

CONCLUSION

This study indicates that the S‐RBD‐specific IgG antibody reaches higher levels after 4 weeks from the onset of COVID‐19 symptoms. We recommend the following selection criteria for optimal donation of COVID‐19 convalescent plasma: 28 days after the onset of symptoms and with a disease presentation of fever lasting longer than 3 days or a body temperature exceeding 38.5°C. Selection based on these criteria can ensure a high likelihood of achieving sufficiently high S‐RBD‐specific IgG titers.
Blood donor recruitment in Guangzhou, China, during the 2019 novel coronavirus (COVID‐19) epidemic
Authors: Ou‐Yang Jian , Li Shi‐Jie , Bei Chun‐hua , He Bo , Chen Jin‐yan , Liang Hua‐qin , Fu Yong‐shui
Published: July 2020

Background

The coronavirus disease 2019 (COVID‐19) epidemic affected blood collection in Guangzhou, China.

Study Design and Methods

This paper includes three studies. The observational study reported the trends of blood collection during the epidemic in Guangzhou, China. The cross‐sectional survey investigated factors influencing blood donation during the COVID‐19 epidemic, and a self‐administered questionnaire was given to 1584 street whole blood donors (SWBDs) who donated during the epidemic. The randomized controlled trial involved 19 491 SWBDs who donated in 2019 but did not donate during the epidemic. Trial participants were randomly assigned to two intervention groups: Group 1 completed Questionnaire 1, which contained precautionary measures in response to COVID‐19 and other messages about blood donation during the epidemic; Group 2 completed Questionnaire 2, which did not include this information. A control group did not receive any questionnaire.

Results

As measures were implemented, the number of blood donors increased accordingly. Both first‐time and repeat SWBDs perceived the same level of blood need and donated blood because it would save lives. SWBDs who completed Questionnaire 1 expressed a greater intention to donate during the epidemic. Enabling blood donors to perceive a higher level of blood need and a lower level of COVID‐19 infection risk related to blood donation mobilized experienced SWBDs to donate within 3 weeks. Intention‐to‐treat analyses and average‐treatment‐effect‐on‐the‐treated estimations confirmed that Questionnaire 1 could motivate SWBDs to actually donate blood.

Conclusion

Various measures could ease blood shortage during the COVID‐19 epidemic. Administration of Questionnaire 1 could increase blood donations during the epidemic.
Electro‐oxidation of phenol in petroleum wastewater using a novel pilot‐scale electrochemical cell with graphite and stainless‐steel electrodes
Authors: Abou‐Taleb Enas M. , Hellal Mohamed S. , Kamal Kholod H.
Published: July 2020

This work investigated the removal of phenol from petroleum wastewater by the electro‐oxidation process. The experimental design was developed on a pilot‐scale electro‐oxidation system equipped with a cylindrical shape of graphite electrodes as an anode and stainless‐steel electrodes as a cathode. An initial study was performed based on operating variables such as current density and time on real petroleum wastewater. The optimum conditions were obtained as a current density of 3 mA/cm2 and time 15 min. Under these applied optimum conditions, complete phenol removal from an initial concentration of about 6.8 mg/L was achieved. Also, 50–60% removal of organic matter in terms of chemical oxygen demand (COD) and biological oxygen demand (BOD). The removal of organic matter using electro‐oxidation requires a long reaction time. Also, the economic study indicated that the energy consumption was determined to be 0.79 kWh/m3 and the operating cost was 0.051 $/m3 which is very economical compared with conventional methods.
Experimental Study on Oscillating Heat Pipe With a Hydraulic Diameter Far Exceeding the Maximum Hydraulic Diameter
Authors: Chu Lilin , Ji Yulong , Ma Hongbin , Li Yantao , Chang Chao , Yu Chunrong , Wang Zongyu
Published: July 2020

In order to understand the heat transfer performance, startup, and fluid flow conditions of oscillating heat pipes (OHPs) with a hydraulic diameter far exceeding the maximum hydraulic diameter (MHD) defined by dh,max≤2σBo/(ρl−ρv)g, an experimental investigation on the OHP heat transfer performance and visualization was conducted. The effects of heat input, working fluid, and orientation on the oscillating motion and heat transfer performance of the investigated OHPs have been conducted. In addition, the detailed flow patterns of the tested OHPs were recorded by a high-speed camera from both vertical and horizontal orientations. Results show that the maximum hydraulic diameter, which can form a train of liquid plugs and vapor bubbles, which is essential for an OHP to function, depends on the heat input, working fluid, and orientation. At a power input of 1000 W, the OHP can still function well even when the tube diameter exceeds the MHD of 91.6%. This maximum hydraulic dimeter depends on the orientation. While the OHP with a dimeter far exceeding the MHD can still function, the heat transfer performance of the OHP in a vertical orientation is better than in a horizontal orientation.
Design and Configuration of Folded Platonic Strapdowns of Biaxial MEMS Accelerometers
Authors: Shan Xiaowei , Angeles Jorge , Forbes James Richard
Published: July 2020

The authors report on the design, configure, and test of isotropic accelerometer strapdowns for high-precision inertial measurement unit (IMU) and folded MEMS configuration. The biaxial low-g MEMS accelerometers are based on the Platonic solids. A Platonic strapdown is integrated into an embedded system for acceleration-array signal acquisition targeting rigid-body pose-and-twist estimation. The electromechanical properties for dynamic sensitivity are tested on a haptic manipulator, which shows that the position estimation matches reasonably well the encoder readouts. The Platonic strapdown is promising in folded MEMS IMU with chip-level miniaturization and high estimation precision.
Shape Optimization Framework for the Path of the Primary Compliance Vector in Compliant Mechanisms
Authors: Kooistra Hylke , Kim Charles J. , van de Sande Werner W. P. J. , Herder Just L.
Published: July 2020

The primary compliance vector (PCV) captures the dominant kinematic behavior of a compliant mechanism. Its trajectory describes large deformation mechanism behavior and can be integrated in an optimization objective in detailed compliant mechanism design. This paper presents a general framework for the optimization of the PCV path, the mechanism trajectory of lowest energy, using a unified stiffness characterization and piecewise curve representation. We present a meaningful objective formulation for the PCV path that evaluates path shape, location, orientation, and length independently and apply the framework to two design examples. The framework is useful for design of planar and shell compliant mechanisms that traverse a specified mechanism trajectory and that are insensitive to load perturbations.
CRISPR-Cas9-Mediated Carbapenemase Gene and Plasmid Curing in Carbapenem-Resistant
Enterobacteriaceae
Authors: Hao Mingju , He Yuzhang , Zhang Haifang , Liao Xiao-Ping , Liu Ya-Hong , Sun Jian , Du Hong , Kreiswirth Barry N. , Chen Liang
Published: July 2020

Combating plasmid-mediated carbapenem resistance is essential to control and prevent the dissemination of carbapenem-resistant
Enterobacteriaceae
(CRE). Here, we conducted a proof-of-concept study to demonstrate that CRISPR-Cas9-mediated resistance gene and plasmid curing can effectively resensitize CRE to carbapenems. A novel CRISPR-Cas9-mediated plasmid-curing system (pCasCure) was developed and electrotransferred into various clinical CRE isolates. The results showed that pCasCure can effectively cure
bla
KPC
,
bla
NDM
, and
bla
OXA-48
in various
Enterobacteriaceae
species of
Klebsiella pneumoniae
,
Escherichia coli
,
Enterobacter hormaechei
,
Enterobacter xiangfangensis
, and
Serratia marcescens
clinical isolates, with a >94% curing efficiency.
Porcine and Bovine Forms of Lactoferrin Inhibit Growth of Porcine Enterotoxigenic Escherichia coli and Degrade Its Virulence Factors
Authors: Dierick Matthias , Van der Weken Hans , Rybarczyk Joanna , Vanrompay Daisy , Devriendt Bert , Cox Eric
Published: July 2020

Currently, postweaning F4+and F18+Escherichia coliinfections in piglets are controlled by the use of antibiotics and zinc oxide, but the use of these antimicrobial agents most likely contributes to an increase in antibiotic resistance. Our work demonstrates that bovine and porcine lactoferrin can inhibit the growth of porcine enterotoxigenicE. colistrains. In addition, we also show that lactoferrin can reduce the adherence of these strains to small intestinal epithelial cells, even at a concentration that does not inhibit bacterial growth. This research could allow us to develop lactoferrin as an alternative strategy to prevent enterotoxigenicE. coli(ETEC) infections in piglets.
Epitope Shaving Promotes Fungal Immune Evasion
Authors: Childers Delma S. , Avelar Gabriela Mol , Bain Judith M. , Pradhan Arnab , Larcombe Daniel E. , Netea Mihai G. , Erwig Lars P. , Gow Neil A. R. , Brown Alistair J. P.
Published: July 2020

The immune system plays a critical role in protecting us against potentially fatal fungal infections. However, some fungal pathogens have evolved evasion strategies that reduce the efficacy of our immune defenses. Previously, we reported that the fungal pathogen
Candida albicans
exploits specific host-derived signals (such as lactate and hypoxia) to trigger an immune evasion strategy that involves reducing the exposure of β-glucan at its cell surface. Here, we show that this phenomenon is mediated by the induction of a major secreted exoglucanase (Xog1) by the fungus in response to these host signals. Inactivating
XOG1
-mediated “shaving” of cell surface-exposed β-glucan enhances immune responses against the fungus. Furthermore, inhibiting exoglucanase activity pharmacologically attenuates
C. albicans
virulence. In addition to revealing the mechanism underlying a key immune evasion strategy in a major fungal pathogen of humans, our work highlights the potential therapeutic value of drugs that block fungal immune evasion.
Roles of ATP Hydrolysis by FtsEX and Interaction with FtsA in Regulation of Septal Peptidoglycan Synthesis and Hydrolysis
Authors: Du Shishen , Pichoff Sebastien , Lutkenhaus Joe
Published: July 2020

Cytokinesis in Gram-negative bacteria requires coordinated invagination of the three layers of the cell envelope; otherwise, cells become sensitive to hydrophobic antibiotics and can even undergo cell lysis.
In
E. coli
, the ABC transporter FtsEX couples the synthesis and hydrolysis of the stress-bearing peptidoglycan layer at the septum by interacting with FtsA and EnvC, respectively. ATP hydrolysis by FtsEX is critical for its function, but the reason why is not clear. Here, we find that in the absence of ATP hydrolysis, FtsEX blocks septal PG synthesis similarly to cephalexin. However, an FtsEX ATPase mutant, under conditions where it cannot block division, rescues
ftsEX
phenotypes as long as a partially redundant cell separation system is present. Furthermore, we find that the FtsEX-FtsA interaction is important for efficient cell separation.
Abundant and Diverse RNA Viruses in Insects Revealed by RNA-Seq Analysis: Ecological and Evolutionary Implications
Authors: Wu Haoming , Pang Rui , Cheng Tong , Xue Liang , Zeng Haiyan , Lei Tao , Chen Moutong , Wu Shi , Ding Yu , Zhang Jumei , Shi Mang , Wu Qingping
Published: July 2020

Insects comprise the largest proportion of animals on earth and are frequently implicated in the transmission of vector-borne diseases. However, considerable attention has been paid to the phytophagous and hematophagous insects, with results that provide insufficient and biased information about the viruses in insects. Here, we have delivered compelling evidence for the exceptional abundance and genetic diversity of RNA viruses in a wide range of insects. Novel viruses were found to cover major categories of RNA viruses, and many formed novel clusters divergent from the previously described taxa, dramatically broadening the range of known RNA viruses in insects. These newly characterized RNA viruses exhibited high levels of genomic plasticity in genome size, open reading frame (ORF) number, intergenic structure, and gene rearrangement and segmentation. This work provides comprehensive insight into the origin, spread, and evolution of RNA viruses. Of course, a large-scale virome project involving more organisms would provide more-detailed information about the virus infections in insects.
Estimated effect of secondary screening for hip dislocation
Authors: Wenger Daniel , Tiderius Carl Johan , Düppe Henrik
Published: July 2020

Objectives

To quantify the effect of secondary screening for hip dislocations.

Design

Retrospective analysis of hospital files from participants in a prospectively collected nationwide registry.

Setting

Child healthcare centres and orthopaedic departments in Sweden.

Participants

Of 126 children with hip dislocation diagnosed later than 14 days age in the 2000–2009 birth cohort, 101 had complete data and were included in the study.

Interventions

The entire birth cohort was subject to clinical screening for hip instability at 6–8 weeks, 6 months and 10–12 months age. Children diagnosed through this screening were compared with children presenting due to symptoms, which was used as a surrogate variable representing a situation without secondary screening.

Main outcome measures

Age at diagnosis and disease severity of late presenting hip dislocations.

Results

Children diagnosed through secondary screening were 11 months younger (median: 47 weeks) compared with those presenting with symptoms (p<0.001). Children diagnosed through secondary screening had 11% risk of having a high (severe) dislocation, compared with 38% for those diagnosed due to symptoms; absolute risk reduction 27% (95% CI: 9.7% to 45%), relative risk 0.28 (95% CI: 0.11 to 0.70). Children presenting due to symptoms had OR 5.1 (95% CI: 1.7 to 15) of having a high dislocation, and OR 11 (95% CI: 4.1 to 31) of presenting at age 1 year or older, compared with the secondary screening group. The secondary screening was able to identify half of the children (55%, 95% CI: 45% to 66%) not diagnosed through primary screening.

Conclusions

Secondary screening at child healthcare centres may have substantially lowered the age at diagnosis in half of all children with late presenting hip dislocation not diagnosed through primary screening, with the risk of having a high dislocation decreased almost to one-quarter in such cases.
Two novel mutations in theCLCNKBgene leading to classic Bartter syndrome presenting as syncope and hypertension in a 13-year-old boy
Authors: Le Binh T , Duong Cuong M , Nguyen Tien Q , Bui Chi-Bao
Published: July 2020

Classic Bartter syndrome is a rare condition caused by mutations in theCLCNKBgene and characterised by metabolic alkalosis, hypokalaemia, hyper-reninaemia and hyperaldosteronism. Early signs and symptoms usually occur before a child’s sixth birthday and include polyuria and developmental delay. We treated a 13-year-old Vietnamese boy with this syndrome presenting with atypical presentations including syncope and hypertension, but normal growth and development. All common causes of hypertension were ruled out. Genetic testing found two novel mutations in theCLCNKBgene, that is, Ser12Ala (exon 2) and Glu192Ter (exon 6). His estimated glomerular filtration rate was 61 mL/min/1.73 m2and a kidney biopsy showed focal segmental glomerulosclerosis. He was well managed with long-term enalapril therapy instead of non-steroidalanti-inflammatory drugs which are recommended in managing the increased prostaglandin E2 production in Bartter syndrome. Paediatricians should be alerted with the variability in its presentation. To preserve the kidney function, treatment must include preventing factors damaging the kidneys.
Ciprofloxacin/dexamethasone precipitate formation in the ear canal of a paediatric patient
Authors: Curtis Stacey D , Egelund Eric F , Ebied Alex M
Published: July 2020

This case report describes a paediatric patient diagnosed with otitis externa and treated with topical ciprofloxacin/dexamethasone. The patient completed the course of therapy and then developed precipitate formation from the pharmacological treatment. Laboratory testing of the precipitate confirmed the presence of a large quantity of ciprofloxacin. Removal of the precipitate required the use of an elephant ear washer system and removal with surgical tweezers. This case report investigated a probable topical ciprofloxacin/dexamethasone-induced ear precipitate formation in the ear canal, which, subsequently, was successfully removed from the patient’s ear canal.
Disseminated cryptococcal disease during treatment with idelalisib and corticosteroids for follicular lymphoma
Authors: Hengeveld Paul J , de Jongh Eva , Westerweel Peter E , Levin Mark-David
Published: July 2020

A patient on a regimen of idelalisib and corticosteroids for a relapse of follicular lymphoma presented to our emergency ward with a fever of unknown origin. Despite the initiation of broad-spectrum antibiotics and fluids, the patient’s clinical condition deteriorated. Eventually, a diagnosis of disseminated cryptococcosis was established and immunophenotyping revealed complete absence of circulating B and CD4+-T lymphocytes, and a markedly diminished CD8+-T lymphocyte count. In this case, treatment with idelalisib and corticosteroids likely resulted in profound lymphopenia and the first reported instance of disseminated cryptococcosis under this regimen. After the withdrawal of idelalisib and steroids and initiation of antifungal therapy, lymphocyte counts partially recovered. After clinical improvement, the patient could be discharged from the hospital. This case highlights that the combination of idelalisib and corticosteroids can cause significant immunocompromise and opportunistic infections. Additionally, we illustrate the rate of lymphocyte reconstitution after withdrawal from idelalisib and corticosteroids.
Changes in choroidal structure following intravitreal aflibercept therapy for
retinal vein occlusion
Authors: Mitamura Yoshinori , Enkhmaa Tserennadmid , Sano Hiroki , Niki Masanori , Murao Fumiko , Egawa Mariko , Sonoda Shozo , Sakamoto Taiji
Published: July 2020

Aims

To examine the choroidal change accompanying retinal vein occlusion (RVO)
in detail, we measured changes in choroidal structure after intravitreal
aflibercept (IVA) injections for RVO using binarisation of enhanced depth
imaging optical coherence tomographic (EDI-OCT) images and assessed
associations with clinical outcome.

Methods

Retrospective, observational case series. Forty treatment-naïve patients
(10 central, 18 major branch and 12 macular branch RVO) were examined by
EDI-OCT before and 1, 3 and 6 months after IVA injections. EDI-OCT images were
binarised using ImageJ. Subfoveal cross-sectional areas of the luminal, stromal
and total choroid over a 1500 µm span were measured and the stromal area to
total choroidal area (S/C) ratio was calculated.

Results

Compared to normal contralateral eyes, afflicted eyes at baseline
exhibited significantly greater stromal area (p<0.001), total choroidal area
(p=0.001) and S/C ratio (p<0.001), but no difference in luminal area
(p=0.083). The stromal area, S/C ratio and total choroidal area were
significantly reduced in afflicted eyes at 1, 3 and 6 months after IVA (all
p<0.006). Baseline S/C ratio was significantly correlated with baseline
visual acuity (VA), baseline central retinal thickness (CRT) and VA and CRT
improvement at 1, 3 and 6 months post-treatment even after adjusting for the
axial length, age and sex (all p<0.012).

Conclusion

RVO induces substantial oedema of the choroidal stromal area that is
detectable by binarisation of EDI-OCT images. This stromal oedema likely stems
from high intraocular vascular endothelial growth factor levels. Changes in
choroidal structure may be used to assess severity and prognosis of
RVO.
Thinner retinal nerve fibre layer in young adults with foetal alcohol spectrum disorders
Authors: Gyllencreutz Emelie , Aring Eva , Landgren Valdemar , Landgren Magnus , Gronlund Marita Andersson
Published: July 2020

Background/Aims

Ophthalmological abnormalities such as ptosis, strabismus, refractive errors and optic nerve hypoplasia have been reported in foetal alcohol spectrum disorders (FASD). The purpose of this study was to investigate whether retinal thickness, retinal nerve fibre layer (RNFL) and optic disc area (ODA) differ between individuals with FASD and healthy controls.

Methods

Best-corrected visual acuity (BCVA) in terms of logarithm of the minimum angle of resolution (logMAR), refraction, and fundus variables measured by optical coherence tomography were obtained from 26 young adults with FASD (12 women, median age 23 years) and 27 controls (18 women, median age 25 years).

Results

The total thickness of the peripapillary RNFL was significantly lower in the FASD group than in controls; median (range) in the right/left eye was 96.5 (60–109)/96 (59–107) µm in the FASD group and 105 (95–117)/103 (91–120) µm among controls (p=0.001 and p=0.0001). Macular RNFL and retinal thickness measurements from the FASD group were also lower in most of the nine ETDRS areas, except for the central parts. Median (range) BCVA in the best eye was 0.00 (−0.1–0.3) logMAR in the FASD group and 0.00 (−0.2–0.0) logMAR in controls (p=0.001). No significant differences between the groups were found regarding ODA or refraction.

Conclusion

Significant differences in peripapillary and macular RNFL, retinal thickness and BCVA were found in this group of young adults with FASD compared with healthy controls. However, there were no differences in the size of the optic disc.
Evaluation of 0.2 µg/day fluocinolone acetonide (ILUVIEN) implant in a cohort of previously treated patients with diabetic macular oedema (DMO): a 36-month follow-up clinical case series
Authors: Ahmed Muna , Putri Christine , Quhill Hibba , Quhill Fahd
Published: July 2020

Objective

To assess the real-world effectiveness and safety of single injection of a fluocinolone acetonide (FAc) implant in previously treated patients with recurrent diabetic macular oedema (DMO) over a 36-month follow-up period.

Methods and Analysis

This is a retrospective study conducted at a single ophthalmology department at the Royal Hallamshire Hospital, Sheffield, UK. Data were collected using electronic medical records to identify all patients treated with a FAc implant for DMO between March 2014 and November 2014, followed with a 36-month clinic follow-up. Outcomes measured included mean change in best-recorded visual acuity (BRVA) and central macular thickness (CMT) over the period of 36 months, treatment burden pre-implant and post-implant, and functional and anatomical responder rates.

Results

Twenty-six eyes (n=22 patients) were treated with single intravitreal FAc implant followed with 36 months of follow-up. At 24 and 36 months, 86.4% and 75.0% of patients maintained or gained vision post-FAc implant in routine clinical practice. The mean BRVA increased from 41.8 to 54.6 letters at month 24 and 45.8 letters at month 36, with 50.0% and 33.3% of patients achieving a ≥15 letter improvement at months 24 and 36, respectively. The mean CMT reduced from 600.8 µm at baseline to 351.0 µm and 392.5 µm at months 24 and 36, respectively. Overall, a mean of one treatment every 13.33 months post-FAc implant (vs 3.24 months pre-FAc implant) was reported. Eleven eyes had an increased intraocular pressure of ≥10 mm Hg and 12 eyes had an increase to ≥25 mm Hg from baseline.

Conclusion

These results further support the effectiveness and safety of FAc implant in previously treated patients with persistent or recurrent DMO in a real-world clinical practice.
Digital pathology and artificial intelligence will be key to supporting clinical and academic cellular pathology through COVID-19 and future crises: the PathLAKE consortium perspective
Authors: Browning Lisa , Colling Richard , Rakha Emad , Rajpoot Nasir , Rittscher Jens , James Jacqueline A , Salto-Tellez Manuel , Snead David R J , Verrill Clare
Published: July 2020

The measures to control the COVID-19 outbreak will likely remain a feature of our working lives until a suitable vaccine or treatment is found. The pandemic has had a substantial impact on clinical services, including cancer pathways. Pathologists are working remotely in many circumstances to protect themselves, colleagues, family members and the delivery of clinical services. The effects of COVID-19 on research and clinical trials have also been significant with changes to protocols, suspensions of studies and redeployment of resources to COVID-19. In this article, we explore the specific impact of COVID-19 on clinical and academic pathology and explore how digital pathology and artificial intelligence can play a key role to safeguarding clinical services and pathology-based research in the current climate and in the future.
IV tPA is associated with increase in rates of intracerebral hemorrhage and length of stay in patients with acute stroke treated with endovascular treatment within 4.5 hours: should we bypass IV tPA in large vessel occlusion?
Authors: Hassan Ameer E , Ringheanu Victor M , Preston Laurie , Tekle Wondwossen , Qureshi Adnan I
Published: July 2020

Background

Endovascular treatment (EVT) is a widely proved method to treat patients diagnosed with intracranial large vessel occlusions (LVOs); however, there has been controversy about the safety and efficacy of incorporating intravenous tissue plasminogen activator (IV tPA) as pretreatment for EVT.

Objective

To compare the outcomes of all patients with LVO treated with IV tPA +EVT versus EVT alone within 4.5 hours of stroke onset.

Methods

A prospectively collected endovascular database at a comprehensive stroke center between 2012 and 2019 was used to examine variables such as demographics, comorbid conditions, symptomatic/asymptomatic intracerebral hemorrhage (ICH), mortality rate, and good/poor outcomes as shown by the modified Thrombolysis in Cerebral Infarction score and modified Rankin Scale (mRS) assessment at discharge. The outcomes between patients receiving IV tPA+EVT on admission and patients who underwent EVT alone were compared.

Results

Of 588 patients with acute ischemic stroke treated with EVT, a total of 189 met the criteria for the study (average age 70.44±12.90 years, 42.9% women). Analysis of 109 patients from the group receiving EVT+IV tPA (average age 68.17±14.28 years, 41.3% women), and 80 patients from the EVT alone group was performed (average age 73.54±9.84 years, 45.0% women). Four patients (5.0%) in the EVT alone group experienced symptomatic ICH versus 15 patients (13.8%) in the IV tPA+EVT group (p=0.0478); significant increases were also noted in the length of stay for patients treated with IV tPA (8.2 days vs 11.0 days; p=0.0056).

Conclusion

IV tPA in addition to EVT was associated with an increase in the rate of ICH in patients with LVO treated within 4.5 hours and in patients’ length of stay. Further research is required to determine whether EVT treatment alone in patients with LVO treated within 4.5 hours is a more effective option.
Brain atrophy predicts mortality after mechanical thrombectomy of proximal anterior circulation occlusion
Authors: Lauksio Iisa , Lindström Iisa , Khan Niina , Sillanpää Niko , Hernesniemi Jussi , Oksala Niku , Protto Sara
Published: July 2020

Background

Brain atrophy is associated with an inferior functional outcome in patients undergoing mechanical thrombectomy (MT) for acute ischemic stroke. We hypothesized that brain atrophy determined from pre-interventional non-contrast-enhanced CT scans would also be linked to increased mortality in this cohort.

Methods

A total of 204 patients treated with MT for acute occlusions of the internal carotid artery (ICA) or the M1 segment of the middle cerebral artery (M1) at Tampere University Hospital, Finland between 2013 and 2017 were retrospectively studied. Brain atrophy index (BAI), masseter muscle surface area and density, chronic ischemic lesions, and white matter lesions were evaluated from pre-interventional CT studies. Logistic regression was applied in analyzing the association of BAI with 3-month mortality.

Results

Median age at baseline was 69.9 years (IQR 15.6) and mortality at 3 months was 13.2% (n=27). BAI, measured with excellent reproducibility (intraclass correlation coefficient ≥0.894, p<0.001), was significantly associated with age (r=0.54), white matter lesions (r=0.43), dental status (r=−0.31), masseter area (r=−0.24), masseter density (r=−0.28), and chronic ischemic lesions (r=0.24) (p≤0.001 for all). In univariable analysis, BAI demonstrated a strong association with mortality (OR 2.02, 95% CI 1.34 to 3.05, per 1 SD increase), and none of the other factors associated with mortality remained as significant when included in the same multivariable model. The results remained similar when extending the follow-up up to 2.5 years.

Conclusions

Brain atrophy predicts 3-month mortality after MT of the ICA or the M1 independent of age, masseter sarcopenia, chronic ischemic lesions, or white matter lesions.
Influence of pipelines and environmental factors on the endangered plant,Halimolobos virgata(Nutt.) O.E. Schultz over a 10 year period
Authors: Naeth M. Anne , Locky David Alexander , Wilkinson Sarah Rachel , Bryks Candace Leanne , Low Caitlin Heather , Nannt Meghan Robyn
Published: July 2020

We investigated the effects of pipeline construction and environmental factors on the occurrence and characteristics of the endangered plant Halimolobos virgata (Nutt.) O.E. Schultz. The plants were surveyed from 2007 to 2016 at three sites along the Keystone Pipeline in southern Alberta, Canada. Plant height, number of flowers and siliques, as well as microhabitat and climate data were collected up to 300 m away from the pipeline. Pipeline construction and distance had no effect on plant numbers or physical characteristics, with occurrences increasing markedly over time. Greater litter cover and depth and spring precipitation were associated with plant height and number of flowers and siliques. Vegetation cover was negatively correlated with H. virgata cover; however, plant height and number of flowers and seed pods were positively influenced by graminoid cover. The highest occurrences of H. virgata coincided with the driest and wettest years, and higher winter and spring temperatures. Some of this pattern can be attributed to the plant’s annual, biennial, and short perennial life forms, which may overlap and create a temporary exponential growth rate for an annual plant under ideal conditions. This research highlights the importance of understanding a species’ life history for the development of effective conservation and recovery strategies.
Further optimization of macronutrient delivery for subirrigated greenhouse-grown chrysanthemums: calcium and magnesium
Authors: Duncan Stephens Skye , Flaherty Edward J. , Sutton William J. , MacDonald William N. , Shelp Barry J.
Published: July 2020

Moderate levels of calcium or magnesium were applied to two cultivars of subirrigated, potted, pinched chrysanthemums during vegetative growth. Market-quality plants were produced with sufficient leaf-calcium or leaf-magnesium even though the delivery of the respective nutrient could be reduced by approximately 87.5%, compared with industry standards. This practice could contribute to low-input production of floricultural crops.
Gravitational Möller scattering, Lorentz violation and finite temperature
Authors: Santos A. F. , Khanna Faqir C.
Published: July 2020

A formal analogy between the gravitational and the electromagnetic fields leads to the notion of Gravitoelectromagnetism (GEM) to describe gravitation. A Lagrangian formulation for GEM is developed for scattering processes with gravitons as an intermediate state, in addition to photons for electromagnetic scattering. The differential cross section is calculated for gravitational Möller scattering based on GEM theory. This gravitational cross section is obtained for cases where the Lorentz symmetry is maintained or violated. The Lorentz violation is introduced with the non-minimal coupling term. In addition, using the Thermo Field Dynamics formalism, thermal corrections to the differential cross section are investigated. By comparing the electromagnetic and GEM versions, of Möller scattering, it is shown that the gravitational effect may be measured at an appropriate energy scale.
Quantum influence of magnetic flux on spin-0 scalar charged particles in the presence of external field in a spinning cosmic string space-time
Authors: Ahmed Faizuddin
Published: July 2020

In this work, we investigate spin-0 massive charged particles in the background space-time induced by a spinning cosmic string coupled to a homogeneous external magnetic field parallel to the string including a magnetic quantum flux. We compute the energy eigenvalues and eigenfunctions and analyze a relativistic analogue of the Aharonov-Bohm effect.