bluuebunny/crossref_metadata_2025 huggingface dataset:
Medial unicondylar knee arthroplasty should be reserved for patients with complete joint space collapse
Authors: Wurm Alexander , Zechling Anna , Leitner Hermann , Dammerer Dietmar , Pfeifer Bernhard , Krismer Martin , Liebensteiner Michael
Published: May 2021

Purpose

To determine whether preoperative radiologic joint space width (JSW) is related to the outcome of medial unicondylar knee arthroplasty (UKA) (primary hypothesis).

Methods

A retrospective comparative analysis was performed. One group was comprised of UKA patients with preoperative JSW 0–1 mm. Another group was made up of patients with preoperative JSW ≥ 2 mm (range 0–4 mm). The JSW was measured from preoperative weight-bearing Schuss-view radiographs. The clinical outcome was determined with the Western Ontario and MacMaster Universities (WOMAC) Osteoarthritis Index score preoperatively and 1 year after medial UKA. Implant survival data were obtained from the arthroplasty register of Tyrol.

Results

There were 80 patients with a preoperative JSW 0–1 mm (age 66, BMI 27.8) and 70 patients with a preoperative JSW ≥ 2 mm (age 64, IQR 15, BMI 28.1). WOMAC total was 10 ± 10 in patients with 0–1 mm JSW and 25 ± 47 in patients with ≥ 2 mm JSW at 1 year postoperative (p = 0.052). WOMAC pain at 1 year postoperative was 7 ± 16 in patients with 0–1 mm JSW and 18 ± 46 in patients with ≥ 2 mm JSW (p = 0.047). WOMAC function at 1 year postoperative was 10 ± 9 in patients with 0–1 mm JSW and 17 ± 51 in patients with ≥ 2 mm JSW (p = 0.048). In patients with 0–1 mm JSW 5 year prosthesis survival was 92.3% and in patients with ≥ 2 mm JSW, it was 81.1% (p = 0.016).

Conclusions

In patients with preoperative complete joint space collapse (0–1 mm JSW), clinical outcome was superior to that of patients with incomplete joint space collapse. This was true for both 1 year postoperative WOMAC pain and WOMAC function and for 5 year implant survival rates. On the basis of our findings, it is recommended that ‘complete joint space collapse’ especially be used to achieve best clinical outcome in medial UKA surgery.

Level of evidence

IV.
Diagnostic value of [18F]FDG-PET/CT for treatment monitoring in large vessel vasculitis: a systematic review and meta-analysis
Authors: van der Geest K. S. M. , Treglia G. , Glaudemans A. W. J. M. , Brouwer E. , Sandovici M. , Jamar F. , Gheysens O. , Slart R. H. J. A.
Published: May 2021

Purpose

Monitoring disease activity in patients with large vessel vasculitis (LVV) can be challenging. [18F]FDG-PET/CT is increasingly used to evaluate treatment response in LVV. In this systematic review and meta-analysis, we aimed to summarize the current evidence on the value of [18F]FDG-PET/CT for treatment monitoring in LVV.

Methods

PubMed/MEDLINE and the Cochrane library database were searched from inception through October 21, 2020. Studies containing patients with LVV (i.e. giant cell arteritis, Takayasu arteritis and isolated aortitis) that received treatment and underwent [18F]FDG-PET/CT were included. Screening, full-text review and data extraction were performed by 2 investigators. The risk of bias was examined with the QUADAS-2 tool. Meta-analysis of proportions and diagnostic test accuracy was performed by a random-effects model and bivariate model, respectively.

Results

Twenty-one studies were included in the systematic review, of which 8 studies were eligible for meta-analysis. Arterial [18F]FDG uptake decreased upon clinical remission in longitudinal studies. High heterogeneity (I2 statistic 94%) precluded meta-analysis of the proportion of patients in which the scan normalized during clinical remission. Meta-analysis of cross-sectional studies indicated that [18F]FDG-PET/CT may detect relapsing/refractory disease with a sensitivity of 77% (95%CI 57–90%) and specificity of 71% (95%CI 47–87%). Substantial heterogeneity was observed among the cross-sectional studies. Both variation in clinical aspects and imaging procedures contributed to the heterogeneity.

Conclusion

Treatment of LVV leads to reduction of arterial [18F]FDG uptake during clinical remission. [18F]FDG-PET/CT has moderate diagnostic accuracy for detecting active LVV. [18F]FDG-PET/CT may aid treatment monitoring in LVV, but its findings should be interpreted in the context of the clinical suspicion of disease activity. This study underlines the relevance of published procedural recommendations for the use of [18F]FDG-PET/CT in LVV.
CD38 identifies pre-activated CD8+ T cells which can be reinvigorated by anti-PD-1 blockade in human lung cancer
Authors: Wu Pin , Zhao Lufeng , Chen Yongyuan , Xin Zhongwei , Lin Mingjie , Hao Zhixing , Chen Xiaoke , Chen Di , Wu Dang , Chai Ying
Published: May 2021

Background

CD38 has been observed expressing in activated T cells, while the features and functions of CD38+ T cells in human NSCLC are still unclear.

Methods

Here we uncovered the correlation between CD38 expression and survival and immune infiltration levels in tumor of NSCLC. Then, we collected samples from 51 NSCLC patients to study the biological feature and response to anti-PD-1 of tumor-infiltrating CD38+ CD8+ T cells in vitro.

Results

We found CD38 expression correlated with the survival and immune infiltration levels of NSCLC. It is interesting that CD38+ CD8+ T cells enriched in the tumors expressed higher level of cytotoxic molecule, cytokines and PD-1 than CD38− CD8+ T cells. Moreover, PD-1+ subset in tumor-infiltrating CD38+ CD8+ T cells expressed higher level of activated markers than PD-1+ CD38− CD8+ T cells. Next, we found tumor-infiltrating CD38+ CD8+ T cells expressed higher level of CD103, IFN-γ, TNF-α and perforin than CD38− CD8+ T cells when were reactivated in vitro. Finally, we observed that CD38+ CD8+ T cells isolated from tumors could be reinvigorated by anti-PD-1 in vitro.

Conclusions

Our findings demonstrate that CD38 expression defines a subset of CD8+ T cells enriched in tumors of NSCLC which have paradoxical phenotypes and response to anti-PD-1. Our results suggest a pre-priming of these cells is may exist in tumor and consequentially facilitate it acquiring both anti-tumor potency and exhausted phenotype which can be reinvigorated by PD-1 blockade.
Extremity Tourniquet Training at High Seas
Authors: Yánez Benítez Carlos , Ribeiro Marcelo A. F. , Khan Mansoor , Lorente‐Aznar Teófilo , Asensio Esther , López José Antonio , Martínez Isabel , Blas Juan L. , Güemes Antonio
Published: May 2021

Background

Future navy officers require unique training for emergency medical response in the isolated maritime environment. The authors issued a workshop on extremity bleeding control, using four different commercial extremity tourniquets onboard a training sail ship. The purposes were to assess participants' perceptions of this educational experience and evaluate self‐application simplicity while navigating on high seas.

Methods

A descriptive observational study was conducted as part of a workshop issued to volunteer training officers. A post‐workshop survey collected their perceptions about the workshops' content usefulness and adequacy, tourniquet safety, self‐application simplicity, and device preference. Tourniquet preference was measured by frequency count while the rest of the studied variables on a one‐to‐ten Likert scale. Frequencies and percentages were calculated for the studied variables, and application simplicity means compared using the ANOVA test (p < 0.05).

Results

Fifty‐one Spanish training naval officers, aged 20 or 21, perceived high sea workshop content's usefulness, adequacy, and safety level at 8.6/10, 8.7/10, and 7.5/10, respectively. As for application simplicity, CAT and SAM‐XT were rated equally with a mean of 8.5, followed by SWAT (7.9) and RATS (6.9), this one statistically different from the rest (p < 0.01). Windlass types were preferred by 94%.

Conclusions

The training sail ship's extremity bleeding control workshop was perceived as useful and its content adequate by the participating midshipmen. Windlass types were regarded as easier to apply than elastic counterparts. They were also preferred by nine out of every ten participants.
Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process
Authors: García-Vicuña Rosario , Garrido Noemí , Gómez Susana , Joven Beatriz , Queiro Rubén , Ramírez Julio , Rebollo Francisco , Loza Estíbaliz , Sellas Agustí
Published: May 2021

To establish practical recommendations for the management of patients with psoriatic arthritis (PsA) with particular clinical situations that might lead to doubts in the pharmacological decision-making. A group of six expert rheumatologists on PsA identified particular clinical situations in PsA. Then, a systematic literature review (SLR) was performed to analyse the efficacy and safety of csDMARDs, b/tsDMARDs in PsA. In a nominal group meeting, the results of the SLR were discussed and a set of recommendations were proposed for a Delphi process. A total of 65 rheumatologists were invited to participate in the Delphi. Agreement was defined if ≥ 70% of the participants voted ≥ 7 (from 1, totally disagree to 10, totally agree). For each recommendation, the level of evidence and grade of recommendation was established based on the Oxford Evidence-Based Medicine categorisation. Particular clinical situations included monoarthritis, axial disease, or non-musculoskeletal manifestations. The SLR finally comprised 131 articles. A total of 16 recommendations were generated, all but 1 reached consensus. According to them, it is crucial to carefully analyse the impact of individual manifestations on patients (disability, quality of life, etc.), but also to recognise the impact of each drug singularities on selected clinical phenotypes to adopt the most appropriate treatment strategy. Early diagnosis and treatment to target approach, along with a close risk management, is also necessary. These recommendations are intended to complement gaps in national and international guidelines by helping health professionals address and manage particular clinical situations in PsA.
Expanding the spectrum of reactive arthritis (ReA): classic ReA and infection-related arthritis including poststreptococcal ReA, Poncet’s disease, and iBCG-induced ReA
Authors: Taniguchi Yoshinori , Nishikawa Hirofumi , Yoshida Takeshi , Terada Yoshio , Tada Kurisu , Tamura Naoto , Kobayashi Shigeto
Published: May 2021

Reactive arthritis (ReA) is a form of sterile arthritis that occurs secondary to an extra-articular infection in genetically predisposed individuals. The extra-articular infection is typically an infection of the gastrointestinal tract or genitourinary tract. Infection-related arthritis is a sterile arthritis associated with streptococcal tonsillitis, extra-articular tuberculosis, or intravesical instillation of bacillus Calmette–Guérin (iBCG) therapy for bladder cancer. These infection-related arthritis diagnoses are often grouped with ReA based on the pathogenic mechanism. However, the unique characteristics of these entities may be masked by a group classification. Therefore, we reviewed the clinical characteristics of classic ReA, poststreptococcal ReA, Poncet’s disease, and iBCG-induced ReA. Considering the diversity in triggering microbes, infection sites, and frequency of HLA-B27, these are different disorders. However, the clinical symptoms and intracellular parasitism pathogenic mechanism among classic ReA and infection-related arthritis entities are similar. Therefore, poststreptococcal ReA, Poncet’s disease, and iBCG-induced ReA could be included in the expanding spectrum of ReA, especially based on the pathogenic mechanism.
Microhabitats of sharknose goby (Elacatinus evelynae) cleaning stations and their links with cleaning behaviour
Authors: Whittey Kathryn E. , Dunkley Katie , Young Grace C. , Cable Jo , Perkins Sarah E.
Published: May 2021

Coral reefs are renowned for the complexity of their habitat structures and their resulting ability to host more species per unit area than any another marine ecosystem. Dedicated cleaner fish, which acquire all their food resources through client interactions, rely on both the habitat structures (by using topological cleaning stations) and the wide diversity of fish species available on coral reefs, to function. As a result of natural and anthropogenic threats, coral reef habitat structures and their complexity are being lost—despite this threat it is unclear how important reef geometry is to key ecological interactions, like cleaning. Using an established Caribbean reef study site, three-dimensional constructions of discrete coral heads were used to investigate how fine-scale structural complexity traits (structural complexity—measured by rugosity and vector dispersion—height, volume, surface area, percentage live coral cover and refuge availability) relate to cleaner occupancy, abundance and their cleaning interactions with clients. Coral height was a particularly important trait for cleaning, correlating with both the occurrence of cleaning stations on a reef, and with increased cleaning durations and reduced cleaning frequencies/rates. Cleaning stations were also more structurally complex than non-cleaning coral heads, and the increased availability of uneven surfaces (creating cracks and crevices) and refuge availability linked with increased cleaning durations/rates. By understanding habitat features important to cleaner fish on a typical Caribbean fringing reef, we can gain a better understanding of how important reef geometry might be for governing the occurrence and dynamics of such mutualisms.
Optometrische Schulreihenuntersuchungen
Authors: Kaymak Hakan , Neller Kai , Funk Saskia , Langenbucher Achim , Seitz Berthold , Schwahn Hartmut
Published: May 2021

Hintergrund

Wir stellen ein Projekt zur Verbesserung der Augengesundheit bei Schulkindern vor: Jährliche optometrische Reihenuntersuchungen mit Fokus auf die Früherkennung der Schulmyopie. Die logistische Machbarkeit wird am Beispiel eines Pilotprojektes an einem staatlichen Gymnasium in Nordrhein-Westfalen beleuchtet. Die erhobenen biometrischen Parameter tragen außerdem zur Erhebung epidemiologischer Daten bei.

Material und Methoden

An organisierten Untersuchungstagen wurde bei den Schulkindern der 5. bis 7. Klassen (Alter 9 bis 16 Jahre) die objektive und subjektive Refraktion ermittelt, auf Auffälligkeiten im Binokularsehen getestet und der photopische und mesopische Pupillendurchmesser bestimmt. Mittels berührungsfreier Biometrie wurden die Hornhautradien, zentrale Hornhautdicke, Vorderkammertiefe, Linsendicke und die Achslänge der Augen gemessen. Mittels optischer Kohärenztomographie (OCT) wurde außerdem die zentrale Aderhautdicke der Augen bestimmt. Mit Fragebögen wurden die Sehgewohnheiten der Schulkinder erfragt.

Ergebnisse

Im Herbst 2019 nahmen 274 Schulkinder (11,2 ± 1,2 Jahre) freiwillig an den Untersuchungen teil; 22 % (61) zeigten eine Myopie (sphärisches Äquivalent ≤ −0,50 dpt), hiervon waren 11 % (7) bisher unkorrigiert (unkorrigierter Fernvisus < 0,8); 8 % (5) der Schulkinder zeigten eine Zunahme der Myopie um mehr als −0,5 dpt verglichen mit ihrem aktuellen Brillenwert (Fernvisus mit Brillenwert < 0,8). Eine Schulklasse mit ca. 25 Kindern kann innerhalb von 2 Schulstunden optometrisch untersucht werden.

Diskussion

Die Notwendigkeit der optometrischen Reihenuntersuchung ist objektiv gegeben, da insgesamt 4,4 % (12) myope Schulkinder identifiziert werden konnten, die aufgrund ihrer Brillenkorrektion einen Fernvisus von kleiner 0,8 aufwiesen. Durch die Ermittlung der Achslänge und der Einordnung dieses Wertes in Abhängigkeit des Alters in die Literatur kann das individuelle Myopierisiko abgeschätzt und Eltern und Kinder können sensibilisiert werden, um dem Missstand zu begegnen. Die geplanten Wiederholungsuntersuchungen werden genauere Aussagen zum Bulbuswachstum bei Schulkindern liefern.
El Niño teleconnection to the Euro-Mediterranean late-winter: the role of extratropical Pacific modulation
Authors: Benassi Marianna , Conti Giovanni , Gualdi Silvio , Ruggieri Paolo , Materia Stefano , García-Serrano Javier , Palmeiro Froila M. , Batté Lauriane , Ardilouze Constantin
Published: May 2021

El Niño Southern Oscillation (ENSO) represents the major driver of interannual climate variability at global scale. Observational and model-based studies have fostered a long-standing debate on the shape and intensity of the ENSO influence over the Euro-Mediterranean sector. Indeed, the detection of this signal is strongly affected by the large internal variability that characterizes the atmospheric circulation in the North Atlantic–European (NAE) region. This study explores if and how the low-frequency variability of North Pacific sea surface temperature (SST) may impact the El Niño-NAE teleconnection in late winter, which consists of a dipolar pattern between middle and high latitudes. A set of idealized atmosphere-only experiments, prescribing different phases of the anomalous SST linked to the Pacific Decadal Oscillation (PDO) superimposed onto an El Niño-like forcing in the tropical Pacific, has been performed in a multi-model framework, in order to assess the potential modulation of the positive ENSO signal. The modelling results suggest, in agreement with observational estimates, that the PDO negative phase (PDO−) may enhance the amplitude of the El Niño-NAE teleconnection, while the dynamics involved appear to be unaltered. On the other hand, the modulating role of the PDO positive phase (PDO+) is not reliable across models. This finding is consistent with the atmospheric response to the PDO itself, which is robust and statistically significant only for PDO−. Its modulation seems to rely on the enhanced meridional SST gradient and the related turbulent heat-flux released along the Kuroshio–Oyashio extension. PDO− weakens the North Pacific jet, whereby favoring more poleward propagation of wave activity, strengthening the El Niño-forced Rossby wave-train. These results imply that there might be conditional predictability for the interannual Euro-Mediterranean climate variability depending on the background state.
Megadroughts and pluvials in southwest Australia: 1350–2017 CE
Authors: O’Donnell Alison J. , McCaw W. Lachlan , Cook Edward R. , Grierson Pauline F.
Published: May 2021

Declining winter rainfall coupled with recent prolonged drought poses significant risks to water resources and agriculture across southern Australia. While rainfall declines over recent decades are largely consistent with modelled climate change scenarios, particularly for southwest Australia, the significance of these declines is yet to be assessed within the context of long-term hydroclimatic variability. Here, we present a new 668-year (1350–2017 CE) tree-ring reconstruction of autumn–winter rainfall over inland southwest Australia. This record reveals that a recent decline in rainfall over inland southwest Australia (since 2000 CE) is not unusual in terms of either magnitude or duration relative to rainfall variability over the last seven centuries. Drought periods of greater magnitude and duration than those in the instrumental record occurred prior to 1900 CE, including two ‘megadroughts’ of > 30 years duration in the eighteenth and nineteenth centuries. By contrast, the wettest > decadal periods of the last seven centuries occurred after 1900 CE, making the twentieth century the wettest of the last seven centuries. We conclude that the instrumental rainfall record (since ~ 1900 CE) does not capture the full scale of natural hydroclimatic variability for inland southwest Australia and that the risk of prolonged droughts in the region is likely much higher than currently estimated.
Diverticular disease is associated with an increased incidence rate of depression and anxiety disorders
Authors: Loosen Sven H. , Paffenholz Pia , Luedde Tom , Kostev Karel , Roderburg Christoph
Published: May 2021

Background

Diverticular disease represents a gastrointestinal disorder of high prevalence in developed countries that often leads to psychological distress. Here, we aimed at evaluating a potential association between diverticular disease and depression or anxiety disorders in outpatients in Germany.

Methods

Using the Disease Analyzer database featuring data of over 8 million patients treated in German general practices, we identified 61.556 patients with diverticular disease (ICD-10: K57) who were 1:1 matched by age, sex, index year, and the Charlson Comorbidity Index to 61.556 patients without diverticular disease. The association between diverticular disease and depression or anxiety disorders was evaluated in Cox regression models.

Results

Within 5 years after the initial diagnosis of diverticular disease, 14.0% of patients with and 10.6% of individuals without diverticular disease were diagnosed with depression (HR 1.34, 95%CI 1.29–1.39, p < 0.001). Similarly, the incidence of anxiety disorder was significantly higher in patients with diverticular disease (HR 1.55, 95%CI 1.46–1.64, p < 0.001). Finally, the prescription rate for antidepressant drugs was significantly higher in diverticular disease patients compared to individuals without diverticular disease (9.4% vs. 6.1%, HR 1.56, 95%CI 1.49–1.62, p < 0.001). These associations were confirmed for different age groups and both sexes.

Conclusion

Our data provide evidence that diverticular disease is associated with an increased incidence of depression and anxiety disorders. Despite that fact that confounding factors such as deprivation and patient personality have to be taken into account, we suggest that patients with diverticular disease are regularly screened for symptoms of depression and anxiety disorders.
The use of an in-vitro batch fermentation (human colon) model for investigating mechanisms of TMA production from choline, l-carnitine and related precursors by the human gut microbiota
Authors: Day-Walsh Priscilla , Shehata Emad , Saha Shikha , Savva George M. , Nemeckova Barbora , Speranza Jasmine , Kellingray Lee , Narbad Arjan , Kroon Paul A.
Published: May 2021

Purpose

Plasma trimethylamine-N-oxide (TMAO) levels have been shown to correlate with increased risk of metabolic diseases including cardiovascular diseases. TMAO exposure predominantly occurs as a consequence of gut microbiota-dependent trimethylamine (TMA) production from dietary substrates including choline, carnitine and betaine, which is then converted to TMAO in the liver. Reducing microbial TMA production is likely to be the most effective and sustainable approach to overcoming TMAO burden in humans. Current models for studying microbial TMA production have numerous weaknesses including the cost and length of human studies, differences in TMA(O) metabolism in animal models and the risk of failing to replicate multi-enzyme/multi-strain pathways when using isolated bacterial strains. The purpose of this research was to investigate TMA production from dietary precursors in an in-vitro model of the human colon.

Methods

TMA production from choline, l-carnitine, betaine and γ-butyrobetaine was studied over 24–48 h using an in-vitro human colon model with metabolite quantification performed using LC–MS.

Results

Choline was metabolised via the direct choline TMA-lyase route but not the indirect choline–betaine-TMA route, conversion of l-carnitine to TMA was slower than that of choline and involves the formation of the intermediate γ-BB, whereas the Rieske-type monooxygenase/reductase pathway for l-carnitine metabolism to TMA was negligible. The rate of TMA production from precursors was choline > carnitine > betaine > γ-BB. 3,3-Dimethyl-1-butanol (DMB) had no effect on the conversion of choline to TMA.

Conclusion

The metabolic routes for microbial TMA production in the colon model are consistent with observations from human studies. Thus, this model is suitable for studying gut microbiota metabolism of TMA and for screening potential therapeutic targets that aim to attenuate TMA production by the gut microbiota.

Trial registration number

NCT02653001 (http://www.clinicaltrials.gov), registered 12 Jan 2016.
Home-based devices in dermatology: a systematic review of safety and efficacy
Authors: Cohen Marc , Austin Evan , Masub Natasha , Kurtti Alana , George Christopher , Jagdeo Jared
Published: May 2021

There is increasing demand for home-based devices for the treatment of dermatologic conditions and cosmesis. Commercially available devices include intense pulsed light, laser diodes, radiofrequency, light-emitting diodes, and ultraviolet B phototherapy. The objective of this report is to evaluate the current evidence regarding the efficacy and safety of home-based devices for the treatment of skin conditions. A systematic search of PubMed, Embase, and Cinahl was conducted on November 9, 2020 using PRISMA guidelines. Original research articles that investigated the efficacy and safety of home-based devices for dermatologic use were included. Bibliographies were screened for additional relevant articles. Strength of evidence was graded using the Oxford Centre for Evidence-Based Medicine guidelines. Clinical recommendations were then made based on the quality of the existing literature. After review, 37 clinical trials were included—19 were randomized controlled trials, 16 were case series, and 2 were non-randomized controlled trials. Ultimately, from our analysis, we recommend the home-based use of intense pulsed light for hair removal, laser diodes for androgenic alopecia, low power radiofrequency for rhytides and wrinkles, and light-emitting diodes for acne vulgaris. Trials investigating ultraviolet B phototherapy for psoriasis revealed mixed evidence for home treatments compared to clinic treatments. All devices had favorable safety profiles with few significant adverse events. Limitations to our review include a limited number of randomized controlled trials as well as a lack of data on the long-term efficacy and safety of each device.
A matter of atrophy: differential impact of brain and spine damage on disability worsening in multiple sclerosis
Authors: Ruggieri Serena , Petracca Maria , De Giglio Laura , De Luca Francesca , Giannì Costanza , Gurreri Flavia , Petsas Nikolaos , Tommasin Silvia , Pozzilli Carlo , Pantano Patrizia
Published: May 2021

As atrophy represents the most relevant driver of progression in multiple sclerosis (MS), we investigated the impact of different patterns of brain and spinal cord atrophy on disability worsening in MS. We acquired clinical and MRI data from 90 patients with relapsing–remitting MS and 24 healthy controls (HC). Clinical progression at follow-up (mean 3.7 years) was defined according to the Expanded Disability Status Scale-Plus. Brain and spinal cord volumes were computed on MRI brain scans. After normalizing each participants’ brain and spine volume to the mean of the HC, z-score cut-offs were applied to separate pathologically atrophic from normal brain and spine volumes (accepting a 2.5% error probability). Accordingly, MS patients were classified into four groups (Group I: no brain or spinal cord atrophy N = 40, Group II: brain atrophy/no spinal cord atrophy N = 11, Group III: no brain atrophy/ spinal cord atrophy N = 32, Group IV: both brain and spinal cord atrophy N = 7). All patients’ groups showed significantly lower brain volume than HC (p < 0.0001). Group III and IV showed lower spine volume than HC (p < 0.0001 for both). Higher brain lesion load was identified in Group II (p = 0.049) and Group IV (p = 0.023) vs Group I, and in Group IV (p = 0.048) vs Group III. Spinal cord atrophy (OR = 3.75, p = 0.018) and brain + spinal cord atrophy (OR = 5.71, p = 0.046) were significant predictors of disability progression. The presence of concomitant brain and spinal cord atrophy is the strongest correlate of progression over time. Isolated spinal cord atrophy exerts a similar effect, confirming the leading role of spinal cord atrophy in the determination of motor disability.
Placenta histopathology in SARS-CoV-2 infection: analysis of a consecutive series and comparison with control cohorts
Authors: Bertero Luca , Borella Fulvio , Botta Giovanni , Carosso Andrea , Cosma Stefano , Bovetti Marialuisa , Carosso Marco , Abbona Giancarlo , Collemi Giammarco , Papotti Mauro , Cassoni Paola , Benedetto Chiara
Published: May 2021

Infection by SARS-CoV-2 has been shown to involve a wide range of organs and tissues, leading to a kaleidoscope of clinical conditions. Within this spectrum, an involvement of the fetal-maternal unit could be expected, but, so far, the histopathological evaluation of placentas delivered by women with SARS-CoV-2 infection did not show distinct hallmarks. A consecutive series of 11 placentas, delivered by 10 women with COVID-19 admitted to our Obstetrics and Gynecology clinic have been investigated and compared to a control cohort of 58 pre-COVID-19 placentas and 28 placentas delivered by women who had a previous cesarean section. Four out of eleven placentas showed changes consistent with chronic villitis/villitis of unknown etiology (VUE), while in one case, chronic histiocytic intervillositis was diagnosed. Thrombo-hemorrhagic alterations were observed in a subset of cases. Compared to the control cohort, chronic villitis/VUE (p < 0.001), chronic deciduitis (p = 0.023), microvascular thrombosis (p = 0.003), presence of infarction areas (p = 0.047) and of accelerated villous maturation (p = 0.005) showed higher frequencies in placentas delivered by women with COVID-19. Chronic villitis/VUE (p = 0.003) and accelerated villous maturation (p = 0.019) remained statistically significant by restricting the analysis to placentas delivered after a previous cesarean section. The observed differences in terms of pathological findings could be consistent with SARS-CoV-2 pathogenesis, but just a subset of alterations remained statistically significant after adjusting for a previous cesarean section. A careful consideration of potential confounders is warranted in future studies exploring the relationship between COVID-19 and pregnancy.
What we actually know about the pathogenicity of Bacteroides pyogenes
Authors: Majewska Anna , Kierzkowska Marta , Kawecki Dariusz
Published: May 2021

The aim of the study was to evaluate the pathogenic potential of Bacteroides pyogenes, rarely identified in clinical laboratories anaerobic bacteria. To increase the knowledge about this poorly understood anaerobic microorganism, the study also includes cases of infections described so far in the literature. Only the use of 16S rRNA sequencing and mass spectrometry technique allowed the identification of B. pyogenes from clinical specimens. We reported 13 severe human infections caused by B. pyogenes. Bacteria were cultured from the wound after biting by animals, chronic infections within the oral cavity, from patients with histologically or radiological proven osteomyelitis, surgical site infection, and from urine sample collected after a urological procedure. Most (9/13) of the patients required hospitalization. Almost 70% of them needed urgent admission via the emergency room. Two inpatients due to a life-threatening condition were admitted to the intensive care unit. Almost 50% of isolates were resistant to penicillin. All resistant to penicillin strains were isolated from skin and mucous membrane infections.
Effectiveness of fast-track pathway for diabetic foot ulcerations
Authors: Meloni Marco , Lazaro-Martínez Jose Luis , Ahluwalia Raju , Bouillet Benjamin , Izzo Valentina , Di Venanzio Michela , Iacopi Elisabetta , Manu Chris , Garcia-Klepzig José Luis , Sánchez-Ríos Juan Pedro , Lüedemann Claas , De Buruaga Víctor Rodriguez-Saenz , Vouillarmet Julien , Guillaumat Jérôme , Aleandri Anna Rita , Giurato Laura , Edmonds Micheal , Piaggesi Alberto , Van Acker Kristien , Uccioli Luigi
Published: May 2021

Aim

To investigate the effectiveness of fast-track pathway (FTP) in the management of diabetic foot ulceration (DFU) after 2 years of implementation.

Methods

The study group was composed of patients who referred to a specialized DF centre due to DFUs. Those were divided in two groups: early referral (ER) and late referral (LR) patients. According to FTP, ER were considered patients who referred after 2 weeks in the case of uncomplicated non-healing ulcers (superficial, not infected, not ischemic), within 4 days in the case of complicated ulcers (ischemic, deep, mild infection) and within 24 h in the case of severely complicated ulcers (abscess, wet gangrene, fever). Healing, healing time, minor and major amputation, hospitalization, and survival were evaluated. The follow-up was 6 months.

Results

Two hundred patients were recruited. The mean age was 70 ± 13 years, 62.5% were male, 91% were affected by type 2 diabetes with a mean duration of 18 ± 11 years. Within the group, 79.5% had ER while 20.5% had LR. ER patients showed increased rates of healing (89.9 vs. 41.5%, p = 0.001), reduced healing time (10 vs. 16 weeks, p = 0.0002), lower rates of minor (17.6 vs. 75.6%, p < 0.0001) and major amputation (0.6 vs. 36.6%, p < 0.0001), hospitalization (47.1 vs. 82.9%, p = 0.001), and mortality (4.4 vs. 19.5%, p = 0.02) in comparison to LR. At multivariate analysis, ER was an independent predictor of healing, while LR was an independent predictor for minor and major amputation and hospitalization.

Conclusion

After the FTP implementation, less cases of LR were reported in comparison to ER. ER was an independent predictor of positive outcomes such as healing, healing time, limb salvage, hospitalization, and survival.
Irrational risk aversion in an ant
Authors: De Agrò Massimo , Grimwade Daniel , Bach Richard , Czaczkes Tomer J.
Published: May 2021

Animals must often decide between exploiting safe options or risky options with a chance for large gains. Both proximate theories based on perceptual mechanisms, and evolutionary ones based on fitness benefits, have been proposed to explain decisions under risk. Eusocial insects represent a special case of risk sensitivity, as they must often make collective decisions based on resource evaluations from many individuals. Previously, colonies of the antLasius nigerwere found to be risk-neutral, but the risk preference of individual foragers was unknown. Here, we tested individualL. nigerin a risk sensitivity paradigm. Ants were trained to associate one scent with 0.55 M sucrose solution and another with an equal chance of either 0.1 or 1.0 M sucrose. Preference was tested in a Y-maze. Ants were extremely risk-averse, with 91% choosing the safe option. Based on the psychophysical Weber–Fechner law, we predicted that ants evaluate resources depending on their logarithmic difference. To test this hypothesis, we designed 4 more experiments by varying the relative differences between the alternatives, making the risky option less, equally or more valuable than the safe one. Our results support the logarithmic origin of risk aversion in ants, and demonstrate that the behaviour of individual foragers can be a very poor predictor of colony-level behaviour.
Genomic Characterization of the Barnacle Balanus improvisus Reveals Extreme Nucleotide Diversity in Coding Regions
Authors: Alm Rosenblad Magnus , Abramova Anna , Lind Ulrika , Ólason Páll , Giacomello Stefania , Nystedt Björn , Blomberg Anders
Published: May 2021

Barnacles are key marine crustaceans in several habitats, and they constitute a common practical problem by causing biofouling on man-made marine constructions and ships. Despite causing considerable ecological and economic impacts, there is a surprising void of basic genomic knowledge, and a barnacle reference genome is lacking. We here set out to characterize the genome of the bay barnacleBalanus improvisus(= Amphibalanus improvisus) based on short-read whole-genome sequencing and experimental genome size estimation. We show both experimentally (DNA staining and flow cytometry) and computationally (k-mer analysis) thatB. improvisushas a haploid genome size of ~ 740 Mbp. A pilot genome assembly rendered a total assembly size of ~ 600 Mbp and was highly fragmented with an N50 of only 2.2 kbp. Further assembly-based and assembly-free analyses revealed that the very limited assembly contiguity is due to theB. improvisusgenome having an extremely high nucleotide diversity (π) in coding regions (average π ≈ 5% and average π in fourfold degenerate sites ≈ 20%), and an overall high repeat content (at least 40%). We also report on high variation in the α-octopamine receptor OctA (average π = 3.6%), which might increase the risk that barnacle populations evolve resistance toward antifouling agents. The genomic features described here can help in planning for a future high-quality reference genome, which is urgently needed to properly explore and understand proteins of interest in barnacle biology and marine biotechnology and for developing better antifouling strategies.
MURAME parameter setting for creditworthiness evaluation: data-driven optimization
Authors: Corazza Marco , Fasano Giovanni , Funari Stefania , Gusso Riccardo
Published: May 2021

In this paper, we amend a multi-criteria methodology known as MURAME, to evaluate the creditworthiness of a large sample of Italian Small and Medium-sized Enterprises, using as input their balance sheet data. This methodology produces results in terms of scoring and of classification into homogeneous rating classes. A distinctive goal of this paper is to consider a preference disaggregation method toendogenouslydetermine some parameters of MURAME, by solving a nonsmooth constrained optimization problem. Because of the complexity of the involved mathematical programming problem, for its solution we use an evolutionary metaheuristic, coupled with a specific efficient initialization. This is combined with an unconstrained reformulation of the problem, which provides a reasonable compromise between the quality of the solution and the computational burden. An extensive numerical experience is reported, comparing an exogenous choice of MURAME parameters with our approach.
The Empirical and the Holistic Turn: A Hegelian Dialectics of Technoscience Revisited
Authors: Zwart Hub
Published: May 2021

My effort to address the comments made by the two distinguished scholars (to “negate their negations” as it were), consists of three steps. I will start with a brief resume of Hegel’s dialectical logic, to provide a scaffold for the debate. Subsequently, I will address the comments made. In the case of Hans-Jörg Rheinberger, I will focus on his reference to Althusser. In the case of Bart Gremmen, I will focus on the dialectics of biology (on biology as an inherently dialectical science), notably on his reference to Mendel. Finally, I will address the tension between the conceptual and the empirical dimension of philosophical scholarship.
Integrating qualitative research methodologies and phenomenology—using dancers’ and athletes’ experiences for phenomenological analysis
Authors: Ravn Susanne
Published: May 2021

This paper sets out from the hypothesis that the embodied competences and expertise which characterise dance and sports activities have the potential to constructively challenge and inform phenomenological thinking. While pathological cases present experiences connected to tangible bodily deviations, the specialised movement practices of dancers and athletes present experiences which put our everyday experiences of being a moving body into perspective in a slightly different sense. These specialised experiences present factual variations of how moving, sensing and interacting can be like for us as body-subjects. To use of these sources inevitably demands that qualitative research methodologies – especially short-term ethnographical fieldwork – form part of the research strategy and qualify the way the researcher involves a second-person perspective when interviewing dancers and athletes about their experiences. In the subsequent phases analysing the data generated, I argue that researchers first strive to achieve internal consistency of empirical themes identified in the case of movement practices in question thus keeping to a contextualised and lived perspective, also denoted as an emic perspective. In subsequent phases phenomenological insights are then actively engaged in the exploration and discussion of the possible transcendental structures making the described subjective experiences possible. The specialised and context-defined experiences of ‘what a moving body can be like’ are accordingly involved as factual variations to constructively add to and potentially challenge phenomenological descriptions. Lastly, I exemplify how actual research strategies have been enacted in a variety of projects involving professional dancers’, golfers’ and sports dancers’ practices and experiences, respectively.
The effect of target, catchment, and comparison site operationalization on CCTV impact evaluations: methodological considerations from a case study
Authors: Kronkvist Karl
Published: May 2021

Objectives

To examine the extent to which different operationalizations of target, displacement, and comparison sites affect the interpretation of a CCTV impact evaluation.

Methods

Different operationalizations are used to examine change in property and violent crime before and after CCTV was introduced in a residential neighbourhood in Malmö, Sweden, using paired t tests, odds ratio effect sizes and weighted displacement quotients.

Results

Despite most results being non-significant as a result of low statistical power, different operationalizations appear to produce varying results. This issue is most prominent for target sites and property crime while it is less so for catchment and comparison sites, and violent crime outcomes.

Conclusion

Valid operationalizations of research areas are highly important for CCTV impact evaluations and may affect the study outcome. Future research with access to larger data sets is encouraged to elaborate on these findings and further analyse the impact of measurement choices on experimental outcomes.
Mapping Unobserved Item–Respondent Interactions: A Latent Space Item Response Model with Interaction Map
Authors: Jeon Minjeong , Jin Ick Hoon , Schweinberger Michael , Baugh Samuel
Published: May 2021

Classic item response models assume that all items with the same difficulty have the same response probability among all respondents with the same ability. These assumptions, however, may very well be violated in practice, and it is not straightforward to assess whether these assumptions are violated, because neither the abilities of respondents nor the difficulties of items are observed. An example is an educational assessment where unobserved heterogeneity is present, arising from unobserved variables such as cultural background and upbringing of students, the quality of mentorship and other forms of emotional and professional support received by students, and other unobserved variables that may affect response probabilities. To address such violations of assumptions, we introduce a novel latent space model which assumes that both items and respondents are embedded in an unobserved metric space, with the probability of a correct response decreasing as a function of the distance between the respondent’s and the item’s position in the latent space. The resulting latent space approach provides an interaction map that represents interactions of respondents and items, and helps derive insightful diagnostic information on items as well as respondents. In practice, such interaction maps enable teachers to detect students from underrepresented groups who need more support than other students. We provide empirical evidence to demonstrate the usefulness of the proposed latent space approach, along with simulation results.
Photoactive titanium dioxide nanoparticles modify heterotrophic microbial functioning
Authors: Bundschuh Mirco , Zubrod Jochen P. , Konschak Marco , Baudy Patrick , Frombold Bianca , Schulz Ralf
Published: May 2021

Nanoparticulate titanium dioxide (nTiO2) is frequently applied, raising concerns about potential side effects on the environment. While various studies have assessed structural effects in aquatic model ecosystems, its impact on ecosystem functions provided by microbial communities (biofilms) is not well understood. This is all the more the case when considering additional stressors, such as UV irradiation — a factor known to amplify nTiO2-induced toxicity. Using pairwise comparisons, we assessed the impact of UV (UV-A = 1.6 W/m2; UV-B = 0.7 W/m2) at 0, 20 or 2000 μg nTiO2/L on two ecosystem functions provided by leaf-associated biofilms: while leaf litter conditioning, important for detritivorous invertebrate nutrition, seems unaffected, microbial leaf decomposition was stimulated (up to 25%) by UV, with effect sizes being higher in the presence of nTiO2. Although stoichiometric and microbial analyses did not allow for uncovering the underlying mechanism, it seems plausible that the combination of a shift in biofilm community composition and activity together with photodegradation as well as the formation of reactive oxygen species triggered changes in leaf litter decomposition. The present study implies that the multiple functions a microbial community performs are not equally sensitive. Consequently, relying on one of the many functions realized by the same microbial community may be misleading for environmental management.
Suicide by intoxication with iron (III) chloride
Authors: Majdanik Sławomir , Potocka-Banaś Barbara , Glowinski Sebastian , Borowiak Krzysztof
Published: May 2021

Purpose

Cases of iron intoxication are not very often encountered in toxicology practice, and most of those reported concern accidental intoxications with iron supplements in young children. The paper presents a rare case of a suicide by intoxication in an adult woman who ingested a solution of iron (III) chloride.

Methods

A forensic was at the Department of Forensic Medicine, PMU in Szczecin. Toxicology tests of blood sampled from the deceased were performed using a 644 CIBA CORNING ion selective analyzer and proprietary reagent kits. Histopathological was with the use of the standard staining protocol (hematoxylin and eosin) and staining specific for iron (Prussian blue).

Results

Autopsy revealed a distinct yellow discolouration and thrombotic necrosis of the oral mucosa and almost the whole gastrointestinal tract, as well as similar changes in the adjacent internal organs. Considerably high levels of iron and chloride ions were detected in specimens of internal organs preserved during autopsy. Histopathological analysis performed with the use of staining specific for iron (Prussian blue) also confirmed the presence of iron in the examined tissues, especially in the intestines and liver.

Conclusions

Considering the above findings, it was concluded in the forensic report that the death of the woman was caused by the ingestion of iron chloride. The reported case of fatal intoxication is one of the few described in the literature, and its course implies that in the case of initially diagnosed intoxication with corrosive compounds, the possibility of using metal-containing poison should also be considered in the differential diagnosis. In addition to routine toxicological tests performed in fatal cases we also draw attention to the possibility of using specific staining protocols for microscopic specimens.