bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between physical activity, sedentary behaviour and self-rated health among the general population of children and adolescents: a systematic review and meta-analysis
Authors: Zhang Tong , Lu Guohua , Wu Xiu Yun
Published: September 2020

Background

Self-rated health (SRH) is an indicator that captures a person’s perception of their overall health status. The relationship between physical activity (PA), sedentary behaviour (SB) and SRH has been investigated in systematic reviews among adult and elderly populations. No systematic review to date has synthesized the relationship between PA, SB and SRH among children and adolescents. The purpose of this systematic review and meta-analysis was to synthesize the associations between PA, SB and SRH in the general population of children and adolescents and to investigate the dose-response relationship between PA, SB and SRH.

Methods

We conducted a computer search for English language studies in the databases of MEDLINE, EMBASE and PSYCINFO that were published between 1946 and 2019. We searched PubMed, Google Scholar, and the references of the identified publications for additional studies. A meta-analysis was employed to synthesize the associations between PA, SB respectively and SRH. The dose-response association was tested using a random effects meta-regression model. The review was reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

Results

Sixty-eight published articles were included in the final review, including 59 cross-sectional and nine longitudinal studies. We found evidence that PA was associated with better SRH, and SB was associated with lower SRH among children and adolescents. A dose-response relationship between PA and SRH was observed, where a higher level of PA was associated with better SRH than a lower level of PA. The relationship between PA, SB and SRH was observed in both boys and girls, and did not show a significant gender difference.

Conclusions

The findings in the systematic review suggest that health intervention programmes targeting promoting PA and reducing SB among children and adolescents may enhance their overall health status. Future research is needed to expand prospective cohort and intervention studies to address directionality and causality in the relationships between PA, SB and SRH among children and youth.

Trial registration

PROSPERO - CRD42019142244. Registered on October 18, 2019.
A case report of severe degenerative lumbar scoliosis associated with windswept lower limb deformity
Authors: Yang Xi , Zou Qiang , Song Yueming , Liu Limin , Zhou Chunguang
Published: September 2020

Background

The windswept lower limb deformity describes valgus deformity in one leg with varus deformity in the other. It is mostly seen in young children with metabolic bone diseases (such as rickets) and may lead to leg length discrepancy (LLD) and Degenerative scoliosis (DS) in older age. To the best of our knowledge, there was no report of the spinal surgery in patient with severe DS associated with windswept deformity. The objective of this study is to report the unique case of a 60-year-old woman with severe degenerative scoliosis (DS) associated with windswept deformity caused by rickets who underwent a posterior correction and fusion surgery in spine.

Case presentation

The patient was diagnosed as rickets windswept lower limb deformity for 50 years but never went through routine treatment. Then, she performed lumbar scoliosis for more than 20 years and suffered from severe back pain for 4 years. After overall clinical evaluation and radiographic measures, we performed a posterior surgical correction and fusion from T9-L5. With this surgery, the main thoracolumbar curve Cobb angle corrected from 72.5° to 21.0°, the coronal balance from 0 cm to 2.0 cm while the sagittal vertical axis (SVA) from 1.5 cm to − 1.0 cm. At 2 years postoperative follow-up, her back pain has almost completely relieved with a satisfied fixation and bone fusion showed on CT scans. However, a coronal imbalance was found with C7-CSVLdistance equal to 4.0 cm. This coronal imbalance was highly correlated to the untreated LLD and pelvic obliquity, and should be improved by standing posture or shoe lifts.

Conclusions

For such patient, the pure spinal correction and fusion surgery, in spite of lower limbs deformity, can achieve good relieve of back pain symptom, however may accompany by the complication of coronal imbalance due to the unimproved pelvic obliquity and LLD. However, longer follow-up is necessary to observe the long-term outcome of this patient’s postoperative coronal imbalance.
Copy number variant hotspots in Han Taiwanese population induced pluripotent stem cell lines - lessons from establishing the Taiwan human disease iPSC Consortium Bank
Authors: Huang Ching-Ying , Li Ling-Hui , Hsu Wan-Tseng , Cheng Yu-Che , Nicholson Martin W. , Liu Chun-Lin , Ting Chien-Yu , Ko Hui-Wen , Syu Shih-Han , Wen Cheng-Hao , Yan Zhuge , Huang Hsiang-Po , Su Hong-Lin , Chiang Po-Min , Shen Chia-Ning , Chen Hsin-Fu , Yen B. Lin Ju , Lu Huai-En , Hwang Shiaw-Min , Chiou Shih-Hwa , Ho Hong-Nerng , Wu Jer-Yuarn , Kamp Timothy J. , Wu Joseph C. , Hsieh Patrick C. H.
Published: September 2020

Background

The Taiwan Human Disease iPSC Service Consortium was established to accelerate Taiwan’s growing stem cell research initiatives and provide a platform for researchers interested in utilizing induced pluripotent stem cell (iPSC) technology. The consortium has generated and characterized 83 iPSC lines: 11 normal and 72 disease iPSC lines covering 21 different diseases, several of which are of high incidence in Taiwan. Whether there are any reprogramming-induced recurrent copy number variant (CNV) hotspots in iPSCs is still largely unknown.

Methods

We performed genome-wide copy number variant screening of 83 Han Taiwanese iPSC lines and compared them with 1093 control subjects using an Affymetrix genome-wide human SNP array.

Results

In the iPSCs, we identified ten specific CNV loci and seven “polymorphic” CNV regions that are associated with the reprogramming process. Additionally, we established several differentiation protocols for our iPSC lines. We demonstrated that our iPSC-derived cardiomyocytes respond to pharmacological agents and were successfully engrafted into the mouse myocardium demonstrating their potential application in cell therapy.

Conclusions

The CNV hotspots induced by cell reprogramming have successfully been identified in the current study. This finding may be used as a reference index for evaluating iPSC quality for future clinical applications. Our aim was to establish a national iPSC resource center generating iPSCs, made available to researchers, to benefit the stem cell community in Taiwan and throughout the world.
FDA orphan products clinical trial grants: assessment of outcomes and impact on rare disease product development
Authors: Miller Kathleen L. , Mueller Christine , Liu Gumei , Miller Needleman Katherine I. , Maynard Janet
Published: September 2020

Background

The Office of Orphan Products Development (OOPD) of the United States (U.S.) Food and Drug Administration (FDA) has awarded over 700 grants to conduct clinical trials of medicals products for rare diseases since 1983, leading to over 70 marketing approvals. However, despite recent progress in rare disease product development, thousands of rare diseases still have no approved treatments. An assessment of this clinical trial grants program was undertaken to provide an in-depth analysis of the characteristics and outcomes of the program. Results of this analysis will be used to inform future goals of the program, as well as internal data collection to continue to maximize the program’s impact in supporting rare disease product development.

Results

Between fiscal years 2007—2011, OOPD funded 85 clinical trial grants. These grants spanned 18 therapeutic areas, included all pre-approval phases (Phases 1–3), and approximately 75% of the grants studied small molecule drugs. Nine (11%) product approvals, of seven drugs and two devices, were at least partially supported by grants funded within this 5-year timeframe. Four of the seven drugs approved were new molecular entities (NMEs). The average time from funding to approval was seven years. We also found a suggested association between collaboration with multiple types of stakeholders and the success of grants, where we defined success as either positive or negative study findings or a future marketing approval.

Conclusions

The clinical trials funded by OOPD provided valuable information for future product development, and there were a notable number of approvals that occurred using the support of the grants program. There was a suggested association between collaboration and successful outcomes. Efficient and innovative trial designs and collaboration among stakeholders appear vital to continue to effectively bring products to rare disease patients. Ongoing program assessments will ensure that the funding continues to be used to optimally meet the treatment needs of the rare disease community.
Modeling tumor development and metastasis using paired organoids derived from patients with colorectal cancer liver metastases
Authors: Li He , Dai Weixing , Xia Xi , Wang Renjie , Zhao Jing , Han Lingyu , Mo Shaobo , Xiang Wenqiang , Du Lin , Zhu Guangya , Xie Jingjing , Yu Jun , Liu Nan , Huang Mingzhu , Zhu Jidong , Cai Guoxiang
Published: September 2020

Tumor metastasis accounts for the majority of cancer-related deaths; it is therefore important to develop preclinical models that faithfully recapitulate disease progression. Here, we generated paired organoids derived from primary tumors and matched liver metastases in the same colorectal cancer (CRC) patients. Despite the fact that paired organoids exhibit comparable gene expression and cell morphology, organoids from metastatic lesions demonstrate more aggressive phenotypes, tumorigenesis, and metastatic capacity than those from primary lesions. Transcriptional analyses of the paired organoids reveal signature genes and pathways altered during the progression of CRC, including SOX2. Further study shows that inducible knockdown of SOX2 attenuated invasion, proliferation, and liver metastasis outgrowth. Taken together, we use patient-derived paired primary and metastatic cancer organoids to model CRC metastasis and illustrate that SOX2 is associated with CRC progression and may serve as a potential prognostic biomarker and therapeutic target of CRC.
Cough-induced rib fracture in a smoker: a case report
Authors: Daccache Aimee , Haddad Jad , Ghanem Ahmad , Feghali Elio Junior , El Osta Bassel
Published: September 2020

Background

Coughing is considered an important mechanism that helps the body get rid of foreign substances or prevent their entry into the tracheobronchial tree. Infrequently, after the onset of coughing, patients presenting with persistent chest pain are found to have rib fractures. Among the cases reported for cough-induced rib fractures, the maximum number of fractured ribs was found to be four.

Case presentation

In this report, we present a case of a healthy 50-year-old Lebanese smoker who developed a total of six fractures in five ribs, asymmetrically, after coughing for 2.5 months.

Conclusion

This case report is, to our knowledge, the first to describe six cough-induced rib fractures in a smoker without an underlying predisposition.
Using an ultraviolet cabinet improves compliance with the World Health Organization’s hand hygiene recommendations by undergraduate medical students: a randomized controlled trial
Authors: Dray Sandrine , Lehingue Samuel , Valera Sabine , Nouguier Philippe , Boussen Michel Salah , Daviet Florence , Bastian Delphine , Pilarczik Estelle , Jousset Isabelle , Le Floch Sébastien , Grech Georgette , Leonetti Georges , Papazian Laurent , Cassir Nadim , Forel Jean-Marie
Published: September 2020

Background

Appropriate hand hygiene (HH) is key to reducing healthcare-acquired infections. The World Health Organization (WHO) recommends education and training to improve HH knowledge and compliance. Physicians are ranked among the worst of all healthcare workers for compliant handrubbing with its origin probably being the failure to learn this essential behavior during undergraduate medical studies. This study evaluated if the use of Ultraviolet-cabinets (UVc) for fluorescent-alcohol-based handrubs (AHR) during an undergraduate medical student training improved the compliance rate to the WHO hand hygiene recommendations (completeness of AHR application and HH opportunities).

Methods

This randomized trial compared a HH training with personal feedback (using UVc) to a control group. The first year, the students (2nd degree) were convened by groups (clusters) of 6–9 for a demonstration of the correct execution of WHO procedure. Randomization by cluster was done prior HH training. In the control group, the students hand rubbed under visual supervision of a tutor. In the intervention group after the same visual supervision, completeness of fluorescent-AHR hand application was recorded under UVc and was shown to the student. The intervention group had free access to the UVc until complete application. HH practices were included in simulation sessions for the both groups. One year after (3rd degree), all the students were asked to hand rub with fluorescent-AHR. A tutor (blinded to the study group) assessed the completeness of hand application under UVc and the compliance with the WHO opportunities. Complete application of AHR was defined as fluorescence for all the surfaces of hands and wrists.

Results

242 students participated (140 in the intervention group and 102 in the control group). One year after the initial training, the rate of complete application of AHR was doubled in the intervention group (60.0% vs. 30.4%, p < 0.001). In a multivariate analysis which included gender, additional HH or UVc training, surgical traineeship and regular use of AHR, the hazard ratio for the intervention was 3.84 (95%CI: 2.09–7.06). The compliance with the HH WHO’s opportunities was increased in the intervention group (58.1% vs. 42.4%, p < 0.018).

Conclusion

Using UVc for undergraduate medical students education to hand hygiene improves their technique and compliance with WHO recommendations.
Frontiers in the COVID-19 vaccines development
Authors: Haq Ehtisham Ul , Yu Jifeng , Guo Jiancheng
Published: September 2020

Novel corona virus caused pneumonia first reported in December, 2019 in Wuhan, China was later named COVID-19. Due to its special pathogenicity, COVID-19 transmitted with high speed beyond borders and has significantly affected normal life. Currently, no specific drugs, treatment or vaccines are available. Vaccine development for COVID-19 is a highly complex process involving viral genomic studies, identification of target for vaccine, vaccine design, manufacturing, storage and distribution, preclinical and clinical safety and efficacy studies. The high levels of efforts and global collaboration at this scale is unprecedented. The World Health Organization (WHO) has documented 160 different COVID-19 vaccine candidates as of July 13, 2020 with 26 currently on clinical evaluation while 137 vaccines on preclinical evaluation. COVID-19 vaccine efforts mark the first use of mRNA-type vaccines ever evaluated. Numerous research organizations have successfully initiated clinical evaluation of COVID-19 vaccines. This review aims to summarize the advances and challenges for COVID-19 vaccines development.
Intravenous calcium as a pressor in a swine model of hypoxic pseudo-pulseless electrical mechanical activity—a preliminary report
Authors: Lindqwister Alexander L. , Lampe Joshua W. , Gould Jeffrey R. , Kaufman Christopher L. , Moodie Karen L. , Paradis Norman A.
Published: September 2020

Background

Pseudo-pulseless electrical activity (pseudo-PEA) is a lifeless form of profound cardiac shock characterized by measurable cardiac mechanical activity without clinically detectable pulses. Pseudo-PEA may constitute up to 40% of reported cases of cardiac arrest. Resuscitation from pseudo-PEA is often associated with hypotension refractory to catecholamine pressors. We hypothesized that this post-resuscitation state may be associated with hypocalcemic hypotension responsive to intravenous calcium.

Methods

Using pre-existing data from our hypoxic swine pseudo-PEA model, we measured blood pressure, hemodynamics, and electrolytes. Physiological data were analyzed on a heartbeat by heartbeat basis. The midpoint of the calcium response was defined using change of curvature feature detection. Hemodynamic parameters were shifted such that the value at the midpoint was equal to zero.

Results

In 9 animals with refractory hypotension, we administered 37 boluses of intravenous calcium in the dosage range of 5-20 mg. Comparisons were made between the average values in the time period 40-37 s before the midpoint and 35-40 s after the midpoint. Of the 37 administered boluses, 34 manifested a change in the blood pressure, with mean aortic pressure, systolic and diastolic pressures all increasing post bolus administration.

Conclusions

Administration of intravenous calcium may be associated with a pressor-like response in refractory hypotension after resuscitation from pseudo-PEA. Relative ionized hypocalcemia may cause hypotension after resuscitation from pseudo-PEA. Therapy with intravenous calcium should be further investigated in this setting.
Impact of gasoline fuel emissions on Rhizopus stolonifer (Ehrenb.) Vuill. and Fusarium oxysporum (Schlecht.)
Authors: Balogun Kayode Peter , Aborisade Abiola Titilola , Oladele Oluwole Olakunle
Published: September 2020

Background

Alteration in the normal composition of gasses in the atmosphere referred to as air pollution can occur as a result of different processes, including emissions from vehicles and power generators. Gasses affect living things directly and indirectly by playing roles in respiration, membrane function, synthesis, and growth. The gasses contained in fumes emitted from vehicles and generators may likely have effect on microorganisms in the environment including microfungi. Two microfungi were selected to study the effect of generator emissions on their growth.

Results

The gaseous emissions from power generators fueled by gasoline caused reduction in spore germination and germ tube lengths of R. stolonifer and F. oxysporum. For the former, spore germination decreased with length of exposure after an initial increase by ~ 100%. The fungus exhibited a single major germination peak at 10 min and a minor one at 30–35 min exposures. Germ tube length of the fungus also decreased with increased exposure. F. oxysporum too showed reduced spore germination and germ tube length with exposure but the fungus seemed to adjust better to the unfavorable environment created by emitted gasses showing multiple peaks of reduced heights as time progressed, though another rise that could reach a peak appeared at the 45-min maximum exposure for germ tube length. The peaks were however more broad for spore germination experiments indicating more stability in adjustment than observed for germ tube length. Greatest reduction in spore germination was by 25% in R. stolonifer and 71% in F. oxysporum Germ tube length reduction for R. stolonifer was by 24–76%, the greatest occurring at 35-min exposure, while for F. oxysporum it was 5–83%, the greatest occurring at 40 min exposure.

Conclusions

These observations reveal the toxicity of the gasses emitted to the growth of the two filamentous fungi and the potential harmful effect to other fungi which might be useful in the ecosystem as decomposers and to those that may be pathogenic to higher plants.
Unique Genomic Landscape of High-Grade Neuroendocrine Cervical Carcinoma: Implications for Rethinking Current Treatment Paradigms
Authors: Eskander Ramez N. , Elvin Julia , Gay Laurie , Ross Jeffrey S. , Miller Vincent A. , Kurzrock Razelle
Published: September 2020

PURPOSE

High-grade neuroendocrine cervical cancer (HGNECC) is an uncommon malignancy with limited therapeutic options; treatment is patterned after the histologically similar small-cell lung cancer (SCLC). To better understand HGNECC biology, we report its genomic landscape.

PATIENTS AND METHODS

Ninety-seven patients with HGNECC underwent comprehensive genomic profiling (182-315 genes). These results were subsequently compared with a cohort of 1,800 SCLCs.

RESULTS

The median age of patients with HGNECC was 40.5 years; 83 patients (85.6%) harbored high-risk human papillomavirus (HPV). Overall, 294 genomic alterations (GAs) were identified (median, 2 GAs/sample; average, 3.0 GAs/sample, range, 0-25 GAs/sample) in 109 distinct genes. The most frequently altered genes were PIK3CA (19.6% of cohort), MYC (15.5%), TP53 (15.5%), and PTEN (14.4%). RB1 GAs occurred in 4% versus 32% of HPV-positive versus HPV-negative tumors ( P < .0001). GAs in HGNECC involved the following pathways: PI3K/AKT/mTOR (41.2%); RAS/MEK (11.3%); homologous recombination (9.3%); and ERBB (7.2%). Two tumors (2.1%) had high tumor mutational burden (TMB; both with MSH2 alterations); 16 (16.5%) had intermediate TMB. Seventy-one patients (73%) had ≥ 1 alteration that was theoretically druggable. Comparing HGNECC with SCLC, significant differences in TMB, microsatellite instability, HPV-positive status, and in PIK3CA, MYC, PTEN, TP53, ARID1A, and RB1 alteration rates were found.

CONCLUSION

This large cohort of patients with HGNECC demonstrated a genomic landscape distinct from SCLC, calling into question the biologic and therapeutic relevance of the histologic similarities between the entities. Furthermore, 73% of HGNECC tumors had potentially actionable alterations, suggesting novel treatment strategies for this aggressive malignancy.
Pecs Blocks for Chronic Pain: A Case Report of Successful Postmastectomy Pain Syndrome Management
Authors: Bawany Mohammad H. , Oswald Jessica
Published: September 2020

Mastectomies can be complicated by difficult-to-treat postmastectomy pain syndrome (PMPS) and axillary web syndrome (AWS). We present a case of PMPS and AWS successfully treated with Pecs I and II blocks and trigger point injections. At follow-up after 4 months, our patient reported 70% improvement in pain, movement, function, and discontinuation of opioids. This case presents the utility of a multimodal approach for a patient with pain after mastectomy. This case report is the first-time demonstration of Pecs blocks to treat chronic PMPS.
The Engineering Tools That Shaped the Rational Expectations Revolution
Authors: Boumans Marcel
Published: September 2020

The rational expectations revolution was not based only on the introduction of Muth’s idea of rational expectations to macroeconomics; this introduction alone cannot explain the more drastic changes to the mathematical toolbox, concepts, and research strategies since the 1980s. The shift from “Keynesian economics” to “new classical economics” is based on a shift from a control engineering approach to an information engineering methodology. This “revolution” was even more radical; it also changed the epistemology and ontology of macroeconomics. The ontology of information engineering, and hence of new classical economics, is a world populated by machines that communicate by the exchange of noisy information. The decisions these machines make are conditioned on the (noisy) information they have about the current state of the world but which at the same time will affect future states. Policy in this world therefore means tracing an optimal trajectory taking all these issues into account. To show this shift in epistemology and ontology, the history of economics is interwoven with the history of mathematics, which cannot be detangled from the emergence of the digital computer. The computer changed the nature of mathematics in a specific way by adopting a new concept of solution, namely the algorithm.
A novel tool for improving the interpretation of isotope bone scans in metastatic prostate cancer
Authors: Alshehri ALI H.D. , Osman Sarah O.S. , Prise Kevin M. , Campfield Caoimhghin , Turner PG , Jain Suneil FRCR PhD , O’Sullivan Joe M. , Cole Aidan J.
Published: September 2020

Objectives:

The isotope bone scan (IBS) is the gold-standard imaging modality for detecting skeletal metastases as part of prostate cancer staging. However, its clinical utility for assessing skeletal metastatic burden is limited due to the need for subjective interpretation. We designed and tested a novel custom software tool, the Metastatic Bone Scan Tool (MetsBST), aimed at improving interpretation of IBSs, and compared its performance with that of an established software programme.

Methods:

We used IBS images from 62 patients diagnosed with prostate cancer and suspected bone metastases to design and implement MetsBST in MATLAB by defining thresholds used to identify the texture and size of metastatic bone lesions. The results of MetsBST were compared with those of the commercially available automated Bone Scan Index (aBSI) with regression analysis.

Results:

There was strong agreement between the MetsBST and aBSI results (R2 = 0.9189). In a subregional analysis, MetsBST quantified the extent of metastatic disease in multiple bone sites in patients receiving multimodality therapy (radium-223 and external beam radiotherapy) to illustrate the differences in bone metastatic response to different treatments.

Conclusion:

The results of MetsBST and the commercial software aBSI were highly consistent. MetsBST introduces novel clinical utility by its ability to differentiate between the responses of different bone metastases to multimodality therapies.

Advances in knowledge:

MetsBST reduces the variability in assessment of tumour burden caused by subjective interpretation. Therefore, it is a useful aid to physicians reporting nuclear medicine scans, and may improve decision-making in the treatment of metastatic prostate cancer.
ASSESSMENT OF YIELD AND ADAPTIVE POTENTIAL OF PEA VARIETIES IN THE CONDITIONS OF THE SOUTHERN FOREST STEPPE OF THE NORTHERN URALS
Authors: Sapega Valeriy , Mitrikovskiy Aleksandr
Published: September 2020

The studies were carried out in 2015–2018 in the southern forest-steppe of Tyumen region in order to assess the yield, realize its potential and ecological plasticity of pea varieties admitted for use in the region, to identify the best genotypes. The material for the study was the data on the yield of eight varieties of peas. The index of environmental conditions and ecological plasticity were determined according to the method of S.A. Eberhart, W.A. Russell, the share of yield, relative to the average variety, and the realization of its potential - according to L.A. Zhivotkov and E.D. Nettevich, the yield range - according to V.A. Zykin. The index of environmental conditions in the years of testing varied from 0.89 (2015) to -1.04 (2016). Salamanca variety was characterized by the highest yield potential and the highest adaptability, in comparison with the average variety, in the most favorable (120.3%) and most unfavorable conditions (141.7%). On average for 2015–2018 the best in terms of yield was Omskiy 9 variety (1.98 t/ha). At the same time, the range of variation in the value of this indicator for the analyzed was significant - from 73.8% (Yamalskiy) to 89.0% (Kumir). Omskiy 9 variety (69.0%) was characterized by the highest value of the realization of the yield potential, and the lowest - Kumir (50.7%). The varieties Omskiy 9 (bi = 1.17), Kumir (bi = 1.13) and Salamanca (bi = 1.15) were characterized by the highest responsiveness to changes in environmental conditions - these are varieties of the intensive type. Weak responsiveness to changes in environmental conditions was found in the varieties Yamalsky (bi = 0.80) and Yamal (bi = 0.86). The varieties Batrak, Agrointel and Tomas, with a regression coefficient equal to or close to one, are classified as plastic. The Tomas variety was the most stable (Si2 = 0.16), the least - Kumir (Si2 = 15.98). On the basis of a comprehensive assessment of yield and parameters of ecological adaptability, the best varieties in the southern forest-steppe zone of Tyumen region were recognized as Omskiy 9 and Salamanca
DERMATOMYOSITIS: A CLINICAL CASE
Authors: Barieva B.
Published: September 2020

Dermatomyositis (DM) refers to idiopathic inflammatory myopathies (IIM). IIM -a group of chronic autoimmune diseases, the main clinical manifestation of which is muscle weakness, which is associated with inflammation of the striated muscles. The article presents a clinical case of dermatomyositis in a 45-year-old man, the trigger of which was insolation. Due to the polymorphism of the DM clinical picture, the patient was initially hospitalized in a skin and venereal dispensary, and from there transferred to the rheumatology Department. Timely diagnosis and specialized treatment led to stabilization of the patient and prevention of disease progression up to complete immobilization of the patient.
Discharge Before Return to Respiratory Baseline in Children with Neurologic Impairment
Authors: Steuart Rebecca , Tan Rachel , Melink Katherine , Chinchilla Sofia , Warniment Amanda , Shah Samir S , Thomson Joanna
Published: September 2020

BACKGROUND: Children with neurologic impairment (NI) are commonly hospitalized with acute respiratory infections (ARI). These children frequently require respiratory support at baseline and are often discharged before return to respiratory baseline. OBJECTIVE: To determine if discharge before return to respiratory baseline is associated with reutilization among children with NI hospitalized with ARI. METHODS: This single-center retrospective cohort study included children with NI aged 1 to 18 years hospitalized with ARI who required increased respiratory support between January 2010 and September 2015. The primary exposure was discharge before return to respiratory baseline. The primary outcome was 30-day hospital reutilization. A generalized estimating equation was used to examine the association between exposure and outcome while accounting for within-patient clustering and patient-level clinical complexity and illness severity. RESULTS: In the 632 hospitalizations experienced by 366 children, children were discharged before return to respiratory baseline in 30.4% of hospitalizations. Compared with those hospitalizations in which children were discharged at baseline, hospitalizations with a discharge before return to respiratory baseline were more likely to be for privately insured, technology-dependent children with respiratory comorbidities. Compared with discharges at respiratory baseline, discharges with increased respiratory support had no difference in 30-day reutilization (32.8% vs 31.8%; P = .81; adjusted OR 0.80, 95% CI 0.51-1.26). CONCLUSIONS: Among children with NI hospitalized with ARI, discharge before return to respiratory baseline was common, but it was not associated with hospital reutilization. Return to respiratory baseline may not be a necessary component of discharge criteria in this population.
Effect of Arthrospira Microalga Fortification on Physicochemical Properties of Yogurt
Authors: Pan-utai Wanida , Atkonghan Jariya , Onsamark Tipakorn , Imthalay Wachiraya
Published: September 2020

Arthrospira (Spirulina) platensis, a blue-green microalga, is a rich source of organic nutrients. Microalgae are used as food supplements with enhanced nutritional and functional values. Consumption of fermented milk products such as yogurt has recently increased. Both oven-dried and fresh Arthrospira biomass supplemented into yogurt at different concentrations of 0.1, 0.3, and 0.5% (w/v) and 1, 5, and 10% (v/v), respectively improved physicochemical properties. Arthrospira supplemented in yogurt fermentation gave faster decrease in pH value with green color index of finished yogurt. Oven drying is a convenient method; however, fresh biomass gave similar nutritional value with higher C-phycocyanin content. During storage, pH, titratable acidity, and color of yogurt showed negligible variations. Results indicated that Arthrospira increased both nutritional composition and functional properties of yogurt as a natural food ingredient.
ROBERT LOUIS STEVENSON E O INSÓLITO JOGO DE ESPELHOS EM "MARKHEIM" (1884)
Authors: De Castro Renato Barros
Published: September 2020

Este trabalho aborda um dos temas mais caros à literatura fantástica, a saber, o tema da duplicidade e da multiplicidade do “eu”, construído em uma narrativa de crime que privilegia uma série de eventos insólitos. A partir de uma análise sobre as discussões acerca do gênero fantástico e do seu surgimento, tendo por fundamentação teórica autores como Tzvetan Todorov e David Roas, o artigo pretende analisar o conto Markheim (1884), de Robert Louis Stevenson (1850-94), sob a perspectiva da construção da alteridade na narrativa, sem deixar de considerar os demais elementos que dialogam com textos de Edgar Allan Poe, um dos predecessores canônicos no gênero. Em Markheim, como em nenhuma outra narrativa de Stevenson (mesmo O estranho caso de Dr. Jekyll e Mr. Hyde), pode-se apreciar com tanta clareza a capacidade construtiva do autor e a forma como orquestra o uso dos elementos emblemáticos do fantástico e do insólito, conduzindo o leitor gradativamente ao estado de hesitação de que fala Todorov. Tudo isso não apenas por conta da meticulosa escolha das palavras, mas também graças a uma habilidade ímpar em evocar imagens, criar atmosferas e – principalmente – levar o tema da duplicidade ao ponto de proporcionar, ao leitor, uma reflexão aprofundada sobre a consciência humana e aos estranhos “eus” que carrega em si mesmo. Estudando o modo como se dá a construção dos elementos emblemáticos do fantástico na narrativa de crime Markheim – bem como os elementos de desestabilização da realidade –, este estudo espera trazer à tona um dos esteios da obra de Stevenson, revelador das angústias de toda uma geração de escritores.
Desvelando processos formativos das práticas extensionistas em Educação Popular na saúde
Authors: Cruz Pedro , Vasconcelos Eymard Mourão
Published: September 2020

Esse   artigo   pretende   explicitar   elementos   pedagógicos   das práticas de extensão orientadas pela educação popular. Foi construído com as metodologias da consulta documental e pesquisa bibliográfica, por meio das quais foram levantados depoimentos de estudantes extensionistas, com ênfase em suas percepções acerca dos processos de aprendizagem. Apontaram-se então pressupostos e desafios da extensão em educação popular no desenvolvimento de um agir crítico em saúde. A extensão em educação popular desvela uma aprendizagem que, ao mesmo tempo, não se restringe à dimensão técnica e é tecida em meio ao trabalho social para a garantia do direito à saúde. Das dimensões reveladas, destacaram-se: extensão como espaço mobilizador de uma pedagogia reorientadora da formação em saúde; mergulho na realidade social e em suas complexidades como etapa fundadora desse processo; perplexidade estudantil (diante das experiências) como processo a ser valorizado, acolhido e problematizado. Tal processo demanda espaços reflexivos com acolhimento e problematização das emoções e das percepções estudantis diante de sua inserção na realidade. Nesses espaços, desvelam-se as estratégias para a construção dos aprendizados significativos na direção do trabalho em saúde orientado pela integralidade, pela promoção humana e pelo compromisso com os grupos socialmente excluídos.
“Porque espanca as trevas da ignorância”: as concepções de biblioteca, leitura e poesia presentes no jornal Despertar (1947-54), de Caxias do Sul
Authors: Arendt João Claudio
Published: September 2020

No contexto de uma ampla pesquisa sobre periódicos, este artigo analisa as concepções de biblioteca, leitura e poesia presentes no jornal Despertar, publicado em Caxias do Sul entre setembro de 1947 e novembro de 1954. Concebido como forma estratégica de aproximação entre a administração municipal e o público escolar, especialmente o do meio rural, o periódico veiculava notícias sobre educação, orientações pedagógicas para professores, atividades para alunos, poemas para recitar, dicas de higiene e até conselhos sobre agricultura. A fundamentação teórica e crítica da análise advém, entre outros, de estudos realizados por MANGUEL (1997), HARELLOU-LAFARGE e SEGRÉ (2010) e OLIVEIRA e SOUZA (2012).
A literatura frenética finissecular nos folhetins de Gomes Leal
Authors: Batalha Maria Cristina
Published: September 2020

A produção novelística de António Duarte Gomes Leal (1848-1921), um dos mais novos da Geração de 70, é marcada por uma tensão erótica, entre o delírio e o mistério, nos moldes da chamada “literatura frenética”, dominante, na França, nos meados do século XIX, e mais para o fim do século, em Portugal, coincidindo com  o período conhecido por “decadentismo”. Em sua obra, Eros é submetido à dor e à morte, e as paixões violentas se desenvolvem em locais soturnos, imersos em escuridão, nos quais predomina  o sentimento de aprisionamento face ao exterior (cemitérios, castelos). O satanismo manifesta-se no gosto pelo excesso e o arrebatamento. Através de três novelas de Gomes Leal, publicadas em fascículos como brinde aos leitores do jornal Diário de Notícias, destacam-se a concepção de um universo marcado pelo fantástico e o grotesco, pelo masoquismo e o sadismo, expressando uma visão dualista do homem, inspirada em  Baudelaire, e bem ao gosto dos leitores dos folhetins do final do século XIX.
Why nurses in primary care need to be research active: the case of venous leg ulceration
Authors: Saghdaoui Layla Bolton , Onida Sarah , Davies Alun Huw , Wells Mary
Published: September 2020

Venous leg ulceration (VLU) is predominantly managed in primary care by district nurses, however much of the research takes place in secondary care. This study aimed to identify to what extent nurses are involved in publishing VLU research and to ascertain how much VLU research is conducted in primary care. Three searches of literature published between 2015 and 2020 were undertaken, reviewing VLU publications on interventions, quality of life and qualitative research. Some 37% of intervention studies had one or more nurse authors, compared with 65% of quality of life studies and 86% of qualitative research publications. Of papers that providing details of recruitment, 39% of intervention and quality of life studies included primary care as a recruitment setting. Qualitative studies were more likely to recruit from primary as well as secondary care (50%). Nurses are involved in leading VLU research but are more likely to publish quality of life and qualitative research than intervention studies. The majority of nurse authors in this field are based in academic institutions. A minority of studies utilise primary care as a recruitment setting for VLU research. More must be done to enable VLU research in community settings and to promote the involvement of clinical nurses in research.
Reducing pressure ulcers in care homes in Barnet: a quality improvement project
Authors: Anaba-Wright Ugomma , Kefas Jemimah
Published: September 2020

Pressure ulcers are increasingly seen as an untoward event for patients. While there has been a strong focus on patients in the acute sector, community services have also had to be increasingly innovative in addressing this issue. Carers in care homes in the London borough of Barnet were identified as needing additional support to improve their knowledge and skills surrounding pressure ulcer prevention and treatment. An informal pilot training session showed that carers felt better equipped in terms of identifying new pressure ulcers and were able to escalate issues to district nurses in record time. Subsequently, there was a noticeable reduction in the reporting of pressure ulcers of categories 2 and above. In the present article, the authors describe the quality improvement project undertaken at Barnet care homes to prevent pressure ulcers.
Changes in the management of iron in pregnancy
Authors: Flynn Avril
Published: September 2020

There is now a growing body of evidence which suggests that proactively preventing the progression from low iron to treating iron deficiency in pregnancy with scientifically modern supplements might offer the best course of action, rather than traditional oral iron supplements or treating with high-dose iron medicines later. Despite the huge importance of iron for human health, it is the most common nutritional deficiency in the world ( World Health Organization, 2008 ). For many years, this has been a neglected area of study or improvement ( Auerbach and Georgieff, 2020 ).
A service evaluation of a specialist migrant maternity service from the user's perspective
Authors: Filby Alex , Robertson Wendy , Afonso Eugenia
Published: September 2020

Background

Meeting the complex needs of pregnant migrants requires an innovative approach. Migrant women's experiences and opinions should directly guide service development if these needs are to be met effectively.

Aims

To evaluate the specialist migrant maternity service provided by Kings College Hospital London based upon users' experience and satisfaction.

Methods

A qualitative service evaluation via semi-structured, multi-lingual, in-depth interviews with 10 service users. Data was analysed using a general inductive approach for thematic analysis.

Findings

Positive aspects: access to midwife and referrals, provision of essentials and transport, respect and kindness of caregivers. Negative aspects: poor maternal nutrition, lack of access to hygienic infant-feeding equipment, lack of social support building and lack of service signposting.

Conclusion

Women conveyed a high level of satisfaction with the service. The negative aspects that persist are, arguably, not within the immediate remit of the maternity team, yet they negatively affect the health of these women, and therefore merit awareness raising if holistic care is to be achieved. Seven service recommendations have been made.
Maternal and neonatal outcomes for the gentle caesarean section in breech presentation
Authors: Brethouwer Christa H , Scherjon Sicco A , Elvan-Taşpinar Ayten
Published: September 2020

Background

The gentle caesarean section (GCS) is an alternative to the conventional caesarean section. It aims to optimise the wellbeing of mother and child by mimicking certain aspects of a vaginal delivery when a caesarean section is indicated.

Aim

To compare the maternal and neonatal outcomes of a GCS in cephalic and breech presentation.

Methods

In this retrospective study, the outcomes of 180 women who underwent a GCS were analysed, where 120 fetuses were in cephalic and 60 were in breech position. Comparisons were made using Chi-square, Mann-Whitney U and t-tests. Maternal and neonatal outcomes were analysed.

Results

Apgar 1 was significantly lower for breech position (P=0.019). The Apgar 5 and 10 showed no difference. Neonatal temperature was slightly lower in breech position (36.8°C ± 0.36 versus 36.9°C ± 0.39, P=0.046). Birthweight was significantly lower for breech position (P=0.009). Blood loss was significantly higher in cephalic position (441 ± 230 versus 353 ± 151, P=0.002).

Conclusions

When performing a GCS, there is no clinically significant difference in maternal or neonatal outcome between a cephalic and a breech presentation. It seems safe to perform a GCS for breech presentation.
Continuity and consultation
Authors: Hajjaj June Pembroke
Published: September 2020

Providing continuity of carer is one way to work towards the NHS Better Births goal. June Pembroke Hajjaj discusses its development and implementation in London North West Healthcare
Leonardo’s Brain: Understanding da Vinci’s Creative Genius, Leonard Shlain (2014)
Authors: Morrison James C.
Published: September 2020

Leonardo’s Brain: Understanding da Vinci’s Creative Genius, Leonard Shlain (2014)

Guilford, CT: Lyons Press, an imprint of Rowman & Littlefield, 256 pp.,

ISBN 978-1-49300-335-8, h/bk, $25.95,

ISBN 978-1-49300-939-8, p/bk, $18.95,

ISBN 978-1-49152-985-0, CD audio, $14.95
Gangguan Perilaku pada Anak Perempuan dengan Hiperplasia Adrenal Kongenital: Persepsi Orang Tua
Authors: Hanifah Nida , Ediati Annastasia , Ariani Mahayu Dewi , Faradz Sultana MH , Utari Agustini
Published: September 2020

Latar belakang. Paparan androgen sejak prenatal diduga berdampak pada banyak aspek perkembangan anak perempuan dengan Hiperplasia Adrenal Kongenital (HAK). Namun, data mengenai gangguan emosi atau gangguan perilaku pada anak dengan HAK di Indonesia masih terbatas.Tujuan. Mengetahui problem emosi/perilaku pada anak dengan HAK.Metode. Penelitian ini menggunakan desain belah lintang. Subyek penelitian diambil dari 11 anak perempuan dengan HAK berumur 6-18 tahun. Kontrol (n=11) diambil dari anak tanpa HAK dengan umur dan jenis kelamin yang sesuai dengan sampel. Data diambil dengan kuesioner CBCL/6-18 yang diisi oleh orang tua. Analisis data menggunakan Uji Mann-Whitney untuk melihat perbedaan skor antara anak dengan HAK dan tanpa HAK.Hasil. Terdapat perbedaan perilaku yang signifikan antara anak dengan HAK dan kontrol (p<0,05) dalam hal problem sosial, problem perhatian, perilaku agresif, dan gangguan perilaku secara keseluruhan (skor total). Ada kecenderungan anak dengan HAK mengalami lebih banyak problem internalisasi daripada anak tanpa HAK, tetapi statistik kurang mendukung (p=0,052). Namun demikian, nilai T-score pada anak dengan HAK masih dalam rentang normal (T<65).Kesimpulan. Asesmen dan pendampingan psikologis bagi anak dengan HAK sangat diperlukan, terutama pada anak perempuan dengan HAK. Penanganan HAK secara dini dapat segera dilakukan untuk mencegah eskalasi problem psikologis pasca pubertas.
Mi calle favorita
Authors: Carinhas Raquel , Araújo e Sá Maria Helena , Moore Danièle
Published: September 2020

Este trabalho faz parte de uma investigação em curso e visa analisar um conjunto de atividades de um projeto plurilingue e interdisciplinar, concebido e implementado em Montevideu, Uruguai, em 2019, por uma rede de atores educativos integrando professores, mediadores de museus, famílias e investigadores. O projeto inscreve-se dentro de uma abordagem do      plurilinguismo como meio e finalidade (GROMMES; HU, 2014) e pretende estabelecer espaços de continuidade entre as aprendizagens na escola, nas famílias e na comunidade, numa perspetiva ecológica da paisagem do lugar. Pretende também promover o reconhecimento da diversidade linguística e cultural e da dimensão multissituada do conhecimento. Foram recolhidos dados multimodais, compreendendo documentação visual e sonora da paisagem linguística da Ciudad Vieja, desenhos e colagens produzidos pelas crianças, registos audiovisuais das diversas atividades e diário de investigação. Nesta contribuição, discutimos as implicações das paisagens linguísticas (PL) como instrumento para a criação de cenários pedagógicos interdisciplinares promotores de aprendizagens multissituadas e de reflexões críticas em torno do plurilinguismo e da multimodalidade, bem como as incidências destes cenários na apropriação e (re)conceptualização do espaço que rodeia os aprendentes na relação com o desenvolvimento da sua identidade. O estudo demonstra o potencial das PL como espaços de aprendizagem e como recursos contextuais para uma maior sensibilização para a diversidade linguística e cultural.
valor das línguas na realidade de ensino-aprendizagem em Cabo Verde
Authors: Pandim Gildaris Ferreira
Published: September 2020

Este artigo registra um panorama a propósito de algumas das medidas político-educacionais empreendidas no que toca ao ensino do português enquanto língua oficial e não-materna na realidade africana. Atenta especificamente à situação sociolinguística de Cabo Verde, cuja língua materna é um fator de diversidade a ser incluído nessa conjuntura. O reconhecimento jurídico ou o não reconhecimento das línguas faladas numa nação orienta seus estatutos na sociedade, contribuindo para valorações positivas ou negativas. Considera-se que a língua permite o desenvolvimento psíquico e permeia os relacionamentos interacionais. Ao ser alfabetizado num idioma não-materno, questiona-se o processo de construção da identidade social do aprendiz, na relação com o ambiente escolar, com sua própria língua e com a língua do outro. O artigo objetiva demonstrar, para a realidade em estudo, que a interpenetração da língua e da cultura na sociedade dá-se diferentemente em cada um dos idiomas, o cabo-verdiano e o português.