bluuebunny/crossref_metadata_2025 huggingface dataset:
Fluralaner (Bravecto®) induces long-term mortality of Lutzomyia longipalpis after a blood meal in treated dogs
Authors: Queiroga Tamyres Bernadete Dantas , Ferreira Henrique Rafael Pontes , dos Santos Wilo Victor , de Assis Ana Beatriz Lourenço , de Araújo Neto Vicente Toscano , da Câmara Antônia Cláudia Jácome , Fagundes Neto João Ciro , dos Reis Romeika Karla , Nascimento Manuela Sales Lima , Gama Renata Antonaci , Guedes Paulo Marcos Matta
Published: December 2020

Background

Leishmania infantum is the etiological agent of visceral leishmaniasis (VL) in the New World, where the sand fly Lutzomyia longipalpis and domestic dogs are considered the main vector and host reservoirs, respectively. Systemic insecticides have been studied as an alternative to control vector-borne diseases, including VL. Fluralaner, an isoxazoline class compound, is a systemic insecticide used in dogs, with proven efficiency against different species of phlebotomine sand flies. However, to date no studies have demonstrated the efficacy of fluralaner on Lu. longipalpis. The aim of this study was to evaluate the insecticidal effect of fluralaner (Bravecto®) on the sand fly Lu. longipalpis after blood meal in treated dogs.

Methods

Healthy mongrel dogs (n = 8) were recruited from the Zoonoses Control Center in the city of Natal, Rio Grande do Norte, Brazil, and randomized into two groups: fluralaner treated (n = 4) and non-treated control (n = 4). Colony-reared female specimens of Lu. longipalpis (n = 20) were allowed to feed on all dogs for 40 min before treatment (for fluralaner-treated dogs), at day 1 after treatment and then monthly until 1 year post-treatment.

Results

In the treatment group, there was 100% mortality of Lu. longipalpis for up to 5 months after treatment initiation, decreasing to 72.5% at 6 months post-treatment initiation. The efficacy of fluralaner ranged from 100% at day 1 (P = 0.0002) to 68% ( P = 0.0015) at 6 months, decreasing to 1.4% at 1 year post-treatment. Sand fly mortality carried out blood meal in non-treated control dogs remained constant at ≤ 15%.

Conclusions

Taken together, our results suggest that fluralaner may be used as a control strategy for VL in dogs in VL endemic areas.

Graphical Abstract
Mapping evidence on adolescents’ HIV-positive status disclosure in sub-Saharan Africa: a protocol for a scoping review
Authors: Adzordor Patience , Avoka Clement , Bawontuo Vitalis , Agbesi Silas , Kuupiel Desmond
Published: December 2020

Background

Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA.

Methods

The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool.

Discussion

The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.
Trends and determinants of an acceptable antenatal care coverage in Ethiopia, evidence from 2005-2016 Ethiopian demographic and health survey; Multivariate decomposition analysis
Authors: Birhan Tilahun Yemanu , Seretew Wullo Sisay
Published: December 2020

Background

an acceptable antenatal care (ANC4+) is defined as attending at least four antenatal care visit, received at least one dose of tetanus toxoid (TT) injections and consumed 100 iron-folic acids (IFA) tablets/syrup during the last pregnancy. Since maternal health care service utilization continues to be an essential indicator for monitoring the improvements of maternal and child health outcomes. This study aimed to analyze the trends and determinants that contributed to the change in an acceptable antenatal care visit over the last 10 years in Ethiopia.

Methods

Nationally representative repeated cross-sectional survey was conducted using 2005, 2011, and 2016 Ethiopian Demographic and Health Survey datasets. The data were weighted and analyzed by STATA 14.1 software. Multivariate decomposition regression analysis was used to identify factors that contribute for the change in an acceptable antenatal care visit. A p-value < 0.05 was taken to declare statistically significant predictors to acceptable antenatal care visit.

Results

among the reproductive age women the rate of an acceptable antenatal care visits was increased from 16% in 2005 to 35% in 2016 in Ethiopia. In the multivariate decomposition analysis, about 29% of the increase in acceptable antenatal care visit was due to a difference in composition of women (endowments) across the surveys. Residence, religion, husband educational attainment, and wealth status was the main source of compositional change factors for the improvements of an acceptable antenatal care visit. Almost two-thirds of an overall change in acceptable antenatal care visit was due to the difference in coefficients/ change in behavior of the population. Religion, educational attainment (both women and husband), and residence are significantly contributed to the change in full antenatal care visit in Ethiopia over the last decades.

Conclusion

Besides the relevance of receiving an acceptable antenatal care visit for pregnant women and their babies, an acceptable antenatal care visit was slightly increased over time in Ethiopia. Women’s characteristics and behavior change were significantly associated with the change in acceptable antenatal care visits. Public interventions needed to improve acceptable antenatal care coverage, women’s education, and further advancing of health care facilities in rural communities should be done to maintain the further improvements acceptable antenatal care visits.
Administration of Saccharomyces boulardii mafic-1701 improves feed conversion ratio, promotes antioxidant capacity, alleviates intestinal inflammation and modulates gut microbiota in weaned piglets
Authors: Zhang Wenxiu , Bao Chengling , Wang Jian , Zang Jianjun , Cao Yunhe
Published: December 2020

Background

Probiotics are used as a means to improve animal health and intestinal development. Saccharomyces boulardii is a well-known probiotic; however, few studies have examined the effects of S. boulardii on weaned piglet performance. Therefore, this 28-day study compared the effects of S. boulardii mafic-1701 and aureomycin in diets for weaned piglets on growth performance, antioxidant parameters, inflammation and intestinal microbiota. One hundred and eight piglets, weaned at 28 d of age (8.5 ± 1.1 kg), were randomly divided into the three dietary treatment groups with six pens and six piglets per pen (half male and half female). The dietary treatment groups were as follows: 1) basal diet (CON); 2) basal diet supplemented with 75 mg/kg aureomycin (ANT); 3) basal diet supplemented with 1 × 108 CFU/kg S. boulardii mafic-1701 (SB).

Results

Compared to CON group, SB group had higher feed efficiency (P < 0.05) in the last 14 d and lower diarrhea rate (P <  0.05) over the entire 28 d. Total superoxide dismutase in serum was markedly increased in SB group (P < 0.05). Moreover, compared with CON group, SB group decreased the levels of pro-inflammatory cytokines interleukin-6 (P <  0.01) and Tumor necrosis factor-α (P < 0.05) in jejunum. Supplementation of S. boulardii mafic-1701 increased the abundance of Ruminococcaceae_UCG_009 and Turicibacter (P < 0.05), whereas the abundance of unclassified_Clostridiaceae_4 was decreased (P < 0.05). Furthermore, S. boulardii mafic-1701 administration increased cecal concentration of microbial metabolites, isobutyrate and valerate (P < 0.05).

Conclusions

The improvement in feed conversion ratio, reduction in diarrhea rate in weaned piglets provided diets supplemented with S. boulardii mafic-1701 may be associated with enhanced antioxidant activity, anti-inflammatory responses and improved intestinal microbial ecology.
Efficacy and safety of bempedoic acid alone or combining with other lipid-lowering therapies in hypercholesterolemic patients: a meta-analysis of randomized controlled trials
Authors: Zhao Xiang , Ma Xubiao , Luo Xing , Shi Zhihua , Deng Ziwen , Jin Yuanxiang , Xiao Zhipeng , Tan Liming , Liu Pingfang , Jiang Shilong , Shu Yuanglu , Tang Bing , Qiu Chengfeng
Published: December 2020

Background

Bempedoic acid is a new drug that reduces cholesterol synthesis via inhibiting ATP citrate lyase. It remains unclear whether the combination of bempedoic acid and other lipid-lowering drugs is better than these drugs alone. This study systematically reviewed the efficacy and safety of bempedoic acid monotherapy or combination togethers in hypercholesterolemic patients.

Methods

Randomized controlled trials were searched across Medline, Embase, Cochrane library, web of science, etc. The net change scores [least squares mean (LSM) percentage change] in LDL-C level were meta-analyzed using weighted mean difference. The reductions in other lipids including total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein (ApoB) and high sensitivity C reactive protein (hsCRP) were also assessed. Odds ratio (OR) of the incidence of adverse events (AEs) were calculated to evaluate the safety of bempedoic acid.

Results

A total of 13 trials (4858 participates) were included. Pooled data showed that the combination togethers resulted in greater reductions in LDL-C level than monotherapies (bempedoic acid + statin vs. statin: LSM difference (%), − 18.37, 95% CI, − 20.16 to − 16.57, I2 = 0; bempedoic acid + ezetimibe vs. ezetimibe: LSM difference (%), − 18.89, 95% CI, − 29.66 to − 8.13, I2 = 87%). But the difference in efficacy between bempedoic acid and ezetimibe was not obvious. Meta-regression analysis showed the treatment duration was a source of heterogeneity (adj R2 = 16.92, 95% CI, 0.04 to 0.72). Furthermore, the background therapy of statin before screening decreased the efficacy of bempedoic acid. In addition, bempedoic acid also resulted in a significant reduction in TC, non-HDL-C, ApoB and hsCRP level. The OR of muscle-related AEs by the combination of bempedoic acid and statin was 1.29 (95% CI, 1.00 to 1.67, I2 = 0) when compared with statin alone.

Conclusion

This study showed the efficacy of combination togethers were similar but stronger than these drugs alone. Of note, a trend of high risk of muscle-related AEs by the combination of bempedoic acid and statin was observed, though it is not statistically significant, such risk is needed to be confirmed by more trials, because it is important for us to determine which is the better combinative administration for statin-intolerant patients.
Dialogic discussion as a platform for constructing knowledge: student-teachers’ interaction patterns and strategies in learning to teach English
Authors: Zhang Lawrence Jun , Zhang Donglan
Published: December 2020

Beginning teachers are frequently heard making observations that the knowledge and skills they have acquired on the training programmes do not come handy when they want to apply them in their real-work situations. They have also reported lacking the ability to integrate theory and practice in reality. Henceforth, teacher-educators are faced with challenges of how to proportionally balance the two strands of pivotal knowledge that are necessarily connected with teacher-education curricula in pre-service teacher preparation. One of the approaches to examining the issue is to investigate student teachers’ dialogues for knowledge-construction to uncover the interaction patterns and strategies they use in negotiating lesson objectives and processes. Against such a background, this paper reports on a study of 24 student teachers receiving training in English language teaching on the Postgraduate Diploma in Education programme at a teacher education institution in Singapore. It was intended to find out the negotiation processes in relation to lesson-planning objectives and how student teachers positioned themselves and others in the processes in the pre-service teacher-education classroom. Results show that student teachers were more concerned about surviving the first lesson than about promoting pupil learning in constructing knowledge about language teaching. The stronger peers’ dominance in the discussion process was taken for granted, suggesting that learning took place in a mutually beneficial and constructive manner and that student teachers’ willingness to cooperate and readiness to express themselves were indicative of their intention to maintain group cohesion and dynamics. These, in turn, are necessary prerequisites for student teachers to become collaborative and reflective practitioners.
Development of acute kidney injury with massive granular casts and microscopic hematuria in patients with COVID-19: two case presentations with literature review
Authors: Fujimaru Takuya , Shimada Keiki , Hamada Takayuki , Watanabe Kimio , Ito Yugo , Nagahama Masahiko , Taki Fumika , Isokawa Shutaro , Hifumi Toru , Otani Norio , Nakayama Masaaki
Published: December 2020

Background

Complications of acute kidney injury (AKI) are common in patients with coronavirus disease in 2019 (COVID-19). However, clinical characteristics of COVID-19-associated AKI are poorly described. We present two cases of severe COVID-19 patients with AKI.

Case presentation

A 77-year-old woman was suspected of having vancomycin-associated AKI, and a 45-year-old man was suspected of having heme pigment-induced AKI caused by rhabdomyolysis. The granular cast, which is known to be a valuable diagnostic tool for confirming the diagnosis of acute tubular necrosis, was detected in both patients at the onset of AKI. Interestingly, both patients also developed microscopic hematuria at the occurrence of AKI, and one patient had elevated d-dimer and low platelet levels simultaneously.

Conclusions

Some reports suggested that COVID-19-associated microangiopathy contributed to the kidney damage. Therefore, it is possible that our patients might have accompanied renal microangiopathy, and that this pathological background may have caused exaggerated tubular damage by vancomycin or heme pigment. The etiology of AKI in patients with COVID-19 is multifactorial. Superimposition of nephrotoxin(s) and virus-associate intra-renal microangiopathy may be a crucial trigger of kidney injury leading to severe AKI in COVID-19 patients. Therefore, in COVID-19 patients, risk factors for AKI should be taken into consideration to prevent its progression into severe AKI.
Individual differences in susceptibility to false memories for COVID-19 fake news
Authors: Greene Ciara M. , Murphy Gillian
Published: December 2020

Exposure to ‘fake news’ can result in false memories, with possible consequences for downstream behaviour. Given the sharp rise in online misinformation during the coronavirus pandemic, it is important to understand the factors that influence the development of false memories. The present study measured susceptibility to false memories following exposure to fabricated news stories about the pandemic in a sample of 3746 participants. We investigated the effect of individual differences in (1) knowledge about COVID-19, (2) engagement with media or discussion about the coronavirus, (3) anxiety about COVID-19 and (4) analytical reasoning. Notably, objectively and subjectively assessed knowledge about COVID-19 were not significantly correlated. Objectively assessed knowledge was associated with fewer false memories but more true memories, suggesting a true discrimination between true and fake news. In contrast, participants who merely believed themselves to be very knowledgeable were more likely to report a memory for true stories, but showed no reduction in false memories. Similarly, individuals who reported high levels of media engagement or anxiety about COVID-19 reported an increase in true (but not false) memories. Finally, higher levels of analytical reasoning were associated with fewer memories for both true and fabricated stories, suggesting a stricter threshold for reporting a memory for any story. These data indicate that false memories can form in response to fake COVID-19 news and that susceptibility to this misinformation is affected by the individual’s knowledge about and interaction with COVID-19 information, as well as their tendency to think critically.
Prognostic factors for the short-term mortality of patients with rheumatoid arthritis admitted to intensive care units
Authors: Fujiwara Toshifumi , Tokuda Kentaro , Momii Kenta , Shiomoto Kyohei , Tsushima Hidetoshi , Akasaki Yukio , Ikemura Satoshi , Fukushi Jun-ichi , Maki Jun , Kaku Noriyuki , Akahoshi Tomohiko , Taguchi Tomoaki , Nakashima Yasuharu
Published: December 2020

Background

Patients with rheumatoid arthritis (RA) have high mortality risk and are frequently treated in intensive care units (ICUs).

Methods

This was a retrospective observational study. This study included 67 patients (20 males, 47 females) with RA who were admitted at the ICU of our institution for ≥48 h between January 2008 and December 2017. We analyzed the 30-day mortality of these patients and the investigated prognostic factors in RA patients admitted to our ICU.

Results

Upon admission, the median age was 70 (range, 33–96) years, and RA duration was 10 (range, 0–61) years. The 5-year survival after ICU admission was 47%, and 30-day, 90-day, and 1-year mortality rates were 22, 27, and 37%, respectively. The major reasons for ICU admission were cardiovascular complications (24%) and infection (40%) and the most common ICU treatments were mechanical ventilation (69%), renal replacement (25%), and vasopressor (78%). In the 30-day mortality group, infection led to a fatal outcome in most cases (67%), and nonsurvival was associated with a significantly higher glucocorticoid dose, updated Charlson’s comorbidity index (CCI), and acute physiology and chronic health evaluation (APACHE) II score. Laboratory data obtained at ICU admission showed that lower platelet number and total protein and higher creatinine and prothrombin time international normalized ratio (PT-INR) indicated significantly poorer prognosis. The multivariate Cox proportional hazard model revealed that nonuse of csDMARDs, high updated CCI, increased APACHE II score, and prolonged PT-INR were associated with a higher risk of mortality after ICU admission.

Conclusion

Our study demonstrated that the nonuse of csDMARDs, high updated CCI, elevated APACHE II score, and coagulation abnormalities predicted poorer prognosis in RA patients admitted to the ICU.
Embolization of the false lumen using IMPEDE-FX embolization plugs as part of treatment of an infrarenal post-dissection aneurysm: a case report
Authors: Jansen Anne-Jet S. , van Schaik Paul M. , Martens Jasper M. , Reijnen Michel M. P. J.
Published: December 2020

Background

This case report demonstrates the value of IMPEDE-FX plugs in an embolization procedure of a false lumen of an infrarenal post-dissection aneurysm.

Case presentation

A 69-year-old patient was treated with mitral valve replacement, complicated by a Stanford type-A dissection. After 9 years he presented with an enlarging infrarenal post-dissection aneurysm. The false lumen was embolized using multiple IMPEDE-FX plugs as part of the treatment in addition to embolization of the inferior mesenteric artery and overstenting of the re-entry in the right iliac artery. At 15 months the CTA showed a fully thrombosed false lumen and remodeling of the true lumen.

Conclusions

The false lumen of an infrarenal post-dissection aneurysm can successfully be embolized using IMPEDE-FX embolization plugs as part of the treatment strategy. Prospective trials on patients with non-thrombosed false lumina are indicated.
Usefulness of coil-assisted retrograde transvenous obliteration II (CARTO-II) for the treatment of ascending colonic varix: a case report
Authors: Maeda Hiroyuki , Kageyama Ken , Yamamoto Akira , Jogo Atsushi , Sohgawa Etsuji , Matsushita Kazuki , Asano Kazuo , Yonezawa Hiroki , Nota Takehito , Murai Kazuki , Ogawa Satoyuki , Miki Yukio
Published: December 2020

Background

Colonic varices are rare among ectopic varices. A previous report demonstrated that once bleeding from colonic varices occurs, it can be fatal. Several treatments for colonic varices exist, including surgical, endoscopic, and endovascular treatments; however, management of colonic varices has not been standardized. For colonic varices, minimally invasive therapies would be desirable. Balloon-occluded retrograde transvenous obliteration (B-RTO) is one of the treatment options for colonic varices to prevent their rupture. Two cases of successful conventional B-RTO for these varices have already been reported. However, B-RTO using coil-assisted retrograde transvenous obliteration II (CARTO-II) procedure for these varices has not been reported.

Case presentation

A 71-year-old male patient had liver cirrhosis caused by hepatitis C virus infection. A varix was located at the ascending colon, which was coincidentally found on colonic endoscopy. Contrast-enhanced computed tomography (CT) showed that the feeder vein was the ileocolic vein and that the main draining vein was the right renal vein. Physicians concluded that treatment was required to avoid the risk of death from massive bleeding due to varix rupture. However, endoscopic and surgical treatments were difficult due to the anatomical location of the varix and the high risk of operative compilations, respectively. This ascending colonic varix was treated by balloon-occluded retrograde transvenous obliteration (B-RTO) using coil-assisted retrograde transvenous obliteration II (CARTO-II) procedure via the right renal vein. There were no complications during the procedure and no recurrences for 36 months during long-term follow-up.

Conclusions

CARTO-II can be one of the effective treatment techniques for ascending colonic varices.
Virucidal activity of silver nanoparticles against Banana bunchy top virus (BBTV) in banana plants
Authors: Mahfouze Heba A. , El-Dougdoug Noha K. , Mahfouze Sherin A.
Published: December 2020

Background

Banana bunchy top virus(BBTV) is a destructive viral disease in many countries including Egypt; it causes severe economic losses in banana crop. Recently, nanotechnology was used to generate resistance against plant viruses. The main purpose of this study was to use silver nanoparticles (AgNPs) as antiviral agents against BBTV. In this research, three different concentrations of AgNPs (40, 50 and 60 ppm) were applied by foliar spray post-BBTV inoculation. In addition, photopigments, oxidative enzymes, proline and phenolic compounds were determined. Besides, Random amplified polymorphic DNA (RAPD) and Sequence-related amplified polymorphism (SRAP) markers were used to evaluate the genotoxicity of AgNPs as antiviral factors against BBTV, compared with the control plants.

Results

In the current study, it was observed that banana plants infected with BBTV and treated with 50 ppm AgNPs have not shown any external symptoms where the rate of infection was 36%. On the other hand, banana plants treated with 50 ppm AgNPs after viral infection gave a significant increase in dry weight and leaf area, compared with BBTV infected banana plants (viral control). Our study showed that 50 ppm AgNPs treatment post-virus inoculation induced non-significantly and significant changes in chlorophyll (a and b) and carotenoids, respectively, compared with healthy and nano-controls. In contrast, phenol, proline and oxidative enzymes were significantly increased in all plants treated with 50 ppm AgNPs post-virus inoculation, compared with the healthy control. Our findings observed that the banana plants sprayed with 50 ppm AgNPs after BBTV infection induced a few changes at the genomic DNA level in the banana plants, whereas both RAPD and SRAP markers scored nearly the same polymorphism 36.99 and 37.5%, respectively. So, genotoxicity induced by banana plants treated with 50 ppm AgNPs post-BBTV inoculation was low.

Conclusions

It is evident from the study results the role of AgNPs as a novel, safe and effective antiviral agent against BBTV. These results should be taken into consideration in future for the use of AgNPs for plant viruses management.
Heel pain in female patients with early knee osteoarthritis
Authors: Imam Mohamed Hassan , Korium Hamdy , Afifi Ahmed Hafez Ahmed , Abd El-Moniem Heba Alla Mohamed , Abdel-Fatah Yousra Hisham
Published: December 2020

Background

Multiple lower limb joint involvement is one of the most common and debilitating musculoskeletal conditions, while the complaints from both heel and knee pain are considered the most frequent. For that reason, in this cross-sectional study, the association between heel pain (HP) and early knee osteoarthritis (EKOA) was investigated; the most painful site and side of HP, the prevalence, and risk factors for disabling HP in patients with EKOA were identified.

Results

Bilateral HP (56%) and posterior HP (54%) were found to be the most prevalent complaints, and 66% of patients reported the HP to be non-disabling. There was a very high positive statistically significant correlation between the Manchester Foot Pain Disability Index (MFPDI) and both the Health Assessment Questionnaire (HAQ) and the total Western Ontario and McMaster University Osteoarthritis (WOMAC) score (p≤ 0.001), while there was a high negative statistically significant correlation between MFPDI and quadriceps angle of the most affected knee (p= 0.002). A higher total WOMAC score (OR 1.077, 95% CI 1.014 to 1.145) significantly increases the risk of developing disabling HP, while wearing 2–3-cm heels during the past month was found to be protective against the development of disabling HP (odds ratio < 1).

Conclusion

Disabling HP was present in a third of patients with EKOA and HP, and it was associated with flat shoe wear as well as a high total WOMAC score. Also, it had a statistically significant correlation with varus knee mal-alignment. Furthermore, decreased functional ability in the presence of HP was found to lead to significant disability. Moreover, a striking finding in this study was the longer mean duration of HP compared to the duration of knee symptoms.
Creatine kinase elevation and discontinuation of clozapine: fear-driven clinical practice in a forensic case with treatment-resistant schizophrenia and persistent violent behaviour
Authors: Bokern Hein , Jonker Niels , Cohen Dan
Published: December 2020

In forensic settings, the most common indication for clozapine is treatment-resistant schizophrenia (TRS). Clozapine has also been shown to be effective in reducing hostility, aggression and violence in patients with schizophrenia and is of benefit in comorbid substance use disorders. The decision to initiate or to discontinue recently initiated clozapine can have a profound beneficial or detrimental influence on the lives and safety of patients and the staff caring for them. We present a case in which treatment with clozapine proved effective in spite of earlier repeated discontinuation of clozapine out of fear of neuroleptic malignant syndrome (NMS). Elevation of creatine kinase was deemed to be indicative of NMS in the absence of clinical signs of NMS. In somatic medicine, it is well known that creatine kinase elevation has many causes, most of them non-harmful. Collaboration with clinical chemistry was shown to be very useful, if not essential; research in the 1980s found replicated evidence for both sex and race differences in creatine kinase levels. In addition, substantial intra-individual variation has been found over time in healthy individuals. The creatine kinase levels of this patient of African descent were within normal limits for the African population. Baseline creatine kinase assessment and repetition of this assessment after 2 weeks with careful interpretation are recommended in all clozapine-treated patients. The authors advocate the introduction of evidence-based creatine kinase cut-off points that reflect the biological differences between the sexes and among races. More intensive contact between psychiatrists and clinical chemist can facilitate faster diagnosis and better treatment.
Autosomal Dominant Hypocalcemia With Atypical Urine Findings Accompanied by Novel CaSR Gene Mutation and VitD Deficiency
Authors: Tsuji Tomoya , Hiroyuki Ariyasu , Uraki Shinsuke , Doi Asako , Morita Shuhei , Iwakura Hiroshi , Nishi Masahiro , Furuta Hiroto , Akamizu Takashi
Published: December 2020

Introduction

Autosomal dominant hypocalcemia (ADH) is caused by gain-of-function mutations of the calcium sensing receptor (CaSR). It is characterized by hypercalciuria in spite of hypocalcemia. Vitamin D deficiency increases calcium reabsorption in the distal tubules of the kidneys, resulting in hypocalciuria.

Materials and methods

A 38-year-old female proband had hypocalcemia, hypocalciuria, and vitamin D deficiency. Her father and brother also had hypocalcemia, but her mother was normocalcemic. We analyzed the CaSR gene abnormality in this family. Polymerase chain reaction (PCR) and sequence analysis were performed to explore the CaSR gene mutation. Mutagenesis, transfection, and functional analysis were performed on the discovered genetic abnormalities.

Result

PCR and sequence analysis revealed that the proband, her father, and brother had a novel heterozygous mutation of the CaSR genes that causes threonine to asparagine substitution at codon 186 (T186N). Using HEK293 cells transfected with wild-type or T186N CaSR complementary DNA, we assessed the intracellular Ca2+ concentration in response to changes in the extracellular Ca2+ concentration. The cells transfected mutant CaSR gene had higher activity than that of wild-type. Therefore, we determined our patient had ADH with a novel mutation of the CaSR gene and hypocalciuria resulting from a vitamin D deficiency. We administered vitamin D to the proband, which caused elevation of her urinary calcium level, a typical finding of ADH.

Conclusion

Vitamin D deficiency was suggested to potentially mask hypercalciuria in ADH. Hypocalcemia with vitamin D deficiency should be diagnosed with care.
Kindlin-2 promotes rear focal adhesion disassembly and directional persistence during cell migration
Authors: Liu Jie , Liu Zhongzhen , Chen Keng , Chen Wei , Fang Xiyuan , Li Meng , Zhou Xuening , Ding Ning , Lei Huan , Guo Chen , Qian Tao , Wang Yilin , Liu Lin , Chen Yonglong , Zhao Hui , Sun Ying , Deng Yi , Wu Chuanyue
Published: December 2020

Cell migration involves front-to-rear asymmetric focal adhesion (FA) dynamics, which facilitates trailing edge detachment and directional persistence. Here, we show that kindlin-2 is crucial for FA sliding and disassembly in migrating cells. Loss of kindlin-2 markedly reduced FA number and selectively impaired rear FA sliding and disassembly, resulting in defective rear retraction and reduced directional persistence during cell migration. Kindlin-2-deficient cells failed to develop serum-induced actomyosin-dependent tension at FAs. At the molecular level, kindlin-2 directly interacted with myosin light chain kinase (MYLK, hereafter referred to as MLCK), which was enhanced in response to serum stimulation. Serum deprivation inhibited rear FA disassembly, which was released in response to serum stimulation. Overexpression of the MLCK-binding kindlin-2 F0F1 fragment (amino acid residues 1–167), which inhibits the interaction of endogenous kindlin-2 with MLCK, phenocopied kindlin-2 deficiency-induced migration defects. Inhibition of MLCK, like loss of kindlin-2, also impaired trailing-edge detachment, rear FA disassembly and directional persistence. These results suggest a role of kindlin-2 in promoting actomyosin contractility at FAs, leading to increased rear FA sliding and disassembly, and directional persistence during cell migration.
Gap junction internalization and processing in vivo: a 3D immuno-electron microscopy study
Authors: Norris Rachael P. , Terasaki Mark
Published: December 2020

Gap junctions have well-established roles in cell–cell communication by way of forming permeable intercellular channels. Less is understood about their internalization, which forms double membrane vesicles containing cytosol and membranes from another cell called connexosomes or annular gap junctions. Here, we systematically investigated the fate of connexosomes in intact ovarian follicles. High-pressure frozen, serial-sectioned tissue was immunogold labeled for connexin 43 (Cx43, also known as GJA1). Within a volume corresponding to ∼35 cells, every labeled structure was categorized and had its surface area measured. Measurements support the concept that multiple connexosomes form from larger invaginated gap junctions. Subsequently, the inner and outer membranes separate, Cx43 immunogenicity is lost from the outer membrane, and the inner membrane appears to undergo fission. One pathway for processing involves lysosomes, based on localization of cathepsin B to some processed connexosomes. In summary, this study demonstrates new technology for high-resolution analyses of gap junction processing.

This article has an associated First Person interview with the first author of the paper.
Binding Evaluation of Pradimicins for Oligomannose Motifs from Fungal Mannans
Authors: Nakagawa Yu , Yamaji Fumiya , Miyanishi Wataru , Ojika Makoto , Igarashi Yasuhiro , Ito Yukishige
Published: December 2020

Pradimicins (PRMs) are a unique family of natural products that exhibit antifungal activity via binding to cell wall mannans of fungi. Although their mannan-targeted antifungal action has attracted considerable interest, there is still only limited knowledge as to how PRMs bind to mannans. In this study, we evaluated the relative binding affinity of PRMs for synthetic oligomannoses, which reflect the structural motifs characteristic of cell wall mannans from Candida albicans. Two complementary binding assays revealed a strong preference of PRMs for branched oligomannose motifs with multiple mannose residues at the non-reducing ends. In addition, oligomannose mimics, in which two mannoses are bridged by polyethylene glycol spacers, were found to behave similarly to two-branched oligomannoses in both assays. These results indicate that PRMs preferentially bind to highly branched regions of fungal mannans via the simultaneous recognition of multiple terminal mannose residues.
Cross-sectional study of Facebook addiction in a sample of Nepalese population
Authors: Atreya Alok , Nepal Samata , Thapa Prakash
Published: December 2020

Background: Facebook addiction is said to occur when an individual spends an excessive amount of time on Facebook, disrupting one’s daily activities and social life. The present study aimed to find out the level of Facebook addiction in the Nepalese context and briefly discuss the issues associated with its unintended use.

Methods: A descriptive cross-sectional study was conducted in the Department of Forensic Medicine of Lumbini Medical College. The study instrument was the Bergen Facebook Addiction Scale typed into a Google Form and sent randomly to Facebook contacts of the authors. The responses were downloaded in a Microsoft Excel spreadsheet and analyzed using Statistical Package for Social Sciences version 16.

Results: The study consisted of 103 Nepalese participants, of which 54 (52.42%) were males and 49 females (47.58%). There were 11 participants (10.68%) who had more than one Facebook account. It was observed that 8.73% (n=9) to 39.80% (n=41) were addicted to Facebook.

Conclusion: When used properly Facebook has its own advantages. Excessive use is linked with health hazards including addiction and dependency. Students who engage more on Facebook may have less time studying, leading to poor academic performance. People need to be made aware of the issues associated with the misuse of Facebook.
Assessment of the performance of the Brazilian Portuguese Nottingham Health Profile in adult growth hormone deficiency and pulmonary hypertension
Authors: Heaney Alice , de Oliveira Rafael W. R. , Bizzi Mariana , Correa Ricardo Amorim , Corso Pereira Monica , Simao Mol Suelem , Santana Soares Beatriz , McKenna Stephen P. , Ribeiro-Oliveira Jr Antonio ,   Study Investigators
Published: December 2020

Background: The Nottingham Health Profile (NHP) is a generic measure of perceived distress that has been used widely as an outcome measure in clinical practice and trials. The availability of two Brazilian datasets provided the opportunity to assess the psychometric performance of the NHP in different populations - adult growth hormone deficiency (GHD) and pulmonary hypertension (PH). The purpose of the study was to see how valuable the NHP could be in assessing outcomes in diseases where no disease-specific measures are available.

Methods: Secondary analyses were performed with NHP data. Patients diagnosed with adult GHD or PH were administered the NHP during clinic visits on two occasions, two weeks apart. A disease-specific measure of quality of life (QoL) was also administered to the relevant sample of patients on each occasion.

Results: The psychometric properties of the NHP were good for both disease groups. As expected, both samples reported high scores on energy level, the PH sample scored high on physical functioning and the GHD sample on emotional reactions. For both samples, most of the NHP sections were able to distinguish between groups of respondents with different ratings of perceived general health. While most sections of the NHP were relatively highly correlated with the QoL measures, pain and sleep did not seem to be important predictors of QoL in either of the samples.

Conclusions: The use of the NHP in adult GHD and PH populations in Brazil is not recommended as there are high-quality disease-specific measures available for each disease. However, where no disease-specific measures are available, the NHP can provide good descriptive information of the impact of disease on different patient populations.
The future of genomics in Ireland – focus on genomics for health
Authors: Seoighe Cathal , Bracken Adrian P. , Buckley Patrick , Doran Peter , Green Robert , Healy Sandra , Kavanagh David , Kenny Elaine , Lawler Mark , Lowery Maeve , Morris Derek , Morrissey Darrin , O'Byrne James J. , Shields Denis , Smith Owen , Steward Charles A. , Sweeney Brian , Kolch Walter
Published: December 2020

Genomics is revolutionizing biomedical research, medicine and healthcare globally in academic, public and industry sectors alike. Concrete examples around the world show that huge benefits for patients, society and economy can be accrued through effective and responsible genomic research and clinical applications. Unfortunately, Ireland has fallen behind and needs to act now in order to catch up. Here, we identify key issues that have resulted in Ireland lagging behind, describe how genomics can benefit Ireland and its people and outline the measures needed to make genomics work for Ireland and Irish patients. There is now an urgent need for a national genomics strategy that enables an effective, collaborative, responsible, well-regulated, and patient centred environment where genome research and clinical genomics can thrive.  We present eight recommendations that could be the pillars of a national genomics health strategy.
The Source Base for Research into Training of Water Sports Coaches-Teachers at Higher Education Establishments of Ukraine (the second half of XX – the beginning of XXI century)
Authors:   State Institution Luhansk Taras Shevchenko National University, Plotnikova Katerina
Published: December 2020

The article analyses the source base of the issue of training water sports coaches-teachers in higher education institutions of Ukraine. The study has used a set of sources divided into certain groups on several grounds. Sources of archives, libraries and sources of own storage have been singled out according to the location. A number of unknown and inaccessible sources have been described. They have enabled the author to highlight the socio-economic and pedagogical preconditions for training of water sports coaches-teachers in higher education institutions of Ukraine (the second half of XX – the beginning of XXI century). The library array of literary sources relevant for the representation of a picture of the formation, development of the general bases, the maintenance, means, forms and methods of training the specialists has been addressed. Self-storage documents have also been studied. This has elucidated and allowed to track the process of improving the qualification component of water sports coaches-teachers in the process of training in higher education institutions of Ukraine (the second half of XX – the beginning of XXI century). Groups of sources according to the types of publications have been analysed. It has been discovered that the study of the problem of training of water sports coaches-teachers in higher education institutions of Ukraine (the second half of XX – the beginning of XXI century) is based on materials that contain: legal documents, reference and encyclopedic sources, statistical materials, literary works on History of Pedagogy and History of Physical Education and Sports, educational and methodical publications, dissertations, abstracts, periodicals and conference materials.
Implications of a US study on infection prevention and control in community settings in the UK
Authors: Dowding Dawn , McDonald Margaret V. , Shang Jingjing
Published: December 2020

Healthcare-associated infections are a significant reason for readmission to hospital post-discharge to the community. In this paper, the authors describe some of the key findings from a programme of work conducted in a home care agency (community care organisation) in the US. A survey was conducted to explore home care nurses' knowledge, attitudes and beliefs around infection control (n=415); 400 nurse-patient visits were observed, and 50 nurses were interviewed about their infection control practices. Nurses reported high compliance with infection control practices. However, the overall average adherence rate to observed hand hygiene practices was 45.6%. Interview data provided valuable insights into specific challenges faced by nurses in a home care setting. This study provides insights that can be used to enhance infection control practice in community care in the UK.
Major new survey of care home leaders confirms severe impact of COVID-19
Authors: Bradby Matthew
Published: December 2020

The Queen's Nursing Institute, the world's oldest nursing charity, has published a major new report on the effect of the COVID-19 pandemic on the UK's nursing and residential homes.
Arthroscopic and open debridement in primary elbow osteoarthritis: a systematic review and meta-analysis
Authors: de Klerk Huub H. , Welsink Chantal L. , Spaans Anne J. , Verweij Lukas P. E. , van den Bekerom Michel P. J.
Published: December 2020

Primary osteoarthritis (OA) of the elbow can cause disabling symptoms of pain, locking, stiffness, and a limitation in the range of motion. There is no consensus regarding the role of open and arthroscopic debridement in the treatment of symptomatic primary elbow OA. The aim of this study is to systematically review the outcome of surgical debridement. A preoperative/postoperative comparison will be made between the two surgical procedures. All studies reporting on debridement as treatment for primary elbow OA with a minimum of one-year follow-up were included. Outcome parameters were functional results, complications, and performance scores. Data were extracted from 21 articles. The arthroscopic group consisted of 286 elbows with a weighted mean follow-up of 40 ± 17 months (range, 16–75). The open group consisted of 300 elbows with a weighted mean follow-up of 55 ± 20 months (range, 19–85). Both procedures showed improvement in Mayo Elbow Performance Score (MEPS), range of motion (ROM) flexion-extension, and ROM pronation-supination. Only in ROM flexion was a statistically significant difference in improvement seen between the groups in favour of the open group. The arthroscopic group showed improvement in pain visual analogue scale (VAS) scores. Nothing could be stated about pain VAS scores in the open group due to a lack of data. In the arthroscopic group 18 complications (6%) were described, in the open group 29 complications (12%). Surgical debridement is an effective treatment for the disabling symptoms of primary elbow OA with an acceptable complication rate.

Cite this article: EFORT Open Rev 2020;5:874-882. DOI: 10.1302/2058-5241.5.190095
Robotics in total hip arthroplasty: a review of the evolution, application and evidence base
Authors: St Mart Jean-Pierre , Goh En Lin , Shah Zameer
Published: December 2020

Robotic systems used in orthopaedics have evolved from active systems to semi-active systems. Early active systems were associated with significant technical and surgical complications, which limited their clinical use. The new semi-active system Mako has demonstrated promise in overcoming these limitations, with positive early outcomes. There remains a paucity of data regarding long-term outcomes associated with newer systems such as Mako and TSolution One, which will be important in assessing the applicability of these systems. Given the already high satisfaction rate of manual THA, further high-quality comparative studies are required utilizing outcome scores that are not limited by high ceiling effects to assess whether robotic systems justify their additional expense.

Cite this article: EFORT Open Rev 2020;5:866-873. DOI: 10.1302/2058-5241.5.200037
An analytical review on electric Propulsion system for space satellites
Authors: BASU Sourav , CHATURVEDI Sudhir Kumar , BANERJEE Saikat , ADHIKARY Subhrangshu
Published: December 2020

This paper describes the latest advances in electric propulsion systems prepared for the new space exploration activity. Missions to the Moon and Mars will require these new thrusters to convey the huge amounts of provisions that would be expected to help changeless bases on other universes. The new advancements are likewise being utilized for unmanned investigation missions that will go to the furthest reaches of the nearby planetary group. This paper is expected to provide some insight into some ideas for electric propulsion - standards and work skills, as well as a diagram of mission applications that would benefit from these frame drives and their use with state-of-the-art control systems.