bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence and predictors of COVID-19 and flares in patients with rare autoimmune diseases: a systematic survey and serological study at a national reference center in France
Authors: Felten Renaud , Scherlinger Marc , Guffroy Aurélien , Poindron Vincent , Meyer Alain , Giannini Margherita , Korganow Anne-Sophie , Sordet Christelle , Chatelus Emmanuel , Javier Rose-Marie , Meyer Aurore , Pijnenburg Luc , Kleinmann Jean-François , Gottenberg Jacques-Eric , Sibilia Jean , Martin Thierry , Arnaud Laurent
Published: July 2021

Background

The risk of severe COVID-19 and its determinants remain largely unknown in patients with autoimmune and inflammatory rheumatic diseases. The objective of this study was to assess the prevalence of COVID-19 infection in patients followed for rare autoimmune diseases as well as the predictors of COVID-19 and disease flare-ups.

Methods

Cross-sectional phone survey from April 9, 2020, to July 2, 2020, during which patients with autoimmune diseases followed at the National Reference Center for Rare Autoimmune diseases of Strasbourg were systematically contacted by phone and sent a prescription for a SARS-CoV-2 serology.

Results

One thousand two hundred thirty-two patients were contacted. One thousand fifty-five patients with a confirmed diagnosis of systemic autoimmune disease were included (4 unreachable, 4 moves abroad, 5 deaths before pandemic, 50 without consent, and 114 without autoimmune disease). Among them, 469 (44.5%) patients were tested for SARS-CoV-2 serology.

Thirty-nine patients (7.9%) had SARS-CoV-2 infection (either through chest CT-scan [n = 5], RT-PCR on nasopharyngeal swab [n = 14], or serology [n = 31]) among the 496 who underwent at least one of those 3 diagnosis modalities. Of the 39 proven cases, 33 had clinical manifestations (6 asymptomatic patients were diagnosed through systematic serology testing), 31 were managed by home care, 3 were hospitalized due to a need for oxygenation, two required admission to an intensive care unit, and one died. Among patients with confirmed SARS-CoV-2 infection, reported flares were more frequent than in uninfected patients (26.3% [10/38] vs. 7.0% [32/457], p < 0.0001). Preventive sick leave had no significant impact on the prevalence of SARS-CoV-2 infection (5.8% [3/53]) compared to work continuation (7.6% [30/397], p = 0.64).

Overall, the seroprevalence of SARS-CoV-2 was 6.6% (31/469) which was numerically lower to the Grand-Est general population estimated to be 9.0%.

Conclusions

This systematic survey of more than 1000 patients with rare systemic autoimmune diseases reports a low prevalence of proven SARS-CoV-2 infection and very rare severe infections, probably related to good compliance with prophylactic measures in these patients.
Circulating microRNA alternations in primary hyperuricemia and gout
Authors: Bohatá Jana , Horváthová Veronika , Pavlíková Markéta , Stibůrková Blanka
Published: July 2021

Objectives

MicroRNAs (miRNAs) are short single-stranded RNAs that play a role in the post-transcriptional regulation of gene expression. Their deregulation can be associated with various diseases, such as cancer, neurodegenerative, and immune-related diseases. The aim of our study was to compare miRNA levels in plasma that could potentially influence the progression of hyperuricemia to gout, since the mechanism of progression is still unclear.

Methods

Total RNA, including miRNA, was isolated from the plasma of 45 patients with asymptomatic hyperuricemia, 131 patients with primary gout (including 16 patients having a gout attack), and 130 normouricemic controls. The expression of 18 selected miRNAs (cel-miR-39 and cel-miR-54 as spike-in controls, hsa-miR-16-5p and hsa-miR-25-3p as endogenous controls, hsa-miR-17-5p, hsa-miR-18a-5p, hsa-miR-30a-3p, hsa-miR-30c-5p, hsa-miR-126-3p, hsa-miR-133a-3p, hsa-miR-142-3p, hsa-miR-143-3p, hsa-miR-146a-5p, hsa-miR-155-5p, hsa-miR-222-3p, hsa-miR-223-3p, hsa-miR-488-3p and hsa-miR-920) was measured using qPCR.

Results

We found that hsa-miR-17-5p, hsa-miR-18a-5p, hsa-miR-30c-5p, hsa-miR-142-3p, and hsa-miR-223-3p were significantly upregulated (p< 0.001) in the plasma of hyperuricemia and gout patients compared to normouricemic individuals. As part of the follow-up of our previous study, we found a negative correlation between hsa-miR-17-5p, hsa-miR-30c-5p, hsa-miR-126-3p, hsa-miR-142-3p, and hsa-miR-223-3p with plasma levels of chemokine MCP-1. Additionally, we found a positive correlation between CRP and plasma levels of hsa-miR-17-5p, hsa-miR-18a-5p, hsa-miR-30c-5p, hsa-miR-126-3p, hsa-miR-142-3p, hsa-miR-146a-5p, hsa-miR-155-5p, hsa-miR-222-3p, and hsa-miR-223-3p. Five of those miRNAs (hsa-miR-126-3p, hsa-miR-142-3p, hsa-miR-146a-5p, hsa-miR-155-5p, and hsa-miR-222-3p) also had a positive correlation with serum creatinine and therefore a negative correlation with eGFR.

Conclusion

Five miRNAs were significantly upregulated in the plasma of patients with hyperuricemia and gout (and those during a gout attack) compared to normouricemic controls. We also found a correlation between the plasma levels of several miRNA and plasma levels of MCP-1, CRP, serum creatinine, and eGFR.
Right-sided strangulating diaphragmatic hernia in an adult without history of trauma: a case report
Authors: Spiridakis Konstantinos G. , Flamourakis Mathaios E. , Gkionis Ioannis G. , Kaloeidi Eleni I. , Fachouridi Anthoula I. , Konstantoulaki Styliani E. , Tsagkataki Eleni S. , Giakoumakis Michail I. , Vassilogiannakis Emmamouil A. , Kostakis Georgios E. , Christodoulakis Manousos S.
Published: July 2021

Background

Diaphragmatic hernia involves protrusion of abdominal contents into the thorax through a defect in the diaphragm. This defect can be caused either by developmental failure of the posterolateral foramina to fuse properly, or by traumatic injury of the diaphragm. Left-sided diaphragmatic hernias are more common (80–90%) because the right pleuroperitoneal canal closes earlier and the liver protects the right diaphragm. Diaphragmatic hernias in adults are relatively asymptomatic, but in some cases may lead to incarcerated bowel, intraabdominal organ dysfunction, or severe pulmonary disease. The aim of this report is to enlighten clinical doctors about this rare entity that can have fatal consequences for the patient.

Case presentation

We present a rare case of a right-sided strangulating diaphragmatic hernia in an adult Caucasian patient without history of trauma. Clinical examination revealed bowel sounds in the right hemithorax, which were confirmed by the presence of loops of small intestine into the right part of the thorax through the right diaphragm, as was shown on chest X-ray and computerized tomography. Deterioration of the clinical status of the patient led to an operation, which revealed strangulated necrotic small bowel. Approximately 1 m of bowel was removed, and laterolateral anastomosis was performed. The patient had an uneventful postoperative recovery and was discharged 8 days later.

Conclusions

Surgery is required to replace emerged organs into the abdomen and to repair diaphragmatic lesion. A delayed approach can have catastrophic complications for a patient.
Complete remission in metastatic primary malignant melanoma of the esophagus with nivolumab: a case report
Authors: Okamoto Takeshi , Nakano Eriko , Yamauchi Teruo
Published: July 2021

Background

Primary malignant melanoma of the esophagus is a rare form of mucosal melanoma with a poor prognosis. While immune checkpoint inhibitors have recently extended overall survival in metastatic melanoma, data on their effects on primary malignant melanoma of the esophagus are limited because of its rarity. Here, we report the first case of long-term complete remission of metastatic primary malignant melanoma of the esophagus after nivolumab monotherapy.

Case presentation

A 79-year-old Asian man with a history of prostate cancer, gallbladder cancer, deep vein thrombosis, hypertension, and diabetes mellitus presented with gross hematuria. Cystoscopy revealed a solitary tumor on the right posterior wall of the bladder, and transurethral resection of bladder tumor was performed. Pathology was consistent with metastatic melanoma. A pigmented submucosal tumor-like growth in the esophagus was discovered on esophagogastroduodenoscopy. Computed tomography showed widespread metastases. The patient was diagnosed as having primary malignant melanoma of the esophagus with metastases to the stomach, subcutaneous tissue, lung, bladder, pleura, and peritoneum. Complete remission was achieved after seven cycles of triweekly nivolumab monotherapy. While nivolumab was discontinued because of kidney injury, the patient has remained tumor-free for over 4 years without further treatment.

Conclusion

Immune checkpoint inhibitors may have astonishing curative effects in selected populations. More research is warranted to identify factors that increase the likelihood of achieving complete remission in primary malignant melanoma of the esophagus as well as in other melanomas.
A solitary pulmonary nodule caused by Mycobacterium avium with pleural effusion and pleuritis after transbronchial biopsy: a case report
Authors: Nukaga Shigenari , Murakami Hiroaki , Yagi Kazuma , Satomi Ryosuke , Oyama Takahiko , Maeshima Arafumi , Oyamada Yoshitaka
Published: July 2021

Background

Pleural effusion and pleuritis are uncommon manifestations of Mycobacterium avium complex pulmonary disease. Pleuritis caused by Mycobacterium avium complex pulmonary disease presenting as a solitary pulmonary nodule is extremely rare. The pathogenesis of Mycobacterium avium complex pleuritis has not been elucidated. However, it has been suggested that secondary spontaneous pneumothorax from Mycobacterium avium complex pulmonary disease is one of the causes of Mycobacterium avium complex pleuritis.

Case presentation

A 67-year-old Japanese woman who presented with a solitary pulmonary nodule developed a transient pneumothorax after transbronchial biopsy. A definitive diagnosis of solitary pulmonary nodule could not be made on bronchoscopy, so video-assisted thoracoscopic surgery was performed 1 month after bronchoscopy. On the day of hospitalization for the procedure, a left-sided pleural effusion appeared on a chest radiograph. Thickening of the parietal and visceral pleura and numerous scattered white small granules were seen on thoracoscopy. Histologic examination of the resected left lower lobe and a biopsy of the parietal pleura showed Mycobacterium avium complex solitary pulmonary nodule and Mycobacterium avium complex pleuritis.

Conclusion

Iatrogenic pneumothorax can be a cause of pleuritis in a patient with Mycobacterium avium complex pulmonary disease. Clinicians should watch for the appearance of secondary pleuritis after transbronchial biopsy even in a patient with localized disease such as Mycobacterium avium complex solitary pulmonary nodule.
Potential application of human neural crest-derived nasal turbinate stem cells for the treatment of neuropathology and impaired cognition in models of Alzheimer’s disease
Authors: Lim Jung Yeon , In Park Sang , Park Soon A. , Jeon Jung Ho , Jung Ho Yong , Yon Jung-Min , Jeun Sin-Soo , Lim Hyun Kook , Kim Sung Won
Published: July 2021

Background

Stem cell transplantation is a fascinating therapeutic approach for the treatment of many neurodegenerative disorders; however, clinical trials using stem cells have not been as effective as expected based on preclinical studies. The aim of this study is to validate the hypothesis that human neural crest-derived nasal turbinate stem cells (hNTSCs) are a clinically promising therapeutic source of adult stem cells for the treatment of Alzheimer’s disease (AD).

Methods

hNTSCs were evaluated in comparison with human bone marrow-derived mesenchymal stem cells (hBM-MSCs) according to the effect of transplantation on AD pathology, including PET/CT neuroimaging, immune status indicated by microglial numbers and autophagic capacity, neuronal survival, and cognition, in a 5 × FAD transgenic mouse model of AD.

Results

We demonstrated that hNTSCs showed a high proliferative capacity and great neurogenic properties in vitro. Compared with hBM-MSC transplantation, hNTSC transplantation markedly reduced Aβ42 levels and plaque formation in the brains of the 5 × FAD transgenic AD mice on neuroimaging, concomitant with increased survival of hippocampal and cortex neurons. Moreover, hNTSCs strongly modulated immune status by reducing the number of microglia and the expression of the inflammatory cytokine IL-6 and upregulating autophagic capacity at 7 weeks after transplantation in AD models. Notably, compared with transplantation of hBM-MSCs, transplantation of hNTSCs significantly enhanced performance on the Morris water maze, with an increased level of TIMP2, which is necessary for spatial memory in young mice and neurons; this difference could be explained by the high engraftment of hNTSCs after transplantation.

Conclusion

The reliable evidence provided by these findings reveals a promising therapeutic effect of hNTSCs and indicates a step forward the clinical application of hNTSCs in patients with AD.
A low-complexity channel training method for efficient SVD beamforming over MIMO channels
Authors: Kettlun Felipe , Rosas Fernando , Oberli Christian
Published: July 2021

Singular value decomposition (SVD) beamforming is an attractive tool for reducing the energy consumption of data transmissions in wireless sensor networks whose nodes are equipped with multiple antennas. However, this method is often not practical due to two important shortcomings: it requires channel state information at the transmitter and the computation of the SVD of the channel matrix is generally too complex. To deal with these issues, we propose a method for establishing an SVD beamforming link without requiring feedback of actual channel or SVD coefficients to the transmitter. Concretely, our method takes advantage of channel reciprocity and a power iteration algorithm (PIA) for determining the precoding and decoding singular vectors from received preamble sequences. A low-complexity version that performs no iterations is proposed and shown to have a signal-to-noise-ratio (SNR) loss within 1 dB of the bit error rate of SVD beamforming with least squares channel estimates. The low-complexity method significantly outperforms maximum ratio combining diversity and Alamouti coding. We also show that the computational cost of the proposed PIA-based method is less than the one of using the Golub–Reinsch algorithm for obtaining the SVD. The number of computations of the low-complexity version is an order of magnitude smaller than with Golub–Reinsch. This difference grows further with antenna array size.
Novel channel-hopping pattern-based wireless IoT networks in smart cities for reducing multi-access interference and jamming attacks
Authors: Liu Yiming , Zeng Qi , Zhao Yue , Wu Kaijun , Hao Yao
Published: July 2021

In smart cities, the Internet-of-Thing (IoT) provides an enabling communication infrastructure to support tremendous amount of data exchange. Most IoT applications, e.g., wireless local area network, Bluetooth and so forth, utilize the channel-hopping scheme to suppress the transmission security threats. In this paper, to reduce the mutual interference and external jamming attacks, multiple novel channel-hopping patterns, i.e., traditional no-hit-zone (NHZ) hopping pattern and generalized NHZ hopping pattern, are introduced to suit to IoT networks. Particularly the design of probabilistic hopping pattern is first proposed, which has the various usage probabilities with regard to various channels. The properties of these hopping patterns are investigated by the step-to-step examples. Then, the error-rate performance of the multi-node IoT systems adopting these hopping patterns in the presence of jamming attacks is comprehensively analyzed. The extensive simulations show that the traditional/generalized NHZ hopping patterns are in favor of combating the mutual interference but with the limited capability of reducing jamming attacks, while the probabilistic hopping pattern possesses the opposite feature, that is, it has the predominant merit in suppressing jamming attacks. Thus, the novel channel-hopping pattern-based IoT could provide the secure transmission for communication applications in smart cities. Note that, as the physical-layer security technique, the channel-hopping patterns investigated in this paper are convenient to integrate with the security policies implemented in upper layers (e.g., encryption, authentication and so forth).
Building an indoor air quality monitoring system based on the architecture of the Internet of Things
Authors: Sung Wen-Tsai , Hsiao Sung-Jung
Published: July 2021

With rapidly changing technology, people have more and more requirements for thermal comforts regarding indoor temperature, humidity, and wind speed, and pay more attention to air quality. Indoor air quality has serious effects on the elderly, children, and those with respiratory allergies. Based on the architecture of the Internet of Things smart home, this study constructed an indoor air quality monitoring system to explore how people can live in an environment with good air quality. Among the numerous air quality indices (AQIs), the carbon dioxide index and AQI of the American Society of Heating, Refrigerating and Air-Conditioning Engineers are selected as the indices suitable for this study. The common points of the two indices are combined, and then, based on the data of the Environmental Protection Administration, indoor and outdoor environmental parameters are analyzed, and controllable environment variables are simulated to analyze their effects on air quality. This study designed effective load control using fuzzy control and developed a fuzzy rule base for simulation of the environment variables. Decision logic was used to replace the threshold control of indoor air quality in the past, and a comfortable air quality monitoring system was designed by combining the Arduino Uno development board and ESP8266 Wi-Fi wireless transmission modules.
Multiple-sets split feasibility problem and split equality fixed point problem for firmly quasi-nonexpansive or nonexpansive mappings
Authors: Xu Tongxin , Shi Luoyi
Published: July 2021

In this paper, we propose a new iterative algorithm for solving the multiple-sets split feasibility problem (MSSFP for short) and the split equality fixed point problem (SEFPP for short) with firmly quasi-nonexpansive operators or nonexpansive operators in real Hilbert spaces. Under mild conditions, we prove strong convergence theorems for the algorithm by using the projection method and the properties of projection operators. The result improves and extends the corresponding ones announced by some others in the earlier and recent literature.
Generalized homogeneous q-difference equations for q-polynomials and their applications to generating functions and fractional q-integrals
Authors: Cao Jian , Zhou Hong-Li , Arjika Sama
Published: July 2021

In this paper, our aim is to build generalized homogeneousq-difference equations forq-polynomials. We also consider their applications to generating functions and fractionalq-integrals by using the perspective ofq-difference equations. In addition, we also reveal relevant relations of various special cases of our main results involving some known results.
Antimicrobial stewardship in rural and remote primary health care: a narrative review
Authors: Yau Jun Wern , Thor Sze Mun , Tsai Danny , Speare Tobias , Rissel Chris
Published: July 2021

Background

Antimicrobial resistance is an emerging problem worldwide and poses a significant threat to human health. Antimicrobial stewardship programmes are being implemented in health systems globally, primarily in hospitals, to address the growing threat of antimicrobial resistance. Despite the significance of primary health care services in providing health care to communities, antimicrobial stewardship programmes are not well established in this sector, especially in rural and remote settings. This narrative review aims to identify in rural and remote primary health care settings the (1) correlation of antimicrobial resistance with antibiotic prescribing and volume of antibiotic use, (2) appropriateness of antimicrobial prescribing, (3) risk factors associated with inappropriate use/prescribing of antibiotics, and (4) effective antimicrobial stewardship strategies.

Methods

The international literature was searched for English only articles between 2000 and 2020 using specified keywords. Seven electronic databases were searched: Scopus, Cochrane, Embase, CINAHL, PubMed, Ovid Medline and Ovid Emcare. Publication screening and analysis were conducted using Joanna Briggs Institute systematic review tools.

Results

Fifty-one eligible articles were identified. Inappropriate and excessive antimicrobial prescribing and use directly led to increases in antimicrobial resistance. Increasing rurality of practice is associated with disproportionally higher rates of inappropriate prescribing compared to those in metropolitan areas. Physician knowledge, attitude and behaviour play important roles in mediating antimicrobial prescribing, with strong intrinsic and extrinsic influences including patient factors. Antimicrobial stewardship strategies in rural and remote primary health care settings focus on health care provider and patient education, clinician support systems, utility of antimicrobial resistance surveillance, and policy changes. Results of these interventions were generally positive with decreased antimicrobial resistance rates and improved appropriateness of antimicrobial prescribing.

Conclusions

Inappropriate prescribing and excessive use of antimicrobials are an important contributor to the increasing resistance towards antimicrobial agents particularly in rural and remote primary health care. Antimicrobial stewardship programmes in the form of education, clinical support, surveillance, and policies have been mostly successful in reducing prescribing rates and inappropriate prescriptions. The narrative review highlighted the need for longer interventions to assess changes in antimicrobial resistance rates. The review also identified a lack of differentiation between rural and remote contexts and Indigenous health was inadequately addressed. Future research should have a greater focus on effective interventional components and patient perspectives.
No changes in dietary intake after quitting smoking; a prospective study in Switzerland
Authors: Patriota Pollyanna , Guessous Idris , Marques-Vidal Pedro
Published: July 2021

Background

After quitting smoking, quitters frequently increase their weight and change their dietary intake. Still, most studies on the topic are over 20 years old and focused on few dietary markers. We analysed the changes in weight and dietary intake after quitting smoking using a large panel of dietary markers.

Methods

Prospective study including 5064 participants, 169 of whom (3.3%) quitted during a median follow-up of 5 years. Dietary intake was assessed using a food frequency questionnaire. Participants were excluded if they lacked dietary data or reported extreme total energy intakes (TEI) < 850 or > 4000 kcal/day.

Results

Data from 128 participants (43.8% women, aged 56.0 ± 10.0 years) were used. After quitting smoking, mean weight increased 2.1 ± 0.7 kg; the majority (58%) of the participants gained over 1 kg, and only 7.1% were on a diet to reduce their weight. Total protein intake increased from (median [interquartile range]) 14.4 [12.9–16.4] to 15.1 [13.4–17.9] % of total energy intake (TEI), p = 0.008, while animal protein intake increased from 9.7 [8.0–12.1] to 10.8 [8.5–13.5] %TEI, p = 0.011. Fish intake increased from 27 [17–45] to 37 [19–55] g/day, p = 0.016 and dairy intake decreased from 177 [94–288] to 150 [77–243] g/day, p = 0.009. No other changes were found. Among the 68 (53%) participants who reported time since quitting, quitting for <=1 year led to a decreased consumption of fruits, while the opposite was found for participants who quit for longer than one year. No associations were found between weight or dietary changes and time since quitting.

Conclusions

People who quit smoking tend to gain weight, do not significantly change their dietary intake, and seem to make little effort to prevent weight gain. Systematic dietary support should be provided to all smokers wishing to quit.
Seroprevalence of SARS-CoV-2 antibody among individuals aged above 15 years and residing in congregate settings in Dire Dawa city administration, Ethiopia
Authors: Shaweno Tamrat , Abdulhamid Ibrahim , Bezabih Lemlem , Teshome Daniel , Derese Behailu , Tafesse Hiwot , Shaweno Debebe
Published: July 2021

Background

Determining the extent of seropositivity of SARS-CoV-2 antibody has the potential to guide prevention and control efforts. We aimed to determine the seroprevalence of SARS-CoV-2 antibody among individuals aged above15 years and residing in the congregate settings of Dire Dawa city administration, Ethiopia.

Method

We analyzed COVID-19 seroprevalence data on 684 individuals from a community based cross-sectional survey conducted among individuals aged above 15 years and residing in congregate settings in Dire Dawa from June 15 to July 30, 2020. Data were collected using interview and blood sample collection. Participants were asked about demographic characteristics, COVID-19 symptoms, and their practice of preventive measures. Seroprevalence was determined using SARS-CoV-2 IgG test. Bivariate and multivariate multilevel mixed effects logistic regression model was fitted and statistical significance was set at p value < 0.05.

Result

The estimated SARS-CoV-2 seroprevalence was 3.2% (95 % CI 2.0–4.8) in the study region with no differences by age and sex but considerable differences were observed by self-reported practice of COVID-19 preventive measures. The cluster effect is not significant (P = 0.396) which has suggested no evidence of heterogeneity in SARS-CoV-2 seroprevalence among the clusters. The odds of SARS-CoV-2 antibody seroprevalence were higher for individuals who were employed and work by moving from home to work area (AOR; 9.73 95% CI 2.51, 37.68), reported of not wearing facemasks when leaving home (AOR; 6.4 95% CI 2.30, 17.66) and did not practice physical distancing measures (AOR; 10 95% CI 3.01, 33.20) compared to their counterparts, respectively. Our estimated seroprevalence of SARS-CoV-2 among participants who reported not to have practiced social distancing measures was 12.8 (95% CI, 7.0, 19) and 1.5 (95% CI, 0.5, 2.5) among those who reported of practicing them. More than 80% of study participants reported of implementing infection prevention measures (face masks and physical distancing recommendations).

Conclusion

The detected SARS-CoV-2 seroprevalence among the study participants was low at the time of the survey indicating higher proportion of population yet to be infected. COVID-19 preventive measures were associated with reduced seroprevalence and should be promoted to avoid transmission to the uninfected majority.
Epidemic of plague amidst COVID-19 in Madagascar: efforts, challenges, and recommendations
Authors: Aborode Abdullahi Tunde , dos Santos Costa Ana Carla , Mohan Anmol , Goyal Samarth , Rabiu Aishat Temitope , Tsagkaris Christos , Uwishema Olivier , Outani Oumaima , Ahmad Shoaib , Essar Mohammad Yasir
Published: July 2021

The plague has been wreaking havoc on people in Madagascar with the COVID-19 pandemic. Madagascar’s healthcare sector is striving to respond to COVID-19 in the face of a plague outbreak that has created a new strain on the country’s public health system. The goal and activities of the gradual epidemic of plague in Madagascar during COVID-19 are described in this research. In order to contain the plague and the COVID-19 pandemic in this country, we have suggested long-term recommendations that can help to contain the outbreak so that it may spread to non-endemic areas.
Coevolution of global brachiopod palaeobiogeography and tectonopalaeogeography during the Carboniferous
Authors: Li Ning , Wang Cheng-Wen , Zong Pu , Mao Yong-Qin
Published: July 2021

The global brachiopod palaeobiogeography of the Mississippian is divided into three realms, six regions, and eight provinces, while that of the Pennsylvanian is divided into three realms, six regions, and nine provinces. On this basis, we examined coevolutionary relationships between brachiopod palaeobiogeography and tectonopalaeogeography using a comparative approach spanning the Carboniferous. The appearance of the Boreal Realm in the Mississippian was closely related to movements of the northern plates into middle–high latitudes. From the Mississippian to the Pennsylvanian, the palaeobiogeography of Australia transitioned from the Tethys Realm to the Gondwana Realm, which is related to the southward movement of eastern Gondwana from middle to high southern latitudes. The transition of the Yukon–Pechora area from the Tethys Realm to the Boreal Realm was associated with the northward movement of Laurussia, whose northern margin entered middle–high northern latitudes then. The formation of the six palaeobiogeographic regions of Mississippian and Pennsylvanian brachiopods was directly related to “continental barriers”, which resulted in the geographical isolation of each region. The barriers resulted from the configurations of Siberia, Gondwana, and Laurussia, which supported the Boreal, Tethys, and Gondwana realms, respectively. During the late Late Devonian–Early Mississippian, the Rheic seaway closed and North America (from Laurussia) joined with South America and Africa (from Gondwana), such that the function of “continental barriers” was strengthened and the differentiation of eastern and western regions of the Tethys Realm became more distinct. In the Barents Ocean tectonic domain during the Pennsylvanian, the brachiopods on the northern margin of the Barents Ocean formed the Verkhoyansk–Taymyr Province, while those on the southern margin formed the Yukon–Pechora Province. The Mongolia–Okhotsk Province was formed by brachiopods of the Mongolia–Okhotsk Ocean tectonic domain. The Northern Margin of the Palaeo-Tethys Ocean Province and the Southern Margin of the Palaeo-Tethys Ocean Province were formed, respectively, by brachiopods on the northern and southern margins of the Palaeo-Tethys Ocean tectonic domain. South China and Southeast Asia were dissociated from the major continental blocks mentioned above, and formed the South China Province.
Learning from the past: inequalities and discrimination in psychiatry's chequered history
Authors: Hilton Claire , Freudenthal Robert
Published: July 2021

The Royal College of Psychiatrists’ antiquarian book collection originated from the library of psychiatrist Daniel Hack Tuke (1827–1895). A proposal to name the collection after him led us to investigate aspects of his life and work, particularly related to his attitudes concerning race, gender and homosexuality. We juxtaposed his ideas with those of some of his contemporaries. We cannot separate psychiatrists, past or present, from the societal and scientific context that shapes their professional understanding and standards. However, changes in language, knowledge, values and other sociocultural factors over time can affect how we perceive our forebears and how future generations of psychiatrists may perceive us.
Association of Fatigue and Outcomes in Advanced Cancer: An Analysis of Four SWOG Treatment Trials
Authors: Mo Julia , Darke Amy K. , Guthrie Katherine A. , Sloan Jeff A. , Unger Joseph M. , Hershman Dawn L. , O'Rourke Mark , Bakitas Marie , Krouse Robert S.
Published: July 2021

PURPOSE:

Patient-reported outcomes may be associated with cancer outcomes. We evaluated clinically significant fatigue (CSF), overall survival, adverse events (AEs), and quality of life (QOL) during cancer treatment.

METHODS:

We compared outcomes in four phase II or III chemotherapy trials, two advanced non–small-cell lung cancer and two advanced hormone-refractory prostate cancer, with or without baseline CSF. CSF was defined as a rating of two or greater on the Functional Assessment of Cancer Therapy fatigue question or a European Organization for Research and Treatment of Cancer Quality of Life Questionnaire—Core 30 fatigue symptom score of 50% or greater. Survival was compared according to CSF using Kaplan-Meier estimates and Cox regression models. Differences in AE rates by CSF were assessed via chi-squared tests, and QOL changes from baseline to 3 months via linear regression.

RESULTS:

Of 1,994 participants, 1,907 (median age 69 years, range: 32-91) had complete baseline QOL survey data, with 52% reporting CSF at baseline. For the two hormone-refractory prostate cancer studies, baseline CSF was associated with higher mortality rates, with adjusted hazard ratios of (95% CI, P value) 1.32 (1.13 to 1.55, P < .001) and 1.31 (1.02 to 1.67, P = .03) and with increased incidence of grade 3-5 constitutional (16.5% v 9.4%, P = .002; 13.9% v 6.3%, P = .002) and neurologic (11.7% v 6.1%, P = .006; 9.0% v 3.9%, P = .01) AEs, respectively. Baseline CSF was associated with a higher mortality rate in one non–small-cell lung cancer study: hazard ratio 1.44 and 1.04 to 2.00, P = .03.

CONCLUSION:

Oncology trial participants with baseline CSF had poorer survival and experienced more AEs than participants without CSF. This indicates fatigue as an important baseline prognostic factor in oncology treatment trials.
Hypothalamic-Pituitary Autoimmunity and Related Impairment of Hormone Secretions in Chronic Fatigue Syndrome
Authors: De Bellis Annamaria , Bellastella Giuseppe , Pernice Vlenia , Cirillo Paolo , Longo Miriam , Maio Antonietta , Scappaticcio Lorenzo , Maiorino Maria Ida , Bellastella Antonio , Esposito Katherine , Montoya José G
Published: July 2021

Context

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe chronic illness that reduces the quality of life. A potential role of neuroendocrine autoimmune dysfunction has been hypothesized.

Objective

This work aims to investigate the occurrence of antipituitary (APA) and antihypothalamic (AHA) antibodies and possible related hypothalamic/pituitary dysfunctions in ME/CSF patients.

Methods

This is a case-control study conducted in a university hospital setting (Stanford, California, USA; and Naples, Italy). Thirty women with ME/CSF (group 1) diagnosed according to Fukuda, Canadian, and Institute of Medicine criteria, at Stanford University, were enrolled and compared with 25 age-matched healthy controls. APA and AHA were detected by immunofluorescence; moreover, we investigated hormonal secretions of anterior pituitary and respective target glands. APA and AHA titers both were assessed and the prevalence of pituitary hormone deficiencies was also investigated.

Results

Patients in group 1 showed a high prevalence of AHA (33%) and APA (56%) and significantly lower levels of adrenocorticotropin (ACTH)/cortisol, and growth hormone (GH) peak/insulin-like growth factor-1 (IGF-1) vs controls (all AHA/APA negative). Patients in group 1A (13 patients positive at high titers, ≥ 1:32) showed ACTH/cortisol and GH peak/IGF-1 levels significantly lower and more severe forms of ME/CFS with respect to patients in group 1B (7 positive at middle/low titers, 1:16-1:8) and 1C (10 antibody-negative patients).

Conclusion

Both AHA and/or APA at high titers were associated with hypothalamic/pituitary dysfunction, suggesting that hypothalamic/pituitary autoimmunity may play an important role in the manifestations of ME/CFS, especially in its more severe forms.
Genome-wide Association Study of Estradiol Levels and the Causal Effect of Estradiol on Bone Mineral Density
Authors: Schmitz Daniel , Ek Weronica E , Berggren Elin , Höglund Julia , Karlsson Torgny , Johansson Åsa
Published: July 2021

Context

Estradiol is the primary female sex hormone and plays an important role for skeletal health in both sexes. Several enzymes are involved in estradiol metabolism, but few genome-wide association studies (GWAS) have been performed to characterize the genetic contribution to variation in estrogen levels.

Objective

Identify genetic loci affecting estradiol levels and estimate causal effect of estradiol on bone mineral density (BMD).

Design

We performed GWAS for estradiol in males (n = 147 690) and females (n = 163 985) from UK Biobank. Estradiol was analyzed as a binary phenotype above/below detection limit (175 pmol/L). We further estimated the causal effect of estradiol on BMD using Mendelian randomization.

Results

We identified 14 independent loci associated (P < 5 × 10−8) with estradiol levels in males, of which 1 (CYP3A7) was genome-wide and 7 nominally (P < 0.05) significant in females. In addition, 1 female-specific locus was identified. Most loci contain functionally relevant genes that have not been discussed in relation to estradiol levels in previous GWAS (eg, SRD5A2, which encodes a steroid 5-alpha reductase that is involved in processing androgens, and UGT3A1 and UGT2B7, which encode enzymes likely to be involved in estradiol elimination). The allele that tags the O blood group at the ABO locus was associated with higher estradiol levels. We identified a causal effect of high estradiol levels on increased BMD in both males (P = 1.58 × 10−11) and females (P = 7.48 × 10−6).

Conclusion

Our findings further support the importance of the body’s own estrogen to maintain skeletal health in males and in females.
An uncommon [K+(Mg2+)2] metal ion triad imparts stability and selectivity to the Guanidine-I riboswitch
Authors: Trachman Robert J. , Ferré-D'Amaré Adrian R.
Published: July 2021

The widespread ykkC-I riboswitch class exemplifies divergent riboswitch evolution. To analyze how natural selection has diversified its versatile RNA fold, we determined the X-ray crystal structure of the Burkholderia sp. TJI49 ykkC-I subtype-1 (Guanidine-I) riboswitch aptamer domain. Differing from the previously reported structures of orthologs from Dickeya dadantii and Sulfobacillus acidophilus, our Burkholderia structure reveals a chelated K+ ion adjacent to two Mg2+ ions in the guanidine-binding pocket. Thermal melting analysis shows that K+ chelation, which induces localized conformational changes in the binding pocket, improves guanidinium-RNA interactions. Analysis of ribosome structures suggests that the [K+(Mg2+)2] ion triad is uncommon. It is, however, reminiscent of metal ion clusters found in the active sites of ribozymes and DNA polymerases. Previous structural characterization of ykkC-I subtype-2 RNAs, which bind the effector ligands ppGpp and PRPP, indicate that in those paralogs, an adenine responsible for K+ chelation in the Burkholderia Guanidine-I riboswitch is replaced by a pyrimidine. This mutation results in a water molecule and Mg2+ ion binding in place of the K+ ion. Thus, our structural analysis demonstrates how ion and solvent chelation tune divergent ligand specificity and affinity among ykkC-I riboswitches.
Pre-trial proceedings in a criminal case
Authors: Rossinskiy Sergey
Published: July 2021

The genesis of the Russian pre-trial proceedings in a criminal case is considered and the reasons that predetermined its modern system are analyzed.
The purpose of pre-trial proceedings is highlighted; the procedural status of subjects authorized to initiate and preliminary investigation of criminal cases is disclosed.
The essence is characterized and the legal conditions for the implementation of pre-trial stages of criminal proceedings are considered. The article describes in detail the criminal procedural mechanisms included in the content of pre-trial proceedings:
investigative actions, forensic examinations, "technical" methods of collecting evidence, measures of criminal procedural coercion, the procedure for bringing as an accused and the end of the preliminary investigation.
For students and students of universities who master the educational programs of the master's degree in legal orientation. The textbook may be useful for students, cadets and trainees studying under bachelor's and specialty programs, researchers and practitioners, teachers, graduate students (adjuncts).
Protestanci w Rzeczypospolitej 1777-1786 – między unią sielecką a konfliktami (zarys problematyki)
Authors: Filipczak Witold
Published: July 2021

Protestants in the Polish-Lithuanian Commonwealth in the Years 1777-1786: Between the Union of Sielec and Conflicts (Introduction to the Topic) This article examines the eighteenth century attempts to stimulate cooperation amog Protestants in the Polish-Lithuanian Commonwealth. Such endeavors were undertaken in the years 1775-1776 in Great Poland, while in 1777 the Union of Sielec between Protestants of Little Poland and Mazowsze was concluded. The union was intended to bring together Protestant congregations as religious entities without interfering in particular doctrinal and religious differences among them. In 1780, Protestants representing all parts of the Commonwealth met at a general council in Węgrów. Unfortunately, the existing differences among the groups prevailed and led to conflict. In effect, the followers of the Sielec Union failed to find a conciliatory platform with the Great Poland Protestants, who were backed by the Russian Ambassador Otto von Stackelberg. In 1782, the General Council of Węgrów was dissolved, which led to the collapse of the Sielec Union. The latter section of the article examines the political prosecution of Protestants, who were attacked by the Permanent Council and the Parliament of 1784. Stackelberg’s interference, as well as the attitude of the Polish king Stanislaus Augustus towards Protestants, have been also presented.
The relationship between working environment and quality of nursing care: an integrative literature review
Authors: Amaliyah Eli , Tukimin Sansuwito
Published: July 2021

Background/Aims

There is evidence that work environment is positively related to quality of care in different healthcare professions, but the nature of this relationship needs further exploration. This study aimed to synthesise the evidence about the relationship between work environment and quality of care in nursing.

Methods

An integrative literature search was conducted to identify articles and studies investigating work environment and quality of care in nursing. Studies that were published between January 2000 and February 2020 in PubMed and EBSCOhost databases were included in the review.

Results

A total of 12 studies were included in the final analysis, of which four used an explicit theoretical framework to guide their research. Sample sizes were generally large. Work environmental was classified as consisting of physical, psychological, environmental and organisational factors. Most studies reported a direct positive correlation between work environment and quality of nursing care. Only one study found that work environment indirectly influenced quality of care through job satisfaction and burnout.

Conclusions

There is clear evidence that the quality of care delivered by nurses is influenced by the work environment. Particularly important factors were support from management and adequate staffing. To improve quality of care, healthcare leaders should focus on improving the work environment.
Challenging misconceptions about eating disorders in healthcare services: an urgent issue
Authors: Harris Gemma
Published: July 2021

Gemma Harris explains how training clinicians to recognise and address eating disorders could improve access to early intervention and prevent acute services becoming overwhelmed.
Defining the word ‘play’
Authors: Dubiel Jan
Published: July 2021

A professional language for a complex process in a misunderstood profession – why we should reconsider using the word ‘play’ in an educational context.
Is play beyond definition?
Authors: Bottrill Greg
Published: July 2021

There's something that hangs over you, me and childhood that couldn't care less about how we define play, it's that thing called neoliberalism and it creates and shapes our days without us being aware of it most of the time.
Technology for communication
Authors: Hewson Claire
Published: July 2021

Technology can be a useful tool to support the development of children's communication and language skills. It is important that technology is used to encourage conversation and face-to-face interaction.
Lunate dislocations: anatomy, diagnosis and management
Authors: Garner Madeleine , Rudran Branavan , Khan Amir , Tang Quen , Mathew Philip
Published: July 2021

Lunate dislocation is an uncommon but serious wrist injury, often resulting from a high energy mechanism of trauma. Advanced trauma life support protocols should be followed to diagnose and treat concomitant life-threatening pathology. Thorough neurovascular and soft tissue examination is required to identify open wounds and median nerve dysfunction, including acute onset carpal tunnel syndrome. Imaging is undertaken to appreciate injury severity, which is graded by the Mayfield classification. Closed reduction in the emergency department is the initial management, which alleviates pressure on neurovascular structures. Definitive management is surgical, most commonly via open reduction and direct ligamentous stabilisation. The aims of surgery are to restore anatomical carpal alignment and maintain stability, allowing repair and healing of the important wrist ligaments. Medium-to long-term functional outcomes are adequate, with most patients returning to work within 6 months. However, progressive radiographic midcarpal arthrosis is common, as well as permanent loss of grip strength, range of motion and chronic pain. This article considers the anatomy, diagnosis and management of acute lunate and perilunate dislocations.
RESEARCH ROUNDUP
Authors: Mcgloin Claudia
Published: July 2021

In this regular feature, aesthetic nurse Claudia McGloin presents a brief synopsis of a range of recently published articles on medical aesthetics. Research roundup aims to provide an overview, rather than a detailed summary and critique, of the papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided at the end of each study summary
Incorporating a Cooperative Teaching and Learning Approach in Life Orientation Lesson Planning
Authors: Seherrie Aloysius Claudian , Mawela Ailwei Solomon
Published: July 2021

In the field of education, globally, teachers are recognised as important contributors in shaping learners’ interaction in a cooperative learning environment through effective lesson planning. There is a plethora of research conducted internally on lesson planning, as a critical instructional competency for good teaching and as a purposeful activity that precedes the delivery of instruction. This study aimed to explore Life Orientation teachers’ lesson planning incorporating a cooperative teaching and learning approach in secondary schools in De Aar, South Africa. The researchers adopted a mixed-methods phenomenological research design. Seven Grade 10 Life Orientation teachers were purposely selected to collect semi-structured interviews data, non-participatory observation, and document analysis. Data were analysed using inductive thematic analysis and supported with the literature review and the theory underpinning this study. This paper suggests an enactment between teachers’ subject and pedagogical content knowledge and instructional material. Lastly, it is also evident that many teachers lack knowledge, insufficient instructional resources, and an understanding of effective lesson planning to implement a cooperative teaching approach.