bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptomatic myopathies in sarcoidosis: disease spectrum and myxovirus resistance protein A expression
Authors: Chompoopong Pitcha , Skolka Michael P , Ernste Floranne C , Milone Margherita , Liewluck Teerin
Published: November 2022

Objectives

Symptomatic myopathy in sarcoidosis patients is not always due to sarcoid myopathy (ScM). We investigated the clinical and pathological spectrum including myxovirus resistance protein A (MxA) expression among sarcoidosis patients.

Methods

We reviewed the Mayo Clinic database (May 1980–December 2020) to identify sarcoidosis patients with myopathic symptoms and pathological evidence of myopathy.

Results

Among 5885 sarcoidosis patients, 21 had symptomatic myopathy. Eight carried a diagnosis of sarcoidosis 5.5 years (median) prior to myopathy onset. Eleven patients had ScM. The remaining had non-sarcoid myopathies (five IBM, one immune-mediated necrotizing myopathy, one non-specific myositis, two non-specific myopathy and one steroid myopathy). Estimated frequency of IBM is 85 per 100 000 sarcoidosis patients. The following features were associated with non-sarcoid myopathies (P < 0.05): (i) predominant finger flexor and quadriceps weakness, (ii) modified Rankin scale (mRS) >2 at time of diagnosis, (iii) creatine kinase >500 U/l, and (iv) absence of intramuscular granulomas. Sarcoplasmic MxA expression was observed in scattered myofibres in three patients, two of whom were tested for DM-specific autoantibodies and were negative. Immunosuppressive therapy led to improvement in mRS ≥1 in 5/10 ScM, none of the five IBM, and 3/3 remaining patients with non-sarcoid myopathies.

Discussion

Symptomatic myopathy occurred in 0.36% of sarcoidosis. IBM was the second most common cause of myopathies after ScM. Frequency of IBM in sarcoidosis is higher than in the general population. Recognition of features suggestive of alternative aetiologies can guide proper treatment. Our findings of abnormal MxA expression warrant a larger study.
Prevalence and predictors of atlanto-axial subluxation in rheumatoid arthritis after 12-years’ follow-up (ESPOIR Cohort)
Authors: Le Quellec Aurore , Guyard Thibaut , Carvajal Alegria Guillermo , Ruyssen-Witrand Adeline , Fautrel Bruno , Flipo René Marc , Garrigues Florent , Saraux Alain
Published: November 2022

Objectives

Anterior atlanto-axial subluxation (AAS), defined as an anterior atlanto-dental interval ≥3 mm, can occur in RA and carries a risk of severe neurological impairments. Our objective was to determine the prevalence and predictors of radiographic aAAS after 12 years’ follow-up of patients with early polyarthritis.

Methods

We studied patients enrolled in the early polyarthritis cohort ESPOIR (Study and Monitoring of Early Undifferentiated Arthritis) between 2002 and 2005 (at least two swollen joints for >6 weeks and <6 months, no other diagnosis than RA, and no previous exposure to glucocorticoids or DMARDs). All patients still in the cohort after 12 years had dynamic cervical-spine radiographs taken then read by two blinded observers. To evaluate how well combinations of tests performed at baseline and 10 years predicted aAAS after 12 years, univariate analysis and multiple logistic regression procedure were applied.

Results

Of 323 patients followed for 12 years, 15 (4.6%; 95% CI 2.8, 6.4) had aAAS. Among baseline variables, only IgA RFs were associated (P < 0.05) with aAAS (sensitivity 60%, specificity 75%). Among data collected after 10 years, oral CS therapy during the 10-year interval, treatment by DMARDs, CRP (mg/dl) and positive tests for RFs were associated with aAAS after 12 years, but only CRP and RFs remained in a model of logistic regression (combination predicted aAAS with a sensitivity of 60% for a specificity of 90%).

Conclusion

In conclusion, the prevalence of aAAS after 12 years was 4.6% in the ESPOIR cohort, with no patients having severe aAAS. Although some factors were found to be statistically associated to AAS, the event is too rare to allow a clinical relevance.
Periprocedure Management of Blood Pressure After Acute Ischemic Stroke
Authors: Sharma Deepak
Published: November 2022

The management of acute ischemic stroke primarily revolves around the timely restoration of blood flow (recanalization/reperfusion) in the occluded vessel and maintenance of cerebral perfusion through collaterals before reperfusion. Mechanical thrombectomy is the most effective treatment for acute ischemic stroke due to large vessel occlusions in appropriately selected patients. Judicious management of blood pressure before, during, and after mechanical thrombectomy is critical to ensure good outcomes by preventing progression of cerebral ischemia as well hemorrhagic conversion, in addition to optimizing systemic perfusion. While direct evidence to support specific hemodynamic targets around mechanical thrombectomy is limited, there is increasing interest in this area. Newer approaches to blood pressure management utilizing individualized cerebral autoregulation-based targets are being explored. Early efforts at utilizing machine learning to predict blood pressure treatment thresholds and therapies also seem promising; this focused review aims to provide an update on recent evidence around periprocedural blood pressure management after acute ischemic stroke, highlighting its implications for clinical practice while identifying gaps in current literature.
Impact of COVID-19 on urology services at a quaternary referral center in Johannesburg, South Africa
Authors: Christofides Chris , Carides Michaela , Masa Martha , Zamparini Jarrod , Adam Ahmed
Published: November 2022

Background

South Africa was placed into a nationwide lockdown on March 26, 2020, to limit the transmission of severe acute respiratory syndrome coronavirus 2. Medical facilities were overwhelmed, and the redeployment of medical staff to deal with coronavirus disease 2019 (COVID-19) cases resulted in the disruption of typical urology services. This has led to the reprioritization of care for urology patients with delays in all elective cases.

Materials and methods

In this retrospective study, we compared the numbers and types of patients seen in our urology outpatient clinics, ward admissions, and theater cases 90 days before and after the first COVID-19 lockdown. The changes in numbers were calculated as percentages, and Fisher exact test was used to determine p values.

Results

The number of patients in urology outpatient clinics significantly declined (26.4%) after the lockdown started. Outpatient procedures, which were mostly diagnostic, decreased by 28.6%, with no change observed in therapeutic procedures. A decrease in the total number of theater cases (37.4%) and ward admissions (45.0%) was also observed after the lockdown because of a decrease in elective cases, although the number of emergency and oncology patients was relatively stable.

Conclusions

Coronavirus disease 2019 and the lockdown forced the urology department to shift the focus to only emergency and oncology cases. This resulted in delays in the treatment of benign elective conditions and a subsequent increase in the backlog of pending surgeries for these conditions, which could potentially lead to future complications. Although COVID-19 is a major problem requiring many resources, ensuring that urological patients still receive adequate care and management is also important.
A Prognostic Score To Predict Atrial fibrillation Recurrence After External Electrical Cardioversion—SLAC Score
Authors: Thangjui Sittinun , Yodsuwan Ratdanai , Thyagaturu Harshith , Navaravong Leenhapong , Zoltick Jerel
Published: November 2022

Introduction:

Atrial fibrillation (AF) recurrence after a successful external electrical cardioversion (ECV) is common. Assessing an individual’s risk of AF recurrence is a critical part of the treatment plan. We aimed to develop a prognostic prediction score to predict AF recurrence in AF patients who underwent successful ECV.

Methods:

A retrospective cohort study that included AF patients who underwent successful ECV was conducted with a primary outcome of AF recurrence at 6 months. Logistic regression analysis was done to identify variables, and a prognostic prediction score was created and internally validated.

Results:

Four prognostic predictors were identified, including the type of AF, persistent AF (1 point) and long-standing persistent AF (4 points), previous cardioversion (1 point), stroke/transient ischemic attack (3 points), and left atrial volume index ≥40 mL/m2 (6 points). The total score of 14 was further divided into 3 risk groups; low-risk (0–2 points), moderate-risk (3–7 points), and high-risk (8–14 points). The positive likelihood ratio for a moderate-risk patient was 2.08 (95% CI, 1.64-2.63) and for a high-risk patient was 7.90 (95% CI, 2.48-25.17). The score showed good discrimination power with the c-statistic of 0.74 (95% CI, 0.69-0.79).

Conclusions:

A simple prognostic prediction score for AF recurrence after successful ECV was created with a promising internally validated discrimination power. An external assessment of its usefulness as a tool to identify patients with low, moderate, and high risk for AF recurrence is warranted.
Evaluation of the Practice Guideline Used for Rule-Out of Myocardial Infarction at a Tertiary Cardiology Center
Authors: Sheikh Sharbafan Reza , Farrokhpour Hossein , Keykhaei Mohammad , Rashedi Sina , Foroumadi Roham , Mehrani Mehdi , Tajdini Masih
Published: November 2022

Introduction:

With the current high burden on the healthcare system and limited resources, the efficient utilization of facilities is of utmost importance. We sought to present the practice guideline used at a high prevalence tertiary cardiology center and compare its safety and efficacy performance with the single high-sensitivity cardiac troponin T strategy, conventional and modified HEART score.

Methods:

In this prospective cohort study, consecutive patients presenting to the emergency department with chest pain or an angina equivalent were recruited. The primary endpoints consisted of major adverse cardiac events at index visits and 30-day follow-up. Patients were managed according to the practice guideline, and sensitivity and negative predictive values were compared.

Results:

Of the total 1548 patients, the mean age was 50.4 ± 15.7 years. Ninety-nine (10.9%) patients were admitted at the index visit, and 89 patients were consequently diagnosed with acute coronary symptoms. Six (0.007%) patients experienced major adverse cardiac events within the 30-day follow-up among discharged patients. Among 911 patients with at least 1 troponin, using single high-sensitivity cardiac troponin T, HEART score, and modified HEART score would have further admitted 805, 450, and 609 patients, respectively. The negative predictive value for all 4 algorithms did not significantly differ (99.2% vs. 100% vs. 99.3% vs. 99.6%, respectively).

Conclusions:

The Tehran Herat Center protocol was a relatively safe protocol with high efficacy. Despite the high safety of the other diagnostic pathways, the high volume of patients needing additional evaluation could impose a high burden on the health care system.
Distal Trans-radial Access Compared to Conventional Trans-radial Access in Coronary Interventions: A Meta-analysis
Authors: Talha Khawaja M. , Waqar Eisha , Ashley Kellan E. , Cohen Mauricio G. , Lemor Alejandro , McMullan Michael R. , Winscott John G. , Hernandez Gabriel A.
Published: November 2022

Background:

Distal trans-radial access (dTRA) is a novel technique of arterial cannulation in coronary interventions. The comparative efficacy of dTRA and conventional trans-radial access (TRA) in attenuating peri-procedural complications is unknown.

Methods:

Embase and PubMed/MEDLINE were searched from their inception until June 25, 2022, for randomized clinical trials. Outcomes included were radial artery occlusion (RAO), radial artery spasm, hemostasis time, access time, unsuccessful cannulation, crossover rate, and early discharge after trans-radial stenting of coronary arteries (EASY) type I-III hematomas. Statistical analysis was conducted using the random effects model to derive risk ratios (RRs) and mean differences (MDs) with their corresponding 95% confidence intervals (CIs).

Results:

A total of 6 randomized clinical trials comprising 3240 patients were included. Subjects were predominantly male (73%) and had a mean age of 66 years. The dTRA group had a lower risk of RAO [RR 0.43 (95% CI, 0.26-0.69); P = 0.0005; I2 = 0%] and had a shorter hemostasis time [MD −22.85 min (95% CI, −39.06 to −6.65); P = 0.006; I2 = 99%]. The dTRA group had a higher crossover rate [RR 3.04 (95% CI, 1.88-4.91); P = 0.00001; I2 = 56%] and a longer access time [MD 0.68 min (95% CI, 0.17-1.18); P = 0.009; I2 = 99%]. The TRA group had a lower rate of unsuccessful cannulation [RR 0.81 (95% CI, 0.70-0.95); P = 0.01; I2 = 92%]. There was no significant difference between the groups for radial artery spasm and EASY type I-III hematomas.

Conclusion:

dTRA is a safe alternative to conventional TRA for coronary interventions with a lower risk of RAO. Future trials are required to further compare both approaches.
Comparison of Artificial Intelligence With Other Interventions to Improve Adenoma Detection Rate for Colonoscopy
Authors: Aziz Muhammad , Haghbin Hossein , Sayeh Wasef , Alfatlawi Halah , Gangwani Manesh K. , Sohail Amir H. , Zahdeh Tamer , Weissman Simcha , Kamal Faisal , Lee-Smith Wade , Nawras Ali , Sharma Prateek , Shaukat Aasma
Published: November 2022

Introduction:

Recent randomized controlled trials (RCTs) and meta-analysis have demonstrated improved adenoma detection rate (ADR) for colonoscopy with artificial intelligence (AI) compared with high-definition (HD) colonoscopy without AI. We aimed to perform a systematic review and network meta-analysis of all RCTs to assess the impact of AI compared with other endoscopic interventions aimed at increasing ADR such as distal attachment devices, dye-based/virtual chromoendoscopy, water-based techniques, and balloon-assisted devices.

Methods:

A comprehensive literature search of PubMed/Medline, Embase, and Cochrane was performed through May 6, 2022, to include RCTs comparing ADR for any endoscopic intervention mentioned above. Network meta-analysis was conducted using a frequentist approach and random effects model. Relative risk (RR) and 95% CI were calculated for proportional outcome.

Results:

A total of 94 RCTs with 61,172 patients (mean age 59.1±5.2 y, females 45.8%) and 20 discrete study interventions were included. Network meta-analysis demonstrated significantly improved ADR for AI compared with autofluorescence imaging (RR: 1.33, CI: 1.06 to 1.66), dye-based chromoendoscopy (RR: 1.22, CI: 1.06 to 1.40), endocap (RR: 1.32, CI: 1.17 to 1.50), endocuff (RR: 1.19, CI: 1.04 to 1.35), endocuff vision (RR: 1.26, CI: 1.13 to 1.41), endoring (RR: 1.30, CI: 1.10 to 1.52), flexible spectral imaging color enhancement (RR: 1.26, CI: 1.09 to 1.46), full-spectrum endoscopy (RR: 1.40, CI: 1.19 to 1.65), HD (RR: 1.41, CI: 1.28 to 1.54), linked color imaging (RR: 1.21, CI: 1.08 to 1.36), narrow band imaging (RR: 1.33, CI: 1.18 to 1.48), water exchange (RR: 1.22, CI: 1.06 to 1.42), and water immersion (RR: 1.47, CI: 1.19 to 1.82).

Conclusions:

AI demonstrated significantly improved ADR when compared with most endoscopic interventions. Future RCTs directly assessing these associations are encouraged.
The need for biomarkers to determine response to enteral nutrition during and after critical illness: an update
Authors: Reintam Blaser Annika , Preiser Jean-Charles , Forbes Alastair
Published: November 2022

Purpose of review

Biomarkers proposed to provide prognosis or to determine the response to enteral nutrition have been assessed in a number of experimental and clinical studies which are summarized in the current review.

Recent findings

There are several pathophysiological mechanisms identified which could provide biomarkers to determine response to enteral nutrition. Several biomarkers have been studied, most of them insufficiently and none of them has made its way to clinical practice. Available studies have mainly assessed a simple association of a biomarker with outcomes, but are less focused on dynamic changes in the biomarker levels. Importantly, studies on pathophysiology and clinical features of gastrointestinal dysfunction, including enteral feeding intolerance, are also needed to explore the mechanisms potentially providing specific biomarkers. Not only an association of the biomarker with any adverse outcome, but also a rationale for repeated assessment to assist in treatment decisions during the course of illness is warranted.

There is no biomarker currently available to reliably provide prognosis or determine the response to enteral nutrition in clinical practice, but identification of such a biomarker would be valuable to assist in clinical decision-making.
Turner syndrome: fertility counselling in childhood and through the reproductive lifespan
Authors: Bollig Kassie J. , Mainigi Monica , Senapati Suneeta , Lin Angela E. , Levitsky Lynne L. , Bamba Vaneeta
Published: November 2022

Purpose of review

The potential for fertility in Turner syndrome has improved in recent years. Understanding of associated risks and approaches is important for the care of girls and women with this condition. This review focuses on reproductive health, fertility options and appropriate counselling for women with Turner syndrome and their families.

Recent findings

Women with Turner syndrome have rapidly declining ovarian function beginning in utero. Therefore, counselling regarding fertility concerns should begin at a young age and involve discussion of options, including ovarian tissue cryopreservation, oocyte preservation and use of nonautologous oocytes. Clinical guidance on fertility management and pregnancy risk assessment based on karyotype, associated comorbidities and fertility is still not fully data driven. Realistic expectations regarding reproductive options and associated outcomes as well as the need for multidisciplinary follow-up during pregnancy are crucial to the ethical and safe care of these patients.

Fertility care in women with Turner syndrome is evolving as current management techniques improve and new approaches are validated. Early counselling and active management of fertility preservation is critical to ensure positive and well tolerated reproductive outcomes.
The prognostic value of post thyroidectomy Tc-99m pertechnetate thyroid scan in patients with differentiated thyroid cancer
Authors: Eloteify L.M. , Algizawy Samy M. , Abdelnaim Aya K.M. , Mekkawy Nesreen
Published: November 2022

Aim

To evaluate the prognostic value of postoperative Tc-99m pertechnetate scanning in patients with differentiated thyroid cancer (DTC).

Method

Patients with pathologically proven low or intermediate-risk DTC were enrolled in this study. Postoperative Tc-99m pertechnetate scintigraphy was performed 20 min after IV of 185 MBq of Tc-99m pertechnetate Positive thyroid residual uptake was characterized as higher Tc-99m pertechnetate uptake at the thyroid bed than the surrounding background’s activity. A negative residual was considered if there was no definite abnormal radioactivity at the thyroid bed. Follow-up by thyroglobulin, thyroglobulin antibodies (Tg Abs), neck ultrasound (US) and diagnostic I-131 WBS (Dx WBS) were considered the reference standard. Successful ablation outcome was considered if there was free Dx WBS, stimulated serum thyroglobulin < 1 ng/ml with negative Tg Abs, and free US

Result

Two hundred and two patients, mean age; of 38.8 years were retrospectively recruited in this study. Positive residual uptake at the thyroid scan was detected in 131 patients wherea the remaining 71 patients had no detectable uptake. According to the reference standard we encountered 114 and 88 cases with successful ablation and unsuccessful ablation respectively, Tc-99m pertechnetate scanning successfully detected 63 true positive and 46 true negative cases giving 72% sensitivity, 40% specificity, 48% positive predictive value and 56% negative predictive value.

Conclusion

In low- and intermediate-risk DTC patients; despite the relatively high sensitivity of postoperative Tc-99m pertechnetate thyroid scan, it has low specificity and low negative predictive value so it cannot be used to predict the ablation outcome.
Vertebral and ribs enhancement in Tc-99m methylene diphosphonate bone scan image by blind deconvolution algorithm
Authors: Kaur Gagandeep , Pandey Anil Kumar , Chaudhary Jagrati , Hemrom Angel , Sharma Param D. , Patel Chetan , Kumar Rakesh
Published: November 2022

Aims and objectives

The objective of the study was to restore Tc-99m methylene diphosphonate (MDP) bone scan image using blind deconvolution (BD) algorithm so that ribs, vertebrae, and lesions present in them become prominent.

Materials and methods

Our study consists of retrospective data in which 356 Tc-99m MDP bone scan images (178 anterior and 178 posterior) were processed using dynamic stochastic resonance algorithm, block-matching 3D filter, and then restored using BD algorithm. Two nuclear medicine (NM) physicians compared restored image with its input image; they especially lookedfor: (a) improvement in lesions detectability, (b) artifacts if any, (c) deterioration in ribs and vertebra, and (d) contrast enhancement in adjacent vertebra and adjacent ribs. They selected one out of two (restored and input) images, which had better quality. The overall image quality was also assessed using the following image quality metrics: brightness, blur, global contrast factor, and contrast per pixel. The Wilcoxon signed-rank test was applied for finding significant difference between the value of image quality metrics of restored image and input image at level of significance alpha = 0.05.

Results

According to NM physicians, 80.3% (286 out of 356) of restored images were acceptable, whereas 19.6% (70 out of 356) were unacceptable. Ribs and vertebrae were prominent in 161 out of 178 posterior restored images. Lumbar vertebrae were enhanced and well differentiated from adjacent vertebrae in 125 out of 178 anterior restored images. The value of image quality metrics of restored and input images were found to be significantly different (P-value < 0.0001).

Conclusion

Ribs, vertebrae, and lesions present in them become prominent in the most of Tc-99m MDP bone scan images (80.3%) restored using BD algorithm.
Comprehensive access strategies to the frontal sinus
Authors: Turri-Zanoni Mario , Battaglia Paolo , Bignami Maurizio , Castelnuovo Paolo , Arosio Alberto D.
Published: November 2022

Purpose of review

Despite the impressive evolutions in endoscopic endonasal approaches and instrumentations, the frontal sinus remains a challenging area. Different surgical options have been described over the years, but the main criticism lies in choosing the most suitable approach for a given case, based on the anatomy of each patient and the disease to treat. The purpose of this study is to provide a comprehensive review of surgical access strategies currently available to address the frontal sinus, including both endonasal and traditional external procedures, analysing indications, contraindications, complications and outcomes.

Recent findings

Frontal sinus surgery includes minimally invasive endonasal approaches (balloon dilatation, Draf type I); extended endonasal approaches (Draf type IIA-IIB-IIC, Draf type III and their modifications via orbital transposition and contralateral pyriform aperture resection); external procedures (superior eyelid incision, frontal osteoplastic flap, Riedel procedure, Riedel-Mosher operation); and combined approaches.

Recent advances in endoscopic endonasal techniques have deeply reshaped the surgical options to manage frontal sinus diseases, in an attempt to minimize the invasiveness of the procedures and maximize their outcomes. Traditional external procedures should be used in selected cases nonamenable for endonasal surgery. The appropriate selection of cases appears to be of paramount importance to obtain successful outcomes.
Loneliness, social isolation, and living alone associations with mortality risk in individuals living with cardiovascular disease: A systematic review, meta-analysis, and meta-regression
Authors: Long Róisín M. , Terracciano Antonio , Sutin Angelina R. , Creaven Ann-Marie , Gerstorf Denis , D’Arcy-Bewick Sinéad , O’Súilleabháin Páraic S.
Published: November 2022

Objective

To conduct a systematic review and meta-analysis of associations between loneliness, social isolation, and living alone and risk of mortality among individuals with established Cardiovascular Disease (CVD).

Methods

Five electronic databases were searched [MEDLINE (Ovid), PsycINFO, EMBASE, PubMed and SCOPUS] from inception to 25th November 2021. In all, 35 studies were included in a narrative synthesis and where appropriate, a meta-analytic evaluation using a random effects model.

Results

Living alone was associated with increased risk of all-cause mortality [k = 15, n = 80243, HR = 1.48, 95% CI (1.20-1.83), I2
= 83%] and meta-regressions found that the effects were stronger in studies from Europe and with longer follow-up. However, there was evidence of publication bias. Social isolation was associated with increased risk of all-cause mortality, measured both as a dichotomous variable [k = 3, n = 2648, HR = 1.46, 95% CI (1.08-2.04), I
2 = 31%] and as a continuous variable [k = 5, n = 2388, HR = 1.11, 95% CI (1.02-1.24), I
2 = 51%]. Meta-analysis was not feasible for loneliness as exposure, but narrative synthesis of four studies suggested a tentative association between loneliness and increased risk of all-cause mortality.

Conclusions

Supporting public health concerns, our review finds that loneliness, social isolation, and living alone are associated with premature mortality among individuals with established CVD. However, evidence of publication bias and large methodological differences across studies point to the need for more rigorous research.
Analysis of Pediatric Maxillofacial Fractures: A 10-year Retrospective Study
Authors: Huang Wu , Hu Sunqiang , Wang Chi , Xiao Jin
Published: November 2022

Background:

The aim of this study is to analyze patterns of maxillofacial fractures in children and adolescent in southeast of China,in a period of 10 years.

Material and Methods:

In this retrospective study, the medical records of 162 hospitalized patients under 18 years old were analyzed in the Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Wenzhou Medical University, China. Age, gender, etiology, site, and type of fracture, monthly distribution, weekly distribution, dental complications, and treatment were evaluated. The cases were divided into 3 age groups: group A: 0 to 6 years, group B: 7 to 12 years, and group C: 13 to 18 years.

Results:

Three hundred thirty-four maxillofacial fractures in 162 patients younger than 18 years were analyzed. The male to female ratio was 2.24:1 and mean age of these patients was 9.85 years old . Falls were the leading cause of maxillofacial fractures.The most frequent fracture site was mandible. Most patients with maxillofacial fractures were treated by open reduction. And it was done more in adolescents than in children.

Conclusions:

Falls were the main reason for maxillofacial fracutres in childern, and traffic accidents was the leading cause in adolescent. Preventive measures should be applied to reduce occurrences of pediatric facial fractures .Children can not be left at home alone, and monitoring is very necessary when children play in the high place. The government can consider related e-bike driving skills training. Teenagers must pass the relevant electric vehicle test before they can drive. Make the law that the driver of e-bike must wear a safety helmet. Our study shows that open reduction was a good choice for pediatric facial fractures, but usually conservative treatment is a better choice for condylar fractures.
Sex differences in cooperative coalitions: a mammalian perspective
Authors: Smith Jennifer E. , Jaeggi Adrian V. , Holmes Rose K. , Silk Joan B.
Published: November 2022

In group-living species, cooperative tactics can offset asymmetries in resource-holding potential between individuals and alter the outcome of intragroup conflicts. Differences in the kinds of competitive pressures that males and females face might influence the benefits they gain from forming intragroup coalitions. We predicted that there would be a female bias in intragroup coalitions because females (1) are more like to live with kin than males are, and (2) compete over resources that are more readily shared than resources males compete over. We tested this main prediction using information about coalition formation across mammalian species and phylogenetic comparative analyses. We found that for nearly all species in which intragroup coalitions occur, members of both sexes participate, making this the typical mammalian pattern. The presence and frequency of female or male coalitions were not strongly associated with key socio-ecological factors like resource defensibility, sexual dimorphism or philopatry. This suggests that once the ability to form intragroup coalitions emerges in one sex, it is likely to emerge in the other sex as well and that there is no strong phylogenetic legacy of sex differences in this form of cooperation.

This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.
Weak, but not strong, ties support coalition formation among wild female chimpanzees
Authors: Fox Stephanie A. , Muller Martin N. , González Nicole Thompson , Enigk Drew K. , Machanda Zarin P. , Otali Emily , Wrangham Richard , Thompson Melissa Emery
Published: November 2022

In social species, individuals may be able to overcome competitive constraints on cooperation by leveraging relationships with familiar, tolerant partners. While strong social ties have been linked to cooperation in several social mammals, it is unclear the extent to which weak social ties can support cooperation, particularly among non-kin. We tested the hypothesis that weakly affiliative social relationships support cooperative coalition formation using 10 years of behavioural data on wild female chimpanzees. Female chimpanzees typically disperse and reside with non-kin as adults. Their social relationships are differentiated but often relatively weak, with few dyads sharing strong bonds. Females occasionally form aggressive coalitions together. Three measures of relationship quality—party association, five-metre proximity and whether a dyad groomed—positively predicted coalitions, indicating that relationship quality influenced coalition partnerships. However, dyads that groomed frequently did not form more coalitions than dyads that groomed occasionally, and kin did not cooperate more than expected given their relationship quality. Thus, strong bonds and kinship did not bolster cooperation. We conclude that cooperative coalitions among female chimpanzees depend on social tolerance but do not require strong bonds. Our findings highlight social tolerance as a distinct pathway through which females can cultivate cooperative relationships.

This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.
Association patterns of female gorillas
Authors: Young Christopher , Robbins Martha M.
Published: November 2022

Social interactions ultimately impact health and fitness in gregarious mammals. However, research focusing on the strength of affiliative interactions has primarily been conducted on female philopatric species. Gorillas provide an interesting counterpoint to previous research as females emigrate multiple times throughout their lives. We compare female–female association strength, duration and consistency in wild mountain (Gorilla beringei beringei) and western gorillas (Gorilla gorilla gorilla). Additionally, we examine whether the alpha male influences female association strength and if these associations are an artefact of both females concurrently in spatial proximity of the alpha male. In this between-species comparison, female gorillas had differentiated association patterns that were consistent on average for 2 years. The alpha males did not influence female association strength, with associations being similar in his presence or absence. Finally, we found more variability in association patterns among mountain gorillas with higher average association scores and higher proportion of ‘preferred associates' than western gorillas. The rare dispersal pattern in theGorillagenus may lead to greater flexibility in female association patterns than in species exhibiting female philopatry and strong kinship bonds. This may echo ancestral human society and provide new evidence to help us understand the evolution of modern human society.

This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.
Shodagor women cooperate across domains of work and childcare to solve an adaptive problem
Authors: Starkweather K. E. , Reynolds A. Z. , Zohora F. , Alam N.
Published: November 2022

Across human societies, women's economic production and their contributions to childcare are critical in supporting reproductive fitness for themselves, their spouses and children. Yet, the necessity of performing both work and childcare tasks presents women with an adaptive problem in which they must determine how best to allocate their time and energy between these tasks. Women often use cooperative relationships with alloparents to solve this problem, but whether or not women cooperate across different domains (e.g. work and childcare) to access alloparents remains relatively under-explored. Using social network data collected with Shodagor households in Bangladesh, we show that women who need childcare help in order to work draw on cooperative work partners as potential alloparents, and that all women rely heavily on kin, but not reciprocal cooperation for childcare help. These results indicate that Shodagor women strategize to create work and childcare relationships in ways that help solve the adaptive problem they face. We discuss the implications of our results and the example provided by Shodagor women for a broader understanding of women's cooperative relationships, including the importance of socio-ecological circumstances and gendered divisions of labour in shaping women's cooperative strategies.

This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.
Sedentarization and maternal childcare networks: role of risk, gender and demography
Authors: Page Abigail E. , Migliano Andrea B. , Dyble Mark , Major-Smith Daniel , Viguier Sylvain , Hassan Anushé
Published: November 2022

Women cooperate over multiple domains and while research from western contexts portrays women's networks as limited in size and breadth, women receive help, particularly with childcare, from a diverse range of individuals (allomothers). Nonetheless, little exploration has occurred into why we see such diversity. Wide maternal childcare networks may be a consequence of a lack of resource accumulation in mobile hunter–gatherers—where instead households rely on risk-pooling in informal insurance networks. By contrast, when households settle and accumulate resources, they are able toretain riskby absorbing losses. Thus, the size and composition of mothers' childcare networks may depend on risk-buffering, as captured by mobile and settled households in the Agta, a Philippine foraging population with diverse lifestyles. Across 78 children, we find that childcare from grandmothers and sisters was higher in settled camps, while childcare from male kin was lower, offering little support for risk-buffering. Nonetheless, girls’ workloads were increased in settled camps while grandmothers had fewer dependent children, increasing their availability. These results point to gender-specific changes associated with shifting demographics as camps become larger and more settled. Evidently, women's social networks, rather than being constrained by biology, are responsive to the changing socioecological context.

This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.
Dynamics of cooperative networks associated with gender among South Indian Tamils
Authors: Simpson Cohen R. , Power Eleanor A.
Published: November 2022

Helping behaviour is thought to play a major role in the evolution of group-living animals. Yet, it is unclear to what extent human males and human females use the same strategies to secure support. Accordingly, we investigate help-seeking over a 5-year period in relation to gender using data from virtually all adults in two Tamil villages (N= 782). Simulations of network dynamics (i.e. stochastic actor-oriented models) calibrated to these data broadly indicate that women are more inclined than men to create and maintain supportive bonds via multiple mechanisms of cooperation (e.g. reciprocity, kin bias, friend bias, generalized exchange). However, gender-related differences in the simulated dynamics of help-seeking are modest, vary based on structural position (e.g. out-degree), and do not appear to translate to divergence in the observed structure of respondents' egocentric networks. Findings ultimately suggest that men and women in the two villages are similarly social but channel their sociality differently.

This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.
No strong evidence for universal gender differences in the development of cooperative behaviour across societies
Authors: House Bailey , Silk Joan B. , McAuliffe Katherine
Published: November 2022

Human cooperation varies both across and within societies, and developmental studies can inform our understanding of the sources of both kinds of variation. One key candidate for explaining within-society variation in cooperative behaviour is gender, but we know little about whether gender differences in cooperation take root early in ontogeny or emerge similarly across diverse societies. Here, we explore two existing cross-cultural datasets of 4- to 15-year-old children's preferences for equality in experimental tasks measuring prosociality (14 societies) and fairness (seven societies), and we look for evidence of (i) widespread gender differences in the development of cooperation, and (ii) substantial societal variation in gender differences. This cross-cultural approach is crucial for revealing universal human gender differences in the development of cooperation, and it helps answer recent calls for greater cultural diversity in the study of human development. We find that gender has little impact on the development of prosociality and fairness within these datasets, and we do not find much evidence for substantial societal variation in gender differences. We discuss the implications of these findings for our knowledge about the nature and origin of gender differences in cooperation, and for future research attempting to study human development using diverse cultural samples.

This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.
Sustaining the potential for cooperation as female competitive strategy
Authors: Cassar Alessandra , Rigdon Mary
Published: November 2022

The lower female competitiveness often found in economic experiments presents a puzzle. If accumulating wealth and reaching high status affords women essential benefits for themselves and their children, why do women appear less competitive? By looking at behavioural strategies from a cooperative breeding perspective, we propose that women may have evolved an adaptation to strategically suppress competitiveness to elicit cooperation for the benefit of raising offspring. To support this idea, we review the literature that shows that women's behaviour is, in general, more reactive than men's to the social conditions of the different games. In particular, we focus on our experimental work where we show that women are not less competitive than men once the games evoke a parenting frame (by substituting cash with rewards that could benefit the participants' offspring), a gender-typical one (by using vouchers for prizes acceptable as domain of female interests), or include a prosocial option (by allowing winners to share some of the gains with losers). We conclude that, for women, nurturing the potential for cooperation intertwines with competitiveness to produce a complex, adaptive female social strategy.

This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.
Repercussions of patrilocal residence on mothers' social support networks among Tsimane forager–farmers
Authors: Seabright Edmond , Alami Sarah , Kraft Thomas S. , Davis Helen , Caldwell Ann E. , Hooper Paul , McAllister Lisa , Mulville Sarah , Veile Amanda , von Rueden Christopher , Trumble Benjamin , Stieglitz Jonathan , Gurven Michael , Kaplan Hillard
Published: November 2022

While it is commonly thought that patrilocality is associated with worse outcomes for women and their children due to lower social support, few studies have examined whether the structure of female social networks covaries with post-marital residence. Here, we analyse scan sample data collected among Tsimane forager–farmers. We compare the social groups and activity partners of 181 women residing in the same community as their parents, their husband's parents, both or neither. Relative to women living closer to their in-laws, women living closer to their parents are less likely to be alone or solely in the company of their nuclear family (odds ratio (OR): 0.6, 95% CI: 0.3–0.9), and more likely to be observed with others when engaging in food processing and manufacturing of market or household goods, but not other activities. Women are slightly more likely to receive childcare support from outside the nuclear family when they live closer to their parents (OR = 1.8, 95% CI 0.8–3.9). Their social group size and their children's probability of receiving allocare decrease significantly with distance from their parents, but not their in-laws. Our findings highlight the importance of women's proximity to kin, but also indicate that patrilocalityper seis not costly to Tsimane women.

This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.
INTERMEDIATE VAGINAL FLORA IS ASSOCIATED WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN HIV POSITIVE PREGNANT WOMEN ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN KISUMU, KENYA.
Authors: Auma Awiti Caleb , Guya Benard , Mjiwa Maxwel
Published: November 2022

Introduction

A number of studies have linked Highly Active Antiretroviral Therapy (HAART) to adverse pregnancy outcome but the mechanism is not well understood.

Hypothesis

This study postulated abnormal vaginal flora (AVF) as the link between HAART and adverse pregnancy outcome.

Objective

The study was designed to determine correlates of AVF with special emphasis on the association between AVF and HAART in HIV-1 positive pregnant women on HAART in Kisumu, Kenya.

Method

This cross sectional study was carried out at Lumumba sub county hospital. The facility receive patients from Kisumu county and its surrounding; a region with high HIV and BV prevalence plus high maternal and neonatal morbidities and mortalities. Willing 76 pregnant women who started HAART on or before first trimester were enrolled after signing informed consent forms. Using formatted questionnaire participants were interviewed on demographic, clinical and behavioral information. The samples were collected in second trimester and BV determined by Nugent’s criteria. Fisher Exact Chi square test and multinomial logistic regression was used to determine the association of HAART and participants characteristics with AVF.

Results

Vaginal douching any time earlier than two weeks to specimen collection [9.67(1.03-90.41)] and non efavirenz based HAART [24.57(2.39-253.14)] were positively associated with BV and intermediate vaginal flora respectively while self-employment [0.06(0.01-0.88)] and one sexual partner in the last two months [0.13(0.02-0.70)] being negatively associated with intermediate vaginal flora. Meanwhile non efavirenz based HAART [17.10(1.18-247.34)] and vaginal douching anytime earlier than two weeks to specimen collection [12.70(1.10-146.)]  had independent positive association with intermediate vaginal flora and BV respectively.

Conclusion

This study found a positive independent association between HAART and intermediate vaginal flora. Similar to BV, it has been discovered that intermediate vaginal flora is linked to poor pregnancy outcome. This study has therefore proved that HAART alters vaginal flora leading to adverse pregnancy outcome.
Machine Learning-Enabled Prediction of Speech Perception Improvement Based on Diffusion Tensor Imaging of Young Cochlear Implant Candidates
Authors: Geng Xiujuan , Wong Patrick CM , Tournis Elizabeth , Ryan Maura , Young Nancy M
Published: November 2022

Prediction of improvement in speech perception after cochlear implantation (CI) is clinically important to optimize pediatric habilitation. Conventional methods using non-neural measures do not permit accurate prediction on the individual child level. In this study, we investigate whether white matter patterns detected by diffusion tensor imaging (DTI) magnetic resonance imaging (MRI) predict speech perception improvement. Pre-surgical DTI of CI candidates was compared to matched normal-hearing (NH) children to determine cortical regions affected by hearing impairment. Speech Recognition Index in Quiet was measured at baseline and 6 months post implantation to compute improvement in speech perception. Machine learning prediction of speech perception improvement (high or low) was performed using non-imaging and DTI white matter characteristics of whole, affected and unaffected brain. Affected and unaffected white matter regions were determined by comparing DTI multi-voxel pattern similarity maps of white matter integrity indices between CI and NH. Abnormal white matter patterns were found throughout brain of CI candidates. Prediction of 6-month post-CI improvement accuracy, sensitivity and specificity using unaffected regions (0.86, 0.91, 0.80, respectively) and whole brain white matter (0.85, 0.91, 0.80, respectively) yielded similar results, and were more predictive than regions affected by hearing impairment (0.72, 0.74, 0.70, respectively) or non-imaging features (0.67, 0.55, 0.78, respectively). Findings support that presurgical neural white matter pathways, especially in the association auditory and cognitive regions not affected by auditory deprivation, play a critical role in speech development after CI and are more predictive of outcome than traditional non-neural variables such as age at implant.