bluuebunny/crossref_metadata_2025 huggingface dataset:
Association Between Rotator Cuff Muscle Size and Glenoid Deformity in Primary Glenohumeral Osteoarthritis
Authors: Aleem Alexander W. , Chalmers Peter N. , Bechtold Daniel , Khan Adam Z. , Tashjian Robert Z. , Keener Jay D.
Published: September 2019

Background:

Although glenoid morphology has been associated with fatty infiltration of the rotator cuff in arthritic shoulders, the association of rotator cuff muscle area with specific patterns of glenoid wear has not been studied. The purpose of our study was to assess the associations of glenoid deformity in primary glenohumeral osteoarthritis and rotator cuff muscle area.

Methods:

A retrospective study of 370 computed tomographic (CT) scans of osteoarthritic shoulders was performed. Glenoid deformity according to the modified Walch classification was determined, and retroversion, inclination, and humeral-head subluxation were calculated using automated 3-dimensional software. Rotator cuff muscle area was measured on sagittal CT scan reconstructions. A ratio of the area of the posterior rotator cuff muscles to the subscapularis was calculated to approximate axial plane potential force imbalance. Univariate and multivariate analyses to determine associations with glenoid bone deformity and rotator cuff measurements were performed.

Results:

Patient age and sex were significantly related to cuff muscle area across glenoid types. Multivariate analysis did not find significant differences in individual rotator cuff cross-sectional areas across glenoid types, with the exception of a larger supraspinatus area in Type-B2 glenoids compared with Type-A glenoids (odds ratio [OR], 1.5; p = 0.04). An increased ratio of the posterior cuff area to the subscapularis area was associated with increased odds of a Type-B2 deformity (OR, 1.3; p = 0.002). Similarly, an increase in this ratio was significantly associated with increased glenoid retroversion (beta = 0.92; p = 0.01) and humeral-head subluxation (beta = 1.48; p = 0.001). Within the Type-B glenoids, only posterior humeral subluxation was related to the ratio of the posterior cuff to the subscapularis (beta = 1.15; p = 0.001).

Conclusions:

Age and sex are significantly associated with cuff muscle area in arthritic shoulders. Asymmetric glenoid wear and humeral-head subluxation in osteoarthritis are associated with asymmetric atrophy within the rotator cuff transverse plane. Increased posterior rotator cuff muscle area compared with anterior rotator cuff muscle area is associated with greater posterior glenoid wear and subluxation. It is unclear if the results are causative or associative; further research is required to clarify the relationship.

Level of Evidence:

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Long-Term Outcomes of Pectoralis Major Transfer for the Treatment of Irreparable Subscapularis Tears
Authors: Ernstbrunner Lukas , Wieser Karl , Catanzaro Sabrina , Agten Christoph A. , Fornaciari Paolo , Bauer David E. , Gerber Christian
Published: September 2019

Background:

One recognized salvage option in the treatment of an irreparable subscapularis tear is the pectoralis major tendon transfer (PMT). We aimed to analyze the long-term clinical and imaging outcome of PMT for irreparable subscapularis deficiency.

Methods:

Twenty-eight consecutive patients representing 30 shoulders underwent PMT at a mean age of 53.0 years (range, 35 to 67 years). At a mean of 19.7 years (range, 18 to 22 years) postoperatively, 24 shoulders (80%) were clinically examined and 21 were radiographically and sonographically assessed. The long-term results were compared with preoperative findings and previously published short-term results.

Results:

The mean relative Constant score (percentage of age and sex-matched normal scores; CS%) and the Subjective Shoulder Value (SSV) both improved significantly from preoperatively (CS%, 47%, and SSV, 22%) to postoperatively (CS%, 77%, and SSV, 71%; p < 0.001 for both). All patients rated their results as good or excellent. Active anterior elevation was improved from preoperatively (120°) to postoperatively (131°), but the difference was not significant. Active internal and external rotation decreased significantly from the short-term (32-month) follow-up to the time of the latest follow-up (p = 0.005 and p = 0.002, respectively); however, internal rotation remained at 6 points compared with the 8 points recorded at short-term follow-up and external rotation decreased only from a mean of 51° to 39°. Loss of active range of motion was not observed subjectively and was not subjectively limiting, represented by the high ultimate SSV and overall satisfaction. Four shoulders (19%) showed evidence of glenohumeral arthropathy (Samilson and Prieto grade 3), but clinically were mildly symptomatic to asymptomatic at the time of the latest follow-up (CS% range, 67% to 88%; SSV range, 70% to 80%). Rupture of the PMT was sonographically identified in 2 patients (10%) and was associated with radiographic evidence of advanced cuff tear arthropathy (Hamada stages ≥4). Six (20%) of the initial 30 shoulders were revised, and 1 (4%) of the 24 shoulders that were clinically examined underwent reverse total shoulder arthroplasty.

Conclusions:

At long-term follow-up, PMT for isolated and combined subscapularis tears is associated with good to excellent clinical results. Although one-third of the shoulders developed mildly symptomatic or asymptomatic osteoarthritis, the need for salvage with use of reverse total shoulder arthroplasty was rare.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Comparison of Topical and Intravenous Tranexamic Acid for Total Knee Replacement
Authors: Jules-Elysee Kethy M. , Tseng Audrey , Sculco Thomas P. , Baaklini Lila R. , McLawhorn Alexander S. , Pickard Amanda J. , Qin WeiGe , Cross Justin R. , Su Edwin P. , Fields Kara G. , Mayman David J.
Published: September 2019

Background:

Tranexamic acid (TXA) is an antifibrinolytic drug. Topical administration of TXA during total knee arthroplasty (TKA) is favored for certain patients because of concerns about thrombotic complications, despite a lack of supporting literature. We compared local and systemic levels of thrombogenic markers, interleukin (IL)-6, and TXA between patients who received intravenous (IV) TXA and those who received topical TXA.

Methods:

Seventy-six patients scheduled for TKA were enrolled in this randomized double-blinded study. The IV group received 1.0 g of IV TXA before tourniquet inflation and again 3 hours later; a topical placebo was administered 5 minutes before final tourniquet release. The topical group received an IV placebo before tourniquet inflation and again 3 hours later; 3.0 g of TXA was administered topically 5 minutes before final tourniquet release. Peripheral and wound blood samples were collected to measure levels of plasmin-anti-plasmin (PAP, a measure of fibrinolysis), prothrombin fragment 1.2 (PF1.2, a marker of thrombin generation), IL-6, and TXA.

Results:

At 1 hour after tourniquet release, systemic PAP levels were comparable between the IV group (after a single dose of IV TXA) and the topical group. At 4 hours after tourniquet release, the IV group had lower systemic PAP levels than the topical group (mean and standard deviation, 1,117.8 ± 478.9 µg/L versus 1,280.7 ± 646.5 µg/L; p = 0.049), indicative of higher antifibrinolytic activity after the second dose. There was no difference in PF1.2 levels between groups, indicating that there was no increase in thrombin generation. The IV group had higher TXA levels at all time points (p < 0.001). Four hours after tourniquet release, wound blood IL-6 and TXA levels were higher than systemic levels in both groups (p < 0.001). Therapeutic systemic TXA levels (mean, 7.2 ± 7.4 mg/L) were noted in the topical group. Calculated blood loss and the length of the hospital stay were lower in the IV group (p = 0.026 and p = 0.025).

Conclusions:

Given that therapeutic levels were reached with topical TXA and the lack of a major difference in the mechanism of action, coagulation, and fibrinolytic profile between topical TXA and a single dose of IV TXA, it may be a simpler protocol for institutions to adopt the use of a single dose of IV TXA when safety is a concern.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Confronting the Opioid Crisis: Practical Pain Management and Strategies
Authors: Mir Hassan R. , Miller Anna N. , Obremskey William T. , Jahangir A. Alex , Hsu Joseph R.
Published: September 2019

The United States is in the midst of an opioid crisis. Clinicians have been part of the problem because of overprescribing of narcotics for perioperative pain management. Clinicians need to understand the pathophysiology and science of addiction to improve perioperative management of pain for their patients. Multiple modalities for pain management exist that decrease the use of narcotics. Physical strategies, cognitive strategies, and multimodal medication can all provide improved pain relief and decrease the use of narcotics. National medical societies are developing clinical practice guidelines for pain management that incorporate multimodal strategies and multimodal medication. Changes to policy that improve provider education, access to naloxone, and treatment for addiction can decrease narcotic misuse and the risk of addiction.
Hip Joint Capsular Anatomy, Mechanics, and Surgical Management
Authors: Ng K.C. Geoffrey , Jeffers Jonathan R.T. , Beaulé Paul E.
Published: September 2019

➤ Hip joint capsular ligaments (iliofemoral, ischiofemoral, and pubofemoral) play a predominant role in functional mobility and joint stability.

➤ The zona orbicularis resists joint distraction (during neutral positions), and its aperture mechanism stabilizes the hip from adverse edge-loading (during extreme hip flexion-extension).

➤ To preserve joint function and stability, it is important to minimize capsulotomy size and avoid disrupting the zona orbicularis, preserve the femoral head size and neck length, and only repair when or as necessary without altering capsular tensions.

➤ It is not fully understood what the role of capsular tightness is in patients who have cam femoroacetabular impingement and if partial capsular release could be beneficial and/or therapeutic.

➤ During arthroplasty surgery, a femoral head implant that is nearly equivalent to the native head size with an optimal neck-length offset can optimize capsular tension and decrease dislocation risk where an intact posterior hip capsule plays a critical role in maintaining hip stability.
TCIRG1 Transgenic Rescue of Osteoclast Function Using Induced Pluripotent Stem Cells Derived from Patients with Infantile Malignant Autosomal Recessive Osteopetrosis
Authors: Chen Weili , Twaroski Kirk , Eide Cindy , Riddle Megan J. , Orchard Paul J. , Tolar Jakub
Published: September 2019

Background:

Osteoclasts are hematopoietic stem cell-derived multinucleated cells necessary for bone remodeling and resorption. TCIRG1 encodes a protein that is an adenosine triphosphate (ATP)-dependent vacuolar proton pump required for this process. Recessive loss-of-function mutations in both copies of this gene lead to impairment of osteoclast function, with increased bone density, increased skeletal mass, and early mortality.

Methods:

We isolated fibroblasts from a patient with the compound heterozygous TCIRG1 mutations c.1549G>A (p.517D>N) and c.2236C>T (p.746Q>X), and reprogrammed them into iPS (induced pluripotent stem) cells. The function of osteoclasts derived from these cells was then rescued by transgenic expression of TCIRG1 cDNA.

Results:

In addition to the known effects of TCIRG1 loss of function, iPS cell-derived osteoclasts from this patient had reduced expression of the bone remodeling enzymes cathepsin K (CTSK) and tartrate-resistant acid phosphatase (TRAP), leading to reduced in vitro bone remodeling. Expression of both genes and pit formation were restored in iPS cell-derived osteoclasts following transgenic restoration of TCIRG1 expression.

Conclusions:

Transgenic overexpression of TCIRG1 was sufficient to restore osteoclast function in iPS cell-derived osteoclasts from a patient with infantile malignant autosomal-recessive osteopetrosis.

Clinical Relevance:

This work provides a proof of concept for an autologous approach to treating osteopetrosis, potentially avoiding the risks associated with hematopoietic stem cell transplantation in a young patient population.
Superior Mesenteric Artery Syndrome Complicated by Gastric Mucosal Necrosis Following Congenital Scoliosis Surgery
Authors: Moyer Kathleen , Thompson George H. , Poe-Kochert Constance , Splawski Judy
Published: September 2019

Case:

This is a report of severe superior mesenteric artery (SMA) syndrome in an 11-year-old girl with congenital scoliosis following posterior spinal fusion and segmental spinal instrumentation. This was complicated by gastric mucosal necrosis but resolved satisfactory with prolonged nasogastric suction, intravenous fluids, and total parental nutrition.

Conclusions:

All pediatric spine surgeons should be aware of SMA syndrome following spine surgery. This case demonstrates that although rare, significant complications such as gastric mucosal necrosis can occur. When present, it can be treated successfully with prolonged conservative management. Comanagement with pediatric gastroenterology and pediatric general surgery is recommended.
Produced-Water Reinjection in Deep Offshore Miocene Reservoirs, Block 17, Angola
Authors: Mainguy Marc , Perrier Sebastien , Buré Erwan
Published: September 2019

In this paper we examine the changes in the injectivity of wells reinjecting produced water in two fields from Block 17, offshore Angola. This analysis suggests that the water quality has a direct impact on well injectivity during matrix injection. Well impairment caused by desulfated seawater treated with membrane technology appears immaterial in comparison with the injectivity declines observed during produced-water reinjection (PWRI). The decline rate is much quicker for the field with the worst quality of treated produced water. Injectivity enhancements observed during seawater-injection tests demonstrate that the matrix decline is partially reversible. However, permanent damage also develops with time; it is not possible to recover the initial injectivity after a long period of injection with produced water.

The analysis also shows that fracture injection can effectively mitigate the strong injectivity declines experienced in the field with the worst quality of treated produced water. Fracture injection comes with higher injection pressures, even when operating the wells at low flow rates. As a result, the injectivity index (II), as conventionally defined, displays a strong flow-rate dependency, making it inappropriate for measuring the well performance in fracture condition. Besides the limitations of the high injection pressures, fracture injection was found detrimental to injection conformance in wells with commingled water injection in several reservoir layers. In this situation, most of the injection is thought to take place in the shallowest layer where the fracture is likely to grow, leaving little injection for deeper reservoir layers.
Adaptation and Validation of a Spanish version of the Treatment Burden Questionnaire in Patients with Multiple Sclerosis
Authors: Ysrraelit Maria Celica , Fiol Marcela Paula , Peña Fernando Vazquez , Vanotti Sandra , Terrasa Sergio Adrián , Tran Viet Thi , Montori Victor M , Correale Jorge
Published: September 2019

Background: The Treatment Burden Questionnaire (TBQ) is a self-reported measure of the effect of treatment workload on patient wellbeing. We sought to validate the TBQ in Spanish and use it to estimate the burden of treatment in Argentinian patients with multiple sclerosis (MS). Methods: The TBQ was forward-backward translated into Spanish. Two focus groups and 25 semi-structured interviews focused on wording and possible item exclusion. Validation was performed in 2 steps. First, 162 patients across a range of MS severity completed the questionnaire. Confirmatory factor analysis assessed the dimensional structure of the TBQ. Construct validity was assessed by studying correlations with fatigue and quality of life (QoL). Then, in a second cohort of 171 patients, we evaluated the association between TBQ scores and patients’ sex, age, education level, employment status, type of MS, disease duration, comorbidities, EDSS, pharmacological treatment and medication adherence. Results: The questionnaire presented a 3-factor structure in which burden was related to pharmacological treatment; comprehensive health assistance; and psycho-social-economic context. Composite reliability was > 0.8 for all factors. TBQ showed positive correlation with fatigue (rs= 0.467, p=0.006), negative correlation with QoL (rs -0.446, p=0.009). For the second cohort, total TBQ score was 43 (SD 29). Lowest scores were observed on self-monitoring (0.53, SD 1.3) and highest for administrative load (4.2, SD 3.4). Inverse association was found between the TBQ score and medication adherence (r 0.243 p=0.001). TBQ scores also correlated with daily patient pill/injection requirements (r 0.175 p=0.020). Individuals receiving injectable treatment scored higher than patients on oral drugs (total TBQ 51 (SD 32) vs 39 (SD 27) p=0.002). Conclusions: The TBQ in Spanish is a reliable instrument and showed adequate correlation with QoL and adherence scales in MS patients. TBQ may benefit health resources allocation and provide tailor therapeutic interventions to construct a minimally disruptive care.
RNA 3D structure prediction guided by independent folding of homologous sequences
Authors: Magnus Marcin , Kappel Kalli , Das Rhiju , Bujnicki Janusz
Published: September 2019

Background

The understanding of the importance of RNA has dramatically changed over recent years. As in the case of proteins, the function of an RNA molecule is encoded in its tertiary structure, which in turn is determined by the molecule's sequence. The prediction of tertiary structures of complex RNAs is still a challenging task.

Results

Using the observation that RNA sequences from the same RNA family fold into conserved structure, we test herein whether parallel modeling of RNA homologs can improve ab initio RNA structure prediction method. EvoClustRNA is a multi-step modeling process, in which homologous sequences for the target sequence are selected using the Rfam database. Subsequently, independent folding simulations using Rosetta FARFAR and SimRNA are carried out. The model of the target sequence is selected based on the most common structural arrangement of the common helical fragments. As a test, on two blind RNA-Puzzles challenges, EvoClustRNA predictions ranked as the first of all submissions for the L-glutamine riboswitch and as the second for the ZMP riboswitch. Moreover, through a benchmark of known structures, we discovered several cases in which particular homologs were unusually amenable to structure recovery in folding simulations compared to the single original target sequence.

Conclusion

This work, for the first time to our knowledge, demonstrates how important is the selection of the target sequence from an alignment of an RNA family for the success of RNA 3D structure prediction. These observations prompt investigations into a new direction of research for checking 3D structure “foldability” or “predictability” of related RNA sequences to obtain accurate predictions. To support new research in this area, we provide all relevant scripts in a documented and ready-to-use form. By exploring new ideas and identification of limitations of the current RNA 3D structure prediction methods, this work is bringing us closer to the near-native computational RNA 3D models.
Prestroke statins use reduces oxidized low density lipoprotein levels and improves clinical outcomes in patients with atrial fibrillation related acute ischemic stroke
Authors: he lanying , Xu Ronghua , Wang Jian , Zhang LIli , Zhang Lijuan , Zhao Wang , Dong Weiwei
Published: September 2019

Background: Atrial fibrillation (AF) is a common cause of cerebral infarction, which could lead to endothelial dysfunction, increased reactive oxygen species (ROS) and oxidized low density lipoprotein (Ox-LDL).AF is associated with higher mortality and more severe neurologic disability. Statins may exert neuroprotective effects that are independent of LDL-C lowering. The purpose of our study was to investigate whether prestroke statins use could reduce plasma Ox-LDL levels and improve clinical outcomes in patients with AF-related acute ischemic stroke (AIS).
Methods: This was a multicenter prospective study that involved four medical centers, 242 AIS patients with AF were identified, who underwent a comprehensive clinical investigation and a 72h-Holter electrocardiogram monitoring. All patients were divided into two groups: prestroke statins use and n o prestroke statins use groups , who were followed up for 3 months. Plasma Ox-LDL levels were measured using enzyme-linked immunosorbent assay (ELISA) on admission and at 3 months. The outcome was death, major disability (modified Rankin Scale score≥3), and composite outcome (death/major disability) at 3 months after AIS.
Results: 136 patients were in no prestroke statins use group, and 106 in prestroke statins use group . Plasma Ox-LDL levels were significantly lower in prestroke statins use than in no prestroke statins use on admission and at 3 months (P<0.001). Plasma Ox-LDL levels on admission were associated with 3-month mortality [adjusted odds ratio (OR), 1.05; 95% confidence interval(CI), 0.99-1.12; P=0.047]. In fully adjusted models, prestroke statins use was associated with reduced 3-month mortality [adjusted OR, 0.38; 95% CI, 0.16–0.91; P=0.031)], major disability (adjusted OR, 0.38; 95%CI, 0.15–0.99; P=0.047), and composite outcome (adjusted OR, 0.31; 95% CI,0.17–0.74; P=0.009).
Conclusions: Prestroke statins use can reduce plasma Ox-LDL levels and improve clinical outcomes in patients with AF-related AIS.
Accuracy of Prescribing Documentation by UK Junior Doctors Undertaking Psychiatry Placements: a Multi-centre Observational Study
Authors: Dey Mrinalini , Buhagiar Kurt , Jabbar Farid
Published: September 2019

Objectives : Medical records are critical to patient care, but often contain incomplete information. In UK hospitals, record-keeping is traditionally undertaken by junior doctors, who are increasingly completing early-career placements in psychiatry, but negative attitudes towards psychiatry may affect their performance. Little is known about the accuracy of medical records in psychiatry in general. This study aimed to evaluate the accuracy of Electronic Medical Records (EMRs) pertinent to clinical decision-making (“rationale”) for prescribing completed by junior doctors during a psychiatry placement, focusing on the differences between psychotropic vs. non-psychotropic drugs and the temporal association during their placement.
Results : EMRs of 276 participants yielding 780 ward round entries were analysed, 100% of which were completed by Foundation Year or General Practice specialty training junior doctors rather than more senior clinicians. Compared with non-psychotropic drugs, documentation of prescribing rationale for psychotropic drugs was less likely (OR=0.24, 95% CI 0.16-0.36, p <0.001). The rate of rationale documentation significantly declined over time especially for psychotropic drugs ( p <0.001). Prescribing documentation of non-psychotropic drugs for people with mental illness is paradoxically more accurate than that of psychotropic drugs. Early-career junior doctors are therefore increasingly shaping EMRs of people receiving psychiatric care.
Asymptomatic pharyngeal carriage rate of Streptococcus pyogenes, its associated factors and antibiotic susceptibility pattern among school children in Hawassa town, southern Ethiopia
Authors: Anja Asrat , Beyene Getenet , S/mariam Zewudineh , DAKA DERESSE
Published: September 2019

Objectives The aim of this study was to determine the asymptomatic pharyngeal carriage rate of S. pyogenes, antimicrobial pattern and related risk factors among school children in Hawassa, Southern Ethiopia. Results Out of 287school children’s screened, 35(12.2%) were colonized with S. pyogenes. The carriage rate was significantly associated with factors such as sex (Female p=0.013) occupational status of mother (p=0.002), lower income source (500-900ETB, 1000-1500ETB) (p=0.001, and p=0.042), history of hospitalization (p=0.00) and residence of the children (p=0.002). High level resistant to tetracycline and low level to Vancomycine were observed, while penicillin, Amoxicillin, Erythromycin, Chloramphenicol, and Ceftriaxone were found to be effective.
The COngenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry: a descriptive study from single-center hospital registry of adult congenital heart disease and pulmonary hypertension in Indonesia
Authors: Dinarti Lucia Kris , Hartopo Anggoro Budi , Kusuma Arditya Damar , Dewanto Vera Christina , Setiawan Monika , Hadwiono Muhammad Reyhan , Pradana Aditya Doni , Anggrahini Dyah Wulan
Published: September 2019

Backgrounds The COngenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry is the first congenital heart disease (CHD) and PH registry in Indonesia. The study aims to describe prevalence, demographics, and hemodynamics data of adult CHD and PH in Indonesia.Methods The COHARD-PH registry is a hospital-based, single-center, and prospective cohort registry which includes adult patients with CHD and CHD-related PH. The patients were enrolled consecutively. We evaluate the registry patients from July 2012 until July 2018. The enrolled patients underwent clinical examination, electrocardiography, chest x-ray, 6 minute walking test, laboratory measurement, and transthoracic and transoesofageal echocardiography. Right Heart Catheterization (RHC) was performed to measure hemodynamics and confirmed the diagnosis of pulmonary artery hypertension (PAH).Results We registered 803 patients during the study. The majority were young-adult females. The majority of CHD was secundum ASD (79.0%). The main symptom was dyspneu on effort. The majority (78.1%) already develops signs of PH assessed by echocardiography. The Eisenmenger syndrome was encountered in 17.3% subjects. Based on the RHC, 67.8% subjects had developed PAH. Patients with PAH were significantly older, lower peripheral oxygen saturation, lower 6 minute walking distance, and higher NTproBNP. There was an increased of PAH prevalence according to age range, with the highest prevalence between 51 and 60 years old.Conclusions The COHARD-PH registry is the first Indonesian adult-CHD and PH registry. The incidence, demographics data, and hemodynamics data of this registry reflects situation in developing countries which need to be compared with similar registries from developed countries.
Next-Generation Sequencing Identified Novel Desmoplakin Frame-shift Variant in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy
Authors: Lin Xiaoping , Ma Yuankun , Cai Zhejun , Wang Qiyuan , Wang Lihua , Huo Zhaoxia , Hu Dan , Wang Jian'an , Xiang Meixiang
Published: September 2019

Background Arrhythmogenic right ventricular cardiomyopathy (ARVC) is one of the leading causes for sudden cardiac death (SCD). Recent studies have identified mutations in cardiac desmosomes as key players in the pathogenesis of ARVC. However, the specific etiology in individual families remains largely unknown.
Methods A 4-generation family presenting with syncope, lethal ventricular arrhythmia and SCD was recruited. Targeted next generation sequencing (NGS) was performed and validated by Sanger sequencing. Plasmid containing the mutation and wild type (WT) was constructed, western-blot and immunofluorescence were performed to detect the functional change due to the mutation.
Results The proband, a 56-year-old female, presented with recurrent palpitation and syncope. An ICD was implanted due to her family history of SCD/ aborted SCD. NGS revealed a novel heterozygous frame-shift variant ( c.832delG ) in Desmoplakin ( DSP ) among 5 family members. The variant led to a frame-shift and a premature termination codon, producing a truncated protein. Cardiac magnetic resonance (CMR) of the family members carrying the same variant shown myocardium thinning and fatty infiltration in the right ventricular, positive bi-ventricular late gadolinium enhancement and severe RV dysfunction, fulfilling the diagnostic criteria of ARVC. HEK293T cells transfected with mutant expressed truncated DSP protein, upregulation of nuclear junction plakoglobin ( PG ) and downregulation of β-catenin, when compared with WT.
Conclusion We infer that the novel c.832delG variant in DSP was associated with ARVC in this family, likely through Wnt/β-catenin signaling pathway.
Incidence and associated factors of laryngospasm among pediatric patients who undergone surgery under general anesthesia, in university of Gondar Compressive Specialized Hospital, Northwest Ethiopia, 2019: Cross sectional study
Authors: Chekol Wubie Birlie , Melese Debas Yaregal
Published: September 2019

Objective: this study was aimed to assess the incidence and associated factors of laryngospasm among pediatric patients who undergone surgery under general anesthesia (GA).
Results : The incidence of laryngospasm among pediatric patients who undergone surgery under GA was 57 (18.39%) . Of this 34 (59.6%) were happened during emergence, 12 (21.1%) during maintenance and 11 (19.3%) during induction phase of GA.
In multivariable analysis, airway anomalies (AOR : 14.64,95%CI:1.71,125.04) , orophyrangeal secretion (AOR : 2.45,95%CI:1.19,5.06), attempts of airway devices insertion (AOR : 2.47,95%CI:1.16,5.22) , upper respiratory tract infection (AOR : 2.91,95%CI:1.008,8.41) and inadequate depth of anesthesia (AOR : 7.92,95%CI:2.7,23.22) were significantly associated with incidence of laryngospasm .
Glucose 6 Phosphate Dehydrogenase Deficiency and Hemoglobinopathy in South Western Region Nepal: A Boon or Burden
Authors: Gautam Narayan , Gaire Bhagwati , Manandhar Trishna , Marasini Bishnu P , Parajuli Niranjan , Lekhak Sunil P , Nepal Monica
Published: September 2019

Objectives: The study was carried out to optimize the phenotypic method to characterize the sickle cell trait (SCT), sickle cell anaemia (SCA) and β-thalassemia (β-TT) suspected sample from tharu community of South Western province-5, Nepal. SCT and SCA were further evaluated by genotypic method employing amplification refractory mutation system (ARMS PCR). Moreover, Glucose 6 Phosphate Dehydrogenase (G6PD) was estimated in those hemoglobinopathy to observe its prevalence. The accurate and reliable method can play an important role in reduction of morbidity and mortality rate.
Results: The 100 suspected cases were subjected to phenotypic method adopting cellulose acetate electrophoresis and genotypic metod using ARMS PCR which portraits (5%) SCA positive test showing HBS/HBS, (38%) SCT positive trait HBA/HBS and (36%) cases normal HBA/HBA. β-TT (21%) cases were confirmed by electropherogram. G6PD deficiency was observed in (40%) of SCA, (18.4%) of SCT, (4.8%) of β-TT and (2.8%) in normal cases. Increased G6PD were developed only in SCT (5.3 %) and β-TT (4.8%). The study highlighted sickle cell disorder (SCD) and β-TT as the most common hemoglobinopathy coexisting with G6PD deficiency. Though hemoglobinopathy sometime could be protective in malaria but G6PD deficiency can cause massive hemolysis which may exacerbate the condition.
Identification of Schistosoma mansoni eggs and other soil transmitted intestinal parasites in stool using Odongo-Aginya method
Authors: Byagamy John Paul , Malinga Geoffrey Maxwell , Angwech Harriet , Echodu Richard , Odongo-Aginya Emmanuel Igwaro
Published: September 2019

Objective
World Health Organisation recommends Kato-Katz technique for quantitative diagnosis of Schistosoma (S) mansoni and other soil transmitted intestinal parasites in field research. However, the prepared slides in Kato-Katz technique cannot be examined immediately and after 1 to 2 hours, the eggs of parasites with thin cell walls over clear in glycerine and morphology of the eggs are not preserved. These disadvantages are overcome using Odongo-Aginya method as illustrate by S. mansoni eggs and other soil transmitted intestinal parasites in stool in the results.
Result
The Odongo-Aginya method composed of compound stains of 7.5% nigrosin in 10% formalin and 0.5% eosin yellowin10% formalin mixed 1:1 ratio can be examined immediately. This method illustrated very clearly morphological appearance of S. mansoni and other soil transmitted intestinal parasites. This method showed a clear appearance of intestinal parasites eggs and larvae immediately after preparation and also after six weeks. The prepared slide also maintains the morphological appearance of the eggs even of the hookworm for a long time when the slides are kept in cool dry place. This method is reliable, reproducible, cost effective, easy to learn, quick and safe especially when handling specimens from Human Immunodeficiency virus infected patients.
Prevalence of postpartum depression and associated factors among postnatal care attendees in Debre Berhan, Ethiopia, 2018.
Authors: dargie abate , Dagne Kefyalew
Published: September 2019

Background: Postpartum depression explains various groups of depressive symptoms and syndromes that take place during the first 6 weeks following birth. The postpartum period is a critical time where both mild and severe mood disorders occur. The familiar forms are baby blues and postpartum depression. Determination of the prevalence and associated factors of postpartum depression is mandatory for early detection and treatment. Methods: Institution based cross-sectional study was conducted from May to June 2018 by using systematic random sampling technique. The data was collected from each health centers and referral hospital. The study participants were eligible women who came to Debre Berhan referral hospital and health centers for postnatal care and vaccination service. The Edinburg postnatal depression scale was used to assess postpartum depression. The collected data were coded and entered into Epi-info version 7 and transported to SPSS version 20 for analysis. Both Bivariate and Multivariate Binary Logistic Regression were done to identify associated factors. During bivariate analysis, variables with p-value < 0.05 were included in multivariate analysis. Odds Ratios and their 95% Confidence Intervals were computed and variables with p-value less than 0.05 were considered significantly associated factors (multivariate analysis). Results: A total of 308 mothers who attend postnatal care included with a response rate of 100%. The prevalence of postnatal depression was found to be 15.6 %( 95%CI=11.7, 19.8). Being widowed/widower (AOR=4.17 (95% CI=1.14, 15.20)), having poor social support (AOR=5.11(95% CI= 1.00, 26.18), having hospitalized child (AOR=3.32(95%CI= 1.39, 7.93), and having died close family or relative (AOR=2.92(95%CI=1.01, 8.50)) were significantly associated factor with postpartum depression. Conclusions: Though significant proportions of mothers are depressed, the prevalence of postpartum depression was lower than most studies in different areas. It will be better if health care professionals give special attention to maternal mental health issues and consult mothers to mitigate the problem. It will be better if Health care professionals working in maternal and child health clinics to give special attention to mothers who are widowed/widower, having poor social support, having hospitalized child, having died close family or relative. Therefore, the authors failed to accept both null hypotheses.
Suitability of fecal sludge from composting toilets as feedstock for carbonization
Authors: Hübner Tobias , Herrmann André , Kretzschmar Jörg , Harnisch Falk
Published: September 2019

Composting toilets provide a promising decentralized alternative to sewer based sanitation systems. However, the valorization of fecal sludge from composting toilets (CFS) by conventional technologies is limited. In this study, we evaluated carbonization as an alternative valorization route for CFS, providing a time-efficient, decentral applicable and hygienically safe treatment option. CFS was carbonized using either pyrolysis (at 500 °C for 1 h) or hydrothermal carbonization (HTC, at 200 °C for 4 h). CFS exhibits promising feedstock characteristics, such as high total solids (TS, 21 ± 9%) and low ash content (9 ± 2%TS). HTC of CFS exhibits high char yields (75 ± 7%) while pyrolysis char from CFS exhibits elevated higher heating values (25 ± 2 MJ kg−1) and low ash content (24 ± 5%TS) compared to chars produced from fecal sludge (FS) from other sources. Further calculations showed that FS with low TS amended with sawdust can be used as inexpensive feedstock to achieve energy self-sufficient pyrolysis operation.
Variações semânticas no (des)uso do clítico se no português falado em vitória da conquista
Authors: Teixeira Jodalmara Oliveira Rocha , Silva Jorge Augusto Alves da
Published: September 2019

Neste artigo, objetivamos descrever as variações semânticas no (des)uso do clítico SE, em estruturas tradicionalmente classificadas como reflexivas, na fala vernácula de Vitória da Conquista-BA. Tais variações atuam como indícios de trajetória de mudança, que fazem com que o SE caminhe da função original de clítico reflexivo para a categoria de afixo verbal, via gramaticalização. Para testar essa hipótese, analisamos dados extraídos dos corpora orais PPVC (Corpus do Português Popular de Vitória da Conquista) e PCVC (Corpus do Português Culto de Vitória da Conquista), baseados nos pressupostos da Sociolinguística Variacionista e do Sociofuncionalismo. Os nossos resultados evidenciaram a preferência dos conquistenses pelo emprego do clítico.  Quanto ao condicionamento linguístico, a presença do SE revelou-se sensível ao tipo de clítico e à classe semântica do verbo. Relativamente ao condicionamento social, verificamos que o uso do SE é mais favorecido entre os informantes mais escolarizados e da faixa intermediária.
A method of identifying the durability indicator of microcircuitry
Authors: Dolgopolov B. A. , Zayko Yu. G. , Mikhaylov V. A.
Published: September 2019

The Aim of this paper is to ensure the compliance of the requirements for the durability of long-life space technology with the fact that regulatory documents for microcircuitry do not contain durability indicators. Thus, in accordance with OST V 11 0998-99, the dependability requirements only contain indicators of reliability and storability. On the other hand, along with the requirements for reliability and storability, the dependability specifications for space technology feature requirements for durability in operation that are usually equal to the gamma-percentile life Тl.г = 100 000 h and more if г = 99.9%. Therefore, for such long-life systems one must define durability indicators that are now absent in the technical conditions or other delivery documents. The definition of such indicators by means of durability testing is costly and time-consuming. Thus, an analytical method was proposed, according to which the lower estimate boundary for the gamma-percentile life Тl.г of microcircuitry can be obtained by equalizing the probability of no-failure of the microcircuit over time Тl.г to the probability of non-occurrence of life failures that put the microcircuit into the limit state, upon which its operation shall be terminated. In this case, in order to obtain Тl.г = 99.9% = 100 000 h, a nonredundant microcircuit or another product must have the failure rate of 10-8 1/h. In the case of more complex microcircuits, it does not appear to be possible to obtain the required value of Тl.г=99.9% = 100 000 h. The paper suggests extending the use of the proposed method of durability indicator identification taking into consideration the fact that in the systems under consideration the failure of any one product is not allowed and, in this view, various ways of ensuring equipment redundancy are used. Hot standby is understood as a redundancy with one or several backup modules that operate similarly to the main module. Warm standby is understood as a redundancy with one or several modules that operate at a lower rate that the main module until they start functioning as the main module. The paper considers a number of redundancy architectures of a complex microcircuit that enable the specified high durability indicators. The formula was obtained for calculation of the durability indicator for more general cases, when the microcircuit is part of a module backed-up by another identical module. In this case, if the second module is in warm standby, a high durability indicator can be ensured for the microcircuit. If the second module is in hot standby, the specified durability indicator of the microcircuit is not ensured. The considered method of durability indicator identification can be used for other redundancy architectures of modules in a system.
Okul Öncesi Eğitim Kurumlarına Devam Eden 48-71 Aylık Çocukların Okul Algılarının Çizimler Aracılığıyla İncelenmesi
Authors: Civek İlknur , Çamlıbel Çakmak Özlem
Published: September 2019

Bu araştırmanın amacı, okul öncesi
eğitim kurumlarına devam eden 48–71 aylık çocukların okul algılarının
çizdikleri resimler yoluyla incelenmesidir. Araştırmanın çalışma grubunu Bolu
il merkezindeki 4 ilköğretim okulunun ana sınıfları ile 3 bağımsız
anaokulundaki 48–71 aylık 117 çocuk oluşturmaktadır. Araştırmanın amacı
doğrultusunda nitel araştırma yöntemlerinden betimleyici durum çalışması deseni
kullanılmıştır. Araştırma verileri “Bana bir okul resmi çiz” yönergesi
verilerek resim çizdirme tekniği yoluyla toplanmış ve betimsel analiz yoluyla
analiz edilmiştir. Araştırmada çocukların büyük çoğunluğunun resimlerinde okul
binası çizdikleri ve okulu fiziksel özellikleri ile algıladıkları tespit
edilmiştir. Okulun bazı çocukların resimlerinde sosyal ilişkilerin
geliştirildiği sosyal bir ortam, bazı çocukların resinlerinde ise oyun ve
hareket ihtiyaçlarını karşılayan bir yer olarak görüldüğü ortaya çıkmıştır.
Araştırma sonucunda, çocukların okula ilişkin algılamalarında okul öncesi
eğitim kurumlarının nitelik ve niceliğinin etkili olduğu sonucuna ulaşılmıştır.
First Synthesis for Bis-Spirothiazolidine Derivatives as a Novel Heterocyclic Framework and Their Biological Activity
Authors: Flefel Eman M. , El-Sofany Walaa I. , Awad Hanem M. , El-Shahat Mahmoud
Published: September 2019

Background:

Spirothiazolidines are versatile synthetic scaffold possessing wide spectrum
of biological interests involving potential anticancer activity.

Objectives:

To report the first synthesis of Bis Spiro-thiazolidine as a novel heterocyclic ring system.

Method:

One-pot three-component reaction including condensation of p-phenyllene diamine; cyclohexanone
and thioglycolic acid produced Spiro-thiazolidine 4, which underwent further condensation
with cyclohexanone and thioglycolic acid with equimolar ratio to introduce Bis-Spiothiazolidine 5 as
the first synthesis. Also, bis spiro-thiazolidine arylidene derivatives 6-13 were synthesized by the reaction
of Bis-Spiothiazolidine 5 with different aromatic benzaldehydes.

Results:

Four compounds 13, 12, 9 and 11 have shown highly significant anticancer activity compared
to Doxorubicin® (positive control) against Human liver carcinoma (HepG2) and Human Normal Retina
pigmented epithelium (RPE-1) cell lines.

Conclusion:

The novel bis-spirothiazolidine deriviatives have been synthesized for the first time and
showed excellent anticancer activities compare with the corresponding spirothiazolidine derivatives.
Guideline Adherence and the Factors Associated with Better Care for Type 2 Diabetes Mellitus Patients in Lithuanian PHC: Diabetes Mellitus Guideline Adherence in Lithuania PHC
Authors: Gediminas Raila , Ida Liseckienė , Lina Jarusevičienė , Valius Leonas
Published: September 2019

Background:

Type 2 diabetes mellitus is one of the most common chronic conditions, which requires appropriate management and care at PHC level, which is described in guidelines. However, guideline adherence at the international arena is insufficient and little is known about the reasons for guideline non-adherence.

Objective:

The aim of the survey was to analyse to what extent the Lithuanian family practitioners adhere to diabetes guidelines in order to compare to international data and to discover the factors associated with better diabetes care.

Methods:

The present study is a part of EUPRIMECARE Project, which sets out to develop a framework aiming at the analysis of PHC across Europe. The sample strategy was based on an unequal probability sampling design. An audit of 4 public and 6 private PHC medical records of the year 2011 was carried out in Kaunas region, clinical records of 382 diabetes type 2 patients were reviewed. Demography, diseases and diabetes performance indicators data were collected using a uniform template. Binary and multivariable logistic regression analyses were used in the investigation of the factors related to better diabetes guideline adherence.

Results:

Three guideline adherence levels were identified: high performance (performed in more than 90% cases) - BP measurement and HbA1c exam; good performance (performed in more than 50% cases) - ECG examination and serum creatinine check; insufficient performance (performed in less than 50% of cases) - annual endocrinologist consultation, eye fundus and foot examinations, LDL check and BMI calculation. Insufficient glycaemic control was positive associated with increased endocrinologist consultation and foot exam rates, elevated BP demonstrated the positive effect to creatinine check rate, multimorbidity had positive association to the annual eye, ECG, creatinine check rates; frequent FP attendance showed no positive effect on process indicators. Rural patients have a negative association to foot and ECG exam rates compared to urban patients. In a stepwise logistic regression model, 3 dependent variables had statistically significant impact on overall diabetes care indicator performance: negative - rural location of patients (OR 0.4, 95% CI 0.2-0.8), elevated mean BP (OR 0.6, 95% CI 0.4-0.9); positive - multimorbidity (OR 2.0, 95% CI 1.2-3.4).

Conclusion:

Guideline adherence for T2DM is not optimal in Lithuanian PHC. The best are BP and HbA1c checks. Suboptimal are BMI and LDL annual checks. The situation with these is almost the same as in other European countries. The better guideline adherence has been observed in urban (foot exam, ECG exam), multimorbidity (eye, ECG, creatinine exams), controlled by means of BP patients (serum creatinine test).