bluuebunny/crossref_metadata_2025 huggingface dataset:
Environmental peacebuilding from below: customary approaches in Timor-Leste
Authors: Ide Tobias , Palmer Lisa R , Barnett Jon
Published: January 2021

Environmental peacebuilding is the integration of natural resource management into conflict prevention, resolution and recovery so as to support peace and environmental sustainability. Most studies have been of cases where there is significant involvement of external (usually international) actors. They thus provide implicit support for liberal peacebuilding practice, which is itself the subject of much critique. Conversely, documented examples of environmental peacebuilding from below are rare. We analyse an endogenously emerging environmental peacebuilding institution, the customary tara bandu process in Timor-Leste. We explain the way tara bandu is used bottom-up to promote the sustainable use of natural resources and more peaceful relations. Tara bandu proves to be a successful, locally diverse environmental peacebuilding institution. We further show how recent attempts by international peacebuilders and state institutions to employ tara bandu have somewhat ignored the way it is deeply interwoven with local social and spiritual relations, and in so doing have jeopardized its legitimacy and efficacy. This suggests that attempts from outside actors to facilitate environmental peacebuilding may be constrained by a mismatch between theorized norms of social and environmental relations (such as ‘shared interests’) and local cultural particularities.
Water and ‘imperfect peace’ in the Euphrates–Tigris river basin
Authors: Kibaroglu Aysegül , Sayan Ramazan Caner
Published: January 2021

Transboundary water relations in the Euphrates–Tigris (ET) basin are often marked by political confrontation and rivalry between Iraq, Syria and Turkey. Even in the absence of political stability, riparian states have remained in contact with one another over the ET rivers at different levels by establishing and revitalizing joint governance mechanisms. In these processes, multiple actors—ranging from bureaucracies and heads of state and government, to epistemic communities—have focused on cooperative socio-economic development aspects of otherwise divisive water-related matters in the basin. Hence, the article aims to examine various emerging actors and mechanisms, arguing that their co-existence in the basin demonstrates a case of ‘imperfect peace’. Since the invasion of Iraq in 2003 and with the start of the domestic unrest in Syria in 2011, transboundary water relations in the basin have been carried out within the context of an unstable international security environment, particularly with the emergence of the non-state armed groups who have used water as a weapon against their opponents. The article therefore addresses policy-relevant research questions, such as what kind of joint security mechanism the riparian states should create to cope with violent non-state actors who control water and infrastructure under the conditions of ‘imperfect peace’. In the same vein, the article analyses the strategic role that water plays in environmental peacebuilding and discusses the possible ways and means to improve the protection of water during and after armed conflicts.
The nature of Women, Peace and Security: a Colombian perspective
Authors: Yoshida Keina , Céspedes-Báez Lina M
Published: January 2021

On 12 November 2019, the Special Jurisdiction for Peace (JEP), handed down a landmark decision in the case of ‘Katsa Su’ concerning the Awa indigenous group in Colombia. The Colombian conflict has particularly affected indigenous groups, such as the Awa people, and has also affected the territory in which they live. In this article, we explore the decision of the JEP, within a broader analysis of the Colombian peace agreement and consider how it might help us to think about the place of the environment in the Women, Peace and Security agenda and in international law. We call for a gendered and intersectional approach to environmental peacebuilding which is attentive to the importance of gender and different groups. Further, we highlight how the Colombian example shows how concepts such as relief, recovery and reparations are often confined in international law to women's recovery and redress with respect to sexual violence and yet, this conceptualization should be much broader. The Katsa Su case provides an example of the fact that reparations and redress must address other forms of violence, spiritual and ecological, which women also suffer in times of conflict.
Vein or artery-first resection in right middle lobe segmentectomy: which preserves more lung?
Authors: Zhang Min , Mao Ning , Wu Qing-Chen , Ge Ming-Jian
Published: January 2021

We report the thoracoscopic RS5 segmentectomy with VVBA (V, vein; V, ventilation; B, bronchus; A, artery) method and confirmed that the segmental plane visualized by vein-first resection is slightly narrower than the traditional artery-first resection.
The prevalence and underreporting of needlestick injuries among hospital workers: a cross-sectional study
Authors: Bahat Hilla , Hasidov-gafni Adi , Youngster Ilan , Goldman Michael , Levtzion-korach Osnat
Published: January 2021

Objective

Needlestick and sharps injuries (NSIs) are known occupational risks among health-care workers. Reporting these injuries is important for early prevention and management of blood-borne infections. We investigated the prevalence and characteristics of NSIs and underreporting among hospital workers (HWs) from different sectors.

Methods

A single-center cross-sectional study, involving an anonymous survey delivered to 2205 HWs. The survey included demographic information about the worker and information about training, injuries and reporting.

Results

Of the 844 HWs respondents (40%), NSIs occurred in 443 of them (53%); the majority were from needles (68%) and at bedside (51%). Significantly higher prevalences of injuries (P < 0.001) were noted among physicians (75%) and workers in their 40s (61%) and in the emergency and surgical departments (66% and 55%, respectively). NSIs were reported among 28% of workers who did not directly use needles. Underreporting was found in 46%, with a significant decrease in the report rate as the number of injuries increased (P < 0.001). Underreporting was significantly more common (P < 0.001) among physicians (59%), especially seniors (72%), workers without training about NSIs (59%), older age groups (56% in workers above 51 years, P = 0.003) and males (54%, P = 0.01). The highest underreporting rate was in injuries occurring in the operating room and the lowest in witnessed injuries occurring while passing a needle (82% vs. 31%, P < 0.001).

Conclusions

NSIs and underreporting are common among HWs from all sectors, including those who do not use needles. Improving preventive measures and reporting should be encouraged. We recommend reducing bedside procedures as possible and assigning two workers to procedures at risk for injuries, to increase the report rate.
EduRecomSys: An Educational Resource Recommender System Based on Collaborative Filtering and Emotion Detection
Authors: Bustos López Maritza , Alor-Hernández Giner , Sánchez-Cervantes José Luis , Paredes-Valverde Mario Andrés , Salas-Zárate María del Pilar
Published: January 2021

Due to the large amount of data that is available on the Web, it has become increasingly difficult to locate educational resources that satisfy specific learning needs. Furthermore, the searching process can become increasingly frustrating, time-consuming and little accurate when users do not know how to perform a search. Recommender systems aim at reducing this burden by predicting and recommending users relevant elements of interest. In the educational domain, recommender systems can take advantage of user cognitive states and emotions to generate more personalized recommendations. This work proposes EduRecomSys, an educational recommender system that combines collaborative filtering with emotion detection techniques to suggest users educational resources based on the preferences/interests of other users and the user’s emotion previously detected through face recognition technologies. Likewise, EduRecomSys allows users to retrieve educational resources from multiple sources, including social networks, linked data and learning object repositories. EduRecomSys was evaluated in qualitative and quantitative terms. The qualitative evaluation relied on the participation of three domain experts: a teacher, a pedagogue and a software engineer. The quantitative evaluation was conducted with the help of 20 graduate students. The evaluation results seem encouraging and suggest that EduRecomSys has the potential to provide effective support to the teaching-learning process.
Homogenate Extraction of Dihydroartemisinin from Artemisia Hedinii and Its Antifungal Activity
Authors: You Cong , Yu Jun , Qin Guangjiong , Yang JinPeng , Yang Chunlei , Hu Guoyuan
Published: January 2021

Background

Artemisia hedinii is a well-known traditional Chinese medicine. It can be used to extract dihydroartemisinin (DHA).

Objective

The purpose of this study was to explore the optimal conditions for the homogenate extraction of DHA from A. hedinii and the antifungal activity of DHA.

Methods

In this study, single-factor experiments and the response surface method were used to determine the optimal extraction conditions of crude extract and DHA. The method of spore germination was used to study the antifungal activity of DHA on Alternaria alternata.

Results

The optimal conditions were found as follows: ratio of liquid to material 22 mL/g; extraction time 60 s; and soaking time 34 min. Under these conditions, extraction yield of DHA was (1.76 ± 0.04%). When the concentrations of crude extract were 0.5 and 8 mg/mL, the spore germination inhibition rates of A. alternata were (17.00 ± 2.05%) and (92.56 ± 2.01%), which were 3.34 and 1.15 times that of the DHA standard, respectively.

Conclusions

Homogenate extraction technology is a fast and efficient method for extracting DHA from A. hedinii. The crude extract has significant antifungal activity against A. alternata and is inexpensive, providing possible DHA usage in the prevention and treatment of plant pathogenic fungi.

Highlights

The optimum conditions of the extraction of DHA from A. hedinii by homogenate extraction were obtained. DHA has antifungal activity against A. alternata. Compared with pure DHA, the crude extract has stronger antifungal activity against A. alternata.
Solving a Two-stage Supply Chain Network Design Problem with Fixed Costs by a Hybrid Genetic Algorithm
Authors: Cosma Ovidiu , Pop Petrică C , Sabo Cosmin
Published: January 2021

In this paper we investigate a particular two-stage supply chain network design problem with fixed costs. In order to solve this complex optimization problem, we propose an efficient hybrid algorithm, which was obtained by incorporating a linear programming optimization problem within the framework of a genetic algorithm. In addition, we integrated within our proposed algorithm a powerful local search procedure able to perform a fine tuning of the global search. We evaluate our proposed solution approach on a set of large size instances. The achieved computational results prove the efficiency of our hybrid genetic algorithm in providing high-quality solutions within reasonable running-times and its superiority against other existing methods from the literature.
Many Classes, Restricted Measurement (MACREM) Models for Improved Measurement of Activities of Daily Living
Authors: Flaherty Brian P , Shono Yusuke
Published: January 2021

Scientists use latent class (LC) models to identify subgroups in heterogeneous data. LC models reduce an item set to a latent variable and estimate measurement error. Researchers typically use unrestricted LC models, which have many measurement estimates, yet scientific interest primarily concerns the classes. We present highly restricted LC measurement models as an alternate method of operationalization. MACREM (Many Classes, Restricted Measurement) models have a larger number of LCs than a typical unrestricted model, but many fewer measurement estimates. Goals of this approach include producing more interpretable classes and better measurement error estimates. Parameter constraints accomplish this structuring. We present unrestricted and MACREM model results using data on activities of daily living (ADLs) from a national survey (N = 3,485). We compare a four-class unrestricted model with a fourteen-class MACREM model. The four-class unrestricted model approximates a dimension of functional limitation. The fourteen-class model includes unordered classes at lower levels of limitation, but ordered classes at higher levels of limitation. In contrast to the four-class model, all measurement error rates are reasonably small in the fourteen-class model. The four-class model fits the data better, but the fourteen-class model is more parsimonious (forty-three versus twenty-five parameters). Three covariates reveal specific associations with MACREM classes. In multinomial logistic regression models with a no limitation class as the reference class, past 12-month diabetes only distinguishes low limitation classes that include cutting one’s own toenails as a limitation. It does not distinguish low limitation classes characterized by other common limitations. Past 12-month asthma and current disability status perform similarly, but for heavy housework and walking limitation classes, respectively. These limitation-specific covariate associations are not apparent in the unrestricted model analyses. Identifying such connections could provide useful information to advance theory and intervention efforts.
Gradient flow exact renormalization group
Authors: Sonoda Hidenori , Suzuki Hiroshi
Published: January 2021

The gradient flow bears a close resemblance to the coarse graining, the guiding principle of the renormalization group (RG). In the case of scalar field theory, a precise connection has been made between the gradient flow and the RG flow of the Wilson action in the exact renormalization group (ERG) formalism. By imitating the structure of this connection, we propose an ERG differential equation that preserves manifest gauge invariance in Yang–Mills theory. Our construction in continuum theory can be extended to lattice gauge theory.
J-GEM optical and near-infrared follow-up of gravitational wave events during LIGO’s and Virgo’s third observing run
Authors: Sasada Mahito , Utsumi Yousuke , Itoh Ryosuke , Tominaga Nozomu , Tanaka Masaomi , Morokuma Tomoki , Yanagisawa Kenshi , Kawabata Koji S , Ohgami Takayuki , Yoshida Michitoshi , Abe Fumio , Adachi Ryo , Akitaya Hiroshi , Chong Yang , Daikuhara Kazuki , Hamasaki Ryo , Honda Satoshi , Hosokawa Ryohei , Iida Kota , Imazato Fumiya , Ishioka Chihiro , Iwasaki Takumi , Jian Mingjie , Kamei Yuhei , Kanai Takahiro , Kaneda Hidehiro , Kaneko Ayane , Katoh Noriyuki , Kawai Nobuyuki , Kubota Keiichiro , Kubota Yuma , Mamiya Hideo , Matsubayashi Kazuya , Morihana Kumiko , Murata Katsuhiro L , Nagayama Takahiro , Nakamura Noriatsu , Nakaoka Tatsuya , Niino Yuu , Nishinaka Yuki , Niwano Masafumi , Nogami Daisaku , Oasa Yumiko , Oeda Miki , Ogawa Futa , Ohsawa Ryou , Ohta Kouji , Oide Kohei , Onozato Hiroki , Sako Shigeyuki , Saito Tomoki , Sekiguchi Yuichiro , Shigeyama Toshikazu , Shigeyoshi Takumi , Shikauchi Minori , Shiraishi Kazuki , Suzuki Daisuke , Takagi Kengo , Takahashi Jun , Takarada Takuya , Takayama Masaki , Takeuchi Himeka , Tamura Yasuki , Tanaka Ryoya , Toma Sayaka , Tozuka Miyako , Uchida Nagomi , Uzawa Yoshinori , Yamanaka Masayuki , Yasuda Moeno , Yatsu Yoichi
Published: January 2021

The Laser Interferometer Gravitational-wave Observatory Scientific Collaboration and Virgo Collaboration (LVC) sent out 56 gravitational-wave (GW) notices during the third observing run (O3). The Japanese Collaboration for Gravitational wave ElectroMagnetic follow-up (J-GEM) performed optical and near-infrared observations to identify and observe an electromagnetic (EM) counterpart. We constructed a web-based system that enabled us to obtain and share information on candidate host galaxies for the counterpart, and the status of our observations. Candidate host galaxies were selected from the GLADE catalog with a weight based on the 3D GW localization map provided by LVC. We conducted galaxy-targeted and wide-field blind surveys, real-time data analysis, and visual inspection of observed galaxies. We performed galaxy-targeted follow-ups to 23 GW events during O3, and the maximum probability covered by our observations reached 9.8$\%$. Among these, we successfully started observations for 10 GW events within 0.5 days after the detection. This result demonstrates that our follow-up observation has the potential to constrain EM radiation models for a merger of binary neutron stars at a distance of up to $\sim$100 Mpc with a probability area of $\leq$ 500 deg$^2$.
Dividends versus Stock Repurchases and Long-Run Stock Returns under Heterogeneous Beliefs
Authors: Bayar Onur , Chemmanur Thomas J , Liu Mark H
Published: January 2021

We analyze a firm’s choice between dividends and stock repurchases under heterogeneous beliefs. Firm insiders, owning a certain fraction of equity, choose between paying out cash available through a dividend payment or a stock repurchase, and simultaneously choose the scale of the firm’s project. Outsiders have heterogeneous beliefs about project success and may disagree with insiders. In equilibrium, the firm distributes value through dividends alone, through a repurchase alone, or through a combination of both. In some situations, the firm may raise external financing to fund its payout. We also develop results for long-run stock returns following dividends and repurchases. (JEL G32, G35)

Received June 2, 2020; editorial decision November 3, 2020 by Editor Andrew Ellul. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
The history of the neglected tropical disease movement
Authors: Molyneux David H , Asamoa-Bah Anarfi , Fenwick Alan , Savioli Lorenzo , Hotez Peter
Published: January 2021

The history of the neglected tropical disease movement is seen through the lens of authors who worked during the last 4 decades in different roles and in different settings, from Western-based laboratories to clinical roles in endemic countries and in critical policy roles in the World Health Organization (WHO). The authors seek to identify key players from the introduction of the word ‘neglected’ by the late Kenneth Warren in his Rockefeller Foundation–supported Great Neglected Diseases of Mankind movement through to the more recent developments after the London Declaration of 2012. The role of the various actors—endemic countries, major pharmaceutical companies, the WHO, non-government development organizations, bilateral donors and academia—are discussed. The critical events and decisions are highlighted that were essential enabling factors in creating a viable and successful movement and with a resultant massive global public health and antipoverty impact. The importance of advocacy is emphasized in creating the momentum to establish a globally recognized public health ‘brand’ as a target in the United Nations Sustainable Development Goals.
Minced Skin Grafting: A Minimally Invasive and Low-Cost Procedure to Treat Pyoderma Gangrenosum
Authors: Cammarata Edoardo , Giorgione Roberto , Esposto Elia , Mazzoletti Vanessa , Boggio Paolo , Savoia Paola
Published: January 2021

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that usually presents as a painful ulcer with erythematous and undermined borders and is often characterized by pathergy. Although this condition precludes a surgical approach, in cases resistant to treatment with immunosuppressive agents, skin grafts and amputation are considered last resorts. Both expose the patient to the risk of developing new lesions. A minimally invasive autologous graft, “minced micrografts,” is a possible alternative to speed up the healing process, reducing the risk of pathergy.

This procedure was implemented in a 28-year-old man with PG who was prescribed prednisone and dapsone and who had a large ulcer on the arm and armpit that had persisted for 4 months and was undergoing slow re-epithelialization. A sample of finely minced skin previously taken from the clavicular region suspended in a hydrogel was spread on the wound bed in a proportion of less than 1:6 with respect to the receiving site. Seven days later, initial signs of re-epithelialization appeared, and the wound healed in 3 months.

In patients with PG, the minced micrograft method could facilitate ulcer healing by releasing cytokines, chemokines, and growth factors, thus promoting granulation tissue formation, neoangiogenesis. Because this method does not require special equipment or complex surgical techniques and is very low cost, it should be an integral part of the arsenal of procedures aimed at improving the quality of life of patients with PG.
Smart Dressings for Wound Healing: A Review
Authors: Barros Almeida Isabella , Garcez Barretto Teixeira Luciana , Oliveira de Carvalho Fernanda , Ramos Silva Érika , Santos Nunes Paula , Viana dos Santos Márcio Roberto , Antunes de Souza Araújo Adriano
Published: January 2021

OBJECTIVE

To provide an overview of sensors incorporated into wound dressings that can be used to assess and manage healing parameters.

DATA SOURCES

Authors conducted an extensive literature search of the Science Direct, Scopus, MEDLINE-PubMed, and Web of Science databases.

STUDY SELECTION

A total of 587 studies that evaluated dressings used to manage wound healing parameters were identified in the search, but only 16 met all of the review criteria and were included in the final analysis.

DATA EXTRACTION

Chronic wounds were the most common type of injury among studies. Six articles involved a wireless transmission system.

DATA SYNTHESIS

All studies evaluated the physical and chemical characteristics of the dressings.

CONCLUSIONS

This review demonstrates the lack of studies examining wound dressing sensors. New studies are required to assess sensors that allow not only wound monitoring, but also the application of drugs in a single dressing, providing a better and more cost-effective treatment for wounds.
Maternal and Perinatal Outcomes of Expectant Management of Full-Term, Low-Risk, Nulliparous Patients
Authors: Tita Alan T.N. , Doherty Lindsay , Grobman William A. , Reddy Uma M. , Silver Robert M. , Mallett Gail , Rice Madeline Murguia , El-Sayed Yasser Y. , Wapner Ronald J. , Rouse Dwight J. , Saade George R. , Thorp John M. , Chauhan Suneet P. , Costantine Maged M. , Chien Edward K. , Casey Brian M. , Srinivas Sindhu K. , Swamy Geeta K. , Simhan Hyagriv N. , Macones George A. ,   for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network
Published: January 2021

OBJECTIVE:

To compare risks of maternal and perinatal outcomes by completed week of gestation from 39 weeks in low-risk nulliparous patients undergoing expectant management.

METHODS:

We conducted a secondary analysis of a multicenter randomized trial of elective induction of labor at 39 weeks of gestation compared with expectant management in low-risk nulliparous patients. Participants with nonanomalous neonates, who were randomized to and underwent expectant management and attained 39 0/7 weeks of gestation, were included. Delivery gestation was categorized by completed week: 39 0/7–39 6/7 (39 weeks), 40 0/7–40 6/7 (40 weeks), and 41 0/7–42 2/7 (41–42 weeks) (none delivered after 42 2/7). The coprimary outcomes were cesarean delivery and a perinatal composite (death, respiratory support, 5-minute Apgar score 3 or less, hypoxic ischemic encephalopathy, seizure, sepsis, meconium aspiration syndrome, birth trauma, intracranial or subgaleal hemorrhage, or hypotension requiring vasopressor support). Other outcomes included a maternal composite (blood transfusion, surgical intervention for postpartum hemorrhage, or intensive care unit admission), hypertensive disorders of pregnancy, peripartum infection, and neonatal intermediate or intensive care unit admission. For multivariable analysis,P<.0125 was considered to indicate statistical significance for the coprimary outcomes.

RESULTS:

Of 2,502 participants who underwent expectant management, 964 (38.5%) delivered at 39 weeks of gestation, 1,111 (44.4%) at 40 weeks, and 427 (17.1%) at 41–42 weeks. The prevalence of medically indicated delivery was 37.9% overall and increased from 23.8% at 39 weeks of gestation to 80.3% at 41–42 weeks. The frequency of cesarean delivery (17.3%, 22.0%, 37.5%;P<.001) and the perinatal composite (5.1%, 5.9%, 8.2%;P=.03) increased with 39, 40, and 41–42 weeks of gestation, respectively, and hypertensive disorders of pregnancy decreased (16.4%, 12.1%, 10.8%,P=.001). The adjusted relative risk, 95% CI (39 weeks as referent) was significant for cesarean delivery at 41–42 weeks of gestation (1.93, 1.61–2.32) and for hypertensive disorders of pregnancy at 40 weeks (0.71, 0.58–0.88) and 41–42 weeks (0.61, 0.45–0.82). None of the other outcomes were significant.

CONCLUSION:

In expectantly managed low-risk nulliparous participants, the frequency of medically indicated induction of labor, and the risks of cesarean delivery but not the perinatal composite outcome, increased significantly from 39 to 42 weeks of gestation.
The Effects of ICU Crisis Reorganization on Outcomes in Patients Not Infected With Coronavirus Disease 2019 During the Initial Surge of the Coronavirus Disease 2019 Pandemic
Authors: Rana Sameer , Hughes Laura A. , Rana Siddharth , Adam Laura A.
Published: January 2021

Objectives:

To determine if ICU reorganization due to the coronavirus disease 2019 pandemic affected outcomes in critically ill patients who were not infected with coronavirus disease 2019.

Design:

This was a Before-After study, with coronavirus disease 2019-induced ICU reorganization as the intervention. A retrospective chart review of adult patients admitted to a reorganized ICU during the coronavirus disease 2019 surge (from March 23, 2020, to May 06, 2020: intervention group) was compared with patients admitted to the ICU prior to coronavirus disease 2019 surge (from January 10, 2020, to February 23, 2020: before group).

Setting:

High-intensity cardiac, medical, and surgical ICUs of a community hospital in metropolitan Missouri.

PATIENTS:

All patients admitted to the ICU during the before and intervention period were included. Patients younger than 18 years old and those admitted after an elective procedure or surgery were excluded. Patients with coronavirus disease 2019 were excluded.

Interventions:

None.

Measurements and Main Results:

We identified a total of 524 eligible patients: 342 patients in the before group and 182 in the intervention group. The 28-day mortality was 25.1% (86/342) and 28.6% (52/182), respectively (p = 0.40). The ICU length of stay, ventilator length of stay, and ventilator-free days were similar in both groups. Rates of patient adverse events including falls, inadvertent endotracheal tube removal, reintubation within 48 hours of extubation, and hospital acquired pressure ulcers occurred more frequently in the study group (20 events, 11%) versus control group (12 events, 3.5%) (p = 0.001).

Conclusions:

Twenty-eight-day mortality, in patients who required ICU care and were not infected with coronavirus disease 2019, was not significantly affected by ICU reorganization during a pandemic.
Role of PVT1 polymorphisms in the glioma susceptibility and prognosis
Authors: Ding Xiaoying , Zhao Yaqin , Yuan Haozheng , Zhang Yong , Gao Ya
Published: January 2021

Background

Genetic factors play a crucial role in the glioma risk and prognosis of glioma patients. To explore the role of plasmacytoma variant translocation 1 (PVT1) polymorphism in the susceptibility and survival of glioma in the Chinese Han population, we conducted a case-control study.

Methods

The three single-nucleotide polymorphisms (SNPs) in PVT1 were genotyped using Agena MassARRAY from 575 patients with glioma and 500 healthy controls. We used the χ2 test to analyze the differences in distribution of allele and genotype between the cases and controls. Odds ratio and 95% confidence interval (CI) were calculated by logistic regression analysis to evaluate the association SNPs with glioma risk. The effects of polymorphisms and clinical features on survival of glioma patients were evaluated using the log-rank test, Kaplan–Meier and Cox regression analysis.

Results

We found that rs13255292 was associated with a decreased risk of glioma in the recessive model in overall or male; and rs4410871 was significantly associated with an increased the risk of glioma in age ≤40 years old or female. Moreover, the extent of resection and chemotherapy were found to be key prognostic factors in survival of glioma patients. However, the gender, age, tumor grade, radiotherapy and PVT1 polymorphisms have no effect on prognosis of glioma patients.

Conclusions

Our results indicated that PVT1 polymorphisms (rs13255292 and rs4410871) were associated with glioma susceptibility, but have no effect on prognosis of glioma patients. Further studies with large samples are required to confirm the results.
A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse
Authors: Sun Zhi-Jing , Wang Xiu-Qi , Lang Jing-He , Xu Tao , Lu Yong-Xian , Hua Ke-Qin , Han Jin-Song , Li Huai-Fang , Tong Xiao-Wen , Wang Ping , Wang Jian-Liu , Yang Xin , Huang Xiang-Hua , Liu Pei-Shu , Song Yan-Feng , Jin Hang-Mei , Xie Jing-Yan , Wang Lu-Wen , Wu Qing-Kai , Gong Jian , Wang Yan , Wang Li-Qun , Li Zhao-Ai , Xu Hui-Cheng , Xia Zhi-Jun , Gu Li-Na , Liu Qing , Zhu Lan
Published: January 2021

Background:

It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011.

Methods:

A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided).

Results:

The number of different procedures during October 1, 2011−September 30, 2018 was more than twice that during October 1, 2004−September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004–September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011–September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P < 0.001). Regarding synthetic mesh surgeries related to POP, the rates of transvaginal placement of surgical mesh (TVM) procedures decreased from 94.1% (4983/5298) to 82.2% (11,603/14,107) (Z = 20.79, P < 0.001), but the rate of laparoscopic sacrocolpopexy (LSC) procedures increased from 5.9% (315/5298) to 17.8% (2504/14,107).

Conclusions:

The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly. The rate of TVM procedures decreased while the rate of LSC procedures increased significantly.

Trial registration number:

NCT03620565, https://register.clinicaltrials.gov.
Shared Decision-Making During Initial Diagnostic and Treatment Planning Visits for Children with Autism Spectrum Disorder
Authors: Mulé Christina M. , Lavelle Tara A. , Sliwinski Samantha K. , Wong John B.
Published: January 2021

Objective:

Although shared decision-making (SDM) can improve patient engagement, adherence, and outcomes, evidence on the use of SDM within the context of autism spectrum disorder (ASD) initial diagnosis and treatment planning remains limited. The goal of this study was to objectively assess the occurrence of SDM in these visits and to compare this assessment with parent and provider perceptions of SDM in the same encounter.

Methods:

After audio-recording and transcribing initial clinical visits between parents (n = 22) and developmental behavioral pediatricians (n = 6) discussing the diagnosis of ASD and treatment options, we used the OPTION5 Item scale to assess the occurrence of SDM. Afterward, parents and providers completed the OPTION5 Item, and parents also participated in a semistructured qualitative interview. Analysis consisted of descriptive statistics for OPTION5 Item scores and a modified grounded theory framework for interviews.

Results:

Low levels of SDM were observed, with 41% of visits having no elements of SDM. On average, visits scored 1.1 of a possible 20 points on the OPTION5 Item scale for SDM. By contrast, parents and providers indicated on the OPTION5 Item scale that providers made a “moderate” to “skilled” effort to engage parents in SDM. Qualitative interviews with parents were consistent with their OPTION5 Item ratings.

Conclusion:

The level of SDM determined by parent and provider reports was higher than the level of SDM determined by objective observation using a standard validated rating method. The findings reinforce the need for further research into barriers and facilitators of SDM methods and outcomes within ASD.
The Relationship Between GSTT1, GSTM1, GSTO1, GSTP1 and MTHFR Gene Polymorphisms and DNA Damage of BRCA1 and BRCA2 Genes in Arsenic-Exposed Workers
Authors: Qian Shuran , Tan Jingwen , Zhou Qian , Yin Jinyao , Li Hui , He Yuefeng
Published: January 2021

Objective:

To investigate the associations between genetic polymorphisms of GSTT1, GSTM1, GSTO1, GSTP1 and MTHFR genes and the DNA damage levels of BRCA1 and BRCA2 genes.

Methods:

Peripheral blood samples were used to measure DNA damage levels and genetic polymorphisms, and urine samples were collected to analyze arsenic metabolites in 79 arsenic-exposed workers and 24 non–arsenic-exposed workers.

Results:

The BRCA1 and BRCA2 damage levels in exposure group were significantly higher than that in control group. Significant associations were detected between GSTT1 and GSTO1 polymorphisms and DNA damage levels of BRCA1 and BRCA2 genes in subjects (P < 0.05).

Conclusions:

Our findings suggest that the DNA damage levels of BRCA1 and BRCA2 genes may modulate by genetic variations of GSTT1 and GSTO1 when individuals are exposed to carcinogens, such as arsenic.
The clinical significance of HERV-H LTR –associating 2 expression in cervical adenocarcinoma
Authors: Byun Jung Mi , Cho Hwa Jin , Park Ha Young , Lee Dae Sim , Choi In Hak , Kim Young Nam , Jeong Chul Hoi , Kim Da Hyun , Hwa Im Do , Min Byoung Jin , Lee Kyung Bok , Sung Moon Su , Jeong Dae Hoon
Published: January 2021

HERV-H LTR –associating 2 (HHLA2) is a recently discovered member of the B7-family of immune checkpoint molecules that is overexpressed in several types of cancer. The aim of the present study was to investigate the expression of HHLA2 in cervical adenocarcinoma (AC) and the relationship between its expression and clinicopathological factors to assess its use as a potential marker for AC prognosis.

This study included 76 patients diagnosed with cervical AC. Their resected specimens were obtained and a tissue microarray was constructed. Expression of HHLA2 was detected by the immunohistochemistry. Based on the follow-up data, correlation of HHLA2 expression and clinicopathological features, including overall survival (OS) and disease-free survival, was evaluated. Furthermore, we investigated the correlation between the expression of HHLA2 and programmed death ligand 1 (PD-L1).

A total of 76 cases of invasive cervical AC were evaluated. High HHLA2 expression was detected in 62 cases (81.6%) and low HHLA2 expression was presented in 14 cases (18.4%). HHLA2 expression showed a significant negative correlation with lymph node metastasis (P = .011). Disease free survival was 75.0% and 49.0% in high-expression and the low expression group, respectively (P = .057). Although there was no statistical significance, an improved OS was observed in the high expression group (83.1% vs 64.9%, P = .479). Further, the expression of HHLA2 and PD-L1 correlated positively (P = .005). Thus, an improved OS was observed in the PD-L1 expression group (90.7% vs 66.2%, P = .037).

High expression of HHLA2 is related to tumor progression and prognosis in patients with cervical AC. Therefore, HHLA2 may be a potential biomarker for predicting prognosis of cervical AC.
Takotsubo syndrome triggered by change in position in a patient with thoracic vertebral fracture
Authors: Zhang Zhen , Kong Hao , Zhang Si-Yu , Guan Ting-Ting
Published: January 2021

Rationale:

Takotsubo syndrome (TTS) is characterized by recovery of wall motion abnormalities and acute left ventricular dysfunction, which are often caused by acute physical or emotional stressors. It is rarely reported that TTS can be precipitated by change in position in the patient in the operating room. We report a case of a patient with a thoracic vertebral fracture who presented with TTS precipitated by changing from a supine to a prone position before percutaneous kyphoplasty (PKP) under local anesthesia.

Patient concerns:

A 76-year-old man who was diagnosed with a fracture in a thoracic vertebra was sent to the operating room to undergo PKP under local anesthesia. Approximately 5 minutes after changing from a supine to a prone position, which is necessary for PKP, the patient experienced chest pain, headache, and sweating.

Diagnosis:

A fracture in a thoracic vertebra; TTS.

Interventions:

As a result of 12-lead electrocardiography, echocardiography, left ventriculogram, and cardiac catheterization, the diagnosis of TTS was retained, and supportive therapy was initiated.

Outcomes:

Two hours later, the patient's symptoms mitigated significantly and the ST segment returned to baseline. Four days later, echocardiography showed normal systolic function without wall motion abnormalities and the patient returned to the orthopedics ward for further treatment.

Lessons:

It is necessary for anesthetists to recognize TTS which is life-threatening during monitored anesthetic care (MAC). We highlight the importance of being alerted to the possibility of TTS when managing patients with thoracic vertebral fractures undergoing surgery under local anesthesia.
XXYLT1 methylation contributes to the occurrence of lung adenocarcinoma
Authors: Zeng Hui , Wang Ying , Wang Ying , Zhang Yongjun
Published: January 2021

Background:

There is evidence that DNA methylation play major roles in lung cancer. In our previously study, C3 or f21 , also referred to as XXYLT1, rs2131877 polymorphism is associated with a reduced risk of lung adenocarcinoma. So, we explored the role of XXYLT1 methylation in lung adenocarcinoma.

Methods:

This study was conducted in 2 steps. In the first step, we recruited 15 patients with lung adenocarcinoma. Cancer tissues and para-carcinoma tissues were obtained from each of the patients. In the second step, 150 patients with lung adenocarcinom were enrolled, and cancer and normal lung tissue were obtained from each patients, respectively. The expression levels of XXYLT1 mRNA were determined, the deoxyribonucleic acid methylation status was analyzed by MassARRAY Spectrometry. The methylation data of individual units were generated by EpiTyper v1.0.5 software.

Results:

The XXYLT1 mRNA expression was significantly lower in cancer tissues than in para-carcinoma and normal lung tissues. Meanwhile, the methylation rates of three CpG units (CpG_23, CpG_25, and CpG_60.61.62.63.64.65) within the XXYLT1 gene were higher in cancer tissues compared to the para-carcinoma and the normal lung tissues. This difference was particularly significant in male patients.

Conclusions:

Our results suggested that methylation of XXYLT1 may have significance in the pathogenesis of lung adenocarcinoma.
The occurrence of delayed neuropsychologic sequelae in acute carbon monoxide poisoning patients after treatment with hyperbaric or normobaric oxygen therapy
Authors: Yang Chih-Chieh , Chuang Yi-Fei , Chen Pei-En , Tao Ping , Tung Tao-Hsin , Chien Ching-Wen
Published: January 2021

This study aimed at assessing which one of the 2 therapies is better for treating carbon monoxide (CO) poisoning from the perspective of reducing delayed neuropsychologic sequelae (DNS).

We used Taiwan's National Health Insurance Research Database (NHIRD) to conduct a nationwide population-based cohort study to assess which therapy is better for CO poisoning patients. To accurately identify patients with DNS, the definition of DNS is included neurological sequelae, and cognitive and psychological sequele. The independent variable was therapy and the dependent variable was DNS occurred within 1 year after discharge from a medical institution. The control variables were age, gender, the severity of CO poisoning, and comorbidities present before CO poisoning admission.

The risk of developing DNS in patients treated with Hyperbaric Oxygen (HBO) was 1.87-fold (P < .001) than normobaric oxygen (NBO) therapy. The severity of CO poisoning and comorbidities were also found to have significant influences on the risk of developing DNS.

HBO may be a risk therapy for treating CO poisoning.
Paroxysmal supraventricular tachycardia as a major clinical presentation of the primary coronary sinus lymphoma
Authors: Wang Ling , Cai Lixia , Chen Xiangyu , Zheng Zhelan
Published: January 2021

Rationale:

Primary cardiac lymphoma is a rare tumor, especially a tumor located in coronary sinus (CS). The most common symptom of cardiac tumors is dyspnea, accounting for 64%, followed by chest pain, accounting for 26%. However, the cases with paroxysmal supraventricular tachycardia (SVT) as a major clinical presentation are extremely rare.

Patient concerns:

We report a 55-year-old female patient with primary CS lymphoma and paroxysmal SVT.

Diagnoses:

After the surgical resection, pathology revealed the evidence of diffuse large B-cell lymphoma.

Interventions:

The patient underwent chemotherapy after CS tumor resection.

Outcomes:

The patient was disease-free during the 6-month follow-up.

Lessons:

CS enlargement may be the cause of SVT. Echocardiography should focus on the CS section to arrive at the right diagnosis.
Silicon stent placement via rigid bronchoscopy for the treatment of central airway obstruction in infants
Authors: Yu Tingting , Sun Le , Liu Xinmei , Zhu Wei
Published: January 2021

Introduction:

Rigid bronchoscopy has been proven to be an excellent tool for the diagnosis and management of several causes of central airway obstruction (CAO). The invasive treatment of silicone bronchobrachial stenting has been performed in children and adults with CAO, and satisfying results were obtained in previous studies. However, there are few reports on infants with central airway obstruction treated with stenting via rigid bronchoscopy. This technique remains a challenge to pediatric thoracic surgeons, pediatric interventional pulmonologists, and otolaryngologists who struggle to treat airway obstruction disease.

Patient concerns:

Four patients were presented to our hospital with complaints of dyspnea for a period of time after their birth

Diagnosis:

Three patients were diagnosed as tracheobronchomalacia, and tracheoesophageal fistula.

Interventions:

Four patients were treated with silicone stenting through rigid bronchoscopy.

Outcomes:

Silicon stent was adequate for improving the obstruction of the tracheal tract. All the patients were followed-up longer than 6 months. Three patients could breathe normally; the stent migrated in only 1 patient.

Conclusion:

Invasive silicone tracheobronchial stenting via rigid bronchoscopy is a viable option for infants with CAO. Choosing an appropriate size is a critical factor for success of stenting according to our experience.
A spontaneous bilateral fallopian tube pregnancy with didelphic uterus
Authors: Zeng Xi , Luo Li , Ou-Yang Yun-Wei
Published: January 2021

Rationale:

In this article, we report interesting clinical manifestation of spontaneous bilateral fallopian tube pregnancies in a patient with a didelphic uterus.

Patient concerns:

A 26-year-old female patient, gravida 2, para 0 + 1, suffered from progressive abdominal pain and vaginal bleeding. A laboratory exam revealed a human chorionic gonadotropin level of 1091 IU/L. Transvaginal ultrasound detected no embryo sacs in the uterus but revealed a didelphic uterus, and a mass measuring 39 mm x 32 mm in the left adnexa region with another mass measuring 42 x 28 mm in the right adnexa region.

Diagnoses:

An ectopic pregnancy in the left adnexa region and a corpus hemorrhagicum in the right adnexa region were suspected.

Interventions:

Laparoscopic exploration operation confirmed a didelphic uterus, and pathological biopsy revealed bilateral fallopian tube pregnancies.

Outcomes:

The patient made a good recovery and the human chorionic gonadotropin became normal within the following 2 months.

Lessons:

To the best of our knowledge, clinical manifestation of spontaneous bilateral fallopian tube pregnancies in a patient with a didelphic uterus has never been reported before. Based on the experience with this case, we suggest that if a gestational sac is found in 1 fallopian tube, the contralateral fallopian tube needs to be examined for an ectopic pregnancy during surgery.
Arthritis associated with Mycoplasma pneumoniae in a pediatric patient
Authors: Mărginean Cristina Oana , Georgescu Anca Meda , Meliţ Lorena Elena
Published: January 2021

Introduction:

Mycoplasma pneumoniae (MP) infection in infants is usually overlooked and it might result in important complications if left untreated. MP-induced arthritis is probably the least common extrapulmonary manifestation and frequently leads to delays in the diagnosis.

Patient concerns:

We report the case of a 2-year-old female child admitted in our clinic for prolonged fever (onset 2 weeks before the admission), for which the general practitioner established the diagnosis of acute pharyngitis and recommended antibiotics. But the fever persisted and the patient was referred to a pediatrician.

Diagnosis:

The laboratory tests revealed leukocytosis with neutrophilia, elevated C-reactive protein and liver cytolysis. The blood and urine cultures, as well as the serological hepatitis B and C, toxoplasmosis, Epstein Barr virus, Rubella, Herpes virus, and cytomegalovirus were negative. The chest X-ray established the diagnosis of pneumonia. The fever persisted for approximately 2 weeks after admission. On the 2nd week of admission, the patient began to experience gait difficulties complaining of pain in the right hip and ankle. The cardiology and pneumology consults revealed no pathological findings. The evolution was favorable after the initiation of Levofloxacin and MP infection was detected as we suspected. Moreover, the ultrasound of the hip revealed a mild joint effusion, while the ankle joint appeared to be normal at ultrasound. Thus, we established the diagnosis of hip and ankle arthritis based on the clinical and ultrasound findings.

Interventions:

Levofloxacin by vein was continued for 5 days, replaced afterwards with clarithromycin orally for 2 weeks.

Outcomes:

The gait difficulties persisted for approximately 5 months from the initial diagnosis, and improved once the titer of immunoglobulin M anti-MP antibodies lowered considerably. After more than 8 months, the patient was completely asymptomatic and the immunoglobulin M anti-MP was close to the normal range.

Conclusion:

The awareness of MP-induced arthritis in children represents the cornerstone in preventing diagnostic delays and initiating the proper treatment.