bluuebunny/crossref_metadata_2025 huggingface dataset:
Antimicrobial resistance in commensal Escherichia coli and Enterococcus spp. is influenced by production system, antimicrobial use, and biosecurity measures on Spanish pig farms
Authors: Mencía-Ares Oscar , Argüello Héctor , Puente Héctor , Gómez-García Manuel , Manzanilla Edgar G. , Álvarez-Ordóñez Avelino , Carvajal Ana , Rubio Pedro
Published: March 2021

Background

Antimicrobial resistance (AMR) is a global public health threat consequence of antimicrobial use (AMU) in human and animal medicine. In food-producing animals factors such as management, husbandry or biosecurity may impact AMU. Organic and extensive Iberian swine productions are based on a more sustainable and eco-friendly management system, providing an excellent opportunity to evaluate how sustained differences in AMU impact the AMR in indicator bacteria. Here, we evaluate the usefulness of commensal Escherichia coli and Enterococcus spp. isolates as AMR bioindicators when comparing 37 Spanish pig farms from both intensive and organic-extensive production systems, considering the effect of AMU and biosecurity measures, the last only on intensive farms.

Results

The production system was the main factor contributing to explain the AMR differences in E. coli and Enterococcus spp. In both bacteria, the pansusceptible phenotype was more common (p < 0.001) on organic-extensive farms when compared to intensive herds. The microbiological resistance in commensal E. coli was, for most of the antimicrobials evaluated, significantly higher (p < 0.05) on intensive farms. In enterococci, the lincosamides usage revealed the association between AMR and AMU, with an increase in the AMR for erythromycin (p < 0.01), quinupristin-dalfopristin (p < 0.01) and the multidrug-resistant (MDR) phenotype (p < 0.05). The biosecurity measures implemented on intensive farms influenced the AMR of these bioindicators, with a slightly lower resistance to sulfamethoxazole (p < 0.01) and the MDR phenotype (p < 0.05) in E. coli isolated from farms with better cleaning and disinfection protocols. On these intensive farms, we also observed that larger herds had a higher biosecurity when compared to smaller farms (p < 0.01), with no significant associations between AMU and the biosecurity scores.

Conclusions

Overall, this study evidences that the production system and, to a lesser extent, the biosecurity measures, contribute to the AMR development in commensal E. coli and Enterococcus spp., with antimicrobial usage as the main differential factor, and demonstrates the potential value of these bacteria as bioindicators on pig farms in AMR surveillance programs.
A behaviour change intervention to reduce home exposure to second hand smoke during pregnancy in India and Bangladesh: a theory and evidence-based approach to development
Authors: Satyanarayana Veena A. , Jackson Cath , Siddiqi Kamran , Chandra Prabha S. , Huque Rumana , Dherani Mukesh , Nasreen Shammi , Murthy Pratima , Rahman Atif
Published: March 2021

Background

Home exposure to secondhand smoke (SHS) is highly prevalent amongst pregnant women in low- and middle-income countries like India and Bangladesh. The literature on the efficacy of behaviour change interventions to reduce home exposure to SHS in pregnancy is scarce.

Methods

We employed a theory and evidence-based approach to develop an intervention using pregnant women as agents of change for their husband’s smoking behaviours at home. A systematic review of SHS behaviour change interventions led us to focus on developing a multicomponent intervention and informed selection of behaviour change techniques (BCTs) for review in a modified Delphi survey. The modified Delphi survey provided expert consensus on the most effective BCTs in reducing home exposure to SHS. Finally, a qualitative interview study provided context and detailed understanding of knowledge, attitudes and practices around SHS. This insight informed the content and delivery of the proposed intervention components.

Results

The final intervention consisted of four components: a report on saliva cotinine levels of the pregnant woman, a picture booklet containing information about SHS and its impact on health as well strategies to negotiate a smoke-free home, a letter from the future baby to their father encouraging him to provide a smoke-free home, and automated voice reminder and motivational messages delivered to husbands on their mobile phone. Intervention delivery was in a single face-to-face session with a research assistant who explained the cotinine report, discussed key strategies for ensuring a smoke-free environment at home and practised with pregnant women how they would share the booklet and letter with their husband and supportive family members.

Conclusion

A theory and evidence-based approach informed the development of a multicomponent behaviour change intervention, described here. The acceptability and feasibility of the intervention which was subsequently tested in a pilot RCT in India and Bangladesh will be published later.
Deceptively complex diagnosis of early onset primary chronic osteomyelitis: a case report
Authors: Kavya Priya T. , Hadhimane Amith , Rai Kirthi Kumar , Shiva Kumar H. R. , Upasi Amarnath P. , Naik Vinayak Gourish
Published: March 2021

Background

Primary chronic osteomyelitis is a rare occurrence in the pediatric mandible though it exclusively affects the mandible with no age preference. The absence of pus, fistula and sequestration are characteristic with insidious onset lacking an acute state. It is a chronic inflammatory disease of unknown etiology. It has two peaks of incidence: initial peak at adolescence and the second peak after the age of 50 years. Clinical and radiological presentation does not suffice the diagnosis of Primary chronic osteomyelitis necessitating biopsy followed by histopathological examination. Use of several terms in the literature to describe this disease entity has led to further confusion. The Zurich classification system satisfactorily describes the early onset Primary Chronic Osteomyelitis based on etiology and pathogenesis.

Case presentation

A case of Early Onset Primary Chronic Osteomyelitis in a 10 year old boy is reported comprehensively from clinical presentation to diagnosis and treatment. A meticulous hierarchical order of investigations leads the way to final diagnosis with the aid of existing literature. Extra-oral biopsy, decortication and antibiotic therapy proved to be an effective treatment with no recurrence at 1 year follow-up.

Conclusion

The clinical and radiological features of Early Onset Primary Chronic Osteomyelitis are deceptively complex throwing an array of differential diagnosis including malignant tumors whilst histopathology reveals only chronic inflammation making this entity an enigma. This disease entity should be included in the differential diagnosis for a pediatric posterior mandibular swelling that occurs without an infectious nidus, pus discharge and fistula formation.
Clinical management and mortality risk in those with eating disorders and self-harm: e-cohort study using the SAIL databank
Authors: John Ann , Marchant Amanda , Demmler Joanne , Tan Jacinta , DelPozo-Banos Marcos
Published: March 2021

Background

Individuals with eating disorders who self-harm are a vulnerable group characterised by greater pathology and poorer outcomes.

Aims

To explore healthcare utilisation and mortality in those with a record of: self-harm only; eating disorders only; and both co-occurring.

Method

We conducted a retrospective whole population e-cohort study of individuals aged 10–64 years from 2003 to 2016. Individuals were divided into: record of self-harm only; eating disorders only; both self-harm and eating disorders; and no record of self-harm or eating disorders. We used linked routinely collected healthcare data across primary care, emergency departments, hospital admissions and out-patient appointments to examine healthcare contacts and mortality.

Results

We identified 82 627 individuals: n = 75 165 with self-harm only; n = 5786 with eating disorders only; n = 1676 with both combined. Across all groups and settings significantly more individuals attended with significantly more contacts than the rest of the population. The combined group had the highest number of contacts per person (general practitioner, incident rate ratio IRR = 3.3, 95% CI 3.1–3.5; emergency department, IRR = 5.2, 95% CI 4.7–5.8; hospital admission, IRR = 5.2, 95% CI 4.5–6.0; out-patients, IRR = 3.9, 95% CI 3.5–4.4). Standardised mortality ratios showed the highest excess mortality overall in the self-harm only group (SMR = 3.2, 95% CI 3.1–3.3), particularly for unnatural causes of death (SMR = 17.1, 95% CI 16.3–17.9). SMRs and years of life lost showed an increased risk of mortality in younger age groups in the combined group. Adjusted hazard ratios showed increased mortality across all groups (self-harm only, HR = 5.3, 95% CI 5.2–5.5; eating disorders only, HR = 4.1, 95% CI 3.4–4.9; combined group, HR = 6.8, 95% CI 5.4–8.6).

Conclusions

Individuals in all groups had higher healthcare service utilisation than the general population. The increased mortality risk in young people with a record of both eating disorders and self-harm highlights the need for early specialist intervention and enhanced support.
A comparison of clinical outcomes, service satisfaction and well-being in people using acute day units and crisis resolution teams: cohort study in England
Authors: Lamb Danielle , Steare Thomas , Marston Louise , Canaway Alastair , Johnson Sonia , Kirkbride James B. , Lloyd-Evans Brynmor , Morant Nicola , Pinfold Vanessa , Smith Deb , Weich Scott , Osborn David P.
Published: March 2021

Background

For people in mental health crisis, acute day units (ADUs) provide daily structured sessions and peer support in non-residential settings, often as an addition or alternative to crisis resolution teams (CRTs). There is little recent evidence about outcomes for those using ADUs, particularly compared with those receiving CRT care alone.

Aims

We aimed to investigate readmission rates, satisfaction and well-being outcomes for people using ADUs and CRTs.

Method

We conducted a cohort study comparing readmission to acute mental healthcare during a 6-month period for ADU and CRT participants. Secondary outcomes included satisfaction (Client Satisfaction Questionnaire), well-being (Short Warwick–Edinburgh Mental Well-being Scale) and depression (Center for Epidemiologic Studies Depression Scale).

Results

We recruited 744 participants (ADU: n = 431, 58%; CRT: n = 312, 42%) across four National Health Service trusts/health regions. There was no statistically significant overall difference in readmissions: 21% of ADU participants and 23% of CRT participants were readmitted over 6 months (adjusted hazard ratio 0.78, 95% CI 0.54–1.14). However, readmission results varied substantially by setting. At follow-up, ADU participants had significantly higher Client Satisfaction Questionnaire scores (2.5, 95% CI 1.4–3.5, P < 0.001) and well-being scores (1.3, 95% CI 0.4–2.1, P = 0.004), and lower depression scores (−1.7, 95% CI −2.7 to −0.8, P < 0.001), than CRT participants.

Conclusions

Patients who accessed ADUs demonstrated better outcomes for satisfaction, well-being and depression, and no significant differences in risk of readmission, compared with those who only used CRTs. Given the positive outcomes for patients, and the fact that ADUs are inconsistently provided in the National Health Service, their value and place in the acute care pathway needs further consideration and research.
Evolution of the Cancer Registrar in the Era of Informatics
Authors: Merriman Kelly W. , Broome Ronda G. , De Las Pozas Giordana , Landvogt Lisa D. , Qi Ying , Keating Judith
Published: March 2021

The cancer registrar reports accurate, complete, and timely abstracted cancer data to various healthcare agencies. The data are used for understanding the incidence of cancer, evaluating the effectiveness of public health efforts in the prevention of new cases and improving patient care outcomes and survival. There are increasing demands placed on registrars for additional data points with real-time submission to reporting agencies. To that end, registrars are increasing the use of informatics to meet the demand. The purpose of this article is the role of the registrar in the collection and reporting of critical cancer data and how registrars are currently using informatics to enhance their work. This article describes how informatics can be leveraged in the future and how registrars play a vital role in meeting the increasing demands placed on them to provide timely, meaningful, and accurate data for the cancer community.
Tumor Response Dynamics During First-Line Pembrolizumab Therapy in Patients With Advanced Non–Small-Cell Lung Cancer
Authors: Nishino Mizuki , Hong Fangxin , Ricciuti Biagio , Hatabu Hiroto , Awad Mark M.
Published: March 2021

PURPOSE

The objectives of the study were to characterize the tumor burden dynamics on serial computed tomography scans in patients with advanced non–small-cell lung cancer treated with first-line pembrolizumab and to identify imaging markers for prolonged overall survival (OS).

MATERIALS AND METHODS

Eighty-eight patients treated with first-line pembrolizumab monotherapy were evaluated on serial computed tomography scans to characterize their quantitative tumor burden during therapy. Tumor burden dynamics were studied for the association with OS.

RESULTS

The overall response rate was 42% (37/88), with the median tumor burden changes at the best overall response of −18.3% (range, −100.0% to +103.6%). Response rates were higher in men than in women ( P = .05) and in patients with higher programmed cell death ligand-1 expression levels ( P = .02). Tumor burden stayed below the baseline burden throughout therapy in 55 patients (63%). In an 8-week landmark analysis, patients with tumor burden below the baseline burden during the first 8 weeks of therapy had longer OS compared with patients who had ≥ 0% increase (median OS, 30.7 v 16.2 months; hazard ratio [HR] = 0.44; P = .01). In the extended Cox models, patients whose tumor burden stayed below the baseline burden throughout therapy had significantly reduced hazards of death (HR = 0.41, P = .003, univariate; HR = 0.35, P = .02, multivariate). Only one patient (1.1%) experienced pseudoprogression with initial tumor increase and subsequent tumor regression.

CONCLUSION

In patients with advanced non–small-cell lung cancer treated with first-line single-agent pembrolizumab, tumor burden reduction below the baseline burden during therapy was an independent marker for prolonged OS, which may serve as a practical guide for treatment decisions.
Steroid Sulfation in Adrenal Tumors
Authors: Mueller Jonathan Wolf , Vogg Nora , Lightning Thomas Alec , Weigand Isabel , Ronchi Cristina L , Foster Paul A , Kroiss Matthias
Published: March 2021

Context

The adrenal cortex produces specific steroid hormones including steroid sulfates such as dehydroepiandrosterone sulfate (DHEAS), the most abundant steroid hormone in the human circulation. Steroid sulfation involves a multistep enzyme machinery that may be impaired by inborn errors of steroid metabolism. Emerging data suggest a role of steroid sulfates in the pathophysiology of adrenal tumors and as potential biomarkers.

Evidence Acquisition

Selective literature search using “steroid,” “sulfat*,” “adrenal,” “transport,” “mass spectrometry” and related terms in different combinations.

Evidence Synthesis

A recent study highlighted the tissue abundance of estrogen sulfates to be of prognostic impact in adrenocortical carcinoma tissue samples using matrix-assisted laser desorption ionization mass spectrometry imaging. General mechanisms of sulfate uptake, activation, and transfer to substrate steroids are reasonably well understood. Key aspects of this pathway, however, have not been investigated in detail in the adrenal; these include the regulation of substrate specificity and the secretion of sulfated steroids. Both for the adrenal and targeted peripheral tissues, steroid sulfates may have relevant biological actions beyond their cognate nuclear receptors after desulfation. Impaired steroid sulfation such as low DHEAS in Cushing adenomas is of diagnostic utility, but more comprehensive studies are lacking. In bioanalytics, the requirement of deconjugation for gas-chromatography/mass-spectrometry has precluded the study of steroid sulfates for a long time. This limitation may be overcome by liquid chromatography/tandem mass spectrometry.

Conclusions

A role of steroid sulfation in the pathophysiology of adrenal tumors has been suggested and a diagnostic utility of steroid sulfates as biomarkers is likely. Recent analytical developments may target sulfated steroids specifically.
Plasma Concentrations of Per- and Polyfluoroalkyl Substances and Body Composition From Mid-Childhood to Early Adolescence
Authors: Janis Jaclyn A , Rifas-Shiman Sheryl L , Seshasayee Shravanthi M , Sagiv Sharon , Calafat Antonia M , Gold Diane R , Coull Brent A , Rosen Clifford J , Oken Emily , Fleisch Abby F
Published: March 2021

Context

Per- and polyfluoroalkyl substances (PFAS) may alter body composition by lowering anabolic hormones and increasing inflammation, but data are limited, particularly in adolescence when body composition is rapidly changing.

Objective

To evaluate associations of PFAS plasma concentrations in childhood with change in body composition through early adolescence.

Methods

A total of 537 children in the Boston-area Project Viva cohort participated in this study. We used multivariable linear regression and Bayesian kernel machine regression (BKMR) to examine associations of plasma concentrations of 6 PFAS, quantified by mass spectrometry, in mid-childhood (mean age, 7.9 years; 2007-2010) with change in body composition measured by dual-energy x-ray absorptiometry from mid-childhood to early adolescence (mean age, 13.1 years).

Results

In single-PFAS linear regression models, children with higher concentrations of perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorodecanoate (PFDA), and perfluorohexane sulfonate (PFHxS) had less accrual of lean mass (eg, −0.33 [95% CI: −0.52, −0.13] kg/m2 per doubling of PFOA). Children with higher PFOS and PFHxS had less accrual of total and truncal fat mass (eg, −0.32 [95% CI: −0.54, −0.11] kg/m2 total fat mass per doubling of PFOS), particularly subcutaneous fat mass (eg, −17.26 [95% CI −32.25, −2.27] g/m2 per doubling of PFOS). Children with higher PFDA and perfluorononanoate (PFNA) had greater accrual of visceral fat mass (eg, 0.44 [95% CI: 0.13, 0.75] g/m2 per doubling of PFDA). Results from BKMR mixture models were consistent with linear regression analyses.

Conclusion

Early life exposure to some but not all PFAS may be associated with adverse changes in body composition.
Massive Leak in CO2 Absorber of Perseus A500 Did Not Inhibit Mechanical Ventilation but Manual Bag Ventilation: A Case Report With Experimental Reproduction
Authors: Watanabe Hidenobu , Moriyama Kiyoshi , Tokumine Joho , Tabuchi Saori , Motoyasu Akira , Kageyama Eiji , Yorozu Tomoko
Published: March 2021

Massive leaks in the anesthesia circuit may cause intraoperative hypoventilation and awareness; we experienced this with a disposable CO2 absorber in Perseus A500, which uses turbine ventilation to create positive-pressure ventilation. Consequently, manual ventilation was rendered impossible. During prolonged surgeries, CO2 absorbers may be replaced by a new one. In our case, the replacement had an occult leak. Absorbers should be checked before the exchange, and the econometer or reservoir bag’s filling state should be monitored. Anesthesia providers should know an anesthesia machine’s dynamics and breathing system to provide appropriate management of such a leak.
Superficial Cervical Plexus Block for Awake Large-Bore Central Line Placement in Parturients: A Case Series
Authors: Sheikh Maria , Carvalho Brendan , Boublik Jan , Ansari Jessica
Published: March 2021

Pregnant patients with high-risk conditions including abnormal placentation or severe cardiovascular disease may require large-bore central venous access at the time of delivery. Central lines are generally inserted while obstetric patients are awake, either because neuraxial anesthesia is planned or to minimize fetal exposure to anesthetic medications. Despite local infiltration, the procedure can cause significant patient discomfort. This case series describes use of a superficial cervical plexus block (SCPB) to facilitate line placement in 4 pregnant women with high-risk conditions. SCPB is technically straightforward with low reported complication rates and should be considered for pregnant patients requiring large-bore central lines.
“Merde Alors!”
Authors: Bernini Lorenzo
Published: March 2021

In recent history, Italy has repeatedly emerged as a successful laboratory for political experiments. After WWI, Fascism was invented there by Mussolini, and it quickly spread across Europe. In the 1990s, Berlusconi anticipated Trump's entrepreneurial populism. Today, there is a risk that Italy will once again perform the role of a political avant-garde: that it will export to Europe a sovereign populism of a new kind that is nonetheless in continuity with disquieting features of the worst past. The essay performs a close reading of the programmatic speech that Minister of Home Affairs and Deputy Prime Minister of Italy Matteo Salvini delivered in July 2018 at the thirty-second annual gathering of the Lega party. Its aim is to detect the presence in it of the politics of abjection (Judith Butler), a “Fascist archetype” (Umberto Eco) that affects both racialized and non-heterosexual people.
Rohith-Movement, Conversion, and Renaming
Authors: Leonard Dickens
Published: March 2021

Reflecting on the “suicide” of the anti-caste student activist in India, Rohith Vemula, now a Dalit icon, this paper looks at the various meanings that his suicide note generates for the Dalit present. Mobilizing historical and philosophical material, particularly the work of anti-caste intellectuals such as Ambedkar and Iyothee Thass, the paper argues that conversion and renaming, among the oppressed, are acts that move toward becoming-other.
Cultural Politics of Historically Marginalized Students in Indian Universities
Authors: Pathania Gaurav J.
Published: March 2021

The university space, the most endangered zone in Indian democracy in the present, is witnessing the ideological churnings, contradictions, and emergent possibilities of affinity among radical voices contesting culturally hegemonic practices. Student activism in general and anti-caste activism in particular offer a complex interplay of caste, gender, culture, and politics in the university space, traditionally defined as neutral. Envisioning a democratic, socially just, and genuinely secular nation, historically marginalized students challenge and critique hegemonic narratives. This article argues that anti-caste activism on campuses invokes the democratic space of universities, where ideological meanings are constructed and deconstructed to unveil the suppression of historically marginalized voices in contemporary network society. The dominant culture and politics are actually rooted in the iron laws of ancient hierarchies intrinsically opposed to the self-historicizing and well-informed democratic aspirations of student activism.
الفلسطينيّون داخل إسرائيل
Authors: كيّال مجد
Published: March 2021

ملخّص

تأسست الحركة الطلابيّة الفلسطينيّة في جامعات إسرائيل داخل بيئة أكاديميّة معادية. لم ينخرط الطلّاب الفلسطينيّون في الإنتاج المؤسساتيّ للمعرفة في الجامعات، ولم يتطوّر أي إطار معرفيّ بديل مناهض للاستعمار ضمن الأكاديميّة الإسرائيليّة. هذه الظروف تركت الحركة الطلابيّة الوطنيّة مجرّد مرآة للأحزاب السياسيّة الفلسطينيّة التقليديّة في إسرائيل، تتبنّى مواقف الأحزاب التقليديّة بشكلٍ غير نقديّ. أدارت الأحزاب الحركة الطلابيّة على جميع المستويات، ما حرمها أي استقلاليّة فكريّة أو تنظيميّة، وهو ما لم يترك مجالًا لأي قطيعة رديكاليّة عن العمل السياسيّ التقليديّ. هذه العلاقة القويّة أضعفت أيّ توجّه ثوريّ معادٍ للصهيونيّة داخل الحركة الطلابيّة، وأدى لاحقًا إلى انهيار الحركة تدريجيًا.
Germline sexual fate is determined by the antagonistic action of dmrt1 and foxl3/foxl2 in tilapia
Authors: Dai Shengfei , Qi Shuangshuang , Wei Xueyan , Liu Xingyong , Li Yibing , Zhou Xin , Xiao Hesheng , Lu Baoyue , Wang Deshou , Li Minghui
Published: March 2021

Germline sexual fate has long been believed to be determined by the somatic environment, but this idea is challenged by recent studies of foxl3 mutants in medaka. Here, we demonstrate that the sexual fate of tilapia germline is determined by the antagonistic interaction of dmrt1 and foxl3, which are transcriptionally repressed in male and female germ cells, respectively. Loss of dmrt1 rescued the germ cell sex reversal in foxl3Δ7/Δ7 XX fish, and loss of foxl3 partially rescued germ cell sex reversal but not somatic cell fate in dmrt1Δ5/Δ5 XY fish. Interestingly, germ cells lost sexual plasticity in dmrt1Δ5/Δ5 XY and foxl3Δ7/Δ7 XX single mutants, as aromatase inhibitor (AI) and estrogen treatment failed to rescue the respective phenotypes. However, recovery of germ cell sexual plasticity was observed in dmrt1/foxl3 double mutants. Importantly, mutation of somatic cell-specific foxl2 resulted in testicular development in foxl3Δ7/Δ7 or dmrt1Δ5/Δ5 mutants. Our findings demonstrate that sexual plasticity of germ cells relies on the presence of both dmrt1 and foxl3. The existence of dmrt1 and foxl3 allows environmental factors to influence the sex fate decision in vertebrates.
Soft Tissue Sarcoma of Lower Extremity: Functional Outcome and Quality of Life
Authors: Kask Gilber , Repo Jussi P. , Tukiainen Erkki J. , Blomqvist Carl , Barner-Rasmussen Ian
Published: March 2021

Background

Few studies have focused on patient-related factors in analyzing long-term functional outcome and health-related quality of life (HRQoL) in patients with postoperative lower extremity soft tissue sarcoma (STS).

Objective

The purpose of this study was to investigate factors associated with postoperative functional outcome and HRQoL in patients with lower extremity STS.

Methods

This cross-sectional study was performed in a tertiary referral center using the Toronto Extremity Salvage Score (TESS), Quality-of-Life Questionnaire (QLQ)-C30 and 15 Dimension (15D) measures. Functional outcome and HRQoL data were collected prospectively. All patients were treated by a multidisciplinary team according to a written treatment protocol.

Results

A total of 141 patients who had undergone limb-salvage surgery were included. Depending on the outcome measure used, 19–51% of patients were completely asymptomatic and 13–14% of patients had an unimpaired HRQoL. The mean score for TESS, 15D mobility score, and QLQ-C30 Physical Functioning scale were 86, 0.83, and 75, respectively, while the mean score for 15D was 0.88, and 73 for QLQ-C30 QoL. Lower functional outcome was statistically significantly associated with higher age, higher body mass index (BMI), and the need for reconstructive surgery and radiotherapy, while lower HRQoL was statistically significantly associated with higher age, higher BMI, and reconstructive surgery.

Conclusion

Functional outcome and HRQoL were generally high in this cross-sectional study of patients with STS in the lower extremity. Both tumor- and treatment-related factors had an impact but patient-related factors such as age and BMI were the major determinants of both functional outcome and HRQoL.
First record of Eobania vermiculata (O. F. Müller, 1774) (Gastropoda: Eupulmonata: Helicidae) in Romania
Authors: Grigore Stelian
Published: March 2021

Eobania vermiculata (O. F. Müller) is recorded for the first time in Romania. Other Mediterranean and Balkan species have entered the south of Romania – Dobrogea, or will do so in the near future. We expect the rest of Romania to be invaded, because the Danube is not an insurmountable barrier for some of these species.
Ανίχνευση παροξυσμικής κολπικής μαρμαρυγής σε ασθενείς με κρυπτογενή ισχαιμικά αγγειακά εγκεφαλικά επεισόδια
Authors: Λιαντινιώτη Χρυσούλα
Published: March 2021

Το ισχαιμικο εγκεφαλικό επεισόδιο(ΙΑΕΕ) είναι η πιο συχνή υποομάδα των ΑΕΕ που εμφανίζεται σε όλες τις ηλικιακές ομάδες και ο καθορισμός του αιτιοπαθολογικού μηχανισμού καθορίζει σε σημαντικό βαθμό την αντιμετώπιση, την έκβαση και την δευτερογενή πρόληψη στους ασθενείς αυτούς. Σε ένα ποσοστό 30-40% των ΙΑΕΕ παρά τον εκτεταμένο διαγνωστικό έλεγχο δεν βρίσκεται ο μηχανισμός και τα έμφρακτα αυτά ονομάζονται κρυπτογενή. Τα τελευταία χρόνια τα κρυπτογενή ΙΑΕΕ έχουν γίνει αντικείμενο μελέτης ιδιαιτέρα προς την κατεύθυνση ανίχνευσης κολπικής μαρμαρυγής (ΚΜ) ως υποκείμενο αιτιοπαθολογικό μηχανισμό. Η αρρυθμία αυτή που συχνά είναι παροξυσμική και ασυμπτωματική, επιφέρει υψηλό κίνδυνο θρομβοεμβολής με την αντιπηκτική αγωγή να υπερτερεί της αντιαιμοπεταλιακής στην πρόληψη ΙΑΕΕ και συστημικών εμβολών. Σκοπός της μελέτης αυτής ήταν να διερευνήσουμε την συχνότητα εμφάνισης παροξυσμικής κολπικής μαρμαρυγής (ΠΚΜ) σε ασθενείς με κΙΑΕΕ με τον κλασσικό καρδιολογικό έλεγχο και με επαναλαμβανόμενα 24ωρα Holter ρυθμού, να μελετήσουμε την πιθανή συσχέτιση νευρουπερηχογραφικών ή και νευροαπεικονιστικών ευρημάτων με την συχνότητα ανίχνευσης ΠΚΜ, καθώς επίσης να εξετάσουμε την πιθανή συσχέτιση της διάρκειας της ΠΚΜ με την νευρολογική βαρύτητα του ΙΑΕΕ.
Sobre la categoría gramatical de las locuciones cuantificativas elativas con estructura de sintagma nominal
Authors: Lisowska Monika
Published: March 2021

En el presente artículo se exponen algunos argumentos que podrían corroborar la hipótesis de que las locuciones cuantificativas elativas con estructura de sintagma nominal son de categoría adverbial, y no adjetiva, en la cuantificación de nombres. Las observaciones presentadas se refieren al comportamiento de la preposición de en tales locuciones y a los rasgos morfosintácticos de estas en comparación con los de los adjetivos indefinidos.
Public–private partnerships in Iran's healthcare sector: towards an economic evaluation
Authors: Shaarbafchizadeh Nasrin , Yarmohammadian Mohammad H , Akbari Faezeh
Published: March 2021

Partnerships between public and private providers have been used in healthcare systems worldwide, but are often met with challenges and controversy. This article discusses how these complex relationships have developed in Iran and what is needed to move forwards.
Evaluating the cost-effectiveness of biologics in the treatment of psoriasis: challenges and recommended methods
Authors: Taylor Matthew
Published: March 2021

The use of biologics for autoimmune conditions has increased considerably since they were first introduced. Matthew Taylor discusses this group of medications for the treatment of psoriasis, weighing up costs with quality of life gains for patients and highlighting areas of research that require further investigation.
Journal scan
Authors: Welyczko Nikki
Published: March 2021

A brief overview of recently published articles on gastroenterology, hepatology and stoma care
Introducing JETS Workforce
Authors:   JAG Endoscopy
Published: March 2021

The Joint Advisory Group (JAG) on Gastrointestinal Endoscopy's introduces the Endoscopy Training System Workforce programme, a structured approach to endoscopy training
A standardised patient education programme for peptic ulcer patients: impact on quality of life and medication adherence
Authors: Fahimi Sara , Allahbakhshian Maryam , Sadeghi Amir , Allahbakhshian Atefeh , Nasiri Malihe
Published: March 2021

Background:

Peptic ulcers can have a major negative impact on patients' quality of life (QoL), especially if patients do not adhere to prescribed medication.

Aim:

This study was carried out to investigate the impact on QoL and adherence of an educational programme for peptic ulcer patients, delivered by a variety of methods.

Methods:

The population in this single-blind randomised control experimental study included 120 peptic ulcer patients randomly assigned to four groups. Data were collected using the Gastrointestinal Patients' Quality of Life Index and the Morisky Medication Adherence Scale.

Findings:

A significant increase was observed in the mean scores related to QoL (p=0.001) and medication adherence (p=0.003) compared with the control group after the educational intervention in the intervention groups. One-way ANOVA test for four independent groups indicated a significant difference between the mean scores related to QoL and medication adherence in the four groups after the intervention (p<0.05). In addition, a significant difference was reported in the mean score changes before and after the intervention in QoL and medication adherence between messenger group and face-to-face, web and control groups.

Conclusions:

Although all three methods of face-to-face, web-based and messenger-based education improved the QoL and medication adherence in peptic ulcer patients, the last method enhanced these patient-related outcomes more effectively than the other two.
3rd World Congress of GI Endoscopy to take place in Japan, May 2022
Authors: Emura Fabian , Tajiri Hisao
Published: March 2021

Looking forward to the next global conference from the World Endoscopy Organization, in partnership with the Japan Gastroenterological Endoscopy Society
The impact of a spinal best practice tariff on compliance with the British Spine Registry
Authors: Habeebullah Awais , Rajgor Harshadkumar Dhirajlal , Gardner Adrian , Jones Morgan
Published: March 2021

Aims

The British Spine Registry (BSR) was introduced in May 2012 to be used as a web-based database for spinal surgeries carried out across the UK. Use of this database has been encouraged but not compulsory, which has led to a variable level of engagement in the UK. In 2019 NHS England and NHS Improvement introduced a new Best Practice Tariff (BPT) to encourage input of spinal surgical data on the BSR. The aim of our study was to assess the impact of the spinal BPT on compliance with the recording of surgical data on the BSR.

Methods

A retrospective review of data was performed at a tertiary spinal centre between 2018 to 2020. Data were collated from electronic patient records, theatre operating lists, and trust-specific BSR data. Information from the BSR included operative procedures (mandatory), patient consent, email addresses, and demographic details. We also identified Healthcare Resource Groups (HRGs) which qualified for BPT.

Results

A total of 3,587 patients were included in our study. Of these, 1,684 patients were eligible for BPT. Between 2018 and 2019 269/974 (28%) records were complete on the BSR for those that would be eligible for BPT. Following introduction of BPT in 2019, 671/710 (95%) records were complete having filled in the mandatory data (p < 0.001). Patient consent to data collection also improved from 62% to 93%. Email details were present in 43% of patients compared with 68% following BPT introduction.

Conclusion

Our study found that following the introduction of a BPT, there was a statistically significant improvement in BSR record completion compliance in our unit. The BPT offers a financial incentive which can help generate further income for trusts. National data input into the BSR is important to assess patient outcome following spinal surgery. The BSR can also aid future research in spinal surgery. Cite this article: Bone Jt Open 2021;2-3:198–201.
National operating volume for primary hip and knee arthroplasty in the COVID-19 era: a study utilizing the Scottish arthroplasty project dataset
Authors: Yapp Liam Z. , Clarke Jon V. , Moran Matthew , Simpson A Hamish R W. , Scott Chloe E H.
Published: March 2021

Aims

The COVID-19 pandemic led to a national suspension of “non-urgent” elective hip and knee arthroplasty. The study aims to measure the effect of the COVID-19 pandemic on total hip arthroplasty (THA) and total knee arthroplasty (TKA) volume in Scotland. Secondary objectives are to measure the success of restarting elective services and model the time required to bridge the gap left by the first period of suspension.

Methods

A retrospective observational study using the Scottish Arthroplasty Project dataset. All patients undergoing elective THAs and TKAs during the period 1 January 2008 to 31 December 2020 were included. A negative binomial regression model using historical case-volume and mid-year population estimates was built to project the future case-volume of THA and TKA in Scotland. The median monthly case volume was calculated for the period 2008 to 2019 (baseline) and compared to the actual monthly case volume for 2020. The time taken to eliminate the deficit was calculated based upon the projected monthly workload and with a potential workload between 100% to 120% of baseline.

Results

Compared to the period 2008 to 2019, primary TKA and THA volume fell by 61.1% and 53.6%, respectively. Since restarting elective services, Scottish hospitals have achieved approximately 40% to 50% of baseline monthly activity. With no changes in current workload, by 2021 there would be a reduction of 9,180 and 10,170 for THA and TKA, respectively. Conversely, working at 120% baseline monthly output, it would take over four years to eliminate the deficit for both TKA and THA.

Conclusion

This national study demonstrates the significant impact that COVID-19 pandemic has had on overall THA and TKA volume. In the six months after resuming elective services, Scottish hospitals averaged less than 50% normal monthly output. Loss of operating capacity will increase treatment delays and likely worsen overall morbidity. Cite this article: Bone Joint Open 2021;2(3):203–210.
Splenogonadal fusion: aiding detection and avoiding radical orchidectomy
Authors: Fadel MG , Walters U , Smith A , Bedi N , Davies C , Brock C , Dinneen M
Published: March 2021

Splenogonadal fusion is a rare benign congenital anomaly in which there is an abnormal connection between the gonad and the spleen. It was first described over 100 years ago with limited reports in the literature since then. Its similarity in presentation to testicular neoplasia poses a significant challenge in diagnosis and management, often resulting in radical orchidectomy. We present the case of a 31-year-old man who presented with a rapidly growing left-sided testicular mass and suspicious ultrasound findings; histology from the subsequent radical inguinal orchidectomy showed findings consistent with splenogonadal fusion. We describe points for consideration in the clinical history, examination and imaging that could suggest splenogonadal fusion, including preoperative technetium-99m-sulfur colloid imaging and intraoperative frozen section evaluation, which may confirm the diagnosis and prevent unnecessary orchidectomy.
Ultralow-noise broadband source for interferometric fiber optic
gyroscopesemploying a semiconductor optical amplifier
Authors: Suo Xinxin , Yu Haicheng , Yang Yongbin , Feng Wenshuai , Xie Pei , Chang Yujia , He Yang , Tang Mengxi , Xiang Zheng
Published: March 2021

A novel scheme of an ultralow relative intensity noise (RIN) broadband source module employing a double pumped backward (DPB) Er-doped superfluorescence fiber source (EDSFS) and a semiconductor optical amplifier for interferometric fiber optic gyroscopes (IFOGs) is proposed. With optimized parameters, the optimal twin-peak output profile of the source is obtained. The effective optical spectrum width of the source is 38.6 nm, and the output power is about 12.5 mW. Compared with the DPB EDSFS with a similar spectrum, the ultralow RIN broadband source proposed demonstrates a lower RIN of about 8.4 dB. A high-precision IFOG utilizing the ultralow RIN broadband source is set up, and the performance of the IFOG is experimentally studied. An angle random walk coefficient of

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is demonstrated, which is reduced by about 31.5% compared with the same IFOG system utilizing conventional DPB EDSFS with a similar spectrum profile. The ultralow RIN broadband source module proposed is quite feasible for high-precision IFOGs used in strategic-grade navigation systems and satellites.
Fifth-order intrinsic aberration calculation method for soft x-ray and vacuum ultraviolet optical systems
Authors: Cao Yiqing , Shen Zhijuan
Published: March 2021

In this paper, we propose the fifth-order intrinsic aberration calculation method for soft x-ray and vacuum ultraviolet optical systems. First, the sixth-order intrinsic wave aberrations with the aperture-ray coordinates on the optical surface are derived based on the wave aberration method, and then applying the sixth-order mapping relationship of aperture-ray coordinates between the optical surface and the reference exit wavefront, the expressions with those on the reference exit wavefront can be obtained. Second, we derived the calculation expression for the fifth-order intrinsic aberration on the image plane. Finally, the fifth-order intrinsic aberration calculation expressions of the soft x-ray and vacuum ultraviolet optical system derived in this paper are applied to calculate the aberration distribution on the image plane of two design examples of this kind of optical system, and the calculation results are compared with the ray-tracing ones with Shadow software to validate the aberration expressions. The study shows that the accuracy of the aberration expressions is satisfactory.
Microwave photonic de-chirp receiver for breaking the detection range swath limitation
Authors: Mo Zhenwei , Liu Chenyu , Yang Jiyao , Sun Yuchuang , Wang Ruixuan , Dong Jingwen , Li Wangzhe
Published: March 2021

A novel microwave photonics-based de-chirp radar receiver which breaks the limitation of the detection range swath is proposed and demonstrated. In the proposed receiver, a multi-channel time-division photonics de-chirp processing is implemented to increase the detection range swath. A linear frequency modulated pulse train is sent to multiple reception channels and temporally delayed in the optical domain to form reference signal replicas, enabling time-division photonics-de-chirp processing with echoes reflected from different distance regions so that the total detection range swath is increased and determined by the number of reference replicas. Hardware-in-the-loop simulation experiments are demonstrated and an inverse synthetic aperture 2D imaging is carried out, showing that the MWP radar with the proposed photonics de-chirp receiver is capable of achieving a detection range swath of 13km which is 20 times larger than that when employing a conventional de-chirp receiver with the same parameters.
Deep D2C-Net: deep learning-based display-to-camera communications
Authors: Tamang Lakpa Dorje , Kim Byung Wook
Published: March 2021

In this paper, we propose Deep D2C-Net, a novel display-to-camera (D2C) communications technique using deep convolutional neural networks (DCNNs) for data embedding and extraction with images. The proposed technique consists of fully end-to-end encoding and decoding networks, which respectively produce high-quality data-embedded images and enable robust data acquisition in the presence of optical wireless channel. For encoding, Hybrid layers are introduced where the concurrent feature maps of the intended data and cover images are concatenated in a feed-forward fashion; for decoding, a simple convolutional neural network (CNN) is utilized. We conducted experiments in a real-world environment using a smartphone camera and a digital display with multiple parameters, such as transmission distance, capture angle, display brightness, and resolution of the camera. Experimental results prove that Deep D2C-Net outperforms the existing state-of-the-art algorithms in terms of peak signal-to-noise ratio (PSNR) and bit error rate (BER), while the data-embedded image displayed on the screen yields high visual quality for the human eye.
Photoacoustic Brillouin spectroscopy of gas-filled anti-resonant hollow-core optical fibers
Authors: Zhao Yan , Qi Yun , Ho Hoi Lut , Gao Shoufei , Wang Yingying , Jin Wei
Published: March 2021

Photoacoustic spectroscopy, a powerful tool for gas analysis, typically uses bulky gas cells and discrete microphones. Here we exploit light-gas-acoustic interaction in a gas-filled anti-resonant hollow-core-fiber (AR-HCF) to demonstrate photoacoustic Brillouin spectroscopy (PABS). Pump absorption of gas molecules excites the acoustic resonances of the fiber, which modulates the phase of a probe beam propagating in the fiber. Detection of the phase modulation enables spectroscopic characterization of gas species and concentration as well as the fiber microstructure. Studying the acoustic resonances allows us to characterize the longitudinal inhomogeneity of the fiber microstructure. By tuning the pump modulation frequency to a wine-glass-like capillary mode of a 30-cm-long AR-HCF and the pump wavelength across a gas absorption line, we demonstrate detection of acetylene at the parts-per-billion level. PABS has great potential for high sensitivity gas sensing and non-invasive fiber characterization.
NCK-associated protein 1 like (nckap1l) minor splice variant regulates intrahepatic biliary network morphogenesis
Authors: Ghaffari Kimia , Pierce Lain X. , Roufaeil Maria , Gibson Isabel , Tae Kevin , Sahoo Saswat , Cantrell James R. , Andersson Olov , Lau Jasmine , Sakaguchi Takuya F.
Published: March 2021

Impaired formation of the intrahepatic biliary network leads to cholestatic liver diseases, which are frequently associated with autoimmune disorders. Using a chemical mutagenesis strategy in zebrafish combined with computational network analysis, we screened for novel genes involved in intrahepatic biliary network formation. We positionally cloned a mutation in thenckap1lgene, which encodes a cytoplasmic adaptor protein for the WAVE regulatory complex. The mutation is located in the last exon after the stop codon of the primary splice isoform, only disrupting a previously unannotated minor splice isoform, which indicates that the minor splice isoform is responsible for the intrahepatic biliary network phenotype. CRISPR/Cas9-mediatednckap1ldeletion, which disrupts both the primary and minor isoforms, showed the same defects. In the liver ofnckap1lmutant larvae, WAVE regulatory complex component proteins are degraded specifically in biliary epithelial cells, which line the intrahepatic biliary network, thus disrupting the actin organization of these cells. We further show thatnckap1lgenetically interacts with the Cdk5 pathway in biliary epithelial cells. These data together indicate that althoughnckap1lwas previously considered to be a hematopoietic cell lineage-specific protein, its minor splice isoform acts in biliary epithelial cells to regulate intrahepatic biliary network formation.