bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary abdominal cocoon with cryptorchidism: a case report
Authors: Song Wei-Jie , Liu Xin-Yi , Saad Galal Abdullah Ali , Khan Aawrish , Yang Kai-Yan , Zhang Yi , Liu Jian-Ye , He Le-Ye
Published: October 2020

Background

We report a rare case of primary abdominal cocoon with bilateral cryptorchidism.

Case presentation

The patient had a history of laparoscopic surgery for bilateral cryptorchidism 6 years earlier. He was admitted to the hospital again due to intestinal obstruction. Surgery was performed on the patient after the failure of conservative treatment. The patient was diagnosed with primary abdominal cocoon. Instead of the greater omentum, many cocoon-like tissues surrounding the bowel were seen during operation. Abdominal surgery can increase the risk of intestinal adhesion, which is one of the main causes of intestinal obstruction, especially in patients with abdominal cocoon. We hypothesize that the surgery 6 years earlier to address transabdominal bilateral cryptorchidism accelerated the patient’s intestinal obstruction.

Conclusion

This case implies that it is important for urologists to evaluate whether their patients exhibit abdominal cocoon before cryptorchidism surgery, to choose better surgical methods and reduce the risks of poor prognosis.
Spatial patterns and associated factors of HIV Seropositivity among adults in Ethiopia from EDHS 2016: a spatial and multilevel analysis
Authors: Hailu Bayuh Asmamaw , Tadese Fentaw , Bogale Getahun Gebre , Molla Asressie , Miheretu Birhan Asmame , Beyene Joseph
Published: October 2020

Background

HIV is a major public health issue, especially in developing countries. It is important to track and design successful intervention programs to explore the spatial pattern, distribution, and associated factors of HIV Seropositivity. This study therefore showed the spatial variation of HIV Seropositivity and related factors in Ethiopia.

Methods

A total sample of 25,774 individual data collected from the 2016 EDHS data were primarily HIV biomarkers, IR, MR, and GPS. Spatial heterogeneity analysis was used with methods such as Morans I, Interpolation, and Kulldorff ‘s scan statistic. Spatial analysis was conducted using open source tools (QGIS, GeoDa, SaTScan). Multilevel logistic regression analysis was performed using Stata14 to identify HIV-associated factors. Finally, the AOR with a 95% confidence interval was used to report the mixed-effect logistic regression result in the full model.

Result

The prevalence of HIV / AIDS at national level was 0.93%. The highest prevalence regions were Gambela, Addis Abeba, Harari and Diredawa, accounting for 4.79, 3.36, 2.65 and 2.6%, respectively. Higher HIV seropositive spatial clusters have been established in the Gambela and Addis Ababa regions. Multilevel analysis at the individual level being married [AOR = 2.19 95% CI: (1.11–4.31)] and previously married [AOR = 6.45, 95% CI: (3.06–13.59)], female [AOR = 1.8, 95% CI: (1.19–2.72)], first-sex at age ≤15 [AOR = 4.39, 95% CI: (1.70–11.34)], 18—19 [AOR = 2.67 95% CI: (1.05–6.8)], middle age group (25-34) [AOR = 6.53, 95% CI: (3.67–11.75)], older age group (>34) [AOR = 2.67 95% CI: (1.05–6.8)], primary school [AOR = 3.03, 95% CI: (1.92–4.79)], secondary school [AOR = 3.37, 95% CI: (1.92–5.92) were significantly associated with serropositivity. Regarding household level, place of residence [urban: AOR = 6.13 CI: (3.12, 12.06)], female-headed households (AOR = 2.24 95% CI: (1.57–3.73), media exposure [low exposure (AOR = 0.53 95% CI: (0.33–0.86), no exposure AOR = 0.39 95% CI: (0.23–0.65)] and increased household size [AOR = 0.72 95% CI: (0.65–0.8)] were associated with HIV Seropositivity.

Conclusion

High cluster HIV cases were found in Gambela, Addis Abeba, Harari, and Diredawa. Having a history of married, start sex at a younger age, female-headed household, urban residence, and lower household size is more affected by HIV/AIDS. So any concerned body work around this risk group and area can be effective in the reduction of transmission.
Six-year follow-up of a survivor of cervical spine fracture and dislocation with oesophageal perforation following long scarf syndrome - a case report and literature review
Authors: Li Xiang , Wang Fangyong , Zhang Junwei , Hong Yi , Yang Yong
Published: October 2020

Background

Accidental strangulation due to scarf getting caught in the wheels of a vehicle or machine was called “Isadora Duncan Syndrome” or “Long Scarf Syndrome”. Survival of concomitant fracture dislocation of cervical spine and oesophageal perforation following Long Scarf Syndrome was rarely described and medium-term follow-up for this lesion has not been reported.

Case presentation

We present a 39-year-old female who suffered accidental strangulation caused by the scarf around her neck getting trapped in the wheels of the a vehicle and was referred to our hospital forty days post injury. The CT examination showed a fracture dislocation at C5/6 levels with complete dissociation of the supporting structures. She developed paravertebral abscesses, cutaneous fistulas and oesophageal perforation confirmed by oesophagoscope. The patient was treated conservatively because of poor general condition and inappropriate initial treatment. Halo-vest was used to immobilize the cervical spine. The oesophagus-cutaneous fistula was managed with enteral tube feeding and repeated local care. The patient survived despite such severe injury. Nine months after the injury, the oesophageal perforation closed spontaneously and fixed malunion of the cervical spine was achieved. Six-year follow-up demonstrated that the patient survived with complete C5 tetraplegia. Literature associated with this lesion was reviewed and factors contributing to the survival were discussed.

Conclusions

Concomitant fracture dislocation of cervical spine and oesophageal perforation following Long Scarf Syndrome is extremely rare with high risk of mortality. Though surgical intervention is always necessary, the optimal management for this kind of lesion should be made on an individual basis through a multidisciplinary approach.
CASCADE: a phase 2, randomized, double-blind, placebo-controlled, parallel-group trial to evaluate the effect of tezepelumab on airway inflammation in patients with uncontrolled asthma
Authors: Emson Claire , Diver Sarah , Chachi Latifa , Megally Ayman , Small Cherrie , Downie John , Parnes Jane R. , Bowen Karin , Colice Gene , Brightling Chris E.
Published: October 2020

Background

Patients with severe, uncontrolled asthma, particularly those with a non-eosinophilic phenotype, have a great unmet need for new treatments that act on a broad range of inflammatory pathways in the airway. Tezepelumab is a human monoclonal antibody that blocks the activity of thymic stromal lymphopoietin, an epithelial cytokine. In the PATHWAY phase 2b study (NCT02054130), tezepelumab reduced exacerbations by up to 71% in adults with severe, uncontrolled asthma, irrespective of baseline eosinophilic inflammatory status. This article reports the design and objectives of the phase 2 CASCADE study.

Methods

CASCADE is an ongoing exploratory, phase 2, randomized, double-blind, placebo-controlled, parallel-group study aiming to assess the anti-inflammatory effects of tezepelumab 210 mg administered subcutaneously every 4 weeks for 28 weeks in adults aged 18–75 years with uncontrolled, moderate-to-severe asthma. The primary endpoint is the change from baseline to week 28 in airway submucosal inflammatory cells (eosinophils, neutrophils, T cells and mast cells) from bronchoscopic biopsies. Epithelial molecular phenotyping, comprising the three-gene-mean technique, will be used to assess participants’ type 2 (T2) status to enable evaluation of the anti-inflammatory effect of tezepelumab across the continuum of T2 activation. Other exploratory analyses include assessments of the impact of tezepelumab on airway remodelling, including reticular basement membrane thickening and airway epithelial integrity. At the onset of the COVID-19 pandemic, the protocol was amended to address the possibility that site visits would be limited. The amendment allowed for: at-home dosing of study drug by a healthcare professional, extension of the treatment period by up to 6 months so patients are able to attend an onsite visit to undergo the end-of-treatment bronchoscopy, and replacement of final follow-up visits with a virtual or telephone visit.

Discussion

CASCADE aims to determine the mechanisms by which tezepelumab improves clinical asthma outcomes by evaluating the effect of tezepelumab on airway inflammatory cells and remodelling in patients with moderate-to-severe, uncontrolled asthma. An important aspect of this study is the evaluation of the anti-inflammatory effect of tezepelumab across patients with differing levels of eosinophilic and T2 inflammation.

Trial registration

NCT03688074 (ClinicalTrials.gov). Registered 28 September 2018.
NAVIGATOR: a phase 3 multicentre, randomized, double-blind, placebo-controlled, parallel-group trial to evaluate the efficacy and safety of tezepelumab in adults and adolescents with severe, uncontrolled asthma
Authors: Menzies-Gow Andrew , Colice Gene , Griffiths Janet M. , Almqvist Gun , Ponnarambil Sandhia , Kaur Primal , Ruberto Gennaro , Bowen Karin , Hellqvist Åsa , Mo May , Garcia Gil Esther
Published: October 2020

Background

Patients with severe, uncontrolled asthma have a significant unmet need for new treatments that have broader effects on airway inflammation, and that provide greater improvements in asthma outcomes than currently approved biologics and standard-of-care therapies. Tezepelumab is a human monoclonal antibody that blocks the activity of the epithelial cytokine thymic stromal lymphopoietin. In the PATHWAY phase 2b study (NCT02054130), tezepelumab significantly reduced exacerbations by up to 71% in adults with severe, uncontrolled asthma, irrespective of baseline disease phenotype. This article reports the design and objectives of the pivotal phase 3 NAVIGATOR study.

Methods

NAVIGATOR (NCT03347279) is an ongoing randomized, double-blind, placebo-controlled trial in adults (18–80 years old) and adolescents (12–17 years old) with severe, uncontrolled asthma, who are receiving treatment with medium- or high-dose inhaled corticosteroids plus at least one additional controller medication with or without oral corticosteroids (N = 1061). The study population includes approximately equal proportions of patients with high (≥ 300 cells/μL) and low (< 300 cells/μL) blood eosinophil counts. The study comprises a 5–6-week screening period, a 52-week treatment period and a 12-week post-treatment follow-up period. All patients will receive their prescribed controller medications without change throughout the study. The primary efficacy endpoint is the annualized asthma exacerbation rate during the 52-week treatment period. Key secondary endpoints include the effect of tezepelumab on lung function, asthma control and health-related quality of life.

Discussion

NAVIGATOR is evaluating the effect of tezepelumab in patients with a broad range of severe asthma phenotypes at baseline, including those with low blood eosinophil counts. The target sample size for NAVIGATOR (N = 1060) was achieved, and it is the largest clinical study of tezepelumab in severe, uncontrolled asthma to date. NAVIGATOR aims to further investigate the effect of tezepelumab on exacerbations and build on observations from the phase 2b PATHWAY study, and to demonstrate further the potential of tezepelumab to provide patients with severe, uncontrolled asthma with improvements in lung function, asthma control and health-related quality of life.

Trial registration

NCT03347279 (ClinicalTrials.gov). Registered 20 November 2017.
The correlation between the Th17/Treg cell balance and bone health
Authors: Zhu Lei , Hua Fei , Ding Wenge , Ding Kai , Zhang Yige , Xu Chenyang
Published: October 2020

With the ageing of the world population, osteoporosis has become a problem affecting quality of life. According to the traditional view, the causes of osteoporosis mainly include endocrine disorders, metabolic disorders and mechanical factors. However, in recent years, the immune system and immune factors have been shown to play important roles in the occurrence and development of osteoporosis. Among these components, regulatory T (Treg) cells and T helper 17 (Th17) cells are crucial for maintaining bone homeostasis, especially osteoclast differentiation. Treg cells and Th17 cells originate from the same precursor cells, and their differentiation requires involvement of the TGF-β regulated signalling pathway. Treg cells and Th17 cells have opposite functions. Treg cells inhibit the differentiation of osteoclasts in vivo and in vitro, while Th17 cells promote the differentiation of osteoclasts. Therefore, understanding the balance between Treg cells and Th17 cells is anticipated to provide a new idea for the development of novel treatments for osteoporosis.
Evaluation on the application of transcranial Doppler (TCD) and electroencephalography (EEG) in patients with vertebrobasilar insufficiency
Authors: Ke Changmin , Zheng Chu-na , Wang Juan , Yao Dongying , Fang Xiaojuan , Luo Yan , Wu Jianglin , Zheng Xiaoqing , Wang Peiping
Published: October 2020

Background

To evaluate the diagnostic value of transcranial Doppler (TCD) and electroencephalography (EEG) in patients with vertebrobasilar insufficiency (VBI) during clinical diagnosis and treatment

Methods

Eighty patients diagnosed with VBI in our hospital from June 2018 to December 2019 were randomly selected as the observation group, and 80 healthy people who received physical examination in the same period were selected as the control group. The abnormal rate, main performance and results, and the peak velocity of blood flow and vertebrobasilar artery blood flow of the two groups were compared.

Results

The abnormal rate of EEG and TCD in VBI patients was 38.75% (31/80) and the 93.75% (75/80), respectively. In TCD examination, ACA, PCA, MCA, and VA of both sides of the observation group were higher than those of the control group, while BA was lower than that of the control group (P < 0.05). The Vs, Vd, and Vm on both sides of BA and VA in the observation group were lower than those in the control group, while PI and RI were higher than those in the control group (P < 0.05).

Conclusions

TCD examination is highly sensitive to the degree and pattern of cerebral ischemia in VBI patients. EEG examination will define the changes of brain cell function after cerebral ischemia. Therefore, EEG and TCD have their own advantages. The application of TCD and EEG can be considered in the early diagnosis, curative effect, and prognosis evaluation of VBI patients, so as to improve the accuracy of diagnosis and prognosis.
Performance and community structure dynamics of microbial electrolysis cells operated on multiple complex feedstocks
Authors: Satinover Scott J. , Rodriguez Miguel , Campa Maria F. , Hazen Terry C. , Borole Abhijeet P.
Published: October 2020

Background

Microbial electrolysis is a promising technology for converting aqueous wastes into hydrogen. However, substrate adaptability is an important feature, seldom documented in microbial electrolysis cells (MECs). In addition, the correlation between substrate composition and community structure has not been well established. This study used an MEC capable of producing over 10 L/L-day of hydrogen from a switchgrass-derived bio-oil aqueous phase and investigated four additional substrates, tested in sequence on a mature biofilm. The additional substrates included a red oak-derived bio-oil aqueous phase, a corn stover fermentation product, a mixture of phenol and acetate, and acetate alone.

Results

The MECs fed with the corn stover fermentation product resulted in the highest performance among the complex feedstocks, producing an average current density of 7.3 ± 0.51 A/m2, although the acetate fed MECs outperformed complex substrates, producing 12.3 ± 0.01 A/m2. 16S rRNA gene sequencing showed that community structure and community diversity were not predictive of performance, and replicate community structures diverged despite identical inoculum and enrichment procedure. The trends in each replicate, however, were indicative of the influence of the substrates. Geobacter was the most dominant genus across most of the samples tested, but its abundance did not correlate strongly to current density. High-performance liquid chromatography (HPLC) showed that acetic acid accumulated during open circuit conditions when MECs were fed with complex feedstocks and was quickly degraded once closed circuit conditions were applied. The largest net acetic acid removal rate occurred when MECs were fed with red oak bio-oil aqueous phase, consuming 2.93 ± 0.00 g/L-day. Principal component analysis found that MEC performance metrics such as current density, hydrogen productivity, and chemical oxygen demand removal were closely correlated. Net acetic acid removal was also found to correlate with performance. However, no bacterial genus appeared to correlated to these performance metrics strongly, and the analysis suggested that less than 70% of the variance was accounted for by the two components.

Conclusions

This study demonstrates the robustness of microbial communities to adapt to a range of feedstocks and conditions without relying on specific species, delivering high hydrogen productivities despite differences in community structure. The results indicate that functional adaptation may play a larger role in performance than community composition. Further investigation of the roles each microbe plays in these communities will help MECs to become integral in the 21st-century bioeconomy to produce zero-emission fuels.
Cord blood DNA methylome in newborns later diagnosed with autism spectrum disorder reflects early dysregulation of neurodevelopmental and X-linked genes
Authors: Mordaunt Charles E. , Jianu Julia M. , Laufer Benjamin I. , Zhu Yihui , Hwang Hyeyeon , Dunaway Keith W. , Bakulski Kelly M. , Feinberg Jason I. , Volk Heather E. , Lyall Kristen , Croen Lisa A. , Newschaffer Craig J. , Ozonoff Sally , Hertz-Picciotto Irva , Fallin M. Daniele , Schmidt Rebecca J. , LaSalle Janine M.
Published: October 2020

Background

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with complex heritability and higher prevalence in males. The neonatal epigenome has the potential to reflect past interactions between genetic and environmental factors during early development and influence future health outcomes.

Methods

We performed whole-genome bisulfite sequencing of 152 umbilical cord blood samples from the MARBLES and EARLI high-familial risk prospective cohorts to identify an epigenomic signature of ASD at birth. Samples were split into discovery and replication sets and stratified by sex, and their DNA methylation profiles were tested for differentially methylated regions (DMRs) between ASD and typically developing control cord blood samples. DMRs were mapped to genes and assessed for enrichment in gene function, tissue expression, chromosome location, and overlap with prior ASD studies. DMR coordinates were tested for enrichment in chromatin states and transcription factor binding motifs. Results were compared between discovery and replication sets and between males and females.

Results

We identified DMRs stratified by sex that discriminated ASD from control cord blood samples in discovery and replication sets. At a region level, 7 DMRs in males and 31 DMRs in females replicated across two independent groups of subjects, while 537 DMR genes in males and 1762 DMR genes in females replicated by gene association. These DMR genes were significantly enriched for brain and embryonic expression, X chromosome location, and identification in prior epigenetic studies of ASD in post-mortem brain. In males and females, autosomal ASD DMRs were significantly enriched for promoter and bivalent chromatin states across most cell types, while sex differences were observed for X-linked ASD DMRs. Lastly, these DMRs identified in cord blood were significantly enriched for binding sites of methyl-sensitive transcription factors relevant to fetal brain development.

Conclusions

At birth, prior to the diagnosis of ASD, a distinct DNA methylation signature was detected in cord blood over regulatory regions and genes relevant to early fetal neurodevelopment. Differential cord methylation in ASD supports the developmental and sex-biased etiology of ASD and provides novel insights for early diagnosis and therapy.
Treatment variables associated with outcome in emergency department patients with suspected sepsis
Authors: Sivayoham Narani , Blake Lesley A. , Tharimoopantavida Shafi E. , Chughtai Saad , Hussain Adil N. , Rhodes Andrew
Published: October 2020

Background

Early treatment is advocated in the management of patients with suspected sepsis in the emergency department (ED). We sought to understand the association between the ED treatments and outcome in patients admitted with suspected sepsis. The treatments studied were: (i) the time to antibiotics, where time zero is the time the patient was booked in which is also the triage time; (ii) the volume of intravenous fluid (IVF); (iii) mean arterial pressure (MAP) after 2000 ml of IVF and (iv) the final MAP in the ED.

Methods

We performed a retrospective analysis of the ED database of patients aged ≥ 18 year who met two SIRS criteria or one red flag sepsis criteria on arrival, received intravenous antibiotics for a suspected infection and admitted between 8th February 2016 and 31st August 2017. The primary outcome measure was all-cause in-hospital mortality. The four treatments stated above were controlled for severity of illness and subject to multivariate logistic regression and Cox proportional-hazard regression to identify independent predictors of mortality.

Results

Of the 2,066 patients studied 272 (13.2%) died in hospital. The median time to antibiotics was 48 (interquartile range 30–82) minutes. The time to antibiotics was an independent predictor of mortality only in those who developed refractory hypotension (RH); antibiotics administered more than 55 mins after arrival was associated with an odds ratio (OR) for mortality of 2.75 [95% confidence interval (CI) 1.22–6.14]. The number-needed-to-treat was 4. IVF > 2000 ml (95% CI > 500– > 2100), except in RH, and a MAP ≤ 66 mmHg after 2000 ml of IVF were also independent predictors of mortality. The OR for mortality of IVF > 2,000 ml in non-RH was 1.80 (95% CI 1.15–2.82); Number-needed-to-harm was 14. The OR for morality for a MAP ≤ 66 mmHg after 2000 ml of IVF was 3.42 (95% CI 2.10–5.57). A final MAP < 75 mmHg in the ED was associated with, but not an independent predictor of mortality. An initial systolic blood pressure of < 100 mmHg has a sensitivity of 63.3% and specificity of 88.4% for the development of RH.

Conclusion

In this study, antibiotics were found to be time-critical in RH. Intravenous fluids > 2000 ml (except in RH) and a MAP ≤ 66 mmHg after 2000 ml of IVF were also independent predictors of mortality.
pCLIF-SOFA is a reliable outcome prognostication score of critically ill children with cirrhosis: an ESPNIC multicentre study
Authors: Claude Caroline , Deep Akash , Kneyber Martin , Siddiqui Salman , Renolleau Sylvain , Morin Luc , Jacquemin Emmanuel , Teglas Jean-Paul , Gajdos Vincent , Tissières Pierre , Durand Philippe ,   the ESPNIC liver failure, support working group
Published: October 2020

Background and aims

Data on outcome of critically ill children with cirrhosis are scarce. We aimed to evaluate the prognostic accuracy of sequential organs scoring systems in children with cirrhosis admitted to Paediatric Intensive Care Units (PICU).

Methods

We performed a multicentre retrospective analysis of children with cirrhosis admitted into four European PICUs between 2011 and 2016. Investigators were members of the ESPNIC liver failure and support working group. Paediatric End-Stage Liver Disease (PELD) and paediatric chronic liver failure sequential organ failure assessment score (pCLIF-SOFA) diagnostic accuracy for 28- and 60-day liver transplantation, 28-day mortality and 60-day composite outcome (ie. death or liver transplantation) were tested.

Results

One-hundred-and-thirty children were included. The main causes for PICU admission were acute-on-chronic liver failure (ACLF), gastrointestinal bleeding and sepsis. Twenty-nine percent died and 22.3% were transplanted by day-60 after PICU admission. On multivariable analysis, pCLIF-SOFA was the only predictor of mortality at day-28 and of composite outcome. Both pCLIF-SOFA and ACLF were independently associated with emergent liver transplantation. The pCLIF-SOFA score higher than 9 well predicted a 28-day mortality with a sensitivity of 87.8% and a specificity of 77.3%. A pCLIF-SOFA score higher than 7 was independently associated with liver transplantation on day-60. Stage 3 AKI assessed with KDIGO classification was significantly associated with 28-day mortality.

Conclusions

Half of critically ill cirrhotic children admitted to PICU either died or were transplanted within the initial 28-day period. On admission pCLIF-SOFA score accurately identify patients transplanted at day-28 and day-60 to those alive without LT and is associated with 28-day mortality and composite outcome at day-60.
Inequality in fertility rate among adolescents: evidence from Timor-Leste demographic and health surveys 2009–2016
Authors: Yaya Sanni , Zegeye Betregiorgis , Ahinkorah Bright Opoku , Oladimeji Kelechi Elizabeth , Shibre Gebretsadik
Published: October 2020

Background

Despite a decline in global adolescent birth rate, many countries in South East Asia still experience a slower pace decline in adolescent birth rates. Timor-Leste is one of the countries in the region with the highest adolescent birth rate and huge disparities between socio-economic subgroups. Hence, this study assessed the magnitude and trends in adolescent fertility rates within different socio-demographic subgroups in Timor-Leste.

Methods

Using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the Timor-Leste Demographic and Health surveys (TLDHS) were analyzed between 2009 and 2016. We approached the inequality analysis in two steps. First, we disaggregated adolescent fertility rates by four equity stratifiers: wealth index, education, residence and region. Second, we measured the inequality through summary measures, namely Difference, Population Attributable Risk, Ratio and Population Attributable Fraction. A 95% confidence interval was constructed for point estimates to measure statistical significance.

Results

We found large socio-economic and area-based inequalities over the last 7 years. Adolescent girls who were poor (Population Attributable Fraction: -54.87, 95% CI; − 57.73, − 52.02; Population Attributable Risk: -24.25, 95% CI; − 25.51, − 22.99), uneducated (Difference: 58.69, 95% CI; 31.19, 86.18; Population Attributable Fraction: -25.83, 95% CI; − 26.93, − 24.74), from rural areas (Ratio: 2.76, 95% CI; 1.91, 3.60; Population Attributable Risk: -23.10, 95% CI; − 24.12, − 22.09) and from the Oecussi region (Population Attributable Fraction: -53.37, 95% CI; − 56.07, − 50.67; Difference: 60.49, 95% CI; 29.57, 91.41) had higher chance of having more births than those who were rich, educated, urban residents and from the Dili region, respectively.

Conclusions

This study identified disproportionately higher burden of teenage birth among disadvantaged adolescents who are, poor, uneducated, rural residents and those living in regions such as Oecussi, Liquica and Manufahi, respectively. Policymakers should work to prevent child marriage and early fertility to ensure continuous education, reproductive health care and livelihood opportunities for adolescent girls. Specialized interventions should also be drawn to the subpopulation that had disproportionately higher adolescent childbirth.
Human distribution and spatial-temporal clustering analysis of human brucellosis in China from 2012 to 2016
Authors: Liang Pei-Feng , Zhao Yuan , Zhao Jian-Hua , Pan Dong-Feng , Guo Zhong-Qin
Published: October 2020

Background

Brucellosis is a major public health issue in China, while its temporal and spatial distribution have not been studied in depth. This study aims to better understand the epidemiology of brucellosis in the mainland of China, by investigating the human, temporal and spatial distribution and clustering characteristics of the disease.

Methods

Human brucellosis data from the mainland of China between 2012 and 2016 were obtained from the China Information System for Disease Control and Prevention. The spatial autocorrelation analysis of ArcGIS10.6 and the spatial-temporal scanning analysis of SaTScan software were used to identify potential changes in the spatial and temporal distribution of human brucellosis in the mainland of China during the study period.

Results

A total of 244 348 human brucellosis cases were reported during the study period of 2012–2016. The average incidence of human brucellosis was higher in the 40–65 age group. The temporal clustering analysis showed that the high incidence of brucellosis occurred between March and July. The spatial clustering analysis showed that the location of brucellosis clustering in the mainland of China remained relatively fixed, mainly concentrated in most parts of northern China. The results of the spatial-temporal clustering analysis showed that Heilongjiang represents a primary clustering area, and the Tibet, Shanxi and Hubei provinces represent three secondary clustering areas.

Conclusions

Human brucellosis remains a widespread challenge, particularly in northern China. The clustering analysis highlights potential high-risk human groups, time frames and areas, which may require special plans and resources to monitor and control the disease.
Study of a robotic system to detect water leakage and fuel debris-System proposal and feasibility study of visual odometry providing intuitive bird’s eye view-
Authors: Wang Zhenyu , Endo Gen , Takahashi Masashi , Nabae Hiroyuki , Suzumori Koichi , Tsuzuki Nobuyoshi , Takahashi Hideharu , Kimoto Kazushi , Ihara Tomonori , Kikura Hiroshige
Published: October 2020

To obtain the necessary information on fuel debris and water leakages during the decommissioning task of the Fukushima Daiichi Nuclear Power Plant, an ultrasonic-based method was proposed for future internal investigation of the primary containment vessel (PCV). In this article, we describe the rotatable winch mechanism and visual localization method, which were used to aid the investigation. We used the rotatable winch mechanism to adjust the height and orientation of the ultrasonic sensor and localized the robot with cameras to localize the sensor, to provide assisting information for data combination. We studied the feasibility of the conventional visual odometry method for application to the situation and performed localizing accuracy evaluation experiments with a mobile robotic platform prototype. The results showed that the visual odometry method could generate intuitive bird’s-eye-view maps, and provided an average error rate of 35 mm/1500 mm, which met the required maximum error rate of 100 mm/1500 mm for the grating movement. Experiments were also conducted with adjustable parameter ranges that could provide the required accuracy.
A case of irreversible bradycardia after rituximab therapy for diffuse large B-cell lymphoma
Authors: Ko Ko Nway Le , Minaskeian Nareg , El Masry Hicham Z.
Published: October 2020

This is a case of a middle-aged woman with underlying cardiac conduction system with episodes of AV Wenckebach, who subsequently developed significant AV conduction system abnormalities after receiving one standard dose of Rituximab infusion for diffuse large B-cell lymphoma. Rituximab, being a monoclonal antibody against CD-20 antigen, is effective in treatment of B-cell lymphoma but may also cause bradyarrythmias likely due to the calcium ion channel property of CD-20 antigen.
Preoperative flexion contracture is a predisposing factor for cartilage degeneration at the patellofemoral joint after open wedge high tibial osteotomy
Authors: Otsuki Shuhei , Ikeda Kuniaki , Wakama Hitoshi , Okuno Nobuhiro , Okamoto Yoshinori , Okayoshi Tomohiro , Miyamoto Yuki , Neo Masashi
Published: October 2020

Purpose

The purpose of the study was to determine the effect of cartilage degeneration at the patellofemoral joint on clinical outcomes after open wedge high tibial osteotomy and to investigate the predisposing factors for progressive patellofemoral cartilage degeneration.

Methods

Seventy-two knees were evaluated on second-look arthroscopy in patients who opted for plate and screw removal at an average of 20.1 months after osteotomy. Cartilage degeneration at the patellofemoral joint was evaluated using the International Cartilage Repair Society grading system, with cases divided into progression and nonprogression groups. Radiographic parameters of the patellofemoral anatomy, knee range of motion, and clinical outcomes were evaluated from the preoperative baseline to the final follow up, on average 50 months after osteotomy. A contracture > 5° was considered a flexion contracture.

Results

Cartilage degeneration progressed in 31 knees, and preoperative knee flexion contracture was significantly associated with progressive degeneration (P < 0.01). The Lysholm and Kujala scores were significantly lower in the progression group (87.9 and 85.3, respectively) than in the nonprogression group (91.6 and 93.6, respectively) (P < 0.05). The odds ratio of the flexion contracture resulting in progression of patellofemoral cartilage degeneration was 4.63 (95% confidence interval, 1.77–12.1). No association was detected between progressive degeneration and age, sex, body mass index, Kellgren-Lawrence grade, or radiographic parameters.

Conclusions

Flexion contracture may be associated with progression of cartilage degeneration at the patellofemoral joint and may negatively affect the clinical outcomes after open wedge, high tibial osteotomy.
Can a combination of two neuropsychological tests screen for mild neurocognitive disorder better than each test alone? A cross-sectional study
Authors: ELbedewy Reem Mohamed Sabry , ELOKL Mohamed
Published: October 2020

Background

Early symptoms of dementia may not be apparent and are sometimes even concealed during short office visits initiated for other complaints. The aim of the study is to find out if the combined use of VF/CDT, VF/BNT, or CDT/BNT could improve the accuracy of detecting mild NCD in an outpatient setting, compared with either test used alone.

Participants

Community-dwelling older adults, attending the outpatient Geriatrics Clinic at Ain Shams University hospitals between June 1, 2017 and January 31, 2018. All participants received a comprehensive geriatric assessment (CGA) which included the mini-mental state examination test. Participants with a score of less than 24 and fulfil DSM5 criteria for mild neurocognitive disorder (NCD) are considered cognitively impaired otherwise are considered normal. Then participants were further examined by the Arabic versions of CDT, BNT, and VF animal category.

Results

We recruited 143 male and female participants mean age 67.17 ± 5.41, females are 56.6%, and 48.9% of all participants have mild NCD according to DSM5 criteria. AUC for individual neurocognitive tests in illiterates is 0.893 for clock drawing test, 0.907 for verbal fluency animal category, and 0.904 for Boston naming test, while AUC for neurocognitive test combinations in illiterates is 0.932 for VF + CDT, 0.917 for VF + BNT, and 0.932 for BNT + CDT. On the other hand, AUC for individual neurocognitive tests in educated participants is 0.925 for clock drawing test, 0.921 for verbal fluency animal category, and 0.907 for Boston naming test, whereas AUC for neurocognitive test combinations in educated participants is 0.958 for VF + CDT, 0.963 for VF + BNT, and 0.953 for BNT + CDT.

Conclusion

From the current study, we can conclude that any of the studied combinations have better diagnostic accuracy (although small) than individual test in both literate and illiterate older adults.
Erratum: Spatio-temporal propagation of COVID-19 pandemics
Authors: Gross Bnaya , Zheng Zhiguo , Liu Shiyan , Chen Xiaoqi , Sela Alon , Li Jianxin , Li Daqing , Havlin Shlomo
Published: October 2020

Original article:
EPL, 131 (2020) 58003.
The ELIXIR Human Copy Number Variations Community: building bioinformatics infrastructure for research
Authors: Salgado David , Armean Irina M. , Baudis Michael , Beltran Sergi , Capella-Gutierrez Salvador , Carvalho-Silva Denise , Dominguez Del Angel Victoria , Dopazo Joaquin , Furlong Laura I. , Gao Bo , Garcia Leyla , Gerloff Dietlind , Gut Ivo , Gyenesei Attila , Habermann Nina , Hancock John M. , Hanauer Marc , Hovig Eivind , Johansson Lennart F. , Keane Thomas , Korbel Jan , Lauer Katharina B. , Laurie Steve , Leskošek Brane , Lloyd David , Marques-Bonet Tomas , Mei Hailiang , Monostory Katalin , Piñero Janet , Poterlowicz Krzysztof , Rath Ana , Samarakoon Pubudu , Sanz Ferran , Saunders Gary , Sie Daoud , Swertz Morris A. , Tsukanov Kirill , Valencia Alfonso , Vidak Marko , Yenyxe González Cristina , Ylstra Bauke , Béroud Christophe
Published: October 2020

Copy number variations (CNVs) are major causative contributors both in the genesis of genetic diseases and human neoplasias. While “High-Throughput” sequencing technologies are increasingly becoming the primary choice for genomic screening analysis, their ability to efficiently detect CNVs is still heterogeneous and remains to be developed. The aim of this white paper is to provide a guiding framework for the future contributions of ELIXIR’s recently established human CNV Community, with implications beyond human disease diagnostics and population genomics. This white paper is the direct result of a strategy meeting that took place in September 2018 in Hinxton (UK) and involved representatives of 11 ELIXIR Nodes. The meeting led to the definition of priority objectives and tasks, to address a wide range of CNV-related challenges ranging from detection and interpretation to sharing and training. Here, we provide suggestions on how to align these tasks within the ELIXIR Platforms strategy, and on how to frame the activities of this new ELIXIR Community in the international context.
Dysplasia, malformation, or deformity? - explanation of the basis of hip development disorders and suggestions for future diagnostics and treatment
Authors: Dygut Jacek , Piwowar Monika
Published: October 2020

This publication focuses on processes which disrupt proper development of the hip. Four pathomechanisms underlying human developmental defects are described in literature, i.e. dysplasia, malformation, disruption, and deformity. In the case of hip development, arguably the greatest challenge involves confusion between dysplasia and deformity, which often leads to misdiagnosis, incorrect nomenclature, and incorrectly chosen treatment.

The paper presents a description of hip joint development disorders in the context of their pathomechanisms. An attempt was made to answer the question whether these disorders are rooted in a primary disorder of tissue growth, resulting in its incorrect anatomy, or are the result of anatomical deformation with secondary modifications in tissue structures of a degenerative or adaptive nature, based on Deplesch-Heuter-Volkmann growth and remodeling laws. In addition, emphasis is placed on attention to the presence of the so-called clinically and diagnostically mute cases. The need to augment diagnostic procedures with genetic tests in order to increase the sensitivity of screening has also been suggested. Based on the arguments presented in the paper, a new division of developmental hip disorders has been proposed.
Improving open and rigorous science: ten key future research opportunities related to rigor, reproducibility, and transparency in scientific research
Authors: Valdez Danny , Vorland Colby J. , Brown Andrew W. , Mayo-Wilson Evan , Otten Justin , Ball Richard , Grant Sean , Levy Rachel , Svetina Valdivia Dubravka , Allison David B.
Published: October 2020

Background:As part of a coordinated effort to expand research activity around rigor, reproducibility, and transparency (RRT) across scientific disciplines, a team of investigators at the Indiana University School of Public Health-Bloomington hosted a workshop in October 2019 with international leaders to discuss key opportunities for RRT research.

Objective:The workshop aimed to identify research priorities and opportunities related to RRT.

Design:Over two-days, workshop attendees gave presentations and participated in three working groups: (1) Improving Education & Training in RRT, (2) Reducing Statistical Errors and Increasing Analytic Transparency, and (3) Looking Outward: Increasing Truthfulness and Accuracy of Research Communications. Following small-group discussions, the working groups presented their findings, and participants discussed the research opportunities identified. The investigators compiled a list of research priorities, which were circulated to all participants for feedback.

Results:Participants identified the following priority research questions: (1) Can RRT-focused statistics and mathematical modeling courses improve statistics practice?; (2) Can specialized training in scientific writing improve transparency?; (3) Does modality (e.g. face to face, online) affect the efficacy RRT-related education?; (4) How can automated programs help identify errors more efficiently?; (5) What is the prevalence and impact of errors in scientific publications (e.g., analytic inconsistencies, statistical errors, and other objective errors)?; (6) Do error prevention workflows reduce errors?; (7) How do we encourage post-publication error correction?; (8) How does ‘spin’ in research communication affect stakeholder understanding and use of research evidence?; (9) Do tools to aid writing research reports increase comprehensiveness and clarity of research reports?; and (10) Is it possible to inculcate scientific values and norms related to truthful, rigorous, accurate, and comprehensive scientific reporting?

Conclusion:Participants identified important and relatively unexplored questions related to improving RRT. This list may be useful to the scientific community and investigators seeking to advance meta-science (i.e. research on research).
Application of Project Tasks for the Development of Intellectual Abilities of Students in Primary School
Authors: Aksyuchic Svetlana , Vasina E.
Published: October 2020

The article reveals the essence of the concepts of "intelligence", "abilities", "intellectual abilities", "intellectual operations" from psychological and pedagogical positions. Based on the analysis of psychological and pedagogical research and practical experience, the effectiveness of the widespread use of design tasks in the educational process of primary school is proved, which stimulates the successful formation of intellectual operations in children of primary school age and the development of intellectual abilities. The peculiarities of conducting classes in which junior schoolchildren solve project problems are characterized. As an example, a description of a lesson on the implementation by fourth grade students of the final annual work aimed at implementing the previously mastered skills to solve design problems is given. In turn, this ensures the readiness of schoolchildren in the future to think and act not according to a template both in a non-standard educational situation and in a problematic life situation.
Scenario Grouping and Decomposition Algorithms for Chance-Constrained Programs
Authors: Deng Yan , Jia Huiwen , Ahmed Shabbir , Lee Jon , Shen Siqian
Published: October 2020

A lower bound for a finite-scenario-based chance-constrained program is the quantile value corresponding to the sorted optimal objective values of scenario subproblems. This quantile bound can be improved by grouping subsets of scenarios at the expense of solving larger subproblems. The quality of the bound depends on how the scenarios are grouped. In this paper, we formulate a mixed-integer bilevel program that optimally groups scenarios to tighten the quantile bounds. For general chance-constrained programs, we propose a branch-and-cut algorithm to optimize the bilevel program, and for chance-constrained linear programs, a mixed-integer linear-programming reformulation is derived. We also propose several heuristics for grouping similar or dissimilar scenarios. Our computational results demonstrate that optimal grouping bounds are much tighter than heuristic bounds, resulting in smaller root-node gaps and better performance of scenario decomposition for solving chance-constrained 0-1 programs. Also, the optimal grouping bounds can be greatly strengthened using larger group size.

Summary of Contribution: Chance-constrained programs are in general NP-hard but widely used in practice for lowering the risk of undesirable outcomes during decision making under uncertainty. Assuming finite scenarios of uncertain parameter, chance-constrained programs can be reformulated as mixed-integer linear programs with binary variables representing whether or not the constraints are satisfied in corresponding scenarios. A useful quantile bound for solving chance-constrained programs can be improved by grouping subsets of scenarios at the expense of solving larger subproblems. In this paper, we develop algorithms for optimally and heuristically grouping scenarios to tighten the quantile bounds. We aim to improve both the computation and solution quality of a variety of chance-constrained programs formulated for different Operations Research problems.
Dynamic Incentive-Aware Learning: Robust Pricing in Contextual Auctions
Authors: Golrezaei Negin , Javanmard Adel , Mirrokni Vahab
Published: October 2020

In many practical settings, the decision makers have to learn their best actions by experimenting with possible options and collecting feedback (data) over time. It is often assumed that the collected data can be trusted as they reflect the ground truth. But this assumption is violated when the data are generated by strategic players. Consider online advertising market in which the ad exchange (decision maker) aims at learning the best reserve prices in the repeated auctions. In this setting, the data are advertisers’ submitted bids. Such data can be strategically corrupted by advertisers to trick the learning algorithm of the ad exchange to offer them lower reserve prices in the future auctions. In “Dynamic Incentive-Aware Learning: Robust Pricing in Contextual Auctions,” N. Golrezaei, A. Javanmard, and V. Mirrokni design effective learning algorithms with sublinear regret in such environments that are robust to the strategic behavior of the players.
Quantile Regression–Based Estimation of Dynamic Statistical Contingency Fuel
Authors: Kang Lei , Hansen Mark
Published: October 2020

Reducing fuel consumption is a unifying goal across the aviation industry. One fuel-saving opportunity for airlines is reducing contingency fuel loading by dispatchers. Many airlines’ flight planning systems (FPSs) provide recommended contingency fuel for dispatchers in the form of statistical contingency fuel (SCF). However, because of limitations of the current SCF estimation procedure, the application of SCF is limited. In this study, we propose to use quantile regression–based machine learning methods to account for fuel burn uncertainties and estimate more reliable SCF values. Utilizing a large fuel burn data set from a major U.S.-based airline, we find that the proposed quantile regression method outperforms the airline’s FPS. The benefit of applying the improved SCF models is estimated to be in the range $19 million–$65 million in fuel expense savings as well as 132 million–451 million kilograms of carbon dioxide emission reductions per year, with the lower savings being realized even while maintaining the current, extremely low risk of tapping the reserve fuel. The proposed models can also be used to predict benefits from reduced fuel loading enabled by increasing system predictability, for example, with improved air traffic management.