bluuebunny/crossref_metadata_2025 huggingface dataset:
Chordomas and chondrosarcomas of the skull base: treatment and outcome analysis in a consecutive case series of 24 patients
Authors: Metcalfe Christopher , Muzaffar Jameel , Kulendra Kevin , Sanghera Paul , Shaw Simon , Shad Amjad , Saravanappa Natarajan , Paluzzi Alessandro , Ahmed Shahzada
Published: March 2021

Background

We present our 9-year consecutive case series of skull base chordomas and chondrosarcomas from a UK tertiary referral centre, discussing treatments offered and outcomes. This was carried out to improve understanding around current treatment and to better inform the management of future patients.

Methods

Consecutive case series over a 9-year period (2007–2016). Retrospective data analysis from the electronic skull base multidisciplinary team database and the digital patient records at a UK tertiary referral centre

Results

Twenty-four patients were identified (11 chordomas, 13 chondrosarcomas, mean age 52). Nineteen had proton beam therapy (PBT) postoperatively; two had intensity-modulated radiotherapy; two had no further treatment. One patient was lost to follow-up. All chordomas were resected via a transnasal endoscopic approach. Of the 19 patients undergoing resection with PBT, 13 were disease free at latest follow-up, and six patients had local recurrence, of which two died (mean follow up 7.4 years). Of the three patients treated with surgery then IMRT/TomoTherapy, one died 4 years post-treatment, and the other two are alive after 4 and 5 years of follow-up respectively. Of the two patients treated with surgery alone, one was lost to follow-up, and the other is alive after more than 8 years. Chondrosarcoma 5-year survival was 91.6%, and chordoma 4-year survival was 75%.

Conclusion

Skull base chordomas and chondrosarcomas can be challenging to resect, and most cases require adjuvant therapy to achieve control. Where complete resection is not possible, it is critical to undertake sufficient resection to permit high-dose radiation.
Expression of Talin-1 in endometriosis and its possible role in pathogenesis
Authors: Tang Xian , Li Qing , Li Lijie , Jiang Jianfa
Published: March 2021

Background

Endometriosis is a disease that involves active cell invasion and migration. Talin-1 can promote cell invasion, migration and adhension in various cancer cells, but its role in endometriosis has not been investigated. This study was to investigate the expression level of Talin-1 in endometriosis and the role of Talin-1 in the proliferation, adhesion, migration, and invasion of human endometrial stromal cells (ESCs).

Methods

Ectopic and eutopic endometrial tissues were collected from women with endometriosis, and the control endometrial tissues were obtained from patients without endometriosis. The expression level of Talin-1 was detected in each sample using quantitative real-time polymerase chain reaction and immunohistochemistry. The expression of Talin-1 was inhibited using RNA interference in ESCs, and its proliferation, apoptosis, adhesion, migration, and invasion capacity were analyzed. Western blotting was performed to detect the expression of related molecules after the downregulation of Talin-1.

Results

The results showed that the mRNA and protein expression of Talin-1 were significantly increased in the ectopic endometrium and eutopic endometrial tissues compared with the controls. The knockdown of Talin-1 did not affect the proliferation and apoptosis of ESCs. The results indicated that the downexpression of Talin-1 inhibited the adhesion, invasion, and migration of ESCs. In addition, the expressions of N-cadherin, MMP-2, and integrin β3 were significantly lower after the deregulation of Talin-1, whereas the levels of E-cadherin were significantly increased.

Conclusions

The expression of Talin-1 was increased in the ectopic and eutopic endometrial tissues compared with the control endometrium. The downregulation of Talin-1 inhibited the adhesion, invasion, and migration of ESCs.
Proximal deep vein thrombosis and pulmonary embolism in COVID-19 patients: a systematic review and meta-analysis
Authors: Longchamp Gregoire , Manzocchi-Besson Sara , Longchamp Alban , Righini Marc , Robert-Ebadi Helia , Blondon Marc
Published: March 2021

Background

COVID-19 appears to be associated with a high risk of venous thromboembolism (VTE). We aimed to systematically review and meta-analyze the risk of clinically relevant VTE in patients hospitalized for COVID-19.

Methods

This meta-analysis included original articles in English published from January 1st, 2020 to June 15th, 2020 in Pubmed/MEDLINE, Embase, Web of science, and Cochrane. Outcomes were major VTE, defined as any objectively diagnosed pulmonary embolism (PE) and/or proximal deep vein thrombosis (DVT). Primary analysis estimated the risk of VTE, stratified by acutely and critically ill inpatients. Secondary analyses explored the separate risk of proximal DVT and of PE; the risk of major VTE stratified by screening and by type of anticoagulation.

Results

In 33 studies (n = 4009 inpatients) with heterogeneous thrombotic risk factors, VTE incidence was 9% (95%CI 5–13%, I2 = 92.5) overall, and 21% (95%CI 14–28%, I2 = 87.6%) for patients hospitalized in the ICU. Proximal lower limb DVT incidence was 3% (95%CI 1–5%, I2 = 87.0%) and 8% (95%CI 3–14%, I2 = 87.6%), respectively. PE incidence was 8% (95%CI 4–13%, I2 = 92.1%) and 17% (95%CI 11–25%, I2 = 89.3%), respectively. Screening and absence of anticoagulation were associated with a higher VTE incidence. When restricting to medically ill inpatients, the VTE incidence was 2% (95%CI 0–6%).

Conclusions

The risk of major VTE among COVID-19 inpatients is high but varies greatly with severity of the disease. These findings reinforce the need for the use of thromboprophylaxis in all COVID-19 inpatients and for clinical trials testing different thromboprophylaxis regimens in subgroups of COVID-19 inpatients.

Trial registration

The review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews (CRD42020193369).
LncRNA-Gm9795 promotes inflammation in non-alcoholic steatohepatitis via NF-$$\kappa {}$$B/JNK pathway by endoplasmic reticulum stress
Authors: Ye Liangying , Zhao Dan , Xu Yangzhi , Lin Jiaen , Xu Jiahui , Wang Kunyuan , Ye Zhanhui , Luo Yufeng , Liu Shiming , Yang Hui
Published: March 2021

Background

Non-alcoholic steatohepatitis (NASH) is a key stage in leading development of non-alcoholic simple fatty liver (NAFL) into cirrhosis and even liver cancer. This study aimed at exploring the lncRNAs expression profile in NASH and the biological function of a novel LncRNA-gm9795.

Methods

Microarray analysis was performed to compare the expression profiles of lncRNAs in the liver of NASH, NAFLD and normal mice (5 mice for each group). Methionine-choline-deficient Medium (MCD) with Lipopolysaccharide (LPS) or palmitic acid (PA)were used to built NASH cell models. The role and mechanism of LncRNA-gm9795 in NASH were explored by knocking down or over-expressing its expression.

Results

A total of 381 lncRNAs were found to be not only highly expressed in NAFLD, but also is going to go even higher in NASH. A novel LncRNA-gm9795 was significantly highly expressed in liver tissues of NASH animal models and NASH cell models. By staining with Nile red, we found that gm9795 did not affect the fat accumulation of NASH. However, gm9795 in NASH cell models significantly promoted the expression of TNF $$\alpha {}$$

α

, IL-6, IL-1$$\beta {}$$

β

, the important inflammatory mediators in NASH. At the same time, we found that gm9795 upregulated the key molecules in endoplasmic reticulum stress (ERS), while NF-$$\kappa {}$$

κ

B/JNK pathways were also activated. When ERS activator Thapsigargin (TG) was introduced in cells with Ggm9757 si-RNA, NF-$$\kappa {}$$

κ

B and JNK pathways were activated. Conversely, ERS inhibitor Tauroursodeoxycholic acid (TUDCA) inhibited NF-kB and JNK pathways in cells with gm9795 overexpression plasmid.

Conclusion

LncRNA-gm9795 promotes inflammatory response in NASH through NF-kB and JNK pathways by ERS, which might provide theoretical basis for revealing the pathogenesis of NASH and discovering new therapeutic targets
The association between early in marriage fertility pressure from in-laws’ and family planning behaviors, among married adolescent girls in Bihar and Uttar Pradesh, India
Authors: Dixit Anvita , Bhan Nandita , Benmarhnia Tarik , Reed Elizabeth , Kiene Susan M. , Silverman Jay , Raj Anita
Published: March 2021

Background

Married adolescent girls are vulnerable to risky sexual and reproductive health outcomes. We examined the association of fertility pressure from in-laws’ early in marriage with contraceptive use ever, parity, time until first birth, and couple communication about family size, among married adolescent girls.

Methods

Data were taken from a cross-sectional survey with married girls aged 15–19 years (N = 4893) collected from September 2015 to July 2016 in Bihar and Uttar Pradesh, India. Multivariable regression assessed associations between in-laws’ fertility pressure and each outcome, adjusting for sociodemographic covariates.

Results

We found that 1 in 5 girls experienced pressure from in-laws’ to have a child immediately after marriage. In-laws’ fertility pressure was associated with lower parity (Adj. β Coef. − 0.10, 95% CI − 0.17, − 0.37) and couple communication about family size (AOR = 1.77, 95% CI 1.39, 2.26), but not contraceptive use or time until birth.

Conclusions

Our study adds to the literature identifying that in-laws’ pressure on fertility is common, affects couple communication about family size, and may be more likely for those yet to have a child, but may have little effect impeding contraceptive use in a context where such use is not normative.
The politest form of racism: sexual and reproductive health and rights paradigm in Canada
Authors: El-Mowafi Ieman M. , Yalahow Abdiasis , Idriss-Wheeler Dina , Yaya Sanni
Published: March 2021

The Canadian national identity is often understood as what it is not; American. Inundation with American history, news, and culture around race and racism imbues Canadians with a false impression of egalitarianism, resulting in a lack of critical national reflection. While this is true in instances, the cruel reality of inequity, injustice and racism is rampant within the Canadian sexual and reproductive health and rights realm. Indeed, the inequitable health outcomes for Black, Indigenous and people of color (BIPOC) are rooted in policy, research, health promotion and patient care. Built by colonial settlers, many of the systems currently in place have yet to embark on the necessary process of addressing the colonial, racist, and ableist structures perpetuating inequities in health outcomes. The mere fact that Canada sees itself as better than America in terms of race relations is an excuse to overlook its decades of racial and cultural discrimination against Indigenous and Black people. While this commentary may not be ground-breaking for BIPOC communities who have remained vocal about these issues at a grassroots level for decades, there exists a gap in the Canadian literature in exploring these difficult and often underlying dynamics of racism. In this commentary series, the authors aim to promote strategies addressing systemic racism and incorporating a reproductive justice framework in an attempt to reduce health inequities among Indigenous, Black and racialized communities in Canada.
Diagnostics and monitoring tools for noncommunicable diseases: a missing component in the global response
Authors: Bernabé-Ortiz Antonio , Zafra-Tanaka Jessica H. , Moscoso-Porras Miguel , Sampath Rangarajan , Vetter Beatrice , Miranda J. Jaime , Beran David
Published: March 2021

A key component of any health system is the capacity to accurately diagnose individuals. One of the six building blocks of a health system as defined by the World Health Organization (WHO) includes diagnostic tools. The WHO’s Noncommunicable Disease Global Action Plan includes addressing the lack of diagnostics for noncommunicable diseases, through multi-stakeholder collaborations to develop new technologies that are affordable, safe, effective and quality controlled, and improving laboratory and diagnostic capacity and human resources. Many challenges exist beyond price and availability for the current tools included in the Package of Essential Noncommunicable Disease Interventions (PEN) for cardiovascular disease, diabetes and chronic respiratory diseases. These include temperature stability, adaptability to various settings (e.g. at high altitude), need for training in order to perform and interpret the test, the need for maintenance and calibration, and for Blood Glucose Meters non-compatible meters and test strips. To date the issues surrounding access to diagnostic and monitoring tools for noncommunicable diseases have not been addressed in much detail. The aim of this Commentary is to present the current landscape and challenges with regards to guidance from the WHO on diagnostic tools using the WHO REASSURED criteria, which define a set of key characteristics for diagnostic tests and tools. These criteria have been used for communicable diseases, but so far have not been used for noncommunicable diseases. Diagnostic tools have played an important role in addressing many communicable diseases, such as HIV, TB and neglected tropical diseases. Clearly more attention with regards to diagnostics for noncommunicable diseases as a key component of the health system is needed.
“I just need to be with my family”: resettlement experiences of asylum seeker and refugee survivors of torture
Authors: Griswold Kim S. , Vest Bonnie M. , Lynch-Jiles Angelique , Sawch Douglas , Kolesnikova Kateryna , Byimana Leonce , Kefi Pamela
Published: March 2021

A global migration of individuals fleeing persecution, violence and armed conflict reached almost 60 million world-wide in 2015. This world-wide crisis of displacement reflects people seeking safety across borders and oceans; dangerous journeys that compound the trauma endured by these women, men and children. Refugees/asylum seekers face barriers upon entry to the U.S. The Western New York Center for Survivors (WNYCST) provides care coordination/trauma-informed care to mitigate these challenges. The objective of this study was to explore the resettlement experiences of survivors of torture living in Western New York, who had received services from the WNYCST; identifying challenges, unmet needs, and services that were helpful. Secondarily, we describe the experiences of asylum seekers and legally resettled refugees, who due to their differing legal status, might be expected to have different experiences. Data were collected using semi-structured qualitative interviews.

Results

Three themes emerged: mental health challenges, relating to their experiences in their home country and their separation from family; unmet needs, including lack of a sense of purpose and meaning, difficulty navigating services, and missing connections to community; and coping strategies, including WNYCST assistance with connecting with sources of social support in their new community. WNYCST services were helpful, particularly the assistance and connection with care coordinators and local support groups. This care and outreach helped to mitigate feelings of separation and apartness from their home countries and families.

Conclusions

Some refugees/asylum seekers continue to struggle with unmet needs, issues of loss and isolation. If care providers recognize signs of stress early, appropriate interventions can be implemented. Care connections and trauma informed treatment with an emphasis on recreating ties with communities, may be one important factor in ensuring successful integration.
To explore the reasonable selection of clavicular hook plate to reduce the occurrence of subacromial impingement syndrome after operation
Authors: Qiao Rui , Yang Jiarui , Zhang Kun , Song Zhe
Published: March 2021

Background

Acromioclavicular joint dislocation is a shoulder joint injury common in the clinical setting and is generally surgically treated with clavicular hook plate technique with confirmed curative effect. However, symptoms such as shoulder abduction limitation, shoulder discomfort and joint pain postoperatively may occur in some patients. Therefore, this study aimed to explore whether the existing clavicular hook plate can be reasonably selected to reduce the incidence of subacromial impingement syndrome (SIS) and provide a reference for clinical diagnosis and treatment.

Materials and methods

Patients with SIS admitted from March 2018 to June 2020 were selected as the experimental group and asymptomatic patients postoperatively, as the control group. The hook end depth and acromial height of the hook plate used in patients were recorded, and the difference between them was calculated.

Results

The difference between the hook plate depth and acromial height was 7.500±1.912 mm and 6.563±1.537 mm in the experimental and control groups, respectively, with statistically significant difference (t=3.021, P=0.006). A difference of >0.6 mm as a grouping index is required to perform a single factor analysis, with statistically significant difference (t=3.908, P=0.048).

Conclusions

The occurrence of SIS after placing the clavicular hook plate may be related to the difference between its depth and the acromial height. A difference of >6 mm may be a factor affecting the occurrence of SIS. Pre-imaging measurement of the acromial height can provide suggestions for selecting the type of hook plate intraoperatively.
Medical dispatchers’ perception of the interaction with the caller during emergency calls - a qualitative study
Authors: Møller Thea Palsgaard , Jensen Hejdi Gamst , Viereck Søren , Lippert Freddy , Østergaaard Doris
Published: March 2021

Background

Medical dispatching is a highly complex procedure and has an impact upon patient outcome. It includes call-taking and triage, prioritization of resources and the provision of guidance and instructions to callers. Whilst emergency medical dispatchers play a key role in the process, their perception of the process is rarely reported. We explored medical dispatchers’ perception of the interaction with the caller during emergency calls. Secondly, we aimed to develop a model for emergency call handling based on these findings.

Methods

To provide an in-depth understanding of the dispatching process, an explorative qualitative interview study was designed. A grounded theory design and thematic analysis were applied.

Results

A total of 5 paramedics and 6 registered nurses were interviewed. The emerging themes derived from dispatchers’ perception of the emergency call process were related to both the callers and the medical dispatchers themselves, from which four and three themes were identified, respectively. Dispatchers reported that for callers, the motive for calling, the situation, the perception and presentation of the problem was influencing factors. For the dispatchers the expertise, teamwork and organization influenced the process. Based on the medical dispatchers´ perception, a model of the workflow and interaction between the caller and the dispatcher was developed based on themes related to the caller and the dispatcher.

Conclusions

According to medical dispatchers, the callers seem to lack knowledge about best utilization of the emergency number and the medical dispatching process, which can be improved by public awareness campaigns and incorporating information into first aid courses. For medical dispatchers the most potent modifiable factors were based upon the continuous professional development of the medical dispatchers and the system that supports them. The model of call handling underlines the complexity of medical dispatching that embraces the context of the call beyond clinical presentation of the problem.
COVID-19 quarantine: Psychological impact and support for children and parents
Authors: Demaria Francesco , Vicari Stefano
Published: March 2021

In response to the coronavirus (COVID-19) pandemic, national governments have imposed urgent sanitary and social measures to control the spread of the virus. One such measure is quarantine, which involves restricting people’s movement through the isolation of infected or suspected infected individuals in order to reduce the risk of new infections. Research has shown that quarantine is a psychologically stressful experience. With respect to children, lack of school and interruptions to daily routines could have a negative impact on their physical and mental health. Parents may also pass their psychological distress to children and practice inappropriate parenting behaviors, which could contribute to the development of post-traumatic stress symptoms in children.

In order to prevent these negative outcomes, governments must carefully consider any their decision to impose quarantine and family social care services must work together with children’s mental health services to ensure that the experience is as tolerable and safe as possible.
Autism spectrum disorder and anorexia nervosa: an Italian prospective study
Authors: Pruccoli Jacopo , Solari Altea , Terenzi Letizia , Malaspina Elisabetta , Angotti Marida , Pignataro Veronica , Gualandi Paola , Sacrato Leonardo , Cordelli Duccio Maria , Franzoni Emilio , Parmeggiani Antonia
Published: March 2021

Background

Potential overlaps exist between psychopathological features of Anorexia Nervosa (AN) and Autism Spectrum Disorder (ASD). The impact of malnutrition on autistic traits in patients with AN should be considered. This study investigates possible associations among the psychopathology of Eating Disorders (EDs), ASD traits and BMI in a group of young patients with AN, using the EDI-3 (Eating Disorder Inventory-3) test and gold-standard measures for ASD.

Methods

Prospective study involving 23 inpatients admitted to an Italian Centre for paediatric ED. ASD traits and ED psychopathology were assessed administering the ADOS-2 (Autism Diagnostic Observation Schedule-2), AQ (Autism Quotient) and EDI-3 tests. Both present and past autistic traits were investigated using different versions of AQ. Correlations were adjusted for BMI, Obsessive Compulsive Disorder (OCD) comorbidity and concurrent antipsychotic treatments.

Results

An ASD diagnosis was possible in 22% of patients. Significant correlations were documented between ASD traits and ED psychopathology: AQ total-Interpersonal problems (IPC) (p = 0.041); AQ total-Global psychological maladjustment (GMPC) (p = 0.027); AQ social skills-Ineffectiveness (IC) (p = 0.018); AQ social skills-IPC (p = 0.019); AQ social skills-Affective problems (APC) (p = 0.025); AQ social skills-GMPC (p = 0.007); AQ attention switching-IPC (p = 0.020); ADOS-2 imagination-IC (p = 0.035). These correlations were independent of BMI, OCD and antipsychotic treatments.

Conclusions

ASD traits presented high prevalence in a group of young inpatients with AN. These traits were significantly correlated to 4 specific EDI-3 subscales and independent of BMI. This is the first study to investigate the relationship between ASD traits as measured with gold-standard measures, EDI-3 scores, and BMI.
Six-year trend and risk factors of unsuccessful pulmonary tuberculosis treatment outcomes in Thai Community Hospital
Authors: Charoensakulchai Sakarn , Lertpheantum Chaiyapun , Aksornpusitpong Chanapon , Trakulsuk Peeranut , Sakboonyarat Boonsub , Rangsin Ram , Mungthin Mathirut , Piyaraj Phunlerd
Published: March 2021

Objective

Tuberculosis (TB) is a major cause of morbidity and mortality globally. Despite efforts to eliminate TB in Thailand, the incidence rate has declined slowly. This study aimed to identify the incidence and risk factors of unsuccessful pulmonary TB treatment (failed, died and loss-to- follow up) in a community hospital in Chachoengsao Province, Thailand from 1st January 2013 to 31st December 2019.

Results

A total of 487 patients were eligible for the study. The incidence of unsuccessful treatment was 21.67/100 population person year. Risk factors of unsuccessful pulmonary TB treatment were unemployment (adjusted hazard ratio (AHR) 3.12, 95%CI 1.41–6.86), HIV co-infection (AHR 2.85, 95%CI 1.25–6.46), previous history of TB (AHR 2.00, 95%CI 1.04–3.81), positive sputum AFB at the end of the intensive phase (AHR 5.66, 95%CI 2.33–13.74), and sputum AFB was not performed at the end of the intensive phase (AHR 18.40, 95%CI 9.85–34.35). This study can be utilized to improve prevention and intervention of TB treatment by strengthening public health system on treatment quality especially TB patient monitoring tools or methods easy for accessing to patients in communities.
A Geospatial database of gastric cancer patients and associated potential risk factors including lifestyle and air pollution
Authors: Hashemi Amin Fatemeh , Ghaemi Mahtab , Mostafavi Sayyed Mostafa , Goshayeshi Ladan , Rezaei Khadijeh , Vahed Mehdi , Kiani Behzad
Published: March 2021

Objectives

Gastric cancer (GC) is a multifactorial disease and the fifth most frequent diagnosed cancer worldwide. It accounts for one third of cancer-related mortalities. Geospatial analysis using geographical information systems (GIS) can provide an efficient solution to identify spatial disparities associated with GC. As such, GIS enables policymakers to control cancer in a better way and identify the regions where interventions are needed. This study aims to publish a comprehensive dataset, which was applied to conduct a spatial analysis of GC patients in the city of Mashhad, Iran.

Data description

We provide a personal geodatabase, a Microsoft Access database that can store, query, and manage both spatial and non-spatial data, which contains four feature classes. “Male_Stomach_Cancer_Patients” and “Female_Stomach_Cancer_Patients” are point feature classes, which show the age and geographical location of 1156 GC cancer patients diagnosed between 2014 and 2017. “Air_Polution_Mashhad” is another point feature class that reveals the amount of six air pollutants, which was taken from Mashhad Environmental Pollutants Monitoring Center between 2017 and 2018. Finally, “Stomach_Cancer_and_Risk_Factors” is a polygon feature class of neighborhood division of Mashhad, consisting of contributor risk factors including dietary habits, smoking, alcohol use, body mass index and population by age groups for all 165 city neighborhoods.
A retrospective study on the usefulness of the JJ risk engine for predicting the incidence rate of coronary heart disease in type 2 diabetes patients
Authors: Yamashita Yasunari , Kitajima Rina , Matsubara Kiyoshi , Inoue Gaku , Matsubara Hajime
Published: March 2021

Objective

In 2018, we conducted a retrospective survey using the medical records of 484 patients with type 2 diabetes. The observed value of coronary heart disease (CHD) incidence after 5 years and the predicted value by the JJ risk engine as of 2013 were compared and verified using the discrimination and calibration values.

Results

Among the total cases analyzed, the C-statistic was 0.588, and the calibration was p < 0.05; thus, the JJ risk engine could not correctly predict the risk of CHD. However, in the group expected to have a low frequency of hypoglycemia, the C-statistic was 0.646; the predictability of the JJ risk engine was relatively accurate. Therefore, it is difficult to accurately predict the complication rate of patients using the JJ risk engine based on the diabetes treatment policy after the Kumamoto Declaration 2013. The JJ risk engine has several input items (variables), and it is difficult to satisfy them all unless the environment is well-equipped with testing facilities, such as a university hospital. Therefore, it is necessary to create a new risk engine that requires fewer input items than the JJ risk engine and is applicable to several patients.
Levonorgestrel intrauterine system embedded within tubal ectopic pregnancy: a case report
Authors: Makena Dorothy , Gichere Ingrid , Warfa Khadija
Published: March 2021

Background

The presence of the levonorgestrel-releasing intrauterine system embedded within an ectopic pregnancy is a rare occurrence. Tubal migration of an intrauterine device is not well understood and has not been extensively studied in literature.

Case presentation

A 34-year-old African woman, para 1, gravida 2, presented with symptoms of ruptured ectopic pregnancy. She underwent a laparoscopy where a ruptured left ectopic pregnancy was found with a levonorgestrel-releasing intrauterine system inserted 2 years prior embedded within the tube. A left salpingectomy was performed with removal of the levonorgestrel-releasing intrauterine system. The patient recovered well and proceeded to have an intrauterine pregnancy 3 months later.

Conclusion

Migration of the levonorgestrel-releasing intrauterine system into the fallopian tube is a rare occurrence that is not well understood. In the case presented, levonorgestrel-releasing intrauterine system was found embedded within the fimbrial end of the left fallopian tube, which had a ruptured ectopic pregnancy. Surgical treatment with laparoscopy is recommended for intraabdominal intrauterine device to prevent complications.
Diversity oriented Deep Reinforcement Learning for targeted molecule generation
Authors: Pereira Tiago , Abbasi Maryam , Ribeiro Bernardete , Arrais Joel P.
Published: March 2021

In this work, we explore the potential of deep learning to streamline the process of identifying new potential drugs through the computational generation of molecules with interesting biological properties. Two deep neural networks compose our targeted generation framework: the Generator, which is trained to learn the building rules of valid molecules employing SMILES strings notation, and the Predictor which evaluates the newly generated compounds by predicting their affinity for the desired target. Then, the Generator is optimized through Reinforcement Learning to produce molecules with bespoken properties. The innovation of this approach is the exploratory strategy applied during the reinforcement training process that seeks to add novelty to the generated compounds. This training strategy employs two Generators interchangeably to sample new SMILES: the initially trained model that will remain fixed and a copy of the previous one that will be updated during the training to uncover the most promising molecules. The evolution of the reward assigned by the Predictor determines how often each one is employed to select the next token of the molecule. This strategy establishes a compromise between the need to acquire more information about the chemical space and the need to sample new molecules, with the experience gained so far. To demonstrate the effectiveness of the method, the Generator is trained to design molecules with an optimized coefficient of partition and also high inhibitory power against the Adenosine $$A_{2A}$$

A

2
A

and $$\kappa$$
κ
opioid receptors. The results reveal that the model can effectively adjust the newly generated molecules towards the wanted direction. More importantly, it was possible to find promising sets of unique and diverse molecules, which was the main purpose of the newly implemented strategy.
Impact of contouring methods on pre-treatment and post-treatment dosimetry for the prediction of tumor control and survival in HCC patients treated with selective internal radiation therapy
Authors: Nodari Guillaume , Popoff Romain , Riedinger Jean Marc , Lopez Olivier , Pellegrinelli Julie , Dygai-Cochet Inna , Tabouret-Viaud Claire , Presles Benoit , Chevallier Olivier , Gehin Sophie , Gallet Matthieu , Latournerie Marianne , Manfredi Sylvain , Loffroy Romaric , Vrigneaud Jean Marc , Cochet Alexandre
Published: March 2021

Introduction

The aim of this study was to evaluate the impact of the contouring methods on dose metrics and their predictive value on tumor control and survival, in both situations of pre-treatment and post-treatment dosimetry, for patients with advanced HCC treated with SIRT.

Methods

Forty-eight patients who underwent SIRT between 2012 and 2020 were retrospectively included in this study. Target volumes were delineated using two methods: MRI-based contours manually drawn by a radiologist and then registered on SPECT/CT and PET/CT via deformable registration (Pre-CMRI and Post-CMRI), 99mTc-MAA-SPECT and 90Y-microspheres-PET 10% threshold contouring (Pre-CSPECT and Post-CPET). The mean absorbed dose (Dm) and the minimal absorbed dose delivered to 70% of the tumor volume (D70) were evaluated with both contouring methods; the tumor-to-normal liver uptake ratio (TNR) was evaluated with MRI-based contours only. Tumor response was assessed using the mRECIST criteria on the follow-up MRIs.

Results

No significant differences were found for Dm and TNR between pre- and post-treatment. TNR evaluated with radiologic contours (Pre-CMRI and Post-CMRI) were predictive of tumor control at 6 months on pre- and post-treatment dosimetry (OR 5.9 and 7.1, respectively; p = 0.02 and 0.01). All dose metrics determined with both methods were predictive of overall survival (OS) on pre-treatment dosimetry, but only Dm with MRI-based contours was predictive of OS on post-treatment images with a median of 23 months for patients with a supramedian Dm versus 14 months for the others (p = 0.04).

Conclusion

In advanced HCC treated with SIRT, Dm and TNR determined with radiologic contours were predictive of tumor control and OS. This study shows that a rigorous clinical workflow (radiologic contours + registration on scintigraphic images) is feasible and should be prospectively considered for improving therapeutic strategy.
Research on energy-efficient routing algorithm based on SWIPT in multi-hop clustered WSN for 5G system
Authors: Han Shu , Liu Xiao-ming , Huang Hong-yu , Wang Fei , Zhong Yuan-hong
Published: March 2021

As one of the basic supporting technologies of 5G system, wireless sensor networks technology is facing a new challenge to improve its transmission energy efficiency. This paper considers combining simultaneous wireless information and power transfer (SWIPT) technique and routing technique, and applying them to multi-hop clustered wireless sensor networks (MCWSN), where each node can decode information and harvest energy from a received radio-frequency signal. And the relay nodes in MCWSN can utilize the harvest energy to forward data to their next hop nodes according to the routing scheme. First, we formulate an energy-efficient routing problem of MCWSN with SWIPT. Then, a heuristic energy efficient cooperative SWIPT routing algorithm (EECSR) is presented to find a transmission path with the maximum energy efficiency. Specifically, in EECSR, the resource allocation problem in each hop of the path is transformed to some equivalent convex optimization problems, which are resolved via dual decomposition. Moreover, a distributed routing protocol based on EECSR is proposed. As far as we know, this is the first solution that considers energy efficiency optimization based on routing and SWIPT in MCWSN. Simulation results show that our EECSR algorithm has high energy efficiency and good robustness. And our distributed routing protocol has better real-time performance than traditional protocols.
Integral transforms for logharmonic mappings
Authors: Arbeláez Hugo , Bravo Víctor , Hernández Rodrigo , Sierra Willy , Venegas Osvaldo
Published: March 2021

Bieberbach’s conjecture was very important in the development of geometric function theory, not only because of the result itself, but also due to the large amount of methods that have been developed in search of its proof. It is in this context that the integral transformations of the type $f_{\alpha }(z)=\int _{0}^{z}(f(\zeta )/\zeta )^{\alpha }\,d\zeta $

f
α

(
z
)
=

∫
0
z

(
f
(
ζ
)
/
ζ
)

α

d
ζ
or $F_{\alpha }(z)=\int _{0}^{z}(f'(\zeta ))^{\alpha }\,d\zeta $

F
α

(
z
)
=

∫
0
z

(

f
′

(
ζ
)
)

α

d
ζ
appear. In this note we extend the classical problem of finding the values of $\alpha \in \mathbb{C}$
α
∈
C
for which either $f_{\alpha }$

f
α

or $F_{\alpha }$

F
α

are univalent, whenever f belongs to some subclasses of univalent mappings in $\mathbb{D}$
D
, to the case of logharmonic mappings by considering the extension of the shear construction introduced by Clunie and Sheil-Small in (Clunie and Sheil-Small in Ann. Acad. Sci. Fenn., Ser. A I 9:3–25, 1984) to this new scenario.
Investigation on dynamics of an impulsive predator–prey system with generalized Holling type IV functional response and anti-predator behavior
Authors: Sirisubtawee Sekson , Khansai Nattawut , Charoenloedmongkhon Akapak
Published: March 2021

In the present article, we propose and analyze a new mathematical model for a predator–prey system including the following terms: a Monod–Haldane functional response (a generalized Holling type IV), a term describing the anti-predator behavior of prey populations and one for an impulsive control strategy. In particular, we establish the existence condition under which the system has a locally asymptotically stable prey-eradication periodic solution. Violating such a condition, the system turns out to be permanent. Employing bifurcation theory, some conditions, under which the existence and stability of a positive periodic solution of the system occur but its prey-eradication periodic solution becomes unstable, are provided. Furthermore, numerical simulations for the proposed model are given to confirm the obtained theoretical results.
Implementation facilitation to introduce and support emergency department-initiated buprenorphine for opioid use disorder in high need, low resource settings: protocol for multi-site implementation-feasibility study
Authors: McCormack Ryan P. , Rotrosen John , Gauthier Phoebe , D’Onofrio Gail , Fiellin David A. , Marsch Lisa A. , Novo Patricia , Liu David , Edelman E. Jennifer , Farkas Sarah , Matthews Abigail G. , Mulatya Caroline , Salazar Dagmar , Wolff Jeremy , Knight Randolph , Goodman William , Hawk Kathryn
Published: March 2021

Background

For many reasons, the emergency department (ED) is a critical venue to initiate OUD interventions. The prevailing culture of the ED has been that substance use disorders are non-emergent conditions better addressed outside the ED where resources are less constrained. This study, its rapid funding mechanism, and accelerated timeline originated out of the urgent need to learn whether ED-initiated buprenorphine (BUP) with referral for treatment of OUD is generalizable, as well as to develop strategies to facilitate its adoption across a variety of ED settings and under real-world conditions. It both complements and uses methods adapted from Project ED Health (CTN-0069), a Hybrid Type 3 implementation-effectiveness study of using Implementation Facilitation (IF) to integrate ED-initiated BUP and referral programs.

Methods

ED-CONNECT (CTN 0079) was a three-site implementation study exploring the feasibility, acceptability, and impact of introducing ED-initiated BUP in rural and urban settings with high-need, limited resources, and different staffing structures. We used a multi-faceted approach to develop, introduce and iteratively refine site-specific ED clinical protocols and implementation plans for opioid use disorder (OUD) screening, ED-initiated BUP, and referral for treatment. We employed a participatory action research approach and use mixed methods incorporating data derived from abstraction of medical records and administrative data, assessments of recruited ED patient-participants, and both qualitative and quantitative inquiry involving staff from the ED and community, patients, and other stakeholders.

Discussion

This study was designed to provide the necessary, time-sensitive understanding of how to identify OUD and initiate treatment with BUP in the EDs previously not providing ED-initiated BUP, in communities in which this intervention is most needed: high need, low resource settings.

Trial registration: The study was prospectively registered on ClinicalTrials.gov (NCT03544112) on June 01, 2018: https://clinicaltrials.gov/ct2/show/NCT03544112.
“Non-timber forest products and climate change adaptation among forest dependent communities in Bamboko forest reserve, southwest region of Cameroon”
Authors: Tieminie Robinson Nghogekeh , Loh Chia Eugene , Tieguhong Julius Chepezi , Nghobuoche Manyiadieh Frankline , Mandiefe Piabuo Serge , Tieguhong Mamboh Rolland
Published: March 2021

Background

Forests are naturally endowed to combat climate change by protecting people and livelihoods as well as creating a base for sustainable economic and social development. But this natural mechanism is often hampered by anthropogenic activities. It is therefore imperative to take measures that are environmentally sustainable not only for mitigation but also for its adaptation. This study was carried out to assess the role of Non-timber forest products (NTFPs) as an adaptation strategy based on local perception to cope with the impacts of climate change among forest-dependent communities around the Bamkoko Forest Reserve in the South West Region of Cameroon.

Methods

Datasets were collected through household questionnaires (20% of the population in each village that constitute the study site was sample), participatory rural appraisal techniques, transect walks in the 4 corners of the Bamboko Forest Reserve with a square sample of 25 m2 × 25 m2 to identified and record NTFPs in the reserve,and direct field observations.). Both qualitative and quantitative (statistics) methods were used to analyze the collected data.

Results

A total of 18 plant species were identified as being harvested as Non Timber Forest Products by the residents around Bamkoko Forest Reserve. The majority of the respondents (88%) perceived that there has been a change in climate patterns due to increased temperatures and unpredictable rainfalls. Eru was the most affected NTFPs with a standard deviation of 1.66799 and agricultural crops was the most affected livelihood activity by climate change around Bamboko Forest Reserve with a standard deviation of 1.20459 and local population used more than one strategy to cope with these adverse effects

Conclusions

The study concluded that with the increasing climate change effects on crop production and other livelihoods, non-timber forest products still play a safety net role to assist communities. The need to ensure sustainable harvesting, improved processing, and access to non-timber forest products markets cannot be over-emphasized.
Probing 3-D electrical conductivity of the mantle using 6 years of Swarm, CryoSat-2 and observatory magnetic data and exploiting matrix Q-responses approach
Authors: Kuvshinov Alexey , Grayver Alexander , Tøffner-Clausen Lars , Olsen Nils
Published: March 2021

This study presents results of mapping three-dimensional (3-D) variations of the electrical conductivity in depths ranging from 400 to 1200 km using 6 years of magnetic data from the Swarm and CryoSat-2 satellites as well as from ground observatories. The approach involves the 3-D inversion of matrix Q-responses (transfer functions) that relate spherical harmonic coefficients of external (inducing) and internal (induced) origin of the magnetic potential. Transfer functions were estimated from geomagnetic field variations at periods ranging from 2 to 40 days. We study the effect of different combinations of input data sets on the transfer functions. We also present a new global 1-D conductivity profile based on a joint analysis of satellite tidal signals and global magnetospheric Q-responses.
The ionospheric condition and GPS positioning performance during the 2013 tropical cyclone Usagi event in the Hong Kong region
Authors: Yu Shiwei , Liu Zhizhao
Published: March 2021

The ionosphere plays a critical role in the electromagnetic waves in communication systems such as the global positioning system (GPS). However, it is suspected that the strong convection during the tropical cyclone (TC) events can be a trigger to anomalous electron density variation in the ionosphere. This study analyzed the variation of three ionosphere-related parameters based on the GPS data including scintillation index S4, cycle slips, and total electron content (TEC) rate (TECR) during the tropical cyclone event (the 2013 TC Usagi) in the Hong Kong region. The results showed that the ionosphere-related parameters had a consistent significant increase on the second day after the Usagi made landfall near Hong Kong. Consequently, the positioning performance of GPS precise point positioning (PPP) and relative positioning modes was degraded. The degradation was ~ 138%, ~ 181%, and ~ 460% in the east (root mean square (RMS) 0.050 m), north (RMS 0.045 m), and up (RMS 0.185 m), respectively, compared with the RMS of 0.021 m in the east, 0.016 m in the north, and 0.033 m in the up on the normal day. Regarding the relative positioning, the positioning errors in the east (RMS 0.134 m) and north (RMS 0.118 m) directions were ~ 7.1 and ~ 7.9 times, respectively, as large as the RMS of 0.019 m in the east and 0.015 m in the north on the normal day. The positioning errors in the up (RMS 0.513 m) direction were ~ 12.2 times larger than the RMS of 0.042 m on the normal day.
The Caribbean House of Mirrors
Authors: Rodríguez-Silva Ileana M.
Published: March 2021

This article introduces the house of mirrors as an analytical device with the aim of cracking open binary comparative work. It offers close readings of debates regarding US colonialism among Puerto Rican intellectuals and politicians at two distinct historical moments. These are the 1910s, prompted specifically by the 1912 War in Cuba, and the early Cold War, the 1950s and 1960s moment of intentionally modeling Puerto Rico as the “Showcase of the Americas.” In changing the focus to examine the play of images intrinsic to the house of mirrors, this meditation seeks to avoid reproducing the single and contained national gaze that often frames comparative narratives, even when they acknowledge the overlapping geographic, sociocultural, and political circuits shaping historical subjects. Instead, the house of mirrors reveals the operational mechanisms of the national modern gaze historical actors often employed to organize their experiences, project themselves onto others, and advance their political desires.
Full methylation of H3K27 by PRC2 is dispensable for initial embryoid body formation but required to maintain differentiated cell identity
Authors: Miller Sara A. , Damle Manashree , Kim Jongmin , Kingston Robert E.
Published: March 2021

Polycomb repressive complex 2 (PRC2) catalyzes methylation of histone H3 on lysine 27 and is required for normal development of complex eukaryotes. The nature of that requirement is not clear. H3K27me3 is associated with repressed genes, but the modification is not sufficient to induce repression and, in some instances, is not required. We blocked full methylation of H3K27 with both a small molecule inhibitor, GSK343, and by introducing a point mutation into EZH2, the catalytic subunit of PRC2, in the mouse CJ7 cell line. Cells with substantively decreased H3K27 methylation differentiate into embryoid bodies, which contrasts with EZH2 null cells. PRC2 targets had varied requirements for H3K27me3, with a subset that maintained normal levels of repression in the absence of methylation. The primary cellular phenotype of blocked H3K27 methylation was an inability of altered cells to maintain a differentiated state when challenged. This phenotype was determined by H3K27 methylation in embryonic stem cells through the first 4 days of differentiation. Full H3K27 methylation therefore was not necessary for formation of differentiated cell states during embryoid body formation but was required to maintain a stable differentiated state.