bluuebunny/crossref_metadata_2025 huggingface dataset:
Jejunal perforation secondary to blind insertion of peritoneal dialysis catheter: a case report and review of literature
Authors: Jacobs Lucas , Salaouatchi Mohammed , Taghavi Maxime , Sanoussi Said , Nortier Joelle , Mesquita Maria
Published: April 2023

Background

Peritoneal dialysis (PD) depends upon a functioning and durable access to the peritoneal cavity. Many techniques exist to insert a peritoneal catheter, showing similar outcomes and benefits. Blind percutaneous insertion represents a bedside intervention predominantly performed by nephrologists requiring only local anesthesia, sedation and minimal transcutaneous access. Although current guidelines recommend insertion techniques allowing visualization of the peritoneal cavity, the blind percutaneous approach is still widely used and has been proven safe and effective to bring durable peritoneal dialysis access. Herein, we described a rare case of jejunal perforation secondary to blind PD catheter placement, and conduct a review of the current medical literature describing early bowel perforations secondary to PD catheter placement, gathering descriptions of symptomatology and outcomes and their relations to the insertion technique.

Clinical presentation

We herein describe the case of a 48 year-old patient with a history of appendectomy who suffered from triple jejunal perforation after blind percutaneous insertion and subsequent embedment of his peritoneal catheter. Accurate diagnosis was made 1 month after insertion due to atypical clinical presentation and because physicians had no access to the peritoneal cavity after catheter embedment. After surgical repair and broad-spectrum antibiotics, the patient was switched to HD.

Conclusion

Early catheter-related visceral injury is a rare, yet threatening condition that is almost always causing a switch to hemodialysis or death. Our review highlights that laparoscopic catheter placement might bring better outcomes if perforation occurs, as it allows immediate diagnosis and treatment. On the contrary, catheter embedment may delay clinical diagnosis and therefore bring worse outcomes.
Sex-dependent gut microbiota-brain-cognition associations: a multimodal MRI study
Authors: Zhang Shujun , Cai Huanhuan , Wang Chunli , Zhu Jiajia , Yu Yongqiang
Published: April 2023

Background

There is bidirectional communication between the gut microbiota and the brain. Empirical evidence has demonstrated sex differences in both the gut microbiome and the brain. However, the effects of sex on the gut microbiota-brain associations have yet to be determined. We aim to elucidate the sex-specific effects of gut microbiota on brain and cognition.

Methods

One hundred fifty-seven healthy young adults underwent brain structural, perfusion, functional and diffusion MRIs to measure gray matter volume (GMV), cerebral blood flow (CBF), functional connectivity strength (FCS) and white matter integrity, respectively. Fecal samples were collected and 16S amplicon sequencing was utilized to assess gut microbial diversity. Correlation analyses were conducted to test for sex-dependent associations between microbial diversity and brain imaging parameters, and mediation analysis was performed to further characterize the gut microbiota-brain-cognition relationship.

Results

We found that higher gut microbial diversity was associated with higher GMV in the right cerebellum VI, higher CBF in the bilateral calcarine sulcus yet lower CBF in the left superior frontal gyrus, higher FCS in the bilateral paracentral lobule, and lower diffusivity in widespread white matter regions in males. However, these associations were absent in females. Of more importance, these neuroimaging biomarkers significantly mediated the association between gut microbial diversity and behavioral inhibition in males.

Conclusions

These findings highlight sex as a potential influential factor underlying the gut microbiota-brain-cognition relationship, and expose the gut microbiota as a biomarker-driven and sex-sensitive intervention target for mental disorders with abnormal behavioral inhibition.
Prenatally detected six duplications at Xp22.33-p11.22: a case report
Authors: Zhang Xue , Li Jian , Zhang Lan , Liu Hongli , Yi Hong , Liang Mingxing , Luo Jianyu , Li Junnan , Dong Yanling
Published: April 2023

Background

The discrepancy between the results of cytogenetics and the results of chromosome microarray analysis (CMA) has often led to confusion over genetic counselling for prenatal diagnosis.

Case presentation

The prenatal ultrasound results of a congenital heart defect (CHD) foetus displayed an apartial endocardial pad defect and permanently dilated coronary sinus and left superior vena cava at 21 weeks of gestation. Cytogenetic analysis, CMA, fluorescent in situ hybridization (FISH) and multiplex ligation-dependent probe amplification (MLPA) with foetal cord blood samples were used to detect the genetic aetiology. Routine G-binding cytogenetic analysis showed normal karyotypes in both the foetus’ and parents’ blood samples. CMA results demonstrated that there were 53.973-Mb recurrent CNVs at Xp22.33-p11.22, as confirmed by MLPA assay.

Conclusions

Herein, we described the CNV of six duplications at Xp22.33-p11.22 and the 53.973 Mb duplication CNV that was not found in foetal cord blood samples by conventional cytogenetic methods, and it was confirmed by CMA and MLPA. Our novel findings will provide helpful information for prenatal diagnosis and genetic counselling for foetal CHDs.
The impact of PIK3CA mutations and PTEN expression on the effect of neoadjuvant therapy for postmenopausal luminal breast cancer patients
Authors: Hayama Shouko , Nakamura Rikiya , Ishige Takayuki , Sangai Takafumi , Sakakibara Masahiro , Fujimoto Hiroshi , Ishigami Emi , Masuda Takahito , Nakagawa Ayako , Teranaka Ryotaro , Ota Satoshi , Itoga Sakae , Yamamoto Naohito , Nagashima Takeshi , Otsuka Masayuki
Published: April 2023

Background

There is pressing needs to find the biomarker in the selection of neoadjuvant therapy in postmenopausal luminal breast cancer patients. We examined the hypothesis that PIK3CA mutations and low phosphatase and tensin homolog (PTEN) expression affect the response to neoadjuvant therapy and prognosis in postmenopausal luminal breast cancer patients.

Methods

Postmenopausal patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative breast cancer, up to stage II, who underwent neoadjuvant chemotherapy (NAC; n = 60) or neoadjuvant endocrine therapy (NAE; n = 55) were selected. PIK3CA exon 9 and exon 20 mutations were screened by high resolution melting analysis and confirmed by Sanger sequence. PTEN expression was evaluated by immunohistochemistry. The relationships among PIK3CA mutations, PTEN expression, clinicopathological features, the pathological effect of neoadjuvant therapy, recurrence-free survival (RFS) and overall survival were analyzed.

Results

Among 115 patients, PIK3CA mutations and low PTEN expression before treatment were detected in 35 patients (30.4%) and in 28 patients (24.3%), respectively. In the NAC group, tumor with PIK3CA mutations showed significantly poorer response than tumor with PIK3CA wild-type (p = 0.03). On the other hand, in the NAE group, there was no significant difference in pathological therapeutic effect between tumor with PIK3CA mutations and tumor with PIK3CA wild-type (p = 0.54). In the NAC group, the log-rank test showed no difference in RFS between patients with PIK3CA mutations and PIK3CA wild-type (p = 0.43), but patients with low PTEN expression showed significantly worse RFS compared to patients with high PTEN expression (5 year RFS 0.64 vs. 0.87, p = 0.01). In the Cox proportional hazards model for RFS, PTEN expression, progesterone receptor, and pathological therapeutic effect were predictive factors for time to recurrence (All p < 0.05).

Conclusions

PIK3CA mutations are associated with resistance to NAC but do not affect the response to NAE. Low PTEN expression does not affect response to either NAC or NAE but correlates with shorter RFS in patients who received NAC. These biomarkers will be further evaluated for clinical use to treat postmenopausal luminal breast cancer patients.
Long-term surgical outcomes of basic-type exotropia in patients with hyperopia
Authors: Jeon Hyeshin , Choi Hee-young
Published: April 2023

Background

To investigate the surgical outcomes of basic-type exotropia in patients with hyperopia.

Methods

The medical records of patients who underwent surgery for basic-type exotropia and had been followed up for ≥ 2 years were retrospectively recruited. Patients with myopia and spherical equivalent (SE) < -1.0 diopters (D) were excluded. The patients were classified according to the SE: group H had a SE ≥  + 1.0 D, and group E had -1.0 ≤ SE <  + 1.0 D. The surgical success rate and sensory outcome were compared. Surgical success was defined as exodeviation ≤ 10 prism diopters (PD) and esodeviation ≤ 5 PD at 6 m fixation. Stereoacuity was measured using the Titmus Preschool Stereoacuity Test.

Results

Seventy-five patients (24 males and 51 females, mean age 5.1 ± 2.6 years, range 2.7–14.8) were included. The SE ranged from -0.9 to 4.4 and 21 patients were classified into group H and 54 into group E. The success rates were higher in group H than in group E during the entire follow-up period, but the differences were significant only at the final examination. At the final follow-up, 11 of the 21 (52.4%) patients in group H and 15 of the 54 (27.7%) in group E maintained successful alignment, whereas 10 (47.6%) and 38 (70.4%) patients exhibited recurrence. Overcorrection was exhibited in one (1.9%) patient in group E. Sensory results were comparable between the groups. The follow-up period did not differ between the two groups. The survival analysis showed no difference in the surgical results between the two groups.

Conclusions

Surgery for basic-type intermittent exotropia resulted in superior outcomes in patients with hyperopia compared to those with emmetropia.
Dynamic nomogram prediction model for diabetic retinopathy in patients with type 2 diabetes mellitus
Authors: Zhang Chunhui , Zhou Liqiong , Ma Minjun , Yang Yanni , Zhang Yuanping , Zha Xu
Published: April 2023

Background

To develop a dynamic prediction model for diabetic retinopathy (DR) using systemic risk factors.

Methods

This retrospective study included type 2 diabetes mellitus (T2DM) patients discharged from the Second Affiliated Hospital of Kunming Medical University between May 2020 and February 2022. The early patients (80%) were used for the training set and the late ones (20%) for the validation set.

Results

Finally, 1257 patients (1049 [80%] in the training set and 208 [20%] in the validation set) were included; 360 (28.6%) of them had DR. The areas under the curves (AUCs) for the multivariate regression (MR), least absolute shrinkage and selection operator regression (LASSO), and backward elimination stepwise regression (BESR) models were 0.719, 0.727, and 0.728, respectively. The Delong test showed that the BESR model had a better predictive value than the MR (p = 0.04899) and LASSO (P = 0.04999) models. The DR nomogram risk model was established according to the BESR model, and it included disease duration, age at onset, treatment method, total cholesterol, urinary albumin to creatinine ratio (UACR), and urine sugar. The AUC, kappa coefficient, sensitivity, specificity, and compliance of the nomogram risk model in the validation set were 0.79, 0.48, 71.2%, 78.9%, and 76.4%, respectively.

Conclusions

A relatively reliable DR nomogram risk model was established based on the BESR model.
Eosinophilia and potential antibody cross-reactivity between parasites in a child with pinworm and immune dysregulation: a case report
Authors: Di Cicco Maria , Bertolucci Giulia , Gerini Carlotta , Bruschi Fabrizio , Peroni Diego G.
Published: April 2023

Background

Intestinal parasitic infections are common in humans, especially among young children. These conditions are often asymptomatic and self-limiting, and diagnosis is mainly based on the search for ova and parasites in the stools since serology may be biased due to cross reactivity between parasites. Pinworm is common in children and is not usually associated with hypereosinophilia; adhesive-tape test is the gold standard testing for the microscopic detection of Enterobious vermicularis (Ev) eggs.

Case presentation

A 13-year-old boy was referred due to a self-resolving episode of vomiting and palpebral oedema after dinner, together with a history of chronic rhinitis, chronic cough, absolute IgA deficiency and Hashimoto’s thyroiditis and hypereosinophilia (higher value = 3140/µl). On evaluation we detected only palpable thyroid and hypertrophic nasal turbinates. Food allergy was excluded, but skin prick tests showed sensitization to house dust mites and cat epithelium and spirometry showed a marked obstructive pattern with positive bronchodilation test prompting the diagnosis of asthma for which maintenance inhaled treatment was started. Chest x-ray and abdomen ultrasound were negative. Further blood testing showed positive IgG anti-Echinococcus spp. and Strongyloides stercoralis and positive IgE for Ascaris, while Ev were detected both by the adhesive tape test and stool examination, so that we made a final diagnosis of pinworm infection. Three months after adequate treatment with pyrantel pamoate the adhesive-tape test turned out negative and blood testing showed a normal eosinophil count. The child later developed also type 1 diabetes.

Conclusions

We suggest the need to investigate for enterobiasis in children with hypereosinophilia and to consider autoimmunity as a potential confounding factor when interpreting serology for helminths.
The efficacy and safety of Sanqi Qushi Granule in patients with idiopathic membranous nephropathy ——protocol of a multicenter, randomized control trial (SQ-AUTUMN)
Authors: Li Chuang , Shan Wenjun , Liang Xing , Zhang Qinghua , Qin Xindong , Jiang Sha , Hong Xiaofan , Wang Lijuan , Li Ping , Gu Haowen , Wang Yi , Bao Kun
Published: April 2023

Background

Adult nephropathy is mainly caused by idiopathic membranous nephropathy (IMN). In cases of proteinuria, Modified Ponticelli Regimens (MPR) are often successful. However, it can cause adverse side effects. Oral Sanqi Qushi Granule (SQG) with MPR is effective in patients with IMN. However, whether it can improve the remission rate of IMN and shorten the remission time is unknown. In this trial, SQG with MPR on IMN will be evaluated clinically for its efficacy and safety.

Methods

We will randomly assign IMN patients who meet the criteria to receives SQG plus cyclical Cyclophosphamide (CTX)/steroids or with placebo plus cyclical CTX/steroids for 6 months. A 12-month follow-up will be conducted on them. Status of remission will be used to assess treatment efficacy.

Discussion

This study aims to appraise whether treatment with SQG plus cyclical CTX/steroids is superior to placebo plus cyclical CTX/steroids in the remission rate of patients with adult IMN. Adverse events of SQG plus MPR will be also evaluated for further researches about Chinese Medicine and MPR on whether it can improve the remission rate of IMN in half a year and shorten the remission time and relieve adverse effects will also be clarified.

Trial registration

Chinese Clinical Trial Registry ChiCTR2200061953. Registered on 13 July 2022.
A rare case of ocular and testicular T-cell lymphoma in a hermaphrodite koi carp (Cyprinus carpio Linnaeus 1758): clinical, histopathological, and immunohistochemical study
Authors: Rahmati-Holasoo Hooman , Shokrpoor Sara , Marandi Amin , Torjani Niyousha , Ebrahimzadeh Mousavi Hosseinali
Published: April 2023

Background

Lymphatic neoplasia may occur in various types, such as lymphoma, lymphosarcoma, lympholeukemia, and plasmacytoid leukemia. Lymphoma, defined as a malignant tumour of lymphoid tissue, has been found in a number of fish families including Esocidae and Salmonidae. However, the occurrence of lymphoma is rare in those belonging to the Cyprinidae. A final diagnosis of ocular and testicular T-cell lymphoma in the present study was based on the clinical signs, morphology, and texture of the tumour masses in the macroscopic and microscopic examinations. In addition, histopathological and immunohistochemical findings corresponded to T-cell lymphoma characteristics.

Case presentation

A 2-year-old hermaphrodite koi carp (Cyprinus carpio Linnaeus 1758) with a large ocular mass and severe exophthalmia in the right eye was referred to the Ornamental Fish Clinic in October 2020. Under anesthesia, enucleation was performed. 57 days after enucleation of the right eye, exophthalmia in the left eye was discovered. 221 days after surgery, the fish was discovered to be dead. At necropsy, a large soft tissue mass attached to the left testis was discovered. There were also small whitish nodules on the surface of the liver. Histopathology revealed a hypercellular ocular mass with scant connective tissue. The sections also revealed multifocal hemorrhages, round to ovoid neoplastic cells, mild-to-moderate anisokaryosis and anisocytosis, and mitotic figures. Basophilic neoplastic cells were found in blood vessels within the testicular mass, raising the possibility of systemic spread. The liver showed microscopic metastasis with morphologic similarities to the ocular and testicular tumors. The neoplastic cells infiltrating the left and right eyes as well as the testicular mass were immunohistochemically positive for CD3 but negative for CD20. The masses were diagnosed as T-cell lymphoma based on histopathological and immunohistochemical findings.

Conclusions

This case report provides the first evidence of clinical, histopathological, morphological, and immunohistochemical findings of an ocular and testicular T-cell lymphoma in a hermaphrodite koi carp (Cyprinus carpio) in Iran.
Enhanced in vivo and ex vivo thrombin generation after lower-leg trauma, but not after knee arthroscopy
Authors: Touw Carolina E. , Nemeth Banne , van Adrichem Raymond A. , van Hylckama Vlieg Astrid , Nelissen Rob G. H. H. , Lisman Ton , Cannegieter Suzanne C.
Published: April 2023

Background

There is room for improvement of prevention of venous thromboembolism (VTE) after lower-leg cast application or knee arthroscopy. Information about the mechanism of clot formation in these patients may be useful to identify new prophylaxis targets. We aimed to study the effect of 1) lower-leg injury and 2) knee arthroscopy on thrombin generation.

Methods

A cross-sectional study was conducted using plasma samples of POT-(K)CAST trials to measure ex vivo thrombin generation (Calibrated Automated Thrombography [CAT]) and plasma levels of prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin (TAT), fibrinopeptide A (FPA). Plasma was obtained shortly after lower-leg trauma or before and after (< 4 h) knee arthroscopy. Participants were randomly selected from those who did not develop VTE. For aim 1, samples of 88 patients with lower-leg injury were compared with 89 control samples (i.e., preoperative samples of arthroscopy patients). Linear regression was used to obtain mean differences (or ratios if ln-retransformed because of skewedness) adjusted for age, sex, body mass index, comorbidities. For aim 2, pre- and postoperative samples of 85 arthroscopy patients were compared, for which mean changes were obtained.

Results

In patients with lower-leg injury (aim 1), endogenous thrombin potential, thrombin peak, velocity index, FPA and TAT were increased as compared with controls. In arthroscopy patients (aim 2), pre- and postoperative levels were similar for all parameters.

Conclusion

Lower-leg trauma increases thrombin generation both ex vivo and in vivo, in contrast to knee arthroscopy. This may imply that the pathogenesis of VTE is different in both situations.
Taxonomic reclassification of Kaposi Sarcoma identifies disease entities with distinct immunopathogenesis
Authors: Openshaw M. R. , Gervasi E. , Fulgenzi C. A. M. , Pinato D. J. , Dalla Pria A. , Bower M.
Published: April 2023

Background

The taxonomy of Kaposi Sarcoma (KS) is based on a classification system focused on the description of clinicopathological features of KS in geographically and clinically diverse populations. The classification includes classic, endemic, epidemic/HIV associated and iatrogenic KS, and KS in men who have sex with men (MSM). We assessed the medical relevance of the current classification of KS and sought clinically useful improvements in KS taxonomy.

Methods

We reviewed the demographic and clinicopathological features of 676 patients with KS, who were referred to the national centre for HIV oncology at Chelsea Westminster hospital between 2000 and 2021.

Results

Demographic differences between the different subtypes of KS exist as tautological findings of the current classification system. However, no definitive differences in clinicopathological, virological or immunological parameters at presentation could be demonstrated between the classic, endemic or MSM KS patients. Reclassifying patients as either immunosuppressed or non-immunosuppressed, showed that the immunosuppressed group had a significantly higher proportion of adverse disease features at presentation including visceral disease and extensive oral involvement, classified together as advanced disease (chi2 P = 0.0012*) and disseminated skin involvement (chi2 P < 0.0001*). Immunosuppressed patients had lower CD4 counts, higher CD8 counts and a trend towards higher HHV8 levels compared to non-immunosuppressed patients, however overall survival and disease specific (KS) survival was similar across groups.

Conclusion

The current system of KS classification does not reflect meaningful differences in clinicopathological presentation or disease pathogenesis. Reclassification of patients based on the presence or absence of immunosuppression is a more clinically meaningful system that may influence therapeutic approaches to KS.
Critical value in surgical pathology: evaluating the current status in a multicenter study
Authors: Soleimani Neda , Zare Sheibani Atefe , Khajeh Samira , Mohammadzadeh Sahand , Taheri Negar , Mokhtari Maral , Farhadi Mahsa , Hajizade Zahra , Khaleghpanah Saeideh , Dehghani Sima
Published: April 2023

Background

The concept of critical value is not evident in surgical pathology, and there is no established protocol for determining, reporting, and documenting these results.

Materials and methods

A questionnaire was designed regarding critical value in surgical pathology, and all pathologists and some clinicians from five laboratories were asked to participate through an invitation link. The most important items were selected, and all pathologists were instructed to follow a standard operating procedure to deal with critical results for a year.

Results

A total of 43 pathologists and 44 non-pathologists participated in the study. Some critical or unexpected items were selected. Most participants agreed that the optimal time to announce critical reports is within 24 h of establishing the final diagnosis, and a phone call was the most dependable communication option. In addition, the most qualified recipients were the attending physicians. Therefore, a written policy was implemented for a year. One hundred seventy-seven critical or unexpected cases (0.5%) were detected. Mucormycosis and cytomegalovirus (CMV) were the most frequent critical cases.

Conclusion

There are no set criteria for critical items or the reporting process in surgical pathology. It is possible to establish more uniform norms for reporting these cases by boosting pertinent research efforts and recruiting more pathologists and physicians. Additionally, it is advised that each medical facility compile its own unique critical or unexpected diagnosis list.
Anesthesia for the dog with heartworm disease: a brief, practical review
Authors: Quandt Jane
Published: April 2023

Dogs with heartworm disease may present for procedures that require anesthesia. This article is a brief, practical review of anesthetic techniques for dogs with heartworm. Dogs with heartworm, such as in a shelter that undergo spay and neuter procedures, may be safely anesthetized prior to heartworm treatment. The dog presenting with caval syndrome may require emergent anesthesia for extraction of the heartworms; anesthetic drugs and potential adverse effects are discussed. The anesthetic agents that have been used are discussed.
Retrospective analyses of heartworm (Dirofilaria immitis) disease and ectoparasite preventive medication compliance in veterinary practices in the USA
Authors: Mwacalimba Kennedy , Sears Derek , Brennan Christopher , Poulsen Nautrup Barbara , Sheehy Jenifer , Smith Kristine , Adolph Christopher
Published: April 2023

Background

Compliance failure with administration of heartworm (HW) disease preventives has been reported as the main contributor to HW disease incidence in medicalized dogs. This study aimed to evaluate purchase compliance with different canine HW preventive products in the USA.

Methods

Anonymized transaction data from clinics throughout the USA served as the basis for two retrospective analyses. We first examined the monthly equivalent doses of HW preventive purchases from clinics that had implemented extended-release moxidectin injectables ProHeart® 6 (PH6) and/or ProHeart® 12 (PH12) compared to clinics that prescribed monthly HW preventatives (MHWP) only. In the second analysis, the purchase compliance in practices that dispensed only flea and tick (FT) and HW products separately but did not dispense combination products (dual-therapy practices) was compared to the purchase compliance with the combination product Simparica Trio® (sarolaner, moxidectin, and pyrantel chewable tablets), purchased in clinics having implemented combination therapy in their formulary (combination-therapy practices). In both analyses, the numbers of monthly doses dispensed annually per dog were calculated.

Results

Transaction data from 3,539,990 dogs in 4615 practices were included in the first analysis. In dogs administered PH12 or PH6, the numbers of monthly equivalent doses were 12 and 8.1, respectively. In both clinic types, the average annual number of MHWP doses totaled 7.3. In the second analysis, a total of 919 practices were identified as combination-therapy practices and 434 as dual-therapy-only practices. A total of 246,654 dogs (160,854 dogs in dual-therapy practices and 85,800 dogs in combination-therapy practices) were included in the calculation of the average annual number of monthly doses, which totaled 6.8 (HW preventive products) and 4.4 (FT products) in dual-therapy practices compared to 7.2 months for both FT and HW preventives with Simparica Trio® across both practice types.

Conclusions

The injectable HW preventive PH12 is the only product that provides 12 months of heartworm disease prevention in a single veterinarian-administered injection. When choosing a monthly preventive, the combination therapy was associated with a greater purchase compliance compared with FT and HW products being dispensed separately.

Graphical Abstract
MT-GAN: toward realistic image composition based on spatial features
Authors: Li Xiang , Teng Guowei , An Ping , Yao Hai-yan
Published: April 2023

The purpose of image composition is to combine the visual elements of different natural images to produce a natural image. The performance of most existing image composition methods drops significantly when they solve multiple issues, such as image harmonization, image blending, shadow generation, object placement, and spatial transformation. To address this problem, we propose a multitask GAN for image compositing based on spatial features, aiming to simultaneously address the geometric and appearance inconsistency. We use three related learning objective functions to train the network. Moreover, a new dataset including 7756 images with RoI region annotations is contributed to help evaluate the multitask image compositing results. Extensive experiments demonstrate that our proposed method is effective on our dataset.
Examine the association between self-employment and return migrants in Ethiopia: evidence from Gondar city youth returnees
Authors: Alene Endalew Terefe
Published: April 2023

Purpose

This study attempted to contribute to the existing literature on return migration by framing the discussion within the association between self-employment and returning migrants in the context of Ethiopia particularly on Gondar city youth returnees.

Design/methodology/approach

The study has used a combination of cross-sectional and descriptive research design with a quantitative approach. Quantitative data from 195 youth returnees using a survey questionnaire were employed to address the study objectives. A Census sampling strategy was employed to select study participants. To test the study hypothesizes, a χ2 test was implemented to show the association between independent and dependent variables.

Findings

The findings of this study showed that there is no association between self-employment and return migrants. More specifically, the study results revealed that sectoral and occupational experience gained from abroad do not help return migrants for new business formation.

Research limitations/implications

This study which was focused only on self-employed return migrants where comes from Saudi Arabia, likely does not represent the whole return migrants from abroad. In addition, this study does not include all independent variables that influence the self-employment of return migrants. It only considers occupational and sectoral experience. To understand comprehensively, future research will do by considering all indicators of self-employment of return migrants and also make a comparative analysis between urban and rural return migrants' possibility to become self-employed.

Practical implications

Return migration is one of the demographic phenomena in the world which needs attention from government and non-government organizations. Taking into account this, the paper will serve as an input for policymakers and local officials to consider self-employment carefully to support returnees' sustainable entrepreneurial performance and economic growth. It will also help officials to understand some of the challenges that self-employed returnees have been faced including the provision of working area, formal credit, and pieces of training consistent with the experience brought from abroad and tax incentives.

Originality/value

Studies on youth return migration in sub-Saharan Africa countries are limited and this study will contribute to the return migration literature with an attempt to examine the association between self-employment and return migration in the context of Ethiopia. Accordingly, it examines the relationship between self-employment among youth return migrants by taking sectoral and occupational experience as major indicators.
Evaluation of inverted papilloma recurrence rates and factors associated recurrence after endoscopic surgical resection: A retrospective review
Authors: Yu Sheila , Grose Elysia , Lee Daniel J. , Wu Vincent , Pellarin Mitchell , Lee John M.
Published: April 2023

Background

Sinonasal inverted papillomas (IP) are benign tumours arising from the mucosal lining of the nasal cavity and paranasal sinuses with a high propensity for recurrence and malignant transformation. Advances in endoscopic surgery and improved radiologic navigation have increased the role of endoscopic surgical resection in the treatment of IPs. The current study aims to evaluate the rate of IP recurrence after endoscopic endonasal resection and to evaluate factors which impact recurrence.

Methods

This was a single-centre retrospective chart review of all patients who underwent endoscopic sinus surgery for management of IP between January 2009 and February 2022. Primary outcomes were the rate of IP recurrence and time to IP recurrence. Secondary outcome measures were patient and tumour factors that contributed to IP recurrence.

Results

Eighty-five patients were included. The mean age was 55.7 and 36.5% of patients were female. The mean follow-up time was 39.5 months. Of the 85 cases, 13 cases (15.3%) had recurrence of their IP and the median time to recurrence was 22.0 months. All recurrent tumours recurred at the attachment site of the primary tumour. The univariate analysis did not identify any significant demographic, clinical, or surgical predictors of IP recurrence. There were no significant changes in sinonasal symptoms at the time IP recurrence was detected.

Conclusion

Endoscopic endonasal resection of IPs represents an effective surgical approach, however, the relatively high rate of recurrence and lack of symptomatic changes at the time of recurrence necessitates long term follow up. Better delineation of risk factors for recurrence can help identify high-risk patients and inform postoperative follow up strategies.
Ameloblastic carcinoma of the mandible: a case report
Authors: Ogane Satoru , Fujii Arisa , Suzuki Taiki , Hashimoto Kazuhiko , Hashimoto Sadamitsu , Takano Masayuki , Katakura Akira , Nomura Takeshi
Published: April 2023

Background

Ameloblastic carcinoma is a malignant form of ameloblastoma and a very rare odontogenic tumor. We report a case of ameloblastic carcinoma that occurred after removal of a right-sided mandibular dental implant.

Case presentation

A 72-year-old female patient visited her family dentist with a complaint of pain around a lower right implant placed 37 years previously. Although the dental implant was removed with the diagnosis of peri-implantitis, the patient experienced dullness of sensation in the lower lip and was followed up by her dentist, but after no improvement. She was referred to a highly specialized institution where she was diagnosed with osteomyelitis and treated the patient with medication; however, there was no improvement. In addition, granulation was observed in the same area leading to a suspicion of malignancy, and the patient was referred to our oral cancer center. The diagnosis of squamous cell carcinoma was made after a biopsy at our hospital. Under general anesthesia, the patient underwent mandibulectomy, right-sided neck dissection, free flap reconstruction with an anterolateral thigh flap, immediate reconstruction with a metal plate, and tracheostomy. Histological analysis of the resected specimen on hematoxylin and eosin staining showed structures reminiscent of enamel pulp and squamous epithelium in the center of the tumor. The tumor cells were highly atypical, with nuclear staining, hypertrophy, irregular nuclear size, and irregular nuclear shape, all of which were suggestive of cancer. Immunohistochemical analysis showed that Ki-67 was expressed in more than 80% of the targeted area, and the final diagnosis was primary ameloblastic carcinoma.

Conclusion

After reconstructive flap transplantation, occlusion was re-established using a maxillofacial prosthesis. The patient remained disease-free at the 1-year 3-month follow-up.
Is simultaneous bilateral unicompartmental knee arthroplasty and total knee arthroplasty better than simultaneous bilateral total knee arthroplasty?
Authors: Nagata Naosuke , Hiranaka Takafumi , Okamoto Koji , Fujishiro Takaaki , Tanaka Toshikazu , Kensuke Anjiki , Kitazawa Daiya , Kotoura Ken
Published: April 2023

Introduction

This retrospective study aims to clarify if there are benefits of performing unicompartmental knee arthroplasty (UKA) on just one indicated side in patients who undergo simultaneous bilateral knee arthroplasty.

Materials and methods

We compared 33 cases of simultaneous bilateral UKA/total knee arthroplasty (TKA) (S-UT) with 99 cases of simultaneous bilateral TKA (S-TT). Comparison included blood tests [C-reactive protein (CRP), albumin, and D-dimer], the incidence of deep vein thrombosis (DVT), range of motion (ROM), and clinical scores before and 1 year after surgery.

Results

Clinical scores were not significantly different between the groups. The postoperative flexion angle was significantly better in UKA sides. Blood tests showed that the S-UT had a significantly higher albumin value at 4 and 7 days after surgery. The CRP value at 4 and 7 days, and the D-dimer value at 7 and 14 days after surgery were significantly lower in the S-UT. The S-UT had significantly lower incidence of DVT.

Conclusions

In cases of bilateral arthroplasty, if there is an indication on only one side, a better flexion angle can be obtained by UKA on that side, and with less surgical invasion. Moreover, the incidence of DVT is low, which is considered to be a benefit of performing UKA on just one side.
Prevalence and pattern of electroencephalographic changes associated with clozapine treatment: a cross-sectional study
Authors: Roub Mehroosh , Dar Mohammad Maqbool , Dar Shabir Ahmad
Published: April 2023

Background

Clozapine is a second-generation antipsychotic which is known to have superior efficacy as compared to other antipsychotics. It is particularly used in treatment-resistant schizophrenia (10–30%). However, its use is limited due to the serious side effect of inducing seizures which can occur at all doses. The purpose of our study was to analyse patients taking clozapine for any electroencephalographic (EEG) abnormalities. We undertook a cross-sectional study on 107 patients with a different diagnosis taking clozapine who visited the outdoor treatment facility of a tertiary care psychiatric diseases hospital in Kashmir. A 32-channel digital EEG was obtained and evaluated visually for any abnormalities in these patients. The data was tabulated and analysed using SPSS 23.0.

Results

EEG abnormalities were reported in 60.75% of patients receiving clozapine out of which slow waves and epileptiform activities were present in 48.60% and 30.84% of patients, respectively. Background slowing was often in the delta and theta ranges. Our study showed that there was a statistically significant relationship between the dose of clozapine and EEG abnormalities. Clinical seizure occurred in only one patient receiving clozapine 450 mg/day and was a smoker who had recently stopped smoking.

Conclusions

EEG abnormalities occur frequently in clozapine-treated patients specifically those taking higher doses of clozapine. This calls for utilising EEG as a useful clinical investigation in these patients along with clinical monitoring of seizures especially in those taking higher doses of clozapine in order to hint towards early signs of clozapine toxicity. Caution needs to be taken in patients who are smokers and show a pattern of change in their smoking habits. Moreover, EEG abnormalities though frequently associated with clozapine are not reliable predictors of seizures. Therefore, anticonvulsants may not be routinely indicated in patients on clozapine even in the presence of epileptiform discharges.
Hepatitis C virus infection in children and adolescents: a management update
Authors: Begum Fahmida , Mazumder Md.Wahiduzzaman , Nahid Khan Lamia , Jesmin Tahmina , Musabbir Nadira
Published: April 2023

Hepatitis C virus infection is an emerging problem for children and adolescents. Chronic HCV infection affects approximately 3.5–5 million children worldwide. Unaddressed HCV infection in children progresses to decompensated liver disease and hepatocellular carcinoma during adulthood. Early detection of HCV and the administration of appropriate antiviral therapy are required for the prevention of long-term morbidity associated with chronic HCV infection. The perinatal route is the most common source of childhood HCV infection. Anti-HCV positivity at or after 18 months of age necessitates an HCV-RNA assay after age 3 to recognize chronic HCV infection. Both anti-HCV and HCV-RNA positivity are the indications for antiviral therapy. At present, various combinations of oral, direct-acting antivirals (DAAs) have been approved for children above 3 years of age. Their efficacy is high. Apart from the effectiveness of DAA therapy, steps should be taken to screen pregnant women to prevent the transmission of viral infection from mother to child. To increase awareness about the mode of HCV spread, NAT-based tests in blood banks for better screening and making the DAAs available at a subsidized rate in the public sector are necessary to eradicate HCV infection.
The design and evaluation of ciprofloxacin-loaded nanoformulations using Ipomoea batatas starch nanoparticles
Authors: Ajala Tolulope O. , Omoteso Omobolanle A. , Awe Oladotun M.
Published: April 2023

Background

Starch nanoparticle derivatives are gaining popularity as drug delivery vehicles because of their biocompatibility, better mechanical characteristics, heat stability properties, impediment qualities, permeability capabilities, and flexibility to be changed for specific predetermined functions. The effect of techniques and processing time on the physiochemical and drug release characteristics of sweet potato (Ipomoea batatas) starch nanoparticles and their ciprofloxacin-loaded nanoformulations was studied.

Results

Scanning electron microscopy confirmed that the treated starch formed nanoparticles and also revealed significant changes in the morphology of the treated starches. The water absorption capacity of chemically treated starch nanoparticles (CTSN)-3 days was the highest, whereas CTSN-6 days had the maximum solubility. The functional groups present in the starch nanoparticles were confirmed by Fourier transform infrared spectroscopy and Raman. The thermal characteristics of starch nanoparticles were established using hot-stage microscopy, differential scanning calorimetry, and thermogravimetric analysis. The percentage drug content and loading efficiency of the model drug were extensively boosted by the chemical and mechanical treatment of Ipomoea batatas starch. In comparison with the untreated potato starch (UPS), release times for loaded drug were significantly longer for the chemically treated starch nanoparticles and mechanically treated starch nanoparticles (MTSN) starches in the rank order of T80%, CTSN-3 days > MTSN-3 days > CTSN-6 days > MTSN-6 days > UPS. The main kinetics of drug release were Fickian diffusion.

Conclusion

After 3 days of acid hydrolysis, sweet potato starch yielded nanoparticulate carriers that can be employed for controlled or extended release of medicines that are poorly water soluble.
Otolaryngology Considerations of Pituitary Surgery: What an Endocrinologist Should Know
Authors: Cheng Michael Z , Saraswathula Anirudh , Qureshi Hannan A , Mukherjee Debraj , Rowan Nicholas R
Published: April 2023

Endoscopic endonasal skull base surgery is the preferred surgical approach for the management of pituitary adenomas. Perioperative management of pituitary lesions requires multidisciplinary care and typically includes a dual surgeon team consisting of a neurosurgeon and an otolaryngologist. The involvement of the otolaryngologist allows for a safe surgical approach with excellent intraoperative visualization of the tumor to enable an effective resection of the tumor by the neurosurgeon. Detection and treatment of sinonasal pathology is essential prior to surgery. Patients may experience sinonasal complaints following endoscopic transsphenoidal surgery, although this is typically temporary. Sinonasal care in the postoperative period can expedite recovery to baseline. Here we discuss the perioperative factors of endoscopic pituitary surgery that endocrinologists should be aware of, ranging from preoperative patient selection and optimization to postoperative care, with a particular emphasis on anatomic and surgical factors.
The influence of claw morphology on gripping efficiency
Authors: Turnbull Graham , Chari Sutejas , Li Zehao , Yang Ziyue , Alam Catharina Maria , Clemente Christofer J. , Alam Parvez
Published: April 2023

This paper considers the effects of claw morphology on the gripping efficiency of arboreal (Varanus varius) and burrowing (Varanus gouldii and Varanus panoptes) lizards. To ensure a purely morphological comparison between the lizards, we circumvent the material effects of claws from different species, by modelling and testing claw replicates of the same material properties. We correlate climbing efficiency to critical morphological features including; claw height (hc), width (wc), length (lc), curvature () and tip angle (γ), which are expressed as ratios to normalise mechanically beneficial claw structures. We find that there is strong correlation between the static grip force Fsg and the claw aspect and the cross-sectional rigidity ratio , and milder correlation (i.e. higher scatter) with the profile rigidity ratio . These correlations are also true for the interlocking grip force Fint over different shaped and sized protuberances, though we note that certain protuberance size-shape couplings are of detriment to the repeatability of Fint. Of the three lizard species, the claws of the arboreal (V. varius) are found to be superior to those of the burrower lizards (V. gouldii and V. panoptes) as a result of the V. varius claws having a smaller aspect, a higher cross-sectional rigidity ratio and a small profile rigidity ratio, which are deemed noteworthy morphological parameters that influence a claw's ability to grip effectively.
Macrophage-stem cell crosstalk: regulation of the stem cell niche
Authors: Manneken Jessica D. , Currie Peter D.
Published: April 2023

The cells of the innate immune system are the sentinels of tissue homeostasis, acting as ‘first responders’ to cellular damage and infection. Although the complex interplay of different immune cells during the initial inflammatory phases of infection and repair has been documented over many decades, recent studies have begun to define a more direct role for specific immune cells in the modulation of tissue repair. One particular cell of the innate immune system, the macrophage, has emerged as a central integrator of the complex molecular processes that drive tissue repair and, in some cases, the development of specific cell types. Although macrophages display directed orchestration of stem cell activities, bidirectional cellular crosstalk mechanisms allow stem cells to regulate macrophage behaviour within their niche, thus increasing the complexity of niche regulation and control. In this Review, we characterize the roles of macrophage subtypes in individual regenerative and developmental processes and illustrate the surprisingly direct role for immune cells in coordinating stem cell formation and activation.
Crosstalk between androgen receptor and WNT/β-catenin signaling causes sex-specific adrenocortical hyperplasia in mice
Authors: Lyraki Rodanthi , Grabek Anaëlle , Tison Amélie , Weerasinghe Arachchige Lahiru Chamara , Peitzsch Mirko , Bechmann Nicole , Youssef Sameh A. , de Bruin Alain , Bakker Elvira R. M. , Claessens Frank , Chaboissier Marie-Christine , Schedl Andreas
Published: April 2023

Female bias is highly prevalent in conditions such as adrenal cortex hyperplasia and neoplasia, but the reasons behind this phenomenon are poorly understood. In this study, we show that overexpression of the secreted WNT agonist R-spondin 1 (RSPO1) leads to ectopic activation of WNT/β-catenin signaling and causes sex-specific adrenocortical hyperplasia in mice. Although female adrenals show ectopic proliferation, male adrenals display excessive immune system activation and cortical thinning. Using a combination of genetic manipulations and hormonal treatment, we show that gonadal androgens suppress ectopic proliferation in the adrenal cortex and determine the selective regulation of the WNT-related genes Axin2 and Wnt4. Notably, genetic removal of androgen receptor (AR) from adrenocortical cells restores the mitogenic effect of WNT/β-catenin signaling. This is the first demonstration that AR activity in the adrenal cortex determines susceptibility to canonical WNT signaling-induced hyperplasia.