bluuebunny/crossref_metadata_2025 huggingface dataset:
Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania: a community-based cross-sectional survey
Authors: Orwa James , Gatimu Samwel Maina , Mantel Michaela , Luchters Stanley , Mugerwa Michael A. , Brownie Sharon , Subi Leonard , Mrema Secilia , Nyaga Lucy , Edwards Grace , Mwasha Loveluck , Isangula Kahabi , Selestine Edna , Jadavji Sofia , Pell Rachel , Mbekenga Columba , Temmerman Marleen
Published: October 2020

Background

Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania.

Methods

We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016–2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study.

Results

Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7 and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14–2.20, secondary: aOR: 2.24, 95% CI: 1.39–3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15–2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80–2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93–2.67), postpartum (aOR: 2.69, 95% CI: 1.24–5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13–1.78).

Conclusion

Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.
Seeking healthcare at their ‘right’ time; the iterative decision process for women with breast cancer
Authors: Agbeko Anita Eseenam , Arthur Joshua , Bayuo Jonathan , Kaburi Basil Benduri , Kyei Ishmael
Published: October 2020

Background

About 85% of breast cancer patients attending Komfo Anokye Teaching Hospital (KATH), Ghana, present with stage III/IV disease. In spite of great investments into the early diagnosis and management of breast cancer, late presentation persists and poses a barrier to realising the possible benefits of the gains made in breast cancer management. This study assessed the symptom appraisal and medical health seeking behaviour of women with either locally advanced or metastatic breast cancer attending breast clinic at KATH.

Method

In-depth interviews of women presenting with clinical stage III/IV breast cancer were conducted to explore the women’s care seeking pathways after symptom identification until arrival at KATH from May 2015 to March 2016. Thematic data analysis was conducted using the Andersen behavioural model for health service use.

Results

Fifteen women aged 24–79 years were interviewed. The time from symptom identification to reporting to KATH was 4–24 months. The initial symptom was a breast lump or breast swelling which all the women identified themselves. These were initially appraised as not serious because most importantly, they did not interfere with their daily function. Symptom progression such as prevented them from undertaking their usual economic, social and family function triggered seeking care from health facilities. The availability of money to pay for care and diagnostic investigations influenced the time taken to navigate the referral pathway. While the women initially deferred healthcare for reasons related to their ability to perform economic, family and social roles, ultimately, aggressively pursuing healthcare was also for the same economic, family and social reasons or goals.

Conclusion

Deciding to seek care and pursue treatment for breast cancer symptoms may be much more complicated than it appears. Economic, family and social function significantly drive the health seeking process both at the personal and health facility phases of health seeking. Breast cancer education messages must be adapted to incorporate these functional goals and their influence on symptom appraisal and decision making to seek help and not just focus on the breast symptom as an isolated entity.
Orbital teratoma in the foetus: a rare case without proptosis
Authors: Chen Xi , Yang Jiaxiang , He Guannan , Cheng Chunlan , Zhang Chunguo , Wang Hongli , He Lihong , Yang Zhirong , Chen Li , Zhao Jing
Published: October 2020

Background

Congenital orbital teratoma is relatively rare, and few reports of prenatal ultrasound findings in such cases have been published.

Case presentation

A rare case of congenital orbital teratoma at 24 + 2 weeks of gestation was previously diagnosed as microphthalmia, noting how orbital teratoma without proptosis is different from microphthalmia, retinoblastoma and intracranial teratoma. Ultrasound examination, analysis of gross specimens, and histopathological evaluation confirmed the diagnosis of orbital teratoma.

Conclusion

Prenatal ultrasound examination is useful for diagnosis and differential diagnosis of congenital orbital teratoma.
Comparison of efficacy of corticosteroid injection versus extracorporeal shock wave therapy on inferior trigger points in the quadratus lumborum muscle: a randomized clinical trial
Authors: Eftekharsadat Bina , Fasaie Negar , Golalizadeh Dina , Babaei-Ghazani Arash , Jahanjou Fatemeh , Eslampoor Yashar , Dolatkhah Neda
Published: October 2020

Background

In this study, we aimed to compare the efficacy of corticosteroid trigger point injection (TPI) versus extracorporeal shock wave therapy (ESWT) on inferior trigger points in the quadratus lumborum (QL) muscle.

Methods

In this single-blind randomized clinical trial, 54 low back pain patients with myofascial trigger points on QL muscle were investigated. Participants were randomly allocated into two groups with A and B pockets. Patients in group A underwent radial ESWT and received 5 treatment sessions (1 per week) and actually were not followed-up. However, patients in group B received corticosteroid TPI and received one session of corticosteroid treatment and followed-up for 4 weeks after injection. Oswestry Disability Index (ODI), visual analogue scale (VAS), pain pressure threshold (PPT) and short form (36) health survey (SF-36) were measured in both groups before, two weeks after and four weeks after intervention.

Results

The between group comparison indicated that corticosteroid TPI leaded to significant higher improvements of ODI (P-value< 0.01), VAS (Pvalue< 0.001), and PPT (P-value = 0.001) scores compared to the ESWT group at two-week follow-up time-point. ESWT group recorded significant higher improvement of ODI (P-value< 0.01) and SF-36 (P-value< 0.001) compared to the corticosteroid TPI at 4th week post treatment evaluation. At four-week follow-up time-point, the patients in the ESWT group were 1.46 times more likely to achieve 30% reduction in VAS, 2.67 times more likely to achieve 30% reduction in ODI, and 2.30 times more likely to achieve 20% improvement in SF-36 compared to the participants in corticosteroid TPI group. These results refer to large effect size for all study outcomes in ESWT group (d = 4.72, d = 1.58, d = 5.48, and d = 7.47 for ODI, PPT, SF-36, and VAS, respectively).

Conclusion

Corticosteroid TPI was more effective compared to ESWT in short-term controlling of pain and disability caused by myofascial pain syndrome of QL muscle. However, after 4 weeks treatment, ESWT further improved the quality of life and disability and was related with more probability of achievement the minimal clinically important difference concerning pain, disability and quality of life and large effect size for all study outcomes in treated patients compared to corticosteroid TPI.

Trial registration

www.irct.ir,IRCT20100827004641N14, retrospectively registered 2019-01-19.
A comparative study examining laparoscopic and open inguinal hernia repair in children: a retrospective study from a single center in China
Authors: Liu Jie , Wu XiongWei , Xiu WenLi , Hao XiWei , Zhao Jing , Wei Bin , Dong Qian
Published: October 2020

Background

Pediatric inguinal hernia (PIH) is a common disease in children. Laparoscopic hernia repair (LHR) has developed rapidly in recent years, but there are still different opinions compared with traditional open hernia repair (OHR). The purpose of this study was to compare the advantages and disadvantages of LHR and OHR in the treatment of pediatric inguinal hernia.

Methods

We performed a retrospective review of all children (< 14 years) who underwent repair of inguinal hernia in the pediatric surgery center of the Affiliated Hospital of Qingdao University from January 2015 to December 2015. We collected the medical records of all the children and analyzed the clinical characteristics, operation-related information and follow-up.

Results

In the OHR group, 202 cases underwent unilateral inguinal hernia repair, and 43 cases underwent bilateral inguinal hernia repair. In the LHR group, 168 cases underwent unilateral inguinal hernia repair, and 136 cases underwent bilateral inguinal hernia repair. There was a significant difference in the operation time between the two groups, but there were no significant differences in postoperative hospitalization time and incidence of ipsilateral recurrent hernia between the two groups. The incidence rates of metachronous contralateral hernia (MCH) and surgical site infection in LHR group were significantly lower than those in the OHR group.

Conclusion

Our study shows that compared with OHR, LHR has the advantages of concealed incision, minimal invasiveness, reduced operation time, detection of contralateral patent processus vaginalis, and reduced incidence of MCH. In conclusion, LHR is safe and effective in the treatment of pediatric indirect inguinal hernia.
Oral hygiene habits and possible transmission of COVID-19 among cohabitants
Authors: González-Olmo María José , Delgado-Ramos Bendición , Ruiz-Guillén Ana , Romero-Maroto Martín , Carrillo-Díaz María
Published: October 2020

Background

To find out whether misuse of dental hygiene, in terms of certain dental habits, may facilitate the spread of COVID-19 among cohabiting individuals.

Methods

302 COVID-19 infected (PCR +) subjects cohabiting with someone else at home were selected for an observational cross-sectional study. An anonymous online questionnaire was developed using Google forms to avoid person-to-person contact. The structured questionnaire consisted of questions covering several areas: sociodemographic data, cross transmission to another person living together, oral hygiene habits during confinement, care and disinfection control behaviours in the dental environment like sharing toothbrush, sharing toothbrush container, sharing toothpaste, placing brush vertically, placing cap with hole for brush, disinfecting brush with bleach, closing toilet lid before flushing.

Results

Tongue brushing was more used in the group where there was no transmission of the disease to other members (p < 0.05). Significant differences were found for shared toothbrush use (p < 0.05), although shared use was a minority in this group (4. 7%), significant differences were also found for the use of the same container (p < 0.01), shared use of toothpaste (p < 0.01), toothbrush disinfection with bleach (p < 0.01), brush change after PCR + (p < 0.05). The women performed significantly more disinfection with toothbrush bleach (p < 0.01), closing the toilet lid (p < 0.05) and changing the brush after PCR + (p < 0.05).

Conclusions

The use of inappropriate measures in the dental environment could contribute to the indirect transmission of COVID-19 between cohabitants.
Learning curve of digital intraoral scanning – an in vivo study
Authors: Róth Ivett , Czigola Alexandra , Joós-Kovács Gellért Levente , Dalos Magdolna , Hermann Péter , Borbély Judit
Published: October 2020

Background

The spread of digital technology in dentistry poses new challenges and sets new goals for dentists. The aim of the present in vivo study was to determine the learning curve of intraoral scanning described by (1) scanning time and (2) image number (count of images created by intraoral scanner during the scanning process).

Methods

Ten dental students of Semmelweis University took part in the study. Dental students took digital study impressions using a 3Shape Trios 3® (3Shape, Copenhagen, Denmark) intraoral scanning device. Each student took 10 digital impressions on volunteers. Volunteer inclusion criteria included full dentition (except for missing third molars) and no prosthetic/restorative treatment. Digital impression taking was preceded by tuition consisting of both theoretical education and practical training. Digital impressions were taken of the upper and lower arches, and the bite was recorded according to the manufacturer's instructions. Total scanning times and image numbers were recorded.

Results

The difference in scanning time between the first and the tenth digital impressions was significant (p = 0.007). The average scanning time for the first impressions was 23 min 9 s; for the tenth impressions, it was 15 min 28 s. The difference between the scanning times of the first and the tenth procedures was 7 min 41 s. The average image count for the first impressions was 1964.5; for the tenth impressions, it was 1468.6. The image count difference between the first and the tenth procedures was 495.9. The image count versus sequential number of measurement curve shows an initial decreasing tendency followed by a trough around the sixth measurement and a final increasing phase.

Conclusion

Our results indicate an association between the sequential number of measurements and the outcome variables. The drop in scanning time is probably explained by a practice effect of repeated use, i.e. the students learned to move the scanning tip faster. The image count first showed a decreasing tendency, and after the sixth measurement, it increased; there was no consistent decline in mean scan count. Shorter scanning times are associated with poorer coverage quality, with the operator needing to make corrections by adding extra images; this manifests as the time function of image counts taking an increase after the sixth measurement.
Assessing clinical reasoning in undergraduate medical students during history taking with an empirically derived scale for clinical reasoning indicators
Authors: Fürstenberg Sophie , Helm Tillmann , Prediger Sarah , Kadmon Martina , Berberat Pascal O. , Harendza Sigrid
Published: October 2020

Background

The clinical reasoning process, which requires biomedical knowledge, knowledge about problem-solving strategies, and knowledge about reasons for diagnostic procedures, is a key element of physicians’ daily practice but difficult to assess. The aim of this study was to empirically develop a Clinical Reasoning Indicators-History Taking-Scale (CRI-HT-S) and to assess the clinical reasoning ability of advanced medical students during a simulation involving history taking.

Methods

The Clinical Reasoning Indictors-History Taking-Scale (CRI-HT-S) including a 5-point Likert scale for assessment was designed from clinical reasoning indicators identified in a qualitative study in 2017. To assess indicators of clinical reasoning ability, 65 advanced medical students (semester 10, n = 25 versus final year, n = 40) from three medical schools participated in a 360-degree competence assessment in the role of beginning residents during a simulated first workday in hospital. This assessment included a consultation hour with five simulated patients which was videotaped. Videos of 325 patient consultations were assessed using the CRI-HT-S. A factor analysis was conducted and the students’ results were compared according to their advancement in undergraduate medical training.

Results

The clinical reasoning indicators of the CRI-HT-S loaded on three factors relevant for clinical reasoning: 1) focusing questions, 2) creating context, and 3) securing information. Students reached significantly different scores (p < .001) for the three factors (factor 1: 4.07 ± .47, factor 2: 3.72 ± .43, factor 3: 2.79 ± .83). Students in semester 10 reached significantly lower scores for factor 3 than students in their final year (p < .05).

Conclusions

The newly developed CRI-HT-S worked well for quantitative assessment of clinical reasoning indicators during history taking. Its three-factored structure helped to explore different aspects of clinical reasoning. Whether the CRI-HT-S has the potential to be used as a scale in objective structured clinical examinations (OCSEs) or in workplace-based assessments of clinical reasoning has to be investigated in further studies with larger student cohorts.
Configurations for obtaining in-consultation assistance from supervisors in general practice training, and patient-related barriers to trainee help-seeking: a survey study
Authors: Sturman Nancy J. , Tapley Amanda , van Driel Mieke L. , Holliday Elizabeth G. , Ball Jean I. , Davey Andrew R. , Fielding Alison , FitzGerald Kristen , Spike Neil A. , Magin Parker J.
Published: October 2020

Background

General practice (GP) trainees may seek supervisor assistance to complete their patient consultations. This in-consultation assistance plays a key role in the supervisory oversight of trainees and in trainee learning. It may be obtained face-to-face, or using phone or messaging systems, and either in front of patients or outside their hearing. Trainee concerns about decreased patient impressions of their competence, and discomfort presenting patients within their hearing, act as barriers to seeking help during consultations. Little is known about the frequency and associations of trainee concerns about these patient-related barriers, or the various trainee-supervisor-patient configurations used to obtain in-consultation assistance.

Methods

Australian GP trainees rated their frequency of use of five specific configurations for obtaining in-consultation assistance, perceived change in patient impressions of their competence after this assistance, and relative trainee comfort presenting patients outside, compared to within, patients’ hearing. Statistical analyses included descriptive statistics and multivariable logistic regression.

Results

Responses were received from 778 Australian GP trainees (response rate 89%). Help-seeking configurations did not differ between trainees at different training stages, except for greater use of electronic messaging in later stages. In-consultation assistance was most commonly provided by phone between trainee and supervisor consulting rooms, or outside the trainee’s patient’s hearing. Supervisor assistance in the trainee’s room face-to-face with the patient was reported as either never or rarely obtained by 12% of respondents. More trainees (25%) perceived that patient impressions of their competence increased after help-seeking than perceived that these impressions decreased (19%). Most trainees (55%) preferred to present patients outside their hearing. Trainee age was the only variable associated with both patient-related barriers.

Conclusion

Supervisors appear to have considerable influence over trainee help-seeking, including which configurations are used and trainee perceptions of patient-related barriers. In-consultation supervision may actually increase trainee perceptions of patient impressions of their competence. Many supervisors and trainees may benefit from additional educational and workplace interventions to facilitate comfortable and effective trainee help-seeking in front of patients. More work is required to understand the clinical and educational implications of different help-seeking configurations when trainees require ‘just in time’ supervisor assistance.
FABP4 promotes invasion and metastasis of colon cancer by regulating fatty acid transport
Authors: Tian Wenying , Zhang Wenjia , Zhang Yan , Zhu Tianyue , Hua Yuting , Li Hui , Zhang Qinglin , Xia Min
Published: October 2020

Background

The prognosis of colon cancer is poor for metastasis, while the mechanism, especially adipocytes related, is not yet clear. The purpose of this study is to determine the effects of fatty acid binding protein 4 (FABP4), a transporter for lipids, on colon cancer progression.

Methods

The distribution of lipids and FABP4 was tested in the colon cancer tissues and adjacent normal tissues, and their relationship was also verified in vitro. Experiments about cellular invasion, migration and proliferation were performed to detect the impacts of FABP4 on the biological behaviors of colon cancer, and the positive results were checked in vivo. Meanwhile, the regulatory role of FABP4 in the energy and lipid metabolism was evaluated by the levels of triglyceride, ATP, LDH, glycerol and NEFA. At last, GO and KEGG analysis based on FABP4 overexpressed cells was performed, and the AKT pathway and epithelial–mesenchymal transition (EMT)-related proteins were determined by Western blot.

Results

Higher accumulation of lipids and stronger FABP4 transcription were observed in colon cancer tissues. Having been incubated with adipose tissue extract and overexpressed FABP4, colon cancer cells demonstrated enhanced lipid accumulation. In functional experiments, co-culture with adipose tissue extract significantly enhanced the invasion and migration of colon cancer cells, as well as the energy and lipid metabolism, and all these processes were reversed by FABP4 inhibitor. In addition, the metastasis of FABP4-overexpressed colon cancer cells was also significantly enhanced in vitro and in vivo. In terms of mechanism, the bioinformatics analysis showed that FABP4 was enriched in 11 pathways related to metabolic processes in FABP4 overexpressed cells. Finally, FABP4 overexpression improved EMT progression of colon cancer, as evidenced by the upregulation of Snail, MMP-2 and MMP-9, the downregulation of E-cadherin. The expression of p-Akt was also elevated.

Conclusion

FABP4 overexpression could increase FAs transport to enhance energy and lipid metabolism, and activate AKT pathway and EMT to promote the migration and invasion of colon cancer cells.
Addressing the caste system in U.S. healthcare in the era of COVID-19
Authors: Sivashanker Karthik , Couillard Cheri , Goldsmith Jennifer , Walker Normella , Eappen Sunil
Published: October 2020

In healthcare, we find an industry that typifies the unique blend of racism, classism, and other forms of structural discrimination that comprise the U.S. caste system—the artificially-constructed and legally-reinforced social hierarchy for assigning worth and determining opportunity for individuals based on race, class, and other factors. Despite myths of meritocracy, healthcare is actually a casteocracy; and conversations about racism in healthcare largely occupy an echo chamber among the privileged upper caste of hospital professionals. To address racism in healthcare, we must consider the history that brought us here and understand how we effectively perpetuate an employee caste system within our own walls.
Sensory neurons from dorsal root ganglia regulate endothelial cell function in extracellular matrix remodelling
Authors: Leroux Alice , Paiva dos Santos Bruno , Leng Jacques , Oliveira Hugo , Amédée Joëlle
Published: October 2020

Background

Recent physiological and experimental data highlight the role of the sensory nervous system in bone repair, but its precise role on angiogenesis in a bone regeneration context is still unknown. Our previous work demonstrated that sensory neurons (SNs) induce the osteoblastic differentiation of mesenchymal stem cells, but the influence of SNs on endothelial cells (ECs) was not studied.

Methods

Here, in order to study in vitro the interplay between SNs and ECs, we used microfluidic devices as an indirect co-culture model. Gene expression analysis of angiogenic markers, as well as measurements of metalloproteinases protein levels and enzymatic activity, were performed.

Results

We were able to demonstrate that two sensory neuropeptides, calcitonin gene-related peptide (CGRP) and substance P (SP), were involved in the transcriptional upregulation of angiogenic markers (vascular endothelial growth factor, angiopoietin 1, type 4 collagen, matrix metalloproteinase 2) in ECs. Co-cultures of ECs with SNs also increased the protein level and enzymatic activity of matrix metalloproteinases 2 and 9 (MMP2/MMP9) in ECs.

Conclusions

Our results suggest a role of sensory neurons, and more specifically of CGRP and SP, in the remodelling of endothelial cells extracellular matrix, thus supporting and enhancing the angiogenesis process.
Increased percentage of PD-L1+ natural killer cells predicts poor prognosis in sepsis patients: a prospective observational cohort study
Authors: Jiang Wenqiang , Li Xusheng , Wen Miaoyun , Liu Xiaoyu , Wang Kangrong , Wang Qiaosheng , Li Ya , Zhou Maohua , Liu Mengting , Hu Bei , Zeng Hongke
Published: October 2020

Background

Natural killer (NK) cells play a major role in immune tolerance after sepsis, and the programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) system mediates evasion of host immunity. The correlation between PD-L1 levels in NK cells and the prognosis of patients with sepsis, however, has not been elucidated. Thus, it was hypothesized that PD-L1 in NK cells could be a novel biomarker of the mortality for sepsis patients.

Methods

A prospective, observational, cohort study in a general intensive care unit had earlier enrolled patients according to the sepsis-3 criteria, and peripheral blood samples were collected within 24 h post-recruitment. The expression of four co-signaling molecules (PD-1, CD28, PD-L1, and CD86) in NK cells was assayed, and the sequential organ failure assessment (SOFA) scores were recorded on day 1. Patients were followed up until 28 days. Multivariate regression analysis assessed the independent risk factors for 28-day mortality. The association between biomarkers and 28-day mortality was assessed by Cox regression survival analysis. The accuracy of biomarkers for mortality was determined by the area under the receiver operating characteristic (ROC) curve (AUC) analysis.

Results

A total of 269 patients were recruited, and 114 patients were finally included for final analysis. Of these, 30 (26.3%) patients died during 28 days. The percentage of PD-L1+ NK cells (OR 1.022; 95% CI 1.002–1.043) and SOFA scores (OR 1.247; 95% CI 1.092–1.424) were independent risk factors for 28-day mortality. The AUC of the percentage of PD-L1+ NK cells, SOFA scores, and their combination model were 0.655 (0.559–0.742), 0.727 (0.635–0.807) and 0.808 (0.723–0.876), respectively. The combination model was the indicator with the best AUC to predict mortality in 28 days (all p < 0.05). Patients with the percentage of PD-L1+ NK cells above the cutoff point 5.58% (hazard ratio (HR) 10.128 (1.372–74.772), p = 0.001), and the combination model prediction possibility above 0.1241 (HR 13.730 (3.241–58.158), p < 0.001) were the indexes that had greater discriminative capacity to predict 28 days mortality.

Conclusions

The percentage of PD-L1+ NK cells at admission serves as a novel prognostic biomarker for predicting mortality and contributes to improve the predictive capacity of SOFA score in patients with sepsis.
The use of venous Doppler to predict adverse kidney events in a general ICU cohort
Authors: Spiegel Rory , Teeter William , Sullivan Scott , Tupchong Keegan , Mohammed Nabeel , Sutherland Mark , Leibner Evan , Rola Philippe , Galvagno Samuel M. , Murthi Sarah B.
Published: October 2020

Background

Changes in Doppler flow patterns of hepatic veins (HV), portal vein (PV) and intra-renal veins (RV) reflect right atrial pressure and venous congestion; the feasibility of obtaining these assessments and the clinical relevance of the findings is unknown in a general ICU population. This study compares the morphology of HV, PV and RV waveform abnormalities in prediction of major adverse kidney events at 30 days (MAKE30) in critically ill patients.

Study design and methods

We conducted a prospective observational study enrolling adult patients within 24 h of admission to the ICU. Patients underwent an ultrasound evaluation of the HV, PV and RV. We compared the rate of MAKE-30 events in patients with and without venous flow abnormalities in the hepatic, portal and intra-renal veins. The HV was considered abnormal if S to D wave reversal was present. The PV was considered abnormal if the portal pulsatility index (PPI) was greater than 30%. We also examined PPI as a continuous variable to assess whether small changes in portal vein flow was a clinically important marker of venous congestion.

Results

From January 2019 to June 2019, we enrolled 114 patients. HV abnormalities demonstrate an odds ratio of 4.0 (95% CI 1.4–11.2). PV as a dichotomous outcome is associated with an increased odds ratio of MAKE-30 but fails to reach statistical significance (OR 2.3 95% CI 0.87–5.96), but when examined as a continuous variable it demonstrates an odds ratio of 1.03 (95% CI 1.00–1.06). RV Doppler flow abnormalities are not associated with an increase in the rate of MAKE-30

Interpretation

Obtaining hepatic, portal and renal venous Doppler assessments in critically ill ICU patients are feasible. Abnormalities in hepatic and portal venous Doppler are associated with an increase in MAKE-30. Further research is needed to determine if venous Doppler assessments can be useful measures in assessing right-sided venous congestion in critically ill patients.
An optimized secretory expression system and immunogenicity evaluation for glycosylated gp90 of avian reticuloendotheliosis virus
Authors: Pan Qing , Wang Jing , Hussain Altaf , Gao Yulong , Cui Hongyu , Li Kai , Qi Xiaole , Liu Changjun , Zhang Yanping , Zhang Shide , Wang Xiaomei
Published: October 2020

Reticuloendotheliosis is an important immunosuppressive disease, associated with avian reticuloendotheliosis virus (REV) infection, and causes notable economic losses worldwide. Glycoprotein gp90 is an important structural protein of REV, and considered to be the most important immunogenic antigen, which can induce neutralizing antibodies against REV. In this study, an optimized suspension culture system was developed and applied to secretory express the immunogenic surface antigen gp90. To achieve an optimal glycosylation, the gp90 was designed to secretory expressed into the supernatant of the cell culture, which also occurs in the natural protein maturation procedure of REV. Serum-free culture medium was introduced to simplify the purification process and reduce the production costs. Based on the purified glycosylated gp90, an oil-emulsion subunit REV vaccine candidate was developed and evaluated in chickens. The subunit gp90-based vaccine induced fast immune responses, high levels of antibodies (REV-specific antibody, gp90-specific antibody, and neutralizing antibody against REV), and preferential T helper 2 (Th2) (interleukin-4 secretion) not Th1 (interferon-γ secretion) response. Furthermore, the viremia induced by REV infection was significantly reduced in chickens immunized with the glycosylated gp90. Overall, an optimized secretory expression system for glycosylated gp90 was developed, and the glycosylated gp90 obtained in this study retained good immunogenicity and could be an attractive vaccine candidate to protect chickens against REV horizonal infection.
E93-depleted adult insects preserve the prothoracic gland and molt again
Authors: Kamsoi Orathai , Belles Xavier
Published: October 2020

Insect metamorphosis originated around the middle Devonian, associated with the innovation of the final molt; this occurs after the histolysis of the prothoracic gland (PG; which produces the molting hormone) in the first days of adulthood. We previously hypothesized that transcription factor E93 was crucial in the emergence of metamorphosis, since it triggers metamorphosis in extant insects. This work on the cockroach Blattella germanica reveals that E93 also plays a crucial role in the histolysis of PG, which fits the above hypothesis. Previous studies have shown that the transcription factor FTZ-F1 is essential for PG histolysis. We have found that FTZ-F1 depletion, towards the end of the final nymphal instar, downregulates the expression of E93, while E93-depleted nymphs molt to adults that retain a functional PG. Interestingly, these adults are able to molt again, which is exceptional in insects. The study of insects able to molt again in the adult stage may reveal clues as to how nymphal epidermal cells definitively become adult cells, and if it is possible to revert this process.
Pretreatment Primary Tumor Stage is a Risk Factor for Recurrence in Patients with Esophageal Squamous Cell Carcinoma Who Achieve Pathological Complete Response After Neoadjuvant Chemoradiotherapy
Authors: La Mendola Roberta , Bencivenga Maria , Torroni Lorena , Alberti Luca , Sacco Michele , Casella Francesco , Ridolfi Cecilia , Simoni Nicola , Micera Renato , Pavarana Michele , Verlato Giuseppe , Giacopuzzi Simone
Published: October 2020

Background

Although pathological complete response (pCR) after multimodal treatment for esophageal cancer is associated to the best prognosis, recurrence may occur in 20–40% of cases. The present study investigated the recurrence pattern and predictive factors of recurrence after pCR in patients with esophageal cancer.

Methods

In this study, 427 patients received preoperative treatment for either esophageal squamous cell carcinoma (SCC) or adenocarcinoma at Verona University Hospital between 2000 and 2018. Of these, 145 patients (34%) achieved a pCR. Long-term prognosis, recurrence pattern, and risk factors for relapse in pCR patients were analysed.

Results

During a median follow-up of 52 months, 37 relapses (25.5%) occurred, mostly at distant level (n = 28). Nearly all locoregional relapses (8/9) were detected in SCC cases. The 5-year overall survival and cancer-related survival were 71.7% (95% confidence interval [CI] 62.6–78.9%) and 77.5% (95% CI 68.5–84.2%) respectively. Male sex, higher body mass index, and cT4 were significant risk factors for recurrence at univariate analysis. The multivariate analysis confirmed the role of cT4 as predictor of recurrence only in SCCs.

Conclusions

Esophageal cancer recurs in about one-fourth of pCR cases. A fair number of local recurrences occurs in SCCs, but the main problem is the systemic disease control. According to our analysis, SCCs patients with cT4 stage have an increased risk to recur, so they should be managed differently by a personalized approach in terms of adjuvant treatment and follow-up.
Interactions of Ruthenium(III) Complexes Bearing Bis(2-pyridylcarbonyl)aminate with Cations at the Carbonyl Group
Authors: Misawa-Suzuki Tomoyo , Etoh Mami , Nagao Hirotaka
Published: October 2020

Bis(2-pyridylcarbonyl)aminate (bpca) coordinates to a ruthenium center with three nitrogen atoms of two pyridyl and one aminate group and the biscarbonylaminate moiety ({O-C-N-C-O}−) functions as an alternative coordination site. Interactions of the carbonyl groups of bis(2-pyridylcarbonyl)aminato with cations (Mz+; Li+, Na+, K+, and Mg2+) were investigated using chloridoacetonitrileruthenium(III) complexes in three different charges, [RuIIICl3−n(NCCH3)n(bpca)]m (n = 0, m = −1; [1]−, n = 1, m = 0; [2], n = 2, m = +1; [3]+). While the interactions of the Ru(III)-bpca moiety with divalent cation, Mg2+, were observed, monovalent cations, Li+ and Na+, interacted with the Ru-bpca moiety in the Ru(III) state or accompanied by one-electron reduction via a metal ion-coupled electron transfer (MCET). The interactions with cations were related to the electronic structure of the Ru(III)-bpca moiety which was influenced by the electrostatic nature of three co-existing ligands, the charge of the complex and the charge density of Mz+.
Langmuir-Blodgett Films of Chiral Perfluorinated Gelators: Effects of Chirality and Chain Length on Two-Dimensional Behavior
Authors: Yamagishi Akihiko , Umemura Yasushi , Tamura Kenji , Yajima Tomoko , Sato Hisako
Published: October 2020

Surface pressure versus molecular area (π-A) curves were measured on pure water as a subphase for a series of N,N′-diperfluoroalkanoyl-1,2(R,R)-diaminocyclohexanes. A molecule is denoted as RR-CFn, where n is the number of carbon atoms in a perfluoroalkanoyl chain (or n − 2 = the number of difluoromethylene units). The chain length was varied for n = 4, 5, 6, 8, 9, and 10. The results for n = 7 were reported previously. The effects of chain length and optical purity on film formation were investigated. The surface morphology of a film deposited onto a hydrophilic glass plate was observed using an atomic force microscope (AFM). For n = 4, 5, and 6, the floating films were already multilayered before compression and the deposited films were composed of rectangular or rod-like aggregates. For n = 7, 8, 9, and 10, monolayered films were formed and underwent structural transformation upon compression. From the AFM images, the films deposited after the transformation were composed of fiber-like aggregates. For a racemic mixture, no monolayer film was formed, and the film transfer was impossible irrespective of the chain length. p-Polarized infrared multiple angle incidence resolution spectrometry (pMAIRS) measurements were carried out on a film of RR-CF8 deposited onto a silicon wafer to determine the orientation of the composite molecules. The results were compared with the monolayer behavior reported for a compound having a single perfluoroalkyl chain. The relation to their gelation behavior is also discussed.
Detection of Spermine Using Cucurbit[7]uril-phenazopyridine Host-Guest Inclusion Complex as a Platform
Authors: Zhang Huaqing , Liu Mei , Zhu Xiaofei , Li Hui
Published: October 2020

We proposed a competitive method for rapid and sensitive detection of spermine using CB[7]-PHE (CB[7] = cucurbit[7]uril, PHE = phenazopyridine) as a platform. The LOD was determined to be 21 nM and showed good calibration in the concentration range of 0.071–14 µM, which is sufficiently below the critical concentration for cancer diagnosis. More interestingly, the addition of spermine to CB[7]-PHE led to color change from light brown to yellow, which indicating potential applications for colorimetric analysis of spermine.
Tres casos de periodismo narrativo en México impulsados por la crisis de las instituciones gubernamentales
Authors: Vargas Pasaye Rafael Gerardo
Published: October 2020

La sociedad en México ha perdido parte de la credibilidad y la confianza de algunas instituciones gubernamentales en buena medida porque estas no dan respuesta a sus necesidades, y se ven rebasadas en ámbitos relacionados con corrupción, procuración de justicia y seguridad. En esos espacios, el periodismo narrativo actual ha descrito las injusticias y consecuencias de la crisis que representa dicho debilitamiento. Este texto analiza tres piezas que, por su oportunidad, relevancia y reconocimiento público, lo ejemplifican: El cártel de Sinaloa de Diego Enrique Osorno (2009), La fosa de agua de Lydiette Carrión (2017) y La estafa maestra de Nayeli Roldán, Miriam Castillo y Manuel Ureste (2018). Selección que responde a la relevancia y el reconocimiento público, ya que, además de oportunos, llegaron a convertirse incluso en un parámetro comparativo que forma parte del lenguaje cotidiano. Se recurre al método hermenéutico bajo la lógica de su forma de trabajo: interpretación del texto, consideración del contexto y conclusión, para lo cual se concluye con una generación de categorías para los tres casos: elementos de denuncia, pruebas, testimonios, seguimiento y metáforas, por lo que se pueden analizar como un conjunto de piezas perteneciente a un contexto mexicano. Se concluye que el debilitamiento de las instituciones en México con índices de calificación más bajos por abuso de autoridad, ausencia de resultados y exceso de corrupción, por ejemplo, incrementaron un vacío de poder que detonó parte del periodismo narrativo que ahora se observa, y que también refleja las consecuencias de esa crisis.
An advanced nurse-led clinic for patients following percutaneous coronary intervention
Authors: Ingram Shirley , Quirke Mary B , Loo Bryan
Published: October 2020

Percutaneous coronary intervention (PCI) is internationally recognised as the preferred initial treatment for acute coronary syndrome and as a treatment option for chronic coronary heart disease. The use of PCI has led to shorter inpatient stays. However, reduced length of stay can mean less opportunity for patient education. Once discharged from hospital, timely outpatient review encompassing symptom reassessment, advanced physical assessment, medication and cardiovascular risk management is a key component of patient care. In an Irish acute hospital setting, cardiology clinical nurse specialists and advanced nurse practitioners have established an advanced nurse-led post-PCI clinic. This article describes the post-PCI clinic and provides an overview of the patient profile and outcomes over a 2-year period, with an emphasis on advanced nursing roles and patient symptoms.
An International Focus on Cardiac Surgery Nursing: Patient Experience
Authors: Sanders Julie , Wynne Rochelle , Martorella Geraldine , Fredericks Suzanne
Published: October 2020

This six-paper series in the International Year of the Nurse and Midwife aims to draw together two important themes: celebrating the role of nursing in advancing care in cardiac surgery and providing an international perspective of cardiac surgery nursing.
Postprandial Hypotension: Lessons from Sir Roger Bannister's Textbook
Authors: Cowan Helen
Published: October 2020

In the fourth article of the new Neurocardiology series, Helen Cowan looks at postprandial hypotension as described in Sir Roger Bannister's textbook and subsequent research.
NITROFURANTOIN
Authors: Rees Sharon
Published: October 2020

In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #nitrofurantoin
Fiber-Optic Differential Absorption Low Coherence Interferometry Technique for Sensing Glucose Selectively
Authors: John Pauline , Vasa Nilesh J. , Sujatha N.
Published: October 2020

Fiber-optic differential absorption low coherence interferometry system with dual light sources at 1310 nm and 1589 nm to detect glucose selectively in the aqueous humor of an eye model is presented in this paper. © 2020 The Author(s)
El loco del pelo rojo (1956) de Vincente Minelli. La patología dual de Vincent Van Gogh
Authors: Abad Vila Miguel
Published: October 2020

Diversas teorías han tratado de explicar los síntomas del pintor Vincent Willem van Gogh (Zundert, 3º de marzo de 1853 – Auvers-sur-Oise, 29 de julio de 1890), uno de los máximos exponentes del postimpresionismo. La fuente principal de información, junto a los informes médicos especializados de quienes le trataron en las diferentes etapas de su vida, es la dilatada correspondencia sostenida con su hermano Theodorus «Theo» van Gogh (Zundert, 1 de mayo de 1857 – Utrecht, 25 de enero de 1891), alrededor de 800 cartas. El loco del pelo rojo (1956) de Vincente Minelli, representa una estupenda aproximación a las tribulaciones del artista, rodada en muchos de los escenarios reales que él mismo habitó, e interpretada por el recientemente fallecido actor Kirk Douglas, a los 103 años de edad. Considerando las enfermedades psiquiátricas padecidas por Vincent van Gogh, y su dependencia a sustancias como el tabaco y el alcohol, podríamos encontrarnos ante un caso de patología dual.
Noticias sobre medicina y salud en un diario de difusión nacional. Potencial utilidad educativa en estudiantes de ciencias de la salud
Authors: González-García María , Cantabrana Begoña , Hidalgo Agustín
Published: October 2020

Las noticias de prensa tienen potencial interés formativo en estudiantes de ciencias de la salud por una serie de motivos: a) son frecuentes; b) cubren, al menos parcialmente, la demanda social de información sobre salud; c) aportan información sobre hechos incidentales de forma ágil, lo que favorece el debate crítico; d) permiten la apropiación social del conocimiento propio de las profesiones sanitarias incluyendo la educación para la salud; e) permiten apreciar la difusión del lenguaje médico; f) aportan el contexto sociológico que puede condicionar, al menos en parte, la enfermedad, su imagen social y las medidas que los sistemas públicos ponen en funcionamiento para la atención a los ciudadanos; g) facilitan el desarrollo de competencias de análisis crítico, habilidades de documentación y comunicación; y h) se adaptan bien a la utilización de diferentes metodologías docentes. El artículo propone aspectos de interés formativo a los que pueden contribuir las noticias de prensa, y presenta ejemplos para el abordaje de algunos de ellos.
La canción en el rock argentino, Almendra, un comienzo
Authors: Goldsack Elina
Published: October 2020

El presente trabajo se ocupa de las canciones de un disco fundacional en la historia del rock en la argentina: Almendra. Grabado entre abril y septiembre de 1969 en los estudios T.N.T. y editado por RCA, Sony Music, el disco contiene nueve canciones caracterizadas por el eclecticismo poético y musical. Considerando este disco como una bisagra de la canción popular argentina, nos proponemos indagar fundamentalmente en la relación texto-música. Poniendo el foco en ese vínculo complejo donde se potencian el decir de la palabra y el decir de los sonidos.

¿Dónde radica la innovación en relación a este vínculo? ¿En particularidades métricas? ¿En formas que no responden al esquema estrofa-estribillo? ¿En armonías o melodías que enfaticen estas particularidades? A partir del análisis musical focalizado en estos aspectos pretendemos encontrar algunas respuestas. 

Esta investigación se encuentra enmarcada en el CAI+D 2016 «Cambios en innovaciones en la canción popular argentina a partir de los ‘60. Desafíos a las categorías vigentes» que se desarrolla en el Instituto Superior de Música de la Universidad Nacional del Litoral.
La experiencia narrada como vehículo de construcción colectiva en la música de Luc Ferrari
Authors: Reyna Alejandro
Published: October 2020

El artículo propone interpretar la experiencia narrada que aparece en la música de Ferrari como una búsqueda por articular un sentido colectivo. En otras palabras, toda la exposición de la vida personal del compositor que aparece en las obras posee un sentido que excede la simple anécdota personal. Luego de plantear una definición de experiencia considerada pertinente en relación a nuestros objetivos, en un primer momento se habla de la obra Hétérozygote y del field recording como «gatillo» de experiencias. A continuación, nos abocamos a reflexionar sobre las historias compartidas por Ferrari. Finalmente, en el apartado «Lo colectivo en el gesto de contarse», se analiza en términos colectivos la exposición personal que propone Ferrari, tomando como ejemplo la obra Chantal, ou le portrait d’une villageoise.