bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated With Medication Adherence in Vascular Surgery Patients
Authors: Minami Hataka R. , Zemela Mark S. , Ring Adam C. , Williams Michael S. , Smeds Matthew R.
Published: July 2020

Introduction:

Patients with vascular disease have higher mortality rates than age-matched peers and medical management of coexisting diseases may alter these outcomes. We sought to understand factors associated with medication nonadherence in vascular surgery patients at a single University vascular surgery clinic over a 3-month period.

Materials and Methods:

Consecutive vascular surgery patients were surveyed from June to August 2019. The survey included demographic questions, the validated Morisky Medication Adherence Scale, the 4-item Patient Health Questionnaire for Anxiety and Depression scales, and other medication-related questions. Medical and surgical histories were retrospectively collected from charts. Univariate and multivariate analyses were used to compare among high, intermediate, and low adherence.

Results:

A total of 128 (74%) of 174 patients met study inclusion criteria. On univariate analysis, lower medication adherence was associated with younger age ( P = .004), anxiety and depression ( P = .001), higher daily pain ( P < .001), and patients who believed their medications were less important for treating their vascular disease ( P < .001). Adherence was not associated with symptomatic vascular disease, gender, education level, marital status, employment, insurance, or the use of medication usage reminders. Multivariate analysis significantly predicted high adherence relative to low adherence with 5-year increase in age (odds ratio [OR] = 1.252, P = .021) and low adherence relative to high adherence with greater perceived pain (OR = 0.839, P = .016).

Conclusions:

Younger age and high level of pain were associated with lower medication adherence. Informing patients of the importance of prescribed medication and addressing anxiety or depression symptoms may improve adherence.
Interpretation of Peripheral Arterial and Venous Doppler Waveforms: A Consensus Statement From the Society for Vascular Medicine and Society for Vascular Ultrasound
Authors: Kim Esther S. H. , Sharma Aditya M. , Scissons Robert , Dawson David , Eberhardt Robert T. , Gerhard-Herman Marie , Hughes Joseph P. , Knight Steve , Kupinski Ann Marie , Mahe Guillaume , Neumyer Marsha , Poe Patricia , Shugart Rita , Wennberg Paul , Williams David M. , Zierler R. Eugene
Published: July 2020

This expert consensus statement on the interpretation of peripheral arterial and venous spectral Doppler waveforms was jointly commissioned by the Society for Vascular Medicine (SVM) and the Society for Vascular Ultrasound (SVU). The consensus statement proposes a standardized nomenclature for arterial and venous spectral Doppler waveforms using a framework of key major descriptors and additional modifier terms. These key major descriptors and additional modifier terms are presented alongside representative Doppler waveforms, and nomenclature tables provide context by listing previous alternate terms to be replaced by the new major descriptors and modifiers. Finally, the document reviews Doppler waveform alterations with physiologic changes and disease states, provides optimization techniques for waveform acquisition and display, and provides practical guidance for incorporating the proposed nomenclature into the final interpretation report.
An Analysis of Complications and Bone Defect Length With the Use of Induced Membrane Technique in the Upper Limb: A Systematic Review
Authors: O’Connor Casey M. , Perloff Eric , Drinane James , Cole Keegan , Marinello Patrick G.
Published: July 2020

Background: The induced membrane technique was originally described as a technique for the reconstruction of long bone defects. The authors performed a systematic review to determine whether the use of the induced membrane technique is effective in large bony defects in the upper extremity. Methods: A qualitative systematic review was conducted using PubMed, EBSCO, and Google Scholar databases to record all studies reporting on complications of the induced membrane technique in the upper extremity. Studies written after 1990 in English language journals met the inclusion criteria. Exclusion criteria were non-English language publications, animal studies, failure to identify the location of the bone defect, failure to identify whether complications were associated with the procedure, and failure to define the length of bone defect. Results: A total of 1422 studies were identified in the original search. Twelve studies satisfied the criteria for inclusion. A total of 70 patients with 83 upper extremity cases were reported: 1 proximal interphalangeal joint, 22 phalanges, 8 metacarpals, 37 forearms, 14 humeri, and 1 clavicle. The mean bone defect size was 4.0 cm (SD, 1.5). The most common complication was infection. We found that complication rates were independent of the location of the bone defect. Complication rates in the upper extremity ranged from 0% to 100%, with a total weighted mean of 10%. Conclusion: The induced membrane technique is an emerging possible treatment of large bone defects in the upper extremity. More research is needed to determine the outcomes of the induced membrane technique in the upper extremity.
The antireflux mechanism – Angiographic anatomy and clinical implications
Authors: Gailloud Philippe
Published: July 2020

Background

Early anatomists suspected that the radiculomedullary veins draining the spinal cord had valves preventing their retrograde filling with anatomical casting material. Modern investigations have discarded the presence of true valves and introduced instead the notion of a pseudo-valvular configuration for which the term antireflux mechanism was coined in the 1970s. The angiographic anatomy of the antireflux mechanism has not been well documented so far.

Methods

This article discusses anatomical and clinical features of the antireflux mechanism with a series of 12 angiographic observations documenting the antireflux mechanism under normal and pathological circumstances.

Results

The antireflux mechanism divides radiculomedullary veins into intradural and extradural segments. While the structure of the antireflux mechanism is not yet fully clarified, it includes at least a tight narrowing of the radiculomedullary vein at its point of passage through the thecal sac, which is angiographically detectable and likely protects the intradural venous system from transient or persistent surges in venous pressure (e.g. sneezing, pregnancy). This tight narrowing of the antireflux mechanism likely also represents an obstacle to normal anterograde flow, potentially leading to venous stagnation and thrombosis.

Conclusions

The antireflux mechanism includes at least a tight narrowing of the radiculomedullary vein, which likely influences the development and clinical expression of low-flow spinal arteriovenous fistulas and might impact the spinal venous drainage even in the absence of arteriovenous shunts.
Rethinking Concepts and Categories for Understanding the Neurodevelopmental Effects of Childhood Adversity
Authors: Smith Karen E. , Pollak Seth D.
Published: July 2020

Discovering the processes through which early adverse experiences affect children’s nervous-system development, health, and behavior is critically important for developing effective interventions. However, advances in our understanding of these processes have been constrained by conceptualizations that rely on categories of adversity that are overlapping, have vague boundaries, and lack consistent biological evidence. Here, we discuss central problems in understanding the link between early-life adversity and children’s brain development. We conclude by suggesting alternative formulations that hold promise for advancing knowledge about the neurobiological mechanisms through which adversity affects human development.
The prospect of serum and glucocorticoid-inducible kinase 1 (SGK1) in cancer therapy: a rising star
Authors: Zhu Ruizhe , Yang Gang , Cao Zhe , Shen Kexin , Zheng Lianfang , Xiao Jianchun , You Lei , Zhang Taiping
Published: July 2020

Serum and glucocorticoid-inducible kinase 1 (SGK1) is an AGC kinase that has been reported to be involved in a variety of physiological and pathological processes. Recent evidence has accumulated that SGK1 acts as an essential Akt-independent mediator of phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) signaling pathway in cancer. SGK1 is overexpressed in several tumors, including prostate cancer, colorectal carcinoma, glioblastoma, breast cancer, and endometrial cancer. The functions of SGK1 include regulating tumor growth, survival, metastasis, autophagy, immunoregulation, calcium (Ca2+) signaling, cancer stem cells, cell cycle, and therapeutic resistance. In this review, we introduce the pleiotropic role of SGK1 in the development and progression of tumors, summarize its downstream targets, and integrate the knowledge provided by preclinical studies that the prospect of SGK1 inhibition as a potential therapeutic approach.
Defending Foreign Policy at Home: Indonesia and the ASEAN-Based Free Trade Agreements
Authors: Syarip Rakhmat
Published: July 2020

Scholars have devoted little attention to foreign policy motive of Indonesia’s free trade agreement (FTA) policy. This article finds that, under competitive international pressure, Indonesia has instrumentalised some FTAs to serve its “Association of Southeast Asian Nations (ASEAN)-first” foreign policy, specifically to ensure the geopolitical and geoeconomic relevance of ASEAN. Three FTAs display this motive: the ASEAN Free Trade Area, later extended to the ASEAN Economic Community, the ASEAN–China FTA, and the Regional Comprehensive Economic Partnership. Domestically, the pro-ASEAN group has supported this motive against other influential domestic actors, especially the nationalist and the pro-liberalisation groups. However, diffused political authority has led to an inconsistent FTA policy across various trade policymaking phases. The “pro-ASEAN” FTA policy has been relatively stronger in both the negotiation and ratification, but substantially weaker in the implementation phases.
Obesity and pituitary gland volume – a correlation study using three-dimensional magnetic resonance imaging
Authors: Fehrenbach Uli , Jadan Anas , Auer Timo A , Kreutz Katharina , Geisel Dominik , Ziagaki Athanasia , Bobbert Thomas , Wiener Edzard
Published: July 2020

Purpose

Obesity has become a major health problem and is associated with endocrine disorders and a disturbed hypothalamic-pituitary axis. The purpose of this study was to correlate pituitary gland volume determined by routine magnetic resonance imaging with patient characteristics, in particular body mass index and obesity.

Material and methods

A total of 144 ‘healthy’ patients with normal findings in cerebral magnetic resonance imaging were retrospectively included. Pituitary gland volume was measured in postcontrast three-dimensional T1-weighted sequences. A polygonal three-dimensional region of interest covering the whole pituitary gland was assessed manually. Physical characteristics (gender, age, body height and body mass index) were correlated with pituitary gland volume. Multiple subgroup and regression analyses were performed.

Results

Pituitary gland volumes were significantly larger in females than in males ( p<0.001) and young individuals (<35 years) versus middle-aged patients (35–47 years) ( p=0.042). Obese patients (body mass index ≥30) had significantly larger pituitary gland volumes than overweight (25<body mass index<30; p=0.011) and normal-weight (body mass index <25; p=0.005) patients. In males, pituitary gland volumes of body mass index subgroups showed significant differences ( p=0.038). Obese males had larger pituitary gland volumes than overweight patients ( p=0.066) and significantly larger volumes than normal-weight ( p=0.023) patients. Obese females also had larger pituitary gland volumes but without statistical significance ( p>0.05). Regression analysis showed that increased pituitary gland volume is associated with higher body mass index independent from gender, age and body height.

Conclusion

Pituitary gland volume is increased in obese individuals and a high body mass index can be seen as an independent predictor of increased pituitary gland volume. Therefore, gland enlargement might be an imaging indicator of dysfunction in the hypothalamus-pituitary axis. Besides gender and age, body mass index should be considered by radiologists when diagnosing abnormal changes in pituitary gland volume.
Playground as meaning-making space: Multimodal making and re-making of meaning in the (virtual) playground
Authors: Potter John , Cowan Kate
Published: July 2020

This article takes as its starting point a recognition of play as meaning-making, and the playground as a rich and dynamic ‘meaning-makerspace’ where children draw moment-to-moment, rapidly and readily on the multiple resources available to them to make signs of their interest evident. These resources are drawn from their own lifeworlds, folkloric and site-specific imagination, transmitted game forms from the past, and their pleasure and affective response to contemporary media. The playground is, therefore, a dynamic site for making and re-making, reflecting the concept of ‘makerspace as mindset’, where creative, collaborative meaning-making occurs ceaselessly in a range of modes. To illustrate this position, we share findings from ‘Playing the Archive’, an ‘Engineering and Physical Sciences Research Council’ funded project exploring archives, spaces and technologies of play. Building upon the Iona and Peter Opie Archive of play from the 1950s–1960s, the project involved ethnographic research in two contemporary London primary school playgrounds, working with children aged 7–11 as co-researchers. A range of multimodal methods were used with the children to gain insights into their play, including iPads as filmmaking devices, chest-mounted GoPro cameras, voice recorders, drawings and mapping of playspaces. The research highlights that contemporary play exists not only in physical playgrounds, but increasingly in globalised ‘virtual playgrounds’ such as video games and social media. While these playworlds may at first appear separate, we identified ways in which virtual play intersects and inflects activity in the physical playground. We argue that play should therefore be seen as a series of ‘laminates’ drawing variously on media culture, folklore and the children’s everyday lived experiences, re-mixed and re-mediated inventively in the playground.
A case of toxic epidermal necrosis–like cutaneous eruption as the first manifestation and clue to the diagnosis of systemic lupus erythematosus: A case report
Authors: Zargham Hanieh , Ghazal Stephanie , Watters Kevin , Nguyen Khue Huu
Published: July 2020

We present a rare case of a 61-year-old woman presenting with a widespread erosive eruption on her torso and extremities. Although the lesions were histologically compatible with toxic epidermal necrolysis, clinically the patient was hemodynamically stable, had no mucosal involvement and had no relevant medical history or potentially incriminating medications. Further investigations uncovered a new diagnosis of systemic lupus erythematosus, with this toxic epidermal necrolysis–like eruption being the first presentation of the disease. This case highlights the importance of broadening the differential diagnosis in patients presenting with acute widespread cleavage of the epidermis, using the spectrum of acute syndrome of apoptotic pan-epidermolysis as a reference.
The new simplified MARIA score applies beyond clinical trials: A suitable clinical practice tool for Crohn’s disease that parallels a simple endoscopic index and fecal calprotectin
Authors: Roseira Joana , Ventosa Ana Rita , de Sousa Helena Tavares , Brito Jorge
Published: July 2020

Background

A simplified magnetic resonance enterography (MRe) index (sMARIA) for Crohn’s disease (CD) was recently developed and validated.

Objective

Our aims were (a) to assess sMARIA’s accuracy in a sample other than the validation cohort; (b) to evaluate its correlation with a simpler endoscopy index (SES‐CD) and fecal calprotectin (FC); and (c) to assess the need of an expert radiologist to reliably use sMARIA.

Methods

Patients with CD who underwent MRe, ileocolonoscopy and FC within 2–4 weeks had their MRe retrospectively reviewed by two blinded raters. Disease activity was evaluated through sMARIA, SES‐CD and FC. sMARIA’s accuracy, indices correlation, and interrater reliability were assessed.

Results

In total, 84 patients were included, comprising 420 intestinal segments evaluations. sMARIA ≥1 accurately identified segments with active disease (90% sensitivity, 98% specificity; area under the curve 0.94, 95% confidence interval (CI) 0.91–0.97; p  < 0.01). sMARIA correlated with endoscopy, both for ileal and colonic segments (R = 0.94 and R = 0.82; p  < 0.01). Per patient, there was a strong correlation between sMARIA, endoscopy (R = 0.95; p  < 0.01) and FC (R = 0.91; p  < 0.01). Interrater agreement was excellent (intraclass correlation coefficient 0.95; 95% CI 0.94–0.96; p  < 0.01).

Conclusion

sMARIA accurately measured CD activity using SES‐CD as standard of reference, and exhibited high correlation with a simple endoscopic index and a biomarker. The interrater reliability between a radiology resident and an expert was excellent.
Primary central nervous system ALK-positive anaplastic large cell lymphoma with CD56 abnormally expression in a Chinese child: Challenge in diagnostic practice
Authors: Liu Qian , Chen Xian , Li Gandi , Ye Yunxia , Liu Weiping , Zhao Sha , Zhang Wenyan
Published: July 2020

Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALK + ALCL) is most frequent in youth and possesses a broad morphologic spectrum. However, involvement in central nervous system (CNS) is definitely rare. The case we presented was a 12-year-old Chinese male who presented with headache and emesis for a couple of days. The neoplastic component was smaller cells resembling starry-sky growth pattern and immunohistochemical stained positively for CD30, ALK1, and CD56. Monoclonal T-cell receptor (TCRγ) gene rearrangement and gene translocation involving ALK identified by fluorescence in situ hybridization (FISH) using ALK break apart probe supported the diagnosis of ALK + ALCL. This case showed ALK + ALCL occur in a rare site with an abnormal CD56 expression. Awareness of this entity is important to distinguish it from other intracranial lymphoma.
Spot phone calls: A new method for measuring time use
Authors: Rost Lucia Aline
Published: July 2020

Time-use research can provide important insights for different research questions. However, many time-use measures do not capture seasonal differences, qualitative dimensions of time use, and activities that are considered less ‘important’ or ‘desirable’. To address these issues, this article proposes spot phone calls as a new method for measuring time use. The spot phone calls methodology was piloted as part of a research project on time use of adults and children in northern Uganda. In different periods of the year, participants were called on their phones at different times of the day to be asked about their time use. The method was cost and time effective and made it possible to identify and understand seasonal differences in time use. It captured emotional and relational aspects of time use and accounted for activities that were undercounted in other measures, such as ‘doing nothing’ and men’s participation in unpaid care and domestic work. This article calls for the method to be tested with a larger sample.
On the Measurement of Positive Labor Market Mobility
Authors: Symeonaki Maria , Stamatopoulou Glykeria
Published: July 2020

The present article proposes a new labor market index, called the positive labor market mobility index, which focuses on quantifying the amount of “desired” labor market mobility present in the transitions of young individuals, providing a useful way of comparing countries on that matter. Well-established indices in the literature aiming at measuring mobility take into account all movements among states and/or the diagonal elements of the transition probability matrix that denote immobility. On the contrary, the index proposed in this study uses only “favorable” or “desired” movements among labor market states, providing a more relevant to labor mobility assessment index, where the interest lies in quantifying positive transitions, from education or training to employment, for example. The positive mobility index is estimated for individuals in Europe, whose age was 15 to 29 during the years of the financial crisis, from 2008 to 2015. Annually raw micro-data from the European Union Labour Force Survey (EU-LFS) for these 8 years are used for this purpose. Moreover, the values of the proposed labor market mobility index are correlated with an early job insecurity indicator, estimated for the same age group. The results reveal the significant differences among European countries, when “desired” transitions of young individuals are taken into account. Moreover, the analysis performed indicates that the proposed index could be a good predictor for the degree of early job insecurity for young individuals in EU member states.
Propositions for the Aesthetic Continuity of Urban Landscapes
Authors: Chang Hyejung
Published: July 2020

While many global societies have undergone radical transformations, places have suffered from the irreversible loss of public memory. The value of continuity in the urban landscape has gradually declined due to the culture of “avant-gardism.” This article explores the enduring values necessary for human cohabitation and aesthetic qualities inherent in the rapidly changing urban environments of today. It draws attention to the ethical significance of continuity as the whole notion of “place” hinges, and argues that the experience of urban continuity in everyday life is an intrinsic and instrumental factor for our sense of identity, well-being, and belonging. Continuity, as predicated on human existence, is essential for the evolutionary, ecological, cognitive, cultural, and spiritual experience of the shared environment. The proposed dimensions of an aesthetic continuity are intended to provide a normative and pragmatic framework useful for application to placemaking in ever-changing urban environments.
Prevalence of groin pain in unicycle athletes: A nationwide questionnaire survey
Authors: Kobayashi Daigo , Kobayashi Naomi , Oishi Takayuki , Choe Hyonmin , Tezuka Taro , Higashihira Shota , Inaba Yutaka
Published: July 2020

Background and purpose:

This nationwide questionnaire survey was performed to clarify the prevalence of groin pain in unicycle athletes and to reveal the relationship between groin pain and factors such as age or athletic career.

Patients and methods:

To evaluate the prevalence of groin pain, the questionnaire was sent to 1304 unicyclists belonging to the Japan Unicycle Association. All subjects aged 6 years or older at the time they answered the questionnaire.

Results:

Overall, 17% of unicyclists complained of groin pain. Pain was more common in those aged 13–19 years and in those with a career lasting more than 6 years.

Conclusion:

The incidence of groin pain (17%) among unicyclists is higher than that among athletes participating in other sports. Unicyclists aged between 13 and 19 years old and those with an athletic career of more than 6 years often suffer from groin pain.
Handling Sexual Harassment Complaints in Sri Lanka: Fair Process and Best Practices
Authors: Adikaram Arosha S. , Kailasapathy Pavithra
Published: July 2020

Sexual harassment at the workplace continues to be an issue all over the world. While there are many policies with well laid-out procedures specifying the process to follow when complaints of sexual harassment are received, there is still a lack of knowledge on actual practices of handling sexual harassment complaints and best practices. Data were collected from 35 HR professionals (HRPs) from over 30 companies in Sri Lanka on how sexual harassment complaints were handled. Based on this empirical evidence and literature as well as the theory of organisational justice, a six-stage process that HRPs should follow for a fair, just and effective handling of sexual harassment complaints is proposed. The process comprises of (a) complaint stage, (b) assessment of complaint stage, (c) investigation stage, (d) action stage, (e) appeal stage and (f) post-settlement stage. Best practices of handling sexual harassment complaints identified through the empirical data and literature are also highlighted.
High-Grade Patellar Chondral Defects: Promising Results From Management With Osteochondral Autografts
Authors: Figueroa David , Calvo Rodriguez Rafael , Donoso Rodrigo , Espinoza Jaime , Vaisman Alex , Yañez Claudio
Published: July 2020

Background:

Patellar chondral defects represent up to 34.6% of defects found during routine arthroscopy. Surgical management has evolved during the past 20 years in an effort to develop techniques to replace hyaline cartilage. Currently, the only technique that achieves this is osteochondral autologous transfer (OAT). Although good and excellent results have often been reported at midterm and long-term follow-up for femoral lesions, little is known about isolated patellar defects.

Purpose:

To assess clinical and imaging results of patients treated with OAT for high-grade patellar defects.

Study Design:

Case series; Level of evidence, 4.

Methods:

This was a retrospective study on all patients who received OAT for high-grade symptomatic patellar chondral defects between 2010 and 2018 at our institution. The study included patients younger than 40 years of age with anterior knee pain and a grade 4 International Cartilage Repair Society patellar chondral defect between 1 and 2.5 cm2. Patients with surgery in other knee compartments, concomitant anterior cruciate ligament ruptures, infection, rheumatoid arthritis, and degenerative lesions were excluded. Six months postoperatively, all patients underwent magnetic resonance imaging (MRI) to allow assessment of graft integrity via the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score to evaluate morphologic features and integration. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Kujala scores were used to assess functional outcomes at final follow-up.

Results:

A total of 26 patients who received a patellar OAT were included. Most patients were male (88.4%), and the mean ± SD age was 28.5 ± 9.7 years. Patellar chondral defects had a median size of 180 mm2 (range, 64-250 mm2), and patients received a median of 1 autograft (range, 1-3). Functional outcomes assessed at a minimum of 1 year after surgery showed a mean Kujala score of 90.42 ± 6.7 and a mean WOMAC score of 95 ± 3.6. MRI revealed a median MOCART score of 75 points (range, 20-90 points).

Conclusion:

To our knowledge, this is the largest series to date regarding isolated patellar OAT. At midterm follow-up, most patients reported good and excellent results regarding symptoms and activity levels. Most autografts showed good osseous integration and excellent filling of the chondral surface, as evidenced on MRI. OAT is a good alternative to treat high-grade patellar chondral defects, especially among young patients.
Lessons From Starting a New Subspecialty in a Rural State
Authors: Rosen Paul , Mullett Charles
Published: July 2020

In starting a new pediatric rheumatology service in a rural state, we designed the practice to focus on patient access, patient quality, and patient experience. We created a clinical experience that starts with an intake call to optimize the face-to-face visit. A team-based care approach is used. Weekend appointments are offered to avoid school and work absence. The social determinants of health are addressed. In our first year, our patients have reported their appreciation for a high-touch, patient-centered experience.
Urban function recognition by integrating social media and street-level imagery
Authors: Ye Chao , Zhang Fan , Mu Lan , Gao Yong , Liu Yu
Published: July 2020

Recognizing urban functions is crucial for understanding urban spatial structures and urban planning. Previous work has investigated urban functions based on human activities that were derived from mobile phone positioning data, check-in data, taxi data, etc. However, urban functions can only be comprehensively sensed from both human activities and the physical environment together. To do so, a deep learning method was proposed to predict urban functions by integrating social media data and street-level imagery. The verbs extracted from social media posts were taken as the proxy for human activities, and we identified urban physical environmental information from street-level imagery. Then urban functions were uncovered from both the verbs in terms of human activities and street-level imagery from the perspective of the physical environment. Twelve types of urban function were recognized by verbs in social media posts, which were then improved by integrating street-level imagery within the 5th Ring Road of Beijing, China. The experiment demonstrated that verbs as direct proxies for human activities can avoid noise, and the multi-source data integration eliminated biases caused by a single data source. This work provides a comprehensive understanding of urban structure and dynamics for urban management and planning.
Non-target screening of organic pollutants and target analysis of halogenated polycyclic aromatic hydrocarbons in the atmosphere around metallurgical plants by high-resolution GC/Q-TOF-MS
Authors: Yang Lili , Wu Jiajia , Zheng Minghui , Cao Zhe , Li Cui , Shi Miwei , Liu Guorui
Published: July 2020

Background

The 16 priority polycyclic aromatic hydrocarbons (PAHs) issued by US Environmental protection agency are a major focus in atmosphere in previous studies. Many more PAH congeners or their substitutes could be produced during combustion or thermal industrial processes and released into the atmosphere. However, a full screening of various organic pollutants in air surrounding important industrial sources has not been conducted. Identifying and characterizing organic pollutants in air is essential for accurate risk assessment. This study conducted non-target screening of organic pollutants and simultaneous target analysis of emerging contaminants including 8 polychlorinated naphthalenes and 30 higher cyclic halogenated PAHs by high-resolution gas chromatography quadrupole time-of-flight mass spectrometry (GC/Q-TOF-MS) and applied to the air samples collected surrounding metallurgical plants. Emerging organic chemicals of high toxicity in air were identified.

Results

We identified and characterized 187 organic chemicals categorized as PAHs, alkylated polycyclic aromatic compounds (PACs), heterocyclic PACs, and aliphatic hydrocarbons in atmosphere around industrial sources. Some of these identified chemicals, such as phthalic acid esters, dimethylbenz[a]anthracene, and hydroquinone with alkane substituents are of potential high toxicities and have not been the focus of previous studies of airborne contaminants. Moreover, hydroquinone with alkane substituents may be critical intermediates and precursors of an emerging contaminant—environmentally persistent free radicals. Thus, the presence of those identified highly toxic chemicals in the air merits attention. Moreover, 38 chlorinated and brominated PAHs as target compounds were accurately quantitated by using isotopic dilution method by application of GC/Q-TOF-MS, and the findings were similar to those of high-resolution magnetic mass spectrometry.

Conclusion

In this study, both non-target screening of organic pollutants and target analysis of halogenated PAHs in air were achieved by GC/Q-TOF-MS. The method could be of significance for simultaneous analysis of those trace pollutants containing multiple congeners. Specific pollutants of potential high toxicity in atmosphere around industrial sources were identified. Those knowledge could be helpful for comprehensively recognizing the organic contaminants in air surrounding metallurgical plants and better understanding their potential health risks.
Severe euglycemic diabetic ketoacidosis of multifactorial etiology in a type 2 diabetic patient treated with empagliflozin: case report and literature review
Authors: Sampani Erasmia , Sarafidis Pantelis , Dimitriadis Chrysostomos , Kasimatis Efstratios , Daikidou Dimitra , Bantis Konstantinos , Papanikolaou Alexios , Papagianni Aikaterini
Published: July 2020

Background

Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are a relatively novel class of oral medications for the treatment of Type 2 DM with a generally acceptable safety profile. However, these agents have been associated with rare events of a serious and potentially life-threatening complication named euglycemic diabetic ketoacidosis (euDKA). euDKA is not identical with the typical diabetic ketoacidosis, as it often presents with serious metabolic acidosis but only mild to moderate glucose and anion gap elevation.

Case presentation

We report a case of a 51-year old female with Type 2 DM treated with an SGLT-2 inhibitor, developing severe metabolic acidosis with only mild blood glucose elevation after a routine surgery. A careful evaluation of involved factors led to the diagnosis of euDKA, followed by cautious application of simple therapeutic measures that resulted in complete restoration of acidosis and glycemic control in less than 48-h.

Conclusions

Euglycemic ketoacidosis is a rare but rather serious complication of SGLT-2 inhibitors use, often with a multifactorial etiology. Its atypical presentation requires a high level of awareness by physicians as early recognition of this complication can quickly and safely restore acid-base balance.
“The right time is just after birth”: acceptability of point-of-care birth testing in Eswatini: qualitative results from infant caregivers, health care workers, and policymakers
Authors: Sacks Emma , Khumalo Philisiwe , Tsabedze Bhekisisa , Montgomery William , Mthethwa Nobuhle , Nhlabatsi Bonisile , Masuku Thembie , Cohn Jennifer , Chouraya Caspian
Published: July 2020

Background

Testing for HIV at birth has the potential to identify infants infected in utero, and allows for the possibility of beginning treatment immediately after birth; point of care (POC) testing allows rapid return of results and faster initiation on treatment for positive infants. Eswatini piloted birth testing in three public maternities for over 2 years.

Methods

In order to assess the acceptability of POC birth testing in the pilot sites in Eswatini, interviews were held with caregivers of HIV-exposed infants who were offered birth testing (N = 28), health care workers (N = 14), and policymakers (N = 10). Participants were purposively sampled. Interviews were held in English or SiSwati, and transcribed in English. Transcripts were coded by line, and content analysis and constant comparison were used to identify key themes for each respondent type.

Results

Responses were categorized into: knowledge, experience, opinions, barriers and challenges, facilitators, and suggestions to improve POC birth testing. Preliminary findings reveal that point of care birth testing has been very well received but challenges were raised. Most caregivers appreciated testing the newborns at birth and getting results quickly, since it reduced anxiety of waiting for several weeks. However, having a favorable experience with testing was linked to having supportive and informed family members and receiving a negative result. Caregivers did not fully understand the need for blood draws as opposed to tests with saliva, and expressed the fears of seeing their newborns in pain. They were specifically grateful for supportive nursing staff who respected their confidentiality. Health care workers expressed strong support for the program but commented on the high demand for testing, increased workload, difficulty with errors in the testing machine itself, and struggles to implement the program without sufficient staffing, especially on evenings and weekends when phlebotomists were not available. Policymakers noted that there have been challenges within the program of losing mothers to follow up after they leave hospital, and recommended stronger linkages to community groups.

Conclusions

There is strong support for scale-up of POC birth testing, but countries should consider ways to optimize staffing and manage demand.
Effectiveness of preemptive antifibrinolysis with tranexamic acid in rheumatoid arthritis patients undergoing total knee arthroplasty: a study protocol for a randomized controlled trial
Authors: Lei Yiting , Liu Jiacheng , Liang Xi , Hu Ning , Pei Fuxing , Huang Wei
Published: July 2020

Background

Patients with rheumatoid arthritis (RA) who have undergone total knee arthroplasty are at increased risk of requiring a blood transfusion. This study is designed to compare the effects of preemptive antifibrinolysis of single-dose and repeat-dose tranexamic acid (TXA) in in RA patients undergoing total knee arthroplasty (TKA).

Methods/design

The study will be a double-blind randomized controlled trial with two parallel groups of RA patients. Group A will be given 100 ml normal saline twice daily starting from 3 days before the operation, Group B will be given TXA 1.5 g twice daily starting from 3 days before the operation. All patients will be given TXA 1.5 g 30 min before the operation. The primary outcomes will be evaluated with total blood loss and hidden blood loss. Other outcome measurements such as, fibrinolysis parameters, inflammatory factors, visual analogue scale for post-operative pain, analgesia usage, coagulation parameters, transfusion, the length of stay (LOS), total hospitalization costs, the incidence of thromboembolic events and other complications will be recorded and compared. Recruitment is scheduled to begin on 1 August 2020, and the study will continue until 31 May 2021.

Discussion

In current literature there is a lack of evidence with regard to the efficacy of TXA in RA patients. The findings of this study, whether positive or negative, will contribute to the formulation of further recommendations on the use of TXA in RA patients undergoing TKA.

Trial registration

Chinese Clinical Trial Registry, ChiCTR2000029720. Registered 14 February 2020.
Recurrent granular cell tumor of the thyroid: a case report and literature review
Authors: He Yu-qin , Lu Hai-zhen , Li De-zhi , Chen Mo-qi , Wang Kai , Xu Zhen-gang , Liu Shao-yan
Published: July 2020

Background

Granular cell tumor (GCT) of the thyroid is a rare benign tumor of Schwann cell origin with a favorable prognosis and only 10 cases have been reported so far in scientific literature. The present case study describes the first case of recurrent thyroid GCT.

Case presentation

Our case describes a 20-year-old woman who had undergone lobectomy for GCT of the thyroid 4 years ago. Hematoxylin-eosin (HE) staining revealed that the lesion was composed of epithelioid cells with an abundance of eosinophilic granular cytoplasm. Immunohistochemical analysis showed that tumor cells tested positive for S-100 protein and negative for desmin. Both histological and immunohistochemical analyses supported the diagnosis of recurrent GCT of the thyroid.

Conclusions

Our case suggested that a tumor-free margin excision and post-operative follow-up are necessary for the treatment of GCT of the thyroid.
A novel pleural-bladder pump for the management of recurrent malignant pleural effusions: a feasibility animal study
Authors: Laroumagne S. , Guinde J. , Berdah S. , Dutau H. , Capel J. , Astoul P.
Published: July 2020

Background

Recurrent malignant pleural effusions (MPE) are common and associated with significant morbidity in cancer patients. A new pump connecting the pleural cavity and the bladder may have application for the management of recurrent MPE. In a pre-clinical study, we investigated the utility of this pump in healthy pigs.

Methods

A novel pump system (Pleurapump® system) was inserted into four pigs under general anaesthesia. A tunnelled-pleural catheter was connected to a subcutaneously implanted pump while the urinary bladder was connected by percutaneous technique. Animals were ventilated mechanically and pump functioning was tested using a range of ventilation parameters and spontaneous breathing. Fluid was added to the pleural space to mimic pleural effusion and to assess the effectiveness of the pump at removing fluid to the bladder.

Results

The ‘pleurapump’ system successfully transported fluid from the pleural cavity to the bladder. Pressure variations caused by respiration and variations in the amount of fluid in the pleural cavity had no impact on the pumping. Pumping stopped when the pleural cavity was drained.

Conclusion

This pump can be implanted into pigs and successfully removed fluid from the pleural cavity to the bladder and may represent a new treatment for management of recurrent MPE. Evaluation in humans is planned.
Plasmodium falciparum genetic factors rather than host factors are likely to drive resistance to ACT in Ghana
Authors: Hodoameda Peter , Duah-Quashie Nancy Odurowah , Hagan Charles Oheneba , Matrevi Sena , Abuaku Benjamin , Koram Kwadwo , Quashie Neils Ben
Published: July 2020

Background

Artemisinin-based combination therapy (ACT) partner drugs, currently used in Ghana are lumefantrine, amodiaquine and piperaquine. Plasmodium falciparum isolates with reduced susceptibility to these partner drugs may affect treatment outcome. Mutations in pfmdr1 gene is linked to reduced parasite susceptibility to amodiaquine and lumefantrine. In addition, the potency of the partner drugs in vivo depends on the metabolism by the cytochrome P450 (CYP) enzyme in the host. Mutations in the CYP2C8 and CYP3A4 genes are linked to reduced metabolism of amodiaquine and lumefantrine in vitro, respectively. This study investigated the host and parasite genetic factors affecting the susceptibility of the malaria parasite to ACT partner drugs.

Methods

Archived samples from 240 patients age ≤ 9 years participating in anti-malarial drug resistance survey in Ghana, and given artemether with lumefantrine (AL) or artesunate with amodiaquine (AA), were selected and analysed. Polymerase chain reaction (PCR) followed by Sanger sequencing was used to determine the polymorphisms in CYP2C8, CYP3A4 and pfmdr1 genes.

Results

For CYP3A4, all had wild type alleles, suggesting that the hosts are good metabolizers of lumefantrine. For CYP2C8 60% had wild type alleles, 35% heterozygous and 5% homozygous recessive alleles suggesting efficient metabolism of amodiaquine by the hosts. For pfmdr1 gene, at codon 86, 95% were wild type (N86) and 5% mutant (Y86). For codon 184, 36% were wild type (Y184) and 64% mutant (F184) while for codons 1034, 1042 and 1246, 100% (all) were wild type. The high prevalence of N86-F184-D1246 haplotype (NFD) suggest presence of parasites with reduced susceptibility to lumefantrine and not amodiaquine. Delayed clearance was observed in individuals with mutations in the pfmdr1 gene and not cytochrome 450 gene. Both synonymous and non-synonymous mutations were observed in the pfmdr1 at low prevalence.

Conclusion

The outcome of this study indicates that the parasite's genetic factors rather than the host’s are likely to drive resistance to ACT in Ghana.
Transurethral needle electrode resection and transurethral holmium laser resection of bladder cancer
Authors: Zhou Yu , Zhang Zheng-Long , Luo Mao-Hua , Yang Hua
Published: July 2020

Purpose

The aim of the present study was to explore the efficacy and safety of transurethral needle electrode resection and transurethral holmium laser resection of non-muscular invasive bladder cancer (NMIBC).

Patients and methods

In this prospective, case-control study, patients from the Urinary Surgery or Oncology Department who met the inclusion and exclusion criteria received transurethral needle electrode resection (n = 52) or transurethral holmium laser resection (n = 51).

Results

A total of 103 patients with NMIBC were included in the present study, with 68 males and 35 females. Their mean age was 57.3 years. Sixty-two patients had Ta, 15 patients had T1, and 26 patients had Tis. Operative time, intraoperative blood loss, postoperative gross hematuria time, bladder irrigation time, and postoperative hospitalization time were all significantly lower in the transurethral holmium laser resection group than the transurethral needle electrode resection group. After resection, transurethral holmium laser resection significantly decreased the value of HGF, TSH, and TNF-α versus the transurethral needle electrode resection group. The incidence of obturator reflex was significantly lower in the transurethral holmium laser resection group than the transurethral needle electrode resection group. There was no significant difference in disease-free survival rate and progression-free survival rate between the two groups.

Conclusions

Transurethral holmium laser resection has clinical advantages in the treatment of NMIBC.
The extracellular vesicle of gut microbial Paenalcaligenes hominis is a risk factor for vagus nerve-mediated cognitive impairment
Authors: Lee Kyung-Eon , Kim Jeon-Kyung , Han Sang-Kap , Lee Dong Yun , Lee Hae-Ji , Yim Sung-Vin , Kim Dong-Hyun
Published: July 2020

Background

In a pilot study, we found that feces transplantation from elderly individuals to mice significantly caused cognitive impairment. Paenalcaligenes hominis and Escherichia coli are increasingly detected in the feces of elderly adults and aged mice. Therefore, we isolated Paenalcaligenes hominis and Escherichia coli from the feces of elderly individuals and aged mice and examined their effects on the occurrence of age-related degenerative cognitive impairment and colonic inflammation in mice.

Results

The transplantation of feces collected from elderly people and aged mice caused significantly more severe cognitive impairment in transplanted young mice than those from young adults and mice. Oral gavage of Paenalcaligenes hominis caused strong cognitive impairment and colitis in specific pathogen-free (SPF) and germ-free mice. Escherichia coli also induced cognitive impairment and colitis in SPF mice. Oral gavage of Paenalcaligenes hominis, its extracellular vesicles (EVs), and/or lipopolysaccharide caused cognitive impairment and colitis in mice. However, celiac vagotomy significantly inhibited the occurrence of cognitive impairment, but not colitis, in mice exposed to Paenalcaligenes hominis or its EVs, whereas its lipopolysaccharide or Escherichia coli had no such effects. Vagotomy also inhibited the infiltration of EVs into the hippocampus.

Conclusions

Paenalcaligenes hominis, particularly its EVs, can cause cognitive function-impaired disorders, such as Alzheimer’s disease, and its EVs may penetrate the brain through the blood as well as the vagus nerve.