bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical characteristics and long-term outcomes of Libman–Sacks endocarditis in patients with systemic lupus erythematosus
Authors: Yoo Byung-Woo , Lee Sang-Won , Song Jason Jungsik , Park Yong-Beom , Jung Seung Min
Published: June 2020

Objective

Treatment of Libman–Sacks (LS) endocarditis in patients with systemic lupus erythematosus (SLE) is challenging due to the lack of data. This study aimed to identify the clinical characteristics of SLE patients and LS endocarditis, and to investigate the treatment and prognosis of LS endocarditis.

Methods

Of all the patients with SLE who underwent echocardiography between 2010 and 2019, 11 and 29 patients with and without LS endocarditis, respectively, were included. We compared the inflammatory and thrombotic profiles between patients with and without LS endocarditis, and investigated the treatment and long-term outcome of LS endocarditis.

Results

No significant differences were observed in disease activity, clinical characteristics and inflammatory marker levels between patients with and without LS endocarditis. Patients with LS endocarditis had a significantly higher prevalence of antiphospholipid antibody (aPL) but a lower prevalence of SLE-specific antibody. Triple positivity of aPL was found in 72.7% and 13.8% of patients with and without LS endocarditis, respectively. Of 11 patients with LS endocarditis, six patients received anticoagulation therapy, and five patients received augmented immunosuppressive therapies. One patient who did not receive anticoagulation therapy developed cerebral infarction. Nine (82%) patients with LS endocarditis were classified as having antiphospholipid syndrome (APS). Despite the residual vegetation and valve dysfunction, surgical intervention was not required during the follow-up period of 56.8 months.

Conclusion

A significant correlation was observed between APS and LS endocarditis. Anticoagulation therapy should be considered to prevent thromboembolic complications in SLE patients with LS endocarditis.
Systematic vs. stepwise parameter optimization for discriminant model development: A case study of differentiating Pinellia ternata from Pinellia pedatisecta with near infrared spectroscopy
Authors: Sun Fei , Chen Yu , Qiu Yunqi , Wang Shumei , Liang Shengwang
Published: June 2020

Near infrared (NIR) spectroscopy is an effective technique for adulteration detection in traditional Chinese medicine. The aim is to develop a discriminant model with the aid of chemometrics tools. The discriminant model is conventionally established by the means of stepwise optimization. This approach is often limited to trial-and-error and considered as a burden. In this study, a systematic optimization approach was proposed to develop the discriminant model with the aid of the design of experiment tools and applied to a case study of differentiating Pinellia ternata from Pinellia pedatisecta and adulterated Pinellia ternata using NIR spectroscopy. Spectral pretreatment, variable selection, and discriminant methods were identified as critical factors. The classification accuracy and no-error rate of the calibration set, cross-validation, and the prediction set were calculated to evaluate the performance of discriminant models. A full factorial design was applied to analyze the effect of critical factors at different levels on the model performance and optimize these factors. Three discriminant models including discriminant analysis coupled with principal component analysis (PCA-DA), partial least squares – discriminant analysis (PLS-DA), and k-nearest neighbors (KNN) were obtained by systematic optimization. The performance of PCA-DA and PLS-DA models obtained by systematic optimization was very good, and no samples were misclassified, which were better than those obtained by stepwise optimization. The performance of the KNN model obtained by systematic optimization was not desired and it was equal to that obtained by stepwise optimization. The results showed that Pinellia ternata could be successfully discriminated from Pinellia pedatisecta and adulterated Pinellia ternata by the PCA-DA and PLS-DA models. Compared to the stepwise optimization approach, the systematic optimization approach can improve the PCA-DA and PLS-DA model performance for differentiating Pinellia ternata from Pinellia pedatisecta and adulterated Pinellia ternata.
Secondary Angiosarcoma With C-MYC Amplification Following Prophylactic Bilateral Mastectomy and Autologous Breast Reconstruction: Report of a Case and Review of the Literature
Authors: Webb Chrisopher , Partain Natalia , Koduru Prasad , Hwang Helena , Sarode Venetia R.
Published: June 2020

In this article, we report a very rare case of secondary angiosarcoma in a young woman with no prior history of breast cancer who had bilateral prophylactic mastectomies with autologous reconstruction due to a strong family history of breast cancer and BRCA1 gene variant of uncertain significance. The surgery was complicated by recurrent fat necrosis requiring several excisions and additional reconstruction followed by the development of localized lymphedema and subsequent angiosarcoma in the reconstructed breast 10 years later. The angiosarcoma was high grade with prominent epithelioid features associated with abundant tumor-infiltrating lymphocytes. Amplification of C-MYC locus 8q21.24 was demonstrated by fluorescence in situ hybridization study. We postulate that chronic trauma from several surgeries including tissue hypoxia and impaired lymphatic drainage may have provided a milieu for angiogenesis and mutagenic transformation. Amplification of C-MYC locus 8q21.24 was most likely a strong oncogenic driver of angiosarcoma. To the best of our knowledge, this is the first report of its kind in the literature.
Two Decades of Nursing Home Compare: What Have We Learned?
Authors: Tamara Konetzka R. , Yan Kevin , Werner Rachel M.
Published: June 2020

Approximately two decades ago, federally mandated public reporting began for U.S. nursing homes through a system now known as Nursing Home Compare. The goals were to provide information to enable consumers to choose higher quality nursing homes and to incent providers to improve the quality of care delivered. We conduct a systematic review of the literature on responses to Nursing Home Compare and its effectiveness in meeting these goals. We find evidence of modest but meaningful response by both consumers and providers. However, we also find evidence that some improvement in scores does not reflect true quality improvement, that disparities by race and income have increased, that risk-adjustment of the measures is likely inadequate, and that several key domains of quality are not represented. Our results support moderate success of Nursing Home Compare in achieving intended goals but also reveal the need for continued refinement.
Temporal dominance of sensations and check-all-that-apply analysis of restructured cooked hams elaborated with different salt content and pork quality meats
Authors: de Oliveira Paula Marielle Maria , Massingue Armando Abel , de Moura Ana Paula Rocha , de Deus Souza Carneiro João , de Lemos Souza Ramos Alcinéia , Ramos Eduardo Mendes
Published: June 2020

This study aimed to evaluate the effects of salt (NaCl) content of 1.2%, 1.6%, and 2.0% in the sensory characteristics of restructured cooked hams, formulated with abnormal (PSE; pale, soft, and exudative) and normal (RFN; reddish pink, firm, and non-exudative) meats. The products with 1.2% added salt had higher ( P < 0.05) acceptance scores for flavor, regardless of the type of meat used. Hams manufactured with PSE meat and 1.2% salt content had higher ( P < 0.05) overall impression scores and were associated with the terms “characteristic ham flavor”, “juicy”, and “soft” in the check-all-that-apply analysis. RFN meat samples with 1.6% and 2.0% salt content were respectively associated to “rubbery” and “firm” texture. The ham flavor was always reported at the beginning of the temporal dominance of sensation test, followed by the term “salty” for the samples with 2.0% salt and “meaty” in the samples with 1.2% salt. The term “umami taste” appears to be associated to that samples made with PSE meat. These results led to the conclusion that PSE meat had a positive effect on the sensory profile of restructured cooked hams, especially in those formulated with 1.2% salt.
The strange case of ‘Ugo Fantozzi robot’: Control and resistance through comics in a bank
Authors: Carollo Luca
Published: June 2020

In this article, I examine a graphic novel created by the management of a banking company and periodically circulated through the company’s intranet as part of a training initiative directed at several tens of thousands of employees working at the branch level. Theoretically, my study draws on two main streams of literature: that on Human Resource Management systems as meaning-creating devices to govern the employment relationship and that on the ever-tighter relation between popular culture and organizations. In addition, I elaborate on Umberto Eco’s semiotic theory—which to date has been largely overlooked in organization studies—to decipher the ‘mystery’ represented by the organizational comics case, along with the individual and collective reactions that followed it. On the basis of the available empirical material, I theorize ‘Semiological Guerrilla Warfare’ as a collective strategy to subvert organizations’ internal mass communications. In the final part of the article, I discuss the innovative possibilities that Semiological Guerrilla Warfare, comic strips, and Eco’s semiotics offer to organization studies and to all those interested in expanding the repertoire of resistance strategies to managerial control in organizations.
Challenges faced by residential aged care staff in decision-making for residents with dementia
Authors: Cameron Nadine , Fetherstonhaugh Deirdre , Bauer Michael
Published: June 2020

Care staff in residential aged care facilities (nursing homes) in Australia are obligated, under the Australian National Framework for Action on Dementia 2015–2019, to support residents to exercise choice and make decisions. Research indicates, however, that care staff are often given little guidance regarding which residents’ decisions should be supported or how to make decisions on their behalf. This lack of guidance can result in a denial of residents’ rights and inconsistent treatment by staff, placing residents’ wellbeing at risk. Through providing an analysis of the responses of staff at RACFs in Victoria and Queensland to two case scenarios, this study seeks to provide some understanding of the difficulties staff face in supporting residents’ self-determination and their own need for greater organisational support.
Using antibacterial fibers and metallic wires to make woven fabrics used as smart diapers
Authors: Shiu Bing-Chiuan , Jhang Jia-Ci , Li Ting-Ting , Peng Hao-kai , Wu Li-wei , Lou Ching-Wen , Lin Jia-Horng
Published: June 2020

Cloth diapers also known as eco-diapers, traditional sandwich-structured eco-diapers are composed of top and bottom layers that are made of cotton or polyester nonwoven fabrics. On account of the hydrophilic bottom layer, urine permeates when the water absorption reaches saturation. In this study, polypropylene is melt-blown into hydrophobic polypropylene nonwoven fabrics to be used as the top and bottom layer. Polypropylene is hydrophobic but after being fabricated into nonwoven fabrics, the porous structure enables the urine to leak to the absorbent interlayer of eco-diapers. Hence, the top layer of diaper does not contain urine, which makes smart diapers more comfortable than cloth diapers that are made of cotton or other moisture-absorbent materials. Moreover, the sensing mechanism via Bluetooth module can detect the water content of the interlayer with a view to improving the demerit of urine leakage. The interlayer is the sensing layer that has antibacterial function. Two types of antibacterial yarns are treated by zinc oxide and silver ions. The yarns are fabricated into antibacterial woven fabrics, after which the antibacterial properties of fabrics are investigated with quantitative and qualitative tests. Next, two parallel metallic wires are assembled in order to trigger short circuit when sensing moisture, thereby obtaining different electric resistance based on different moisture levels. Furthermore, the miniature senor can signify the cellular phones or buzzers when the two metallic wires generate electrical resistance due to the presence of urine. The metallic wires are silver-plated copper yarns, stainless steel fibers, and copper fibers, which possess different electric resistance for the corresponding miniature sensors. This study proposes an efficient manufacture of smart diapers that require only a combination of woven fabrics and two metallic wires to sense moisture, the design of which can be encompassed in diverse fields.
Label-free characterization of collagen fibers in cancerous esophagus tissues using ratiometric nonlinear optical microscopy
Authors: Chen Wei-Chung , Chen Yu-Jen , Lin Shih-Ting , Hung Wei-Han , Chan Ming-Che , Wu I-Chen , Wu Ming-Tsang , Kuo Chie-Tong , Das Subir , Kao Fu-Jen , Zhuo Guan-Yu
Published: June 2020

A quantitative analytical method to discriminate among the various types of cancerous esophagus tissue is essential for accurate cancer staging. This paper reports on the use of ratiometric nonlinear optical microscopy to reveal the ratio of two-photon excited fluorescence (TPEF) to second harmonic generation (SHG) and forward to backward (F/B) SHG from single collagen fibers only in submucosa of esophageal squamous cell carcinoma. This makes it possible to accurately differentiate among the four stages of esophageal cancer, providing results that are in good agreement with histopathology. Furthermore, it is confirmed by polarization-dependent SHG that the varied SHG response in esophageal cancer tissues is mainly from the shrinkage in diameter of collagen fibers instead of the collagen triple helixes altered by cancer cells. Based on the results of TPEF/SHG and F/B SHG ratio, they can cooperatively improve the precision of diagnostics on esophageal cancer and could be transferred to other types of cancer diseases with changed collagen fibers.

Impact statement

The issue of classifying esophageal cancer at various developmental stages is crucial for determining the optimized treatment protocol for the patients, as well as the prognosis. Precision improvement in staging esophageal cancer keeps seeking quantitative and analytical imaging methods that could augment histopathological techniques. In this work, we used nonlinear optical microscopy for ratiometric analysis on the intrinsic signal of two-photon excited fluorescence (TPEF) and second harmonic generation (SHG) from single collagen fibers only in submucosa of esophageal squamous cell carcinoma (ESCC). The blind tests of TPEF/SHG and forward (F)/backward (B) SHG were demonstrated to compare with the histology conclusion. The discussion of sensitivity and specificity was provided via statistical comparison between the four stages of esophageal cancer. To the best of our knowledge, this is the first study of using these two ratios in combination for staging ESCC.
The prognostic value of Immunoscore in patients with cancer: A pooled analysis of 10,328 patients
Authors: Zhang Xingxia , Yang Jie , Du Liang , Zhou Yong , Li Ka
Published: June 2020

Objectives:

Over the past decade, some publications have reported that Immunoscore was associated with the prognosis of several cancers. To better understand this issue, we conducted this pooled analysis.

Methods:

We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library from their inceptions to 15 May 2019 to identify relevant articles. The pooled hazard ratio (HR) and 95% confidence interval (CI) was estimated for overall survival, disease-free survival, and disease-specific survival.

Results:

A total of 26 cohort studies with 10,328 patients involving eight cancer specialties were evaluated mainly by the consensus Immunoscore. The pooled analysis indicated that a lower Immunoscore was associated with a poor overall survival (HR 2.23, 95% CI 1.58, 2.70), disease-free survival (HR 2.40, 95% CI 1.96, 2.49), and disease-specific survival (HR 2.81, 95% CI 2.10, 3.77) for all cancers. The same convincing results were found in colorectal cancer, gastric cancer, and non-small cell lung cancer (especially the consensus Immunoscore for colon cancer). In five other types of cancer the results were similar, but the sample sizes were limited.

Conclusions:

These findings support that Immunoscore is significantly associated with the prognosis of patients with cancer. It provides a reliable estimate of the risk of recurrence in patients with colon cancer. However, more high-quality studies are necessary to assess the prognostic value of Immunoscore in non-colon cancers.
Economic evaluation of the Melbourne Mobile Stroke Unit
Authors: Kim Joosup , Easton Damien , Zhao Henry , Coote Skye , Sookram Garveeta , Smith Karen , Stephenson Michael , Bernard Stephen , W Parsons Mark , Yan Bernard , M Desmond Patricia , J Mitchell Peter , CV Campbell Bruce , Donnan Geoffrey A , M Davis Stephen , Cadilhac Dominique A
Published: June 2020

Background

The Melbourne Mobile Stroke Unit (MSU) is the first Australian service to provide prehospital acute stroke treatment, including thrombolysis and facilitated triage for endovascular thrombectomy.

Aims

To estimate the cost-effectiveness of the MSU during the first full year of operation compared with standard ambulance and hospital stroke care pathways (standard care).

Methods

The costs and benefits of the Melbourne MSU were estimated using an economic simulation model. Operational costs and service utilization data were obtained from the MSU financial and patient tracking reports. The health benefits were estimated as disability-adjusted life years (DALYs) avoided using local data on reperfusion therapy and estimates from the published literature on their effectiveness. Costs were presented in Australian dollars. The robustness of results was assessed using multivariable (model inputs varied simultaneously: 10,000 Monte Carlo iterations) and various one-way sensitivity analyses.

Results

In 2018, the MSU was dispatched to 1244 patients during 200 days of operation. Overall, 167 patients were diagnosed with acute ischemic stroke, and 58 received thrombolysis, endovascular thrombectomy, or both. We estimated 27.94 DALYs avoided with earlier access to endovascular thrombectomy (95% confidence interval (CI) 15.30 to 35.93) and 16.90 DALYs avoided with improvements in access to thrombolysis (95% CI 9.05 to 24.68). The MSU was estimated to cost an additional $30,982 per DALY avoided (95% CI $21,142 to $47,517) compared to standard care.

Conclusions

There is evidence that the introduction of MSU is cost-effective when compared with standard care due to earlier provision of reperfusion therapies.
Prevalence of stroke in Argentina: A door-to-door population-based study (EstEPA)
Authors: Ameriso SF , Gomez-Schneider MM , Hawkes MA , Pujol-Lereis VA , Dossi DE , Alet MJ , Rodriguez-Lucci F , Povedano GP , Gonzalez CD , Melcon MO
Published: June 2020

Background

Stroke burden is highest and is still rising in low- and middle-income countries. Epidemiologic stroke data are lacking in many of these countries. Stroke prevalence in Argentina has been unexplored for almost three decades.

Aim

This population-based study aims to determine prevalence of stroke in a representative sample of the Argentinean population.

Methods

We performed a door-to-door survey of randomly selected households in a city of 18,650 inhabitants. A structured questionnaire screening for potential stroke cases was used. All subjects screened positive were then evaluated by stroke neurologists for final adjudication. Data about stroke subtypes, neurological status, vascular risk factors, medications, and diagnostic tests were also collected.

Results

Among 2156 surveys, 294 were screened positive for a possible stroke. After neurological evaluation, there were 41 confirmed cases. The adjusted stroke prevalence was 1,974/100,000 inhabitants older than 40 years, and it was higher in men than in women (26.3‰ vs 13.2‰, p<0.01). Prevalence of ischemic stroke, intracranial hemorrhage, and transient ischemic attack were 15.8‰, 2.93‰, and 2.93‰, respectively. The most prevalent vascular risk factors in stroke survivors were hypertension, obstructive sleep apnea, and dyslipidemia.

Conclusion

Approximately 2 in every 100 subjects older than 40 years in this population are stroke survivors. Stroke prevalence in Argentina has remained stable over the last 30 years; it is higher than in most Latin American countries and similar to western populations.
The perceptual, heart rate and technical-tactical characteristics of 3 × 3 basketball
Authors: McGown Riley B , Ball Nick B , Legg Jan S , Mara Jocelyn K
Published: June 2020

The aim of this study was to investigate the perceptual, heart rate and technical-tactical characteristics of elite male and female 3 × 3 basketball games. Eleven male and twenty-two female elite basketball players were monitored using heart rate telemetry, Ratings of Perceived Exertion (RPE) and video analysis across three 3 × 3 basketball tournaments. Linear mixed models were performed to determine the influence of round (pool game, quarter-final, semi-final, final, classification game) and sex on all dependent variables (alpha = 0.05). There was no difference between sexes for heart rate variables (p = 0.53 - 0.85). The greatest percentage (56.9 ± 20.1%) of game time was spent in heart rate zone 5 (90-100% peak heart rate). Overall RPE was higher in semi-finals (7.2 ± 1.5, p ≤ 0.001, ES: 1.27) and finals (7.7 ± 1.6 p ≤ 0.001, ES: 1.67) compared to pool games (5.1 ± 1.5). An analysis of the technical-tactical actions revealed that there were less steals in semi-finals (p = 0.01, ES = 0.56) and finals (p = 0.01, ES = 0.71) compared to pool games, with no sex-related differences present (p = 0.06 - 0.97). Players generally spent one minute on the bench for every three minutes on the court, creating a 3:1 work to rest ratio. Physical preparation programs for elite 3 × 3 basketball athletes should include exposure to high-intensity activity in which heart rates ≥80% of peak heart rate are reached for periods of time similar to that experienced during gameplay. A 3:1 work-to-rest ratio may be beneficial during conditioning training for this population.
Efficient finite element hyperelasticity solver for blood vessel simulations
Authors: Wang Xinhong , Yan Zhengzheng , Jiang Yi , Chen Rongliang
Published: June 2020

The blood vessels play a key role in the human circulatory system. As a tremendous amount of efforts have been devoted to develop mathematical models for investigating the elastic behaviors of human blood vessels, high performance numerical algorithms aiming at solving these models have attracted attention. In this work, we present an efficient finite element solver for an elastodynamic model which is commonly used for simulating soft tissues under external pressure loadings. In particular, the elastic material is assumed to satisfy the Saint–Venant–Kirchhoff law, the governing equation is spatially discretized by a finite element method, and a fully implicit backward difference method is used for the temporal discretization. The resulting nonlinear system is then solved by a Newton–Krylov–Schwarz method. It is the first time to apply the Newton–Krylov–Schwarz method to the Saint–Venant–Kirchhoff model for a patient-specific blood vessel. Numerical tests verify the efficiency of the proposed method and demonstrate its capability for bioengineering applications.
Four-corner arthrodesis with a dorsal locking plate: 4–9-year follow-up
Authors: Athlani Lionel , Sabau Sophie , Pauchard Nicolas , Dap François , Dautel Gilles
Published: June 2020

We report the outcomes of four-corner arthrodesis for advanced wrist collapse in 50 patients (51 wrists) using a dorsal locking plate. At a mean follow-up of 6 years (range 4–9), pain was significantly reduced and wrist function was significantly improved compared with preoperative status. After four-corner arthrodesis, grip strength was 80% of the contralateral side, and wrist motion averaged 50° flexion–extension and 30° radioulnar deviation. Immobilization time was 5 weeks (4–6) and sick-leave was 3 months (2–5) following surgery. There were seven nonunions (14%) that underwent repeat arthrodesis. Three wrists were later converted to total arthrodesis due to persisting pain. Radiographic dorsal impingement was found in five wrists after four-corner arthrodesis and did not require reoperation. The outcomes appear not remarkably different from those reported using other fixation methods other than an apparent earlier return to activities.

Level of evidence: IV
In utero inflammatory challenge induces an early activation of the hepatic innate immune response in late gestation fetal sheep
Authors: Zarate Miguel A , Wesolowski Stephanie R , Nguyen Leanna M , De Dios Robyn K , Wilkening Randall B , Rozance Paul J , Wright Clyde J
Published: June 2020

Chorioamnionitis is associated with inflammatory end-organ damage in the fetus. Tissues in direct contact with amniotic fluid drive a pro-inflammatory response and contribute to this injury. However, due to a lack of direct contact with the amniotic fluid, the liver contribution to this response has not been fully characterized. Given its role as an immunologic organ, we hypothesized that the fetal liver would demonstrate an early innate immune response to an in utero inflammatory challenge. Fetal sheep (131 ± 1 d gestation) demonstrated metabolic acidosis and high cortisol and norepinephrine values within 5 h of exposure to intra-amniotic LPS. Likewise, expression of pro-inflammatory cytokines increased significantly at 1 and 5 h of exposure. This was associated with NF-κB activation, by inhibitory protein IκBα degradation, and nuclear translocation of NF-κB subunits (p65/p50). Corroborating these findings, LPS exposure significantly increased pro-inflammatory innate immune gene expression in fetal sheep hepatic macrophages in vitro. Thus, an in utero inflammatory challenge induces an early hepatic innate immune response with systemic metabolic and stress responses. Within the fetal liver, hepatic macrophages respond robustly to LPS exposure. Our results demonstrate that the fetal hepatic innate immune response must be considered when developing therapeutic approaches to attenuate end-organ injury associated with in utero inflammation.
Antisemitism on Twitter: Collective Efficacy and the Role of Community Organisations in Challenging Online Hate Speech
Authors: Ozalp Sefa , Williams Matthew L. , Burnap Pete , Liu Han , Mostafa Mohamed
Published: June 2020

In this article, we conduct a comprehensive study of online antagonistic content related to Jewish identity posted on Twitter between October 2015 and October 2016 by UK-based users. We trained a scalable supervised machine learning classifier to identify antisemitic content to reveal patterns of online antisemitism perpetration at the source. We built statistical models to analyze the inhibiting and enabling factors of the size (number of retweets) and survival (duration of retweets) of information flows in addition to the production of online antagonistic content. Despite observing high temporal variability, we found that only a small proportion (0.7%) of the content was antagonistic. We also found that antagonistic content was less likely to disseminate in size or survive for a longer period. Information flows from antisemitic agents on Twitter gained less traction, while information flows emanating from capable and willing counter-speech actors—that is, Jewish organizations—had a significantly higher size and survival rates. This study is the first to demonstrate that Sampson’s classic sociological concept of collective efficacy can be observed on social media (SM). Our findings suggest that when organizations aiming to counter harmful narratives become active on SM platforms, their messages propagate further and achieve greater longevity than antagonistic messages. On SM, counter-speech posted by credible, capable and willing actors can be an effective measure to prevent harmful narratives. Based on our findings, we underline the value of the work by community organizations in reducing the propagation of cyberhate and increasing trust in SM platforms.
Monitoring intrapartum fetal heart rates by mothers in labour in two public hospitals: an initiative to improve maternal and neonatal healthcare in Liberia
Authors: Borzie K. , Jasper N. , Southall D. P. , MacDonald R. , Kola A. A. , Dolo O. , Magnus A. , Watson S. D. , Casement M. , Dahn B. , Jallah W.
Published: June 2020

Background

In low-resource settings with few health workers, Fetal Heart Rate (FHR) monitoring in labour can be inconsistent and unreliable. An initiative to improve fetal monitoring was implemented in two public hospitals in rural Liberia; the country with the second lowest number of midwives and nurses in the world (1.007 per 10,000 of the population). The initiative assessed the feasibility of educating women in labour to monitor their own FHR and alert a midwife of changes detected.

Methods

Four hundred seventy-four women admitted in labour without obstetric complications were approached. Four hundred sixty-one consented to participate (97%) and 13 declined. Those consenting were trained to monitor their FHR using a sonicaid for approximately 1 minute immediately following the end of every uterine contraction and to inform a midwife of changes. If changes were confirmed, standard clinical interventions for fetal distress (lateral tilt, intravenous fluids and oxygen) were undertaken and, when appropriate, accelerated delivery by vacuum or Caesarean section. Participants provided views on their experiences; subsequently categorized into themes. Neonatal outcomes regarding survival, need for resuscitation, presence of birth asphyxia, and treatment were recorded.

Results

Four hundred sixty-one out of 474 women gave consent, of whom 431 of 461 (93%) completed the monitoring themselves. Three hundred eighty-seven of 400 women who gave comments, reported positive and 13 negative experiences. FHR changes were reported in 28 participants and confirmed in 26. Twenty-four of these 26 FHR changes were first identified by mothers. Fetal death was identified on admission during training in one mother. Thirteen neonates required resuscitation, with 12 admitted to the neonatal unit. One developed temporary seizures suggesting birth asphyxia. All 26 neonates were discharged home apparently well. In 2 mothers, previously unrecognized obstetric complications (cord prolapse and Bandl’s ring with obstructed labour) accompanied FHR changes. Resuscitation was needed in 8 neonates without identified FHR changes including one of birth weight 1.3 Kg who could not be resuscitated. There were no intrapartum stillbirths in participants.

Conclusions

Women in labour were able to monitor and detect changes in their FHR. Most found the experience beneficial. The absence of intrapartum stillbirths after admission and the low rate of poor neonatal outcomes are promising and warrant further investigation.
PHGDH supports liver ceramide synthesis and sustains lipid homeostasis
Authors: Kang Yun Pyo , Falzone Aimee , Liu Min , González-Sánchez Paloma , Choi Bo-Hyun , Coloff Jonathan L. , Saller James J. , Karreth Florian A. , DeNicola Gina M.
Published: June 2020

Background

d-3-phosphoglycerate dehydrogenase (PHGDH), which encodes the first enzyme in serine biosynthesis, is overexpressed in human cancers and has been proposed as a drug target. However, whether PHGDH is critical for the proliferation or homeostasis of tissues following the postnatal period is unknown.

Methods

To study PHGDH inhibition in adult animals, we developed a knock-in mouse model harboring a PHGDH shRNA under the control of a doxycycline-inducible promoter. With this model, PHGDH depletion can be globally induced in adult animals, while sparing the brain due to poor doxycycline delivery.

Results

We found that PHGDH depletion is well tolerated, and no overt phenotypes were observed in multiple highly proliferative cell compartments. Further, despite detectable knockdown and impaired serine synthesis, liver and pancreatic functions were normal. Interestingly, diminished PHGDH expression reduced liver serine and ceramide levels without increasing the levels of deoxysphingolipids. Further, liver triacylglycerol profiles were altered, with an accumulation of longer chain, polyunsaturated tails upon PHGDH knockdown.

Conclusions

These results suggest that dietary serine is adequate to support the function of healthy, adult murine tissues, but PHGDH-derived serine supports liver ceramide synthesis and sustains general lipid homeostasis.
Clinical outcomes and patient perspectives of Dental Monitoring® GoLive® with Invisalign®—a retrospective cohort study
Authors: Hansa Ismaeel , Semaan Steven J. , Vaid Nikhilesh R.
Published: June 2020

Background

The aims of the study were to compare the effects of Invisalign® with and without Dental Monitoring® (DM) GoLive® on the following parameters: treatment duration, number of appointments, number of refinements, total number of refinement aligners, and time to initial refinement. The patients’ perspectives on Dental Monitoring® were also evaluated using an online questionnaire. A sample of 155 consecutively treated Invisalign® patients (67 control, 88 DM) fit the inclusion and exclusion criteria.

Results

The two groups were homogeneous (P > .05) for age, gender, angle classification, Little’s Irregularity Index, and number of initial aligners. The DM group had significantly fewer office visits compared to the control (7.56 vs 9.82; P < .001). There were no significant differences between the DM and control groups respectively pertaining to treatment duration (14.58 vs 13.91), number of refinements (1.00 vs 0.79), number of refinement aligners (19.91 vs 19.85), and time to first refinement (9.46 vs 9.97). Questionnaire results showed that 68.8% (44 respondents) indicate that DM scans were “easy” or “very easy” to perform while 16 responders (25%) found it “difficult” or “very difficult.” 71.9% (46 responders) were “satisfied or very satisfied” with the level of communication with the orthodontist using DM and 16% (10 responders) were “dissatisfied” or “very dissatisfied.” The mean duration observed by patients to take a scan was 5.16 ± 3.6 min. Eighty-eight percent (56 responders) of patients prefer few office visits as possible, while 12% (8 responders) would actually prefer additional office visits. Overall, the mean satisfaction of patients with DM was 4.25 on the 5-point Likert scale.

Conclusion

The DM group had a significantly reduced number of appointments (7.56) compared with the control group (9.82) (a reduction of 23%) over the treatment duration. There were no significant differences between the two groups in treatment duration, number of refinements, number of refinement aligners, or time to 1st refinement. Overall, DM was well received by patients. However, there was a small percentage (usually less than 15%) that was generally unsatisfied with DM in varying aspects and preferred more frequent, traditional office visits.
Geospatial characteristics of non-motor vehicle and assault-related trauma events in greater Phoenix, Arizona
Authors: Cook Alan , Harris Robin , Brown Heidi E. , Bedrick Edward
Published: June 2020

Background

Injury-causing events are not randomly distributed across a landscape, but how they are associated with the features and characteristics of the places where they occur in Arizona (AZ) remains understudied. Clustering of trauma events and associations with areal sociodemographic characteristics in the greater Phoenix (PHX), AZ region can promote understanding and inform efforts to ameliorate a leading cause of death and disability for Arizonans. The outcomes of interest are trauma events unrelated to motor vehicle crashes (MVC) and the subgroup of trauma events due to interpersonal assaults.

Methods

A retrospective, ecological study was performed incorporating data from state and national sources for the years 2013–2017. Geographically weighted regression models explored associations between the rates of non-MVC trauma events (n/10,000 population) and the subgroup of assaultive trauma events per 1000 and areal characteristics of socioeconomic deprivation (areal deprivation index [ADI]), the density of retail alcohol outlets for offsite consumption, while controlling for race/ethnicity, population density, and the percentage urban population.

Results

The 63,451 non-MVC traumas within a 3761 mile2 study area encompassing PHX and 22 surrounding communities, an area with nearly 60% of the state’s population and 54% of the trauma events in the AZ State Trauma Registry for the years 2013–2017. Adjusting for confounders, ADI was associated with the rates of non-MVC and assaultive traumas in all census block groups studied (mean coefficients 0.05 sd. 0.001 and 0.07 sd. 0.002 for non-MVC and assaultive trauma, respectively). Alcohol retail outlet density was also associated with non-MVC and assaultive traumas in fewer block groups compared to ADI.

Conclusion

Socioeconomic deprivation and alcohol outlet density were associated with injury producing events in the greater PHX area. These features persist in the environment before and after the traumas occur. Ongoing research is warranted to identify the most influential areal predictors of traumatic injury-causing events in the greater PHX area to inform and geographically target prevention initiatives.
Collegiate female athletes’ body image and clothing behaviors
Authors: Nemeth Mary Claire , Park Huiju , Mendle Jane
Published: June 2020

This study investigated the body image experiences unique to collegiate female athletes in relation to their apparel wear. Female athletes (n = 36) participated in interview sessions, 3D body scanning, and photography of garment fit, and the Multidimensional Body-Self Relations Questionnaire (MBSRQ). Through Qualtrics, the MBSRQ was distributed to female college students nationwide, to obtain a larger participant pool (Lean sport athletes (n = 36), non-lean sport athletes (n = 42) and non-athletes (n = 101). Results indicated that both sports groups were most influenced by sport specific body ideals. Correlation of body image and athletic uniforms was more influenced by the fit of the uniform than by the categorization of the sport. Both lean and non-lean sport group participants expressed dissatisfaction in pant fit. 3D body scans revealed similar body proportions and shape between sports groups. MBSRQ results indicated no significant difference between sports groups but higher body image scores in comparison to non-athletes.
Coil-assisted retrograde transvenous obliteration (CARTO) for the treatment of gastric varices via a single access route using steerable microcatheter: a case report
Authors: Terada Kanako , Ogi Takahiro , Yoneda Norihide , Yokka Akira , Sugiura Takumi , Koda Wataru , Kobayashi Satoshi , Gabata Toshifumi
Published: June 2020

Background

Coil-assisted retrograde transvenous obliteration (CARTO) is a modified balloon-occluded retrograde transvenous obliteration (BRTO) technique using coils instead of an indwelling balloon. A method involving two microcatheter systems forming a double access route has been reported. We report a case of CARTO using a steerable microcatheter to successfully treat gastric varices (GV).

Case presentation

A 79-year-old man was admitted for treatment of intractable GV due to liver cirrhosis. The GV were drained mainly into the left inferior phrenic vein, not the usual gastrorenal shunt. Introducing the balloon catheter to the left inferior phrenic vein was difficult due to mild stenosis between the inferior vena cava and inferior phrenic vein and the shunt angle. A CARTO technique was performed with 5% ethanolamine oleate with iopamidol from a single access route by inverting the steerable microcatheter distal to the coil placement site.

Conclusion

CARTO has advantages in cases where performing BRTO is difficult. Using a steerable microcatheter simplifies the procedure by reducing the required access routes in CARTO.
Double aneuploidy 48,ХХХ,+21 of a Bulgarian newborn with Down phenotype: a case report
Authors: Tsvetkova Mariya , Levkova Mariya , Tsvetkova Snezhinka , Hachmeriyan Mari , Kovachev Emil , Angelova Lyudmila
Published: June 2020

Background

Aneuploidy is one of the most important chromosomal aberrations, which involves an abnormal number of the chromosomes. Trisomy 21 (Down syndrome) and numerical aberrations of the sex chromosomes have a relatively high prevalence in the general population. However, the patients usually have one of the above genetic disorders and combined cases of two different trisomies are unusual.

Case presentation

We report a case of a patient with double aneuploidy—a combination of trisomy 21 and triple X syndrome. The proband had typical features of Down syndrome and did not manifest any symptoms of polysomy X. The patient had hypotonia, a cardiac defect, and an annular pancreas. A clinical diagnosis of Down syndrome was established, but the cytogenetic analysis found two free full trisomies—trisomy 21 (Down syndrome) and triple X.

Conclusion

Cases of double aneuploidy, combining trisomy 21 and trisomy of a sex chromosome, could be challenging because the patients manifest only symptoms, typical for Down syndrome. The discovery of a second complete free trisomy X in our case was an incidental finding. This illustrates the importance of the cytogenetic analysis, despite the evident phenotype of trisomy 21.
A quasi-randomized clinical trial: virtual reality versus proprioceptive neuromuscular facilitation for postmastectomy lymphedema
Authors: Atef Doaa , Elkeblawy Mohmed Maher , El-Sebaie Ashraf , Abouelnaga Walid Ahmed Ibrahim
Published: June 2020

Background

Postmastectomy lymphedema can be considered the main cause of upper extremity functional impairment in patients with breast cancer. Fatigue, pain, and limited range of motion are common symptoms. If left untreated, lymphedema causes cellulitis, which can lead to gangrene in rare cases. This study was carried out to identify and compare the therapeutic advantages of virtual reality-based exercises and proprioceptive neuromuscular facilitation for postmastectomy lymphedema. Thus, a quasi-randomized comparative study of thirty female patients with unilateral postmastectomy lymphedema was conducted. Fifteen patients performed virtual reality-based exercises as well as manual lymphatic drainage, pneumatic compression, and home programs, while the other fifteen patients performed proprioceptive neuromuscular facilitation as well as manual lymphatic drainage, pneumatic compression, and home programs. The excess arm volume between the healthy and affected limbs was estimated before and after eight sessions of treatment for both groups. In addition, the affected limb functional score was calculated. Arm volume was calculated by the truncated cone formula and girth measurements obtained by the circumferential method. The Arabic version of the QuickDASH-9 scale was used to assess extremity function.

Results

The excess arm volume significantly decreased in both the virtual reality group (p = 0.001) and proprioceptive neuromuscular facilitation group (p = 0.005), and there was no significant difference between the two groups (p = 0.902). Age was inversely related to the improvement percentage of the QuickDASH-9 score in the virtual reality group. The functional improvement percentage was statistically significantly different between the two groups (p = 0.045).

Conclusion

It can be concluded that both virtual reality and proprioceptive neuromuscular facilitation have a beneficial therapeutic effect on edema in patients with unilateral postmastectomy lymphedema; neither method was found to be superior, except virtual reality was found to be superior to proprioceptive neuromuscular facilitation in motivating patients and providing visual feedback.

Trial registration

ClinicalTrials.gov, NCT04185181 Registered 4 December 2019 - Retrospectively registered.
Irradiation free conditioning regimen is associated with high relapse rate in Egyptian patients with acute lymphoblastic leukemia following allogeneic hematopoietic stem cell transplantation
Authors: Abdelaty Mona Mahrous , Gawaly Amr , Fathy Gamal M. , Kabbash Ibrahim , Taha Atef
Published: June 2020

Background

Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is a curative treatment for adult patients with acute lymphoblastic leukemia (ALL). Cyclophosphamide plus total body irradiation (TBI/Cy) or plus busulfan (Bu/Cy) is a widely used pre-transplant conditioning regimen for ALL. We retrospectively compared the overall survival (OS), disease-free survival (DFS), and other transplant outcomes of allo-HSCT in 119 adult patients with ALL who received an HLA-matched sibling allo-HSCT using TBI-based versus non-TBI-based conditioning regimens. Patients were divided into two groups by their conditioning regimen: TBI/Cy or Bu/Cy.

Results

Median OS was 11 months in the TBI/Cy group and 6.2 months in the Bu/Cy group. Median DFS was 11.1 months in the TBI group versus 6.8 months in the Bu group, without a statistically significant difference. A higher risk of relapse was observed with the Bu/Cy regimen (HR 2.709, CI 95% 1.106 to 6.638,p= 0.029). Patients who received a transplant in ≥ CR2 were associated with poor DFS.

Conclusion

Despite the high relapse rate in the non-TBI regimen (Bu/Cy), both regimens had no statistically significant differences in OS, DFS, and NRM. Additional prospective studies are indeed warranted to evaluate the long-term outcomes of radiation-free regimens, including oral and intravenous busulfan, and compare these regimens with TBI-based ones.
Applied 3D salt body reconstruction using shape optimization with level sets
Authors: Dahlke Taylor , Biondi Biondo , Clapp Robert
Published: June 2020

As oil and gas extraction becomes more advanced, deep-water exploration becomes increasingly focused on imaging near or under complex salt geology, which necessitates detailed velocity models with strong contrast interfaces. These interfaces can be elegantly tracked using the level sets of an implicit surface. One can invert for the velocity model that best fits the recorded data in a full-waveform inversion (FWI) style objective function by reparameterizing the model in terms of an implicit surface representation of the salt interface. With this parameterization of the FWI objective function, we find the Hessian and solve a conjugate gradient system for the Newton step at every nonlinear iteration. We sparsify the representation of the implicit surface using radial basis functions, which can hasten convergence of the inner inversion by reducing the number of model parameters. We have developed a guided inversion approach that embeds information about the certainty of different salt boundary regions by the initialization of the implicit surface slope at the salt interface. This can help guide the inversion away from perceived local minima. The results of testing this inversion workflow on a 3D Gulf of Mexico data set show that it can be a useful tool for refining salt models because the initial and final seismic images show clearer and more consistent features below the updated salt area.