bluuebunny/crossref_metadata_2025 huggingface dataset:
Diversity and distribution of avifauna at Warathenna-Hakkinda Environmental Protection Area in Kandy, Sri Lanka
Authors: Thilakarathne Dinelka , Lakkana Tithira , Hirimuthugoda Gayan , Wijesundara Chaminda , Kumburegama Shalika
Published: October 2021

The present study was carried out in the recently established Warathenna-Hakkinda EPA in the Kandy District, Sri Lanka to investigate the avifaunal diversity and conservation threats. Sampling was conducted in two main habitat types: river islands and riverine forests. Both point count (10 m radius) and line transect (200 m long) methods were utilized and maximum of 30 minutes was used to sample the birds in each point. Food habit, niche type, endemism, abundance, and diversity indices (Shannon & Margalef) were calculated to compare the two habitats in this area. A total of 74 bird species belonging to 61 genera and 35 families were encountered from the study site. Among these, seven species are endemic: Sri Lanka Grey Hornbill, Sri Lanka Green Pigeon, Sri Lanka Wood Pigeon, Sri Lanka Hanging Parrot, Crimson-fronted Barbet, Yellow-fronted Barbet, and Sri Lanka Hill Mynah; while six were migratory: Green Sandpiper, Common Sandpiper, Indian Pitta, Asian Brown Flycatcher, Yellow Wagtail, and Grey Wagtail and the rest were non-endemic natives. Most of them were canopy and sub canopy dwellers associated with riverine forests and islands. According to the National Red List of Sri Lanka, three species, the Sri Lanka Wood Pigeon, Sri Lanka Hill Mynah, and Alpine Swift, are listed as threatened. Ardeidae, Alcedinidae, Columbidae, Accipitridae, and Apodidae were the most species rich families in this habitat. Out of the sampled species, 31% and 25% of the birds were carnivores and insectivores, respectively, while 5% were nectarivores. According to the avifauna, the riverine forests are more diverse (Shannon index H’= 2.55; Margalef’s index M= 10.92) than the river islands (H’= 2.29; M= 5.07) in this landscape. The variety of habitats along the Mahaweli River at Warathenna appears to aid in sustaining a rich bird community and this Environmental Protection Area will help create a safe haven for the birds.
Are the uplifted reef beds in North Andaman letting nesting Olive Ridley Sea Turtle Lepidochelys olivacea stranded?
Authors: Prabakaran Nehru , Vedagiri Thirumurugan  , Raj Singh Anoop
Published: October 2021

During our survey to understand vegetation colonization, focused on mangroves, in the uplifted reef beds near the Radhanagar creek in North Andaman on 10 February 2021 (Lat: 13°24'40.70"N; Lon: 92°50'57.73"E), we came across four carcasses of Olive Ridley turtles within a 500 m transect. The carcasses were probably a week old and are characterized by the presence of degenerating flesh, and foul smell. The article describes the potential reasons behind turtle mortality and future research needs for the holistic understanding of such incidences.
African Witchcraft and Religion among the Yoruba: Translation as Demarcation Practice within a Global Religious History
Authors: Bachmann Judith
Published: October 2021

For years, self-identified witches have demanded the public acknowledgement of witchcraft as “religion” in Nigeria. These political debates are reflected in a long-ongoing scholarly discussion about whether “witchcraft” in Africa should be regarded as religion or not. At its core, this discussion concerns the quest for African meanings. I argue that we should focus on the translingual practice as the reason for today’s perception of “African” and “European” differences as incommensurable. Tracing back today’s understanding of witchcraft among the Yoruba (àjé), the Alatinga anti-witchcraft movement of the early 1950s becomes the nodal point of Yoruba witchcraft history. Discussing the Alatinga as translingual practice, I understand Yoruba witchcraft concepts as products of a global religious history. Only in the aftermath of the Alatinga, a hybrid movement, did the need arise to demarcate “African” and “European” meanings. Thus, Yoruba translingual practice has also affected European understandings of religion and witchcraft today.
Clinician and carer moral concerns when caring for children who tube-feed
Authors: Dadich Ann , Hockey Kaitlyn , Kaplun Cathy , Fleming Catharine , Hopwood Nick , Moraby Khadeejah , Elliot Chris
Published: October 2021

Child healthcare can be vexed by moral concerns – this extends to the care of children who tube-feed. Children who tube-feed often receive care from family members and clinicians of various disciplines. Each brings expertise, experiences, values, and views to a situation, prioritising the child’s needs while attending to those they deem important in potentially disparate ways. Their understanding of a situation is shaped by beliefs, feelings, and perceptions. How then are key decisions made about the care of a child who tube-feeds? This article explores clinicians’ and carers’ moral concerns when caring for children who tube-feed. Interviews with clinicians ( n = 9) and carers ( n = 9) clarified three findings: first, there are often disparate beliefs about the need for tube-feeding; second, tube-feeding can evoke strong emotions; and third, it can be difficult to normalise tube-feeding. This article demonstrates how challenges can emerge when relationships between clinicians and carers diverge. Furthermore, it establishes how an ethic of care can bring different interests together to bolster the relationships required to optimise feeding care and promote health outcomes among children who tube-feed and their carers. This requires improved dialogue between and among clinicians and carers to create shared understandings of what is, what should be, and how to benefit children who tube-feed.
Non-use of telemedicine: A scoping review
Authors: Reinhardt Gesine , Schwarz Peter EH , Harst Lorenz
Published: October 2021

Many telemedicine interventions fail to be implemented in medical care with non-use and discontinued use by patients being among the major reasons. The aim of this scoping review was to provide an overview of barriers associated with non-use and discontinued use of telemedicine. An electronic search was conducted in Pubmed in October 2019 and updated in November 2020, followed by a hand search in the beginning of 2021. All potential articles were screened by two independent reviewers based on predefined inclusion and exclusion criteria. A qualitative content analysis according to Mayring was carried out. The topics ‘intervention’, ‘context of use’ and ‘user’ were chosen as overarching themes. Out of 1377 potentially relevant articles, 73 were included. User-related barriers were mentioned in most of the analysed studies, followed by barriers related to the intervention. The analysis provides the basis for overcoming non-use issues in telemedicine.
Outcomes of Primary Rhegmatogenous Retinal Detachment Repair in Eyes With Preoperative Grade B or C Proliferative Vitreoretinopathy
Authors: Peck Travis J. , Starr Matthew R. , Yonekawa Yoshihiro , Khan M. Ali , Obeid Anthony , Ryan Edwin H. , Ryan Claire , Ammar Michael , Patel Luv G. , Forbes Nora J. , Capone Antonio , Emerson Geoffrey G. , Joseph Daniel P. , Eliott Dean , Regillo Carl D. , Hsu Jason , Gupta Omesh P. , Kuriyan Ajay E. ,   for the Primary Retinal Detachment Outcomes (PRO) Study Group
Published: October 2021

Purpose:

This work evaluates the anatomic and functional outcomes of primary rhegmatogenous retinal detachments (RRDs) with preoperative grade B and C proliferative vitreoretinopathy (PVR) vs eyes without PVR.

Methods:

As a multi-institutional, interventional, retrospective study of all patients undergoing primary RRD surgical procedures from January 1, 2015, through December 31, 2015, this study evaluated the visual acuity (VA) outcomes and single-surgery anatomic success rates (SSAS) of patients with primary grade B and C PVR at the time of RRD repair.

Results:

A total of 2486 eyes underwent primary RD surgery during the study period, of which 153 eyes (6.2%) had documented preoperative PVR grade B or C. Eyes without PVR had better SSAS compared with eyes with grade B or C PVR (87% vs 83% vs 75%, respectively, P < .0001). Eyes without PVR also had better final mean (SD) logMAR VA (0.35 [0.47]; 20/45 Snellen equivalent) than eyes with PVR of grade B (0.50 [0.56]; 20/63 Snellen equivalent) or grade C ( P < .0001). In only eyes with preoperative PVR, there were no significant differences in final VA or SSAS on multivariate analysis based on surgical approach or use of retinectomy or membrane peeling alone in the intraoperative management of PVR.

Conclusions:

Eyes with primary preoperative grade B and C PVR appear to have significantly worse VA outcomes and lower surgical success rates. Surgical approach and management of PVR membranes did not appear to affect VA or success rates, indicating that preoperative PVR severity may dictate these outcomes.
Heightened turnover and failed maturation of monocyte-derived macrophages in murine chronic granulomatous disease
Authors: Gibbings Sophie L. , Haist Kelsey C. , Nick Heidi , Frasch S. Courtney , Glass Teagan H. , Vestal Brian , Danhorn Thomas , Mould Kara J. , Henson Peter M. , Bratton Donna L.
Published: October 2021

Loss of NADPH oxidase activity leads to altered phagocyte responses and exaggerated inflammation in chronic granulomatous disease (CGD). We sought to assess the effects of Nox2 absence on monocyte-derived macrophages (MoMacs) in gp91phox-/y mice during zymosan-induced peritonitis. MoMacs from CGD and wild-type (WT) peritonea were characterized over time after zymosan injection. Although numbers lavaged from both genotypes were virtually identical, there were marked differences in maturation: newly recruited WT MoMacs rapidly enlarged and matured, losing Ly6C and gaining MHCII, CD206, and CD36, whereas CGD MoMacs remained small and were mostly Ly6C+MHCII–. RNA-sequencing analyses showed few intrinsic differences between genotypes in newly recruited MoMacs but significant differences with time. WT MoMacs displayed changes in metabolism, adhesion, and reparative functions, whereas CGD MoMacs remained inflammatory. PKH dye labeling revealed that although WT MoMacs were mostly recruited within the first 24 hours and remained in the peritoneum while maturing and enlarging, CGD monocytes streamed into the peritoneum for days, with many migrating to the diaphragm where they were found in fibrin(ogen) clots surrounding clusters of neutrophils in nascent pyogranulomata. Importantly, these observations seemed to be driven by milieu: adoptive transfer of CGD MoMacs into inflamed peritonea of WT mice resulted in immunophenotypic maturation and normal behavior, whereas altered maturation/behavior of WT MoMacs resulted from transfer into inflamed peritonea of CGD mice. In addition, Nox2-deficient MoMacs behaved similarly to their Nox2-sufficient counterparts within the largely WT milieu of mixed bone marrow chimeras. These data show persistent recruitment with fundamental failure of MoMac maturation in CGD.
Asxl1 loss cooperates with oncogenic Nras in mice to reprogram the immune microenvironment and drive leukemic transformation
Authors: You Xiaona , Liu Fabao , Binder Moritz , Vedder Alexis , Lasho Terra , Wen Zhi , Gao Xin , Flietner Evan , Rajagopalan Adhithi , Zhou Yun , Finke Christy , Mangaonkar Abhishek , Liao Ruiqi , Kong Guangyao , Ranheim Erik A. , Droin Nathalie , Hunter Anthony M. , Nikolaev Sergey , Balasis Maria , Abdel-Wahab Omar , Levine Ross L. , Will Britta , Nadiminti Kalyan Vara Ganesh , Yang David , Geissler Klaus , Solary Eric , Xu Wei , Padron Eric , Patnaik Mrinal M. , Zhang Jing
Published: October 2021

Mutations in chromatin regulator ASXL1 are frequently identified in myeloid malignancies, in particular ∼40% of patients with chronic myelomonocytic leukemia (CMML). ASXL1 mutations are associated with poor prognosis in CMML and significantly co-occur with NRAS mutations. Here, we show that concurrent ASXL1 and NRAS mutations defined a population of CMML patients who had shorter leukemia-free survival than those with ASXL1 mutation only. Corroborating this human data, Asxl1−/− accelerated CMML progression and promoted CMML transformation to acute myeloid leukemia (AML) in NrasG12D/+ mice. NrasG12D/+;Asxl1−/− (NA) leukemia cells displayed hyperactivation of MEK/ERK signaling, increased global levels of H3K27ac, upregulation of Flt3. Moreover, we find that NA-AML cells overexpressed all the major inhibitory immune checkpoint ligands: programmed death-ligand 1 (PD-L1)/PD-L2, CD155, and CD80/CD86. Among them, overexpression of PD-L1 and CD86 correlated with upregulation of AP-1 transcription factors (TFs) in NA-AML cells. An AP-1 inhibitor or short hairpin RNAs against AP-1 TF Jun decreased PD-L1 and CD86 expression in NA-AML cells. Once NA-AML cells were transplanted into syngeneic recipients, NA-derived T cells were not detectable. Host-derived wild-type T cells overexpressed programmed cell death protein 1 (PD-1) and T-cell immunoreceptor with immunoglobulin and ITIM domains (TIGIT) receptors, leading to a predominant exhausted T-cell phenotype. Combined inhibition of MEK and BET resulted in downregulation of Flt3 and AP-1 expression, partial restoration of the immune microenvironment, enhancement of CD8 T-cell cytotoxicity, and prolonged survival in NA-AML mice. Our study suggests that combined targeted therapy and immunotherapy may be beneficial for treating secondary AML with concurrent ASXL1 and NRAS mutations.
Why is AAV FVIII gene therapy not approved by the US Food and Drug Administration yet?
Authors: Arruda Valder R.
Published: October 2021

The prospect of a clinical strategy using an adeno-associated virus (AAV) vector for expression of therapeutic levels of factor VIII (FVIII) has been highly desirable. This was initially anticipated by promising data from clinical studies on AAV5-FVIII in men with severe hemophilia A. However, long-term follow-up showed a unique efficacy concern on the sustainability and durability derived from a continuous decline in the FVIII transgene levels starting 1 year after vector injection through year 5. Additional follow-up of early-phase studies and outcomes of an ongoing phase 3 study will likely provide evidence on the feasibility of this approach. Here, the potential underlying mechanisms of the FVIII declining levels, together with the revision of several unique early and late onset findings, are discussed. The lack of long-term preclinical studies in large animal models prevents the firm conclusion that FVIII levels decline was unexpected. It is possible that the combination of vector manufacturing platform and dose, accompanied with ectopic expression of supraphysiologic levels of FVIII at short-term follow-up, may all contribute to the sustainability and durability of the transgene levels. Notably, vector readministration to further improve the FVIII levels is not feasible at this time. Thus, the need of a one-and-done AAV strategy to achieve sustain FVIII levels of expression is sine qua non to impact favorably the disease phenotype.
Primary graft failure, but not relapse, may be identified by early chimerism following double cord blood unit transplantation
Authors: Hough Rachael , Lopes Andre , Patrick Pip , Russell Nigel , Raj Kavita , Tholouli Eleni , A. Snowden John , Collin Matthew , El-Mehidi Nadjet , Lawrie Anthony , Clifton-Hadley Laura , Veys Paul , Craddock Charles , Mackinnon Stephen , Cook Gordon , Shaw Bronwen , Marks David
Published: October 2021

Umbilical cord blood transplantation (UCBT) has increased access to potentially curative therapy for patients with life-threatening disorders of the bone marrow and immune system. The introduction of reduced intensity conditioning (RIC) regimens and double umbilical cord unit infusions (DUCBT) has broadened the applicability of UCBT to more frail or larger recipients. The kinetics of chimerism after RIC DUCBT and their clinical utility are poorly understood. The RIC CBT trial reported here sought to prospectively evaluate the role of lineage-specific chimerism after DUCBT in adult patients with hematologic malignancies in the United Kingdom. Fifty-eight patients with a median age of 52 years were recruited, with overall and progression-free survivals of 59% (95% confidence interval [CI], 45%-71%) and 52% (95% CI, 39%-64%), respectively, at 2 years. Nonrelapse mortality was 4% (95% CI, 1%-13%) at day 100, and the relapse rate was 31% (95% CI, 21%-45%) at 1 year. Peripheral blood lineage-specific chimerism was feasible from day 7 after transplant onward. Five patterns of chimerism were observed including (1) complete single unit dominance (39 patients), (2) sustained donor-donor mixed chimerism (3 patients), (3) sustained donor-recipient mixed chimerism (5 patients), (4) dominance reversion (1 patient), and (5) primary graft failure (4 patients). The RIC CBT trial enabled adult patients with high-risk hematologic malignancies to safely access UCBT in the United Kingdom and provided novel insights into the kinetics of donor and recipient chimerism after RIC DUCBT that are clinically relevant. This trial was registered at https://www.clinicaltrialsregister.eu/ctr-search/trial/2004-003845-41/GB as #NCT00959231 and EudraCT 2004-003845-41.
Genome-wide analysis of Claviceps paspali: insights into the secretome of the main species causing ergot disease in Paspalum spp
Authors: Oberti H. , Spangenberg G. , Cogan N. , Reyno R. , Feijoo M. , Murchio S. , Dalla-Rizza M.
Published: October 2021

Background

The phytopatogen Claviceps paspali is the causal agent of Ergot disease in Paspalum spp., which includes highly productive forage grasses such as P. dilatatum. This disease impacts dairy and beef production by affecting seed quality and producing mycotoxins that can affect performance in feeding animals. The molecular basis of pathogenicity of C. paspali remains unknown, which makes it more difficult to find solutions for this problem. Secreted proteins are related to fungi virulence and can manipulate plant immunity acting on different subcellular localizations. Therefore, identifying and characterizing secreted proteins in phytopathogenic fungi will provide a better understanding of how they overcome host defense and cause disease. The aim of this work is to analyze the whole genome sequences of three C. paspali isolates to obtain a comparative genome characterization based on possible secreted proteins and pathogenicity factors present in their genome. In planta RNA-seq analysis at an early stage of the interaction of C. paspali with P. dilatatum stigmas was also conducted in order to determine possible secreted proteins expressed in the infection process.

Results

C. paspali isolates had compact genomes and secretome which accounted for 4.6–4.9% of the predicted proteomes. More than 50% of the predicted secretome had no homology to known proteins. RNA-Seq revealed that three protein-coding genes predicted as secreted have mayor expression changes during 1 dpi vs 4 dpi. Also, three of the first 10 highly expressed genes in both time points were predicted as effector-like. CAZyme-like proteins were found in the predicted secretome and the most abundant family could be associated to pectine degradation. Based on this, pectine could be a main component affected by the cell wall degrading enzymes of C. paspali.

Conclusions

Based on predictions from DNA sequence and RNA-seq, unique probable secreted proteins and probable pathogenicity factors were identified in C. paspali isolates. This information opens new avenues in the study of the biology of this fungus and how it modulates the interaction with its host. Knowledge of the diversity of the secretome and putative pathogenicity genes should facilitate future research in disease management of Claviceps spp.
Comparative genomics reveals molecular mechanisms underlying health and reproduction in cryptorchid mammals
Authors: Chai Simin , Huang Xin , Wu Tianzhen , Xu Shixia , Ren Wenhua , Yang Guang
Published: October 2021

Background

Mammals have wide variations in testicular position, with scrotal testes in some species and ascrotal testes in others. Although cryptorchidism is hazardous to human health, some mammalian taxa are natural cryptorchids. However, the evolution of testicular position and the molecular mechanisms underlying the maintenance of health, including reproductive health, in ascrotal mammals are not clear.

Results

In the present study, comparative genomics and evolutionary analyses revealed that genes associated with the extracellular matrix and muscle, contributing to the development of the gubernaculum, were involved in the evolution of testicular position in mammals. Moreover, genes related to testicular position were significantly associated with spermatogenesis and sperm fertility. These genes showed rapid evolution and the signature of positive selection, with specific substitutions in ascrotal mammals. Genes associated with testicular position were significantly enriched in functions and pathways related to cancer, DNA repair, DNA replication, and autophagy.

Conclusions

Our results revealed that alterations in gubernaculum development contributed to the evolution of testicular position in mammals and provided the first support for two hypotheses for variation in testicular position in mammals, the “cooling hypothesis”, which proposes that the scrotum provides a cool environment for acutely heat-sensitive sperm and the “training hypothesis”, which proposes that the scrotum develops the sperm by exposing them to an exterior environment. Further, we identified cancer resistance and DNA repair as potential protective mechanisms in natural cryptorchids. These findings provide general insights into cryptorchidism and have implications for health and infertility both in humans and domestic mammals.
A rare variation of duplicated portal vein: left branch derived from splenic vein mimicking cavernous transformation
Authors: Yang Qian , Li Jun , Wang Hanwei , Wang Shunan
Published: October 2021

Background

Duplication of the portal vein is a rare type of anatomic variant of the portal vein (PV) system that can be incidentally found and can lead to various challenges and consequences. Herein, we report an unusual case to increase our understanding of such anatomic variants.

Case presentation

A 67-year-old asymptomatic woman was diagnosed with a liver space-occupying lesion by ultrasonography on a routine physical examination. The laboratory examinations from a local hospital suggested that her liver function tests were normal. The liver appeared normal on pre-contrast enhanced CT images. However, there were multiple complex abnormalities of PV found on contrast-enhanced CT scans, including two independent sources of PV (duplication), preduodenal PV, circum-portal pancreas, mimic cavernous transformation, abnormal branches of PV, and transient abnormal perfusion in the left lobe of the liver. MRI showed fatty infiltration in the left lobe of the liver.

Conclusion

This case extends our current understanding of the anatomical variations of the PV system. Knowledge of these complex and rare anatomical variations will help clinical doctors make a confident diagnosis or assist with proper planning of a surgical procedure.
Sexual violence in older adults: a Belgian prevalence study
Authors: Nobels Anne , Cismaru-Inescu Adina , Nisen Laurent , Hahaut Bastien , Beaulieu Marie , Lemmens Gilbert , Adam Stéphane , Schapansky Evelyn , Vandeviver Christophe , Keygnaert Ines
Published: October 2021

Background

Sexual violence (SV) is an important public health problem which may cause long-lasting health problems. SV in older adults remains neglected in research, policies and practices. Valid SV prevalence estimates and associated risk factors in older adults are currently unavailable. In this study we measured lifetime and past 12-months sexual victimisation in older adults living in Belgium, its correlates, assailant characteristics and the way that victims framed their SV experiences.

Methods

SV was measured using behaviourally specific questions based on a broad definition of SV. Participants were selected via a cluster random probability sampling with a random route finding approach. Information on sexual victimisation, correlates, assailant characteristics and framing was collected via structured face-to-face interviews with adults aged 70 years and older living in Belgium (community-dwelling, assisted living and nursing homes).

Results

Among the 513 participants, the lifetime SV prevalence was 44% (55% F, 29% M). Past 12-months prevalence was 8% (9% F, 8% M). Female sex and a higher number of sexual partners were associated with lifetime SV (p < .05), non-heterosexual sexual orientation with past 12-months SV (p < .05). Correlates identified to be linked to elder abuse and neglect in previous studies were not linked with SV in our sample. ‘Someone unknown’ was identified as most common assailant.

Conclusions

Sexual victimisation appears to be common in older adults in Belgium. Both correlates and assailant characteristics seem to differ from previous studies on elder abuse and neglect. Recognizing older adults as a risk group for sexual victimisation in research, policies and practices is of the utmost importance.
Personalized multicomponent exercise programs using smartphone technology among older people: protocol for a randomized controlled trial
Authors: Netz Yael , Argov Esther , Yekutieli Ziv , Ayalon Moshe , Tchelet Keren , Ben-Sira David , Amar Yihya , Jacobs Jeremy M.
Published: October 2021

Background

Optimal application of the recently updated World Health Organization (WHO) guidelines for exercise in advanced age necessitates an accurate adjustment for the age-related increasing variability in biological age and fitness levels, alongside detailed recommendations across a range of motor fitness components, including balance, strength, and flexibility. We previously developed and validated a novel tool, designed to both remotely assess these fitness components, and subsequently deliver a personalized exercise program via smartphone. We describe the design of a prospective randomized control trial, comparing the effectiveness of the remotely delivered personalized multicomponent exercise program to either WHO exercise guidelines or no intervention.

Methods

Participants (n = 300) are community dwelling, healthy, functionally independent, cognitively intact volunteers aged ≥65 at low risk for serious fall injuries, assigned using permuted block randomization (age/gender) to intervention, active-control, or control group. The intervention is an 8-week program including individually tailored exercises for upper/lower body, flexibility, strength, and balance (dynamic, static, vestibular); active-controls receive exercising counselling according to WHO guidelines; controls receive no guidance. Primary outcome is participant fitness level, operationalized as 42 digital markers generated from 10 motor fitness measures (balance, strength, flexibility); measured at baseline, mid-trial (4-weeks), trial-end (8-weeks), and follow-up (12-weeks). Target sample size is 300 participants to provide 99% power for moderate and high effect sizes (Cohen’s f = 0.25, 0.40 respectively).

Discussion

The study will help understand the value of individualized motor fitness assessment used to generate personalized multicomponent exercise programs, delivered remotely among older adults.

Trial registration

ClinicalTrials.govIdentifier:NCT04181983
Re-evaluation of high-risk breast mammography lesions by target ultrasound and ABUS of breast non-mass-like lesions
Authors: Zhang Jianxing , Cai Lishang , Chen Ling , Pang Xiyan , Chen Miao , Yan Dan , Liu Jia , Luo Liangping
Published: October 2021

Objective

The purpose of this study was to reevaluate the high-risk breast non-mass-like lesions (NMLs) in mammography (MG) by target ultrasound (US) and Automated breast ultrasonography (ABUS), and to analyze the correlation between different imaging findings and the factors influencing the classification of lesions.

Methods

A total of 161 patients with 166 breast lesions were recruited in this retrospectively study. All cases were diagnosed as BI-RADS 4 or 5 by MG and as NML on ultrasound. While all NMLs underwent mammography, target US and ABUS before breast surgery or biopsy in the consistent position of breast. The imaging and pathological features of all cases were collected. All lesions were classified according to the lexion of ACR BI-RADS®.

Results

There were significant differences between benign and malignant breast NML in all the features of target US and ABUS. US, especially ABUS, was superior to MG in determining the malignant breast NML. There was a significant difference in the detection rate of calcification between MG and Target US (P < 0.001), and there was a significant difference in the detection rate of structural distortion between ABUS and MG (P < 0.001).

Conclusions

Target US, especially ABUS, can significantly improve the sensitivity, specificity and accuracy of the diagnosis of high-risk NMLs in MG. The features of Target US and ABUS such as blood supply, hyperechogenicity, ductal changes, peripheral changes and coronal features could be employed to predict benign and malignant lesions. The coronal features of ABUS were more sensitive than those of Target HHUS in showing structural abnormalities. Target US was less effective than MG in local micro-calcification.
Elevated nitric oxide and carbon monoxide concentration in nasal-paranasal sinus air as a diagnostic tool of migraine: a case – control study
Authors: Bandara S. M. R. , Samita S. , Kiridana A. M. , Herath H. M. M. T. B.
Published: October 2021

Background

A recent study showed that 60–s paranasal air suction results in an immediate pain relief in acute migraine. This is the study to assess the Nitric Oxide (NO) and Carbon Monoxide (CO) concentration in nasal-paranasal sinus air of migraine patients and to compare it with healthy controls.

Methodology

The NO and CO levels of air sucked out from nasal-paranasal sinuses of 20 migraine adolescent and young adults among school students, aged 16 –19 years, and 22 healthy similar aged school students as controls were measured as key responses using a portable NO and a portable CO analyzer.

Results

Patients had comparatively high values compared to the controls for paranasal NO (both left and right sides), paranasal CO (both left and right sides), Fraction Exhaled NO (FeNO) and Fraction Exhaled CO (FeCO). Patients had median paranasal NO contents of 132.5 ppb and 154 ppb on left and right sides respectively compared to 36 ppb and 34.5 ppb corresponding values in controls (P <  0.0001). Similar pattern was observed with paranasal CO (P <  0.0001). FeNO and FeCO content were also higher in patients (P <  0.0001). Receiver characteristic operating curves of all gas measurements showed that they all could classify patients and controls effectively and NO was the most effective followed by paranasal CO. After air suction, the mean pain scores of general headache and tenderness dropped by a very large margin in migraine patients (P <  0.0001).

Conclusions

Suctioned out high nasal-paranasal sinus NO and CO levels can be used to distinguish migraine patients from healthy subjects. In fact, suctioned out paranasal NO measurements of both sides with a cutoff point of 50 ppb provided a perfect classification of patients and controls. Increased sinus NO and CO during acute episode of migraine is an observation we had and we agree that further studies are needed to conclude that NO and CO can be a causative molecule for migraine headache.

Trail registration

Clinical Trial Government Identification Number – 1548/2016.

Ethical Clearance Granted Institute – Medical Research Institute, Colombo, Sri Lanka (No 38/2016).

Sri Lanka Clinical Trial Registration number: SLCTR/ 2017/018 (29/06/2017).

Approval Granting Organization to use the device in the clinical trial– National Medicines Regulatory Authority Sri Lanka (16/06/2018), The device won award at Geneva international inventers exhibition in 2016 and President award in 2018 in Sri Lanka. It is a patented device in Sri Lanka and patent number was SLKP/1/18295.

All methods were carried out in accordance with CONSORT 2010 guidelines.
Perampanel as first add-on antiseizure medication: Italian consensus clinical practice statements
Authors: Bonanni Paolo , Gambardella Antonio , Tinuper Paolo , Acone Benedetto , Perucca Emilio , Coppola Giangennaro
Published: October 2021

Background

When use of a single antiseizure medication (ASM) fails to induce seizure remission, add-on therapy is justified. Perampanel (PER) is approved in Europe as adjunctive therapy for focal, focal to bilateral tonic-clonic seizures and generalized tonic-clonic seizures. Aim of the study was to establish whether PER is suitable for first add-on use.

Methods

A Delphi methodology was adopted to assess consensus on a list of 39 statements produced by an Expert Board of 5 epileptologists. Using an iterative process, statements were finalized by a Delphi Panel of 84 Italian pediatric and adult neurologists. Each statement was rated anonymously to determine level of agreement on a 9-point Likert scale. Consensus was established as agreement by at least 80% of the panelists. The relevance of each statement was also assessed on a 3-point scale.

Results

Consensus was achieved for 37 statements. Characteristics of PER considered to justify its use as first add-on include evidence of a positive impact on quality of life based on long term retention data, efficacy, tolerability, and ease of use; no worsening of cognitive functions and sleep quality; a low potential for drug interactions; a unique mechanism of action. Potential unfavorable factors are the need for a relatively slow dose titration; the potential occurrence of behavioral adverse effects; lack of information on safety when used in pregnancy; limited access to plasma PER levels.

Conclusion

Perampanel has many features which justify its use as a first add-on. Choice of an ASM as first add-on should be tailored to individual characteristics.
Pre-conception and prenatal factors influencing gestational weight gain: a prospective study in Tigray region, northern Ethiopia
Authors: Misgina Kebede Haile , van der Beek Eline M. , Boezen H. Marike , Bezabih Afework Mulugeta , Groen Henk
Published: October 2021

Background

In low-income countries, the high prevalence of pre-pregnancy undernutrition remains a challenge for the future health of women and their offspring. On top of good nutrition, adequate gestational weight gain has been recognized as an essential prerequisite for optimal maternal and child health outcomes. However, good-quality data on factors influencing gestational weight gain is lacking. Therefore, this study was aimed to prospectively identify pre-conception and prenatal factors influencing gestational weight gain in Ethiopia.

Methods

A population based prospective study was undertaken between February 2018 and January 2019 in the Tigray region, northern Ethiopia. Firstly, the weight of non-pregnant women of reproductive age living in the study area was measured between August and October 2017. Subsequently, eligible pregnant women identified during the study period were included consecutively and followed until birth. Data were collected through an interviewer-administered questionnaire and anthropometric measurements complemented with secondary data. Gestational weight gain, i.e., the difference between 32 to 36 weeks of gestation and pre-pregnancy weights, was classified as per the Institute of Medicine (IOM) guideline. Linear, spline, and logistic regression models were used to estimate the influence of pre-conception and prenatal factors on gestational weight gain.

Results

The mean gestational weight gain (standard deviation[SD]) was 10.6 (2.3) kg. Overall, 64.0% (95% CI 60.9, 67.1) of the women did not achieve adequate weight gain. Factors associated with higher gestational weight gain were higher women empowerment (B 0.60, 95% CI 0.06, 1.14), dietary diversity (B 0.39, 95% CI 0.03, 0.76), pre-pregnancy body mass index (B 0.13, 95% CI 0.05, 0.22), and haemoglobin (B 0.54, 95% CI 0.45, 0.64). Additionally, adequate prenatal care (B 0.58, 95% CI 0.28, 0.88) was associated with higher gestational weight gain.

Conclusions

Adequate gestational weight gain was not achieved by most women in the study area, primarily not by those who were underweight before pregnancy. Interventions that advance women’s empowerment, dietary quality, pre-pregnancy nutritional status, and prenatal care utilization may improve gestational weight gain and contribute to optimizing maternal and child health outcomes.
Successful pregnancy and term delivery after treatment of unicornuate uterus with non-communicating rudimentary horn pregnancy with local methotrexate injection followed by laparoscopic resection: a case report and literature review
Authors: Ueda Makiko , Ota Kuniaki , Takahashi Toshifumi , Suzuki Satoshi , Suzuki Daisuke , Kyozuka Hyo , Jimbo Masatoshi , Soeda Shu , Watanabe Takafumi , Fujimori Keiya
Published: October 2021

Background

Pregnancy in a rudimentary horn is an extremely rare type of ectopic pregnancy. A rudimentary uterine horn pregnancy is associated with a risk of spontaneous rupture and bleeding during surgery due to the increased uterine blood flow. Recent advances in imaging modalities have enabled laparoscopic surgery to be performed in cases without rupture in the early stages of pregnancy. However, there are few reports of successful pregnancies and deliveries after treatment of rudimentary horn pregnancies. We report the successful management of a case of non-communicating rudimentary horn pregnancy by local injection of methotrexate followed by complete laparoscopic excision along with a review of the literature.

Case presentation

The patient was a 29-year-old Japanese woman, gravida 2, nullipara. She was diagnosed with a left unicornuate uterus with a right non-communicating rudimentary horn on hysterosalpingography and magnetic resonance imaging. A gestational sac with a heartbeat was observed in the right rudimentary uterine horn at 6 weeks of gestation. A diagnosis of ectopic pregnancy in a non-communicating rudimentary horn was made. Color Doppler detected multiple blood flow signals around the gestational sac, which were clearly increased compared to the left unicornuate uterus. Her serum human chorionic gonadotropin level was 104,619 mIU/ml. A 100 mg methotrexate injection into the gestational sac was administered, and laparoscopic surgery was performed on day 48 after the methotrexate treatment. The right rudimentary horn and fallopian tube were successfully excised with minimal bleeding. A spontaneous normal pregnancy was established 6 months after the surgery. The pregnancy was uneventful, and a baby girl was born by elective cesarean section at 38w0d.

Conclusion

Combined local methotrexate injection and laparoscopic surgery are safe treatment options for patients with a unicornuate uterus with a non-communicating rudimentary horn pregnancy.
Utility of droplet digital polymerase chain reaction for TERT and BRAF mutational profiling of thyroid nodules
Authors: Rosvall Brandon R. , Kostiuk Morris , Williams Jordana , Matkin Ashlee , Harris Jeffrey , Seikaly Hadi , O’Connell Daniel A. , Biron Vincent L.
Published: October 2021

Background

Mutations involving BRAF and TERT are important predictors of disease severity in thyroid cancer, but molecular testing is limited by cost and lack of adequate tissue sample. This study aimed to assess the utility of BRAFV600E and TERT testing using droplet digital PCR (ddPCR) as a diagnostic and prognostic tool for thyroid fine needle aspirate biopsy (FNAB).

Methods

Patients with thyroid nodules were prospectively enrolled from March 2015 to September 2018. Pre-operative FNAB was collected for standard cytology and molecular testing. BRAFV600E and TERT levels were analyzed by ddPCR. Cytology (Bethesda system) and ddPCR results were correlated to surgical pathology.

Results

A total of 222 patients were enrolled, of which 124 received thyroid surgery. Pre-operative cytology alone with Bethesda ≥5 was 100% specific and 70% sensitive for malignancy on final surgical pathology. BRAFV600E positivity or TERT overexpression was 100% specific and 60.0% sensitive. Combining cytology (Bethesda ≥5) with BRAFV600E and TERT testing increased the sensitivity of a malignant diagnosis to 80.0%. High TERT levels and/or BRAFV600E was associated with aggressive or advanced stage pathology.

Conclusions

Combining cytology with ddPCR analysis of BRAFV600E and TERT can improve the diagnostic accuracy of thyroid FNAB, and help predict aggressive pathology.
Conspicuity of malignant pleural mesothelioma in contrast enhanced MDCT – arterial phase or late phase?
Authors: Luerken Lukas , Thurn Philipp Laurin , Zeman Florian , Stroszczynski Christian , Hamer Okka Wilkea
Published: October 2021

Background

To determine if late phase is superior to arterial phase intraindividually regarding conspicuity of MPM in contrast enhanced chest MDCT.

Methods

28 patients with MPM were included in this retrospective study. For all patients, chest CT in standard arterial phase (scan delay ca. 35 s) and abdominal CT in portal venous phase (scan delay ca. 70 s) was performed. First, subjective analysis of tumor conspicuity was done independently by two radiologists. Second, objective analysis was done by measuring Hounsfield units (HU) in tumor lesions and in the surrounding tissue in identical locations in both phases. Differences of absolute HUs in tumor lesions between phases and differences of contrast (HU in lesion – HU in surrounding tissue) between phases were determined. HU measurements were compared using paired t-test for related samples. Potential confounding effects by different technical and epidemiological parameters between phases were evaluated performing a multiple regression analysis.

Results

Subjective analysis: In all 28 patients and for both readers conspicuity of MPM was better on late phase compared to arterial phase. Objective analysis: MPM showed a significantly higher absolute HU in late phase (75.4 vs 56.7 HU, p < 0.001). Contrast to surrounding tissue was also significantly higher in late phase (difference of contrast between phases 18.5 HU, SD 10.6 HU, p < 0.001). Multiple regression analysis revealed contrast phase and tube voltage to be the only significant independent predictors for tumor contrast.

Conclusions

In contrast enhanced chest-MDCT for MPM late phase scanning seems to provide better conspicuity and higher contrast to surrounding tissue compared to standard arterial phase scans.
Response to: “letter to the editor regarding the article “the global distribution of acute unintentional pesticide poisoning: estimations based on a systematic review”” by Dunn et al. 2021 in BMC public health
Authors: Boedeker Wolfgang , Watts Meriel , Clausing Peter , Marquez Emily
Published: October 2021

In a correspondence to BMC Public Health, Dunn et al. (Dunn SE, Reed J and Neumann C. BMC Public Health (n.d)) respond to our review on the occurrence of unintentional, acute pesticide poisoning (UAPP). Based on a systematic review and further data sources we estimated that about 385 million cases of UAPP occur annually world-wide including around 11,000 fatalities (Boedeker W. et al. BMC Public Health:1875, 2020).
Leisure-time physical activities and the risk of cardiovascular mortality in the Malmö diet and Cancer study
Authors: Bergwall Sara , Acosta Stefan , Ramne Stina , Mutie Pascal , Sonestedt Emily
Published: October 2021

Background

The association between leisure-time physical activity and cardiovascular mortality has been previously studied, but few studies have focused on specific activities and intensities.

Methods

The association between different leisure-time physical activities and cardiovascular mortality was investigated among 25,876 individuals without diabetes or cardiovascular disease from the population-based Malmö Diet and Cancer Study cohort. The individuals estimated the average duration spent on 17 physical activities at baseline in 1991–1996 and after 5 years. Cardiovascular mortality was obtained from a register during a mean of 20 years of follow-up.

Results

A total leisure-time physical activity of 15–25 metabolic equivalent task (MET) hours/week was associated with a decreased risk of cardiovascular mortality (HR 15–25 vs < 7.5 MET-h/week =0.80, 95% CI 0.69–0.93), with no further risk reduction at higher levels. Several high-intensity activities (i.e., lawn tennis and running) and moderate-intensity activities (i.e., golf, cycling and gardening) were associated with a reduced risk. Individuals who engaged in high-intensity physical activity for an average of 2.29 MET h/week (30 min/week) had an 18% (95% CI 0.72–0.93) reduced risk of cardiovascular mortality compared with non-participants, and no further risk reductions were observed at higher levels. Decreased risk was observed among individuals who had started (HR 0.56, 95% CI 0.32–0.97) or continued (HR 0.49, 95% CI 0.36–0.66) high-intensity activities at the five-year follow-up.

Conclusions

Moderate- and high-intensity leisure-time physical activities reduced the risk of cardiovascular mortality. With regard to total leisure-time physical activity, the largest risk reduction was observed for 15–25 MET-h/week (equivalent to walking for approximately 5 h/week).
Risk factors of pin tract infection during bone transport using unilateral external fixator in the treatment of bone defects
Authors: Liu Kai , Abulaiti Alimujiang , Liu Yanshi , Cai Feiyu , Ren Peng , Yusufu Aihemaitijiang
Published: October 2021

Background

The bone transport using the unilateral external fixator, one of the Ilizarov techniques, is widely practiced in lower limb reconstructive surgery. Pin tract infection (PTI), one of most common complication, has become the important postoperative problems which plague clinicians gradually.

Methods

A group of 130 patients who received bone transport surgery for tibia or femur defects using the unilateral external fixation (Orthofix limb reconstruction system, Verona, Italy) and met the inclusion criteria were selected for the study from 2015 to 2019. Regular pin tract care was performed twice a day, and the conditions of the pin tract were evaluated by the same observer using clinical appearance criteria. The Saw’s classification of PTI was used to assess the condition around screws. After the data were significant by the T-test or Pearson’s Chi-square test analyzed, odds ratios were calculated using logistic regression tests to describe factors associated with the diagnosis of PTI.

Results

Ninety-one males and thirty-nine females with a mean age of 43 years (range 28–58 years) were included in this cohort. 7816 observations were documented from 12 to 36 months, and 58 cases (44.6%) of PTI (thirty-nine cases in grade 1, 17 cases in grade 2, and 2 cases in grade 3). The top five risk factors were agricultural work (OR 1.86, CI 0.94–2.39), non-urban living (OR 1.75, CI 1.24–3.26), male (OR 1.71, CI 1.02–2.31), smoking (OR 1.53, CI 0.76–1.89), and diabetes (OR 1.26, CI 1.12–2.64). No long-term sequelae were observed at the latest clinical visit.

Conclusion

Occupation, gender, living environment (non-urban), smoking, and diabetes were the top five significant risk factors for PTI in the period of bone transport using unilateral external fixation. Awareness of predictable risk factors of PTI is beneficial to avoid or early detect the severe complications which can affect the effectiveness.