bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends, patterns and cause-specific neonatal mortality in Tanzania: a hospital-based retrospective survey
Authors: Mangu Chacha D , Rumisha Susan F , Lyimo Emanuel P , Mremi Irene R , Massawe Isolide S , Bwana Veneranda M , Chiduo Mercy G , Mboera Leonard E G
Published: August 2020

Background

Globally, large numbers of children die shortly after birth and many of them within the first 4 wk of life. This study aimed to determine the trends, patterns and causes of neonatal mortality in hospitals in Tanzania during 2006–2015.

Methods

This retrospective study involved 35 hospitals. Mortality data were extracted from inpatient registers, death registers and International Classification of Diseases-10 report forms. Annual specific hospital-based neonatal mortality rates were calculated and discussed. Two periods of 2006–2010 and 2011–2015 were assessed separately to account for data availability and interventions.

Results

A total of 235 689 deaths were recorded and neonatal deaths accounted for 11.3% (n=26 630) of the deaths. The majority of neonatal deaths (87.5%) occurred in the first week of life. Overall hospital-based neonatal mortality rates increased from 2.6 in 2006 to 10.4 deaths per 1000 live births in 2015, with the early neonates contributing 90% to this rate constantly over time. The neonatal mortality rate was 3.7/1000 during 2006–2010 and 10.4/1000 during 2011–2015, both periods indicating a stagnant trend in the years between. The leading causes of early neonatal death were birth asphyxia (22.3%) and respiratory distress (20.8%), while those of late neonatal death were sepsis (29.1%) and respiratory distress (20.0%).

Conclusion

The majority of neonatal deaths in Tanzania occur among the early newborns and the trend over time indicates a slow improvement. Most neonatal deaths are preventable, hence there are opportunities to reduce mortality rates with improvements in service delivery during the first 7 d and maternal care.
Sources of Random Variation of Pesticide Residue Analytical Results
Authors: Ambrus Árpád , Kerekes Kata , Szemánné-Dobrik Henriet , Domák Zsuzsanna
Published: August 2020

Background

Pesticide residues are analyzed in thousands of samples yearly by national authorities and private laboratories. Intensive research is ongoing to develop new methods or improve existing ones concentrating on extraction, cleanup, and detection techniques. Little attention has been paid to the contribution of prior steps in the determination process to overall laboratory sampling errors, though several publications demonstrate their practical importance. Consequently, the repeatability and reproducibility of the results are often reported based on the recovery tests alone. A few previous publications are cited in this paper which illustrate the magnitude of random errors derived from subsampling, comminution of analytical samples, and selection of small test portions.

Objectives

We aim to call attention to the importance of considering all steps of laboratory sampling and analysis processes in calculating the combined uncertainty of results and realistic performance assessments of methods including their long-term intermediate precision.

Method

Validation of laboratory sampling of large fruits is used to illustrate the recommended procedures, determination of their random error, and long-term method performance.

Results

The results indicate that subsampling, comminution, and selection of test portions can be major contributors to the combined uncertainty of results.

Conclusions

All these steps should be considered in estimation of random variation (uncertainty) of measured residues.

Highlights

Random error of laboratory sampling for pesticide residues. Mass reduction of large crop units. Internal quality control of laboratory operations.
Validation of the Legionella pneumophila SG1 DETECT Kit for Quantification of Legionella pneumophila Serogroup 1 Bacteria in Potable Waters, Process Waters, and Surface Waters: AOAC Performance Tested MethodSM 052002
Authors: Keserue Hans-Anton , Cornillie Nathalie , Ehlert Anna-Katharina , Mills Dominic C , Morger Damien , Piffaretti Andrea , Schaffhauser Daniel F , Schwyzer Irène I
Published: August 2020

The L.p.SG1 DETECT Kit is a rapid, quantitative method for the detection and enumeration of Legionella pneumophila serogroup 1 (L.p. SG1) bacteria from different water matrixes. The method is based on a combination of immunomagnetic separation (IMS) and flow cytometric (FCM) quantification. To this end, the method employs magnetic particles conjugated to anti-L.p. SG1 antibodies for the IMS of the target bacteria from environmental matrices and fluorescently labeled anti-L.p. SG1 antibodies for subsequent quantification by FCM. The IMS can be performed either manually with a magnetic rack (rqmicro.MIMS) or automated with the rqmicro.STREAM sample preparation instrument. Compared to the reference method ISO 11731:2017, which is based on culturing and enumeration of colony forming units (CFU) on agar plates, and can take up to 10 days until results are available, analysis with the L.p. SG1 DETECT Kit is culture-independent and delivers results within 2 h. This Performance Tested Method validation study demonstrates a robust method with recoveries exceeding 69%, inclusivity of 100%, exclusivity of 97.2%, and a shelf life of at least 6 months at 4°C or 40 days at 25°C. The Limit of Detection (LOD) was determined at 21 CFU/L and the Limit of Quantification (LOQ) at 80 CFU/L for potable water using the rqmicro.STREAM. The matrix study across three different types of water matrixes (potable, surface, and industrial process water), demonstrates superior repeatability and reproducibility, as well as equivalent or even superior detection of L.p. SG1 bacteria compared to the standard ISO 11731 method.
Effect of Chemical Pollution and Parasitism on Heat Tolerance in Dung Beetles (Coleoptera: Scarabaeinae)
Authors: González-Tokman Daniel , Gil-Pérez Yorleny , Servín-Pastor Mariana , Alvarado Fredy , Escobar Federico , Baena-Díaz Fernanda , García-Robledo Carlos , Martínez-M. Imelda
Published: August 2020

Ecosystem services provided by insects are threatened by recent increasing global temperatures, particularly in the tropics, where insects live close to their thermal limits. Given that tolerance to high temperatures depends on individual metabolism and physiological stress response, it may also be sensitive to other stressors that are common in natural and human-modified environments, such as pollution and parasite pressure. The effects of multiple stressors could be synergistic and can be particularly relevant in insects that provide highly valuable ecosystem services, such as dung beetles in cattle pastures. Here we measured heat tolerance (critical thermal maximum, CTmax) in dung beetles exposed to ivermectin, a toxic parasiticide excreted in cattle dung, with known negative effects on coprophagous fauna, and in beetles exposed to an immune challenge. We also exposed a group of beetles to a combination of both ivermectin and immune challenge to test for potential synergistic effects of both stressors. Contrary to our predictions, CTmax did not change with ivermectin exposure, but increased in immune-challenged beetles. As found in other insects, CTmax was higher in larger beetles, highlighting the importance of body size on thermal tolerance in ectotherms. We discuss potential mechanisms responsible of increased heat tolerance in immune-challenged beetles and highlight the importance of natural and human-induced environmental pressures that now interact with global warming and threaten ecosystem services provided by wild animals.
Brief collaborative care intervention to reduce perceived unmet needs in highly distressed breast cancer patients: randomized controlled trial
Authors: Akechi Tatsuo , Momino Kanae , Katsuki Fujika , Yamashita Hiroko , Sugiura Hiroshi , Yoshimoto Nobuyasu , Wanifuchi-Endo Yumi , Toyama Tatsuya
Published: August 2020

Objectives

Our newly developed brief collaborative care intervention program has been suggested to be effective in reducing breast cancer patients’ unmet needs and psychological distress; however, there has been no controlled trial to investigate its effectiveness. The purpose of this study was to examine the effectiveness of the program in relation to patients’ perceived needs and other relevant outcomes for patients including quality of life, psychological distress and fear of recurrence (Clinical trial register; UMIN-CTR, Clinical registration number; R5172).

Methods

Fifty-nine highly distressed breast cancer patients receiving adjuvant chemotherapy and/or hormonal therapy were randomly assigned either to a treatment as usual group or to a collaborative care intervention, consisting of four sessions that mainly included assessment of the patients’ perceived needs, learning skills of problem-solving treatment for coping with unmet needs and psycho-education provided by trained nurses supervised by a psycho-oncologist.

Results

Although >80% of the eligible patients agreed to participate, and >90% of participants completed the intervention, there were no significant differences with regard to patients’ needs, quality of life, psychological distress and fear of recurrence, both at 1 and 3 months after intervention.

Conclusion

Newly developed brief collaborative care intervention program was found to be feasible and acceptable. The trial, however, failed to show the effectiveness of the program on patients’ relevant subjective outcomes. Further intervention program having both brevity and sufficient intensity should be developed in future studies.
“Musique cannibale”: The Evolving Sound of Indigeneity in Heitor Villa-Lobos’s Tres poêmas indigenas
Authors: Burns Chelsea
Published: August 2020

Heitor Villa-Lobos’s Tres poêmas indigenas (1926, published 1929) provide an unusual image of Brazilian indigeneity: in three short songs, he creates a narrative of progress, one that ends with redefining himself and modernist colleague Mário de Andrade as Amerindian. The first two songs set melodies collected in 1557 and 1912, the third a new poem by Andrade (1926). The set begins with a narrow pitch collection, thin textures, and ostinatos and ends with a lied-like approach to text–music relations. In this way, Villa-Lobos creates an evolving image of Amerindian music-making that capitalizes on Indianist fantasies while redefining indigeneity as encompassing even the most modern and urbane Brazilians.
Anomalous strain effect on the thermal conductivity of low-buckled two-dimensional silicene
Authors: Ding Bin , Li Xiaoyan , Zhou Wuxing , Zhang Gang , Gao Huajian
Published: August 2020

The thermal conductivity of two-dimensional materials, such as graphene, typically decreases when tensile strain is applied, which softens their phonon modes. Here, we report an anomalous strain effect on the thermal conductivity of monolayer silicene, a representative low-buckled two-dimensional (LB-2D) material. ReaxFF-based molecular dynamics simulations are performed to show that biaxially stretched monolayer silicene exhibits a remarkable increase in thermal conductivity, by as much as 10 times the freestanding value, with increasing applied strain in the range of [0, 0.1], which is attributed to increased contributions from long-wavelength phonons. A further increase in strain in the range of [0.11, 0.18] results in a plateau of the thermal conductivity in an oscillatory manner, governed by a unique dynamic bonding behavior under extreme loading. This anomalous effect reveals new physical insights into the thermal properties of LB-2D materials and may provide some guidelines for designing heat management and energy conversion devices based on such materials.
A First Look at the Impact of COVID-19 on Commercial Real Estate Prices: Asset-Level Evidence
Authors: Ling David C , Wang Chongyu , Zhou Tingyu
Published: August 2020

This is the first paper to examine how the COVID-19 shock transmitted from the asset markets to capital markets. Using a novel measure of the exposure of commercial real estate (CRE) portfolios to the increase in the number of COVID-19 cases (GeoCOVID), we find a one-standard-deviation increase in GeoCOVID on day t-1 is associated with a 0.24 to 0.93 percentage points decrease in abnormal returns over 1- to 3-day windows. There is substantial variation across property types. Local and state policy interventions helped to moderate the negative return impact of GeoCOVID. However, there is little evidence that reopenings affected the performance of CRE markets.
Patients’ and Physicians’ Knowledge of Radiation Exposure Related to Spine Surgery
Authors: Scott Michelle C. , Galivanche Anoop R. , Mets Elbert J. , Pathak Neil , Kahan Joseph B. , Burroughs Patrick J. , Varthi Arya G. , Rubin Lee E. , Grauer Jonathan N.
Published: August 2020

Study Design.

Cross-sectional survey.

Objective.

Examine patients’ and physicians’ estimates of radiation exposure related to spine surgery.

Summary of Background Data.

Patients are commonly exposed to radiation when undergoing spine surgery. Previous studies suggest that patients and physicians have limited knowledge about radiation exposure in the outpatient setting. This has not been assessed for intraoperative imaging.

Methods.

A questionnaire was developed to assess awareness/knowledge of radiation exposure in outpatient and intraoperative spine care settings. Patients and surgeons estimated chest radiograph (CXR) equivalent radiation from: cervical and lumbar radiographs (anterior-posterior [AP] and lateral), computed tomography (CT), magnetic resonance imaging (MRI), intraoperative fluoroscopy, and intraoperative CT (O-arm). Results were compared to literature-reported radiation doses.

Results.

Overall, 100 patients and 26 providers completed the survey. Only 31% of patients were informed about outpatient radiation exposure, and only 23% of those who had undergone spine surgery had been informed about intraoperative radiation exposure. For lumbar radiographs, patients and surgeons underestimated CXR-equivalent radiation exposures: AP by five-fold (P < 0.0001) and seven-fold (P < 0.0001), respectively, and lateral by three-fold (P < 0.0001) and four-fold (P = 0.0002), respectively. For cervical CT imaging, patients and surgeons underestimated radiation exposure by 18-fold (P < 0.0001) and two-fold (P = 0.0339), respectively. For lumbar CT imaging, patients and surgeons underestimated radiation exposure by 31-fold (P < 0.0001) and three-fold (P = 0.0001), respectively. For intraoperative specific cervical and lumbar imaging, patients underestimated radiation exposure for O-arm by 11-fold (P < 0.0001) and 22-fold (P = 0.0002), respectively. Surgeons underestimated radiation exposure of lumbar O-arm by three-fold (P = 0.0227).

Conclusion.

This study evaluated patient and physician knowledge of radiation exposure related to spine procedures. Underestimation of radiation exposure in the outpatient setting was consistent with prior study findings. The significant underestimation of intraoperative cross-sectional imaging (O-arm) is notable and needs attention in the era of increased use of such technology for imaging, navigation, and robotic spine surgery.

Level of Evidence: 4
Practices in Triage and Transfer of Critically Ill Patients: A Qualitative Systematic Review of Selection Criteria
Authors: Dahine Joseph , Hébert Paul C. , Ziegler Daniela , Chenail Noémie , Ferrari Nicolay , Hébert Réjean
Published: August 2020

Objectives:

To identify and appraise articles describing criteria used to prioritize or withhold a critical care admission.

Data Sources:

PubMed, Embase, Medline, EBM Reviews, and CINAHL Complete databases. Gray literature searches and a manual review of references were also performed. Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed.

Study Selection:

We sought all articles and abstracts of original research as well as local, provincial, or national policies on the topic of ICU resource allocation. We excluded studies whose population of interest was neonatal, pediatric, trauma, or noncritically ill. Screening of 6,633 citations was conducted.

Data Extraction:

Triage and/or transport criteria were extracted, based on type of article, methodology, publication year, and country. An appraisal scale was developed to assess the quality of identified articles. We also developed a robustness score to further appraise the robustness of the evidence supporting each criterion. Finally, all criteria were extracted, evaluated, and grouped by theme.

Data Synthesis:

One-hundred twenty-nine articles were included. These were mainly original research (34%), guidelines (26%), and reviews (21%). Among them, we identified 200 unique triage and transport criteria. Most articles highlighted an exclusion (71%) rather than a prioritization mechanism (17%). Very few articles pertained to transport of critically ill patients (4%). Criteria were classified in one of four emerging themes: patient, condition, physician, and context. The majority of criteria used were nonspecific. No study prospectively evaluated the implementation of its cited criteria.

Conclusions:

This systematic review identified 200 criteria classified within four themes that may be included when devising triage programs including the coronavirus disease 2019 pandemic. We identified significant knowledge gaps where research would assist in improving existing triage criteria and guidelines, aiming to decrease arbitrary decisions and variability.
Impact of residential mobility on estimated environmental exposures in a prospective cohort of older women
Authors: Medgyesi Danielle N. , Fisher Jared A. , Cervi Meredith M. , Weyer Peter J. , Patel Deven M. , Sampson Joshua N. , Ward Mary H. , Jones Rena R.
Published: August 2020

Background:

Longitudinal studies of environmental hazards often rely on exposure estimated at the participant’s enrollment residence. This could lead to exposure misclassification if participants move over time.

Methods:

We evaluated residential mobility in the Iowa Women’s Health Study (age 55–69 years) over 19 years of follow-up (1986–2004). We assessed several environmental exposures of varying spatial scales at enrollment and follow-up addresses. Exposures included average nitrate concentrations in public water supplies, percent of agricultural land (row crops and pasture/hay) within 750 m, and the presence of concentrated animal feeding operations within 5 km. In comparison to gold standard duration–based exposures averaged across all residences, we evaluated the sensitivity and specificity of exposure metrics and attenuation bias for a hypothetical nested case–control study of cancer, which assumed participants did not move from their enrollment residence.

Results:

Among 41,650 participants, 32% moved at least once during follow-up. Mobility was predicted by working outside the home, being a former/current smoker, having a higher education level, using a public drinking water supply, and town size of previous residence. Compared with duration-based exposures, the sensitivity and specificity of exposures at enrollment ranged from 94% to 99% and 97% to 99%, respectively. A hypothetical true odds ratio of 2.0 was attenuated 8% for nitrate, 9%–10% for agricultural land, and 6% for concentrated animal feeding operation exposures.

Conclusions:

Overall, we found low rates of mobility and mobility-related exposure misclassification in the Iowa Women’s Health Study. Misclassification and attenuation of hypothetical risk estimates differed by spatial variability and exposure prevalence.
POLYPOIDAL CHOROIDAL VASCULOPATHY FEATURES VARY ACCORDING TO SUBFOVEAL CHOROIDAL THICKNESS
Authors: Jordan-Yu Janice Marie , Teo Kelvin Yi Chong , Chakravarthy Usha , Gan Alfred , Tan Anna Cheng Sim , Cheong Kai Xiong , Wong Tien Yin , Cheung Chui Ming Gemmy
Published: August 2020

Purpose:

To evaluate associations between choroidal thickness and features of polypoidal choroidal vasculopathy (PCV) lesions based on multimodal imaging.

Methods:

This cross-sectional analysis included treatment-naive PCV eyes from a prospectively recruited observational cohort. Associations between of subfoveal choroidal thickness (SFCT) and qualitative and quantitative morphologic features of PCV lesions on color fundus photographs, indocyanine green and fluorescein angiography, and spectral-domain optical coherence tomography were evaluated.

Results:

We included 100 eyes with indocyanine green angiography–proven PCV. Subfoveal choroidal thickness showed a bimodal distribution with peaks at 170 µm and 350 µm. There was a significant linear increase in the total lesion area (P-trend = 0.028) and the polypoidal lesion area (P-trend = 0.030 and P-continuous = 0.037) with increasing SFCT. Pairwise comparisons between quartiles showed that the total lesion area (4.20 ± 2.61 vs. 2.89 ± 1.43 mm2, P = 0.024) and the polypoidal lesion area (1.03 ± 1.01 vs. 0.59 ± 0.45 mm2, P = 0.042) are significantly larger in eyes in Q4 (SFCT ≥ 350 μm) than eyes in Q1 (SFCT ≤ 170 μm). Although there was no significant linear trend relating SFCT to best-corrected visual acuity, pairwise comparisons showed that eyes in Q4 (SFCT ≥ 350 μm) have significantly worse vision (0.85 ± 0.63 vs. 0.55 ± 0.27 logMAR, P = 0.030) than eyes in Q2 (SFCT 170–260 μm).

Conclusion:

Total lesion areas and polypoidal lesion areas tend to be larger in eyes with increasing SFCT. Choroidal background may influence the phenotype or progression pattern of PCV.
Corneal Folds After Descemet Membrane Endothelial Keratoplasty in Congenital Hereditary Endotheial Dystrophy
Authors: Fogla Rajesh , Srinivasan Bhaskar
Published: August 2020

Purpose:

To report a new clinical sign of corneal folds after Descemet membrane endothelial keratoplasty (DMEK) in the eyes with congenital hereditary endothelial dystrophy (CHED).

Methods:

Retrospective review of cases of CHED who presented with unusual folds in recipient cornea after the DMEK procedure for CHED. Clinical outcomes including visual acuity, pachymetry, specular microscopy, anterior segment optical coherence tomography, and corneal clarity, besides postoperative complications were analyzed.

Results:

Fifteen eyes of 11 cases of CHED successfully underwent DMEK. Five eyes of 4 patients, mean age 17.2 ± 5.8 years (range 10–23 years), developed unusual folds in the anterior cornea after resolution of stromal edema. Mean follow-up was 7.8 ± 2.5 months (range 6–12 months). Mean best spectacle-corrected visual acuity improved from 0.8 ± 0.3 LogMAR preoperatively to 0.3 ± 0.2 LogMAR postoperatively. Corneal thickness improved from 991 ± 65 μm (range 924–1088 μm) preoperatively to 595 ± 78 μm postoperatively (range 525–730 μm). Average endothelial cell counts were 1708 ± 271 cell/mm2 at the last follow-up. No intraoperative or postoperative complications were reported. The corneal folds remained unchanged during the follow-up. Comparative analysis with remaining 10 eyes did not show any significant differences.

Conclusions:

Cornea can present with unusual folds in the anterior stroma after successful DMEK in CHED. These folds may possibly be due to difference in collagen structure between anterior and posterior corneal stroma and needs to be studied further.
Evaluation of the Safety and Efficacy of a Low-Temperature Plasma Surgical System for Pterygium
Authors: Huang Haixiang , Li Saiqun , Zhong Jing , Wang Bowen , Peng Lulu , Deng Yuqing , Wang Mingwu , Yuan Jin
Published: August 2020

Purpose:

Surgical excision is the standard treatment for pterygium. This study was conducted to evaluate the safety and efficacy of a novel technique using low-temperature plasma (LTP) for excision and hemostasis in pterygium surgery.

Methods:

A prospective, comparative, and randomized clinical trial was conducted on 60 patients (60 eyes) undergoing pterygium excision with conjunctival autografts using fibrin glue. Patients were equally divided into the following 2 groups: a control group and a LTP group. Postoperative follow-up visits were scheduled on day 1, week 1, and months 1 and 3, and recurrence was evaluated at 1 year. Patients were examined for operative time, best corrected visual acuity, conjunctival autograft inflammation (CAI), graft stability (GS), pain, recurrence, and final appearance. Factors related to pterygium recurrence and final appearance were analyzed.

Results:

Mean operative times were shorter in the LTP group (16.7 ± 3.4 min) than those in the control group (20.1 ± 4.7 min, P = 0.002). LTP eyes had milder CAI than control eyes at postoperative day 1 (P = 0.000) and week 1 (P = 0.000). Patients in the LTP group exhibited better GS (P = 0.01) and milder pain (P = 0.04) than those in the control group on day 1. Two control patients (6.7%) and no (0%) LTP patients experienced recurrence (P = 0.08). GS and CAI were the significant factors contributing to recurrence (GS: R = 0.425, P = 0.001; CAI: R = 0.309, P = 0.016).

Conclusions:

LTP to replace surgical blades and disposable cautery for ablation and hemostasis is safe and efficient for pterygium surgery, resulting in shorter operative time, milder inflammation, and better graft stability without increasing complication risk.
Customized corneal crosslinking for treatment of progressive keratoconus: Clinical and OCT outcomes using a transepithelial approach with supplemental oxygen
Authors: Mazzotta Cosimo , Sgheri Arianna , Bagaglia Simone Alex , Rechichi Miguel , Di Maggio Alessandro
Published: August 2020

Purpose:

To evaluate the outcomes of customized corneal crosslinking (CXL) for treatment of progressive keratoconus (KC) using a transepithelial approach with supplemental oxygen.

Setting:

Siena Crosslinking Center, Siena, Italy.

Design:

Prospective interventional case series.

Methods:

Twenty-seven eyes of 24 patients (mean age 29.3 ± 7.3 years) with progressive KC underwent customized corneal CXL using a transepithelial approach with supplemental oxygen. Ultraviolet (UV)-A irradiation of 365 nm wavelength was delivered in an accelerated (30 mW/cm2) pulsed-light UV light exposure in a 2-zone elliptical pattern. A total dose of 10 J/cm2 was delivered at the KC apex, surrounded by a broadbeam spot of 7.2 J/cm2. After 0.25% riboflavin corneal soaking, the UV-A irradiation was initiated in the presence of additional oxygen (≥90% concentration) delivered through special goggles connected to an oxygen delivery system (flow-rate 2.5 liters per minute). Key outcome measures included corrected distance visual acuity (CDVA), keratometry (AK, K1, K2, and K-average), corneal higher-order aberrations, topographic and manifest cylinder, corneal optical coherence tomography (OCT) demarcation line, and endothelial cell count.

Results:

Of the 27 eyes studied, a significant improvement of CDVA was recorded at 6-month follow-up visits, from baseline 0.19 ± 0.06 logarithm of the minimum angle of resolution (logMAR) to 0.11 ± 0.04 logMAR (P < .05). Significant flattening of steep keratometry (K2) was reported with mean change of −1.9 diopters (D) (P < .05), and coma values improved from 0.47 ± 0.28 µm to 0.28 ± 0.16 µm (P < .05). OCT revealed 2 demarcation lines at mean depths of 218.23 ± 43.32 µm and 325.71 ± 39.70 µm.

Conclusions:

In this series, customized CXL using a transepithelial approach with intraoperative supplemental oxygen resulted in clinically meaningful improvements in corneal curvature and CDVA without significant adverse events.
Risk of ischemic stroke in patients with end-stage renal disease receiving peritoneal dialysis with new-onset atrial fibrillation
Authors: Lee Yin-Hao , Chen Yung-Tai , Chang Chun-Chin , Hsu Chien-Yi , Su Yu-Wen , Li Szu-Yuan , Huang Chin-Chou , Leu Hsin-Bang , Huang Po-Hsun , Chen Jaw-Wen , Lin Shing-Jong
Published: August 2020

Background:

The clinical effect of atrial fibrillation (AF)-related ischemic cardiovascular events in patients undergoing peritoneal dialysis (PD) remains uncertain. This study aimed to investigate the risk of ischemic events in patients undergoing PD with new-onset AF compared with that in patients without AF and ascertain the association between the CHA2DS2-VASc score and risk of ischemic stroke.

Methods:

This nationwide, population-based cohort study used data from Taiwan’s National Health Insurance Research Database from 1998 to 2011 for patients receiving PD with or without new-onset AF. The clinical endpoints included ischemic stroke, all-cause death, and in-hospital cardiovascular death.

Results:

Patients undergoing PD with new-onset AF (N = 505) had significantly higher risks of ischemic stroke (adjusted hazard ratio [aHR], 1.98; 95% CI, 1.40-2.80), all-cause death (aHR, 1.61; 95% CI, 1.40-1.85), and in-hospital cardiovascular death (aHR, 1.82; 95% CI, 1.50.2.21) compared with those in patients undergoing PD without AF. After considering in-hospital death as a competing risk, AF remained associated with an increased risk of ischemic stroke (hazard ratio [HR], 1.67; 95% CI, 1.17-2.37). The CHA2DS2-VASc score was associated with the risk of ischemic stroke (HR, 1.28; 95% CI, 1.12-1.46).

Conclusion:

The risks of ischemic stroke, all-cause death, and in-hospital cardiovascular death were significantly higher in patients undergoing PD with AF than those in patients without AF. The CHA2DS2-VASc score remained associated with the risk of ischemic stroke in patients undergoing PD with AF.
Clinical and genetic characterization of congenital lipoid adrenal hyperplasia
Authors: Ullah Asmat , Bibi Farah , Haider Nighat , Shahid Gulbin , Abdullah  , Mustajab Tamanna , Khaliq Tanwir , Ahmad Wasim
Published: August 2020

Disorders of steroid synthesis are a group of anomalies caused by defects in any step of conversion of cholesterol into steroid hormones. The disorders are characterized by defects leading to abnormalities of salt-water balance and/or sexual differentiation. Congenital lipoid adrenal hyperplasia (CLAH) is the most severe form of steroid synthesis disorder caused by the accumulation of cholesterol in the outer mitochondrial membrane due to steroidogenic acute regulatory protein (StAR) deficiency. Pathogenic sequence variants in the gene STAR encoding StAR protein leads to CLAH. In the present study, a Pakistani family was clinically diagnosed with the LAH phenotype. Sanger sequencing of STAR in the family revealed a novel homozygous nonsense mutation [c.295G>T, p.(Glu99*)] in the living affected individual. The study was designed to assist in carrier testing and prenatal diagnosis within the affected family. In addition, searching for common variants in the STAR gene would help in designing low-cost targeted variation testing in other patients.
Ultrasound-Guided Percutaneous Tenotomy and Its Associated Pain Reduction and Functionality Outcomes in Nonelite Active Adults
Authors: Lavallee Mark , Bush Chelsea
Published: August 2020

Objective

The aim of this study was to evaluate changes in pain and functionality after ultrasound-guided percutaneous tenotomy (USGPT) for treatment of tendinopathy.

Design

This was a prospective cohort study of patients undergoing USGPT as an alternative to surgery. Nonelite, active adults completed pain and functionality assessments before USGPT. The visual analog scale (VAS) was used to quantify pain. The Lower Extremity Functionality Scale and the Disabilities of the Arm, Shoulder, and Hand were used to evaluate functionality. Repeat VAS scores were obtained at 1 wk, 1 mo, 2 mos, 3 mos, 6 mos, and 1 yr postprocedure, and repeat functionality assessments, at 1 yr postprocedure. Changes in VAS and functionality were analyzed with paired-sample t-tests.

Results

A total of 103 subjects (61 women, 42 men) underwent USGPT in the following tendons: Achilles, patellar, plantar fascia, flexor carpi ulnaris, extensor carpi radialis brevis, and supraspinatus. Subjects experienced statistically significant decreases in VAS and functionality scores at all time points. The mean VAS score decreased from 7.3 to 3.8 (P < 0.0001) 1 wk postprocedure, with a 5.8-point mean decrease at 1 yr (P < 0.0001). Lower Extremity Functionality Scale scores improved from 42.5 to 65.8 (P < 0.001) and Disabilities of the Arm, Shoulder, and Hand scores improved from 41.5 to 10.4 (P < 0.001) at 1 yr.

Conclusion

Recipients of USGPT procedures can expect to benefit from less invasive procedures and improved pain and functionality without invasive surgical procedures.
The Application of Three-Dimensional Technology Combined With Image Navigation in Nasal Skull Base Surgery
Authors: Chen Min , Xia Nan , Dong Qian , Wen Junfeng , Cui Xin , Yu Longgang , Wei Bin , Wang Yanqing , Hao Dapeng , Jiang Yan
Published: August 2020

Three-dimensional (3D) technology including 3D reconstruction and 3D printing technology, has been widely used in clinical treatment, especially in surgical planning, and image navigation technology, which can make surgical procedures more accurate, now is also increasingly favored by surgeons. But the combination of those 2 technologies was rarely reported. Thus, this study will preliminarily investigate the feasibility and the effect of the combination of 2 technologies in endonasal skull base surgery. Eight patients were involved in this study (from October 2016 to July 2017 at The Affiliated Hospital of Qingdao University), 5 cases of nasal skull base tumors and 3 cases of foreign body perforation. All operations were done under the assistance of 3D technology and image guidance system. Surgical discussion with patient, preoperative planning and clinical teaching were investigated between 2D images and 3D models by voting. For all cases, 3D reconstruction model and 3D printed model were deemed to be more helpful than CT/MRI images in surgical discussion with the patient; surgical simulation on 3D model in preoperative planning was largely deemed to be helpful and very helpful; and in clinical teaching, 3D models combined with image guidance system were deemed to be more helpful in understanding the disease than using 2D images. Besides, all patients recovered well after surgery, no recurrence and complications were found in the follow-up. The combination of 3D technology and electromagnetic image guidance system could improve surgical efficiency and the quality of clinical teaching.
The Surgery-first Approach to Orthognathic Surgery
Authors: Hoang Tuan-Anh , Lee Kevin C. , Chuang Sung-Kiang
Published: August 2020

The purpose of this study was to compare the outcomes between the conventional surgical approach (CSA) and the surgery-first approach (SFA) for both traditional orthognathic osteotomies (LeFort/BSSO) and anterior segmental osteotomies (ASO). This was a retrospective cohort study of patients treated at the Hanoi Plastic Surgery Center from January 2000 to December 2012. The study predictors were the type (LeFort/BSSO or ASO) and timing (CSA or SFA) of surgery. The study outcomes were total treatment time and the rates of complication and relapse. 146 patients were included in the study, of whom 99 (67.8%) were treated with traditional osteotomies and 47 (32.2%) were treated with ASO. In the traditional osteotomy group, there were no significant differences in complication (P = 0.84) or relapse (P = 0.77) rates between CSA and SFA. There were no complications or relapses in the ASO group. Total treatment time was significantly decreased when using the SFA for both orthognathic osteotomies (−3.9 months, P < 0.01) and ASO (−3.3 months, P < 0.01). Our results showed that the SFA was able to achieve similar clinical outcomes to CSA but in a shorter treatment time. The SFA was effective for not only traditional orthognathic osteotomies but also ASO.
Phase II Adjuvant Cancer-specific Vaccine Therapy for Esophageal Cancer Patients Curatively Resected After Preoperative Therapy With Pathologically Positive Nodes; Possible Significance of Tumor Immune Microenvironment in its Clinical Effects
Authors: Yasuda Takushi , Nishiki Kohei , Hiraki Yoko , Kato Hiroaki , Iwama Mitsuru , Shiraishi Osamu , Yasuda Atsushi , Shinkai Masayuki , Kimura Yutaka , Sukegawa Yasushi , Chiba Yasutaka , Imano Motohiro , Takeda Kazuyoshi , Satou Takao , Shiozaki Hitoshi , Nakamura Yusuke
Published: August 2020

Objectives:

To elucidate the efficacy of adjuvant vaccine monotherapy using 3 Human Leukocyte Antigen (HLA)-A∗24-restricted tumor-specific peptide antigens for ESCC, upregulated lung cancer 10, cell division cycle associated 1, and KH domain-containing protein overexpressed in cancer 1.

Summary of Background Data:

ESCC patients with pathologically positive nodes (pN(+)) have a high risk for postoperative recurrence, despite curative resection after preoperative therapy. Subclinical micrometastases are an appropriate target for cancer vaccine.

Methods:

This is a non-randomized prospective phase II clinical trial (UMIN000003557). ESCC patients curatively resected after preoperative therapy with pN(+) were allocated into the control and vaccine groups (CG and VG) according to the HLA-A status. One mg each of three epitope peptides was postoperatively injected 10 times weekly followed by 10 times biweekly to the VG. The primary and secondary endpoints were relapse-free survival (RFS) and esophageal cancer-specific survival (ECSS), respectively.

Results:

Thirty were in the CG and 33 in the VG. No significant difference was observed in RFS between the CG and VG (5-year RFS: 32.5% vs 45.3%), but the recurrence rate significantly decreased with the number of peptides which induced antigen-specific cytotoxic T lymphocytes. The VG showed a significantly higher 5-year ECSS than the CG (60.0% vs 32.4%, P = 0.045) and this difference was more prominent in patients with CD8+ and programmed death-ligand 1 double negative tumor (68.0% vs 17.7%, P = 0.010).

Conclusions:

Our cancer peptide vaccine might improve the survival of ESCC patients, which is warranted to be verified in the phase III randomized controlled study.
Arterial Resection in Pancreatic Cancer Surgery
Authors: Loos Martin , Kester Tobias , Klaiber Ulla , Mihaljevic André L. , Mehrabi Arianeb , Müller-Stich Beat M. , Diener Markus K. , Schneider Martin A. , Berchtold Christoph , Hinz Ulf , Feisst Manuel , Strobel Oliver , Hackert Thilo , Büchler Markus W.
Published: August 2020

Objective:

To investigate the perioperative and oncologic long-term outcomes of patients with LAPC after surgical resection at a high-volume center for pancreatic surgery.

Background:

The role of surgery in LAPC with arterial involvement is controversial.

Methods:

We analyzed 385 consecutive patients undergoing PAR (n = 195) or PAD (n = 190) of the encased artery for LAPC between January 1, 2003 and April 30, 2019.

Results:

There were 183 total pancreatectomies, 113 partial pancreatoduodenectomies, 79 distal pancreatectomies, and 10 resections for tumor recurrences, including 121 multivisceral resections and 171 venous resections. Forty-three patients (11.4%) had resectable oligometastatic disease. All of the 190 patients undergoing PAD (100%) and 95 of the 195 patients undergoing PAR (48.7%) received neoadjuvant chemotherapy. The R0 (circumferential resection margin negative) resection rate was 28%. The median hospital stay was 15 days (range: 3–236). The median survival after surgery for LAPC was 20.1 months and the overall 5-year survival rate 12.5%. In-hospital mortality was 8.8% for the entire patient cohort (n = 385). With increasing case load and growing expertise, there was a significant reduction of in-hospital mortality to 4.8% (n = 186) after 2013 (P = 0.005). The learning curve of experienced pancreatic surgeons for PAR was 15 such procedures.

Conclusion:

Our data demonstrate that an arterial surgical approach is effective in LAPC with promising long-term survival. PAD after neoadjuvant treatment is safe. PAR is a technically demanding procedure and requires a high level of expertise.
Emerging trends in eating disorders among sexual and gender minorities
Authors: Nagata Jason M. , Ganson Kyle T. , Austin S. Bryn
Published: August 2020

Purpose of review

To review the recent literature on eating disorders, disordered eating behaviors (DEB), and body image dissatisfaction among sexual and gender minority populations, including, but not limited to, gay, lesbian, bisexual, and transgender people.

Recent findings

Overall, eating disorders, DEB, and body dissatisfaction are common among sexual and gender minority populations. Lifetime prevalence for anorexia nervosa (1.7%), bulimia nervosa (1.3%), and binge-eating disorder (2.2%) diagnoses are higher among sexual minority adults compared with cisgender heterosexual adults in the United States. Lifetime prevalence of eating disorders by self-report of a healthcare provider's diagnosis are 10.5% for transgender men and 8.1% for transgender women in the United States, including anorexia nervosa (4.2 and 4.1%) and bulimia nervosa (3.2 and 2.9%), respectively. DEB may be perpetuated by minority stress and discrimination experienced by these individuals. Body dissatisfaction may be a core stressor experienced by transgender people; gender dysphoria treatment has been shown to increase body satisfaction. A particular clinical challenge in caring for transgender youth with eating disorders is the standard use of growth charts based on sex.

Novel research demonstrates that sexual and gender minorities with eating disorders have unique concerns with regards to disordered eating and body image.
The relationship between eating disorder psychopathology and sexuality: etiological factors and implications for treatment
Authors: Castellini Giovanni , Rossi Eleonora , Ricca Valdo
Published: August 2020

Purpose of review

There is a remarkable overlap between eating disorders and sexual problems, both in terms of sexual dysfunctions and risky sexual behaviors. This systematic review of the recent literature aimed at clarifying the nature of this relationship in terms of psychopathological meaning.

Recent findings

Body image disturbance, and particularly body dissatisfaction and embodiment disorder, emerged as shared psychopathological dimensions between eating disorder symptoms and sexual dysfunctions. Interpersonal difficulties, a disturbed intimacy and insecure attachment style, but not a history of sexual abuse per se, resulted to play a pivotal role in the interconnection between eating disorder psychopathology and sexual dysfunctions. On the other hand, several studies confirmed the association between eating disorder symptoms and risky sexual behaviors, which has been explained in terms of several common psychopathological dimensions, including impulsivity and addiction.

Sexuality is deeply interconnected with eating disorder psychopathology, and it should be considered a fundamental aspect in managing these disorders. An accurate assessment of sexual function might allow to characterize etiological information (e.g., sexual abuse) and maintaining factors (embodiment disorder and emotion dysregulation). Accordingly, the recovery of a good sexuality should be considered a crucial signal of recovery.
A computational strategy for rapid on-site 16S metabarcoding with Oxford Nanopore sequencing
Authors: Marino Stefano M.
Published: August 2020

The investigation of microbial communities through nucleotide sequencing has become an essential asset in environmental science, not only for research oriented activities but also for on-site monitoring; one technology, in particular, holds great promises for its application directly in the field: the Oxford Nanopore Technologies (ONT) MinION sequencer is a portable and affordable device, that produces long reads, with a remarkable sequencing output (in terms of bases/hour). One of the most common approaches in microbiological investigations through sequencing is the analysis of the 16S rRNA gene, known as 16S metabarcoding. Only recently the application of MinION has extended to 16S metabarcoding; to date, a limitation is still represented by the available computational protocols: due to the intrinsic, unique features of the technology ONT long reads cannot be adequately analyzed with tools developed for previous technologies (e.g. for Illumina). In this work a computational pipeline, specifically tailored to the usage of ONT reads in 16S metabarcoding, is developed, tested and discussed. This study is particularly addressed to on site evaluations, for environmental investigations or monitoring, where running time, costs and overall efficient usage of resources are particularly important.
Synergy of calcium release site determinants in control of calcium release events in cardiac myocytes
Authors: Iaparov B. I. , Zahradnik I. , Moskvin A. S. , Zahradnikova A.
Published: August 2020

Recent data on structure of dyads in cardiac myocytes indicate variable clustering of RyR calcium release channels. The question arises as to how geometric factors of RyR arrangement translate to their role in formation of calcium release events (CRE). Since this question is not experimentally testablein situ, we performedin silicoexperiments on a large set of calcium release site (CRS) models. The models covered the range of RyR spatial distributions observed in dyads, and included gating of RyRs with open probability dependent on Ca2+and Mg2+concentration. The RyR single-channel calcium current, varied in the range of previously reported values, was set constant in the course of CRE simulations. Other known features of dyads were omitted in the model formulation for clarity. CRE simulations initiated by a single random opening of one of the RyRs in a CRS produced spark-like responses with characteristics that varied with RyR vicinity, a newly defined parameter quantifying spatial distribution of RyRs in the CRSs, and with the RyR single-channel calcium current. The CRE characteristics followed the law of mass action with respect to a CRS state variable, defined as a weighed product of RyR vicinity and RyR single-channel calcium current. The results explained the structure-function relations among determinants of cardiac dyads on synergy principles and thus allowed to evolve the concept of CRS as a dynamic unit of cardiac dyad.
FAM13A regulates KLRG1 expression and interferon gamma production of natural killer cells
Authors: Zeng Ni , Theresine Maud , Capelle Christophe , Patil Neha D. , Masquelier Cécile , Davril Caroline , Baron Alexandre , Coowar Djalil , Dervillez Xavier , Poli Aurélie , Leonard Cathy , Balling Rudi , Ollert Markus , Zimmer Jacques , Hefeng Feng Q.
Published: August 2020

The polymorphism of the geneFAM13A(family with sequence similarity 13, member A) is strongly linked to the risk of lung cancer and chronic obstructive pulmonary disease, which are among the leading causes of mortality and morbidity in lung-related diseases worldwide. However, the underlying molecular and cellular mechanisms through whichFAM13Acontributes to the pathogenesis of these diseases largely remain unclear. Here, using aFam13aknock out (KO) mouse model, we showed thatFam13adepletion upregulated the expression of the terminal differentiation and inhibitory marker, KLRG1 (killer cell lectin-like receptor G1) in natural killer (NK) cells. NK cells fromFam13a-deficient mice showed impaired IFN-γ production either against target tumor cells or following various cytokine cocktail stimulations. Furthermore, the number of lung metastases induced by B16F10 melanoma cells was increased inFam13a-KO mice. Collectively, our data suggest a key role ofFAM13Ain regulating NK cell functions, indicating that the key lung-disease risk geneFAM13Amight contribute to the pathogenesis of several lung diseases via regulating NK cells.