bluuebunny/crossref_metadata_2025 huggingface dataset:
Glomus tumors with malignant features of the extremities: a case series
Authors: Wood Taylor R. , McHugh Jonathan B. , Siegel Geoffrey W.
Published: October 2020

Background

Malignant glomus tumors are exceedingly rare, however they can be locally aggressive and have the potential to metastasize. There is limited information available in the literature regarding treatment and outcomes, therefore we present a case series of 5 patients with glomus tumors with malignant features confined to the extremities that have presented to our tertiary sarcoma center within the last 20 years. This is the largest case series of its kind in the malignant glomus tumor literature, to our knowledge.

Methods

We performed a retrospective chart review of all patients with histologically confirmed glomus tumors with malignant features in the extremities found within the University of Michigan EMERSE database since January 1st, 2000.

Results

Five patients met our inclusion and exclusion criteria. Three patients were diagnosed with malignant glomus tumors, one patient with glomus tumor with uncertain malignant potential, and the last patient with malignant glomus tumor with leiomyosarcomatous features. Males and females were equally represented. Age range was 9–49 years at time of first presentation. All patients underwent an initial surgical resection. Three of the five patients (60%) underwent initial resection at an outside hospital prior to referral to tertiary sarcoma center, and all three required re-resection. One of these patients had local tumor recurrence after a planned positive margin resection and radiotherapy. Another patient had distant metastasis after a positive margin surgical resection and a short course of radiotherapy. All patients are still alive according to their medical record with the average time from initial treatment to last follow up of 59.2 months.

Conclusions

Our study supports the current literature that wide-local resection with the goal of negative margins is still the current gold standard treatment for glomus tumors with malignant features. Studies with larger cohorts are necessary before recommending for or against radiotherapy or chemotherapy. Early biopsy and referral to a tertiary sarcoma center prior to surgical resection may help reduce the re-resection rate and potential seeding of the tumor in these patients, thereby improving outcomes.
Practices and attitudes of bariatric surgeons in Israel during the first phase of the COVID-19 pandemic
Authors: Beglaibter Nahum , Zelekha Orly , Keinan-Boker Lital , Sakran Nasser , Mahajna Ahmad
Published: October 2020

Introduction

Israel ranks very high globally in performing bariatric surgery (BS) per capita. In the first phase of the COVID-19 pandemic the bariatric surgeons’ community faced many concerns and challenges, especially in light of a decree issued by the Ministry of Health (MOH) on March 22nd, to ban all elective surgery in public hospitals. The aim of this study is to portray the practices and attitudes of Israeli bariatric surgeons in the first phase of the pandemic.

Methods

Anonymous web-based questionnaire sent to all active bariatric surgeons in Israel. Statistical analysis was performed using SAS software package.

Results

53 out of 63 (84%) active surgeons responded to the survey. 18% practice in the public sector only, 4% in the private sector only and 78% in both sectors. 76% practice BS for more than 10 years and 68% perform more than 100 procedures a year. Almost all the surgeons (98%) experienced a tremendous decrease in operations. Nevertheless, there were substantial differences by sectors. In the public sector, 86% of the surgeons ceased to operate while 14% did not comply with the government’s decree. In the public sector 69% of the surgeons were instructed by the administrators to stop operating. The majority of surgeons who continued to operate (77%) changed nothing in the indications or contra-indications for surgery. Among the surgeons who opted to refrain from operating on special sub-groups, the most frequent reasons were pulmonary disease (82%), age above 60 (64%), Ischemic heart disease (55%) and living in heavily affected communities. Roughly only half (57%) of the surgeons implemented changes in informed consent and operating room (OR) measures, contrary to guidelines and recommendations by leading professional societies. When asked about future conditions for reestablishing elective procedures, the reply frequencies were as follows: no special measures - 40%; PCR negativity - 27%; IgG positivity - 15%; waiting until the end of the pandemic- 9%.

Conclusions

We showed in this nation-wide survey that the variance between surgeons, regarding present and future reactions to the COVID-19 pandemic, is high. There were substantial differences between the private and the public sectors. Although the instructions given by the MOH for the public sector were quite clear, the compliance by surgeons and administrators was far from complete. The administrators in the public sector, but more so in the private sector were ambiguous in instructing staff, leading surgeons to a more “personal non-structured” practice in the first phase of the pandemic. These facts must be considered by regulators, administrators and surgeons when planning for reestablishing elective BS or in case a second wave of the pandemic is on its way.
Screening for sickle cell disease in newborns: a systematic review
Authors: Runkel Britta , Klüppelholz Birgit , Rummer Anne , Sieben Wiebke , Lampert Ulrike , Bollig Claudia , Markes Martina , Paschen Ulrike , Angelescu Konstanze
Published: October 2020

Background

Sickle cell disease (SCD) is an inherited autosomal recessive disorder caused by the replacement of normal haemoglobin (HbA) by mutant Hb (sickle Hb, HbS). The sickle-shaped red blood cells lead to haemolysis and vaso-occlusion. Especially in the first years of life, patients with SCD are at high risk of life-threatening complications. SCD prevalence shows large regional variations; the disease predominantly occurs in sub-Saharan Africa. We aimed to systematically assess the evidence on the benefit of newborn screening for SCD followed by an earlier treatment start.

Methods

We systematically searched bibliographic databases (MEDLINE, EMBASE, Cochrane Databases, and the Health Technology Assessment Database), trial registries, and other sources to identify systematic reviews and randomised controlled trials (RCTs) or non-randomised trials on newborn screening for SCD. The last search was in 07/2020. Two reviewers independently reviewed abstracts and full-text articles and assessed the risk of bias of the studies included. Data were extracted by one person and checked by another. As meta-analyses were not possible, a qualitative summary of results was performed.

Results

We identified 1 eligible study with direct evidence: a Jamaican retrospective study evaluating newborn screening for SCD followed by preventive measures (prevention of infections and education of parents). The study included 500 patients with SCD (intervention group, 395; historical control group, 105). Although the results showed a high risk of bias, the difference between the intervention and the control group was very large: mortality in children decreased by a factor of about 10 in the first 5 years of life (0.02% in the intervention group vs. 0.19% in the control group, odds ratio 0.09; 95% confidence interval [0.04; 0.22],p< 0.001).

Conclusion

The results are based on a single retrospective study including historical controls. However, the decrease of mortality by a factor of 10 is unlikely to be explained by bias alone. Therefore, in terms of mortality, data from this single retrospective study included in our systematic review suggest a benefit of newborn screening for SCD (followed by preventive measures) versus no newborn screening for SCD (weak certainty of conclusions).
Multidrug-resistant enterobacteriaceae in coastal water: an emerging threat
Authors: Cohen Regev , Paikin Svetlana , Rokney Assaf , Rubin-Blum Maxim , Astrahan Peleg
Published: October 2020

Background

The environmental role of carbapenemase-producing Enterobacteriaceae (CPE) acquisition and infection in human disease has been described but not thoroughly investigated. We aimed to assess the occurrence of CPE in nearshore aquatic bodies.

Methods

Enterobacteriaceae were cultured from coastal and estuary water near Netanya, Israel in June and July of 2018. Bacteria were identified by VITEK2® and their antimicrobial susceptibility was tested according to the CLSI guidelines. Enterobacteriaceae genomes were sequenced to elucidate their resistome and carbapenemase types.

Results

Among other clinically relevant bacteria, four CPE (threeEnterobacterspp and oneEscherichia coliisolate) were isolated from two river estuaries (Poleg and Alexander Rivers) and coastal water at a popular recreational beach (Beit Yanai). Molecular analysis and genome sequencing revealed the persistent presence of rare beta-lactamase resistance genes, includingblaIMI-2and a previously unknownblaIMI-20allele, which were not found among the local epidemiological strains. Genome comparisons revealed the high identity of riverine and marine CPE that were cultivated one month apart.

Conclusions

We show that CPE contamination was widespread in nearshore marine and riverine habitats. The high genome-level similarity of riverine and marine CPEs, isolated one month apart, hints at the common source of infection. We discuss the clinical implications of these findings and stress the urgent need to assess the role of the aquatic environment in CPE epidemiology.
Correction to: The role of passive immunization in the age of SARS-CoV-2: an update
Authors: Fischer Johannes C. , Zänker Kurt , van Griensven Martijn , Schneider Marion , Kindgen-Milles Detlef , Knoefel Wolfram Trudo , Lichtenberg Artur , Tamaskovics Balint , Djiepmo-Njanang Freddy Joel , Budach Wilfried , Corradini Stefanie , Ganswindt Ute , Häussinger Dieter , Feldt Torsten , Schelzig Hubert , Bojar Hans , Peiper Matthias , Bölke Edwin , Haussmann Jan , Matuschek Christiane
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Patient-evaluated cognitive function measured with smartphones and the association with objective cognitive function, perceived stress, quality of life and function capacity in patients with bipolar disorder
Authors: Faurholt-Jepsen Maria , Miskowiak Kamilla Woznica , Frost Mads , Christensen Ellen Margrethe , Þórarinsdóttir Helga , Bardram Jakob Eyvind , Vinberg Maj , Kessing Lars Vedel
Published: October 2020

Background

Cognitive impairments in patients with bipolar disorder (BD) have been associated with reduced functioning. Aims: To investigate the association between (1) patient-evaluated cognitive function measured daily using smartphones and stress, quality of life and functioning, respectively, and (2) patient-evaluated cognitive function and objectively measured cognitive function with neuropsychological tests.

Methods

Data from two randomized controlled trials were combined. Patients with BD (N = 117) and healthy controls (HC) (N = 40) evaluated their cognitive function daily for six to nine months using a smartphone. Patients completed the objective cognition screening tool, the Screen for Cognitive Impairment in Psychiatry and were rated with the Functional Assessment Short Test. Raters were blinded to smartphone data. Participants completed the Perceived Stress Scale and the WHO Quality of Life questionnaires. Data was collected at multiple time points per participant. p-values below 0.0023 were considered statistically significant.

Results

Patient-evaluated cognitive function was statistically significant associated with perceived stress, quality of life and functioning, respectively (all p-values < 0.0001). There was no association between patient-evaluated cognitive function and objectively measured cognitive function (B:0.0009, 95% CI 0.0017; 0.016, p = 0.015). Patients exhibited cognitive impairments in subjectively evaluated cognitive function in comparison with HC despite being in full or partly remission (B:− 0.36, 95% CI− 0.039;− 0.032, p < 0.0001).

Conclusion

The present association between patient-evaluated cognitive function on smartphones and perceived stress, quality of life and functional capacity suggests that smartphones can provide a valid tool to assess disability in remitted BD. Smartphone-based ratings of cognition could not provide insights into objective cognitive function.
Black, pinto and white beans lower hepatic lipids in hamsters fed high fat diets by excretion of bile acids
Authors: Alves Priscila L. S. , Berrios Jose De J , Pan James , Yokoyama Wallace H.
Published: October 2020

Hypolipidemic and anti-obesity properties of extruded black, pinto and white beans were examined in male Syrian hamsters fed high fat diets for 3 weeks. The efficiency and effectiveness of extruder processing to eliminate heat-labile antinutrients were also determined. Hamsters fed a high fat diet containing 40% extruded black beans gained the same amount of weight as animals on a low-fat chow diet (based on AIN-93G). Total plasma cholesterol of the hamsters fed bean flour- based diets tended to be lower, ranging between 298 and 356 mg/dL, compared to 365 mg/dL for the control group and total and free liver cholesterol was about 50 and 33% lower, respectively, in the livers (freeze-dried) of hamsters fed the black turtle bean (BB) and pinto bean (PB) diets. The nitrogen content of the feces from hamsters fed the PB and white bean (WB) diets were 2.6x higher than the control and the excretion of deoxycholic acid (DCA) and lithocholic acid (LCA) was higher in all legume fed hamsters The results show that extrusion efficiently and economically reduces anti-nutritive factors that inhibit the digestion and absorption of proteins and carbohydrates.

Graphical abstract
Inversion of reservoir fluid mobility from frequency-dependent seismic data — A case study of gas-bearing reservoirs
Authors: Zhang Yijiang , Wen Xiaotao , Zhou Dongyong , Wang Wenhua , Lu Man , Fang Huijing
Published: October 2020

Reservoir fluid mobility is by definition the ratio of rock permeability to fluid viscosity. This attribute can be applied to reservoir physical property and permeability evaluation. Thus far, the only means of obtaining the reservoir fluid mobility over a large range of exploration areas is based on the extraction method. However, the location of high fluid mobility obtained by the extraction method is close to the reservoir interface. To obtain fluid mobility in the middle of the reservoir, an approximate inversion method of reservoir fluid mobility from frequency-dependent seismic data is proposed. First, we have calculated the reservoir fluid mobility coefficient using well data according to the relationship of fluid parameters. Then, we establish an inversion equation based on the low-frequency reflection coefficient and the reservoir fluid mobility. Taking the reservoir fluid mobility coefficient calculated from well data as an a priori constraint, the low-frequency model is subsequently constructed and applied with the inversion equation to obtain an inversion objective function. Next, the inversion equation is solved by the basis pursuit algorithm. Finally, the proposed reservoir fluid mobility inversion method is applied to synthetic and real data of gas-bearing reservoirs. The real data processing results show that the proposed reservoir fluid mobility inversion method can estimate the fluid mobility in the actual position of the reservoir more effectively.
Neuropsychiatric sequelae of Parkinson's disease: what every clinician needs to know
Authors: Okai David
Published: October 2020

Jones et al's review of the assessment and management of the neuropsychiatric manifestations of Parkinson's disease serves as a practical guide to clinicians. This commentary outlines some of the underlying neuroscience and psychological sequelae of this range of conditions, offering a takeaway message to the clinician with an interest in Parkinson's neuropsychiatry.
Development of a Model for Predicting Early Discontinuation of Adjuvant Chemotherapy in Stage III Colon Cancer
Authors: Boyne Devon J. , Brenner Darren R. , Sajobi Tolulope T. , Hilsden Robert J. , Yusuf Dimas , Xu Yuan , Friedenreich Christine M. , Cheung Winson Y.
Published: October 2020

PURPOSE

To develop a tool that can be used to predict early discontinuation of adjuvant chemotherapy among patients with stage III colon cancer.

PATIENTS AND METHODS

Through record linkage of Alberta administrative and tumor registry databases, we identified a cohort of individuals age ≥ 18 years who were diagnosed with stage III colon cancer and who received adjuvant chemotherapy in Alberta between 2004 and 2015. Early discontinuation was defined as receipt of < 5 months of a planned 6-month course of chemotherapy. By a systematic review of the literature and a survey of medical oncologists, the following candidate variables were identified: age (years), number of comorbidities (0, 1, ≥ 2), cancer stage (IIIC v IIIA-B), type of chemotherapy (fluorouracil, leucovorin, and oxaliplatin; capecitabine and oxaliplatin; or monotherapy), time from surgery to chemotherapy initiation (weeks), type of treatment facility (academic or community), and distance from home to treatment center (kilometers). Models developed using penalized logistic regression and the random forest algorithm were compared. Model performance was assessed using the C-statistic, Brier score, and a calibration plot. Internal validation was performed using the bootstrap method.

RESULTS

From an initial 3,115 patients identified, 1,378 were deemed eligible for inclusion. Of these patients, 474 patients (34.4%) failed to complete at least 5 months of chemotherapy. Although well calibrated, the penalized logistic regression model had poor discrimination (optimism-adjusted C-statistic, 0.63; 95% CI, 0.60 to 0.67). In contrast, the random forest model achieved adequate discrimination (optimism-adjusted C-statistic, 0.80; 95% CI, 0.79 to 0.82). Although the degree of calibration of the random forest was acceptable, it was slightly worse than that of the penalized logistic regression model.

CONCLUSION

Internal validation of our random forest model suggests that it may have clinical utility. Additional research regarding its external validation and clinical impact is needed.
Population Health Informatics Can Advance Interoperability: National Program of Cancer Registries Electronic Pathology Reporting Project
Authors: Pollack Lori A. , Jones Sandra F. , Blumenthal Wendy , Alimi Temitope O. , Jones David E. , Rogers Joseph D. , Benard Vicki B. , Richardson Lisa C.
Published: October 2020

PURPOSE

Given the reach, breadth, and volume of data collected from multiple clinical settings and systems, US central cancer registries (CCRs) are uniquely positioned to test and advance cancer health information exchange. This article describes a current Centers for Disease Control and Prevention (CDC) National Program of Cancer Registries (NPCR) cancer informatics data exchange initiative.

METHODS

CDC is using an established cloud-based platform developed by the Association of Public Health Laboratories (APHL) for national notifiable disease reporting to enable direct transmission of standardized electronic pathology (ePath) data from laboratories to CCRs in multiple states.

RESULTS

The APHL Informatics Messaging Services (AIMS) Platform provides an infrastructure to enable a large national laboratory to submit data to a single platform. State health departments receive data from the AIMS Platform through a secure portal, eliminating separate data exchange routes with each CCR.

CONCLUSION

Key factors enabling ePath data exchange from laboratories to CCRs are having established cancer registry data standards and using a single platform/portal to reduce data streams. NPCR plans to expand this approach in alignment with ongoing cancer informatics efforts in clinical settings. The 50 CCRs supported by NPCR provide a variety of scenarios to develop and disseminate cancer data informatics initiatives and have tremendous potential to increase the implementation of cancer data exchange.
Nivolumab and Ipilimumab in Metastatic Uveal Melanoma: Results From a Single-Arm Phase II Study
Authors: Pelster Meredith S. , Gruschkus Stephen K. , Bassett Roland , Gombos Dan S. , Shephard Michael , Posada Liberty , Glover Maura S. , Simien Rinata , Diab Adi , Hwu Patrick , Carter Brett W. , Patel Sapna P.
Published: October 2020

PURPOSE

Metastatic uveal melanoma has poor overall survival (OS) and no approved systemic therapy options. Studies of single-agent immunotherapy regimens have shown minimal benefit. There is the potential for improved responses with the use of combination immunotherapy.

PATIENTS AND METHODS

We conducted a phase II study of nivolumab with ipilimumab in patients with metastatic uveal melanoma. Any number of prior treatments was permitted. Patients received nivolumab 1 mg/kg and ipilimumab 3 mg/kg for four cycles, followed by nivolumab maintenance therapy for up to 2 years. The primary outcome of the study was overall response rate (ORR) as determined by RECIST 1.1 criteria. Progression-free survival (PFS), OS, and adverse events were also assessed.

RESULTS

Thirty-five patients were enrolled, and 33 patients were evaluable for efficacy. The ORR was 18%, including one confirmed complete response and five confirmed partial responses. The median PFS was 5.5 months (95% CI, 3.4 to 9.5 months), and the median OS was 19.1 months (95% CI, 9.6 months to NR). Forty percent of patients experienced a grade 3-4 treatment-related adverse event.

CONCLUSION

The combination regimen of nivolumab plus ipilimumab demonstrates activity in metastatic uveal melanoma, with deep and sustained confirmed responses.
Chronic administration of P2X7 receptor antagonist JNJ-47965567 delays disease onset and progression, and improves motor performance in ALS SOD1G93A female mice
Authors: Ruiz-Ruiz Cristina , García-Magro Nuria , Negredo Pilar , Avendaño Carlos , Bhattacharya Anindya , Ceusters Marc , García Antonio G.
Published: October 2020

Neuroinflammation is one of the main physiopathological mechanisms of amyotrophic lateral sclerosis (ALS), produced by the chronic activation of microglia in the CNS. This process is triggered by the persistent activation of the ATP-gated P2X7 receptor (P2RX7, hereafter referred to as P2X7R). The present study aimed to evaluate the effects of the chronic treatment with the P2X7R antagonist JNJ-47965567 in the development and progression of ALS in the SOD1G93A murine model. SOD1G93A mice were intraperitoneally (i.p.) injected with either 30 mg/kg of JNJ-47965567 or vehicle 4 times per week, from pre-onset age (here, postnatal day 60; P60) until study endpoint. Body weight, motor coordination, phenotypic score, disease onset and survival were measured throughout the study, and compared between vehicle- and drug-injected groups. Treatment with the P2X7R antagonist JNJ-47965567 delayed disease onset, reduced body weight loss and improved motor coordination and phenotypic score in female SOD1G93A mice, although it did not increase lifespan. Interestingly, neither beneficial nor detrimental effects were observed in males in any of the analyzed parameters. Treatment did not affect motor neuron survival or ChAT, Iba-1 and P2X7R protein expression in endpoint individuals of mixed sexes. Overall, chronic administration of JNJ-47965567 for 4 times per week to SOD1G93A mice from pre-onset stage altered disease progression in female individuals while it did not have any effect in males. Our results suggest a partial, yet important, effect of P2X7R in the development and progression of ALS.
The multifaceted functions of ATG16L1 in autophagy and related processes
Authors: Gammoh Noor
Published: October 2020

Autophagy requires the formation of membrane vesicles, known as autophagosomes, that engulf cellular cargoes and subsequently recruit lysosomal hydrolases for the degradation of their contents. A number of autophagy-related proteins act to mediate the de novo biogenesis of autophagosomes and vesicular trafficking events that are required for autophagy. Of these proteins, ATG16L1 is a key player that has important functions at various stages of autophagy. Numerous recent studies have begun to unravel novel activities of ATG16L1, including interactions with proteins and lipids, and how these mediate its role during autophagy and autophagy-related processes. Various domains have been identified within ATG16L1 that mediate its functions in recognising single and double membranes and activating subsequent autophagy-related enzymatic activities required for the recruitment of lysosomes. These recent findings, as well as the historical discovery of ATG16L1, pathological relevance, unresolved questions and contradictory observations, will be discussed here.
Discrete Prices and the Incidence and Efficiency of Excise Taxes
Authors: Conlon Christopher T. , Rao Nirupama L.
Published: October 2020

This paper uses UPC-level data to examine the relationship between excise taxes, retail prices, and consumer welfare in the distilled spirits market. We document a nominal rigidity in retail prices that arises because firms largely choose prices that end in 99 cents and change prices in whole-dollar increments. A correctly specified model, like an ordered logit, takes this discreteness into account when predicting the effects of alternative taxes. Explicitly accounting for price points substantially impacts estimates of tax incidence and the excess burden cost of tax revenue. Meaningful nonmonotonicities in these quantities expand the potential considerations in setting excise taxes. (JEL H22, H71, L11, L66)
Normalized apparent diffusion coefficient: a novel paradigm for characterization of endometrial and subendometrial lesions
Authors: Vora Zainab , Manchanda Smita , Sharma Raju , Das Chandan Jyoti , Hari Smriti , Mathur Sandeep , Kumar Sunesh , Kachhawa Garima , Khan Maroof Ahmad
Published: October 2020

Objectives:

To assess the role of normalized apparent diffusion coefficient (ADC) in characterization of endometrial and subendometrial masses, measured as a ratio of the mean ADC of the pathology to mean ADC of two different internal controls, normal myometrium and gluteus maximus muscle, referred to as nADCm and nADCg respectively.

Methods:

55 females with pathologically proven endometrial and subendometrial lesions, including 27 cases of endometrial carcinoma, and 28 cases of benign masses were enrolled in this prospective study and assessed with single-shot echoplanar diffusion-weighted imaging. The normalized and absolute ADC of the lesions, measured by two radiologists, were compared in different pathologies and receiver operating characteristics (ROC) performed to distinguish benign and malignant endometrial masses. In the endometrial carcinoma group, the ADC values were further compared with tumor grade and subtype.

Results:

There was good interobserver agreement (>0.800) for both internal controls, however it was higher for myometrium [intraclass correlation coefficient-0.92; confidence interval (0.86–0.95)] than gluteus maximus muscle [ICC-0.84; CI (0.72–0.90)]. There were statistically significant differences in absolute ADC (p-0.02), nADCm (p-0.02) and nADCg (p < 0.0001) of benign and malignant endometrial masses.

Conclusion:

Normalized ADC is useful to distinguish benign and malignant masses with comparable accuracy as absolute ADC.

Advances in knowledge:

Normalized ADC represents an easily measurable quantitative parameter which limits the influence of endogenous and exogenous factors that affect its reproducibility.
Diagnosing cystic duct patency during myocardial perfusion imaging (MPI), using Tc99m Sestamibi (MIBI), as an adjunct benefit in the acute setting
Authors: Semaan Hassan , Elsamaloty Haitham , Bazerbashi Mohamad , Obri Joud , Elsamaloty Mazzin , Arroyo Alberto J , Obri Tawfik
Published: October 2020

Objective:

Tc99m methoxy isobutyl isonitrile (MIBI) has been used for myocardial perfusion imaging (MPI) for the detection of ischemia. This study aimed to investigate the feasibility of effectively evaluating cystic duct patency, during routine visual analysis of the raw MPI and/or with the three-dimensional reconstructed data.

Methods:

A retrospective investigation of 91 patients undergoing cardiac MIBI scan for acute chest pain and hepatobiliary scintigraphy (HBS) was performed, within no more than 3 months for suspected gallbladder obstructive disease. Gallbladder visualization during either the stress or rest portion of the MIBI was indicative of cystic duct patency. These results were compared to those by the HBS studies.

Results:

Ten patients had the MIBI and HBS 4 days apart, both analyses concurred 100% with the diagnosis of cystic duct patency. 16 patients had both examinations between 4 days and 3 weeks and had an agreement of 87.5% with cystic duct patency. 65 patients had both tests 3 weeks to 3 months apart and had an agreement of 84.6% with cystic duct patency.

Conclusion:

The initial results of this study indicate that MPI with Tc99m MIBI is useful in detecting a patent cystic duct, above all in the setting of acute gallbladder pathology.

Advances in knowledge:

In this article, we introduce a novel method to diagnose cystic duct patency in the acute setting thus effectively ruling out acute cholecystitis, during MPI. Our method can potentially improve patient outcomes by reducing the volume of imaging needed to exclude a diagnosis of acute gallbladder pathology. This in turn, keeps in line with decreasing the cost for the patient, leading to a more sound value-based care.
Effect of homeopathy in the function and morphology of salivary parotid glands of irradiated rats
Authors: Alencar Phillipe Nogueira Barbosa , Lopes Luiza Lassi de Araújo , Neto Francisco Haiter , Venancio Paulo Cesar , Groppo Francisco Carlos , Barbosa Gabriella Lopes de Rezende , Silva Paulo Goberlânio de Barros , Avelar Rafael Linard
Published: October 2020

Objective: To evaluate the radioprotective effect of a homeopathic solution in salivary function and parotid glands morphology of irradiated rats. Materials and Methods: The sample consisted of 150 rats randomly divided into 6 groups. The groups were named based on the substance administered: Control- saline solution; Irradiated Control- saline solution and 15 Gy of X radiation; Alcohol-hydroalcoholic solution dynamized at 15 CH; Irradiated Alcohol- hydroalcoholic solution dynamized at 15 CH and 15 Gy of X radiation; Homeopathy- 0.25 ml (1mL/kg) of the irradiated hydroalcoholic solution and dynamized at 15 CH; Irradiated homeopathy- homeopathic solution and 15 Gy of X radiation. Each group was subdivided into 5 different subgroups, based on the time point of euthanasia: 12 hours, 3, 10, 17, and 24 days. The medication was administered for 7 days before and 7 days after the radiation treatment. On the day of euthanasia, salivation was induced with pilocarpine and collected. The animals were then sacrificed and the parotid glands were removed. Results: Salivary function analysis showed that only group irradiated homeopathy euthanized on day 17 had a statistically significant difference when compared to other irradiated groups, presenting a higher salivation flow rate. The only group that showed a statistically significant difference in the number of acini over time was the irradiated alcohol group, which presented a tendency of reduction. Conclusion: The homeopathic solution presented a late radioprotective effect based on salivary function and morphological analysis of the parotid gland.
Infection and Death Patterns of COVID-19 Disease in Bangladesh
Authors: Muyeed Abdul , Siddiqi Md. Nure Alam , Saha Tushar Kanti , Goni Md. Abdul
Published: October 2020

Objectives: This study aimed to reveal the prevalence of COVID-19 and investigate the patterns of deaths due to novel coronavirus in Bangladesh. Methods: The data about daily incidences, sex and deaths by the geography of COVID-19 for Bangladesh as of August 29, 2020 have been collected from the daily press releases of the Institute of Epidemiology, Disease Control and Research (IEDCR) and Directorate General of Health Services (DGHS). Case fatality rates (CFR), doubling time, correlation coefficient and graphical presentation were used to investigate the prevalence and patterns of infection and deaths. Results: Infection to tests, recovery to infections and death to infection rates due to novel coronavirus in Bangladesh until August 29, 2020 was 20.25%, 64.37% and 1.36% respectively. The correlation coefficient between daily tests and infections has found 0.978 with a 95% confidence interval 0.971 to 0.984. About 78.46% male and only 21.54% of females have died. Most deaths were found in the Dhaka division (48.26%) and the least deaths in the Mymensingh division (2.12%). The sex ratio of males to females in deaths was 364.23%. The age below 10 has found the least prevalent (0.45%) to deaths and above 60 has found most vulnerable (49.26%) to death. Conclusions: This study showed a strong positive relationship between daily tests and infections. The doubling time of infections and deaths in Bangladesh increased over time maintaining very low differences. Male people are more vulnerable to death compare to females. Aged people are extremely vulnerable to death. The most deaths geographical division is Dhaka and the least deaths in Mymensingh.
Effects of stretching exercises on human gait: a systematic review and meta-analysis
Authors: Vialleron Thomas , Delafontaine Arnaud , Ditcharles Sebastien , Fourcade Paul , Yiou Eric
Published: October 2020

Background: Stretching is commonly used in physical therapy as a rehabilitation tool to improve range of motion and motor function. However, is stretching an efficient method to improve gait, and if so, for which patient category?

Methods: A systematic review of randomized and non-randomized controlled trials with meta-analysis was conducted using relevant databases. Every patient category and every type of stretching programs were included without multicomponent programs. Data were meta-analysed where possible. Estimates of effect sizes (reported as standard mean difference (SMD)) with their respective 95% confidence interval (95% CI) were reported for each outcome. The PEDro scale was used for the quality assessment.

Results: Twelve studies were included in the analysis. Stretching improved gait performance as assessed by walking speed and stride length only in a study with a frail elderly population, with small effect sizes (both SMD= 0.49; 95% CI: 0.03, 0.96; PEDro score: 3/10). The total distance and the continuous walking distance of the six-minute walking test were also improved only in a study in an elderly population who had symptomatic peripheral artery disease, with large effect sizes (SMD= 1.56; 95% CI: 0.66, 2.45 and SMD= 3.05; 95% CI: 1.86, 4.23, respectively; PEDro score: 5/10). The results were conflicting in healthy older adults or no benefit was found for most of the performance, spatiotemporal, kinetic and angular related variables. Only one study (PEDro score: 6/10) showed improvements in stance phase duration (SMD=-1.92; 95% CI: -3.04, -0.81), swing phase duration (SMD=1.92; 95 CI: 0.81, 3.04), double support phase duration (SMD= -1.69; 95% CI: -2.76, -0.62) and step length (SMD=1.37; 95% CI: 0.36, 2.38) with large effect sizes.

Conclusions: There is no strong evidence supporting the beneficial effect of using stretching to improve gait. Further randomized controlled trials are needed to understand the impact of stretching on human gait.
Age, neutrophil lymphocyte ratio, and radiographic assessment of the quantity of lung edema (RALE) score to predict in-hospital mortality in COVID-19 patients: a retrospective study
Authors: Sensusiati Anggraini Dwi , Amin Muhammad , Nasronudin Nasronudin , Rosyid Alfian Nur , Ramadhan Nanda Aulya , Lathifah Rofida , Puspitasari Eva , Wahyuningtyas Ria Indah , Soebakti Erika
Published: October 2020

Background: Case fatality rate of COVID-19 patients in Surabaya is higher than global cases. Thus, it is important to identify risk factors to reduce the mortality rate. This study aimed to assess the factors associated with hospital mortality of COVID-19 patients, and develop a prediction score based on these findings.

Methods: We analyzed 111 patients, who were diagnosed with COVID-19 based on reverse-transcriptase polymerase chain reaction. The following patient characteristics were obtained from records: age, gender, type of symptoms, onset of symptoms, neutrophil lymphocyte ratio (NLR), absolute lymphocyte count, chest x-ray abnormalities, lung involvement, type of lesion, radiographic assessment of the quantity of lung edema (RALE) score, and mortality. Data were analyzed using SPSS 25.0.

Results Multivariate analysis showed that age >50 years (p=0.043), NLR score >5.8 (p=0.016) and RALE score >2 (p=0.002) can predict the mortality of COVID-19 patients in the hospital. ROC curve analysis of the score ability to predict mortality showed an area under the curve of 0.794. The cut-off point is 4.5, with a sensitivity of 96.7% and specificity of 49.4% to predict the mortality of COVID-19 patient in the hospital.

Conclusions Age, NLR score and RALE score were associated with mortality of COVID-19 patients in the hospital and could be used as a predictor for discharge probability of COVID-19 patients in low health care resource setting. The prediction score may be useful for frontline physicians to effectively manage patients with a higher score to prevent mortality.
Impact evaluation of national nutrition policies to address obesity through implementation of sin taxes in Gulf Cooperation Council countries: Bahrain, Saudi Arabia, Oman, United Arab Emirates, Kuwait and Qatar
Authors: Al-Jawaldeh Ayoub , Megally Rania
Published: October 2020

Background: Around 7% of under-five aged children in the Eastern Mediterranean are overweight, and there are higher rates in Gulf Cooperation Council (GCC) countries. This had led the GCC to impose policies that aim to decrease obesity, overweight, and diabetes rates. The objective of this research is to measure the impact of one such implemented policy to reduce obesity, i.e. sin taxes applied to sugar-sweetened beverages (SSB) in GCC.

Methods: The impact of sin taxes on SSB has been measured using a panel data set that covers sales volumes of soft drinks in GCC countries from 2010 to 2020.

Results: Growth rate of sales volumes decreased from 5.44% to 1.33% in Saudi Arabia, 7.37% to 5.93% in United Arab Emirates, and 5.25% to 5.09% in Bahrain from 2016 to 2017; sin taxes were implemented in these countries in 2017. In Qatar and Oman, sin taxes were implemented in 2019, and a reduction in sales volumes was observed from 2018 to 2019 (Qatar: 2.30% to 3.78%; Oman: 3.60% to 2.99%). Kuwait was the last GCC country to implement sin taxes in 2020. Growth rate of sales volumes decreased from 6.31% to 5.47% from 2019 to 2020.

Conclusions: Awareness campaigns should promote the reduction of the consumption of SSB and substitute with more consumption of water, unsweetened milk for children, fresh fruits and vegetables. These recommendations align with the recommended priority actions by the World Health Organization for the strategy on nutrition for the Eastern Mediterranean Region 2020-2030.
Long-term health effects of antipyretic drug use in the ageing population: protocol for a systematic review
Authors: Mahesh Seema , van der Werf Esther , Mallappa Mahesh , Vithoulkas George , Lai Nai Ming
Published: October 2020

Background: Fever is suppressed with drugs due to discomfort and risk of organ damage. However, there is some compelling evidence for the benefits of fever. The elderly are a special population in this regard as they have a blunted fever response. The benefit-harm balance of antipyretic use in this population is unclear.  

This study aims to provide the synthesized best evidence regarding long-term health effects of antipyretic treatment in the elderly during infections, investigating the onset/worsening of common chronic diseases, for e.g., thyroid disorders, connective tissue diseases and chronic obstructive pulmonary disease/asthma.

Methods: A systematic review will be performed to establish the best evidence available regarding antipyretic treatment in the elderly, searching databases such as Medline, Embase and Cochrane CENTRAL from their inception till date for all types of studies. Studies that consider the drugs in analgesic role will be excluded. The search will be reported following the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ (PRISMA) guidelines. Randomized control trials, quasi experimental studies, observational studies, case series and reports will be included. The primary outcome measure being onset/worsening of chronic inflammatory diseases. Other outcomes include relief of symptoms, length of hospital stay, patient satisfaction, mortality, blood/immune parameters indicative of morbidity and complications of the infection.

Risk of biases in randomized studies will be assessed through the Cochrane risk of bias tool. For other study types, appropriate tools such as CASP/QUIPS/Cochrane non-randomised studies tool will be used. Meta-analysis will be conducted on the Cochrane RevMan software and where pooling of data is not possible, a narrative synthesis will be performed. Overall certainty of evidence will be assessed through the GRADE approach.

Discussion: The study aims to provide evidence regarding benefit-harm balance of antipyretic use in the elderly population to inform clinical practice and future research. 

Systematic review registration: PROSPERO CRD42020160854
Situação de insegurança alimentar e nutricional em famílias quilombolas maranhenses
Authors: Araujo Silva Bruna De Moura , Da Cruz Silveira Victor Nogueira , Padilha Luana Lopes , Araújo Frota Maria Tereza Borges
Published: October 2020

Introdução: A segurança alimentar e nutricional está relacionada às condições de moradia, saneamento básico, água de qualidade, acesso a programas sociais, escolaridade, emprego e acesso ao consumo de alimentos. Objetivo: Avaliar a prevalência e os fatores associados à insegurança alimentar e nutricional em famílias de comunidades quilombolas maranhenses. Métodos: Foram coletados dados socioeconômicos, demográficos e de saúde de 373 famílias quilombolas, nos municípios de Penalva e Viana - MA, em 2015, por meio de formulário aplicado nos domicílios. A insegurança alimentar e nutricional foi avaliada utilizando-se a Escala Brasileira de Insegurança Alimentar. Os fatores associados à insegurança alimentar foram obtidos por meio da análise fatorial de classe latente (p<0,05). Resultados: A prevalência de segurança alimentar e nutricional foi de 20,1%, enquanto a de insegurança alimentar e nutricional foi de 79,9%, das quais 32,2% foram classificadas como leve, 25,7% moderada e 22,0% grave. Famílias chefiadas por mulheres, domicílios com mais de cinco pessoas, renda familiar per capita inferior a um quarto de salário mínimo e a não cobertura pela Estratégia Saúde da Família foram as variáveis associadas às classes de insegurança leve e moderada (p<0,05); na grave, todas as variáveis do modelo foram associadas (p<0,05). Conclusão: A insegurança alimentar e nutricional é elevada nas comunidades quilombolas estudadas, especialmente a grave. Esses resultados apontam para a necessidade de políticas públicas voltadas para assegurar acesso à educação, aumento da oferta de trabalho, garantia da renda mínima e expansão da cobertura da Estratégia Saúde da Família nas comunidades quilombolas.
Evaluation of the psychometric properties of the Quality Index for School Food Menus
Authors: Camargo Rafaella Guimarães Moraes , Bandoni Daniel Henrique , Domene Semíramis Martins Álvares
Published: October 2020

Objetivo: Avaliar as propriedades psicométricas do Indicador de Qualidade para cardápios da Alimentação Escolar (IQCAE). Métodos: Estudo metodológico utilizou dados secundários do Prêmio Gestor Eficiente da Merenda Escolar (Brasil) com 2.500 cardápios de 500 municípios brasileiros. Foram avaliados: (1) validade de conteúdo; (2) validade de critério; (3) reprodutibilidade; e (4) a análise de consistência interna. Resultados: O estudo de validade de conteúdo verificou que os componentes do IQCAE foram contemplados no consenso sobre alimentação escolar saudável. Para confirmar a validade de critério, não houve diferença entre a avaliação dos especialistas e do IQCAE. A reprodutibilidade foi ratificada por meio da concordância em estudo interexaminadores. O componente carnes e ovos foi o mais fortemente correlacionado com a pontuação total (r= 0,74), seguido de vegetais, leguminosas e cereais, e tubérculos (r= 0,73; r= 0,68; e r= 0,59; respectivamente). Quatro dos componentes apresentaram esta correlação inversa: laticínios (r= -0,34), horário compatível com a refeição (r= -0,12), embutidos (r= 0,19) e doces como sobremesa (r= 0,20). Conclusão: Os resultados do estudo mostraram que o IQCAE apresentou propriedades psicométricas suficientes para avaliar e monitorar a qualidade de cardápios da alimentação escolar brasileira.
Conhecimento de estudantes de Gastronomia acerca da doença celíaca
Authors: Freitas Vanessa Silva , Machado Martha Luisa , Giaretta Andréia Gonçalves , Moreira Caroline Camila
Published: October 2020

Objetivo: Avaliar o conhecimento de estudantes do curso de Gastronomia acerca da doença celíaca. Métodos: Estudo descritivo realizado com estudantes de um curso de Tecnologia em Gastronomia de Dourados-MS. Coleta de dados realizada em abril de 2019, por meio da aplicação de questionário organizado em três seções: (1) Sociodemográfica; (2) Conhecimento acerca da doença celíaca e dieta isenta de glúten; e (3) Conhecimento sobre cuidados especiais em preparações culinárias para celíacos. Resultados: Participaram 60 estudantes, com média de idade de 31,5 anos, sendo a maioria do sexo feminino (70%) e tendo se autodeclarado branca (73,3%). A maioria já ouviu falar da doença celíaca e glúten (61,7% e 100%, respectivamente), todavia 66,1% responderam erroneamente ou não souberam responder sobre o conceito da doença. Somente 15,5% acertaram que glúten é uma proteína. Apenas 24,5% dos estudantes mencionaram corretamente todos os cereais que contêm glúten e 5,4% indicaram corretamente todas as opções de substitutos para os cereais com glúten. Embora a maioria tenha relatado práticas convergentes sobre cuidados especiais em preparações isentas de glúten, um número expressivo de estudantes errou ou não soube responder sobre o compartilhamento de óleo, utensílios/equipamentos entre alimentos com e sem glúten (31,6% e 41,7%, respectivamente). Aproximadamente um terço dos estudantes (31,6%) não considera necessário verificar a presença de glúten no rótulo dos alimentos. Conclusão: Os estudantes de Gastronomia apresentaram conhecimento insatisfatório acerca da doença celíaca, dieta isenta de glúten e práticas culinárias para evitar a contaminação cruzada por glúten, o que pode implicar futuramente a qualidade dos serviços prestados na área de alimentação por esses profissionais e, consequentemente, na qualidade de vida dos celíacos. Os achados indicam a necessidade de reforma do currículo e criação de diretrizes curriculares para os cursos de Tecnologia em Gastronomia no Brasil.