bluuebunny/crossref_metadata_2025 huggingface dataset:
Retrospective cohort study on radial head arthroplasty comparing long-term outcomes between valgus type injury and fracture dislocation
Authors: Chen Alvin Chao-Yu , Weng Chun-Jui , Chiu Chih-Hao , Chang Shih-Sheng , Cheng Chun-Ying , Chan Yi-Sheng
Published: November 2020

Background

Radial head arthroplasty (RHA) has been commonly adopted for irreparable radial head fractures while little information is addressed on valgus type injury. The purpose of this study is to report long-term outcomes and radiographic analysis in RHA for valgus type injury with comparison to fracture dislocation injury.

Methods

A retrospective cohort study was conducted in patients receiving unilateral RHA with loose-fit, modular metal prosthesis for irreparable radial head fractures between 2004 and 2012. Totally, 33 patients with a mean follow up of 9 years (range, 7 to 15 years) were enrolled and divided into two groups including 14 valgus injuries and 19 fracture-dislocations. Demographics of the patients, injury details, clinical and radiographic outcomes, and correlation analysis were investigated and compared between two groups.

Results

In patient demographics, significant difference was noted in sex distribution (p = 0.001), lateral collateral ligament involvement (p = 0.000) and time from injury to RHA (p = 0.031) between two groups. No patient underwent subsequent removal or revision of prosthesis. Good to excellent results according to Mayo Elbow Performance Score (MEPS) was achieved in 13 and 14 patients in group A and B respectively. Final motion range and Disabilities of the Arm, Shoulder, and Hand score was significantly better in valgus injury group. Radiographic analysis demonstrated fewer patients in valgus injury group presented periprosthetic osteolysis with weak to moderate negative correlation between radiolucency score and MEPS.

Conclusions

With an average of 9 years follow-up, RHA using loose-fit, modular metal prosthesis achieves encouraging outcomes for both valgus injury and fracture dislocation. In valgus type injury, better motion range, lower disability score and lower incidence of periprosthetic osteolysis is noted while correlation analysis of radiolucency score suggests extended, long-term investigation.
Implementing early mobilisation after knee or hip arthroplasty to reduce length of stay: a quality improvement study with embedded qualitative component
Authors: Chua Happy , Brady Bernadette , Farrugia Melissa , Pavlovic Natalie , Ogul Shaniya , Hackett Danella , Farag Dimyana , Wan Anthony , Adie Sam , Gray Leeanne , Nazar Michelle , Xuan Wei , Walker Richard M. , Harris Ian A. , Naylor Justine M.
Published: November 2020

Background

Models of care for managing total knee or hip arthroplasty (TKA, THA) incorporating early mobilisation are associated with shorter acute length-of-stay (LOS). Few studies have examined the effect of implementing early mobilisation in isolation, however. This study aimed to determine if an accelerated mobilisation protocol implemented in isolation is associated with a reduced LOS without undermining care.

Method

A Before-After (quasi-experimental) study was used. Standard practice pre-implementation of the new protocol was physiotherapist-led mobilisation once per day commencing on post-operative Day 1 (Before phase). The new protocol (After phase) aimed to mobilise patients four times by end of Day 2 including an attempt to commence on Day 0; physiotherapy weekend coverage was necessarily increased. Poisson regression modelling was used to determine associations between study period and LOS. Additional outcomes to 12 weeks post-surgery were monitored to identify unintended consequences of the new protocol. Time to first mobilisation (hours) and proportion mobilising Day 0 were monitored to assess protocol compliance. An embedded qualitative component captured staff perspectives of the new protocol.

Results

Five hundred twenty consecutive patients (n = 278, Before; n = 242, After) were included. The new protocol was associated with no change in unadjusted LOS, a small reduction in adjusted LOS (8.1%, p = 0.046), a reduction in time to first mobilisation (28.5 (10.8) vs 22.6 (8.1) hrs, p < 0.001), and an increase in the proportion mobilising Day 0 (0 vs 7%, p < 0.001). Greater improvements were curtailed by an unexpected decrease in physiotherapy staffing (After phase). There were no significant changes to the rates of complications or readmissions, joint-specific pain and function scores or health-related quality of life to 12 weeks post-surgery. Qualitative findings of 11 multidisciplinary team members highlighted the importance of morning surgery, staffing, and well-defined roles.

Conclusion

Small reductions in LOS are possible utilising an early mobilisation protocol in isolation after TKA or THA although staff burden is increased likely undermining both sustainability and the magnitude of the change. Simultaneous incorporation of other changes within the pathway would likely secure larger reductions in LOS.
Outcomes of hemi- versus whole liver transplantation in patients from mainland china with high model for end-stage liver disease scores: a matched analysis
Authors: Kong LingXiang , Lv Tao , Jiang Li , Yang Jian , Yang Jiayin
Published: November 2020

Background

Adult hemiliver transplantation (AHLT) is an important approach given the current shortage of donor livers. However, the suitability of AHLT versus adult whole liver transplantation (AWLT) for recipients with high Model for End-Stage Liver Disease (MELD) scores remains controversial.

Methods

We divided patients undergoing AHLT and AWLT into subgroups according to their MELD scores (≥ 30: AHLT, n = 35; AWLT, n = 88; and < 30: AHLT, n = 323; AWLT, n = 323). Patients were matched by demographic data and perioperative conditions according to propensity scores. A cut-off value of 30 for MELD scores was determined by comparing the overall survival data of 735 cases of nontumor liver transplantation.

Results

Among patients with an MELD score ≥ 30 and < 30, AHLT was found to be associated with increased warm ischemia time, operative time, hospitalization time, and intraoperative blood loss compared with AWLT (P < 0.05). In the MELD ≥ 30 group, although the 5-year survival rate was significantly higher for AWLT than for AHLT (P = 0.037), there was no significant difference between AWLT and AHLT in the MELD < 30 group (P = 0.832); however, we did not observe a significant increase in specific complications following AHLT among patients with a high MELD score (≥ 30). Among these patients, the incidence of complications classified as Clavien-Dindo grade III or above was significantly higher in patients undergoing AHLT than in those undergoing AWLT (25.7% vs. 11.4%,P = 0.047). For the MELD < 30 group, there was no significant difference in the incidence of complications classified as Clavien-Dindo grade III or above for patients undergoing AHLT or AWLT.

Conclusion

In patients with an MELD score < 30, AHLT can achieve rates of mortality and overall survival comparable to AWLT. In those with an MELD score ≥ 30, the prognosis and incidence of complications classified as Clavien-Dindo III or above are significantly worse for AHLT than for AWLT; therefore, we may need to be more cautious regarding the conclusion that patients with a high MELD score can safely undergo AHLT.
Bleeding “sarcomatosis” as a rare presentation of vascular graft-related angiosarcoma: case report and review of the literature
Authors: Presacco Stefano , Agnes Amedea L. , Magalini Sabina , Carbone Arnaldo , Martini Maurizio , Agnes Annamaria
Published: November 2020

Background

Angiosarcoma is a rare malignant tumor, originating from vascular endothelial cells, accounting for approximatively 1–2% of soft tissue sarcomas. It is characterized by a rapid proliferation and high metastatic potential. Some cases of angiosarcoma are described in association with vascular prosthesis, orthopedic devices and foreign bodies. Hereby, we report a case of a patient treated with the endovascular placement of a PTFE aorto bis-iliac prosthesis for aortic aneurysm, who developed a graft-related angiosarcoma with bone and peritoneal localizations. The peritoneal “sarcomatosis” led to an acute presentation with hemoperitoneum and anemia. We perform a thorough review of the literature summarizing the description of similar cases, their epidemiology and the possibilities for treatment.

Case presentation

An 84-year-old male with a history of abdominal aortic aneurysm endovascular repair presented to our emergency department complaining with low back pain radiating to the left limb. He underwent a type II endoleak embolization of the aneurysmal sac nine days before. During hospitalization he underwent a spine MRI which documented a vertebral alteration of non-univocal interpretation. Vertebral biopsy was performed revealing groups of cells of uncertain nature. He lately underwent percutaneous L2–L4 arthrodesis. Forty-two days after admission, he developed acute anemia. Emergency laparotomy revealed a massive hemoperitoneum and actively bleeding peritoneal nodules. Abdominal packing was performed, and several nodules were sent for definitive histological examination. After surgery, he developed progressive and severe hypovolemic shock and expired on postoperative day 5.

Conclusions

Angiosarcoma associated with foreign bodies, especially vascular prosthesis, is a very rare entity. In patients who have a history of prosthetic vascular graft placement that present with lumbar pain, osteolytic changes at radiologic imaging or the development of ascites, angiosarcoma should be considered in the differential diagnosis. Despite the poor prognosis, a prompt diagnosis might give access to an adequate treatment planning, with the aim for disease control and increased survival.
GIS-based approaches on the accessibility of referral hospital using network analysis and the spatial distribution model of the spreading case of COVID-19 in Jakarta, Indonesia
Authors: Silalahi Florence Elfriede Sinthauli , Hidayat Fahrul , Dewi Ratna Sari , Purwono Nugroho , Oktaviani Nadya
Published: November 2020

Background

The outbreak of the novel coronavirus (COVID-19) has rapidly spread, causing million confirmed cases, thousands of deaths, and economic losses. The number of cases of COVID-19 in Jakarta is the largest in Indonesia. Furthermore, Jakarta is the capital city of Indonesia which has the densest population in the country. There is need for geospatial analysis to evaluate the demand in contrast to the capacity of Referral Hospitals and to model the spreading case of Covid-19 in order to support and organize an effective health service.

Methods

We used the data from local government publicity for COVID-19 as trusted available sources. By using the verifiable data by observation from the local government, we estimated the spatial pattern of distribution of cases to estimate the growing cases. We performed service area and Origin-Destination (OD) Cost Matrix in support to existing referral hospital, and to create Standard Deviational Ellipse (SDE) model to determine the spatial distribution of COVID-19.

Results

We identified more than 12.4 million people (86.7%) based on distance-based service area, live in the well served area of the referral hospital. A total 2637 positive-infected cases were identified and highly concentrated in West Jakarta (1096 cases). The results of OD cost matrix in a range of 10 km show a total 908 unassigned cases from 24 patient’s centroid which was highly concentrated in West Jakarta.

Conclusions

Our results indicate the needs for additional referral hospitals specializing in the treatment of COVID-19 and spatial illustration map of the growth of COVID-19′ case in support to the implementation of social distancing in Jakarta.
A comparison of health communication effectiveness and the improvement of management strategies: taking two Chinese traditional medicine hospitals’ WeChat public accounts as examples
Authors: Wang Jie , Wu Lanting
Published: November 2020

Background

In the light of “Internet plus”, hospitals are following the trend of using mobile internet and adopting a strategy of spreading public health knowledge through mobile terminals. WeChat is a social media with the largest number of users in China. Its public account has become the most popular service among the public.

Methods

We examine the health communication of medical institutions on social media platforms. The WeChat public accounts of Zhejiang Provincial Chinese Traditional Medicine Hospital and Jiangxi Provincial Chinese Traditional Medicine Hospital were taken as cases to measure the communication effect from the following dimensions: update interval, content positioning and design, numbers of clicks and likes as well as topic types.

Results

The update interval of WeChat public account of Jiangxi Provincial Hospital of Traditional Chinese Medicine was regular, compared with that of the other hospital. The accounts of the two hospitals both set up special sections to facilitate patients to obtain medical services online. There is an extremely significant difference between the two hospitals’ mean numbers of clicks (p < 0. 001), compared with no significant difference between their mean numbers of likes. One-way analysis of variance suggests the type of topic on posts is significantly correlated with the number of clicks. Moreover, there is an extremely significant difference between public health knowledge and news propaganda.

Conclusion

The development of hospitals’ WeChat public accounts can promote people’s health and equity in accessing medical information and service, and also boost “Internet plus health care” service. The topic type of hospital’s news publicity is paid a relatively lower attention by users. Therefore, hospitals’ WeChat public accounts need to adjust their strategy from propaganda-oriented to users-centered, with topic planning and posts designed to fulfill users’ needs.
Incident reports involving hospital administrative staff: analysis of data from the Japan Council for Quality Health care nationwide database
Authors: Akiyama Naomi , Akiyama Tomoya , Hayashida Kenshi , Shiroiwa Takeru , Koeda Keisuke
Published: November 2020

Background

Task shifting and task sharing in health care are rapidly becoming more common as the shortage of physicians increases. However, research has not yet examined the changing roles of hospital administrative staff. This study clarified: (1) the adverse incidents caused by hospital administrative staff, and the direct and indirect impact of these incidents on patient care; and (2) the incidents that directly involved hospital administrative staff.

Methods

This study used case report data from the Japan Council for Quality Health care collected from April 1, 2010 to March 31, 2019, including a total of 30,823 reports. In April 2020, only the 88 self-reported incidents by hospital administrative staff were downloaded, excluding incidents reported by those in medical and co-medical occupations. Data from three reports implicating pharmacists were rejected and the quantitative and textual data from the remaining 85 case reports were analyzed in terms of whether they impacted patient care directly or indirectly.

Results

Thirty-nine reports (45.9%) involved direct impact on patient care, while 46 (54.1%) involved indirect impact on patient care. Most incidents that directly impacted patient care involved administrative staff writing prescriptions on behalf of a doctor (n = 24, 61.5%); followed by errors related to system administration, information, and documentation (n = 7, 17.9%). Most reported errors that indirectly affected patient care were related to system administration, information, and documentation used by administrative staff (n = 22, 47.8%), or to reception (n = 9, 19.6%). Almost all errors occurred during weekdays. Most frequent incidents involved outpatients (n = 23, 27.1%), or occurred next to examination/operation rooms (n = 12, 14.1%). Further, a total of 14 cases (16.5%) involved patient misidentification.

Conclusions

Incidents involving hospital administrative staff, the most common of which are medication errors from incorrect prescriptions, can lead to severe consequences for patients. Given that administrative staff now form a part of medical treatment teams, improvements in patient care may require further submission and review of incident reports involving administrative staff.
Regular consumption of soft drinks is associated with type 2 diabetes incidence in Mexican adults: findings from a prospective cohort study
Authors: Torres-Ibarra Leticia , Rivera-Paredez Berenice , Hernández-López Rubí , Canto-Osorio Francisco , Sánchez-Romero Luz María , López-Olmedo Nancy , González-Morales Romina , Ramírez Paula , Salmerón Jorge , Barrientos-Gutiérrez Tonatiuh
Published: November 2020

Background

Although high consumption of soft drinks has been associated with excess of type 2 diabetes risk, the strength of this association in the Mexican population, where a type 2 diabetes genetic susceptibility has been well established, has been scarcely studied. This study aimed to estimate the risk of type 2 diabetes due to soft drinks consumption in a cohort of Mexicans.

Methods

We used data on 1445 participants from the Health Workers Cohort Study, a prospective cohort conducted in Cuernavaca, Mexico. Soft drinks consumption was assessed with a semi-quantitative 116-item food frequency questionnaire. Incident type 2 diabetes was defined as self-report of physician-diagnosed type 2 diabetes, fasting glucose > 126 mg/dl, or hypoglycemic medication at any examination. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models.

Results

With a total of 9526.2 person-years of follow-up, 109 incident cases of type 2 diabetes were observed. Type 2 diabetes incidence rate was 7.6, 11.0, and 17.1 per 1000 person-years across levels of soft drinks consumption of < 1, 1–4, and ≥ 5 servings/week, respectively (p < 0.001 for trend). The intake of ≥5 soft drinks/week was significantly associated with an increased risk of type 2 diabetes (HR 1.9 95% CI:1.0–3.5) compared with consumption of < 1/week (p-trend = 0.040). The HR was attenuated by further adjustment for body mass index (HR 1.5 95%CI:0.8–2.8) and abdominal obesity (HR 1.6 95%CI:0.8–3.0).

Conclusions

The consumption of soft drinks was associated with a higher risk of type 2 diabetes in a cohort of Mexican adults. Our results further support recommendations to limit soft drinks intake to address the growing diabetes epidemic in Mexico.
A novel HSP90 inhibitor targeting the C-terminal domain attenuates trastuzumab resistance in HER2-positive breast cancer
Authors: Park Jung Min , Kim Yoon-Jae , Park Soeun , Park Minsu , Farrand Lee , Nguyen Cong-Truong , Ann Jihyae , Nam Gibeom , Park Hyun-Ju , Lee Jeewoo , Kim Ji Young , Seo Jae Hong
Published: November 2020

Trastuzumab resistance in HER2-positive breast cancer is associated with a poorer prognosis. HSP90 is thought to play a major role in such resistance, but N-terminal inhibitors of this target have had little success. We sought to investigate the utility of NCT-547, a novel, rationally-designed C-terminal HSP90 inhibitor in the context of overcoming trastuzumab resistance. NCT-547 treatment significantly induced apoptosis without triggering the heat shock response (HSR), accompanied by caspase-3/− 7 activation in both trastuzumab-sensitive and -resistant cells. NCT-547 effectively promoted the degradation of full-length HER2 and truncated p95HER2, while also attenuating hetero-dimerization of HER2 family members. The impairment of cancer stem-like traits was observed with reductions in ALDH1 activity, the CD24low/CD44high subpopulation, and mammosphere formation in vitro and in vivo. NCT-547 was an effective inhibitor of tumor growth and angiogenesis, and no toxic outcomes were found in initial hepatic and renal analysis. Our findings suggest that NCT-547 may have applications in addressing trastuzumab resistance in HER2-positive breast cancer.
Diastolic function and its association with diabetes, hypertension and age in an outpatient population with normal stress echocardiography findings
Authors: Sundqvist Martin G. , Sahlén Anders , Ding Zee Pin , Ugander Martin
Published: November 2020

Background

Diastolic dysfunction can be caused by hypertension or diabetes mellitus, and it is also often found with increasing age. In a given patient, the cause of diastolic dysfunction is therefore not always obvious. We sought to study the interplay of these risk factors for diastolic dysfunction in an outpatient population with a low likelihood of ischemic heart disease.

Methods

Consecutive patients referred for stress echocardiography were included retrospectively. Exclusion criteria included pathological stress response, atrial arrhythmia, left ventricular ejection fraction < 55%, and more than mild valvular disease. Standard diastolic parameters were recorded in all patients. In a subset of patients, mechanistic analysis of early filling was performed using the parameterized diastolic filling (PDF) method.

Results

We included 726 patients (median [interquartile range] age 56 (44–65) years, 57% male). The prevalence of diabetes and hypertension was 43 and 49%, respectively. In multiple linear regression modeling, the presence of diabetes, hypertension, sex and increasing age explained a moderate amount of the variance in e’ velocities, E/A ratio and E/e’ (R2 = 0.31–0.48, p < 0.001), and a low amount of the variance in left atrial volume index (LAVI) and the PDF parameters (n = 446, R2 = 0.05–0.17, p < 0.001). Sex was only related to LAVI and E/e’ for the conventional parameters (beta − 0.94, p = 0.04, and beta − 0.91, p < 0.001, respectively).

Conclusions

Diabetes, hypertension, increasing age, and to a lesser extent sex, explain a moderate amount of the variance in conventional diastolic parameters related to myocardial tissue velocities and E/A ratio in a healthy outpatient population. The effect of these risk factors was substantially less pronounced on left atrial volume index and the PDF parameters.
The effect of letrozole versus artificial hormonal endometrial preparation on pregnancy outcome after frozen-thawed embryos transfer cycles: a randomized clinical trial
Authors: Hosseini-Najarkolaei Azadeh , Moini Ashraf , Kashani Ladan , Farid Mojtahedi Maryam , Hosseini-Najarkolaee Elnaz , Salehi Ensieh
Published: November 2020

Background

Considering that clinical trial studies are limited in polycystic ovary syndrome (PCOS) patients, and there is no consensus on an optimum endometrial preparation protocol for frozen embryo transfer (FET), the present study was designed as a randomized clinical trial to compare the reproductive outcomes following stimulated cycles with letrozole plus human menopausal gonadotropin (HMG) for endometrial preparation compared with routine AC-FET.

Methods

This randomized controlled trial was carried out on infertile PCOS patients who underwent IVF/ICSI and FET cycles in Arash Women’s Hospital affiliated to Tehran University of Medical Sciences between September 2018 and January 2020. PCOS diagnosis was based on the Rotterdam criteria. Eligible patients were randomly allocated into two groups: stimulated cycle with letrozole plus (HMG) (intervention group) and routine artificial hormonal endometrial preparation (control group).

Results

One hundred seventy-seven infertile patients were recruited for participation in the study. Of these, 57 women were excluded due to non-eligibility for entering the study, and a total of 120 patients were randomly assigned to two study groups. After follow up, the cycle outcomes of 57 patients in the intervention group and 59 patients in the control group were compared. The data analysis showed that the two groups did not have significant differences in fundamental and demographic characteristics. After the intervention, there were no significant differences in implantation rate, chemical, ectopic, and clinical pregnancy rates between groups. Moreover, the rates of miscarriage and ongoing pregnancy were similar between groups (P > 0.05).

Conclusions

We found similar pregnancy outcomes with two endometrial preparation methods. Noting that each treatment centre should select the most beneficial and cost-effective method with the least adverse effects for patients, letrozole preparations for FET could be incorporated into possible options; however, establishing this approach as first-line treatment is premature in light of current evidence, and future randomized clinical trials with larger sample sizes are required for widespread application.

Trial registration

The study was also registered in theIranian Registry of Clinical Trials on March 20th, 2020.(IRCT20090526001952N12atwww.irct.ir, registered retrospectively).
MiR-103a-3p promotes tumour glycolysis in colorectal cancer via hippo/YAP1/HIF1A axis
Authors: Sun Zhenqiang , Zhang Qiuge , Yuan Weitang , Li Xiaoli , Chen Chen , Guo Yaxin , Shao Bo , Dang Qin , Zhou Quanbo , Wang Qisan , Wang Guixian , Liu Jinbo , Kan Quancheng
Published: November 2020

Background

Glycolysis plays an essential role in the growth and metastasis of solid cancer and has received increasing attention in recent years. However, the complex regulatory mechanisms of tumour glycolysis remain elusive. This study aimed to explore the molecular effect and mechanism of the noncoding RNA miR-103a-3p on glycolysis in colorectal cancer (CRC).

Methods

We explored the effects of miR-103a-3p on glycolysis and the biological functions of CRC cells in vitro and in vivo. Furthermore, we investigated whether miR-103a-3p regulates HIF1A expression through the Hippo/YAP1 pathway, and evaluated the role of the miR-103a-3p-LATS2/SAV1-YAP1-HIF1A axis in promoting glycolysis and angiogenesis in CRC cells and contributed to invasion and metastasis of CRC cells.

Results

We found that miR-103a-3p was highly expressed in CRC tissues and cell lines compared with matched controls and the high expression of miR-103a-3p was associated with poor patient prognosis. Under hypoxic conditions, a high level of miR-103a-3p promoted the proliferation, invasion, migration, angiogenesis and glycolysis of CRC cells. Moreover, miR-103a-3p knockdown inhibited the growth, proliferation, and glycolysis of CRC cells and promoted the Hippo-YAP1 signalling pathway in nude mice in a xenograft model. Here, we demonstrated that miR-103a-3p could directly target LATS2 and SAV1. Subsequently, we verified that TEAD1, a transcriptional coactivator of Yes-associated protein 1 (YAP1), directly bound to the HIF1A promoter region and the YAP1 and TEAD1 proteins co-regulated the expression of HIF1A, thus promoting tumour glycolysis.

Conclusions

MiR-103a-3p, which is highly expressed in CRC cells, promotes HIF1A expression by targeting the core molecules LATS2 and SAV1 of the Hippo/YAP1 pathway, contributing to enhanced proliferation, invasion, migration, glycolysis and angiogenesis in CRC. Our study revealed the functional mechanisms of miR-103a-3p/YAP1/HIF1A axis in CRC glycolysis, which would provide potential intervention targets for molecular targeted therapy of CRC.
Multiple ileo-ileal intussusception associated with duodenal atresia in a 5-day-old infant: case report
Authors: Candy Gilang Vigorous Akbar Eka , Supangat Supangat
Published: November 2020

Background

Intussusception is the most common intestinal obstruction among infants and young children. Most of the pediatric cases are ileo-cecal, while jejuno-jejunal and ileo-ileal combined contribute only 2.5% of the cases.

Case presentation

A 5-day-old child presented with recurrent non-bilious vomiting since birth. Physical examination revealed a slightly distended abdomen. A plain radiograph revealed a countable bubble appearance. The initial clinical diagnosis was gastric outlet obstruction. During surgery, we discovered multiple ileo-ileal intussusception associated with duodenal atresia. We manually reduced the intussusceptions and bypassed the duodenal atresia using Kimura’s procedure. We did not find any significant morbidity in the post-operative phase.

Conclusion

Multiple ileo-ileal intussusception rarely associates with duodenal atresia. In our case report, the intussusceptions might be indirectly caused by duodenal atresia through various pathophysiology. Other unusual findings also supported this suggestion.
Multistakeholder Needs Assessment to Inform the Development of an mHealth-Based Ultrasound-Guided Breast Biopsy Training Program in Nigeria
Authors: Lynch Kathleen A. , Omisore Adeleye D. , Atkinson Thomas M. , Famurewa Olusola C. , Vera Jacqueline A. , Kingham T. Peter , Alatise Olusegun I. , Hricak Hedvig , Morris Elizabeth A. , Sutton Elizabeth J. ,   on behalf of the,   African Research Group for Oncology Collaborative
Published: November 2020

PURPOSE

The incidence of breast cancer is rising in Nigeria, and one major barrier to care is the lack of affordable and appropriate breast cancer diagnosis by ultrasound (US)–guided biopsy. The prohibitive cost of US devices limits their availability in low- and middle-income countries. The emergence of mobile health (mHealth) imaging devices may offer an acceptable low-cost alternative. The purpose of this research was to perform a comprehensive needs assessment to understand knowledge, use, training needs, and attitudes as regards image-guided biopsy in Nigeria to inform the development of an mHealth-based US-guided biopsy training program.

METHODS

A multistakeholder needs assessment was conducted at the Sixth Annual African Research Group for Oncology Symposium. Voluntary anonymous surveys were administered to all attendees. A subset of attendees (ie, surgeons, radiologists, pathologists, and nurses) participated in six focus groups. Survey items and interview guides were developed collaboratively with local and international input.

RESULTS

Surveys focusing on use, training needs, and attitudes regarding US-guided biopsies were completed with a 55% response rate (n = 54 of 98) among participants from 22 hospitals across Nigeria. Respondents expressed dissatisfaction with the way breast biopsies were currently performed at their hospitals and high interest in having their institution participate in a US-guided biopsy training program. Focus group participants (n = 37) identified challenges to performing US-guided procedures, including equipment functionality and cost, staff training, and access to consumables. Groups brainstormed the design of an mHealth US-guided biopsy training program, preferring a train-the-trainer format combining in-person teaching with independent modules.

CONCLUSION

A multidisciplinary needs assessment of local stakeholders identified a need for and acceptability of an mHealth-based US-guided biopsy training program in Nigeria.
Update on PCOS: Consequences, Challenges, and Guiding Treatment
Authors: Hoeger Kathleen M , Dokras Anuja , Piltonen Terhi
Published: November 2020

Polycystic ovary syndrome (PCOS) is one of the most common reproductive endocrine disorders in women and despite this, diagnostic challenges, delayed diagnosis, and less-than-optimal treatment regimens plague the condition. The International PCOS network, consisting of geographically diverse international experts in PCOS as well as consumers, engaged in a multi-year international evidence-based guideline development process that was jointly sponsored by the European Society for Human Reproduction and Embryology (ESHRE) and the American Society of Reproductive Medicine (ASRM). The guideline was published in 2018 and endorsed by more than 40 international societies involved in PCOS. Translation of this evidence-based guideline to medical practice and consumer groups remains a priority. However, there remain many challenges to both understanding the diagnosis and treatment of PCOS. Evidence suggests that both clinicians and consumers are not satisfied with the timeliness of diagnosis and treatment options. This review summarizes the important findings for diagnosis and treatment from the guidelines and expands on recent developments in the literature since its publication. Special attention to diagnosis at the ends of the reproductive spectrum are discussed and remaining areas of controversy are noted. Additionally, the review highlights some of the remaining challenges in the understanding and management of PCOS to help guide clinicians and investigators in this perplexing condition.
Maternal High-Fat Diet Multigenerationally Impairs Hippocampal Synaptic Plasticity and Memory in Male Rat Offspring
Authors: Lin ChengCheng , Lin YanYan , Luo Ji , Yu JunRu , Cheng YaNi , Wu XiaoYun , Lin Lin , Lin YuanShao
Published: November 2020

As advances are made in the field of developmental origins of health and disease, there is an emphasis on long-term influence of maternal environmental factors on offspring health. Maternal high-fat diet (HFD) consumption has been suggested to exert detrimental effects on cognitive function in offspring, but whether HFD-dependent brain remodeling can be transmitted to the next generations is still unclear. This study tested the hypothesis that HFD consumption during rat pregnancy and lactation multigenerationally influences male offspring hippocampal synaptic plasticity and cognitive function. We observed that hippocampus-dependent learning and memory was impaired in 3 generations from HFD-fed maternal ancestors (referred as F1-F3), as assessed by novel object recognition and Morris water maze tests. Moreover, maternal HFD exposure also affected electrophysiological and ultrastructure measures of hippocampal synaptic plasticity across generations. We observed that intranasal insulin replacement partially rescued hippocampal synaptic plasticity and cognitive deficits in F3 rats, suggesting central insulin resistance may play an important role in maternal diet-induced neuroplasticity impairment. Furthermore, maternal HFD exposure enhanced the palmitoylation of GluA1 critically involved in long-term potentiation induction, while palmitoylation inhibitor 2-bromopalmitate counteracts GluA1 hyperpalmitoylation and partially abolishes the detrimental effects of maternal diet on learning and memory in F3 offspring. Importantly, maternal HFD-dependent GluA1 hyperpalmitoylation was reversed by insulin replacement. Taken together, our data suggest that maternal HFD exposure multigenerationally influences adult male offspring hippocampal synaptic plasticity and cognitive performance, and central insulin resistance may serve as the cross-talk between maternal diet and cognitive impairment across generations.
The Role of Androgen Signaling in Male Sexual Development at Puberty
Authors: Rey Rodolfo A
Published: November 2020

Puberty is characterized by major changes in the anatomy and function of reproductive organs. Androgen activity is low before puberty, but during pubertal development, the testes resume the production of androgens. Major physiological changes occur in the testicular cell compartments in response to the increase in intratesticular testosterone concentrations and androgen receptor expression. Androgen activity also impacts on the internal and external genitalia. In target cells, androgens signal through a classical and a nonclassical pathway. This review addresses the most recent advances in the knowledge of the role of androgen signaling in postnatal male sexual development, with a special emphasis on human puberty.
An open interface in the pre-80S ribosome coordinated by ribosome assembly factors Tsr1 and Dim1 enables temporal regulation of Fap7
Authors: Rai Jay , Parker Melissa D. , Huang Haina , Choy Stefan , Ghalei Homa , Johnson Matthew C. , Karbstein Katrin , Stroupe M. Elizabeth
Published: November 2020

During their maturation, nascent 40S subunits enter a translation-like quality control cycle, where they are joined by mature 60S subunits to form 80S-like ribosomes. While these assembly intermediates are essential for maturation and quality control, how they form, and how their structure promotes quality control, remains unknown. To address these questions, we determined the structure of an 80S-like ribosome assembly intermediate to an overall resolution of 3.4 Å. The structure, validated by biochemical data, resolves a large body of previously paradoxical data and illustrates how assembly and translation factors cooperate to promote the formation of an interface that lacks many mature subunit contacts but is stabilized by the universally conserved methyltransferase Dim1. We also show how Tsr1 enables this interface by blocking the canonical binding of eIF5B to 40S subunits, while maintaining its binding to 60S. The structure also shows how this interface leads to unfolding of the platform, which allows for temporal regulation of the ATPase Fap7, thus linking 40S maturation to quality control during ribosome assembly.
PERANCANGAN SCIENCE CORNER (SCI-CO) SEBAGAI MEDIA BANTU VISUAL IMAGE BAGI GURU TK PGRI PALATTAE
Authors: Syaifullah Adji , Akbar Asfar Andi Muhamad Iqbal , Taufan Asfar Andi Muhammad Irfan , F.A A Nurannisa , Marlina Marlina , Nurjannah Sitti
Published: November 2020

It is currently endeavored to try to learn science learning from an early age to children, especially in kindergarten. Learning is directed towards creative and critical thinking that is able to direct children's high order thinking skills. The community service program with the PKM-M scheme was carried out at TK PGRI, Palattae Village, Bone Regency regarding the problems of teachers as partners in teaching science in the classroom to make it easier and more interactive through the design of a science corner (Sci-Co). This service was carried out in three main stages, namely counseling, design, and dissemination of the Sci-Co design. Learning using Sci-Co will be able to make children more critical and able to analyze events or phenomena that are often encountered in a child's environment, such as rain. Even though this program is conducted online, it is able to build teachers' skills in presenting Sci-Co in a simple way, the result of the teacher's own creativity with less than one week of processing time at the same time the teacher claims that this Sci-Co will help him accommodate children's knowledge in learning so that it is more meaningful less than one hour.
PELATIHAN DAN PENDAMPINGAN PENGOLAHAN SAMPAH MENJADI PRODUK BERNILAI EKONOMI PADA BANK SAMPAH BERSIH BERSAMA KARANGANOM, SITIMULYO, PIYUNGAN, BANTUL
Authors: Budiyanto Tri , Astuti Reni Dwi , Purwani Annie
Published: November 2020

The“Bersih Bersama” Waste Bank located in Karanganom, Sitimulyo, Piyungan, Bantul, Yogyakarta Special Region was a waste bank that still exists to manage waste from the local community. The problems faced include that management ware still limited to receiving from customers, then collected and handed over to collectors. The customer was not always doing the sorting process, so the managers have to sort and even have to clean it first. In addition, the level of community awareness to manage waste is still lacking. The purpose of community service was to provide additional skills to members of the waste bank to convert used goods that were originally only sorted and sold, converted into products that have use value and sale value. Community service activities were carried out by organizing training and assistance in making coffee sachet bags using waste paper and coffee sachets (plastic) directly to the community. This training was carried out in 2 stages, namely on September 20 for stage 1 and October 10, 2020 for stage 2. The results of the implementation of community service were increased knowledge about the use of paper and plastic waste, the ability to make new products in the form of coffee sachet bags with attractive motifs that have value. added. A positive impact can be seen from the increased knowledge and understanding of waste bank members in the use of paper and plastic waste into useful and economic goods. In addition, the Karanganom Sitimulyo community can contribute to reducing plastic waste in their environment
Z+/Z− lithium niobate optical waveguide sensitivity related to pyroelectric effect
Authors: Pointel Anne-Laure , Devaux Fabrice , Hauden Jérôme
Published: November 2020

Lithium niobate crystal is widely used for the design and fabrication of integrated electro-optic modulators. As a ferroelectric material, one sees its spontaneous polarization change with temperature variations. This phenomenon, known as the pyroelectric effect, induces strong waveguide transmission variations for waveguides realized on

Z

-cut wafers. Waveguides made by titanium in-diffusion either on the

Z

+

or

Z

−

side of the crystal show a significant difference in temperature behavior. Experimental data, enlightened by numerical simulations, help to show why

Z

−

waveguides are more immune to temperature changes than

Z

+

ones.
Light depolarization based on dispersion degree of polarization
Authors: Zou Kang , Miao Lijun , Wang Guofa , Bi Ran , Chen Kan , She Xuan , Shu Xiaowu
Published: November 2020

The dispersion degree of polarization, a new definition of the depolarization degree of partially polarized beams, is first proposed, to the best of our knowledge, to measure the performance of fiber depolarizers. First, the description of the polarization based on the Poincaré sphere is introduced. Then, the modified Delaunay triangulation algorithm is introduced, and the calculation formula of the dispersion degree of polarization is given based on this algorithm. The experimental device was set up, and the dispersion degree of polarization of the depolarized light after the fiber depolarizer was measured to be 47.3%. The components and proportions of polarization in the depolarized light were also obtained. Compared with the degree of polarization, the dispersion degree of polarization can quantitatively analyze the light polarization evaluation in the time dimension and provide a numerical reference for improving the depolarizer, thus increasing the fiber sensor’s accuracy.
Arbitrarily directed emission of integrated cylindrical vector vortex beams by geometric phase engineering
Authors: Sebbag Yoel , Levy Uriel
Published: November 2020

Integrated cylindrical vector vortex (CVV) emitters have been introduced and studied for their potential applications in classical optics and quantum optics technologies. In this work, we demonstrate that the emission angle of integrated CVV emitters can be engineered by taking advantage of the geometrical phase of a microring resonator. Two methods to superimpose an arbitrary phase profile on top of the integrated emitters are presented and compared. Angled emission of integrated vector vortex beams enables the use of chip-scale emitters for integrated nonlinear optics and for beam steering applications with orbital angular momentum.
Unique genetic signatures of local adaptation over space and time for diapause, an ecologically relevant complex trait, in Drosophila melanogaster
Authors: Erickson Priscilla A. , Weller Cory A. , Song Daniel Y. , Bangerter Alyssa S. , Schmidt Paul , Bergland Alan O.
Published: November 2020

Organisms living in seasonally variable environments utilize cues such as light and temperature to induce plastic responses, enabling them to exploit favorable seasons and avoid unfavorable ones. Local adapation can result in variation in seasonal responses, but the genetic basis and evolutionary history of this variation remains elusive. Many insects, includingDrosophila melanogaster, are able to undergo an arrest of reproductive development (diapause) in response to unfavorable conditions. InD.melanogaster, the ability to diapause is more common in high latitude populations, where flies endure harsher winters, and in the spring, reflecting differential survivorship of overwintering populations. Using a novel hybrid swarm-based genome wide association study, we examined the genetic basis and evolutionary history of ovarian diapause. We exposed outbred females to different temperatures and day lengths, characterized ovarian development for over 2800 flies, and reconstructed their complete, phased genomes. We found that diapause, scored at two different developmental cutoffs, has modest heritability, and we identified hundreds of SNPs associated with each of the two phenotypes. Alleles associated with one of the diapause phenotypes tend to be more common at higher latitudes, but these alleles do not show predictable seasonal variation. The collective signal of many small-effect, clinally varying SNPs can plausibly explain latitudinal variation in diapause seen in North America. Alleles associated with diapause are segregating in Zambia, suggesting that variation in diapause relies on ancestral polymorphisms, and both pro- and anti-diapause alleles have experienced selection in North America. Finally, we utilized outdoor mesocosms to track diapause under natural conditions. We found that hybrid swarms reared outdoors evolved increased propensity for diapause in late fall, whereas indoor control populations experienced no such change. Our results indicate that diapause is a complex, quantitative trait with different evolutionary patterns across time and space.
Prevalence and correlates of diagnosed and undiagnosed epilepsy and migraine headache among people with severe psychiatric disorders in Ethiopia
Authors: Ayano Getinet , Demelash Sileshi , Yohannes Zegeye , Haile Kibrom , Tsegay Light , Tesfaye Abel , Haile Kelemua , Tulu Mikias , Tsegaye Belachew , Solomon Melat , Hibdye Getahun , Assefa Dawit , Dachew Berihun Assefa
Published: November 2020

Background

There is a paucity of research on the prevalence of diagnosed as well as undiagnosed neurological disorders with episodic manifestations such as epilepsy and migraine headaches in people with severe psychiatric disorders (SPD). To the best of our knowledge, this is the first study analyzing and comparing the prevalence of diagnosed and undiagnosed chronic neurological disorders with episodic manifestations including epilepsy and migraine headache in people with SPD.

Method

This quantitative cross-sectional survey was undertaken among 309 patients with SPD selected by a systematic random sampling technique. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was used to confirm SPD among the participants. The International Classification of Headache Disorders (ICHD-3) and International League Against Epilepsy (ILAE) were used to define migraine headache and epilepsy, respectively]. Risk factors for chronic neurologic disorders were explored by using logistic regression models.

Result

In this study, the prevalence of overall neurological disorders, epilepsy, and migraine headache among people with SPD were found to be 5.2% (95%CI 3.2–8.3), 1.6% (95%CI 0.7–3.9), and 3.9% (95%CI 2.2–6.7), respectively. We found that a considerably higher proportion of people with SPD had undiagnosed overall neurological disorder (87.5%; 14/16), epilepsy (60%; 3/5), as well as migraine headaches (100%; 12/12). On the other hand, in this study, 12.5%, 40%, and 0% of patients with overall neurologic disorder, epilepsy, and migraine headaches respectively were diagnosed by the professionals. Higher disability score (WHODAS score) was associated with increased odds of having neurological disorders compared with the lower WHODAS score [OR = 1.30 (95% CI 1.02–1.66)].

Conclusion

Whilst the prevalence estimates of neurological disorders with episodic manifestations including epilepsy and migraine headache was high among people with SPD, the vast majority of them remained undiagnosed. The diagnosis rates of those disorders were significantly low, perhaps surprisingly zero for migraine headache. High WHODAS score was associated with increased odds of having neurological disorders. Routine screening and management of epilepsy and migraine headache are imperative among people with SPD.