bluuebunny/crossref_metadata_2025 huggingface dataset:
More Stick than Carrot?: Xi’s Policy toward Establishment Intellectuals
Authors: YANG FLORENCE W.
Published: June 2021

After President Xi Jinping came to office, the Chinese government tightened its ideological control over establishment intellectuals and particularly the university teachers. This project aims to answer the question of why and when an authoritarian state chooses to do so. It focuses on the CCP’s policy toward establishment intellectuals under Xi and explores the most applicable explanation for this policy shift. Based on the existing literature on the cyclical model of state-intellectual relations in China, we propose a new model of “Dual Methods in State-Intellectual Relations.” The model demonstrates that the CCP has employed dual methods of repression and co-optation on intellectuals adopting different roles. Leaders choose repression when they perceive that the legitimacy of their rule is challenged externally or internally by criticism and collective actions led by intellectuals. In this case, the goal of repression is to either set up a new “red line” or warn intellectuals that they have crossed it.
Modular reorganization of gait in chronic but not in artificial knee joint constraint
Authors: Cruz-Montecinos Carlos , Pérez-Alenda Sofía , Cerda Mauricio , Maas Huub
Published: June 2021

It is currently unknown if modular reorganization does occur if not the central nervous system, but the musculoskeletal system is affected. This study showed that in the short-term a knee constraint does not affect the modular organization of gait, but in the long-term a knee constraint results in modular reorganization. These results indicate that modular reorganization may also occur when changes in the mechanics of the musculoskeletal system is the primary cause of the motor impairment.
A Five-Gene Prognostic Nomogram Predicting Disease-Free Survival of Differentiated Thyroid Cancer
Authors: Ruchong Pan , Haiping Tang , Xiang Wang
Published: June 2021

Background. Differentiated thyroid cancer (DTC) is the most common type of thyroid tumor with a high recurrence rate. Here, we developed a nomogram to effectively predict postoperative disease-free survival (DFS) in DTC patients. Methods. The mRNA expressions and clinical data of DTC patients were downloaded from the Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) database. Seventy percent of patients were randomly selected as the training dataset, and thirty percent of patients were classified into the testing dataset. Multivariate Cox regression analysis was adopted to establish a nomogram to predict 1-year, 3-year, and 5-year DFS rate of DTC patients. Results. A five-gene signature comprised of TENM1, FN1, APOD, F12, and BTNL8 genes was established to predict the DFS rate of DTC patients. Results from the concordance index (C-index), area under curve (AUC), and calibration curve showed that both the training dataset and the testing dataset exhibited good prediction ability, and they were superior to other traditional models. The risk score and distant metastasis (M) of the five-gene signature were independent risk factors that affected DTC recurrence. A nomogram that could predict 1-year, 3-year, and 5-year DFS rate of DTC patients was established with a C-index of 0.801 (95% CI: 0.736, 0.866). Conclusion. Our study developed a prediction model based on the gene expression and clinical characteristics to predict the DFS rate of DTC patients, which may be applied to more accurately assess patient prognosis and individualized treatment.
Robust Assignment of Natural Frequencies and Antiresonances in Vibrating Systems through Dynamic Structural Modification
Authors: Caracciolo Roberto , Richiedei Dario , Tamellin Iacopo
Published: June 2021

This paper proposes a novel method for the robust partial assignment of natural frequencies and antiresonances, together with the partial assignment of the related eigenvectors, in lightly damped linear vibrating systems. Dynamic structural modification is exploited to assign the eigenvalues, either of the system or of the adjoint system, together with their sensitivity with respect to some parameters of interest. To handle with constraints on the feasible modifications, the inverse eigenvalue problem is cast as a minimization problem and a solution method is proposed through homotopy optimization. Variables lifting for bilinear and trilinear terms, together with bilinear and double‐McCormick’s constraints, are exploited to provide a convexification of the problem and to boost the attainment of the global optimum. The effectiveness of the proposed method is assessed through four numerical examples.
Bacteria and Mold Spore Heat Resistance in Guava Juice and Its Control by pH and Sodium Benzoate
Authors: Evelyn  , Chairul
Published: June 2021

Heat-resistant bacteria and molds can survive the pasteurization conditions used in high-acid fruit juices. The objective of this study was to evaluate the log reductions and thermal inactivation kinetics of spores of Bacillus subtilis bacteria and ascospores of Talaromyces flavus and Eupenicillium javanicum molds under influence of pH and sodium benzoate preservative. The spores were suspended in guava juice, processed at 90-100°C for B. subtilis and at 80-90°C for T. flavus and E. javanicum, and decimal reduction (

D

) values were estimated from the log survivor curves. Next, the effects of pH change (3.5-4.5) and 0.015% sodium benzoate addition on the

D

values of spores were investigated. Lower

D

values were obtained at higher temperatures (

D

100
°
C

value of 2.32 min vs.

D

90
°
C

value of 15.33 min for B. subtilis,

D

90
°
C

value of 2.96 min vs.

D

80
°
C

value of 59.52 min for T. flavus, and

D

90
°
C

value of 1.58 min vs.

D

80
°
C

value of 21.32 min for E. javanicum). The

D

values decreased further (to 1.8 min at 100°C for B. subtilis, to 2.33 min at 90°C for T. flavus, and to 1.49 min at 90°C for E. javanicum) when the pH of guava juice was decreased from 4.1 to 3.5. Inclusion of sodium benzoate in pH 3.5 juice enhanced the thermal inactivation of spores (

D

100
°
C

value decreased to 1.4 min for B. subtilis, to 1.98 min for T. flavus, and to 1.34 min for E. javanicum). To conclude, the combination of low pH and sodium benzoate provided the best method for spore inactivation, which could enhance food safety and extend food’s shelf life.
Buoyancy Effect on a Micropolar Fluid Flow Past a Vertical Riga Surface Comprising Water-Based SWCNT–MWCNT Hybrid Nanofluid Subject to Partially Slipped and Thermal Stratification: Cattaneo–Christov Model
Authors: Mohammed Alshehri Ahmed , Huseyin Coban Hasan , Ahmad Shafiq , Khan Umair , Alghamdi Wajdi Mohamad
Published: June 2021

This paper provides a comprehensive analysis of the mixed convective flow that comprises SWCNT-MWCNT/water hybrid nanofluid containing micropolar fluid through a partially slipped vertical Riga surface. A Cattaneo–Christov heat flux model is used to examine the heat transport rate. The energy equation is gaining more significance with the effect of viscous dissipation and thermal stratification. The flow model is transformed by convenient transformation into nondimensionless form. The numerical results of nonlinear complex equations are collected using the bvp4c built-in function from MATLAB which is based on the finite difference method. The graphical results are obtained for both hybrid nanofluid and simple nanofluid. The temperature distribution for hybrid nanofluid is higher than that for simple nanofluid when the solid volume fraction increases. The axial friction factor increases with solid volume fraction, porosity parameter, and mixed convection parameter. The velocity graph varies inversely with nanofluid volume fraction and micropolar parameter.
Metabolomics and Network Pharmacology-Based Investigation into the Mechanisms Underlying the Therapeutic Effect of a New Chinese Traditional Medicine (Cui Nai Ling) on Bromocriptine-Induced Hypogalactia
Authors: Meng Xianglong , Lyu Chenzi , Ma Junnan , Zhang Xiaoyan , Hu Cong , Su Xiaojuan , Ning Chenxu , Xie Wenbin , Zhang Shuosheng
Published: June 2021

As a traditional veterinary medicine to promote lactation, Cui Nai Ling (CNL) can not only increase milk supply and promote health but also improve the overall physiological function and immunity of the animals. In order to further improve CNL’s effect on lactation, we have previously made a new CNL (NCNL) by adding Tetrapanacis Medulla and replacing Vaccariae Semen with fried Vaccariae Semen in CNL. We have demonstrated that the lactation-promoting effect of NCNL is better than that of CNL. However, the underlying mechanisms by which NCNL promotes lactation are unclear. In this study, we performed metabolomics, network pharmacology, and pharmacodynamic studies to explore the underlying mechanisms by which NCNL promotes lactation in rats with bromocriptine-induced hypogalactia. The results showed that NCNL significantly improved the loss of appetite in female adult rats and the weight loss of pups caused by the disorder of lactation. Biochemical analysis showed that NCNL could regulate the levels of PRL, T4, E2, Ca, UREA, GLU, ALT, AST, TCHO, and TG in serum. The pathological results showed that NCNL could promote lactation and increase the mammary gland index by improving breast acinar tissue morphology in rats with hypogalactia. Network pharmacology studies showed that NCNL promotes lactation through P13K-Akt, insulin resistance, and prolactin signaling pathways, among which the most frequently affected pathway was the P13K-Akt signaling pathway. Metabolomics studies showed that NCNL can significantly upregulate phenylalanine, tyrosine, and tryptophan biosynthesis and tyrosine metabolism pathways and downregulate cysteine and methionine metabolism pathways. NCNL can significantly increase the serum prolactin concentration, improve the glucose and lipid metabolism disorders, and regulate PI3K-Akt, insulin resistance, and prolactin pathways to affect the amino acids’ metabolism in the mammary gland and ultimately exert its therapeutic effect on bromocriptine-induced postpartum hypogalactia. These findings revealed the effect and application value of NCNL on animals with postpartum hypogalactia.
Sensenbrenner Syndrome Presenting with Severe Anorexia, Failure to Thrive, Chronic Kidney Disease and Angel-Shaped Middle Phalanges in Two Siblings
Authors: Brndiarova Miroslava , Mraz Martin , Kolkova Zuzana , Cisarik Frantisek , Banovcin Peter
Published: June 2021

Sensenbrenner syndrome is a very rare autosomal recessive disorder caused by variants in genes involved in the functional development of primary cilia. Typical clinical manifestations include craniofacial and skeletal abnormalities, hence the alternative name cranioectodermal dysplasia. Chronic kidney disease due to progressive tubulointerstitial nephritis (nephronophthisis) has been described in these patients. The authors present 2siblings with severe anorexia, failure to thrive, chronic kidney disease, and angel-shaped middle phalanges. Two previously described variants p.(Leu641*) and p.(Asp841Val) were identified in the WDR35 gene which is most commonly affected in this condition. Analysis of all coding exons of the GDF5 gene was normal. This is the first report of Sensenbrenner syndrome presenting with severe anorexia and failure to thrive at early age. Angel-shaped middle phalanges in the absence of the GDF5 variant may represent an overlapping phenotypic manifestation of ciliopathy.
Intrapleural Foreign Body: Case Report
Authors: Di Marco Berardino Alessandro , Rendina Erino Angelo , Bonifazi Martina , Zuccatosta Lina , Latini Letizia Lara , Gonnelli Francesca , Latini Agnese , Cirilli Laura , Gasparini Stefano
Published: June 2021

The detection of foreign bodies in the pleural cavity is rare and mostly consequent to iatrogenic or traumatic events. The migration of an inhaled foreign body from the airways to the pleural space through a bronchopleural fistula is an exceptional event. We report a case of a pleural empyema consequent to an inhaled wooden skewer. CT scan and bronchoscopy were unable to identify the foreign body, due to its migration in the peripheral airways. The thin and pointed foreign body perforated the visceral pleural surface emerging in the pleural cavity.
Association of Exposure to Particulate Matters and Multiple Sclerosis: A Systematic Review and Meta-Analysis
Authors: Lotfi Fatemeh , Mansourian Marjan , Mirmoayyeb Omid , Najdaghi Soroush , Shaygannejad Vahid , Esmaeil Nafiseh
Published: June 2021

The association between air pollution and multiple sclerosis (MS) is not entirely clear. This meta-analysis was aimed at determining the correlation between particulate matter (PM)2.5, PM10, and MS incidence/relapse. The literature search was performed in EMBASE, Web of Science, PubMed, and the gray literature. Sixteen articles were retrieved, and ten articles were included and evaluated. Three measures of association were used for the meta-analysis: odds ratio (cross-sectional and case-control studies), incidence rate ratio, or hazard ratio (cohort studies). Meta-analysis of those 3 studies on PM2.5 indicated that exposure to PM2.5 was associated with MS relapse and incidence ([95% confidence interval; CI] 1.178 [1.102, 1.279]), p > 0.05. Also, assessment of risk ratio for all studies showed a correlation between PMs (PM10 and PM2.5) and MS incidence and relapse ([95% CI] 1.28, [1.13–1.43]) p < 0.05. Collectively, we found that PM exposure (PM10 and PM2.5) in MS patients associates with the occurrence and relapse of disease.
A Questionnaire-Based Study on Clinical REM Sleep Behavior Disorder and Subtypes in Multiple System Atrophy
Authors: Wu Dong-dong , Su Wen , Li Shu-hua , He Jing , Li Kai , Chen Hai-Bo , Jin Ying
Published: June 2021

Objectives: Studies documenting the association between rapid eye movement sleep behavior disorder (RBD) and subtypes of multiple system atrophy (MSA) are rare. In this study, we investigated the presence of clinical RBD in MSA patients and compared the prevalence and severity of RBD in patients with MSA-P and MSA-C subtypes. Methods: We evaluated 54 consecutive patients presenting with MSA and hospitalized in the neurology ward of Beijing Hospital from February 2012 to June 2020. The healthy control (HC) group consisted of 100 healthy individuals who came to our hospital for physical examination. The clinical diagnosis of RBD was based on the minimal diagnostic criteria of International Classification of Sleep Disorders, revised. The severity of clinical RBD was rated on a digital scale from 0 to 3. The patients were divided into 2 subgroups: MSA-P and MSA-C. The MSA and HC groups were compared in terms of frequency of clinical RBD. The MSA-P and MSA-C subgroups were compared with each other for age, sex, onset age, disease duration, and features of clinical RBD. The correlation between severity of clinical RBD and clinical characteristics of MSA was analyzed in the patient groups. Results: The frequency of clinical RBD in MSA and HC groups was 70.4% (38/54) and 5% (5/100), respectively. The difference between 2 groups was significant (χ2 = 74.453, p = 0.000). Among the patients, 57.4% (31/54) had the MSA-P subtype. There were no significant differences between MSA-P and MSA-C subtypes in the prevalence (χ2 = 1.734, p = 0.188) and severity (χ2 = 1.776, p = 0.412) of clinical RBD. The onset of clinical RBD during the premotor period was not different between the subtypes of MSA, either in patients’ number of preceding the onset of motor symptoms (χ2 = 0.581, p = 0.446) or the preceding time (Z = −0.550, p = 0.582). For the MSA-C patients, there was a negative correlation between the score of severity of the RBD scale and RBD preceding motor symptoms (r = −0.482, p = 0.020). Conclusion: In our study, the prevalence of clinical RBD is unrelated to the subtypes of MSA. The onset of clinical RBD during the premotor period was not different between subtypes of MSA. However, we found that the severity of RBD occurring before the motor symptoms was more than that occurring after the motor symptoms in MSA-C patients. Our results showed that MSA-P and MSA-C patients may have a probable indicator for the similar pathologic mechanism of the disease and its sleep problems.
Cryptaphelenchus abietis n. sp. (Tylenchomorpha: Aphelenchoididae) isolated from Cryphalus piceae (Ratzeburg) (Coleoptera: Scolytinae) emerged from Abies veitchii Lindl. (Pinaceae) from Nagano, Japan
Authors: Kanzaki Natsumi , Ekino Taisuke , Degawa Yousuke
Published: June 2021

An undescribed Cryptaphelenchus species was isolated from a bark beetle, Cryphalus piceae that had emerged from a dead log of the Veitch’s fir, Abies veitchii, collected from Sugadaira Montane Research Center, University of Tsukuba, Nagano, Japan. The new species is characterised by its female post-vulval uterine sac (PUS) of less than one vulval body diam. in length and female posterior body end (tail) conical with elongate posterior part and variably shaped tip, seven male genital papillae, which are composed/arranged as a precloacal P1, P2 pair slightly anterior to cloacal opening, and two small pairs of glandpapillae near tail tip and very narrow bursal flap-like cuticular extension surrounding the male tail. In addition to these characters, the male apophysis appears wing-like in ventral view. In possessing an elongate posterior part, Cryptaphelenchus abietis n. sp. shares the female tail shape with C. borlossi, C. leptocaudus and C. sutoricus, and shares a short PUS with C. iranicus, C. varicaudatus, C. baujardi and C. paravaricaudatus. However, the new species can be distinguished from these species by other typological and morphometric characters and its molecular phylogenetic status. Phylogenetically, the new species is closest to Bursaphelenchus minutus, but can be clearly distinguished by morphological and molecular sequence characters.
Apprentissages non formels et développement des compétences professionnelles dans les centres de métiers à Kinshasa
Authors: Alokpo Dieudonné Musa
Published: June 2021

Non-formal apprenticeship opportunities have a clear record of effectiveness, as evidenced by several research studies. After completing short-term vocational training, apprentices demonstrate the required vocational skills. How is learning constructed in a non-formal learning process? What forms of interaction are developed? What are the determinants of the effectiveness demonstrated by apprentices?

This article answers these questions by analysing data from a survey that evaluates the elements of the training context and the level of skills acquired by apprentices. It shows that there is great flexibility in the organisation and techniques of learning, as well as permanent interdependence between apprentices, which facilitates the co-construction of skills.
The West Africa Agricultural Productivity Programme (waapp)
Authors: Fadairo Olushola Samuel , Keita Moussa Sanguiana
Published: June 2021

An understanding of how the System of Rice Intensification method of the West Africa Agricultural Productivity Programme (WAAPP) has influenced sustainable solutions to smallholder paddy farmers’ challenges of poor yield and marketing in Kindia Prefecture, Guinea informed this study.

Causal research design was used, involving a survey of 126 beneficiaries and 78 non-beneficiaries of waapp. Data were collected mainly on the farmers’ enterprise characteristics: improvement in productivity, sales, and income from paddy. Data were summarised using descriptive, t-test and regression statistics at α0.05.

waapp- and non-waapp-participating farmers had >10 years of farming experience. Most waapp farmers (67.5%) achieved higher sales and income from paddy than in the past. The productivity of the waapp farmers was higher and significantly different from that of the non-waapp farmers (t = 3.173; p < 0.05). Farmers’ opinion of market prospects after waapp intervention (β = 0.190) and their age (β = 0.237) significantly influenced their change in productivity. The waapp increased paddy production.
Dissenting Opinions of Judges of the unclos Tribunal in the Chagos Case
Authors: Mahadew Roopanand , Bhowarkan Arzeena
Published: June 2021

Mauritius won its first victory when the “tribunal constituted under Annex vii of the United Nations Convention on the Law of the Sea” delivered its award “in the matter of the Chagos Marine Protected Area (mpa) Arbitration, between the Republic of Mauritius and the United Kingdom”. The award declared that the mpa established around Chagos by the United Kingdom was against international law. However, the decision desired by both Mauritius and the Chagossians is found in the dissenting opinion, which is, as a matter of law, non-binding. The dissenting opinion is to the effect that the tribunal had jurisdiction to consider the issue of sovereignty over Chagos and that if such issue was considered, Mauritius had a strong case for winning back sovereignty over Chagos. This article aims to make the dissenting opinions more widely known and reflect on the legal value of such opinions, alongside their high political and moral value and relevance to Mauritius and the Chagossians.
Financial Sustainability of Microfinance Institutions at Growth Stage: Do Lending Terms Matter?
Authors: Nyamsogoro Ganka Daniel
Published: June 2021

The financial sustainability of microfinance institutions (mfi s) is crucial if their benefits are to be enjoyed in the long run. This study investigated the determinants of mfi s’ financial sustainability at growth stage. The study aimed to address the following questions: are factors influencing financial sustainability at maturity equally important at growth stage? What influence do lending terms have on financial sustainability at growth stage? The study used panel regression models and four-year survey data from 106 rural mfi s in Tanzania. Decomposition of lending types was adopted to unveil the contribution of lending terms to financial sustainability. We found that most factors influencing financial sustainability at maturity stage are equally important in influencing sustainability at growth stage. In addition, two factors appear to affect financial sustainability at growth stage only. Moreover, lending terms matter in determining financial sustainability at growth stage. The study provides insights on how lending terms can be used to influence financial sustainability at growth stage.
Reinstatement of the independent specific status of Oldenlandia violacea (Rubiaceae) from the synonymy of O. monanthos
Authors: ZHOU YA-DONG , AMENU SARA GETACHEW , MWACHALA GEOFFREY , HU GUANG-WAN , WANG QINGFENG
Published: June 2021

Oldenlandia violacea (Rubiaceae) was previously treated as a synonym of O. monanthos. However, a detailed examination of the specimens and additional living materials in the field clearly indicated that O. violacea is distinct from O. monanthos in the size of leaves and flowers, and the shape of fruits. The phylogenetic analysis also showed that O. violacea and O. monanthos are nested within Oldenlandia s.str., and could be well separated in the phylogenetic tree. Thus, O. violacea is re-instated here as an independent species.
Four new species of Pomphopsilla Jałoszyński in Rwanda, Burundi and DR Congo (Coleoptera: Staphylinidae: Scydmaeninae)
Authors: JAŁOSZYŃSKI PAWEŁ
Published: June 2021

The cephenniine genus Pomphopsilla currently comprises seven nominal species distributed in Kenya, DR Congo and the Seychelles. Four new species are described: P. punctata sp. n. (Rwanda), P. cyanguguana sp. n. (Rwanda), P. kivuana sp. n. (DR Congo), and P. burundiana sp. n. (Burundi). Key characters of each species are illustrated, and the distribution of Pomphopsilla is summarized.
New species of Phaloria (Orthoptera: Phalangopsidae: Phaloriinae) from West Papua (Indonesia)
Authors: TAN MING KAI , RAHMADI CAHYO , ROBILLARD TONY
Published: June 2021

The genus Phaloria belongs to the monophyletic cricket subfamily Phaloriinae. It is s speciose group comprising 68 species found across Southeast Asia and New Guinea and Australia. The numerical diversity of Phaloria in New Guinea is impressive, but more species still await discovery owing to the large size and remoteness of the island. Based on new material collected from Lobo and Kumawa in West Papua (Indonesia), we describe six new species: Phaloria dischidia Tan & Robillard, sp. nov. from Lobo; Phaloria paradischidia Tan & Robillard, sp. nov. from Kumawa; Phaloria tukul Tan & Robillard, sp. nov. from Lobo; Phaloria brevis Tan & Robillard, sp. nov. from Kumawa; Phaloria berbeda Tan & Robillard, sp. nov. from Lobo; Phaloria lobulata Tan & Robillard, sp. nov. from Kumawa. We also record new localities for a species widespread in Lobo and Kumawa: Phaloria nr. aspersa Gorochov, 1996.
Creative Capabilities of Learning-Disabled and Normal Students
Authors: Graham Steve , Sheinker Al
Published: June 2021

The Torrance Tests of Creative Thinking (Figural Form A) and Sounds and Images were administered to 26 learning-disabled and 30 average students in Grades 3, 4, and 5. Significant differences between the two groups were noted on all measures except fluency. Although learning-disabled students produced an equivalent number of relevant creative responses in comparison to their average peers, they were less able to generate new ideas and change their initial approach.
Outcomes of Mastoidectomy With Antibiotic Catheter Irrigation for Patients With Draining Ventilation Tubes
Authors: Jones Joel W. , Ballard Daniel P. , Hillman Todd A. , Chen Douglas A.
Published: June 2021

Objectives:

To evaluate the effectiveness of mastoidectomy with antibiotic catheter irrigation in patients with chronic tympanostomy tube otorrhea.

Methods:

A chart review of adult and pediatric patients with persistent tympanostomy tube otorrhea who had failed outpatient medical management and underwent mastoidectomy with placement of a temporary indwelling catheter for antibiotic instillation was performed. Patients were retrospectively followed for recurrent drainage after 2 months and outcomes were categorized as resolution (0-1 episodes of otorrhea or otitis media with effusion during follow-up), improvement (2-3 episodes), or continued episodic (>3 episodes).

Results:

There were 22 patients and 23 operated ears. Median age was 46 years (interquartile range, IQR = 29-65). The median duration of otorrhea from referral was 5.5 months (IQR = 2.8-12). Following surgery, 14 ears had resolution of drainage, 6 had improvement, and 3 had episodic. The observed percentage of resolved/improved ears (87%) was significant ( P = .0005, 95% CI = 67.9%-95.5%). Median follow-up time was 25 months (IQR = 12-59). Pre and postoperative pure tone averages improved (difference of medians = −3.3 dB, P = .02) with no significant difference in word recognition scores ( P = .68). Methicillin-resistant Staphylococcus aureus was the most common isolated microbe while no growth was most frequently noted on intraoperative cultures.

Conclusions:

Mastoidectomy with antibiotic catheter irrigation may be an effective surgical strategy, and single stage alternative to intravenous antibiotics, for select patients with persistent tube otorrhea who have failed topical and oral antibiotics.
Outcomes of early hemivertebrectomy in children with congenital scoliosis: A prospective follow-up study
Authors: Oksanen Hanna M. , Jalanko Tuomas , Helenius Ilkka J.
Published: June 2021

Background and objective:

Posterolateral hemivertebrectomy with monosegmental instrumentation at an early age is an established method to correct congenital scoliosis but is associated with a relatively high risk of instrumentation failure and health-related quality of life outcomes are not available. We aimed to investigate the effects hemivertebrectomy with postoperative hip spica cast on complications and health-related quality of life in small children with congenital scoliosis.

Methods:

A follow-up study of 30 children (at mean age = 3.4 years, range = 1.0–8.5 years) undergoing posterolateral hemivertebrectomy and short pedicle instrumentation. Children were immobilized postoperative with hip spica cast for 6 weeks and immobilization for 4 months using a rigid thoracolumbosacral orthosis. The Caregivers filled out Scoliosis Research Society 24 outcome questionnaire preoperatively, at 6 months, and at final follow-up visit on behalf of their child. Standing radiographs were obtained preoperatively, postoperatively in the cast, and standing at final follow-up.

Results:

Mean major curve was 41° (range = 26°–87°) preoperatively and was corrected to 14° (4.0°–35°) at final follow-up. Eight (27%) children had postoperative complications, including three (10%) deep surgical site infections. The Scoliosis Research Society 24 back domain showed an improvement from a mean of 3.8 preoperatively to 4.4 at final follow-up ( p < 0.001). Function from back condition domain showed a significant deterioration from 4.2 preoperatively to 3.7 at 6 months ( p = 0.020) but improved back to baseline at final follow-up (4.2, p = 0.0022 6 months vs final follow-up).

Conclusions:

Hemivertebrectomy with short instrumentation resulted into 64% correction of scoliosis and improved health-related quality of life in back pain and function domains.
Bioelectric, tissue, and molecular characteristics of the gastric mucosa at different times of ischemia
Authors: Eduardo Peña-Mercado , Mario Garcia-Lorenzana , Carlos César Patiño-Morales , Mayra Montecillo-Aguado , Sara Huerta-Yepez , E Beltran Nohra
Published: June 2021

Gastrointestinal ischemia may be presented as a complication associated with late shock detection in patients in critical condition. Prolonged ischemia can cause mucosal integrity to lose its barrier function, triggering alterations that can induce organ dysfunction and lead to death. Electrical impedance spectroscopy has been proposed to identify early alteration in ischemia-induced gastric mucosa in this type of patients. This work analyzed changes in impedance parameters, and tissue and molecular alterations that allow us to identify the time of ischemia in which the gastric mucosa still maintains its barrier function. The animals were randomly distributed in four groups: Control, Ischemia 60, 90, and 120 min. Impedance parameters were measured and predictive values were determined to categorize the degree of injury using a receiver operating characteristic curve. Markers of inflammatory process and apoptosis (iNOS, TNFα, COX-2, and Caspase-3) were analyzed. The largest increase in impedance parameters occurred in the ischemia 90 and 120 min groups, with resistance at low frequencies (RL) and reactance at high frequencies (XH) being the most related to damage, allowing prediction of the occurrence of reversible and irreversible tissue damage. Histological analysis and apoptosis assay showed progressive mucosal deterioration with irreversible damage ( p < 0.001) starting from 90 min of ischemia. Furthermore, a significant increase in the expression of iNOS, TNFα, and COX-2 was identified in addition to apoptosis in the gastric mucosa starting from 90 min of ischemia. Tissue damage generated by an ischemia time greater than 60 min induces loss of barrier function in the gastric mucosa.
Perceived Social Influences on Women's Decisions to use Medications not Studied in Pregnancy. A Qualitative Ethical Analysis of Preexposure Prophylaxis Implementation Research in Kenya
Authors: Ngure Kenneth , Trinidad Susan B. , Beima-Sofie Kristin , Kinuthia John , Matemo Daniel , Kimemia Grace , Njoroge Anne , Achiro Lillian , Pintye Jillian , Mugo Nelly R. , Bukusi Elizabeth A. , Baeten Jared M. , Heffron Renee , John-Stewart Grace , Kelley Maureen C.
Published: June 2021

Implementation research ethics can be particularly challenging when pregnant women have been excluded from earlier clinical stages of research given greater uncertainty about safety and efficacy in pregnancy. The evaluation of human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) during pregnancy offered an opportunity to understand important ethical considerations and social influences shaping women's decisions to participate in the evaluation of PrEP and investigational drugs during pregnancy. We conducted interviews with women ( n = 51), focus groups with male partners (five focus group discussions [FGDs]), interviews with health providers ( n = 45), four FGDs with pregnant/postpartum adolescents and four FGDs with young women. Data were analyzed using thematic content analysis, including ethical aspects of the data. Our study reveals that women navigate a complex network of social influences, expectations, support, and gender roles, not only with male partners, but also with clinicians, family, and friends when making decisions about PrEP or other drugs that lack complete safety data during pregnancy.
Improvement of functional neurological disorder after administration of esketamine nasal spray: a case report
Authors: Vendrell-Serres Júlia , Soto-Angona Óscar , Rodríguez-Urrutia Amanda , Arteaga-Henríquez Gara , Ramos-Quiroga Josep A.
Published: June 2021

Functional neurological disorder (FND) is a complex neuropsychiatric condition characterized by the presence of neurological symptoms and signs (either motor or sensory) that cannot be explained by any known medical or mental disease. It is frequently presented with psychiatric comorbidities, such as major depression. Its prognosis is poor, with low improvement or recovery rates at 1 year after their onset, and no particular treatment has demonstrated significant efficacy in this regard. Here, we describe the management of a patient affected by treatment-resistant depression (TRD) and FND characterized by mixed paralysis (sensory and motor) in the left arm, and who was successfully treated with esketamine nasal spray, achieving remission in both disorders. The US Food and Drug Administration and the European Medicines Agency recently approved esketamine, the S-enantiomer of ketamine, for treatment of TRD. It is a fast-acting drug that provides a rapid-onset improvement of depressive symptoms. We have presented the first case, to our knowledge, of functional neurological symptoms being successfully treated with esketamine in a patient with comorbid TRD. While the novelty of this data implies a clear need for further research, it is suggested that esketamine might be a useful tool for the treatment of FND, acting through different theorized mechanisms that are in tune with recent advances in knowledge of the etiopathology of FND.
A Content Analysis of English Textbook of Punjab Textbook Board of Grade 8 in Pakistan
Authors: Baig Sana , Javed Fareeha , Siddiquah Aishah , Khanam Afifa
Published: June 2021

The present study analyzes the English textbook of Grade 8 published by Punjab Textbook Board in Pakistan in the light of student learning outcomes (SLOs) of four competencies: reading and thinking skills, writing skills, oral communication skills, and formal and lexical aspects of language of the latest English curriculum in Pakistan. Competency (C), standards (S), benchmarks (B), and SLOs are the parameters given in the National Curriculum. A semi-structured checklist was developed by the researchers, validated by three experts from the relevant field, and improved in the light of experts’ opinion and pilot study findings. To evaluate the textbook competencies and their SLOs, the evidence was sought from the textbook, and remarks were given in the last column (remarks/analysis) of the checklist. The results revealed that the textbook understudy focuses on reading comprehension only. There is thus a dire need to incorporate thinking skills, writing skills, oral/aural communication skills, and formal and lexical aspects of language in the textbook.
Mediastinal effusion due to pericardiocentesis with cardiac tamponade: a case report
Authors: Zhang Qian , Wang Difen , Liu Ying
Published: June 2021

Background

Pericardiocentesis is an effective treatment for cardiac tamponade, but there are risks, including haemorrhagic events, cardiac perforation, pneumothorax, arrhythmia, acute pulmonary oedema and so on. Mediastinal effusion caused by puncture is rarely reported.

Case presentation

A 47-year-old man who had a history of right leg deep vein thrombosis and pulmonary artery embolism with implantation of an inferior vena cava filter presented for inferior vena cava filter removal. Within 30 min after the procedure, he developed chest pain, nausea, vomiting and presyncope with shock. Echocardiography confirmed massive pericardial effusion with evidence of cardiac tamponade. Emergency pericardiocentesis was performed. Confusingly, only 3 mL of bloody pericardial effusion was drained in total, and subsequently, the patient’s symptoms rapidly improved with stable haemodynamics. Repeat echocardiography showed that the pericardial effusion had disappeared. Urgent computed tomography pulmonary angiography demonstrated localized effusion, which was not seen the previous computed tomography results and was noted around the left ventricle in the mediastinal apace. No intervention was performed, given that there was no bleeding tendency or further adverse events related to the mediastinal effusion. The patient was subsequently discharged in a stable condition a few days later, and outpatient follow-up was advised.

Conclusions

Mediastinal effusion is a rare complication of pericardiocentesis. In the case described herein, the most likely cause was pericardial effusion extravasated into the mediastinum through the needle insertion site in the puncture process due to large pressure variations in the intrapericardial space with tamponade, differing from cases of over-anticoagulation reported in the previous literature. Just as our case demonstrates that conservative treatment of an hemodynamic insignificant mediastinal effusion may be appropriate. Echocardiography is useful and effective to minimize complication rates.
Seroprevalence of diphtheria toxoid IgG antibodies in the Malaysian population
Authors: Yusoff Ahmad Faudzi , Mohd Sharani Zatil Zahidah , Kee Chee Cheong , Md Iderus Nuur Hafizah , Md Zamri Ahmed Syahmi Syafiq , Nagalingam Tharmarajah , Mohamad Bashaabidin Mohd Safrin , Wan Ibadullah Wan Abdul Hannan , Ghazali Sumarni Mohd , Yusof Ainur Yusniza , Ching Yee Ming , Mohamed Nor Nurhanani , Kamarudin Balqis , Ahmad Norazah , Arip Masita
Published: June 2021

Background

Despite high childhood immunization coverage, sporadic cases of diphtheria have been reported in Malaysia in recent years. This study aims to evaluate the seroprevalence of diphtheria among the Malaysian population.

Methods

A total of 3317 respondents age 2 years old to 60 years old were recruited in this study from August to November 2017. Enzyme-linked immunosorbent assay (ELISA) was used to measure the level of IgG antibody against the toxoid of C. diphtheriae in the blood samples of respondents. We classified respondent antibody levels based on WHO definition, as protective (≥0.1 IU/mL) and susceptible (< 0.1 IU/mL) to C. diphtheriae infection.

Results

Among the 3317 respondents, 57% were susceptible (38.1% of children and 65.4% of adults) and 43% (61.9% of children and 34.6% of adults) had protective antibody levels against diphtheria. The mean antibody level peaked among individuals aged 1–2 years old (0.59 IU/mL) and 6–7 years old (0.64 IU/mL) but generally decreased with age, falling below 0.1 IU/mL at around 4–6 years old and after age 20 years old. There was a significant association between age [Children: χ2 = 43.22(df = 2),p < 0.001)], gender [Adults: χ2 = 5.58(df = 1),p = 0.018] and ethnicity [Adults: χ2 = 21.49(df = 5),p = 0.001] with diphtheria toxoid IgG antibody level.

Conclusions

About 57% of the Malaysian population have inadequate immunity against diphtheria infection. This is apparently due to waning immunity following childhood vaccination without repeated booster vaccination in adults. Children at age 5–6 years old are particularly vulnerable to diphtheria infection. The booster vaccination dose normally given at 7 years should be given earlier, and an additional booster dose is recommended for high-risk adults.
Cerebellar venous thrombosis mimicking a cerebellar tumor due to polycythemia vera: a case report
Authors: Wen Hongfeng , Jin Di , Chen Yu , Cui Bin , Xiao Tianyi
Published: June 2021

Background

Cerebral venous thrombosis (CVT) occurs rarely in the general population and is frequently associated with confused clinical findings and delayed diagnosis. Isolated cerebellar cortical vein thrombosis is a very rare phenomenon.

Case presentation

This report describes a case with CVT, which is manifested as space-occupying lesions of the cerebellar hemisphere and mimics a cerebellar tumor at the beginning. The diagnosis of CVT was finalized given the laboratory and brain biopsy findings. The etiology may be related to polycythemia vera with Janus Kinase 2 V617F mutation.

Conclusion

Isolated cerebellar vein thrombosis should be considered when swelling and enhancing cerebellar lesions are detected. Polycythemia vera, especially with a positive JAK2 V617F mutation, may be a rare risk factor for CVT.
Accuracy of pre-operative fistula diagnostics in anorectal malformations
Authors: Tofft Louise , Salö Martin , Arnbjörnsson Einar , Stenström Pernilla
Published: June 2021

Background

Surgical safety during posterior sagittal anorectal plasty (PSARP) for anorectal malformations (ARM) depends on accurate pre-operative fistula localization. This study aimed to evaluate accuracy of pre-operative fistula diagnostics.

Methods

Ethical approval was obtained. Diagnostic accuracy of pre-PSARP symptoms (stool in urine, urine in passive ostomy, urinary tract infection) and examination modalities (voiding cystourethrogram (VCUG), high-pressure colostogram, cystoscopy and ostomy endoscopy) were compared to final intra-operative ARM-type classification in all male neonates born with ARM without a perineal fistula treated at a tertiary pediatric surgery center during 2001–2020.

Results

The 38 included neonates underwent reconstruction surgery through PSARP with diverted ostomy. Thirty-one (82%) had a recto-urinary tract fistula and seven (18%) no fistula. Ostomy endoscopy yielded the highest diagnostic accuracy for fistula presence (22 correctly classified/24 examined cases; 92%), and pre-operative symptoms the lowest (21/38; 55%). For pre-operative fistula level determination, cystoscopy yielded the highest diagnostic accuracy (14/20; 70%), followed by colostogram (23/35; 66%), and VCUG (21/36; 58%). No modality proved to be statistically superior to any other.

Conclusions

Ostomy endoscopy has the highest diagnostic accuracy for fistula presence, and cystoscopy and high-pressure colostogram for fistula level determination. Correct pre-operative ARM-typing reached a maximum of 60–70%.
Female genital mutilation/cutting (FGM/C) coding capacities in Swiss university hospitals using the International Classification of Diseases (ICD)
Authors: Cottler-Casanova S. , Horowicz M. , Gayet-Ageron A. , Abdulcadir J.
Published: June 2021

Background

The real prevalence and incidence of women living with or at risk of female genital mutilation/cutting (FGM/C) is unknown in Switzerland and many parts of Europe, as there are no representative surveys similar to DHS or MICS for European countries. Indirect estimates are commonly used to estimate the number of women with FGM/C in high-income countries, but may not reflect the actual FGM/C prevalence among migrants. Direct measures may provide more accurate estimates that could guide policy- and clinical decision-making. Swiss hospital data may provide a sample of patients that can be used to describe the prevalence of FGM/C in Swiss hospitals. Our study assesses the number of inpatient women and girls in Swiss university hospitals from countries with high FGM/C prevalence, and of inpatients with a coded diagnosis of FGM/C.

Methods

We conducted an exploratory descriptive study in Switzerland to assess the number of women and girls admitted to Swiss university hospitals between 2016 and 2018 from 30 FGM/C practicing countries, as well as inpatients with a coded diagnosis of FGM/C using anonymized data. We calculated indirect estimates for inpatient women and girls living with or at risk of FGM/C and compared them with the number of inpatients with a coded diagnosis of FGM/C.

Results

8720 women and girls from FGM/C practicing countries were admitted. 207 patients had a coded diagnosis of FGM/C, including 7 with a nationality outside the 30 targeted countries, corresponding to an overall prevalence of 2.3% (95%CI, 2.0–2.6). The number of FGM/C cases by hospital was significantly different across years (P < 0.001), with a higher proportion of cases collected in Geneva, Switzerland.

Conclusions

The comparison between indirect estimates of inpatients with or at risk of FGM/C and the low number of FGM/C cases coded, suggests low recording and coding capacities of FGM/C.

Tweetable abstract

The capacity of coding primary and secondary diagnosis of FGM/C in Swiss university hospitals seems low.

Protocol number: 2018–01851: SwissEthics Committee, Canton of Geneva, Switzerland.
Hidden patterns among the fatally injured pedestrians in an Iranian population: application of categorical principal component analysis (CATPCA)
Authors: Jamali-Dolatabad Milad , Sarbakhsh Parvin , Sadeghi-bazargani Homayoun
Published: June 2021

Background

Identifying hidden patterns and relationships among the features of the Fatal Pedestrian Road Traffic Injuries (FPRTI) can be effective in reducing pedestrian fatalities. This study is thus aimed to detect the patterns among the fatally injured pedestrians due to FPRTI in East Azerbaijan province, Iran.

Methods

This descriptive-analytic research was carried out based on the data of all 1782 FPRTI that occurred in East Azerbaijan, Iran from 2010 to 2019 collected by the forensic organization. Categorical Principal Component Analysis (CATPCA) was performed to recognize hidden patterns in the data by extracting principal components from the set of 13 features of FPRTI. The importance of each component was assessed by using the variance accounted for (VAF) index.

Results

The optimum number of components to fit the CATPCA model was six which explained 71.09% of the total variation. The first and most important component with VAF = 22.04% contained the demographic and socioeconomic characteristics of the killed pedestrians. The second-ranked component with VAF = 12.96% was related to the injury type. The third component with VAF = 10.56% was the severity of the injury. The fourth component with VAF = 9.07% was somehow related to the knowledge and observance of the traffic rules. The fifth component with VAF = 8.63% was about the quality of medical relief and finally, the sixth component with VAF = 7.82% dealt with environmental conditions.

Conclusion

CATPCA revealed hidden patterns among the fatally injured pedestrians in the form of six components. The revealed patterns showed that some interactions between correlated features led to a higher mortality rate.