bluuebunny/crossref_metadata_2025 huggingface dataset:
Improvement of long-term clinical outcomes by successful PCI in the very elderly women with ACS
Authors: Wang Jia-li , Guo Chun-yan , Chen Hui , Li Hong-wei , Zhao Xue-qiao , Zhao Shu-mei
Published: March 2021

Background

Whether very elderly women with acute coronary syndromes (ACS) should receive aggressive percutaneous coronary intervention (PCI) is still controversial. We assessed the effectiveness and long-term clinical outcomes of successful PCI in this population and identified prognostic factors which might contribute to the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) in the very elderly female PCI cohort.

Methods

Female ACS patients aged ≥ 80 years were consecutively enrolled (n = 729) into the study. All the patients were divided into female PCI group (n = 232) and medical group (n = 497). MACCE was followed up, including non-fatal myocardial infarction (MI), stroke, heart failure requiring hospitalization (HFRH), cardiovascular (CV) death, and the composite of them. After propensity score matching (1:1), the incidences of MACCE were compared between the two groups. Clinical and coronary artery lesion characteristics were compared between the female PCI patients with (n = 56) and without MACCE (n = 176). Multivariate Cox regression analysis was performed to identify risk factors which independently associated with MACCE in the female PCI patients. MACCE of male PCI patients, who aged ≥ 80 years and hospitalized in the same period (n = 264), was also compared with that of the female PCI patients.

Results

A total of 32% very elderly female ACS patients received PCI in the present study. (1) Compared to female medical group, PCI procedure significantly alleviated the risks of MACCE: non-fatal MI (6.2% vs. 20.2%,P < 0.001), HFRH (10.9% vs. 22.5%,P = 0.012), CV death (12.4% vs. 28.7%,P < 0.001) and the composite MACCE (24.0% vs. 44.2%,P < 0.001) during the median follow-up period of 36 months. (2) Between very elderly female and male PCI patients, there were no significant differences in occurrence of MACCE (P = 0.232) and CV death (P = 0.951). (3) Multivariate Cox analysis revealed that ST-segment elevation myocardial infarction (STEMI) (HR 1.944, 95% CI 1.11–3.403,P = 0.02) and elevated log- N-Terminal pro-brain natriuretic peptide (NT-proBNP) (HR 1.689, 95% CI 1.029–2.773,P = 0.038) were independently associated with the incidence of MACCE in the female PCI patients.

Conclusions

PCI procedure significantly attenuated the risk of MACCE and improved the long-term clinical outcomes in very elderly female ACS patients. Aggressive PCI strategy may be reasonable in this population.
Prospective verification of sonographic fetal weight estimators among term parturients in Uganda
Authors: Sereke Senai Goitom , Omara Richard Okello , Bongomin Felix , Nakubulwa Sarah , Kisembo Harriet Nalubega
Published: March 2021

Background

Accuracy of fetal weight estimation by ultrasound is essential in making decisions on the time and mode of delivery. There are many proposed formulas for fetal weight estimation such as Hadlock 1, Hadlock 2, Hadlock 3, Hadlock 4 and Shepard. What best applies to the Ugandan population is not known since no verification of any of the formulas has been done before. The primary aim of this study was to determine the accuracy of sonographic estimation of fetal weight using five most commonly used formulas, and analyze formula variations for different weight ranges.

Methods

This was a hospital based prospective cohort study at Mulago National Referral Hospital, Kampala, Uganda. A total of 356 pregnant women who consented and were within 3 days of birth were enrolled. Prenatal ultrasound fetal weight determined by measuring the biparietal diameter, head circumference, abdominal circumference, femoral length, and then was compared with actual birth weight.

Results

The overall accuracy of Hadlock 1, Hadlock 2, Hadlock 3, Hadlock 4 and Shepard formula were 66.9, 73.3, 77.3, 78.4 and 69.7% respectively. All Hadlocks showed significant mean difference between weight estimates and actual birth weight (p < 0.01) whereas Shepard formula did not [p - 0.2], when no stratification of fetal weights was done. However, all Hadlocks showed a none significant (p-values > 0.05) mean difference between weight estimates and actual birth weight when the actual birth weight was ≥4000.0 g. Shepard weight estimates showed a none significant mean difference when actual birth weight was < 4000 g. Bland-Altman graphs also showed a better agreement of weight estimated by Shepard formula and actual birth weights.

Conclusion

All the five formulas were accurate at estimating actual birth weights within 10% accuracy. However, this accuracy varied with the fetal birth weight. Shepard was more accurate in estimating actual birth weights < 4000 g whereas all Hadlocks were more accurate when the actual birthweight was ≥4000 g.
Common mental disorders and intimate partner violence against pregnant women living with HIV in Cameroon: a cross-sectional analysis
Authors: Parcesepe Angela M. , Cordoba Evette , Gallis John A. , Headley Jennifer , Tchatchou Berenger , Hembling John , Soffo Claudian , Baumgartner Joy Noel
Published: March 2021

Background

Women living with HIV are at increased risk of poor mental health and intimate partner violence (IPV). Mental health disorders have been consistently associated with suboptimal HIV-related outcomes. Little is known about the prevalence or correlates of mental health disorders among pregnant women living with HIV in sub-Saharan Africa.

Methods

This study assessed the prevalence of probable common mental disorders (CMD), i.e., depressive or anxiety disorders, and the relationship between probable CMD and recent IPV among pregnant women living with HIV in Cameroon. The sample included 230 pregnant women living with HIV aged > 18 enrolled in care at 10 HIV clinics in Cameroon. Probable CMD was assessed with the WHO Self Reporting Questionnaire (SRQ-20). Multivariable logistic regression was conducted to assess the relationship between IPV and probable CMD.

Results

Almost half (42%) of participants had probable CMD using a 7/8 cut-off of the SRQ-20. Emotional, physical, and sexual IPV were reported by 44, 37, and 31% of respondents, respectively. In multivariable regression analyses, all forms of IPV assessed were significantly associated with greater odds of probable CMD.

Conclusions

Pregnant women living with HIV in Cameroon had a high prevalence of probable CMD and IPV. Screening and services to address IPV and mental health are urgently needed for this population. Integrated interventions to both prevent and screen and address IPV and probable CMD should be developed, implemented, and evaluated.
Prognostic value of the micronucleus assay for clinical endpoints in neoadjuvant radiochemotherapy for rectal cancer
Authors: Dröge Leif Hendrik , Hennies Steffen , Lorenzen Stephan , Conradi Lena-Christin , Quack Henriette , Liersch Torsten , Helms Christian , Frank Miriam Alice , Schirmer Markus Anton , Rave-Fränk Margret , Beißbarth Tim , Wolff Hendrik Andreas
Published: March 2021

Background

The question whether lymphocyte radiosensitivity is representative of patients’ response to radiotherapy (RT) remains unsolved. We analyzed lymphocyte cytogenetic damage in patients who were homogeneously treated with preoperative radiochemotherapy (RCT) for rectal cancer within clinical trials. We tested for interindividual variation and consistent radiosensitivity after in-vivo and in-vitro irradiation, analyzed the effect of patients’ and RCT characteristics on cytogenetic damage, and tested for correlations with patients’ outcome in terms of tumor response, survival and treatment-related toxicity.

Methods

The cytokinesis-block micronucleus cytome (CBMNcyt) assay was performed on the peripheral blood lymphocytes (PBLCs) of 134 patients obtained before, during, at the end of RCT, and during the 2-year follow-up. A subset of PBLCs obtained before RCT was irradiated in-vitro with 3 Gy. RCT included 50.4 Gy of pelvic RT with 5-fluorouracil (5-FU) alone (n = 78) or 5-FU plus oxaliplatin (n = 56). The analyzed variables included patients’ age, gender, RT characteristics (planning target volume size [PTV size], RT technique), and chemotherapy characteristics (5-FU plasma levels, addition of oxaliplatin). Outcome was analyzed as tumor regression, patient survival, and acute and late toxicity.

Results

Cytogenetic damage increased significantly with the radiation dose and varied substantially between individuals. Women were more sensitive than men; no significant age-dependent differences were observed. There was a significant correlation between the cytogenetic damage after in-vitro irradiation and in-vivo RCT. We found a significant effect of the PTV size on the yields of cytogenetic damage after RCT, while the RT technique had no effect. Neither the addition of oxaliplatin nor the 5-FU levels influenced cytogenetic damage. We found no correlation between patient outcome and the cytogenetic damage.

Conclusions

We found consistent cytogenetic damage in lymphocytes after in-vivo RCT and in-vitro irradiation. Gender was confirmed as a well-known, and the PTV size was identified as a less well-known influencing variable on lymphocyte cytogenetic damage after partial-body irradiation. A consistent level of cytogenetic damage after in-vivo and in-vitro irradiation may indicate the importance of genetic factors for individual radiosensitivity. However, we found no evidence that in-vivo or in-vitro irradiation-induced cytogenetic damage is an adequate biomarker for the response to RCT in rectal cancer patients.
Prediction of ipsilateral lateral cervical lymph node metastasis in papillary thyroid carcinoma: a combined dual-energy CT and thyroid function indicators study
Authors: Zou Ying , Zhang Huanlei , Li Wenfei , Guo Yu , Sun Fang , Shi Yan , Gong Yan , Lu Xiudi , Wang Wei , Xia Shuang
Published: March 2021

Background

Predicting the possibility of ipsilateral lateral cervical lymph node metastasis (ipsi-LLNM) was crucial to the operation plan for patients with papillary thyroid carcinoma (PTC). This study aimed to investigate the independent risk factors for ipsi-LLNM in PTC patients by combining dual-energy computed tomography (DECT) with thyroid function indicators.

Methods

We retrospectively enrolled 406 patients with a pathological diagnosis of PTC from Jan 2016 to Dec 2019. Ensure the DECT images were clear and the thyroid function indicators were complete. Univariate and multivariate logistic analyses explored the independent risk factors for ipsi-LLNM. To evaluate the cutoff value of each risk factor by using receiver operating characteristic (ROC) curves.

Results

A total of 406 patients with PTC were analyzed, including 128 with ipsi-LLNM and 278 without ipsi-LLNM. There were statistical differences of parameters between the two groups (P < .0001), including serum Tg, Anti-Tg, Anti-TPO, the volume of the primary lesion, calcification, extrathyroidal extension (ETE), and iodine concentration (IC) in the arterial and the venous phases. Independent risk factors for ipsi-LLNM included serum Tg, Anti-Tg, ETE, and IC in the arterial and the venous phases (P < .05). The combined application of the above independent risk factors can predict the possibility of ipsi-LLNM, with an AUC of 0.834. Ipsi-LLNM was more likely to occur when the following conditions were met: with ETE, Tg >  100.01 ng/mL, Anti-Tg >  89.43 IU/mL, IC in arterial phase > 3.4 mg/mL and IC in venous phase > 3.1 mg/mL.

Conclusions

The combined application of DECT quantitative parameters and thyroid function indicators can help clinicians accurately predict ipsi-LLNM before surgery, thereby assisting the individualized formulation of surgical procedures.
Trastuzumab Emtansine (T-DM1) and stereotactic radiation in the management of HER2+ breast cancer brain metastases
Authors: Mills Matthew N. , Walker Chelsea , Thawani Chetna , Naz Afrin , Figura Nicholas B. , Kushchayev Sergiy , Etame Arnold , Yu Hsiang-Hsuan Michael , Robinson Timothy J. , Liu James , Vogelbaum Michael A. , Forsyth Peter A. , Czerniecki Brian J. , Soliman Hatem H. , Han Hyo S. , Ahmed Kamran A.
Published: March 2021

Background

Due to recent concerns about the toxicity of trastuzumab emtansine (T-DM1) with stereotactic radiation, we assessed our institutional outcomes treating HER2-positive breast cancer brain metastases (BCBM) with T-DM1 and stereotactic radiation.

Methods

This is a single institution series of 16 patients with HER2-positive breast cancer who underwent 18 stereotactic sessions to 40 BCBM from 2013 to 2019 with T-DM1 delivered within 6 months. The Kaplan-Meier method was used to calculate overall survival (OS), local control (LC), distant intracranial control (DIC), and systemic progression-free survival (sPFS) from the date of SRS. A neuro-radiologist independently reviewed follow-up imaging.

Results

One patient had invasive lobular carcinoma, and 15 patients had invasive ductal carcinoma. All cases were HER2-positive, while 10 were hormone receptor (HR) positive. Twenty-four lesions were treated with stereotactic radiosurgery (SRS) to a median dose of 21 Gy (14–24 Gy). Sixteen lesions were treated with fractionated stereotactic radiation (FSRT) with a median dose of 25 Gy (20-30Gy) delivered in 3 to 5 fractions. Stereotactic radiation was delivered concurrently with T-DM1 in 19 lesions (48%). Median follow up time was 13.2 months from stereotactic radiation. The 1-year LC, DIC, sPFS, and OS were 75, 50, 30, and 67%, respectively. There was 1 case of leptomeningeal progression and 1 case (3%) of symptomatic radionecrosis.

Conclusions

We demonstrate that stereotactic radiation and T-DM1 is well-tolerated and effective for patients with HER2-positive BCBM. An increased risk for symptomatic radiation necrosis was not noted in our series.
Clonazepam-induced lichenoid drug eruption: a case report
Authors: Yang Hee Won , Bae Jong Bin , Na Jung-Im , Kim Ki Woong
Published: March 2021

Background

Lichenoid drug eruption is rare and can mimic idiopathic lichen planus and other dermatoses. Clonazepam, a commonly used drug for the treatment of anxiety-related disorders and seizures, is known to be an unlikely cause of cutaneous adverse effects. Only one case report of LDE due to clonazepam has been reported.

Case presentation

A 81-year-old male patient with Alzheimer’s disease developed a lichenoid eruption after taking clonazepam. He developed a violaceous scaly patch on his lower extremities, from both buttocks to the feet. The cutaneous eruption resolved 2 months after cessation of clonazepam and with initiation of corticosteroid therapy.

Conclusion

A skin eruption that develops after clonazepam administration can be a lichenoid drug eruption, which is less likely to resolve spontaneously and requires discontinuation of clonazepam administration.
Assessing the links between human rights and global tobacco control through statements made on global fora
Authors: Sircar Neiloy R. , Bialous Stella A.
Published: March 2021

Background

Increasingly, international health bodies frame public health measures, including tobacco control, in the context of human rights (HR). It is unclear how prevalent is the connection between human rights and tobacco control within global health governance. This paper describes the inclusion of HR in tobacco control governance, and the inclusion of tobacco control in HR treaty oversight. We depict the current reach of HR’s normative influence in framing the tobacco epidemic in global, regional, and country-specific contexts.

Methods

We reviewed documents (agenda, reports) from 2010 to 2019 from the World Health Assembly (WHA); the WHO Western Pacific Regional Committee Meetings (RCM); the WHO Framework Convention on Tobacco Control (WHO FCTC) Conferences of the Parties (COP); and documents provided by Pacific Island Countries party to, or by committees overseeing, HR treaties. We purposively selected the Western Pacific Region, and Pacific Island Countries specifically, to represent countries of varying populations, capacities, and governance.

Results

Tobacco control and HR are infrequently mentioned together in the WHAs, and primarily in only one COP. Tobacco control is mentioned in 47 HR treaty committee documents for Pacific Island Countries, mostly under the Convention of the Rights of the Child recognizing or calling for ratification of the WHO FCTC. HR and tobacco control are connected in WHO Western Pacific RCM, particularly through their two most-recent action plans adopted by respective RCMs.

Discussion

Tobacco control as a HR concern is gaining traction within HR treaty bodies, at least with respect to children’s health in the Western Pacific Region.

Conclusion

Globally, HR is just emerging as an influence in global health governance for tobacco discussions. Within the Western Pacific Region however tobacco control is seen by some authorities as a HR issue. Similarly, to HR experts, tobacco control is becoming important to how Pacific Island Countries fulfill their treaty obligations, suggesting tobacco control advocates might explore these mechanisms to further influence the development of strong tobacco control measures to implement the WHO FCTC.
Neighborhood farm density, types of agriculture, and depressive symptoms among older farmers: a cross-sectional study
Authors: Kanamori Mariko , Hanazato Masamichi , Kondo Katsunori , Stickley Andrew , Kondo Naoki
Published: March 2021

Background

Farmers may have an increased risk for poor mental health. In connection with this, factors specific to the neighborhood environment such as farm density and the type of agriculture, might be important for mental wellbeing. In this study we aimed to clarify the cross-level interaction on depressive symptoms between farm density at the neighborhood level by type of agriculture and the longest occupation of individuals (farmer or non-farmer).

Methods

Data came from the 2016 wave of the Japan Gerontological Evaluation Study (JAGES) that were linked to governmental agricultural data. Information was analyzed from 147,549 respondents aged 65 years or older, residing in 1024 neighborhoods in 39 municipalities. We calculated farm (crop or animal husbandry) density at the neighborhood level, dividing the number of agricultural management entities by the population. Three-level (individual, neighborhood, and municipality) Poisson regression analysis was used to calculate the prevalence rate ratios of depressive symptoms.

Results

The prevalence of depressive symptoms was higher among individuals whose longest occupation was farmer compared to non-farmer. The estimated probability of depressive symptoms by a cross-level interaction analysis showed that among farmers of both genders, those who were residing in neighborhoods where the farm density was low had a higher prevalence of depressive symptoms, regardless of the type of agriculture. The slope of the relationship between depressive symptoms and animal husbandry farm density varied by occupation, with a higher prevalence of depressive symptoms observed in male farmers compared to male non-farmers.

Conclusions

The high prevalence of depressive symptoms among farmers in neighborhoods with a low farm density may reflect a scarcity of formal and informal social support in such communities. The health effects of the neighborhood environment on farmers, such as farm density, which may vary by the type of agriculture, should be further researched.
Lower normal free thyroxine is associated with a higher risk of metabolic syndrome: a retrospective cohort on Chinese population
Authors: Ding Xi , Zhu Chun-Ying , Li Rui , Wu Li-Ping , Wang Yue , Hu Shi-Qian , Liu Yi-Ming , Zhao Feng-Yi , Zhao Yang , Zhang Meng , He Ming-Qian , Chen Zi-Yi , Shi Bing-Yin
Published: March 2021

Background

Recently, the relationship between thyroid hormones (THs) across the euthyroid ranges and metabolic syndrome (MetS) has been widely discussed. This study aimed to present specific cutoff values of THs to assess the association between THs and MetS in a euthyroid cohort.

Methods

Data of 2694 subjects, aged 18–80 years, who attended health examination in Xi’an Electric Power Central Hospital from April 2011 to December 2015 were collected and analyzed. The first cohort enrolled 929 participants (followed up by 2221 person-years totally) to assess correlations between serum thyrotropin (TSH), triiodothyronine (T3), thyroxine (T4) levels and MetS. The second cohort included 698 participants (followed up by 1709 person-years totally) to evaluate relationships between serum free triiodothyronine (FT3), free thyroxine (FT4) levels and MetS. MetS was defined according to the criteria of the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) scientific statements of 2009. Euthyroidism was defined as serum TSH, FT3 and FT4 levels within the reference ranges without taking any thyroid medication.

Results

The cutoff values for TSH, T3, T4, FT3 and FT4 were 2.0mIU/L, 1.9 nmol/L, 117 nmol/L, 4.3 pmol/L and 16 pmol/L, respectively. Participants were categorized into two groups according to cutoff values: the lower-THs group and the higher-THs group. There was no significant difference in the risk of MetS between two groups in TSH, T3, T4 and FT3. The incidence of MetS was significantly higher in lower-FT4 group than higher-FT4 group (1.00 vs 0.622 (0.458, 0.846),P = 0.002). The lower-FT4/higher-TSH group had the highest hazard ratios of MetS. (2.131vs 1.0 (1.380,3.291),P = 0.006).

Conclusions

Lower normal FT4 (FT4 ≤ 16.0 pmol/L) is an independent risk factor for MetS, and lower normal thyroid function (TSH > 2.0 mIU/L and FT4 ≤ 16.0 pmol/L) is associated with a higher risk of developing MetS.
Correction to: Lymphocyte subset abnormalities in early diffuse cutaneous systemic sclerosis
Authors: Fox David A. , Lundy Steven K. , Whitfield Michael L. , Berrocal Veronica , Campbell Phillip , Rasmussen Stephanie , Ohara Ray , Stinson Alexander , Gurrea-Rubio Mikel , Wiewiora Evan , Spino Catherine , Bush Erica , Furst Daniel , Pillai Shiv , Khanna Dinesh
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Effect of photodynamic therapy using diode laser and a novel plant extract irrigant against Enterococcus faecalis and Candida albicans
Authors: Sadony Doaa M. , Khallaf Maram E. , Kamal Jackline Samir
Published: March 2021

Background

To evaluate the antibacterial effect of diode laser and photodynamic therapy using methylene blue dye when used alone or in combination with Moringa oleifera extract on root canal microbes. A total of 50 single root canals with single straight canals were prepared with ProTaper files, sterilized in an autoclave device, contaminated with root canal microbes (Enterococcus faecalis and Candidia albicans) and placed in incubator for 21 days. They were then randomly divided into 6 groups. Laser group: (10 root canals) were subjected to laser only. Moringa group: (10 root canals) were irrigated using plant extract only (Moringa). PDT group: (10 root canals) were irrigated using Moringa and Methylene blue then subjected to laser. Methylene blue and laser group: (10 root canals) were irrigated using methylene blue then subjected to laser. Negative control group: (10 root canals) weren't irrigated. After treatment microbial assessment (colony count) was done. Data was analyzed using ANOVAs test.

Results

Moringa/laser group and PDT group showed statistically least bacterial count for both E. faecalis and Candida albicans. Moringa only group showed statistically less bacterial count than control group.

Conclusion

The combined use of PDT together with Moringa oleifera has the best antimicrobial effect.
Probiotics mediated gut microbiota diversity shifts are associated with reduction in histopathology and shedding of Lawsonia intracellularis
Authors: Muwonge Adrian , Karuppannan Anbu K. , Opriessnig Tanja
Published: March 2021

Background

Clinical intervention during bacterial infections in farm animals such as pigs commonly includes the use of antimicrobials. With the rise of antimicrobial resistance and the attempts to reduce the use of antibiotics in food animals, effective alternatives are urgently needed to reduce or even remove pathogens and disease risks. Improving clinical outcomes and overall pig health by using probiotics appears attractive. However, reliable data sets on the efficacy of probiotics are scarce. The obligate intracellular bacterium Lawsonia intracellularis is widespread in pigs and associated with severe enteropathy, mainly in the ileum, commonly resulting in substantial reduction in weight gain. The impact of three in-feed probiotics and a commercial live L. intracellularis vaccine was compared in a pig challenge model. Probiotic treatment was associated with reduced L. intracellularis fecal shedding and reduced gut lesions. Here, the bacterial microbiota of the ileum of these pigs was characterized with 16S rRNA gene sequencing and was subsequently analyzed with bioinformatics tools.

Results

The greatest microbial richness was observed in the probiotic treated group T03-LAW, which accounted for 87% of richness observed in the study. Treatment had a significant impact on both the microbiota structure and taxonomic profile in the ileum, explaining between 26 and 36% of the structural variation, with the strongest association in the T03-LAW group. Overall, the largest changes were observed for the pigs treated with in-feed Bacillus pumilus; the microbiota of these pigs had the greatest diversity and highest richness. We also observed depleted and enriched core microbiota amongst the groups; however, there was no correlation with clinical characteristics. The results suggest that an increased diversity of the ileal microbiota is associated with a reduction in shedding, i.e. a unit increase in Shannon diversity index resulted in 2.8 log reduction in shedding.

Conclusions

Probiotic supplementation of a base feed ration increased ileum microbiota diversity leading to a mitigation of the effects of a pathogenic L. intracellularis challenge. An even and diverse microbiota community benefits pigs infected with L. intracellularis, however, investigations are needed to determine if this is also true for other pathogens. The study unambiguously demonstrates the usefulness of probiotic supplementation in reducing the impact of enteric pathogens and pathogen shedding rates in food animals without the use of antimicrobials.
Acral vascular syndrome Lennert type T cell lymphoma—a case report
Authors: Klanidhi Kamal Bandhu , Monian S. Ashwin , Chakrawarty Avinash
Published: March 2021

Background

Acral vascular syndrome clinically presents as digital ischemia with Raynaud’s phenomenon and erythromelalgia but can be rarely seen in the malignant condition. Patients may present pain, permanent digital blanching or cyanosis, and desquamation or ulceration of the fingers. Acral vascular syndrome is rarely associated with lymphoid neoplasm and is associated with smoking, autoimmune connective tissue diseases, and vasculitis. Here, we describe a 79-year-old female who was diagnosed with vitiligo and peripheral T cell lymphoma Lennert type stage 4 with anemia of chronic disease with digital acral vascular syndrome.

Case presentation

A 79-year-old female with vitiligo presented with gangrene of the distal extremities associated with pain and intermittent fever for 2 months. On evaluation, she was found to have anemia of chronic disease and generalized lymphadenopathy and diagnosed as peripheral T cell lymphoma Lennert type with bone marrow involvement and digital acral vascular syndrome.

Conclusion

Acral vascular syndrome can be a presentation of lymphoma; if intervened earlier, the patient can be saved from the amputation of fingers or affected limb. Though it is a rare presentation of lymphoma, it should be considered if there is a rapid progression of gangrene. Early initiation of chemotherapy may result in the reduction of further progression of digital gangrene and thus prevents functional dependence on caregivers. In our patient, gangrene of other fingers was prevented even though it is an aggressive variant of T cell lymphoma.
Fertility Drain or Fertility Gain? Emigration and Fertility During the Great Recession in Italy
Authors: Anelli Massimo , Balbo Nicoletta
Published: March 2021

How does emigration affect fertility in the country of origin? We address this question by estimating counterfactual fertility during the Great Recession in order to understand what the effect of the recession on fertility would be in the absence of emigration. Between 2009 and 2014, Southern European countries suffered from harsh economic instability, which triggered a sharp drop in fertility and a spike in emigration. We focus on Italy, exploiting the richness of the Italian Administrative Registry of Italians Residing Abroad (AIRE), which records information about all Italian citizens moving their residence abroad, as well as Italian birth records. Using an instrumental variable approach, which helps overcome endogeneity issues in the fertility-migration relationship, we find a positive impact of emigration on the total fertility rate at the Italian province level. This result suggests that emigrants are selected among those individuals who have a lower risk of having children. Therefore, in the absence of emigration, counterfactual fertility would have been lower than it actually is. Such a positive effect of out-migration on fertility in the area of origin could thereby lead to an underestimation of the effect of the recession on fertility.
PERFORMATIVE SUBJECTHOODS: LESBIAN REPRESENTATIONS IN SPLIT BRITCHES’ BELLE REPRIEVE
Authors:   Universidad de Sevilla, BENÍTEZ OLIVAR INMACULADA
Published: March 2021

Emerging postmodern theories of gender and sexuality frame the terms in which society has understood these concepts in an evolutionary way throughout history. The last century has witnessed the radical changes carried out mainly by feminist and LGTB movements. On the other hand, the theater, a subversive space where it is possible to experiment with different forms of subjecthood and communication, has been the laboratory in which it has been attempted to give a plastic form to these new currents of thought. In this sense, the work of Split Britches is remarkable for the innovative ways of bringing the abject to the political forefront. From the lesbian body to drag representation, Belle Reprieve (1991) is developed under the queer premise to dismantle heteropatriarchal hegemony and the binary gender system.
GAMBARAN UPAYA IBU DALAM PEMENUHAN KONSUMSI SAYUR DAN BUAH PADA ANAK PRASEKOLAH
Authors: Syaputri Riauni , Anggreny Yecy , Niriyah Sekani
Published: March 2021

The period of growth and development in preschoolers is strongly influenced by the provision of nutrition and food intake, but mothers can not always to fulfil these needs, especially in fulfilling the consumption of vegetables and fruit. This study aims to determine the description of maternal efforts in fulfilling the consumption of vegetables and fruit in preschool children. This research was a quantitative study with a descriptive research design. The study population was all mothers who have preschool children in Public Health Centre “Payung Sekaki Pekanbaru”. Total sample 192 people, taken by Proportional Random Sampling technique. The process of collecting data using an instrument in the form of a questionnaire. Data were analyzed by the Chi-square test. The results showed that of the 192 respondents most of which are 169 people (88.0%) have adequate eating habits, parenting eating most obtained good parenting patterns that are 191 people (99.5%), feeding practices of most respondents were correct namely 97 people (50.5%), the majority of respondents provide good food namely 190 people (99.0%), and the method of food processing shows that the majority of respondents have processed food properly, namely 145 people (75.5%). Mother's efforts in fulfilling the consumption of vegetables and fruit in preschool children in the work area of Payung Sekaki Health Center are good. It is expected that the public health centre will always provide counselling to the public on the importance of balanced food consumption, one of which is to consume spinach and spinach as well as papaya and bananas which have many benefits for children's growth and development, as well as educating parents to more routinely provide vegetable and fruit intake in children every meal hour.
The changing face of rhinology in the NHS: a study of septoplasty, septorhinoplasty and rhinoplasty hospital episode statistics
Authors: Balai E , Jolly K , Bhamra N , Osborne MS , Barraclough J
Published: March 2021

Introduction

In 2011, septorhinoplasty and rhinoplasty were reclassified as procedures of limited clinical value in the NHS. The criteria for funding these operations varies across England. We used hospital episode statistics and freedom of information requests to review the total number of rhinology procedures performed across the previous decade, looking at trends in practice related to time, demographics and commissioning policy.

Materials and methods

Hospital episode statistics for 2012–2019 were used to calculate the number of septoplasty, septorhinoplasty, rhinoplasty and reduction rhinoplasty procedures performed in children and adults. Freedom of information requests were also made to all clinical commissioning groups in England asking for number of procedures performed and number of individual funding requests made.

Results

A total of 158,031 procedures were performed over this period; the majority were in adult (99.0%) men (65.7%). Septoplasty was the most frequently performed operation; however, the total numbers declined by 5.4% over this period. There was a yearly reduction in the overall number of septorhinoplasty, rhinoplasty and reduction rhinoplasty operations. Four clinical commissioning groups provided a detailed breakdown of data by year and procedure. Those that required individual funding requests for all cases saw septorhinoplasty numbers fall by 81% and 75% over the period. Those that did not, saw numbers increase or remain the same.

Conclusions

We found an overall year-on-year reduction in the number of rhinology operations being performed in the NHS, but variation in trends between different clinical commissioning groups. A reduction in operative activity likely represents the effect of underlying restrictions on commissioning rather than reduced clinical need.
Posterior urethral valves masquerading as neuropathic bladder following sacrococcygeal teratoma resection
Authors: Green PA , Hyde Linda , Corbett HJ , Losty PD
Published: March 2021

Neuropathic bladder may be a co-associated morbidity in newborn babies following resection of a sacrococcygeal teratoma. We report a case of a male newborn showing features of incomplete urinary voiding requiring intermittent catheterisation after operation for bladder emptying. Videourodynamic assessment excluded neuropathic bladder and posterior urethral valves were demonstrated on micturating cystography. Urology outcomes have been excellent following curative valve ablation. This report highlights the crucial importance of being aware of the rare coexistence of lower urinary tract pathology in male babies with sacrococcygeal teratoma. Routine urodynamic assessment should be considered in all children following sacrococcygeal teratoma resection.
Design of a high-throughput telescope based on scanning an off-axis three-mirror anastigmat system
Authors: Ji Huiru , Zhu Zhengbo , Tan Hao , Shan Yuefan , Tan Wei , Ma Donglin
Published: March 2021

A high-throughput optical system possesses a large field of view (FOV) and high resolution. However, it is a major challenge to design such a telescope with these two conflicting specifications. In this paper, we propose a method to design a high-throughput telescope based on the classical off-axis three-mirror anastigmat (TMA) configuration by introducing a scanning mechanism. We derive the optimum initial design for the TMA system with no primary aberrations through characteristic ray tracing. During the design process, a real exit pupil is necessitated to accommodate the scanning mirror. By gradually increasing the system’s FOV during the optimization procedure, we finally obtained a high-throughput telescope design with an F-number of 6, a FOV of

6

0

∘

×

1

.

5

∘

, and a long focal length of 876 mm. In addition, a tolerance analysis is also conducted to demonstrate the instrumentation feasibility. We believe that this kind of large rectangle FOV telescope with high resolution has broad future applications in the optical remote sensing field.
Age-structured non-pharmaceutical interventions for optimal control of COVID-19 epidemic
Authors: Richard Quentin , Alizon Samuel , Choisy Marc , Sofonea Mircea T. , Djidjou-Demasse Ramsès
Published: March 2021

In an epidemic, individuals can widely differ in the way they spread the infection depending on their age or on the number of days they have been infected for. In the absence of pharmaceutical interventions such as a vaccine or treatment, non-pharmaceutical interventions (e.g. physical or social distancing) are essential to mitigate the pandemic. We develop an original approach to identify the optimal age-stratified control strategy to implement as a function of the time since the onset of the epidemic. This is based on a model with a double continuous structure in terms of host age and time since infection. By applying optimal control theory to this model, we identify a solution that minimizes deaths and costs associated with the implementation of the control strategy itself. We also implement this strategy for three countries with contrasted age distributions (Burkina-Faso, France, and Vietnam). Overall, the optimal strategy varies throughout the epidemic, with a more intense control early on, and depending on host age, with a stronger control for the older population, except in the scenario where the cost associated with the control is low. In the latter scenario, we find strong differences across countries because the control extends to the younger population for France and Vietnam 2 to 3 months after the onset of the epidemic, but not for Burkina Faso. Finally, we show that the optimal control strategy strongly outperforms a constant uniform control exerted over the whole population or over its younger fraction. This improved understanding of the effect of age-based control interventions opens new perspectives for the field, especially for age-based contact tracing.
Ccdc113/Ccdc96 complex, a novel regulator of ciliary beating that connects radial spoke 3 to dynein g and the nexin link
Authors: Bazan Rafał , Schröfel Adam , Joachimiak Ewa , Poprzeczko Martyna , Pigino Gaia , Wloga Dorota
Published: March 2021

Ciliary beating requires the coordinated activity of numerous axonemal complexes. The protein composition and role of radial spokes (RS), nexin links (N-DRC) and dyneins (ODAs and IDAs) is well established. However, how information is transmitted from the central apparatus to the RS and across other ciliary structures remains unclear. Here, we identify a complex comprising the evolutionarily conserved proteins Ccdc96 and Ccdc113, positioned parallel to N-DRC and forming a connection between RS3, dynein g, and N-DRC. Although Ccdc96 and Ccdc113 can be transported to cilia independently, their stable docking and function requires the presence of both proteins. Deletion of either CCDC113 or CCDC96 alters cilia beating frequency, amplitude and waveform. We propose that the Ccdc113/Ccdc96 complex transmits signals from RS3 and N-DRC to dynein g and thus regulates its activity and the ciliary beat pattern.
The determinant factors for the adoption of CRM in the Palestinian SMEs: The moderating effect of firm size
Authors: Salah Omar Hasan , Yusof Zawiyah Mohammad , Mohamed Hazura
Published: March 2021

CRM adoption can provide innumerable benefits to the SMEs performance, including solving customer problems in a timely manner, enhancing customer satisfaction by appointing an expert to solve issues and queries, and the like. This study aims to examine the moderating effects of the firm size in the adoption of CRM in the Palestinian SMEs. A quantitative approach was used to investigate the relationships between the variables, which are compatibility, IT infrastructure, complexity, relative advantage, security, top management support, customer pressure, and competitive pressure. A questionnaire was designed to collect data from 420 SMEs in Palestine. A total of 331 respondents completed and returned the survey. The Partial Least Square-Structural Equation Model (PLS-SEM) approach was used to assess both the measurement and structural models. The Diffusion of Innovation Theory (DOI) and Technology, Organization, and Environment Framework (TOE) framework were employed to identify the determinant factors from the technological, organizational, and environmental perspectives. The findings and conclusions of this study provide show that the moderating effect of firm size has significant effect compatibility, top management support, customer pressure, and IT infrastructure factors.
Mental Health in The Context of The COVID 19 Pandemic
Authors: Yadav Ravinder , Saini Varinder
Published: March 2021

We explore the global evidence of major health crisis potential impacts and the factors influencing the mental health outcomes among the population during the outbreak of COVID-19. Preparation measures for a COVID-19 focus on rapid quarantine of social isolation and economic concerns have risen metal health considerations that become an integrated part of the pandemic outbreak. This outbreak of novel Coronavirus disease (COVID-19) pandemic is swayed an overall 213 countries, areas or territories, with over 2,921,439 confirmed cases and 203,289 confirmed deaths reported till 26 April 2020. This created a lot of strain and fear; fear of falling ill and dying of being infected leading to heightened levels of insurmountable psychological pressure. This scrutiny attempt to assess the widespread outbreaks of COVID-19 on mental health professionals, healthcare workers and general population in association with adverse mental health sequelae like generalized anxiety disorder (GAD), depressive symptoms, insomnia, panic attacks, post-traumatic stress disorder, OCD, suicidal behavior, delirium, psychosis, harmful alcohol consumption, and drug use. There is a need for more evocative exploration to intensify awareness to address the potential psychological and behavioral risks that will remain elevated as long as the COVID-19 pandemic continues in the community. In conclusion, incessant surveillance of the subsyndromal mental health problems for outbreaks should be part of galvanized global action during the quarantine.
Talent (be)werten
Authors: Janetzko Alexandra
Published: March 2021

Wie werden Talente im Sport gemacht? Dieser Frage widmet sich Alexandra Janetzko, indem sie Bundeskadersichtungen in den kontrastreichen Sportarten Lateinamerikanische Tänze und 400-Meter-Sprint analysiert. Aus einer praxis- und subjektivierungstheoretischen Perspektive nimmt sie zwei miteinander zusammenhängende Forschungsinteressen in den Blick: Wie wird Talent in Sichtungspraktiken konstruiert und damit sicht- und bewertbar gemacht? Und wie werden Athlet*innen in Bewertungsprozessen zu (Nicht-)Talenten subjektiviert? Die Studie gewährt Einblicke in Prozesse des (Be)Wertens und ihre subjektivierenden Effekte. Damit leistet sie auch über den Sport hinaus einen Beitrag zum Talentdiskurs.
Deep industrial transfer learning at runtime for image recognition
Authors: Maschler Benjamin , Kamm Simon , Weyrich Michael
Published: March 2021

The utilization of deep learning in the field of industrial automation is hindered by two factors: The amount and diversity of training data needed as well as the need to continuously retrain as the use case changes over time. Both problems can be addressed by industrial deep transfer learning allowing for the performant, continuous and potentially distributed training on small, dispersed datasets. As a specific example, a dual memory algorithm for computer vision problems is developed and evaluated. It shows the potential for state-of-the-art performance while being trained only on fractions of the complete ImageNet dataset at multiple locations at once.
Petrinetzbasierte Verlässlichkeitsanalyse einer sicherheitsrelevanten, bordautonomen Zugortung auf Grundlage von PROFUND
Authors: Dodinoiu Andreas , Geffert Arne , Lan Tianxiang , Becker Uwe
Published: March 2021

Die bevorstehende Modernisierung des Schienenverkehrs wird sich auf die Zugsicherungs- und Signaltechnik auswirken, z. B. auf die Zugortung, die bordautonom und satellitenbasiert werden soll. Um schon in frühen Entwicklungsstadien Aussagen über die Verlässlichkeit eines solchen Systems treffen zu können, ist eine prospektive Risikoabschätzung auf funktionaler Ebene erforderlich. Durch Weiterentwicklung der PROFUND-Methode kann mithilfe einer petrinetzbasierten Modellierung und einer Monte-Carlo-Simulation eine quantitative Aussage über die Verlässlichkeit des Systems getroffen werden.
Association of thyroid autoimmunity and the response to recombinant human growth hormone in Turner syndrome
Authors: Song Yuyao , Yang Hongbo , Wang Linjie , Gong Fengying , Pan Hui , Zhu Huijuan
Published: March 2021

Objectives

Short stature and thyroid autoimmunity are common comorbidities in Turner syndrome (TS). Recombinant human growth hormone (rhGH) significantly improves height growth in TS individuals. This study aims to investigate the association of thyroid autoimmunity and the response to rhGH treatment in TS patients.

Methods

Medical records of 494 patients with TS were reviewed. Among 126 patients who regularly tested for thyroid autoantibodies, 108 patients had received rhGH treatment. Clinical characteristics, including karyotype and the presence of autoimmune thyroid diseases, as well as rhGH treatment records were analyzed. Height velocity (HV) of patients with or without thyroid autoimmunity was compared to assess the response to rhGH treatment. For patients who developed thyroid autoantibodies during rhGH treatment, HV before and after antibody presence were compared.

Results

45XO monosomy presented in 36% (176/496) of patients. 42.1% of patients (53/126) had elevated circulating anti-thyroid peroxidase antibody and anti-thyroglobulin antibody. In 108 patients who received rhGH treatment, HVs were significantly correlated to age, height, weight and BMI at the initiation of treatment. For patients who developed thyroid autoantibodies during rhGH treatment, HVs after thyroid autoantibody presence significantly decreased compared with HVs before thyroid autoantibody detection (n=44, p=0.0017).

Conclusions

Our data suggested that in TS patients who developed thyroid autoantibodies during rhGH treatment, the response to rhGH is negatively associated with the development of thyroid autoimmunity.
Superficiality and Representation: Adding Aesthetics to “Knowledge without Truth”
Authors: Vaillo Gonzalo
Published: March 2021

This article has two parts. The first one compares the ontological and epistemological implications of two main philosophical stances on how reality relates to appearance. I call the first group the “plane of superficiality,” where reality and appearance are the same; there is no gap between what a thing is and how it manifests itself. I call the second group “volume of representation,” in which reality is beyond appearances; there is an insurmountable gap between the thing and its phenomena. The second part of the article focuses on Graham Harman’s Object-Oriented Ontology (OOO) as the second group’s contemporary position. Within the OOO epistemological model of “knowledge without truth,” Harman’s schema of the observer’s participation in the object’s knowledge production is questioned. Alternatively, based on the notion proposed here of “flat representativity” in which each appearance is equally valuable to represent different aspects of the object, I argue for the full spectrum of the sensual as the basis for “knowledge without truth.” In particular, the aesthetic method, excluded from Harman’s concerns about knowledge, is suggested as another contribution to the episteme.