bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical simulation and optimization of casting process of copper alloy water-meter shell
Authors: Zheng Kaikui , Lin Youxi , Chen Weiping , Liu Lei
Published: May 2020

The water-meter shell has a complex-structured thin-walled cavity, and it can cause casting defects such as shrinkage and misrun. On the basis of structural analysis of a water-meter shell, a three-dimensional model and a finite element model of the water-meter shell were constructed using the SOLIDWORKS and ProCAST software as a modeling tool and a casting numerical simulation tool, respectively. Three processes associated with the bottom gating system without a riser, a step gating system with a preliminary riser, and a step gating system with an optimum riser were successively numerically simulated. The mold-filling sequence, temperature distribution, liquid-phase distribution during solidification, and shrinkage distribution of these three processes are discussed here. The numerical simulation results indicated that optimization of the casting process and the rational assembling of the riser led to the shrinkage volumes at the inlet position, regulating sleeve, and sealing ring of the water-meter shell decreasing from 0.68 to 0 cm3, 1.39 to 0.22 cm3, and 1.32 to 0.23 cm3, respectively. A comparison between model predictions and experimental measurements indicated that the castings produced by the optimized process had good surface quality and beautiful appearance, without casting defects, demonstrating that numerical simulation can be used as an effective tool for improving casting quality.
Circulating cytokines and angiogenic factors based signature associated with the relative dose intensity during treatment in patients with advanced hepatocellular carcinoma receiving lenvatinib
Authors: Ono Atsushi , Aikata Hiroshi , Yamauchi Masami , Kodama Kenichiro , Ohishi Waka , Kishi Takeshi , Ohya Kazuki , Teraoka Yuji , Osawa Mitsutaka , Fujino Hatsue , Nakahara Takashi , Murakami Eisuke , Miki Daiki , Kawaoka Tomokazu , Abe-Chayama Hiromi , Zhang Peiyi , Liu Songyao , Makokha Grace Naswa , Tsuge Masataka , Imamura Michio , Hayes C. Nelson , Chayama Kazuaki
Published: May 2020

Background:

Although lenvatinib was recently approved for treatment of advanced unresectable hepatocellular carcinoma (HCC) based on the phase III REFLECT trial, no biomarkers for management of lenvatinib treatment have been established. The aim of this study is to identify predictive biomarkers for the management of lenvatinib treatment in advanced HCC patients.

Methods:

A total of 41 patients with advanced HCC were enrolled in this retrospective study. Serum levels of 22 circulating cytokines and angiogenic factors (CAFs) were measured by multiplex Luminex assay. Profiles of CAFs, clinical chemistry/hematology parameters, and clinical background were evaluated to explore biomarkers associated with clinical outcomes.

Results:

Relative dose intensity (RDI) decreased significantly between weeks 1–2 and 3–4 ( p < 0.001), and RDI during weeks 3–4 was a prominent indicator of progression-free survival (PFS). A signature based on baseline serum levels of nine CAFs associated with low RDI was identified. In a multivariate Cox regression analysis, patients with a favorable 9-CAFs signature [hazard ratio (HR) 0.42, 95% confidence interval (CI) 0.18–0.96, p = 0.040] had lower risk, and Child-Pugh grade B (HR 1.6, 95% CI 1.1–8.3, p = 0.026) and presence of macrovascular invasion (MVI; HR 2.9, 95% CI 1.0–8.3, p = 0.045) had higher risk of shorter PFS.

Conclusion:

This study demonstrates that RDI is an important predictive factor for longer PFS during lenvatinib treatment. In this hypothesis-generating exploratory analysis, we report that a CAF-signature associated with adverse events and RDI could predict PFS, which might contribute to improved management of lenvatinib treatment in HCC patients.
A Synergy of Failures: Environmental Protection and Chinese Capital in Southeast Europe
Authors: Tsimonis Konstantinos , Rogelja Igor , Ciută Ioana , Frantzeskaki Anastasia , Nikolovska Elena , Pesha Besjan
Published: May 2020

Chinese economic presence in Europe is primarily discussed as a security threat with its impact on sustainability remaining a rather marginal issue. This article investigates the repercussions of Chinese capital’s surge in Europe for environmental protection and analyses the reasons behind its poor performance. We examine five key Chinese projects in Southeast Europe, a sub-region that includes countries with different forms of association with European institutions and with varying levels of development and state capacity. We find that the negative environmental impact of these projects cannot be attributed to the commonly held perception of the Chinese as inherently “bad” investors and of host states as “weak” and dependent. Rather, we identify a synergy of failures between investors, host states and regional institutions that results in poor regulation and compliance. This finding calls for the inclusion of sustainability in foreign investment screening mechanisms and the abandonment of contradictory developmental priorities in the region.
Outcomes of Partial Meniscectomy in Obese Patients: A Systematic Review and Meta-Analysis
Authors: Zhang Tina , Jauregui Julio J. , Foster Michael , Packer Jonathan D. , Meredith Sean J. , Leong Natalie L. , Henn R. Frank
Published: May 2020

Objective

Arthroscopic partial meniscectomy (APM) is one of the most commonly performed surgical procedures. However, the indications for APM are controversial and obese patients may have worse outcomes. This study’s primary purpose was to investigate differences in outcome after APM associated with elevated body mass index (BMI). Secondary objectives included differences in pathophysiology, surgical complications/failures, or osteoarthritis development.

Design

MEDLINE, EMBASE, and OVID databases were systematically searched for eligible studies reporting on APM outcomes at a minimum of 1 year postoperatively. Studies that did not include BMI categorization were excluded. Meta-analysis was conducted with random-effects modeling where data from at least 2 studies was available.

Results

A total of 16 articles were included. Overweight/obese BMI was associated with worse preoperative Lysholm (mean difference, −6.06 [95% CI, −11.70 to −0.42]) and visual analogue scale pain scores (0.43 [0.07 to 0.79]). Worse postoperative normalized knee-specific patient-reported outcome scores were also associated with obese BMI (−4.57 [−5.33 to −3.81]). There were no significant differences in clinical improvement or osteoarthritis progression among BMI groups. Two studies found higher complication/failure rates, 3 articles associated medial meniscus posterior root tears, and 1 article found differences in gene transcript expression with increased BMI.

Conclusions

Obesity is associated with worse knee function after APM, and patients with elevated BMI have worse preoperative knee pain and function. However, there is no difference in amount of improvement between elevated and normal BMI patients. Further prospective research is necessary to determine the comparative effectiveness of APM in patients with elevated BMI.
What lies downstream? A case of superior vena cava syndrome presenting in the dermatology clinic: A case report
Authors: Tonkin Rochelle , Sladden Christopher
Published: May 2020

A 75-year-old female presented with a 1 year history of a firm, diffusely swollen, and erythematous facial plaque. She had preceding unsuccessful investigations and treatment for angioedema. Full-skin examination revealed multiple prominent varicosities on the chest and abdomen. Superior vena cava syndrome was suspected. Solid facial edema (Morbihan’s syndrome) and various infiltrates included in the differential diagnosis were ruled out with a skin biopsy. Chest computed tomography confirmed a complete superior vena cava thrombosis. Extensive workup for associated malignancy has to date been unremarkable, and as yet an underlying cause remains to be found.
Postobstructive pulmonary edema: A fatal complication in suicidal near-hanging
Authors: Mesrati Mohamed Amin , Jaoued Oussama , Mahjoub Yosra , Boussaid Marwa , Fkih Hassen Med , Atrous Souheil , Aissaoui Abir
Published: May 2020

Postobstructive pulmonary edema is a life-threatening complication that occurs after the removal of severe upper airway obstruction. Development of postobstructive pulmonary edema has been described after several cases of upper airway obstruction. However, postobstructive pulmonary edema developing after non-lethal hanging has not been reported widely in the literature. Herein, we describe a fatal case of postobstructive pulmonary edema in a 10-year-old girl, which was brought to the hospital with history of attempted suicide by hanging. At presentation, the girl was breathing laboriously. The oxygen saturation was of 82% and pulmonary auscultation revealed bilateral and diffuse crepitations. The chest computed tomographic scan showed bilateral diffuse infiltrates consistent with pulmonary edema. After 3 days of hospitalization, the respiratory state of the girl worsened leading to death despite intensive care. An autopsy was conducted and confirmed the diffuse pulmonary edema. Hence, this case confirms that delayed death in near hanging may occur. Pulmonary edema which develops subsequently in such patients is an uncommon mechanism of death that physicians should consider in emergency room.
Youngsters and WMAs (WeChat Moments Advertisement): Do We Need the English Language in WMAs?
Authors: Nawaz Muhammad Zahid , Tao Meng , Ahmad Hassan , Haque Md Jamirul , Nawaz Shahid , Shafique Muhammad Nauman
Published: May 2020

Social media marketing is considered an integral part of the today’s marketing plans alongside the conventional tools. Social media’s practical application has changed the way of communication between organizations and consumers. In particular, the dynamics of interactions have been diversified in the Chinese technological cross-cultural environment. Foreigners are increasing in China and influencing the business markets. The reason for writing this article is to investigate the effects of the English language as a moderator on the viability of social media measurements and empirically test the electronic customer involvement regarding likes and comments that define the dedication and commitment. This research has analyzed the responses of 287 foreigners. The response was taken through online questionnaires distributed on a random sampling basis to social media users. Empirical research was performed by using SmartPLS3 for analysis to observe the relationships. The resultant role represents that all determinants are not similarly suitable, and are much diversified, in the context of China for the step-up of electronic customer involvement. More particularly, social media advertisement characteristics are more effective in the enhancement of electronic customers’ involvement than advertisement contents. Moreover, the use of the English language is significantly affecting the electronic customer involvement level. Tencent corporation and social media marketers should use this research to make new advertisement plans for further marketing purpose as it will guide them on how to create an innovative advertisement that will positively reap the cross-cultural environment.
Using Virtual Reality to Validate the Chinese Version of the Independent Television Commission-Sense of Presence Inventory
Authors: Yan Bangyi , Ni Shiguang , Wang Xi , Liu Jin , Zhang Qianjing , Peng Kaiping
Published: May 2020

The English version of the Independent Television Commission-Sense of Presence Inventory (ITC-SOPI), which was developed in 2001 to measure how involved or present participants are when experiencing different media, has substantial psychometric evidence. This study was used to translate and validate the ITC-SOPI in interactive virtual environments among the Chinese population. We used the forward-backward translation procedure. An expert panel reviewed the translated ITC-SOPI until the Chinese version of the ITC-SOPI was finalized. A total of 210 participants (133 males and 77 females), with a mean age of 23.05 years ( SD = 3.56, range = 17–47), completed the Chinese ITC-SOPI. The following psychometric properties were examined: factor structure, internal consistency, test–retest reliability, and convergent validity. Confirmatory factor analysis (CFA) showed a good fit (χ2 /df = 1.70, Tucker–Lewis Index [TLI] = 0.91, comparative fit index [CFI] = 0.92, root mean square error of approximation [RMSEA] = 0.058) of the four-factor model (spatial presence, engagement, ecological validity, and negative effects). For each factor, the Chinese ITC-SOPI had high internal consistency (Cronbach’s α ranging from 0.75 to 0.87) and test–retest reliability (intraclass correlation coefficient ranging from 0.82 to 0.91). Significant correlations were identified between all factors and the Interpersonal Reactivity Index-C (IRI-C) and the Generalized Anxiety Disorder-7 (GAD-7). The Chinese ITC-SOPI had good psychometric properties, suggesting that it is a reliable and valid tool for evaluating media users’ sense of presence in a Chinese-speaking context.
The Language of Positive Mental Health: Findings From a Sample of Russian Facebook Users
Authors: Bogolyubova Olga , Panicheva Polina , Ledovaya Yanina , Tikhonov Roman , Yaminov Bulat
Published: May 2020

Positive mental health is considered to be a significant predictor of health and longevity; however, our understanding of the ways in which this important characteristic is represented in users’ behavior on social networking sites is limited. The goal of this study was to explore associations between positive mental health and language used in online communication in a large sample of Russian Facebook users. The five-item World Health Organization Well-Being Index (WHO-5) was used as a self-report measure of well-being. Morphological, sentiment, and semantic analyses were performed for linguistic data. The total of 6,724 participants completed the questionnaire and linguistic data were available for 1,972. Participants’ mean age was 45.7 years ( SD = 11.6 years); 73.4% were female. The dataset included 15,281 posts, with an average of 7.67 ( SD = 5.69) posts per participant. Mean WHO-5 score was 60.0 ( SD = 19.1), with female participants exhibiting lower scores. Use of negative sentiment words and impersonal predicates (“should statements”) demonstrated an inverse association with the WHO-5 scores. No significant correlation was found between the use of positive sentiment words and the WHO-5 scores. This study expands current understanding of the association between positive mental health and language use in online communication by employing data from a non-Western sample.
The Assessment of Pain and the Quality of Postoperative Pain Management in Surgical Patients
Authors: Köse Tamer Laika , Sucu Dağ Gülten
Published: May 2020

The aim of the study was to investigate surgical patients’ pain experience and the quality of nursing care in managing acute postoperative pain. A descriptive cross-sectional study using a Strategic and Clinical Quality Indicators in Postoperative Pain Management Questionnaire collected data of 247 patients who underwent surgery in the surgical clinics of a state hospital. Data of 141 patients were included in the analysis. The mean scores for the scale items indicated that the quality of care was acceptable or low. The level of postoperative care, nursing interventions, and environmental subscales of the questionnaire were at an acceptable level, but pain management subscales of the questionnaire were low. These results suggest that health care, including measurable, applicable quality indicators, should be planned and evaluated to maintain professional nursing services, to achieve postoperative pain management and to relieve pain.
Exploring the Role of Translation in Communicative Language Teaching or the Communicative Approach
Authors: Adil Mohammad
Published: May 2020

This study aims to investigate the perception of language teachers and their experience regarding the use of translation as a language teaching approach in Saudi Arabia. The study adopted a cross-sectional qualitative design to investigate the role of translation as a communicative approach in language teaching. Data were collected through a semi-structured interview with 20 professors and lecturers who were teaching at a university in Saudi Arabia. The interview results revealed that language translation strategy is effective in developing the necessary communicative ability among Saudi language learners. Also, the use of translation should be based on the skill set and competence level. It concludes that the judicious use of the translation should be practiced for Communicative Language Teaching.
Consumer satisfaction–based social commerce service quality management
Authors: Shin Nina , Park Sangwook , Kim Hyunjung
Published: May 2020

Social commerce (s-commerce) is a social media service enabling consumers’ participation in the online marketing and sale of products and services. This study aims to (a) identify key functional and hedonic quality factors that affect consumer satisfaction based on consumers’ perspective and (b) analyze the degree of efficiency of the quality–satisfaction relationship to propose distinct and actionable improvement strategies from the firms’ perspective. The results identified the following key quality determinants: functional aspects of durability and safety, and hedonic aspects of enjoyment, awareness, novelty, and image. The result implies that most s-commerce service firms fail to efficiently convert the enhancement of safety, awareness, and novelty into consumer satisfaction. This study contributes to the stream of literature on both s-commerce and service operations management by determining key service quality elements based on consumers’ perceptions and providing a decision-making aid to firms for quality-satisfaction efficiency improvement.

JEL CLASSIFICATION: M10; L20; L81
Introduction to a review series on secondary leukemia
Authors: Soulier Jean
Published: May 2020

In this commissioned series of reviews introduced by Associate Editor Jean Soulier, experts provide new insights into the pathobiology of secondary acute myeloid leukemias arising in diverse genetic or acquired, benign or malignant hematologic disorders.
Progress in Bio-inspired Anti-solid Particle Erosion Materials: Learning from Nature but Going beyond Nature
Authors: Zhang Shuaijun , Zhang Junqiu , Zhu Bin , Niu Shichao , Han Zhiwu , Ren Luquan
Published: May 2020

Solid particle erosion is a common phenomenon in engineering fields, such as manufacturing, energy, military and aviation. However, with the rising industrial requirements, the development of anti-solid particle erosion materials remains a great challenge. After billions of years of evolution, several natural materials exhibit unique and exceptional solid particle erosion resistance. These materials achieved the same excellent solid particle erosion resistance performance through diversified strategies. This resistance arises from their micro/nanoscale surface structure and interface material properties, which provide inspiration for novel multiple solutions to solid particle erosion. Here, this review first summarizes the recent significant process in the research of natural anti-solid particle erosion materials and their general design principles. According to these principles, several erosion-resistant structures are available. Combined with advanced micro/nanomanufacturing technologies, several artificial anti-solid particle erosion materials have been obtained. Then, the potential applications of anti-solid particle erosion materials are prospected. Finally, the remaining challenges and promising breakthroughs regarding anti-solid particle erosion materials are briefly discussed.
Airway management in children with hemifacial microsomia: a restropective study of 311 cases
Authors: Xu Jin , Deng Xiaoming , Yan Fuxia
Published: May 2020

Background

Hemifacial microsomia (HFM) is a congenital craniofacial malformation which is associated with difficult airway. Anesthesiologists may experience difficult intubation in children with HFM. Mandibular distraction could increase the length of the mandible. Theoretically, it should be advantageous to laryngeal view during tracheal intubation. This study reviewed airway management in children with HFM, assessed the efficiency of direct laryngoscopy versus airway-visualizing equipment during the tracheal intubation and determined whether mandibular distraction could improve the laryngoscopic view in children with HFM.

Methods

A retrospective review of cases involving children with HFM aged 5 to 17 years old underwent anesthesia from December 2016 to April 2019 at a single center was performed. The demographic data, preoperative airway assessments, procedure type, anesthetic technique, method of airway management, anesthetists’ comments on mask ventilation, laryngoscopy and intubation parameters were collected.

Results

At last, 136 HFM children entered this study, a total of 311 anesthesia procedures were completed during the study period. Face mask ventilation was possible for most of children except 1 child (bilateral involvement) required two practitioners. The success rates of intubation for the primary video laryngoscopy and fibroscopy were both 100%, but 79.5% for direct laryngoscopy (P < 0.001). 95 (38.9%) children who had difficult laryngoscopic view (DLV) were significantly correlated with failed direct laryngoscopy (P < 0.001). Airway-visualizing equipment (video laryngoscope and Fiberscope) was the primary airway technique in 3 (75%) bilaterally involved children. 60 children underwent both mandibular distraction osteogenesis and the removal of distractor. The laryngoscopic views improved in 26 (43%) children after treatment with mandibular distraction (P < 0.001).

Conclusions

Airway-visualizing equipment can be effectively utilized for intubation in HFM children with DLV. Mandibular distraction could improve the laryngeal view effectively.
Which factors influence the ED length-of-stay after anterior shoulder dislocations: a retrospective chart review in 716 cases
Authors: Schuur Daan , Baden David , Roetman Martijn , Boeije Tom , Burg Michael , Mullaart-Jansen Nieke
Published: May 2020

Background

Anterior shoulder dislocations (ASD) are commonly seen in Emergency Departments (ED). ED overcrowding is increasingly burdening many healthcare systems. Little is known about factors influencing ED length-of-stay (LOS) for ASD. This study defines the factors influencing ED LOS for ASD patients.

Methods

Retrospective chart reviews were performed on all patients ≥12 years admitted with an anterior shoulder dislocation at two regional hospitals in the Netherlands between 2010 and 2016. The electronic patient records were reviewed for baseline patient characteristics, trauma mechanism, reduction methods, medication used, complications and the LOS at the ED. The main objective was determining factors influencing the LOS in patients with an anterior shoulder dislocation at the ED.

Results

During the study period, 716 ASD occurred in 574 patients, 374 (65.2%) in males. There were 389 (54.3%) primary ASD; the remainder (327, 45.7%) were recurrent. Median LOS was 92 min (IQR 66 min), with a significantly shorter LOS in those with recurrent dislocations (p < 0.001), younger age group (p < 0.03) and in patients who received no medications in the ED (p < 0.001). Traction-countertraction and leverage techniques were associated with a significant more use of ED medication compared to other techniques. Although the use of more medication might suggest the LOS would be longer for these techniques, we did not find a significant difference between different reduction techniques and LOS.

Conclusion

To our knowledge this study is the largest of its kind, demonstrating ED LOS in ASD patients is influenced by age, the need for medication and dislocation history, primary versus recurrent. Notably, we found that biomechanical reduction techniques, which are not primarily traction-countertraction or leverage techniques, e.g. scapular manipulation and Cunningham, were associated with less ED medication use. Further research is needed to define how reduction methods influence ED medication use, patient satisfaction and ED throughput times.
Arterial reconstruction using the donor’s gonadal vein in living renal transplantation with multiple renal arteries: a case report and a literature review
Authors: Tomizawa Mitsuru , Hori Shunta , Nishimura Nobutaka , Omori Chihiro , Nakai Yasushi , Miyake Makito , Yoneda Tatsuo , Fujimoto Kiyohide
Published: May 2020

Background

Arterial reconstruction is one of the paramount procedures in kidney transplantation (KT) and greatly important if the procured kidney has multiple renal arteries (MRA). Despite various established techniques for arterial reconstruction, sometimes, the surgeon finds performing arterial anastomoses challenging in case of MRA. In our case, the donor’s gonadal vein and recipient’s internal iliac artery graft were used for arterial anastomoses, and 3 years after KT, the allograft did not present vascular complications.

Case presentation

A 34-year-old man underwent ABO-incompatible preemptive living KT. The allograft had three renal arteries and four renal veins. After donor nephrectomy, arterial reconstruction was performed on a back table. These arteries were reconstructed into one piece using the recipient’s internal iliac artery graft. The two arteries at the middle of the renal hilum were reconstructed using the conjoined method. As the superior renal artery was too short to anastomose, the donor’s gonadal vein was used for extension. The internal iliac artery graft was anastomosed to the original internal iliac artery. Intraoperative Doppler ultrasonography revealed that the blood flow in each renal artery was adequate, resulting in sufficient blood flow throughout the allograft. The allograft function was maintained with a serum creatinine level of approximately 0.9 mg/dL without vascular complications 3 years after KT.

Conclusions

The donor’s gonadal vein can be a candidate for extension of the renal artery in the allograft with MRA. Further follow-up is needed for the assessment of long-term outcomes.
Incidence of acute kidney injury and use of renal replacement therapy in intensive care unit patients in Indonesia
Authors: Jonny Jonny , Hasyim Moch , Angelia Vedora , Jahya Ayu Nursantisuryani , Hilman Lydia Permata , Kusumaningrum Venna Febrian , Srisawat Nattachai
Published: May 2020

Background

Currently, there is limited epidemiology data on acute kidney injury (AKI) in Indonesia. Therefore, we assessed the incidence of AKI and the utilization of renal replacement therapy (RRT) in Indonesia.

Methods

Demographic and clinical data were collected from 952 ICU participants. The participants were categorized into AKI and non-AKI groups. The participants were further classified according to the 3 different stages of AKI as per the Kidney Disease Improving Global Outcome (KDIGO) criteria.

Results

Overall incidence of AKI was 43%. The participants were divided into three groups based on the AKI stages: 18.5% had stage 1, 33% had stage 2, and 48.5% had stage 3. Primary diagnosis of renal disease and high APACHE II score were the risk factors associated with AKI (OR = 4.53, 95% CI: 1.67–12.33, p = 0.003 and OR = 1.14 per 1 unit increase, 95% CI: 1.09–1.20, p < 0.001, respectively). Chronic kidney disease was the risk factor for severe AKI. Sepsis was the leading cause of AKI. Among the AKI participants, 24.6% required RRT. The most common RRT modalities were intermittent hemodialysis (71.7%), followed by slow low-efficiency dialysis (22.8%), continuous renal replacement therapy (4.3%), and peritoneal dialysis (1.1%).

Conclusions

This study showed that AKI was a common problem in the Indonesian ICU. We strongly believe that identification of the risk factors associated with AKI will help us develop a predictive score for AKI so we can prevent and improve AKI outcome in the future.
Reinvestigation of the origins of pineal meningiomas based on its related veins and arachnoid membranes
Authors: Yu Lei , Orazmyradov Berdimyrat , Qi Songtao , Song Ye , Fang Luxiong
Published: May 2020

Background

A series of patients harboring pineal region meningiomas were respectively analyzed to explore the origin of these tumors and the true meaning of the term “velum interpositum (VI) meningiomas”.

Methods

21 patients with pineal meningiomas underwent operation in Nanfang Hospital of Southern Medical University from January 2005 to December 2016 were retrospectively included to analyze the clinical features, imaging findings and surgical video data of these patients. According to the method of literature, the data of this group were also divided into falcotentorial (FT) meningiomas and VI meningiomas, and the differences between the two types of tumors were compared.

Results

Among the 21 cases of tumor, there were 12 cases of FT meningiomas, including 4 cases originating from cerebral falx, 4 cases from tentorium of cerebellum and 4 cases from straight sinus; there were 9 cases of VI meningiomas, 7 of which originated from the arachnoid sleeve of the Galen vein, 1 from the posterior part of the internal cerebral vein and 1 from the posterior surface of the pineal gland. Postoperative pathological examination showed meningiomas in all the 21 patients, including 16 cases of total resection and 5 cases of subtotal resection. Postoperatively limitation of binocular vertical motion was found in 3 cases, homotropic hemianopia in 7 cases, hemiplegia in 1 case and death in 1 case.

Conclusions

This study suggests that pineal meningiomas are more suitable to be described by FT meningioma and meningiomas of the arachnoid of the pineal region by analyzing the origin of tumors. The term “VI meningiomas” can only reflect a part of meningiomas of the arachnoid of the pineal region. Before the removal of pineal meningiomas, more attention should be paid to the effects of the two types of tumors on the Galen vein and the straight sinus, and the establishment of venous collateral circulation.
The clinical significance of the T2-FLAIR mismatch sign in grade II and III gliomas: a population-based study
Authors: Corell Alba , Ferreyra Vega Sandra , Hoefling Nickoleta , Carstam Louise , Smits Anja , Olsson Bontell Thomas , Björkman-Burtscher Isabella M. , Carén Helena , Jakola Asgeir Store
Published: May 2020

Background

The T2-FLAIR mismatch sign is an imaging finding highly suggestive of isocitrate dehydrogenase mutated (IDH-mut) 1p19q non-codeleted (non-codel) gliomas (astrocytomas). In previous studies, it has shown excellent specificity but limited sensitivity forIDH-mut astrocytomas. Whether the mismatch sign is a marker of a clinically relevant subtype ofIDH-mut astrocytomas is unknown.

Methods

We included histopathologically verified supratentorial lower-grade gliomas (LGG) WHO grade II-III retrospectively during the period 2010–2016. In the period 2017–2018, patients with suspected LGG radiologically were prospectively included, and in this cohort other diagnoses than glioma could occur. Clinical, radiological and molecular data were collected. For clinical evaluation we included all patients withIDH-mut astrocytomas. In the 2010–2016 cohort DNA methylation analysis with Infinium MethylationEPIC BeadChip (Illumina) was performed for patients with anIDH-mut astrocytoma with available tissue. We aimed to examine the association of the T2-FLAIR mismatch sign with clinical factors and outcomes. Additionally, we evaluated the diagnostic reliability of the mismatch sign and its relation to methylation profiles.

Results

Out of 215 patients with LGG, 135 had knownIDH-mutation and 1p19q codeletion status. Fifty patients had anIDH-mut astrocytoma and 12 of these (24.0%) showed a mismatch sign. The sensitivity and specificity of the mismatch sign forIDH-mut detection were 26.4 and 97.6%, respectively. There were no differences between patients with anIDH-mut astrocytoma with or without mismatch sign when grouped according to T2-FLAIR mismatch sign with respect to baseline characteristics, clinical outcomes and methylation profiles. The overall interrater agreement between neuroradiologist and clinical neurosurgeons for the T2-FLAIR mismatch sign was significant when all 215 MRI examination assessed (κ = 0.77,p < 0.001,N = 215).

Conclusion

The T2-FLAIR mismatch sign in patients with anIDH-mut astrocytoma is not associated with clinical presentation or outcome. It seems unlikely that theIDH-mut astrocytomas with mismatch sign represent a specific subentity. Finally, we have validated that the T2-FLAIR mismatch sign is a reliable and specific marker ofIDH-mut astrocytomas.
Yield of household contact investigation of patients with pulmonary tuberculosis in southern Ethiopia
Authors: Yassin Mubarek A. , Yirdaw Kesetebirhan D. , Datiko Daniel G. , Cuevas Luis E. , Yassin Mohammed A.
Published: May 2020

Background

Household Contacts (HHCs) of patients with pulmonary tuberculosis (PTB) have a higher risk of developing TB. Contact investigation is recommended to reach this group and identify undiagnosed cases. In this study, we have determined the yield of contact investigation among HHCs of patients with smear-positive PTB, and estimated TB burden.

Methods

We conducted retrospective record review for the occurrence of TB among HHCs of Index PTB+ cases treated between November 2010 and April 2013 in 12 public health facilities in Boricha district. HHCs were followed up monthly and revisited between March and June 2015. Information on additional TB cases diagnosed and treated among HHCs were documented. HHCs who were diagnosed as having TB after the index cases were diagnosed and treated were considered as ‘incident cases’. Presumptive TB case was defined as those having cough for ≥2 weeks or enlarged lymph node. Diagnosis of TB among HHCs were made using smear-microscopy and/or X-rays, and clinically for Extra-pulmonary TB (EPTB).

Results

One thousand five hundred and seventeenth HHCs of 344 index cases were visited and screened for TB and followed up for a median of 37 months. 77 (5.1% - 72 with PTB and 5 with EPTB) HHCs developed TB during 4713 person-years of follow-up with an estimated incidence of 1634 (95% CI: 1370-2043) per 100,000 person-years follow-up which is much higher than the estimated TB incidence for the general population in Ethiopia of 210/100,000. Half (41/77) of incident TB cases were diagnosed within the first year of diagnosis of the index cases and 88% (68/77) were adults (Hazard Ratio: 4.03; 95% CI: 2.00–8.12).

Conclusion

HHCs of index PTB+ cases have high risk of developing active TB. Long term follow-up of HHCs could help improve TB case finding depending on country contexts. Further studies on effectiveness and feasibility of the approach and integration in routine settings are needed.
Migrants and imported disease: Trends of admission in an Italian infectious disease ward during the migration crisis of 2015–2017
Authors: Del Puente Filippo , Riccardi Niccolò , Taramasso Lucia , Sarteschi Giovanni , Pincino Rachele , Di Biagio Antonio
Published: May 2020

Background

Since 2014, the migrant population residing in Europe has dramatically increased. Migrants’ unmet health needs represent a barrier to integration and should be promptly addressed, without stigma, in order to favour resettlement.

Methods

All-cause of admissions in the migrant population at the Infectious Disease Clinic of Policlinico San Martino Hospital in Genoa between 2015 and 2017 were analysed. Patients were classified by duration of residence in Italy according to the Recommendation on Statistics of International Migration, cause of hospitalization, and region of origin. All data were evaluated with SPSS Statistics.

Results

Two hundred thirty-five people were admitted, 86 (36.5%) of them residing in Italy for less than 1 year. Except for a significant increase in migrants from Africa, there was no change considering the area of origin, hospitalization reason or by comparing residency in Italy for more or less than 1 year. A considerable number of hospitalizations were related to non-communicable pathologies and latent tuberculosis infection. Residents in Italy for less than 1 year or with active tuberculosis had prolonged hospitalizations, while HIV-infected had shorter hospital stays.

Conclusions

No difference in terms of diagnosis were found between migrants with longer or shorter period of residence in Italy. Adequate outpatient services for the management of communicable diseases could significantly reduce the length of hospitalizations in the migrant population.
A cross-sectional analysis of falsified, counterfeit and substandard medicines in a low-middle income country
Authors: Khurelbat Daariimaa , Dorj Gereltuya , Sunderland Bruce , Sanjjav Tsetsegmaa , Bayarsaikhan Enkhtuul , Damdinjav Davaadagva , Dorj Gantuya , Jigjidsuren Altantuya , Lkhagvasuren Oyun , Erdenetsetseg Baasandorj
Published: May 2020

Background

High prevalence of falsified, counterfeit and substandard medicines pose a threat to public health and treatment failure. This study aimed to investigate the quality of selected essential medicines available in Mongolia.

Methods

A cross-sectional study collected essential medicines from pharmacy outlets in Mongolia, during June and July, 2017. These products were then submitted for pharmacopoeial analysis and registration status.

Results

A total of 1770 samples from 118 pharmacy entities were purchased from wholesalers in urban and rural areas. Pharmacopoeial analysis found 179 (10.1%) samples or eleven product groups were unacceptable. The prevalence of substandard locally produced medicines (n = 105, 5.9%) was higher than imported equivalents [(n = 74, 4.17%, p = 0.0001)]. Approximately one-third of all unacceptable tests were related to assay (n = 73, 30.8%) and weight variation. Of 1770 samples, 76 (4.3%) were unregistered and the prevalence of unregistered samples was 3.8% in Ulaanbaatar city and 5.8% in rural areas, respectively.

Conclusions

This study has indicated that falsified and substandard medicines are prevalent in Mongolia. Considerable effort is required by regulatory authorities, private manufacturers, as well as importers to increase the quality of essential medicines in Mongolia.
Seroprevalence and associated risk factors for chlamydiosis, coxiellosis and brucellosis in sheep and goats in Borana pastoral area, southern Ethiopia
Authors: Tesfaye Asamenew , Sahele Mesfin , Sori Teshale , Guyassa Chala , Garoma Abebe
Published: May 2020

Background

Abortion is considered an important disease problem of small ruminants in Borana pastoral area. A cross-sectional study was conducted to estimate the prevalence and risk factors of chlamydiosis, coxiellosis (Q-fever) and brucellosis in small ruminants in selected districts of Borana zone.

Results

A total of 506 sheep and goats were tested using serological tests. Fifty (9.88%; 95% CI: 7.42, 12.82), 144 (28.46%; 95% CI: 24.56, 32.61) and none (0.00%; 95% CI: 0.00, 0.59) of them were positive for chlamydiosis, coxiellosis and brucellosis, respectively. History of abortion was recorded in 136 (32.00%; CI: 27.59, 36.67) of sheep and goats in the study area. The logistic regression analysis, however, showed that statistically significant difference ccurred among districts and between the species of small ruminants. The prevalence odd of antibodies against C. abortus was significantly lower in Miyo, Dire and Teltelle districts compared to Dillo. The odd of infection with this bacterium was lower in sheep than goats. Similarly the odd of infection with C. burnettii was significantly higher in Dillo district than the rest of the districts studied, higher in goats than sheep and higher in adult animals than young ones.

Conclusion

High prevalence of abortion is observed in sheep and goats in the study area. High seropositivity of C. burnetii and C. abortus in both sheep and goats tested implies risks of human infection by both diseases. Thus, attention needs to be paid to further study of both diseases in animals and humans in the area.
Cisplatin treatment induced interleukin 6 and 8 production alters lung adenocarcinoma cell migration in an oncogenic mutation dependent manner
Authors: Kiss Edit , Abdelwahab El Husseiny Mohamed Mahmud , Steib Anita , Papp Emoke , Torok Zsofia , Jakab Laszlo , Smuk Gabor , Sarosi Veronika , Pongracz Judit Erzsebet
Published: May 2020

Background

The predominant metastatic site of lung cancer (LC) is the brain. Although outdated, conventional cisplatin treatment is still the main therapeutic approach for patients with advanced non-small cell lung cancer (NSCLC), since targeted therapy that offers better tumor control is not always possible. In the present study brain metastasis associated cytokine expression was investigated in primary NSCLC adenocarcinoma (AC) tissues with known oncogenic mutations in the presence or absence of platina based and tyrosine kinase inhibitor (TKI) drugs.

Methods

Primary lung tumor samples were isolated, DNA was sequenced and then the samples were grouped based on mutation. Experiments were also performed using KRAS mutant A549 and EGFR mutant PC-9 cells. Drug response was analyzed in three dimensional (3D) tissue cultures. We assessed drug response and IL-6 and IL-8 cytokine expression in relation to cellular invasion using ATP dependent cell viability, qRT-PCR analysis, cytokine bead array, and migration assay.

Results

In 3D co-cultures, primary NSCLC derived cells harboring EGFR mutation responded better to erlotinib treatment than KRAS mutant or KRAS/EGFR wild type (WT) cancer cells. In contrast, under the same culture conditions KRAS/EGFR WT or KRAS mutant cancer cells are more sensitive to cisplatin than EGFR mutant cells. Drug response and pro-inflammatory cytokine production varied depending on the driver mutations. Cisplatin but not erlotinib increased both IL-6 and IL-8 secretion and only IL-6 increased cellular migration and proliferation.

Conclusion

In vitro assays are available to determine the response to planned therapeutic approach of lung cancer subtypes. The sequence of administration of therapeutic drugs determines cytokine production and therefore therapeutic response.
Adipocytes promote tumor progression and induce PD-L1 expression via TNF-α/IL-6 signaling
Authors: Li Zhi , Zhang Cai , Du Jing-Xia , Zhao Jia , Shi Meng-Ting , Jin Man-Wen , Liu Hui
Published: May 2020

Background

Obesity confers increased risk for various types of cancer. PD-L1 is a key molecule in tumor immune evasion by inducing T cell exhaustion. The relationship between obesity and PD-L1 is still ambiguous. This study was designed to reveal the development of hepatocellular carcinoma and melanoma in obese mice and to investigate if adipocytes regulate PD-L1 expression and the underlying mechanism.

Methods

Monosodium glutamate-induced obese mice were inoculated with H22 tumor cells and High fat diet (HFD)-induced obese mice were inoculated with B16-F1 mouse melanoma cells. Human hepatoma HepG2 cells and B16-F1 cells were treated with conditional media from 3T3-L1 adipocytes (adi-CM). Neutralized anti-TNF-α and anti-IL-6 antibodies and inhibitor of NF-κB or STAT3 were used to reveal the mechanism of effect of adi-CM.

Results

In obese mice, H22 and B16-F1 tumor tissues grew faster and PD-L1 expression in tumor tissue was increased. Adi-CM up-regulated PD-L1 level in HepG2 and B16-F1 cells in vitro. Differentiated 3T3-L1 adipocytes secreted TNF-α and IL-6, and neutralizing TNF-α and/or IL-6 reduced PD-L1 expression in adi-CM-treated cells. p-NF-κB/NF-κB level was downregulated in HepG2 and B16-F1 cells, and p-STAT3/STAT3 level was also decreased in HepG2 cells. In addition, inhibitor of NF-κB or STAT3 reversed the effect of adi-CM on PD-L1 expression.

Conclusions

TNF-α and IL-6 secreted by adipocytes up-regulates PD-L1 in hepatoma and B16-F1 cells, which may be at least partially involved in the role of obesity in promoting tumor progression.
Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016–2018
Authors: Chung Amanda Marr , Case Peter , Gosling Jonathan , Gosling Roland , Madinga Munashe , Chikodzore Rudo , Hove Macdonald , Viljoen Greyling , Chitapi Precious , Gumbi Matsiliso , Mnguni Peliwe , Murungu Joseph , Dube Busisani , Dhliwayo Patience , Mberikunashe Joseph
Published: May 2020

Background

Focus for improved malaria programme performance is often placed on the technical challenges, while operational issues are neglected. Many of the operational challenges that inhibit malaria programme effectiveness can be addressed by improving communication and coordination, increasing accountability, maintaining motivation, providing adequate training and supervision, and removing bureaucratic silos.

Methods

A programme of work was piloted in Zimbabwe with one malaria eliminating province, Matabeleland South in 2016–2017, and scaled up to include two other provinces, Matabeleland North and Midlands, in 2017–2018. The intervention included participatory, organization development and quality improvement methods.

Results

Workshop participants in Matabeleland South reported an improvement in data management. In Matabeleland North, motivation among nurses improved as they gained confidence in case management from training, and overall staff morale improved. There was also an improvement in data quality and data sharing. In Midlands, the poorly performing district was motivated to improve, and both participating districts became more goal-oriented. They also became more focused on monitoring their data regularly. Participants from all provinces reported having gained skills in listening, communicating, facilitating discussions, and making presentations. Participation in the intervention changed the mindset of malaria programme staff, increasing ownership and accountability, and empowering them to identify and solve problems, make decisions, and act within their sphere of influence, elevating challenges when appropriate.

Conclusions

This pilot demonstrates that a participatory, organization development and quality improvement approach has broad ranging effects, including improving local delivery of interventions, tailoring strategies to target specific populations, finding efficiencies in the system that could not be found using the traditional top-down approach, and improving motivation and communication between different cadres of health workers. Scale-up of this simple model can be achieved and benefits sustained over time if the process is imbedded into the programme with the training of health staff who can serve as management improvement coaches. Methods to improve operational performance that are scalable at the district level are urgently needed: this approach is a possible tactic that can significantly contribute to the achievement of global malaria eradication goals.