bluuebunny/crossref_metadata_2025 huggingface dataset:
Microscopic Colitis with Escitalopram Use and New Onset Vitiligo
Authors: Iqbal Humzah , Haddadin Rakahn
Published: November 2022

Microscopic colitis is a common cause of chronic diarrhea, particularly in patients with autoimmune disorders. Colonic mucosa appears normal and only shows inflammation on histological examination. There are two histological variations of microscopic colitis. It has been associated with several drug classes, and certain drugs are associated with one variation or another. In this case report, we discuss the case of a patient who is on a drug not previously associated with her variation of microscopic colitis and who has an autoimmune condition whose relationship to microscopic colitis is not well studied. We aim to outline the potential triggers for the disease and to call for further studies regarding how certain drugs and/or autoimmune disorders trigger it in order to further our understanding and improve management.
Unilateral C1 Posterior Arch Screw-C2 Laminar Screw Posterior Fixation for Vertebral Artery Preservation in Bow Hunter’s Syndrome
Authors: Tanaka Tatsuya , Fujiwara Ren , Funao Haruki , Ebata Shigeto , Sashida Ryohei , Hirokawa Yu , Wakamiya Tomihiro , Michiwaki Yuhei , Shimoji Kazuaki , Suehiro Eiichi , Onoda Keisuke , Yamane Fumitaka , Ishii Ken , Kawashima Masatou , Matsuno Akira
Published: November 2022

Pedicle or lateral mass screws, which are usually used to fix atlantoaxial instability, increase the risk of vertebral artery (VA) injury in patients with bone or arterial anomalies or osteoporotic bone. Here, we report the use of a unilateral C1 posterior arch screw-C2 laminar screw posterior fixation with a contralateral C1 lateral mass screw for VA preservation in a patient with bow hunter’s syndrome (BHS). A 65-year-old male presented with recurrent loss of consciousness in the right rotational and backward-bending head positions for 1 year. Cerebral angiography in the same head position showed that the left VA was disrupted at C1/2 and the right VA was hypoplastic. The patient was diagnosed with BHS. C1-2 posterior fixation and iliac bone grafting were performed. The left VA was on the dominant side, and the VA was in a high position; thus, a C1 posterior arch screw was selected for the left side, a C1 lateral mass screw was selected for the right side, and a C2 laminar screw with O-arm navigation and a C-arm was used to prevent arterial injury. Intraoperative findings revealed no VA injury, and postoperative computed tomography showed the screw at the planned site. In a patient with BHS, posterior fixation with a unilateral C1 posterior arch screw-C2 laminar screw prevented VA injury because the screw could be inserted while avoiding the VA.
ATP—Sensitive Potassium Channel Opener Diazoxide Reduces Myocardial Stunning in a Porcine Regional With Subsequent Global Ischemia Model
Authors: Velez Ana K. , Etchill Eric , Giuliano Katherine , Kearney Sean , Jones Melissa , Wang Jie , Cho Brian , Brady Mary Beth , Dodd‐o Jeffrey , Meyer Joseph M. , Lawton Jennifer S.
Published: November 2022

Background

ATP‐sensitive potassium channels are inhibited by ATP and open during metabolic stress, providing endogenous myocardial protection. Pharmacologic opening of ATP potassium channels with diazoxide preserves myocardial function following prolonged global ischemia, making it an ideal candidate for use during cardiac surgery. We hypothesized that diazoxide would reduce myocardial stunning after regional ischemia with subsequent prolonged global ischemia, similar to the clinical situation of myocardial ischemia at the time of revascularization.

Methods and Results

Swine underwent left anterior descending occlusion (30 minutes), followed by 120 minutes global ischemia protected with hyperkalemic cardioplegia±diazoxide (N=6 each), every 20 minutes cardioplegia, then 60 minutes reperfusion. Cardiac output, time to wean from cardiopulmonary bypass, left ventricular (LV) function, caspase‐3, and infarct size were compared. Six animals in the diazoxide group separated from bypass by 30 minutes, whereas only 4 animals in the cardioplegia group separated. Diazoxide was associated with shorter but not significant time to wean from bypass (17.5 versus 27.0 minutes;
P
=0.13), higher, but not significant, cardiac output during reperfusion (2.9 versus 1.5 L/min at 30 minutes;
P
=0.05), and significantly higher left ventricular ejection fraction at 30 minutes (42.5 versus 15.8%;
P
<0.01). Linear mixed regression modeling demonstrated greater left ventricular developed pressure (
P
<0.01) and maximum change in ventricular pressure during isovolumetric contraction (
P
<0.01) in the diazoxide group at 30 minutes of reperfusion.

Conclusions

Diazoxide reduces myocardial stunning and facilitates separation from cardiopulmonary bypass in a model that mimics the clinical setting of ongoing myocardial ischemia before revascularization. Diazoxide has the potential to reduce myocardial stunning in the clinical setting.
YASSIADA’DA KEMALİZM VE ANAYASA TARTIŞMALARI
Authors: ALPBAZ Mustafa Mert
Published: November 2022

Bu makalenin amacı, 27 Mayıs darbesinin Kemalizm anlayışını kuvvetler ayrılığı düşüncesi ve 1924 Anayasası çerçevesinde ortaya koymaktır. Yassıada Mahkemesinde, Anayasaya aykırı kanunlar çıkarılması Atatürk İlke ve İnkılaplarına karşı bir hareket olarak nitelendirilmiş ve 1924 Anayasasının kuvvetler ayrılığına dayandığı yorumu yapılmıştır. Savunmalarda ise Anayasanın kuvvetler birliğine dayandığı ve Tek Parti (CHP) Döneminde nasıl uygulandığı üzerinde durulmuştur. 27 Mayıs darbesinin Kemalizm anlayışında kuvvetler birliği düşüncesi yer almamakta, Kemalizm özgürlük ile özdeşleştirilmektedir. Yassıada Mahkemesindeki iddialar ve savunmalar karşılaştırılmış, CHP ve DP Programları ışığında değerlendirilmiştir.
Tragedy of the Non-Visible: Aesthetic and Ontological Differences in Early Computer versus Conceptual Art
Authors: Samuels Miranda
Published: November 2022

This article considers the complex relationship between early computer and Conceptual art in the late 1960s and early 1970s in the United States and Europe. It assesses a range of accounts that explain the simultaneous decline in art world support for computer art and growing institutional traction enjoyed by Conceptual art. The author argues that these accounts overlook a subtle but consequential difference in the aesthetic and ontological conditions of the two art forms. Comparative analysis of writings by computer and Conceptual artists and theorists ultimately shows that the relationship between the visible output and the non-visible code or algorithm in computer art is not akin to the relationship between materiality and immateriality in Conceptual art, as is oftentimes assumed. The paper suggests that historical accounts explaining the divergent trajectories of computer and Conceptual art address this difference to avoid oversimplifying computer art’s aesthetic and ontological conditions.
Age differences in functional brain networks associated with loneliness and empathy
Authors: Mwilambwe-Tshilobo Laetitia , Setton Roni , Bzdok Danilo , Turner Gary R. , Spreng R. Nathan
Published: November 2022

Loneliness is associated with differences in resting-state functional connectivity (RSFC) within and between large-scale networks in early- and middle-aged adult cohorts. However, age-related changes in associations between sociality and brain function into late adulthood are not well understood. Here, we examined age differences in the association between two dimensions of sociality—loneliness and empathic responding—and RSFC of the cerebral cortex. Self-report measures of loneliness and empathy were inversely related across the entire sample of younger (mean age = 22.6y, n = 128) and older (mean age = 69.0y, n = 92) adults. Using multivariate analyses of multi-echo fMRI RSFC, we identified distinct functional connectivity patterns for individual and age group differences associated with loneliness and empathic responding. Loneliness in young and empathy in both age groups was related to greater visual network integration with association networks (e.g., default, fronto-parietal control). In contrast, loneliness was positively related to within- and between-network integration of association networks for older adults. These results extend our previous findings in early- and middle-aged cohorts, demonstrating that brain systems associated with loneliness, as well as empathy, differ in older age. Further, the findings suggest that these two aspects of social experience engage different neurocognitive processes across human life-span development.
Diagnosing the State: Medical Metaphors in Ottoman Political Writing
Authors: Topal Alp Eren , Wigen Einar
Published: November 2022

This paper traces the transformation in how Ottoman scribes, statesmen, and bureaucrats imagined the body politic from the sixteenth to the nineteenth century by focusing on metaphors derived from medicine and the human body. As others have shown, sixteenth- and seventeenth-century Ottoman political writing demonstrates a clear influence of Galenic medicine and Aristotelian and Avicennan metaphysics in conceptualizing state and society. During the eighteenth century, however, we see the adoption of a Khaldunian conception of society as an organic unity with a determined lifespan, something that implies a shift in emphasis from spatiality to temporality of the polity. From the early Tanzimat onwards, we see sporadic use of modern medical, disease, and germ-related concepts to explain the problems of Ottoman politics and society. Our argument is that instead of a sudden shift from a Galenic to a modern medical vocabulary due to the impact of the West, Ottoman political imagery gradually changed over the seventeenth and eighteenth centuries in response to administrative challenges. In narrating this transformation, we also reflect on how examining metaphors can contribute to our understanding of conceptual transformation and, particularly in our case, the concept of “state”.
The making of Islamic reform (iṣlāḥ) in Colonial Algeria (1882–1938): Ibadi scholars, French officials and the conceptual foundations of modern Islamic studies
Authors: Jomier Augustin
Published: November 2022

Among the conceptual foundations on which scholars of modern Islam have built their narratives for decades, ideas such as “reform” and “reformism” have been singled out for charges of Eurocentricism and Orientalism. At the same time, research on early modern Islam leads us to question the specificities of these nineteenth and twentieth-century concepts. Building on this scholarship, this article examines the case of Algerian Ibadi reform (iṣlāḥ) in order to reassert the specificity of the early twentieth century as a moment when Islamic concepts acquired new meanings, but also as a moment of deep entanglements between Islamic and colonial knowledge production. It shows that a systematic understanding of iṣlāḥ as social and religious reform linked to the idea of progress developed only during the interwar period. It also demonstrates that the emic and etic uses of iṣlāḥ and “reform” developed together, a result of the confluence between modern Islamic scholarship and scholarship about Islam in the early twentieth-century Algerian colonial public sphere. Thus, the conceptual history of iṣlāḥ warns us against approaches that consider emic and etic categories bounded entities and invites us instead to unravel their complexities.
Tracing the Nationalisation of Millet in the Late Ottoman Period: A Conceptual History Approach
Authors: Dressler Markus
Published: November 2022

During its last century, the Ottoman Empire faced strong contestation of its political order, which had undergone radical changes that are generally discussed in relation to modernisation. Against this background, key social and political concepts in Ottoman Turkish shed old meanings and acquired new ones. This article examines the trajectory of the term millet in this period as a case study. Drawing on political and lexicographic texts from the Tanzimat era and afterwards, the article discusses the semantic shifts through which millet, traditionally closely related to din/religion, acquired connotations of a political community, not the least proto-national ones. This led to a polysemy that remained relatively stable until the end of the Ottoman era, when the political meaning of the term millet as “nation” gained dominance. This secularisation of the term reached its peak in the early Turkish republic, although the older, religious connotations of the term were never totally forgotten and are still evoked in conservative religious discourse.
Sexual Health, Morality and the Missionary Press in Britain and the South Pacific, 1795–1850
Authors: Tilson Kate
Published: November 2022

This article explores the London Missionary Society’s textual production on the South Pacific in the first half of the nineteenth century and argues that sexuality was connected to moral and physical understandings of health in missionary texts. This was due to the nature of missionary and indigenous entanglements in the South Pacific and the era’s burgeoning medical print network. The discussion builds on current debates on mission and the cultural underpinnings of the British empire through showcasing the processes involved in the making of missionary texts and colonial knowledge production from the South Pacific.
Becoming a People of Greater Hospitality
Authors: Francisco Jose Mario
Published: November 2022

Unlike some religious traditions elsewhere, Philippine Catholicism readily recognized the severity of the Covid-19 pandemic as described by medical science and public health protocols. Given this general perspective, it promoted communal worship online and inclusive feeding programs – practices integral to Catholicism and rooted in the local religious ethos. The defining characteristics of these practices during the pandemic invite critical inquiry on its theological foundations. The first provides greater accessibility to the ekklesia and interrogates therefore the traditional notion of Catholic belonging and identity. The second exemplifies a more inclusive framework for social ministry on account of the wide diversity of roles among those involved and its integration of charitable services with structural change. Thus both practices challenge Philippine Catholicism to become a people of greater hospitality.
Meristotheca lysonensis sp. nov. (Solieriaceae, Rhodophyta), a new flattened species from Vietnamese waters
Authors: NGUYEN XUAN-VY , NGUYEN XUAN-THUY , KITTLE III RONALD P. , McDERMID KARLA J.
Published: November 2022

This study presents a new flattened species of Meristotheca collected from southern Viet Nam. Meristotheca lysonensis sp. nov. is proposed based upon several morphological characters and genetic differences when compared to the closely related species documented in Southeast Asia: M. procumbens. This new species shows larger size and blade thickness, as well as both basal and lateral pit-connections between tetrasporangia and the parental supporting cells. The phylogenetic analyses also support Meristotheca lysonensis as a new species.
The Scoliidae wasps (Hymenoptera: Scolioidea) of Mexico: taxonomy and biogeography
Authors: RAMÍREZ-GUILLÉN LUIS DAMIÁN , FALCON-BRINDIS ARMANDO , GÓMEZ BENIGNO
Published: November 2022

The family Scoliidae is represented by approximately 560 species worldwide. Of these, 64 species are known to occur in the New World. The greatest diversity of these wasps is concentrated in the Pantropical region. However, both the biology and the taxonomy of Scoliidae has remained understudied over the last six decades in the Americas. Taxonomic keys for the New World species are limited to certain regions of North and South America, showing ambiguous descriptions and unillustrated specimens. This situation has largely restricted aspects such as the species richness, ecology, and thus conservation status of these wasps, especially in Mexico, where there are no taxonomic revisions. In this work, the Scoliidae species from Mexico were revised from 12 entomological collections to update and homologize the list of species. In total, we examined 747 specimens from 23 morphospecies and 9 genera. The diagnosis of each species is presented, including their distribution, and a species checklist is provided. Moreover, the first taxonomic key for the Mexican species is presented. Stygocampsomeris servillei Guérin is a new record for the country. Also, two new Nearctic and four Neotropical records are added. The occurrence records are now expanded to 30 Mexican states. Most species (41.6%) occur in both Nearctic and Neotropical regions. The species Scolia fuscipennis Bartlett is still known from a single sex. This work is the first attempt towards the taxonomy and biogeography of the Mexican Scoliidae; thus, it could be an important baseline for faunistic, ecological, and conservation purposes. Overall, the family Scoliidae has been overlooked and poorly represented in Mexican collections. The specimens were scarce and frequently in bad condition, and none of them include biological or ecological attributes. Systematic sampling and appropriate curation of specimens would help to conduct future revisions, as well as the possible integration of barcoding information allowing integrative taxonomic approaches.
Investigating the plant growth promoting and biocontrol potentiality of endophytic Streptomyces SP. SP5 against early blight in Solanum lycopersicum seedlings
Authors: Devi Sapna , Sharma Manish , Manhas Rajesh Kumari
Published: November 2022

Background

Early blight (EB), caused by Alternaria solani, is one of the alarming diseases that restrict tomato production globally. Existing cultural practices and fungicide applications are not enough to control early blight diseases. Therefore, the study aimed to isolate, identify, and characterize an endophytic Streptomyces exhibiting the potential to control early blight in tomato and also promote plant growth.

Results

From a Citrus jambhiri leaf, an endophytic Streptomyces sp. with antagonistic activity against Alternaria solani, Colletotrichum acutatum, Cladosporium herbarum, Alternaria brassicicola, Alternaria sp., Fusarium oxysporum and Fusarium sp. was isolated. It was identified as a Streptomyces sp. through 16S ribosomal DNA sequence analysis and designated as SP5. It also produced indole acetic acid which was confirmed by Salkowski reagent assay, TLC and HPLC analysis. Treatment of pathogen infected plants with Streptomyces sp. SP5 antagonists (culture cells/culture supernatant/solvent extract/ acetone precipitates) decreased the early blight disease incidence and significantly increased the various agronomic traits.

Conclusion

The present study concluded that Streptomyces sp. SP5 possessed antifungal activity against different fungal phytopathogens and had significant potential to control early blight disease and promote plant growth.
Comparative plastomes and phylogenetic analysis of seven Korean endemic Saussurea (Asteraceae)
Authors: Yun Seona , Kim Seung-Chul
Published: November 2022

Background

Saussurea is one of the most species-rich genera in the Cardueae, Asteraceae. There are approximately 40 Saussurea species distributed in Korea, with nearly 40% of them endemics. Infrageneric relationships remain uncertain due to insufficient resolutions and low statistical support. In this study, we sequenced the plastid genomes of five Korean endemic Saussurea (S. albifolia, S. calcicola, S. diamantica, S. grandicapitula, and S. seoulensis), and comparative analyses including two other endemics (S. chabyoungsanica and S. polylepis) were conducted.

Results

The plastomes of Korean endemics were highly conserved in gene content, order, and numbers. Exceptionally, S. diamantica had mitochondrial DNA sequences including two tRNAs in SSC region. There were no significant differences of the type and numbers of SSRs among the seven Korean endemics except in S. seoulensis. Nine mutation hotspots with high nucleotide diversity value (Pi > 0.0033) were identified, and phylogenetic analysis suggested that those Korean endemic species most likely evolved several times from diverse lineages within the genus. Moreover, molecular dating estimated that the Korean endemic species diverged since the late Miocene.

Conclusions

This study provides insight into understanding the plastome evolution and evolutionary relationships of highly complex species of Saussurea in Korean peninsula.
The impact of Hydroxyurea on the rates of Vaso–occlusive crises in patients with sickle cell disease in Saudi Arabia: a single–center study
Authors: Alkhalifah Sahar Abdullah , Alanazi Miteb , Almasaoud Majed Ali , Al-Malki Hazim Saeed , Al-Murdhi Faisal Mohammed , Al-hazzaa Mohammed Saad , Al-Mufarrij Suliaman Musaed , Albabtain Mohammed Ali , Alshiakh Abdulrahman Abdullah , AlRuthia Yazed
Published: November 2022

Background

Vaso–occlusive crises (VOCs) are acute and common painful complication of sickle cell disease (SCD), and are the main reason behind the frequent emergency department visits among SCD patients. Hydroxyurea (HU) is an old and commonly used medication that demonstrated its effectiveness in reducing the risk of VOCs and the incidence of hospitalization. Although multiple studies have examined the impact of HU on the rates of VOCs, few have explored its effectiveness among SCD patients in Saudi Arabia.

Methods

This was a single–center retrospective cohort study in which the electronic medical records of patients with SCD who have not had any previous exposure to HU prior to the initiation of HU treatment for ≥12 months were recruited. Paired t–test was conducted to examine the difference in the rates of VOCs, and levels of hemoglobin (Hgb), hematocrit (HCT), and platelet counts (PLT Ct) prior to the initiation of HU therapy and 12 months later. Multiple linear regression was conducted to examine whether age, gender, use of opioid analgesics, Hgb, HCT, and PLT Ct levels predict higher or lower rates of VOCs.

Results

One hundred and fifty–six patients met the inclusion criteria and were included in the analysis. About 51% of the patients were males, and their mean age was 12.69 years. The mean HU dosage was 16.52 mg/kg/day, and the mean reduction in the rate of VOCs was 1.36 events per patient per year (95% CI [1.03–1.70], p < 0.0001) after the initiation of HU. Females were more likely to have greater reduction in the rates of VOCs in comparison to their male counterparts (β–estimate = 12.85, 95% CI [0.759–24.93], p = 0.0374).

Conclusion

The use of HU results in a significant reduction in the rates of VOCs and emergency department visits. Future studies with robust research designs should be conducted to further examine the impact of HU on VOCs, hospitalization, and length of stay as well as compare HU to other newly approved medications for SCD, such as crizanlizumab.
Access to general practice for people with intellectual disability in Australia: a systematic scoping review
Authors: Shea Bradley , Bailie Jodie , Dykgraaf Sally Hall , Fortune Nicola , Lennox Nicholas , Bailie Ross
Published: November 2022

Background

People with intellectual disability experience inadequate access to general practice and poorer health outcomes than the general population. While some access barriers have been identified for this population, these studies have often used narrow definitions of access, which may not encompass the multiple dimensions that influence access to general practice. To address this gap, we conducted a scoping review to identify factors impacting access to general practice for people with intellectual disability in Australia, using a holistic framework of access conceptualised by Levesque and colleagues.

Methods

This scoping review followed Joanna Briggs Institute methodology and was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Medline (Ovid), Scopus, CINAHL, Informit and PsycINFO databases were searched. Screening, full-text review and data extraction were completed by two independent reviewers, with consensus reached at each stage of the study. Data were extracted, coded and synthesised through deductive qualitative analysis – using the five corresponding conceptual dimensions within Levesque and colleagues’ theoretical framework of access, which incorporate both supply-side features of health systems and services, and demand-side characteristics of consumers and populations.

Results

The search identified 1364 publications. After duplicate removal, title and abstract screening and full-text review, 44 publications were included. Supply-side factors were more commonly reported than demand-side factors, with the following issues frequently identified as impacting access to general practice: limited general practitioner education about, and/or experience of, people with intellectual disability; communication difficulties; and inadequate continuity of care. Less frequently included were factors such as the health literacy levels, promotion of general practice services and availability of complete medical records.

Conclusions

This is the first scoping review to assess access barriers for people with intellectual disability using a comprehensive conceptualisation of access. The findings highlight the need for increased efforts to address demand-side dimensions of access to general practice and offer a basis for a balanced portfolio of strategies that can support recent policy initiatives to enhance access to care for people with intellectual disability.
Perception of risk of hypertension related complications and adherence to antihypertensive drugs: a primary healthcare based cross-sectional study
Authors: Shiraly Ramin , Khani Jeihooni Ali , Bakhshizadeh Shirazi Rozita
Published: November 2022

Background

Blood pressure control is suboptimal in more than half of treated hypertensive patients. The purpose of this study was to assess perceived risk of high blood pressure sequelae and adherence to medications in known cases of hypertension.

Methods

A cross-sectional study was designed using a sample of 600 hypertensive patients who were randomly selected from 32 primary healthcare centers in Shiraz, Iran. A structured interviewer-administered questionnaire was used to collect data. Participants were asked about their basic demographic information, smoking history, access to healthcare services, duration of antihypertensive therapy, number of drugs taken concurrently and their perceived risk of hypertension-related complications. The outcome of interest was adherence to antihypertensive medications measured by the Persian version of the Morisky Medication Adherence Scale (MMAS-8). Multivariate logistic regression analysis was used to identify independent factors associated with better adherence.

Results

Nearly half (48.8%) of participants had uncontrolled hypertension. Just over one fifth (22.3%) of all the patients reported high adherence to antihypertensive medications. Independent factors associated with better adherence to antihypertensive medications were higher educational level (OR: 1.71, CI 95%: 1.06–2.75), being a never smoker (OR: 1.62, CI 95%: 1.06–2.46), having easy access to healthcare services (OR: 1.91, CI 95%: 1.10–3.35), lower mean treatment duration (OR: 0.96, CI 95%: 0.92–0.99), and having higher perceived risk of hypertension-related complications (OR:2.34, CI 95%: 1.52–3.60).

Conclusion

High perceived risk of hypertension-related complications is significantly associated with adherence to antihypertensive therapy. Our findings suggest that primary care physicians should regularly emphasize on negative consequences of uncontrolled/poorly controlled blood pressure while visiting hypertensive patients.
Antepartum and intrapartum stillbirth rates across gestation: a cross-sectional study using the revised foetal death reporting system in the U.S.
Authors: Ncube Collette N. , McCormick Sarah M. , Badon Sylvia E. , Riley Taylor , Souter Vivienne L.
Published: November 2022

Background

There is a renewed call to address preventable foetal deaths in high-income countries, especially where progress has been slow. The Centers for Disease Control and Prevention released publicly, for the first time, the initiating cause and estimated timing of foetal deaths in 2014. The objective of this study is to describe risk and characteristics of antepartum versus intrapartum stillbirths in the U.S., and frequency of pathological examination to determine cause.

Methods

We conducted a cross-sectional study of singleton births (24–43 weeks) using 2014 U.S. Fetal Death and Natality data available from the National Center for Health Statistics. The primary outcome was timing of death (antepartum (n = 6200), intrapartum (n = 453), and unknown (n = 5403)). Risk factors of interest included maternal sociodemographic, behavioural, medical and obstetric factors, along with foetal sex. We estimated gestational week-specific stillbirth hazard, risk factors for intrapartum versus antepartum stillbirth using multivariable log-binomial regression models, conditional probabilities of intrapartum and antepartum stillbirth at each gestational week, and frequency of pathological examination by timing of death.

Results

The gestational age-specific stillbirth hazard was approximately 2 per 10,000 foetus-weeks among preterm gestations and > 3 per 10,000 foetus-weeks among term gestations. Both antepartum and intrapartum stillbirth risk increased in late-term and post-term gestations. The risk of intrapartum versus antepartum stillbirth was higher among those without a prior live birth, relative to those with at least one prior live birth (RR 1.32; 95% CI 1.08–1.61) and those with gestational hypertension, relative to those with no report of gestational hypertension (RR 1.47; 95% CI 1.09–1.96), and lower among Black, relative to white, individuals (RR 0.70; 95% CI 0.55–0.89). Pathological examination was not performed/planned in 25% of known antepartum stillbirths and 29% of known intrapartum stillbirths.

Conclusion

These findings suggest greater stillbirth risk in the late-term and post-term periods. Primiparous mothers had greater risk of intrapartum than antepartum still birth, suggesting the need for intrapartum interventions for primiparous mothers in this phase of pregnancy to prevent some intrapartum foetal deaths. Efforts are needed to improve understanding, prevention and investigation of foetal deaths as well as improve stillbirth data quality and completeness in the United States.
Oxytocin receptor single nucleotide polymorphism predicts atony-related postpartum hemorrhage
Authors: Erickson Elise N. , Krol Kathleen M. , Perkeybile Allison M. , Connelly Jessica J. , Myatt Leslie
Published: November 2022

Background

Postpartum hemorrhage remains a key contributor to overall maternal morbidity in the United States. Current clinical assessment methods used to predict postpartum hemorrhage are unable to prospectively identify about 40% of hemorrhage cases. Oxytocin is a first-line pharmaceutical for preventing and treating postpartum hemorrhage, which acts through oxytocin receptors on uterine myocytes. Existing research indicates that oxytocin function is subject to variation, influenced in part by differences in the DNA sequence within the oxytocin receptor gene. One variant, rs53576, has been shown to be associated with variable responses to exogenous oxytocin when administered during psychological research studies. How this variant may influence myometrial oxytocin response in the setting of third stage labor has not been studied. We tested for differences in the frequency of the oxytocin receptor genotype at rs53576 in relationship to the severity of blood loss among a sample of individuals who experienced vaginal birth.

Methods

A case–control prospective design was used to enroll 119 postpartum participants who underwent vaginal birth who were at least 37 weeks of gestation. Cases were defined by either a 1000 mL or greater blood loss or instances of heavier bleeding where parturients were given additional uterotonic treatment due to uterine atony. Controls were matched to cases on primiparity and labor induction status. Genotype was measured from a maternal blood sample obtained during the 2nd postpartum month from 95 participants. Statistical analysis included bivariate tests and generalized linear and Poisson regression modeling.

Results

The distribution of the genotype across the sample of 95 participants was 40% GG (n = 38), 50.5% AG (n = 48) and 9.5% AA (n = 9). Blood loss of 1000 mL or greater occurred at a rate of 7.9% for GG, 12.5% for AG and 55.6% for AA participants (p = 0.005). Multivariable models demonstrated A-carriers (versus GG) had 275.2 mL higher blood loss (95% CI 96.9–453.4, p < 0.01) controlling for parity, intrapartum oxytocin, self-reported ancestry, active management of third stage or genital tract lacerations. Furthermore, A-carrier individuals had a 79% higher risk for needing at least one second-line treatment (RR = 1.79, 95% CI = 1.08–2.95) controlling for covariates. Interaction models revealed that A-carriers who required no oxytocin for labor stimulation experienced 371.4 mL greater blood loss (95% CI 196.6–546.2 mL).

Conclusions

We provide evidence of a risk allele in the oxytocin receptor gene that may be involved in the development of postpartum hemorrhage among participants undergoing vaginal birth, particularly among those with fewer risk factors. The findings, if reproducible, could be useful in studying pharmacogenomic strategies for predicting, preventing or treating postpartum hemorrhage.
Cisplatin-based concurrent chemoradiotherapy improved the survival of locoregionally advanced nasopharyngeal carcinoma after induction chemotherapy by reducing early treatment failure
Authors: Yang Xing-Li , Zhang Lu-Lu , Kou Jia , Zhou Guan-Qun , Wu Chen-Fei , Sun Ying , Lin Li
Published: November 2022

Purpose

The aims of this study focusing on Locoregionally advanced nasopharyngeal carcinoma (LANPC) were mainly two-fold: on the one hand, to establish a cut-off value to differentiate early and late failure based on prognosis after recurrence or metastasis; and on the other hand, to investigate the duration of concurrent cisplatin benefit over follow-up time. The results of our study have the potential to guide clinical practice and follow-up.

Methods

In total, 3123 patients with stage III-IVa NPC receiving Induction chemotherapy followed by concurrent cisplatin or not were analysed. The cut-off value of treatment failure was calculated using the minimum P-value approach. Random survival forest (RSF) model was to simulate the cumulative probabilities of treatment failure (locoregional recurrence and /or distant metastasis) over-time, as well as the monthly time-specific, event-occurring probabilities, for patients at different treatment groups.

Results

Based on subsequent prognosis, early locoregional failure (ELRF) should be defined as recurrence within 14 months (P = 1.47 × 10 − 3), and early distant failure (EDF) should be defined as recurrence within 20 months (P = 1.95 × 10 − 4). A cumulative cisplatin dose (CCD) > 200 mg/m2 independently reduced the risk of EDF (hazard ratio, 0.351; 95% confidence interval (CI), 0.169–0.732; P = 0.005). Better failure-free survival (FFS) and overall survival (OS) were observed in concurrent chemotherapy settings ([0 mg/m2 vs. 1-200 mg/m2 vs. >200 mg/m2]: FFS: 70.4% vs. 74.4% vs. 82.6%, all P < 0.03; OS: 79.5% vs. 83.8% vs. 90.8%, all P < 0.01). In the monthly analysis, treatment failure mainly occurred during the first 4 years, and the risk of distant failure in patients treated with concurrent chemotherapy never exceeded that of patients without concurrent chemotherapy.

Conclusion

Locoregional failure that developed within 14 months and/or distant failure within 20 months had poorer subsequent survival. Concurrent chemotherapy provides a significant FFS benefit, primarily by reducing EDF, translating into a long-term OS benefit.
Decreased circulating levels of free triiodothyronine in Sepsis children and correlation analysis
Authors: Fu Li’na , Long Wenjun , Liu Tonglin , Chen Yu , Wu Shimin , Li Dandan , Liu Kang , Gao Yuan , Luo Xiaoping
Published: November 2022

Background

Intensive physical stress in sepsis can induce the disorder of endocrine function and impact the clinical course and prognosis. Low T3 syndrome has been verified to be the predictive indicator of poor prognosis in several researches. Reports on the influence factors of thyroid hormonal levels in children with severe sepsis are rare. We aim to investigate the thyroid hormonal variations in the course of sepsis and analyze that how to be affected by clinical data and inflammatory biomarkers.

Methods

In the case-control study, 184 children with sepsis and 323 controls were included in Tongji Hospital, Wuhan, China, in 2019. Data on clinical and inflammatory parameters were collected from all participants. Circulating FT3(Free Triiodothyronine) levels were measured by Electrochemiluminescence immunoassay. Finally, we investigated the correlation between FT3 and related variables with linear regression analysis.

Results

Serum FT3 was lower in the sepsis group than in control group(2.59 + 1.17 vs 2.83 + 1.01 pg/mL, p < 0.05). Significant moderately negative correlations(|r| > 0.3) of FT3 levels with ferritin, PCT, duration of symptoms, SOFA score, and mortality were revealed. Moreover, we observed that FT3 had the positive correlation with albumin, as well as white blood cell count.

Conclusions

Concentrations of serum FT3 are dramatically declined in sepsis children than in control children. Our results demonstrate that recognizing the potential abnormality of thyroid hormones in sepsis patients and examine timely through abnormal common clinical data and inflammatory biomarkers is a fine option.
Adapting Lot Quality Assurance Sampling to accommodate imperfect diagnostic tests: application to COVID-19 serosurveillance in Haiti
Authors: Fulcher Isabel R. , Clisbee Mary , Lambert Wesler , Leandre Fernet Renand , Hedt-Gauthier Bethany
Published: November 2022

Background

Lot Quality Assurance Sampling (LQAS), a tool used for monitoring health indicators in low resource settings resulting in “high” or “low” classifications, assumes that determination of the trait of interest is perfect. This is often not true for diagnostic tests, with imperfect sensitivity and specificity. Here, we develop Lot Quality Assurance Sampling for Imperfect Tests (LQAS-IMP) to address this issue and apply it to a COVID-19 serosurveillance study design in Haiti.

Methods

We first derive a modified procedure, LQAS-IMP, that accounts for the sensitivity and specificity of a diagnostic test to yield correct classification errors. We then apply the novel LQAS-IMP to design an LQAS system to classify prevalence of SARS-CoV-2 antibodies among healthcare workers at eleven Zanmia Lasante health facilities in Haiti. Finally, we show the performance of the LQAS-IMP procedure in a simulation study.

Results

We found that when an imperfect diagnostic test is used, the classification errors in the standard LQAS procedure are larger than specified. In the modified LQAS-IMP procedure, classification errors are consistent with the specified maximum classification error. We then utilized the LQAS-IMP procedure to define valid systems for sampling at eleven hospitals in Haiti.

Conclusion

The LQAS-IMP procedure accounts for imperfect sensitivity and specificity in system design; if the accuracy of a test is known, the use of LQAS-IMP extends LQAS to applications for indicators that are based on laboratory tests, such as SARS-CoV-2 antibodies.
Mothers as advocates for healthier lifestyle behaviour environments for their children: results from INFANT 3.5-year follow-up
Authors: Delisle Nyström Christine , Campbell Karen J , Crawford David , Hesketh Kylie D
Published: November 2022

Background

The amount of time children spend outside of their home environment has increased over the past decades. Therefore, the quality of the health behaviour environments where young children spend time is likely to impact their health behaviour opportunities. The aim of this study was to describe the proportion of mothers who consider it possible to make changes in their local communities to increase opportunities for children to eat healthily, be physically active, and limit screen time exposure, as well as the proportion who have attempted to do so. The characteristics of mothers with differing advocacy beliefs and intentions were explored.

Methods

Cross-sectional data collected using questionnaires from 307 mothers who participated in the 3.5-year follow-up of the INFANT cluster-randomized controlled trial were used. Frequencies were used to assess the number of mothers who thought it possible to bring about change in their local communities and for the those who had attempted to do so. Binary logistic regression analyses were used to compare sociodemographic characteristics of mothers with differing responses.

Results

Most mothers thought it was possible to bring about change in their local community with regards to providing more opportunities for their child to eat healthily (83.7%), be physically active (90.9%) as well as limit exposure to screen time (63.5%). However, less than 19% and 11% of mothers have thought about or tried to bring about change in their child’s childcare centre or local community, respectively. No sociodemographic differences were found between the mothers who thought it was possible to bring about actioning change (p-values > 0.1) or for those that have thought about change (p-values > 0.1).

Conclusion

As children are continuously being exposed to obesogenic environments future quantitative and qualitative studies are needed to describe how to promote parental advocacy and engagement, in order to provide children with environments that support healthy lifestyle behaviours.
Clinical outcomes of patients with pigmented villonodular synovitis of the shoulder after arthroscopic synovectomy
Authors: Li Yinghao , Mei Lu , Li Tao , Pang Long , Tang Xin , Li Jian
Published: November 2022

Background

Shoulder pigmented villonodular synovitis (PVNS) is a severe clinical condition, while few studies have focused on this situation due to its rarity. This study was to investigate the efficacy of arthroscopic treatment of patients diagnosed with shoulder PVNS.

Methods

From Jan 1st, 2010 to Dec. 31st, 2019, 6 patients (5 females and 1 male) diagnosed with shoulder PVNS underwent arthroscopic synovectomy in our hospital and combined rotator cuff repair was performed in 3 of them. The outcomes of this study include Constant score, Visual Analogue Scale (VAS), University of California, Los Angeles (UCLA) score and American Shoulder and Elbow Surgeons (ASES) score. The data were retrieved from the patients’ medical records.

Results

With a mean follow-up of 52.0 months (range, 28–92 months), the mean difference of Constant, VAS, UCLA and ASES scores were 27.83 ± 21.60, 2.83 ± 2.56, 11.67 ± 10.93 and 17.83 ± 25.35, respectively. Statistically significant improvements were detected in all the patient-reported outcomes except ASES score. One of the patients suffered from recurrence. Two patients suffered from mild complications after the surgeries while both of them achieved satisfactory recovery finally.

Conclusion

Arthroscopic synovectomy in the setting of shoulder PVNS can improve patients’ function. A concurrent rotator cuff repair is recommended if it is needed. The conclusion still needs testifying by further high-quality research with larger sample size.
Favorable revision-free survivorship of cemented arthroplasty following failed proximal femoral nail antirotation: a case series with a median follow-up of 10 years
Authors: Li Yi , Zhang Yaodong , Yu Minji , Huang Tao , Li Kunhong , Ye Junxing , Huang Heng , Yu Weiguang
Published: November 2022

Background

Given the ever-increasing rate of failure related to proximal femoral nail antirotation (PFNA), it is expected that an increasing number of PFNA individuals will undergo conversion to total hip arthroplasty (THA). The long-term survivorship of conversion of the initial PFNA to cemented THA is still debated. The aim of this retrospective study was to assess the long-term revision-free survivorship of cemented THAs after initial failures of PFNA in geriatric individuals.

Methods

Consecutive geriatric individuals who underwent secondary cemented THA after initial PFNA fixation from July 2005 to July 2018, were retrospectively identified from three medical centres. The primary outcome was revision-free survivorship estimated using the Kaplan–Meier method and Cox proportional hazards regression with revision for any reason as the endpoint; secondary outcomes were functional outcomes and key THA-related complications. Follow-ups occurred at 3 months, 6 months, 12 months and then every 12 months after conversion.

Results

In total, 186 consecutive patients (186 hips) were available for study inclusion. The median follow-up was 120.7 months (60–180 months) in the cohort. Kaplan–Meier survivorship with revision for any reason as the end point showed that the 10-year revision-free survival rate was 0.852 (95% confidence interval [CI], 0.771–0.890). Good functional outcomes were seen, and the HHS decreased markedly over the 24th month to the final follow-up interval from 92.2 to 75.1 (each p < 0.05). The overall rate of key THA-related complications was 16.1% (30/186).

Conclusion

Cemented THA executed following initial PFNA failure may yield satisfactory revision-free survival and, at least for the initial 10 years after conversion, good functional outcomes and a 16.1% complication rate of key THA-related complications, which supports the trend towards increased use of cemented THA.
Microwave ablation combined with cementoplasty under real-time temperature monitoring in the treatment of 82 patients with recurrent spinal metastases after radiotherapy
Authors: Wang Baohu , Zhang Kaixian , Zhang Xusheng , Yang Sen , Hu Miaomiao , Li Peishun , Yang Wanying , Fan Jing , Xing Chao , Yuan Qianqian
Published: November 2022

Background

The spine is the most frequently affected part of the skeletal system to metastatic tumors. External radiotherapy is considered the first-line standard of care for these patients with spine metastases. Recurrent spinal metastases after radiotherapy cannot be treated with further radiotherapy within a short period of time, making treatment difficult. We aimed to evaluate the effectiveness and safety of MWA combined with cementoplasty in the treatment of spinal metastases after radiotherapy under real-time temperature monitoring.

Methods

In this retrospective study, 82 patients with 115 spinal metastatic lesions were treated with MWA and cementoplasty under real-time temperature monitoring. Changes in visual analog scale (VAS) scores, daily morphine consumption, and Oswestry Disability Index (ODI) scores were noted. A paired Student’s t-test was used to assess these parameters. Complications during the procedure were graded using the CTCAE version 5.0.

Results

Technical success was attained in all patients. The mean VAS score was 6.3 ± 2.0 (range, 4–10) before operation, and remarkable decline was noted in one month (1.7 ± 1.0 [P < .001]), three months (1.4 ± 0.8 [P < .001]), and six months (1.3 ± 0.8 [P < .001]) after the operation. Significant reductions in daily morphine consumption and ODI scores were also observed (P < .05). Cement leakage was found in 27.8% (32/115) of lesions, with no obvious associated symptoms.

Conclusion

MWA combined with cementoplasty under real-time temperature monitoring is an effective and safe method for recurrent spinal metastases after radiotherapy.