bluuebunny/crossref_metadata_2025 huggingface dataset:
Causes of the gender divide within entrepreneurship ecosystems
Authors: Motoyama Yasuyuki , Muntean Susan Clark , Knowlton Karren , Ozkazanc-Pan Banu
Published: February 2021

Knowledge about connections within a local economic system holds implication for understanding the ways in which individuals and categories of entrepreneurs access the system itself and resources provided within. While scholars have recently found complex divisions of networks within local entrepreneurship ecosystems, we still have a limited understanding about why these chasms exist. We present a case study with qualitative research in the entrepreneurial ecosystem of St. Louis, Missouri, which identifies structural sources of divergence in networks. Specifically, we find a gender gap in the ecosystem that reveals patterns of difference in access to resources and in the experiences of women relative to men entrepreneurs. Thus, we contribute a more nuanced understanding of how discrete elements within a system’s networks diverge, as well as identifying the root causes of this divergence. The article concludes with implications for theories and practice.
Longitudinal sliding resistance characteristics of the WJ-8 conventional resistance fastner
Authors: Zeng Zhiping , Di Wang , Shuaibu Abdulmumin Ahmed , Zhu Zhihui , Lin Zhihua
Published: February 2021

In this paper, the longitudinal resistance and displacement of the WJ-8 conventional resistance fastener under vertical and torque loadings were experimentally conducted and the relationship between longitudinal resistance and displacement was established. To validate the experimental results, numerical simulation using a finite-element model of the fastener was established to obtain the longitudinal resistance variation of the conventional-resistance. Results of the analysis show that both results of the experiment and simulation are in agreements. Furthermore, the skid resistance frictional coefficient of the fastener system under the vertical load was studied and its variation rule under both vertical and torque loads was obtained. The longitudinal sliding resistance of fasteners under different torques and/or vertical loads followed a linear trend. Under load and no-load conditions, the skid-resistance frictional coefficient of the fastener system varied significantly.
Numerical investigation on flow instabilities in low-pressure steam turbine last stage under different low-load conditions
Authors: Hu Ping , Lin Tong , Yang Rui , Zhu Xiaocheng , Du Zhaohui
Published: February 2021

The modern power generation system requires steam turbines operating at flexible operating points, and flow instabilities readily occur in the low-pressure (LP) last stage under low-load conditions, which may cause failure of the last stage moving blades. Some studies have shown that within this operating range, a shift of the operating point may lead to flow instabilities. Numerical simulation has gradually developed into a popular method for such researches, but it is expensive for a complex model, which has to be balanced between efficiency and accuracy. This work is divided into three parts: Firstly, one of the low-load conditions is selected to provide both URANS model and the Scale-Adaptive Simulation (SAS) model. The results of the two models are compared to evaluate specific flow phenomena; Secondly, through calculations of different low-load conditions, the flow structure and propagation characteristics of instabilities in the last stage are obtained; Finally, flow analysis is applied to explain the formation mechanism of flow instabilities in LP steam turbines. The results show that, the introduction of SAS model increases the randomness of flow over time, but does not fundamentally change the flow instabilities. Flow instabilities take different forms at different flow rate, from rotating instability to rotating stall. The formation of flow instabilities is related to the radial flow in the cascade passages.
The impact of volute aspect ratio and tilt on the performance of a mixed flow turbine
Authors: Lee Samuel P , Barrans Simon M , Nickson Ambrose K
Published: February 2021

Current trends in the automotive industry towards engine downsizing means turbocharging now plays a vital role in engine performance. The purpose of turbocharging is to increase the engine inlet air density by utilising, the otherwise wasted energy in the exhaust gas. This energy extraction is commonly accomplished through the use of a radial turbine. Although less commonly used, mixed flow turbines can offer aerodynamic advantages due to the manipulation of blade leading (LE) angles, improving performance at low velocity ratios. The current paper investigates the performance of a mixed flow turbine with four volute designs, two radial and two tilted volutes each with one variant with an aspect ratio (AR)=0.5 and one with AR = 2. To ensure constant mass flow parameter (MFP) for aerodynamic similarity, volute area to radius ratio (A/r) was manipulated between the design variants. The maximum variation of cycle averaged normalized efficiency measured between the designs was 2.87%. Purely in the rotor region, the variation in normalized cycle averaged efficiency was 3%. The smallest volute AR designs showed substantial secondary flow development. The introduction of volute tilt further complicated the secondary flow development with the introduction of asymmetry to the flows. It was established that both AR and tilt have a notable effect on secondary flows, rotor inlet conditions and over all mixed flow turbine performance.
A Review of the Talc Industry’s Influence on Federal Regulation and Scientific Standards for Asbestos in Talc
Authors: Bird Tess , Steffen Joan E. , Tran Triet H. , Egilman David S.
Published: February 2021

The talc industry and Food and Drug Administration (FDA) have asserted that talc has been asbestos-free since 1976 when the industry created a voluntary specification for the asbestos content of cosmetic talc. However, recent evidence reveals that cosmetic talc is not and never was asbestos-free. This narrative review examines the talc industry’s role in delaying and ultimately blocking federal regulation of cosmetic talc from the 1970s to today. We review primary source material, including corporate documents released in recent litigation and FDA documents released in response to Freedom of Information Act requests. Our results indicate that the talc industry exerted considerable influence over three key areas: regulatory proceedings at the FDA; testing methods and the manipulation of test results (including undisclosed results); and press coverage and the medical literature. The talc companies’ actions and FDA indifference have had a lasting effect on consumer health, including the regulation of talc by other government agencies.
Patient-reported outcomes and digital literacy of patients treated in an oncology day hospital unit
Authors: del Rosario García Betel , Morales Barrios José Alberto , Viña Romero María M , Ramos Díaz Ruth , Nazco Casariego Gloria J , Jiménez Sosa Alejandro , Oramas Rodríguez Juana M , Gutiérrez Nicolás Fernando
Published: February 2021

Introduction

Patient-reported outcomes (PROs) use, via a computer registry, allows patients to report their symptoms enabling the detection of early signs of progression of the disease. For such a record, the patient needs to show certain skills in new technologies use. The present study aimed to analyse the perception and degree of digital literacy of patients undergoing oncological treatment in an Oncology Day Hospital (ODH).

Methods

A cross-sectional descriptive study was performed, where the degree of literacy of patients attending antineoplastic treatment at the ODH was examined by means of an anonymous survey.

Results

A total of 122 patients have been included in the study. The proportion of subjects who use the electronic mail (TM) and the Internet on a daily basis was 45.1% and 70.5%, respectively, and up to 77.9% from the subjects considered that the use of digital 2.0 strategies could help improve communication between healthcare professional and patient. The TM was determined by the age, educational level and employment status of the individual. Furthermore, the age of the patients conditioned their perception of the usefulness of the web 2.0 tools (T2.0).

Conclusion

This study allowed us to establish a target patient profile to conduct the efficient monitoring of cancer progression by PROs. The results have shown that approximately 60% of the patients in our population could be potential candidates to receive PROs-based health care. This approach enables earlier detection of symptoms and signs of progression and consequently, improves health outcomes for cancer patients.
Ammonia level as a proxy of asparaginase inactivation in children: A strategy for classification of infusion reactions
Authors: Santos Amanda C , Land Marcelo G P , Lima Elisangela C
Published: February 2021

Introduction

Allergic hypersensitivity reactions related to enzyme asparaginase may occur during intravenous infusion of drugs and other adverse reactions (non-allergic hypersensitivity and hyperammonemia), which do not require discontinuation of therapy as the first case. It makes differential diagnoses between infusion reactions essential to assure the team regarding the right decision to make after the adverse event. This study evaluated a pharmacovigilance strategy of differentiating infusion reactions to asparaginase in pediatric patients, based on the measurement of serum ammonia and the classification of the reactions by clinical symptoms and severity.

Methodology

We included children, diagnosed with ALL, and treated with native Escherichia coli asparaginase in a university hospital. The professional team monitored and evaluated all asparaginase infusions for continuity of treatment (rechallenge), seeing the measurement of serum ammonia and classification of reactions for type and severity grade. Data from this monitoring was collected retrospectively. Chi-square and Mann-Whitney tests were used to compare the ratios between serum ammonia concentration posterior and before asparaginase infusion.

Results

245 infusions in 32 patients were monitored, and 19 reactions were observed in 17 children (53%). Three children have hyperammonemia and continue their treatment. The variation of the serum ammonia levels before and after the infusion was statistically significant, comparing the groups with no reaction or hyperammonemia versus the group with the hypersensitivity reaction.

Conclusion

The pharmacovigilance strategy applied in the hospital investigated was a useful and inexpensive tool that supported clinical decision-making and enabled the maintenance of asparaginase therapy for three (9,4%) patients followed up.
Prediction of acoustic wave transmission features of the multilayered plate constructions: A review
Authors: Zarastvand MR , Ghassabi M , Talebitooti R
Published: February 2021

This study collects all of the existent papers in the field of acoustic transmission across multilayered plate constructions. Herewith, a comprehensive source is proposed wherein approximately 410 references are reviewed and described from the first [Formula: see text] to [Formula: see text]. In the first part, in addition to the presentation of a complete explanation about the importance of the acoustic analysis of these structures, appropriate formulations are also provided. Furthermore, an overview of the thematic correspondent is carried out. Since the type of material used in these constructions can be very important in sound insulation, the significance of this subject is remarked. The papers are then classified based on their acoustic excitation fields containing plane wave, diffuse, random, and point source. After analyzing the research approaches according to different environmental properties, the articles are ordered based on their boundaries as finite and infinite. To present reliable outcomes, it is necessary to investigate a proper theory proportional to the structure’s thickness. Herewith, this issue is also discussed in detail. The review is also expanded to focus on the different vibroacoustic solutions. Before concluding remarks, the authors' research works are presented wherein either optimization algorithms or control techniques improve the acoustic performance of these structures.
Studies on needle punched nonwoven fabrics made from natural fiber blends for oil sorbent applications
Authors: Vijayasekar R , Saravanan Dhandapani
Published: February 2021

Oil retention of needle punched nonwoven fabrics made from coarse cotton, fine cotton, jute, kapok and its blends were reported. Based on the previous research work, oil retention of nonwoven fabrics is highly influenced by fiber diameter, fabric porosity and oil properties. In this study blended needle punched nonwoven samples were produced using fibers with wide variation in fiber diameter. Coarse jute fiber was blended with fine fibers of cotton and kapok to improve structural stability after sorption of oil. Needle punched nonwoven fabrics were produced using jute fiber ratio of 5%, 10%, 15%, 20% with 25% kapok, 25% coarse cotton and remaining fine cotton fibers. Oil retention capacities of needle punched nonwoven fabrics were found to be in the range of 7.75 g/g to 16.60 g/g under various process conditions. It has been noted that an increase in the jute fiber content in the nonwoven fabrics increases the oil retention capacity of the samples. Jute fibers act as columns in fiber structural assembly and it is the stiffer fiber than other three fibers used in the needle punched nonwovens. Thickness of nonwoven needle punched fabrics change after sorption of oil from 1.5% to 5%, which reduced on increasing jute fiber content in the blends.
Emerging evidence that adaptive bone formation inhibition by non-steroidal anti-inflammatory drugs increases stress fracture risk
Authors: Staab Jeffery S , Kolb Alexander L , Tomlinson Ryan E , Pajevic Paola Divieti , Matheny Ronald W , Hughes Julie M
Published: February 2021

There is mounting evidence suggesting that the commonly used analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), may inhibit new bone formation with physical training and increase risk of stress fractures in physically active populations. Stress fractures are thought to occur when bones are subjected to repetitive mechanical loading, which can lead to a cycle of tissue microdamage, repair, and continued mechanical loading until fracture. Adaptive bone formation, particularly on the periosteal surface of long bones, is a concurrent adaptive response of bone to heightened mechanical loading that can improve the fatigue resistance of the skeletal structure, and therefore may play a critical role in offsetting the risk of stress fracture. Reports from animal studies suggest that NSAID administration may suppress this important adaptive response to mechanical loading. These observations have implications for populations such as endurance athletes and military recruits who are at risk of stress fracture and whose use of NSAIDs is widespread. However, results from human trials evaluating exercise and bone adaptation with NSAID consumption have been less conclusive. In this review, we identify knowledge gaps that must be addressed to further support NSAID-related guidelines intended for at-risk populations and individuals.
The Effectiveness of Dichloroacetate on Human Glioblastoma Xenograft Growth Depends on Na+ and Mg2+ Cations
Authors: Stakišaitis Donatas , Damanskienė Eligija , Curkūnavičiūtė Rūta , Juknevičienė Milda , Alonso Marta Maria , Valančiūtė Angelija , Ročka Saulius , Balnytė Ingrida
Published: February 2021

The study’s aim was to investigate the effectiveness of sodium dichloroacetate (NaDCA) or magnesium dichloroacetate (MgDCA) on adult U87 MG and pediatric PBT24 cell lines glioblastoma (GB) xenografts in a chicken chorioallantoic membrane (CAM) model. The study groups were: treated with 10 mM, 5 mM of NaDCA, and 5 mM, 2.5 mM of MgDCA, and controls. The U87 MG and PBT24 xenografts growth, frequency of tumor invasion into CAM, CAM thickening, and the number of blood vessels in CAM differed depending on the dichloroacetate salt treatment. NaDCA impact on U87 MG and PBT24 tumor on proliferating cell nunclear antigen (PCNA) and enhancer of zeste homolog 2 (EZH2) expression in the tumor was different, depending on the NaDCA dose. The 5 mM MgDCA impact was more potent and had similar effects on U87 MG and PBT24 tumors, and its impact was also reflected in changes in PCNA and EZH2 expression in tumor cells. The U87 MG and PBT24 tumor response variations to treatment with different NaDCA concentration on tumor growth or a contrast between NaDCA and MgDCA effectiveness may reflect some differences in U87 MG and PBT24 cell biology.
Endoscopic management of idiopathic subglottic stenosis in pregnancy
Authors: Kanzara Todd , Rotman Anthony , Kinshuck Andrew , Al Yaghchi Chadwan , Tan Min Yi , Yu Christina , Sandu Guri
Published: February 2021

Aims

To describe the use of laser, endoscopic balloon dilatation with jet ventilation anaesthesia in the treatment of pregnant women with idiopathic subglottic stenosis.

Materials and methods

This is a case review of pregnant women with idiopathic subglottic stenosis, presenting to a tertiary referral centre with worsening breathlessness. Data were extracted from patient case notes.

Results

Four women underwent surgical management of subglottic stenosis in pregnancy. One patient required two procedures during the course of their pregnancy due to restenosis. All women had improvement in symptoms post-operatively and went on to deliver healthy babies at term.

Conclusion

Endoscopic balloon dilatation of idiopathic subglottic stenosis is a safe and viable treatment option in pregnancy and should be offered as first-line treatment in symptomatic women.
Maintaining fair and efficient health care during the COVID-19 pandemic: Theoretical context and practical implications
Authors: Milionis Charalampos , Ntzigani Maria , Milioni Stella Olga , Ilias Ioannis
Published: February 2021

Coronavirus disease 2019 is a respiratory infection that has evolved to a pandemic with an enormous burden both on human life and health care. States throughout the world have pursued strategies to restrict the transmission of the virus in the community. Health systems have a crucial dual role as they are at the frontline of the fight against the pathogen and at the same time they must continue to offer emergency and routine health services. The provision of health care in the context of the COVID-19 pandemic finds certain barriers. The simultaneous protection of both universal health coverage and health care efficiency is a difficult task due to conflicting challenges of these two goals. Key actions need to be decided and implemented in the fields of health policy, operation of health services, and clinical interaction between health personnel and patients, so that health care continues to perform its mission in a sustainable manner. As the scientific community prepares for the widespread production and application of effective protective and therapeutic agents against COVID-19, it is vital for the general population to remain safe and for the health systems to survive. Allocation of resources and priority setting need to be applied fairly and efficiently for the achievement of the maximum benefit.
Clinical evaluation of preoperative embolization, vertebroplasty, and decompression in the treatment of aggressive vertebral hemangiomas
Authors: Xu Derong , Kong Meng , Zhu Kai , Han Xing , Zhang Wenwei , Zeng Xiangxu , Zhou Chuanli , Ma Xuexiao
Published: February 2021

Objective:

To evaluate the efficacy and safety of preoperative embolization and vertebroplasty in the treatment of aggressive hemangioma.

Methods:

A retrospective clinical review of patients diagnosed with aggressive vertebral hemangiomas was conducted. All the patients were assigned to three groups according to the treatment strategies: patients in Group A underwent embolization and decompression with internal fixation, patients in Group B underwent vertebroplasty and decompression with internal fixation, patients in Group C received all three treatments. Clinical indexes were compared within three groups.

Results:

There were 16 patients received embolization and decompression (Group A), 19 patients underwent decompression with vertebroplasty (Group B) and 16 patients in Group C. The operative duration of patients in group A (198.33 ± 38.43 min) were less than another two groups ( p = 0.001). The intraoperative blood loss of patients in group C was 713.33 ± 165.13 mL, which was significantly less than group A and group B ( p = 0.045). Patients in group C exhibited the lowest volume of drainage on POD 1 (178.33 ± 66.76 mL), which showed significant difference compared with group A (368.33 ± 191.15 mL, p = 0.01). There was no significant difference of preoperative and postoperative VAS and JOA score among three groups, as well as drainage on POD 2, total volume and hospital duration.

Conclusion:

Both embolization and vertebroplasty are efficient and safe measures to reduce blood loss in the surgical treatment of aggressive vertebral hemangiomas, combination of all three methods is also competent.
Effects of intermittent pneumatic compression on femoral vein peak venous velocity during active ankle exercise
Authors: Sakai Kenta , Takahira Naonobu , Tsuda Kouji , Akamine Akihiko
Published: February 2021

Introduction:

The risk of developing deep vein thrombosis (DVT) is high even after the period of bed rest following major general surgery including total joint arthroplasty (TJA). Mobile intermittent pneumatic compression (IPC) devices allow the application of IPC during postoperative exercise. Although ambulation included ankle movement, no reports have been made regarding the effects of IPC during exercise, including active ankle exercise (AAE), on venous flow. This study was performed to examine whether using a mobile IPC device can effectively augment the AAE-induced increase in peak velocity (PV).

Methods:

PV was measured by Doppler ultrasonography in the superficial femoral vein at rest, during AAE alone, during IPC alone, and during AAE with IPC in 20 healthy subjects in the sitting position. PV in AAE with IPC was measured with a mobile IPC device during AAE in the strong compression phase. AAE was interrupted from the end of the strong compression phase to minimize lower limb fatigue.

Results:

AAE with IPC (76.2 cm/s [95%CI, 69.0–83.4]) resulted in a significant increase in PV compared to either AAE or IPC alone (47.1 cm/s [95%CI, 38.7–55.6], p < 0.001 and 48.1 cm/s [95%CI, 43.7–52.4], p < 0.001, respectively).

Discussion:

Reduced calf muscle pump activity due to the decline in ambulation ability reduced venous flow. Therefore, use of a mobile IPC device during postoperative rehabilitation in hospital and activity including self-training in an inpatient ward may promote venous flow compared to postoperative exercise without IPC.

Conclusion:

Use of a mobile IPC device significantly increased the PV during AAE, and simultaneous AAE with IPC could be useful evidence for the prevention of DVT in clinical settings, including after TJA.
MR. HOLMES Bakehouse: Surviving the Coronavirus
Authors: Reed Marlene M. , Palich Les
Published: February 2021

This case is about Aaron Caddel, an entrepreneur, who owned several coffee houses and bakeries in San Francisco and Los Angeles and had to rethink his businesses during the Covid 19 pandemic in early 2020. Aaron pulled the plug on his operations on March18, operated as a grocery store until March 21. With no knowledge of e-commerce but possessing a staff of skilled bakers and a 4,200 square foot warehouse, Aaron believed he could pivot his business and keep his workers employed. His concern was the steps he should take to support a business that would help him keep his workers employed during the pandemic.
Molecular investigation of an outbreak associated with total parenteral nutrition contaminated with NDM-producing Leclercia adecarboxylata
Authors: Garza-González Elvira , Bocanegra-Ibarias Paola , Rodríguez-Noriega Eduardo , González-Díaz Esteban , Silva-Sanchez Jesús , Garza-Ramos Ulises , Contreras-Coronado-Tovar Iván Fernando , Santos-Hernández José Ecil , Gutiérrez-Bañuelos David , Mena-Ramirez Juan Pablo , Ramírez-De-los-Santos Saúl , Camacho-Ortiz Adrián , Morfín-Otero Rayo
Published: February 2021

Background

This study aimed to determine the epidemiological, microbiological, and molecular characteristics of an outbreak of carbapenem-resistant Leclercia adecarboxylata in three hospitals associated with the unintended use of contaminated total parental nutrition (TPN).

Methods

For 10 days, 25 patients who received intravenous TPN from the same batch of a formula developed sepsis and had blood cultures positive for L. adecarboxylata. Antimicrobial susceptibility and carbapenemase production were performed in 31 isolates, including one from an unopened bottle of TPN. Carbapenemase-encoding genes, extended-spectrum β-lactamase–encoding genes were screened by PCR, and plasmid profiles were determined. Horizontal transfer of carbapenem resistance was performed by solid mating. Clonal diversity was performed by pulsed-field gel electrophoresis. The resistome was explored by whole-genome sequencing on two selected strains, and comparative genomics was performed using Roary.

Results

All 31 isolates were resistant to aztreonam, cephalosporins, carbapenems, trimethoprim/sulfamethoxazole, and susceptible to gentamicin, tetracycline, and colistin. Lower susceptibility to levofloxacin (51.6%) and ciprofloxacin (22.6%) was observed. All the isolates were carbapenemase producers and positive for blaNDM-1, blaTEM-1B, and blaSHV-12 genes. One main lineage was detected (clone A, 83.9%; A1, 12.9%; A2, 3.2%). The blaNDM-1 gene is embedded in a Tn125-like element.

Genome analysis showed genes encoding resistance for aminoglycosides, quinolones, trimethoprim, colistin, phenicols, and sulphonamides and the presence of IncFII (Yp), IncHI2, and IncHI2A incompatibility groups. Comparative genomics showed a major phylogenetic relationship among L. adecarboxylata I1 and USDA-ARS-USMARC-60222 genomes, followed by our two selected strains.

Conclusion

We present epidemiological, microbiological, and molecular evidence of an outbreak of carbapenem-resistant L. adecarboxylata in three hospitals in western Mexico associated with the use of contaminated TPN.
‘Menstruation means impurity’: multilevel interventions are needed to break the menstrual taboo in Nepal
Authors: Thapa Subash , Aro Arja R.
Published: February 2021

Background

During their menstrual period, women are generally considered impure in Nepal; in the rural areas of the western part of the country, they are even banished to stay in sheds (called chhaupadi) during this time, which increases their vulnerability to a variety of health consequences. There is lack of clarity regarding the effectiveness of interventions that have been implemented to address menstrual taboo and improve menstrual hygiene and practices in Nepal (e.g., public awareness, community sensitization and legislation). In this paper, we discuss why menstruation management interventions, particularly those implemented to change the menstrual taboo might not work, and the opinions and experiences regarding the implementation of such interventions.

Main text

Anecdotal reports from the field and empirical studies suggest that interventions to address menstrual taboos have only been effective for short durations of time due to several reasons. First, local community stakeholders have been reluctant to take actions to abandon retrogressive menstrual practices in rural areas. Second, women who have stopped practising chhaupadi have faced stigma (e.g., fear of exclusion) and discrimination (e.g., blaming, physical and verbal abuse). Third, contextual factors, such as poverty and illiteracy, limit the effectiveness of such interventions. Fourth, community sensitization activities against chhaupadi have faced resistance from community leaders and traditional healers. Fifth, the law prohibiting chhaupadi has also faced implementation problems, including poor filing of complaints.

Conclusion

Multilevel, multisectoral interventions could be more effective than single-component interventions in breaking the prevailing menstrual taboo and in improving menstrual health and hygiene practices among young girls and women in the rural areas of Nepal. Moreover, interventions that have an active community mobilization component could be effective within local contexts and cultural groups.
Economic burden of moderate to severe burns and its association with health-related quality of life of Nigerian women
Authors: Chinweuba Anthonia U. , Chinweuba Ifunanya S. , Diorgu Faith C. , Ubochi Nneka E. , Ezeruigbo Chinwe S. , Wasini Kenneth B. , Nnabuenyi Anthonia I.
Published: February 2021

Background

Burns cases are frequent in Nigeria hospitals, however, literature on its economic burden and the association with health-related quality of life (HRQOL) of women in Nigeria is scarce. This study determined the burden of hospitalization after burns on women’s economic status and its associated HRQOL.

Methods

This was a three-month cross-sectional study of female patients ≥ 25 years, treated of mixed or full thickness burns in four teaching hospitals in south-east Nigeria, discharged between September–November, 2018. Study instruments were participants’ case notes for socio-demographic and disease history, interviewer-administered questionnaires, namely-economic-burden-of-burns questionnaire and English version of the EuroQol Five-Dimensions-Three-Level Health Questionnaire for Nigeria. Data were collected on second- or third-day post-discharge through home visits or phone calls. This lasted for 13 weeks.

Results

A total of seventy-three female patients with burn were successfully enrolled. Most participants were married, fairly educated, mainly traders or housewives. Thirty-four (46.6%) had subjective estimated family monthly income below NGN 50,000 (low economic status). Participants’ average monthly income reduced drastically after hospitalization. Their average family monthly income was NGN110,439 (USD307), while their average total expenses incurred during hospitalization was NGN691,093 (USD1,920). Almost all (93.2%) had at least one surgical intervention during management. Their average length of hospital stay was 35.4 days; eleven consequently lost their job. Many had moderate to severe economic burden of treatment; only eleven could bear all the treatment expenses independently. Anxiety/depression and pain/discomfort were common problems reported, However, these Euroqol dimensions varied according to their SES, education and occupation. Women in the low economic class were more inclined to poor HRQOL (Mean ± SD VAS = 53.33 ± 17.619) than women in high economic class (Mean ± SD VAS = 76.67 ± 21.794).

Conclusion

Burns places high level of economic burden on women and unfortunately, Nigerian government’s commitment to healthcare of burns patients is low. The long course of hospitalization and economic depletion impact negatively on the women’s HRQOL. Based on these findings, we recommend that government parastatals create special trust fund for burns treatment and the National Health Insurance Scheme be restructured for more accessibility.
A powerful qPCR-high resolution melting assay with taqman probe in Plasmodium species differentiation
Authors: Lamien-Meda Aline , Fuehrer Hans-Peter , Leitsch David , Noedl Harald
Published: February 2021

Background

The use of highly sensitive molecular tools in malaria diagnosis is currently largely restricted to research and epidemiological settings, but will ultimately be essential during elimination and potentially eradication. Accurate diagnosis and differentiation down to species levels, including the two Plasmodium ovale species and zoonotic variants of the disease, will be important for the understanding of changing epidemiological patterns of the disease.

Methods

A qPCR-high resolution melting (HRM) method was to detect and differentiate all human Plasmodium species with one forward and one reverse primer set. The HRM detection method was further refined using a hydrolysis probe to specifically discriminate Plasmodium falciparum.

Results

Out of the 113 samples tested with the developed HRM-qPCR- P. falciparum probe assay, 96 (85.0 %) single infections, 12 (10.6 %) mixed infections, and 5 (4.4 %) were Plasmodium negative. The results were concordant with those of the nested PCR at 98.2 %. The assay limit of detection was varied from 21.47 to 46.43 copies /µl, equivalent to 1–2.11 parasites/µl. All P. falciparum infections were confirmed with the associated Taqman probe.

Conclusions

Although the dependence on qPCR currently limits its deployment in resource-limited environments, this assay is highly sensitive and specific, easy to perform and convenient for Plasmodium mono-infection and may provide a novel tool for rapid and accurate malaria diagnosis also in epidemiological studies.
Uterine metabolic disorder induced by silica nanoparticles: biodistribution and bioactivity revealed by labeling with FITC
Authors: Duan Shuyin , Zhang Meihua , Li Junxia , Tian Jiaqi , Yin Haoyu , Wang Xietong , Zhang Lin
Published: February 2021

Extensive application of nanomaterials has dramatically increased the risk of silica nanoparticle (SiNP, SiO2) exposure, yet their biological effect on reproduction has not been fully elucidated. By tracking the uterine biodistribution of SiNP in pregnant mice, this study was conducted to evaluate the biological effect of SiNP on reproduction. First, SiNP was conjugated with FITC, and then the FITC-SiNP was administrated to trophoblast (100 µg/mL, 24 h) in vitro and pregnant mice (0.25 mg/mouse, 2–24 h) in vivo. It was found that the FITC-SiNP was internalized by trophoblast and deposited in the uterus. The internalization of SiNP caused trophoblast dysfunction and apoptosis, while SiNP accumulation in the uterus induced diffuse inflammatory infiltration. The genome-wide alteration of gene expression was studied by high throughput sequencing analysis, where 75 genes were found to be dysregulated after SiNP exposure, among which ACOT2, SCD1, and CPT1A were demonstrated to regulate the biosynthesis of unsaturated fatty acids. Moreover, the suppression of unsaturated fatty acids caused mitochondrial overload of long-chain fatty acyl-CoA (LACoA), which further induced both trophoblast apoptosis and endometrial inflammation. In conclusion, the successful conjugation of FITC onto SiNP facilitated the tracking of SiNP in vitro and in vivo, while exposure to FITC-SiNP induced uterine metabolic disorder, which was regulated by the ACOT/CPT1A/SCD1 axis through the biosynthesis of unsaturated fatty acids signaling pathway.
High lymphocyte population-related predictive factors for a long-term response in non-small cell lung cancer patients treated with pemetrexed: a retrospective observational study
Authors: Sumiyoshi Issei , Okabe Takahiro , Togo Shinsaku , Takagi Haruhi , Motomura Hiroaki , Ochi Yusuke , Shimada Naoko , Haraguchi Mizuki , Shibayama Rina , Fujimoto Yuichi , Watanabe Junko , Iwai Moe , Kadoya Kotaro , Iwakami Shin-ichiro , Takahashi Kazuhisa
Published: February 2021

Background

Regimens combining pemetrexed (PEM) and immune checkpoint inhibitors (ICIs) targeting programmed cell death-1 (PD-1) or programmed death-ligand 1 (PD-L1) are widely used for the treatment of advanced non-squamous non-small-cell lung cancer (NSq-NSCLC). Recently, PEM was shown to induce immunogenic cell death (ICD) and to enhance immune-regulatory genes. Some patients demonstrate an extremely long-term response to PEM. It is possible that the continued response in these patients is dependent on not only the pharmacological induction of cytotoxic cell death but also antitumor immunity. However, factors that can predict outcomes associated with long-term PEM administration using blood test results have not yet been elucidated. We investigated the clinical characteristics and predictive factors in patients with advanced NSq-NSCLC who underwent long-term PEM maintenance therapy.

Methods

In total, 504 patients with advanced NSq-NSCLC who received PEM combination therapy/monotherapy (n = 414) or paclitaxel (PTX) combination therapy (n = 90) between January 2010 and November 2019 were recruited; 381 patients were retained for the final analysis. Patients treated with PEM (n = 301) were divided into subgroups according to the total cycles of PEM (≥ 17 [n = 25] for the long-term administration group and ≤ 16 [n = 276] for the intermediate/short-term group) and compared with another population (n = 80) treated with PTX combination regimen. We investigated clinical features and predictive biomarkers, focusing on immune-regulatory factors, absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), and PD-1 and PD-L1 expression, to predict long-term response to PEM.

Results

The long-term PEM administration group exhibited a higher ALC and a lower NLR than the shorter-term group did. Both these markers displayed greater association with progression-free survival and overall survival in the PEM combination therapy group than in the PTX combination therapy group. Increased PD-1 lymphocytes were associated with the long-term PEM response group, as PD-L1 expression in tumors was associated with a high incidence of immune-related adverse effects following ICI administration.

Conclusions

ALC, NLR, and PD-1 expression are PEM-mediated predictive biomarkers that are indirectly related to tumor immunity and can provide useful predictive information on the long-term response to PEM in patients with NSq-NSCLC.
Study of a nonlinear multi-terms boundary value problem of fractional pantograph differential equations
Authors: Bahar Ali Khan Muhammad , Abdeljawad Thabet , Shah Kamal , Ali Gohar , Khan Hasib , Khan Aziz
Published: February 2021

In this research work, a class of multi-term fractional pantograph differential equations (FODEs) subject to antiperiodic boundary conditions (APBCs) is considered. The ensuing problem involves proportional type delay terms and constitutes a subclass of delay differential equations known as pantograph. On using fixed point theorems due to Banach and Schaefer, some sufficient conditions are developed for the existence and uniqueness of the solution to the problem under investigation. Furthermore, due to the significance of stability analysis from a numerical and optimization point of view Ulam type stability and its various forms are studied. Here we mention different forms of stability: Hyers–Ulam (HU), generalized Hyers–Ulam (GHU), Hyers–Ulam Rassias (HUR) and generalized Hyers–Ulam–Rassias (GHUR). After the demonstration of our results, some pertinent examples are given.
Analyzing the contribution of crop diversification in improving household food security among wheat dominated rural households in Sinana District, Bale Zone, Ethiopia
Authors: Mengistu Dereje Derso , Degaga Degefa Tolossa , Tsehay Abraham Seyoum
Published: February 2021

Background

Agriculture is considered an important strategy for overcoming many of the emergencies faced by rural households in developing countries. In rural Ethiopia household access to food largely depends on what the household grows, either because they consume what they grow, or they purchase food with the income earned from what they grow. This study examines effect of crop diversification on food security and determinants of household food security among rural farm households of Sinana District, Oromia Regional state. The study uses a multi stage sampling procedure to select 384 sample households. Data were collected using a household survey, a focus group discussant (FGD), and key informant interviews. Ordinary least squares regression (OLS) and multinomial logistic regression model were used to analyze the data collected.

Results

We found that crop diversification had a positive and significant effect on household food security. Although crop diversification was positively associated with household food security, several other factors were found to be as or more important in increasing household food security. The education of the household head, access to irrigation system, livestock owned, total income, and remittance positively affected household food security. In contrast, age of household head and distance to nearest market were negatively associated with food security.

Conclusions

The study conclude that any effort to increase household food security should consider empowerment of farmers through adequate training and informal education, enhancing crop diversification, strengthening the rural infrastructural development (roads, market centers, and cooperatives).
Severe Bone Microarchitecture Impairment in Women With Pregnancy and Lactation-Associated Osteoporosis
Authors: Scioscia Maria Florencia , Vidal Maritza , Sarli Marcelo , Guelman Rodolfo , Danilowicz Karina , Mana Daniela , Longobardi Vanesa , Zanchetta María Belén
Published: February 2021

Context

Pregnancy- and lactation-associated osteoporosis (PLO) is a rare condition characterized by fragility fractures, mostly vertebral, during the third trimester of pregnancy or the early postpartum period.

Objective

The aim of this study was to evaluate bone microarchitecture in women with PLO to better understand the pathophysiology of this disease.

Methods

In this retrospective study, we included women with PLO referred to our bone center between November 2007 and July 2012. We assessed bone mineral density (BMD) by dual-energy x-ray absorptiometry, bone turnover markers, and bone microarchitecture by high-resolution peripheral quantitative computed tomography. Results were compared with a control group of healthy lactating women.

Results

Of the 7 primiparous patients with PLO, 6 suffered vertebral fractures and 1 developed a hip fracture during the seventh month of gestation. Fractures occurred within the eighth month of pregnancy and the fourth month post partum; vertebral fractures were multiple in 85.7%. Major or minor risk factors for osteoporosis were present in 86% of our patients. Trabecular density, number, and thickness were 34%, 20% and 22% lower than controls (P < .01, P = .01, and P = .01, respectively). Cortical parameters were also deteriorated but to a lesser extent.

Conclusion

In comparison with healthy lactating women, patients with PLO presented severe deterioration of bone trabecular and cortical microarchitecture. This significant compromise may explain the occurrence of multiple fractures in these otherwise healthy young women. Further prospective studies are needed to determine whether bone microarchitecture might be able to be restored in the future.
Correction of adolescent idiopathic scoliosis using a convex pedicle screw technique with low implant density
Authors: Ferlic Peter W. , Hauser Laurenz , Götzen Michael , Lindtner Richard Andreas , Fischler Stefan , Krismer Martin
Published: February 2021

Aims

The aim of this retrospective study was to compare the correction achieved using a convex pedicle screw technique and a low implant density achieved using periapical concave-sided screws and a high implant density. We hypothesized that there would be no difference in outcome between the two techniques.

Methods

We retrospectively analyzed a series of 51 patients with a thoracic adolescent idiopathic scoliosis. There were 26 patients in the convex pedicle screw group who had screws implanted periapically (Group 2) and a control group of 25 patients with bilateral pedicle screws (Group 1). The patients’ charts were reviewed and pre- and postoperative radiographs evaluated. Postoperative patient-reported outcome measures (PROMs) were recorded.

Results

The number of implants (14.5 vs 17.1) and the implant density (1.5 vs 1.9) were significantly lower in Group 2 (p < 0.001). Operating time was 27 minutes shorter in Group 2 than in Group 1, with a mean of 217 minutes (SD 50.5; 120 to 346). The duration of surgery per instrumented vertebra was reduced by 19% in Group 2 (p = 0.011). No statistical difference was found in the postoperative Cobb angle, vertebral rotation, the relative correction achieved, or postoperative PROMs.

Conclusion

Despite a lower implant density and achieving correction through a convex rod, surgical correction of the Cobb angle and vertebral body rotation was similar in both groups. Periapical pedicle screws and primary correction on the concave side do not seem to be mandatory in order to achieve good surgical results in idiopathic thoracic scoliosis. The operating time was shorter in the group with lower implant density. In conclusion, the technique provided good results and has the potential to reduce complications and costs. Cite this article: Bone Joint J 2021;103-B(3):536–541.
Osteoarticular infection in children
Authors: Coulin Benoit , Demarco Giacomo , Spyropoulou Vanessa , Juchler Celine , Vendeuvre Tanguy , Habre Céline , Tabard-Fougère Anne , Dayer Romain , Steiger Christina , Ceroni Dimitri
Published: February 2021

Aims

We aimed to describe the epidemiological, biological, and bacteriological characteristics of osteoarticular infections (OAIs) caused by Kingella kingae.

Methods

The medical charts of all children presenting with OAIs to our institution over a 13-year period (January 2007 to December 2019) were reviewed. Among these patients, we extracted those which presented an OAI caused by K. kingae and their epidemiological data, biological results, and bacteriological aetiologies were assessed.

Results

K. kingae was the main reported microorganism in our paediatric population, being responsible for 48.7% of OAIs confirmed bacteriologically. K. kingae affects primarily children aged between six months and 48 months. The highest prevalence of OAI caused by K. kingae was between seven months and 24 months old. After the patients were 27 months old, its incidence decreased significantly. The incidence though of infection throughout the year showed no significant differences. Three-quarters of patients with an OAI caused by K. kingae were afebrile at hospital admission, 11% had elevated WBCs, and 61.2% had abnormal CRPs, whereas the ESR was increased in 75%, constituting the most significant predictor of an OAI. On MRI, we noted 53% of arthritis affecting mostly the knee and 31% of osteomyelitis located primarily in the foot.

Conclusion

K. kingae should be recognized currently as the primary pathogen causing OAI in children younger than 48 months old. Diagnosis of an OAI caused by K. kingae is not always obvious, since this infection may occur with a mild-to-moderate clinical and biological inflammatory response. Extensive use of nucleic acid amplification assays improved the detection of fastidious pathogens and has increased the observed incidence of OAI, especially in children aged between six months and 48 months. We propose the incorporation of polymerase chain reaction assays into modern diagnostic algorithms for OAIs to better identify the bacteriological aetiology of OAIs. Cite this article: Bone Joint J 2021;103-B(3):578–583.