bluuebunny/crossref_metadata_2025 huggingface dataset:
Mapping reflexivity in situ: A multimodal exploration of negotiated textbook discourses in Korean university EFL classrooms
Authors: Smith Christopher A.
Published: June 2021

The present study identifies and maps the reflexive praxis of two experienced English as a foreign language (EFL) instructors as they reconstruct and negotiate textbook material in situ. An abundance of critical studies underscoring social injustices in the contents of globally published EFL textbooks do not sufficiently address the negotiation of their multimodal discourses during class time. Although reflexive teaching practice in language learning classrooms has a robust pool of research, limited scholarly attention has been given to the active negotiation of a textbook’s multimodal discourse in Korean university classrooms. The present study asks: (1) How do two instructors at different Korean universities negotiate the contents of an EFL textbook with their students during class? (2) How do the students react to the multimodal discourse negotiated in their textbooks? (3) What pedagogical implications do the findings lend to EFL textbook instruction in Korean university contexts? Using Norris’ (2004) framework for video transcription of multimodal interaction in two Korean university English communication classes, the findings reveal that reflexive negotiation between students and instructors is a kind of rhetorical accomplishment that lessens the potential for cultural marginalization in the multimodal discourse of EFL textbooks. Implications suggest that textbook reflexivity in situ raises the value of student EFL learning investments.
Book review: Deeming, C. and Smyth, P. (eds.). 2018: Reframing Global Social Policy: Social Investment for Sustainable and Inclusive Growth
Authors: Sun Yue , Chang Yen-Chiang
Published: June 2021

Deeming, C. and Smyth, P. (eds.). 2018: Reframing Global Social Policy: Social Investment for Sustainable and Inclusive Growth. Bristol: Policy Press, 350 pp. GBP 80.00 (Hardcover). ISBN: 978-1-4473-3249-7.
Early Attention to Animacy: Change-Detection in 11-Month-Olds
Authors: Hofrichter Ruth , Siddiqui Hasan , Morrisey Marcus N. , Rutherford M. D.
Published: June 2021

Adults are faster and more accurate at detecting changes to animate compared to inanimate stimuli in a change-detection paradigm. We tested whether 11-month-old children detected changes to animate objects in an image more reliably than they detected changes to inanimate objects. During each trial, infants were habituated to an image of a natural scene. Once the infant habituated, the scene was replaced by a scene that was identical except that a target object was removed. Infants dishabituated significantly more often if an animate target had been removed from the scene. Dishabituation results suggested that infants, like adults, preferentially attend to animate rather than to inanimate objects.
“Awake” Spinal Cord Monitoring Under Local Anesthesia and Conscious Sedation in Fenestrated and Branched Endovascular Aortic Repair
Authors: Abisi Said , Musto Liam , Lyons Oliver , Carmichael Michelle , Sallam Morad , Gkoutzios Panos , Zayed Hany , Puchakayala Madhusudan
Published: June 2021

Introduction

Endovascular repair of thoracoabdominal aortic aneurysms carries a risk of spinal cord ischemia, the causes of which remain uncertain. We hypothesized that local anesthesia (LA) with conscious sedation could abrogate the potential suppressive cardiovascular effects of general anesthesia (GA) and facilitate intraoperative monitoring of neurological function. Here, we examine the feasibility of this technique during fenestrated (FEVAR) or branched endovascular aortic repair (BEVAR).

Materials and Methods

Consecutive patients undergoing FEVAR or BEVAR under LA and conscious sedation by a team at a single center were analyzed. Patients received conscious sedation using intravenous remifentanil and propofol infusions in conjunction with a local anesthetic agent. No patient had a prophylactic spinal drain inserted. Outcome measures included conversion to GA, need for vasopressors and/or spinal drainage, length of stay, complications, and patient survival.

Results

A total of 44 patients underwent FEVAR or BEVAR under LA and conscious sedation. The cohort included thoracoabdominal aortic aneurysms (n=41) and pararenal aneurysms treated with endografts covering the supraceliac segment (n=3). Four patients (9%) required conversion to GA at a median operative duration of 198 minutes (range 97–495 minutes). Vasopressors were required intraoperatively in 3 of the cases that were converted to GA. No patient developed spinal cord ischemia and none had insertion of a spinal drain. The median hospital length of stay was 4 days (range 2–41 days). Postoperative delirium and hospital-acquired pneumonia was seen in 7% of patients. All patients survived to 30 days, with 95% alive at a median follow-up of 15 months (range 3–26 months).

Conclusion

LA and conscious sedation is a feasible anesthetic technique for the endovascular repair of thoracoabdominal aortic aneurysms.
“Hurricane-like” Presentation of a Recurrent Marjolin's Ulcer in a Young Female
Authors: Goswami Aakansha G. , Basu Somprakas , Shukla Vijay K.
Published: June 2021

Marjolin’s ulcer (MU) with rapid progression and multiple distant metastases is rare. We report a case of an MU of the thigh developing in a postburn scar, which after successful R0 resection developed multiple bony and visceral metastasis to femur, vertebra, skull, lung, and liver within 3 months of excision. We highlight the “hurricane-like” recurrence in an MU, which is unusual for the metachronous disease. We stress that MUs, unlike conventional wisdom, need a thorough metastatic workup at presentation, and prognostication of a possible rapidly progressive course after surgery which may lead to grave prognosis and mortality.
Reflections on volunteer nurses' work and caring experiences during COVID-19: a phenomenological study
Authors: Chung Loretta Yuet Foon , Han Lin , Du Yifei , Liu Libo
Published: June 2021

Background

With epidemics emerging at a hastened pace, a phenomenological study allows researchers to cast aside their perceptions to understand nurses’ lived experiences, and from there to discover previously unavailable insights at the epicentre of a pandemic.

Aims

To understand volunteer nurses’ lived experiences in Wuhan.

Methods

A descriptive phenomenological study with a purposive sampling strategy was used to describe volunteer nurses’ experiences in Wuhan. Interviews continued until data saturation. Ten semi-structured interviews of 30 to 60 minutes duration were conducted from 27 to 30 March 2020. The narrative data were audiotaped, transcribed and analysed using Colaizzi’s method.

Results

Four themes emerged: mission and challenges denoted the participants’ realisation of the grim challenges ahead; challenges called for actions that described the concerted actions through partnerships and familial bonds; caring acts from all around revealed an external support system; and actions that made a difference portrayed the interplay of actions with feelings, thoughts and further actions to accomplish the mission.

Conclusions

This phenomenological study showed the interplay of nurses’ intentions and actions, and ‘actions speak louder than words’ when nurses were motivated by workmates’ actions to change their feelings, thoughts and actions. The concerted efforts can be used to develop educational programmes, management strategies and institutional policy on structure, system and resource utilisation, as well as dissemination of scientific knowledge to global healthcare workers and the public.
Organozinc-mediated direct cross-coupling under microwave irradiation
Authors: Li Chun-Jing
Published: June 2021

We report a direct cross-coupling reaction between (het)aryl pivalates/tosylates and di(het)arylzinc species in 2-methyltetrahydrofuran/ N-methyl pyrrolidone (1:1), which occurs via C–O bond cleavage under microwave irradiation. The reaction takes place smoothly in short reaction times without the addition of any catalyst or ligand. The reaction is suitable for a broad scope of substrates and exhibits good functional group compatibility, utilizes a simple work-up procedure, and gives the desired products in high purity.
The status and progress of first-line treatment against Helicobacter pylori infection: a review
Authors: Liu Caiqi , Wang Yuan , Shi Jiaqi , Zhang Chunhui , Nie Jianhua , Li Shun , Zheng Tongsen
Published: June 2021

Helicobacter pylori (HP) is a major causative agent of chronic gastritis and peptic ulcer. HP is also engaged in the development of gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma. It is an important pathogenic factor in various other systemic diseases, such as vitamin B12 deficiency, iron deficiency, and idiopathic thrombocytopenia. The current consensus is that unless there is a special reason, eradication therapy should be implemented whenever HP infection is found, and it is ideally successful the first time. International guidelines recommend that under certain conditions, treatment should be personalized based on drug susceptibility testing. However, drug susceptibility testing is often not available because it is expensive, time-consuming, and difficult to obtain living tissue. Each region has separately formulated guidelines or consensuses on empirical therapy. Owing to an increasing drug resistance rate in various places, the eradication rate of proton pump inhibitor (PPI) triple therapy and sequential therapy has been affected. These regimens are rarely used; the PPI triple especially has been abandoned in most areas. Currently, radical treatment regimens for HP involve bismuth-containing quadruple therapy and concomitant therapy. However, quadruple therapy has its own limitations, such as complex drug administration. To improve the effectiveness, safety, and compliance, many clinical studies have proposed useful modified regimens, which mainly include the modified bismuth-containing quadruple regimen, high-dose dual therapy, and vonoprazan-containing regimens. Studies have shown that these emerging regimens have acceptable eradication rates and safety, and are expected to become first-line treatments in empirical therapy. However, the problem of decline in the eradication rate caused by drug resistance has not been fundamentally solved. This review not only summarizes the effectiveness of mainstream regimens in the first-line treatment of HP infection with the currently increasing antibiotic resistance rates, but also summarizes the effectiveness and safety of various emerging treatment regimens.
You start where you are: Literary spaces of Palestine solidarity
Authors: Bernard Anna
Published: June 2021

This essay discusses the contributions that three of the most prominent diasporic Palestinian Anglophone spoken word poets—Suheir Hammad (US), Remi Kanazi (US), and Rafeef Ziadah (Tunisia/Canada/UK)—have made to a contemporary literature of Palestine solidarity, in relation to the tension between liberationist and humanitarian articulations of solidarity that characterizes many contemporary appeals for solidarity with Palestine. I focus on their political and stylistic commitment to plain speaking, an approach that distances their work from the stylistic conventions of human rights advocacy and literary modernism, which both tend to discourage the explicit articulation of political belief. These poets demand that the listener/reader “start where you are,” as Hammad puts it, and conceive of the Palestine solidarity movement as part of a global liberation struggle in which we are all implicated. An examination of how each poet constructs the solidarity relation through their creative uses of analogy, address, voice, and performance helps us to see how this forthright invitation to the listener/reader works in practice.
Histological scores and tumor size on stage II in adrenocortical carcinomas
Authors: Oliveira Rui Caetano , Martins Maria João , Moreno Carolina , Almeida Rui , Carvalho João , Teixeira Paulo , Teixeira Miguel , Silva Edgar Tavares , Paiva Isabel , Figueiredo Arnaldo , Cipriano Maria Augusta
Published: June 2021

Adrenocortical carcinomas (ACC) are aggressive tumors with a poor prognosis. Histological scores are advised for the diagnosis, however, there are borderline cases that may be misjudged as adrenocortical adenomas (ACA). The three main scores used are: Weiss Modified System (WMS), Reticulin Algorithm (RA), and Helsinki Score (HS). We intend to compare the accuracy of the three scores in ACC diagnosis and to identify predictive factors of overall survival (OS). Retrospective study (2004–2016) at Centro Hospitalar e Universitário de Coimbra of the adrenal tumors, classified as ACC or ACA, with a history of posterior tumor relapse/metastases, without lesions in the contralateral adrenal gland: 13F and 6M, with a median age of 51 ± 12.41 years. Nodules’ median size was 9.20 ± 6.2 cm. Patients had a median OS of 52 ± 18.6 months, with 57.9% and 46.3%, at 3 and 5 years. Seven patients had local recurrence and nine had metastases. Thirteen cases were in stage II. The WMS and the HS allowed a diagnosis of ACC in 15 cases and the RA defined ACC in 17 cases. All cases had, at least, focal disruption of the reticulin framework. More than 5 mitosis/50 HPF was associated with worse OS: 49.67 ± 21.43 versus 108.86 ± 14.02 months ( p = 0.026). In patients with stage II, tumor size ⩾10 cm was associated with worse OS: 19.25 ± 7.15 versus 96.11 ± 16.7 months ( p = 0.007), confirmed by multivariate analysis ( p = 0.031). The correct diagnosis of ACC is a pathologist responsibility. The RA seems the most accurate. Any loss of the reticulin framework should raise awareness for malignancy. In patients on stage II, a size ⩾10 cm is a predictor of worse prognosis.
Developing a digital health strategy for people who use drugs: Lessons from COVID-19
Authors: Perri Melissa , Guta Adrian , Gagnon Marilou , Bonn Matt , Leece Pamela , Bayoumi Ahmed M , Rai Nanky , Touesnard Natasha , Strike Carol
Published: June 2021

COVID-19 has significantly exacerbated negative health and social outcomes for people who use drugs (PWUD) around the world. The closure of harm reduction services, ongoing barriers to employment and housing, and pre-existing physical and mental health conditions have increased harms for diverse communities of PWUD. Adapting current models of health and human service delivery to better meet the needs of PWUD is essential in minimizing not only COVID-19 but also drug-related morbidity and mortality. This article draws on research, practice, and advocacy experiences, and discusses the potential for digital health tools such as remote monitoring and telecare to improve the continuum of care for PWUD. We call for a digital health strategy for PWUD and provide recommendations for future program development and implementation.
Long-Segmental Posterior Fusion Combined With Vertebroplasty and Wiring: Alternative Surgical Technique for Kummell’s Disease With Neurologic Deficits – A Retrospective Case Series
Authors: Park Hyung-Youl , Kim Ki-Won , Ryu Ji-Hyun , Yoon S. Tim , Baek In-Hwa , Jang Tae-Yang , Lee Jun-Seok
Published: June 2021

Purpose:

Various surgical methods have been reported for Kummell’s disease with neurologic deficits. The aim of this study was to introduce long-segmental posterior fusion (LPF) combined with vertebroplasty (VP) and wiring as an alternative surgical technique.

Material and Methods:

We retrospectively analyzed 10 patients undergoing posterior decompression and LPF combined with VP and wiring for Kummell’s disease with neurologic deficits from January 2011 to December 2014. The radiologic outcomes included the local kyphotic angle (LKA) and vertebral wedge angle (VWA). Clinical outcomes, including the visual analog scale (VAS), the Oswestry Disability Index (ODI) and the Frankel grade were assessed. Surgery-related complications were also evaluated.

Results:

The mean age of the included patients was 77 ± 8 years with a mean follow-up period of 31.4 ± 4.9 months and a mean bone mineral density of −3.5 ± 0.7 (T-score). The mean operation time was 220 ± 32.3 minutes with a mean blood loss of 555 ± 125.7 mL. The preoperative LKA and VWA were significantly corrected postoperatively (37.9 ± 8.7° vs. 15.3 ± 5.3°, p = 0.005 for LKA; 21.3 ± 5.1° vs. 7.6 ± 2.8°, p = 0.005 for VWA) without a loss of correction at the last follow-up. The VAS and ODI were also significantly improved (7.7 ± 1.1 vs. 3.0 ± 1.6, p = 0.007 for VAS; 90.3 ± 8.9 vs. 49.6 ± 22.7, p = 0.007 for ODI). The Frankel grade of all patients was improved by at least 1 or 2 grades at the last follow-up. Surgery-related complications such as intraoperative cement leakage and implant loosening during the follow-up were not observed.

Conclusions:

LPF combined with VP and wiring might be an effective surgical option for Kummell’s disease with neurologic deficits, especially for the elderly patients with morbidities.

Level of Evidence:

level IV.
Pravastatin-Induced Acute Pancreatitis: A Case Report and Literature Review
Authors: Tarar Zahid Ijaz , Zafar Muhammad Usman , Ghous Ghulam , Farooq Umer , Shoukat Hafiz Muhammad Hassan
Published: June 2021

Pancreatitis is inflammation of pancreas associated most commonly with chronic alcoholism and gallstones. Other less common causes of pancreatitis are hyperlipidemia, infections, surgery, trauma, post endoscopic retrograde cholangiopancreatography, and drugs. Drugs are now increasingly recognized as a cause of pancreatitis, and high suspicion and exclusion of other most common causes is required before considering drug-induced pancreatitis. There are few case reports of acute pancreatitis in the literature after statin use, but out of these, only 3 are after starting pravastatin. We are reporting a case of 49-year-old male who presented with nausea, vomiting, and abdominal pain. His laboratory findings were significant for lipase more than 10 000 on admission, and computed tomography scan of abdomen was showing peripancreatic fat stranding and inflammation. After exclusion of most common causes of pancreatitis, pravastatin was found probable culprit for his symptoms, which he started taking 2 weeks ago. We also reviewed the literature on statins-induced acute pancreatitis. With increased uses of statins, physician need to be vigilant to suspect statins as a culprit in cases of pancreatitis with unknown etiology. Prompt discontinuation of statins is required in these cases.
The Lasting Legacy of Rudine Sims Bishop: Mirrors, Windows, Sliding Glass Doors, and More
Authors: McNair Jonda C. , Edwards Patricia A.
Published: June 2021

This essay profiles Dr. Rudine Sims Bishop, the 2020 Distinguished Scholar Lifetime Achievement Award recipient. It begins with biographical information about Bishop and her career trajectory in education followed by descriptions of three of her landmark works and the ways a sampling of scholars have utilized and expanded upon them. The three works are the book Shadow and Substance: Afro-American Experience in Contemporary Children’s Fiction, an article titled “Strong Black Girls: A Ten Year Old Responds to Fiction About Afro-Americans,” and the groundbreaking article “Mirrors, Windows, and Sliding Glass Doors.” The essay concludes with thoughts from various individuals about the ways her scholarship has impacted them and the field.
Transcript annotation tool (TransAT): an R package for retrieving annotations for transcript-specific genetic variants
Authors: Shih Ching-Yu , Chattopadhyay Amrita , Wu Chien-Hui , Tien Yu-Wen , Lu Tzu-Pin
Published: June 2021

Background

An individual’s genetics play a role in how RNA transcripts are generated from DNA and consequently in their translation into protein. Transcriptional and translational profiling of patients furnishes the information that a specific marker is present; however, it fails to provide evidence whether the marker correlates with response to a therapeutic agent. A comparative analysis of the frequency of genetic variants, such as single nucleotide polymorphisms (SNPs), in diseased and general populations can identify pathogenic variants in individual patients. This is in part because SNPs have considerable effects on protein function and gene expression when they occur in coding regions and regulatory sequences, respectively. Therefore, a tool that can help users to obtain the allele frequency for a corresponding transcript is the need of the day. Several annotation tools such as SNPnexus and VariED are publicly available; however, none of them can use transcript IDs as input and provide the corresponding genomic positions of variants.

Results

In this study, we developed an R package, called transcript annotation tool (TransAT), that provides (i) SNP ID and genomic position for a user-provided transcript ID from patients, and (ii) allele frequencies for the SNPs from publicly available global populations. All data elements are extracted, collected, and displayed in an easily downloadable format in two simple command lines. TransAT is available on Windows/Linux/MacOS and is operative for R version 4.0.4 or later. It is available at https://github.com/ShihChingYu/TransAT and can be downloaded and installed using devtools::install_github("ShihChingYu/TransAT", force=T) on the R execution page. Thereafter, all functions can be executed by loading the package into R with library(TransAT).

Conclusions

TransAT is a novel tool that seamlessly provides genetic annotations for queried transcripts. Such easily obtainable information would be greatly advantageous for physicians, assisting them to make individualized decisions about specific drug treatments. Moreover, allele frequencies from user-chosen global ethnic populations will highlight the importance of ethnicity and its effect on patient pathogenicity.
DNA methylation-based sex classifier to predict sex and identify sex chromosome aneuploidy
Authors: Wang Yucheng , Hannon Eilis , Grant Olivia A. , Gorrie-Stone Tyler J. , Kumari Meena , Mill Jonathan , Zhai Xiaojun , McDonald-Maier Klaus D. , Schalkwyk Leonard C.
Published: June 2021

Background

Sex is an important covariate of epigenome-wide association studies due to its strong influence on DNA methylation patterns across numerous genomic positions. Nevertheless, many samples on the Gene Expression Omnibus (GEO) frequently lack a sex annotation or are incorrectly labelled. Considering the influence that sex imposes on DNA methylation patterns, it is necessary to ensure that methods for filtering poor samples and checking of sex assignment are accurate and widely applicable.

Results

Here we presented a novel method to predict sex using only DNA methylation beta values, which can be readily applied to almost all DNA methylation datasets of different formats (raw IDATs or text files with only signal intensities) uploaded to GEO. We identified 4345 significantly (p<0.01) sex-associated CpG sites present on both 450K and EPIC arrays, and constructed a sex classifier based on the two first principal components of the DNA methylation data of sex-associated probes mapped on sex chromosomes. The proposed method is constructed using whole blood samples and exhibits good performance across a wide range of tissues. We further demonstrated that our method can be used to identify samples with sex chromosome aneuploidy, this function is validated by five Turner syndrome cases and one Klinefelter syndrome case.

Conclusions

This proposed sex classifier not only can be used for sex predictions but also applied to identify samples with sex chromosome aneuploidy, and it is freely and easily accessible by calling the ‘estimateSex’ function from the newestwateRmelonBioconductor package (https://github.com/schalkwyk/wateRmelon).
Lung ultrasound predicts clinical course but not outcome in COVID-19 ICU patients: a retrospective single-center analysis
Authors: Stecher Stephanie-Susanne , Anton Sofia , Fraccaroli Alessia , Götschke Jeremias , Stemmler Hans Joachim , Barnikel Michaela
Published: June 2021

Background

Point-of-care lung ultrasound (LU) is an established tool in the first assessment of patients with coronavirus disease (COVID-19). Purpose of this study was to evaluate the value of lung ultrasound in COVID-19 intensive care unit (ICU) patients in predicting clinical course and outcome.

Methods

We analyzed lung ultrasound score (LUS) of all COVID-19 patients admitted from March 2020 to December 2020 to the Internal Intensive Care Unit, Ludwig-Maximilians-University (LMU) of Munich. LU was performed according to a standardized protocol at ICU admission and in case of clinical deterioration with the need for intubation. A normal lung scores 0 points, the worst LUS has 24 points. Patients were stratified in a low (0–12 points) and a high (13–24 points) lung ultrasound score group.

Results

The study included 42 patients, 69% of them male. The most common comorbidities were hypertension (81%) and obesity (57%). The values of pH (7.42 ± 0.09 vs 7.35 ± 0.1; p = 0.047) and paO2 (107 [80–130] vs 80 [66–93] mmHg; p = 0.034) were significantly reduced in patients of the high LUS group. Furthermore, the duration of ventilation (12.5 [8.3–25] vs 36.5 [9.8–70] days; p = 0.029) was significantly prolonged in this group. Patchy subpleural thickening (n = 38; 90.5%) and subpleural consolidations (n = 23; 54.8%) were present in most patients. Pleural effusion was rare (n = 4; 9.5%). The median total LUS was 11.9 ± 3.9 points. In case of clinical deterioration with the need for intubation, LUS worsened significantly compared to baseline LU. Twelve patients died during the ICU stay (29%). There was no difference in survival in both LUS groups (75% vs 66.7%, p = 0.559).

Conclusions

LU can be a useful monitoring tool to predict clinical course but not outcome of COVID-19 ICU patients and can early recognize possible deteriorations.
The impact of multimodal analgesia based enhanced recovery protocol on quality of recovery after laparoscopic gynecological surgery: a randomized controlled trial
Authors: Geng Zhiyu , Bi Hui , Zhang Dai , Xiao Changji , Song Han , Feng Ye , Cao Xinni , Li Xueying
Published: June 2021

Background

Our objective was to evaluate the impact of multimodal analgesia based enhanced recovery protocol on quality of recovery after laparoscopic gynecological surgery.

Methods

One hundred forty female patients scheduled for laparoscopic gynecological surgery were enrolled in this prospective, randomized controlled trial. Participants were randomized to receive either multimodal analgesia (Study group) or conventional opioid-based analgesia (Control group). The multimodal analgesic protocol consists of pre-operative acetaminophen and gabapentin, intra-operative flurbiprofen and ropivacaine, and post-operative acetaminophen and celecoxib. Both groups received an on-demand mode patient-controlled analgesia pump containing morphine for rescue analgesia. The primary outcome was Quality of Recovery-40 score at postoperative day (POD) 2. Secondary outcomes included numeric pain scores (NRS), opioid consumption, clinical recovery, C-reactive protein, and adverse events.

Results

One hundred thirty-eight patients completed the study. The global QoR-40 scores at POD 2 were not significantly different between groups, although scores in the pain dimension were higher in Study group (32.1 ± 3.0 vs. 31.0 ± 3.2,P = 0.033). In the Study group, NRS pain scores, morphine consumption, and rescue analgesics in PACU (5.8% vs. 27.5%;P = 0.0006) were lower, time to ambulation [5.0 (3.3–7.0) h vs. 6.5 (5.0–14.8) h;P = 0.003] and time to bowel function recovery [14.5 (9.5–19.5) h vs.17 (13–23.5) h;P = 0.008] were shorter, C-reactive protein values at POD 2 was lower [4(3–6) ng/ml vs. 5 (3–10.5) ng/ml;P = 0.022] and patient satisfaction was higher (9.8 ± 0.5 vs. 8.8 ± 1.2,P = 0.000).

Conclusion

For minimally invasive laparoscopic gynecological surgery, multimodal analgesia based enhanced recovery protocol offered better pain relief, lower opioid use, earlier ambulation, faster bowel function recovery and higher patient satisfaction, while no improvement in QoR-40 score was found.

Trial registration

ChiCTR1900026194; Date registered: Sep 26,2019.
Detection of diarrhoea associated rotavirus and co-infection with diarrhoeagenic pathogens in the Littoral region of Cameroon using ELISA, RT-PCR and Luminex xTAG GPP assays
Authors: Ghapoutsa Rahinatou N. , Boda Maurice , Gautam Rashi , Ndze Valantine Ngum , Mugyia Akongnwi E. , Etoa Francois-Xavier , Bowen Michael D. , Esona Mathew D.
Published: June 2021

Background

Despite the global roll-out of rotavirus vaccines (RotaTeq/Rotarix / ROTAVAC/Rotasiil), mortality and morbidity due to group A rotavirus (RVA) remains high in sub-Saharan Africa, causing 104,000 deaths and 600,000 hospitalizations yearly. In Cameroon, Rotarix™ was introduced in March 2014, but, routine laboratory diagnosis of rotavirus infection is not yet a common practice, and vaccine effectiveness studies to determine the impact of vaccine introduction have not been done. Thus, studies examining RVA prevalence post vaccine introduction are needed. The study aim was to determine RVA prevalence in severe diarrhoea cases in Littoral region, Cameroon and investigate the role of other diarrheagenic pathogens in RVA-positive cases.

Methods

We carried out a study among hospitalized children < 5 years of age, presenting with acute gastroenteritis in selected hospitals of the Littoral region of Cameroon, from May 2015 to April 2016. Diarrheic stool samples and socio-demographic data including immunization and breastfeeding status were collected from these participating children. Samples were screened by ELISA (ProSpecT™ Rotavirus) for detection of RVA antigen and by gel-based RT-PCR for detection of the VP6 gene. Co-infection was assessed by multiplexed molecular detection of diarrheal pathogens using the Luminex xTAG GPP assay.

Results

The ELISA assay detected RVA antigen in 54.6% (71/130) of specimens, with 45, positive by VP6 RT-PCR and 54, positive using Luminex xTAG GPP. Luminex GPP was able to detect all 45 VP6 RT-PCR positive samples. Co-infections were found in 63.0% (34/54) of Luminex positive RVA infections, with Shigella (35.3%; 12/34) and ETEC (29.4%; 10/34) detected frequently. Of the 71 ELISA positive RVA cases, 57.8% (41/71) were fully vaccinated, receiving two doses of Rotarix.

Conclusion

This study provides insight on RVA prevalence in Cameroon, which could be useful for post-vaccine epidemiological studies, highlights higher than expected RVA prevalence in vaccinated children hospitalized for diarrhoea and provides the trend of RVA co-infection with other enteric pathogens. RVA genotyping is needed to determine circulating rotavirus genotypes in Cameroon, including those causing disease in vaccinated children.
The global prevalence of familial multiple sclerosis: an updated systematic review and meta-analysis
Authors: Ehtesham Naeim , Rafie Maryam Zare , Mosallaei Meysam
Published: June 2021

Background

Considering that many recent studies have reported the prevalence of familial multiple sclerosis (FMS), we performed an updated meta-analysis of the worldwide prevalence of FMS by the addition of recent publications.

Methods

A search in PubMed, Scopus, the ISI Web of Science, and Google Scholar was undertaken up to 20 December 2020. The inclusion criteria were based on the CoCoPop approach (condition, context, and population). Meta-analysis of the qualified studies was conducted by comprehensive meta-analysis ver. 2 software.

Results

The pooled prevalence of MS in relatives of 16,179 FMS cases was estimated to be 11.8% (95% CI: 10.7–13) based on a random-effects model. The pooled mean age of disease onset in adult probands was calculated to be 28.7 years (95% CI: 27.2 ± 30.2). Regarding 13 studies that reported the data of FMS in pediatrics (n = 877) and adults (n = 6636), the FMS prevalence in pediatrics and adults was 15.5% (95% CI: 13.8–17.4) and 10.8% (95% CI: 8.1–14.2), respectively. The prevalence of FMS in affected males (n = 5243) and females (n = 11,503) was calculated to be 13.7% (95% CI: 10.1–18.2) and 15.4% (95% CI: 10.3–22.4), respectively. The odds ratio of male/female in FMS cases was not statistically significant (OR = 0.9; 95% CI: 0.6–1.2, P = 0.55). Subgroup analysis demonstrated a significant difference in the prevalence of FMS between the geographical areas (P = 0.007). The meta-regression model indicated that the prevalence of FMS is lower with higher latitude and higher MS prevalence (P < 0.001). In contrast, meta-regression based on prevalence day was not statistically significant (P = 0.29).

Conclusions

The prevalence of FMS is higher in the pediatric group than that of adults, distinct between geographical areas, and diminishes with the increment of MS prevalence and latitude. Also, the symptoms initiate relatively at younger ages in the FMS cases. Interestingly, our analysis unveiled that FMS is not more prevalent in men than women and the risk of MS development in relatives is not higher when the affected proband is male.
Amniotic band syndrome in a monochorionic diamniotic twin pregnancy after rupture of the dividing membrane in the early second trimester: A case report
Authors: Nakashima Mizuki , Iizuka Takashi , Kagami Kyosuke , Yamazaki Rena , Ono Masanori , Fujiwara Hiroshi
Published: June 2021

Background

Amniotic band syndrome is a rare phenomenon, but it can result in serious complications. We report herein our experience of amniotic band syndrome in a monochorionic diamniotic twin pregnancy where rupture of the dividing membrane occurred early in the second trimester.

Case Presentation

A 29-year-old nulliparous woman was referred to us for management of her monochorionic diamniotic twin pregnancy at 10 weeks of gestation. When we were unable to identify a dividing membrane at 15 weeks of gestation using two-dimensional ultrasonography, we used three-dimensional ultrasonography to confirm its absence. Both modalities showed that the left arm of baby B was swollen and attached to a membranous structure originating from the placenta at 18 weeks of gestation. Tangled umbilical cords were noted on magnetic resonance imaging at 18 weeks of gestation. Emergency cesarean delivery was performed at 30 weeks of gestation because of the nonreassuring fetal status of baby A. The left arm of baby B had a constrictive ring with a skin defect. Both neonates had an uncomplicated postnatal course and were discharged around 2 months after delivery.

Conclusions

Attention should be paid to the potential for amniotic band syndrome if rupture of the dividing membrane between twins is noted during early gestation.
Brigatinib versus other second-generation ALK inhibitors as initial treatment of anaplastic lymphoma kinase positive non-small cell lung cancer with deep phenotyping: study protocol of the ABP trial
Authors: Christopoulos Petros , Bozorgmehr Farastuk , Brückner Lena , Chung Inn , Krisam Johannes , Schneider Marc A. , Stenzinger Albrecht , Eickhoff Regina , Mueller Daniel W. , Thomas Michael
Published: June 2021

Background

Availability of potent anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKI) has pushed the median survival of ALK+ non-smallcell lung cancer (NSCLC) patients to over five years. In particular, second-generation ALK TKI have demonstrated superiority compared to the first-generation compound crizotinib and are meanwhile standard first-line treatment. However, clinical courses of individual patients vary widely, with secondary development of drug resistance and intracranial progression remaining important problems. While these limitations highlight the need for better disease monitoring and additional therapeutic tools, molecular tumor features are increasingly recognized as crucial determinants of clinical outcome. This trial aims to optimize management of ALK+ NSCLC by analyzing the efficacy of second-generation ALK inhibitors in conjunction with deep longitudinal phenotyping across two treatment lines.

Methods/design

In this exploratory prospective phase II clinical trial, newly diagnosed ALK+ NSCLC patients will be randomized into two treatment arms, stratified by presence of brain metastases and ECOG performance status: brigatinib (experimental arm) vs. any other approved second-generation ALK TKI. Tumor tissue and blood samples will be collected for biomarker analysis at the beginning and throughout the study period to investigate baseline molecular tumor properties and analyze the development of acquired drug resistance. In addition, participating investigators and patients will have the possibility of fast-track molecular tumor and ctDNA profiling at the time of disease progression using state-of-the-art next-generation sequencing (NGS), in order to support decisions regarding next-line therapy.

Discussion

Besides supporting therapeutic decisions for enrolled patients, the ABP trial primarily aims to deepen the understanding of the underlying biology and facilitate development of a framework for individualized management of ALK+ NSCLC according to molecular features. Patients with low molecular risk and the perspective of a “chronic disease” will be distinguished from “high-risk” cases, molecular properties of which will be utilized to elaborate improved methods of non-invasive monitoring and novel preclinical models in order to advance therapeutic strategies.

Trial registration

Clinicaltrials.gov, NCT04318938. Registered March 182,020, https://www.clinicaltrials.gov/ct2/show/NCT04318938

Eudra-CT, 2019–001828-36. Registered September 302,019, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2019-001828-36
Correlation between intraocular pressure reduction and anterior chamber aqueous flare after micropulse transscleral cyclophotocoagulation
Authors: Kimura Akitoshi , Nakashima Kei-Ichi , Inoue Toshihiro
Published: June 2021

Background

Micropulse transscleral cyclophotocoagulation (MP-CPC) is a technique that has been approved in recent years to treat glaucoma. MP-CPC causes anterior chamber inflammation; a relationship with reduced intraocular pressure (IOP) has not been reported. Therefore, we analyzed the correlation between IOP and anterior chamber aqueous flare after MP-CPC.

Methods

This retrospective study included 37 eyes of 37 patients who underwent MP-CPC between November 2018 and October 2020. IOP and flare values were measured at 1, 4, and 12 weeks after MP-CPC. Correlations were assessed between the percentage IOP reduction and flare elevation by calculating Spearman’s rank correlation coefficient.

Results

The percentage IOP reduction at 1 week after surgery was correlated with the flare elevation at 1 week after surgery (ρ = 0.47, P = 0.006). The percentage IOP reduction at 12 weeks after surgery was correlated with the flare elevation at 4 weeks after surgery (ρ = 0.53, P = 0.006).

Conclusions

A short-term correlation was implied between reduced IOP and flare elevation after MP-CPC.
Type 2 sclerotic Modic change affect fusion result in patients undergoing PLIF with pedicle screw instrumentation: a retrospective study
Authors: Li Hao , Chen Shou , Wei He-Yu , Han Chuang-Ye , Zeng Fan-Yue , Yuan Shuang-Shuang , Qin Hong-Yu , Yang Jin-Song
Published: June 2021

Background

Bony fusion rate was significantly lower in patients with type 3 Modic change than patients with normal endplates. It is not known whether there are relevant differences in fusion efficiency among patients with type 2 sclerotic Modic change or non-sclerotic Modic change, or no Modic change.

Methods

A retrospective study contained 196 lumbar segments in 123 subjects undergoing posterior lumbar interbody fusion (PLIF) with pedicle screw instrumentation (PSI) to assess the effect of type 2 sclerotic Modic change on fusion efficiency. These endplates were allocated into groups A, B, and C, according to their Modic changes. Group A had endplates with type 2 Modic change and endplate sclerosis. Group B had type 2 Modic change without endplate sclerosis. Group C had neither Modic change nor endplate sclerosis. The presence of Modic change was determined by magnetic resonance imaging (MRI). Endplate sclerosis in type 2 Modic change was detected by computed tomography (CT) before the operation. We collected CT data 3 months to more than 24 months after operation in patients to assess bony fusion.

Results

Incidences of bony fusion were 58.8% in group A, 95.0% in group B, 94.3% in group C. The bony fusion rate was significantly lower in group A than in either group B or C. There was no significant difference between groups B and C. Thus, endplates with type 2 sclerotic Modic change had a lower fusion rate in patients undergoing PLIF with PSI.

Conclusion

Type 2 sclerotic Modic change could be an important factor that affects solid bony fusion in patients undergoing PLIF with PSI. CT may help diagnose endplate sclerosis in patients with type 2 change and inform the choice of the best site for spinal fusion.
Effects of a medical second opinion programme on patients’ decision for or against knee arthroplasty and their satisfaction with the programme
Authors: Weigl Martin , Pietzner Jens , Kisch Rebecca , Paulus Alexander , Jansson Volkmar , Grill Eva
Published: June 2021

Background

German social legislation gives patients the right to obtain a second opinion before elective surgery and defines quality criteria for reimbursement by statutory health insurances. However, the effects of second opinions before elective surgery are largely unknown. The aim of this study was to evaluate the effects of a second opinion programme in patients recommended for knee arthroplasty.

Methods

The largest statutory health insurance funds in Bavaria offered patients who had been recommended to have knee arthroplasty the opportunity to partake in a second opinion programme which consisted of an in person presentation to an experienced knee surgeon. In this cohort study, consecutive patients from this second opinion programme who signed informed consent were included from 07/10/2016 to 14/02/2020. Data were collected before and after the second opinion visit.

Results

A total of 141 (66%) of 215 patients who presented for a second opinion participated in the evaluation study. The second opinion physician recommended knee arthroplasty to 40% of the patients, later knee arthroplasty if the conditions worsened to 40%, and no knee arthroplasty to 20%. After receiving the second opinion 28 of 56 (41%) undecided patients preferred knee arthroplasty, 14 no knee arthroplasty, 14 remained undecided. Four of 46 patients with a preference for “arthroplasty” changed their decision to “no arthroplasty”, five of 35 patients from “no arthroplasty” to “arthroplasty”. The patients were more confident in their decision according to the decision confidence scale (before: 5.4 ± 3.0; after: 7.8 ± 2.5; p < 0.001). They rated their satisfaction with the second opinion programme with a mean grade of 1.35 (± 0.60) (best:1; worst:6). Logistic regression analyses showed that the recommendation of the second opinion physician for joint arthroplasty was associated with the guideline criteria radiological severity of osteoarthritis (p = 0.001) and knee-joint-specific quality of life (p = 0.041).

Conclusion

The second opinion of an experienced knee surgeon frequently deviates from the initial recommendation for knee arthroplasty. The association of guideline criteria to the second recommendation suggests a high quality of the second opinion. From the patient perspective, the second opinion reduces uncertainties in their treatment decision.
Nicotinamide attenuates streptozotocin-induced diabetes complications and increases survival rate in rats: role of autonomic nervous system
Authors: Cruz Paula L. , Moraes-Silva Ivana C. , Ribeiro Amanda A. , Machi Jacqueline F. , de Melo Marcelo Dantas Tavares , dos Santos Fernando , da Silva Maikon Barbosa , Strunz Celia Maria Cassaro , Caldini Elia Garcia , Irigoyen Maria-Claudia
Published: June 2021

Background

To evaluate the effect of nicotinamide prior to streptozotocin-induced (STZ) diabetes in baroreflex sensitivity and cardiovascular autonomic modulation, and its association with hemodynamics and metabolic parameters.

Methods

Methods: Male Wistar rats were divided into control (Cont) and STZ-induced diabetes (Diab). Half of the rats from each group received a single dose of nicotinamide (100 mg/Kg) before STZ injection (Cont+NicA and Diab+NicA). All groups were followed-up for 5 weeks.

Results

Body weight loss of more than 40% was observed in Diab throughout the period (Diab: 271.00 ± 12.74 g; Diab+NicA: 344.62 ± 17.82). Increased glycemia was seen in Diab rats (541.28 ± 18.68 mg/dl) while Diab+NicA group had a slight decrease (440.87 ± 20.96 mg/dl). However, insulin resistance was observed only in Diab. In relation to Cont, heart rate, mean blood pressure and diastolic function were reduced when compared to Diab, together with parasympathetic modulation and baroreflex sensitivity. All of these parameters were improved in Diab+NicA when compared to Diab. Improved baroreflex sensitivity and parasympathetic modulation were correlated with glycemia, insulin resistance, and body weight mass. Additionally, Diab+NicA group increased survival rate.

Conclusions

Results suggest that the association of nicotinamide in STZ-induced diabetic rats prevents most of the expected derangements mainly by preserving parasympathetic and baroreflex parameters.
Lifestyle modifications after the diagnosis of gynecological cancer
Authors: Paepke Daniela , Wiedeck Clea , Hapfelmeier Alexander , Kiechle Marion , Brambs Christine
Published: June 2021

Background

The influence of lifestyle factors on the quality of life, incidence and tumor recurrence has been evaluated in several studies and is gaining increasing importance in cancer research. However, the extent of the influence of such lifestyle factors on the quality of life of cancer patients remains largely unclear, as does the number of patients actually pursuing these lifestyle changes. The purpose of this study was to examine the prevalence and predictors of lifestyle changes in patients with gynecological cancer.

Methods

The survey consisted of a pseudonymous questionnaire that was conducted from January to May 2014 via a telephone interview with 141 patients with a gynaecological malignancy who had undergone surgery at our Department of Gynaecology and Obstetrics. Lifestyle factors (diet, physical activity, stress level, alcohol and nicotine consumption) prior to and after the diagnosis of cancer were evaluated.

Results

89% (n = 125) of the patients reported lifestyle changes after being diagnosed with cancer. There was a significant association between the implementation of lifestyle changes and age as well as the use of complementary medicine. Nutrition: 66% of the patients (n = 93) consumed more fruit and vegetables and 65% ate less meat (n = 92). Physical activity: 37% (n = 52) reported no change in their exercise routine, 36% (n = 51) described a decrease, 27% (n = 38) an increase in their physical activity. Subjective feeling of stress: 77% of the patients (n = 108) described a reduction in their perceived level of stress. Nicotine consumption: 63% (n = 12) of the 19 patients who were smokers at the time of the diagnosis quit or reduced smoking thereafter. Alcohol consumption: 47% (n = 61/129) of the patients reduced their alcohol consumption.

Conclusions

Most of the patients from our study group implemented lifestyle changes after being diagnosed with cancer. Prospective randomized trials are needed in order to determine the benefit of lifestyle changes (physical activity, dietary habits and stress reduction) for cancer survivors. The potential impact of lifestyle on the quality of life and the trajectory of the disease should be discussed with all oncological patients.