bluuebunny/crossref_metadata_2025 huggingface dataset:
Association Between Age and Nodal Metastasis in Papillary Thyroid Carcinoma
Authors: Shukla Navika , Osazuwa‐Peters Nosayaba , Megwalu Uchechukwu C.
Published: October 2020

Objective

To determine the relationship between age and rate of lymph node metastasis, nodal burden of disease, as well as rate of lateral neck disease in papillary thyroid cancer, especially in patients aged <30 years.

Study Design

Population‐based cross‐sectional study.

Setting

Population‐based cancer database.

Methods

Data were extracted from the SEER 18 database (Surveillance, Epidemiology, and End Results) of the National Cancer Institute. The study cohort included 59,330 patients diagnosed with papillary thyroid cancer between 1988 and 2015. Patients aged 0 to 10 years, 11 to 20 years, and 21 to 30 years old were compared with those >30 years. All analyses were adjusted for sex, race, and T classification.

Results

The overall rate of lymph node metastasis was 26.11%, which increased with decreasing age. Adjusted odds ratios of lymph node metastasis were 7.19 (95% CI, 3.76‐13.75) for the 0‐ to 10‐year‐old group, 3.45 (95% CI, 3.08‐3.87) for the 11‐ to 20‐year‐old group, and 2.28 (95% CI, 2.15‐2.41) for the 21‐ to 30‐year‐old group, relative to the group >30 years old. Decreased age was also associated with increased total positive nodes, increased lymph node ratio, and increased risk of lateral neck disease.

Conclusion

Pediatric and early young adult patients with papillary thyroid carcinoma have a greater risk of lymph node metastasis, greater burden of nodal disease, and a greater risk of lateral neck metastases.
Ethnographic Gameness: Theorizing Extra-methodological Fieldwork Practices in a Study of Outlaw Motorcycle Clubs
Authors: Schmid Christian Johann
Published: October 2020

This article theorizes the fieldwork experiences that I gained while studying outlaw biker subculture. Drawing on Bourdieu’s practice theory and Goffman’s dramaturgical interactionism, I argue that ethnography in practice is pre-disposed by the ethnographer’s primary habitus, which shapes symbolic interaction. To substantiate this claim, I disclose my own upbringing in a troubled working-class family and my personal ties with outlaw bikers, both prior to and beyond my research. This article then illustrates how my habitus helped me to compensate for the vagueness of ethnography in theory with regard to three recurrent issues of fieldwork, which are the practices of (1) approaching/entering the field, (2) negotiating participation, and (3) managing (un)fortunate circumstances. After reflecting on my cleft habitus as the buddy and/or researcher in ethnographic practice, this article concludes with the metaphor of gameness. This concept, which is borrowed from early prize fighting, is used to outline and label the ideal-type of the ethnographer who is well-suited for the immersion into deviant, criminalized, or otherwise culturally elitist fields.
Influence of tip clearance and cavity depth on heat transfer in a cutback squealer tip
Authors: Wang Weijie , Lu Shaopeng , Jiang Hongmei , Deng Qiusheng , Teng Jinfang , Yu Wensheng
Published: October 2020

Numerical simulations are conducted to present the aerothermal performance of a turbine blade tip with cutback squealer rim. Two different tip clearance heights (0.5%, 1.0% of the blade span) and three different cavity depths (2.0%, 3.0%, and 6.0% of the blade span) are investigated. The results show that a high heat transfer coefficient (HTC) strip on the cavity floor appears near the suction side. It extends with the increase of tip clearance height and moves towards the suction side with the increase of cavity depth. The cutback region near the trailing edge has a high HTC value due to the flush of over-tip leakage flow. High HTC region shrinks to the trailing edge with the increase of cavity depth since there is more accumulated flow in the cavity for larger cavity depth. For small tip clearance cases, high HTC distribution appears on the pressure side rim. However, high HTC distribution is observed on suction side rim for large tip clearance height. This is mainly caused by the flow separation and reattachment on the squealer rims.
Between universalism and targeting: Exploring policy pathways for an Australian Basic Income
Authors: Spies-Butcher Ben , Phillips Ben , Henderson Troy
Published: October 2020

Despite growing interest in proposals for a universal basic income, little advance has been made in implementation. Here we explore policy options for an Australian Basic Income. Our analysis responds to concerns that Basic Income is both too expensive and too radical a departure from existing welfare state structures to be a feasible policy option. Drawing on policy and Basic Income scholarship we identify changes to Australia’s current means-tested benefits structures that move substantially towards Basic Income while remaining consistent with historic policy norms, which we call ‘affluence testing’. Using microsimulation we explore fiscal and distributional trade-offs associated with the implementation of an affluence-tested Basic Income. Our results suggest Basic Income has the potential to significantly reduce inequality and poverty while also requiring taxes to rise substantially. Placing these trade-offs in international context we find the policy would reduce inequality to levels similar to Nordic welfare states while increasing overall taxation to approximately the OECD average.
Status of Anaemia and Malaria Co-infection With HIV From HAART Clinics in Federal Capital Territory, Nigeria: A Cross-Sectional Study
Authors: Anyanwu Nneoma Confidence JeanStephanie , Oluwatimileyin David Jesutobi , Sunmonu Peace Temitope
Published: October 2020

Background:

Malaria and HIV are 2 significant infections of critical public health concern globally. Malaria infection is one of the preceding causes of morbidity and mortality in endemic developing countries, and its co-infections in HIV patients worsen prognosis; with anaemia being the most common haematologic outcome of the infections.

Context and Purpose of Study:

This study was aimed at determining the prevalence of anaemia and malaria co-infection among HIV-infected patients attending selected hospitals in Abuja between February and July 2019.

Methods:

A cross-sectional study was carried out to detect malaria in 420 HIV-positive patients who were 12 to 67 years old, using enzyme immunoassay and microscopy. A structured questionnaire was used to capture socio-demographic and risk factors ([Frequency of] Use of Malaria preventive Measures, History of anaemia, Blood type, malaria antecedents, and CD4+ Count) while packed cell volume was checked using micro haematocrit reader to determine anaemia status. Data were analysed using IBM SPSS v25.

Results:

The mean age of the study participants was 37.5 (±12.48). A total of 142 (33.8%) samples were positive for malaria, and 68 of the HIV-infected patients (16.2%) were anaemic; 4.8% of the 420 patients had malaria co-infection and anaemia simultaneously. More male participants had malaria co-infection (36.0%, P = .617) while more female participants had anaemia (22.7%, P = .058). Patients aged 61 to 70 years had the highest rates of malaria and those aged 51 to 60 years were most anaemic. Except for patients with normal CD4+ count, those who were more exposed to the evaluated risk factors were more co-infected and anaemic. Malaria co-infection did not significantly affect the onset of anaemia. Test for the validity of Microscopy against Enzyme Immunoassay (EIA) showed 83.1% sensitivity and 98.6% specificity. No association was observed between the variables and the parasitaemia density of the patients.

Conclusions:

This study highlighted higher rates of malaria co-infection and anaemia among HIV patients when compared with previous reports in the region although co-infection did not significantly affect anaemia status. Given this trend, strategies must be put in place to checkmate these ailments. Population studies are also advocated.
An SVDD-based post-processing approach for vibration risk assessment of the hydro-turbine-generator in a large hydropower station
Authors: Zhang Jinliang , Yang Fengwei , Liang Chao , Zhang Yuansheng , Li Yongchang
Published: October 2020

Due to the frequently occurred adverse vibration of hydraulic structures, vibration risk assessment is significant for the water energy efficiency of hydropower station and the safety of people and structures. Recently, the abnormal vibration of hydro-turbine-generator in a large hydropower station occurred and the main influencing factors of vibration are analyzed based on the prototype data and engineering experience. Different from the deterministic variable features in traditional support vector domain description (SVDD) algorithms, the feature of vibration amplitude is actually a random variable so that the different target objects will be obtained at different confidence levels. In order to assess the vibration range and excessive vibration probability, the original SVDD boundary at relatively low confidence level is firstly calculated. Then, the boundary extension operation with detailed theoretical deduction is performed and the extended boundary is further optimized inspired by path planning problem. The advantage of proposed approach is that it can improve the data fitting performance for single dimension (i.e. vibration amplitude) without leading to complex boundary which cannot be used for vibration risk assessment. By applying this approach to the practical vibration problem, the quantitative and slightly conservative assessment results are conveniently obtained, which indicate that this approach is reasonable and cost-effective.
Readmissions and complications in breast ductal carcinoma in situ: A retrospective study comparing screen- and non-screen-detected patients
Authors: Politi Julieta , Sala María , Domingo Laia , Vernet-Tomas María , Román Marta , Macià Francesc , Castells Xavier
Published: October 2020

Objective:

Population-wide mammographic screening programs aim to reduce breast cancer mortality. However, a broad view of the harms and benefits of these programs is necessary to favor informed decisions, especially in the earliest stages of the disease. Here, we compare the outcomes of patients diagnosed with breast ductal carcinoma in situ in participants and non-participants of a population-based mammographic screening program.

Methods:

A retrospective cohort study of all patients diagnosed with breast ductal carcinoma in situ between 2000 and 2010 within a single hospital. A total of 211 patients were included, and the median follow-up was 8.4 years. The effect of detection mode (screen-detected and non-screen-detected) on breast cancer recurrences, readmissions, and complications was evaluated through multivariate logistic regression analysis.

Results:

In the majority of women, breast ductal carcinoma in situ was screen-detected (63.5%). Screen-detected breast ductal carcinoma in situ was smaller in size compared to those non-screen-detected (57.53% < 20 mm versus 78.03%, p = 0.002). Overall, breast-conserving surgery was the most frequent surgery (86.26%); however, mastectomy was higher in non-screen-detected breast ductal carcinoma in situ (20.78% versus 9.7%, p = 0.024). Readmissions for mastectomy were more frequent in non-screen-detected breast ductal carcinoma in situ. Psychological complications, such as fatigue, anxiety, and depression, had a prevalence of 15% within our cohort. Risk of readmissions and complications was higher within the non-screen-detected group, as evidenced by an odds ratio = 6.25 (95% confidence interval = 1.95–19.99) for readmissions and an odds ratio = 2.41 (95% confidence interval = 1.95–4.86) for complications.

Conclusions:

Our findings indicate that women with breast ductal carcinoma in situ breast cancer diagnosed through population-based breast cancer screening program experience a lower risk of readmissions and complications than those diagnosed outside these programs. These findings can help aid women and health professionals make informed decisions regarding screening.
Toward a Transnational Information Ecology on the Right? Hyperlink Networking among Right-Wing Digital News Sites in Europe and the United States
Authors: Heft Annett , Knüpfer Curd , Reinhardt Susanne , Mayerhöffer Eva
Published: October 2020

The recent rise of a more transnationally networked political right across Europe and the United States has been accompanied by an emerging alternative digital news infrastructure through which information circulates and shared epistemologies are established. This paper examines the extent to which digital news sites on the right are interconnected within and across countries. It further explores which additional sites serve as transnationally shared reference points of such news ecology on a transnational scale. To do so, we investigate hyperlink networks between alternative right-wing online news sites (RNS) in six western democracies (Austria, Germany, United States, United Kingdom, Denmark, Sweden). Our analysis draws on hyperlink data harvested from 65 RNS for three months in 2018. The results show that RNS do establish interlinked alternative right-wing news ecologies, as they connect to likeminded RNS within and across borders. Furthermore, we see substantial variation across countries, where RNS from countries with less established alternative right-wing news infrastructure are more likely to link transnationally to RNS. The United States represents an outlier in that it features the largest and domestically most integrated network of RNS, while U.S. sites function as hubs for transnational connections from European RNS. Apart from connections between RNS, we find that legacy news media are crucial transnationally shared reference points. We conclude that rather than presenting an insulated, alternative sphere, the emerging digital news ecology on the right seeks to link up to the broader information environment across borders.
ADVIA® LabCell™ Provides a Modular System to Manage the Workflow of Samples in Clinical Laboratories
Authors: Campanelli Michael , Mitchell Diane S.
Published: October 2020

The changes in clinical laboratories are occurring at an ever-increasing pace. Cost pressures on healthcare systems continue to escalate and the laboratory remains a target.
Rice straw powder/polylactic acid biocomposites for three-dimensional printing
Authors: Yu Wangwang , Dong Lili , Lei Wen , Shi Jianan
Published: October 2020

The research aim of this work was to understand the effects of the soil burial of rice straw on the morphology and properties of 3D-printed rice straw powder (RSP)/polylactic acid (PLA) biocomposites. The rice straw buried in the soil for various days was grounded and sieved into powder at 120 mesh. The RSP was then mixed with PLA at a mass ratio of 15/100 and the mixture was extruded into filament, followed by a fused deposition modeling 3D printing process. The as-prepared products were characterized in terms of morphological, mechanical, thermal, and nonisothermal crystallization properties. The results show that cavities with large holes induced by fused deposition modeling exhibit on the cross section of RSP/PLA biocomposite. The longer the burial duration of rice straw, the more the cavities with large holes could be observed on the surface. Therefore, soil burial of rice straw improved the thermal stability of the biocomposites while depressing their mechanical properties due to the amplification of the cavities. The crystallinity of the biocomposites was maintained at a low level (<9%) before and after the soil burial process.
Sulfide partial melting and galena–tetrahedrite intergrowth texture: An experimental study
Authors: Govindarao Boddepalli , Pruseth Kamal Lochan , Mishra Biswajit
Published: October 2020

Galena–tetrahedrite intergrowth textures have been observed in some quenched run products of melting experiments conducted at 500 and 600°C in the systems ZnS–PbS–FeS–Cu2S–Sb2S3 and ZnS–PbS–FeS–Cu2S–Sb2S3–As2S3, using the evacuated silica-tube method. At 600°C the intergrowth formed an interface between sulfide melt and galena, whereas at 500°C it existed as inclusions partially embedded or completely embedded within tetrahedrite. At 600°C tetrahedrite was absent in PbS-bearing experiments, instead galena and melt were a part of the equilibrium phase assemblage. From the disposition of the galena–tetrahedrite intergrowths at 500°C it is evident that droplets of galena–tetrahedrite melt coexisted with tetrahedrite or tetrahedrite + galena and gave rise to these intergrowths upon quenching. The intergrowths coexisting with galena probably represent compositions on the galena-rich liquidus in the galena–tetrahedrite binary and those coexisting with tetrahedrite represent points on the tetrahedrite-rich liquidus. A eutectic at galena:tetrahedrite = ~30:70, very close to 500°C is apparent. It is clearly indicated that galena–tetrahedrite intergrowths can be formed by sulfide partial melting, and could be used as a potential indicator of partial melting in metamorphosed sulfide ore deposits.
Genetic inbreeding depression load for morphological traits and defects in the Pura Raza Española horse
Authors: Poyato-Bonilla Julia , Perdomo-González Davinia I. , Sánchez-Guerrero María J. , Varona Luis , Molina Antonio , Casellas Joaquim , Valera Mercedes
Published: October 2020

Background

Inbreeding is caused by mating between related individuals and is associated with reduced fitness and performance (inbreeding depression). Several studies have detected heterogeneity in inbreeding depression among founder individuals. Recently, a procedure was developed to predict hidden inbreeding depression load that is associated with founders using the Mendelian sampling of non-founders. The objectives of this study were to: (1) analyse the population structure and general inbreeding, and (2) test this recent approach for predicting hidden inbreeding depression load for four morphological traits and two morphology defects in the Pura Raza Española (PRE) horse breed.

Results

The regression coefficients that were calculated between trait performances and inbreeding coefficients demonstrated the existence of inbreeding depression. In total, 58,772,533 partial inbreeding coefficients (Fij) were estimated for the whole PRE population (328,706 horses). We selected the descendants of horses with a Fij ≥ 6.25% that contributed to at least four offspring and for which morphological traits were measured for the subsequent analysis of inbreeding depression load (639 horses). A pedigree was generated with the last five generations (5026 animals) used as the reference population (average inbreeding coefficient of 8.39% and average relatedness coefficient of 10.76%). Heritability estimates ranged from 0.08 (cresty neck) to 0.80 (height at withers), whereas inbreeding depression load ratios ranged from 0.01 (knock knee) to 0.40 (length of shoulder), for an inbreeding coefficient of 10%. Most of the correlations between additive and inbreeding depression load genetic values and correlations between inbreeding depression load genetic values for the different traits were positive or near 0.

Conclusions

Although the average inbreeding depression loads presented negative values, a certain percentage of the animals showed neutral or even positive values. Thus, high levels of inbreeding do not always lead to a decrease in mean phenotypic value or an increase in morphological defects. Hence, individual inbreeding depression loads could be used as a tool to select the most appropriate breeding animals. The possibility of selecting horses that have a high genetic value and are more resistant to the deleterious effects of inbreeding should help improve selection outcomes.
Correction to: Successful implementation of isoniazid preventive therapy at a pediatric HIV clinic in Tanzania
Authors: Hunter Olivia F. , Kyesi Furaha , Ahluwalia Amrit Kaur , Daffé Zeinabou Niamé , Munseri Patricia , von Reyn C. Fordham , Adams Lisa V.
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Risk factors affecting the 1-year outcomes of minor ischemic stroke: results from Xi’an stroke registry study of China
Authors: Liu Zhongzhong , Lin Wenjuan , Lu Qingli , Wang Jing , Liu Pei , Lin Xuemei , Wang Fang , Shi Yaling , Wang Qing , Liu Guozheng , Wu Songdi
Published: October 2020

Background

The prevalence of stroke recurrence, disability, and all-cause mortality of patients with minor ischemic stroke (MIS) remains problematic. The aim of the present study was to identify risk factors associated with adverse outcomes at 1 year after MIS in the Xi’an region of China.

Methods

This prospective cohort study included MIS patients above 18 years old with National Institutes of Health Stroke Scale (NIHSS) score ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year prevalence of stroke recurrence, disability, and all-cause mortality were evaluated, respectively. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes.

Results

In this study, 131(10.5%, 131/1252) patients were lost to follow-up at 1 year. A total of 1121 patients were included for analysis, the prevalence of stroke recurrence, disability, and all-cause mortality at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause mortality. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count.

Conclusions

The 1-year outcomes of MIS in Xi’an region of China were not optimistic, especially with a high prevalence of disability. The present study indicated that age and pneumonia were the common independent risk factors affecting the 1-year outcomes of MIS in Xi’an region of China.
Reducing neonatal morbidity by discontinuing oxytocin during the active phase of first stage of labor: a multicenter randomized controlled trial STOPOXY
Authors: Girault Aude , Goffinet François , Le Ray Camille ,   on behalf of the collaborators of the STOPOXY trial and the Groupe de Recherche en Obstétrique et Gynécologie (GROG), Azria Elie , Barjat Tiphaine , Bertholdt Charline , Blanc Julie , Bohec Caroline , Boudier Eric , Carrara Julie , Desbriere Raoul , Doret Muriel , Garabedian Charles , Heckenroth Hélène , Kayem Gilles , Korb Diane , Levy Gilles , Roth Georges-Emmanuel , Rozenberg Patrick , Sentilhes Loïc , Verspyck Eric , Winer Norbert
Published: October 2020

Background

Oxytocin is effective in reducing labor duration, but can be associated with fetal and maternal complications such as neonatal acidosis and post-partum hemorrhage. When comparing discontinuing oxytocin in the active phase with continuing oxytocin infusion, previous studies were underpowered to show a reduction in neonatal morbidity. Thus, we aim at evaluating the impact of discontinuing oxytocin during the active phase of the first stage of labor on the neonatal morbidity rate.

Methods

STOPOXY is a multicenter, randomized, open-label, controlled trial conducted in 20 maternity units in France. The first participant was recruited January 17th 2020. The trial includes women with a live term (≥37 weeks) singleton, in cephalic presentation, receiving oxytocin before 4 cm, after an induced or spontaneous labor. Women aged < 18 years, with a lack of social security coverage, a scarred uterus, a multiple pregnancy, a fetal congenital malformation, a growth retardation <3rd percentile or an abnormal fetal heart rate at randomization are excluded. Women are randomized before 6 cm when oxytocin is either continued or discontinued. Randomization is stratified by center and parity. The primary outcome, neonatal morbidity is assessed using a composite variable defined by an umbilical arterial pH at birth < 7.10 and/or a base excess > 10 mmol/L and/or umbilical arterial lactates> 7 mmol/L and/or a 5 min Apgar score < 7 and/or admission in neonatal intensive care unit. The primary outcome will be compared between the two groups using a chi-square test with a p-value of 0.05. Secondary outcomes include neonatal complications, duration of active phase, mode of delivery, fetal and maternal complications during labor and delivery, including cesarean delivery rate and postpartum hemorrhage, and birth experience. We aim at including 2475 women based on a reduction in neonatal morbidity from 8% in the control group to 5% in the experimental group, with a power of 80% and an alpha risk of 5%.

Discussion

Discontinuing oxytocin during the active phase of labor could improve both child health, by reducing moderate to severe neonatal morbidity, and maternal health by reducing cesarean delivery and postpartum hemorrhage rates.

Trial registration

Clinical trials NCT03991091, registered June 19th, 2019.
Evaluation of retinal and choroidal variations in thyroid-associated ophthalmopathy using optical coherence tomography angiography
Authors: Yu Lanchu , Jiao Qin , Cheng Yu , Zhu Yanji , Lin Zhongjing , Shen Xi
Published: October 2020

Background

To investigate the difference in retinal nerve fiber layer (RNFL) thickness, choroidal thickness (CT) and superficial retinal vessels between thyroid-associated ophthalmopathy (TAO) patients and healthy controls. To identify the potential influencing factors for these parameters and evaluate their diagnostic abilities in TAO.

Methods

Twenty active TAO patients, 33 inactive TAO patients and 29 healthy participants were enrolled. TAO patients were divided according to the clinical activity score (CAS). RNFL thickness and CT were measured by HD-OCT, while foveal avascular zone (FAZ), vascular density and perfusion density were measured by optical coherence tomography angiography (OCTA). SPSS software was used for statistical analysis.

Results

Active TAO patients had thinner RNFL thickness than the other two groups (P < 0.001, P < 0.001). Both active and inactive TAO patients had significantly higher CT in the macular region (all P < 0.05). The FAZ area in the active TAO group was significantly larger than the other two groups (P = 0.045, P = 0.001). The inactive TAO group had significantly higher vascular density than the other two groups (all P < 0.05). With regard to the perfusion density, significant differences were observed in the temporal and inferior areas (P = 0.045, P = 0.001), as well as the average values (P = 0.032). The FAZ area was positively correlated with intraocular pressure (r = 0.274, P = 0.013), while it was negatively correlated with axial length (r = − 0.344, P = 0.002). The vascular density and perfusion density were not significantly correlated with different clinical variables (all P > 0.05). The AUC analysis indicated these parameters also exhibited a significant discriminatory power in TAO diagnosis.

Conclusions

TAO patients had significant variations in RNFL thickness, choroidal thickness, FAZ area and superficial retinal vessels. These parameters appeared to be potential adjuncts in the evaluation of TAO patients.
The changes of corneal biomechanical properties with long-term treatment of prostaglandin analogue measured by Corvis ST
Authors: Wu Na , Chen Yuhong , Yang Yaping , Sun Xinghuai
Published: October 2020

Background

To investigate the corneal biomechanical changes in primary open angle glaucoma (POAG) patients treated with long-term prostaglandin analogue (PGA).

Methods

One hundred eleven newly diagnosed POAG patients, including 43 high tension glaucoma (HTG) and 68 normal tension glaucoma (NTG), were measured by Corvis ST to obtain intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanical parameters at baseline and at each follow-up visit after initiation of PGA treatment. The follow-up measurements were analyzed by the generalized estimate equation model with an exchangeable correlation structure. Restricted cubic spline was employed to estimate the dose–response relation between follow-up time and corneal biomechanics.

Results

The mean follow-up time was 10.3 ± 7.02 months. Deformation amplitude (β = -0.0015, P = 0.016), the first applanation velocity (AV1, β = -0.0004, P = 0.00058) decreased and the first applanation time (AT1, β = 0.0089, P < 0.000001) increased statistically significantly with PGA therapy over time after adjusting for age, gender, axial length, corneal curvature, IOP and CCT. In addition, AT1 was lower (7.2950 ± 0.2707 in NTG and 7.5889 ± 0.2873 in HTG, P = 0.00011) and AV1 was greater (0.1478 ± 0.0187 in NTG and 0.1314 ± 0.0191 in HTG, P = 0.00002) in NTG than in HTG after adjusting for confounding factors.

Conclusions

Chronic use of PGA probably influences the corneal biomechanical properties directly, which is to make cornea less deformable. Besides, corneas in NTG tended to be more deformable compared to those in HTG with long-term treatment of PGA.
Relevant factors for early liver transplantation after Kasai portoenterostomy
Authors: Ge Liang , Zhan Jianghua , Gao Wei , Zhao Shengqiao , Xu Xiaodan , Dou Ran
Published: October 2020

Background

To explore the relevant factors for early liver transplantation (LT) after Kasai portoenterostomy (KP).

Methods

Retrospective analysis was performed for 200 children with biliary atresia, who underwent LT with hepatic failure after KP. According to the interval between KP and LT, they were divided into three groups: G1 (≤6-month), G2 (6-month~ 2-year) and G3 (> 2-year). Gender, age of Kasai portoenterostomy, jaundice-clearance, cholangitis after KP and liver function indexes before LT were compared among the three groups.

Results

The proportion of patients with age of KP (≤90-day) in G1 was lower than that in G3 (P = 0.003). Jaundice-clearance occurred in 6 (7.6%), 26(28.6%) and 26 (86.7%) patients after KP in G1, G2 and G3 respectively (P < 0.001). There were statistical differences in the incidence of early cholangitis, late cholangitis and repeated cholangitis among the three groups (P = 0.035, < 0.001 and 0.022). The native liver survival (NLS) rate of children at operation age > 90-day was lower than that of children at operation age ≤ 90-day (P = 0.002). The NLS rate of the children with jaundice-clearance after KP was significantly better than that of the children without jaundice-clearance (P < 0.001). The NLS rate of the children with early cholangitis after operation was lower than that in children without early cholangitis (P = 0.026). The NLS rate of patients of G2 and G3 with cholangitis after KP was lower than that in children without cholangitis (P = 0.017). Multiple logistic regression analysis showed uncleared jaundice after KP was a risk factor for the NLS time in patients.

Conclusion

The age of KP (> 90-day), jaundice-unclear and early cholangitis could reduce the NLS time after KP, which were related to early liver transplantation. Jaundice-unclear was a risk factor for early liver transplantation.
Prevalence and associated factors of chronic non-communicable diseases among cross-country truck drivers in Ethiopia
Authors: Yosef Tewodros
Published: October 2020

Background

Non-communicable diseases (NCDs) are diseases that are not transmitted from one person to another. Currently, NCDs are the primary causes of morbidity and mortality globally. Truck driving is an occupation that prone drivers to risk factors for NCDs than other occupations. Eventhough risk of developing NCDs among these population is high, studies that showed the prevalence and associated factors of chronic NCDs among truck drivers in Ethiopia are not available. Therefore, this study aimed to assess the prevalence and associated factors of chronic NCDs among truck drivers in Ethiopia.

Methods

A cross-sectional study was conducted among 422 cross-country truck drivers at the Modjo dry port in Ethiopia. The interviwer-administered questionnaire technique was used to collect the data. The body mass index of the study participants was measured using DHM-15A standardized scale (BMI Height and Weight body fat scale).

Results

Of the 400 truck drivers interviewed, the prevalence of chronic non-communicable diseases was 28.5, 95% CI (24.1–32.9%). Eighty (20%) had hypertension followed by 32(8%), and 22 (5.5%) had diabetes mellitus and asthma, respectively. The study also found that being married (AOR = 3.14, 95%CI [1.78–5.86]) and Separated/Divorced/Widower (AOR = 2.31, 95% CI [1.12–3.55]), having 3 or more family sizes (AOR = 1.46, 95% CI [1.33–4.42]), BMI ≥ 25 (AOR = 4.66, 95% CI [2.85–7.62]), smoking cigarettes [AOR = 1.71, 95% CI [1.03–2.81]), driving 10 or more years (AOR = 3.48, 95% CI [1.89–5.24]) and driving 9 or more hours daily (AOR = 3.76, 95% CI [1.96–6.54]) were statistically associated with chronic non-communicable diseases.

Conclusion

The prevalence of chronic NCDs among truck drivers was significant (28.5%), and we can conclude that chronic NCDs are of public health importance among truck drivers in Ethiopia. This may create a substantial load on the healthcare system as an end result of increased demand and contact with healthcare services. Therefore, a rigorous effort is needed to develop strategies for the prevention and management of NCDs.
Total versus conventional laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy in children with choledochal cysts: a case–control study
Authors: Liu Fei , Xu Xiaogang , Lan Menglong , Tao Boyuan , Li Le , Wu Qiang , Chai Chengwei , Zeng Jixiao
Published: October 2020

Background

To compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs).

Methods

Data from patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-cojejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, and postoperative complications were compared.

Results

All 55 patients (TLH = 30, CLH = 25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57 ± 0.19 d and 4.56 ± 0.27 d, respectively (t = 3.07, P < 0.01), the postoperative hospital stay was 5.50 ± 0.28 d and 7.00 ± 0.74 d (t = 2.03, P < 0.05), and the hospitalization expenses were CNY 40,085 ± 2447 and CNY 26,084 ± 2776 (t = 3.79, P < 0.001). There were no significant differences in intraoperative blood loss (9.57 ± 3.28 ml vs 8.2 ± 1.13 ml, t = 0.37, P = 0.72) or time for jejunum-cojejunum anastomosis (80.5 ± 2.46 min vs 75.00 ± 2.04 min, t = 1.68, P = 0.10). The median follow-up periods of the TLH and CLH groups were 17 and 16 months, respectively. Overall complication rates were comparable between the two groups (10% vs 8%, χ2 = 0.07, P = 0.79).

Conclusions

TLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and a short hospitalization. However, hospitalization is relatively expensive.
Multiple polyurethane implant punctures during fat grafting: case report and review of the literature
Authors: Batiukov Dmitry , Podgaiski V. , Mikulich D. , Kalinin S.
Published: October 2020

Background

Breast augmentation with implants continues to be the most popular aesthetic surgical procedure performed worldwide. Fat grafting may improve the results of breast augmentation and breast reconstruction with implants. However, fat grafting to the breast with implants carries the risk of implant puncture. To our best knowledge this is the first case in which polyurethane implant puncture during fat grafting is described.

Case presentation

We report multiple bilateral implant punctures with the cannula during fat grafting in a patient who previously underwent breast reconstruction with polyurethane implants.

Conclusions

Implants that promote tissue ingrowth may be more prone to puncture with the cannula during fat grafting. Specific planning and surgical maneuvers decrease the risk of implant puncture.

Level of evidence

Level V, case report.
Bioengineered human skeletal muscle capable of functional regeneration
Authors: Fleming J. W. , Capel A. J. , Rimington R. P. , Wheeler P. , Leonard A. N. , Bishop N. C. , Davies O. G. , Lewis M. P.
Published: October 2020

Background

Skeletal muscle (SkM) regenerates following injury, replacing damaged tissue with high fidelity. However, in serious injuries, non-regenerative defects leave patients with loss of function, increased re-injury risk and often chronic pain. Progress in treating these non-regenerative defects has been slow, with advances only occurring where a comprehensive understanding of regeneration has been gained. Tissue engineering has allowed the development of bioengineered models of SkM which regenerate following injury to support research in regenerative physiology. To date, however, no studies have utilised human myogenic precursor cells (hMPCs) to closely mimic functional human regenerative physiology.

Results

Here we address some of the difficulties associated with cell number and hMPC mitogenicity using magnetic association cell sorting (MACS), for the marker CD56, and media supplementation with fibroblast growth factor 2 (FGF-2) and B-27 supplement. Cell sorting allowed extended expansion of myogenic cells and supplementation was shown to improve myogenesis within engineered tissues and force generation at maturity. In addition, these engineered human SkM regenerated following barium chloride (BaCl2) injury. Following injury, reductions in function (87.5%) and myotube number (33.3%) were observed, followed by a proliferative phase with increased MyoD+ cells and a subsequent recovery of function and myotube number. An expansion of the Pax7+ cell population was observed across recovery suggesting an ability to generate Pax7+ cells within the tissue, similar to the self-renewal of satellite cells seen in vivo.

Conclusions

This work outlines an engineered human SkM capable of functional regeneration following injury, built upon an open source system adding to the pre-clinical testing toolbox to improve the understanding of basic regenerative physiology.
The current status of gender equity in medicine in Korea: an online survey about perceived gender discrimination
Authors: Shin Hyun-Young , Lee Hang Aie
Published: October 2020

Background

Although the number of women doctors has increased in South Korea, and efforts to improve gender awareness have gained importance in recent years, the issue of gender equity in the medical field has not been fully evaluated. The aim of this study was to determine the current status of gender equity in the medical profession in Korea.

Methods

An online survey on perceived gender discrimination was conducted for 2 months, with both men and women doctors participating. The results were analyzed using descriptive statistics.

Results

A total of 1170 doctors responded to the survey (9.2% response rate). The survey found that 47.3% of the women respondents and 18.2% of the men had experienced gender discrimination in the resident selection process (P < 0.05), 17.2% of the women and 8.7% of the men had experienced discrimination during the fellowship application process (P < 0.05), and 36.2% of the women and 8.0% of the men had experienced discrimination during the professorship application process (P < 0.05). Both men and women cited the issue of childbirth and parenting as the number one cause of gender discrimination against women doctors.

Conclusions

This study revealed the presence of perceived gender discrimination in the Korean medical society. To address discrimination, a basic approach is necessary to change the working environment so that it is flexible for women doctors, and to change the current culture where the burden of family care, including pregnancy, childbirth, and childcare, is the primary responsibility of women.
Role of extracellular vesicles in tumour microenvironment
Authors: Tao Shi-Cong , Guo Shang-Chun
Published: October 2020

In recent years, it has been demonstrated that extracellular vesicles (EVs) can be released by almost all cell types, and detected in most body fluids. In the tumour microenvironment (TME), EVs serve as a transport medium for lipids, proteins, and nucleic acids. EVs participate in various steps involved in the development and progression of malignant tumours by initiating or suppressing various signalling pathways in recipient cells. Although tumour-derived EVs (T-EVs) are known for orchestrating tumour progression via systemic pathways, EVs from non-malignant cells (nmEVs) also contribute substantially to malignant tumour development. Tumour cells and non-malignant cells typically communicate with each other, both determining the progress of the disease. In this review, we summarise the features of both T-EVs and nmEVs, tumour progression, metastasis, and EV-mediated chemoresistance in the TME. The physiological and pathological effects involved include but are not limited to angiogenesis, epithelial–mesenchymal transition (EMT), extracellular matrix (ECM) remodelling, and immune escape. We discuss potential future directions of the clinical application of EVs, including diagnosis (as non-invasive biomarkers via liquid biopsy) and therapeutic treatment. This may include disrupting EV biogenesis and function, thus utilising the features of EVs to repurpose them as a therapeutic tool in immunotherapy and drug delivery systems. We also discuss the overall findings of current studies, identify some outstanding issues requiring resolution, and propose some potential directions for future research.
Mesenchymal stromal cells for osteonecrosis
Authors: Elgaz S. , Bonig H. , Bader P.
Published: October 2020

Osteonecrosis (ON) is an acquired debilitating skeletal disorder, which is caused by a multitude of traumatic and non-traumatic etiological factors. Vascular damage, mechanical stress and increased intraosseous pressure have been discussed as contributors to ON. The optimal treatment of ON remains to be determined, since the current gold standard, core decompression, is insufficiently effective. Specific properties of mesenchymal stromal cells (MSCs) provide the rationale for their assessment in advanced stages of ON: Osteoinductive potential has been demonstrated and MSC preparations of suitable quality for use as medicinal products have been developed. Here we review the scant information on the use of allogeneic or autologous MSCs in advanced ON as well as potentially supportive data from pre-clinical studies with autologous bone marrow mononuclear cells (auto BM-MNCs), which have been studied quite extensively and the presumed therapeutic effect of which was attributed to the rare MSCs contained in these cell products. Outcomes in clinical trials with MSCs and auto-BM-MNCs remain preliminary and non-definitive, at best promising, with respect to their pharmacological effect. Clearly, though, the application of any of these cell therapies was technically feasible and safe in that it was associated with low complication rates. The heterogeneity of cell type and source, study protocols, cell manufacturing, cell properties, cell doses and surgical techniques might contribute to inconsistent results.
Evaluating the effect of maternal mHealth text messages on uptake of maternal and child health care services in South Africa: a multicentre cohort intervention study
Authors: Coleman Jesse , Black Vivian , Thorson Anna Ekéus , Eriksen Jaran
Published: October 2020

Background

There are high expectations that mobile health (mHealth) strategies will increase uptake of health care services, especially in resource strained settings. Our study aimed to evaluate effects of an mHealth intervention on uptake of maternal health services.

Methods

This was an intervention cohort study conducted at six public antenatal and postnatal care clinics in inner-city Johannesburg, South Africa. The intervention consisted of twice-weekly informative and pregnancy stage-based maternal health information text messages sent to women during pregnancy until their child was one year of age. The intervention arm of 87 mother-infant pairs was compared to a control arm of 90 pairs. Univariate and multivariate analyses were used to compare the probability of the outcome between the two groups.

Results

Intervention participants had higher odds of attending all government-recommended antenatal and postnatal visits, all recommended first year vaccinations (OR: 3.2, 95% CI 1.63–6.31) and had higher odds of attending at least the recommended four antenatal visits (OR: 3.21, 95% CI 1.73–5.98).

Conclusion

We show an improvement in achieving complete maternal-infant continuum of care, providing evidence of a positive impact of informative maternal mHealth messages sent to pregnant women and new mothers.

Trial registration ISRCTN, ISRCTN41772986. Registered 13 February 2019—Retrospectively registered, https://www.isrctn.com/ISRCTN41772986
Relationships between accelerometry and general compensatory movements of the upper limb after stroke
Authors: Barth Jessica , Klaesner Joeseph W. , Lang Catherine E.
Published: October 2020

Background

Standardized assessments are used in rehabilitation clinics after stroke to measure restoration versus compensatory movements of the upper limb. Accelerometry is an emerging tool that can bridge the gap between in- and out-of-clinic assessments of the upper limb, but is limited in that it currently does not capture the quality of a person’s movement, an important concept to assess compensation versus restoration. The purpose of this analysis was to characterize how accelerometer variables may reflect upper limb compensatory movement patterns after stroke.

Methods

This study was a secondary analysis of an existing data set from a Phase II, single-blind, randomized, parallel dose–response trial (NCT0114369). Sources of data utilized were: (1) a compensatory movement score derived from video analysis of the Action Research Arm Test (ARAT), and (2) calculated accelerometer variables quantifying time, magnitude and variability of upper limb movement from the same time point during study participation for both in-clinic and out-of-clinic recording periods.

Results

Participants had chronic upper limb paresis of mild to moderate severity. Compensatory movement scores varied across the sample, with a mean of 73.7 ± 33.6 and range from 11.5 to 188. Moderate correlations were observed between the compensatory movement score and each accelerometer variable. Accelerometer variables measured out-of-clinic had stronger relationships with compensatory movements, compared with accelerometer variables in-clinic. Variables quantifying time, magnitude, and variability of upper limb movement out-of-clinic had relationships to the compensatory movement score.

Conclusions

Accelerometry is a tool that, while measuring movement quantity, can also reflect the use of general compensatory movement patterns of the upper limb in persons with chronic stroke. Individuals who move their limbs more in daily life with respect to time and variability tend to move with less movement compensations and more typical movement patterns. Likewise, individuals who move their paretic limbs less and their non-paretic limb more in daily life tend to move with more movement compensations at all joints in the paretic limb and less typical movement patterns.