bluuebunny/crossref_metadata_2025 huggingface dataset:
Radial artery access is associated with lower mortality in patients undergoing primary PCI: a report from the SWEDEHEART registry
Authors: Dworeck Christian , Redfors Björn , Völz Sebastian , Haraldsson Inger , Angerås Oskar , Råmunddal Truls , Ioanes Dan , Myredal Anna , Odenstedt Jacob , Hirlekar Geir , Koul Sasha , Fröbert Ole , Linder Rickard , Venetsanos Dimitrios , Hofmann Robin , Ulvenstam Anders , Petursson Petur , Sarno Giovanna , James Stefan , Erlinge David , Omerovic Elmir
Published: October 2020

Objectives

The purpose of this observational study was to evaluate the effects of radial artery access versus femoral artery access on the risk of 30-day mortality, inhospital bleeding and cardiogenic shock in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.

Methods

We used data from the SWEDEHEART registry and included all patients who were treated with primary percutaneous coronary intervention in Sweden between 2005 and 2016. We compared patients who had percutaneous coronary intervention by radial access versus femoral access with regard to the primary endpoint of all-cause death within 30 days, using a multilevel propensity score adjusted logistic regression which included hospital as a random effect.

Results

During the study period, 44,804 patients underwent primary percutaneous coronary intervention of whom 24,299 (54.2%) had radial access and 20,505 (45.8%) femoral access. There were 2487 (5.5%) deaths within 30 days, of which 920 (3.8%) occurred in the radial access and 1567 (7.6%) in the femoral access group. After propensity score adjustment, radial access was associated with a lower risk of death (adjusted odds ratio (OR) 0.70, 95% confidence interval (CI) 0.55–0.88, P = 0.025). We found no interaction between access site and age, gender and cardiogenic shock regarding 30-day mortality. Radial access was also associated with a lower adjusted risk of bleeding (adjusted OR 0.45, 95% CI 0.25–0.79, P = 0.006) and cardiogenic shock (adjusted OR 0.41, 95% CI 0.24–0.73, P = 0.002).

Conclusions

In patients with ST-elevation myocardial infarction, primary percutaneous coronary intervention by radial access rather than femoral access was associated with an adjusted lower risk of death, bleeding and cardiogenic shock. Our findings are consistent with, and add external validity to, recent randomised trials.
Retroperitoneoscopic nephrectomy: current status
Authors: Garg Harshit , Yadav Siddharth , Singh Prabhjot , Hemal Ashok , Kumar Rajeev
Published: October 2020

The classic retroperitoneal open surgical access to the kidney has been duplicated while performing laparoscopy but is less common than transperitoneal laparoscopy. We reviewed minimally invasive retroperitoneoscopic nephrectomy as a part of the international consultation on urological diseases and European Association of Urology international consultation on minimally invasive surgery in urology. A Pubmed/Medline search was performed to identify studies assessing the feasibility, safety and efficacy of laparoscopic and robotic retroperitoneoscopic nephrectomy. The articles were reviewed to assess outcomes after simple, radical and donor nephrectomy and comparative trials between retroperitoneoscopic versus the open and transperitoneal route were evaluated. Retroperitoneoscopic nephrectomy is feasible for most cases of benign non-functioning kidneys. Retroperitoneoscopic radical nephrectomy is also feasible for most tumours and may be better suited for posteriorly located tumours. Both retroperitoneoscopic and transperitoneal nephrectomy have similar outcomes but the operative time may be shorter for the former. The data are insufficient for robotic retroperitoneoscopic nephrectomy probably because of limited space and lack of benefit of a robot in ablative surgeries.

Level of evidence: 3a
The ‘neglected’ chemistry: Fuels and materials preparation in China’s ‘two bombs and one satellite’ project
Authors: Zhu Jing
Published: October 2020

The ‘two bombs and one satellite’ project was a major achievement of China after 1949 and has since been an important subject in historical and sociological research on science and technology in modern China. However, most accounts of the history or sociology of the project focus on physicists and engineers, rather than the chemists. This study examines the chemists’ work of preparing fuels and materials in the project and their post-project research. By analysing how Chinese scientists engaged in the project, how they understood the relationship between basic and applied research in their scientific practice and how they positioned themselves on issues of science policy, this article offers different and shifting concepts of basic and applied research with cultural variation in the context of China.
Challenging arthroscopic management of ankle synovial chondromatosis: A case report
Authors: Fetih Tarek N , Mekhemar Ahmed A , Hashad Rashed M
Published: October 2020

Synovial chondromatosis (SC) is a rare benign disorder characterized by the presence of metaplastic cartilage nodules originating from the synovial lining of joints, bursa, and tendon sheaths. The treatment option is usually open surgery for excision of loose bodies and synovectomy, while on literature review only few cases with arthroscopic management are reported. We present a 28-year-old male patient who was evaluated for pain, swelling, and limited range of motion of the right ankle joint. Both physical examination and radiographic investigations were suggestive of primary SC of the ankle joint and arthroscopic surgery was performed. Removal of loose bodies and synovectomy were successfully performed. Histopathology confirmed the diagnosis. SC of the ankle is a rare disorder, and its treatment strategies depend on patient complaint, age, and the stage of the disease. Open or arthroscopic surgery can be performed. This case report suggests that arthroscopic management can provide successful outcome in such cases.
Effect of apolipoprotein E polymorphism on cognition and brain in the Cambridge Centre for Ageing and Neuroscience cohort
Authors: Henson Richard N. , Suri Sana , Knights Ethan , Rowe James B. , Kievit Rogier A. , Lyall Donald M. , Chan Dennis , Eising Else , Fisher Simon E.
Published: October 2020

Polymorphisms in the apolipoprotein E (APOE) gene have been associated with individual differences in cognition, brain structure and brain function. For example, the ε4 allele has been associated with cognitive and brain impairment in old age and increased risk of dementia, while the ε2 allele has been claimed to be neuroprotective. According to the ‘antagonistic pleiotropy’ hypothesis, these polymorphisms have different effects across the lifespan, with ε4, for example, postulated to confer benefits on cognitive and brain functions earlier in life. In this stage 2 of the Registered Report – https://osf.io/bufc4 , we report the results from the cognitive and brain measures in the Cambridge Centre for Ageing and Neuroscience cohort ( www.cam-can.org ). We investigated the antagonistic pleiotropy hypothesis by testing for allele-by-age interactions in approximately 600 people across the adult lifespan (18–88 years), on six outcome variables related to cognition, brain structure and brain function (namely, fluid intelligence, verbal memory, hippocampal grey-matter volume, mean diffusion within white matter and resting-state connectivity measured by both functional magnetic resonance imaging and magnetoencephalography). We found no evidence to support the antagonistic pleiotropy hypothesis. Indeed, Bayes factors supported the null hypothesis in all cases, except for the (linear) interaction between age and possession of the ε4 allele on fluid intelligence, for which the evidence for faster decline in older ages was ambiguous. Overall, these pre-registered analyses question the antagonistic pleiotropy of APOE polymorphisms, at least in healthy adults.
Magical disruption? Alternative protein and the promise of de-materialization
Authors: Guthman Julie , Biltekoff Charlotte
Published: October 2020

Along with seeking to eliminate the inhumane conditions and slaughter involved in animal protein production, alternative protein companies aspire to ameliorate its environmental impacts. They claim to do so by making edible protein from (nearly) nothing, drawing on abundant or mundane resources that will presumably not be missed or have no negative externalities, or “upcycling” byproducts that would otherwise be wasted—to de-materialize in other words. At the same time, these entrepreneurs promise their substitutes will be nutritionally analogous to or better than animal-based proteins and have only salubrious effects on human bodies. Drawing on data collected on alternative protein companies that are based in or have come through Silicon Valley, this article catalogs and examines company representations of their various de-materialization promises. We find that attempting to meet the tripartite, yet competing imperatives of Silicon Valley innovation, namely disruption, transparency, and secrecy, results in representations of processes that obfuscate more than they reveal. The resulting obfuscation is not simply the intentional veiling of pernicious processes; more than selling specific food products, Silicon Valley food tech entrepreneurs aspire to bring a new food system into being and convince their audiences that this food future is both better and achievable. Nevertheless, their representational practices make it difficult, if not impossible, for the public—or anyone really—to meaningfully assess the promises and their potential consequences, much less hold their proponents accountable to anything but pecuniary concerns.
Effect of Computerized Physician Order Entry and Clinical Decision Support System on Adverse Drug Events Prevention in the Emergency Department: A Systematic Review
Authors: Hajesmaeel Gohari Sadrieh , Bahaadinbeigy Kambiz , Tajoddini Shahrad , R. Niakan Kalhori Sharareh
Published: October 2020

Objective: An adverse drug event (ADE) is an injury resulting from a medical intervention related to a drug. The emergency department (ED) is a ward vulnerable to more ADEs because of overcrowding. Information technologies such as computerized physician order entry (CPOE) and clinical decision support system (CDSS) may decrease the occurrence of ADEs. This study aims to review research that reported the evaluation of the effectiveness of CPOE and CDSS on lowering the occurrence of ADEs in the ED. Data Sources: PubMed, EMBASE, and Web of Science databases were used to find studies published from 2003 to 2018. The search was conducted in November 2018. Study Selection and Data Extraction: The search resulted in 1700 retrieved articles. After applying inclusion and exclusion criteria, 11 articles were included. Data on the date, country, type of system, medication process stages, study design, participants, sample size, and outcomes were extracted. Data Synthesis: Results showed that CPOE and CDSS may prevent ADEs in the ED through significantly decreasing the rate of errors, ADEs, excessive dose, and inappropriate prescribing (in 54.5% of articles); furthermore, CPOE and CDSS may significantly increase the rate of appropriate prescribing and dosing in compliance with established guidelines (45.5% of articles). Conclusion: This study revealed that the use of CPOE and CDSS can lower the occurrence of ADEs in the ED; however, further randomized controlled trials are needed to address the effect of a CDSS, with basic or advanced features, on the occurrence of ADEs in the ED.
Prediction of genetic merit for growth rate in pigs using animal models with indirect genetic effects and genomic information
Authors: Poulsen Bjarke G. , Ask Birgitte , Nielsen Hanne M. , Ostersen Tage , Christensen Ole F.
Published: October 2020

Background

Several studies have found that the growth rate of a pig is influenced by the genetics of the group members (indirect genetic effects). Accounting for these indirect genetic effects in a selection program may increase genetic progress for growth rate. However, indirect genetic effects are small and difficult to predict accurately. Genomic information may increase the ability to predict indirect genetic effects. Thus, the objective of this study was to test whether including indirect genetic effects in the animal model increases the predictive performance when genetic effects are predicted with genomic relationships. In total, 11,255 pigs were phenotyped for average daily gain between 30 and 94 kg, and 10,995 of these pigs were genotyped. Two relationship matrices were used: a numerator relationship matrix ($${\mathbf{A}}$$
A
) and a combined pedigree and genomic relationship matrix ($${\mathbf{H}}$$
H
); and two different animal models were used: an animal model with only direct genetic effects and an animal model with both direct and indirect genetic effects. The predictive performance of the models was defined as the Pearson correlation between corrected phenotypes and predicted genetic levels. The predicted genetic level of a pig was either its direct genetic effect or the sum of its direct genetic effect and the indirect genetic effects of its group members (total genetic effect).

Results

The highest predictive performance was achieved when total genetic effects were predicted with genomic information (21.2 vs. 14.7%). In general, the predictive performance was greater for total genetic effects than for direct genetic effects (0.1 to 0.5% greater; not statistically significant). Both types of genetic effects had greater predictive performance when they were predicted with $${\mathbf{H}}$$
H
rather than $${\mathbf{A}}$$
A
(5.9 to 6.3%). The difference between predictive performances of total genetic effects and direct genetic effects was smaller when $${\mathbf{H}}$$
H
was used rather than $${\mathbf{A}}$$
A
.

Conclusions

This study provides evidence that: (1) corrected phenotypes are better predicted with total genetic effects than with direct genetic effects only; (2) both direct genetic effects and indirect genetic effects are better predicted with $${\mathbf{H}}$$
H
than $${\mathbf{A}}$$
A
; (3) using $${\mathbf{H}}$$
H
rather than $${\mathbf{A}}$$
A
primarily improves the predictive performance of direct genetic effects.
Molecular evolutionary and structural analysis of human UCHL1 gene demonstrates the relevant role of intragenic epistasis in Parkinson’s disease and other neurological disorders
Authors: Nawaz Muhammad Saqib , Asghar Razia , Pervaiz Nashaiman , Ali Shahid , Hussain Irfan , Xing Peiqi , Bao Yiming , Abbasi Amir Ali
Published: October 2020

Background

Parkinson’s disease (PD) is the second most common neurodegenerative disorder. PD associated human UCHL1 (Ubiquitin C-terminal hydrolase L1) gene belongs to the family of deubiquitinases and is known to be highly expressed in neurons (1–2% in soluble form). Several functions of UCHL1 have been proposed including ubiquitin hydrolyze activity, ubiquitin ligase activity and stabilization of the mono-ubiquitin. Mutations in human UCHL1 gene have been associated with PD and other neurodegenerative disorders. The present study aims to decipher the sequence evolutionary pattern and structural dynamics of UCHL1. Furthermore, structural and interactional analysis of UCHL1 was performed to help elucidate the pathogenesis of PD.

Results

The phylogenetic tree topology suggests that the UCHL1 gene had originated in early gnathostome evolutionary history. Evolutionary rate analysis of orthologous sequences reveals strong purifying selection on UCHL1. Comparative structural analysis of UCHL1 pinpoints an important protein segment spanning amino acid residues 32 to 39 within secretion site with crucial implications in evolution and PD pathogenesis through a well known phenomenon called intragenic epistasis. Identified critical protein segment appears to play an indispensable role in protein stability, proper protein conformation as well as harboring critical interaction sites.

Conclusions

Conclusively, the critical protein segment of UCHL1 identified in the present study not only demonstrates the relevant role of intraprotein conformational epistasis in the pathophysiology of PD but also offers a novel therapeutic target for the disease.
Correction to: Potential causes and consequences of rapid mitochondrial genome evolution in thermoacidophilic Galdieria (Rhodophyta)
Authors: Cho Chung Hyun , In Park Seung , Ciniglia Claudia , Yang Eun Chan , Graf Louis , Bhattacharya Debashish , Yoon Hwan Su
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
The flattened and needlelike leaves of the pine family (Pinaceae) share a conserved genetic network for adaxial-abaxial polarity but have diverged for photosynthetic adaptation
Authors: Du Hong , Ran Jin-Hua , Feng Yuan-Yuan , Wang Xiao-Quan
Published: October 2020

Background

Leaves have highly diverse morphologies. However, with an evolutionary history of approximately 200 million years, leaves of the pine family are relatively monotonous and often collectively called “needles”, although they vary in length, width and cross-section shapes. It would be of great interest to determine whether Pinaceae leaves share similar morpho-physiological features and even consistent developmental and adaptive mechanisms.

Results

Based on a detailed morpho-anatomical study of leaves from all 11 Pinaceae genera, we particularly investigated the expression patterns of adaxial-abaxial polarity genes in two types of leaves (needlelike and flattened) and compared their photosynthetic capacities. We found that the two types of leaves share conserved spatial patterning of vasculatures and genetic networks for adaxial-abaxial polarity, although they display different anatomical structures in the mesophyll tissue differentiation and distribution direction. In addition, the species with needlelike leaves exhibited better photosynthetic capacity than the species with flattened leaves.

Conclusions

Our study provides the first evidence for the existence of a conserved genetic module controlling adaxial-abaxial polarity in the development of different Pinaceae leaves.
“I lost my happiness, I felt half dead and half alive” - a qualitative study of the long-term aftermath of obstetric near-miss in the urban district of Zanzibar, Tanzania
Authors: Herklots Tanneke , Yussuf Suhaila Salum , Mbarouk Khairat Said , O’Meara Molly , Carson Emma , Plug Sebastiaan Beschoor , van Acht Fleur , Terpstra Pleun , Prebevšek Deja , Franx Arie , Meguid Tarek , Jacod Benoit
Published: October 2020

Background

This study aims to explore the stories of three women from Zanzibar, Tanzania, who survived life-threatening obstetric complications. Their narratives will increase understanding of the individual and community-level burden masked behind the statistics of maternal morbidity and mortality in Tanzania. In line with a recent systematic review of women-centred, qualitative maternal morbidity research, this study will contribute to guidance of local and global maternal health agendas.

Methods

This two-phased qualitative study was conducted in July-August 2017 and July-August 2018, and involved three key informants, who were recruited from a maternal near-miss cohort in May 2017 in Mnazi Mmoja Hospital, Zanzibar. The used methods were participant observation, interviews (informal, unstructured and semi-structured), participatory methods and focus group discussions. Data analysis relied primarily on grounded theory, leading to a theoretical model, which was validated repeatedly by the informants and within the study team. The findings were then positioned in the existing literature. Approval was granted by Zanzibar’s Medical Ethical Research Committee (reference number: ZAMREC/0002/JUN/17).

Results

The impact of severe maternal morbidity was found to be multi-dimensional and to extend beyond hospital discharge and thus institutionalized care. Four key areas impacted by maternal morbidities emerged, namely (1) social, (2) sexual and reproductive, (3) psychological, and (4) economic well-being.

Conclusions

This study showed how three women’s lives and livelihoods were profoundly impacted by the severe obstetric complications they had survived, even up to 16 months later. These impacts took a toll on their physical, social, economic, sexual and psychological well-being, and affected family and community members alike. These findings advocate for a holistic, dignified, patient value-based approach to the necessary improvement of maternal health care in low-income settings. Furthermore, it emphasizes the need for strategies to be directed not only towards quality of care during pregnancy and delivery, but also towards support after obstetric complications.
The impact of stage of labor on adverse maternal and neonatal outcomes in multiparous women: a retrospective cohort study
Authors: Wang Li , Wang Hongxia , Jia Lu , Qing Wenjie , Li Fan , Zhou Jie
Published: October 2020

Background

The correlation between stage of labor and adverse delivery outcomes has been widely studied. Most of studies focused on nulliparous women, it was not very clear what impact the stage of labor duration had on multiparous women.

Methods

A retrospective cohort study was conducted among all the multiparous women of cephalic, term, singleton births, who planned vaginal delivery. The total stage of labor covered the first stage and the second stage in this study, and they were divided into subgroups. Adverse maternal outcomes were defined as referral cesarean delivery, instrumental delivery, postpartum hemorrhage, perineal laceration (III and IV degree), hospitalization stay ≥90th, and adverse neonatal outcomes as NICU, shoulder dystocia, Apgar score ≤ 7(5 min), neonatal resuscitation, assisted ventilation required immediately after delivery.

Results

There were 7109 parturients included in this study. The duration of first stage was 6.2(3.6–10.0) hours, the second stage was 0.3(0.2–0.7) hour, the total stage was 6.9(4.1–10.7) hours in multiparous women. At the first stage, the rates of overall adverse outcome were 21, 23.4, 28.8, 35.5, 38.4% in subgroups < 6 h, 6–11.9 h, 12–17.9 h, 18–23.9 h, ≥24 h, which increased significantly (X2 = 57.64, P < 0.001), and ARR (95% CI) were 1.10 (0.92,1.31), 1.33 (1.04,1.70), 1.80 (1.21,2.68), 2.57 (1.60,4.15) compared with subgroup < 6 h (ARR = 1); At the second stage, the rates of overall adverse outcome were 20.0, 30.7, 38.5, 61.2, 69.6% in subgroups < 1 h, 1–1.9 h, 2–2.9 h, 3–3.9 h, ≥4 h (X2 = 349.70, P < 0.001), and ARR (95% CI) were 1.89 (1.50, 2.39), 2.22 (1.55, 3.18), 10.64 (6.09, 18.59), 11.75 (6.55, 21.08) compared with subgroup < 1 h (ARR = 1)). At the total stage, the rates of overall adverse outcome were 21.5, 30.8, 42.4% in subgroups < 12 h, 12–23.9 h, ≥24 h (X2 = 84.90, P < 0.001), and ARR (95% CI) were 1.41 (1.16,1.72), 3.17 (2.10,4.80) compared with subgroup < 12 h (ARR = 1).

Conclusions

The prolonged stage of labor may lead to increased adverse outcomes in multiparous women, it was an independent risk factor of adverse maternal and neonatal outcomes.
Assessment of choriocapillary blood flow changes in response to half-dose photodynamic therapy in chronic central serous chorioretinopathy using optical coherence tomography angiography
Authors: Liu Juejun , Chen Changzheng , Li Lu , Xu Yishuang , Yi Zuohuizi , He Lu , Zheng Hongmei
Published: October 2020

Background

Optical coherence tomography angiography (OCTA) is a newly developed imaging quantitative technique for analysis of choriocapillaris (CC) flow changes, thereby exploring the pathological mechanism of chronic central serous chorioretinopathy (CCSC) and the therapeutic effects of photodynamic therapy (PDT). In this study, we sought to quantify the blood flow changes in CC of CCSC patients receiving half-dose PDT using OCTA.

Methods

A total of 28 affected eyes and 24 unaffected eyes of 26 CCSC patients receiving half-dose PDT, and 40 eyes of 20 healthy gender- and age-matched subjects were retrospectively enrolled in this study. The proportion of total areas of flow signal voids (FSV, %) in CC level of OCTA was assessed in both eyes of the CCSC patients at baseline and repeated in multiple sections at 1-week, 1-month, 3-month and 6-month intervals after PDT. In addition, the CC patterns in response to PDT at early stage and the subsequent morphologic changes were qualitatively documented using OCTA.

Results

For affected eyes, FSV at 6-m follow-up was significantly lower than that at 1-m follow-up (p = 0.036). When compared to normal control eyes, FSV in affected eyes was significantly higher at 1-m, 3-m and 6-m follow-up (p < 0.05 for all), and FSV in unaffected eyes was significantly higher at baseline, 1-w, 1-m and 3-m follow-up (p < 0.05 for all). Three CC patterns of early response to PDT were identified, including signs of recovery with more even flow signals, transient appearance of worse ischemia and secondary neovascularization within CC level.

Conclusion

Abnormal CC flow attenuation remains in completely resolved eyes of CCSC patients treated with half-dose PDT.
Isolate and irreducible radial head dislocation in children: a rare case of capsular interposition
Authors: Tarallo Luigi , Novi Michele , Porcellini Giuseppe , Catani Fabio
Published: October 2020

Background

Radial head dislocation with no associated lesions, is a relatively uncommon injury in children.

In this case report, it is reported a case of anteromedial locked radial head dislocation in children, and we discuss its clinical presentation and pathogenetic mechanism of injury.

Case presentation

An 8-year-old girl fell off on her right forearm with her right elbow extended in hyperpronation. An isolated radio-capitellar dislocation was identified with no other fractures or neurovascular injuries associated. Elbow presented an extension-flexion arc limited (0°- 90°), and the prono-supination during general anesthesia shows “a sling effect” from maximal pronation (+ 55°) and supination (+ 90°) to neutral position of forearm. The radial head dislocation was impossible to reduce and an open reduction was performed using lateral Kocher approach. The radial head was found “button-holed” through the anterior capsule. The lateral soft tissues were severely disrupted and the annular ligament was not identifiable. Only by cutting the lateral bundle of the capsule was possible to reduce the joint.

At 50 moths follow-up, patient presented a complete Range of motion (ROM), complete functionality and no discomfort or instability even during sport activities.

Discussion and conclusion

It is important to understand the pathogenic mechanisms of locked radial head dislocation in children. Some mechanism described are the distal biceps tendon or the brachialis tendon interposition. However even the anterior capsule can hinder reduction. A characteristic “sling-effect” of the forearm could be pathognomonic for capsular button-holing. Surgical release of the capsular bundle sometimes is the only way to reduce the dislocation and obtain a good outcome.
Mid- and long-term efficacy of surgical treatment of Vancouver B2 and B3 periprosthetic femoral fractures
Authors: Sun Jian-Ning , Zhang Yu , Zhang Ye , Zhang Jia-Ming , Chen Xiang-Yang , Feng Shuo
Published: October 2020

Background

The incidence of fractures around the femoral prosthesis among patients undergoing hip arthroplasty is increasing and has become the third leading cause of hip revision. While numerous methods for the surgical treatment of periprosthetic femoral fractures (PFFs) have been proposed, only few reports have examined the long-term efficacy of surgical treatment. This study aims to examine the mid-and long-term efficacy of surgical treatment among patients with Vancouver B2 and B3 PFFs.

Methods

This retrospective study evaluated the surgical outcomes of patients with Vancouver B2 and B3 PFFs between 2007 and 2011. The minimum follow-up time was eight years. Fracture healing, prosthesis stability, complications, patient quality of life SF-36 score, and survival rate were evaluated during the follow-up assessments.

Results

A total of 83 patients were included and had an average follow-up period of 120.3 months. Among these patients, 69 were classified as Vancouver B2 and were treated with a distal fixation stem, whereas 14 cases were classified as Vancouver B3 and were treated with modular femoral prosthesis by using a proximal femoral allograft technique. A total of 15 patients underwent secondary revision surgery, and prosthesis dislocation was identified as the main cause of secondary revision. 80 (96.4%) cases of fractures were clinically healed. The mortality rate in the first year after surgery was 8.4% (7/83). The overall 5-year Kaplan–Meier survival rate for these patients was 75.9%. Meanwhile, the 5-year Kaplan–Meier survival rate for the implants was 86.9%. The final follow-up SF-36 score of the patients was 48.3 ± 9.8.

Conclusions

Patients with Vancouver B2 and B3 PFFs show high mortality in the first year after their surgery, and the Kaplan–Meier analysis results showed that such mortality tends to plateau after 5 years. Prosthesis dislocation was identified as the primary cause of secondary revision.
Association of microalbuminuria with metabolic syndrome: a cross-sectional study in Bangladesh
Authors: Saadi Muntakim Mahmud , Roy Manindra Nath , Haque Rubena , Tania Farida Akhter , Mahmood Shakil , Ali Nurshad
Published: October 2020

Background and aims

The objectives of this study were to estimate the prevalence of microalbuminuria and examine the association of microalbuminuria with metabolic syndrome (MetS) and its component in a Bangladeshi adult cohort.

Methods

This cross-sectional study included 175 subjects (84 males and 91 females; aged 19–59 years), recruited from the outdoor Department of Medicine and Endocrinology of a medical college hospital in Dhaka, Bangladesh. Lipid profile and fasting blood glucose (FBG) were measured in serum and albumin and creatinine were determined in urine samples. Microalbuminuria was defined as the urinary albumin-to-creatinine ratio (ACR) of 30 to 300 mg/g. The MetS was defined according to the criteria of the National Cholesterol Education Program (NECP). The association of microalbuminuria with MetS and its components was evaluated by multivariate logistic regression analysis.

Results

Among the study subjects, 66.3% were hypertensive and 70.3% were diabetic individuals. Overall, the prevalence of microalbuminuria was 29.7% with 31% in males and 28.6% in females. Microalbuminuria was 2.6 fold higher in hypertensive and diabetic adults than in the non-hypertensive or non-diabetic adults. The prevalence of microalbuminuria was much more frequent in persons with the MetS (36.0%) than the persons without the MetS (5.4%). The levels of FBG, systolic blood pressure (SBP), diastolic blood pressure (DBP) and triglycerides were significantly higher (p < 0.01 for all cases) in subjects with microalbuminuria. In regression analysis, after adjusting for sex, age, and body mass index, microalbuminuria was strongly correlated with MetS followed by elevated BP and FBG (p < 0.01 for all cases).

Conclusions

Microalbuminuria was strongly associated with MetS in Bangladeshi adults. Elevated BP and FBG were the most predominant components of MetS among the study subjects. Comprehensive management of MetS at its early stage can be effective to prevent and reduce the progression of kidney injury and cardiovascular complications.
An epidemiological study of cervical and breast screening in India: district-level analysis
Authors: Monica  , Mishra Raman
Published: October 2020

Background

Breast cancer and cervical cancer, the most common forms of cancer in women worldwide, are on a fast and steady rise, accounting for more deaths in women than any other cancer in the developing world. Cancer screening tests are an important tool to combat cancer-related morbidity and mortality. World Health Organization aims to accelerate action to achieve Goal 3.4 of the Sustainable Development Goals (SDG 3.4) in order to reduce premature mortality from non-communicable disease, including cancer by one-third by 2030. This study aims to examine the geospatial variation of cervical and breast screening across districts and to identify factors that contribute to the utilization of screening among women in India.

Methods

Until recently, there was no evidence pertaining to screening for cervical and breast cancers at the national level. Information on examination of the breast and cervix from over 699,000 women aged 15–49 years was collected for the first time in the fourth round of National Family Health Survey, 2015–16 (NFHS-4). For the present study, the data were aggregated for all 640 districts in India. Moran’s Index was calculated to check for spatial autocorrelation. Univariate Local Indicators of Spatial Association (LISA) maps were plotted to look for spatial dependence associated with the uptake of screening practices. The spatial error model was employed to check for spatial magnitude and direction.

Results

The common factors associated with uptake of both cervical and breast screening at the district level were; women belonging to a general caste, residing in rural areas, being currently married, and being well-off economically. Being insured was positively associated with the uptake of cervical screening only. This study provides spatial inference by showing geographical variations in screening of cervix and breast across districts of India.

Conclusions

By showing geographical disparities in screening practices across districts of India, this study highlights the importance of ensuring a region-specific and organ-specific approach towards control and prevention of cancer. The identified factors responsible for the uptake of screening could be a guiding force to decide how and where tailored interventions may be best targeted.
Effect of social integration on childbirth return among internal migrant pregnant women: a nationally representative study in China
Authors: Ding Lulu , Li Xinying , Tang Xue , Feng Yuejing , Wang Yi , Cheng Jiejie , Sun Mei , Zhou Chengchao
Published: October 2020

Background

Social integration has been demonstrated to be associated with the health care use among migrants, but few studies have focused on migrant pregnant women. This study aims to explore the association between social integration and childbirth at woman’s hometown (childbirth return) of internal migrant pregnant women in China.

Method

Using the data of “Monitoring Data of Chinese Migrants” in 2014, a total of 3412 internal migrant pregnant women were included in this study. Social integration was measured by economic integration, acculturation, and identification. The childbirth locations of internal migrant pregnant women were divided into current residency and the woman’s hometown. Univariate logistic regression and two multivariable logistic regression models were employed to assess the association between social integration and childbirth return among internal migrant pregnant women.

Result

Our study finds that 24.56% of migrant pregnant women choose to have a childbirth return. As for social integration, those who have their own house (OR = 0.351 95% CI 0.207–0.595) in current residence, who have been staying in current residence for at least 5 years (OR = 0.449; 95% CI 0.322–0.626), and who are willing to stay in the current residence for a long time (OR = 0.731; 95% CI 0.537–0.995) are less likely to have a childbirth return. Apart from social integration, our results also show that those migrant pregnant women who are older, who have higher education level, who have at least two family members in current residence, with a migration reason of work and business, who have established health record in the current residency, and who were not covered by medical insurances, are less likely to have a childbirth return.

Conclusion

Social integration is negatively associated with childbirth return among internal migrant pregnant women in China. To improve the utilization of maternal care services for migrant pregnant women in current residence, targeted policies should be made to improve social integration status for migrant pregnant women.
Implementing a clinical cutting-edge and decision-making activity: an ethnographic teamwork approach to a molecular tumorboard
Authors: Bot Nathalie , Waelli Mathias
Published: October 2020

Background

New technology implementation in healthcare must address important challenges such as interdisciplinary approaches. In oncology, molecular tumorboard (MTB) settings require biomedical researchers and clinical practitioners to collaborate and work together. While acknowledging that MTBs have been primarily investigated from a clinical rather than an organizational perspective, this article analyzes team processes and dynamics in a newly implemented MTB.

Methods

A systemic case study of a newly implemented MTB in a Swiss teaching hospital was conducted between July 2017 and February 2018, with in situ work observations, six exploratory interviews and six semi-structured interviews.

Results

An MTB workflow is progressively stabilized in four steps: 1) patient case submissions, 2) molecular analyses and results validation, 3) co-elaboration of therapeutic proposals, and 4) reporting during formal MTB sessions. The elaboration of a therapeutic proposal requires a framework for discussion that departs from the formality of institutional relationships, which was gradually incepted in this MTB.

Conclusions

Firstly, our research showed that an MTB organizational process requires the five teaming components that characterizes a learning organization. It showed that at the organizational level, procedures can be stabilized without limiting practice flexibility. Secondly, this research highlighted the importance of non-clinical outcomes from an MTB, e.g. an important support network for the oncologist community.
Correction to: Assessing inequalities and regional disparities in child nutrition outcomes in India using MANUSH – a more sensitive yardstick
Authors: Jain Ayushi , Agnihotri Satish B.
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
LDL-C/HDL-C is associated with ischaemic stroke in patients with non-valvular atrial fibrillation: a case-control study
Authors: Zhang Xiao-Xue , Wei Meng , Shang Lu-Xiang , Lu Yan-Mei , Zhang Ling , Li Yao-Dong , Zhang Jiang-Hua , Xing Qiang , Tu-Erhong Zu Kela , Tang Bao-Peng , Zhou Xian-Hui
Published: October 2020

Background

This study explored the relationships between the low−/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and other clinical indicators and ischaemic stroke (IS) in patients with non-valvular atrial fibrillation (NVAF) in Xinjiang. The findings could provide a theoretical and therapeutic basis for NVAF patients.

Methods

NVAF patients who were admitted to 10 medical centres across Xinjiang were divided into stroke (798 patients) and control (2671 patients) groups according to the occurrence of first acute IS. Univariate and multivariate logistic regression analysis were used to examine the independent risk factors for IS in NVAF patients. Factor analysis and principal component regression analysis were used to analyse the main factors influencing IS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory ability of LDL-C/HDL-C for predicting the occurrence of IS.

Results

The stroke group had an average age of 71.64 ± 9.96 years and included 305 females (38.22%). The control group had a mean age of 67.30 ± 12.01 years and included 825 females (30.89%). Multivariate logistic regression showed that the risk of IS in the highest LDL-C/HDL-C quartile (≥2.73) was 16.23-fold that of the lowest quartile (< 1.22); IS risk was 2.27-fold higher in obese patients than in normal-weight subjects; IS risk was 3.15-fold higher in smoking patients than in non-smoking patients. The area under the ROC curve of LDL-C/HDL-C was 0.76, the optimal critical value was 2.33, the sensitivity was 63.53%, and the specificity was 76.34%. Principal component regression analysis showed that LDL-C/HDL-C, age, smoking, drinking, LDL-C and hypertension were risk factors for IS in NVAF patients.

Conclusions

LDL-C/HDL-C > 1.22, smoking, BMI ≥24 kg/m2and CHA2DS2-VASc score were independent risk factors for IS in NVAF patients; LDL-C/HDL-C was the main risk factor.
Correction to: HTA and MCDA solely or combined? The case of priority-setting in Colombia
Authors: Castro Héctor E. , Moreno-Mattar Ornella , Rivillas Juan C.
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Development and validation of a robust immune-related prognostic signature in early-stage lung adenocarcinoma
Authors: Wu Pancheng , Zheng Yi , Wang Yanyu , Wang Yadong , Liang Naixin
Published: October 2020

Background

The incidence of stage I and stage II lung adenocarcinoma (LUAD) is likely to increase with the introduction of annual screening programs for high-risk individuals. We aimed to identify a reliable prognostic signature with immune-related genes that can predict prognosis and help making individualized management for patients with early-stage LUAD.

Methods

The public LUAD cohorts were obtained from the large-scale databases including 4 microarray data sets from the Gene Expression Omnibus (GEO) and 1 RNA-seq data set from The Cancer Genome Atlas (TCGA) LUAD cohort. Only early-stage patients with clinical information were included. Cox proportional hazards regression model was performed to identify the candidate prognostic genes in GSE30219, GSE31210 and GSE50081 (training set). The prognostic signature was developed using the overlapped prognostic genes based on a risk score method. Kaplan–Meier curve with log-rank test and time-dependent receiver operating characteristic (ROC) curve were used to evaluate the prognostic value and performance of this signature, respectively. Furthermore, the robustness of this prognostic signature was further validated in TCGA-LUAD and GSE72094 cohorts.

Results

A prognostic immune signature consisting of 21 immune-related genes was constructed using the training set. The prognostic signature significantly stratified patients into high- and low-risk groups in terms of overall survival (OS) in training data set, including GSE30219 (HR = 4.31, 95% CI 2.29–8.11; P = 6.16E−06), GSE31210 (HR = 11.91, 95% CI 4.15–34.19; P = 4.10E−06), GSE50081 (HR = 3.63, 95% CI 1.90–6.95; P = 9.95E−05), the combined data set (HR = 3.15, 95% CI 1.98–5.02; P = 1.26E−06) and the validation data set, including TCGA-LUAD (HR = 2.16, 95% CI 1.49–3.13; P = 4.54E−05) and GSE72094 (HR = 2.95, 95% CI 1.86–4.70; P = 4.79E−06). Multivariate cox regression analysis demonstrated that the 21-gene signature could serve as an independent prognostic factor for OS after adjusting for other clinical factors. ROC curves revealed that the immune signature achieved good performance in predicting OS for early-stage LUAD. Several biological processes, including regulation of immune effector process, were enriched in the immune signature. Moreover, the combination of the signature with tumor stage showed more precise classification for prognosis prediction and treatment design.

Conclusions

Our study proposed a robust immune-related prognostic signature for estimating overall survival in early-stage LUAD, which may be contributed to make more accurate survival risk stratification and individualized clinical management for patients with early-stage LUAD.
Evaluation of neurofilament light chain in the cerebrospinal fluid and blood as a biomarker for neuronal damage in experimental pneumococcal meningitis
Authors: Le Ngoc Dung , Muri Lukas , Grandgirard Denis , Kuhle Jens , Leppert David , Leib Stephen L.
Published: October 2020

Background

Pneumococcal meningitis (PM) remains a global public health concern and affects all age groups. If acquired during infancy or childhood, permanent neurofunctional deficits including cognitive impairment, cerebral palsy, and secondary epilepsy are typical sequelae of neuronal injury. Determination of patients at risk for the development of brain injury and subsequent neurofunctional sequelae could help to identify patients for focused management. Neurofilament light chain (NfL) is an axonal cytoskeletal protein released upon neuronal injury into the cerebrospinal fluid (CSF) and blood. As little is known about the course of neurofilament release in the course of PM, we measured CSF and serum NfL levels longitudinally in experimental PM (ePM).

Methods

Eleven-day-old infant Wistar rats were infected intracisternally withStreptococcus pneumoniaeand treated with ceftriaxone. At 18 and 42 h post-infection (hpi), the blood and CSF were sampled for NfL measurements by a single molecule array technology. Inflammatory cytokines and MMP-9 in CSF were quantified by magnetic bead multiplex assay (Luminex®) and by gel zymography, respectively.

Results

In ePM, CSF and serum NfL levels started to increase at 18 hpi and were 26- and 3.5-fold increased, respectively, compared to mock-infected animals at 42 hpi (p< 0.0001). CSF and serum NfL correlated at 18 hpi (p< 0.05,r= 0.4716) and 42 hpi (p< 0.0001,r= 0.8179). Both CSF and serum NfL at 42 hpi strongly correlated with CSF levels of IL-1β, TNF-α, and IL-6 and of MMP-9 depending on their individual kinetics.

Conclusion

Current results demonstrate that during the peak inflammatory phase of ePM, NfL levels in CSF and serum are the highest among CNS disease models studied so far. Given the strong correlation of CSF versus serum NfL, and its CNS-specific signal character, longitudinal measurements to monitor the course of PM could be performed based on blood sample tests, i.e., without the need of repetitive spinal taps. We conclude that NfL in the serum should be evaluated as a biomarker in PM.
Intimate partner violence against reproductive age women during COVID-19 pandemic in northern Ethiopia 2020: a community-based cross-sectional study
Authors: Gebrewahd Gebremeskel Tukue , Gebremeskel Gebreamlak Gebremedhn , Tadesse Degena Bahrey
Published: October 2020

Background

As the global pandemic of corona virus (COVID-19) spreads across continents and communities, people are forced to respond with strict preventive measures such as staying at home and keeping social distance. In relation with these measures, particularly with the staying at home, increasing rates of domestic violence are beginning to surface. Hence, this study was aimed at determining the prevalence of intimate partner violence against reproductive age women in northern Ethiopia during the COVID-19 pandemic.

Methods

A community-based cross-sectional study design was employed. The data were collected during the period of April to May, 2020 using interviews and a self-administered standard questionnaire. The data were entered into the Epi-data manager version 4.2 and exported to SPSS 22 for analysis. The descriptive analysis such as frequency distribution, percentage, and measures of central tendency were used. This was followed by binary and multiple logistic regression analysis to infer the association between the outcome and independent variables.

Results

A total of 682 participants were included in the study. The prevalence of intimate partner violence against women was found to stood at 24.6% with psychological violence being the most prevalent (13.3%), followed by physical (8.3%) and sexual violence (5.3%). Women were more likely to suffer from violence if they were housewives (AOR, 95% CI (18.062 (10.088, 32.342))), age less than 30 (AOR, 95% CI (23.045 (5.627, 94.377))), women with arrange marriage (AOR, 95% CI (2.535 (1.572, 4.087))) and women with husband’s age being “between” 31–40 (AOR, CI 95% (2.212 (1.024, 4.777))).

Conclusions

This study showed the presence of a relatively high prevalence of intimate partner violence against women. Thus, public reporting of any cases or concerns of abuse is critical and vital to mitigate the problem.