bluuebunny/crossref_metadata_2025 huggingface dataset:
Fetal double aortic arch: prenatal sonographic and postnatal computed tomography angiography features, associated abnormalities and clinical outcomes
Authors: Guo Qiao , Kong Yifan , Zeng Shi , Zhou Jiawei , Wang Xiaofang , Shang Quanliang , Zhou Jia , Yuan Hongxia , Wang Ling , Tong Lili , Yi Aijiao , Zhou Qichang
Published: October 2020

Background

Fetal double aortic arch (DAA) malformation is a rare congenital heart disease with few reported cases in the literature. We aimed to investigate the characteristics of prenatal ultrasound and postnatal computed tomography angiography (CTA) of DAA and to describe the associated anomalies and clinical outcomes to improve prenatal diagnosis and assist in perinatal management.

Methods

The obstetric ultrasound imaging databases of seven tertiary referral centers were reviewed retrospectively to identify fetuses with a prenatal diagnosis of DAA between January 2013 and December 2018. Ultrasonographic findings, associated anomalies, genetic abnormalities, postnatal CTA images, and long-term postnatal outcomes were evaluated.

Results

A total of 36 cases out of 40 prenatally diagnosed DAA fetuses were confirmed by postnatal diagnosis (fetal autopsy, CTA, and surgery). In this cohort of 36 confirmed cases, 24 (67%) were isolated anomalies, while 12 (33%) were associated with intracardiac or extracardiac anomalies, and 2 (6%) had a 22q11.2 chromosome deletion. Among nine cases of pregnancy termination with a fetal autopsy, 7 had other abnormalities. Among the remaining 27 live births, 16 (59%) were asymptomatic and 11 (41%) received surgical treatment due to tracheal or esophageal compression symptoms, all with satisfactory outcomes. Prenatal echocardiography showed that DAA was mainly characterized by a bifurcation of the ascending aorta into the right and left aortic arch and the formation of a complete O-shaped vascular ring around the trachea on the three-vessel tracheal view. A variant in the aortic arch branching pattern was found for the first time. The airway obstruction, branching pattern, and atretic arch of DAA were clearly shown by postnatal CTA.

Conclusions

Fetal DAA has unique features on prenatal echocardiography and postnatal CTA, and systematic prenatal examination and timely postnatal CTA evaluation are required. A certain proportion of intracardiac and extracardiac abnormalities are associated with DAA, but the probability of chromosome abnormalities is low, especially for isolated DAA.The clinical outcomes of isolated DAA are favorable, even if surgery is performed due to symptoms. Determining whether other malformations or chromosomal anomalies exist is crucial for prognosis evaluation and prenatal counseling.
ECCDIA: an interactive web tool for the comprehensive analysis of clinical and survival data of esophageal cancer patients
Authors: Yang Jingcheng , Shang Jun , Song Qian , Yang Zuyi , Chen Jianing , Yu Ying , Shi Leming
Published: October 2020

Background

Esophageal cancer (EC) is considered as one of the deadliest malignancies with respect to incidence and mortality rate, and numerous risk factors may affect the prognosis of EC patients. For better understanding of the risk factors associated with the onset and prognosis of this malignancy, we develop an interactive web-based tool for the convenient analysis of clinical and survival characteristics of EC patients.

Methods

The clinical data were obtained from The Surveillance, Epidemiology, and End Results (SEER) database. Seven analysis and visualization modules were built with Shiny.

Results

The Esophageal Cancer Clinical Data Interactive Analysis (ECCDIA, http://webapps.3steps.cn/ECCDIA/) was developed to provide basic data analysis, visualization, survival analysis, and nomogram of the overall group and subgroups of 77,273 EC patients recorded in SEER. The basic data analysis modules contained distribution analysis of clinical factor ratios, Sankey plot analysis for relationships between clinical factors, and a map for visualizing the distribution of clinical factors. The survival analysis included Kaplan-Meier (K-M) analysis and Cox analysis for different subgroups of EC patients. The nomogram module enabled clinicians to precisely predict the survival probability of different subgroups of EC patients.

Conclusion

ECCDIA provides clinicians with an interactive prediction and visualization tool for visualizing invaluable clinical and prognostic information of individual EC patients, further providing useful information for better understanding of esophageal cancer.
Dietary macro- and micro-nutrients intake adequacy at 6th and 12th month post-bariatric surgery
Authors: Ziadlou Maryam , Hosseini-Esfahani Firoozeh , Mozaffari Khosravi Hassan , Hosseinpanah Farhad , Barzin Maryam , Khalaj Alireza , Valizadeh Majid
Published: October 2020

Background

Bariatric surgery (BS) is considered as an effective solution to control morbid obesity. Food restrictions resulting from the operation may decrease dietary nutrient intakes, particularly during the first year after BS. This study mainly aimed to assess the adequacy of dietary nutrient intakes at 6th and 12th month after BS.

Method

Of the severely obese participants in the Tehran obesity treatment study in 2015–2016, 58 patients undergoing Roux-En-Y gastric bypass (N = 16) or sleeve gastrectomy (N = 42) were selected from Tehran Obesity Treatment Center. To assess the patients’ dietary intake, a three-day, 24-h dietary recall was obtained on three unscheduled days (two non-consecutive weekdays and one weekend day) at 6th and 12th month after BS. To evaluate the adequacy of nutrient intake, the patients’ intakes were compared to the current dietary reference intakes (DRIs), including estimated average requirements (EAR) or Adequate Intakes (AI).

Results

The mean age of the participants (71% women) undergoing BS was 37 ± 8 years. Anthropometric parameters significantly decreased at the 12th month after BS. The percentage of energy from carbohydrate intake increased significantly between the 6th and 12th month after BS (P = 0.04). The mean ± SD of protein intake was lower than the recommended dosage with a dramatic decrease from 45 ± 30 to 31 ± 15 (g/day) between the two intervals (P = 0.001). The mean intake of saturated fatty acid (SFA) decreased dramatically (P < 0.001) from 6 to 12 month; however, the median intake of n3-polyunsaturated fatty acid (n3-PUFA) intake increased (P = 0.02). None of the participants showed nutrient intake adequacy in terms of biotin, fat soluble vitamins, pantothenic acid, potassium, and zinc. Moreover, less than 10% of the participants showed nutrient intake adequacy in terms of folate, magnesium, manganese, and calcium according to DRIs during the both intervals after BS.

Conclusion

Bariatric surgery can reduce dietary intakes, which is more obvious 12 months after the surgery. Out of 21 micronutrients, nearly all could not met the EAR and were received < 50%, also had significant reduction from the 6th to12th month after surgery.
Prevalence and patterns of gender-based violence across adolescent girls and young women in Mombasa, Kenya
Authors: Bhattacharjee Parinita , Ma Huiting , Musyoki Helgar , Cheuk Eve , Isac Shajy , Njiraini Margaret , Gichangi Peter , Mishra Sharmistha , Becker Marissa , Pickles Michael
Published: October 2020

Background

We sought to estimate the prevalence and describe heterogeneity in experiences of gender-based violence (GBV) across subgroups of adolescent girls and young women (AGYW).

Methods

We used data from a cross-sectional bio-behavioural survey among 1299 AGYW aged 14–24 in Mombasa, Kenya in 2015. Respondents were recruited from hotspots associated with sex work, and self-selected into one of three subgroups: young women engaged in casual sex (YCS), young women engaged in transactional sex (YTS), and young women engaged in sex work (YSW). We compared overall and across subgroups: prevalence of lifetime and recent (within previous year) self-reported experience of physical, sexual, and police violence; patterns and perpetrators of first and most recent episode of physical and sexual violence; and factors associated with physical and sexual violence.

Results

The prevalences of lifetime and recent physical violence were 18.0 and 10.7% respectively. Lifetime and recent sexual violence respectively were reported by 20.5 and 9.8% of respondents. Prevalence of lifetime and recent experience of police violence were 34.7 and 25.8% respectively. All forms of violence were most frequently reported by YSW, followed by YTS and then YCS. 62%/81% of respondents reported having sex during the first episode of physical/sexual violence, and 48%/62% of those sex acts at first episode of physical/sexual violence were condomless. In the most recent episode of violence when sex took place levels of condom use remained low at 53–61%. The main perpetrators of violence were intimate partners for YCS, and both intimate partners and regular non-client partners for YTS. For YSW, first-time and regular paying clients were the main perpetrators of physical and sexual violence. Alcohol use, ever being pregnant and regular source of income were associated with physical and sexual violence though it differed by subgroup and type of violence.

Conclusions

AGYW in these settings experience high vulnerability to physical, sexual and police violence. However, AGYW are not a homogeneous group, and there are heterogeneities in prevalence and predictors of violence between subgroups of AGYW that need to be understood to design effective programmes to address violence.
Characterization of total adenosine deaminase activity (ADA) and its isoenzymes in saliva and serum in health and inflammatory conditions in four different species: an analytical and clinical validation pilot study
Authors: Contreras-Aguilar María Dolores , Tvarijonaviciute Asta , Monkeviciene Ingrida , Martín-Cuervo María , González-Arostegui Luis Guillermo , Franco-Martínez Lorena , Cerón José Joaquín , Tecles Fernando , Escribano Damián
Published: October 2020

Background

Measurement of adenosine deaminase (ADA) can provide information about cell-mediated immunity. This report’s objective was to study the enzymatic activity of total ADA (tADA) and its isoenzymes ADA1 and ADA2 in canine, equine, porcine, and bovine serum and saliva and their changes in different inflammatory situations in each species. Besides, an automated method for ADA2 measurement was developed and validated.

Results

tADA was present in serum and saliva of healthy animals of the four species. Erythro-9-(2-hydroxy-3-nonyl) adenine (EHNA) concentration of 0.47 mM was needed for ADA1 inhibition in canine and porcine samples (serum and saliva) and bovine saliva, whereas for equine saliva 0.94 mM was needed. ADA2 activity was not detected in bovine serum and was very low or absent in equine serum and bovine saliva. An automated procedure to measure ADA2 consisting of adding EHNA to a commercial reagent for tADA measurement provided repetitive (coefficients of variation < 8.8% in serum and < 10% in saliva) and accurate (linearity of serial sample dilutions withR2 > 0.90) results, being equivalent to a manual incubation of the sample with EHNA at a similar concentration. Salivary tADA, as well as ADA1 and ADA2, were higher in dogs with leishmaniosis, horses with acute abdominal disease and pigs with lameness than in healthy animals. tADA and isoenzymes in saliva showed a positive significant correlation with serum ferritin in dogs (r = 0.602,P < 0.01;r = 0.555,P < 0.05; andr = 0.632,P < 0.01; respectively for tADA, ADA1 and ADA2) and serum C-reactive protein in pigs (r = 0.700,P < 0.01, for both tADA and ADA1;r = 0.770,P < 0.001, for ADA2), whereas salivary ADA2 significantly correlated with serum amyloid A in horses (r = 0.649,P < 0.01). In cows, salivary tADA and ADA1 significantly increased after calving, correlating with total white blood cell count (r = 0.487,P < 0.05, for both tADA and ADA1).

Conclusions

The activity of total ADA and its different isoenzymes, can be measured in serum and saliva of dogs, horses, pigs and cows by a simple and fast procedure described in this report. When measured in saliva, these analytes correlated with other biomarkers of inflammation and it could potentially be used as a biomarkers of inflammation and immune activation in the species of this study.
Modeling esophageal protection from radiofrequency ablation via a cooling device: an analysis of the effects of ablation power and heart wall dimensions
Authors: Mercado Marcela , Leung Lisa , Gallagher Mark , Shah Shailee , Kulstad Erik
Published: October 2020

Background

Esophageal thermal injury can occur after radiofrequency (RF) ablation in the left atrium to treat atrial fibrillation. Existing methods to prevent esophageal injury have various limitations in deployment and uncertainty in efficacy. A new esophageal heat transfer device currently available for whole-body cooling or warming may offer an additional option to prevent esophageal injury. We sought to develop a mathematical model of this process to guide further studies and clinical investigations and compare results to real-world clinical data.

Results

The model predicts that the esophageal cooling device, even with body-temperature water flow (37 °C) provides a reduction in esophageal thermal injury compared to the case of the non-protected esophagus, with a non-linear direct relationship between lesion depth and the cooling water temperature. Ablation power and cooling water temperature have a significant influence on the peak temperature and the esophageal lesion depth, but even at high RF power up to 50 W, over durations up to 20 s, the cooling device can reduce thermal impact on the esophagus. The model concurs with recent clinical data showing an 83% reduction in transmural thermal injury when using typical operating parameters.

Conclusions

An esophageal cooling device appears effective for esophageal protection during atrial fibrillation, with model output supporting clinical data. Analysis of the impact of ablation power and heart wall dimensions suggests that cooling water temperature can be adjusted for specific ablation parameters to assure the desired myocardial tissue ablation while keeping the esophagus protected.
Responsiveness of health care services towards the elderly in Tanzania: does health insurance make a difference? A cross-sectional study
Authors: Amani Paul Joseph , Tungu Malale , Hurtig Anna-Karin , Kiwara Angwara Denis , Frumence Gasto , San Sebastián Miguel
Published: October 2020

Background

Responsiveness has become an important health system performance indicator in evaluating the ability of health care systems to meet patients’ expectations. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania and to explore the association of health insurance (HI) with responsiveness in this population.

Methods

A community-based cross-sectional study was conducted in 2017 where a pre-tested household survey, administered to the elderly (60 + years) living in Igunga and Nzega districts, was applied. Participants with and without health insurance who attended outpatient and inpatient health care services in the past three and 12 months were selected. Responsiveness was measured based on the short version of the World Health Organization (WHO) multi-country responsiveness survey study, which included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to assess the specific association of the responsiveness index with health insurance adjusted for sociodemographic factors.

Results

A total of 1453 and 744 elderly, of whom 50.1 and 63% had health insurance, used outpatient and inpatient health services, respectively. All domains were rated relatively highly but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (− 1; 95% CI: − 1.45, − 0.45) and inpatient (− 2; 95% CI: − 2.69, − 1.30) care.

Conclusion

The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked poorly. Further research is necessary to reveal the reasons for the lower responsiveness noted among insured elderly. A continuous monitoring of health care system responsiveness is recommended.
The influence of CYP1A1 and CYP1A2 polymorphisms on stroke risk in the Chinese population
Authors: Mao Yan , Yang Lin , Chen Qian , Li Guoqing , Sun Yao , Wu Jiamin , Xiong Zichao , Liu Yuanwei , Li Haiyue , Liu Jianfeng , Zhang Yong
Published: October 2020

Backgrounds

Stroke is a sudden disorder of cerebral blood circulation. Many studies have illustrated that dyslipidemia, hypertension, diabetes, smoking and excessive drinking are the traditional risk factors for stroke. This study aimed to observe the relationship between CYP1A1 and CYP1A2 variants and stroke risk in the Chinese population.

Methods

Agena MassARRAY Assay was used to genotype four single nucleotide polymorphisms (SNPs) in 477 cases and 480 controls. The chi-square test and logistic-regression analysis were used to explore the relationship between CYP1A1 and CYP1A2 variants and stroke risk.

Results

Individuals with CYP1A2 rs762551 C was associated with a lower risk of stroke than that of allele A. Age stratification analysis showed that rs762551 was only observed to be associated with a lower risk of stroke in ≤64ys age group. After gender stratification analysis, a significant association between rs762551 and stroke risk was found in males, but not in females. The four SNPs were found to be correlated with stroke risk in patients with hypertension, coronary heart disease, cerebral infarction and lacunar infarction.

Conclusion

In this study, the results first showed that CYP1A1 and CYP1A2 variants were associated with stroke risk. Larger and well-designed studies are needed to confirm the results.
Fifteen years of heroin-assisted treatment in a Swiss prison—a retrospective cohort study
Authors: Liebrenz Michael , Gamma Alex , Buadze Anna , Schleifer Roman , Baggio Stéphanie , Schwartz Bruce , Schneeberger Andres , Uchtenhagen Ambros
Published: October 2020

Background

In the context of the current US opioid crisis and the compelling fact that a quarter to a third of all those addicted to heroin pass through its prisons and jails each year, the care of incarcerated opioid-using individuals (OUI) needs to be improved.

Aims

Little has been published on the effectiveness or outcomes of heroin-assisted treatment (HAT), a treatment option for severely dependent OUI delivered in a prison setting. The aim of this study was therefore to evaluate such treatment since its implementation. The primary objective was to investigate whether heroin-assisted treatment was associated with severe detrimental health outcomes. The secondary objective was to compare the heroin-assisted treatment group with the general prison population in terms of occupational functioning.

Design

Retrospective cohort study

Setting

An open prison with 120 places

Subjects

Data on 1885 male prisoners with a total of 2239 imprisonment periods between 2000 and 2015 was available. Ninety-seven inmates in heroin-assisted treatment were compared with 1788 inmates from the general prison population (reference group).

Measurements

Mortality, medical complications (including overdoses), and work performance (days worked, sick days, and monthly wages earned).

Findings

Inmates receiving HAT were on average 1 year younger (33.8 vs. 34.9 years), had longer prison stays (7.3 vs. 3.0 months), were more often of Swiss nationality (68.0% vs. 28.9%), and had committed more drug- and property-related offenses (49.5% vs. 23.2% and 63.9% vs. 38.3%, respectively) compared to the reference group. No serious heroin-related medical complication occurred during the 15-year window of observation among inmates with heroin-assisted treatment. Their work performance was comparable to that of the reference group.

Conclusions

This study shows that heroin-assisted treatment can be a valuable treatment option for severely dependent OUI during imprisonment, can be delivered safely by prison health staff over extended periods of time, and allows OUI in treatment to achieve work performance rates comparable to that of the general prison population.
Impacts of hepatitis B and hepatitis C co-infection with tuberculosis, a prospective cohort study
Authors: Feleke Berhanu Elfu , Feleke Teferi Elfu , Adane Wondimu Gebrekiros , Girma Abel
Published: October 2020

Background

This study was conducted to estimate the prevalence, determinants of hepatitis B, hepatitis C and the survival of tuberculosis patients until drug-induced hepatitis.

Methods

Prospective cohort study design was implemented. The data were collected from September 2016 – May 2019. Systematic random sampling was used to select the study participants. Baseline data were collected before the patient starts DOTS, the sign of liver toxicity was assessed every week. Tuberculosis treatment outcomes and WHO clinical stage was recorded at the end of 6th months. Descriptive statistics were used to estimate the prevalence of hepatitis B, hepatitis C viral infections and their effect on tuberculosis treatment outcomes. Binary logistic regression was used to identify the determinants of hepatitis B and C infections. The Kaplan Meier survival curve was used to estimate the survival of tuberculosis patient and Cox regression was used to identify the predictors of drug-induced hepatitis.

Results

A total of 3537 tuberculosis patients were followed. The prevalence of hepatitis B and C viral infection among tuberculosis patients were 15.1 and 17.3% respectively. Hepatitis B viral infection among tuberculosis patients was associated with alcohol, sex, HIV, chronic illness. Hepatitis C viral infection among tuberculosis patients was associated with alcohol, sex, HIV, chronic illness. The incidence density for liver toxicity among tuberculosis patients was 843/15707 person-months and liver toxicity was determined by HIV, Hepatitis B, Hepatitis C, the severity of tuberculosis and chronic illnesses.

Conclusion

Decision-makers should consider incorporating screening for hepatitis B and C viral infection during tuberculosis treatment.
Using Near-infrared reflectance spectroscopy (NIRS) to predict glucobrassicin concentrations in cabbage and brussels sprout leaf tissue
Authors: Renner Ilse E. , Fritz Vincent A
Published: October 2020

Background

Glucobrassicin (GBS) and its hydrolysis product indole-3-carbinol are important nutritional constituents implicated in cancer chemoprevention. Dietary consumption of vegetables sources of GBS, such as cabbage and Brussels sprouts, is linked to tumor suppression, carcinogen excretion, and cancer-risk reduction. High-performance liquid-chromatography (HPLC) is the current standard GBS identification method, and quantification is based on UV-light absorption in comparison to known standards or via mass spectrometry. These analytical techniques require expensive equipment, trained laboratory personnel, hazardous chemicals, and they are labor intensive. A rapid, nondestructive, inexpensive quantification method is needed to accelerate the adoption of GBS-enhancing production systems. Such an analytical method would allow producers to quantify the quality of their products and give plant breeders a high-throughput phenotyping tool to increase the scale of their breeding programs for high GBS-accumulating varieties. Near-infrared reflectance spectroscopy (NIRS) paired with partial least squares regression (PLSR) could be a useful tool to develop such a method.

Results

Here we demonstrate that GBS concentrations of freeze-dried tissue from a wide variety of cabbage and Brussels sprouts can be predicted using partial least squares regression from NIRS data generated from wavelengths between 950 and 1650 nm. Cross-validation models had R2 = 0.75 with RPD = 2.3 for predicting µmol GBS·100 g−1fresh weight and R2 = 0.80 with RPD = 2.4 for predicting µmol GBS·g−1dry weight. Inspections of equation loadings suggest the molecular associations used in modeling may be due to first overtones from O–H stretching and/or N–H stretching of amines.

Conclusions

A calibration model suitable for screening GBS concentration of freeze-dried leaf tissue using NIRS-generated data paired with PLSR can be created for cabbage and Brussels sprouts. Optimal NIRS wavelength ranges for calibration remain an open question.
Type 1 tyrosinemia in Finland: a nationwide study
Authors: Äärelä Linnea , Hiltunen Pauliina , Soini Tea , Vuorela Nina , Huhtala Heini , Nevalainen Pasi I. , Heikinheimo Markku , Kivelä Laura , Kurppa Kalle
Published: October 2020

Background

Introduction of nitisinone and newborn screening (NBS) have transformed the treatment of type 1 tyrosinemia, but the effects of these changes on the long-term outcomes remain obscure. Also, the predictors for later complications, the significance of drug levels and the normalization of laboratory and imaging findings are poorly known. We investigated these issues in a nationwide study.

Results

Type 1 tyrosinemia was diagnosed in 22 children in 1978–2019 in Finland. Incidence was 1/90,102, with a significant enrichment in South Ostrobothnia (1/9990). Median age at diagnosis was 5 (range 0.5–36) months, 55% were girls and 13 had homozygotic Trp262X mutation. Four patients were detected through screening and 18 clinically, their main findings being liver failure (50% vs. 100%, respectively, p = 0.026), ascites (0% vs. 53%, p = 0.104), renal tubulopathy (0% vs. 65%, p = 0.035), rickets (25% vs. 65%, p = 0.272), growth failure (0% vs. 66%, p = 0.029), thrombocytopenia (25% vs. 88%, p = 0.028) and anaemia (0% vs. 47%, p = 0.131). One patient was treated with diet, seven with transplantation and 14 with nitisinone. Three late-diagnosed (6–33 months) nitisinone treated patients needed transplantation later. Kidney dysfunction (86% vs. 7%, p = 0.001), hypertension (57% vs. 7%, p = 0.025) and osteopenia/osteoporosis (71% vs. 14%, p = 0.017) were more frequent in transplanted than nitisinone-treated patients. Blood/serum alpha-fetoprotein decreased rapidly on nitisinone in all but one patient, who later developed intrahepatic hepatocellular carcinoma. Liver values normalized in 31 months and other laboratory values except thrombocytopenia within 18 months. Imaging findings normalized in 3–56 months excluding five patients with liver or splenic abnormalities. Low mean nitisinone concentration was associated with higher risk of severe complications (r = 0.758, p = 0.003) despite undetectable urine succinylacetone.

Conclusions

Prognosis of type 1 tyrosinemia has improved in the era of nitisinone, and NBS seems to provide further benefits. Nevertheless, the long-term risk for complications remains, particularly in the case of late diagnosis and/or insufficient nitisinone levels.
Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis
Authors: Abate Semagn Mekonnen , Mantefardo Bahiru , Basu Bivash
Published: October 2020

Background

The coronavirus disease 2019 (COVID-19) pandemic puts perioperative providers and staff at risk of viral exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) during aerosol-generating procedures, particularly in asymptomatic carriers.However, the perioperative risk for adverse outcomes in SARS-CoV-2 infected patients remain uncertain and the topic of debate. The current study was designed to determine the postoperative mortality in COVID-19 patients based on a systematic review and meta-analysis of the global published peer-reviewed literature.

Methods

A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 29, 2019, to August15, 2020, without language restriction. All observational studies reporting the prevalence of mortality were included while case reports and reviews were excluded. The data from each study were extracted with two independent authors with a customized format excel sheet and the disagreements were resolved by the third author. The methodological quality of included studies was evaluated using a standardized critical appraisal Tool adapted from the Joanna Briggs Institute.

Results

A total of 715 articles were identified from different databases and 45 articles were selected for evaluation after the successive screening. Twenty-three articles with 2947 participants were included. The meta-analysis revealed a very high global rate of postoperative mortality among COVID-19 patients of 20% (95% CI: 15 to 26) and a postoperative ICU admission rate of 15% (95% confidence interval (CI):10 to 21).

Conclusion

The unexpected high postoperative mortality rate in SARS-CoV-2 infected patients of 20% in the global literature mandates further scrutiny in assuring appropriate surgical indications and perioperative surgical safety measures in this vulnerable cohort of patients.

Registration

This systematic review and meta-analysis was registered in Prospero’s international prospective register of systematic reviews (CRD42020203362) on August 10, 2020.
Oxygenation strategies prior to and during prehospital emergency anaesthesia in UK HEMS practice (PREOXY survey)
Authors: Boulton Adam J. , Mashru Amar , Lyon Richard
Published: October 2020

Background

Maintaining effective oxygenation throughout the process of Pre-Hospital Emergency Anaesthesia (PHEA) is critical. There are multiple strategies available to clinicians to oxygenate patients both prior to and during PHEA. The optimal pre-oxygenation technique remains unclear, and it is unknown what techniques are being used by United Kingdom Helicopter Emergency Medical Services (HEMS). This study aimed to determine the current pre- and peri-PHEA oxygenation strategies used by UK HEMS services.

Methods

An electronic questionnaire survey was delivered to all UK HEMS services between 05 July and 26 December 2019. Questions investigated service standard operating procedures (SOPs) and individual clinician practice regarding oxygenation strategies prior to airway instrumentation (pre-oxygenation) and oxygenation strategies during airway instrumentation (apnoeic oxygenation). Service SOPs were obtained to corroborate questionnaire replies.

Results

Replies were received from all UK HEMS services (n = 21) and 40 individual clinicians. All services specified oxygenation strategies within their PHEA/RSI SOP and most referred to pre-oxygenation as mandatory (81%), whilst apnoeic oxygenation was mandatory in eight (38%) SOPs. The most commonly identified pre-oxygenation strategies were bag-valve-mask without PEEP (95%), non-rebreathable face mask (81%), and nasal cannula at high flow (81%). Seven (33%) services used Mapleson C circuits, whilst there were eight services (38%) that did not carry bag-valve-masks with PEEP valve nor Mapleson C circuits. All clinicians frequently used pre-oxygenation, however there was variability in clinician use of apnoeic oxygenation by nasal cannula. Nearly all clinicians (95%) reported manually ventilating patients during the apnoeic phase, with over half (58%) stating this was their routine practice. Differences in clinician pre-hospital and in-hospital practice related to availability of humidified high flow nasal oxygenation and Mapleson C circuits.

Conclusions

Pre-oxygenation is universal amongst UK HEMS services and is most frequently delivered by bag-valve-mask without PEEP or non-rebreathable face masks, whereas apnoeic oxygenation by nasal cannula is highly variable. Multiple services carry Mapleson C circuits, however many services are unable to deliver PEEP due to the equipment they carry. Clinicians are regularly manually ventilating patients during the apnoeic phase of PHEA. The identified variability in clinical practice may indicate uncertainty and further research is warranted to assess the impact of different strategies on clinical outcomes.
Somatic development in children with Shwachman-Diamond syndrome
Authors: Bogusz-Wójcik Agnieszka , Kołodziejczyk Honorata , Klaudel-Dreszler Maja , Oracz Grzegorz , Pawłowska Joanna , Szalecki Mieczysław
Published: October 2020

Background

Shwachman-Diamond syndrome (SDS) is a rare genetic, multi-systemic disease characterized by exocrine pancreatic insufficiency, immune deficiency, bone marrow failure and skeletal abnormalities. Most patients present with failure in somatic development and short stature, but systematic data concerning those features are limited. The aim of the study was to assess the prevalence of failure in somatic development in the children with SDS.

Methods

An analysis of anthropometric measurements of 21 patients (14 girls and 7 boys),aged 2 to 17 years (mean age 6.3 years) with SDS diagnosed in The Children’s Memorial Health Institute in Warsaw, Poland was performed. The patients were measured using a Holtain Limited stadiometer, an electronic scale, a Harpenden anthropometer, a metric tape and a spreading caliper. The assessed anthropometric parameters were expressed as standard deviation scores in relation to the reference values in Poland, suitable for sex as well as calendar and growth age.

Results

A total of 66 measurements was collected and analyzed with a median number of 3 observations per patient. The group of boys presented with a significantly lower height (− 3.0 SD, p < 0.0001) and BMI (− 1.4 SD, p < 0.00001), and in the relation to the growth age a lower weight (− 1.0 SD, p < 0.001) as well as a smaller chest width (− 0.9 SD, p < 0.05), hip width (− 0,5 SD, p < 0,05) and lower limb length (− 0,5 SD, p < 0,05). The group of girls also showed significantly lower height (− 2.6 SD, p < 0.00001) and BMI (− 0.8 SD, p < 0.00001), and in relation to the growth age, lower weight (− 0.5 SD, p < 0.001) as well as decreased width of the chest (− 1.7 SD, p < 0.0001) and shoulder (− 1.0 SD, p < 0.001) were observed. Boys and girls were also characterized by significantly decreased circumference and width of head, additionally, girls had also smaller head length.

Conclusions

Patients with SDS have abnormal somatic development. Both boys and girls are characterized by short stature, decreased weight, BMI, leg length, chest width as well as circumference and width of head. Anthropometric measurements provide important data on the process of growth and body proportions in children with SDS.
The prophylactic and therapeutic effects of moxibustion combined with traditional Chinese medicine decoction for treating chemotherapy-induced myelosuppression in early-stage breast cancer: study protocol for a randomized controlled trial
Authors: Ji Yajie , Li Siyu , Zhang Xinyue , Liu Yu , Lu Qing , Li Qiong , Chen Weili , Sheng Jiayu , Jiang Ke , Liang Hongli , Sha Shanyan , Li Mengting , Chen Zongxin , Zheng Peiyi , Wang Minhong , Feng Yuanyuan , Wang Lei , Wu Huangan , Liu Huirong , Huang Yan , Yin Zhiguang , Xue Xiaohong
Published: October 2020

Background

Traditional Chinese medicine (TCM) has a long history of use in breast cancer, but lacking systematic evidence to support its clinical benefits. In this study, we evaluated the prophylactic and therapeutic effects of moxibustion combined with decoctions for treating chemotherapy-induced myelosuppression (CIM) in early-stage breast cancer patients.

Methods

This is a randomized controlled clinical trial single-blinded for TCM decoction but not moxibustion. Patients are equally divided into the control group without decoction and moxibustion treatment (control), the decoction+moxibustion group (MD), and the placebo+moxibustion group (MP), according to the following stratification factors: age (below 40s, 40s, 50s, and 60s or above), chemotherapy regimen (anthracyclines, taxanes, anthracyclines+taxane, and others), and chemotherapy strategy (adjuvant and neoadjuvant). The TCM decoction is Wenshen Shengbai Decoction. The anticipated sample size is 462 cases (154 cases in each group). All participants are expected to treat with chemotherapy and recombinant human granulocyte colony-stimulating factor (rhG-CSF). The primary outcomes include the proportion of patients with relief of leukopenia and/or neutropenia, the myelosuppression-associated serious adverse event including grade 3–4 leukopenia and/or neutropenia, and febrile neutropenia, and the dose of rhG-CSF. The secondary outcomes include chemotherapy adherence, stratified analysis, adverse reactions, quality of life by EORTC Breast-Cancer-Specific Quality of Life Questionnaire including EORTC QLQ-C30 (V3.0) and QLQ-BR23, TCM Constitution, and 3-year disease-free survival and overall survival. Baseline information including age, surgical approach, chemotherapy regimen and strategy, pathological stage, and molecular subtype will be recorded.

Discussion

This will be the first randomized controlled trial to evaluate the efficacy of moxibustion combined with TCM decoction in treating CIM in early-stage breast cancer patients, aiming to standardize the TCM decoction and moxibustion method, thus providing evidence for its clinical benefit.

Trial registration

chictr.org.cn ChiCTR-INR-16009557. Registered on 23 October 2016.
Epigenomic landscape of enhancer elements during Hydra head organizer formation
Authors: Reddy Puli Chandramouli , Gungi Akhila , Ubhe Suyog , Galande Sanjeev
Published: October 2020

Background

Axis patterning during development is accompanied by large-scale gene expression changes. These are brought about by changes in the histone modifications leading to dynamic alterations in chromatin architecture. The cis regulatory DNA elements also play an important role towards modulating gene expression in a context-dependent manner. Hydra belongs to the phylum Cnidaria where the first asymmetry in the body plan was observed and the oral-aboral axis originated. Wnt signaling has been shown to determine the head organizer function in the basal metazoan Hydra.

Results

To gain insights into the evolution of cis regulatory elements and associated chromatin signatures, we ectopically activated the Wnt signaling pathway in Hydra and monitored the genome-wide alterations in key histone modifications. Motif analysis of putative intergenic enhancer elements from Hydra revealed the conservation of bilaterian cis regulatory elements that play critical roles in development. Differentially regulated enhancer elements were identified upon ectopic activation of Wnt signaling and found to regulate many head organizer specific genes. Enhancer activity of many of the identified cis regulatory elements was confirmed by luciferase reporter assay. Quantitative chromatin immunoprecipitation analysis upon activation of Wnt signaling further confirmed the enrichment of H3K27ac on the enhancer elements of Hv_Wnt5a, Hv_Wnt11 and head organizer genes Hv_Bra1, CnGsc and Hv_Pitx1. Additionally, perturbation of the putative H3K27me3 eraser activity using a specific inhibitor affected the ectopic activation of Wnt signaling indicating the importance of the dynamic changes in the H3K27 modifications towards regulation of the genes involved in the head organizer activity.

Conclusions

The activation-associated histone marks H3K4me3, H3K27ac and H3K9ac mark chromatin in a similar manner as seen in bilaterians. We identified intergenic cis regulatory elements which harbor sites for key transcription factors involved in developmental processes. Differentially regulated enhancers exhibited motifs for many zinc-finger, T-box and ETS related TFs whose homologs have a head specific expression in Hydra and could be a part of the pioneer TF network in the patterning of the head. The ability to differentially modify the H3K27 residue is critical for the patterning of Hydra axis revealing a dynamic acetylation/methylation switch to regulate gene expression and chromatin architecture.
Chemotherapy combined with radiotherapy for successful treatment of angioimmunoblastic T-cell lymphoma: a case report
Authors: Xiong Yudi , Yang Lei , Dai Jing , Zhou Fuxiang , Zhou Yunfeng
Published: October 2020

Background

The incidence of angioimmunoblastic T-cell lymphoma is rare worldwide, and it has a poor prognosis. There is no proven or standard first-line therapy that works for the majority of patients with angioimmunoblastic T-cell lymphoma because of the rarity of this disease. The treatment and management are challenging for clinicians.

Case presentation

This report presents the diagnosis and treatment of a 65-year-old Chinese man who presented with cough and lymph node swellings in the left axillary region. The patient was diagnosed with angioimmunoblastic T-cell lymphoma. He underwent eight cycles of chemotherapy with CHOP (cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone) followed by TOMO radiotherapy (helical tomotherapy, a kind of radiotherapy for cancer treatment using spiral computed tomographic scanning). After treatment, the therapeutic effects were evaluated by magnetic resonance imaging and computed tomography about every 3 months. The patient recovered well with no sign of tumor recurrence and no obvious severe treatment-related adverse effects.

Conclusion

This treatment experience indicates an essential role for the combination of radiation therapy with CHOP, which may have a better prognosis than treatments without radiation therapy. But challenges warrant further validation in prospective studies.
Advances in the role of m6A RNA modification in cancer metabolic reprogramming
Authors: Han Xiu , Wang Lin , Han Qingzhen
Published: October 2020

N6-methyladenosine (m6A) modification is the most common internal modification of eukaryotic mRNA and is widely involved in many cellular processes, such as RNA transcription, splicing, nuclear transport, degradation, and translation. m6A has been shown to plays important roles in the initiation and progression of various cancers. The altered metabolic programming of cancer cells promotes their cell-autonomous proliferation and survival, leading to an indispensable hallmark of cancers. Accumulating evidence has demonstrated that this epigenetic modification exerts extensive effects on the cancer metabolic network by either directly regulating the expression of metabolic genes or modulating metabolism-associated signaling pathways. In this review, we summarized the regulatory mechanisms and biological functions of m6A and its role in cancer metabolic reprogramming.
Revealing historical fire regimes of the Cumberland Plateau, USA, through remnant fire-scarred shortleaf pines (Pinus echinata Mill.)
Authors: Stambaugh Michael C. , Marschall Joseph M. , Abadir Erin R.
Published: October 2020

Background

Vegetation of the Cumberland Plateau (USA) has undergone dramatic transitions since the last glaciation and particularly since the onset of widespread logging and twentieth century fire exclusion. Shortleaf pine (Pinus echinata Mill.), one of the most fire-dependent conifers in the US, occurs throughout the Cumberland Plateau, but its abundance has declined dramatically since Euro-American settlement and continues to decline. To better understand the historical ecology of fire within the natural range of shortleaf pine, we reconstructed fire regimes at three new sites throughout the central and southern Cumberland Plateau region based on fire scars on shortleaf pine trees.

Results

Fire event chronologies extended back to the seventeenth century and revealed historical fire regimes that were frequent and dominated by dormant-season and low-severity events. Fires occurred on average every 4.4 to 5.3 years at the study sites before widespread Euro-American settlement, and were more frequent (2.3 to 3.8 years) following settlement. Cumberland Plateau fires may be linked to adjacent ecoregions such as the Eastern Highland Rim to the west. Among all sites, we found that long-term trends in fire activity were similar and fit into a regional waveform pattern of fire activity likely driven by humans (i.e., Native American depopulation, European settlement, and twentieth century fire exclusion).

Conclusions

The decline in shortleaf pine and other fire-dependent ecosystems across the Cumberland Plateau is due to multiple interacting factors and, based on these data, frequent fire should be considered a historically important ecological driver of these systems.
Real-time integrity monitoring for a wide area precise positioning system
Authors: Wang Yuechen , Shen Jun
Published: October 2020

The wide area precise positioning system (WAPPS) is a high-precision positioning system based on a global navigation satellite system. Using a GEO satellite or a communication network, it provides users, in its service area, with real-time satellite orbit, clock, and other corrections. Users can achieve centimeter-level static positioning or decimeter-level kinematic positioning by precise point positioning. With the demands for applications of both high-precision and safety of life in real time, WAPPS is facing urgent needs to improve its service integrity. This study presents a real-time integrity monitoring approach for WAPPS. Using dual-frequency ionosphere-free corrections of GPS and BDS, along with monitor station data, related error models are established and the integrity monitoring is achieved, based on the analysis of satellite corrected residuals. In addition, satellite faults are simulated for performance verification. The results show that the algorithm can monitor both step and drift faults effectively and alert users in time.
Mesh-free radial-basis-function-generated finite differences and their application in reverse time migration
Authors: Wu Han , Sun Chengyu , Li Shizhong , Tang Jie , Xu Ning
Published: October 2020

Compared with one-way wave equation migration and ray-based migration, reverse time migration (RTM) using two-way wave propagation information can produce accurate imaging results for complex structures. Its computational accuracy and efficiency are mainly determined by numerical methods for wavefield simulation. When using traditional regular grids for seismic modeling, scattering artifacts may occur due to the stepped approximation of layer interfaces and rugged topography. On the other hand, irregular grids require a complex grid generation algorithm, despite having certain geometric flexibility. Mesh-free RTM can effectively reduce the scattered noise under regular grids and avoid the extra computation in the process of irregular grid generation. For implementation of the mesh-free RTM method, an algorithm with fast generation of node distributions is used to discretize the underground velocity model, and radial-basis-function-generated finite difference is used to realize the numerical simulation of wave propagation; the crosscorrelation imaging condition is adopted for imaging. The mesh-free RTM method, which has the flexibility of the simulation region and an abundance of wavefield information, reduces the storage required for RTM, shows the potential of high-accuracy migration in the case of an undulating surface, and provides more accurate migration imaging results for oil and gas exploration under complex geologic conditions.