bluuebunny/crossref_metadata_2025 huggingface dataset:
Changing trends in lipid profile and biomarkers of renal function and bone metabolism before and after switching from tenofovir disoproxil fumarate to tenofovir alafenamide: a prospective observational study
Authors: Ikeda Mahoko , Wakabayashi Yoshitaka , Okamoto Koh , Yanagimoto Shintaro , Okugawa Shu , Moriya Kyoji
Published: May 2021

Background

Antiretrovirals, including tenofovir, can suppress human immunodeficiency virus (HIV) infection but cannot completely eradicate it. Patients with HIV infection are administered antiretroviral drugs over a long term; thus, managing consequent adverse drug reactions, such as renal dysfunction and bone mineral loss, is important. Currently, highly sensitive biomarkers that can detect adverse drug reactions early have not been well studied.

Methods

This single-center, prospective, observational study explored changes in the biomarkers of renal function, bone metabolism, and lipid profile before and after switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) in patients with HIV infection.

Results

All 31 enrolled patients had been treated with antiretrovirals for more than 5 years. The rate of proteinuria decreased significantly after starting TAF-containing antiretroviral regimen. The urinary liver-type fatty acid binding protein (L-FABP)/creatinine ratio was significantly decreased at 3 and 6 months after switching to TAF compared with that before switching to TAF (− 0.5 μg/g Cr at 3 months, and − 0.8 μg/g Cr at 6 months; p < 005 for both at 3 and 6 months). The urinary N-terminal telopeptide (NTx)/creatinine ratio decreased over the study period, and the ratios were significantly different between 3 and 6 months (− 11 nmol/mmol Cr at 3 months, − 15.2 nmol/mmol Cr at 6 months; p = 0.0069 at 3 months, p < 0.0001 at 6 months). Low density lipoprotein-cholesterol level significantly increased at 3 (+ 26 mg/dL) and 6 months (+ 13 mg/dL) compared with that at the baseline (p < 0.0001).

Conclusions

Switching from TDF to TAF decreased the levels of renal and bone biomarkers, such as urinary L-FABP and NTx, but increased low density lipoprotein-cholesterol levels. Future studies should evaluate if these biomarkers, such as urinary L-FABP and NTx, truly detect serious adverse drug reactions early.
Antithrombotic drugs have a minimal effect on intraoperative blood loss during emergency surgery for generalized peritonitis: a nationwide retrospective cohort study in Japan
Authors: Matsuoka Tadashi , Ichihara Nao , Shinozaki Hiroharu , Kobayashi Kenji , Lefor Alan Kawarai , Kimura Toshimoto , Kitagawa Yuko , Kakeji Yoshihiro , Miyata Hiroaki , Sasaki Junichi
Published: May 2021

Background

The effect of antithrombotic drugs on intraoperative operative blood loss volume in patients undergoing emergency surgery for generalized peritonitis is not well defined. The purpose of this study was to investigate the effect of antithrombotic drugs on intraoperative blood loss in patients with generalized peritonitis using a nationwide surgical registry in Japan.

Method

This retrospective cohort study used a nationwide surgical registry data from 2011 to 2017 in Japan. Propensity score matching for the use of antithrombotic drugs was used for the adjustment of age, gender, comorbidities, frailty, preoperative state, types of surgery, surgical approach, laboratory data, and others. The main outcome was intraoperative blood loss: comparison of intraoperative blood loss, ratio of intraoperative blood loss after adjusted for confounding factors, and variable importance of all covariates.

Results

A total of 70,105 of the eligible 75,666 patients were included in this study, and 2947 patients were taking antithrombotic drugs. Propensity score matching yielded 2864 well-balanced pairs. The blood loss volume was slightly higher in the antithrombotic drug group (100 [10–349] vs 70 [10–299] ml). After adjustment for confounding factors, the use of antithrombotic drugs was related to a 1.30-fold increase in intraoperative blood loss compared to non-use of antithrombotic drugs (95% CI, 1.16–1.45). The variable importance revealed that the effect of the use of antithrombotic drugs was minimal compared with surgical approach or type of surgery.

Conclusion

This study shows that while taking antithrombotic drugs is associated with a slight increase in intraoperative blood loss in patients undergoing emergency surgery for generalized peritonitis, the effect is likely of minimal clinical significance.
Potential prognostic value of PD-L1 and NKG2A expression in Indonesian patients with skin nodular melanoma
Authors: Saputro Ridwan Dwi , Rinonce Hanggoro Tri , Iramawasita Yayuk , Ridho Muhammad Rasyid , Pudjohartono Maria Fransiska , Anwar Sumadi Lukman , Setiaji Kunto , Aryandono Teguh
Published: May 2021

Objective

Biomarker mRNA levels have been suggested to be predictors of patient survival and therapy response in melanoma cases. This study aimed to investigate the correlations between the mRNA expression levels of PD-L1 and NKG2A in melanoma tissue with clinicopathologic characteristics and survival in Indonesian primary nodular melanoma patients.

Results

Thirty-one tissue samples were obtained; two were excluded from survival analysis due to Breslow depth of less than 4 mm. The median survival of upregulated and normoregulated PD-L1-patients were 15.800 ± 2.345 and 28.945 ± 4.126 months, respectively. However, this difference was not significant statistically (p = 0.086). Upregulated and normoregulated NKG2A patients differed very little in median survival time (25.943 ± 7.415 vs 26.470 ± 3.854 months; p = 0.981). Expression of PD-L1 and NKG2A were strongly correlated (rs: 0.787, p < 0.001). No clinicopathologic associations with PD-L1 and NKG2A mRNA levels were observed. These results suggest that PD-L1 may have potential as a prognostic factor. Although an unlikely prognostic factor, NKG2A may become an adjunct target for therapy. The strong correlation between PD-L1 and NKG2A suggests that anti-PD-1 and anti-NKG2A agents could be effective in patients with PD-L1 upregulation. The mRNA levels of these two genes may help direct choice of immunotherapy and predict patient outcomes.
Ethanologenesis and respiration in a pyruvate decarboxylase-deficient Zymomonas mobilis
Authors: Rutkis Reinis , Strazdina Inese , Lasa Zane , Bruheim Per , Kalnenieks Uldis
Published: May 2021

Objective

Zymomonas mobilis is an alpha-proteobacterium with a rapid ethanologenic pathway, involving Entner–Doudoroff (E–D) glycolysis, pyruvate decarboxylase (Pdc) and two alcohol dehydrogenase (ADH) isoenzymes. Pyruvate is the end-product of the E–D pathway and the substrate for Pdc. Construction and study of Pdc-deficient strains is of key importance for Z. mobilis metabolic engineering, because the pyruvate node represents the central branching point, most novel pathways divert from ethanol synthesis. In the present work, we examined the aerobic metabolism of a strain with partly inactivated Pdc.

Results

Relative to its parent strain the mutant produced more pyruvate. Yet, it also yielded more acetaldehyde, the product of the Pdc reaction and the substrate for ADH, although the bulk ADH activity was similar in both strains, while the Pdc activity in the mutant was reduced by half. Simulations with the kinetic model of Z. mobilis E-D pathway indicated that, for the observed acetaldehyde to ethanol production ratio in the mutant, the ratio between its respiratory NADH oxidase and ADH activities should be significantly higher, than the measured values. Implications of this finding for the directionality of the ADH isoenzyme operation in vivo and interactions between ADH and Pdc are discussed.
Inflammatory cap polyp of the sigmoid colon: a case report
Authors: Pandit Narendra , Yadav Tek Narayan , Dahal Mona , Awale Laligen , Adhikary Shailesh
Published: May 2021

Background

Inflammatory cap polyp is a very rare benign entity of the distal left colon, characterized by inflammatory polyp with a “cap” of fibrinopurulent exudates. They are usually multiple and commonly present with bleeding per rectum or mucoid discharge. Solitary polyp presenting with intermittent intussusceptions is rare.

Case presentation

We report the case of a 45-year-old Nepalese male with a solitary inflammatory sigmoid colon polyp. The patient presented with a 1-month history of rectal bleeding, mucoid discharge, and severe colicky abdominal pain due to intussusceptions. On colonoscopy, there was an exophytic mass with surface exudates. Colonic resection and anastomosis were performed, due to recurring partial intestinal obstruction. At a 6-month follow-up, the patient was asymptomatic.

Conclusion

Inflammatory cap polyp is a benign entity, and it should be kept in mind as an important differential diagnosis of exophytic colonic mass with surface exudates.
Central retinal vein occlusion in a patient using the antipsychotic drug olanzapine: a case report
Authors: Nowrouzi Ali , Kafiabasabadi Sepideh , Rodriguez-Calzadilla Mario , Benitez-del-Castillo Javier , Soto-Guerrero Alejandro , Diaz-Ramos Antonio , Marques-Cavalcante Kyara Vaneska
Published: May 2021

Background

We report our findings in a patient who developed central retinal vein occlusion (CRVO) and was a chronic user of olanzapine, an antipsychotic medication.

Case presentation

A 50-year-old Caucasian man, non-smoker, was referred to our clinic with the chief complaint of floater appearance in his left eye for the past 3 days. His past medical history indicated that he had been taking antipsychotic drugs (olanzapine) for about 3 years, with no other systemic disease or risk factors for CRVO.

In the examination, his best-corrected visual acuity (BCVA) was 0.7 in the left eye. The fundus showed signs of nonischemic CRVO with subhyaloid hemorrhage and intraretinal hemorrhage in the posterior pole and superior and inferior retina, without macular edema, confirmed by optical coherence tomography (OCT).

We ruled out other probable differential diagnoses and risk factors which lead to CRVO through a complete physical exam and blood analysis (complete blood count, glucose, urea, creatinine, lipid profile, erythrocyte sedimentation rate, C-reactive protein, prothrombin time, partial thromboplastin time, Bleeding time (BT), fibrinogen level, proteins, antiphospholipid antibodies, homocysteine blood level, antithrombin III, protein C and S, factor V Leiden, prothrombin mutation, angiotensin-converting enzyme level, other autoantibodies, and human leukocyte antigen [HLA]-B51). Finally, we confirmed the probable side effect of olanzapine in CRVO, which has not been previously reported. A possible pro-thrombogenic mechanism of olanzapine at the molecular level is an affinity for 5-HT2Aserotonin receptors. Blocking these receptors results in increased platelet aggregation and increased blood coagulability.

Conclusions

These results indicate that CRVO can be a complication of chronic use of antipsychotic medications such as olanzapine, as shown for the first time in our case report. Clinicians should question patients who develop a sudden CRVO whether they are using antipsychotic medications such as olanzapine.
Inadvertent arterial puncture involving the subclavian artery and the aorta during central venous catheterization: a case report
Authors: Alon Mark Henry
Published: May 2021

Background

This case report describes a subclavian vein cannulation that inadvertently led to an arterial puncture with the catheter tip radiologically seen at the level of the aorta. This case emphasizes the importance of postprocedural imaging and the disadvantages of not using ultrasound guidance in central venous catheterization.

Case presentation

A 24-year-old Caucasian man with diabetes mellitus type 1 presented himself to the emergency department due to abdominal pain accompanied by nausea and vomiting. The patient’s vital signs revealed blood pressure of 84/53 mmHg, heart rate of 103 beats per minute, respiratory rate of 18 breaths per minute, and temperature of 98.2 °F (36.7 °C). On physical examination, he was found to have dry oral mucosa with poor skin turgor, with diagnostics showing that he was in diabetic ketoacidosis after running out of insulin for 2 days. The patient was transferred to the intensive care unit to receive a higher level of care. Unfortunately, due to difficulty of peripheral line placement, only a gauge-22 cannula was secured at the left dorsum of the hand. Efforts to replace the current peripheral line were unsuccessful, and a decision to perform a central vein cannulation via the internal jugular vein was made. This was futile as well due to volume depletion, prompting a subsequent right subclavian vein route attempt. The procedure inadvertently punctured the arterial circulation, leading to the catheter tip being visible at the level of the aorta on postprocedure X-ray. The subclavian line was immediately removed with no adverse consequences for the patient. A right femoral line was successfully placed, and continuous management of the diabetic ketoacidosis ensued until normalization of the high anion gap was achieved.

Conclusion

Utilization of real-time ultrasound guidance via the subclavian approach could have allowed for direct visualization of needle insertion to the anatomical structures, guidewire location, and directionality, all of which can lead to decreased complications and improved cannulation success compared with the landmark technique. A leftward direction of the catheter seen on postprocedural X-rays should raise high suspicion of inadvertent catheter placement and immediate correction. This complication should have been prevented if ultrasound guidance had been used.
Weak and strong type estimates for multilinear Calderón–Zygmund operators on differential forms
Authors: Li Xuexin , Xing Yuming , Niu Jinling
Published: May 2021

In this paper, we define the multilinear Calderón–Zygmund operators on differential forms and prove the end-point weak type boundedness of the operators. Based on nonhomogeneous A-harmonic tensor, the Poincaré-type inequalities for multilinear Calderón–Zygmund operators on differential forms are obtained.
A U.S. survey of pre-operative carbohydrate-containing beverage use in colorectal enhanced recovery after surgery (ERAS) programs
Authors: Singh Sunitha M. , Liverpool Asha , Romeiser Jamie L. , Miller Joshua D. , Thacker Julie , Gan Tong J. , Bennett-Guerrero Elliott
Published: May 2021

Background

Carbohydrate-containing drinks (CCD) are administered preoperatively in most enhanced recovery after surgery (ERAS) programs. It is not known which types of CCDs are used, e.g., simple vs. complex carbohydrate, and if the choice of drink differs in patients with diabetes.

Methods

A national survey was performed to characterize the use of preoperative CCDs within the context of adult colorectal ERAS programs. The survey had questions regarding the use of preoperative CCDs, the types of beverages used, and the timing of beverage administration. The survey was administered electronically to members of the American Society for Enhanced Recovery (ASER) and manually to participants at the 2018 Perioperative Quality and Enhanced Recovery Conference in San Francisco, CA.

Results

Responses were received from 78 unique hospitals with a colorectal ERAS program of which 68 (87.2%) reported administering a preoperative drink. Of these, 98.5%, 80.9%, and 60.3% of hospitals administered a beverage to patients without diabetes, patients with diabetes not taking insulin, and patients with diabetes taking insulin, respectively. Surprisingly, one third of programs that administered a beverage to patients with diabetes used a simple carbohydrate drink.

Conclusions

This survey finds a high use of CHO-containing beverages in colorectal ERAS programs. More than half of all programs administer a CHO-containing beverage to patients with diabetes, and surprisingly, there is significant use of simple carbohydrate beverages in patients with diabetes receiving insulin.
Association between phosphate disturbances and mortality among critically ill patients with sepsis or septic shock
Authors: Al Harbi Shmeylan A. , Al-Dorzi Hasan M. , Al Meshari Albatool M. , Tamim Hani , Abdukahil Sheryl Ann I. , Sadat Musharaf , Arabi Yaseen
Published: May 2021

Objective

The aim of this study is to examine the association of hypophosphatemia and hyperphosphatemia on the first day of ICU admission with mortality in septic critically ill patients.

Methods

In this retrospective cohort study, all adult patients who were admitted to the medical-surgical ICUs between 2014 and 2017 with sepsis or septic shock were categorized as having hypophosphatemia, normophosphatemia and hyperphosphatemia based on day 1 serum phosphate values. We compared the clinical characteristics and outcomes between the three groups. We used multivariate analysis to examine the association of hypophosphatemia and hyperphosphatemia with these outcomes.

Results

Of the 1422 patients enrolled in the study, 188 (13%) had hypophosphatemia, 865 (61%) normophosphatemia and 369 (26%) had hyperphosphatemia. The patients in the hyperphosphatemia group had significantly lower GCS, higher APACHE II scores, higher serum creatinine, increased use of vasopressors, and required more mechanical ventilation with lower PaO2/FiO2 ratio compared with the other two groups. In addition, the hyperphosphatemia group showed significantly higher ICU and hospital mortality in comparison with the other two groups.

Conclusion

Hyperphosphatemia and not hypophosphatemia on the first ICU admission day was associated with an increase in the ICU and hospital mortality in septic critically ill patients.
Protective role of Pandanus tectorius Parkinson ex Du Roi in diabetes, hyperlipidemia, liver and kidney dysfunction in alloxan diabetic rats
Authors: Sundus Saima , Hira Khan , Sohail Nida , Habiba  , Tariq Amna , Ara Jehan , Sultana Viqar , Ehteshamul-Haque Syed
Published: May 2021

Background

Diabetes mellitus (DM), an endocrine disease is characterized by increased level of blood glucose. Diabetes may affect other functions of the body and organs including, renal function and lipid metabolism. Pandanus tectorius (P. tectorius) Parkinson ex Du Roi is a small tree used in folk medicine in treatment of many diseases.

Methods

Diabetes in rats was induced by intraperitoneal injection of alloxan at a dose of 100 mg/kg body weight for 3 days. Water and ethanol extracts of root, stem and leave of P. tectorius were given to rats at 200 mg/kg body weight at day 3. Rats were sacrificed on day 4 after 12 h fasting. Serum glucose and other biochemical parameters like liver enzymes; [alanine aminotransferases (ALT), aspartate aminotransferases (AST), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH)], kidney parameters (urea & creatinine), lipid profile [total cholesterol, HDL and LDL cholesterol and triglycerides] and coronary artery risk index (CRI) were estimated in blood serum. Antioxidant potential, polyphenol content and phytochemical constituents in different parts of P. tectorius were also determined.

Results

Results showed that water extract of stem and ethanol extract of root of P. tectorius produced maximum fall in sugar level of alloxan diabetic rats. Extracts of all three plant parts significantly dropped the increased level of urea and creatinine with maximum reduction in creatinine was observed by water extract of root. P.tectorius extracts showed positive effect on liver enzymes and lipid profile by bringing them closer to normal range in comparison to alloxan diabetic control rats. Phytochemical screening indicated presence of flavonoids, alkaloids, tannins and saponin in P. tectorius. In DPPH free radical scavenging test the highest antioxidant potential was found in water extract of roots, while ethanol extract of stem also showed good activity.

Conclusion

The study demonstrated that different parts of P.tectorius have potential to attenuate diabetes and diabetes related complications like, liver, kidney dysfunction and lipid metabolism.
The comparison of epidemiological characteristics between confirmed and clinically diagnosed cases with COVID-19 during the early epidemic in Wuhan, China
Authors: Shi Fang , Wen Haoyu , Liu Rui , Bai Jianjun , Wang Fang , Mubarik Sumaira , Liu Xiaoxue , Yu Yong , Hong Qiumian , Cao Jinhong , Yu Chuanhua
Published: May 2021

Background

To put COVID-19 patients into hospital timely, the clinical diagnosis had been implemented in Wuhan in the early epidemic. Here we compared the epidemiological characteristics of laboratory-confirmed and clinically diagnosed cases with COVID-19 in Wuhan.

Methods

Demographics, case severity and outcomes of 29,886 confirmed cases and 21,960 clinically diagnosed cases reported between December 2019 and February 24, 2020, were compared. The risk factors were estimated, and the effective reproduction number (Rt) of SARS-CoV-2 was also calculated.

Results

The age and occupation distribution of confirmed cases and clinically diagnosed cases were consistent, and their sex ratio were 1.0 and 0.9, respectively. The epidemic curve of clinical diagnosis cases was similar to that of confirmed cases, and the city centers had more cumulative cases and higher incidence density than suburbs in both of two groups. The proportion of severe and critical cases (21.5 % vs. 14.0 %, P < 0.0001) and case fatality rates (5.2 % vs. 1.2 %, P < 0.0001) of confirmed cases were all higher than those of clinically diagnosed cases. Risk factors for death we observed in both of two groups were older age, male, severe or critical cases. Rt showed the same trend in two groups, it dropped below 1.0 on February 6 among confirmed cases, and February 8 among clinically diagnosed cases.

Conclusions

The demographic characteristics and spatiotemporal distributions of confirmed and clinically diagnosed cases are roughly similar, but the disease severity and clinical outcome of clinically diagnosed cases are better than those of confirmed cases. In cases when detection kits are insufficient during the early epidemic, the implementation of clinical diagnosis is necessary and effective.
Mapping full seismic waveforms to vertical velocity profiles by deep learning
Authors: Kazei Vladimir , Ovcharenko Oleg , Plotnitskii Pavel , Peter Daniel , Zhang Xiangliang , Alkhalifah Tariq
Published: May 2021

Building realistic and reliable models of the subsurface is the primary goal of seismic imaging. We have constructed an ensemble of convolutional neural networks (CNNs) to build velocity models directly from the data. Most other approaches attempt to map full data into 2D labels. We exploit the regularity of seismic acquisition and train CNNs to map gathers of neighboring common midpoints (CMPs) to vertical 1D velocity logs. This allows us to integrate well-log data into the inversion, simplify the mapping by using the 1D labels, and accommodate larger dips relative to using single CMP inputs. We dynamically generate the training data in parallel with training the CNNs, which reduces overfitting. Data generation and training of CNNs is more computationally expensive than conventional full-waveform inversion (FWI). However, once the network is trained, data sets with similar acquisition parameters can be inverted much faster than with FWI. The multiCMP CNN ensemble is tested on multiple realistic synthetic models, performs well, and was combined with FWI for even better performance.
Rapid modeling of borehole measurements of nuclear magnetic resonance via spatial sensitivity functions
Authors: Albusairi Mohammad , Torres-Verdín Carlos
Published: May 2021

Borehole measurements of nuclear magnetic resonance (NMR) are routinely used to estimate in situ rock and fluid properties. Conventional NMR interpretation methods often neglect bed-boundary and layer-thickness effects in the calculation of fluid volumetric concentrations and NMR relaxation-diffusion correlations. Such effects introduce notable spatial averaging of intrinsic rock and fluid properties across thinly bedded formations or in the vicinity of boundaries between layers exhibiting large property contrasts. Forward modeling and inversion methods can mitigate the aforementioned effects and improve the accuracy of true layer properties in the presence of mud-filtrate invasion and borehole environmental effects across spatially complex formations. We have developed a fast and accurate algorithm to simulate borehole NMR measurements using the concept of spatial sensitivity functions (SSFs) that honor NMR physics and incorporate tool, borehole, and formation geometry. Tool sensitivity maps are derived from a 3D multiphysics forward model that couples NMR tool properties, magnetization evolution, and electromagnetic propagation. In addition, a multifluid relaxation model based on Brownstein-Tarr’s equation is introduced to estimate layer NMR porosity decays and relaxation-diffusion correlations from pore-size-dependent rock and fluid properties. The latter model is convolved with the SSFs to reproduce borehole NMR measurements. The results indicate that NMR spatial sensitivity is controlled by porosity, electrical conductivity, excitation pulse duration, and tool geometry. We benchmark and verify the SSF-derived forward approximation against 3D multiphysics simulations for a series of synthetic cases with variable bed thickness and petrophysical properties, and in the presence of mud-filtrate invasion in a vertical well. Results indicate that the approximation can be executed in a few seconds in a central processing unit, by a factor of 1000 times faster than rigorous multiphysics calculations, with maximum root-mean-square errors of 1%.
Migration using sea surface-related multiples: Challenges and opportunities
Authors: Lu Shaoping
Published: May 2021

In marine geophysical exploration using seismic data, sea surface-related multiples can be used for imaging and producing extra illumination. However, the imaging of multiples can involve challenges related to acquisition and migration. The acquisition offset, trace spacing, and towing direction are all key factors that control the quality of imaging using multiples. The migration algorithm also affects its successful implementation. Ultimately, the objective of imaging using multiples is not to replace imaging using primaries; instead, imaging using multiples augments conventional migration when the imaging of primaries suffers from illumination issues. The imaging of multiples has the potential to mitigate shallow acquisition footprints and provide high-resolution shallow images, allowing the identification of drilling hazards and a reduction in drilling risks. Additionally, the imaging of multiples can provide high-resolution illumination of complex structures along salt boundaries, which is valuable for velocity model building. Moreover, this technique has the potential to reduce exploration expenses when applied with ocean-bottom seismic data.
Mental Health Around the Transition to First Birth: Does Medically Assisted Reproduction Matter?
Authors: Tosi Marco , Goisis Alice
Published: May 2021

Previous research has shown that childbearing is associated with short-term improvements in women's subjective well-being but that these effects depend on the timing and quantum of the birth as well as on the parents' education and socioeconomic status. These studies did not address whether and, if so, how this effect varies according to the mode of conception. This represents an important knowledge gap, given that conceptions through medically assisted reproduction (MAR) have been increasing rapidly in recent decades, exceeding 5% of live births in some European countries. Drawing on nine waves (2009/2010–2017/2018) of the UK Household Longitudinal Study, we use distributed fixed-effects linear regression models to examine changes in women's mental health before, during, and after natural and MAR conceptions. The results show that the mental health of women who conceived naturally improved around the time of conception and then gradually returned to baseline levels; comparatively, the mental health of women who conceived through MAR declined in the year before pregnancy and then gradually recovered. The findings also indicate that women's happiness decreased both two years and one year before an MAR conception and then increased above the baseline in the year of pregnancy. We further show that the deterioration in mental health and subjective well-being before an MAR conception affects both partners, which could be part of a longer process in which the partners potentially suffer from stress related not solely to the MAR treatments themselves but also to the experience of subfertility.
News Uncertainty in Brexit United Kingdom
Authors: Faccini Renato , Palombo Edoardo
Published: May 2021

After the Brexit referendum, the behavior of the UK economy defied widespread expectations, as it did not exhibit a V-shaped recession but a slow decline in production. We show that this pattern of propagation arises when uncertainty is about future, rather than current, fundamentals and if the expected duration of uncertainty is sufficiently long. We reach this conclusion within the confines of a heterogeneous firms model featuring news uncertainty rather than conventional uncertainty shocks. In the quantitative analysis, uncertainty is informed by firm-level probability distributions on the expected effect of Brexit on sales. (JEL E22, E23, E24, E32, F15)
Spectral detector CT applications in advanced liver imaging
Authors: Majeed Noor Fatima , Braschi Amirfarzan Marta , Wald Christoph , Wortman Jeremy R
Published: May 2021

Objective:

Spectral detector CT (SDCT) has many applications in advanced liver imaging. If appropriately utilized, this technology has the potential to improve image quality, provide new diagnostic information, and allow for decreased radiation dose. The purpose of this review is to familiarize radiologists with the uses of SDCT in liver imaging.

Conclusion:

SDCT has a variety of post-processing techniques, which can be used in advanced liver imaging and can significantly add value in clinical practice.
18F-FDG PET/CT Manifestations of IgG4-related Disease
Authors: Tang Charlene Yu Lin , Chua Wei Ming , Cheng Lenith Tai Jit , Fong Warren , Zaheer Sumbul , Lam Winnie Wing-Chuen
Published: May 2021

Immunoglobulin G4-related disease (IgG4-RD) was not recognised as a systemic condition until 2003, when extra pancreatic manifestations were identified in patients with autoimmune pancreatitis. Since then, IgG4-RD has been described to involve virtually every organ system. It is highly responsive to immunosuppressants but can have detrimental effects if left untreated. Early recognition of the disease is, therefore, critical. The diagnosis of IgG4-RD is frequently challenging owing to its non-specific clinical manifestations, indolent nature and broad differential diagnoses. Although histopathological examination remains the cornerstone of diagnosis, imaging plays an important role in establishing extent of disease and identifying areas suitable for biopsy. 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) has been demonstrated to be useful in assessing organ involvement, guiding biopsy and monitoring disease response. The 18F-FDG PET/CT scan is highly sensitive and able to evaluate multiorgan involvement in a single examination, a key advantage over conventional imaging modalities. A potential pitfall is its low specificity. As such, detailed knowledge of the imaging findings in IgG4-related disease is required to avoid misdiagnosis. This pictorial review aims to depict the diverse spectrum of imaging findings of IgG4-RD and the key imaging features to distinguish it from other important differential diagnoses.
COVID19 pneumonia with cavitation and cystic lung changes: multi-detector computed tomography spectrum of a gamut of etiologies
Authors: Aggarwal Arunima , Tandon Anupama , Bhatt Shuchi , Aggarwal Anivita , Dagar Saloni , Bansal Harshit
Published: May 2021

The COVID19 pandemic since its beginning in March 2020, continues to wreak havoc causing great morbidity and mortality with each passing day. Ample literature is now available describing the imaging features of COVID19 infection; however, there is still a paucity of knowledge on the various causes of pulmonary cavitation and cystic lesions which can be associated with the virus albeit uncommonly. Cavitation in a COVID19 positive patient could be a consequence of the infection itself or a manifestation of sinister etiologies like coinfection with bacterial, fungal or mycobacterial pathogens, or incidental malignancy/metastasis. It could also be a result of multiple cavitating pulmonary nodules as a manifestation of septic emboli and infarct, Granulomatosis with polyangiitis or rheumatoid arthritis creating a diagnostic dilemma. Similarly, the causes of cystic air spaces on chest CT in COVID19 patient can be varied, either primarily due to the infection itself or secondary to coexistent cystic bronchiectasis, emphysema, interstitial lung disease or mechanical ventilation-associated barotrauma as well as complicated pulmonary cysts. Through this pictorial review, we aim to highlight these uncommon imaging manifestations of COVID19 and educate the reader regarding the various causes, MDCT features and differentials to be considered while approaching a cavity/cystic lesion amidst this pandemic.
Keramik und Knochen aus frühtiberischer Zeit
Authors: Ackermann Regula , Winet Ines
Published: May 2021

Gegenstand der Arbeit ist eine mit Abfall verfüllte Grube auf dem Basler Münsterhügel, die im Rahmen der archäologischen Untersuchungen beim Bau der Fernheizungsleitung 1978 teilweise ausgegraben wurde. Sie barg ein interessantes Fundensemble aus frühtiberischer Zeit.  

Sowohl Knochen als auch Keramik waren sehr gut erhalten und die Grube wurde wahrscheinlich innerhalb einer kurzen Zeit verfüllt. Die archäozoologische Auswertung zeigt zudem, dass die Knochen als Speiseabfälle in die Grube gelangten. Anhand des Abfalls aus dieser Grube kann eine stark romanisierte, sozial besser gestellte Gesellschaftsgruppe gefasst werden.
Psychological distress and quality of life following provision of vascular imaging results of the coronary and carotid arteries to asymptomatic adults: a scoping review protocol
Authors: Anokye Reindolf , Jackson Ben , Dimmock James , Dickson Joanne M. , Blekkenhorst Lauren C. , Hodgson Jonathan M. , Lewis Joshua R. , Stanley Mandy
Published: May 2021

Background: Non-invasive screening for atherosclerosis or asymptomatic cardiovascular disease of the coronary and carotid arteries is commonly undertaken, and research has been focussed on how results from these screenings lead to behaviour change. However, no review has focused on the effects of these results on psychological distress and health-related quality of life (HRQoL). This protocol will outline how a scoping review will be conducted to map all available evidence on psychological distress and/or HRQoL outcomes following the provision of vascular imaging results of the coronary and carotid arteries.

Methods: Arksey and O’Malley’s (2005) framework subsequently enhanced by Levac et al. (2010)  and Peters et al (2015, 2017) will guide the scoping review. Databases such as MEDLINE (Clarivate), APA PsychINFO, EMBASE, Social Work Abstracts, Psychology and Behavioural Sciences Collection, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) will be searched using MeSH terms  such as "Coronary stenosis", "Carotid Stenosis", "Psychological Distress" and "Quality of Life" and related terms. Two investigators will screen title and abstract and all articles meeting inclusion criteria will be extracted.  Data on authors, publication year, country of origin, aims/purpose, methodology, intervention, outcome measures as well as key findings that relate to the scoping review questions will be extracted for each included study. The findings will be presented using tables and thematic narrative synthesis. The scoping review will not produce a pooled estimate of the impact of vascular imaging results on psychological distress and HRQoL but will present information from the included studies related to psychological distress and HRQoL.

Conclusion:  The review will highlight and address gaps in knowledge and provide direction for future investigations.
Local attributable burden disease to PM2.5 ambient air pollution in Medellín, Colombia, 2010–2016
Authors: Grisales-Romero Hugo , Piñeros-Jiménez Juan Gabriel , Nieto Emmanuel , Porras-Cataño Sandra , Montealegre Nora , González Difariney , Ospina Dorian
Published: May 2021

Background: Exposure to 2.5-micron diameter air pollutants (PM2.5) has been associated with an increased risk of illness and death worldwide; however, in Latin American health impacts assessment of this risk factor is scarce. Medellín is one of the most polluted cities in the region, with a population growth rate that is twice as high as that of other Colombian cities, which implies a growing population at risk.

Methods: A descriptive study of the disease burden was carried out using the city as the unit of observation. Health events were selected based on epidemiologic evidence and the availability of the population attributable fraction associated with PM2.5. The mortality records were taken from the module of deceased of the Single Registry of Affiliates of the Health System; the morbidity records were taken from the Individual Health Services Registries. For the estimation of the burden of disease, the current Global Burden of Disease guidelines were followed.

Results: Attributable disability-adjusted life years to exposure to ambient PM2.5 pollution (DALYsPM2.5) constituted 13.8% of total burden of the city. Males showed the greatest loss of DALYsPM2.5 due to acute events, while in women the greatest loss was due to chronic events. Ischemic heart disease, chronic diseases of the lower respiratory tract, and influenza and pneumonia were the events that contributed the most to DALYsPM2.5. 71.4% of the DALYsPM2.5 corresponded to mortality, mainly in the population over 65 years of age. Regarding attributable morbidity, acute events were more prevalent in both sexes, especially due to respiratory diseases

Conclusion: Premature death among the elderly population has the greatest weight on burden of disease attributable to ambient PM2.5 pollution, mainly due to respiratory and cardiovascular diseases, without significant differences according to gender.
The efficacy of adjunctive alpha-blockers on ureteroscopy procedure for ureteral stones: a systematic review and meta-analysis
Authors: Serani Sesari Saras , Atmoko Widi , Birowo Ponco , Rasyid Nur
Published: May 2021

Background:Urolithiasis cases are a common condition, and the number is still growing today. The prevalence of urinary tract stones globally currently ranges from 2-20% with a recurrence rate of around 50%. The present study aims to investigate the efficacy of adjunctive alpha-blockers in improving the success rate of ureteroscopy (URS) procedure for urolithiasis.

Methods:We reviewed articles obtained from MEDLINE, CENTRAL, CINAHL, and Elsevier from 14 August to 9 September 2020, comparing alpha-blockers as adjunctive therapy, versus either a placebo or no drug at all, in post-URS urolithiasis patients. There were no restrictions on the type of URS and alpha-blockers given to patients. The quality of studies included was assessed using Cochrane’s Risk of Bias Assessment for Randomized-Controlled Trials.

Results:Forest plot analysis emphasizes the statistically significant difference among the group, where the adjunctive alpha-blocker group had pooled relative risk (RR) of being stone-free, readmitted due to initial URS failure, having an overall complication, having haematuria, getting their ureteral mucous injured, and suffering a colic episode was 1.71 (95% CI, 1.11–1.24), 0.50 (95% CI, 0.25–1.01), 0.41 (95% CI, 0.27–0.61), 0.42 (95% CI, 0.22–0.79), 0.31 (95% CI, 0.13–0.73), and 0.21 (95% CI, 0.06–0.69), respectively.

Conclusions:Alpha blockers minimize the frequency and duration of ureteral contractions, allowing smooth stone expulsion. With this knowledge, it is expected to help clinicians decide the importance of adjunctive alpha-blocker administration.
A review of the Cochrane COVID-19 Study Register reveals inconsistency in the choice and measurement of SARS-CoV-2 infection outcomes in prevention trials
Authors: Dodd Susanna , Gorst Sarah , Avery Kerry , Harman Nicola , Macefield Rhiannon , Williamson Paula , Blazeby Jane ,   COS-COVID-P Steering Committee
Published: May 2021

Background: Multiple studies are evaluating how to prevent SARS-CoV-2 infection. Interventions are wide ranging and include vaccines, prophylactic drugs, public health safety measures, and behavioural interventions. Heterogeneity in the outcomes measured and reported is leading to research waste and inefficiency, slowing worldwide identification and implementation of effective methods to prevent infection. A core outcome set (COS) for studies of interventions to prevent SARS-CoV-2 infection has recently been developed, identifying infection as a critical outcome to measure. This paper examines how SARS-CoV-2 infection outcomes are measured in registered COVID-19 prevention trials and considers how this can be improved.

Methods: We searched the Cochrane COVID-19 Study Register to identify and review SARS-CoV-2 infection outcomes in prevention trials, including the rationale for choice of outcome measurement. We included phase 3 and 4 trials of COVID-19 prevention interventions. Early phase trials and studies relating to the transmission, treatment or management of COVID-19 were excluded.

Results: We identified 430 entries in the register, of which 199 unique prevention trials were included across eight settings and 12 intervention types. Fifteen (8%) trials did not include any SARS-CoV-2 infection outcomes. The remaining 184 (92%) studies included a total of 268 SARS-CoV-2 infection outcomes, of which 32 (17%) did not specify how infection would be measured. Testing (i.e. formal diagnostic test) as a standalone method for determining infection was used in 57 (31%) trials, whereas defining infection by symptoms alone was used in 16 (9%) trials. All other trials (n=79, 43%) included multiple infection outcomes, defined in different ways.

Discussion: There is considerable variation in how SARS-CoV-2 infection is measured within and across different interventions and settings. Furthermore, few studies report the rationale for outcome selection and measurement. Better transparency and standardisation of SARS-CoV-2 infection measurement is needed for the findings from prevention trials to inform decision-making.
Global stability analysis of hepatitis B virus dynamics
Authors: Oludoun Olajumoke , Adebimpe Olukayode , Ndako James , Abiodun Oluwakemi E. , Gbadamosi Babatunde , Aladeitan Benedicta B.
Published: May 2021

This paper considers the impact of an acute individual's spontaneous clearance, recovery of a chronic individual with full immunity, and risk factor reduction on a hepatitis B virus (HBV) model. The existence and the positivity solution of the model are established. The model threshold quantity is defined and sensitivity analysis is analyzed to demonstrate the effect of various parameters on the spread of the virus. The global stability analysis of the equilibrium is shown using Lyapunov and comparison theorem methods. Finally, computational simulation is presented to validate the analytical solution. The results show that treatment, spontaneous clearance and reduction of the risk factor are highly successful in transmitting and regulating HBV transmission. The effective measure of these parameters as substantiated by our simulations, providing an excellent control method of the transmissible infection of HBV.
Knowledge of disease, diagnosis, adherence and impact of research in an Irish cohort of patients with inflammatory arthritis
Authors: Marzaioli Viviana , Canavan Mary , Donnolly Alex , Wade Siobhan , Fraser Alexander , O'Sullivan Tim , Harney Sinead , Ireland Arthritis , Veale Douglas J. , Fearon Ursula
Published: May 2021

Background: Patient engagement with clinicians results in shared decision making and increased adherence to medication. However, in order for strong patient: clinician partnerships to be achieved, communication barriers need to be identified. Therefore, the aim of this study was to examine the level of understanding of inflammatory arthritis patients and the need for strong patient-partnership in research.

Methods: An online anonymous survey was distributed to patients living with inflammatory arthritis which addressed questions about diagnosis, routine tests, medications and how they work, medication adherence, disease flare, heredity, pregnancy, and patient involvement in research.

Results: There were 1,873 respondents, 1416 of which had inflammatory arthritis (IA)- rheumatoid arthritis (RA) (65.8%) and psoriatic arthritis (PsA) (34.2%). They were predominantly female (RA 86%, PsA 85 %), aged 55±13 and 50±12 years. Less than 35% of patients had an understanding of diagnostic tests, what was measured and the implication for disease, with 75.5% also concerned about heredity. There was a high level of understanding of how specific medications treat inflammatory arthritis (72.9%). Adherence was also very high (>87%), with the main reasons for stopping medication without the advice of their clinician,  ‘feeling better’ and ‘side effects’ however  a significant proportion of patients (69.9%) reported a disease-flare following cessation of medication. Patients (31%) were also concerned that inflammatory arthritis reduced their chances of getting pregnant, with only 8% believing arthritis medications were safe to take during pregnancy. Finally, only 9% of patients had ever been asked to participate in a research study.

Conclusions: This study demonstrates a need for the development of stronger patient-partnerships with clinicians and researchers in relation to patient education and engagement with research, to create a platform where patients can have meaningful input and involvement in future research studies.