bluuebunny/crossref_metadata_2025 huggingface dataset:
Gingival manifestation of Crohn’s disease in a paediatric patient: A case report
Authors: Giaccaglia Francesca , Tomasin Marco , Angelini Annalisa , Bacci Christian
Published: November 2021

Crohn's disease (CD) is a complex multisystemic inflammatory disorder and part of the inflammatory bowel diseases (IBDs). About 20% of the subjects affected by IBDs are paediatric patients and 21% of them present extraintestinal manifestations. Among the extraintestinal manifestations of CD, oral manifestations are rather frequent (20–50% of affected people) and can be difficult to identify, being frequently aspecific and not pathognomonic. Their early diagnosis by the dentist is extremely important, because extraintestinal manifestations can precede intestinal symptoms, in all patients but especially in children. The aim of this paper is to report the case of a CD adolescent patient that presented a gingival manifestation.
Ammonium regulates the development of pine roots through hormonal crosstalk and differential expression of transcription factors in the apex
Authors: Ortigosa Francisco , Lobato‐Fernández César , Shikano Hitomi , Ávila Concepción , Taira Shu , Cánovas Francisco M. , Cañas Rafael A.
Published: November 2021

Ammonium is a prominent source of inorganic nitrogen for plant nutrition, but excessive amounts can be toxic for many species. However, most conifers are tolerant to ammonium, a relevant physiological feature of this ancient evolutionary lineage. For a better understanding of the molecular basis of this trait, ammonium‐induced changes in the transcriptome of maritime pine (Pinus pinaster Ait.) root apex have been determined by laser capture microdissection and RNA sequencing. Ammonium promoted changes in the transcriptional profiles of multiple transcription factors, such as SHORT‐ROOT, and phytohormone‐related transcripts, such as ACO, involved in the development of the root meristem. Nano‐PALDI‐MSI and transcriptomic analyses showed that the distributions of IAA and CKs were altered in the root apex in response to ammonium nutrition. Taken together, the data suggest that this early response is involved in the increased lateral root branching and principal root growth, which characterize the long‐term response to ammonium supply in pine. All these results suggest that ammonium induces changes in the root system architecture through the IAA‐CK‐ET phytohormone crosstalk and transcriptional regulation.
Cadmium‐mediated toxicity in plant cells is associated with the DCD/NRP‐mediated cell death response
Authors: Quadros Iana Pedro Silva , Madeira Nayara Nolasco , Loriato Virgílio Adriano Pereira , Saia Thaina Fernanda Fillietaz , Silva Jéssica Coutinho , Soares Fernanda Aparecida Ferrari , Carvalho José Romário , Reis Pedro Augusto Braga , Fontes Elizabeth P. B. , Clarindo Wellington Ronildo , Fontes Renildes L. F.
Published: November 2021

Cadmium (Cd2+) is highly harmful to plant growth. Although Cd2+ induces programmed cell death (PCD) in plant cells, Cd2+ stress in whole plants during later developmental stages and the mechanism underlying Cd2+‐mediated toxicity are poorly understood. Here, we showed that Cd2+ limits plant growth, causes intense redness in leaf vein, leaf yellowing, and chlorosis during the R1 reproductive stage of soybean (Glycine max). These symptoms were associated with Cd2+‐induced PCD, as Cd2+‐stressed soybean leaves displayed decreased number of nuclei, enhanced cell death, DNA damage, and caspase 1 activity compared to unstressed leaves. Accordingly, Cd2+‐induced NRPs, GmNAC81, GmNAC30 and VPE, the DCD/NRP‐mediated cell death signalling components, which execute PCD via caspase 1‐like VPE activity. Furthermore, overexpression of the positive regulator of this cell death signalling GmNAC81 enhanced sensitivity to Cd2+ stress and intensified the hallmarks of Cd2+‐mediated PCD. GmNAC81 overexpression enhanced Cd2+‐induced H2O2 production, cell death, DNA damage, and caspase‐1‐like VPE expression. Conversely, BiP overexpression negatively regulated the NRPs/GmNACs/VPE signalling module, conferred tolerance to Cd2+ stress and reduced Cd2+‐mediated cell death. Collectively, our data indicate that Cd2+ induces PCD in plants via activation of the NRP/GmNAC/VPE regulatory circuit that links developmentally and stress‐induced cell death.
Molecular cloning and yeast two‐hybrid provide new evidence for unique sporophytic self‐incompatibility system of Corylus
Authors: Hou S. , Zhao T. , Yang Z. , Yang D. , Li Q. , Liang L. , Wang G. , Ma Q.
Published: November 2021

The Corylus genus contains several important nut producing species and exhibits sporophytic self‐incompatibility (SSI). However, the underlying molecular mechanisms of SSI in Corylus remain largely unknown.

To clarify whether Corylus and Brassica share the same SSI molecular mechanism. We cloned ChaTHL1/2, ChaMLPK, ChaARC1, ChaEX70A1 genes from Ping’ou hybrid hazelnut using RACE techniques and tested the interaction between the ChaARC1 and ChaSRK1/2. We also examined the pistil–pollen interactions using scanning electron microscopy.

We found no differences in the stigma surface within 1 h after compatible or incompatible pollination. Compatible pollen tubes penetrated the stigma surface, while incompatible pollen did not penetrate the stigma 4 h after pollination. Bioinformatics analysis revealed that ChaTHL1/2, ChaMLPK, ChaARC1 and ChaEX70A1 have corresponding functional domains. Quantitative real‐time PCR (qRT‐PCR) analysis showed that ChaTHL1/2, ChaMLPK, ChaARC1 and ChaEX70A1 were not regularly expressed in compatible or incompatible pollination. Furthermore, the expression patterns of ARC1, THL1/2, MLPK and Exo70A1 were quite distinct between Corylus and Brassica. According to yeast two‐hybrid assays, ChaSRK1/2 did not interact with ChaARC1, confirming that the SRK‐ARC1 signalling pathway implicated in the SSI response of Brassica was not conserved in Corylus.

These results further reinforce the conclusion that, notwithstanding the similarity of the genetic basis, the SSI mechanism of Corylus does not conform in many respects with that of Brassica. Our findings could be helpful to better explore the potential mechanism of SSI system in Corylus.
Evolutionary disruption in the pollination system of Vanilla (Orchidaceae)
Authors: Pansarin E. R. , Ferreira A. W. C.
Published: November 2021

Pollination of the pantropical Vanilla has been linked to melittophily and food deception.

Here we investigated the role of flower traits on the reproduction of Neotropical Vanilla. We also studied the evolution of pollination systems in order to understand the origin of production of flower resources and the diversification of pollinators in this orchid genus. Our study was founded on data of adaptations in flower morphology, production of resources, scent release, pollinators and breeding systems of Vanilla and presenting new data on reproductive biology of V. palmarum. Data on reproductive biology of Vanilla were mapped onto a phylogeny to address our queries on the evolution of pollination systems in this genus.

Vanilla palmarum shows a mixed mating system, with its facultative autogamous flowers being pollinated by hummingbirds. Its yellow flowers are scentless and produces nectar. Mapping of the pollination system onto trees resulted in one origin for bird pollination and at least two origins for autogamy in Vanilla. Nectar secretion has a single origin in the Neotropical thick‐leafed lineage.

Bird pollination of Vanilla is shown for the first time. The origin of ornithophily within a bee‐pollinated clade is supported by flower morphology. Floral transitions to ornithophily have been favoured by the occupation of a distinct niche from that of the other thick‐leafed Vanilla species. Despite its specialized pollination, V. palmarum is autogamous. A mixed mating system can promote reproductive assurance in the case of a decline in pollinator populations, or in areas where pollinator services are irregular or absent.
Modeling Patients' Illness Perception and Equilibrium Analysis of Their Doctor Shopping Behavior
Authors: Huang Fengfeng , Guo Pengfei , Wang Yulan
Published: November 2021

When a patient's illness perception is inconsistent with a doctor's diagnosis, she may seek opinions from multiple doctors without referrals, a behavior called doctor shopping. In this study, we model and derive patients' optimal doctor shopping decisions. After each visit, patients update their beliefs about their health status following the Bayes' rule. We show that the patients' doctor shopping decisions are critically affected by the diagnosis accuracy, the relative value of identifying a severely ill patient, and the cost per visit. We examine how the patients' doctor shopping behavior affects social welfare from two aspects, namely, an objective one that accesses whether doctor shopping improves the judgment accuracy regarding the patient's health status, and a subjective one concerning whether doctor shopping relieves patients' anxiety. We find that allowing patients to conduct doctor shopping exacerbates the system congestion ( congestion effect), but it can help those patients who have decided to join obtain a higher reward ( reward effect). There exists a diagnosis accuracy threshold above which allowing doctor shopping incurs a welfare loss and below which allowing doctor shopping improves welfare. Moreover, this diagnosis accuracy threshold increases as patients become more pessimistic or hold more diverse initial illness perceptions. The objective welfare maximization prefers a higher doctor shopping rate than the subjective welfare maximization does only when the value of identifying a severely ill patient is high enough, which may help explain why doctor shopping is encouraged for the critical illness such as cancer.
A burden too big to bear? The effect of experience‐rated disability insurance premiums on firm bankruptcies and employment*
Authors: de Groot Nynke , Koning Pierre
Published: November 2021

We study whether experience rating for disability insurance (DI) affects the labor costs of firms and the probability of bankruptcy. The experience rating requires firms to contribute to the DI benefit costs of their workers. We use matched worker–firm data of the Netherlands, where the DI premium of firms is a function of historic disability risks. To measure the effect of experience‐rated premiums, we exploit exogenous changes in the schedule that determines the firms’ DI premiums. We find that higher premiums increase not only labor costs but also the probability of firm bankruptcy. These effects are concentrated on small firms.
Recurrent nocardiosis in solid organ transplant recipients: An evaluation of secondary prophylaxis
Authors: Yetmar Zachary A. , Wilson John W. , Beam Elena
Published: November 2021

Background

Immunocompromised individuals are at risk for Nocardia infection, with a recurrence rate of approximately 5%. Solid organ transplant (SOT) recipients often receive secondary prophylaxis due to their requirement of lifelong immunosuppression. However, data supporting this practice is sparse. We sought to evaluate Nocardia recurrence in SOT recipients, specifically evaluating secondary prophylaxis.

Methods

We conducted a retrospective cohort study of SOT recipients diagnosed with nocardiosis from 2000 through 2020. We included adult SOT recipients who completed their course of Nocardia therapy and had at least 6 months of posttherapy follow‐up. The primary outcome was Nocardia recurrence, which included relapse and reinfection.

Results

One hundred two patients met inclusion criteria. Sixty‐six (64.7%) were male and mean age was 58.6 ± 11.7 years. Most common SOT types were kidney (46.1%), heart (18.6%), kidney‐pancreas (11.8%), and lung (10.8%). Most common sites of infection were lung (85.3%), skin (17.6%), and brain (14.7%). Secondary prophylaxis was utilized in 53 (52.0%) patients. Trimethoprim‐sulfamethoxazole (TMP‐SMX) single‐strength daily was the most common prophylaxis agent and dose. Five patients (4.9%) experienced Nocardia recurrence, three of which were receiving secondary prophylaxis at time of recurrence. Two recurrences were with the same Nocardia species. Factors associated with recurrence were lung transplantation (p = .011), chronic lung disease (p = .032), and treatment ≤120 days (p = .006). Time from treatment completion to recurrence ranged from 107 to 875 days.

Conclusions

Nocardia recurrence in SOT recipients is an uncommon event. TMP‐SMX secondary prophylaxis is incompletely protective and recurrence may be dependent upon other factors. Further study of secondary prophylaxis is warranted.
Use of anti‐CMV immunoglobulins in lung transplant recipients: The French experience
Authors: Roy Charlotte , Parquin François , Messika Jonathan , Véronique Boussaud , Brugière Olivier , Degot Tristan , Feuillet Séverine , Lepavec Jérôme , Tissot Adrien , Dromer Claire , Burnet Espérie , Camps Eve , Roux Antoine
Published: November 2021

Rational

Pending the authorization of new anti‐CMV drugs with fewer adverse effects, exploring the possibilities offered by CMV immunoglobulins (CMVIG) seems necessary. In France, access to CMVIG requires official authorization by the national Health authority and is restricted to second line rescue therapy for CMV infection/disease. The aim of this multicenter retrospective study is to describe the indications and clinical situations that justified its use in France.

Methods

A multicenter retrospective study included 22 lung transplant patients over a 3‐year period. Data on clinical indication, tolerance and efficacy were collected.

Results

The main indication for CMVIG initiation, which was documented in 17 of them (82%) was complex clinical situations resulting from side effects to antiviral drug. CMVIG indication was documented as treatment for 15 patients (68%) and as a secondary prophylaxis for 7 patients (32%). Only one side effect (pruritus during infusion with no anaphylactic symptoms) attributable to CMVIG was reported. After CMVIG initiation, no recurrence of infection or disease was observed during a median follow‐up of 174 (12–682) days after treatment initiation for respectively 68% and 66% of the patients.

Conclusion

This study describes an unusual indication of CMVIG use as a last resort treatment in complex situations, based on clinical needs. CMVIG could be useful to change the course of CMV infection with minimal adverse effects or comorbidity.
Alternative splicing triggered by the insertion of a CACTA transposon attenuates LsGLK and leads to the development of pale‐green leaves in lettuce
Authors: Zhang Lei , Qian Jinlong , Han Yuting , Jia Yue , Kuang Hanhui , Chen Jiongjiong
Published: November 2021

Lettuce (Lactuca sativa) is one of the most important vegetable crops in the world. As a leafy vegetable, the polymorphism of lettuce leaves from dark to pale green is an important trait. However, the genetic and molecular mechanisms underlying such variations remain poorly understood. In this study, one major locus controlling the polymorphism of dark‐ and pale‐green leaves in lettuce was identified using genome‐wide association studies (GWAS). This locus was then fine mapped to an interval of 5375 bp on chromosome 4 using a segregating population containing 2480 progeny. Only one gene, homologous to the GLK genes in Arabidopsis and other plants, is present in the candidate region. A complementation test confirmed that the candidate gene, LsGLK, contributes to the variation of dark‐ and pale‐green leaves. Sequence analysis showed that a CACTA transposon of 7434 bp was inserted 10 bp downstream of the stop codon of LsGLK, followed by a duplication of a 1826‐bp fragment covering exons 3–6 of the LsGLK gene. The transposon insertion did not change the expression level of the LsGLK gene. However, because of alternative splicing, only 6% of the transcripts produced from the transposon insertion were wild‐type transcripts, which led to the production of pale‐green leaves. An evolutionary analysis revealed that the insertion of the CACTA transposon occurred in cultivated lettuce and might have been selected in particular cultivars to satisfy the diverse demands of consumers. In this study, we demonstrated that a transposon insertion near a gene may affect its splicing and consequently generate phenotypic variations.
Therapeutic potential of the cytosine deaminase::uracil phosphoribosyl transferase/5‐fluorocytosine suicide system for canine melanoma
Authors: Allende Jesica B. , Finocchiaro Liliana M. E. , Glikin Gerardo C.
Published: November 2021

We tested the efficacy of a yeast cytosine deaminase::uracil phosphoribosyl transferase/5‐fluorocytosine (CDU/5‐FC) non‐viral suicide system on eight established canine melanoma cell lines. Albeit with different degree of sensitivity 5 days after lipofection, this system was significantly efficient killing melanoma cells, being four cell lines highly, two fairly and two not very sensitive to CDU/5‐FC (their respective IC50 ranging from 0.20 to 800 μM 5‐FC). Considering the relatively low lipofection efficiencies, a very strong bystander effect was verified in the eight cell lines: depending on the cell line, this effect accounted for most of the induced cell death (from 70% to 95%). In our assay conditions, we did not find useful interactions either with the herpes simplex thymidine kinase/ganciclovir suicide system (in sequential or simultaneous modality) or with cisplatin and bleomycin chemotherapeutic drugs. Furthermore, only two cell lines displayed limited useful interactions of the CDU/5‐FC either with interferon‐β gene transfer or the proteasome inhibitor bortezomib respectively. These results would preclude a wide use of these combinations. However, the fact that all the tested cells were significantly sensitive to the CDU/5‐FC system encourages further research as a gene therapy tool for local control of canine melanoma.
Finnish Maritime Archaeology through its Publications
Authors:   University of Helsinki, Ilves Kristin , Marila Marko ,   University of Helsinki
Published: November 2021

This article analyses Finnish maritime archaeology through a compiled bibliography of 621 scientific and popular works published between 1942–2020. General trends and turning points in the history of the discipline are identified and discussed vis-a-vis temporal and topical foci discerned in the publications. Special attention is drawn to the concentration in Finnish research on shipwrecks from the historical period, and the low international visibility of scientific production is problematised. While large-scale projects have been carried out in Finnish maritime archaeology, knowledge production within the authorised heritage discourse in particular has aimed to fulfil the needs of local and national rather than international audiences. Our compiled bibliography, which is hereby made available to the wider research community, has potential to become a valuable tool for identifying and developing future research areas.
Waveguide for air-coupled ultrasonic phased-arrays with propagation time compensation and plug-in assembly
Authors: Rutsch Matthias , Unger Alexander , Allevato Gianni , Hinrichs Jan , Jäger Axel , Kaindl Thomas , Kupnik Mario
Published: November 2021

Waveguides allow grating lobe free beamforming for air-coupled ultrasonic phased-arrays by reducing the effective inter-element spacing to half wavelength. Since the sound waves propagate through the waveguide ducts, additional time delays are introduced. In this work, we present analytical, numerical, and experimental methods to estimate these time delays. Afterwards, two different waveguides are compared. The first one consists of equal-length ducts, requiring a time-consuming assembly process of the ultrasonic phased-array. In contrast, the second waveguide consists of Bézier-shaped ducts of unequal lengths but a planar input port allowing fast assembly. The analytical model is based on the geometric lengths of the waveguide ducts. The numerical model relies on a transient finite element analysis. All simulations are validated in an anechoic chamber using a calibrated microphone. The analytical (7.6% deviation) and numerical (3.2% deviation) propagation time models are in good agreement with the measurements. By using the analyzed propagation times for the compensation of the unequal waveguide duct lengths, we restored the beamforming capability without significant sound pressure level (SPL) loss. This work shows the possibility of reduced transducer assembly time for waveguided air-coupled phased-arrays without a reduced SPL.
Comment on “Designing river flows to improve food security futures in the Lower Mekong Basin”
Authors: Halls Ashley S. , Moyle Peter B.
Published: November 2021

The designer flow regime proposed by Sabo
et al
. (Research Articles, 8 December 2017, p. 1270) to support fisheries in the Lower Mekong Basin fails to account for important ecological, political, and economic dimensions. In doing so, they indicate that dam impacts can be easily mitigated. Such an action would serve to increase risks to food and livelihood futures in the basin.
In Vitro
Antimalarial Activity of Inhibitors of the Human GTPase Rac1
Authors: Parapini Silvia , Paone Silvio , Erba Emanuela , Cavicchini Loredana , Pourshaban Manoochehr , Celani Francesco , Contini Alessandro , D’Alessandro Sarah , Olivieri Anna
Published: November 2021

Malaria accounts for millions of cases and thousands of deaths every year. In the absence of an effective vaccine, drugs are still the most important tool in the fight against the disease.
Plasmodium
parasites developed resistance to all classes of known antimalarial drugs.
Activity of Omadacycline in Rat Methicillin-Resistant Staphylococcus aureus Osteomyelitis
Authors: Karau Melissa J. , Schmidt-Malan Suzannah M. , Cunningham Scott A. , Mandrekar Jayawant N. , Pritt Bobbi S. , Keepers Tiffany R. , Serio Alisa W. , Chitra Surya , Patel Robin
Published: November 2021

Omadacycline, vancomycin, and rifampin, as well as rifampin combination therapies, were evaluated in an experimental rat model of methicillin-resistant
Staphylococcus aureus
(MRSA) osteomyelitis. All treatment groups had less MRSA recovered than saline-treated animals.
A Mosquito AgTRIO Monoclonal Antibody Reduces Early
Plasmodium
Infection of Mice
Authors: Chuang Yu-Min , Tang Xu-Dong , Fikrig Erol
Published: November 2021

Malaria begins when an infected mosquito injects saliva containing
Plasmodium
sporozoites into the skin of a vertebrate host. Passive immunization of mice with antiserum against the
Anopheles gambiae
mosquito saliva protein TRIO (AgTRIO) offers significant protection against
Plasmodium
infection of mice.
Supplemental Material: Seismicity recorded in hematite fault mirrors in the Rio Grande rift
Authors: Odlum Margaret , al. et
Published: November 2021

Contains detailed microscopy and thermochronology methodologies, (U-Th)/He data tables, grain size measurements, thermal history model input table, and figures.
The effect of along-strike variation in dip on rupture propagation on strike-slip faults
Authors: Lozos Julian C.
Published: November 2021

Strike-slip faults can be nonplanar in both their strike and dip dimensions. While a large body of work has investigated the effects of changes in strike on earthquake rupture and arrest, no previous studies have investigated the role of along-strike variations in dip on strike-slip ruptures. Here, I use the three-dimensional finite-element method to conduct dynamic simulations of ruptures on strike-slip faults with linear surface traces and changes in dip along strike. I experiment with the amount of dip change as well as the abruptness of that change under a variety of initial stress conditions. In all of my initial stress cases, I find that a change in dip along strike can cause rupture to stop, and that larger dip changes over shorter distances are more likely to do so. This is largely due to the change in strike at depth that inherently comes from changing the dip; the majority of these behaviors are a result of the rupture front being forced to change direction mid-rupture. While some dip-slip movement does occur on the nonvertical parts of the model fault, it does not have a significant effect on rupture extent. However, linear-surface-trace, nonvertical-dip faults do produce different surface slip, stress, and ground motion patterns compared to corresponding nonlinear-strike, vertical-dip faults. Together, my results show that changes in dip along strike-slip faults do considerably impact the rupture process, suggesting that this type of geometrical complexity should be considered in rupture forecasts and hazard assessments.
Neurodevelopmental outcomes of preterm infants after randomisation to initial resuscitation with lower (FiO2 <0.3) or higher (FiO2 >0.6) initial oxygen levels. An individual patient meta-analysis
Authors: Oei Ju Lee , Kapadia Vishal , Rabi Yacov , Saugstad Ola Didrik , Rook Denise , Vermeulen Marijn J , Boronat Nuria , Thamrin Valerie , Tarnow-Mordi William , Smyth John , Wright Ian M , Lui Kei , van Goudoever Johannes B , Gebski Val , Vento Maximo
Published: November 2021

Objective

To determine the effects of lower (≤0.3) versus higher (≥0.6) initial fractional inspired oxygen (FiO2) for resuscitation on death and/or neurodevelopmental impairment (NDI) in infants <32 weeks’ gestation.

Design

Meta-analysis of individual patient data from three randomised controlled trials.

Setting

Neonatal intensive care units.

Patients

543 children <32 weeks’ gestation.

Intervention

Randomisation at birth to resuscitation with lower (≤0.3) or higher (≥0.6) initial FiO2.

Outcome measures

Primary: death and/or NDI at 2 years of age.

Secondary: post-hoc non-randomised observational analysis of death/NDI according to 5-minute oxygen saturation (SpO2) below or at/above 80%.

Results

By 2 years of age, 46 of 543 (10%) children had died. Of the 497 survivors, 84 (17%) were lost to follow-up. Bayley Scale of Infant Development (third edition) assessments were conducted on 377 children. Initial FiO2 was not associated with difference in death and/or disability (difference (95% CI) −0.2%, −7% to 7%, p=0.96) or with cognitive scores <85 (2%, −5% to 9%, p=0.5). Five-minute SpO2 >80% was associated with decreased disability/death (14%, 7% to 21%) and cognitive scores >85 (10%, 3% to 18%, p=0.01). Multinomial regression analysis noted decreased death with 5-minute SpO2 ≥80% (odds (95% CI) 09.62, 0.98 to 0.96) and gestation (0.52, 0.41 to 0.65), relative to children without death or NDI.

Conclusion

Initial FiO2 was not associated with difference in risk of disability/death at 2 years in infants <32 weeks’ gestation but CIs were wide. Substantial benefit or harm cannot be excluded. Larger randomised studies accounting for patient differences, for example, gestation and gender are urgently needed.
Cerebral perfusion and neurological examination characterise neonatal opioid withdrawal syndrome: a prospective cohort study
Authors: Benninger Kristen L , Peng Jin , Ho Mai-Lan , Newton Julia , Wang Danny J J , Hu Houchun H , Stark Ann R , Rusin Jerome A , Maitre Nathalie L
Published: November 2021

Objective

To test the hypothesis that cerebral blood flow (CBF) assessed with arterial spin labelling (ASL) MRI is increased and standardised neurological examination is altered in infants with neonatal opioid withdrawal syndrome (NOWS) compared with those without.

Design

Prospective cohort study.

Setting

Level IV neonatal intensive care unit and outpatient primary care centre.

Participants

Infants with NOWS receiving pharmacological treatment and unexposed controls matched for gestational age at birth and post-menstrual age at MRI.

Main outcomes

CBF assessed by ASL on non-sedated 3-Tesla MRI and standardised Hammersmith Neonatal Neurological Examination (HNNE) within 14 days of birth.

Results

Thirty infants with NOWS and 31 control infants were enrolled and included in the final analysis. Global CBF across the brain was higher in the NOWS group compared with controls (14.2 mL/100 g/min±5.5 vs 10.7 mL/100 g/min±4.3, mean±SD, Cohen’s d=0.72). HNNE total optimality score was lower in the NOWS group compared with controls (25.9±3.6 vs 28.4±2.4, mean±SD, Cohen’s d=0.81). A penalised logistic regression model including both CBF and HNNE items discriminated best between the two groups.

Conclusions

Increased cerebral perfusion and neurological examination abnormalities characterise infants with NOWS compared with those without intrauterine drug exposure and suggest prenatal substance exposure affects fetal brain development. Identifying neurological and neuroimaging characteristics of infants with NOWS can contribute to understanding mechanisms underlying later outcomes and to designing potential new treatments.
Outcome of infants with 10 min Apgar scores of 0–1 in a low-resource setting
Authors: Tylleskär Thorkild , Cavallin Francesco , Höök Susanna Myrnerts , Pejovic Nicolas J , Lubulwa Clare , Byamugisha Josaphat , Nankunda Jolly , Trevisanuto Daniele
Published: November 2021

Background

In high-resource settings, postponing the interruption of cardiopulmonary resuscitation from 10 to 20 min after birth has been recently suggested, but data from low-resource settings are lacking. We investigated the outcome of newborns with Apgar scores of 0–1 at 10 min of resuscitative efforts in a low-resource setting.

Methods

This observational substudy from the NeoSupra trial included all 49 late preterm/full-term newborns with Apgar scores of 0–1 at 10 min of resuscitation. The study was carried out at Mulago National Referral Hospital (Kampala, Uganda) between May 2018 and August 2019. Outcome measures were mortality and hypoxic-ischaemic encephalopathy in the first week of life. All resuscitations were video recorded and daily reviewed by trial researchers.

Results

Median duration of resuscitation was 32 min (IQR 17–37). Advanced resuscitation was provided to 21/49 neonates (43%). Overall, 48 neonates (98%) died within 2 days of life (44 in the delivery room, three on the first day and one on the second day) and one survived at 1 week with severe hypoxic-ischaemic encephalopathy.

Conclusion

Our study adds information from a low-resource setting to the recent evidence from high-resource settings about prolonging the resuscitation in infants with Apgar scores of 0–1 at 10 min. The vast majority died in the delivery room despite prolonged resuscitative efforts. We confirm that duration of resuscitation should be tailored to the setting, while the focus in low-resource settings should be improving the quality of antenatal and immediately after birth care.
Clinical management of complex motor stereotypies
Authors: Bhatoa Raj Seraya , Malik Osman , Robinson Sally , Hedderly Tammy
Published: November 2021

This paper will review complex motor stereotypies and provide a summary of the current proposed treatment pathway.
Rare right acetabulum aneurysmal bone cyst treated with curettage and local adjuvants in a 4-year-old girl
Authors: Wong Kenneth Pak Leung , Mahadev Arjandas
Published: November 2021

Aneurysmal bone cysts are locally aggressive benign bone tumours with a high risk of recurrence. We describe a case in a 4-year-old girl, involving the right acetabulum. A direct posterior approach was used and the lesion ablated with curettage and local adjuvants with bone grafting. The cyst resolved swiftly with an uncomplicated recovery.
Projections of human papillomavirus (HPV) vaccination impact in Ethiopia, India, Nigeria and Pakistan: a comparative modelling study
Authors: Portnoy Allison , Abbas Kaja , Sweet Steven , Kim Jane J , Jit Mark
Published: November 2021

Introduction

Cervical cancer is the second most common cancer among women in Ethiopia, India, Nigeria and Pakistan. Our study objective was to assess similarities and differences in vaccine-impact projections through comparative modelling analysis by independently estimating the potential health impact of human papillomavirus (HPV) vaccination.

Methods

Using two widely published models (Harvard and Papillomavirus Rapid Interface for Modelling and Economics (PRIME)) to estimate HPV vaccination impact, we simulated a vaccination scenario of 90% annual coverage among 10 cohorts of 9-year-old girls from 2021 to 2030 in Ethiopia, India, Nigeria and Pakistan. We estimated potential health impact in terms of cervical cancer cases, deaths and disability-adjusted life years averted among vaccinated cohorts from the time of vaccination until 2100. We harmonised the two models by standardising input data to comparatively estimate HPV vaccination impact.

Results

Prior to harmonising model assumptions, the range between PRIME and Harvard models for number of cervical cancer cases averted by HPV vaccination was: 262 000 to 2 70 000 in Ethiopia; 1 640 000 to 1 970 000 in India; 330 000 to 3 36 000 in Nigeria and 111 000 to 1 33 000 in Pakistan. When harmonising model assumptions, alignment on HPV type distribution significantly narrowed differences in vaccine-impact estimates.

Conclusion

Despite model differences, the Harvard and PRIME models yielded similar vaccine-impact estimates. The main differences in estimates are due to variation in interpretation around data on cervical cancer attribution to HPV-16/18. As countries make progress towards WHO targets for cervical cancer elimination, continued explorations of underlying differences in model inputs, assumptions and results when examining cervical cancer prevention policy will be critical.
Impact of zero-mark-up medicines policy on hospital revenue structure: a panel data analysis of 136 public tertiary hospitals in China, 2012–2020
Authors: Cheng Hanchao , Zhang Yuou , Sun Jing , Liu Yuanli
Published: November 2021

Objective

To quantify the overall and dynamic effects of the implementation of the zero-mark-up medicines policy on the proportionate revenue generated from medicines, medical services and government subsidies at Chinese tertiary public hospitals.

Methods

The revenue data of 136 tertiary public hospitals from 2012 to 2020 and the implementation-time framework of zero-mark-up medicines policy of these hospitals were obtained from the institutional survey of the third-party evaluation of the China Healthcare Improvement Initiative. The study adopted the time-varying difference-in-differences method and combined it with the event study approach to estimate the effects of the zero-mark-up medicines policy.

Results

Following the implementation of the policy, the proportionate medicines revenue decreased by 3.23% (p<0.001); the proportionate medical services revenue increased by 3.48% (p=0.001); and the difference in the proportionate government subsidies revenue was not significant. In the year of implementation, the proportion of revenue generated from medicines decreased by 7.76% (p=0.0148); and that from medical services increased by 8.62% (p=0.0167). The effect of the policy gradually strengthened thereafter. In 2020, the sixth year after some hospitals started the implementation of the policy, the share of revenue generated from medicines decreased the most by 18.43% (p=0.0151), and that generated from medical services increased the most by 15.29% (p=0.0219). The share of revenue generated from government subsidies increased by 2%–5% in the second, third, fifth and sixth years following implementation (p<0.05).

Conclusions

Although the policy goal of adjusting hospital revenue structure has been achieved, the findings were insufficient to conclude whether the policy goal of establishing a scientific compensation mechanism was met by increasing the price of medical services and government input. Additionally, whether there was an unexpected policy effect requires further analysis.
How communication can help women who experience a maternal near-miss: a qualitative study from Tanzania
Authors: Kwezi Hilda Alinda , Mselle Lilian T , Leshabari Sebalda , Hanson Claudia , Pembe Andrea Barnabas
Published: November 2021

Objectives

This study aimed to explore experiences of communication as an element of quality of care, among women surviving a maternal near-miss event, thus women who nearly died but survived haemorrhage, or pre-eclampsia complication during pregnancy, childbirth or within 42 days of termination of pregnancy.

Design

A descriptive, phenomenological, qualitative study using semistructured interviews with women who survived a maternal near-miss in Southern Tanzania.

Setting

The participants were recruited from two selected hospitals in Mtwara Region, where women sought child birth care and developed near-miss condition.

Participants

Participants for this study were women who experienced and survived a maternal near-miss event and who had lived in the study area for at least 1 year. Women were recruited using an adapted version of the WHO criteria for maternal near-miss.

Data collection

We identified 16 women and were able to conduct 10 in-depth interviews with women at their homes, 4 weeks after they were discharged. The interviews were audiorecorded and transcribed and translated word for word from Kiswahili. Thematic analysis was used to identify emerging themes.

Results

Three major themes evolved: (1) Being informed about the care and interaction, (2) Being engaged and encouraged and (3) Being afraid to ask questions. The study highlighted that good communication with women during the provision of care helped women feel grateful, supported and cared for. Women who were unconscious during care were often not informed later of what happened. This created some negative feelings and anxiety.

Conclusion

This study highlights the importance of communication, and of being informed of what happened and why. Empathetic communication with sufficient explanation on what happened and why created trust among women—a positive finding which should encourage the development of consistent approaches to strengthen healthcare provider communication skills.
Acceptability of different mechanisms of action of contraception in women: a questionnaire survey
Authors: Tong Yu Wing , Lo Sue Seen Tsing , Fung Barbara Wai Kwan , Cameron Sharon T , Ng Ernest Hung Yu , Li Raymond Hang Wun
Published: November 2021

Background

The mechanism of action of a contraceptive method is an importantg consideration in a woman’s choice of contraception. For the development of new methods of contraception it is important to understand the acceptability of different contraceptive mechanisms within a population.

Methods

We recruited women attending contraceptive, termination of pregnancy or postnatal care services in Hong Kong for a questionnaire survey on their acceptability of the different ways in which contraceptive methods prevent pregnancy. Univariable and multivariable analyses were used to establish factors which may predict acceptability of the mechanism of action.

Results

A total of 1448 women completed the survey. The acceptability of contraceptive methods that act by preventing fertilisation ranked highest (78%), followed by those that inhibit ovulation (52%), disrupt implantation (43%) and dislodge an implanted embryo (30%). A history of termination of pregnancy was associated with greater acceptance of all posited contraceptive mechanisms. There was a very low degree of agreement between the declared acceptance of the various contraceptive mechanisms and the ever use of a method with the respective mechanism of action (Cohen’s kappa coefficient range 0.017–0.162).

Conclusions

In this population the acceptability of contraceptive methods that act by preventing fertilisation ranked highest, followed by those that inhibit ovulation, disrupt implantation and dislodge an implanted embryo. Women who had ever had a termination of pregnancy were more likely to accept all the posited contraceptive mechanisms.
Which classification system defines best prognosis of mucinous neoplasms of the appendix with peritoneal dissemination: TNM vs PSOGI?
Authors: Martín-Román Lorena , Lozano Pablo , Gómez Yesica , Fernández-Aceñero María Jesús , Vasquez Wenceslao , Palencia Natividad , González-Bayón Luis
Published: November 2021

Aims

Several classification systems are used for pseudomyxoma peritonei. The four-tiered classification system proposed by Peritoneal Surface Oncology Group International (PSOGI) and the two-tiered proposed by the eighth edition of the American Joint Committee on Cancer (AJCC) result from evolution in terminology and pathological insight. The aim is to evaluate the impact of PSOGI and eighth edition of the AJCC classifications on survival.

Methods

Pathological slides were reviewed from a prospectively maintained database including patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for an appendiceal mucinous neoplasm with peritoneal dissemination between January 2009 and December 2019. Patients were reclassified according to PSOGI and AJCC eighth edition criteria. Survival analysis evaluated the impact of each classification system on overall survival (OS) and disease-free survival (DFS) while the concordance-index evaluated their predictive power.

Results

95 patients were identified; 21.1% were reclassified as acellular mucin, 55.8% as low-grade mucinous carcinoma peritonei, 8.4% as high-grade MCP (HGMCP) and 14 as HGMCP with signet ring cells. Median OS was not reached, 5-year OS and DFS were 86.1% and 51.5%, respectively. Multivariate analysis revealed significant associations with OS (PSOGI: HR 10.2, p=0.039; AJCC: HR 7.7, p=0.002) and DFS (PSOGI: HR 12.7, p=0.001; AJCC: HR 3.7, p<0.001). The predictive capacity of both classification systems was unacceptable for OS and DFS (concordance-index values <0.7).

Conclusions

Both classification systems behaved similarly when stratifying our series into prognostic groups. The PSOGI classification provides better histopathological description, but histology alone is insufficient for adequate patient prognostication.
Innervation of the clavicle: a cadaveric investigation
Authors: Leurcharusmee Prangmalee , Maikong Naraporn , Kantakam Perada , Navic Pagorn , Mahakkanukrauh Pasuk , Tran De Q
Published: November 2021

Background

This cadaveric study investigated the innervations of the clavicle and clavicular joints (ie, sternoclavicular and acromioclavicular joints).

Methods

Twenty cadavers (40 clavicles) were dissected. A skin incision was made to permit exposure of the posterior cervical triangle and infraclavicular fossa. The platysma, sternocleidomastoid, and trapezius muscles were cleaned in order to identify the supraclavicular nerves. Subsequently, the suprascapular and subclavian nerves were localized after removal of the prevertebral layer of the deep cervical fascia. In the infraclavicular region, the pectoralis major and minor muscles were retracted laterally in order to visualize the lateral pectoral nerve. The contribution of all these nerves to the clavicular bone and joints were recorded.

Results

Along their entire length, all clavicular specimens received contributions from the supraclavicular nerves. The latter innervated the cephalad and ventral aspects of the clavicular bone. The caudal and dorsal aspects of the clavicle were innervated by the subclavian nerve (middle and medial thirds). The lateral pectoral nerve supplied the caudad aspect of the clavicle (middle and lateral thirds). The sternoclavicular joint derived its innervation solely from the supraclavicular nerves whereas the acromioclavicular joint was supplied by the supraclavicular and lateral pectoral nerves.

Conclusion

The clavicle and clavicular joints are innervated by the subclavian, lateral pectoral, and supraclavicular nerves. Clinical trials are required to determine the relative importance and functional contribution of each nerve.
Comparing belief in short-term versus long-term consequences of smoking and vaping as predictors of non-use in a 3-year nationally representative survey study of US youth
Authors: Jesch Emma , Kikut Ava Irysa , Hornik Robert
Published: November 2021

Introduction

Efforts to prevent youth tobacco use are critical to reducing smoking-related deaths in the USA. Anti-tobacco messaging often focuses on the severe long-term consequences of smoking (eg, fatal lung disease, cancer). It is unclear whether these long-term consequences are more likely to deter youth use than shorter term consequences (eg, headaches, friend disapproval).

Methods

A nationally representative 3-year rolling survey of adolescents and young adults (ages 13–26 years) measured belief in potential consequences of two types of tobacco products: combustible cigarettes (n=11 847) and electronic cigarettes (n=4470) as well as intentions and current use. Independent coders classified 23 consequences as either short or long term. Logistic regression tested the associations between short-term (vs long-term) beliefs and current intentions, as well as non-smoking behaviour at 6-month follow-up.

Results

Believing in both short-term and long-term consequences was associated with outcomes, but short-term beliefs were more highly associated with anti-smoking (OR=1.40, 95% CI (1.30 to 1.51)) and anti-vaping (OR=2.10, 95% CI (1.75 to 2.52)) intentions and better predicted non-smoking behaviour at follow-up, controlling for prior use (OR=1.75, 95% CI (1.33 to 2.31)).

Conclusions

These results support temporal discounting by adolescents and young adults and suggest health communication efforts aiming to reduce youth tobacco use should emphasise shorter term consequences.
Three-photon productions within the $$k_t$$-factorization at the LHC
Authors: Valeshabadi Ramin Kord , Modarres Majid , Rezaie Somayeh
Published: November 2021

Recently, the ATLAS data of isolated three-photon production showed that the next-to-leading order (NLO) collinear factorization is not enough to describe experimental data. Therefore, one needs to calculate the cross section beyond the NLO, and as showed later, these data can be well described by the NNLO calculation within the collinear factorization framework. However, it is shown that the $$k_t$$

k
t

-factorization can be quite successful in describing exclusive and high energy collision processes, henceforth we decided to calculate isolated three-photon production within this framework. In this work we use the Martin, Ryskin, and Watt unintegrated parton distribution functions (MRW UPDFs) at LO and NLO levels, in addition to parton branching (PB) UPDFs in order to calculate cross section which we utilize the KATIE parton level event generator. It will be shown that in contrast to collinear factorization, the $$k_t$$

k
t

-factorization can describe quiet well the three-photon production ATLAS data. Interestingly our results using the NLO-MRW and PB UPDFs can cover the data within their uncertainty bands, similar to the NNLO collinear results.
A review on arbitrarily regular conforming virtual element methods for second- and higher-order elliptic partial differential equations
Authors: Antonietti Paola F. , Manzini Gianmarco , Scacchi Simone , Verani Marco
Published: November 2021

The virtual element method is well suited to the formulation of arbitrarily regular Galerkin approximations of elliptic partial differential equations of order [Formula: see text], for any integer [Formula: see text]. In fact, the virtual element paradigm provides a very effective design framework for conforming, finite dimensional subspaces of [Formula: see text], [Formula: see text] being the computational domain and [Formula: see text] another suitable integer number. In this review, we first present an abstract setting for such highly regular approximations and discuss the mathematical details of how we can build conforming approximation spaces with a global high-order regularity on [Formula: see text]. Then, we illustrate specific examples in the case of second- and fourth-order partial differential equations, that correspond to the cases [Formula: see text] and [Formula: see text], respectively. Finally, we investigate numerically the effect on the approximation properties of the conforming highly-regular method that results from different choices of the degree of continuity of the underlying virtual element spaces and how different stabilization strategies may impact on convergence.