bluuebunny/crossref_metadata_2025 huggingface dataset:
3D impression to facilitate in situ surgical renal segmental artery aneurysm repair: A novel open approach option for an unusual vascular condition
Authors: Cubas W Samir , Albán-Sánchez Franco , Calle-Blácido Cesar , Salazar-Cuizano Milagros , Mayta-Rodríguez Johnny , Pachas-Canales Carlos , Cuentas-Jara Mariano , Sánchez-Huamán Alexis , Pedroza-Silvera Jessica
Published: May 2024

Objectives

Renal Artery Aneurysms (RAA) affect approximately 0.01%–0.97% of the population. Early diagnosis, thorough 3D-preoperative planning, and timely surgical treatment may offer effective and safe management.

Methods

We report the open reparation of a segmental renal artery saccular aneurysm close to the bifurcation with detailed preoperative planning based on 3D printing, and with successful postoperative results.

Results

We report the case of a 36-year-old man with a 3.5 × 5 cm segmental renal artery saccular aneurysm close to the bifurcation, for which endovascular management was ruled out and open management was chosen with detailed preoperative planning based on 3D printing and with successful postoperative results.

Conclusions

When an open approach is chosen in the RAA treatment, a detailed study of the anatomical configuration of the RAAs is mandatory, and life-size 3D printing is a valuable tool that could contribute to the operative technique, reduce surgical times associated with renal ischemia and provide minute details that would make a clear anatomical difference during in situ repair.
Challenging the angiosome concept: Delineating peripheral arterial disease patterns in diabetic foot ulcers
Authors: Sahebalzamani Elham , Tayebi Pouya , Haddad Zavareh Mahmoud Sadeghi , Bijani Ali , Hedayati Goudarzi Mohammad Taghi
Published: May 2024

Objectives

The angiosome concept has significantly impacted diabetic foot ulcer management by highlighting the vascular anatomy’s role in wound healing. However, its clinical applicability and validity remain debated due to complexities in foot blood supply and ulcer location determination.

Methods

A cross-sectional study was conducted on 84 individuals with diabetic foot ulcers undergoing lower limb angiography. Demographics, ulcer characteristics, and angiographic data were collected and analyzed using descriptive statistics and relevant tests.

Results

Digital subtraction angiography assessed 89 limbs with diabetic foot ulcers; males comprised 54.8%, primarily type 2 diabetes (96.4%), averaging 64.36 ± 10.09 years. Of 129 angiosomes, angiosome 2 (40.3%) had the highest ulcer incidence. Posterior tibial artery (PTA) involvement was predominant (72.9%), while external iliac artery (EIA) and profunda femoris artery (PFA) were least affected (2.4% each). Posterior tibial artery showed 46.5% complete occlusion. Angiosome 2 correlated notably with anterior tibial artery (ATA), peroneal artery (CPA), and PTA, but categorizing angiosomes by supply patterns showed no significant artery correlation ( p > .05).

Conclusions

The research indicates inconsistent support for below-the-knee artery involvement correlating with foot ulcer locations in angiosomes. While aiding vascular comprehension, the angiosome concept may not fully elucidate lower limb vascular complexities and ulcer genesis. Factors like collateral circulation should be noticed to understanding ulcer localization and severity, extending beyond angiosomal arterial supply.
Assessment of efficacy and safety of MET tyrosine kinase inhibitors in non-small-cell lung cancer patients with MET alterations
Authors: Wang Yanhua , Xu Manyi , Wang Ke , Hao Yue , Xu Chunwei , Song Zhengbo
Published: May 2024

Background:

While targeted therapy has become the standard treatment for certain non-small-cell lung cancer (NSCLC) patients with gene mutation positivity, there remains a lack of enough reports of the efficacy of mesenchymal–epithelial transition (MET) alterations in the real world.

Objectives:

We aimed to explore the efficacy and toxicity of targeted therapy in NSCLC patients with different types of MET alterations and hope to provide more clinical medication guidance.

Design:

Designed different subgroups to compare the efficacy and safety of targeted therapy in NSCLC patients with MET alterations.

Methods:

We conducted analyses on the efficacy and safety of mesenchymal–epithelial transition factor-tyrosine kinase inhibitor (MET-TKI) therapy in NSCLC patients with MET alterations. Tumor response was evaluated based on the Response Evaluation Criteria in Solid Tumors version 1.1 criteria, and both progression-free survival (PFS) and overall survival were determined using the Kaplan–Meier method.

Results:

Our study encompassed 116 NSCLC patients with MET alterations, including MET ex14 skipping mutation ( n = 50), MET primary amplification (amp) ( n = 25), and secondary amp ( n = 41). Among treated patients, 34 achieved a partial response, while 52 exhibited stable disease. The overall response rate for the entire cohort was 29.31%, with a disease control rate of 74.14%. A significant difference was observed in the median PFS among patients with MET ex14 skipping mutation, MET primary amplification (amp), and secondary amp (10.4 versus 6.6 versus 4.5 months, p = 0.002). In all, 69 patients experienced drug-related adverse effects, with the most common being peripheral edema (35.34%), nausea and vomiting (21.55%), and fatigue (10.34%). In total, 29 patients (25%) encountered drug-related adverse reactions of grade 3 or higher.

Conclusion:

MET-TKI therapy works better for MET ex14 skipping mutation than other types of MET gene alteration. In the two MET amplified groups, the secondary amp was less effective. This study may provide more research support for the treatment of these patients.
Does war improve women’s political representation?
Authors: Kim Nam Kyu
Published: May 2024

An expanding body of scholarly work posits that war, particularly intrastate war, disrupts established power arrangements and social institutions, providing avenues for women to enhance their political influence through reforms in political structures and participation in peace-building processes. Webster, Chen, and Beardsley (2019) systematically explore the nexus between war and women’s political empowerment, demonstrating associations between both interstate and intrastate conflicts and advancements in women’s political empowerment. Extending their analysis, this study investigates the influence of intrastate conflicts on women’s representation in legislative bodies. However, nuanced findings emerge from this analysis. There is no supporting evidence that the occurrence of warfare leads to an increase in women’s legislative representation. Ongoing internal conflicts exhibit a negative impact on the progression of women’s political representation. Conversely, the termination of civil wars, particularly without their prompt resumption, correlates with a higher likelihood of adopting gender quotas, thereby enhancing women’s legislative representation. Furthermore, the correlation between the termination of civil wars and women’s legislative representation appears specific to the context of sub-Saharan Africa. No conclusive evidence supports this relationship as a global phenomenon.
Algorithmic orientalism? Netflix’s representation of China in Brazil
Authors: Araujo Mayara , de Albuquerque Afonso
Published: May 2024

For decades, the geopolitical domination of the United States remained almost unquestioned. However, other countries have emerged as poles of influence in recent years, including China and Brazil. Despite this, cultural and media interaction between the two countries is still limited and often mediated by the United States. This paper explores the algorithmic representation of China by the video streaming platform Netflix and argues that the company acts imperialistically by seeking to establish monopolistic control of the global Internet television market and promoting biases that we call ‘algorithmic orientalism’. By presenting China to the Brazilian public through this lens, Netflix plays the role of cultural gatekeeper that continues to promote hegemonically American worldviews.
Investing in Rural Agriculture in the Face of Innovative Financial Services: Does Financial Literacy Matter in Nigeria?
Authors: Ogbemudia Benedict Imhanrenialena , Wilson Ebhotemhen , Ugwu Cyril Ndubuisi , Benjamin Ibe Chukwu
Published: May 2024

The complex nature of formal financial products and services and the frequently associated innovations occasioned by disruptive technologies inform researchers’ calls for studies on financial literacy, particularly in African rural communities. As a response to the calls, this study explores how financial literacy relates to performance, access to credit facilities, and payment preferences among smallholder rural farmers in Nigeria. Further, the rural farmers’ financial literacy level on each of the four dimensions of the Standard and Poor Global Financial Literacy criteria was assessed. A random sample was drawn from the registered rural farmers in the Central Bank of Nigeria’s Anchored Borrower’s Program for the 2022 farming year. Quantitative data were collected from rural farmers using the Standard and Poor Global Financial Literacy questionnaire. The proposed hypotheses were tested with partial least squares structural equation modeling (PLS-SEM), while descriptive statistics were used to analyze the data. The outcomes show that financial literacy significantly predicts performance, access to credit facilities, and mode of payment preferences among smallholder rural farmers. Also, the analyses of the four dimensions of financial literacy show that the farmers are more literate in risk diversification and inflation than numeracy and compound interest. It is concluded that financial literacy is cardinal to profitable investments in rural farming, and as such, there is a need for the Nigerian government and financial authorities to embark on financial literacy drive with more emphasis on numeracy and compound interest where the rural farmers are more deficient.
Posterolateral Fusion Versus Posterior Lumbar Interbody Fusion for Adult Low-Grade Isthmic Spondylolisthesis: Analysis of Sagittal Radiographic Parameters - A Randomized Controlled Trial
Authors: Ibrahim Mahmoud Fouad , Saeed Fady Samy , El-Morshidy Essam Mohammed , Hassan Khaled Mohammed , Hassan Mohamed Gamal , El-Sharkawi Mohammad , Elnady Belal
Published: May 2024

Study Design

Randomized controlled trial.

Objectives

To compare the effect of posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF) on sagittal radiographic parameters in patients with low-grade isthmic spondylolisthesis. Additionally, to explore the correlation between changes in these parameters and clinical outcomes.

Methods

Forty-six consecutive patients with single-level low-grade isthmic spondylolisthesis were initially enrolled. They were randomly assigned to undergo either PLF or PLIF. Patients were followed up for at least 24 months. Radiographic outcomes included pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, sagittal vertical axis, T1 pelvic angle, slip angle, slip degree and disc height. Clinical outcomes were assessed by the Oswestry Disability Index (ODI) and visual analogue scale (VAS).

Results

Four participants were lost to follow-up. Of the remaining 42 patients, 29 were female. The mean age was 40.23 ± 10.25 years in the PLF group and 35.81 ± 10.58 years in the PLIF group. There was a statistically significant greater correction of all radiographic parameters in the PLIF group. The ODI and VAS improved significantly in both groups, with no significant differences between the two groups. Changes in the ODI and VAS were significantly correlated with changes in disc height, slip angle and lumbar lordosis.

Conclusions

In patients with low-grade isthmic spondylolisthesis, PLIF demonstrates superior efficacy compared to PLF in correcting sagittal radiographic parameters. Nevertheless, this distinction does not seem to influence short-term clinical results. Restoring disc height, correcting the slip angle, and reestablishing normal lumbar lordosis are crucial steps in the surgical management of isthmic spondylolisthesis.
Proletarian Internationalism in the Contemporary Women’s Movement: A Perspective from India
Authors: Prasad Archana
Published: May 2024

This article discusses the influence of internationalist perspectives on the women’s movement in India. It provides a history of anti-imperialist feminism in general but focuses on some of the major women’s organizations in India. The aim is to trace the legacy of anti-imperialist feminist politics as a response to the strategies of Western imperialist powers to counter the influence of radical and socialist politics, particularly after the Russian Revolution. The article also documents women’s participation in radical and socialist struggles for independence and social transformation, which received strong political support from the Soviet Union in the postwar period and extends the analysis to the period of neoliberalism and the structural adjustment policies imposed on the South.
Cnicus benedictus extract-loaded electrospun gelatin wound dressing for treating diabetic wounds: An in vitro and in vivo study
Authors: Zhang Jing , Shen Shen , Zhu Shijie , Jia Fan , Li Jin , Sun Yu
Published: May 2024

In the current study, Cnicus benedictus extract was loaded into electrospun gelatin scaffolds for diabetic wound healing applications. Scaffolds were characterized in vitro by mechanical testing, cell culture assays, electron microscopy, cell migration assay, and antibacterial assay. In vivo wound healing study was performed in a rat model of diabetic wound. In vitro studies revealed fibrous architecture of our developed dressings and their anti-inflammatory properties. In addition, Cnicus benedictus extract-loaded wound dressings prevented bacterial penetration. In vivo study showed that wound size reduction, collagen deposition, and epithelial thickness were significantly greater in Cnicus benedictus extract-loaded scaffolds than other groups. Gene expression studies showed that the produced wound dressings significantly upregulated VEGF and IGF genes expression in diabetic wounds.
Influence of Obstructive Sleep Apnea on the Risk of Dental Caries: Insights from a 13-Year Population-Based Retrospective Study
Authors: Lee H.L. , Chung C.H. , Hsu Y.T. , Chung K.H. , Chien W.C. , Chiu H.C.
Published: May 2024

Obstructive sleep apnea (OSA) is a cyclic condition characterized by a complete or partial obstruction of the upper airway during sleep, often leading to a dry mouth. The main characteristic of dry mouth is that saliva secretion decreases, and saliva can inhibit the growth of microorganisms in the oral cavity. Therefore, in patients with OSA, the self-cleaning ability of the oral cavity is usually decreased, resulting in dental problems such as caries or periodontitis. According to previous studies, OSA is highly related to oral diseases such as periodontitis; however, studies on the association between OSA and dental caries are limited. This study aimed to evaluate the association between OSA and dental caries in a large-scale population-based cohort in Taiwan. A total of 6,060 enrolled patients, including 1,515 patients with OSA and 4,545 age- and sex-matched controls from the Longitudinal Health Insurance Dataset of 2000 to 2013, were selected from a sub data set of the National Health Insurance Research Database. The Fine and Gray competing risk model analysis was used to explore the hazard ratio and 95% confidence interval for the association of OSA with the risk of developing dental caries during the 13-y follow-up period. Overall, patients with OSA had no significant discrepant cumulative risk of developing dental caries in subsequent y ( P from log-rank test = 0.669). However, after the data were analyzed after stratification based on factors such as gender, age, diabetes mellitus, hypertension, hyperlipidemia, obesity, and coronary heart disease, OSA patients aged 45 to 64 y (adjusted hazard ratio [aHR] = 1.201, P = 0.004) and ≥65 y (aHR = 1.206, P = 0.041) had a significantly higher risk of dental caries than patients without OSA did. Our findings demonstrated that once OSA patients are ≥45 y old, they have significantly developed dental caries compared with patients without OSA.

Knowledge Transfer Statement:

Obstructive sleep apnea has been proven to have a great negative impact on patients, and the relationship between sleep apnea and dental caries is still inconclusive. Our study shows that patients with sleep apnea and those older than 45 y have a significant risk of dental caries.
Reporting Psychiatric Disease Characteristics in Post-Mortem- and Biological Research
Authors: Scheepstra Karel , Mizee Mark , Wever Dennis , Hsiao Cheng-Chih , Zhang Lin , Swaab Dick , Hamann Jörg , Huitinga Inge
Published: May 2024

Inflammation is a prominent hypothesis in the neurobiology of depression. In our transcriptomic profiling study of microglia in chronic major depressive disorder (MDD), we revealed a distinct disease-associated microglia (DAM) transcriptomic profile exclusively found in cortical gray matter, that we have designated DepDAM. These DepDAM revealed an immune-suppressed state, with a possible upstream mechanism for microglial suppression, by upregulation of CD200 and CD47 (“don’t eat me signals”) located on synapses. We extensively report on disease characteristics, such as cause of death, reason for euthanasia, and psychiatric state when deceased. When excluding MDD donors in a euthymic state, the trend of lower CD45 membrane expression on white matter microglia became significant, and the difference in gray matter microglia became larger. For Western blot analysis of CD47 and CD200, both means of the definitely depressed donor groups (MDD-D) increased. This underscores the utmost importance of reporting on patient and episode characteristics, such as severity, episode traits, (type of) suicidality, mode of decease, and state of illness at death in post-mortem- and biological psychiatric research. For psychiatric post-mortem research, we suggest using well-characterized donors (eg, after “psychological autopsy”) selected by an experienced clinician.
Unraveling the Connection: Cholesterol, Calcium Signaling, and Neurodegeneration
Authors: Casas Maria , Dickson Eamonn J
Published: May 2024

Cholesterol and calcium play crucial roles as integral structural components and functional signaling entities within the central nervous system. Disruption in cholesterol homeostasis has been linked to Alzheimer’s, Parkinson’s, and Huntington’s Disease while alterations in calcium signaling is hypothesized to be a key substrate for neurodegeneration across many disorders. Despite the importance of regulated cholesterol and calcium homeostasis for brain health there has been an absence of research investigating the interdependence of these signaling molecules and how they can tune each other’s abundance at membranes to influence membrane identity. Here, we discuss the role of cholesterol in shaping calcium dynamics in a neurodegenerative disorder that arises due to mutations in the lysosomal cholesterol transporter, Niemann Pick Type C1 (NPC1). We discuss the molecular mechanisms through which altered lysosomal cholesterol transport influences calcium signaling pathways through remodeling of ion channel distribution at organelle–organelle membrane contacts leading to neurodegeneration. This scientific inquiry not only sheds light on NPC disease but also holds implications for comprehending other cholesterol-associated neurodegenerative disorders.
Life cycle assessment of electric kick scooters: consolidating environmental impact quantification and concluding climate-friendly use options
Authors: Baumgartner Corinna , Helmers Eckard
Published: May 2024

Background

The environmental impact of electric scooters has been the subject of critical debate in the scientific community for the past 5 years. The data published so far are very inhomogeneous and partly methodologically incomplete. Most of the data available in the literature suffer from an average bias of 34%, because end-of-life (EOL) impacts have not been modelled, reported or specified. In addition, the average lifetime mileage of shared fleets of e-scooters, as they are operated in cities around the world, has recently turned out to be much lower than expected. This casts the scooters in an unfavourable light for the necessary mobility transition. Data on impact categories other than the global warming potential (GWP) are scarce. This paper aims to quantify the strengths and weaknesses of e-scooters in terms of their contribution to sustainable transport by more specifically defining and extending the life cycle assessment (LCA) modelling conditions: the modelling is based on two genuine material inventories obtained by dismantling two different e-scooters, one based on a traditional aluminium frame and another, for the first time, based on plastic material.

Results

This study provides complete inventory data to facilitate further LCA modelling of electric kick scooters. The plastic scooter had a 26% lower lifetime GWP than the aluminium vehicle. A favourable choice of electric motor promises a further reduction in GWP. In addition to GWP, the scooter's life cycles were assessed across seven other impact categories and showed no critical environmental or health impacts compared to a passenger car. On the other hand, only the resource extraction impact revealed clear advantages for electric scooters compared to passenger cars.

Conclusions

Under certain conditions, scooters can still be an important element of the desired mobility transition. To assure a lifetime long enough is the crucial factor to make the electric scooter a favourable or even competitive vehicle in a future sustainable mobility system. A scooter mileage of more than 5400 km is required to achieve lower CO2eq/pkm emissions compared to passenger cars, which seems unlikely in today's standard use case of shared scooter fleets. In contrast, a widespread use of e-scooters as a commuting tool is modelled to be able to save 4% of greenhouse gas (GHG) emissions across the German mobility sector.
Copy number variation and elevated genetic diversity at immune trait loci in Atlantic and Pacific herring
Authors: Mohamadnejad Sangdehi Fahime , Jamsandekar Minal S. , Enbody Erik D. , Pettersson Mats E. , Andersson Leif
Published: May 2024

Background

Genome-wide comparisons of populations are widely used to explore the patterns of nucleotide diversity and sequence divergence to provide knowledge on how natural selection and genetic drift affect the genome. In this study we have compared whole-genome sequencing data from Atlantic and Pacific herring, two sister species that diverged about 2 million years ago, to explore the pattern of genetic differentiation between the two species.

Results

The genome comparison of the two species revealed high genome-wide differentiation but with islands of remarkably low genetic differentiation, as measured by anFSTanalysis. However, the lowFSTobserved in these islands is not caused by low interspecies sequence divergence (dxy) but rather by exceptionally high estimated intraspecies nucleotide diversity (π). These regions of low differentiation and elevated nucleotide diversity, termed high-diversity regions in this study, are not enriched for repeats but are highly enriched for immune-related genes. This enrichment includes genes from both the adaptive immune system, such as immunoglobulin, T-cell receptor and major histocompatibility complex genes, as well as a substantial number of genes with a role in the innate immune system, e.g. novel immune-type receptor, tripartite motif and tumor necrosis factor receptor genes. Analysis of long-read based assemblies from two Atlantic herring individuals revealed extensive copy number variation in these genomic regions, indicating that the elevated intraspecies nucleotide diversities were partially due to the cross-mapping of short reads.

Conclusions

This study demonstrates that copy number variation is a characteristic feature of immune trait loci in herring. Another important implication is that these loci are blind spots in classical genome-wide screens for genetic differentiation using short-read data, not only in herring, likely also in other species harboring qualitatively similar variation at immune trait loci. These loci stood out in this study because of the relatively high genome-wide baseline forFSTvalues between Atlantic and Pacific herring.
Atypical skin conditions of the neck and back as a dermal manifestation of anti-HMGCR antibody-positive myopathy
Authors: Kurashige Takashi , Nakamura Rie , Murao Tomomi , Mine Naoko , Sato Mayu , Katsumata Riho , Kanaya Yuhei , Dodo Yoriko , Sugiura Tomohito , Ohshita Tomohiko
Published: May 2024

Background

Immune-mediated necrotizing myopathy (IMNM) is an idiopathic inflammatory myopathy (IIM). Though patients with IMNM were not considered to show skin rash, several reports have showed atypical skin conditions in patients with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibody-positive IMNM (HMGCR-IMNM). The incidence and phenotype of skin conditions in patients with HMGCR-IMNM are not fully known.

Results

Among the 100 IIM patients diagnosed from April 2015 through August 2022, 34 (34%) presented some form of skin condition, with 27 having typical skin rashes; this included 13 patients with dermatomyositis (DM), 8 with anti-synthetase syndrome (ASS), and 6 with IMNM. Meanwhile, 8 of 19 patients with HMGCR-IMNM (42%) presented atypical skin lesions, but no patients with other IIMs did (p < 0.001). Skin eruption with ash-like scales was observed in four HMGCR-IMNM patients, and non-scaly red patches and lumps in the other four patients; accordingly, their skin manifestations were considered as other dermal diseases except for IIM. However, skin and muscle biopsies revealed the atypical skin conditions of patients with HMGCR-IMNM to have the same pathological background, formed by Bcl-2-positive lymphocyte infiltrations.

Conclusions

HMGCR-IMNM patients frequently have atypical skin conditions of the neck and back. Skin biopsy specimens from these lesions showed the same Bcl-2-positive lymphocytic infiltrations as muscle biopsy specimens regardless of the different gross dermal findings. Thus, such atypical skin conditions may be suggestive for HMGCR-IMNM.
Availability of family care resources, bathing assistance and toileting assistance among older adults with functional limitations: an evidence-based study from China
Authors: Zhang Jinxin , Shen Zi , Tong Xiyang , Sun Xiaojie , Yao Nengliang
Published: May 2024

Background

An aging population has contributed to an increasing prevalence of functional limitations among older adults. Family support plays a crucial role in toileting and bathing assistance. Yet, the relationship between availability of family care resources and such actual assistance remains insufficiently explored. Our study aims to describe availability of family care resources and identify the association between availability of family care resources and toileting assistance or bathing assistance.

Methods

This study employed a cross-sectional analysis of data from the 2018 National Survey of the China Health and Retirement Longitudinal Study (CHARLS). The availability of family care resources was assessed using measurements of spouse availability, adult child availability, and living arrangement. Bathing assistance and toileting assistance were measured based on self-reported receipt of such assistance. Descriptive statistics were used to depict the overall and subgroup situation of availability of family care resources. Multivariable logistic models were employed to investigate the relationship between availability of family care resources and the receipt of toileting assistance or bathing assistance.

Results

Among the sample of older adults with functional limitations, 69% had a spouse, 63% had at least one adult child, and 80% resided with family members. Among those with bathing disability, 13% reported lacking bathing assistance, and among those with toileting disability, 54% reported lacking toileting assistance.

Participants with 1-2 adult children had lower odds of receiving toileting assistance (OR: 0.28, 95% CI: 0.09, 0.91, p= 0.034) compared to those with three or more adult children. Spouse availability and living arrangement did not exhibit statistically significant associations with toileting assistance. Participants without a spouse had lower odds of receiving bathing assistance (OR: 0.27, 95% CI: 0.09-0.78, p= 0.016) in comparison to those with a spouse; however, adult child availability and living arrangement did not display statistically significant associations with bathing assistance.

Conclusion

The present findings suggest a gap in family commitment when it comes to assisting older adults with functional limitations in bathing/toileting. To address this, policymakers are encouraged to prioritize the implementation of proactive mechanisms for identifying family caregivers, alongside incentives to enhance their engagement in practical caregiving activities. Furthermore, it is crucial to emphasize the prioritization of affordable and easily accessible formal toileting/bathing assistance options for older adults who lack sufficient family care resources.
Bilateral bartholin’s gland abscesses in a 4-year-old girl with vitamin a deficiency: a case report
Authors: Kihara Tomoko , Kenzaka Tsuneaki , Hasegawa Tomohiro , Uemura Koutaro , Funakoshi Toru
Published: May 2024

Background

A Bartholin’s gland abscess is one of the most common infections in women of reproductive age. Although Bartholin’s gland abscesses have been reported in prepubertal children, they are rarer in prepubertal children than in adults. Herein, we report a case of bilateral Bartholin’s gland abscesses in a 4-year-old girl with vitamin A deficiency.

Case presentation

A 4-year-old girl diagnosed with autism spectrum disorder was admitted to the hospital for close examination and treatment because of persistent fever and malaise. The child was a marked fussy eater and was diagnosed with corneal ulceration and night blindness secondary to vitamin A deficiency. Both of the patient’s labia were swollen, and a diagnosis of a bilateral Bartholin’s gland abscess was made using computed tomography. Incisional drainage was performed under general anesthesia. The patient’s postoperative course was uneventful, and she was discharged from the hospital on day 8 after the surgery. During hospitalization, attempts were made to correct the vitamin deficiency by adding nutritional supplements to the diet. Three months after the surgery, no recurrence of abscesses was noted.

Conclusions

Decreased immunocompetence and mucosal barrier function due to vitamin A deficiency is thought to be the underlying cause of Bartholin’s gland abscesses. Although prepubertal Bartholin’s gland abscesses have been reported, they are rare. To the best of our knowledge, no reports of bilateral Bartholin’s gland abscesses potentially caused by vitamin A deficiency have been reported. When prepubertal girls present with Bartholin’s gland abscesses, the presence of immunodeficiency due to vitamin or trace element deficiency should also be considered.
Carbon monoxide poisoning with hippocampi lesions on MRI: cases report and literature review
Authors: Li Wenxia , Meng Jun , Lei Jing , Li Cheng , Yue Wei
Published: May 2024

Background

Carbon monoxide (CO) poisoning is now one of the leading causes of poisoning-related mortality worldwide. The central nervous system is the most vulnerable structure in acute CO poisoning. MRI is of great significance in the diagnosis and prognosis of CO toxic encephalopathy. The imaging features of CO poisoning are diverse. We report atypical hippocampal lesions observed on MRI in four patients after acute CO exposure.

Case presentations

We report four patients who presented to the emergency department with loss of consciousness. The diagnosis of CO poisoning was confirmed on the basis of their detailed history, physical examination and laboratory tests. Brain MRI in all of these patients revealed abnormal signal intensity in hippocampi bilaterally. They all received hyperbaric oxygen therapy. The prognosis of all four patients was poor.

Conclusion

Hippocampi, as a relatively rare lesion on MRI of CO poisoning, is of important significance both in the early and delayed stages of acute CO poisoning. In this article, we summarize the case reports of hippocampal lesions on MRI in patients with CO poisoning in recent years, in order to provide reference for the diagnosis and prognosis of CO poisoning.
A nomogram based on nutritional and inflammatory parameters to predict DMFS and identify beneficiaries of adjuvant chemotherapy in IVA-stage nasopharyngeal carcinoma
Authors: pan Yuhui , Chen Zihan , Hong Wenquan , Huang Zongwei , Li Ying , Cai Sunqin , Lai Jinghua , Lu Jun , Qiu Sufang
Published: May 2024

Objective

This study aims to develop a nomogram integrating inflammation (NLR), Prognostic Nutritional Index (PNI), and EBV DNA (tumor burden) to achieve personalized treatment and prediction for stage IVA NPC. Furthermore, it endeavors to pinpoint specific subgroups that may derive significant benefits from S-1 adjuvant chemotherapy.

Methods

A total of 834 patients diagnosed with stage IVA NPC were enrolled in this study and randomly allocated into training and validation cohorts. Multivariate Cox analyses were conducted to identify independent prognostic factors for constructing the nomogram. The predictive and clinical utility of the nomogram was assessed through measures including the AUC, calibration curve, DCA, and C-indexes. IPTW was employed to balance baseline characteristics across the population. Kaplan-Meier analysis and log-rank tests were utilized to evaluate the prognostic value.

Results

In our study, we examined the clinical features of 557 individuals from the training cohort and 277 from the validation cohort. The median follow-up period was 50.1 and 49.7 months, respectively. For the overall cohort, the median follow-up duration was 53.8 months. The training and validation sets showed 3-year OS rates of 87.7% and 82.5%, respectively. Meanwhile, the 3-year DMFS rates were 95.9% and 84.3%, respectively. We created a nomogram that combined PNI, NRI, and EBV DNA, resulting in high prediction accuracy. Risk stratification demonstrated substantial variations in DMFS and OS between the high and low risk groups. Patients in the high-risk group benefited significantly from the IC + CCRT + S-1 treatment. In contrast, IC + CCRT demonstrated non-inferior 3-year DMFS and OS compared to IC + CCRT + S-1 in the low-risk population, indicating the possibility of reducing treatment intensity.

Conclusions

In conclusion, our nomogram integrating NLR, PNI, and EBV DNA offers precise prognostication for stage IVA NPC. S-1 adjuvant chemotherapy provides notable benefits for high-risk patients, while treatment intensity reduction may be feasible for low-risk individuals.
The association between humidex and tuberculosis: a two-stage modelling nationwide study in China
Authors: Li Wen , Wang Jia , Huang Wenzhong , Yan Yu , Liu Yanming , Zhao Qi , Chen Mingting , Yang Liping , Guo Yuming , Ma Wei
Published: May 2024

Background

Under a changing climate, the joint effects of temperature and relative humidity on tuberculosis (TB) are poorly understood. To address this research gap, we conducted a time-series study to explore the joint effects of temperature and relative humidity on TB incidence in China, considering potential modifiers.

Methods

Weekly data on TB cases and meteorological factors in 22 cities across mainland China between 2011 and 2020 were collected. The proxy indicator for the combined exposure levels of temperature and relative humidity, Humidex, was calculated. First, a quasi-Poisson regression with the distributed lag non-linear model (DLNM) was constructed to examine the city-specific associations between humidex and TB incidence. Second, a multivariate meta-regression model was used to pool the city-specific effect estimates, and to explore the potential effect modifiers.

Results

A total of 849,676 TB cases occurred in the 22 cities between 2011 and 2020. Overall, a conspicuous J-shaped relationship between humidex and TB incidence was discerned. Specifically, a decrease in humidex was positively correlated with an increased risk of TB incidence, with a maximum relative risk (RR) of 1.40 (95% CI: 1.11–1.76). The elevated RR of TB incidence associated with low humidex (5th humidex) appeared on week 3 and could persist until week 13, with a peak at approximately week 5 (RR: 1.03, 95% CI: 1.01–1.05). The effects of low humidex on TB incidence vary by Natural Growth Rate (NGR) levels.

Conclusion

A J-shaped exposure-response association existed between humidex and TB incidence in China. Humidex may act as a better predictor to forecast TB incidence compared to temperature and relative humidity alone, especially in regions with higher NGRs.
Associated factors of mortality and morbidity in emergency and elective abdominal surgery: a two-year prospective cohort study at lacor hospital, Uganda
Authors: Okidi Ronald , Sambo Vanusa Da Consolacao , Okello Isaac , Ekwem Doris Amarachi , Ekwang Solomon , Obalim Fiddy , Kyegombe Willy
Published: May 2024

Background

The mortality rate associated with open abdominal surgery is a significant concern for patients and healthcare providers. This is particularly worrisome in Africa due to scarce workforce resources and poor early warning systems for detecting physiological deterioration in patients who develop complications.

Methods

This prospective cohort study aimed to follow patients who underwent emergency or elective abdominal surgery at Lacor Hospital in Uganda. The participants were patients who underwent abdominal surgery at the hospital between April 27th, 2019 and July 07th, 2021. Trained research staff collected data using standardized forms, which included demographic information (age, gender, telephone contact, and location), surgical indications, surgical procedures, preoperative health status, postoperative morbidity and mortality, and length of hospital stay.

Results

The present study involved 124 patients, mostly male, with an average age of 35 years, who presented with abdominal pain and varying underlying comorbidities. Elective cases constituted 60.2% of the total. The common reasons for emergency and elective surgery were gastroduodenal perforation and cholelithiasis respectively. The complication rate was 17.7%, with surgical site infections being the most frequent. The mortality rate was 7.3%, and several factors such as preoperative hypotension, deranged renal function, postoperative use of vasopressors, and postoperative assisted ventilation were associated with it. Elective and emergency-operated patients showed no significant difference in survival (P-value = 0.41) or length of hospital stay (P-value = 0.17). However, there was a significant difference in morbidity (p < 0.001).

Conclusion

Cholelithiasis and gastroduodenal perforation were key surgical indications, with factors like postoperative ventilation and adrenaline infusion linked to mortality. Emergency surgeries had higher complication rates, particularly surgical site infections, despite similar hospital stay and mortality rates compared to elective surgeries.
Advanced-stage breast cancer diagnosis and its determinants in Ethiopia: a systematic review and meta-analysis
Authors: Zewdie Amare , Kassie Tadele Derbew , Anagaw Tadele Fentabel , Mazengia Elyas Melaku , Gelaw Sintayehu Shiferaw , Fenta Eneyew Talie , Eshetu Habitu Birhan , Kebede Natnael , Bogale Eyob Ketema
Published: May 2024

Introduction

Worldwide, breast cancer is the primary cause of illness and death. Unless early detected and treated breast cancer is a life-threatening tumor. Advanced-stage presentation is greatly linked with short survival time and increased mortality rates. In Ethiopia nationally summarized evidence on the level of advanced-stage breast cancer diagnosis is scarce. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of advanced-stage breast cancer diagnosis and its determinants in Ethiopia.

Method

By following PRISMA guidelines, a systematic review and meta-analysis were carried out. To include relevant publications, a broad literature search was conducted in the African Online Journal, PubMed, Google Scholar, and Embase which are published until last search date; June 15, 2023. To prevent further duplication this review was registered in PROSPERO database with ID no of CRD42023435096. To determine the pooled prevalence, a weighted inverse variance random effect model was applied. I2 statistics and the Cochrane Q-test were computed to determine heterogeneity. To evaluate publication bias, a funnel plot, and Egger’s regression test were used.

Result

A total of 924 articles were sought and finally 20 articles were included in this review. The pooled prevalence of advanced-stage breast cancer diagnosis in Ethiopia was 72.56% (95%CI; 68.46-76.65%). Use of traditional medicine as first choice (AOR = 1.32, 95% CI: (1.13–1.55)), delay of > 3 months in seeking care (AOR = 1.24, 95% CI: (1.09–1.41)), diagnosis or health system delay of > 2 months (AOR = 1.27, 95% CI: (1.11–1.46)), rural residence (AOR = 2.04, 95% CI: (1.42 − 2.92)), and chief complaint of a painless breast lump (AOR = 2.67, 95% CI: (1.76–4.06)) were significantly associated to advanced-stage diagnosis.

Conclusion

In Ethiopia, more than two-thirds of breast cancer cases are diagnosed at an advanced stage. Use of traditional medicine before diagnostic confirmation, delay in seeking care, health system delay, rural residence, and chief complaint of painless breast lump were positively associated with an advanced-stage diagnosis. Policymakers and program designers give great focus to those delays so as to seek and access modern diagnosis and treatment as early as possible specifically focusing on those who are rurally residing.
Psychometric properties of the experiences of maternity care scale among Iranian women
Authors: Jafari Elham , Asghari-Jafarabadi Mohammad , Mirghafourvand Mojgan , Mohammad-Alizadeh-Charandabi Sakineh
Published: May 2024

Background

Assessing women’s perceptions of the care they receive is crucial for evaluating the quality of maternity care. Women’s perceptions are influenced by the care received during pregnancy, labour and birth, and the postpartum period, each of which with unique conditions, expectations, and requirements. In England, three Experience of Maternity Care (EMC) scales – Pregnancy, Labour and Birth, and Postnatal – have been developed to assess women’s experiences from pregnancy through the postpartum period. This study aimed to validate these scales within the Iranian context.

Methods

A methodological cross-sectional study was conducted from December 2022 to August 2023 at selected health centers in Tabriz, Iran. A panel of 16 experts assessed the qualitative and quantitative content validity of the scales and 10 women assessed the face validity. A total of 540 eligible women, 1–6 months postpartum, participated in the study, with data from 216 women being used for exploratory factor analysis (EFA) and 324 women for confirmatory factor analysis (CFA) and other analyses. The Childbirth Experience Questionnaire-2 was employed to assess the convergent validity of the Labour and Birth Scale, whereas women’s age was used to assess the divergent validity of the scales. Test-retest reliability and internal consistency were also examined.

Results

All items obtained an impact score above 1.5, with Content Validity Ratio and Content Validity Index exceeding 0.8. EFA demonstrated an excellent fit with the data (all Kaiser-Meyer-Olkin measures > 0.80, and all Bartlett’s p < 0.001). The Pregnancy Scale exhibited a five-factor structure, the Labour and Birth Scale a two-factor structure, and the Postnatal Scale a three-factor structure, explaining 66%, 57%, and 62% of the cumulative variance, respectively, for each scale. CFA indicated an acceptable fit with RMSEA ≤ 0.08, CFI ≥ 0.92, and NNFI ≥ 0.90. A significant correlation was observed between the Labour and Birth scale and the Childbirth Experience Questionnaire-2 (r = 0.82, P < 0.001). No significant correlation was found between the scales and women’s age. All three scales demonstrated good internal consistency (all Cronbach’s alpha values > 0.9) and test-retest reliability (all interclass correlation coefficient values > 0.8).

Conclusions

The Persian versions of all three EMC scales exhibit robust psychometric properties for evaluating maternity care experiences among urban Iranian women. These scales can be utilized to assess the quality of current care, investigate the impact of different care models in various studies, and contribute to maternal health promotion programs and policies.
Molecular and phenotypic identification of bacterial species isolated from cows with mastitis from three regions of Poland
Authors: Dobrut Anna , Siemińska Izabela , Sroka-Oleksiak Agnieszka , Drożdż Kamil , Sobońska Joanna , Mroczkowska Urszula , Brzychczy-Włoch Monika
Published: May 2024

Background

Bovine mastitis is a widespread disease affecting dairy cattle worldwide and it generates substantial losses for dairy farmers. Mastitis may be caused by bacteria, fungi or algae. The most common species isolated from infected milk are, among others, Streptococcus spp., Escherichia coli, Staphylococcus aureus and non-aureus staphylococci and mammaliicocci. The aim of this paper is to determine the frequency of occurrence of bacterial species in milk samples from cows with mastitis from three regions of Poland: the north-east, the south-west and the south. To this end 203 milk samples taken from cows with a clinical form (CM) of mastitis (n = 100) and healthy animals (n = 103) were examined, which included culture on an appropriate medium followed by molecular detection of E. coli, S. aureus, Streptococcus agalactiae and Streptococcus uberis, as one of the most common species isolated from mastitis milk.

Results

The results obtained indicated that S. uberis was the most commonly cultivated CM species (38%, n = 38), followed by S. aureus (22%, n = 22), E. coli (21%, n = 21) and S. agalactiae (18%, n = 18). Similar frequencies in molecular methods were obtained for S. uberis (35.1%) and S. aureus (28.0%). The variation of sensitivity of both methods may be responsible for the differences in the E. coli (41.0%, p = 0.002) and S. agalactiae (5.0%, p = 0.004) detection rates. Significant differences in composition of species between three regions of Poland were noted for E. coli incidence (p < 0.001), in both the culture and molecular methods, but data obtained by the PCR method indicated that this species was the least common in north-eastern Poland, while the culture method showed that in north-eastern Poland E. coli was the most common species. Significant differences for the molecular method were also observed for S. uberis (p < 0.001) and S. aureus (p < 0.001). Both species were most common in southern and south-western Poland.

Conclusions

The results obtained confirm the need to introduce rapid molecular tests for veterinary diagnostics, as well as providing important epidemiological data, to the best of our knowledge data on Polish cows in selected areas of Poland is lacking.