bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a preoperative risk score on admission in surgical intermediate care unit in gastrointestinal cancer surgery
Authors: Fernandes Antero , Rodrigues Jéssica , Antunes Luís , Lages Patrícia , Santos Carla Salomé , Moreira-Gonçalves Daniel , Costa Rafael S. , Sousa Joaquim Abreu , Dinis-Ribeiro Mário , Santos Lúcio Lara
Published: August 2020

Background

Gastrointestinal cancer surgery continues to be a significant cause of postoperative complications and mortality in high-risk patients. It is crucial to identify these patients. Our study aimed to evaluate the accuracy of specific perioperative risk assessment tools to predict postoperative complications, identifying the most informative variables and combining them to test their prediction ability as a new score.

Methods

A prospective cohort study of digestive cancer surgical patients admitted to the surgical intermediate care unit of the Portuguese Oncology Institute of Porto, Portugal was conducted during the period January 2016 to April 2018. Demographic and medical information including sex, age, date from hospital admission, diagnosis, emergency or elective admission, and type of surgery, were collected. We analyzed and compared a set of measurements of surgical risk using the risk assessment instruments P-POSSUM Scoring, ACS NSQIP Surgical Risk Calculator, and ARISCAT Risk Score according to the outcomes classified by the Clavien-Dindo score. According to each risk score system, we studied the expected and observed post-operative complications. We performed a multivariable regression model retaining only the significant variables of these tools (age, gender, physiological P-Possum, and ACS NSQIP serious complication rate) and created a new score (MyIPOrisk-score). The predictive ability of each continuous score and the final panel obtained was evaluated using ROC curves and estimating the area under the curve (AUC).

Results

We studied 341 patients. Our results showed that the predictive accuracy and agreement of P-POSSUM Scoring, ACS NSQIP Surgical Risk Calculator, and ARISCAT Risk Score were limited. The MyIPOrisk-score, shows to have greater discrimination ability than the one obtained with the other risk tools when evaluated individually (AUC = 0.808; 95% CI: 0.755–0.862). The expected and observed complication rates were similar to the new risk tool as opposed to the other risk calculators.

Conclusions

The feasibility and usefulness of the MyIPOrisk-score have been demonstrated for the evaluation of patients undergoing digestive oncologic surgery. However, it requires further testing through a multicenter prospective study to validate the predictive accuracy of the proposed risk score.
Finding the match between healthcare worker and expert for optimal audit and feedback on antimicrobial resistance prevention measures
Authors: Keizer J. , Beerlage-De Jong N. , Al Naiemi N. , van Gemert-Pijnen J. E. W. C.
Published: August 2020

Background

The potentials of audit and feedback (AF) to improve healthcare are currently not exploited. To unlock the potentials of AF, this study focused on the process of making sense of audit data and translating data into actionable feedback by studying a specific AF-case: limiting antimicrobial resistance (AMR). This was done via audit and feedback of AMR prevention measures (APM) that are executed by healthcare workers (HCW) in their day-to-day contact with patients. This study’s aim was to counterbalance the current predominantly top-down, expert-driven audit and feedback approach for APM, with needs and expectations of HCW.

Methods

Qualitative semi-structured interviews were held with sixteen HCW (i.e. physicians, residents and nurses) from high-risk AMR departments at a regional hospital in The Netherlands. Deductive coding was succeeded by open and axial coding to establish main codes, subcodes and variations within codes.

Results

HCW demand insights from audits into all facets of APM in their working routines (i.e. diagnostics, treatment and infection control), preferably in the form of simple and actionable feedback that invites interdisciplinary discussions, so that substantiated actions for improvement can be implemented. AF should not be seen as an isolated ad-hoc intervention, but as a recurrent, long-term, and organic improvement strategy that balances the primary aims of HCW (i.e. improving quality and safety of care for individual patients and HCW) and AMR-experts (i.e. reducing the burden of AMR).

Conclusions

To unlock the learning and improvement potentials of audit and feedback, HCW’ and AMR-experts’ perspectives should be balanced throughout the whole AF-loop (incl. data collection, analysis, visualization, feedback and planning, implementing and monitoring actions). APM-AF should be flexible, so that both audit (incl. collecting and combining the right data in an efficient and transparent manner) and feedback (incl. persuasive and actionable feedback) can be tailored to the needs of various target groups. To balance HCW’ and AMR-experts’ perspectives a participatory holistic AF development approach is advocated.
DRP1 deficiency induces mitochondrial dysfunction and oxidative stress-mediated apoptosis during porcine oocyte maturation
Authors: Zhang Haolin , Pan Zhennan , Ju Jiaqian , Xing Chunhua , Li Xiaohan , Shan Mengmeng , Sun Shaochen
Published: August 2020

Background

Environmental pollution induces oxidative stress and apoptosis in mammalian oocytes, which can cause defects in reproduction; however, the molecular regulation of oxidative stress in oocytes is still largely unknown. In the present study, we identified that dynamin-related protein 1 (DRP1) is an important molecule regulating oocyte mitochondrial function and preventing oxidative stress/apoptosis. DRP1 is a member of the dynamin GTPase superfamily localized at the mitochondrial-endoplasmic reticulum interaction site, where it regulates the fission of mitochondria and other related cellular processes.

Results

Our results show that DRP1 was stably expressed during different stages of porcine oocyte meiosis, and might have a potential relationship with mitochondria as it exhibited similar localization. Loss of DRP1 activity caused failed porcine oocyte maturation and cumulus cell expansion, as well as defects in polar body extrusion. Further analysis indicated that a DRP1 deficiency caused mitochondrial dysfunction and induced oxidative stress, which was confirmed by increased reactive oxygen species levels. Moreover, the incidence of early apoptosis increased as detected by positive Annexin-V signaling.

Conclusions

Taken together, our results indicate that DRP1 is essential for porcine oocyte maturation and that a DRP1 deficiency could induce mitochondrial dysfunction, oxidative stress, and apoptosis.
AI-enabled future crime
Authors: Caldwell M. , Andrews J. T. A. , Tanay T. , Griffin L. D.
Published: August 2020

A review was conducted to identify possible applications of artificial intelligence and related technologies in the perpetration of crime. The collected examples were used to devise an approximate taxonomy of criminal applications for the purpose of assessing their relative threat levels. The exercise culminated in a 2-day workshop on ‘AI & Future Crime’ with representatives from academia, police, defence, government and the private sector. The workshop remit was (i) to catalogue potential criminal and terror threats arising from increasing adoption and power of artificial intelligence, and (ii) to rank these threats in terms of expected victim harm, criminal profit, criminal achievability and difficulty of defeat. Eighteen categories of threat were identified and rated. Five of the six highest-rated had a broad societal impact, such as those involving AI-generated fake content, or could operate at scale through use of AI automation; the sixth was abuse of driverless vehicle technology for terrorist attack.
Definitive surgical management for second branchial cleft fistula: A case series
Authors: Reddy Abhita , Valika Taher , Maddalozzo John
Published: August 2020

Background

Second branchial cleft fistulae are rare pediatric anomalies managed with surgical excision and, in certain cases, ipsilateral tonsillectomy to prevent postoperative recurrence or wound infection. Limited information is available in the published literature regarding surgical techniques to maximize patient outcomes and minimize recurrence. Our objective was to describe outcomes for the largest series of branchial cleft fistulae excised using a uniform technique based on embryologic principles.

Methods

We conducted a retrospective analysis of pediatric patients who underwent surgery for second branchial cleft fistula using a uniform technique developed by the senior surgeon between 2006 and 2018 at a tertiary care pediatric hospital. The technique involves dissection to the level of the greater cornu of the hyoid bone as the point of transection, which is the landmark for the base of the tonsillar fossa. Data collected included age at surgery, initial presentation, laterality of fistula tract, final pathology, and follow up data. Measured outcomes included fistula recurrence, wound infection, and other complications.

Results

Of 67 patients, 28 (42%) were male and 10 (15%) had bilateral fistulae, for a total of 77 tracts excised. After a median follow up of 31 months, there were no recurrences and one wound infection that was treated successfully with oral antibiotic therapy. No patients underwent tonsillectomy.

Conclusion

Effective management of second branchial cleft fistulae can be challenging. We present the largest cohort of results using a uniform surgical technique performed at a single center that obviates the need for tonsillectomy, and thus represents a less morbid and effective approach with no evidence of recurrence.
Two independent signals detected by ocean bottom electromagnetometers during a non-eruptive volcanic event: Ogasawara Island arc volcano, Nishinoshima
Authors: Baba Kiyoshi , Tada Noriko , Ichihara Hiroshi , Hamano Yozo , Sugioka Hiroko , Koyama Takao , Takagi Akimichi , Takeo Minoru
Published: August 2020

Nishinoshima is an active oceanic island arc volcano situated approximately 1000 km south of Tokyo, Japan. Since 2016, marine electromagnetic observations using ocean bottom electromagnetometers have been conducted around the island to investigate the electrical structure beneath the volcano for the first time. In contrast to the original purpose of the experiment, the data collected at five sites deployed in 2016–2017 showed distinct time variations in the magnetic field and the tilt of the volcano’s slope. These time variations occurred coincidentally in mid-November 2016; this was during a quiet period between eruptions in 2015 and in 2017. The independence between the observed total magnetic force and tilt data was verified, highlighting that these variations were not artificial rather, associated with volcanic activity that did not invoke an eruption. Sources for demagnetization and deflation were estimated beneath the volcanic slope in the northeast of Nishinoshima Island, assuming a magnetic dipole and a spherical volume change, respectively. The resultant dipole moment and the volume change were too large to maintain simple source assumptions. However, the limited available data only enabled quantitative discussion under simple model settings, suggesting that the source mechanisms were more complex. The observations from this study demonstrate that if deployed strategically, ocean bottom electromagnetometers are useful to monitor island volcano activities.
A Fulbright Scholar’s report on textiles and apparel education in Myanmar
Authors: Lee Jaeil
Published: August 2020

Myanmar, once known as Burma, has a substantial history in the textiles and apparel industry. In the past, the nation’s contribution to the industry was small compared to that of other Asian nations. However, Myanmar’s global trade in textiles and apparel products has increased dramatically after the European Union suspended its sanctions in 2013 and after the United States issued a waiver and general license in 2012 (Kent, Can manufacturing succeed in Myanmar, http://www.forbes.com/sites/connorconnect/2012/10/18/can-manufacturing-succeed-in-myanmar/#73630e4c4b7d, 2012). This trend is expected to continue, with Myanmar’s apparel exports projected to more than double by 2020, reaching $4 billion (www.fibre2fashion.com). Given the economic growth potential of the textiles and apparel industry, it is imperative for Myanmar to support textiles and apparel education regarding design, product development, retailing, and marketing. The author served as a U.S. Fulbright Scholar to Myanmar for the 2018–2019 term. She taught a course in the MBA program at Yangon University of Economics in Yangon, Myanmar, in addition to working in the Myanmar fashion industry to support fashion entrepreneurs using traditional Myanmar textiles and designs. In this report, the author provides her insight on the current status of Myanmar’s textiles and apparel education, along with information on the textiles and apparel industry in Myanmar.
Cortical and subcortical changes following sphenopalatine ganglion blocks in chronic migraine with medication overuse headache: a preliminary longitudinal study
Authors: Newman-Norlund Roger D. , Rorden Chris , Maleki Nasim , Patel Milap , Cheng Brian , Androulakis X. Michelle
Published: August 2020

Objective

The purpose of this pilot study was to investigate potential changes in brain morphology (cortical thickness and cortical/subcortical volume) accompanying a series of sphenopalatine ganglion (SPG) blockade treatments in chronic migraine with medication overuse headaches (CMw/MOH).

Background

Local anesthetization of the SPG via intranasal application is used for the treatment for multiple types of headache disorders, including CM. Our previous longitudinal fMRI study revealed improved network connectivity after such treatment. However, the impact of SPG blocks on cortical, subcortical gray matter volume and cortical thickness has yet to be assessed.

Methods

Using magnetic resonance imaging (MRI), cortical/subcortical volume were measured in 12 chronic migraine patients before and after a series of 12 SPG blocks administered over a 6-week period (2 per week). The average time between MRI assessments was 6 weeks. Targeted, within-subjects t-tests comparing pre-treatment and post-treatment values in specific apriori brain regions of interest, including the hippocampus, amygdala, basal ganglia, somatosensory cortex, temporal cortex and occipital cortex, were used to estimate the impact of repetitive SPG blocks treatment on brain morphology in CMw/MOH.

Results

Compared to baseline values, the number of moderate/severe headache days per month, HIT-6, PHQ-9 scores and allodynia scores were all significantly improved at the end of treatment. Analysis of MRI data revealed that the volume of the right hippocampus and the right palladium significantly decreased following SPG block treatment, while the volume of the left nucleus accumbens significantly increased following treatment. Cortical thickness in the left temporal pole and left lateral occipito-temporal gyrus significantly decreased following SPG block treatment.

Conclusion

Our results suggest SPG block treatment is associated with significant symptom improvement as well as significant structural brain changes in regions known to be associated with migraine and chronic pain processing in CMw/MOH.
Long-acting reversible contraception utilization and associated factors among women in extended postpartum period in Hossana town, southern Ethiopia: cross sectional study
Authors: Woldu Biruktawit Fekade , Ermolo Tadesse Lelago , Lemu Lidiya Gutema , Gejo Negeso Gebeyehu
Published: August 2020

Background

In low and middle-income countries, 95% of postpartum women want to avoid a pregnancy for 2 years, but 70% are not using contraception. Delay in use of contraception by couples during postpartum period can result in many unwanted pregnancies. Long-acting reversible contraception (LARC) is ideal for postpartum women. Therefore this study aimed at assessing the prevalence and factors associated with LARC use among postpartum women.

Methods

Facility based cross sectional study was conducted from July 23-Aug 25, 2018. Systematic random sampling technique was employed to recruit a total of 381 women in extended postpartum period visiting Child Immunization service in hosanna health institutions. Pretested structured questionnaire was used for data collection. Data was analyzed by SPSS version 20. Binary and multiple logistic regression analysis was done. The presence and strength of association was determined using AOR with its 95% CI. Variables with P value less than 0.05 were considered as statistical significant.

Results

The prevalence of LARC use was 36.5% (95%CI (33.05–39.95)). The main reason for not using LARC was fear of side effect and false information. Previous use of LARC (AOR = 3.3, 95%CI (1.7–6.5)) and have ever discussed with health providers on LARC (AOR = 2.5, 95%CI (1.1–5.74)) were found to be significantly associated with LARC use.

Conclusions

The utilization of LARC among postpartum women was found to be higher than other studies in Ethiopia. Provision of effective contraceptive counseling during Antenatal, delivery and postnatal care services with emphasis on LARC/Postpartum Intra-Uterine Device is important.
Intradialytic exercise in the treatment of social frailty: a single-center prospective study—preliminary results during the unexpected COVID-19 pandemic
Authors: Abe Koki , Shimamura Yoshinosuke , Maeda Takuto , Kato Yoshikazu , Yoshimura Yasuyoshi , Tanaka Tomomi , Takizawa Hideki
Published: August 2020

Background

Social frailty—the lack of a connection to society and infrequent social activities—has been reported to be associated with future declines in physical function in elderly individuals. This study aimed to evaluate both the association of social frailty with the physical function and the efficacy of intradialytic exercise as a therapy for social frailty among hemodialysis patients.

Methods

All 16 outpatient hemodialysis patients in the hemodialysis department of a single medical center were enrolled in this single-center prospective single-arm interventional study. Patients received five questions which asked about going out infrequently, lack of visiting friends, feeling unhelpful to friends or family, living alone, and lack of talking with someone. Those to whom two or more of the above were applicable were categorized as socially frail. All patients were placed into exercise therapy to be performed during their thrice-weekly hemodialysis visits. Participants’ physical function (walking speed), muscle strength (grip strength), muscle mass (appendicular skeletal muscle mass index), and social frailty were evaluated at baseline and after 3 months of therapy.

Results

Four (25%) of the 16 participants (median age 71.5 years, 8 women) were categorized as being socially frail. In comparison to the non-socially frail group (non-SF), the socially frail group (SF) had a significantly lower walking speed (0.70 ± 0.12 m/s vs 1.15 ± 0.26 m/s, p = 0.005) and significantly worse performance on the Short Physical Performance Battery. Three months of intradialytic exercise therapy significantly improved their walking speed, from 1.04 ± 0.30 m/s to 1.16 ± 0.29 m/s (p = 0.003). intradialytic exercise therapy significantly improved walking speed in both the SF group and the non-SF group. The 2019 coronavirus disease pandemic unexpectedly occurred in the middle of the intervention period of this study, and although it was not statistically significant, the number of socially frail individuals among our participants increased to seven (43.8%, p = 0.248).

Conclusions

Social frailty was associated with reduced physical function among hemodialysis patients. Intradialytic exercise therapy improved physical function regardless of the presence of social frailty.

Trial registration

UMIN-CTR, UMIN-CTR000038313. Registered November 1, 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000043639.
Pesticide poisoning deaths: a 19-year retrospective study of medicolegal autopsies in center Tunisia
Authors: Mlayeh Souheil , Annabi Khaled , Daly Amal Ben , Jedidi Maher , Dhiab Mohamed Ben
Published: August 2020

Background

Pesticide poisoning is recognized as an important public health problem worldwide, especially in the developing countries, such as Tunisia, where these products are massively used in agriculture. The objective of our study was to document the forensic deaths caused by pesticides reported from a forensic center located in the coastal region of Tunisia.

Methods

This is a 19-year retrospective descriptive study of lethal pesticide poisoning victims autopsied in the Department of Forensic Medicine at Farhat Hached University Hospital in Sousse, Tunisia, from 1991 to 2009.

Results

One hundred thirty deaths were collected. The majority of the victims were female (62% vs 38%). The mean age was 27.46 years with the highest frequency of poisoning deaths occurring in the 21-30 years age group (34%). Eleven percent of the victims were found in a state of coma and 4.6% suffered from respiratory distress. Signs observed during the external examination of the bodies were as follows: bluish discoloration of the lips and the limbs (n = 130, 100%), leakage of urine (n = 13, 10%), foaming at the mouth or the nose (n = 66, 50.8%). The most frequent signs found during autopsies were pulmonary edema in 88.4% of the cases and multiorgan congestion in 86.9%. Toxicological screening of the stomach content was positive for pesticides in 126 cases. Intoxication was mainly caused by cholinesterase inhibitor insecticides: carbamates (50%) and organophosphorus compounds (31.5%). In 92% of cases, death was in a context of suicide.

Conclusions

This study shows that a large proportion of pesticide poisoning deaths are preventable. Prevention is, on the one side, by restricting the availability of pesticides and on the other side by promulgating more vigorous legislation concerning the manufacturing, the marketing, and the use of these products.
Persistent idiopathic unilateral isolated hypoglossal nerve palsy – a report of two cases
Authors: Olesen Clement , Groen Martin Biilmann , Forsberg Jonatan , Antulov Ronald
Published: August 2020

Introduction

Isolated unilateral hypoglossal nerve palsy is an infrequent condition that usually appears in connection to an underlying disease. Rarely, the cause cannot be determined, and there is no symptom remission.

Case description

We report two cases of male patients who developed persistent idiopathic isolated unilateral hypoglossal nerve palsy. The younger patient complained of involuntary movements of the tongue, while the older patient developed dysarthria. In both cases, the symptoms lasted for several weeks before the initial clinical examination, and after comprehensive clinical, laboratory, and imaging investigations, no underlying cause was detected. Both patients did not show remission of symptoms on the follow-up examinations done after several months.

Discussion

Idiopathic isolated unilateral hypoglossal nerve palsy is an underreported condition, most likely due to the expected reversible nature of the disease. In the case of persistence of symptoms, extensive medical assessment is needed before postulating a diagnosis of persistent idiopathic isolated unilateral hypoglossal nerve palsy. There are no treatment guidelines for this condition, but oral steroids were reported as a treatment option. Therefore, physicians should use a systematic approach to exclude serious underlying pathology or identify a treatable condition.
Factors affecting thermal stability of collagen from the aspects of extraction, processing and modification
Authors: Zhang Xiaoxia , Xu Songcheng , Shen Lirui , Li Guoying
Published: August 2020

Collagen, as a thermal-sensitive protein, is the most abundant structural protein in animals. Native collagen has been widely applied in various fields due to its specific physicochemical and biological properties. The beneficial properties would disappear with the collapse of the unique triple helical structure during heating. Understanding thermal stability of collagen is of great significance for practical applications. Previous studies have shown the thermal stability would be affected by the different sources, extraction methods, solvent systems in vitro and modified methods. Accordingly, the factors affecting thermal stability of collagen are discussed in detail in this review.

Graphical abstract
Primary percutaneous coronary intervention with diagnostic catheter in an anomalous origin right coronary artery—a case report
Authors: Dar Mohd Iqbal , Rashid Aamir , Wani Mohd Iqbal , Rather Hilal A. , Khan Khursheed A.
Published: August 2020

Background

Although rare, the possibility of encountering an anomalous coronary artery is a reality. The outcome of such a procedure is greatly influenced by the awareness of the operator about the anatomical variations and the technique required.

Case presentation

A 50-year-old female patient presented with chest pain. On evaluation, she was found to have an inferior wall myocardial infarction. Left coronary angiography showed non-obstructive disease in the left anterior descending (LAD) and left circumflex artery (LCX). The right coronary artery could not be hooked despite multiple attempts and catheter changes. A non-specific aortic angiogram revealed anomalous origin of the right coronary artery (RCA) above the sinotubular junction on the left side. RCA was hooked with the AL-2 diagnostic catheter, and the percutaneous coronary intervention (PCI) procedure was completed via the same diagnostic catheter.

Conclusion

In a life-threatening difficult situation like acute coronary syndrome with anomalous origin of coronary arteries, PCI can be done using a diagnostic catheter.
Comparative study between contrast-enhanced mammography, tomosynthesis, and breast ultrasound as complementary techniques to mammography in dense breast parenchyma
Authors: Azzam Heba , Kamal Rasha Mohamed , Hanafy Mennatallah Mohamed , Youssef Ayda , Hashem Lamia Mohamed Bassam
Published: August 2020

Background

Mammography is accused of having low sensitivity and specificity in dense breast parenchyma. Also, women with dense breasts show an increased risk of developing breast cancer. Breast ultrasound has been used for several years for a better characterization of breast lesions. Contrast-enhanced mammography and tomosynthesis are relative novel imaging techniques that have been implicated in breast cancer detection and diagnosis. We aimed to compare breast tomosynthesis, contrast-enhanced mammography, and breast ultrasound as complementary techniques to mammography in dense breast parenchyma.

Results

The study included 37 patients with 63 inconclusive mammography breast lesions. They all performed contrast-enhanced mammography, single-view tomosynthesis, and breast ultrasound. Mammography had a sensitivity of 83%, a specificity of 48%, a positive predictive value of 68%, a negative predictive value of 68%, and a diagnostic accuracy of 68%. Contrast-enhanced mammography had a sensitivity of 89%, a specificity of 89%, a positive predictive value of 91%, a negative predictive value of 86%, and a diagnostic accuracy of 89%. Tomosynthesis had a sensitivity of 86%, a specificity of 81%, a positive predictive value of 86%, a negative predictive value of 81%, and a diagnostic accuracy of 84%. Breast ultrasound had a sensitivity of 97%, a specificity of 85%, a positive predictive value of 90%, a negative predictive value of 96%, and a diagnostic accuracy of 92%.

Conclusion

Breast ultrasound, tomosynthesis, and contrast-enhanced mammography showed better performance compared to mammography in dense breasts. However, ultrasound being safe with no radiation hazards should be the second step modality of choice after mammography in the assessment of mammography dense breasts. Adding tomosynthesis to mammography in screening increases its sensitivity. Contrast-enhanced mammography should be reserved for cases with inconclusive sonomammographic results.
Implementing Strength after Breast Cancer (SABC) in outpatient rehabilitation clinics: mapping clinician survey data onto key implementation outcomes
Authors: Calo William A. , Doerksen Shawna E. , Spanos Katherine , Pergolotti Mackenzi , Schmitz Kathryn H.
Published: August 2020

Background

While 3.5 million breast cancer survivors in the USA are indicative of promising disease-free survival, many experience adverse effects in recovering from treatment. Evidence-based exercise programs may be a low-cost, easily disseminable solution to the challenge of recovering from adverse treatment affects. Therefore, after establishing efficacy in a large randomized controlled trial, we developed the Strength after Breast Cancer (SABC) program and the accompanying online course for clinicians interested in physical therapy to learn to deliver this rehabilitative exercise program to individuals with breast cancer. We surveyed clinicians who took the course to assess implementation of the program in outpatient rehabilitation clinics.

Methods

Ninety-six clinicians completed the survey between June and December, 2017 (24% response). Guided by Proctor’s implementation outcomes framework, the respondents were asked if they had implemented (adoption) and are still implementing the program (sustainability), and which programmatic components they implemented (fidelity). Respondents were asked how many patients completed the program (reach), how patients got into the program (reach), the program’s delivery format (appropriateness), and whether clinics were reimbursed by third-party payers (cost). Finally, respondents were asked what barriers they faced in delivery of SABC (feasibility) and whether others in the clinic completed the course (penetration).

Results

Seventy-six percent of respondents implemented SABC and among those, 93% (68/73) were still delivering it. All programmatic components were implemented by over two thirds of respondents (67–95%). On average, the program was delivered to 13 patients per clinic by the time respondents took the survey. Most patient referrals were from oncology clinics (50%). The majority of clinicians delivered SABC one-on-one (96%) and 72% of clinics were compensated via third-party payers. Major barriers were lack of referrals from oncologists (40%) and clinic’s competing demands (33%). We found no differences (Fisher’s exact test p > .05) in reported barriers between those who implemented the program and those who did not.

Conclusion

Our findings suggest that the online training was sufficient to successfully implement the SABC program in outpatient rehabilitation clinics with high levels of adoption, fidelity, reach, and capacity for sustainability. Information on patient acceptability, cost-effectiveness, and how to overcome implementation barriers are still needed.
Paracentesis-induced circulatory dysfunction: are there albumin alternatives?
Authors: Alsebaey Ayman , Rewisha Eman , Waked Imam
Published: August 2020

Background

Ascites is one of the main complications of advanced liver cirrhosis. It is defined as a pathological accumulation if free fluid in the peritoneal cavity.

Main body of the abstract

Ascites is a sign of decompensation in patients with liver cirrhosis and is associated with decreased survival. Ascites is associated with bad cosmetic figure and poor quality of life. Ascites is a predisposing factor for developing hydrothorax, hernias, diastolic dysfunction, spontaneous bacterial peritonitis, and renal impairment especially hepatorenal syndrome. The main treatment is salt restriction and diuretics. By the time the patient become non-responder and develop tense ascites, abdominal large volume paracentesis is the treatment of choice. Its advantages are rapid, cheap, and 1 day hospitalization. The main drawback is the development of paracentesis-induced circulatory dysfunction (PICD) if no volume expanding drugs are used. PICD is associated with dilutional hyponatremia, renal impairment, so it is considered the silent killer. Albumin infusion is the standard preventive measure but since costly to other alternatives such as colloids, vasoconstrictors or lowering the standard doses of the albumin was studied and is promising.

Conclusions

This review summarized the effectiveness of other alternative drugs.
Analytical method development and validation of hydrocortisone and clotrimazole in topical dosage form using RP-HPLC
Authors: Iqbal Dure Najaf , Ashraf Adeel , Iqbal Munawar , Nazir Arif
Published: August 2020

Background

Different pharmaceutical topical agents are available in the market for the treatment of fungal infections. A simple, precise, and cost-effective RP-HPLC method was developed and validated for the determination of hydrocortisone and clotrimazole simultaneously in a topical cream dosage form. Chromatographic separation was done on USP L1 (250 × 4.6) mm column with a particle size of 5 μm. The mobile phase employed for this study consists of acetonitrile and buffer in the ratio of 75:25, respectively. The flow rate was kept at 1 mL per minute. The detection of the drug was carried out at 254 nm using a UV detector. The retention times of HYD and CL were 3.0 min and 7.3 min, respectively.

Result

The method is developed and validated for linearity, precision, specificity, accuracy, and robustness.

Conclusion

The stability of finished products gives us knowledge about the effect of different environmental factors like humidity, light, and temperature, and these factors give us information about the quality of finished products.
Design and characterization of camptothecin gel for treatment of epidermoid carcinoma
Authors: Galatage Sunil T. , Hebalkar Aditya S. , Gote Raviraj V. , Mali Omkar R. , Killedar Suresh G. , Bhagwat Durgacharan A. , Kumbhar Vijay M.
Published: August 2020

Background

The objective of present research work is to design and characterize camptothecin gel using Carbopol-934 for the treatment of epidermoid carcinoma. Optimized herbal gel formulations were evaluated for homogeneity and appearance, viscosity, extrudability, spreadability, drug content, drug release, pH, and in vitro skin cancer activity on A431 cell lines.

Results

Mass and Infrared Spectra respectively conforms molecular weight and functional groups present in camptothecin. All the formulations F1 to F5 showed good homogeneity, pH from 6.68 to 6.90, spreadability in the range of 15.81–23.37 gm.cm/s, extrudability 85.51–90.45% w/w, drug content 89.12–96.64%, and in vitro diffusion 88.36–98.40%, respectively. The drug release study showed that all the formulations followed a diffusion-controlled, zero-order release mechanism. Anticancer activity results indicate that camptothecin gel induce cell death in A-439 cells having IC50 48.03 μg and % apoptosis 54.67 ± 4.58.

Conclusion

Topical delivery of camptothecin alleviates the side effects caused by systemic chemotherapy; hence, the developed herbal gel formulation can be effectively useful to deliver camptothecin in the treatment of epidermoid carcinoma on A-431 cells.
Current status of African swine fever
Authors: Penrith Mary Louise
Published: August 2020

African swine fever is a serious viral disease of domestic pigs and Eurasian wild boars that poses a major threat to pig production. For more than thirty years after its discovery in East Africa it was limited to eastern and southern Africa, where it is believed to have originated. The ability of the causative virus to remain viable for long periods in raw or insufficiently cooked pork products has enabled it, through travel and trade, to spread widely throughout sub-Saharan Africa and to other continents. In the second half of the 20
th
century it had caused outbreaks in the majority of African countries where pigs are produced, as well as in a number of European countries, two of the Caribbean islands, and Brazil. By the turn of the century it had been eradicated from all non-African countries except the Italian island of Sardinia. In 2007 African swine fever arrived in the Republic of Georgia, and has subsequently spread insidiously into other Transcaucasian countries, Russia and some of its neighbours. In 2014 it reached the Baltic States and Poland through infected wild boars, and has become established in several wild boar populations from which it is difficult to eradicate. Most recently, in 2018 the first outbreaks were reported in China, home to half of the world’s pig population, where it spread with unprecedented rapidity throughout China and to several other countries in the region, including the island nations of Philippines, Indonesia, Timor-Leste and Papua New Guinea. These events have posed new challenges for control, including some that parallel the situation in Africa, where poor people rely on pigs produced at subsistence level to provide for their needs and where pigs may also be socially and culturally important. The central role that humans play in the maintenance and spread of African swine fever has again been emphasised. This review describes the current status of African swine fever globally and the trends and challenges for management that face veterinarians and pig industries at all levels worldwide.
Linked Entity Attribute Pair (LEAP): A Harmonization Framework for Data Pooling
Authors: Thomas Stacy , Lichtenberg Tara , Dang Kristen , Fitzsimons Michael , Grossman Robert L. , Kundra Ritika , Lavery Jessica A. , Lenoue-Newton Michele L. , Panageas Katherine S. , Sawyers Charles , Schultz Nikolaus D. , Sirintrapun Sahussapont J. , Topaloglu Umit , Welch Angelica , Yu Thomas , Zehir Ahmet , Gardos Stuart
Published: August 2020

PURPOSE

As data-sharing projects become increasingly frequent, so does the need to map data elements between multiple classification systems. A generic, robust, shareable architecture will result in increased efficiency and transparency of the mapping process, while upholding the integrity of the data.

MATERIALS AND METHODS

The American Association for Cancer Research’s Genomics Evidence Neoplasia Information Exchange (GENIE) collects clinical and genomic data for precision cancer medicine. As part of its commitment to open science, GENIE has partnered with the National Cancer Institute’s Genomic Data Commons (GDC) as a secondary repository. After initial efforts to submit data from GENIE to GDC failed, we realized the need for a solution to allow for the iterative mapping of data elements between dynamic classification systems. We developed the Linked Entity Attribute Pair (LEAP) database framework to store and manage the term mappings used to submit data from GENIE to GDC.

RESULTS

After creating and populating the LEAP framework, we identified 195 mappings from GENIE to GDC requiring remediation and observed a 28% reduction in effort to resolve these issues, as well as a reduction in inadvertent errors. These results led to a decrease in the time to map between OncoTree, the cancer type ontology used by GENIE, and International Classification of Disease for Oncology, 3rd Edition, used by GDC, from several months to less than 1 week.

CONCLUSION

The LEAP framework provides a streamlined mapping process among various classification systems and allows for reusability so that efforts to create or adjust mappings are straightforward. The ability of the framework to track changes over time streamlines the process to map data elements across various dynamic classification systems.
Understanding Geospatial Factors Associated With Cervical Cancer Screening Uptake in Amazonian Peruvian Women
Authors: Barrett Benjamin W. , Paz-Soldan Valerie A. , Mendoza-Cervantes Diana , Sánchez Graciela Meza , Córdova López Jhonny J. , Gravitt Patti E. , Rositch Anne F. ,   on behalf of the Proyecto Precancer Study Group
Published: August 2020

PURPOSE

Cervical cancer (CC) is the most common and second-most deadly cancer among Peruvian women. Access to services is strongly associated with CC screening uptake. This study investigated geospatial features contributing to utilization of screening. We used geolocated data and screening information from a Knowledge, Attitudes, and Practice (KAP) survey implemented in Iquitos, Peru in 2017.

MATERIALS AND METHODS

The KAP collected cross-sectional CC screening history from 619 female interviewees age 18-65 years within 5 communities of varying urbanization levels. We used spatial statistics to determine if screened households tended to cluster together or cluster around facilities offering screening in greater numbers than expected, given the underlying population density.

RESULTS

On the basis of K-functions, screened households displayed greater clustering among each other as compared with clustering among unscreened households. Neighborhood-level factors, such as outreach, communication, or socioeconomic condition, may be functioning to generate pockets of screened households. Cross K-functions showed that screened households are generally located closer to health facilities than unscreened households. The significance of facility access is apparent and demonstrates that travel and time barriers to seeking health services must be addressed.

CONCLUSION

This study highlights the importance of considering geospatial features when determining factors associated with CC screening uptake. Given the observed clustering of screened households, neighborhood-level dynamics should be further studied to understand how they may be influencing screening rates. In addition, results demonstrate that accessibility issues must be carefully considered when designing an effective cancer screening program that includes screening, follow-up, and treatment.
Patients With MEN1 Are at an Increased Risk for Venous Thromboembolism
Authors: Lee Maya E , Ortega-Sustache Yashira M , Agarwal Sunita K , Tepede Aisha , Welch James , Mandl Adel , Bansal Rashika , Tirosh Amit , Piaggi Paolo , Cochran Craig , Simonds William F , Weinstein Lee S , Blau Jenny E
Published: August 2020

Background

Multiple endocrine neoplasia type 1 (MEN1) is a rare inherited disorder predisposing the development of multiple functional and nonfunctional neuroendocrine tumors (NETs). Only uncommon MEN1-associated functional NETs such as glucagonomas (<1%) and adenocorticotropic hormone-producing tumors (<5%) are known to be associated with hypercoagulability. It is unknown if patients with MEN1 generally have an increased risk of venous thromboembolism (VTE).

Methods

We queried a prospective natural history study of germline mutation-positive MEN1 patients (n = 286) between 1991 and 2019 for all lifetime events of VTE. The search terms were: DVT, thromb, embol, PE, pulmonary embolism, clot, hematology consult, anticoagulant, coumadin, lovenox, xarelto, warfarin, aspirin, rivaroxaban, and apixaban. Incidence rates were calculated, accounting for age and sex. Comparisons were made to published incidence rates in healthy populations, different types of cancer, and Cushing’s syndrome.

Results

Thirty-six subjects (median age 45 years, range 16–75) experienced a VTE event, yielding a prevalence rate of 12.9%. The age–sex adjusted incidence rate of VTE is 9.11 per 1000 patient-years, with a sex-adjusted lifetime incidence rate of 2.81 per 1000 patient-years. MEN1-associated lifetime incidence rates are ~2-fold higher than the estimated annual incidence rate in the general population and are comparable to the known risk in the setting of various types of cancer. Approximately 80% of patients who had a VTE were diagnosed with pancreatic NETs, of which 24% were insulinomas. Fourteen patients (42%) experienced perioperative VTE events.

Conclusions

MEN1 patients have an increased risk of VTE. Further mechanistic investigation and validation from other MEN1 cohorts are needed to confirm the increased prevalence of VTE in MEN1.
The Caribbean Scorpion
Authors: Thomasson Fredrik
Published: August 2020

Sweden became a slaveholding nation when it acquired its only Caribbean colony, Saint-Barthélemy—a.k.a. St. Barths or St. Barts—from France in 1784. When the island was retroceded in 1878, the records created during ninety-four years of Swedish Caribbean rule were left behind and are now held in France. Examining the history of this archive that stands as a metaphor for Swedish colonial amnesia, this essay discusses the reluctance in Sweden to recognize a past that goes against a self-image untainted by slavery and colonialism. The essay also discusses a project that aims to open the archive to a larger audience through digitization.
Caribbean Technological Thought and Climate Adaptation
Authors: Vaughn Sarah E.
Published: August 2020

This essay offers a critical perspective on the role technology plays in the Caribbean formation of climate adaptation. It locates this critical perspective in “the embodiment of technology,” a concept in the writings of the late political economist Norman Girvan that helped him describe how Caribbean states acquire technology and related infrastructures despite at times not having resources to maintain them. The embodiment of technology is still important today for mapping the possibilities of climate adaptation—that is, if technology transfer is a historically embodied process, then climate adaptation is a measure of how people recognize the political failures and the potentials of technology over time. The essay suggests that attention to Girvan’s writings is central to critical Caribbean scholarship on climate change for two reasons: his writings reflect the forms of intergenerational responsibility that shape climate adaptation, and they examine the shifting meaning of technology to regional identity.
Gallstone ileus with an enterovaginal fistula: a rare complication of pelvic radiotherapy
Authors: Wali Luqman , Husain Fahd , Ali Sharmarke , Humphries Sasha , Turner Linda , Johnson-Smith Thomas , Gough-Palmer Antony
Published: August 2020

Gallstone ileus is a rare cause of small bowel obstruction. Chronic gallstone irritation can lead to the formation of a cholecystoduodenal fistula, with gallstone impaction typically in the terminal ileum. Rarely gallstones can become impacted in other structures such as the colon or can even erode through the bowel. We present an unusual case of a gallstone ileus which resulted in the formation of an enterovaginal fistula, secondary to previous pelvic radiotherapy. Our case highlights the importance of considering fistula formation as a late complication of radiotherapy and how this can alter expected features of other pathologies, such as a gallstone ileus.
Ribo-Pop: simple, cost-effective, and widely applicable ribosomal RNA depletion
Authors: Thompson Mary Kay , Kiourlappou Maria , Davis Ilan
Published: August 2020

The measurement of RNA abundance derived from massively parallel sequencing experiments is an essential technique. Methods that reduce ribosomal RNA levels are usually required prior to sequencing library construction because ribosomal RNA typically comprises the vast majority of a total RNA sample. For some experiments, ribosomal RNA depletion is favored over poly(A) selection because it offers a more inclusive representation of the transcriptome. However, methods to deplete ribosomal RNA are generally proprietary, complex, inefficient, applicable to only specific species, or compatible with only a narrow range of RNA input levels. Here, we describe Ribo-Pop (ribosomal RNA depletion for popular use), a simple workflow and antisense oligo design strategy that we demonstrate works over a wide input range and can be easily adapted to any organism with a sequenced genome. We provide a computational pipeline for probe selection, a streamlined 20-min protocol, and ready-to-use oligo sequences for several organisms. We anticipate that our simple and generalizable “open source” design strategy would enable virtually any laboratory to pursue full transcriptome sequencing in their organism of interest with minimal time and resource investment.