bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative motor unit potential analysis and nerve conduction studies for detection of subclinical peripheral nerve dysfunction in patients with compensated liver cirrhosis
Authors: Elkholy Mostafa M. , Eid Ragaey A.
Published: July 2021

Background

Peripheral neuropathy is an underestimated problem of compensated liver cirrhosis despite its negative effect on quality of life. The aim was to assess the role of meticulous electrophysiological screening (nerve conduction responses and quantitative motor unit potential analysis) of subclinical peripheral nerve dysfunction in patients with compensated cirrhosis and also to explore its relations with different characteristics of liver disease. Severity of cirrhosis was assessed by Child–Pugh and albumin-bilirubin (ALBI) scores.

Results

Prevalence of hepatic neuropathy (HN) was 82%. It involved sensory and motor fibers (66%), and its pathophysiology was axonal (53.7%) or mixed axonal and demyelinating (46.3). The most sensitive discriminating tests were ulnar sensory conduction velocity (area under curve (AUC) = 0.915) and peak latency (AUC = 0.887), peroneal motor conduction velocity (AUC = 0.885), ulnar distal motor latency (AUC = 0.842), and first dorsal interosseous number of phases (AUC = 0.736). HN showed significant correlation with the severity of liver disease assessed by both child (P = 0.029) and ALBI (P = 0.016) scores and also correlated with the low serum albumin level (P = 0.001).

Conclusions

Subclinical mild axonal polyneuropathy is very common in post-hepatitis C compensated cirrhosis picked up by meticulous electrophysiological testing, and it is related to severity of liver cirrhosis and low serum albumin level.
Captivity reduces diversity and shifts composition of the Brown Kiwi microbiome
Authors: San Juan Priscilla A. , Castro Isabel , Dhami Manpreet K.
Published: July 2021

Background

Captive rearing is often critical for animals that are vulnerable to extinction in the wild. However, few studies have investigated the extent to which captivity impacts hosts and their gut microbiota, despite mounting evidence indicating that host health is affected by gut microbes. We assessed the influence of captivity on the gut microbiome of the Brown Kiwi (Apteryx mantelli), a flightless bird endemic to New Zealand. We collected wild (n = 68) and captive (n = 38) kiwi feces at seven sites on the north island of New Zealand.

Results

Using bacterial 16 S rRNA and fungal ITS gene profiling, we found that captivity was a significant predictor of the kiwi gut bacterial and fungal communities. Captive samples had lower microbial diversity and different composition when compared to wild samples. History of coccidiosis, a gut parasite primarily affecting captive kiwi, showed a marginally significant effect.

Conclusions

Our findings demonstrate captivity’s potential to shape the Brown Kiwi gut microbiome, that warrant further investigation to elucidate the effects of these differences on health.
Adaptation and implementation of the WHO Safe Childbirth Checklist around the world
Authors: Molina Rose L. , Benski Anne-Caroline , Bobanski Lauren , Tuller Danielle E. , Semrau Katherine E. A.
Published: July 2021

Background

The World Health Organization (WHO) published the WHO Safe Childbirth Checklist in 2015, which included the key evidence-based practices to prevent the major causes of maternal and neonatal morbidity and mortality during childbirth. We assessed the current use of the WHO Safe Childbirth Checklist (SCC) and adaptations regarding the SCC tool and implementation strategies in different contexts from Africa, Southeast Asia, Europe, and North America.

Methods

This explanatory, sequential mixed methods study—including surveys followed by interviews—of global SCC implementers focused on adaptation and implementation strategies, data collection, and desired improvements to support ongoing SCC use. We analyzed the survey results using descriptive statistics. In a subset of respondents, follow-up virtual semi-structured interviews explored how they adapted, implemented, and evaluated the SCC in their context. We used rapid inductive and deductive thematic analysis for the interviews.

Results

Of the 483 total potential participants, 65 (13.5%) responded to the survey; 55 completed the survey (11.4%). We analyzed completed responses from those who identified as having SCC implementation experience (n = 29, 52.7%). Twelve interviews were conducted and analyzed. Ninety percent of respondents indicated that they adapted the SCC tool, including adding clinical and operational items. Adaptations to structure included translation into local language, incorporation into a mobile app, and integration into medical records. Respondents reported variation in implementation strategies and data collection. The most common implementation strategies were meeting with stakeholders to secure buy-in, incorporating technical training, and providing supportive supervision or coaching around SCC use. Desired improvements included clarifying the purpose of the SCC, adding guidance on relevant clinical topics, refining items addressing behaviors with low adherence, and integrating contextual factors into decision-making. To improve implementation, participants desired political support to embed SCC into existing policies and ongoing clinical training and coaching.

Conclusion

Additional adaptation and implementation guidance for the SCC would be helpful for stakeholders to sustain effective implementation.
A stability-indicating HPLC method for estimation of doxylamine succinate in tablets and characterization of its major alkaline stress degradation product
Authors: Harde Minal T. , Lakade Sameer H.
Published: July 2021

Background

A new selective rapid RP-HPLC-DAD method was developed and evaluated for the quantification of doxylamine succinate (DOX) in bulk and pharmaceutical dosage form. The separation of DOX at different degradation conditions was achieved with a Kromasil C18 (4.6 × 250 mm, 5-μm particle size). The mobile phase employed comprised of phosphate buffer (pH 3.5) and methanol in the ratio of 45:55 v/v. The flow rate was kept maintained at 1.0 ml/min and eluents were detected at 262 nm. The drug was subjected to different stress conditions like acid, base, neutral, hydrolysis, oxidation, photolysis, and thermal degradation. The analytical performance of the proposed HPLC method was thoroughly validated in terms of linearity, precision, accuracy, specificity, robustness, detection, and quantification limits.

Results

The method produces linear responses that were found in the range of 10–50 μg/ml. The regression equation was found to be Y = 42984x − 10260. The correlation coefficient was found to be 0.9998. The LOD and LOQ for DOX were found to be 0.96 and 3.28 μg/ml, respectively. The short-term solution stability of DOX (100 μg/ml) was evaluated under (25 ± 2°C) storage condition and found to be 98.82 to 101%. The percentage recovery for DOX was in the range of 99.73 to 99.91%. The obtained results of the stress degradation study and peak purity data indicate the potential of the developed HPLC method to resolve degradants from DOX peak. The major alkaline degradation product was isolated using preparative chromatographic technique and extensive FT-IR was performed to ascertain the structure of the alkaline degradant.

Conclusion

It was concluded that the proposed method was simple, sensitive, accurate, cost-effective, and less time-consuming for the quantification of DOX. This method was successfully utilized for stability testing of commercially available DOX tablets. Hence, the proposed method can be applied for routine quality control of DOX in bulk drug as well as in marketed formulations.
Characterisation of nitrogen-containing organic compounds by UHPLC-Qtof-MS and anti-amylase activity from the chloroform extract of the bark of Rhizophora mucronata
Authors: Resmi P. , Jitha G. , Murali Vishnu , Gopinath Anu
Published: July 2021

Background

Medicinal importance of mangrove plant Rhizophora mucronata, a red mangrove species found in the Asian countries, has long been recognised in traditional systems of medicine. The identification of its phytoconstituents can be a starting point for the drug development. The aim of the work was to extend the current knowledge of phytoconstituents from R. mucronata and to explore its pharmacological importance in the treatment of diabetes mellitus. In the present study, we analysed the chloroform extract from the bark of the mangrove plant R. mucronata for nitrogen-containing constituents using UHPLC QTOF MS profiling, and α-amylase inhibition assay was carried out.

Results

Four nitrogen-containing compounds were identified from the chloroform extract of the bark of R. mucronata using UHPLC QTOF MS profiling. The compounds identified were N,N′-dicyclohexyl urea, a cryptolepine derivative (C17H15N3O), an aliphatic cyclic compound with hydroxyl and amino groups (C22H43NO), and C16H19NO2 (m/z 258.1495). The anti-amylase activity, an in vitro antidiabetic bioassay, of chloroform extract showed an IC50 value of 220.09 μg/ml.

Conclusions

This is the first report on the identification of nitrogen-containing compounds from the chloroform extract of the bark of the R. Mucronata. One of the compounds identified was a novel cryptolepine derivative (C16H13N3O), and it falls under the rare category indoloquinoline alkaloid. The chloroform extract also showed significant activity towards α-amylase inhibition assay. Thus, the study has gone some way towards our understanding of the efficacy of bark of the R. mucronata for the treatment of diabetes mellitus and is open for further research.
The neuroprotective attribution of Ocimum basilicum: a review on the prevention and management of neurodegenerative disorders
Authors: Seyed Mohamed Ali , Ayesha Siddiqua , Azmi Norazrina , Al-Rabae Fahad Mohamed , Al-Alawy Adel Ibrahim , Al-Zahrani Othman Rashed , Hawsawi Yousef
Published: July 2021

Background

Bioactive principles from various natural resources including medicinal herbs have always played a crucial role in healthcare settings and increasingly became key players in drug discovery and development for many biopharmaceutical applications. Additionally, natural products (NPs) have immense arrangement of distinctive chemical structures with diverse functional groups that motivated numerous investigators including synthetic chemists to discover new therapeutic entities. Numerous pre-clinical investigations involving the animal models have evident the usefulness of these NPs against various human diseases including neurodegenerative disorders (NDs).

Main text

Ocimum basilicum Linn (O. basilicum L.), also known as sweet basil, is well practiced in traditional healthcare systems and has been used to treat various human illnesses, which include malaria, skin disease, diarrhea, bronchitis, dysentery, arthritis, eye diseases, and insect bites and emphasize the significance of the ethno-botanical approach as a potential source of novel drug leads With the growing interest in advanced techniques, herbal medicine and medicinal plants explorations are still considered to be a novel resource for new pharmacotherapeutic discovery and development. O. basilicum L and its bioactive principles including apigenin, eugenol, myretenal, β-sitosterol, luteolin, rosmarinic acid, carnosic acid, essential oil (EO)-rich phenolic compounds, and others like anthocyanins and flavones could be of therapeutic values in NDs by exhibiting their neuro-protective efficacy on various signaling pathways. The present comprehensive review collected various related information using the following searching engines such as PubMed, Science Direct, Google Scholar, etc. and focused mainly the English written documents. The search period comprised of last two decades until present.

Conclusion

Although these efficacious plant genera of prime importance and has potential medical and socioeconomic importance, yet the pivotal evidence for its neuroprotective potential in novel clinical trials remains lacking. However, with the available wealth of obtainable literature on this medicinal plant, which supports this review and concludes that O. basilicum L may function as a promising therapeutics for the treatment of NDs.
Does Eustachian tube function affect the outcome of tympanoplasty?
Authors: El-Antably Adel , Ateya Khaled , Hamela Mo’men A. , Ibrahim Sameh , Hamdy Mona
Published: July 2021

Background

Eustachian tube function has been regarded as a significant factor in the successful outcome of tympanoplasty. Eustachian tube dysfunction has been attributed to many diseases of middle ear cleft ranging from otitis media with effusion to unsafe chronic otitis media. The aim of this study is to evaluate the effect of Eustachian tube function on outcome of tympanoplasty in safe chronic suppurative otitis media patients and detect the correlation between the type of the used graft and the outcome of tympanoplasty. This study included 60 randomly selected patients diagnosed with safe chronic suppurative otitis media. Eustachian tube function was tested with tympanometry and Toynbee’s test. All patients underwent tympanoplasty type I.

Results

Successful statistically significant outcome was observed in 83.3 % of patients with normal eustachian tube function, while in 60 % of patients with eustachian tube dysfunction (p < 0.05).

Conclusion

Eustachian tube function significantly affects the outcome of tympanoplasty surgery. No significant correlation was noted between the type of the used graft and the outcome of tympanoplasty.
Mental Health Gap Action Programme training in Nigeria: reflections for progressive learning among primary care workers
Authors: Ali Alvina , Chakraborty Nandini
Published: July 2021

In the majority of low- and middle-income countries, mental healthcare is delivered by primary care workers. Often, they are the only contact for patients and their families. Although their knowledge base can be limited, they are expected to manage complex cases with few resources. The authors describe their experience of partnership with mental health centres set up by the Nigeria Health Care Project, and training their primary care workers based on the World Health Organization's Mental Health Gap Action Programme. Although the programme was very effective in helping to upskill their knowledge and experience, a need for continued professional development was highlighted. Based on their feedback, multiple evidence-based options are explored, including the use of remote learning and social media (increased significantly around the world because of the COVID-19 pandemic), to help primary care workers improve their knowledge base and maintain their competencies with the limited resources available.
Investigating the relationship between childhood sexual abuse, self-harm repetition and suicidal intent: mixed-methods study
Authors: Troya Maria Isabela , Cully Grace , Leahy Dorothy , Cassidy Eugene , Sadath Anvar , Nicholson Sarah , Ramos Costa Ana Paula , Alberdi-Páramo Íñigo , Jeffers Anne , Shiely Frances , Arensman Ella
Published: July 2021

Background

Research into the association between childhood sexual abuse (CSA) and self-harm repetition is limited.

Aims

We aimed to examine the association between self-harm repetition, mental health conditions, suicidal intent and CSA experiences among people who frequently self-harm.

Method

A mixed-methods study was conducted including consecutive patients aged ≥18 years, with five or more self-harm presentations, in three Irish hospitals. Information was extracted from psychiatric records and patients were invited to participate in a semi-structured interview. Data was collected and analysed with a mixed-methods, convergent parallel design. In tandem, the association between CSA and self-harm repetition, suicidal intent and mental health conditions was examined with logistic regression models and independent sample t-test, with psychiatric records data. Thematic analysis was conducted with interview data, to explore CSA experiences and self-harm repetition.

Results

Between March 2016 and July 2019, information was obtained on 188 consecutive participants, with 36 participants completing an interview. CSA was recorded in 42% of the total sample and 72.2% of those interviewed. CSA was positively associated with self-harm repetition (odds ratio 6.26, 95% CI 3.94−9.94, P = 0.00). Three themes emerged when exploring participants’ CSA experiences: CSA as a precipitating factor for self-harm, secrecy of CSA accentuating shame, and loss experiences linked to CSA and self-harm.

Conclusions

CSA was frequently reported among people who frequently self-harm, and associated with self-harm repetition. Identification of patients at risk of repetition is key for suicide prevention. This is an at-risk group with particular characteristics that must be considered; comprehensive patient histories can help inform and tailor treatment pathways.
Inflammatory Bowel Disease: Its Effects on Physical Activity, Sports Participation, and Athletes
Authors: Cohen Daniel L. , Shirin Haim
Published: July 2021

This article discusses the “bidirectional” relationship between inflammatory bowel disease (IBD) and physical activity. Intestinal symptoms and extraintestinal manifestations of IBD negatively impact a patient's ability to participate in sports. IBD also impacts athletic performance via its effects on muscle mass, muscle function, bone density, and fatigue. Surveys of IBD patients consistently show that IBD interferes with athletic participation. While IBD negatively affects physical activity, there is growing evidence that physical activity can be beneficial for IBD patients. Prospective studies have revealed that structured physical activities may positively influence inflammatory markers, disease activity, muscle strength, bone density, fatigue, stress, anxiety, and quality of life. This suggests that physical activity may be a simple and safe adjuvant therapy for IBD patients. Future studies assessing the optimal activity regimen are warranted. Finally, a cohort of professional athletes with IBD are described for the first time — football players in the National Football League.
Clinical application of “black bone” imaging in paediatric craniofacial disorders
Authors: Low Xi Zhen , Lim Mei Chin , Nga Vincent , Sundar Gangadhara , Tan Ai Peng
Published: July 2021

For decades, CT has been the primary imaging modality for the diagnosis and surveillance of paediatric craniofacial disorders. However, the deleterious effects of ionising radiation in the paediatric population are well established and remain an ongoing concern. This is especially so in the head and neck region, which has relatively poor soft tissue shielding with many radiosensitive organs. The development of “black bone” imaging utilising low flip angles and short echo time (TE) has shown considerable promise in alleviating the use of ionising radiation in many cases of craniofacial disorders. In this review article, we share our experience of utilising “black bone” sequence in children with craniofacial pathologies, ranging from traumatic injuries to craniosynostosis and focal osseous/fibro-osseous lesions such as fibrous dysplasia and Langerhans cell histiocytosis (LCH). A detailed discussion on the technical aspects of “black bone” sequence, including its potential pitfalls and limitations, will also be included.
Analysis of left ventricular function, left ventricular outflow tract and aortic valve area using computed tomography: Influence of reconstruction parameters on measurement accuracy
Authors: Hell Michaela M , Steinmann Bettine , Scherkamp Tassilo , Arnold Martin B , Achenbach Stephan , Marwan Mohamed
Published: July 2021

Objectives:

Computed tomography (CT) allows reproducible assessment of left ventricular (LV) function, left ventricular outflow tract area (LVOTarea) and aortic valve area (AVA). We evaluated the influence of image reconstruction parameters on these measurements.

Methods:

We analyzed 45 contrast-enhanced, retrospectively ECG-gated CT datasets acquired on a third-generation dual source system. A standard filtered-back-projection data set (20 cardiac phases (5% steps, 0–95%), 0.6-mm-slice thickness, 512 × 512 matrix) and eight reconstructions with modified slice thickness (1–8 mm), number of cardiac phases (5, 10), matrix size (256×256) and an iterative reconstruction (IR) algorithm were obtained. LV parameters (ejection fraction (EF), stroke volume (SV), end-diastolic (EDV), end-systolic volumes (ESV)), LVOTarea and AVA were assessed.

Results:

Differences in LV parameters, LVOTarea and AVA, were only minimal between standard reconstructions and those with modified matrix size, IR algorithm and ≤2 mm slice thickness, while reconstructions with 8-mm slice thickness significantly overestimated SV (p < 0.001) and EDV (p = 0.016). AVA planimetry in reconstructions with ≥5 mm slice thickness was not feasible in 56% of patients. A decrease in the number of reconstructed phases (10 or 5) underestimated EF, SV, EDV, LVOTarea and AVA and overestimated ESV.

Conclusions:

Modifications of reconstruction parameters (except a slice thickness ≤2 mm) have only a marginal effect on LV, LVOTarea and AVA assessment. However, a reduced number of reconstructions per cardiac cycle may significantly influence measurements.

Advances in knowledge:

Substantial modifications in number of reconstructions per cardiac cycle significantly affect the assessment of LV function, LVOTarea and AVA also in modern CT scanners.
Radiomics in cervical and endometrial cancer
Authors: Manganaro Lucia , Nicolino Gabriele Maria , Dolciami Miriam , Martorana Federica , Stathis Anastasios , Colombo Ilaria , Rizzo Stefania
Published: July 2021

Radiomics is an emerging field of research that aims to find associations between quantitative information extracted from imaging examinations and clinical data to support the best clinical decision. In the last few years, some papers have been evaluating the role of radiomics in gynecological malignancies, mainly focusing on ovarian cancer. Nonetheless, cervical cancer is the most frequent gynecological malignancy in developing countries and endometrial cancer is the most common in western countries. The purpose of this narrative review is to give an overview of the latest published papers evaluating the role of radiomics in cervical and endometrial cancer, mostly evaluating association with tumor prognostic factors, with response to therapy and with prediction of recurrence and distant metastasis.
MRI of the endometrium - from normal appearances to rare pathology
Authors: Pintican Roxana , Bura Vlad , Zerunian Marta , Smith Janette , Addley Helen , Freeman Susan , Caruso Damiano , Laghi Andrea , Sala Evis , Jimenez-Linan Mercedes
Published: July 2021

MRI was recently included as a standard pre-operative diagnostic tool for patients with endometrial cancer. MR findings allow a better risk assessment and ultimately guides the surgical planning. Therefore, it is vital that the radiological interpretation is as accurate as possible. This requires essential knowledge regarding the appropriate MRI protocol, as well as different appearances of the endometrium, ranging from normal peri- and post-menopausal changes, benign findings (e.g. endometrial hyperplasia, polyp, changes due to exogenous hormones) to common and rare endometrium-related malignancies. Furthermore, this review will emphasize the role of MRI in staging endometrial cancer patients and highlight pitfalls that could result in the underestimation or overestimation of the disease extent.
Assessment of bone marrow oedema-like lesions using MRI in patellofemoral knee osteoarthritis: comparison of different MRI pulse sequences
Authors: Noorveriandi Henry , Parkes Matthew J , Callaghan Michael J , Felson David T , O'Neill Terence W , Hodgson Richard
Published: July 2021

Objective:

To compare bone marrow oedema-like lesion (BML) volume in subjects with symptomatic patellofemoral (PF) knee osteoarthritis (OA) using four different MRI sequences and to determine reliability of BML volume assessment using these sequences and their correlation with pain.

Methods:

76 males and females (mean age 55.8 years) with symptomatic patellofemoral knee OA had 1.5 T MRI scans. PD fat suppressed (FS), STIR, contrast-enhanced (CE) T1W FS, and 3D T1W fast field echo (FFE) sequences were obtained. All sequences were assessed by one reader, including repeat assessment of 15 knees using manual segmentation and the measurements were compared. We used random-effects panel linear regression to look for differences in the log-transformed BML volume (due to positive skew in the BML volume distribution) between sequences and to determine associations between BML volumes and knee pain.

Results:

58 subjects had PF BMLs present on at least one sequence. Median BML volume measured using T1W FFE sequence was significantly smaller (224.7 mm3, interquartile range [IQR] 82.50–607.95) than the other three sequences. BML volume was greatest on the CE sequence (1129.8 mm3, IQR 467.28–3166.02). Compared to CE sequence, BML volumes were slightly lower when assessed using PDFS (proportional difference = 0.79; 95% confidence interval [CI] 0.62, 1.01) and STIR sequences (proportional difference = 0.85; 95% CI 0.67, 1.08). There were strong correlations between BML volume on PDFS, STIR, and CE T1W FS sequences (ρs = 0.98). Correlations were lower between these three sequences and T1W FFE (ρs = 0.80–0.81). Intraclass correlation coefficients were excellent for proton density fat-suppressed, short-tau inversion recovery, and CE T1W FS sequences (0.991–0.995), while the ICC for T1W FFE was good at 0.88. We found no significant association between BML volumes assessed using any of the sequences and knee pain.

Conclusion:

T1W FFE sequences were less reliable and measured considerably smaller BML volume compared to other sequences. BML volume was larger when assessed using the contrast enhanced T1W FS though not statistically significantly different from BMLs when assessed using PDFS and STIR sequences.

Advances in knowledge:

This is the first study to assess BMLs by four different MRI pulse sequences on the same data set, including different fluid sensitive sequences and gradient echo type sequence.
Pathological characteristics and risk stratification in patients with stage I endometrial cancer: utility of apparent diffusion coefficient histogram analysis
Authors: An Taein , Kim Chan Kyo
Published: July 2021

Objectives:

Accurate pre-operative prediction of risk stratification using a non-invasive imaging tool is clinically important for planning optimal treatment strategies, particularly in early-stage endometrial cancer (EC). This study aimed to investigate the utility of apparent diffusion coefficient (ADC) histogram analysis in evaluating the pathological characteristics and risk stratification in patients with Stage I EC.

Methods:

Between October 2009 and December 2014, a total of 108 patients with surgically proven Stage I EC (endometrioid type = 91; non-endometrioid type = 17) excluding stage ≥II that underwent preoperative 3T-diffusion-weighted imaging without administration of contrast medium were enrolled in this retrospective study. Risk stratification was divided into four risk categories based on the ESMO-ESGO-ESTRO Guidelines: low, intermediate, high-intermediate, and high risk. The ADC histogram parameters (minimum, mean [ADCmean], 10th–90th percentile, and maximum [ADCmax]) of the tumor were generated using an in-house software. The ADC histogram parameters were compared between patients with endometrioid type and non-endometrioid type, between Stage IA and IB, between histological grades, and evaluated for differentiating non-high risk group from high risk group. Inter-reader agreement for tumor ADC measurements was also evaluated. Statistical analyses were performed using the Student’s t-test, Mann–Whitney U test, receiver operating characteristics (ROC) analysis, or intraclass correlation coefﬁcient (ICC).

Results:

In differentiating endometrioid type from non-endometrioid type EC, all ADC histogram parameters were statistically significant (p < 0.05). In differentiating histological grades, 90th percentile ADC and ADCmax showed significantly higher values in tumor Grade III than in tumor Grade I-II (p < 0.05). In differentiating superficial myometrial invasion from deep myometrial invasion, all ADC histogram parameters were statistically significant (p < 0.05), except ADCmax. In differentiating non-high risk group from high risk group, ADCmean, 75th–90th percentile ADC, and ADCmax were statistically significant (p < 0.05). For predicting the high risk group, the area under the ROC curve of ADCmax was 0.628 and the highest among other histogram parameters. All histogram parameters revealed moderate to good inter-reader reliability (ICC = 0.581‒0.769).

Conclusion:

The ADC histogram analysis as reproducible tool may be useful for evaluating the pathological characteristics and risk stratification in patients with early-stage EC.

Advances in knowledge:

ADC histogram analysis may be useful for evaluating risk stratification in early-stage endometrial cancer patients.
Progression of long head of the biceps brachii tendon abnormality on magnetic resonance imaging after rotator cuff repair
Authors: Lee Seung Eun , Jung Joon-Yong , Lee So-Yeon , Park Hyerim
Published: July 2021

Objectives

To correlate the deterioration of preserved long head of biceps tendon (LHB) after rotator cuff repair with preoperative and postoperative MRI factors.

Methods

Total of 209 shoulder joints (F:M = 145:64; mean age 57.4 years) which underwent rotator cuff repair and at least two postoperative MRI scans over 10 months after surgery were included. LHB integrity was graded with a five point severity scale. LHB deterioration was defined by increased composite score of integrity and extent score between the preoperative and second postoperative MRI. For preoperative and postoperative MRI factors, size and location of superior cuff -supraspinatus and infraspinatus- and subscapularis tears, fatty degeneration of rotator cuff, preoperative LHB status, subluxation of LHB, superior labral tear, acromion type, repaired rotator cuff status, postoperative capsulitis and acromioplasty state were assessed. Logistic regression was used to evaluate the association between LHB deterioration and aforementioned factors. Same analysis was conducted for 62 shoulder joints with a long-term follow-up MRI.

Results

Of the 209 shoulders, 49.3% (n = 103) showed LHB deterioration on short-term follow-up MRI. In long-term follow-up subgroup, 32 LHBs were further deteriorated. In multivariate analysis, fatty degeneration of superior cuff showed significant association with LHB deterioration in both short-term (p = .04, p = .007) and long-term subgroups (p = .004, p = .005) among preoperative and postoperative factors, respectively.

Conclusions

Degree of fatty degeneration in superior cuff is associated with LHB deterioration on postoperative MRI.

Advances in knowledge

Our results support that tenotomy or tenodesis of LHB should be considered during rotator cuff repair, especially in patients with advanced fatty degeneration of rotator cuff.
Modern imaging of cholangitis
Authors: Pötter-Lang Sarah , Ba-Ssalamah Ahmed , Bastati Nina , Messner Alina , Kristic Antonia , Ambros Raphael , Herold Alexander , Hodge Jacqueline C. , Trauner Michael
Published: July 2021

Cholangitis refers to inflammation of the bile ducts with or without accompanying infection. When intermittent or persistent inflammation lasts 6 months or more, the condition is classified as chronic cholangitis. Otherwise, it is considered an acute cholangitis. Cholangitis can also be classified according to the inciting agent, e.g. complete mechanical obstruction, which is the leading cause of acute cholangitis, longstanding partial mechanical blockage, or immune-mediated bile duct damage that results in chronic cholangitis.

The work-up for cholangitis is based upon medical history, clinical presentation, and initial laboratory tests. Whereas ultrasound is the first-line imaging modality used to identify bile duct dilatation in patients with colicky abdominal pain, cross-sectional imaging is preferable when symptoms cannot be primarily localised to the hepatobiliary system. CT is very useful in oncologic, trauma, or postoperative patients. Otherwise, magnetic resonance cholangiopancreatography is the method of choice to diagnose acute and chronic biliary disorders, providing an excellent anatomic overview and, if gadoxetic acid is injected, simultaneously delivering morphological and functional information about the hepatobiliary system. If brush cytology, biopsy, assessment of the prepapillary common bile duct, stricture dilatation, or stenting is necessary, then endoscopic ultrasound and/or retrograde cholangiography are performed. Finally, when the pathologic duct is inaccessible from the duodenum or stomach, percutaneous transhepatic cholangiography is an option. The pace of the work-up depends upon the severity of cholestasis on presentation. Whereas sepsis, hypotension, and/or Charcot’s triad warrant immediate investigation and management, chronic cholestasis can be electively evaluated.

This overview article will cover the common cholangitides, emphasising our clinical experience with the chronic cholestatic liver diseases.
Blood oxygenation level-dependent MRI at 3T for differentiating prostate cancer from benign tissue: a preliminary experience
Authors: Kim Yongtae , Park Jung Jae , Kim Chan Kyo
Published: July 2021

Objective:

Blood oxygenation-level dependent (BOLD) MRI may identify or quantify the regional distribution of hypoxia within a tumor. We aimed to evaluate the feasibility of BOLD MRI at 3 T in differentiating prostate cancer from benign tissue.

Methods:

A total of 145 patients with biopsy-proven prostate cancer underwent BOLD MRI at 3 T. BOLD MRI was performed using a multiple fast field echo sequence to acquire 12 T  2*-weighted images. The R2* value (rate of relaxation, s−1) was measured in the index tumor, and benign peripheral (PZ) and transition zone (TZ), and the results were compared. The variability of R2* measurements was evaluated.

Results:

Tumor R2* values (25.95 s−1) were significantly different from the benign PZ (27.83 s−1) and benign TZ (21.66 s−1) (p < 0.001). For identifying the tumor, the area under the receiver operating characteristic of R2* was 0.606, with an optimal cut-off value of 22.8 s−1 resulting in 73.8% sensitivity and 52% specificity. In the Bland–Altman test, the mean differences in R2* values were 8.5% for tumors, 13.3% for benign PZ, and 6.8% for benign TZ. No associations between tumor R2* value and Gleason score, age, prostate volume, prostate-specific antigen, or tumor size.

Conclusion:

BOLD MRI at 3 T appears to be a feasible tool for differentiating between prostate cancer and benign tissue. However, further studies are required for a direct clinical application.

Advances in knowledge:

The R2* values are significantly different among prostate cancer, benign PZ, and benign TZ.
Patient treatment pathways of multidrug-resistant tuberculosis cases in coastal South India: Road to a drug resistant tuberculosis center
Authors: Rathi Priya , Shringarpure Kalpita , Unnikrishnan Bhaskaran , Pandey Abhinav , Nair Abhirami
Published: July 2021

Background: Delays in initiating multidrug-resistant tuberculosis (MDR TB) treatment adds risk to individual patients and the community due to disease progression, and on-going transmission. The Government of India offers free TB diagnosis and treatment, however many presumptive MDR TB patients wander within the Indian healthcare system and delay accessing the programme. To improve access to care, it is imperative to understand the treatment pathways taken by MDR TB patients. We aimed to describe the diagnostic and treatment pathway taken by presumptive MDR TB patients registered under Programmatic Management of Drug-resistant TB Program.

Methods: We conducted a cross-sectional study amongst patients registered during August 2016 – April 2017 at one District Drug Resistance Tuberculosis centre of Dakshina Kannada district in Karnataka, India. A semi-structured questionnaire was used to collect the number, type (private and public sector), and dates of healthcare facilities (HCFs) visits prior to the initiation of MDR TB treatment. Delays in pathway were measured in days and summarised as median and interquartile range (IQR), from the date of onset of illness until the initiation of MDR TB treatment.

Results: We found that patients preferred private HCFs; however, due to lack of treatment and unaffordability they shifted to public HCFs. Median delay to register under the program was more in private HCFs (180 days) in comparison with public HCFs (120 days). We also found that the detection rates were much higher in public HCFs (80%).

Conclusion: The present study found that there was substantial patient delay and total delay in diagnosis and treatment of MDR TB patients. Private HCF was first point of contact for most of the patients; however those visited public HCF diagnosed earlier as compared to others. The government should involve private HCFs to provide standard diagnostics and treatment to the patients seeking a private facility.
Congenital web of the common bile duct combined with multiple intrahepatic duct stricture: a case report of successful radiological intervention: a case report
Authors: Lim Hanseul , Hwang Shin , Ko Gi-Young , Han Hyejin
Published: July 2021

Congenital web formations are extremely rare anomalies of the extrahepatic biliary tree. We herein report a case of common bile duct septum combined with multiple intrahepatic bile duct strictures in a 74‐year‐old female patient who was successfully treated with radiological intervention. The patient initially visited the hospital because of upper abdominal pain. Imaging studies revealed multifocal strictures with dilatation in both intra- and extrahepatic ducts; the final clinical diagnosis was congenital common bile duct web combined with multiple intrahepatic duct strictures. Surgical treatment was not indicated because multiple biliary strictures were untreatable, and the disease was clinically diagnosed as benign. The multiple strictures were extensively dilated twice through bilateral percutaneous transhepatic biliary drainage (PTBD) for 2 months. After 1 month of observation, PTBD catheters were successfully removed. The patient is doing well at 6 months after completion of the radiological intervention, with the maintenance of normal liver function. Congenital web of the bile duct is very rare, and its treatment may vary depending on the patterns of biliary stenosis. In cases where surgical intervention is not indicated for congenital web and its associated disease, radiological intervention with balloon dilatation can be a viable therapeutic option.
Development experience of Cooperative Project Management System in an Engineering Company
Authors: Vurdova Nadezhda
Published: July 2021

The article deals with the problems of developing a corporate project management system in an engineering company that implements "full-cycle" projects - from object design to commissioning in the field of industrial water treatment and water treatment. The problems are connected, first of all, with the achieved level of maturity of the business, the fear of any changes, when the stability of the result is more important than further development. The analysis of the process of working on the project from the stage of initiation to completion was carried out, the most problematic, bottlenecks in the current project management system were identified. Based on the conducted research, the company's management has developed and approved a plan for the development of CSU for the next year and for the future.
Convergent Project Management Model
Authors: Tsiteladze David
Published: July 2021

The paper analyzes various project management systems. It is shown that in conditions of rapid changes in the external environment for both complex and very complex projects, the choice of one or even two complementary project management systems may not be effective. The paper analyzes three complementary pairs of project management methods. The advantages and disadvantages of each project management method are shown. At the end of the analysis, a "Convergence Model" of project management methods is presented, in which the values of systems theory, game theory and fuzzy sets are separately noted, allowing the use of project analytics, which relieves companies from excessive formalization of project activities.
Cardiac Tamponade in Adrenoleukodystrophy with Addison’s Disease
Authors: Sá Pereira Mafalda , Freitas Raquel , Correia Azevedo Pedro
Published: July 2021

Cardiac tamponade is a life-threatening medical emergency and can arise in many clinical situations. We present the case of a 59-year-old man with adrenoleukodystrophy and Addison’s disease who was admitted to the emergency department with severe abdominal pain that turned out to be cardiac tamponade of unknown aetiology.  An association between cardiac tamponade and Addison’s disease has been reported in the literature, so this aetiology should be considered in the differential diagnosis for patients presenting with unexplained cardiac tamponade.
Patient-reported outcome measures after hip fracture in patients with chronic cognitive impairment
Authors: Kristoffersen Malfrid H. , Dybvik Eva H. , Steihaug Ole M. , Kristensen Torbjørn B. , Engesæter Lars B. , Ranhoff Anette H. , Gjertsen Jan-Erik
Published: July 2021

Aims

Hip fracture patients have high morbidity and mortality. Patient-reported outcome measures (PROMs) assess the quality of care of patients with hip fracture, including those with chronic cognitive impairment (CCI). Our aim was to compare PROMs from hip fracture patients with and without CCI, using the Norwegian Hip Fracture Register (NHFR).

Methods

PROM questionnaires at four months (n = 34,675) and 12 months (n = 24,510) after a hip fracture reported from 2005 to 2018 were analyzed. Pre-injury score was reported in the four-month questionnaire. The questionnaires included the EuroQol five-dimension three-level (EQ-5D-3L) questionnaire, and information about who completed the questionnaire.

Results

Of the 34,675 included patients, 5,643 (16%) had CCI. Patients with CCI were older (85 years vs 81 years) (p < 0.001), and had a higher American Society of Anesthesiologists (ASA) classification compared to patients without CCI. CCI was unrelated to fracture type and treatment method. EQ-5D index scores were lower in patients with CCI after four months (0.37 vs 0.60; p < 0.001) and 12 months (0.39 vs 0.64; p < 0.001). Patients with CCI had lower scores for all dimensions of the EQ-5D-3L pre-fracture and at four and 12 months.

Conclusion

Patients with CCI reported lower health-related quality of life pre-fracture, at four and 12 months after the hip fracture. PROM data from hip fracture patients with CCI are valuable in the assessment of treatment. Patients with CCI should be included in future studies. Cite this article: Bone Jt Open 2021;2(7):454–465.
Straightness metric for measurement of turbulence-induced distortion in long-range imaging
Authors: Hofmann Julia , Goelzer Rilene , Wegner Daniel , Gladysz Szymon , Stein Karin
Published: July 2021

Algorithms used for mitigation of the effects of atmospheric turbulence on video sequences often rely on a process for creating a reference image to register all of the frames. Because such a pristine image is generally not available, no-reference image quality metrics can be used to identify frames in a sequence that have minimum distortion. Here, we propose a metric that quantifies image warping by measuring image straightness based on line detection. The average length of straight lines in a frame is used to select best frames in a sequence and to generate a reference frame for a subsequent dewarping algorithm. We perform tests with this metric on simulated data that exhibits varying degrees of distortion and blur and spans normalized turbulence strengths between 0.75 and 4.5. We show, through these simulations, that the metric can differentiate between weak and moderate turbulence effects. We also show in simulations that the optical flow that uses a reference frame generated by this metric produces consistently improved image quality. This improvement is even higher when we employ the metric to guide optical flow that is applied to three real video sequences taken over a 7 km path.
Terahertz coded-aperture imaging for moving targets based on an incoherent detection array
Authors: Liu Xingyue , Wang Hongqiang , Luo Chenggao , Peng Long
Published: July 2021

Terahertz coded-aperture imaging relies on sequential coding and sampling. Its capturing speed is limited by the switching rate of the coded-aperture antenna; therefore, it is not suitable for capturing moving targets. In this paper, we focus on imaging for moving targets using the terahertz coded-aperture imaging technique. An incoherent detection array is adopted to replace sequential sampling by spatial sampling, therefore improving the capturing speed significantly. Then, a signal processing method based on phase retrieval and image enhancement is proposed to reconstruct targets with improved quality. Numerical experimental results verify the effectiveness of the method.
Polymer/silica hybrid 3D waveguide thermo-optic mode switch based on cascaded asymmetric directional couplers
Authors: Lin Baizhu , Sun Shijie , Yang Kaidi , Zhu Mu , Gu Yue , Yu Qidong , Wang Xibin , Zhang Daming
Published: July 2021

A polymer/silica hybrid 3D waveguide thermo-optic (TO) mode switch based on cascaded asymmetric directional couplers (ADCs) is theoretically designed and simulated, where the spatial modes of a few-mode silica waveguide can be switched to various single-mode polymer waveguides placed above the few-mode silica waveguide. A beam propagation method is employed to optimize the dimensional parameters of the mode switch to convert the

L
P

11
a

and

L
P

11
b

modes of the few-mode silica waveguide to the

L
P

01

mode of two single-mode polymer waveguides using the cascaded ADC 1 and ADC 2. The coupling ratios are higher than 96.4% (93.4%) and 95.1% (92.8%) for the ADC 1 and ADC 2, respectively, under the TE (TM) polarization within the wavelength range from 1530 to 1570 nm, which shows good wavelength independence. Furthermore, the monolayer graphene is introduced as the heating electrode and buried on the surface of the polymer core to increase the heating efficiency and reduce the power consumption. The power consumption for ADC 1 and ADC 2 is 16.69 mW and 17.35 mW, respectively. Compared to the traditional TO switch with an aluminum (Al) heating electrode, the heating efficiency of the presented device can be improved by

∼

30

%

. Moreover, the response speed of the TO mode switch with a 3D waveguide structure was also significantly improved. Compared to the device with Al electrodes, the introduced graphene electrodes can improve the switching speed of the device by

∼

60

%

. The presented TO mode switch with its small size and easy integration should find applications in reconfigurable mode division multiplexing systems.