bluuebunny/crossref_metadata_2025 huggingface dataset:
Surface-Modified Graphite Nanoplatelets To Enhance Cement Sheath Durability
Authors: Tabatabaei Maryam , Dahi Taleghani Arash , Alem Nasim
Published: February 2020

We propose a novel cement additive made of graphite nanoplatelets (GNPs) for improved hydraulic isolation and durability of oil and gas wells. The primary role of the cement sheath, which is zonal isolation, can be significantly affected by the permeability of set cement (hardened cement slurry). On one hand, it is the inherent microstructural defects of cement, including pores and microcracks, that results in the intrinsic permeability of cement, and on the other hand, cracking, micro-annuli, or other flow paths developed through the disturbed cement by connecting the pre-existing microstructural defects determine the equivalent permeability of set cement. The purpose of this research is containing or at least minimizing the intrinsic and developed flow paths through the cementitious matrix with the help of surface-modified GNPs. GNPs possess high surface area to volume ratios. In this study, we focus on the effect of surface-modified GNPs on the overall mechanical properties of both cement slurry and hardened cement slurry affecting the permeability of cement. We present two dispersion methods on the basis of physical and chemical treatments of the surface properties of GNPs. The efficiency of proposed methods on the overall properties of the cement is examined before and after its setting. To mimic downhole conditions, cement slurries are cured at 3,000 psi and 190°F for 24 hours. Also, some experiments were repeated under the pressure and temperature conditions up to 5,160 psi and 126°F, respectively, to examine pumpability and behavior of cement slurry at bottomhole conditions. To examine the role of spatial distribution of GNPs on the hardened cement nanocomposite, samples with different concentrations of GNPs were tested. We investigated the effect of modified GNPs on the unconfined compressive strength (UCS), shear bond strength, thickening time, rheological characteristics, and the free fluid content. We measured zero free fluid at room temperature for different concentrations of GNPs, demonstrating uniform dispersion of nanoparticles within the cement matrix. On the other hand, the squeeze of water out of the lower parts of the cement slurry and its upward migration can develop preferential paths for oil and gas migration. Therefore, eliminating the above-mentioned water separation can enhance cement sealing properties. We found that an optimum 0.2 vol% concentration of acid-functionalized GNPs improves the compressive and the shear bond strength of the prepared cement by approximately 42 and 175% as compared to the plain cement, respectively.
Genome-wide identification and expression analysis of PUB genes in cotton
Authors: Lu Xuke , Shu Na , Wang Delong , Wang Junjuan , Chen Xiugui , Zhang Binglei , Wang Shuai , Guo Lixue , Chen Chao , Ye Wuwei
Published: February 2020

Background: The U-box gene encodes a ubiquitin ligase that contain U-box domain. The plant U-box gene (PUB) plays an important role in the response to stresses, but few reports about PUBs in cotton were available. Therefore research on PUBs is of great importance and a necessity when studying the mechanisms of stress- tolerance in cotton.Results: In this study, we identified 93, 96, 185 and 208 PUBs from four sequenced cotton species G. raimondii (D5), G. arboreum (A2), G. hirsutum (AD1) and G. barbadense (AD2), respectively. Prediction analysis of subcellular localization showed that the PUBs in cotton were widely localized in cells, but primarily in the nucleus. The PUBs in cotton were classified into six subfamilies (A-F) on the basis of phylogenetic analysis, which was testified by the analysis of conserved motifs and exon-intron structures. Chromosomal localization analysis showed that cotton PUBs were unevenly anchored on all chromosomes, varying from 1 to 14 per chromosome. Through multiple sequence alignment analysis, 3 tandem duplications and 28 segmental duplications in cotton genome D5, 2 tandem duplications and 25 segmental duplications in A2, and 143 homologous gene pairs in A2 and D5 were found; however no tandem duplications in A2 or D5 were found. Additionally, 105, 14 and 17 homologous gene pairs were found in the intra-subgenome of At and Dt, At sub-genome and Dt sub-genome of G. hirsutum, respectively. Functional analysis of GhPUB85A and GhPUB45D showed that these genes positively responded to abiotic stresses, but the expression patterns were different. In addition, although the expression levels of these two homologous genes were similar, their contributions were different when responding to stresses, specifically showing different responses to abiotic stresses and functional differences between the two subgenomes of G. hirsutum. Conclusion: This study reported the genome-wide identification, structure, evolution and expression analysis of PUBs in cotton, and the results showed that the PUBs were highly conserved throughout the evolutionary history of cotton. All PUB genes were involved in the response to abiotic stresses (including salt, drought, hot and cold) to varying degrees.
Genome-wide association studies of Shigella spp. and Enteroinvasive Escherichia coli isolates demonstrate an absence of genetic markers for prediction of disease severity
Authors: Hendriks Amber C. A. , Reubsaet Frans A.G. , Kooistra A.M.D. (Mirjam) , Rossen John W. A. , Dutilh Bas E. , Zomer Aldert L. , Beld Maaike J. C. van den
Published: February 2020

Background: We investigated the association of symptoms and disease severity of shigellosis patients with genetic determinants of infecting Shigella and entero-invasive Escherichia coli (EIEC), because determinants that predict disease outcome per individual patient could be used to prioritize control measures. For this purpose, genome wide association studies (GWAS) were performed using presence or absence of single genes, combinations of genes, and k-mers. All genetic variants were derived from draft genome sequences of isolates from a multicenter cross-sectional study conducted in the Netherlands during 2016 and 2017. Clinical data of patients consisting of binary/dichotomous representation of symptoms and their calculated severity scores were also available from this study. To verify the suitability of the methods used, the genetic differences between the genera Shigella and Escherichia were used as control. Results: The isolates obtained were representative of the population structure encountered in other Western European countries. No association was found between single genes or combinations of genes and separate symptoms or disease severity scores. Our benchmark characteristic, genus, resulted in eight associated genes and >3,000,000 k-mers, indicating adequate performance of the algorithms used. Conclusions: To conclude, using several microbial GWAS methods, genetic variants in Shigella spp. and EIEC that can predict specific symptoms or a more severe course of disease were not identified, suggesting that disease severity of shigellosis is dependent on other factors than the genetic variation of the infecting bacteria. Specific genes or gene fragments of isolates from patients are unsuitable to predict outcomes and cannot be used for development, prioritization and optimization of guidelines for control measures of shigellosis or infections with EIEC.
Prevalence and Associated Factors of Urinary Incontinence in Women Living in China: A Literature Review
Authors: Xue Kaikai , Palmer Mary H , Zhou Fang
Published: February 2020

Background: This review of studies on urinary incontinence (UI) was focused primarily on UI prevalence and associated factors across the adult lifecourse of Chinese women. UI is a urologic symptom that can have a significant impact on women's physical and mental health and quality of life. Although researchers from many countries have reported prevalence rates and associated factors for UI, little is known about the prevalence of UI in China’s large female population. Language may act as a barrier to the inclusion of published studies in English-language journals. To overcome this barrier and to add to the global knowledge base about UI in women, the authors reviewed and discussed findings from epidemiological studies published in China and in Chinese language.
Methods: The authors retrieved research studies from the five databases using the following search terms: "Subject: (Female) * Subject: (Urinary incontinence) * Subject: (Prevalence) * Date: 2013-2019". The authors used PubMed to search English-language studies published in Chinese journals on UI in Chinese women.
Results: This literature review includes 48 articles published between January 2013 and December 2019. The overall UI prevalence rates reported in adult Chinese women ranged from 8.7% to 69.8%. For women aged 17 to 40 years, 41 to 59 years, and 60 years and older, prevalence rates ranged from 2.6% to 30.0%, 8.7% to 47.7%, and 16.9% to 61.6%, respectively. Significant associated factors for overall UI included age, body mass index, constipation, parity, and menopause. Despite the 17 to 40 age range being peak reproductive years, the literature revealed little focus on UI prevalence rates. For women aged 41 to 59 years, the main associated factors included those related to pregnancy and gynecologic diseases. For women 60 years and older, chronic diseases represented most of the associated factors.
Conclusions: About 43 to 349 million Chinese women may experience UI. Many of the identified associated factors could be mitigated to reduce UI incidence and prevalence rates. Little is known about the prevalence rates and associated factors for UI among young Chinese women. Future research should investigate UI in young women to improve bladder health across their lifecourse.
Reliability and correlation of mixture cell correction in methylomic and transcriptomic blood data
Authors: Chaumette Boris , Kebir Oussama , Dion Patrick A. , Rouleau Guy A. , Krebs Marie-Odile
Published: February 2020

Objectives : The number of DNA methylome and RNA transcriptome studies is growing, but investigators have to consider the cell type composition of tissues used. In blood samples, the data reflect the picture of a mixture of different cells. Specialized algorithms can address the cell-type heterogeneity issue. We tested if these corrections are correlated between two heterogeneous datasets. Results : We used methylome and transcriptome datasets derived from a cohort of ten individuals whose blood was sampled at two different timepoints. We examined how the cell composition derived from these omics correlated with each other using “CIBERSORT” for the transcriptome and “EstimateCellCounts function” for the methylome. The correlation coefficients between the two omic datasets ranged from 0.45 to 0.81 but correlations were minimal between two different timepoints. Our results suggest that a posteriori correction of a mixture of cells present in blood samples is reliable. Using an omic dataset to correct a second dataset for relative fractions of cells appears to be applicable, but only when the samples are simultaneously collected. This could be beneficial when there are difficulties to control the cell types in the second dataset, even when the sample size is limited.
Diagnostic efficacy of double-balloon enteroscopy in patients with suspected isolated small bowel Crohn’s disease
Authors: Huang Zihan , Liu Xiang , Yang Fei , Wang Guoxin , Ge Nan , Wang Sheng , Guo Jintao , Sun Siyu
Published: February 2020

Background: Owing to the development of double-balloon enteroscopy (DBE) and video capsule endoscopy (VCE) in recent years, direct visualization of the entire small intestinal mucosa has become possible. Because of the nonspecific symptoms and the anatomic location of the small bowel, diagnosis of isolated small bowel Crohn’s disease (CD) remains a challenge. The aim of this research was to explore the value of DBE for isolated small bowel CD in situations where routine tests cannot confirm the diagnosis.Methods: This study included patients with suspected isolated small bowel CD who were hospitalized in Shengjing Hospital from April 2014 to June 2018. We included patients presenting with chronic diarrhea, abdominal pain, abdominal mass, perianal lesions, and systemic symptoms including weight loss, fever, and anemia after excluding infection factors. Patients with purely colonic CD were excluded from this cohort. Patients with suspected isolated small bowel CD underwent DBE.Results: In 16/18 patients, pathological findings were detected by DBE. In 12 of the cases, small bowel CD was confirmed. The remaining four patients were diagnosed with small bowel inflammation, duodenal carcinoma, ileum inflammation and small bowel ulcers. However, the diagnosis of CD was confirmed in 14/18 (78%) patients by taking into account the clinical presentation, endoscopic and histological results as well as the experimental treatment. DBE assisted in the diagnosis in 86% (12/14) of the patients.Conclusions: In the diagnosis of small bowel CD, DBE is a helpful tool. Before assessment with DBE, clinical features, colonoscopy, and CT were used to initially assess the intestine. According to the lesions indicated by CT, we chose the most appropriate endoscope insertion route, and combined the endoscopic characteristics and pathological results of DBE to confirm the diagnosis.
Defining the short-term disease recurrence after Loop Electrosurgical Excision Procedure (LEEP)
Authors: Papalia Nicholas , Rohla Amanda , Tang Selphee , Nation Jill G. , Nelson Gregg
Published: February 2020

Background
The goal of cervical cancer screening is to identify dysplastic lesions for subsequent excision in order to prevent invasive disease. There is clinical equipoise, on how to best follow women for disease surveillance after treatment with some Canadian provinces exclusively performing colposcopy and some utilizing HPV testing in addition to cervical cytology. Loop Electrosurgical Excision Procedure (LEEP) is used to treat pre-invasive HPV-mediated disease and patients are typically followed for 12 months after disease excision. This study aims to quantify the prevalence of high-grade disease at the time of the second follow-up colposcopy visit, in a practice setting that utilizes laser ablation in addition to LEEP.
Methods
In a retrospective cohort study, consecutive patient charts were accessed through the electronic medical record system, ARIA, at the Tom Baker Cancer Centre, in Calgary, Alberta, from January 2010 to December 2015. Data was extracted and a REDCap database was used to compile pertinent information from charts meeting inclusion criteria. Descriptive and analytic statistics were performed.
Results
Of the 303 patients identified, 221 patients met inclusion criteria. 86% of these patients met discharge criteria from colposcopy after the second follow up visit. 31 (14%) were seen in a subsequent visit for abnormal findings. Of these, 7 (3.2%) underwent further treatment for high-grade disease (CIN 2/3). Of the 31, 23 (10.6%) had a third – negative – visit, resulting in discharge from colposcopy. One patient had a repeat LEEP for persistent LSIL.
Conclusion
In summary, our data demonstrates a prevalence of 3.2% of high-grade disease at the time of a second colposcopic follow up visit after treatment, in a setting which frequently utilizes laser ablation in combination with LEEP, for large lesions. This recurrence rate is consistent with most published literature on recurrence rates of CIN2/3.
First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases
Authors: Hu Jilin , Zhang Jinman , He Guilin , Zhu Shu , Tang Xinhua , Su Jie , Li Qian , Kong Yamin , Zhu Baosheng
Published: February 2020

Background: It is well known that second-trimester maternal serum alpha-fetoprotein (MS-AFP) is a predictor for adverse pregnancy outcomes (APOs), such as preterm birth, stillbirth, preeclampsia and small for gestational age (SGA). However, it is unknown whether first-trimester MS-AFP is also predictive of APOs. Methods: We retrospectively reviewed the data on the first-trimester MS-AFP levels and pregnancy outcomes of 3325 singleton pregnant women. The cutoff value of 2.5 multiple of the median (MoM) was used to evaluate the risks of APOs regarding MS-AFP. The receiver operating characteristic (ROC) curves were used to evaluate the predictive efficiencies of MS-AFP to these disorders. Results: A total of 181 pregnancies resulted in preterm birth, 32 in stillbirth, 81 in preeclampsia, and 362 in SGA. Compared to women with MS-AFP < 2.5MoM, those with MS-AFP ≥ 2.5MoM had increased risks (odds ratio, 95% confidence interval) of preterm birth (2.53, 1.65~3.88), preeclampsia (3.05, 1.71~5.43) and SGA (1.90, 1.34~2.69), and had an earlier distribution of gestational weeks at delivery (P = 0.004) and a lower distribution of neonatal birth weights (P = 0.000), but the actual between-group differences were minuscule. The areas under ROC curves were 0.572 (P = 0.001), 0.579 (P = 0.015) and 0.565 (P = 0.000) for preterm birth, preeclampsia and SGA, respectively. Subdivisions for the disorders did not obviously improve the performances of MS-AFP. Conclusions: Elevated first-trimester MS-AFP is associated with increased risk of preterm birth, preeclampsia and SGA. However, the predictive efficiencies were low and it is not a good predictor for these APOs.
Spatial distribution and Determinants of Optimal ANC visit among pregnant women in Ethiopia: Further analysis of 2016 Ethiopia demographic Health Survey
Authors: Tadesse Zemenu Tessema , Animut Yaregal
Published: February 2020

Background: Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing. Antenatal care coverage is improving in Africa since over two-thirds of pregnant women have at least one ANC contact. However, to realize the complete life-saving potential that ANC guarantees for mothers and babies, at least four visits providing essential evidence-based interventions are required. . Therefore, this study was conducted to identify determinants of an optimal ANC visit and its spatial distribution in Ethiopia. Methods: This study is a secondary data analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS).A total of 8,025 women who had a live birth in the five years preceding the survey were included in this study. STATA 14 software and ArcGIS10.7 software were used for analysis. The generalized estimating equation (GEE) model was fitted to identify factors associated with an optimal ANC visit. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between explanatory and outcome variables. Results: This study revealed that rural residence (AOR=0.59, 95%CI: 0.45-0.77),male partners educational status[secondary school (AOR=1.33, 95%CI: 1.05-1.67)], distance to the health institutions[not a big problem (AOR=1.21, 95%CI: 1.04-1.39)], community-level literacy(AOR=1.07, 95%CI: 1.03-1.12), and community level service utilization(AOR=2.67,95%CI:2.21-3.24) were significantly associated with optimal ANC visits. From the spatial analysis result, an Optimal ANC visit was observed in Addis Ababa, Tigray, Harari, and Dire Dawa regions whereas areas with no optimal ANC visit were Afar, Amhara, Oromia Benishangul, SNNP, and Somalia regions. Conclusion: Living in peripheral regions of the country and in rural areas, lower educational status of male partners and distance to health institutions were prohibiting factors for an adequate number of visits. In this study, community-level literacy and community level service utilizations were were also affect womens’ ANC utilization which implies community-level interventions should be considered for improving antenatal care utilization and better health outcomes. The government should give special attention to the regions like Afar, Amhara, Oromia, Benishangul, SNNP, and Somalia which had low optimal ANC visits. Keywords: Optimal Antenatal Care Visit, Determinant, Spatial distribution, Ethiopia
Cardiac Surgical Outcome Prediction by Blood Pressure Variability Indices Poincaré plot and Coefficient of Variation: an Observational Study
Authors: K Senthil Packiasabapathy , Prasad Varesh , Rangasamy Valluvan , Popok David , Xu Xinling , Novack Victor , Subramaniam Balachundhar
Published: February 2020

Background
Recent literature suggests a significant association between blood pressure variability (BPV) and postoperative outcomes after cardiac surgery. However, its outcome prediction ability remains unclear. Current prediction models use static preoperative patient factors. We explored the ability of Poincaré plots and coefficient of variation (CV) by measuring intraoperative BPV in predicting adverse outcomes.
Methods
In this retrospective, observational, cohort study, 3687 adult patients (> 18 years) undergoing cardiac surgery requiring cardio-pulmonary bypass from 2008 to 2014 were included. Blood pressure variability was computed by Poincare plots and CV. Standard descriptors (SD) SD1, SD2 were measured with Poincare plots by ellipse fitting technique. The outcomes analyzed were the 30-day mortality and postoperative renal failure. Logistic regression models adjusted for preoperative and surgical factors were constructed to evaluate the association between BPV parameters and outcomes. C-statistics were used to analyse the predictive ability.
Results
Analysis found that, 99 (2.7%) patients died within 30 days and 105 (2.8%) patients suffered from in-hospital renal failure. Logistic regression models including BPV parameters (standard descriptors from Poincare plots and CV) performed poorly in predicting postoperative 30-day mortality and renal failure [Concordance(C)-Statistic around 0.5]. They did not add any significant value to the standard STS risk score [C-statistic: STS alone 0.7, STS + BPV parmeters 0.7].
Conclusions
In conclusion, BP variability computed from Poincare plots and CV were not predictive of mortality and renal failure in cardiac surgical patients. Patient comorbid conditions and other preoperative factors are still the gold standard for outcome prediction. Future directions include analysis of dynamic parameters such as complexity of physiological signals in identifying high risk patients and tailoring management accordingly.
Physiological and transcriptomic analyses reveal the mechanisms underlying the salt tolerance of Zoysia japonica Steud.
Authors: Wang Jingjing , An Cong , Guo Hailin , Yang Xiangyang , Chen Jingbo , Zong Junqin , Li Jianjian , Liu Jianxiu
Published: February 2020

Background: Areas with saline soils are sparsely populated and have fragile ecosystems, which severely restricts the sustainable development of local economies. Zoysia grasses are recognized as excellent warm-season turfgrasses worldwide, with high salt tolerance and superior growth in saline-alkali soils. However, the mechanism underlying the salt tolerance of Zoysia species remains unknown. Results: The phenotypic and physiological responses of two contrasting materials, Zoysia japonica Steud. Z004 (salt sensitive) and Z011 (salt tolerant) in response to salt stress were studied. The results show that Z011 was more salt tolerant than was Z004, with the former presenting greater K+/Na+ ratios in both its leaves and roots. To study the molecular mechanisms underlying salt tolerance further, we compared the transcriptomes of the two materials at different time points (0 h, 1 h, 24 h, and 72 h) and from different tissues (leaves and roots) under salt treatment. The 24-h time point and the roots might make significant contributions to the salt tolerance. Moreover, GO and KEGG analyses of different comparisons revealed that the key DEGs participating in the salt-stress response belonged to the hormone pathway, various TF families and the DUF family. Conclusions: Z011 may have improved salt tolerance by reducing Na+ transport from the roots to the leaves, increasing K+ absorption in the roots and reducing K+ secretion from the leaves to maintain a significantly greater K+/Na+ ratio. Twenty-four hours might be a relatively important time point for the salt-stress response of zoysiagrass. The auxin signal transduction family, ABA signal transduction family, WRKY TF family and bHLH TF family may be the most important families in Zoysia salt-stress regulation. This study provides fundamental information concerning the salt-stress response of Zoysia and improves the understanding of molecular mechanisms in salt-tolerant plants.
Resection of retrohepatic inferior vena cava without reconstruction in ex vivo liver resection and autotransplantation: a retrospective study
Authors: Yang Xianwei , Wang Tao , Kong Junjie , Huang Bin , Wang Wentao
Published: February 2020

Background: Retrohepatic inferior vena cava (RIVC) resection without reconstruction in ex vivo liver resection and autotransplantation (ERAT) for advanced alveolar echinococcosis (HAE) is unclear.
Methods: Depending on the presence of a rich collateral circulation and stable blood volume in ERAT, we chose not to rebuild the RIVC. Then, we chose an appropriate revascularization technique for the hepatic and renal veins. Finally, all ERAT procedures were completed, and short- and long-term outcomes were observed.
Results: Between February 2014 and August 2018, 5 advanced HAE patients who underwent ERAT required the described technique. One patient died of circulatory failure 1 day after surgery. Another four patients, with a median follow-up duration of 18 months (range, 10-25 months), demonstrated normal liver and kidney function, no thrombosis and no HAE recurrence.
Conclusions: Through the long-term results of ERAT, the pros and cons of not reconstructing the RIVC need to be re-examined. In cases with a rich collateral circulation, the RIVC can be reconstructed. However, in cases requiring the resection of multiple organs, RIVC reconstruction is prudential.
Healthcare Access and Adverse Family Impact among U.S. Children ages 0-5 years by Prematurity Status
Authors: Lindly Olivia J. , Crossman Morgan K. , Shui Amy M. , Kuo Dennis Z. , Earl Kristen M. , Kleven Amber R. , Perrin James M. , Kuhlthau Karen A.
Published: February 2020

Background: Many children and their families are affected by premature birth. Yet, little is known about their healthcare access and adverse family impact during early childhood. This study aimed to (1) examine differences in healthcare access and adverse family impact among young children by prematurity status and (2) determine associations of healthcare access with adverse family impact among young children born prematurely. Methods: This was a secondary analysis of cross-sectional 2016 and 2017 National Survey of Children’s Health data. The sample included 19,482 U.S. children ages 0-5 years including 242 very low birthweight (VLBW) and 2,205 low birthweight and/or preterm (LBW/PTB) children. Prematurity status was defined by VLBW (i.e., <1,500 grams at birth) and LBW/PTB (i.e., 1,500-2,499 grams at birth and/or born at <37 weeks with or without LBW). Healthcare access measures were adequate health insurance, access to medical home, and developmental screening receipt. Adverse family impact measures were ≥$1,000 in annual out-of-pocket medical costs, having a parent cut-back or stop work, parental aggravation, maternal health not excellent, and paternal health not excellent. The relative risk of each healthcare access and adverse family impact measure was computed by prematurity status. Propensity weighted models were fit to estimate the average treatment effect of each healthcare access measure on each adverse family impact measure among children born prematurely (i.e., VLBW or LBW/PTB). Results: Bivariate analysis results showed that VLBW and/or LBW/PTB children generally fared worse than other children in terms of medical home, having a parent cut-back or stop working, parental aggravation, and paternal health. Multivariable analysis results only showed, however, that VLBW children had a significantly higher risk than other children of having a parent cut-back or stop work. Adequate health insurance and medical home were each associated with reduced adjusted relative risk of ≥$1,000 in annual out-of-pocket costs, having a parent cut-back or stop work, and parental aggravation among children born prematurely. Conclusions: This study’s findings demonstrate better healthcare access is associated with reduced adverse family impact among U.S. children ages 0-5 years born prematurely. Population health initiatives should target children born prematurely and their families.
Clinical characteristics and risk factors of 47 cases with ruptured neuroblastoma in children
Authors: Qin Hong , Author) Shen Yang(Former Corresponding , Cai Siyu , Ren Qinghua , Han Wei , Yang Wei , Cheng Haiyan , Ma Xiaoli , Author) Huanmin Wang(New Corresponding
Published: February 2020

Backgroud: Neuroblastoma (NB) tumor rupture is a rare oncology emergency with poor prognosis. We aimed to evaluate clinical characteristics and risk factors for ruptured NB. Methods: A retrospective study was conducted on 47 confirmed ruptured NB patients in Beijing Children's Hospital between January 2009 and January 2019. To identify tumor rupture risk factors within high-risk NB, we included 93 consecutive nonruptured high-risk NB patients from January 2017 to January 2019. Results: Median age at presentation was 29 months (adrenal and retroperitoneum origin) for 47 ruptured NB patients. Spontaneous tumor rupture occurred in 22 cases; 18 developed tumor rupture during or after the first chemotherapy cycle, and 7 developed after core needle biopsy. Five patients died of tumor rupture, and 17 patients’ parents refused further anti-tumor therapy. Among 25 remaining patients, 6 survived without disease, 5 remained under treatment with stable disease, and 14 died. According to multivariate logistic regression analysis, the maximum diameter of primary tumor > 13.20 cm and MYCN gene amplification were independent risk factors for tumor rupture within high-risk NB. Conclusions: Tumor rupture is an uncommon, life-threatening presentation among NB patients; these patients are most likely to have poor outcomes due to tumor recurrence or rapid progression. Several treatment modalities, including symptomatic support therapy and chemotherapy, are important for saving lives and creating the respective required conditions for subsequent NB risk-based treatment.
Standardised neonatal parenteral nutrition formulations – Australasian Neonatal Parenteral Nutrition Consensus update 2017
Authors: Bolisetty Srinivas , Osborn David , Schindler Tim , Sinn John , Deshpande Girish , Wong Chee Sing , Jacobs Susan , Phad Nilkant , Pharande Pramod , Tobiansky Rodney , Luig Melissa , Trivedi Amit , McIntosh Joanne , Jozsa Eszter , Opie Gillian , Downe Lyn , Anderson Chad , Bhatia Vineesh , Kumar Prasanna , Malinen Katri , Birch Pita , Simmer Karen , McLeod Gemma , Suzanne Quader , Rajadurai Victor Samuel , Hewson Michael , Nair Arun , Williams Megan , Xiao Jing , Ravindranathan Hari , Broadbent Roland , Lui Kei
Published: February 2020

Background: The first consensus standardised neonatal parenteral nutrition formulations were implemented in many neonatal units in Australia in 2012. The current update involving 49 units from Australia, New Zealand, Singapore, Malaysia and India was conducted between September 2015 and December 2017 with the aim to review and update the 2012 formulations and guidelines. Methods: A systematic review of available evidence for each parenteral nutrient was undertaken and new standardised formulations and guidelines were developed. Results: Five existing preterm Amino acid-Dextrose formulations have been modified and two new concentrated Amino acid-Dextrose formulations added to optimise amino acid and nutrient intake according to gestation. Organic phosphate has replaced inorganic phosphate allowing for an increase in calcium and phosphate content, and acetate reduced. Lipid emulsions are unchanged, with both SMOFlipid (Fresenius Kabi, Australia) and ClinOleic (Baxter Healthcare, Australia) preparations included. The physicochemical compatibility and stability of all formulations have been tested and confirmed. Guidelines to standardise the parenteral nutrition clinical practice across facilities have also been developed. Conclusions: The 2017 PN formulations and guidelines developed by the 2017 Neonatal Parenteral Nutrition Consensus Group offer concise and practical instructions to clinicians on how to implement current and up-to-date evidence based PN to the NICU population.
Altered regional gray matter volume in Chinese female patients with bulimia nervosa
Authors: Li Xiao , Liu Xiaowei , Wang Yu , Li Lingfei , Zheng Linli , Liu Yaya , Ma Jing , Zhang Lan
Published: February 2020

Background The bulimia nervosa (BN) is one of the psychiatric disorders, which pathophysiology is not clear currently. Recent studies have concentrated on brain structural and functional changes in BN patients. However, findings have been inconsistent.The aim of this study was to explore the relationships between brain structural alterations and clinical features in Chinese female patients with BN. Method A total of 34 female patients with BN and 34 matched healthy controls (HC) underwent a T1-weighted magnetic resonance imaging (MRI) scanning. VBM analysis was carried out by using SPM8 ( http://www.fil.ion.ucl.ac.uk/spm/software/spm8/ ) to explore the alterations of regional Grey Matter Volume (GMV). The correlation analysis was performed using Statistical Package for the Social Sciences (SPSS) . Results The BN group showed reduced regional grey matter volume of the left medial superior frontal gyrus (SFGmed.L), the right superior temporal gyrus (STG.R), the right median cingulate and paracingulate gyri (DCG.R), the left median cingulate and paracingulate gyri (DCG.L) and the left dorsolateral superior frontal gyrus (SFGdor.L) compared to HC. There was no significantly regional grey matter volume increase in BN patients. The brain areas that GMV altered were uncorrelated with BMI and duration of illness (p>0.05). There was a significantly negtive correlation between age and GMV in the SFGmed.L (P<0.005, r=-0.516), the DCG.R (P<0.005, r=-0.556), the DCG.L (P<0.05, r=-0.576) and the SFGdor.L (P<0.005,r=-0.576). The self-esteem and self-evaluation of BN patients were uncorrelated with the structural alterations of GMV. Conclusions The results show altered regional GMV in females with bulimia nervosa in several brain areas, but it difficult to differentiate whether the GMV changes are the results of BN pathology or the consequences of binge-eating and compensatory behaviour. The structural alterations might be associated with impairments of inhibitory control and body dissatisfaction in BN patients, as well as mood disorder comorbidity.
IDentification of patients in need of general and specialised PALLiative care (ID-PALL©): item generation, content and face validity of a new interprofessional screening instrument.
Authors: Lüthi Fabienne Teike , Bernard Mathieu , Beauverd Michel , Gamondi Claudia , Ramelet Anne-Sylvie , Borasio Gian Domenico
Published: February 2020

Background Early identification of patients requiring palliative care is a major public health concern. A growing number of instruments exist to help professionals to identify these patients, however, thus far, none have been thoroughly assessed for criterion validity. In addition, no currently available instruments differentiate between patients in need of general vs. specialised palliative care, and most are primarily intended for use by physicians. This study aims to develop and rigorously validate a new interprofessional instrument allowing identification of patients in need of general vs specialised palliative care. Methods The instrument development involved four steps: i) literature review to determine the concept to measure; ii) generation of a set of items; iii) review of the initial set of items by experts to establish the content validity; iv) administration of the items to a sample of the target population to establish face validity. We conducted a Delphi process with experts in palliative care to accomplish step 3 and sent a questionnaire to nurses and physicians non-specialised in palliative care to achieve step 4. The study was conducted in the French and Italian-speaking regions of Switzerland. An interdisciplinary committee of clinical experts supervised all steps. Results The literature review confirmed the necessity of distinguishing between general and specialised palliative care needs and of adapting clinical recommendations to these different needs. Thirty-six nurses and physicians participated in the Delphi process and 28 were involved in the face validity assessment. The Delphi process resulted in two lists: a 7-item list to identify patients in need of general PC and an 8-item list for specialised PC needs. The content and face validity were deemed to be acceptable by both the expert and the target populations. Conclusion This instrument makes a significant contribution to the identification of patients with palliative care needs as it has been designed to differentiate between general and specialised palliative care needs. Moreover, diagnostic data is not fundamental to the use of the instrument, thus facilitating its use by healthcare professionals other than physicians, in particular nurses. Internal and criterion validity assessments are ongoing and essential before wider dissemination of the instrument.
Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.
Authors: Ngunyi Yannick Lechedem , Halle-Ekane Gregory , Tendongfor Nicholas , Mbivnjo Etheldreda Leinyuy , Mbarga Armel Evouna , Nembulefack Derick , Abonge Clifford Lo-oh , Egbe Thomas Obinchemti
Published: February 2020

Background

Postpartum febrile morbidity is relatively common, occurring in approximately 5–7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia (PP) is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon.

Methods

This was a 2 – year hospital – based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1 st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP.

Results

A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p<0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p<0.001), and duration of labour >18hours (OR 26.760, 95% CI: 7.100-100.862; p<0.001) were the most significant risk factors associated with PP.

Conclusion

Approximately 1 in every 12 postpartum cases in the DGH presents with PP . Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.
TeamMate: A longitudinal study of New Zealand working farm dogs. I. Methods, population characteristics and health on enrolment.
Authors: Isaksen Katja Elisabeth , Linney Lori , Williamson Helen , Cave Nick J , Beausoleil Ngaio J , Norman Elizabeth Jane , Cogger Naomi
Published: February 2020

Background Working farm dogs are invaluable on New Zealand sheep and beef farms. To date no study describing farm dog population and health has included information about incidence of illness and injury, or risk factors affecting health and career duration. This paper describes the methodology and initial results from TeamMate, a longitudinal study that was designed to address this gap. We describe the study population, husbandry practices, and prevalence of clinical abnormalities on enrolment. Methods Data about the farms, owners, husbandry practices and dogs were collected on farm at approximately 6-month intervals. All dogs over 18 months old and in full work were enrolled. Dogs were given physical examinations by veterinarians. On examination all abnormalities were noted, regardless of clinical significance. Results Six hundred forty-one working farm dogs and 126 owners were enrolled from the South Island of New Zealand. Forty-nine percent of dogs were Heading dogs (314 of 641) and 48% Huntaways (308 of 641). Median age of dogs was four years (range 1.5 – 14) and median body condition score (BCS) was four on a 9-point scale (interquartile range (IQR) 3 – 5). Fifty-four percent of dogs were male (345 of 641), and 6% (41 of 641) were neutered. Eighty-one percent of owners (102 of 126) fed dogs commercial biscuits and meat sourced on farm. Forty-four percent of dogs (279 of 641) had bedding in their kennel, 14% (55 of 393) had insulated kennels, 69% (442 of 641) had been vaccinated and 33% (213 of 641) were insured. Clinical abnormalities were found in 74% of dogs (475 of 641). Common abnormalities involved the musculoskeletal system (43%, 273 of 641), skin (including scars and callouses; 42%, 272 of 641), and oral cavity (including worn and broken teeth; 35%, 227 of 641). Conclusions Our results expand on those from previous surveys and indicate that musculoskeletal illness and injury, and skin trauma are the most commonly seen clinical abnormalities in working farm dogs. These results will provide a baseline for investigation of incidence and risk factors for illness, injury, retirement and death in New Zealand working farm dogs.
Molecular surveillance of antimalarial drug resistance in Democratic Republic of Congo: high variability of chloroquinoresistance and lack of amodiaquinoresistance
Authors: Yobi Doudou Malekita , Kayiba Nadine Kalenda , Mvumbi Dieudonné Makaba , Boreux Raphael , Kabututu Pius Zakayi , Situakibanza Hippolyte Nani-Tuma , Likwela Joris Losimba , De Mol Patrick , Okitolonda Emile Wemakoy , Speybroeck Niko , Mvumbi Georges Lelo , Hayette Marie-Pierre
Published: February 2020

Background The loss of chloroquine (CQ) effectiveness has led to its withdrawal from national policies as first-line treatment for uncomplicated malaria in several endemic countries such as in the Democratic Republic of Congo (DRC). The K76T mutation on the pfcrt gene has been identified as a marker of CQ resistance and the SVMNT haplotype in codons 72–76 on the same gene has been associated with resistance to amodiaquine (AQ). In DRC, the prevalence of K76T has decreased from 100% in 2000 to 63.9% in 2014. The purpose of the study was to determine the prevalence of K76T mutations in P. falciparum circulating strains, sixteen years after CQ withdrawal in DRC and to investigate the presence of SVMNT haplotype. Methods In 2017, ten geographical sites across DRC were selected. Dried blood samples were collected from patients attending health centers. Malaria was first detected by rapid diagnostic test (RDT) available on site (SD Bioline malaria Ag Pf or CareStart Malaria Pf) or thick blood smear and then confirmed by a P. falciparum species-specific real-time PCR assay. A pfcrt gene segment containing a fragment that encodes amino acids at positions 72-76 was amplified by conventional PCR before sequencing. Results A total of 1070 patients were enrolled. Of the 806 PCR-confirmed P. falciparum positive samples, 764 were successfully sequenced. The K76T mutation was detected in 218 (28.5%; 95% CI: 25.4% – 31.9%) samples, mainly (96%) with the CVIET haplotype. The CQ resistance prevalence was unequally distributed across the country ranging from 1.5% in Fungurume to 89.5% in Katana. The SVMNT haplotype, related to AQ resistance, was not detected. Conclusion Overall, the frequency of P. falciparum CQ resistance marker has decreased significantly and no resistance marker to AQ was detected in DRC in 2017. However, the between regions variability of CQ resistance remains high in the country. Further studies are needed for a continuous monitoring of the CQ resistance level for a prospective re-use in malaria management. The absence of AQ resistance is in line with the use of this drug in the current DRC malaria treatment policy.
The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles
Authors: Kubota Rei , Koga Hideyuki , Ozeki Nobutake , Matsuda Junpei , Kohno Yuji , Mizuno Mitsuru , Hisako Hisako , Sekiya Ichiro
Published: February 2020

Background : Meniscal extrusion results in loss of the ability to resist hoop strain and biomechanical overload on the joint articular surface. A centralization technique has been developed to overcome these problems. In this study, we analyzed the biomechanics of the extruded and centralized lateral meniscus (LM) in porcine knee joints at different flexion angles.
Methods : Porcine knee joints (n=8) were set in the universal tester and each knee was tested under the following states: 1) intact; 2) extrusion—meniscal extrusion was created by resecting the posterior root of the LM and posterior synovial capsule; and 3) centralization—centralization was performed by two anchors inserted in the lateral tibial plateau. Deviation distance of the meniscus, contact pressure, and contact area in the anterior LM, middle LM, posterior LM, and the contact pressure of the tibial cartilage were evaluated with an axial compressive force of 200 N at knee flexion angles of 30°, 45°, 60°, and 90°.
Results : The deviation distance of LM significantly increased in extrusion but was restored to the intact status after centralization at all angles. Both the contact pressure and area significantly decreased in extrusion and were restored after centralization close to the intact status in the anterior and middle LM; in the posterior LM, however, decreased contact pressure and area were not restored after centralization. The contact pressure of the tibial cartilage increased significantly in extrusion but decreased close to the intact status after centralization.
Conclusions : This centralization procedure could reduce extrusion of the LM and restore the load-distributing function of the anterior-middle LM. However, the procedure itself could not restore hoop function in cases where the defect lies in the posterior LM.
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