bluuebunny/crossref_metadata_2025 huggingface dataset:
Is NBATS-2 up to the Task? Actual vs. Predicted Patient Volume Shifts With the Addition of Another Trauma Center
Authors: Dooley Jennings H. , Dennis Bradley M. , Magnotti Louis J. , Sharpe John P. , Guillamondegui Oscar D. , Croce Martin A. , Fischer Peter E.
Published: November 2020

Introduction

Version 2 of the Needs-Based Assessment of Trauma Systems (NBATS) tool quantifies the impact of an additional trauma center on a region. This study applies NBATS-2 to a system where an additional trauma center was added to compare the tool’s predictions to actual patient volumes.

Methods

Injury data were collected from the trauma registry of the initial (legacy) center and analyzed geographically using ArcGIS. From 2012 to 2014 (“pre-”period), one Level 1 trauma center existed. From 2016 to 2018 (“post-”period), an additional Level 2 center existed. Emergency medical service (EMS) destination guidelines did not change and favored the legacy center for severely injured patients (Injury Severity Score (ISS) >15). NBATS-2 predicted volume was compared to the actual volume received at the legacy center in the post-period.

Results

4068 patients were identified across 14 counties. In the pre-period, 72% of the population and 90% of injuries were within a 45-minute drive of the legacy trauma center. In the post-period, 75% of the total population and 90% of injuries were within 45 minutes of either trauma center. The post-predicted volume of severely injured patients at the legacy center was 434, but the actual number was 809. For minor injuries (ISS £15), NBATS-2 predicted 581 vs. 1677 actual.

Conclusion

NBATS-2 failed to predict the post-period volume changes. Without a change in EMS destination guidelines, this finding was not surprising for severely injured patients. However, the 288% increase in volume of minor injuries was unexpected. NBATS-2 must be refined to assess the impact of local factors on patient volume.
Use of Artificial Intelligence Deep Learning to Determine the Malignant Potential of Pancreatic Cystic Neoplasms With Preoperative Computed Tomography Imaging
Authors: Watson Michael D. , Lyman William B. , Passeri Michael J. , Murphy Keith J. , Sarantou John P. , Iannitti David A. , Martinie John B. , Vrochides Dionisios , Baker Erin H.
Published: November 2020

Background

Society consensus guidelines are commonly used to guide management of pancreatic cystic neoplasms (PCNs). However, downsides of these guidelines include unnecessary surgery and missed malignancy. The aim of this study was to use computed tomography (CT)-guided deep learning techniques to predict malignancy of PCNs.

Materials and Methods

Patients with PCNs who underwent resection were retrospectively reviewed. Axial images of the mucinous cystic neoplasms were collected and based on final pathology were assigned a binary outcome of advanced neoplasia or benign. Advanced neoplasia was defined as adenocarcinoma or intraductal papillary mucinous neoplasm with high-grade dysplasia. A convolutional neural network (CNN) deep learning model was trained on 66% of images, and this trained model was used to test 33% of images. Predictions from the deep learning model were compared to Fukuoka guidelines.

Results

Twenty-seven patients met the inclusion criteria, with 18 used for training and 9 for model testing. The trained deep learning model correctly predicted 3 of 3 malignant lesions and 5 of 6 benign lesions. Fukuoka guidelines correctly classified 2 of 3 malignant lesions as high risk and 4 of 6 benign lesions as worrisome. Following deep learning model predictions would have avoided 1 missed malignancy and 1 unnecessary operation.

Discussion

In this pilot study, a deep learning model correctly classified 8 of 9 PCNs and performed better than consensus guidelines. Deep learning can be used to predict malignancy of PCNs; however, further model improvements are necessary before clinical use.
Laser Tattoo Removal: A New Tool for Hospital-based Violence Prevention?
Authors: Foran Christopher P. , Clark Damon H. , Alling Torey , Meza Sanchez Irene , Fischer Briah , Henry Reynold , Matsushima Kazuhide , Inaba Kenji , Demetriades Demetrios G.
Published: November 2020

Introduction

Gang-related tattoos may increase an individual’s risk for violent victimization. We present our early experience using a physician-staffed tattoo removal initiative as 1 component of a violence prevention program.

Methods

Surgeons from our trauma department in partnership with a community advocacy group performed voluntary laser tattoo removal for individuals within our catchment area. Clients were asked to complete a voluntary, anonymous survey. This survey addressed tattoo acquisition, identified motives and goals for tattoo removal, and reported if those goals were met by the tattoo removal service. Issues involving gang affiliation and interpersonal violence were specifically queried. Results are listed as simple percentages.

Results

81 of 122 (66%) program enrollees completed the survey. The average number of laser removal sessions at the time of questionnaire was 3 (range 1-15). 41% of respondents possessed gang or “crew” related tattoos. 22% of respondents possessed a tattoo related to an intimate partner who was gang affiliated. 21% of respondents desired tattoo removal for the motive of leaving gang affiliation with 94% of those respondents reporting success. 59% of respondents sought tattoo removal to improve employment opportunities with 81% of those respondents reporting success. 30% of respondents desired tattoo removal to improve personal safety or avoid violence with 80% of those respondents reporting success.

Conclusion

Stated client goals for tattoo removal and their subjective reports of success achieving these goals demonstrate the possible effectiveness of laser tattoo removal as a tool to help clients avoid future violence and progress toward gang disengagement. Trauma departments should consider laser tattoo removal as part of future violence prevention initiatives.
Strategies for General Surgery Training Programs During the COVID-19 Pandemic
Authors: Ragauskas Alyse M. E. , Scott Anthony M. , Christie Dudley B. , Vaughn Danny M. , Christie Amy B. , Ashley Dennis W.
Published: November 2020

The COVID-19 pandemic presented a unique challenge for Medical systems worldwide. Initial response to the crisis situation for the pandemic closely mirrored plans for a mass casualty event. By leveraging resources including human and physical, and by dividing our surgeon workforce into micro teams we were able to create a flexible and responsive infrastructure to address the crisis as it unfolded. By adoption of virtual platforms and equal division of labor, surgical resident education was continued. Specific adjustments to the schedule and curriculum for medical students allowed them to continue their studies safely and on schedule. Our model serves as an example by which hospital systems of similar size may utilize principles of mass casualty preparedness to craft their own plan for a future contagion response strategy.
Measuring Statistics Attitudes at the Student and Instructor Levels: A Multilevel Construct Validity Study of the Survey of Attitudes Toward Statistics
Authors: Xu Chao , Schau Candace
Published: November 2020

Numerous studies have been conducted using the Survey of Attitudes Toward Statistics-36 (SATS-36). Recently, large-scale assessment studies have begun to examine the extent to which students vary in their statistics attitudes across instructors. Yet, empirical evidence linking student responses to the SATS items to instructor-level constructs is still lacking. Using multilevel confirmatory factor analysis, we investigated the factor structure underlying the measure of students’ statistics attitudes at both the student and instructor levels. Results from 13,507 college students taught by 160 introductory statistics instructors support a correlated six-factor model at each level. Additionally, there is evidence for the structural validity of a shared teacher–student attitude impacts construct that may capture meaningful patterns of teaching characteristics and competencies tied to student development of statistics attitudes. These findings provide empirical support for the use of the SATS-36 in studying contextual variables in relation to statistics instructors. Implications for educational practice are discussed.
Fathers’ Perceptions of the Availability of Flexible Working Arrangements: Evidence from the UK
Authors: Cook Rose , O’Brien Margaret , Connolly Sara , Aldrich Matthew , Speight Svetlana
Published: November 2020

A conditional right to request flexible working arrangements (FWAs) has existed for most UK employee parents since 2003. However, there are growing concerns about access, particularly among fathers. Using nationally representative data from the 2015 UK Household Longitudinal Survey, this article examines fathers’ perceptions of the availability of hours reduction, schedule flexibility and working from home. Results show that almost one-third of fathers believe that FWAs that reduce working hours are unavailable to them, compared with one-tenth of mothers. There are no gender differences in perceptions of availability of schedule and location flexibility. Among fathers, those with lower education levels, in lower status occupations, working in the private sector and in workplaces that do not have trade union presence are more likely to believe that FWAs are unavailable. Therefore, even though most employees now have the right to request FWAs, a significant minority of fathers do not perceive FWAs to be available to them.
Periacetabular vascular anatomy in high-riding dysplastic hips: a CT angiographic study
Authors: Demirkale Ismail , Yaradılmış Yüksel Uğur , Uysal Ramadan Selma , Taşkesen Anıl , Ateş Ahmet , Altay Murat
Published: November 2020

Background:

Developmental hip dysplasia (DDH) is shown to have osseous and neural abnormalities but literature is sparse with investigation of vascular structures. Therefore, we aimed to evaluate periacetabular vascular structures.

Methods:

By computerised tomography angiography (CTA), 13 highly dislocated hips of 11 patients’ iliac bone to external iliac and obturatory artery and vein proximities were measured and compared with the same measurements of 20 healthy hips of 12 patients. Numbering from superior to inferior, a total of 7 axial images were created on the 2D CTA coronal images with 1 cm apart, the 4th being at the level of acetabular dome.

Results:

The mean age of the patients was 53 (18–72) years. Dysplastic hips tended to have curved (53%) and healthy hips tended to have straight iliac arteries ( p = 0.037). As compared to healthy hips, external iliac veins were significantly closer to the bone at all levels, but the external iliac arteries were closest at 1st to 4th levels ( p < 0.001) in dysplastic hips. The course of the obturatory arteries was similar in both groups ( p = 0.147).

Conclusions:

The external iliac artery and vein is in close proximity to the iliac bone which dangers acetabular screw, acetabular reaming or retractor placement in highly dislocated hips. The surgeon should be aware of this proximity in operations of these hips to avoid vascular complications.
Modification of Stryker T5TM and Stryker Flyte® Personal Protection Surgical Helmets to Function as Powered Air-Purifying Respirators
Authors: Sachwani-Daswani Gul R. , Atkinson Patrick , Haake Robert S. , Mercer Leo
Published: November 2020

Since the SARS-CoV-2 (COVID-19) outbreak, health-care workers (HCWs) have had to create personal protective equipment (PPE) due to the worldwide demand and thus ensuing shortage. To address the dearth of available PPE, HCWs have quickly explored options to repurpose in-hospital equipment to provide alternative PPE to caregivers. We report the modification of a Stryker T5TM and Stryker Flyte® personal protection surgical helmets as a powered air-purifying respirator.
Substance use identification and follow-up rates among commercial and Medicare health insurance members in primary care and other settings
Authors: Baker John G. , Doxbeck David R. , Washington Melanie E. , Horton Angela , Dunning Adam
Published: November 2020

Background

The objective of this study was to investigate factors associated with substance use disorder identification and follow-up rates among samples of members of a private health insurance plan.

Methods

In an observational study, samples of claims data for 2017 for Commercial and Medicare members from a private health insurer were accessed and analyzed using descriptive statistics, decision tree analysis, and linear regression models.

Results

Commercial and Medicare members differed in age. Medicare members had higher rates of inclusion in a measure of substance use disorder than Commercial members, lower rates of initial short term follow-up, more opioid prescriptions from primary care provides, fewer prescriptions for opioid treatment, and higher rates of selected comorbid conditions. Mental health diagnoses and substance use disorder co-occurred frequently and to a greater extent in the Medicare sample. Among commercial members, there were primarily alcohol problems that increased with age, while opioid problems at about 10% peaked in the mid-twenties. More males were included among all substance types. The overall rate for an initial short term follow-up visit indicating initiation of treatment was 30%. There were large differences in the follow-up rates across settings with a very low rate (4.6% for alcohol and 6.9% for opioid) in primary care settings.

Conclusions

These results suggest that increased attention in primary care to young adult males and to older adults, may help to reduce substance use disorder rates, especially alcohol use disorders.
Health impact of providing informal care in Portugal
Authors: Barbosa Fátima , Voss Gina , Delerue Matos Alice
Published: November 2020

Background

Middle-aged and older adults play an important role in the provision of informal support, however, the impact on the health of those individuals who provide informal care is unclear. The main objectives of this study are: (1) to assess the prevalence of co-residential caregiving provided by individuals aged 50+; (2) to analyze differences between the group of Portuguese co-residential caregivers and the group of Portuguese non-caregivers; (3) to examine the longitudinal effect of providing informal care on the health of co-residential informal caregivers in Portugal.

Methods

Data from wave 4 and wave 6 of the Survey of Health Ageing and Retirement in Europe (SHARE) were used. A linear mixed model and a generalized mixed model were used to analyze the longitudinal effect of providing informal care on the health (physical health and depressive symptoms) of Portuguese individuals aged 50 + .

Results

In both SHARE waves analyzed, Portugal had the highest percentage of co-residential caregivers aged 50+. At baseline, the Portuguese co-residential caregiver population, compared to non-caregivers, has a lower percentage of employed individuals (14.9% compared to 25.7%) and a higher percentage of individuals with four or more depressive symptoms (56.4% compared to 35.5%). The caregivers also have a lower quality of life (CASP-12) (30.93 compared to 32.59). Marginal differences in educational levels between the caregiver and non-caregiver groups were also found, with co-residential caregivers having lower levels of education (72.3% have ISCED 0–2 compared to 64.7%), lower levels of cognitive function (− 2.321 compared to − 1.784), lower levels of physical health (− 0.180 compared to − 0.076) and lower engagement in moderate or vigorous physical activity (14.9% compared to 21.5%). Longitudinal models reveal that providing care within the household is not associated with physical health (b = 0.048; se = 0.035;p = 0.167), butisassociated with depressive symptoms (OR = 1.609; 95% CI = 1.141–2.271;p = < 0.010).

Conclusions

Portugal has the highest percentage of co-residential caregivers aged 50+. In that country, providing informal care to a household member is associated with depressive symptoms. Portuguese policymakers should therefore promote programs to prevent and alleviate the depressive symptoms experienced by individuals aged 50+, who provide co-residential care.
The Haiti cardiovascular disease cohort: study protocol for a population-based longitudinal cohort
Authors: Lookens Jean , Tymejczyk Olga , Rouzier Vanessa , Smith Caleigh , Preval Fabyola , Joseph Inddy , Baptiste Raynold Jean , Victor Joscar , Severe Patrice , Apollon Sandra , Dumont Emelyne , Forestal Guyrlaine , St. Preux Stephano , Rivera Vanessa , Seo Grace , Charles Benedict , Ariste Wilson , Kingery Justin , Devieux Jessy , Koenig Serena , Nash Denis , Fitzgerald Daniel , Safford Monika , Deschamps Marie Marcelle , Pape Jean , McNairy Margaret
Published: November 2020

Background

Cardiovascular disease (CVD) is the leading cause of mortality among Haitians, having surpassed HIV in the last decade. Understanding the natural history of CVD in Haitians, including the age of onset, prevalence, incidence, and role of major risk factors and social determinants, is urgently needed to develop prevention and treatment interventions.

Aim 1: Establish a population-based cohort of 3000 adults from Port-au-Prince and assess the prevalence of CVD risk factors and diseases and their association with social and environmental determinants.

Aim 2: Determine the incidence of CVD risk factors and CVD during 2–3.5 years of follow-up and their association with social and environmental determinants.

Methods

The Haiti CVD Cohort is a longitudinal observational study of 3000 adults> 18 years in Port-au-Prince (PAP), Haiti. The study population is recruited using multistage random sampling from census blocks. Adults receive blood pressure (BP) measurements in the community and those with elevated BP are referred to the Groupe Haitien d’Etude Sarcome de Kaposi et des Infections Opportunistes Clinic for care. After informed consent, participants undergo a clinical exam with medical history. BP, electrocardiogram, echocardiogram, a study questionnaire on health behaviors, and laboratory specimens. Every 6 months, BP is remeasured. At 12 and 24 months, clinical exams and questionnaires are repeated. Labs are repeated at 24 months. Adjudicated study outcomes include the prevalence and incidence of CVD risk factors (hypertension, diabetes, obesity, dyslipidemia, kidney disease, inflammation, poor diet, smoking, and physical inactivity) and events (myocardial infarction, heart failure, stroke, and CVD mortality). We also measure social determinants including poverty. Depression, stress, social isolation, food insecurity, and lead exposure. Blood, urine, and stool samples are biobanked at study enrollment.

Discussion

The Haiti CVD Cohort is the largest population-based cohort study evaluating CVD risk factors and CVD among adults in urban Haiti with the goal of understanding the drivers of the CVD epidemic in Haiti. Study outcomes are comparable with existing international cohorts, and the biobank will provide important data for future research. Our goal is to translate findings from this study into pragmatic prevention and treatment interventions to fight the CVD epidemic in Haiti.
Bacteria and sputum inflammatory cell counts; a COPD cohort analysis
Authors: Beech Augusta S. , Lea Simon , Kolsum Umme , Wang Zhang , Miller Bruce E. , Donaldson Gavin C. , Wedzicha Jadwiga A. , Brightling Christopher E. , Singh Dave
Published: November 2020

Background

There is evidence that bacterial colonisation in chronic obstructive pulmonary disease (COPD) is associated with increased neutrophilic airway inflammation. This study tested the hypothesis that different bacterial phyla and species cause different inflammatory profiles in COPD patients.

Methods

Sputum was analysed by quantitative polymerase chain reaction (qPCR) to quantify bacterial load and 16S rRNA gene sequencing to identify taxonomic composition. Sputum differential cell counts (DCC) and blood DCC were obtained at baseline and 6 months. Patients were categorised into five groups based on bacterial load defined by genome copies/ml of ≥ 1 × 104, no colonisation and colonisation by Haemophilus influenzae (H. influenzae), Moraxella catarrhalis (M. catarrhalis), Streptococcus pneumoniae (S. pneumoniae), or > 1 potentially pathogenic microorganism (PPM).

Results

We observed an increase in sputum neutrophil (%), blood neutrophil (%) and neutrophil–lymphocyte ratio (NLR) in patients colonised with H. influenzae (82.6, 67.1, and 3.29 respectively) compared to those without PPM colonisation at baseline (69.5, 63.51 and 2.56 respectively) (p < 0.05 for all analyses), with similar findings at 6 months. The bacterial load of H. influenzae and Haemophilus determined by qPCR and 16s rRNA gene sequencing respectively, and sputum neutrophil % were positively correlated between baseline and 6 months visits (p < 0.0001, 0.0150 and 0.0002 with r = 0.53, 0.33 and 0.44 respectively).

Conclusions

These results demonstrate a subgroup of COPD patients with persistent H. influenzae colonisation that is associated with increased airway and systemic neutrophilic airway inflammation, and less eosinophilic airway inflammation.
Characterization and validation of long noncoding RNAs as new candidates in prostate cancer
Authors: Ge Shengyang , Mi Yuanyuan , Zhao Xiaojun , Hu Qingfeng , Guo Yijun , Zhong Fan , Zhang Yang , Xia Guowei , Sun Chuanyu
Published: November 2020

Background

Long noncoding RNAs (lncRNAs) have been proved to be an important regulator in gene expression. In almost all kinds of cancers, lncRNAs participated in the process of pathogenesis, invasion, and metastasis. Meanwhile, compared with the large amounts of patients, there is rare knowledge about the role of lncRNAs in prostate cancer (PCa).

Material/Method

In this study, lncRNA expression profiles of prostate cancer were detected by Agilent microarray chip, 5 pairs of case and control specimens were involved in. Differentially expressed lncRNAs were screened out by volcano plot for constructing lncRNA-miRNA-mRNA central network. Then, the top ten up-regulated and down-regulated lncRNAs were validated by qRT-PCR in another 5 tumor specimens and 7 para-cancerous/benign contrasts. Furthermore, we searched for the survival curve of the top 10 upregulated and downregulated lncRNAs.

Results

A total of 817 differentially expressed lncRNAs were filtered out by the criteria of fold change (FC) and t-test p < 0.05. Among them, 422 were upregulated, whereas 395 were downregulated in PCa tissues. Gene ontology and KEGG pathway analyses showed that many lncRNAs were implicated in carcinogenesis. lnc-MYL2-4:1 (FC = 0.00141, p = 0.01909) and NR_125857 (FC = 59.27658, p = 0.00128) had the highest magnitude of change. The subsequent qPCR confirmed the expression of NR_125857 was in accordance with the clinical samples. High expression of PCA3, PCAT14 and AP001610.9 led to high hazard ratio while low expression of RP11-279F6.2 led to high hazard ratio.

Conclusions

Our study detected a relatively novel complicated map of lncRNAs in PCa, which may have the potential to investigate for diagnosis, treatment and follow-up in PCa. Our study revealed the expression of NR_125857 in human PCa tissues was most up-regulated. Further studies are needed to investigate to figure out the mechanisms in PCa.
Right ventricular failure in septic shock: characterization, incidence and impact on fluid responsiveness
Authors: Vieillard-Baron Antoine , Prigent Amélie , Repessé Xavier , Goudelin Marine , Prat Gwenaël , Evrard Bruno , Charron Cyril , Vignon Philippe , Geri Guillaume
Published: November 2020

Objective

Incidence of right ventricular (RV) failure in septic shock patients is not well known, and tricuspid annular plane systolic excursion (TAPSE) could be of limited value. We report the incidence of RV failure in patients with septic shock, its potential impact on the response to fluids, as well as TAPSE values.

Design

Ancillary study of the HEMOPRED prospective multicenter study includes patients under mechanical ventilation with circulatory failure.

Setting

This is a multicenter intensive care unit study

Patients

Two hundred and eighty-two patients with septic shock were analyzed. Patients were classified in three groups based on central venous pressure (CVP) and RV size (RV/LV end-diastolic area, EDA). In group 1, patients had no RV dilatation (RV/LVEDA < 0.6). In group 2, patients had RV dilatation (RV/LVEDA ≥ 0.6) with a CVP < 8 mmHg (no venous congestion). RV failure was defined in group 3 by RV dilatation and a CVP ≥ 8 mmHg. Pulse pressure variation (PPV) was systematically recorded.

Interventions

None.

Measurements and main results

In total, 41% of patients were in group 1, 17% in group 2 and 42% in group 3. A correlation between RV size and CVP was only observed in group 3. Higher RV size was associated with a lower response to passive leg raising for a given PPV. A large overlap of TAPSE values was observed between the 3 groups. 63.5% of patients with RV failure had a normal TAPSE.

Conclusions

RV failure, defined by critical care echocardiography (RV dilatation) and a surrogate of venous congestion (CVP ≥ 8 mmHg), was frequently observed in septic shock patients and negatively associated with response to a fluid challenge despite significant PPV. TAPSE was unable to discriminate patients with or without RV failure.
Müllerian duct anomalies with term pregnancy: a case report
Authors: Engku-Husna Engku Ismail , Nik-Ahmad-Zuky Nik Lah , Muhammad-Nashriq Kadir
Published: November 2020

Background

Müllerian duct anomaly is a rare condition. Many cases remain unidentified, especially if asymptomatic. Thus, it is difficult to determine the actual incidence. Müllerian duct anomaly is associated with a wide range of gynecological and obstetric complications, namely infertility, endometriosis, urinary tract anomalies, and preterm delivery. Furthermore, congenital anomalies in pregnant mothers have a high risk of being genetically transmitted to their offspring.

Case presentation

We report a case of a patient with unsuspected müllerian duct anomaly in a term pregnancy. A 33-year-old Malay woman with previously uninvestigated involuntary primary infertility for 4 years presented with acute right pyelonephritis in labor at 38 weeks of gestation. She has had multiple congenital anomalies since birth and had undergone numerous surgeries during childhood. Her range of congenital defects included hydrocephalus, for which she was put on a ventriculoperitoneal shunt; imperforated anus; and tracheoesophageal fistula with a history of multiples surgeries. In addition, she had a shorter right lower limb length with limping gait. Her physical examination revealed a transverse scar at the right hypochondrium and multiple scars at the posterior thoracic region, levels T10–T12. Abdominal palpation revealed a term size uterus that was deviated to the left, with a singleton fetus in a nonengaged cephalic presentation. The cervical os was closed, but stricture bands were present on the vagina from the upper third until the fornices posteriorly. She also had multiple rectal prolapses and strictures over the rectum due to previous anorectoplasty. An emergency cesarean delivery was performed in view of the history of anorectoplasty, vaginal stricture, and infertility. Intraoperative findings showed a left unicornuate uterus with a communicating right rudimentary horn.

Conclusion

Most cases of müllerian duct anomaly remain undiagnosed due to the lack of clinical suspicion and the absence of pathognomonic clinical and radiological characteristics. Because it is associated with a wide range of gynecological and obstetric complications, it is vital for healthcare providers to be aware of its existence and the role of antenatal radiological investigations in its diagnosis. The presence of multiple congenital abnormalities and a history of infertility in a pregnant woman should warrant the exclusion of müllerian duct anomalies from the beginning. Early detection of müllerian duct anomalies can facilitate an appropriate delivery plan and improve the general obstetric outcome.
Paravertebral compartment syndrome after exercise: a case report
Authors: Ogoshi Tomofumi , Yoshimiya Motoo , Ichibakase Hiroshi , Kimura Takayoshi , Kameoka Masafumi , Yoshioka Hayato , Ueda Takahiro , Homma Masato , Enokida Shinpei
Published: November 2020

Background

Paravertebral compartment syndrome occurring without trauma is quite rare. We report a case of compartment syndrome that occurred after spinal exercises.

Case presentation

A 23-year-old Japanese rower developed severe back pain and was unable to move 1 day after performing exercises for the spinal muscles. Initial evaluation at a nearby hospital revealed hematuria and elevated creatine phosphokinase levels. He was transferred to our hospital, where magnetic resonance imaging revealed no hematoma but confirmed edema in the paravertebral muscles. The compartment pressure measurements were elevated bilaterally. Despite his pain being severe, his creatine phosphokinase levels were expected to peak and decline; his urine output was normal; and surgery was undesirable. Therefore, we opted for conservative management. The next day, the patient’s compartment pressure diminished, and his pain levels decreased to 2/10. After 5 days, he was able to walk without medication.

Conclusions

We present a rare case of compartment syndrome of the paravertebral muscles with good resolution following conservative management. We hope our case findings will help avoid unnecessary surgery in cases of paravertebral compartment syndrome.
Diversity of pathogenic Pseudomonas isolated from citrus in Tunisia
Authors: Oueslati Maroua , Mulet Magdalena , Zouaoui Mohamed , Chandeysson Charlotte , Lalucat Jorge , Hajlaoui Mohamed Rabeh , Berge Odile , García-Valdés Elena , Sadfi-Zouaoui Najla
Published: November 2020

The damages observed in Tunisian citrus orchards have prompted studies on thePseudomonasspp.responsible for blast and black pit. Prospective orchards between 2015 and 2017 showed that the diseases rapidly spread geographically and to new cultivars. A screening ofPseudomonasspp. isolated from symptomatic trees revealed their wide diversity according to phylogenetic analysis of their housekeepingrpoDandctsgenes. The majority of strains were affiliated toPseudomonas syringaepv.syringae(Phylogroup PG02b), previously described in Tunisia. However, they exhibited various BOX-PCR fingerprints and were not clonal. This work demonstrated, for the first time in Tunisia, the involvement ofPseudomonas cerasi(PG02a) andPseudomonas congelans(PG02c). The latter did not show significant pathogenicity on citrus, but was pathogenic on cantaloupe and active for ice nucleation that could play a role in the disease. A comparative phylogenetic study of citrus pathogens from Iran, Montenegro and Tunisia revealed thatP. syringae(PG02b) strains are closely related but again not clonal. InterestinglyP. cerasi(PG02a) was isolated in two countries and seems to outspread. However, its role in the diseases is not fully understood and it should be monitored in future studies. The diversity of pathogenicPseudomonasspp. and the extension of the diseases highlight that they have become complex and synergistic. It opens questions about which factors favor diseases and how to fight against them efficiently and with sustainable means.
TV2++: a novel spatial-temporal total variation for super resolution with exponential-type norm
Authors: Deng Lizhen , Zhou Zhetao , Xu Guoxia , Zhu Hu , Bao Bing-Kun
Published: November 2020

Recently, many super-resolution algorithms have been proposed to recover high-resolution images to improve visualization and help better analyze images. Among them, total variation regularization (TV) methods have been proven to have a good effect in retaining image edge information. However, these TV methods do not consider the temporal correlation between images. Our algorithm designs a new TV regularization (TV2++) to take advantage of the time dimension information of the images, further improving the utilization of useful information in the images. In addition, the union of global low rank regularization and TV regularization further enhances the image super-resolution recovery. And we extend the exponential-type penalty (ETP) function on singular values of a matrix to enhance low-rank matrix recovery. A novel image super-resolution algorithm based on the ETP norm and TV2++ regularization is proposed. And the alternating direction method of multipliers (ADMM) is applied to solve the optimization problems effectively. Numerous experimental results prove that the proposed algorithm is superior to other algorithms.
Transitioning to a sustainable development framework for bioenergy in Malaysia: policy suggestions to catalyse the utilisation of palm oil mill residues
Authors: Salleh Siti Fatihah , Mohd Roslan Mohd Eqwan , Abd Rahman Adlansyah , Shamsuddin Abdul Halim , Tuan Abdullah Tuan Ab Rashid , Sovacool Benjamin K.
Published: November 2020

Background

The global commitment to climate change mitigation enforces the worldwide development of renewable energy sources. Therefore, various studies have investigated the growth of renewable energy in Malaysia, most commonly based on biogas and hydropower. In this article, the dynamics of Malaysia’s renewable energy development is critically examined by using the latest official national reports and other reliable resources.

Results

The study reveals the influencing factors that shape renewable energy growth in a developing country endowed with substantial biomass resources, such as Malaysia. Likewise, it evaluates the evolution of renewable energy in the electricity sector. In 2017, renewable energy represented about 3.5% of the Malaysian electricity generation mix with 1122 MW of installed capacity. A closer look into the renewable energy resources, i.e. biomass, biogas, solar and small hydro power, revealed that over 47% of the grid-connected power generation came from solar photovoltaic (PV) energy. While solar PV capacity continues to accelerate, the development of other renewable resources, especially biomass, is seeing growth at a significantly slower pace. This article investigates the underlying causes of the skewed development rate as well as the potential strategies that may be adopted to promote a diversification of renewable energy resources. In light of this, introduction of a new national bioenergy policy is proposed, through which four essential programmes could be implemented: (i) enhanced bioenergy conversion efficiency and waste management, (ii) biomass co-firing in coal power plants, (iii) conversion of biogas to biomethane and bio-compressed natural gas (bio-CNG), (iv) large-scale biomass power plants. A total of 4487 MW of additional power could be connected to the grid upon successful implementation of a large-scale biomass power plant programme.

Conclusions

The establishment of a comprehensive and inclusive national bioenergy policy will lead towards a sustainable future of renewable energy development in Malaysia.
The changing epidemiology of dog bite injuries in the United States, 2005–2018
Authors: Tuckel Peter S. , Milczarski William
Published: November 2020

Background

In 2018, the most recent year for which data are available, dog bites ranked as the 13th leading cause of nonfatal emergency department visits in the United States. As dog ownership spirals upwards in the United States, it is important to continue to monitor the epidemiology of dog bite injuries. This study provides contemporary data on the incidence of dog bites injuries in the United States and in New York and profiles individuals who have been treated for dog bites in emergency departments. The study also examines the demographic correlates of the rate of injuries at the neighborhood level in New York City and maps the rate in each neighborhood.

Methods

At the national level, the study examines longitudinal data on dog bite injuries from 2005 to 2018 gathered by the Centers for Disease Control and Prevention. For New York, the study analyzes data for 2005–2018 collected by the New York State Department of Health. A negative binomial regression analysis was performed on the state data to measure the simultaneous effects of demographic variables on the incidence of dog-related injuries. A thematically shaded map of the rate of dog bite injuries in New York City’s neighborhoods was created to identify neighborhoods with higher-than-average concentration of injuries.

Results

In both the United States and New York the rate of dog-bite injuries increased from 2005 to 2011 and then underwent a significant decline. Injuries due to dog bites, however, still remain a sizable public health problem. Injuries are more prevalent among school-age children, inhabitants of less-densely populated areas, and residents of poorer neighborhoods. In New York City, poorer neighborhoods are also associated with fewer dogs being spayed or neutered.

Conclusions

To reduce the rate of dog bite injuries, prevention programs – particularly those which center on teaching the dangers of canine interactions with humans – should be targeted at children. Dog bite injuries tend to be clustered in identifiable neighborhoods. Dog bite prevention programs and stricter enforcement of dog laws can target these neighborhoods.
Direct conversion of human fibroblasts into dopaminergic neuron-like cells using small molecules and protein factors
Authors: Qin Hua , Zhao An-Dong , Sun Meng-Li , Ma Kui , Fu Xiao-Bing
Published: November 2020

Background

Generation of neurons is essential in cell replacement therapy for neurodegenerative disorders like Parkinson’s disease. Several studies have reported the generation of dopaminergic (DA) neurons from mouse and human fibroblasts by ectopic expression of transcription factors, in which genetic manipulation is associated with potential risks.

Methods

The small molecules and protein factors were selected based on their function to directly induce human fetal lung IMR-90 fibroblasts into DA neuron-like cells. Microscopical, immunocytochemical, and RT-qPCR analyses were used to characterize the morphology, phenotype, and gene expression features of the induced cells. The whole-cell patch-clamp recordings were exploited to measure the electrophysiological properties.

Results

Human IMR-90 fibroblasts were rapidly converted into DA neuron-like cells after the chemical induction using small molecules and protein factors, with a yield of approximately 95% positive TUJ1-positive cells. The induced DA neuron-like cells were immunopositive for pan-neuronal markers MAP2, NEUN, and Synapsin 1 and DA markers TH, DDC, DAT, and NURR1. The chemical induction process did not involve a neural progenitor/stem cell intermediate stage. The induced neurons could fire single action potentials, which reflected partially the electrophysiological properties of neurons.

Conclusion

We developed a chemical cocktail of small molecules and protein factors to convert human fibroblasts into DA neuron-like cells without passing through a neural progenitor/stem cell intermediate stage. The induced DA neuron-like cells from human fibroblasts might provide a cellular source for cell-based therapy of Parkinson’s disease in the future.
Intensive blood pressure lowering: a practical review
Authors: Camafort Miguel , Redón Josep , Pyun Wook Bum , Coca Antonio
Published: November 2020

According to the last Hypertension guideline recommendations, it may be concluded that intensive BP lowering is only advisable in a subgroup of patients where there is a clear net benefit of targeting to lower BP goals. However, taking into account the relevance of correct BP measurement, estimates of the benefits versus the harm should be based on reliable office BP measurements and home BP measurements.

There is still debate about which BP goals are optimal in reducing morbidity and mortality in uncomplicated hypertensives and in those with associated comorbidities. In recent years, trials and meta-analyses have assessed intensive BP lowering, with some success. However, a careful examination of the results shows that current data are not easily applicable to the general hypertensive population.

This article reviews the evidence on and controversies about intensive BP lowering in general and in specific clinical situations, and the importance of obtaining reliable BP readings in patients with hypertension and comorbidities.
The abundance of a transfer RNA-derived RNA fragment small RNA subpopulation is enriched in cauda spermatozoa
Authors: Stanger Simone J. , Bernstein Ilana R. , Anderson Amanda L. , Hutcheon Kate , Dun Matthew D. , Eamens Andrew L. , Nixon Brett
Published: November 2020

The small RNA (sRNA) landscape of mammalian spermatozoa is considerably altered as these gametic cells migrate through the segment specific microenvironments of the epididymis. More specifically, the microRNA (miRNA) species of sRNA dominates the sRNA landscape of spermatozoa of the proximal caput segment of the epididymis. However, in sperm cells sourced from the distal cauda epididymal segment, the transfer RNA (tRNA)-derived RNA fragment (tRF) sRNA species is the most abundant. Here we show that the 5′ halves of fifteen mature tRNAs were used as processing substrates for the production of a specific subpopulation of tRF sRNAs, 30 to 33 nucleotides (30–33-nt) in length. A quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) approach was used to experimentally validate the sRNA sequencing identified trend of enriched abundance of this specific 30–33-nt tRF subpopulation in cauda spermatozoa. The length, and exclusive alignment of the cauda spermatozoa enriched tRF subpopulation to the 5′ half of each processed tRNA precursor, identified ANGIOGENIN (ANG) as the endonuclease likely responsible for tRF production in the mouse epididymis: a prediction confirmed via immunoblotting assessment of ANG abundance in spermatozoa sourced from the caput, corpus and cauda epididymal segments. When taken together with our previous profiling of miRNA and Piwi-interacting RNA (piRNA) sRNA abundance in spermatozoa sourced from the three segments of physiologically normal mouse epididymides, the tRF profile reported here adds greater depth of coverage to the global sRNA landscape of the mouse epididymis; a roadmap constructed to assist with the future molecular characterization of sRNA-directed responses to a wide range of imposed environmental stressors.
Fabrication and characterization of sterically stabilized liposomes of topotecan
Authors: Patel Dasharath , Patel Niteshkumar
Published: November 2020

Background

Recently, the development of drug delivery which delivers controlled drug release at the tumor sites emerged as an attractive option for enhancing anticancer therapeutics. Next-generation nanotherapeutics must not contain only the nanoscale but should find their way to the solid tumor via active or passive targeting. Surface modification by pegylated lipids is one of the approaches used to made liposomes long-circulating and passively target the tumor. Pegylation of liposomes help them to alter the pharmacokinetics of drug molecule in vivo. The successful journey of such a complex drug delivery system from bench to clinic requires in-depth understanding and characterization. In this research, we fabricated and characterized sterically stabilized liposomes of topotecan which meets the clinical need. Liposomes have been prepared using ethanol injection-solvent evaporation method followed by extrusion for size reduction. Outer medium was replaced with an isotonic sucrose solution using dialysis followed by drug loading. We characterized liposomes’ membrane phase and dynamics, drug and lipid quantification, size distribution, state of encapsulated drug, internal volume and internal pH of liposomes, presence, and thickness of grafted PEG on the liposomes surface, and in vitro leakage test.

Results

All these studied parameters directly or indirectly provide information regarding the pharmacokinetic behavior of the formulation and the tumor-targeting property of the drugs in vivo. We encapsulated the topotecan in nanoliposomes with pegylation on the surface resulting in long-circulating stealth liposomes. Nanoliposomes remotely loaded with topotecan by transmembrane gradient method.

Conclusion

Our in vitro characterization of topotecan liposomes provides an explanation for the good therapeutic efficacy of tumor cells.
Multiple strictures of the small intestine demanding surgical intervention as a rare consequence of graft versus host disease – case report
Authors: Sobkowiak-Sobierajska Agnieszka , Błaszczyński Michał , Mańkowski Przemysław , Wachowiak Jacek
Published: November 2020

Background

Intestinal strictures are an extremely rare and life-threating complication in patients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT). We describe the case of a child operated for multiple strictures of the small intestine secondary to GvHD.

Case presentation

A 7-year-old girl underwent second allo-HSCT from matched unrelated donor for post-CALR-positive-ET myelofibrosis and its relapse after the first HSCT. HSCT was complicated with grade IV acute GvHD (skin and gut). The patient was treated with CsA, with methylprednisolone, and due to corticosteroid resistance subsequently with etanercept and ECP. She required parenteral nutrition due to malabsorption symptoms and anorexia for 15 months after HSCT. On day + 457, the laparotomy was performed due to increasing symptoms of mechanical bowel obstruction. Ten critical cicatricial strictures of the small intestine were revealed. Nine segmental resections of the strictured segments and 6 intestinal anastomoses were done during one surgical procedure. The postoperative period was uncomplicated, and oral feeding was gradually implemented, achieving full coverage. Pathological examination confirmed the diagnosis of overlap syndrome of acute and chronic GvHD. Therefore, the patient started therapy with ruxolitinib which was continued till 30 months after HSCT. Corticosteroids were gradually withdrawn on day + 574. Currently, 32 months after the second HSCT, no GvHD and no gastrointestinal disturbances are observed. The patient remains in hematological and molecular remission of myelofibrosis.

Conclusions

GvHD therapy is largely based on conservative treatment, but a patient presenting with occlusive symptoms due to permanent changes in the gastrointestinal wall needs to undergo surgery to ensure its efficient functioning.