bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Isolated Zygomatic Arch Fractures and a Review of External Fixation Techniques
Authors: Cohn Jason E. , Othman Sammy , Bosco Samuel , Shokri Tom , Evarts Marissa , Papajohn Paul , Zwillenberg Seth
Published: March 2020

Introduction:

Fractures of the zygomatic bone can present with complicated aesthetic and neurological pathology. Specifically, management of isolated zygomatic fracture has been sparsely discussed in the literature, and most studies are based upon older techniques. Here, we compare the results of 2 critical operative techniques as well as review the available literature in the setting of isolated zygomatic fractures.

Methods:

A retrospective chart review was performed at our institution from 2010 to 2018 examining for patients who had sustained an isolated zygomatic fracture confirmed by computed tomography scan. Patients were excluded if they sustained additional maxillofacial fractures. Demographical information, symptoms on presentation, fracture management modality, and postoperative course were all collected and examined.

Results:

A total of 218 patients were identified for inclusion. The average age of this cohort was 45.5 ± 18 years, with 77.5% being male. Assault (55%) was most the frequent cause of injury with accidents being the least common (17.9%). Most patients (78.8%) underwent nonoperative management. Patients who underwent operation more often presented with zygomatic deformity (97.7% vs 18.4%), paresthesia (29.5% vs 2.9%), and trismus (29.5% vs 6.9%) when compared to their nonoperatively managed counterparts. In all, 44 operatively managed patients underwent open reduction with or without eternal fixation (Gillies Approach vs Keen Approach). There were no significant differences in the presence of zygomatic deformity, paresthesia, and trismus between the 2 operative techniques.

Conclusions:

Isolated zygomatic arch fractures can present with discerning symptoms. Unfortunately, the literature on appropriate management is not well described. We find external fixation to provide reestablishment of both form and function with minimal required exposure, although the outcomes may be similar without the use of external fixation.
The Long-Lasting Effects of “Placebo Injections” in Knee Osteoarthritis: A Meta-Analysis
Authors: Previtali Davide , Merli Giulia , Di Laura Frattura Giorgio , Candrian Christian , Zaffagnini Stefano , Filardo Giuseppe
Published: March 2020

Objectives

To quantify the placebo effect of intraarticular injections for knee osteoarthritis in terms of pain, function, and objective outcomes. Factors influencing placebo effect were investigated.

Design

Meta-analysis of randomized controlled trials; Level of evidence, 2. PubMed, Web of Science, Cochrane Library, and grey literature databases were searched on January 8, 2020, using the string: (knee) AND (osteoarthritis OR OA) AND (injections OR intra-articular) AND (saline OR placebo). The following inclusion criteria were used: double-blind, randomized controlled trials on knee osteoarthritis, including a placebo arm on saline injections. The primary outcome was pain variation. Risk of bias was assessed using the RoB 2.0 tool, and quality of evidence was graded following the GRADE (Grading of Recommendations Assessment, Development and Evaluation) guidelines.

Results

Out of 2,363 records, 50 articles on 4,076 patients were included. The meta-analysis showed significant improvements up to the 6-month follow-up: Visual Analogue Scale (VAS)-pain −13.4 mean difference (MD) (95% confidence interval [CI]: −21.7/−5.1; P < 0.001), Western Ontario and McMaster Osteoarthritis Index (WOMAC)-pain −3.3 MD (95% CI: −3.9/−2.7; P < 0.001). Other significant improvements were WOMAC-stiffness −1.1 MD (95% CI: −1.6/−0.6; P < 0.001), WOMAC-function −10.1 MD (95% CI: −12.2/−8.0; P < 0.001), and Evaluator Global Assessment −21.4 MD (95% CI: −29.2/−13.6; P < 0.001). The responder rate was 52% (95% CI: 40% to 63%). Improvements were greater than the “minimal clinically important difference” for all outcomes (except 6-month VAS-pain). The level of evidence was moderate for almost all outcomes.

Conclusions

The placebo effect of knee injections is significant, with functional improvements lasting even longer than those reported for pain perception. The high, long-lasting, and heterogeneous effects on the scales commonly used in clinical trials further highlight that the impact of placebo should not be overlooked in the research on and management of knee osteoarthritis.
Low-intensity regimens versus standard-intensity induction strategies in acute myeloid leukemia
Authors: Vey Norbert
Published: March 2020

Treatment options for elderly patients with acute myeloid leukemia (AML) remain limited. In this age group, AML is frequently associated with poor-risk features, while patients’ present comorbidities and reduced functional reserves. As such, intensive chemotherapy (ICT) is frequently too toxic or ineffective in elderly patients and is restricted to a select minority, though it is standard therapy for the youngest and fittest patients or for those belonging to either the favorable or intermediate-risk groups. The use of hypomethylating agents represent an effective alternative for patients who are unfit for ICT, yet the results remain unsatisfactory. In recent years, prognostic scores were developed that include geriatric assessment tools and improved risk-stratification. In addition, several effective new drugs have emerged. The combination of these drugs with hypomethylating agents or low-dose cytarabine has produced encouraging preliminary results that may change standard practices and offer an alternative to the dilemma of ICT versus low-intensity therapies.
Instagram as a tool for study engagement and community building among adolescents: A social media pilot study
Authors: Thomas Veronica L , Chavez Marisol , Browne Erica N , Minnis Alexandra M
Published: March 2020

Objective

Social media has been recognized as a promising tool for delivering health interventions and facilitating study recruitment. However, research is needed to understand how social media might be used to enhance the experiences of adolescent participants in ongoing studies. In a prospective cohort study addressing social and structural influences on health trajectories among 599 adolescents in a California agricultural community, we evaluated the effectiveness of and engagement with a human-centered, Instagram-based outreach campaign, with a focus on study retention, enhancement of participants’ experiences, and increasing community awareness of the study.

Methods

We adopted a youth-centered approach to design a three-month pilot study, which included participatory design sessions, a geo-targeted Instagram campaign, and in-person events at schools. We conducted pre-/post-pilot surveys with study participants, analyzed social media metrics, and collected process measures, such as study visit show rates.

Results

After three months, the study Instagram account had 209 followers and 806 total engagements. Survey responses showed little change in study participants’ attitudes about the study; most survey respondents agreed that the study is very important for the community (54% pre-pilot and 52% post-pilot). However, the study’s Instagram account appeared to influence study participation, with 43% of post-pilot respondents who use Instagram ( n=65 of 153) indicating that the Instagram account influenced their decision to continue coming to study visits.

Conclusion

Despite little change in the participants’ attitudes about the study, the findings of this pilot study suggest that Instagram is a promising tool to support engagement of adolescent participants in ongoing research, particularly if the content is designed with adolescents as partners. In addition to assessing the effectiveness of an Instagram outreach campaign to support retention, this paper also presents suggestions and insights for creating similar social media interventions targeting youth.
Religion, nationalism, and gender: Perspective from South Asia
Authors: Deo Nandini
Published: March 2020

Religious mobilization often takes the form of engagement with “the woman question”: how should women as carriers of culture comport themselves? This article shows that many of the debates over the role of women and religion in South Asia are misunderstood when they are seen as instances of religious fundamentalism. Rather, the theoretical framework to make sense of public religion and gender debates should be through the lens of postcolonial nationalism. The creation and consolidation of the nation is what is at stake—not the creation of the religious community as such. In order to make this argument, the article offers both a review of the literature on secularism and gender as well as short case studies from India, Pakistan, and Sri Lanka. These three former British colonies have each struggled to arrive at a secular settlement and often the contestation over the place of religion has centered on the rules and roles of women in these societies.
‘From disaster to master’: Exploring the journey beyond desistance in Ireland
Authors: Hart Wayne , Healy Deirdre , Williamson David
Published: March 2020

Desistance scholars maintain that innovative and sustainable mechanisms are needed to support the enhancement of human development. Failure to desist is often attributed to limited personal agency and structural disadvantages such as a lack of education attainment and meaningful employment. Therefore, it is argued that criminal justice responses should break down educational and employment barriers in the desistance process, if we are to help remove hurdles to both social cohesion and social integration. To provide additional insights into this phenomenon, this article presents an autobiographical, reflective and experiential account of these challenges in the life of a desister from multiple perspectives. The narrative reveals that the change process extends beyond the attainment of education and meaningful employment, and describes the challenges faced by both work colleagues and the desister. These accounts are accompanied by a reflective academic commentary that situates these personal work experiences within the wider desistance literature, helping to add a critical appraisal of existing knowledge as viewed through the lens of one person’s desistance process over a 10-year period through education and into employment.
Ten-year results of 55 dysplasia hips of hip offset and leg length reconstruction in total hip arthroplasty with cementless tapered stems having a high offset option designed for dysplastic femur
Authors: Nishino Tomofumi , Mishima Hajime , Kawamura Haruo , Yoshizawa Tomohiro , Miyakawa Shumpei , Yamazaki Masashi
Published: March 2020

Purpose:

In developmental dysplasia of the hip (DDH), the centers of hip rotation move in the superior and lateral direction. In total hip arthroplasty for such cases, movement of the center of hip rotation is in the inferior and medial direction. It causes an increase in leg length and a decrease in acetabular offset. We therefore evaluated the change of hip offset and leg length before and after surgery with two stems having a high offset option.

Patients and Methods:

The preoperative diagnosis was secondary osteoarthritis due to DDH excluded Crowe IV. A stem selection was decided based on preoperative two-dimensional templating. Total 55 hips in 50 patients were followed up for minimum 10 years. Pre- and postoperative clinical evaluations were performed using a hip joint function scoring system. Radiographic evaluations were used for offset and leg length measurements and other associated factors.

Results:

Both stems showed excellent clinical results. A high offset option was used in 60% of all cases. No postoperative dislocations were observed. The biological fixation was stable in all cases. The hip offset was restored without excessive leg lengthening in most cases.

Conclusion:

Anatomical consistency could be maintained by using a stem which matched geometry of the proximal part and had offset option. These cementless tapered stems having a high offset option are suitable for Crowe I to III hip dysplasia if two-dimensional X-ray templates fit the shape of the proximal femurs. They were associated with excellent clinical results and biological fixation. The offset option may be useful to adjust leg length and offset in DDH patients.
An Unusual Etiology of Cerebellar Ataxia
Authors: Kaiser Ryan Sohail , Khemka Arpita , Roy Oishik , Das Subhash , Datta Kalpana
Published: March 2020

Cerebellar ataxia, which is the lack of coordination, has a number of causes none of which are as uncommon or unheard of as Scrub typhus. Scrub typhus very rarely presents itself with CNS manifestations. Here, we present the case of a 7-year-old girl from the Hooghly district in West Bengal, who presented to us with the history of fever, cerebellar signs, and sudden onset of visual loss. She was ultimately diagnosed with scrub typhus cerebellitis.
The Johns Hopkins Neurosciences Intensive Care Nursery Tenth Anniversary (2009-2019): A Historical Reflection and Vision for the Future
Authors: Carrasco Melisa , Stafstrom Carl E. , Tekes Aylin , Parkinson Charla , Northington Frances J. ,   The Johns Hopkins Neurosciences Intensive Care Nursery
Published: March 2020

Since 2009, the Neurosciences Intensive Care Nursery at Johns Hopkins Children’s Center has provided a multidisciplinary approach toward the care of newborns with neurological disorders. The program’s cornerstone is an interdisciplinary approach that involves the primary neonatology team plus experts from more than 10 specialties who convene at a weekly team conference at which newborns with neurological problems are discussed in detail. This interdisciplinary approach fosters in-depth discussion of clinical issues to optimize the management of neonates with neurological problems as well as the opportunity to generate research ideas and provide education about neonatal neuroscience at all levels (faculty, nurses, and trainees). The purpose of this article is to provide a 10-year reflection of our Neurosciences Intensive Care Nursery with a view toward expanding efforts in the 3 areas of our mission: clinical care, research, and education. We hope that our experience will enhance the spread of neonatal neuroscience education, care, and research as widely as possible.
Building Blocks and Challenges for the Implementation of the Global Compact on Refugees in Africa
Authors: Carciotto Sergio , Ferraro Filippo
Published: March 2020

Executive Summary

Forced displacement continues to be a major challenge to human security across the globe. According to the United Nations High Commissioner for Refugees (UNHCR), the global population of forcibly displaced people increased by 2.3 million people in 2018, and by the end of the year, more than 70 million individuals were forcibly displaced worldwide (UNHCR 2019a). UNHCR also estimated that, in 2018, 13.6 million people were newly displaced as a result of conflicts and droughts (ibid.).
Scripting Indian and Chinese urban spatial transformation: Adding new narratives to gentrification and suburbanisation research
Authors: Wu Fulong
Published: March 2020

This paper examines the spatial transformation of Indian and Chinese cities with reference to prevailing gentrification and suburbanisation studies. Focusing on urban redevelopment and peripheral extension, the paper highlights how Indian and Chinese urban studies provide extensive analyses of demolition and displacement in urban renewal and redevelopment, peri-urbanisation, and mega urban projects in urban spatial extension. These studies, often developed by paying attention to specific Indian or Chinese urbanisation, add new narratives to gentrification and suburbanisation research and help to enhance our understanding of contemporary urban changes. Thinking about Indian and Chinese urban spatial transformation, these studies highlight that gentrification and suburbanisation are large research fields rather than defined concepts.
Children’s visual attention characteristics reveal the level of information picture book reading comprehension
Authors: Wang Jin
Published: March 2020

The information picture book, as a very significant type among picture books, has made early childhood educators and parents always feel difficult for the children to understand due to its language expression, content presentation and the connection with children’s life experience. This study has focused on the eye movement level of Chinese children’s reading comprehension of information picture books through an eye-tracking study, exploring the visual attention characteristics of Chinese children’s reading comprehension, understanding the modes and characteristics of children’s endogenous comprehension through their eye movement characteristics. The research mainly answers the following three questions: What do we know about the visual perception of key images in information picture books among children aged 3–5 years? Do children with different levels of reading comprehension have different levels of visual attention characteristics? Is there a correlation between the results of eye movement analysis and the characteristics of children’s cognitive science and understanding?

Based on a randomized sample of 90 children aged 3–5 years from Xi’an, Shaanxi Province of China, we used an eye movement instrument to record children’s eye movement routes when they were reading a selected typical information picture book, and then analyzed the visual attention characteristics of them. Results have shown that there is a high correlation between children’s level of cognitive characteristics of scientific phenomena and understanding phenomena, and children’s visual cognitive level of key images.
Failure study of fiber/epoxy composite laminate interface using cohesive multiscale model
Authors: Moheimani Reza , Sarayloo Reza , Dalir Hamid
Published: March 2020

In this study, finite element modeling is performed to investigate the compressive failure of the composite sandwich structures with layered composite shells. An embedded debond area between the layered composite shell and the foam core is assumed as a defect. The composite shells are several plies of equal thickness Kevlar, carbon fiber composite, and E-glass composite with epoxy resin. Three different lay-ups, namely, (0°/90°/0°/90°/0°/90°), (45°/−45°/0°/90°/60°/−30°), and (60°/−30°/90°/0°/30°/90°) are considered for symmetric and asymmetric sequences. The work focuses on the importance of cohesive zone model versus the previously conducted numerical simulation and experimental results for buckling of sandwich composite structures. This enables one to account for delamination growth between shells and core and improve the correlation results with those of experiments. It has been shown that not only the cohesive model is capable of demonstrating delamination propagation, but it also correlates very well with the experimental data. By compiling user-defined cohesive mesoscale model in Abaqus simulation, the local and global buckling of the face-sheets can be precisely detected and response of sandwich structure becomes mesh independent, while mesh size is reduced.
The walentaite group and the description of a new member, alcantarillaite, from the Alcantarilla mine, Belalcázar, Córdoba, Andalusia, Spain.
Authors: Grey Ian E. , Hochleitner Rupert , Rewitzer Christian , Riboldi-Tunnicliffe Alan , Kampf Anthony R. , MacRae Colin M. , Mumme W. Gus , Kaliwoda Melanie , Friis Henrik , Martin Carlos U.
Published: March 2020

The general structural formula for the walentaite group is [((A1yA1’1–y), A2)(H2O)n][Bx(As2)2–x(As3)M1(M2)2(TO4)2(O,OH)7], based on heteropolyhedral layers of configuration [M1(M2)2(TO4)2(O,OH)6], with surface-coordinated species at the B, As2 and As3 sites, and with interlayer hydrated cation groups centred at the A sites. The group is divided into walentaite and halilsarpite subgroups based on T = P5+ and As5+, respectively. Alcantarillaite, (IMA2019-072), [Fe3+0.5□0.5(H2O)4][CaAs3+2(Fe3+2.5W6+0.5)(AsO4)2O7], is a new member of the walentaite group from the Alcantarilla wolframite mine, Belalcázar, Córdoba, Andalusia, Spain. It occurs most commonly as lemon-yellow fillings together with massive scorodite in fissures and cracks in quartz adjacent to löllingite. It is also found as tiny yellow rosettes lining vugs and as spheroids of ultrathin blades. It is associated with scorodite, pharmacosiderite, ferberite and schneiderhöhnite. Optically it is biaxial (–), with α = 1.703(calc), β = 1.800(5), γ = 1.850(5) and 2V = 68(1)° (white light). Dispersion is r > v, moderate. The optical orientation is X = a, Y = c and Z = b. The calculated density is 3.06 g cm–3. Electron microprobe analyses together with crystal structure refinement results gives the empirical formula [Fe3+0.52□0.48(H2O)4][(Ca0.44K0.11Na0.05Fe2+0.24□0.42)As3+1.83][Fe3+2.54Al0.03W6+0.43)((As0.65P0.35)O4)2O5.86(OH)1.14]. Alcantarillaite is orthorhombic, with an average structure described in Imma, and with a = 24.038(8) Å, b = 7.444(3) Å, c = 10.387(3) Å, V = 1858.6(11) Å3 and Z = 4. The structure (wRobs = 0.078 for 651 reflections to a resolution of 0.91 Å) differs most significantly from other walentaite-group members in having an interlayer A2 site occupied. Square-pyramidal polyhedra centred at the A2 sites form edge-shared dimers, (Fe3+)2O4(H2O)4. The dimers share vertices with TO4 anions in the layers on either side to form 8-sided channels along [010] occupied by H2O molecules.
Processes of metastable-mineral formation in oxidation zones and mine waste
Authors: Majzlan Juraj
Published: March 2020

Oxidation zones and mine wastes are metal-rich, near-surface environments, natural and man-made critical zones of ore deposits, respectively. They contain a number of minerals which, despite their metastability, occur consistently and in abundance. Field studies, presented as examples in this work, show that metastable minerals form not only directly from aqueous solutions, but also from more complex precursors, such as nanoparticles, gels, X-ray amorphous solids, or clusters. Initial precipitation of metastable phases and their conversion to stable phases is described by the Ostwald's step rule. Thermodynamic data show that there is a tendency, but no rule, that structurally more complex phases are also thermodynamically more stable. The Ostwald's step rule could then state that the initial metastable phases are structurally simple and easily assembled from aqueous solutions, nanoparticles, gels, disordered solids, or clusters. The structural similarity of the precursor and the forming phase is a kinetic factor favouring the crystallisation of the new phase. Calculation of saturation indices for mine drainage solutions show that they are mostly supersaturated with respect to the stable phases and the aqueous concentrations are sufficient to precipitate metastable minerals. In our fieldwork, we often encounter gelatinous substances with copper, manganese or tungsten that slowly convert to metastable oxysalt minerals. Another possibility is the crystallisation of various metastable minerals from solid, homogeneous ‘resins’ that are X-ray amorphous. Minerals typical for near-surface environments may be stabilised by their surface energy at high specific surface areas. For example, ferrihydrite is often described as a metastable phase but can be shown to be stable with respect to nanosised hematite.
Erdheim-Chester disease: consensus recommendations for evaluation, diagnosis, and treatment in the molecular era
Authors: Goyal Gaurav , Heaney Mark L. , Collin Matthew , Cohen-Aubart Fleur , Vaglio Augusto , Durham Benjamin H. , Hershkovitz-Rokah Oshrat , Girschikofsky Michael , Jacobsen Eric D. , Toyama Kazuhiro , Goodman Aaron M. , Hendrie Paul , Cao Xin-xin , Estrada-Veras Juvianee I. , Shpilberg Ofer , Abdo André , Kurokawa Mineo , Dagna Lorenzo , McClain Kenneth L. , Mazor Roei D. , Picarsic Jennifer , Janku Filip , Go Ronald S. , Haroche Julien , Diamond Eli L.
Published: March 2020

Erdheim-Chester disease (ECD) is a rare histiocytosis that was recently recognized as a neoplastic disorder owing to the discovery of recurrent activating MAPK (RAS-RAF-MEK-ERK) pathway mutations. Typical findings of ECD include central diabetes insipidus, restrictive pericarditis, perinephric fibrosis, and sclerotic bone lesions. The histopathologic diagnosis of ECD is often challenging due to nonspecific inflammatory and fibrotic findings on histopathologic review of tissue specimens. Additionally, the association of ECD with unusual tissue tropism and an insidious onset often results in diagnostic errors and delays. Most patients with ECD require treatment, except for a minority of patients with minimally symptomatic single-organ disease. The first ECD consensus guidelines were published in 2014 on behalf of the physicians and researchers within the Erdheim-Chester Disease Global Alliance. With the recent molecular discoveries and the approval of the first targeted therapy (vemurafenib) for BRAF-V600–mutant ECD, there is a need for updated clinical practice guidelines to optimize the diagnosis and treatment of this disease. This document presents consensus recommendations that resulted from the International Medical Symposia on ECD in 2017 and 2019. Herein, we include the guidelines for the clinical, laboratory, histologic, and radiographic evaluation of ECD patients along with treatment recommendations based on our clinical experience and review of literature in the molecular era.
Speedometer monitoring when driving with a speed warning system
Authors: Lehtonen Esko , Malhotra Neha , Starkey Nicola J. , Charlton Samuel G.
Published: March 2020

Aim

The study investigated how a speed warning system influence drivers’ speedometer monitoring, and how drivers respond when they receive a speed warning. With a speed warning system, drivers may pay more attention to the exact speed, which would be expected to increase glances to the speedometer.

Methods

Nineteen participants drove in a driving simulator, either with or without a speed warning system implemented on a smartphone, which alerted them if they exceeded the set speed limit. Their glances to the speedometer and speed warning system’s display were recorded with an eye tracker.

Results

Drivers sped less with the warning system. The system did not significantly change the speedometer monitoring. Speeding was preceded by fewer speedometer glances, indicating the speeding was linked to participants’ momentary inattention to their speed control. After a warning, the frequency of speedometer glances increased. Interestingly, drivers often started to glance at the speedometer and release the accelerator a couple of seconds before a warning, suggesting that drivers learn to anticipate warnings. The results suggest that drivers do not only react to warnings, but they also actively try to avoid them. Understanding drivers’ speed control with speed warning system may help to create adaptive ISA systems.
Linking crop traits to transcriptome differences in a progeny population of tetraploid potato
Authors: Alexandersson Erik , Kushwaha Sandeep , Subedi Aastha , Weighill Deborah , Climer Sharlee , Jacobson Daniel , Andreasson Erik
Published: March 2020

Background

Potato is the third most consumed crop in the world. Breeding for traits such as yield, product quality and pathogen resistance are main priorities. Identifying molecular signatures of these and other important traits is important in future breeding efforts. In this study, a progeny population from a cross between a breeding line, SW93–1015, and a cultivar, Désirée, was studied by trait analysis and RNA-seq in order to develop understanding of segregating traits at the molecular level and identify transcripts with expressional correlation to these traits. Transcript markers with predictive value for field performance applicable under controlled environments would be of great value for plant breeding.

Results

A total of 34 progeny lines from SW93–1015 and Désirée were phenotyped for 17 different traits in a field in Nordic climate conditions and controlled climate settings. A master transcriptome was constructed with all 34 progeny lines and the parents through a de novo assembly of RNA-seq reads. Gene expression data obtained in a controlled environment from the 34 lines was correlated to traits by different similarity indices, including Pearson and Spearman, as well as DUO, which calculates the co-occurrence between high and low values for gene expression and trait. Our study linked transcripts to traits such as yield, growth rate, high laying tubers, late and tuber blight, tuber greening and early flowering. We found several transcripts associated to late blight resistance and transcripts encoding receptors were associated to Dickeya solani susceptibility. Transcript levels of a UBX-domain protein was negatively associated to yield and a GLABRA2 expression modulator was negatively associated to growth rate.

Conclusion

In our study, we identify 100’s of transcripts, putatively linked based on expression with 17 traits of potato, representing both well-known and novel associations. This approach can be used to link the transcriptome to traits. We explore the possibility of associating the level of transcript expression from controlled, optimal environments to traits in a progeny population with different methods introducing the application of DUO for the first time on transcriptome data. We verify the expression pattern for five of the putative transcript markers in another progeny population.
The important effect of 5-HTTLPR polymorphism on the risk of depression in patients with coronary heart disease: a meta-analysis
Authors: Zhang Li-Jun , Zeng Xian-Tao , Zhao Ming-Juan , He Dong-Fang , Liu Jian-Yang , Liu Mei-Yan
Published: March 2020

Background

Depression has been recognized as an independent risk factor of coronary heart disease (CHD). Moreover, there is interrelationship of both depression and CHD. However, the potential pathophysiological mechanisms remain unknown. It might be influenced by genetic and environmental factors. According to recent researches, there is potential association between serotonin transporter gene-linked polymorphic region (5-HTTLPR) polymorphism and risk of depression in CHD patients, but the results are still inconclusive. Therefore, we performed this meta-analysis based on unadjusted and adjusted data to ascertain a more precise conclusion.

Methods

We searched relevant articles through PubMed, Embase, Web of Science, Chinese BioMedical Literature (CBM) and Chinese National Knowledge Infrastructure (CNKI) databases up to August 26, 2019. Study selection and data extraction were accomplished by two authors independently. The strength of the correlation was assessed via odds ratios (ORs) with their 95% confidence intervals (95%CIs).

Results

This meta-analysis enrolled six observational studies. Based on unadjusted data, there was significant relationship between 5-HTTLPR polymorphism and depression risk in CHD patients under all genetic models (S vs. L: OR = 1.31, 95%CI = 1.07–1.60; SS vs. LL: OR = 1.73, 95%CI = 1.12–2.67; LS vs. LL: OR = 1.47, 95%CI = 1.13–1.92; LS + SS vs. LL: OR = 1.62, 95%CI = 1.25–2.09; SS vs. LL + LS: OR = 1.33, 95%CI = 1.02–1.74). The results of adjusted data further strengthened this relationship (SS vs. LL: OR = 1.89, 95%CI = 1.28–2.80; LS vs. LL: OR = 1.69, 95%CI = 1.14–2.51; LS + SS vs. LL: OR = 1.80, 95%CI = 1.25–2.59). Subgroup analyses based on ethnicity and major depressive disorder revealed similar results to that of the overall analysis. No evidence of publication bias was observed.

Conclusions

Our results suggest that 5-HTTLPR polymorphism may have an important effect on the risk of depression among patients with CHD, and carriers of the S allele of 5-HTTLPR are more vulnerable to depression.
Artificial neural network-based models used for predicting 28- and 90-day mortality of patients with hepatitis B-associated acute-on-chronic liver failure
Authors: Hou Yixin , Zhang Qianqian , Gao Fangyuan , Mao Dewen , Li Jun , Gong Zuojiong , Luo Xinla , Chen Guoliang , Li Yong , Yang Zhiyun , Sun Kewei , Wang Xianbo
Published: March 2020

Background

This study aimed to develop prognostic models for predicting 28- and 90-day mortality rates of hepatitis B virus (HBV)-associated acute-on-chronic liver failure (HBV-ACLF) through artificial neural network (ANN) systems.

Methods

Six hundred and eight-four cases of consecutive HBV-ACLF patients were retrospectively reviewed. Four hundred and twenty-three cases were used for training and constructing ANN models, and the remaining 261 cases were for validating the established models. Predictors associated with mortality were determined by univariate analysis and were then included in ANN models for predicting prognosis of mortality. The receiver operating characteristic curve analysis was used to evaluate the predictive performance of the ANN models in comparison with various current prognostic models.

Results

Variables with statistically significant difference or important clinical characteristics were input in the ANN training process, and eight independent risk factors, including age, hepatic encephalopathy, serum sodium, prothrombin activity, γ-glutamyltransferase, hepatitis B e antigen, alkaline phosphatase and total bilirubin, were eventually used to establish ANN models. For 28-day mortality in the training cohort, the model’s predictive accuracy (AUR 0.948, 95% CI 0.925–0.970) was significantly higher than that of the Model for End-stage Liver Disease (MELD), MELD-sodium (MELD-Na), Chronic Liver Failure-ACLF (CLIF-ACLF), and Child-Turcotte-Pugh (CTP) (all p < 0.001). In the validation cohorts the predictive accuracy of ANN model (AUR 0.748, 95% CI: 0.673–0.822) was significantly higher than that of MELD (p = 0.0099) and insignificantly higher than that of MELD-Na, CTP and CLIF-ACLF (p > 0.05). For 90-day mortality in the training cohort, the model’s predictive accuracy (AUR 0.913, 95% CI 0.887–0.938) was significantly higher than that of MELD, MELD-Na, CTP and CLIF-ACLF (all p < 0.001). In the validation cohorts, the prediction accuracy of the ANN model (AUR 0.754, 95% CI: 0.697–0.812 was significantly higher than that of MELD (p = 0.019) and insignificantly higher than MELD-Na, CTP and CLIF-ACLF (p > 0.05).

Conclusions

The established ANN models can more accurately predict short-term mortality risk in patients with HBV- ACLF.

The main content has been postered as an abstract at the AASLD Hepatology Conference (10.1002/hep.30257).
Effect of mirabegron on cognitive function in elderly patients with overactive bladder: MoCA results from a phase 4 randomized, placebo-controlled study (PILLAR)
Authors: Griebling Tomas L. , Campbell Noll L. , Mangel Jeffrey , Staskin David , Herschorn Sender , Elsouda Dina , Schermer Carol R.
Published: March 2020

Background

Antimuscarinics are often used for treatment of overactive bladder (OAB), but exposure to medications such as antimuscarinics that have anticholinergic properties has been linked to adverse cognitive effects. A phase 4 placebo-controlled study (PILLAR; NCT02216214) described the efficacy and safety of mirabegron, a β3-adrenoreceptor agonist, for treatment of wet OAB in patients aged ≥65 years. This pre-planned analysis aimed to measure differences in cognitive function between mirabegron and placebo, using a rapid screening instrument for mild cognitive impairment: the Montreal Cognitive Assessment (MoCA).

Methods

Outpatients aged ≥65 years with wet OAB were randomized 1:1 to mirabegron or placebo, stratified by age (<75/≥75 years). There were no exclusion criteria regarding cognitive status. Patients randomized to mirabegron initially received 25 mg/day with an optional increase to 50 mg/day after week 4/8 based on patient/investigator discretion. The MoCA was administered at baseline and end of treatment (EoT, week 12). The study protocol was Independent Ethics Committee/Institutional Review Board-approved.

Results

Of the 887 randomized patients who received ≥1 dose of study drug, 72.3% were female, 79.5% were white, and 28.1% were aged ≥75 years. All patients had ≥1 comorbidity and 94.3% were receiving ≥1 concomitant medication. One third of patients had a history of psychiatric disorders, the most common being depression (17.2%), insomnia (15.7%), and anxiety (11.4%). Baseline mean (standard error, SE) MoCA total scores were 26.9 (0.1) and 26.8 (0.1) in the mirabegron and placebo groups, respectively. Among patients with MoCA data available at baseline/EoT, 27.1% (115/425) and 25.8% (106/411) of mirabegron and placebo group patients, respectively, had impaired cognitive function at baseline (MoCA total score <26). There was no statistically significant change in adjusted mean (SE) MoCA total score from baseline to EoT in the mirabegron group (−0.2 [0.1]) or the placebo group (−0.1 [0.1]).

Conclusions

Treatment with mirabegron for 12 weeks did not contribute to drug-related cognitive side effects in patients aged ≥65 years, as measured by the MoCA. Furthermore, the pattern of change in cognition over time in an older OAB trial population does not appear to differ from that of subjects receiving placebo.

Trial registration

NCT02216214 (prospectively registered August 13, 2014).
Acceptability and feasibility of testing for HIV infection at birth and linkage to care in rural and urban Zambia: a cross-sectional study
Authors: Sutcliffe Catherine G. , Mutanga Jane N. , Moyo Nkumbula , Schue Jessica L. , Hamahuwa Mutinta , Thuma Philip E. , Moss William J.
Published: March 2020

Background

Early infant diagnosis is important for timely identification of HIV-infected infants and linkage to care. Testing at birth has been implemented to facilitate earlier diagnosis of HIV infection but may present new challenges. This study was conducted to understand the acceptability and feasibility of birth testing in urban and rural settings in southern Zambia.

Methods

This cross-sectional study was conducted at 11 hospitals and clinics in Livingstone, Choma, and Macha in Southern Province, Zambia from 2016 to 2018. Infants born to pregnant women living with HIV at the sites were eligible for enrollment. After enrollment, a questionnaire was administered to the mother and a dried blood spot card was collected from infants for testing at a central laboratory. When results were available, mothers were notified to return to the clinic. Acceptability of birth testing was evaluated based on the proportion of women who agreed to participate and the reasons for non-participation among women who declined. Feasibility of testing at birth was evaluated using turnaround times for returning results, the proportion of women receiving results, and linkage to care for infants testing positive.

Results

One thousand four hundred three women were approached for the study. A small proportion declined due to refusal of birth testing (0 to 8.2% across sites). One thousand two hundred ninety women agreed to have their infants tested. The proportion of mothers receiving results ranged from 51.6 to 92.1%, and was significantly lower at the hospital than clinics in Livingstone (51.6% vs. 69.8%; p < 0.0001) and Macha (69.5% vs. 85.7%; p < 0.0001) but not Choma (85.7% vs. 92.1%; p = 0.34). For mothers who received test results, the median turnaround time from sample collection was 67 days in Livingstone and 53 days in Macha and Choma. Overall, 23 (1.8%) infants tested positive for HIV but only 8 (34.8%) were linked to care a median of 68 days (range: 29, 784) after sample collection.

Conclusions

While testing at birth was acceptable, this study highlights the operational challenges under a centralized laboratory testing system. Point-of-care platforms are needed for rapid testing and return of results so HIV-infected children can be identified, linked to care, and treated as early as possible.
Prevalence and risk factors for caesarean delivery following labor induction at a tertiary hospital in North Tanzania: a retrospective cohort study (2000–2015)
Authors: Tarimo Clifford Silver , Mahande Michael J. , Obure Joseph
Published: March 2020

Background

Labor induction is among the common and widely practiced obstetric interventions aiming at achieving vaginal delivery. However, cesarean section (CS) delivery incidences have been reported following its use. This study aimed at determining the prevalence and risk factors for caesarean delivery following labor induction among women who gave birth at a tertiary hospital in north-Tanzania.

Methods

A hospital-based retrospective cohort study was designed using maternally-linked data from Kilimanjaro Christian Medical Centre (KCMC) birth registry among women who gave birth to singleton babies from the year 2000 to 2015. All induced deliveries done in this period were studied. Women with multiple pregnancy, missing information on delivery mode and those with history of CS delivery were excluded. Relative risk and 95% Confidence Interval for risk factors for CS delivery following labor induction were estimated using log-binomial regression models. Robust variance estimation was used to account for repeated deliveries from the same subject.

Results

A total of 1088 deliveries were analysed. The prevalence of CS following labour induction was 26.75%. Independent risk factors for CS delivery were; primiparity (RR = 1.46; 95% CI: 1.18–1.81), high birthweight (RR =1.28; 95% CI: 1.02–1.61), post-term pregnancy (RR = 1.45; 95% CI: 1.09–1.93), and urban residence (RR =1.29; 95%CI: 1.05–1.58).

Conclusion

In patients undergoing labor induction, primiparity, high birthweight, post dates and urban residence were found to associate with an elevated risk of caesarean delivery. Assessment of these factors prior to labor induction intervention is warranted to reduce adverse pregnancy outcomes associated with emergency caesarean delivery.
What do women want? An analysis of preferences of women, involvement of men, and decision-making in maternal and newborn health care in rural Bangladesh
Authors: Rahman Ahmed Ehsanur , Perkins Janet , Salam Shumona Sharmin , Mhajabin Shema , Hossain Aniqa Tasnim , Mazumder Tapas , Arifeen Shams EL
Published: March 2020

Background

To improve the utilization of maternal and newborn health (MNH) care and to improve the quality of care, the World Health Organization (WHO) has strongly recommended men’s involvement in pregnancy, childbirth, and after birth. In this article, we examine women’s preferences for men’s involvement in MNH care in rural Bangladesh and how this compares to husbands’ reported involvement by women.

Methods

A cross-sectional household survey of 1367 women was administered in 2018 in the district of Brahmanbaria. Outcomes of interest included supporting self-care during pregnancy, participation in birth planning, presence during antenatal care, childbirth, and postnatal care, and participation in newborn care. Binary and multiple logistic regressions were done to understand the associations between the outcomes of interest and background characteristics.

Results

Although women preferred a high level of involvement of their husbands in MNH care, husbands’ reported involvement varied across different categories of involvement. However, women’s preferences were closely associated with husbands’ reported involvement. Around three-quarters of the women reported having been the primary decision makers or reported that they made the decisions jointly with their husbands. The likelihood of women reporting their husbands were actively involved in MNH care was 2.89 times higher when the women preferred their husbands to be involved in 3–4 aspects of MNH care. The likelihood increased to 3.65 times when the women preferred their husbands to be involved in 5–6 aspects. Similarly, the likelihood of husbands’ reported active involvement was 1.43 times higher when they jointly participated in 1–2 categories of decision-making. The likelihood increased to 2.02 times when they jointly participated in all three categories.

Conclusion

The findings of our study suggest that women in rural Bangladesh do indeed desire to have their husbands involved in their care during pregnancy, birth and following birth. Moreover, their preferences were closely associated with husbands’ reported involvement in MNH care; that is to say, when women wanted their husbands to be involved, they were more likely to do so. Programmes and initiatives should acknowledge this, recognizing the many ways in which men are already involved and further allow women’s preferences to be realized by creating an enabling environment at home and in health facilities for husbands to participate in MNH care.
Evaluation of the efficacy of optimal pulsed technology treatment in patients with cataract and Meibomian gland dysfunction in the perioperative period
Authors: Ge Jinling , Liu Na , Wang Xiaoming , Du Ying , Wang Chaoqing , Li Zhaorui , Li Jing , Wang Lihua
Published: March 2020

Background

The aim of this study was to evaluate the efficacy and safety of M22 Optimal Pulsed Technology (OPT) applied in patients with age-related cataract and Meibomian gland dysfunction (MGD) in perioperative period.

Methods

This prospective observational study was carried out in the Jinan Mingshui Eye Hospital (Zhangqiu, China). We studied 60 patients (30 in the OPT treatment group and 30 in the conventional surgery group) with age-related cataract and MGD who underwent phacoemulsification and evaluated the efficacy of OPT treatment before and 1 month and 3 months after surgery. Ocular Surface Disease Index (OSDI) questionnaire, biomicroscopic examination of lid margins, Meibomian gland yielding secretion score (MGYSS), corneal fluorescein staining scores (CFS), tear film break-up time (TBUT), tear meniscus height (TMH) and the morphology of the MG (meibography) followed by Keratograph 5 M (K5M) were used to assess the patients’ conditions.

Results

There were significant differences in the scores of OSDI, MGYSS, TBUT, and CFS between the preoperative and postoperative outcomes (p < 0.05). In the OPT treatment group, the postoperative ocular surface condition was obviously better and the patient satisfaction rate was higher than those before surgery. There were significant differences in the scores of OSDI, EMAS, MGYSS and CFS before and 1 month after surgery (p < 0.05). In addition, there were also significant differences in the scores of OSDI, EMAS, MGYSS and MGLS before and 3 months after surgery (p < 0.05). No complications appeared during OPT treatment.

Conclusions

Cataract surgery can aggravate MGD and is detrimental to ocular surface health. OPT treatment was a safe and effective intervention for patients with MGD and cataract during perioperative period.