bluuebunny/crossref_metadata_2025 huggingface dataset:
Birth outcomes in a Swedish population of women reporting a history of violence including domestic violence during pregnancy: a longitudinal cohort study
Authors: Finnbogadóttir Hafrún , Baird Kathleen , Thies-Lagergren Li
Published: March 2020

Background

Victimisation of women is encountered in all countries across the world, it damages the mental and physical health of women. During pregnancy and the postpartum period, women are at a greater risk of experiencing violence from an intimate partner. The aim of this study was to explore childbirth outcomes in a Swedish population of women reporting a history of violence including domestic violence during pregnancy.

Methods

A longitudinal cohort design was used. In total, 1939 pregnant women ≥18 years were recruited to answer two questionnaires, both questionnaires were administered in the early and late stages of their pregnancy. The available dataset included birth records of 1694 mothers who gave birth between June 2012 and April 2014. Statistical analyses included descriptive statistics, T-test and bivariate logistic regression.

Results

Of 1694 mothers 38.7% (n = 656) reported a history of violence and 2% (n = 34) also experienced domestic violence during pregnancy. Women who were single, living apart from their partner, unemployed, smoked and faced financial distress were at a higher risk of experiencing violence (p = 0.001). They also had significant low scores on the SOC-scale and high EDS-scores ≥13 (p = 0.001) when compared to women without a history of violence (p = 0.001). Having a history of violence increased the woman’s risk of undergoing a caesarean section (OR 1.33, 95% CI 1.02–1.70). A history of emotional abuse also significantly increased the risk of having a caesarean section irrespective of whether it was a planned or an emergency caesarean section (OR 1.50, 95% CI 1.09–2.06). Infants born to a mother who reported a history of violence, were at significant risk of being born premature < 37 weeks of gestation compared to infants born by mothers with no history of violence (p = 0,049).

Conclusions

A history of violence and/or exclusively a history of emotional abuse has a negative impact on childbirth outcomes including caesarean section and premature birth. Therefore, early identification of a history of or ongoing violence is crucial to provide women with extra support which may have positive impact on her birth outcomes.
Establishing a normative database for quantitative pupillometry in the pediatric population
Authors: Shah Sanket S. , Ranaivo Hantamalala Ralay , Mets-Halgrimson Rebecca B. , Rychlik Karen , Kurup Sudhi P.
Published: March 2020

Background

Pupillary evaluation is a crucial element of physical exams. Noting size, reactivity, and consensual response is critical in assessing for optic nerve dysfunction. We aim to establish normative data for scotopic pupillary size and function in the pediatric population in a clinical setting.

Methods

Pupillometry was obtained prospectively for consecutive, normal patients < 18 years old being evaluated by Lurie Children’s Ophthalmology. Quantitative data included maximum (MAX) and minimum (MIN) diameters, constriction percentage (CON), latency (LAT), average (ACV) and maximum (MCV) constriction velocities, average dilation velocity (ADV), and 75% recovery time (T75). Iris color was noted as light, intermediate, or dark.

Results

196 eyes of 101 participants (42.6% male, ages 1–17 years, average age 10.3 years) were analyzed. Mean MAX was 6.6 mm (5.1–8.1 mm 95% CI); MIN was 4.7 mm (3.1–6.1 mm 95% CI); CON was 30% (17–42 95% CI); LAT was 230 milliseconds (160–300 ms 95% CI); ACV was 3.70 mm/sec (2.21–5.18 mm/sec 95% CI); and ADV was 0.88 mm/sec (0.38–1.38 mm/sec 95% CI). Age had a positive correlation with MAX, MIN, and CON. 84.2 and 95.8% of participants showed resting pupil asymmetry of ≤0.5 mm and ≤ 1.0 mm, respectively.

Conclusions

Quantitative pupillometry can be a useful tool for screening pediatric patients. We sought to establish normative data in this group. We found males to have significantly greater MCV and CON than females (p < 0.05). Also, age had a positive correlation with MAX, MIN, and CON.
Prevalence of abnormal glucose metabolism among adults attending an outpatient department at a tertiary referral hospital in Swaziland: a cross-sectional study
Authors: Gbadamosi Mojeed Akorede , Tlou Boikhutso
Published: March 2020

Background

The exact prevalence of type 2 diabetes mellitus (T2DM) and pre-diabetes in Swaziland remains unknown. Estimates suggest that the prevalence rate of type 2 diabetes mellitus is between 2.5 and 6.0% in Swaziland. The disparity in these estimates is due to a lack of quality data but the prevalence of diabetes is increasing in Swaziland. This study estimates the prevalence of type 2 diabetes mellitus and pre-diabetes among patients in a tertiary hospital in Manzini, Swaziland.

Methods

A cross-sectional observational survey was used to estimate the crude and age-adjusted prevalence rates of diabetes and pre-diabetes (impaired fasting glucose (IFG) and impaired glucose tolerance (IGT)) in the Manzini regional referral hospital of Swaziland. Diabetes was defined as a fasting blood glucose (FBG) ≥ 7.0 mmol/L (126 mg/dL) and pre-diabetes was defined as an FBG of 6.1–6.9 mmol/L (110–125 mg/dL) and an FBG < 7.0 mmol/L (< 126 mg/dL), respectively for IFG and IGT. A random sample of 385 participants was used. Data analysis was done using SPSS version 26 and the level of statistical significance was set at α < 0.05.

Results

The crude prevalence of type 2 diabetes mellitus and pre-diabetes was 7.3% [95% CI 4.9–10.3] and 6.5% [95% CI 4.2–9.4], respectively, with clear gender differences in the prevalence of diabetes (men 1.6% vs women 5.7%, p = 0.001). On the other hand, significantly more men (3.6%) had pre-diabetes than women (2.9%) (p = 0.004). The overall age-adjusted prevalence rates of type 2 diabetes mellitus and pre-diabetes were 3.9 and 3.8%, respectively. Among the diabetic group, 3 (10.7%) had known T2DM, whereas 25 (89.3%) were newly diagnosed during the study. Advancing age, gender, raised blood pressure, abnormal body mass index, and wealth index were significant risk factors for T2DM or prediabetes.

Conclusion

The prevalence of type 2 diabetes mellitus among adult outpatients in the Raleigh Fitkin Memorial hospital was higher than previously reported in the health facility in Manzini; suggesting the need for routine T2DM screening at outpatient departments.
Modern contraceptive utilization and associated factors among reproductive-age women in Ethiopia: evidence from 2016 Ethiopia demographic and health survey
Authors: Gebre Mamo Nigatu , Edossa Zerihun Kura
Published: March 2020

Background

Modern contraceptive methods enable couples to enjoy sexual intercourse without fear of the risk of pregnancy at any desired time. The evidence from different studies done in Ethiopia on modern contraceptive method utilization was highly varied and not conclusive. Therefore, the current study aims to study the magnitude of modern contraceptive utilization and associated factors among reproductive-age women in Ethiopia based on 2016 EDHS data.

Method

A nationally representative 2016 EDHS data collected between January 18/ 2016 to June 27/2016 were used. Descriptive studies and logistic regression models were used to summarize descriptive data and measure statistical association respectively. Adjusted odds ratio and confidence interval were respectively used to measure association and its statistical significance. Finally, statistical significance was declared using a confidence interval.

Result

In the current study, the overall modern contraceptive utilization among reproductive-age women in Ethiopia was 3203 (20.42%). The injectable contraceptive method was the most commonly used modern contraceptive method, 1886(58.88%) followed by implant/Norplant, 779 (24.32%). The results of multivariable logistic regression showed that age, residence, region, woman’s occupation, number of living children, husband’s education, age at first sexual intercourse, husband’s desire for more children, wealth index and watching TV were independently associated to modern contraceptive utilization among reproductive-age women in Ethiopia.

Conclusions

The magnitude of modern contraceptive utilization among reproductive-age women in Ethiopia in the current study is unexpectedly low. Age, residence, region, woman’s occupation, number of living children, husband’s education, age at first sexual intercourse, husband’s desire for more children, wealth index and watching TV were independent predictors of modern contraceptive use among reproductive-age women in Ethiopia. Any intervention strategy that promotes modern contraceptive method utilization should consider these factors for its better success.
Born to fail: flaws in replication design produce intended results
Authors: Flaxman Abraham D. , Hazard Riley , Riley Ian , Lopez Alan D. , Murray Christopher J. L.
Published: March 2020

We recently published in BMC Medicine an evaluation of the comparative diagnostic performance of InSilicoVA, a software to map the underlying causes of death from verbal autopsy interviews. The developers of this software claim to have failed to replicate our results and appear to have also failed to locate our replication archive for this work. In this Correspondence, we provide feedback on how this might have been done more usefully and offer some suggestions to improve future attempts at reproducible research. We also offer an alternative interpretation of the results presented by Li et al., namely that, out of 100 verbal autopsy interviews, InSilicoVA will, at best, correctly identify the underlying cause of death in 40 cases and incorrectly in 60 – a markedly inferior performance to alternative existing approaches.
Wealth-related inequalities of women’s knowledge of cervical cancer screening and service utilisation in 18 resource-constrained countries: evidence from a pooled decomposition analysis
Authors: Mahumud Rashidul Alam , Keramat Syed Afroz , Ormsby Gail M , Sultana Marufa , Rawal Lal B. , Alam Khorshed , Gow Jeff , Renzaho Andre M. N.
Published: March 2020

Introduction

Resource-constrained countries (RCCs) have the highest burden of cervical cancer (CC) in the world. Nonetheless, although CC can be prevented through screening for precancerous lesions, only a small proportion of women utilise screening services in RCCs. The objective of this study was to examine the magnitude of inequalities of women’s knowledge and utilisation of cervical cancer screening (CCS) services in RCCs.

Methods

A total of 1,802,413 sample observations from 18 RCC’s latest national-level Demographic and Health Surveys (2008 to 2017–18) were analysed to assess wealth-related inequalities in terms of women’s knowledge and utilisation of CCS services. Regression-based decomposition analyses were applied in order to compute the contribution to the inequality disparities of the explanatory variables for women’s knowledge and utilisation of CCS services.

Results

Overall, approximately 37% of women had knowledge regarding CCS services, of which, 25% belonged to the poorest quintile and approximately 49% from the richest. Twenty-nine percent of women utilised CCS services, ranging from 11% in Tajikistan, 15% in Cote d’Ivoire, 17% in Tanzania, 19% in Zimbabwe and 20% in Kenya to 96% in Colombia. Decomposition analyses determined that factors that reduced inequalities in women’s knowledge of CCS services were male-headed households (− 2.24%; 95% CI: − 3.10%, − 1.59%; P < 0.01), currently experiencing amenorrhea (− 1.37%; 95% CI: − 2.37%, − 1.05%; P < 0.05), having no problems accessing medical assistance (− 10.00%; 95% CI: − 12.65%, − 4.89%; P < 0.05), being insured (− 6.94%; 95% CI: − 9.58%, − 4.29%; P < 0.01) and having an urban place of residence (− 9.76%; 95% CI: − 12.59%, − 5.69%; P < 0.01). Similarly, factors that diminished inequality in the utilisation of CCS services were being married (− 8.23%;95% CI: − 12.46%, − 5.80%; P < 0.01), being unemployed (− 14.16%; 95% CI: − 19.23%, − 8.47%; P < 0.01) and living in urban communities (− 9.76%; 95% CI: − 15.62%, − 5.80%; P < 0.01).

Conclusions

Women’s knowledge and utilisation of CCS services in RCCs are unequally distributed. Significant inequalities were identified among socioeconomically deprived women in the majority of countries. There is an urgent need for culturally appropriate community-based awareness and access programs to improve the uptake of CCS services in RCCs.
Supervision as a tool for building surgical capacity of district hospitals: the case of Zambia
Authors: Gajewski Jakub , Monzer Nasser , Pittalis Chiara , Bijlmakers Leon , Cheelo Mweene , Kachimba John , Brugha Ruairi
Published: March 2020

Introduction

Many countries in sub-Saharan Africa have adopted task shifting of surgical responsibilities to non-physician clinicians (NPCs) as a solution to address workforce shortages. There is resistance to delegating surgical procedures to NPCs due to concerns about their surgical skills and lack of supervision systems to ensure safety and quality of care provided. This study aimed to explore the effects of a new supervision model implemented in Zambia to improve the delivery of health services by surgical NPCs working at district hospitals.

Methods

Twenty-eight semi-structured interviews were conducted with NPCs and medical doctors at nine district hospitals and with the surgical specialists who provided in-person and remote supervision over an average period of 15 months. Data were analysed using ‘top-down’ and ‘bottom-up’ thematic coding.

Results

Interviewees reported an improvement in the surgical skills and confidence of NPCs, as well as better teamwork. At the facility level, supervision led to an increase in the volume and range of surgical procedures done and helped to reduce unnecessary surgical referrals. The supervision also improved communication links by facilitating the establishment of a remote consultation network, which enabled specialists to provide real-time support to district NPCs in how to undertake particular surgical procedures and expert guidance on referral decisions. Despite these benefits, shortages of operating theatre support staff, lack of equipment and unreliable power supply impeded maximum utilisation of supervision.

Conclusion

This supervision model demonstrated the additional role that specialist surgeons can play, bringing their expertise to rural populations, where such surgical competence would otherwise be unobtainable. Further research is needed to establish the cost-effectiveness of the supervision model; the opportunity costs from surgical specialists being away from referral hospitals, providing supervision in districts; and the steps needed for regular district surgical supervision to become part of sustainable national programmes.
Skin wound healing triggers epigenetic modifications of histone H4
Authors: Nascimento-Filho Carlos H. V. , Silveira Ericka J. D. , Goloni-Bertollo Eny M. , de Souza Lelia Batista , Squarize Cristiane H. , Castilho Rogerio M.
Published: March 2020

Background

The skin is the largest organ of the human body. Upon injury, the skin triggers a sequence of signaling pathways that induce epithelial proliferation, migration, and ultimately, the re-establishment of the epithelial barrier. Our study explores the unknown epigenetic regulations of wound healing from a histone perspective. Posttranslational modifications of histones enhance chromatin accessibility and modify gene transcription.

Methods

Full-thickness wounds were made in the dorsal skin of twenty-four C57/B6 mice (C57BL/6J), followed by the use of ring-shaped silicone splints to prevent wound contraction. Tissue samples were collected at three time points (post-operatory day 1, 4, and 9), and processed for histology. Immunofluorescence was performed in all-time points using markers for histone H4 acetylation at lysines K5, K8, K12, and K16.

Results

We found well-defined histone modifications associated with the stages of healing. Most exciting, we showed that the epidermis located at a distance from the wound demonstrated changes in histone acetylation, particularly the deacetylation of histone H4K5, H4K8, and H4K16, and hyperacetylation of H4K12. The epidermis adjacent to the wound revealed the deacetylation of H4K5 and H4K8 and hyperacetylation of H4K12. Conversely, the migratory epithelium (epithelial tongue) displayed significant acetylation of H4K5 and H4K12. The H4K5 and H4K8 were decreased in the newly formed epidermis, which continued to display high levels of H4K12 and H4K16.

Conclusions

This study profiles the changes in histone H4 acetylation in response to injury. In addition to the epigenetic changes found in the healing tissue, these changes also took place in tissues adjacent and distant to the wound. Furthermore, not only deacetylation but also hyperacetylation occurred during tissue repair and regeneration.
Association of pre-operative chronic kidney disease and acute kidney injury with in-hospital outcomes of emergency colorectal surgery: a cohort study
Authors: Miyake Katsunori , Iwagami Masao , Ohtake Takayasu , Moriya Hidekazu , Kume Nao , Murata Takaaki , Nishida Tomoki , Mochida Yasuhiro , Isogai Naoko , Ishioka Kunihiro , Shimoyama Rai , Hidaka Sumi , Kashiwagi Hiroyuki , Kawachi Jun , Ogino Hidemitsu , Kobayashi Shuzo
Published: March 2020

Background

Pre-operative kidney function is known to be associated with surgical outcomes. However, in emergency surgery, the pre-operative kidney function may reflect chronic kidney disease (CKD) or acute kidney injury (AKI). We examined the association of pre-operative CKD and/or AKI with in-hospital outcomes of emergency colorectal surgery.

Methods

We conducted a retrospective cohort study including adult patients undergoing emergency colorectal surgery in 38 Japanese hospitals between 2010 and 2017. We classified patients into five groups according to the pre-operative status of CKD (defined as baseline estimated glomerular filtration rate < 60 mL/min/1.73 m2or recorded diagnosis of CKD), AKI (defined as admission serum creatinine value/baseline serum creatinine value ≥ 1.5), and end-stage renal disease (ESRD): (i) CKD(-)AKI(-), (ii) CKD(-)AKI(+), (iii) CKD(+)AKI(-), (iv) CKD(+)AKI(+), and (v) ESRD groups. The primary outcome was in-hospital mortality, while secondary outcomes included use of vasoactive drugs, mechanical ventilation, blood transfusion, post-operative renal replacement therapy, and length of hospital stay. We compared these outcomes among the five groups, followed by a multivariable logistic regression analysis for in-hospital mortality.

Results

We identified 3002 patients with emergency colorectal surgery (mean age 70.3 ± 15.4 years, male 54.5%). The in-hospital mortality was 8.6% (169/1963), 23.8% (129/541), 15.3% (52/340), 28.8% (17/59), and 32.3% (32/99) for CKD(-)AKI(-), CKD(-)AKI(+), CKD(+)AKI(-), CKD(+)AKI(+), and ESRD, respectively. Other outcomes such as blood transfusion and post-operative renal replacement therapy showed similar trends. Compared to the CKD(-)AKI(-) group, the adjusted odds ratio (95% confidence interval) for in-hospital mortality was 2.54 (1.90–3.40), 1.29 (0.90–1.85), 2.86 (1.54–5.32), and 2.76 (1.55–4.93) for CKD(-)AKI(+), CKD(+)AKI(-), CKD(+)AKI(+), and ESRD groups, respectively. Stratified by baseline eGFR (> 90, 60–89, 30–59, and < 30 mL/min/1.73 m2) and AKI status, the crude in-hospital mortality and adjusted odds ratio increased in patients with baseline eGFR < 30 mL/min/1.73 m2among patients without AKI, while these were constantly high regardless of baseline eGFR among patients with AKI. Additional analysis restricting to 2162 patients receiving the surgery on the day of hospital admission showed similar results.

Conclusions

The differentiation of pre-operative CKD and AKI, especially the identification of AKI, is useful for risk stratification in patients undergoing emergency colorectal surgery.
Concurrence of primary pulmonary malignant melanoma with invasive pulmonary adenocarcinoma: a case report
Authors: Yang Luhuan , Lei Yunhong , Zhang Rong , Liu Yufei , Dai Wenli , Tian Fei , Liu Jinglan
Published: March 2020

Background

Primary pulmonary malignant melanoma (PPMM) is an extreme rarity in clinic practice, accounting for only 0.01% of all primary pulmonary tumors. And its diagnosis should meet clinical and pathological diagnosis criteria in addition to excluding the possibility of metastatic melanoma. The mainstay of treatment is surgery. The concurrence of primary pulmonary malignant melanoma and invasive pulmonary adenocarcinoma has not been reported before.

Case presentation

Herein we report the case of a 39-year-old woman who was asymptomatic and accidently found to have the concurrence of PPMM with invasive pulmonary adenocarcinoma. Before considering the diagnosis of primary pulmonary malignant melanoma, a systemic positron emission tomography-computed tomography (PET-CT) was done to excluding primary tumor metastasis from other sites. The pathological biopsy proved that two lesions in the right middle lobe were invasive pulmonary adenocarcinomas and the mass in the right lower lobe was malignant melanoma. She underwent right middle and lower lobectomy of the lung with mediastinal and hilar lymph dissection. She refused adjuvant chemotherapy, genetic molecular testing or immunotherapy. Fifteen months later she had brain metastasis. Then she received brain radiotherapy and underwent follow-up at the outpatient clinic regularly.

Conclusions

We experienced a case of concurrent PPMM and invasive pulmonary adenocarcinoma. The patient reported here is the first case of primary pulmonary malignant melanoma combined with invasive pulmonary adenocarcinoma. This patient remained disease-free 15 months after lung surgery.
Probing the operability regime of an engineered ribocomputing unit in terms of dynamic range maintenance with extracellular changes and time
Authors: Montagud-Martínez Roser , Ventura Jordi , Ballesteros-Garrido Rafael , Rosado Arantxa , Rodrigo Guillermo
Published: March 2020

Synthetic biology aims at engineering gene regulatory circuits to end with cells (re)programmed on purpose to implement novel functions or discover natural behaviors. However, one overlooked question is whether the resulting circuits perform as intended in variety of environments or with time. Here, we considered a recently engineered genetic system that allows programming the cell to work as a minimal computer (arithmetic logic unit) in order to analyze its operability regime. This system involves transcriptional and post-transcriptional regulations. In particular, we studied the analog behavior of the system, the effect of physicochemical changes in the environment, the impact on cell growth rate of the heterologous expression, and the ability to maintain the arithmetic functioning over time. Conclusively, our results suggest 1) that there are wide input concentration ranges that the system can correctly process, the resulting outputs being predictable with a simple mathematical model, 2) that the engineered circuitry is quite sensitive to temperature effects, 3) that the expression of heterologous small RNAs is costly for the cell, not only of heterologous proteins, and 4) that a proper genetic reorganization of the system to reduce the amount of heterologous DNA in the cell can improve its evolutionary stability.
Ascending noradrenergic excitation from the locus coeruleus to the anterior cingulate cortex
Authors: Koga Kohei , Yamada Akihiro , Song Qian , Li Xu-Hui , Chen Qi-Yu , Liu Ren-Hao , Ge Jun , Zhan Cheng , Furue Hidemasa , Zhuo Min , Chen Tao
Published: March 2020

Anterior cingulate cortex (ACC) plays important roles in sensory perception including pain and itch. Neurons in the ACC receive various neuromodulatory inputs from subcortical structures, including locus coeruleus noradrenaline (LC-NA) neurons. Few studies have been reported about synaptic and behavioral functions of LC-NA projections to the ACC. Using viral-genetic method (AAV-DIO-eYFP) on DBH-cre mice, we found that LC-NA formed synaptic connections to ACC pyramidal cells but not interneurons. This is further supported by the electron microscopic study showing NAergic fibers contact the presynaptic inputs and post-synaptic areas of the pyramidal cells. NA application produced both pre- and post-synaptic potentiation effects in ACC excitatory transmission in vivo and in vitro. Activation of LC-NA projection to the ACC by optogenetic method produced enhancement of excitatory transmission in vitro and induced scratching and behavioral sensitization for mechanical stimulation. Our results demonstrate that LC-NA projections enhance or facilitate brain responses to pain and itch by potentiating glutamatergic synaptic transmissions in the ACC.
Characterisation of genetic regulatory effects for osteoporosis risk variants in human osteoclasts
Authors: Mullin Benjamin H. , Tickner Jennifer , Zhu Kun , Kenny Jacob , Mullin Shelby , Brown Suzanne J. , Dudbridge Frank , Pavlos Nathan J. , Mocarski Edward S. , Walsh John P. , Xu Jiake , Wilson Scott G.
Published: March 2020

Background

Osteoporosis is a complex disease with a strong genetic contribution. A recently published genome-wide association study (GWAS) for estimated bone mineral density (eBMD) identified 1103 independent genome-wide significant association signals. Most of these variants are non-coding, suggesting that regulatory effects may drive many of the associations. To identify genes with a role in osteoporosis, we integrate the eBMD GWAS association results with those from our previous osteoclast expression quantitative trait locus (eQTL) dataset.

Results

We identify sixty-nine significantcis-eQTL effects for eBMD GWAS variants after correction for multiple testing. We detect co-localisation of eBMD GWAS and osteoclast eQTL association signals for 21 of the 69 loci, implicating a number of genes includingCCR5,ZBTB38,CPE,GNA12,RIPK3,IQGAP1andFLCN. Summary-data-based Mendelian Randomisation analysis of the eBMD GWAS and osteoclast eQTL datasets identifies significant associations for 53 genes, withTULP4presenting as a strong candidate for pleiotropic effects on eBMD and gene expression in osteoclasts. By performing analysis using the GARFIELD software, we demonstrate significant enrichment of osteoporosis risk variants among high-confidence osteoclast eQTL across multiple GWASPvalue thresholds. Mice lacking one of the genes of interest, the apoptosis/necroptosis geneRIPK3, show disturbed bone micro-architecture and increased osteoclast number, highlighting a new biological pathway relevant to osteoporosis.

Conclusion

We utilise a unique osteoclast eQTL dataset to identify a number of potential effector genes for osteoporosis risk variants, which will help focus functional studies in this area.
Kaempferol ameliorates Cisplatin induced nephrotoxicity by modulating oxidative stress, inflammation and apoptosis via ERK and NF-κB pathways
Authors: Wang Zhu , Sun Wansen , Sun Xi , Wang Ye , Zhou Meilan
Published: March 2020

Anticancer drug like Cisplatin are associated with serious problem like nephrotoxicity. The effect of Kaempferol is a plant-derived flavonoid compound. The present work evaluated the effect of Kaempferol in mouse model of Cisplatin mediated nephrotoxicity also the involved mechanism. Oxidative stress, kidney function, histology, inflammation, apoptosis, level of proteins, Nrf2 translocation and its effect on cascades such as NF-κB and ERK were studied. It was observed that the pre-treatment of KPF reduced the Cisplatin mediated oxidative stress, inflammation, apoptosis and ameliorated renal injury and its functioning. Kaempferol suppressed the Cisplatin induced infiltration of mononuclear cells, levels of TNF-α, iNOS, IL-12, activation of NF-κB, phosphorylation of IκBα and nuclear translocation of p65 in renal tissues. Also KPF attenuated Cisplatin mediated phosphorylation of p38, ERK1/2 and JNK in renal tissues. KPF also corrected the levels of renal antioxidants and elevated the nuclear levels of HO-1 and Nrf2 in renal tissues. KPF attenuated the Cisplatin mediated apoptosis via down-regulating the levels of TP53, Bax/Bcl2 imbalance, activating caspase-3/9 and PARP. The outcomes conclude that KPF ameliorates Cisplatin-mediated nephrotoxicity by modulating oxidative stress, inflammation and apoptosis via ERK and NF-κB pathway.
Radon spectrogram-based approach for automatic IFs separation
Authors: Bruni Vittoria , Tartaglione Michela , Vitulano Domenico
Published: March 2020

The separation of overlapping components is a well-known and difficult problem in multicomponent signals analysis and it is shared by applications dealing with radar, biosonar, seismic, and audio signals. In order to estimate the instantaneous frequencies of a multicomponent signal, it is necessary to disentangle signal modes in a proper domain. Unfortunately, if signal modes supports overlap both in time and frequency, separation is only possible through a parametric approach whenever the signal class is a priori fixed. In this work, time-frequency analysis and Radon transform are jointly used for the unsupervised separation of modes of a generic frequency modulated signal in noisy environment. The proposed method takes advantage of the ability of the Radon transform of a proper time-frequency distribution in separating overlapping modes. It consists of a blind segmentation of signal components in Radon domain by means of a near-to-optimal threshold operation. The inversion of the Radon transform on each detected region allows us to isolate the instantaneous frequency curves of each single mode in the time-frequency domain. Experimental results performed on constant amplitudes chirp signals confirm the effectiveness of the proposed method, opening the way for its extension to more complex frequency modulated signals.
Existence and concentration of positive solutions for a class of discontinuous quasilinear Schrödinger problems in $\mathbb{R}^{N}$
Authors: Yuan Ziqing
Published: March 2020

In this paper, a class of quasilinear Schrödinger equations with discontinuous nonlinearity is considered. After changing variables, by using nonsmooth critical point theory, we obtain the existence and concentration of positive solutions for this problem under suitable conditions. Our results cover and extend some results for these differentiable quasilinear Schrödinger problems.
Association of epigenetics of the PDK4 gene in skeletal muscle and peripheral blood with exercise therapy following artificial knee arthroplasty
Authors: Kamo Tomohiro , Kurose Satoshi , Ohno Hiroshi , Murata Minoru , Saito Takanori , Kimura Yutaka
Published: March 2020

Background

Although exercise is a standard treatment for postoperative osteoarthritis, interindividual differences have been reported. Epigenetic modification (DNA methylation), a factor causing interindividual differences, is altered by the environment and may affect all tissues. Performing a tissue biopsy to investigate methylation of skeletal muscle fat metabolism genes is invasive, and less invasive and convenient alternatives such as blood testing are desired. However, the relationship between tissue and blood is still unclear. Here, we examined the relationship between DNA methylation of the PDK4 gene in skeletal muscle and peripheral blood.

Patients and methods

Five patients who underwent artificial knee arthroplasty between April 2017 and June 2018 at Kansai Medical University Hospital were included (2 men and 3 women; average age, 75.2 years; body mass index, 26.1 kg/m2). We measured the body composition of the patients using dual-energy X-ray absorptiometry. Peripheral blood was collected at the time of hospitalization and 5 months after surgery; skeletal muscles were collected at the time of surgery and 5 months after surgery. Rehabilitation was performed according to the clinical procedure for 3 months after surgery. Patients performed resistance training and aerobic exercise using an ergometer for 20 min twice a week. Biopsy samples were treated with bisulfite after DNA extraction, and the methylation rate was calculated at different CpG islands downstream from the transcription initiation codon of the PDK4 gene.

Results

No significant change in body composition was observed before and after postoperative exercise therapy, and no significant change was noted in the methylation at each position in the promoter region of PDK4 in the skeletal muscle and peripheral blood. However, changes in the methylation rate at CpG1 in peripheral blood significantly correlated with those in skeletal muscle (P = 0.037). Furthermore, the amount of change in the methylation rate of CpG1 in the skeletal muscle was significantly correlated (P = 0.037) with the average methylation rate at the promoter region in peripheral blood.

Conclusions

Methylation rates at CpG1 in the skeletal muscle and peripheral blood were significantly correlated, suggesting that skeletal muscle methylation could be analyzed via peripheral blood rather than skeletal muscle biopsy.
Neuropathological correlates of parkinsonian disorders in a large Dutch autopsy series
Authors: Geut H. , Hepp D. H. , Foncke E. , Berendse H. W. , Rozemuller J. M. , Huitinga I. , van de Berg W. D. J.
Published: March 2020

The clinical diagnosis in patients with parkinsonian disorders can be challenging, and a definite diagnosis requires neuropathological confirmation. The aim of this study was to examine whether a clinical diagnosis of Parkinson’s disease (PD) and atypical parkinsonian disorders predict the presence of Lewy pathology (LP) and concomitant neuropathological lesions.

We included 293 donors with a history of parkinsonism without dementia at disease onset, collected by the Netherlands Brain Bank (NBB) from 1989 to 2015. We retrospectively categorized donors according the International Parkinson and Movement Disorder Society clinical diagnostic criteria for PD (MDS-PD criteria) as ‘not PD’, ‘probable PD’ or ‘established PD’. We compared the final clinical diagnosis to presence of neuropathological lesions as defined by BrainNet Europe and National Institute on Aging – Alzheimer's Association guidelines.

LP was present in 150 out of 176 donors (85%) with a clinical diagnosis of PD, in 8 out of 101 donors (8%) with atypical parkinsonian disorders and in 4 out of 16 donors (25%) without a definite clinical diagnosis. Independent from age at death, stages of amyloid-β, but not neurofibrillary tau or neuritic plaques, were higher in donors with LP compared to other types of pathology (p = 0.009). The MDS-PD criteria at a certainty level of ‘probable PD’ predicted presence of LP with a diagnostic accuracy of 89.3%. Among donors with LP, ‘established PD’ donors showed similar Braak α-synuclein stages and stages of amyloid-β, neurofibrillary tau and neuritic plaques compared to ‘not PD’ or ‘probable PD’ donors.

In conclusion, both a clinical diagnosis of PD as well as MDS-PD criteria accurately predicted presence of LP in NBB donors. LP was associated with more widespread amyloid-β pathology, suggesting a link between amyloid-β accumulation and LP formation.
Adolescent food insecurity in rural Sindh, Pakistan: a cross-sectional survey
Authors: Sheikh Sana , Iqbal Romaina , Qureshi Rahat , Azam Iqbal , Barolia Rubina
Published: March 2020

Background

Food insecurity (FI) is alarmingly high in developing countries including Pakistan. A quarter of Pakistan’s population consists of adolescents yet there is no information on their experience of FI. FI at adolescent age have long term effect on mental and physical health hence we aimed to determine the prevalence of food insecurity (FI) among adolescents and compare it with household FI, and assess social determinants of adolescent FI.

Methods

A cross-sectional survey on 799 households with unmarried adolescents was conducted from September 2015 to June 2016 in three union councils of Hyderabad, Pakistan. Unmarried 10–19 years old girls and boys were interviewed regarding their FI status using Household Food Insecurity Assessment Scale (HFIAS). Household-level FI was also assessed by interviewing mothers of adolescents, and it was compared with adolescent’s FI. Association of adolescent’s FI with socio-demographic determinants was explored through Cox regression using STATA version 14.0. and prevalence ratios were estimated.

Results

FI was found among 52.4% of the adolescents compared to 39% of the households. Thirty percent of the adolescents were food insecure within the food secure households. Female adolescents were found to be less food insecure (Adjusted Prevalence Ratio (APR) 0.4 95% CI [0.3, 0.5]) compared to males. Social determinants like socioeconomic status (SES), crowding index or education of parents were not associated with adolescents’ FI.

Conclusion

Half of the adolescents were found to be food insecure which raises concerns regarding their health in the long run. Gender is an important social determinant of FI among adolescents which suggests an in-depth exploration of social dynamics of adolescent FI. We recommend the mixed-methods study to develop contextually relevant interventions to reduce FI among this group and improve their health status.
Characterization of breast masses: a comparative study between automated breast ultrasound (ABUS) and digital breast tomosynthesis (DBT)
Authors: Hashem Lamiaa Mohamed Bassam , Ali Reham Hussein Mohamed , Helal Maha Hussein , Gemeae Emad ELdin E. L. , Moustafa Amr Farouk Ibrahim
Published: March 2020

Background

Automated three-dimensional (3D) breast ultrasound (US) systems and breast tomosynthesis are promising breast imaging modalities. The study aims to compare the diagnostic indices of the 3D imaging techniques: digital breast tomosynthesis (DBT) and automated breast ultrasound (ABUS) in the characterization of breast masses. This prospective study included 32 women with breast masses either detected by means of clinical examination or with the mammographic exam. All of them have been subjected to tomosynthesis and automatic breast ultrasound examinations. The images from both modalities were then analyzed one at a time by two experienced representative radiologists in consensus. Results were compared to each other and to pathology and follow-up of typically benign findings

Results

The masses statistically evaluated in this study were 37 in number, among which 16 were benign and 21 were malignant. The sensitivity and specificity of tomosynthesis in the characterization of breast masses were 100% and 81.25%, respectively, while automated breast ultrasound were 100% and 75%, respectively.

Conclusion

Tomosynthesis and automated breast ultrasound are two promising modalities in breast imaging. Their diagnostic indices in this study were very close to one another; therefore, they can be used as an adjunct modality to mammography for early diagnosis of breast cancer.
Building a Clinically Relevant Risk Model: Predicting Risk of a Potentially Preventable Acute Care Visit for Patients Starting Antineoplastic Treatment
Authors: Daly Bobby , Gorenshteyn Dmitriy , Nicholas Kevin J. , Zervoudakis Alice , Sokolowski Stefania , Perry Claire E. , Gazit Lior , Baldwin Medsker Abigail , Salvaggio Rori , Adams Lynn , Xiao Han , Chiu Yeneat O. , Katzen Lauren L. , Rozenshteyn Margarita , Reidy-Lagunes Diane L. , Simon Brett A. , Perchick Wendy , Wagner Isaac
Published: March 2020

PURPOSE

To create a risk prediction model that identifies patients at high risk for a potentially preventable acute care visit (PPACV).

PATIENTS AND METHODS

We developed a risk model that used electronic medical record data from initial visit to first antineoplastic administration for new patients at Memorial Sloan Kettering Cancer Center from January 2014 to September 2018. The final time-weighted least absolute shrinkage and selection operator model was chosen on the basis of clinical and statistical significance. The model was refined to predict risk on the basis of 270 clinically relevant data features spanning sociodemographics, malignancy and treatment characteristics, laboratory results, medical and social history, medications, and prior acute care encounters. The binary dependent variable was occurrence of a PPACV within the first 6 months of treatment. There were 8,067 observations for new-start antineoplastic therapy in our training set, 1,211 in the validation set, and 1,294 in the testing set.

RESULTS

A total of 3,727 patients experienced a PPACV within 6 months of treatment start. Specific features that determined risk were surfaced in a web application, riskExplorer, to enable clinician review of patient-specific risk. The positive predictive value of a PPACV among patients in the top quartile of model risk was 42%. This quartile accounted for 35% of patients with PPACVs and 51% of potentially preventable inpatient bed days. The model C-statistic was 0.65.

CONCLUSION

Our clinically relevant model identified the patients responsible for 35% of PPACVs and more than half of the inpatient beds used by the cohort. Additional research is needed to determine whether targeting these high-risk patients with symptom management interventions could improve care delivery by reducing PPACVs.
Genomic Alteration in Metastatic Breast Cancer and Its Treatment
Authors: Li Allen , Schleicher Stephen M. , Andre Fabrice , Mitri Zahi I.
Published: March 2020

Metastatic breast cancer (mBC) remains responsible for the majority of breast cancer deaths. Whereas clinical outcomes have improved with the development of novel therapies, resistance almost inevitably develops, indicating the need for novel therapeutic approaches for the treatment of mBC. Recent investigations into mBC genomic alterations have revealed novel and potential therapeutic targets. Most notably, therapies against PIK3CA mutation and germline BRCA1/2 mutations have solidified the role of targeted therapy in mBC, with treatments against these alterations now approved by the U.S. Food and Drug Administration (FDA) on the basis of clinical benefit for patients with mBC. Familiarity with relevant genomic alterations in mBC, technologies for mutation detection, methods of interpreting genomic alterations, and an understanding of their clinical impact will aid practicing clinicians in the treatment of mBC as the field of breast oncology moves toward the era of precision medicine.
Perioperative COVID-19 Defense: An Evidence-Based Approach for Optimization of Infection Control and Operating Room Management
Authors: Dexter Franklin , Parra Michelle C. , Brown Jeremiah R. , Loftus Randy W.
Published: March 2020

We describe an evidence-based approach for optimization of infection control and operating room management during the coronavirus disease 2019 (COVID-19) pandemic. Confirmed modes of viral transmission are primarily, but not exclusively, contact with contaminated environmental surfaces and aerosolization. Evidence-based improvement strategies for attenuation of residual environmental contamination involve a combination of deep cleaning with surface disinfectants and ultraviolet light (UV-C). (1) Place alcohol-based hand rubs on the intravenous (IV) pole to the left of the provider. Double glove during induction. (2) Place a wire basket lined with a zip closure plastic bag on the IV pole to the right of the provider. Place all contaminated instruments in the bag (eg, laryngoscope blades and handles) and close. Designate and maintain clean and dirty areas. After induction of anesthesia, wipe down all equipment and surfaces with disinfection wipes that contain a quaternary ammonium compound and alcohol. Use a top-down cleaning sequence adequate to reduce bioburden. Treat operating rooms using UV-C. (3) Decolonize patients using preprocedural chlorhexidine wipes, 2 doses of nasal povidone-iodine within 1 hour of incision, and chlorhexidine mouth rinse. (4) Create a closed lumen IV system and use hub disinfection. (5) Provide data feedback by surveillance of Enterococcus, Staphylococcus aureus, Klebsiella, Acinetobacter, Pseudomonas, and Enterobacter spp. (ESKAPE) transmission. (6) To reduce the use of surgical masks and to reduce potential COVID-19 exposure, use relatively long (eg, 12 hours) staff shifts. If there are 8 essential cases to be done (each lasting 1–2 hours), the ideal solution is to have 2 teams complete the 8 cases, not 8 first case starts. (7) Do 1 case in each operating room daily, with terminal cleaning after each case including UV-C or equivalent. (8) Do not have patients go into a large, pooled phase I postanesthesia care unit because of the risk of contaminating facility at large along with many staff. Instead, have most patients recover in the room where they had surgery as is done routinely in Japan. These 8 programmatic recommendations stand on a substantial body of empirical evidence characterizing the epidemiology of perioperative transmission and infection development made possible by support from the Anesthesia Patient Safety Foundation (APSF).
Compliance Behavior in Networks: Evidence from a Field Experiment
Authors: Drago Francesco , Mengel Friederike , Traxler Christian
Published: March 2020

This paper studies the spread of compliance behavior in neighborhood networks in Austria. We exploit a field experiment that varied the content of mailings sent to potential evaders of TV license fees. The data reveal a strong treatment spillover: untreated households are more likely to switch from evasion to compliance in response to mailings received by their network neighbors. Digging deeper into the properties of the spillover, we find that it is concentrated among close neighbors of the targets and increases with the treated households’ diffusion centrality. Local concentration of equally treated households implies a lower spillover. (JEL C93, D12, D85, L82, L88, Z13)
Do Management Interventions Last? Evidence from India
Authors: Bloom Nicholas , Mahajan Aprajit , McKenzie David , Roberts John
Published: March 2020

We revisited Indian weaving firms nine years after a randomized experiment that changed their management practices. While about half of the practices adopted in the original experimental plants had been dropped, there was still a large and significant gap in practices between the treatment and control plants, suggesting lasting impacts of effective management interventions. Few practices had spread across the firms in the study, but many had spread within firms. Managerial turnover and the lack of director time were two of the most cited reasons for the drop in management practices, highlighting the importance of key employees. (JEL D22, D24, L67, L84, M11, O14)
Teaching of health-related physical activity in medical schools: the Brazilian scenario
Authors: Dourado Adriana Akemi , Hallal Pedro Rodrigues Curi , Domingues Marlos Rodrigues , Siqueira Fernando Vinholes
Published: March 2020

Physical activity engagement is a key strategy to improve population health and quality of life. However, studies show that physical activity counseling by physicians is low, and one of the main barriers reported is lack of specific knowledge. The aim of this study is to describe the existence of health-related physical activity content in the curricula of Brazilian Medicine undergraduate courses. A census-type descriptive study was carried out. Online documentation available in institutional websites of all Brazilian Medicine courses curricula were assessed and, when not available, faculty members were contacted. In 2015 we identified 233 medicine courses in Brazil, using data from the Brazilian Ministry of Education. We assessed the documentation in detail of 158 courses (67.8%). We observed that only 12% of curricula presented health-related physical activity and/or physical exercise contents. This proportion was higher in public Medical schools compared to private ones (21.5% vs. 5.4%; p = 0.002). Teaching of health-related physical activity in Brazilian Medicine courses is scarce. We highlight the need for adjustment of curricula considering the well-established benefits of physical activity for public health.