bluuebunny/crossref_metadata_2025 huggingface dataset:
Release and extraction of retained subfoveal perfluorocarbon liquid facilitated by subretinal BSS, vibration, and gravity: a case report
Authors: Takahashi Kosuke , Kimura Shuhei , Hosokawa Mio Morizane , Shiode Yusuke , Doi Shinichiro , Matoba Ryo , Kanzaki Yuki , Yonekawa Yoshihiro , Morizane Yuki
Published: October 2020

Background

Perfluorocarbon liquid (PFCL) is an effective surgical adjuvant in performing vitrectomy for severe vitreoretinal pathologies such as proliferative vitreoretinopathy and giant retinal tears. However, subretinal retention of PFCL can occur postoperatively and retained PFCL causes severe visual disorders, particularly when PFCL was retained under the fovea. Although several procedures have been proposed for subfoveal PFCL removal, such as direct aspiration or submacular injection of balanced salt solution (BSS) to dislodge the subfoveal PFCL, the retinal damage associated with these procedures has been a major problem. Here, we report a case of subfoveal retention of PFCL for which we performed a novel surgical technique that attempts to minimize retinal damage.

Case presentation

A 69-year-old man presented with subfoveal retained PFCL after surgery for retinal detachment. To remove the retained PFCL, the internal limiting membrane overlying the subretinal injection site is first peeled to allow low-pressure (8 psi) transretinal BSS infusion, using a 41-gauge cannula, to slowly detach the macula. A small drainage retinotomy is created with the diathermy tip at the inferior position of the macular bleb, sized to be slightly wider than that of the PFCL droplet. The head of the bed is then raised, and the surgeon gently vibrates the patient’s head to release the PFCL droplet to allow it to migrate inferiorly towards the drainage retinotomy. The bed is returned to the horizontal position, and the PFCL, now on the retinal surface, can be aspirated. The subfoveal PFCL is removed while minimizing iatrogenic foveal and macular damage. One month after PFCL removal, the foveal structure showed partial recovery on optical coherence tomography, and BCVA improved to 20/40.

Conclusion

Creating a macular bleb with low infusion pressure and using vibrational forces and gravity to migrate the PFCL towards a retinotomy can be considered as a relatively atraumatic technique to remove subfoveal retained PFCL.
Residential mobility among adult cancer survivors in the United States
Authors: Liu Bian , Lee Furrina F. , Boscoe Francis
Published: October 2020

Background

While residential mobility affects people’s health, the dynamic of neighborhood tenure and its associated factors among cancer patients and survivors have not been studied in detail. This cross-sectional study aimed to identify sociodemographic factors associated with neighborhood tenure and relocation after the first cancer diagnosis among U.S. adult cancer survivors and patients.

Methods

Based on a nationally representative sample of non-institutionalized civilian adults (≥18 years, n = 185,637) from the 2013–2018 National Health Interview Survey, we compared neighborhood tenure between adults with and without a history of cancer, and identified factors associated with their neighborhood tenure and relocation after the first cancer diagnosis, using propensity score matching, and logistic regression models with survey design incorporated.

Results

Among adults with cancer (9.0%), 39.6% had a neighborhood tenure ≤10 years (vs. 61.2% among those without cancer), and 25.6% (equivalent to 5.4 million) relocated after their first cancer diagnosis. The odds of having shorter neighborhood tenure was higher among the cancer group in the propensity-matched samples (odds ratio = 1.05; 95% CI: 1.05–1.06; n = 17,259). Among cancer survivors, the odds of neighborhood relocation were negatively associated with increasing age, perceived neighborhood social cohesion, having high school level education, and being married; while positively associated with having family income below the poverty threshold, being uninsured, and living in non-Northeast regions.

Conclusions

High residential mobility was found among a sizable proportion of adults with a history of cancer, and was associated with multiple socioeconomic factors. Incorporating and addressing modifiable risk factors associated with residential mobility among cancer patients and survivors may offer new intervention opportunities to improve cancer care delivery and reduce cancer disparities.
Cost–utility and cost–benefit analyses of school-based obesity prevention program
Authors: Xu Haiquan , Li Yanping , Du Songming , Zhang Qian , Liu Ailing , Sun Junmao , Ma Guansheng
Published: October 2020

Background

Economic evaluation of school-based obesity interventions could provide support for public health decision of obesity prevention. This study is to perform cost–utility and cost–benefit assessment of three school-based childhood obesity interventions including nutrition education intervention (NE), physical activity intervention (PA) and comprehensive intervention (both NE and PA, CNP) with secondary data analysis of one randomized controlled trial.

Methods

The standard cost-effectiveness analysis methods were employed from a societal perspective to the health outcome and costs that are attributable to the intervention. NE, PA and CNP were carried out separately for 2 semesters for childhood obesity interventions in primary schools. The additional quality-adjusted life years (QALYs) resulting from the interventions were measured as the health outcome. A cost–utility ratio (CUR) and A cost–benefit ratio (CBR) was calculated as the ratio of implementation costs to the total medical and productivity loss costs averted by the interventions.

Results

The CUR and CBR were ¥11,505.9 ($1646.0) per QALY and ¥1.2 benefit per ¥1 cost respectively, and the net saving was ¥73,659.6 ($10,537.9). The CUR and CBR for nutrition education and physical activity interventions were ¥21,316.4 ($3049.6) per QALY and ¥0.7 benefit per ¥1 cost, ¥28,417.1 ($4065.4) per QALY and ¥0.4 benefit per ¥1 cost, respectively (in 2019 RMB). Compared with PA intervention, the ICERs were ¥10,335.2 ($1478.6) and 4626.3 ($661.8) for CNP and NE respectively. The CBR was ¥1.2, 0.7, and 0.4 benefits per ¥1 cost for CNP, NE, and PA interventions, respectively. Net estimated savings were achieved only through CNP intervention, amounting to ¥73,659.6 ($10,537.9).

Conclusions

Comprehensive school-based obesity intervention is a beneficial investment that is both cost-effective and cost saving. Compared with PA intervention, both CNP and NE intervention were more cost-effective.
Hook plate with or without coracoclavicular ligament augmentation in the treatment of acute acromioclavicular separation
Authors: Liu Chung-Ting , Yang Ten-Fang
Published: October 2020

Background

Acromioclavicular (AC) separation can be treated with the use of a hook plate. Some studies have reported that coracoclavicular (CC) ligament augmentation is necessary to reduce the complications of hook plate fixation, whereas others recommend hook plate fixation alone without augmentation. The aim of this study was to compare the results and complications between these two groups.

Methods

This was an observational case-control study. Patients with acute (less than 2 weeks) Rockwood type V AC separation were treated with a hook plate at our hospital. A total of 105 cases received hook plate fixation with CC ligament augmentation (group I), and 112 cases received hook plate fixation without augmentation (group II). Constant-Murley scores were used to evaluate the function before and after implant removal, and radiographs were taken to evaluate the complications. The results and complications were compared between groups.

Results

Before removal, the Constant-Murley score was significantly higher in group I (mean, 50.1) than in group II (mean, 42.6) (p = 0.004); however, there was no significant difference between groups at 3 and 6 months after removal. The incidence of significant acromion osteolysis was higher in group II (65/112) than in group I (25/105). Before removal, the patients with significant acromion osteolysis had worse Constant-Murley scores than those of the patients without osteolysis in both groups. The incidence of peri-implant fracture of the hook plate was higher in group II (8/112) than in group I (1/105).

Conclusion

The patients without CC ligament augmentation had worse functional results before hook plate removal, a higher incidence of radiographic acromion osteolysis, and a higher incidence of peri-implant fractures than those patients with CC ligament augmentation. Therefore, CC ligament augmentation is highly recommended to improve short-term outcomes and decrease complications for Rockwood type V AC separation treated by hook plate.
Feasibility, technique and accuracy of ultrasound-guided transurethral injections into the urinary sphincter of female cadavers: proof of concept
Authors: Schmid Florian A. , Gascho Dominic , Zoelch Niklaus , Prange Jenny A. , Colacicco Giovanni , Eberli Daniel
Published: October 2020

Background

The injection of muscle precursor cells (MPC) into the external urinary sphincter muscle (EUS) is a promising therapeutic option for regenerative treatment of stress urinary incontinence (SUI). The objective of the present project was to conduct a pre-clinical trial to investigate the feasibility and accuracy of ultrasound (US) guided, transurethral injections into the EUS of female cadavers.

Methods

This is a prospective, anatomical, interventional and radiological cadaveric laboratory investigation. Two urologists performed transurethral US-guided injections to deliver nano-iron particles into the EUS. The intervention was performed in three unfixed, fresh female cadavers. Each cadaver received MRI before and CT as well as MRI of the pelvis after the injections.

Results

The precision and accumulation of nano-iron particles in the EUS was compared using a rating scale to evaluate left versus right and anterior versus posterior distribution in axial and sagittal orientation with US, MRI and CT. The accuracy of our US-guided injections into the anterior target region yielded 4 points on the rating scale. Adequate precision and accumulation of particles in the left versus right EUS were also demonstrated (3 vs. 3.33 points, respectively). Signal intensity in MRI revealed a mean ratio of 0.33 before and after injection. CT scans showed no relevant artefacts impairing the assessment.

Conclusion

US-guided, transurethral injection into the EUS is feasible and imaging reveals a precise accumulation in the target region. Our method provides an appropriate approach to deliver MPC in the EUS muscle for a regenerative treatment of SUI in the near future.
Evaluating the integration of pre-mortem body donor imaging into a dissection-based medical anatomy course
Authors: McBain Kimberly , Azimov Brandon , O’Brien Jeremy , Noël Geoffroy P. J. C. , Ventura Nicole M.
Published: October 2020

Background

Medical faculties are currently embracing a modernistic approach to anatomical education that integrates diagnostic imaging largely through post-mortem computed tomography scanning of body donors. Post-mortem imaging, however, poses a multitude of challenges. The purpose of this study was to assess the implementation of pre-mortem donor-specific diagnostic imaging on student learning and dissection experience in addition to understanding the potential impact on students’ preparation for clinical practice.

Methods

Students in a fourth-year medicine elective course were divided into groups; group 1 received pre-mortem donor-specific diagnostic imaging, while group 2 received pathology-specific diagnostic imaging, a collection of images relating to the type(s) of pathologies the donors exhibited, though not specific to the donors themselves. Both groups also received a donor-specific case vignette. A convergent, parallel mixed methods design was employed. This included integrating data from group responses to a study participant survey and students’ academic assessment scores analyzed quantitatively through statistical analyses with data from focus group sessions investigating the psychosocial aspects of the student dissection experience and perceptions of the imaging use in the course analyzed qualitatively.

Results

As compared to students receiving pathology-specific diagnostic imaging, the quantitative results demonstrated that students receiving pre-mortem donor-specific diagnostic imaging more positively supported the relevancy of diagnostic imaging to their understanding of anatomy, valued the integration for future practice, and suggested an earlier integration within their medical curriculum. Qualitatively, two main themes were observed: the influence of diagnostic imaging integration on dissection experience and on professional mindset. Although both student groups received imaging corresponding to their body donor, consideration towards the humanistic nature of the body donor as a patient with a history was limited to student feedback from the donor- specific diagnostic imaging group.

Conclusion

Overall the integration of pre-mortem donor-specific diagnostic imaging into anatomical dissection provided students with practical skill development, an enhanced dissection experience, and reinforced personal qualities critical for future practice.
Aedes (Stegomyia) aegypti mosquito bite hypersensitivity in a dog: a case report
Authors: Tahir Djamel , Meyer Leon Nicolaas , Lekouch Nouha , Varloud Marie
Published: October 2020

Background

Mosquitoes are vectors of several pathogens of considerable importance to humans and companion animals, including nematode helminths such as Dirofilaria immitis and Dirofilaria repens that cause heartworm disease and subcutaneous dirofilariosis, respectively. In addition to mosquito-borne pathogen transmission, mosquito bites can cause discomfort and irritation in pets, and even lead to severe hypersensitivity reactions. In the present study, we report an acute local hypersensitivity reaction in a dog following experimental exposure to Aedes (Stegomyia) aegypti.

Case presentation

A healthy six-year-old male beagle was included in an efficacy study in which dogs (n = 28) were exposed to Ae. aegypti mosquitoes. On Day − 6, the dog was allocated to one of the study groups, consisting of seven dogs to be treated on Day 0 with an imidacloprid/flumethrin collar. After sedation, animals were exposed to approximately 50 females of Ae. aegypti for 60 (± 5) minutes on Days − 6, 1, 7, 14, 21, 28, 55, and 83. On Day − 6, no allergic reaction to the mosquito bites was observed. However, on Day 1, corresponding to the second challenge, the dog demonstrated an acute allergic reaction characterized by swelling of the face (especially in the base of the muzzle and around the eyes), redness of the eyes, and conjunctival edema of the right eye was also observed. The dog was immediately treated with an intramuscular injection of a commercially available antihistamine treatment, Pen-Hista-Strep® containing a suspension of benzylpenicillin, chlorphenamine, dexamethasone, dihydrostreptomycin, and procaine at a dosage of 1 mL per 10 kg. A few hours after treatment, the dog showed noticeable improvement.

Conclusions

This case provides the first evidence of canine acute local hypersensitivity reaction to mosquito bites under laboratory conditions. This observation suggests that invasive mosquito species such as Aedes spp. may affect the health and comfort of our companion animals, especially for pets with outdoor access without individual protective measures against insect bites.
“Caballo”: risk environments, drug sharing and the emergence of a hepatitis C virus epidemic among people who inject drugs in Puerto Rico
Authors: Abadie R. , Dombrowski K.
Published: October 2020

Background

Sharing drug injection equipment has been associated with the transmission of HCV among PWID through blood contained in the cooker and cotton used to prepare and divide up the drug solution. While epidemiologists often subsume this practice under the sharing of “ancillary equipment,” more attention should be paid to the fact that indirect sharing takes place within the process of joint drug acquisition and preparation.

Methods

We employed an ethnographic approach observing active PWID (N = 33) in four rural towns in Puerto Rico in order to document drug sharing arrangements involved in “caballo”, as this practice is locally known. We explored partners’ motivation to engage in drug sharing, as well as its social organization, social roles and existing norms.

Findings

Findings suggest that drug sharing, is one of the main drivers of the HCV epidemic in this population. Lack of financial resources, drug packaging, drug of choice and the desire to avoid the painful effects of heroin withdrawal motivates participants’ decision to partner with somebody else, sharing injection equipment—and risk—in the process. Roles are not fixed, changing not only according to caballo partners, but also, power dynamics.

Conclusion

In order to curb the HCV epidemic, harm reduction policies should recognize the particular sociocultural contexts in which people inject drugs and make decisions about risk. Avoiding sharing of injection equipment within an arrangement between PWID to acquire and use drugs is more complex than assumed by harm reduction interventions. Moving beyond individual risk behaviors, a risk environment approach suggest that poverty, and a strict drug policy that encourage users to carry small amounts of illicit substances, and a lack of HCV treatment among other factors, contribute to HCV transmission.
Lung metastases from intraductal papillary neoplasm of the bile duct: a case report
Authors: Fujino Rika , Masuoka Yoshihito , Mashiko Taro , Nakano Akira , Hirabayashi Kenichi , Nakagohri Toshio
Published: October 2020

Background

Intraductal papillary neoplasm of the bile duct (IPNB) is considered a pre-cancerous biliary lesion and/or an early cancer lesion, although its classification remains unclear. The 2019 revised edition of the World Health Organization Classification of Tumors of the Digestive System proposed type 1 and type 2 as new classification categories, and meta-analyses and/or multi-center cohort studies are beginning to be reported. However, treatment for IPNB recurrence and metastasis remains unclear.

Case presentation

A 60-year-old man who was referred to our hospital after a suspected liver tumor was diagnosed using abdominal ultrasonography. Imaging findings revealed an irregularly shaped tumor in segment 5 (S5) of the liver (size 20 mm). The S5 lesion was suspected as IPNB, and segmentectomy was performed. The pathological findings revealed invasive carcinoma derived from IPNB, and immunohistochemistry revealed positive expression of MUC1, MUC5AC, and MUC6, but negative expression of CDX2 and MUC2. At 9 months after the surgery, computed tomography revealed a tumor in the right bile duct, which was diagnosed as liver recurrence of IPNB, and right hepatectomy was performed. The histopathological findings were the same as for the first resected specimen (i.e., IPNB). At 45 months after the second surgery, computed tomography revealed nodules in both lungs, which were diagnosed as lung metastases from IPNB and resected in two separate procedures. The pathological findings were metastatic carcinoma from IPNB for both lung lesions. The patient is currently alive and undergoing adjuvant chemotherapy (S-1), which was initiated 64 months after the first resection and 12 months after resection of the lung metastases.

Conclusion

We encountered a rare case of lung metastases from IPNB, which were diagnosed immunohistologically. Because IPNB is generally a slow-growing tumor, resection may be feasible for IPNB recurrence and/or metastasis, which may be detected during long-term follow-up. Thus, even if resection is performed for primary IPNB, additional surgical treatment may be feasible in this setting.
Yes-associated protein (YAP) induces a secretome phenotype and transcriptionally regulates plasminogen activator Inhibitor-1 (PAI-1) expression in hepatocarcinogenesis
Authors: Marquard Simone , Thomann Stefan , Weiler Sofia M. E. , Bissinger Michaela , Lutz Teresa , Sticht Carsten , Tóth Marcell , de la Torre Carolina , Gretz Norbert , Straub Beate K. , Marquardt Jens , Schirmacher Peter , Breuhahn Kai
Published: October 2020

Background

Overexpression and nuclear enrichment of the oncogene yes-associated protein (YAP) cause tumor initiation and support tumor progression in human hepatocellular carcinoma (HCC) via cell autonomous mechanisms. However, how YAP expression in tumor cells affects intercellular communication within the tumor microenvironment is not well understood.

Methods

To investigate how tumor cell-derived YAP is changing the paracrine communication network between tumor cells and non-neoplastic cells in hepatocarcinogenesis, the expression and secretion of cytokines, growth factors and chemokines were analyzed in transgenic mice with liver-specific and inducible expression of constitutively active YAP (YAPS127A). Transcriptomic and proteomic analyses were performed using primary isolated hepatocytes and blood plasma. In vitro, RNAinterference (RNAi), expression profiling, functional analyses and chromatin immunoprecipitation (ChIP) analyses of YAP and the transcription factor TEA domain transcription factor 4 (TEAD4) were performed using immortalized cell lines. Findings were confirmed in cohorts of HCC patients at the transcript and protein levels.

Results

YAP overexpression induced the expression and secretion of many paracrine-acting factors with potential impact on tumorous or non-neoplastic cells (e.g. plasminogen activator inhibitor-1 (PAI-1), C-X-C motif chemokine ligand 13 (CXCL13), CXCL16). Expression analyses of human HCC patients showed an overexpression of PAI-1 in human HCC tissues and a correlation with poor overall survival as well as early cancer recurrence. PAI-1 statistically correlated with genes typically induced by YAP, such as connective tissue growth factor (CTGF) and cysteine rich angiogenic inducer 61 (CYR61) or YAP-dependent gene signatures (CIN4/25). In vitro, YAP inhibition diminished the expression and secretion of PAI-1 in murine and human liver cancer cell lines. PAI-1 affected the expression of genes involved in cellular senescence and oncogene-induced senescence was confirmed in YAPS127A transgenic mice. Silencing of TEAD4 as well as treatment with the YAP/TEAD interfering substance Verteporfin reduced PAI-1 expression. ChIP analyses confirmed the binding of YAP and TEAD4 to the gene promoter of PAI-1 (SERPINE1).

Conclusions

These results demonstrate that the oncogene YAP changes the secretome response of hepatocytes and hepatocyte-derived tumor cells. In this context, the secreted protein PAI-1 is transcriptionally regulated by YAP in hepatocarcinogenesis. Perturbation of these YAP-dependent communication hubs including PAI-1 may represent a promising pharmacological approach in tumors with YAP overexpression.
Socio-economic and demographic predictors of unmet need for contraception among young women in sub-Saharan Africa: evidence from cross-sectional surveys
Authors: Ahinkorah Bright Opoku , Ameyaw Edward Kwabena , Seidu Abdul-Aziz
Published: October 2020

Introduction

Globally, sub-Saharan Africa (SSA) bears the highest proportion of women with unmet need for contraception as nearly 25% of women of reproductive age in the sub-region have unmet need for contraception. Unmet need for contraception is predominant among young women. We examined the association between socio-economic and demographic factors and unmet need for contraception among young women in SSA.

Methods

Data for this study obtained from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 30 sub-Saharan African countries. The sample size consisted of young women (aged 15–24), who were either married or cohabiting and had complete cases on all the variables of interest (N = 59,864). Both bivariate and multivariable binary logistic regression analyses were performed using STATA version 14.0.

Results

The overall prevalence of unmet need for contraception among young women was 26.90% [95% CI: 23.82–29.921], ranging from 11.30% [95% CI: 5.1–17.49] in Zimbabwe to 46.7% [95% CI: 36.92–56.48] in Comoros. Results on socio-economic status and unmet need for contraception showed that young women who had primary [aOR = 1.18; CI = 1.12–1.25, p < 0.001] and secondary/higher levels of formal education [aOR = 1.27; CI = 1.20–1.35, p < 0.001] had higher odds of unmet need for contraception compared to those with no formal education. With wealth status, young women in the richest wealth quintile had lower odds of unmet need for contraception compared with those in the poorest wealth quintile [aOR = 0.89; CI = 0.81–0.97, p < 0.01]. With the demographic factors, the odds of unmet need for contraception was lower among young women aged 20–24 [aOR = 0.74; CI = 0.70–0.77, p < 0.001], compared with 15–19 aged young women. Also, young women who were cohabiting had higher odds of unmet need for contraception compared to those who were married [aOR = 1.35; CI = 1.28–1.43, p < 0.001].

Conclusion

Our study has demonstrated that unmet need for contraception is relatively high among young women in SSA and this is associated with socio-economic status. Age, marital status, parity, occupation, sex of household head, and access to mass media (newspaper) are also associated with unmet need for contraception. It is therefore, prudent that organisations such as UNICEF and UNFPA and the Bill & Melinda Gates Foundation who have implemented policies and programmes on contraception meant towards reducing unmet need for contraception among women take these factors into consideration when designing interventions in sub-Saharan African countries to address the problem of high unmet need for contraception among young women.
Clinical features and efficacy of antiviral drug, Arbidol in 220 nonemergency COVID‐19 patients from East-West-Lake Shelter Hospital in Wuhan: a retrospective case series
Authors: Gao Wei , Chen Si , Wang Kun , Chen Rongzhang , Guo Qian , Lu Jingjing , Wu Xiaodong , He Yanan , Yan Qiaoyun , Wang Shengyun , Wang Feilong , Jin Li , Hua Jing , Li Qiang
Published: October 2020

Objective

We aimed to describe the features of 220 nonemergency (mild or common type) COVID-19 patients from a shelter hospital, as well as evaluate the efficiency of antiviral drug, Arbidol in their disease progressions.

Methods

Basic clinical characteristics were described and the efficacy of Arbidol was evaluated based on gender, age, maximum body temperature of the patients.

Results

Basically, males had a higher risk of fever and more onset symptoms than females. Arbidol could accelerate fever recovery and viral clearance in respiratory specimens, particularly in males. Arbidol also contributed to shorter hospital stay without obvious adverse reactions.

Conclusions

In the retrospective COVID-19 cohort, gender was one of the important factors affecting patient's conditions. Arbidol showed several beneficial effects in these patients, especially in males. This study brought more researches enlightenment in understanding the emerging infectious disease.
Plants, food and treatments used by BaKongo tribes in Uíge (northern Angola) to affect the quality and quantity of human breast milk
Authors: Jendras Gesine , Monizi Mawunu , Neinhuis Christoph , Lautenschläger Thea
Published: October 2020

Background

Angola has one of the highest annual under-five mortality rates in in the world and malnutrition poses a severe problem in the country. This study is the first to focus on the traditional knowledge of plants, foods, and treatments used by the local population in the province of Uíge to affect the quality and quantity of human breast milk, since decades of independence and civil war impeded ethnobotanical studies in this area.

Methods

This study was conducted in eight municipalities in the province of Uíge, Northern Angola in February and March 2018. In 265 semi-structured interviews, 360 informants in 40 rural villages were asked about plants, food, and treatments used to affect the quality and quantity of human breast milk. Additionally, information on child mortality and the duration of breastfeeding were collected. Whenever possible, plant specimens were collected for later identification. To determine the local importance of the collected plants, food, and treatments, the Relative Frequency of Citations was calculated.

Results

Most women reported to have no problems with their breast milk production. The duration of breastfeeding meets the recommendations of the World Health Organization (WHO). Across all use categories, 69 plants from 36 plant families, and 21 other foods and treatments could be identified.

Conclusions

The study shows an overview of a variety of plants, foods, and treatments used by mothers as galactagogues, to “clean” or to reduce their breast milk and those which they avoided to use during the lactation period. There is great potential for further research into this traditional knowledge. Also, further analysis of some of the plants could be of interest.
Complex foot deformities associated with lower limb deformities: a new therapeutic strategy for simultaneous correction using Ilizarov procedure together with osteotomy and soft tissue release
Authors: Boquan Qin , Yi Ren , Tingjiang Gan , Xi Liu , Hui Zhang
Published: October 2020

Aim

The aim of the current study is to introduce a new therapeutic strategy for simultaneous correction of complex foot deformities (CFD) and the associated lower limb deformities (LLD) by using Ilizarov technique with osteotomy and soft tissue procedure and to report its early clinical results.

Methods

A retrospective review of CFD associated with LLD simultaneous correction utilizing the Ilizarov procedure together with osteotomy and soft tissue balance from 2015 to 2019 was conducted.

Results

Thirty-two patients were followed for an average of 42.8 months. The mean external fixation time (EFT) was 6.5 months. The mean healing index (HI) was 1.7 months/cm. At the time of fixator removal, plantigrade feet were achieved in all patient and lower limb deformities were corrected. No recurrence of the deformities occurred. The mean LLRS AIM score was improved from 7.5 to 0.3. At the final follow-up, the ASAMI-Paley score was graded as excellent in all limbs in the aspect of bone results, and functional results were defined as excellent in 29 (90.6%) limbs and good in 3 (9.4%) limbs. The mean modified Dimeglio score was significantly improved from 7.2 to 1.3. No deep infection of the osteotomy site or nonunion was noted in the current study.

Conclusion

The therapeutic strategy by using the Ilizarov procedure together with osteotomy and soft tissue balance is a safe and effective way to simultaneously correct CFD and LLD.

Level of evidence

Level IV, retrospective case series
Apparently benign craniocervical signs in achondroplasia: “neurologic leftovers” identified through a retrospective dataset
Authors: Smid Cory J. , Legare Janet M. , Modaff Peggy , Pauli Richard M.
Published: October 2020

Background

Achondroplasia is the most common dwarfing disorder. It can result in a variety of sequelae, including neurologic complications, among which high cervical myelopathy is one of particular concern. However, some individuals with achondroplasia appear to have persistent signs by physical examination that, while they might suggest the presence of high cervical myelopathy, remain isolated, non-progressive and apparently benign. To document and quantify these apparently benign craniocervical signs (ABCS) a cohort of 477 individuals with achondroplasia was retrospectively analyzed and information regarding persistent neurologic features suggestive of high cervical myelopathy was recorded in a REDCap database.

Results

Within this cohort, 151 individuals (31.7%) had neurologic examinations that were in some manner concerning.
Of these, 46 (30.5% of the subpopulation) required cervicomedullary decompressive surgery. The remaining 105 had concerning signs by examination but no apparent evidence for clinically significant cervical myelopathy. Of those 105 individuals, 88 (83.8%; 18.4% of the entire population) remained neurologically intact throughout their follow-up, and without clinical sequelae.

Conclusions

It appears that many individuals with achondroplasia, if carefully examined, may demonstrate isolated, initially concerning signs suggestive of cervical myelopathy, but in the vast majority these are benign and do not indicate need for aggressive neurosurgical intervention. Further investigations may help to identify ways to differentiate these benign features from the less common but more problematic true myelopathic ones. We postulate that the “neurologic leftovers” may arise from temporally remote, subtle damage to the spinal cord at the craniocervical junction, which damage otherwise does not reach clinical relevance.
Fabrication of polylactic acid/paclitaxel nano fibers by electrospinning for cancer therapeutics
Authors: Chi H. Y. , Chan Vincent , Li Chuan , Hsieh J. H. , Lin P. H. , Tsai Ya-Hui , Chen Yun
Published: October 2020

Polylactic acid (PLA) is a thermoplastic and biodegradable polyester, largely derived from renewable resources such as corn starch, cassava starch and sugarcane. However, PLA is only soluble in a narrow range of solvents such as tetrahydrofuran, dioxane, chlorinated solvents and heated benzene. The limited choices of solvent for PLA dissolution have imposed significant challenges in the development of specifically engineered PLA nanofibers with electrospinning techniques. Generally, the electrospun polymeric materials have been rendered with unique properties such as high porosity and complex geometry while maintaining its biodegradability and biocompatibility for emerging biomedical applications. In this study, a new anticancer drug delivery system composed of PLA nanofibers with encapsulated paclitaxel was developed by the electrospinning of the respective nanofibers on top of a spin-coated thin film with the same chemical compositions. Our unique approach is meant for promoting strong bonding between PLA-based nanofibers and their respective films in order to improve the prolonged release properties and composite film stability within a fluctuative physiochemical environment during cell culture. PLA/paclitaxel nanofiber supported on respective polymeric films were probed by scanning electronic microscope, Fourier transform infrared spectrometer and water contact measurement for determining their surface morphologies, fibers’ diameters, molecular vibrational modes, and wettability, respectively. Moreover, PLA/paclitaxel nanofibers supported on respective spin-coated films at different loadings of paclitaxel were evaluated for their abilities in killing human colorectal carcinoma cells (HCT-116). More importantly, MTT assays showed that regardless of the concentrations of paclitaxel, the growth of HCT-116 was effectively inhibited by the prolonged release of paclitaxel from PLA/paclitaxel nanofibers. An effective prolonged delivery system of paclitaxel based on PLA nanofiber-based film has demonstrated exciting potentials for emerging applications as implantable drug delivery patch in post-surgical cancer eradication.
The histone and non-histone methyllysine reader activities of the UHRF1 tandem Tudor domain are dispensable for the propagation of aberrant DNA methylation patterning in cancer cells
Authors: Vaughan Robert M. , Kupai Ariana , Foley Caroline A. , Sagum Cari A. , Tibben Bailey M. , Eden Hope E. , Tiedemann Rochelle L. , Berryhill Christine A. , Patel Varun , Shaw Kevin M. , Krajewski Krzysztof , Strahl Brian D. , Bedford Mark T. , Frye Stephen V. , Dickson Bradley M. , Rothbart Scott B.
Published: October 2020

The chromatin-binding E3 ubiquitin ligase ubiquitin-like with PHD and RING finger domains 1 (UHRF1) contributes to the maintenance of aberrant DNA methylation patterning in cancer cells through multivalent histone and DNA recognition. The tandem Tudor domain (TTD) of UHRF1 is well-characterized as a reader of lysine 9 di- and tri-methylation on histone H3 (H3K9me2/me3) and, more recently, lysine 126 di- and tri-methylation on DNA ligase 1 (LIG1K126me2/me3). However, the functional significance and selectivity of these interactions remain unclear. In this study, we used protein domain microarrays to search for additional readers of LIG1K126me2, the preferred methyl state bound by the UHRF1 TTD. We show that the UHRF1 TTD binds LIG1K126me2 with high affinity and selectivity compared to other known methyllysine readers. Notably, and unlike H3K9me2/me3, the UHRF1 plant homeodomain (PHD) and its N-terminal linker (L2) do not contribute to multivalent LIG1K126me2 recognition along with the TTD. To test the functional significance of this interaction, we designed a LIG1K126me2 cell-penetrating peptide (CPP). Consistent with LIG1 knockdown, uptake of the CPP had no significant effect on the propagation of DNA methylation patterning across the genomes of bulk populations from high-resolution analysis of several cancer cell lines. Further, we did not detect significant changes in DNA methylation patterning from bulk cell populations after chemical or genetic disruption of lysine methyltransferase activity associated with LIG1K126me2 and H3K9me2. Collectively, these studies identify UHRF1 as a selective reader of LIG1K126me2 in vitro and further implicate the histone and non-histone methyllysine reader activity of the UHRF1 TTD as a dispensable domain function for cancer cell DNA methylation maintenance.
The effect of abolishing instructions to fast prior to contrast-enhanced CT on the incidence of acute adverse reactions
Authors: Tsushima Yoshito , Seki Yuko , Nakajima Takahito , Hirasawa Hiromi , Taketomi-Takahashi Ayako , Tan Shogo , Suto Takayuki
Published: October 2020

Objectives

To evaluate the effect of abolishing instructions to fast prior to contrast-enhanced CT on acute adverse reactions (AARs).

Methods

In our institution, we instructed patients to fast one meal before contrast-enhanced CT examinations. However, we abolished these instructions at the end of March 2019, and solid food intake was not restricted before contrast-enhanced CT after this date. The differences in the incidence of AARs before (December 2015–November 2018, n = 43,927) and after (April 2019–March 2020, n = 14,676) abolishing instructions to fast were compared. We allowed 4 months (December 2018–March 2019) for this policy change to fully permeate the CT referrals. The medical records of patients who vomited were retrospectively reviewed by one of the authors for notations of aspiration or aspiration pneumonia attributable to vomiting.

Results

The overall incidence of AARs before (1.60%, n = 705) and after abolition (1.40%, n = 205) did not change significantly. As the chemotoxic reactions, the incidence of nausea decreased significantly (0.31 to 0.18%, p = 0.006). The incidence of vomiting did not change (0.12 to 0.16%), and there were no cases of aspiration pneumonia attributable to vomiting during the study period. The incidence of severe hypersensitivity/allergy-like reactions did not change (0.06 to 0.05%).

Conclusions

Abolishing instructions to fast decreased the incidence of nausea, but did not affect the incidence of vomiting. No cases of aspiration pneumonia attributable to vomiting were found. Our study confirmed that fasting is not required prior to contrast-enhanced CT.
Giant isolated hydatid lung cyst: two case reports
Authors: Lodhia Jay , Chugulu Samwel , Sadiq Adnan , Msuya David , Mremi Alex
Published: October 2020

Background

Echinococcosis is a parasitic disease caused by Echinococcus granulosus and causes cystic lesions in the liver and lungs commonly. It is endemic in many parts of the world, and though humans are incidental hosts of the parasite, the disease can have severe consequences.

Case presentation

We present two patients from pastoralist (Maasai) communities in rural Tanzania with long-standing chest pain accompanied by hemoptysis. Both were managed surgically after diagnosis, but one patient died of the complications following rapture of the cyst during surgery. Histopathological evaluation of the specimens confirmed the diagnosis of giant hydatid cysts.

Conclusion

Animal-keeping communities such as the Maasai are at risk of echinococcosis because of their close proximity to animals. The diagnosis can be made on the basis of history and radiological as well as laboratory findings. Surgery is a recommended mode of treatment, though it carries a high risk, especially when the cyst ruptures. Primary preventive measures are thus necessary in order to avoid the secondary and tertiary complications of the management of giant hydatid cysts, which is difficult in resource-limited endemic areas.
Resolution and implementation of the nonstationary vorticity velocity pressure formulation of the Navier–Stokes equations
Authors: Abdelwahed Mohamed , Alharbi Ebtisam , Chorfi Nejmeddine , Ouertani Henda
Published: October 2020

This paper deals with the iterative algorithm and the implementation of the spectral discretization of time-dependent Navier–Stokes equations in dimensions two and three. We present a variational formulation, which includes three independent unknowns: the vorticity, velocity, and pressure. In dimension two, we establish an optimal error estimate for the three unknowns. The discretization is deduced from the implicit Euler scheme in time and spectral methods in space. We present a matrix linear system and some numerical tests, which are in perfect concordance with the analysis.
A hybrid method for solving time fractional advection–diffusion equation on unbounded space domain
Authors: Azin H. , Mohammadi F. , Heydari M. H.
Published: October 2020

In this article, a hybrid method is developed for solving the time fractional advection–diffusion equation on an unbounded space domain. More precisely, the Chebyshev cardinal functions are used to approximate the solution of the problem over a bounded time domain, and the modified Legendre functions are utilized to approximate the solution on an unbounded space domain with vanishing boundary conditions. The presented method converts solving this equation into solving a system of algebraic equations by employing the fractional derivative matrix of the Chebyshev cardinal functions and the classical derivative matrix of the modified Legendre functions together with the collocation technique. The accuracy of the presented hybrid approach is investigated on some test problems.
Radiation-induced occult insufficiency fracture or bone metastasis after radiotherapy for cervical cancer? The nomogram based on quantitative apparent diffusion coefficients for discrimination
Authors: Zhong Xi , Jiang Huali , Mai Hui , Xiang Jialin , Li Jiansheng , Huang Zhiqing , Wu Songxin , Luo Liangping , Jiang Kuiming
Published: October 2020

Background

Radiation-induced insufficiency fractures (IF) is frequently occult without fracture line, which may be mistaken as metastasis. Quantitative apparent diffusion coefficient (ADC) shows potential value for characterization of benign and malignant bone marrow diseases. The purpose of this study was to develop a nomogram based on multi-parametric ADCs in the differntiation of occult IF from bone metastasis after radiotherapy (RT) for cervical cancer.

Methods

This study included forty-seven patients with cervical cancer that showed emerging new bone lesions in RT field during the follow-up. Multi-parametric quantitative ADC values were measured for each lesion by manually setting region of interests (ROIs) on ADC maps, and the ROIs were copied to adjacent normal muscle and bone marrow. Six parameters were calculated, including ADCmean, ADCmin, ADCmax, ADCstd, ADCmeanratio (lesion/normal bone) and ADCmeanratio (lesion/muscle). For univariate analysis, receiver operating characteristic curve (ROC) analysis was performed to assess the performance. For combined diagnosis, a nomogram model was developed by using a multivariate logistic regression analysis.

Results

A total of 75 bone lesions were identified, including 48 occult IFs and 27 bone metastases. There were significant differences in the six ADC parameters between occult IFs and bone metastases (p < 0.05), the ADC ratio (lesion/ muscle) showed an optimal diagnostic efficacy, with an area under ROC (AUC) of 0.887, the sensitivity of 95.8%, the specificity of 81.5%, respectively. Regarding combined diagnosis, ADCstdand ADCmeanratio (lesion/muscle) were identified as independent factors and were selected to generate a nomogram model. The nomogram model showed a better performance, yielded an AUC of 0.92, the sensitivity of 91.7%, the specificity of 96.3%, positive predictive value (PPV) of 97.8% and negative predictive value (NPV) of 86.7%, respectively.

Conclusions

Multi-parametric ADC values demonstrate potential value for differentiating occult IFs from bone metastasis, a nomogram based on the combination of ADCstdand ADCmeanratio (lesion/muscle) may provide an improved classification performance.
Testing allometric scaling relationships in plant roots
Authors: Deng Qiang , Yuan Zhiyou , Shi Xinrong , Lock T. Ryan , Kallenbach Robert L.
Published: October 2020

Background

Metabolic scaling theory predicts that plant productivity and biomass are both size-dependent. However, this theory has not yet been tested in plant roots.

Methods

In this study, we tested how metabolic scaling occurs in plants using a comprehensive plant root dataset made up of 1016 observations from natural habitats. We generated metabolic scaling exponents by log-transformation of root productivity versus biomass.

Results

Results showed that the metabolic scaling exponents of fine root (< 2 mm in diameter) productivity versus biomass were close to 1.0 for all ecosystem types and functional groups. Scaling exponents decreased in coarse roots (> 2 mm in diameter).

Conclusions

We found isometric metabolic scaling in fine roots, a metabolically active organ similar to seedlings or saplings. Our findings also indicate a shift in metabolic scaling during plant development. Overall, our study supports the absence of any unified single constant scaling exponent for metabolism-biomass relationships in terrestrial plants, especially for forests with woody species.