bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of neurogenic bladder outlet obstruction mimicking sphincter bradykinesia in male patients with Parkinson’s disease
Authors: Xing Tianying , Ma Jinghong , Ou Tongwen
Published: March 2021

Background

Lower urinary tract symptoms are one of the most common groups of non-movement symptoms in patients with Parkinson’s disease (PD). Storage symptoms are well-acknowledged, but neurogenic voiding dysfunction caused by PD remains a knowledge gap. This study aimed to evaluate the neurogenic bladder outlet obstruction in male patients with PD and its clinical significance.

Methods

Male patients who were diagnosed with PD and underwent urodynamic studies were retrospectively reviewed. The patients with prostate size < 30 ml and bladder outlet obstruction index ≥40 were included in the study. Lower urinary tract symptoms were evaluated by International Prostate Symptom Score (IPSS). Free flowmetry was performed and post void residual (PVR) volume was measured by ultrasound at follow-up.

Results

Six patients were included in the final analysis. The mean age was 68.2 and the mean movement symptom duration was 70.7 months. The patients had a mean IPSS of 12.5 and mean PVR volume of 70.8 ml. All patients had slow stream but none of them reported significant voiding difficulty. Urodynamic studies showed the delayed urinary sphincter relaxation and the special trace pattern. After a mean follow-up of 20 months, they had a mean IPSS of 12.5 and mean PVR volume of 73.3 ml. None of them complained of significant voiding difficulty at follow-up.

Conclusion

The delayed urinary sphincter relaxation is a rare but repeatable phenomenon in male patients with PD. It is unlikely to cause disturbing voiding dysfunction, as reported by the patients, and does not progress prominently during the course of PD. Further studies are needed to investigate the nature of this special type of neurogenic BOO and whether it is peculiar to PD in a larger patient cohort.
Clinical efficacy comparison of avapritinib with other tyrosine kinase inhibitors in gastrointestinal stromal tumors with PDGFRA D842V mutation: a retrospective analysis of clinical trial and real-world data
Authors: von Mehren Margaret , Heinrich Michael C. , Shi Hongliang , Iannazzo Sergio , Mankoski Raymond , Dimitrijević Saša , Hoehn Gerard , Chiroli Silvia , George Suzanne
Published: March 2021

Background

Avapritinib, a potent inhibitor of KIT and platelet-derived growth factor receptor A (PDGFRA) tyrosine kinases, has demonstrated unprecedented clinical activity in PDGFRA D842V-mutant gastrointestinal stromal tumors (GIST).

Methods

This retrospective analysis compared efficacy of avapritinib in patients enrolled in the NAVIGATOR phase 1 trial (NCT02508532) with the efficacy of other tyrosine kinase inhibitors (TKIs) in patients with unresectable/metastatic PDGFRA D842V-mutant GIST enrolled in a retrospective natural history study (Study 1002). The primary endpoint was overall survival (OS) from the start of reference treatment (avapritinib for NAVIGATOR patients or first-line TKI for treatment of unresectable/metastatic GIST for Study 1002 patients); the secondary endpoint was progression-free survival (PFS). Adjusted Kaplan–Meier survival curves were compared by Cox regression.

Results

Fifty-six (NAVIGATOR) and 19 (Study 1002) patients with PDGFRA D842V-mutant GIST were evaluated; of the 56 patients from NAVIGATOR, a subgroup of patients treated with either 300 mg (recommended phase 2 dose) or 400 mg (maximum tolerated dose) avapritinib starting dose (n = 38) were analyzed separately. Patient characteristics were adjusted for imbalances by propensity score between the study groups. Inverse probability of treatment weighting-adjusted Kaplan–Meier analysis of OS showed median OS was not reached for NAVIGATOR patients treated with any of the avapritinib doses tested and was 12.6 months for Study 1002 patients; OS rate at 6/48 months was 100%/63% in NAVIGATOR and 56%/17% in Study 1002 (P = 0.0001). In the 300/400 mg subgroup, adjusted OS rates at 6/36 months were 100%/73 and 68%/20% in Study 1002 (P = 0.0016). Adjusted median PFS was 29.5 months in NAVIGATOR and 3.4 months in Study 1002.

Conclusions

In this indirect, retrospective analysis, avapritinib demonstrated more durable survival outcomes compared with other TKIs in patients with unresectable/metastatic PDGFRA D842V-mutant GIST.

Trial registration

The NAVIGATOR trial was registered at ClinicalTrials.gov as per July 2015, Identifier:NCT02508532.
The role of contraception in preventing HIV-positive births: global estimates and projections
Authors: Sherwood Jennifer , Lankiewicz Elise , Roose-Snyder Beirne , Cooper Bergen , Jones Austin , Honermann Brian
Published: March 2021

Background

Meeting the contraceptive needs of women living with HIV (WLHIV) has primary health benefits for women, in addition to being a key element to prevent mother-to-child HIV transmission. This analysis will estimate the current number of infant HIV infections prevented by contraception in the era of increased HIV treatment coverage and; 2) model the additional HIV benefits of preventing unintended births to WLHIV.

Methods

Secondary data analysis was conducted using publicly available data from the United Nations Programme on HIV/AIDS (UNAIDS) and Population Division, Demographic Health Surveys, and peer-review literature. National data from 70 countries, that had a UNAIDS estimate for the number of WLHIV nationally, were combined into country-level models. Models estimated the current number of infant HIV infections averted by contraception annually and potentially averted if unintended births to WLHIV were prevented. Estimates take into account pregnancy and live birth rates, contraceptive coverage, contraceptive method mix and failure rates, and HIV treatment coverage during pregnancy to prevent mother to child transmission.

Results

Contraception use among WLHIV prevents an estimated 43,559 new infant HIV infections annually across 70 countries. Countries with the largest number of infant infections averted by contraception included South Africa (9441), Nigeria (4195), Kenya (3508), Zimbabwe (2586), and India (2145). Preventing unintended births to WLHIV could avert an additional 43,768 new infant infections per year, with the greatest potential gains to be made in South Africa (12,036), Nigeria (2770), Uganda (2552), and the Democratic Republic of the Congo (2324).

Conclusions

Contraception continues to play an integral role in global HIV prevention efforts in the era of increasing HIV treatment coverage, especially in sub-Saharan Africa. Broad contraceptive availability, increased contraceptive voluntarism and method mix are key components to preventing unintended births and ending new infant HIV infections worldwide.
Pulmonary infiltration as the initial manifestation of chronic lymphoproliferative disorder of natural killer cells: a case report and literature review
Authors: Zhang Jinjing , Wang Pingping , Yan Xiaojing
Published: March 2021

Background

Chronic lymphoproliferative disorder of natural killer cells (CLPD-NK) is an extremely rare haematological disease. To the best of our knowledge, pulmonary infiltration in CLPD-NK has not been reported before. Our case study aimed to present the clinical characteristics, chest computed tomography (CT) findings, and flow cytometry immunophenotyping (FCI) results of an unusual case of migratory pulmonary infiltration in a patient with CLPD-NK.

Case presentation

A 51-year-old female patient was admitted to our hospital on October 8, 2019. Eight months before this visit, she had been diagnosed with pneumonia in a community hospital with 1 month of low-grade fever and had recovered after oral antibiotic administration. During follow-up, the patient presented with persistent peripheral blood (PB) lymphocytosis and ground-glass opacities on lung CT scans without any symptoms and signs or any evidence of infectious, allergic or autoimmunity pulmonary diseases. Abnormal NK cells were identified in the PB, bone marrow and bronchoalveolar lavage fluid (BALF) using FCI in our hospital. Eventually, the patient was diagnosed with pulmonary infiltration of CLPD-NK. The patient had an indolent clinical course without symptoms, hepatosplenomegaly or palpable lymphadenopathy and did not receive any therapy. The patient has remained in a good performance status 13 months after the diagnosis.

Conclusions

Our study described a unique case of pulmonary infiltration in a patient with CLPD-NK. The present case highlights the importance of FCI of the BALF in patients with lymphocytosis and pulmonary shadows to avoid misdiagnosis.
Preoperative factors predicting the severity of BMD loss around the implant after Total hip Arthroplasty
Authors: Morita Akira , Kobayashi Naomi , Choe Hyonmin , Tezuka Taro , Higashihira Shota , Inaba Yutaka
Published: March 2021

Background

Stress shielding after total hip arthroplasty (THA) leads to loss of bone mineral density (BMD) around the femoral implants, particularly in the proximal area. Loss of BMD around the implant is likely to occur within 1 year after THA; however, its severity depends on patient characteristics. This study evaluated preoperative factors correlated with the severity of zone 7 BMD loss after THA.

Methods

This retrospective cohort study included 48 patients who underwent primary THA from October 2011 to December 2015. All patients underwent implantation of a Zweymüller-type femoral component without any postoperative osteoporosis medications. The objective variable was a change in zone 7 BMD after 1 year. Factors evaluated included age, body mass index, Japanese Orthopaedic Association score, Harris Hip Score, Canal Flare Index (CFI), and lumbar BMD on the frontal and lateral sides. Univariate and multivariate regression analyses identified factors correlated with loss of zone 7 BMD.

Results

Univariate regression analysis identified CFI (P = 0.003) and preoperative lumbar BMD on the anterior-posterior (P = 0.003) and lateral (P < 0.001) sides as being correlated with loss of zone 7 BMD. Multivariate regression analysis identified CFI (P = 0.014) and lumbar BMD on the lateral side (P < 0.001) as being correlated independently with loss of zone 7 BMD.

Conclusion

Lower preoperative lumbar BMD on the lateral side and lower CFI were correlated with zone 7 BMD loss after THA. Patients with these characteristics should be monitored carefully for severe BMD loss after THA.
Application of open-door laminoplasty with ARCH plate fixation in cervical intraspinal tumors
Authors: Wang Zhi-Chao , Li Shu-Zhong , Qu Xin-Fei , Yin Chu-Qiang , Sun Yuan-Liang , Wang Yue-Lei , Wang Jie , Liu Chen-Jing , Cao Zhen-Lu , Wang Ting
Published: March 2021

Background

The open-door laminoplasty is an effective procedure for the treatment of cervical spondylotic myelopathy. However, little information is available about the surgical results of open-door laminoplasty in the treatment of intraspinal tumors. In the present study, we aimed to investigate the clinical effect of open-door laminoplasty with ARCH plate fixation in the treatment of cervical intraspinal tumors.

Methods

This was a retrospective study. From January 2013 to May 2018, 38 patients (13 males and 25 females, the average age of 44 ± 17 years) with cervical intraspinal tumors underwent open-door laminoplasty with ARCH plate fixation in our hospital. The operation time, blood loss, pre- and postoperative visual analog scale (VAS), and Japanese Orthopedic Association (JOA) scores were determined. To determine the radiographic outcomes, cervical X-ray film and magnetic resonance imaging (MRI) were performed before and after the operation, and cervical X-ray sagittal film was used to measure Cobb angle. The clinical data before and after the operation were compared by t-test.

Results

A total of 38 patients underwent a successful operation and demonstrated primary healing. The average operation time was 113 ± 12 min. The average blood loss was 120 ± 19 mL. All patients were followed up for 26.1 ± 2.8 months, and the final follow-up time was more than 24 months. VAS scores were much better at 24 months after operation compared with those before the operation, which were decreased from 6.1 ± 1.1 to 1.4 ± 0.7 (t = 32.63, P < 0.01). The JOA score was improved from 9.9 ± 1.5 to 15.5 ± 0.6 (t = − 18.36, P < 0.01), and the mean JOA recovery rate was 79% ± 11% at 24 months after the operation. There was no significant difference in Cobb angle between pre-operation and 24 months after the operation, which was 9.8 ± 2.6 and 10.3 ± 3.1 respectively (t = − 0.61, P > 0.05). Neither spinal malalignment on the coronal plane nor displacement of the laminoplasty flap was observed on postoperative cervical X-ray and MRI examinations at the final follow-up.

Conclusions

Open-door laminoplasty with ARCH plate fixation was a safe and effective surgical approach for the treatment of cervical intraspinal tumors.
The effect of corticotomy on the compensatory remodeling of alveolar bone during orthodontic treatment
Authors: Wu Yi-Fei , Guo Hong-Ming
Published: March 2021

Background

This study aimed to explore whether compensatory remodeling of the alveolar bone surface occurred during the buccal palatal movement of orthodontic teeth. We preliminarily explored whether corticotomy could activate or accelerate osteogenesis in the alveolar bone surface by measuring the expression of TGF-β1 (transforming growth factor-β1), which can facilitate the proliferation and differentiation of osteoblasts and regulate the maturity and formation of bone.

Methods

Sixty 10-week-old male Wistar rats were selected. In the orthodontic group, 20 rats were implanted with a constriction device between the maxillary first molars under general anesthesia. In the corticotomy group, 20 rats were implanted with a constriction device, and a palatal incision was made to penetrate the cortical bone. In the control group, 20 rats underwent no experimental operation except general anesthesia. After 1, 3, 5 and 7 days, the maxillary first molars and the surrounding alveolar bone were harvested, and coronal sections containing the apical mesial buccal root were prepared and observed using tetracycline fluorescence, HE staining and immunohistochemical staining for TGF-β1. Image-Pro Plus software was used to assess the immunohistochemical results, and SPSS 22.0 statistical software was used to analyze variance and perform the LSD test.

Results

The tetracycline fluorescence results showed that in the periosteum near the apical region, an obvious fluorescence signal was observed in the orthodontic group and the corticotomy group compared with the control group. In the orthodontic group and corticotomy group, HE staining showed that the morphology was similar to cube-shaped. The immunohistochemical results showed that TGF-β1 was significantly increased in the periosteum near the apical region in the orthodontic group and corticotomy group, and there were significant differences among the three groups. In addition, the expression of TGF-β1 in the periosteum in the orthodontic group and the corticotomy group gradually increased over time, reaching a peak on day 5 and slightly decreasing on day 7.

Conclusion

Osteogenesis occurred on the alveolar bone surface during the buccal palatal movement of orthodontic teeth, and corticotomy had a positive effect, and TGF-β1 was involved in this process.
Tooth mousse containing casein phosphopeptide-amorphous calcium phosphate prevents biofilm formation of Streptococcus mutans
Authors: Sionov Ronit Vogt , Tsavdaridou Danae , Aqawi Muna , Zaks Batya , Steinberg Doron , Shalish Miriam
Published: March 2021

Background

Streptococcus mutans is a common cariogenic bacterium in the oral cavity involved in plaque formation. Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has been introduced into tooth mousse to encourage remineralization of dental enamel. The aim of this research was to study the effect of tooth mousse containing CPP-ACP (GC Tooth Mousse®) or CPP-ACP with 0.2% fluoride (CPP-ACPF; GC Tooth Mousse Plus®; GCP) on S. mutans planktonic growth and biofilm formation.

Methods

S. mutans was cultivated in the presence of different dilutions of the tooth mousse containing CPP-ACP or CPP-ACPF, and the planktonic growth was determined by ATP viability assay and counting colony-forming units (CFUs). The resulting biofilms were examined by crystal violet staining, MTT metabolic assay, confocal laser scanning microscopy (CLSM), and scanning electron microscope (SEM).

Results

The CPP-ACP tooth mousse (GC) at a dilution of 5–50 mg/ml (0.5–5%) did not inhibit planktonic growth, and even increased the ATP content and the number of viable bacteria after a 24 h incubation. The same was observed for the CPP-ACPF tooth mousse (GCP), except for the higher concentrations (25 and 50 mg/ml) that led to a drop in the bacterial count. Importantly, both compounds significantly decreased S. mutans biofilm formation at dilutions as low as 1.5–3 mg/ml. 12.5 mg/ml GC and 6.25 mg/ml GCP inhibited biofilm formation by 90% after 4 h. After 24 h, the MBIC90 was 6.25 mg/ml for both. CLSM images confirmed the strong inhibitory effect GC and GCP had on biofilm formation when using 5 mg/ml tooth mousse. SEM images of those bacteria that managed to form biofilm in the presence of 5 mg/ml tooth mousse, showed alterations in the bacterial morphology, where the streptococci appear 25–30% shorter on the average than the control bacteria.

Conclusion

Our data show that the tooth mousse containing CPP-ACP reduces biofilm formation of the cariogenic bacterium S. mutans without killing the bacteria. The use of natural substances which inhibit biofilm development without killing the bacteria, has therapeutic benefits, especially in orthodontic pediatric patients.
Association between Medicare’s Hospital Readmission Reduction Program and readmission rates across hospitals by medicare bed share
Authors: Banerjee Souvik , Paasche-Orlow Michael K. , McCormick Danny , Lin Meng-Yun , Hanchate Amresh D.
Published: March 2021

Background

Medicare’s Hospital Readmissions Reduction Program (HRRP), implemented beginning in 2013, seeks to incentivize Inpatient Prospective Payment System (IPPS) hospitals to reduce 30-day readmissions for selected inpatient cohorts including acute myocardial infarction, heart failure, and pneumonia. Performance-based penalties, which take the form of a percentage reduction in Medicare reimbursement for all inpatient care services, have a risk of unintended financial burden on hospitals that care for a larger proportion of Medicare patients. To examine the role of this unintended risk on 30-day readmissions, we estimated the association between the extent of their Medicare share of total hospital bed days and changes in 30-day readmissions.

Methods

We used publicly available nationwide hospital level data for 2009–2016 from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare program, CMS Final Impact Rule, and the American Hospital Association Annual Survey. Using a quasi-experimental difference-in-differences approach, we compared pre- vs. post-HRRP changes in 30-day readmission rate in hospitals with high and moderate Medicare share of total hospital bed days (“Medicare bed share”) vs. low Medicare bed share hospitals.

Results

We grouped the 1904 study hospitals into tertiles (low, moderate and high) by Medicare bed share; the average bed share in the three tertile groups was 31.2, 47.8 and 59.9%, respectively. Compared to low Medicare bed share hospitals, high bed share hospitals were more likely to be non-profit, have smaller bed size and less likely to be a teaching hospital. High bed share hospitals were more likely to be in rural and non-large-urban areas, have fewer lower income patients and have a less complex patient case-mix profile. At baseline, the average readmissions rate in the low Medicare bed share (control) hospitals was 20.0% (AMI), 24.7% (HF) and 18.4% (pneumonia). The observed pre- to post-program change in the control hospitals was − 1.35% (AMI), − 1.02% (HF) and − 0.35% (pneumonia). Difference in differences model estimates indicated no differential change in readmissions among moderate and high Medicare bed share hospitals.

Conclusions

HRRP penalties were not associated with any change in readmissions rate. The CMS should consider alternative options – including working collaboratively with hospitals – to reduce readmissions.
Are price discounts on sugar-sweetened beverages (SSB) linked to household SSB purchases? – a cross-sectional study in a large US household and retail scanner database
Authors: Zhong Yichen , Auchincloss Amy H. , Stehr Mark F. , Langellier Brent A.
Published: March 2021

Background

Price promotions on sugar-sweetened beverages (SSBs) are commonly used by retailers to provide economic incentives for purchasing. Surprisingly, there is a lack of high-quality articles that examine the frequency and magnitude of sugary beverage discounting and consumer responses to discounts. The objective of this study is to quantify the association between exposure to price discounts and SSB purchases.

Methods

This cross-sectional study linked 2016 SSB consumption data from a U.S. household consumer panel (analytic sampleN = 11,299 households) and weekly prices at stores where they shopped. We derived percent of the time SSBs were discounted (annual promotion frequency) and the amount of the discount (annual promotion magnitude) and assessed their association with household annual per capita SSB purchase ounces. Linear regression models adjusted for household size, income per capita, age, education, presence of children, race, occupation, region, and urbanicity. We also evaluated whether the association between promotion and purchase varied by socioeconomic status and race subgroups. Data were analyzed in 2019–2020.

Results

On average, households were exposed to SSBs price promotions 44% of the time. A 10-percentage point increase in annual SSB promotion frequency was associated with 13.7% increase in annual per capita purchasing (P < 0.0001), and a 1-percentage point increase in annual SSB promotion magnitude was associated with 15.3% increase in annual per capita purchasing (P < 0.0001). These associations did no vary significantly across socioeconomic status and race subgroups (InteractionP > 0.2).

Conclusions

More frequent and deeper price promotion was associated with higher annual per capita SSB purchases. Restricting SSB price promotions may be effective at reducing SSB consumption.
Validation of the Portuguese version of Amsterdam Preoperative Anxiety and Information Scale (APAIS)
Authors: Maurício Sandra , Rebêlo Isabel , Madeira Catarina , Resende Filipa , Esteves Susana
Published: March 2021

Background

Preoperative anxiety is common among the oncological surgical population. Due to its psychological and physiological detrimental effects, identifying and addressing it is of uttermost importance to improve anesthetic management and patient’s outcomes. The aim of this study is to validate the Portuguese version of Amsterdam Preoperative Anxiety and Information Scale (APAIS) in the oncological population.

Methods

Following forward and backward translation of the original APAIS scale, further adaptation was obtained through cognitive interviewing. The resulting instrument was tested on the day before surgery on a sample of adult cancer surgical patients from a Portuguese oncology centre. Psychometric evaluation was derived from inter-item correlation, confirmatory factor analysis, Cronbach’s alpha, correlation with comparative scales, receiver operating characteristic curve and Youden index.

Results

109 patients (58 males, 51 females) were included. A three-dimensional model—anxiety about anesthesia, anxiety about surgery and desire for information, showed the best fit to the data. The questionnaire revealed high internal consistency (Cronbach alpha 0.81) and good inter-item correlation. Also, Portuguese APAIS correlated well with the gold standard anxiety scale. Therefore, the psychometric properties of this scale version make it a valid and reliable instrument. The optimal cutoff to maximize both sensitivity and specificity was 12 for the APAIS global anxiety score.

Conclusions

Portuguese APAIS version is an accurate tool to identify preoperative anxiety among cancer patients and might impact its management, from premedication choice to provision of information and reassurance about either anesthesia or surgery.
Prevalence of caregiving and high caregiving strain among late-career medical school faculty members: workforce, policy, and faculty development implications
Authors: Skarupski Kimberly A. , Roth David L. , Durso Samuel C.
Published: March 2021

Background

Nearly one-third of medical school faculty members are age 55 + . As our population ages, the prevalence of family caregiving is increasing, yet we know very little about the caregiving experiences of aging faculty members in academic medicine. Faculty caregiving responsibilities coupled with projected physician shortages will likely impact the future academic medical workforce. We examined the prevalence of caregiving, concomitant caregiving strain, general well-being, and thoughts about retirement for medical school faculty members age 55 and older.

Methods

We analyzed data from a survey of 2,126 full-time medical school faculty 55 + years of age conducted in 2017. Chi-square tests of independence and independent samples t-tests were used to examine statistical differences between subgroups.

Results

Of the 5,204 faculty members invited to complete the parent survey, 40.8% participated (N = 2126). Most were male (1425; 67.2%), White (1841; 88.3%), and married/partnered (1803; 85.5%). The mean age was 62.3 years. Of this sample, 19.0% (n = 396) reported providing care on an on-going basis to a family member, friend, or neighbor with a chronic illness or disability, including 22.4% (n = 154) of the female respondents and 17.3% (n = 242) of the male respondents. Among the caregiving faculty members, 90.2% reported experiencing some or a lot of mental or emotional strain from caregiving. Caregivers gave lower ratings of health, social and emotional support, and quality of life, but greater comfort in religion or spirituality than non-caregivers. Both caregiving and non-caregiving faculty members estimated retiring from full-time employment at age 67.8, on average.

Conclusion

These data highlight caregiving responsibilities and significant concomitant mental or emotional strain of a significant proportion of U.S. medical schools’ rapidly aging workforce. Human resource and faculty development leaders in academia should strategically invest in policies, programs, and resources to meet these growing workforce needs.
Evolutionary trends in fertility among Chinese women, 1990–2015
Authors: Lan Manyu , Kuang Yaoqiu
Published: March 2021

Background

Under the one-child policy of birth control, total fertility rates (TFRs) declined rapidly among women in China. TFRs dropped from 2.29 in 1990 to 1.18 in 2010 and to 1.05 in 2015. However, little is known about the evolution of fertility patterns in China during 1990–2015.

Methods

We used population data from 1990 to 2015 and applied age–period–cohort (APC) models to examine temporal changes and used regression models to analyze the effect of education on fertility across periods and cohorts in China.

Results

Age effects assume an inverted U-shaped curve, which increase and then decline across ages, with a peak value in age groups 20–24 or 25–29. Period effects show a U-shaped curve, which first decline and then increase. Cohort effects show an inverted U-shaped plus V-shaped curve, which first increase, then decline and rebound with different age effects and period effects. The APC effect curves of all-order births are similar to those of first birth, but with different magnitudes.

Conclusions

We revealed the evolutionary trends in fertility patterns among Chinese women from 1990 to 2015. The one-child policy exerted a crowding out effect on education. Even if the well-educated women had an intense fertility intention, the fertility policy offset their desire for more children.
Measurement of three‐dimensional changes in lip vermilion in adult female patients after orthodontic extraction: a retrospective longitudinal study
Authors: Shen Lin-hui , Xie Tian-yi , Jiang Ruo-ping , Jiang Yi-ran , Chen Gui , Xu Tian-min , Han Bing
Published: March 2021

Background

3D facial scanning has changed the way facial aesthetic is evaluated and has numerous advantages for facial analysis. The specific relationship between lip vermilion morphological changes after orthodontic extraction treatment has not been fully explained. The objective of this study was to evaluate 3D morphological changes after orthodontic extraction treatment in lip vermilion of adult females with dentoalveolar protrusion using a structured light-based scanner.

Methods

Forty-two female subjects (25.2 ± 1.9 years) were recruited as the treatment group; these patients had undergone extraction treatment and achieved better sagittal profiles. Twenty female subjects (25.5 ± 2.1 years) were enrolled in the non-treatment group; these patients did not require any orthodontic treatment. The follow up time for the treatment group was more than 24 months and for the non-treatment group was more than 12 months. 3D facial scans were captured using 3D CaMega. Six landmarks (Ls, Li, R.Chp, L.Chp, R.Ch, and L.Ch), three linear measurements (mouth height, philtrum width, and mouth width), and three area measurements (upper, lower, and total vermilion area) were measured. The spatial deviations of three volumetric measurements (upper, lower, and total vermilion) were constructed for quantitative analysis. Color-coded displacement map were constructed for visualization of the soft-tissue displacement as qualitative evaluation.

Results

Mouth height and philtrum width decreased (-0.93 mm and − 1.08 mm, respectively) significantly (p = 0.008 and p = 0.027, respectively), and no significant (p = 0.488) change in mouth width was observed in the treatment group. The lower and total vermilion surface areas decreased (-51.00mm2 and − 69.82mm2, respectively) significantly (p = 0.003 and p = 0.031, respectively) in the treatment group, but no statistically significant (p = 0.752) change was detected in the upper vermilion. In the treatment group, significant retractions were observed in the color-coded displacement map, and three volumetric measurements of vermilion changed significantly (p = 0.012, p = 0.001 and p = 0.004, respectively). Significant differences were found between the treatment group and the non-treatment group in the linear, area and volumetric measurements.

Conclusions

This study established a method for qualitative and quantitative evaluation of the lip vermilion. Significant 3D retraction of the lip vermilion after the extraction treatment was found, with morphological variation between upper and lower vermilion.
New insights in phenotype and treatment of lung disease immuno-deficiency and chromosome breakage syndrome (LICS)
Authors: Willemse Brigitte W. M. , van der Crabben Saskia N. , Kerstjens-Frederikse Wilhelmina S. , Timens Wim , van Montfrans Joris M. , Lindemans Caroline A. , Boelens Jaap Jan , Hennus Marije P. , van Haaften Gijs
Published: March 2021

We report five patients with lung disease immuno-deficiency and chromosome breakage syndrome (LICS) but without recurrent infections and severe immunodeficiency. One patient had extended survival to 6.5 years. Hematopoietic stem-cell transplantation failed to cure another patient. Our findings suggest that the immunological abnormalities can be limited and do not fully explain the LICS phenotype.
May–Thurner syndrome, a diagnosis to consider in young males with no risk factors: a case report and review of the literature
Authors: Hng Joel , Su Shu , Atkinson Noel
Published: March 2021

Background

May–Thurner syndrome is an anatomical condition characterized by compression of the left common iliac vein by the right common iliac artery, causing venous outflow obstruction. It is an uncommon cause of deep vein thrombosis and is more prevalent among women. This paper highlights the importance of considering May–Thurner syndrome in young males without risk factors presenting with left lower limb pain, as endovascular treatment may be required.

Case presentation

A 23 year-old Caucasian male presented with a 1-week history of left lower limb pain, edema, and pallor. He was found to have an unprovoked deep vein thrombosis on Doppler ultrasound involving the left fibular, soleus, gastrocnemius, popliteal, femoral, common femoral, and external iliac veins. A heparin infusion was commenced as the initial treatment for deep vein thrombosis. Further investigation with computer tomography pulmonary angiogram and computer tomography venography of the abdomen and pelvis showed bilateral pulmonary emboli and left common iliac vein compression with left common, internal, and external iliac vein thrombosis. He was diagnosed with May–Thurner syndrome despite having no risk factors. A retrievable Cook Celect Platinum inferior vena cava filter was placed, and thrombus of the left common femoral, external, and common iliac veins was treated successfully with AngioJet thrombectomy, thrombolysis using 200,000 units of urokinase, angioplasty and stenting using two Cook Zilver Vena venous self-expanding stents. Therapeutic enoxaparin was commenced on discharge. His filter was removed after 10 weeks. Hematological follow-up 4 months later showed an overall negative thrombophilia screen, and anticoagulation was switched to apixaban. He has had no recurrent thrombosis.

Conclusions

Clinicians should have a low threshold to investigate for May-Thurner syndrome in patients with left lower limb venous thrombotic events regardless of risk factors, as endovascular treatment may be required to minimize the long-term sequelae of deep vein thrombosis. Duplex ultrasound can be used initially for diagnosis, and computer tomography venography used subsequently if the common iliac vein is not visualized on ultrasound. Endovascular treatment is preferred over anticoagulation alone, especially in otherwise fit patients presenting early, the aim being to reduce the chances of chronic venous hypertension in the lower limb.
Functional characterization of Fur in iron metabolism, oxidative stress resistance and virulence of Riemerella anatipestifer
Authors: Huang Mi , Liu Mafeng , Liu Jiajun , Zhu Dekang , Tang Qianying , Jia Renyong , Chen Shun , Zhao Xinxin , Yang Qiao , Wu Ying , Zhang Shaqiu , Huang Juan , Ou Xumin , Mao Sai , Gao Qun , Sun Di , Wang Mingshu , Cheng Anchun
Published: March 2021

Iron is essential for most bacteria to survive, but excessive iron leads to damage by the Fenton reaction. Therefore, the concentration of intracellular free iron must be strictly controlled in bacteria. Riemerella anatipestifer (R. anatipestifer), a Gram-negative bacterium, encodes the iron uptake system. However, the iron homeostasis mechanism remains largely unknown. In this study, it was shown that compared with the wild type R. anatipestifer CH-1, R. anatipestifer CH-1Δfur was more sensitive to streptonigrin, and this effect was alleviated when the bacteria were cultured in iron-depleted medium, suggesting that the fur mutant led to excess iron accumulation inside cells. Similarly, compared with R. anatipestifer CH-1∆recA, R. anatipestifer CH-1∆recAΔfur was more sensitive to H2O2-induced oxidative stress when the bacteria were grown in iron-rich medium rather than iron-depleted medium. Accordingly, it was shown that R. anatipestifer CH-1∆recAΔfur produced more intracellular ROS than R. anatipestifer CH-1∆recA in iron-rich medium. Electrophoretic mobility shift assays showed that R. anatipestifer CH-1 Fur suppressed the transcription of putative iron uptake genes through binding to their promoter regions. Finally, it was shown that compared with the wild type, R. anatipestifer CH-1Δfur was significantly attenuated in ducklings and that the colonization ability of R. anatipestifer CH-1Δfur in various tissues or organs was decreased. All these results suggested that Fur is important for iron homeostasis in R. anatipestifer and its pathogenic mechanism.
Characterization of smallholder cattle production systems in South-Kivu province, eastern Democratic Republic of Congo
Authors: Mugumaarhahama Yannick , Ayagirwe Rodrigue Balthazar Basengere , Mutwedu Valence Bwana , Cirezi Nadège Cizungu , Wasso Dieudonné Shukuru , Azine Pascaline Ciza , Karume Katcho
Published: March 2021

In South-Kivu province, cattle farming is an integral component of farmers’ livelihoods and one of the few income-generating opportunities for smallholders. However, very few studies have been conducted to characterize smallholders’ cattle production systems. This study documents cattle production systems to better understand their current situation, constraints they face and opportunities they offer. For that purpose, an investigation was conducted based on a structured survey questionnaire and participatory interviews with 863 farmers in South-Kivu province. Collected data were analysed using factorial analysis of mixed data and clustering techniques. The results revealed three types of smallholder cattle farms differing mainly in their herds’ sizes and landholding. The first category is the most common and includes farmers raising small herds (6.3 ± 6.7 cattle) of local breeds in herding system (in this work, “herding system” refers to a rearing system for which the farmer drives and stays with his animals on pastures and fallow land during the day) and grazing fodder in community pastures, fallow lands and roadside grasses, while land constitutes a scarce resource. In the second category, some farmers have small tracts of land (< 5 ha) and others have large tracts (> 5 ha), but all have medium-size herds (45.1 ± 19.4 cattle) made up of local breeds, which they rear in herding system. They also exploit community pastures, fallow land and roadside fodder for animal feeding. The third and last category includes farmers with large cattle herds (78.1 ± 28.1 cattle) of local, crossbred and exotic breeds raised free range in the fenced paddocks on vast areas of land (> 5 ha) found in high-altitude regions. However, while being different according to the above-considered characteristics, the three categories of cattle farming remain extensive pastoral farms dominated by male farmers. Agriculture and/or animal husbandry are their main source of income while their livestock are also composed of goats and poultry, beside cattle. Still, the three farming groups require more inputs and improvement strategies for increased productivity in the challenging environment characterized by low land accessibility and high demand for milk and meat. Fodder cultivation and crop-livestock integration through agro-ecological systems as well as access to credit and extension services are the proposed strategies for the improvement of this economic sector.
An international survey on aminoglycoside practices in critically ill patients: the AMINO III study
Authors:   The Azurea Network, Roger Claire , Louart Benjamin , Elotmani Loubna , Barton Greg , Escobar Leslie , Koulenti Despoina , Lipman Jeffrey , Leone Marc , Muller Laurent , Boutin Caroline , Amour Julien , Banakh Iouri , Cousson Joel , Bourenne Jeremy , Constantin Jean-Michel , Albanese Jacques , Roberts Jason A. , Lefrant Jean-Yves
Published: March 2021

Background

While aminoglycosides (AG) have been used for decades, debate remains on their optimal dosing strategy. We investigated the international practices of AG usage specifically regarding dosing and therapeutic drug monitoring (TDM) in critically ill patients. We conducted a prospective, multicentre, observational, cohort study in 59 intensive-care units (ICUs) in 5 countries enrolling all ICU patients receiving AG therapy for septic shock.

Results

We enrolled 931 septic ICU patients [mean ± standard deviation, age 63 ± 15 years, female 364 (39%), median (IQR) SAPS II 51 (38–65)] receiving AG as part of empirical (761, 84%) or directed (147, 16%) therapy. The AG used was amikacin in 614 (66%), gentamicin in 303 (33%), and tobramycin in 14 (1%) patients. The median (IQR) duration of therapy was 2 (1–3) days, the number of doses was 2 (1–2), the median dose was 25 ± 6, 6 ± 2, and 6 ± 2 mg/kg for amikacin, gentamicin, and tobramycin respectively, and the median dosing interval was 26 (23.5–43.5) h. TDM of Cmax and Cmin was performed in 437 (47%) and 501 (57%) patients, respectively, after the first dose with 295 (68%) patients achieving a Cmax/MIC > 8 and 353 (71%) having concentrations above Cmin recommended thresholds. The ICU mortality rate was 27% with multivariable analysis showing no correlation between AG dosing or pharmacokinetic/pharmacodynamic target attainment and clinical outcomes.

Conclusion

Short courses of high AG doses are mainly used in ICU patients with septic shock, although wide variability in AG usage is reported. We could show no correlation between PK/PD target attainment and clinical outcome. Efforts to optimize the first AG dose remain necessary.

Trial registration Clinical Trials, NCT02850029, registered on 29th July 2016, retrospectively registered, https://www.clinicaltrials.gov
Nuclear lamina invaginations are not a pathological feature of C9orf72 ALS/FTD
Authors: Coyne Alyssa N. , Rothstein Jeffrey D.
Published: March 2021

The most common genetic cause of familial and sporadic amyotrophic lateral sclerosis (ALS) is a GGGGCC hexanucleotide repeat expansion (HRE) in the C9orf72 gene. While direct molecular hallmarks of the C9orf72 HRE (repeat RNA foci, dipeptide repeat protein pathology) are well characterized, the mechanisms by which the C9orf72 HRE causes ALS and the related neurodegenerative disease frontotemporal dementia (FTD) remain poorly understood. Recently, alterations to the nuclear pore complex and nucleocytoplasmic transport have been accepted as a prominent pathomechanism underlying C9orf72 ALS/FTD. However, global disruptions to nuclear morphology and the nuclear lamina itself remain controversial. Here, we use a large number of induced pluripotent stem cell derived spinal neurons and postmortem human motor cortex sections to thoroughly examine nuclear morphology and nuclear lamina disruptions with light microscopy. In contrast to previous studies in artificial overexpression model systems, endogenous levels of the C9orf72 HRE do not increase the frequency of nuclear lamina invaginations. In addition, the C9orf72 HRE has no impact on overall nuclear shape and size. Notably, the frequency of nuclear Lamin B1 invaginations increases with cellular aging, independent of the C9orf72 HRE. Together, our data suggest that nuclear morphology is unaltered in C9orf72 ALS/FTD.
Preliminary photographs and improved positives: discovering the New York Public Library’s Arctic Exploration album
Authors: Basso Elena , Pozzi Federica , Keister Jessica , Cronin Elizabeth
Published: March 2021

In the late 19th and early 20th centuries, original photographs were sent to publishers so that they could be reproduced in print. The photographs often needed to be reworked with overpainting and masking, and such modifications were especially necessary for low-contrast photographs to be reproduced as a letterpress halftone. As altered objects, many of these marked-up photographs were simply discarded after use. An album at The New York Public Library, however, contains 157 such photographs, all relating to the Jackson–Harmsworth expedition to Franz Josef Land, from 1894 to 1897. Received as gifts from publishers, the photographs are heavily retouched with overpainting and masking, as well as drawn and collaged elements. The intense level of overpainting on many of the photographs, but not on others, raised questions about their production and alteration. Jackson’s accounts attested to his practice of developing and printing photographs on site, testing different materials and techniques—including platino-bromide and silver-gelatin papers—to overcome the harsh environmental conditions. In this context, sixteen photographs from the album were analyzed through a combination of non-invasive and micro-invasive techniques, including X-ray fluorescence (XRF) spectroscopy, fiber optics reflectance spectroscopy (FORS), Raman and Fourier-transform infrared (FTIR) spectroscopies, and scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM/EDS). This analytical campaign aimed to evaluate the possible residual presence of silver halides in any of the preliminary and improved photographs. The detection of these compounds would be one of several factors supporting a hypothesis that some of the photographs in the album were indeed printed on site, in the Arctic, and, as a result, may have been impacted by the extreme environment. Additional goals of the study included the evaluation of the extent of retouching, providing a full characterization of the pigments and dyes used in overpainted prints, and comparing the results with contemporaneous photographic publications that indicate which coloring materials were available at the time. Further analyses shed light on the organic components present in the binders and photographic emulsions. This research has increased our knowledge of photographic processes undertaken in a hostile environment such as the Arctic, and shed light on the technical aspects of photographically illustrating books during the late 19th and early 20th centuries.
Characterization of seventeenth century papers from Valvasor's collection of the Zagreb Archdiocese
Authors: Dragojević Andreja , Gregor-Svetec Diana , Vodopivec Tomažič Jedert , Lozo Branka
Published: March 2021

Valvasor's library is a unique example of a Seventeenth century personal library, including over 7300 prints and 1530 books. Today, it is kept in the Metropolitan Library of the Zagreb Archdiocese which is part of the Croatian State Archives. In this study, we analysed a selection of papers from Valvasor's collection (VC) of unknown origin and composition. We used a dual approach, combining the results of the analyses of two sets of samples to find the most useful tools for the characterization of historical handmade papers. 144 randomly selected papers were included in the study. As the VC is a cultural heritage, only non-destructive analyses were used, such as visual inspection, surface imaging, measurements of thickness and the determination of optical properties (brightness, yellowness, opacity and gloss). According to the optical properties, papers from the VC could be characterized as yellowish and opaque, without gloss. Due to the fact that the VC papers could not be destroyed, we took another set of samples consisting of 10 historical papers (HP) from archival materials, dating from the 16th to nineteenth century, and subjected them to non-destructive, as well as micro-destructive analyses. This was done to supplement the findings of non-destructive analyses of the original collection. Initially, spot tests were performed to determine water absorbency and to identify the presence of lignin and starch in the paper samples. SEM–EDS and XRF were applied for the identification of inorganic elements. FTIR analyses were used to identify the chemical structures of the paper components. Microscopic analyses were performed in two ways: the paper surface was imaged with a digital microscope, and the morphological characteristics of the fibres were studied using an optical microscope. The dominant fibres present were flax and hemp, with a smaller proportion of cotton. Additionally, thick and thin light brown fibres resembling straw were detected. The presence of calcium-containing components, gelatine and alum could be confirmed with SEM–EDS, XFR and FTIR analysis. Comparing the results of analyses performed on two sets of samples a connection was explored by which it was possible to define the characterization of VC papers. The main goal of the study was to document and characterize a specific collection for the future use of researchers of handmade paper or paper conservators. Furthermore, the study may serve as a model approach for other researchers who seek to document the characteristics of paper in their collections.