bluuebunny/crossref_metadata_2025 huggingface dataset:
The Value of Thromboelastography in the Diagnosis of Sepsis-Induced Coagulopathy
Authors: Luo Cuizhu , Hu Hongbin , Gong Jian , Zhou Yun , Chen Zhongqing , Cai Shumin
Published: September 2020

Thromboelastography (TEG) is regularly used for monitoring abnormalities of the coagulation system in patients with sepsis. However, it is unclear whether TEG parameters are associated with sepsis-induced coagulopathy (SIC). Thus, we aimed to assess the diagnostic value of TEG for SIC. The medical records of patients who underwent TEG from January 2016 to December 2016 were analyzed retrospectively. The patients were divided into sepsis group and non-sepsis group. Baseline patient characteristics and coagulation function indexes were compared. Receiver–operating characteristic curve analysis was used to determine predictors of SIC. A total of 167 patients were included, of whom 84 had sepsis. The clot formation speed (K) was significantly higher(P < 0.001), and the maximum amplitude (MA) and angle were significantly lower (both P < 0.001) in the sepsis group than that in non-sepsis group. Patients with SIC had higher Sepsis-related Organ Failure Assessment scores than those patients without SIC (P < 0.001). The area under the curve of K for diagnosing SIC was 0.910. The area under the curve of angle and MA for excluding SIC was 0.895 and 0.882, respectively. Thus, TEG parameters have good diagnostic value for SIC.
Honor-Based Abuse in England and Wales: Who Does What to Whom?
Authors: Bates Lis
Published: September 2020

Key findings are presented from an empirical study profiling 1,474 cases of honor-based abuse (HBA) known to police and victim services in England and Wales. Thematic and quantitative (regression) analyses were used to investigate whether and how HBA differed from other forms of domestic abuse and forced marriage. A new typology of HBA is proposed, based principally on the relationship(s) between victim and perpetrator(s). Interpreted within an overarching lens of gender-based violence, it is argued that Type 1 (partner abuse) and Type 3 (partner plus family abuse) are culturally specific forms of domestic abuse, whereas Type 2 (family abuse) is distinct.
Acute cardiomyopathy following a single dose of doxorubicin in a patient with adult T-Cell leukemia/lymphoma
Authors: Farina Kyle , Kalac Matko , Kim Sara
Published: September 2020

Introduction

Anthracycline-based chemotherapy regimens are associated with decreased cardiac function with cumulative dosing, yet there is limited information regarding the acute cardiotoxic potential of these medications and appropriate medical management strategies. Herein, we report a case of cardiomyopathy following a single dose of doxorubicin and describe our pharmacologic management approach.

Case report

A 37 year old Jamaican male presented for work-up and treatment of HTLV-1 associated T-cell leukemia/lymphoma. Upon diagnosis, the patient received one cycle of CHOEP, which was complicated by tumor lysis syndrome. Subsequently, the treatment was changed to DA-EPOCH, however, immediately after the initiation of DA-EPOCH on day 1, the patient was found to have t-wave inversions on EKG and an ejection fraction (EF) of 20% with new mitral regurgitation. EPOCH infusion was discontinued within 3 hours of initiation. Management and outcome: The chemotherapy regimen was modified to DA-EPOC with the removal of doxorubicin. The patient was started on metoprolol succinate 12.5 mg once daily for 2 days and subsequently switched to carvedilol 3.125 mg twice daily and lisinopril 5 mg once daily; the patient’s ejection fraction improved to baseline after 2.5 months of therapy.

Discussion

Though anthracyclines are associated with cardiotoxicity at high cumulative doses, this case highlights the cardiotoxic potential of these medications in the acute setting. Management of anthracycline cardiotoxicity is similar to heart failure management, with data suggesting benefit of using carvedilol and lisinopril. It is unclear if our patient would have benefited from prophylactic angiotensin converting enzymes inhibitors (ACEi) and/or beta-blocker therapy, as he had no known cardiac disease. Acute anthracycline-induced cardiac toxicity is an adverse drug reaction with which providers should be familiar and know how to appropriately manage.
Physical literacy and policy alignment in sport and education in Australia
Authors: Scott Joseph J , Hill Susan , Barwood Donna , Penney Dawn
Published: September 2020

Sport Australia released the Australian Physical Literacy Framework (APLF) in 2019 to advance a national agenda for physical literacy (PL) and specifically, clarify and promote the development of PL in Australian sport and education sectors. For teachers, this policy initiative followed a period of curriculum development guided by the Australian Curriculum for Health and Physical Education (AC: HPE). The AC: HPE makes no explicit reference to PL, but nevertheless seeks to support young people to lead active healthy lives. This study acknowledged that HPE teachers are now challenged to navigate the divide between the APLF and AC: HPE and find ways to appropriately integrate the APLF into HPE programmes. The premise for the study was that investigating conceptual ‘common ground’ between the APLF and AC: HPE in relation to PL could provide an important foundation for coherent policy enactment. Accordingly, Whitehead’s (2001) foundational conceptualisation of PL was employed as an analytic framework for examination of both policy texts. The purpose was to identify points of conceptual connection between the APLF, AC: HPE and Whitehead’s conceptualisation of PL, and thereby strategically extend the PL discourses ‘at play’ across the Australian sport and education sectors. Findings suggest that while the AC: HPE and the APLF reflect differing policy agendas, the two texts both have some points of alignment with dimensions of Whitehead’s framework. Discussion pursues the significance of distinctions and commonalities identified and addresses issues that HPE teachers and other stakeholders need to consider to promote a coherent approach to PL in Australia.
Dynamical analysis of hollow-shaft dual-rotor system with circular cracks
Authors: Yongfeng Yang , Jianjun Wang , Yanlin Wang , Chao Fu , Qingyang Zheng , Kuan Lu
Published: September 2020

In this paper, we considered a dual-rotor system with crack in shaft. The influence of circular crack in hollow shaft on dynamical response was studied. The equations of motion of 12 elements dual-rotor system model were derived. Harmonic balance method was employed to solve the equations. The critical speed and sub-critical speed responses were investigated. It was found that the circular crack in hollow shaft had greater influence on the first-backward critical speed than the first-forward critical speed. Owing to the influence of crack, the vibration peaks occurred at the 1/2, 1/3 and 1/4 critical speeds of the rotor system, along with a reduction in sub-critical speeds and critical speeds. The deeper crack away from the bearing affected the rotor more significantly. The whirling orbits, the time-domain responses and the spectra were obtained to show the super-harmonic resonance phenomenon in hollow-shaft cracked rotor system.
Midterm Results of Retrograde In Situ Needle Fenestration During Thoracic Endovascular Aortic Repair of Aortic Arch Pathologies
Authors: Luo Mingyao , Fang Kun , Fan Bowen , Li Quanming , Li Ming , He Hao , Li Xin , Guo Yuanyuan , Xue Yunfei , Zhao Jiawei , Wang Tun , Yang Chenzi , Li Jiehua , Nienaber Christoph A. , Shu Chang
Published: September 2020

Purpose:

To evaluate the safety and feasibility of the in situ needle fenestration (ISNF) technique for reconstruction of the left subclavian artery (LSA) during thoracic endovascular aortic repair (TEVAR) of complicated aortic arch pathologies.

Materials and Methods:

A retrospective review was conducted from January 2014 to December 2019 of 50 patients (mean age 60.2±11.1; 45 men) who underwent ISNF to revascularize the LSA during TEVAR. Twenty-one of the patients also required revascularization of the left common carotid artery (LCCA; n=19) and innominate artery (IA; n=2) using physician-modified in vitro fenestration. Overall, 73 supra-aortic branches were targeted for revascularization.

Results:

ISNF was successful in 48 patients (96%); one LSA could not be stented and a tortuous LSA prevented the needle from fenestrating the graft. No perioperative major adverse event occurred. There were no type I and 4 type III endoleaks (8%), 3 of which occurred among the first 20 cases. Types II and IV endoleaks were found in 3 (6%) and 6 (12%) cases, respectively; all disappeared during a median follow-up of 15 months (range 3–66). One death (2%) occurred within 12 months due to cerebral hemorrhage. Two patients (4%) required open reinterventions at 6 and 62 months.

Conclusion:

ISNF for revascularization of the LSA during TEVAR seems to be feasible with acceptable midterm outcomes. The learning curve and evolving patient selection criteria affected technical success, complications, and the need for reinterventions. Long-term durability requires further evaluation.
Anatomical Suitability of the Aortic Arch Arteries for a 3-Inner-Branch Arch Endograft
Authors: Spanos Konstantinos , Haulon Stephan , Eleshra Ahmed , Rohlffs Fiona , Tsilimparis Nikolaos , Panuccio Giuseppe , Kölbel Tilo
Published: September 2020

Purpose:

To analyze aortic arch anatomy of patients who were already treated with a 2-inner-branch arch endograft (2-IBAE) in order to assess the anatomical suitability of the supra-aortic arteries as target vessels for a 3-IBAE.

Materials and Methods:

Three different configurations of the Cook Zenith Arch endograft were designed with distances of 110 mm (model 1), 90 mm (model 2), and 70 mm (model 3) between the orifices of the first and third inner branches. Preoperative measurements of the aortic arch anatomy from 104 consecutive patients treated electively with custom-made 2-IBAEs at 2 European centers between 2014 and 2019 were analyzed. A previously described standard methodology with a planning sheet was used. Data and measurements included the treatment indication for the aortic arch pathology, the type of landing zone, the type of arch, and the inner and outer lengths of the ascending aorta from the sinotubular junction to the innominate artery (IA). Additionally, the diameters and clock positions of the IA, left common carotid artery (LCCA), and left subclavian artery (LSA) were assessed, along with the distances between the IA and the LCCA, the IA and the LSA, and the distal landing zone.

Results:

Type I was the most common arch configuration (75/104, 72%). The mean clock positions were 12:30±00:28 for the IA, 12:00±00:23 for the LCCA, and 12:15±00:29 for the LSA. The mean diameters were 14.2±2.2 mm for the IA, 8.8±1.8 mm for the LCCA, and 10.5±2 mm for the LSA. The mean distances between the IA and LCCA and between the IA and LSA were 14.7±5.8 mm and 33±9.4 mm, respectively. Model 2 (branch distance 90 mm) had the highest suitability (79%), while models 1 and 3 showed suitability rates of 73% and 68%, respectively. The most frequent exclusion criterion in all models was the diameter of the LSA, followed by the IA to LSA distance.

Conclusion:

The suitability for a 3-IBAE among patients who had a 2-IBAE implanted is high, favoring a 90-mm distance between the retrograde LSA branch and baseline.
Intravascular Lithotripsy for Treatment of Calcified Lesions During Carotid Artery Stenting
Authors: Giannopoulos Stefanos , Speziale Francesco , Vadalà Giuseppe , Soukas Peter , Kuhn Brian A. , Stoltz Chad L. , Foteh Mazin I. , Mena-Hurtado Carlos , Armstrong Ehrin J.
Published: September 2020

Purpose:

To report the use of intravascular lithotripsy (IVL) in the treatment of calcified carotid artery lesions.

Materials and Methods:

The records of 21 high-surgical-risk patients (mean age 75.1±8.1 years; 17 men) who were treated at 8 centers for carotid artery stenosis ≥70% were retrospectively reviewed. Twelve patients had a history of cerebrovascular disease. All patients had heavily calcified carotid artery lesions: 19 de novo and 2 in-stent restenoses (ISR). The mean baseline stenosis was 82.3%±9.7%. IVL was utilized at the discretion of the operator, followed by balloon angioplasty. Embolic protection devices were used in all cases.

Results:

In 19 patients, IVL was followed by stent implantation; the 2 ISR lesions were dilated only. The mean IVL balloon diameter was 4.64±1.13 mm, and the mean number of IVL pulses applied was 67.2±61.4 (range 10–180). All procedures were technically successful (<30% residual stenosis). No patients developed symptomatic bradycardia or hypotension due to IVL, and there were no adverse events associated with IVL delivery. All patients were discharged on dual antiplatelet therapy. Seventeen days after the procedure, 1 patient experienced an ischemic stroke that was deemed due to aortic arch manipulation during transfemoral access. Carotid duplex ultrasound examination identified significant restenosis (>70%) in 1 asymptomatic patient at 12 months after the index procedure. No patients required reintervention during a median follow-up of 6 months (range 1–12).

Conclusion:

This preliminary experience demonstrates that IVL can be a safe and effective approach for the management of severely calcified carotid lesions. Further research is warranted to determine the longer-term safety and efficacy of IVL for dilation of calcified carotid artery lesions as an adjunct to carotid artery stenting.
CD248+CD8+ T lymphocytes suppress pathological vascular remodeling in human thoracic aortic aneurysms
Authors: Hu Xiaojuan , Wu Ting , Wang Chenxi , Li Jun , Ying Chunmei
Published: September 2020

Aortic aneurysms are characterized by vascular inflammation, neovascularization, and extracellular matrix destruction of the aortic wall. Although experimental studies indicate a potential role of CD248 in microvessel remodeling, the functions of CD248 in human vascular pathologies remain unexplored. Here we aimed to study how CD248 interferes with pathological vascular remodeling of human aortic aneurysms. Immunofluorescent staining showed that CD248 expression was mainly localized in the CD8+ T cells infiltrating in the adventitia and media of aortic walls of patients with ascending thoracic aortic aneurysms. qPCR and immunofluorescent staining analyses revealed increased aortic CD248 expression and infiltrating CD248+CD8+ T cells in aortic aneurysms than in nonaneurysmal aortas. Flow cytometry analysis of human peripheral blood further identified a fraction of circulating CD248+ cells which was confined in the CD8+ T-cell compartment. The increased infiltrating of CD248+CD8+ T cells was coincident with reduced circulating CD248+CD8+ T cells in patients with ascending TAA when compared with patients with coronary artery diseases and healthy donors. The CD248+CD8+ T cells were characterized by upregulated IL-10 and downregulated IL-1β/INF-γ expression when compared with CD248-CD8+ T cells. Moreover, when co-cultured with human aortic endothelial cells, the CD248+CD8+ T cells not only downregulated endothelial expression of ICAM1/VCAM1 and MMP2/3 but also suppressed endothelial migration. This study shows that CD248 reduces pathological vascular remodeling via anti-inflammatory CD248+CD8+ T cells, revealing a CD248-mediated cellular mechanism against human aortic aneurysms.
Evaluation and Revision of an Instrument Measuring Attitudes toward the Amish
Authors: Anderson Cory , Decker Lee
Published: September 2020

The attitudes non-members hold toward the Amish—or any ethnic, racial, and religious group—has consequences for that population, from criminal victimization to an ability to exercise human rights. Given their rapid growth and expansion in North America, an effective tool is needed to measure public attitudes toward the Amish. William McGuigan recently led the development of an Attitudes Toward the Amish (ATA) instrument, which was tested in northwestern Pennsylvania. In using the ATA in northeastern Missouri, we encountered problems with the instrument’s operational validity: no significant differences were found in the responses between a university undergraduate population of largely urban/suburban origin and the local rural population when we would otherwise expect differences. We revised the instrument and administered it to the same populations. Of the 16 items in the revised version, 14 were significantly different at the p < .05 level. A factor analysis revealed four components with face validity. Based on these results, we offer the Revised ATA (RATA) as an improved instrument and make recommendations for designing instruments intended to measure attitudes toward outgroups.
The psychic life of consumer power: Judith Butler, Ernest Dichter, the American marketing reception of Freud, and the rituals of consuming religion
Authors: Gonzalez George
Published: September 2020

First, a close reading of Judith Butler’s The Psychic Life of Power underscores the ways in which Butler’s account of power liquidates issues of political economy and problematically ontologizes Freudianism as a kind of first philosophy of the subject. Second, drawing largely from secondary sources, the religious studies reader is introduced to the life and work of Ernest Dicther, the father of motivational research, an influential American mid-twentieth century psychoanalytic school of marketing that Freudianized marketing discourse and transformed it into the present day. Third, drawing from primary sources in Dichter’s published archive, a comparative reading of Butler and Dichter reveals strong points of confluence around the psychology and performativity of (consumer) ritual, concomitantly highlighting scholars’ hidden participation in the American religious history Kathryn Lofton figures according to the terms of ‘consuming religion’.
Contesting the greening of the urban growth machine: Ecological modernization and the promethean counter-discourse
Authors: Scanu Emiliano , Cloutier Geneviève , Trudelle Catherine
Published: September 2020

Urban environmental governance and planning are increasingly characterized by the adoption of “sustainability fixes,” namely political compromises which try to conciliate economic and ecological goals in order to safeguard long-term growth. If sustainability fixes have been harshly criticized for being sociospatially selective, resistance to them does not always come from radical groups who demand stronger and fairer measures, but from actors who oppose the idea of sustainability because it goes against their interests, habits, or values. This paper focuses on this “contestation of the greening of the urban growth machine,” by presenting an empirical study of a sustainable mobility policy in Quebec City, Canada, which has given rise to a controversy opposing two divergent perspectives. The first is an ecological modernization discourse advocating for a green and attractive public transit system. The second is a promethean counter-discourse which supports the unconditional growth of automobility and urban sprawl. Results show that even if urban environmental policies are increasingly attuned to the “growth first” logic, they could still face strong opposition, especially from suburban and conservative interests. More generally, this paper shows that, in some contexts, sustainability fixes could be a “better than nothing” solution, namely a step toward fairer and greener cities.
Beyond remediation: Containing, confronting and caring for the Giant Mine Monster
Authors: Beckett Caitlynn
Published: September 2020

Mine remediation entails long-term risks associated with the containment and monitoring of dangerous materials. To date, research on mine remediation in Canada has focused primarily on technical fixes; little is known about the socio-political and colonial aspects of remediation. Using the Giant Mine in Yellowknife (Northwest Territories, Canada) as a case study, this research investigates the story of the Giant Mine ‘Monster’, how it was defined, how it has changed and how nearby communities will care for the mine in the future. Using a mixed-methods approach, this research combines literature reviews, archival analysis, key informant interviews and participant observation in analyzing the multiple experiences, practices and stories of the Giant Mine Remediation Project. Directed by the frameworks of ecological restoration, Indigenous environmental justice and science and technology studies theories of care, this research reveals that, by focusing on the technical containment of arsenic trioxide pollution, the Giant Mine Remediation Project sidelined community objectives for compensation, independent oversight and a perpetual care plan. However, through the ongoing activism of the Yellowknives Dene First Nations and community allies, the Giant Mine Monster is being creatively reframed as something to care for and live with for generations to come – a responsibility for mining wastes that settlers across Canada have yet to meaningfully reckon with. I argue that the Giant Mine case points to a critical reconceptualization of environmental remediation as an anti-colonial mechanism to (re)structure, or (re)mediate, relationships with both land and people. Without a community objectives based approach to remediation, such projects risk continuing systems of colonization, marginalization and environmental injustice.
The Importance of Sonographic Imaging With Alcoholic Liver Disease: A Case Study
Authors: Briggler Amber , Simmons Layla Q. , Lane Megan
Published: September 2020

Alcoholic liver disease (ALD), a precursor to alcohol-induced cirrhosis, is a disease caused by excessive ingestion of alcoholic substances that directly affects liver functions. Abnormal liver function can cause the liver to damage other organs within the abdomen. This case study examines the physiological nature of alcohol-induced cirrhosis and its pathogenesis, external and internal clinical presentations, and treatment options. Treatments for alcohol-induced cirrhosis include liver transplant for permanent correction as well as varied options to manage symptoms. This case study analyzes alcoholic liver disease within one male patient whose condition highlights the importance of sonography in routinely monitoring patients with ALD.
Ponatinib coronary microangiopathy: novel bedside diagnostic approach and management with N-acetylcysteine
Authors: Wu Melinda D. , Hodovan James , Kumar Kris , Moulton Bart , Olson Sven , Gilbert Aubre , Wood Matthew D. , Lindner Jonathan R.
Published: September 2020

Key Points

Ponatinib produces a coronary microangiopathy that mimics myocardial infarction and can be detected rapidly by contrast echocardiography. N-acetylcysteine therapy can potentially resolve ischemic complications caused by ponatinib-related microangiopathy.
Exosomal miR-223 derived from natural killer cells inhibits hepatic stellate cell activation by suppressing autophagy
Authors: Wang Ling , Wang Yinghao , Quan Jun
Published: September 2020

Background

Activation of hepatic stellate cells (HSCs) is a prominent driver of liver fibrosis. We previously demonstrated that exosomes derived from natural killer (NK) cells (NK-Exo) attenuated TGF-β1-induced HSC activation. Herein, this study was designed to investigate the mechanism underlying the action of NK-Exo.

Methods

NK-Exo was isolated from NK-92MI cells and then administered into TGF-β1-treated LX-2 (human HSC line) cells. MiR-223 expression in NK-Exo was downregulated by transfecting NK-92MI cells with miR-223 inhibitor followed by exosome isolation. The HSC activation was evaluated by determining cell proliferation using CCK-8 assay and measuring the protein levels of α-SMA and CoL1A1 using western blot in LX-2 cells. The expression of miR-223 was detected by qRT-PCR. The interaction between miR-223 and ATG7 was analyzed by a dual-luciferase activity assay. The autophagy was evaluated by measuring the autophagy-related proteins using western blot.

Results

miR-223 was highly expressed in NK-Exo and inhibition of miR-223 expression in NK-Exo abrogated the inhibitory effect of NK-Exo on TGF-β-induced HSC activation. ATG7 was confirmed as a direct target of miR-223. Furthermore, treatment with the autophagy activator rapamycin and ATG7 overexpression in LX-2 cells abolished the HSC activation-suppressive effect of NK-Exo.

Conclusion

NK-Exo attenuated TGF-β-induced HSC activation by transferring miR-223 that inhibited autophagy via targeting ATG7.
Genome-wide survey, characterization, and expression analysis of bZIP transcription factors in Chenopodium quinoa
Authors: Li Feng , Liu Jianxia , Guo Xuhu , Yin Lili , Zhang Hongli , Wen Riyu
Published: September 2020

Background

Chenopodium quinoaWilld. (quinoa) is a pseudocereal crop of the Amaranthaceae family and represents a promising species with the nutritional content and high tolerance to stressful environments, such as soils affected by high salinity. The basic leucine zipper (bZIP) transcription factor represents exclusively in eukaryotes and can be related to many biological processes. So far, the genomes of quinoa and 3 other Amaranthaceae crops (Spinacia oleracea,Beta vulgaris, andAmaranthus hypochondriacus) have been fully sequenced. However, information about thebZIPsin these Amaranthaceae species is limited, and genome-wide analysis of thebZIPfamily is lacking in quinoa.

Results

We identified 94bZIPsin quinoa (named asCqbZIP1-CqbZIP94). All theCqbZIPswere phylogenetically splitted into 12 distinct subfamilies. The proportion ofCqbZIPswas different in each subfamily, and members within the same subgroup shared conserved exon-intron structures and protein motifs. Besides, 32 duplicatedCqbZIPgene pairs were investigated, and the duplicatedCqbZIPshad mainly undergone purifying selection pressure, which suggested that the functions of the duplicatedCqbZIPsmight not diverge much. Moreover, we identified thebZIPmembers in 3 other Amaranthaceae species, and 41, 32, and 16 orthologous gene pairs were identified between quinoa andS. oleracea,B. vulgaris, andA. hypochondriacus, respectively. Among them, most were a single copy being present inS. oleracea,B. vulgaris, andA. hypochondriacus, and two copies being present in allotetraploid quinoa. The function divergence within thebZIPorthologous genes might be limited. Additionally, 11 selectedCqbZIPshad specific spatial expression patterns, and 6 of 11CqbZIPswere up-regulated in response to salt stress. Among the selectedCqbZIPs, 3 of 4 duplicated gene pairs shared similar expression patterns, suggesting that these duplicated genes might retain some essential functions during subsequent evolution.

Conclusions

The present study provided the first systematic analysis for the phylogenetic classification, motif and gene structure, expansion pattern, and expression profile of thebZIPfamily in quinoa. Our results would lay an important foundation for functional and evolutionary analysis of CqbZIPs, and provide promising candidate genes for further investigation in tissue specificity and their functional involvement in quinoa’s resistance to salt stress.
Why do women not prepare for pregnancy? Exploring women’s and health care providers’ views on barriers to uptake of preconception care in Mana District, Southwest Ethiopia: a qualitative study
Authors: Teshome Firanbon , Kebede Yohannes , Abamecha Fira , Birhanu Zewdie
Published: September 2020

Background

Preconception care has the potential to reduce maternal and child morbidities and mortalities. It is a window of opportunity to timely alter or eliminate risk factors for adverse pregnancy outcomes. However, despite strong evidence on the effectiveness of preconception care in safeguarding maternal and child health, its uptake remains low. Therefore, this study aimed to explore barriers to the uptake of preconception care.

Methods

A descriptive qualitative study was conducted in Mana district, Jimma Zone, Oromia region, Southwest Ethiopia from March 02 to April 10, 2019. A purposive sampling approach was used, and 13 key informant interviews (6 in rural and 7 in urban areas) were held with women of different age groups, health extension workers, and health care providers of different professions. In addition, 4 focused group discussions with women of reproductive age groups (two with rural women only and two with urban women only) were conducted. The data were collected by trained experts using semi-structured guides. An inductive process of thematic analysis was employed and the data were coded, categorized, and thematized using Atlas ti version 7.0.71 software.

Results

Four women of reproductive age groups, 1 older woman (grandmother), 2 health extension workers, and 6 health care providers of different professions were interviewed. In addition, a total of 38 women of reproductive age groups participated in the 4 focused group discussions: 20 in the two rural-focused group discussions and 18 in the two urban-focused group discussions. The findings indicated the presence of many barriers affecting the uptake of preconception care and organized into five themes: women-related barriers, husband-related barriers, community-related barriers, health-service-related barriers, and media-related barriers.

Conclusions

This study found a diverse array of potentially modifiable barriers to the uptake of preconception care. The findings imply the importance of scaling up health education and counseling, establishing preconception care strategies and functional units that can address all the components at all levels of health care facilities. Therefore, we recommend all stakeholders, such as program planners and managers, non-governmental organizations, media personnel, and health care providers to work in collaboration to increase the uptake of preconception care.
Outcomes of a postoperative perfluorocarbon liquid tamponade for complex retinal detachments: 12 years of experience in southern Thailand
Authors: Bhurayanontachai Patama , Seepongphun Usanee
Published: September 2020

Background

The study evaluates both functional and anatomical outcomes of retinal detachment (RD) repair by vitrectomy and perfluorocarbon liquid (PFCL) tamponade.

Methods

A retrospective chart review of patients who underwent vitrectomy using PFCL tamponade for RD repair from causes such as giant tear, chronic RD, or RD with previously failed surgery.

Results

This study included 122 eyes from 121 patients. One-hundred fourteen eyes (93.5%) had baseline vision worse than 20/200. The median duration of intraocular PFCL retainment was 14 days before gas or silicone oil replacement. The retinal reattachment rate was 80.3%. At 1 year, the retention probability of retinal reattachment was 0.84 (95% confidence interval, 0.77–0.91). Although visual improvement was found in 45.9% of patients, the median of final vision was not different between baseline and the last visit.

Conclusion

The rate of retinal reattachment operated with a short- to medium-term PFCL tamponade achieved a high satisfaction rate. However, postoperative hypotony was a predictor for unfavorable visual and anatomical outcomes.
Correction to: Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis
Authors: Eylem Ozlem , de Wit Leonore , van Straten Annemieke , Steubl Lena , Melissourgaki Zaneta , Danışman Gözde Topgüloğlu , de Vries Ralph , Kerkhof Ad J. F. M. , Bhui Kamaldeep , Cuijpers Pim
Published: September 2020

An amendment to this paper has been published and can be accessed via the original article.
Publisher Correction to: Protocol of a population-based prospective COVID-19 cohort study Munich, Germany (KoCo19)
Authors: Radon Katja , Saathoff Elmar , Pritsch Michael , Guggenbühl Noller Jessica Michelle , Kroidl Inge , Olbrich Laura , Thiel Verena , Diefenbach Max , Riess Friedrich , Forster Felix , Theis Fabian , Wieser Andreas , Hoelscher Michael ,   the KoCo19 collaboration group, Fuchs Christiane , Bakuli Abhishek , Eckstein Judith , Froeschl Günter , Geisenberger Otto , Geldmacher Christof , Heiber Arlett , Hoffmann Larissa , Huber Kristina , Metaxa Dafni , Pletschette Michel , Rothe Camilla , Schunk Mirjam , Wallrauch Claudia , Zimmer Thorbjörn , Prückner Stephan , Hasenauer Jan , Castelletti Noemi , Zeggini Eleftheria , Laxy Michael , Leidl Reiner , Schwettmann Lars
Published: September 2020

An amendment to this paper has been published and can be accessed via the original article.
The synergistic hepatoprotective potential of Beta vulgaris juice and 2,3- dimercaptosuccinic acid in lead-intoxicated rats via improving the hepatic oxidative and inflammatory stress
Authors: Shaban Nadia Z. , Abdelrahman Samah A. , El-Kersh Mohamed A. L. , Mogahed Fayed A. K. , Talaat Iman M. , Habashy Noha H.
Published: September 2020

Background

Lead (Pb) is observed in all areas of the environment, mainly derived from human operations such as mining, processing, and burning fossil fuels. Pb toxicity is one of the most prevalent causes of human hepatotoxicity. The available chelator drugs used now have many adverse effects and therefore the world is looking for natural and secure alternatives.

Methods

Here, we evaluated the hepatoprotective role of the oral administration (1 g/kg b.w.) of the lyophilized Beta vulgaris juice (BVJ) against Pb-induced rat hepatotoxicity. We also examined the possible synergistic hepatoprotective impact of the combination between BVJ and 2,3- dimercaptosuccinic acid (DMSA, the currently approved drug for Pb-toxicity). The evaluation depends on the ability of BVJ, DMSA, or their combination (BVJ-DMSA) to reduce serum and hepatic Pb level and to avoid oxidative stress and inflammation caused by Pb. The level of lipid peroxidation, reduced glutathione (GSH), total antioxidant capacity, and the activity of the antioxidant enzymes were quantified. In addition, the level of interleukin (IL)-6, nitric oxide (NO), DNA fragmentation, and liver histology were studied.

Results

The results showed that BVJ contained considerable amounts of betalains, vitamin C, and various types of phenolic compounds. Therefore, BVJ displayed a significant (p < 0.05) preventive influence on the elevation of Pb levels in blood and liver as well as the hepatic DNA fragmentation. In addition, it significantly (p < 0.05) improved most of the studied antioxidant and inflammatory markers in the Pb-intoxicated rats. However, the combined extract (BVJ-DMSA) revealed synergistic (combination index < 1) activities in most of the tested parameters. The histopathological results verified the biochemical findings of this research.

Conclusion

BVJ has a potent efficiency in the protection from Pb-induced hepatotoxicity through the reduction of its accumulation in blood and liver and the prevention of the oxidative stress and inflammation induced by Pb. Additionally, the treatment of hepatotoxicity with BVJ and DMSA in combination showed a synergistic effect and reduced the adverse effects induced by DMSA. Thus, BVJ can be a promising hepatoprotective extract against lead toxicity and its combination with DMSA potentiates this effect.
Inequitable access to an outpatient parenteral antimicrobial therapy service: linked cross-sectional study
Authors: Sumpter Colin , Russell Clark D. , Mackintosh Claire
Published: September 2020

Study aim

To assess whether Outpatient Parenteral Antimicrobial Therapy (OPAT) is provided equitably across gender and social groups in a tertiary care setting.

Background

OPAT is a widely used and growing approach in high income countries to early discharge or admission avoidance for patients requiring intravenous antimicrobials. There is however a risk that equitable access to healthcare could be eroded unintentionally by expansion of outpatient or ambulatory approaches such as this. Anecdotal evidence in our service, and from published studies, have identified a gender and social group equity gap in outpatient services.

Methods

Service data on inpatient cellulitis episodes over a seven-year period were matched to OPAT referral data to create a retrospective cross-sectional linked dataset. All individuals admitted from 2012 to 2017 inclusive for a primary diagnosis of cellulitis were included: 6295 admissions of 4944 individuals. Demographics, number of co-morbidities, length of hospital stay, number of admissions, distance from OPAT unit and Scottish Index of Multiple Deprivation (SIMD; as a metric of deprivation) were recorded. Adjusted odds of a referral to OPAT across SIMD quintiles and for females compared to males were calculated using multiple logistic regression.

Results

Inequitable access to OPAT was identified. Deprivation was negatively associated with likelihood of OPAT referral. Inpatients from the most affluent SIMD quintile were more than twice as likely to have received an OPAT referral compared to those resident in the most deprived quintile (adjusted OR 2.08, 95% CI: 1.60–2.71, p <  0.0001). Women were almost a third less likely to receive an OPAT referral than men (adjusted OR 0.69, 95% CI: 0.58 to 0.82, p <  0.001). Results were adjusted for age, number of co-morbidities, admissions, length of stay, distance from nearest OPAT unit, time since first admission, deprivation and gender.

Conclusions

OPAT services and other ambulatory care programmes should routinely evaluate the equity of their service provision and consider how they can reduce any identified imbalance. It is a critical responsibility of service planning to ensure an inequitable system does not develop, with those least able to access ambulatory care dispossessed of the associated benefits.
Effect of resilience on infertile couples’ quality of life: an actor–partner interdependence model approach
Authors: Ha Ju-Young , Ban Seon-Hwa
Published: September 2020

Background

Infertility is an emerging socioeconomic issue affecting an individual’s life and the nation. However, only few studies have examined the influence of resilience on the quality of life (QoL) of spouses as actors and partners. Hence, this study aimed to analyze the influence of resilience, a positive factor that infertile couples may have, on QoL using the actor–partner interdependence model (APIM).

Methods

By the analyses of couples’ data, we analyzed the effect of resilience on the QoL of infertile couples as actors and partners. This cross-sectional study included 150 infertile couples. The Fertility Quality of Life and Resilience Scale was used to measure couples’ QoL and resilience. APIM was applied to analyze QoL.

Results

In terms of actor effects, the resilience of both wives (β = 0.201, p <  0.001) and husbands (β = 0.713, p <  0.001) had a significant effect on individual QoL. With regard to partner effects, husbands’ resilience (β = 0.351, p <  0.001) had a significant impact on wives’ QoL and the wives’ resilience (β = 0.219, p = 0.009) had a significant impact on husbands’ QoL.

Conclusions

The resilience of an infertile actor was found to affect both his/her own QoL and his/her partner’s QoL. In the future, if a program is to be developed to improve couples’ QoL, both spouses should work together to improve their resilience, thereby improving their QoL.
Risk factors of lymph node metastasis in the splenic hilum of gastric cancer patients: a meta-analysis
Authors: Du Jun , Shen Yangchao , Yan Wenwu , Wang Jinguo
Published: September 2020

Background

The issue of whether or not splenic hilum lymph nodes (SHLN) should be excised in radical gastrectomy with D2 lymph node dissection remains controversial. In this study, we identified the clinicopathological features in patients with gastric cancer that could serve as predictive risk factors of SHLN metastasis.

Methods

We searched Medline, Embase, PubMed, and Web of Science databases from inception to May 2020 and consulted the related references. Overall, 15 articles evaluating a total of 4377 patients were included for study. The odds ratios (OR) of each risk factor and corresponding 95% confidence intervals (CI) were determined using the Revman 5.3 software.

Results

Our meta-analysis revealed tumor size greater than 5 cm (p< 0.01), tumor localization in the greater curvature (p< 0.01), diffuse type (Lauren’s classification) (p< 0.01), Borrmann types 3–4 (p< 0.01), poor differentiation and undifferentiation (p< 0.01), depth of invasion T3–T4 (p< 0.01), number of lymph node metastases N2–N3 (p< 0.01), distant metastasis M1 (p< 0.01), TNM stages 3–4 (p< 0.01), vascular invasion (p= 0.01), and lymphatic invasion (p< 0.01) as potential risk factors of SHLN metastasis. Moreover, positivity of Nos. 1, 2, 3, 4sa, 4sb, 4d, 6, 7, 9, 11, and 16 lymph nodes for metastasis was strongly associated with SHLN metastasis.

Conclusions

Tumor size, tumor location, Lauren’s diffuse type, Borrmann type, degree of differentiation, T stage, N stage, M stage, TNM stage, vascular invasion, lymphatic infiltration, and other positive lymph nodes are risk factors for SHLN metastasis.
GST null polymorphisms may affect the risk of coronary artery disease: evidence from a meta-analysis
Authors: Su Hongling , Cao Yunshan , Li Jing , Zhu Yan , Ma Xuming
Published: September 2020

Background

Whether glutathione S-transferase (GST) null polymorphisms, namely GSTM1 null, GSTP1 null and GSTT1 null polymorphisms, influence the risk of coronary artery disease (CAD) or not remains unclear. Thus, the authors performed a meta-analysis to more robustly estimate associations between GST null polymorphisms and the risk of CAD by integrating the results of previous publications.

Methods

Medline, Embase, Wanfang, VIP and CNKI were searched comprehensively for eligible studies, and 45 genetic association studies were finally selected to be included in this meta-analysis.

Results

We found that GSTM1 null polymorphism was significantly associated with the risk of CAD in overall population (OR = 1.37, p = 0.003) and mixed population (OR = 1.61, p = 0.004), GSTP1 null polymorphism was significantly associated with the risk of CAD in overall population (OR = 1.23, p = 0.03), whereas GSTT1 null polymorphism was significantly associated with the risk of CAD in overall population (OR = 1.23, p = 0.02), Caucasians (OR = 1.23, p = 0.02) and East Asians (OR = 1.38, p < 0.0001).

Conclusions

This meta-analysis demonstrated that GSTM1 null, GSTP1 null and GSTT1 null polymorphisms were all significantly associated with an increased risk of CAD.
Implementation and evaluation of a Project ECHO telementoring program for the Namibian HIV workforce
Authors: Bikinesi Leonard , O’Bryan Gillian , Roscoe Clay , Mekonen Tadesse , Shoopala Naemi , Mengistu Assegid T. , Sawadogo Souleymane , Agolory Simon , Mutandi Gram , Garises Valerie , Pati Rituparna , Tison Laura , Igboh Ledor , Johnson Carla , Rodriguez Evelyn M. , Ellerbrock Tedd , Menzies Heather , Baughman Andrew L. , Brandt Laura , Forster Norbert , Scott John , Wood Brian , Unruh Kenton T. , Arora Sanjeev , Iandiorio Michelle , Kalishman Summers , Zalud-Cerrato Sarah , Lehmer Jutta , Lee Stephen , Mahdi Mohammed A. , Spedoske Samantha , Zuber Alexandra , Reilley Brigg , Ramers Christian B. , Hamunime Ndapewa , O’Malley Gabrielle , Struminger Bruce
Published: September 2020

Background

The Namibian Ministry of Health and Social Services (MoHSS) piloted the first HIV Project ECHO (Extension for Community Health Outcomes) in Africa at 10 clinical sites between 2015 and 2016. Goals of Project ECHO implementation included strengthening clinical capacity, improving professional satisfaction, and reducing isolation while addressing HIV service challenges during decentralization of antiretroviral therapy.

Methods

MoHSS conducted a mixed-methods evaluation to assess the pilot. Methods included pre/post program assessments of healthcare worker knowledge, self-efficacy, and professional satisfaction; assessment of continuing professional development (CPD) credit acquisition; and focus group discussions and in-depth interviews. Analysis compared the differences between pre/post scores descriptively. Qualitative transcripts were analyzed to extract themes and representative quotes.

Results

Knowledge of clinical HIV improved 17.8% overall (95% confidence interval 12.2–23.5%) and 22.3% (95% confidence interval 13.2–31.5%) for nurses. Professional satisfaction increased 30 percentage points. Most participants experienced reduced professional isolation (66%) and improved CPD credit access (57%). Qualitative findings reinforced quantitative results. Following the pilot, the Namibia MoHSS Project ECHO expanded to over 40 clinical sites by May 2019 serving more than 140 000 people living with HIV.

Conclusions

Similar to other Project ECHO evaluation results in the United States of America, Namibia’s Project ECHO led to the development of ongoing virtual communities of practice. The evaluation demonstrated the ability of the Namibia HIV Project ECHO to improve healthcare worker knowledge and satisfaction and decrease professional isolation.
MiR-199a-3p/5p participated in TGF-β and EGF induced EMT by targeting DUSP5/MAP3K11 in pterygium
Authors: He Siying , Huang Yifang , Dong Shiqi , Qiao Chen , Yang Guohua , Zhang Shuai , Wang Chen , Xu Yuting , Zheng Fang , Yan Ming
Published: September 2020

Background

Recently, it has been reported that miRNA is involved in pterygium, however the exact underlying mechanism in pterygium is unrevealed and require further investigation.

Methods

The differential expression of miRNA in pterygium was profiled using microarray and validated with quantitative real-time polymerase chain reaction (qRT-PCR). Human conjunctival epithelial cells (HCEs) were cultured and treated with transforming growth factor β (TGF-β) and epidermal growth factor (EGF) and transfected with miR-199a-3p/5p mimic and inhibitor. Markers of epithelial-mesenchymal transition (EMT) in HCEs were detected using western blot and immunohistochemistry. Cell migration ability was determined using wound healing and transwell assay, while apoptosis was determined by flow cytometry. The target genes of miR-199a were confirmed by the dual-luciferase reporter assay.

Results

TGF-β and EGF could induced EMT in HCEs and increase miR-199a-3p/5p but suppress target genes, DUSP5 and MAP3K11. With the occurrence of EMT, cell migration ability was enhanced, and apoptosis was impeded. Promoting miR-199a-3p/5p expression could induce EMT in HCEs without TGF-β and EGF, while suppressing miR-199a-3p/5p could inhibit EMT in TGF-β and EGF induced HCEs. In a word, TGF-β and EGF induced EMT could be regulated with miR-199a-3p/5p-DUSP5/MAP3K11 axes. The validated results in tissues showed that, compared with control conjunctival tissues, miR-199a-3p/5p were more overexpressed in pterygium, while DUSP5/MAP3K11 were lower expressed. In addition, bioinformatics analysis indicated the miR-199a-3p/5p-DUSP5/MAP3K11 was belong to MAPK signalling pathway.

Conclusions

TGF-β and EGF induce EMT of HCEs through miR-199a-3p/5p-DUSP5/MAP3K11 axes, which explains the pathogenesis of EMT in pterygium and may provide new targets for pterygium prevention and therapy.