bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived organizational culture and its relationship with job satisfaction in primary hospitals of Jimma zone and Jimma town administration, correlational study
Authors: Mesfin Dereje , Woldie Mirkuzie , Adamu Ayinengida , Bekele Fitsum
Published: May 2020

Background

The concept of Organizational Culture (OC) which refers to the pattern of values, norms, beliefs, attitudes and assumptions may not be articulated through verbal language. However, it shapes the way people behave and the way things get done in an organization. The management of organizational culture is increasingly viewed as necessary part of health system reform. Major cultural transformation of an organization must be secured alongside structural and procedural changes in order to achieve desired quality and performances improvements in health systems. It is therefore essential to understand organizational culture, job satisfaction level of the health workers and the link between them.

Methodology

Facility based cross sectional study was conducted in four primary hospitals of Jimma zone and town administration. A self-administered questionnaire was used to collect the data. The collected data were checked for completeness, entered and documented into Epi-data version 3.1 and Exported to SPSS version 21 for analysis. Finally descriptive statistics, Paired t-test and multiple linear regression analysis were used to assess the relationship between organizational culture and job satisfaction and the results were presented using tables and charts.

Result

It was indicated from the finding that, the dominant existing organizational culture typology in the primary hospitals was Hierarchy culture (MS = 22.31, ±2.82).and the preferred organizational culture typology was Innovative culture (MS = 26.09, ±4.72). The health workers had low to medium level of job satisfaction where only (29.40%) of the health workers were very satisfied with their hospital physical working environment. Existing perceived clan culture had positive and significant correlation with health workers’ satisfaction in relation to work relation dimension (r = .16, p < 0.002).

Conclusion

while acknowledging all limitation of observational study we reached to the conclusion that an employees of the respective primary hospitals would prefer to work in environment characterized by innovative and clan culture and their satisfaction level is medium so that the managers should undertake major cultural transformation and must work to improve the job satisfaction level of health workers within their respective hospitals.
Statin use and lung cancer risk in chronic obstructive pulmonary disease patients: a population-based cohort study
Authors: Raymakers AJN , Sin D. D. , Sadatsafavi M. , FitzGerald JM , Marra C. A. , Lynd L. D.
Published: May 2020

Background

Patients living with chronic obstructive pulmonary disease (COPD) are at an increased risk of lung cancer. A common comorbidity of COPD is cardiovascular disease; as such, COPD patients often receive statins. This study sought to understand the association between statin exposure and lung cancer risk in a population-based cohort of COPD patients.

Methods

We identified a population-based cohort of COPD patients based on having filled at least three prescriptions for an anticholinergic or short-acting beta-agonist (SABA). We used an array of methods of defining medication exposure including three conventional methods (ever statin exposure, cumulative duration of use, and cumulative dose) and two novel methods (recency-weighted cumulative duration of use and recency-weighted cumulative dose). To assess residual confounding, a negative control exposure was used to test the validity of our results. All exposure variables were time-dependent.

Results

The population-based cohort of COPD had 39,879 patients with mean age of 70.6 (SD: 11.2) years and, of which, 53.5% were female. There were 12,469 patients who received at least one statin prescription. Results from the reference case multivariable analysis indicated a reduced risk from statin exposure (HR: 0.85 (95% CI: 0.73–1.00) in COPD patients, but this result not statistically significant. Using the two recency-weighted modelling approaches, statin exposure was associated with a statistically significant reduction in lung cancer risk (recency-weighted cumulative dose, HR: 0.85 (95% CI: 0.77–0.93) and recency-weighted cumulative duration of use, HR: 0.97 (95% CI: 0.96–0.99). Multivariable analysis incorporating the negative control exposure was not statistically significant (HR: 0.89 (95% CI: 0.75–1.10).

Conclusions

The results of this population-based analysis indicate that statin use in COPD patients may reduce the risk of lung cancer. While the effect was not statistically significantly across all exposure definitions, the overall results support the hypothesis that COPD patients might benefit from statin therapy.
Longitudinal functional changes with clinically significant radiographic progression in idiopathic pulmonary fibrosis: are we following the right parameters?
Authors: Taha Nada , D’Amato Dejanira , Hosein Karishma , Ranalli Tiziana , Sergiacomi Gianluigi , Zompatori Maurizio , Mura Marco
Published: May 2020

Background

Progression of the disease in idiopathic pulmonary fibrosis (IPF) is difficult to predict, due to its variable and heterogenous course. The relationship between radiographic progression and functional decline in IPF is unclear. We sought to confirm that a simple HRCT fibrosis visual score is a reliable predictor of mortality in IPF, when longitudinally followed; and to ascertain which pulmonary functional variables best reflect clinically significant radiographic progression.

Methods

One-hundred-twenty-three consecutive patients with IPF from 2 centers were followed for an average of 3 years. Longitudinal changes of HRCT fibrosis scores, forced vital capacity (FVC), total lung capacity and diffusing lung capacity for carbon monoxide were considered. HRCTs were scored by 2 chest radiologists. The primary outcome was lung transplant (LTx)-free survival after the follow-up HRCT.

Results

During the follow-up period, 43 deaths and 11 LTx occurred. On average, the HRCT fibrosis score increased significantly, and a longitudinal increase > 7% predicted LTx-free survival significantly, with good specificity, but limited sensitivity. The correlation between radiographic and functional progression was moderately significant. HRCT progression and FVC decline predicted LTx-free survival independently and significantly, with better sensitivity, but worse specificity for a ≥ 5% decline of FVC. However, the area under the curve towards LTx-survival were only 0.61 and 0.62, respectively.

Conclusions

The HRCT fibrosis visual score is a reliable and responsive tool to detect clinically meaningful disease progression. Although no individual pulmonary function test closely reflects radiographic progression, a longitudinal FVC decline improves sensitivity in the detection of clinically significant disease progression. However, the accuracy of these methods remains limited, and better prognostication models need to be found.
Ulipristal acetate before in vitro fertilization: efficacy in infertile women with submucous fibroids
Authors: Morgante Giuseppe , Centini Gabriele , Troìa Libera , Orvieto Raoul , De Leo Vincenzo
Published: May 2020

Background

The presence of submucous fibroids strongly impacts on IVF results, therefore, these patients should be considered for surgical or medical treatment. The aim of this study was to assess the role of Ulipristal acetate (UPA), a selective progesterone receptor modulator, in restoring uterine cavity deformation due to submucous fibroids, in infertile patients attempting an IVF treatment. The secondary study outcome was to evaluate the impact of preconception UPA treatment on rate of biochemical pregnancy, ongoing pregnancy, and live birth compared to a control group without fibroids.

Methods

Infertile patients with submucosal fibroid (Type 1 and Type 2 according to FIGO classification) were enrolled in the study as fibroids group and received 1 to 3 treatment cycles of UPA, according to their response, as reflected by fibroid volume reduction and restoration of normal uterine cavity. Patients in control group were randomly selected from a general IVF cohort by a ratio of 2:1 with fibroids group, matched by age, BMI, type and cause of infertility and antral follicle count. The impact of UPA on fibroids volume reduction was evaluated. IVF outcome was compared between groups.

Results

Twenty-six patients underwent UPA treatment revealed a mean volume reduction of their fibroids of 41%. A total of 15 (57.6%) biochemical pregnancy were obtained, resulting in 13 (50%) ongoing pregnancy and 9 (34.6%) healthy babies were already delivered. Similar results were obtained in control group.

Conclusion

Restoration of normal uterine cavity by UPA treatment prior to IVF treatment avoids surgery and establishes a pregnancy rate comparable to a control group without fibroids.
Mitigation of helium irradiation-induced brain injury by microglia depletion
Authors: Allen Barrett D. , Syage Amber R. , Maroso Mattia , Baddour Al Anoud D. , Luong Valerie , Minasyan Harutyun , Giedzinski Erich , West Brian L. , Soltesz Ivan , Limoli Charles L. , Baulch Janet E. , Acharya Munjal M.
Published: May 2020

Background

Cosmic radiation exposures have been found to elicit cognitive impairments involving a wide-range of underlying neuropathology including elevated oxidative stress, neural stem cell loss, and compromised neuronal architecture. Cognitive impairments have also been associated with sustained microglia activation following low dose exposure to helium ions. Space-relevant charged particles elicit neuroinflammation that persists long-term post-irradiation. Here, we investigated the potential neurocognitive benefits of microglia depletion following low dose whole body exposure to helium ions.

Methods

Adult mice were administered a dietary inhibitor (PLX5622) of colony stimulating factor-1 receptor (CSF1R) to deplete microglia 2 weeks after whole body helium irradiation (4He, 30 cGy, 400 MeV/n). Cohorts of mice maintained on a normal and PLX5622 diet were tested for cognitive function using seven independent behavioral tasks, microglial activation, hippocampal neuronal morphology, spine density, and electrophysiology properties 4–6 weeks later.

Results

PLX5622 treatment caused a rapid and near complete elimination of microglia in the brain within 3 days of treatment. Irradiated animals on normal diet exhibited a range of behavioral deficits involving the medial pre-frontal cortex and hippocampus and increased microglial activation. Animals on PLX5622 diet exhibited no radiation-induced cognitive deficits, and expression of resting and activated microglia were almost completely abolished, without any effects on the oligodendrocyte progenitors, throughout the brain. While PLX5622 treatment was found to attenuate radiation-induced increases in post-synaptic density protein 95 (PSD-95) puncta and to preserve mushroom type spine densities, other morphologic features of neurons and electrophysiologic measures of intrinsic excitability were relatively unaffected.

Conclusions

Our data suggest that microglia play a critical role in cosmic radiation-induced cognitive deficits in mice and, that approaches targeting microglial function are poised to provide considerable benefit to the brain exposed to charged particles.
Selective neural electrical stimulation restores hand and forearm movements in individuals with complete tetraplegia
Authors: Tigra Wafa , Dali Mélissa , William Lucie , Fattal Charles , Gélis Anthony , Divoux Jean-Louis , Coulet Bertrand , Teissier Jacques , Guiraud David , Azevedo Coste Christine
Published: May 2020

Background

We hypothesized that a selective neural electrical stimulation of radial and median nerves enables the activation of functional movements in the paralyzed hand of individuals with tetraplegia. Compared to previous approaches for which up to 12 muscles were targeted through individual muscular stimulations, we focused on minimizing the number of implanted electrodes however providing almost all the needed and useful hand movements for subjects with complete tetraplegia.

Methods

We performed acute experiments during scheduled surgeries of the upper limb with eligible subjects. We scanned a set of multicontact neural stimulation cuff electrode configurations, pre-computed through modeling simulations. We reported the obtained isolated and functional movements that were considered useful for the subject (different grasping movements).

Results

In eight subjects, we demonstrated that selective stimulation based on multicontact cuff electrodes and optimized current spreading over the active contacts provided isolated, compound, functional and strong movements; most importantly 3 out of 4 had isolated fingers or thumb flexion, one patient performed a Key Grip, another one the Power and Hook Grips, and the 2 last all the 3 Grips. Several configurations were needed to target different areas within the nerve to obtain all the envisioned movements. We further confirmed that the upper limb nerves have muscle specific fascicles, which makes it possible to activate isolated movements.

Conclusions

The future goal is to provide patients with functional restoration of object grasping and releasing with a minimally invasive solution: only two cuff electrodes above the elbow.

Ethics Committee / ANSM clearance prior to the beginning of the study (inclusion period 2016–2018): CPP Sud Méditerranée, #ID-RCB:2014-A01752–45, first acceptance 10th of February 2015, amended 12th of January 2016.

Trial registration

(www.clinicaltrials.gov): #NCT03721861, Retrospectively registered on 26th of October 2018.
Exclusive breastfeeding during the 40-day rest period and at six months in Lebanon: a cross-sectional study
Authors: Chehab Rana F. , Nasreddine Lara , Zgheib Racha , Forman Michele R.
Published: May 2020

Background

Exclusive breastfeeding is recommended for the first 6 months of life with well-established benefits to the mother and child. The traditional practice of the 40-day rest period helps establish and maintain exclusive breastfeeding. This study aims to estimate the prevalence and examine the factors associated with exclusive breastfeeding at 40 days and at 6 months in Lebanon.

Methods

A cross-sectional survey was conducted in 2011–2012 as part of the “Early Life Nutrition and Health in Lebanon” study. A nationally representative sample of 1005 children aged five years or younger and their mothers was drawn from households using a stratified cluster sampling design. Trained nutritionists interviewed eligible mothers about sociodemographic characteristics of the household and maternal and child characteristics including infant feeding practices. Anthropometric measurements of the mother and child were collected. Multinomial logistic regression analysis was conducted to examine the characteristics associated with exclusive breastfeeding.

Results

The prevalence of exclusive breastfeeding was 41.5% at 40 days and 12.3% at 6 months. Children in families with three or more children had higher odds of exclusive breastfeeding for 40 days (Adjusted Odds Ratio [AOR] 1.76, 95% Confidence Interval [CI] 1.19, 2.60). Children in families owning two or more cars had lower odds of exclusive breastfeeding for 40 days (AOR 0.45, 95% CI 0.24, 0.83) and at 6 months (AOR 0.32, 95% CI 0.14, 0.77). Similarly, children delivered via Caesarian section had lower odds of exclusive breastfeeding for 40 days (AOR 0.49, 95% CI 0.34, 0.71) and at 6 months (AOR 0.39, 95% CI 0.24, 0.65). The odds of exclusive breastfeeding for 6 months were lower among children of overweight (AOR 0.50, 95% CI 0.26, 0.95) or obese (AOR 0.56, 95% CI 0.32, 0.98) mothers.

Conclusions

The association between higher socio-economic status, as reflected by car ownership, and C-section delivery with lower odds of exclusive breastfeeding persisted across the first 6 months in Lebanon. Future research should investigate the factors associated with exclusive breastfeeding in prospective cohort studies and help to better understand the cultural practice of the 40-day rest period in relation to breastfeeding.
Predicting per-lesion local recurrence in locally advanced non-small cell lung cancer following definitive radiation therapy using pre- and mid-treatment metabolic tumor volume
Authors: Binkley Michael S. , Koenig Julie L. , Kashyap Mehr , Xiang Michael , Liu Yufei , Sodji Quaovi , Maxim Peter G. , Diehn Maximilian , Loo Billy W. , Gensheimer Michael F.
Published: May 2020

Background

We evaluated whether pre- and mid-treatment metabolic tumor volume (MTV) predicts per lesion local recurrence (LR) in patients treated with definitive radiation therapy (RT, dose≥60 Gy) for locally advanced non-small cell lung cancer (NSCLC).

Methods

We retrospectively reviewed records of patients with stage III NSCLC treated from 2006 to 2018 with pre- and mid-RT PET-CT. We measured the MTV of treated lesions on the pre-RT (MTVpre) and mid-RT (MTVmid) PET-CT. LR was defined per lesion as recurrence within the planning target volume. Receiver operating characteristic (ROC) curves, cumulative incidence rates, and uni- and multivariable (MVA) competing risk regressions were used to evaluate the association between MTV and LR.

Results

We identified 111 patients with 387 lesions (112 lung tumors and 275 lymph nodes). Median age was 68 years, 69.4% were male, 46.8% had adenocarcinoma, 39.6% had squamous cell carcinoma, and 95.5% received concurrent chemotherapy. Median follow-up was 38.7 months. 3-year overall survival was 42.3%. 3-year cumulative incidence of LR was 26.8% per patient and 11.9% per lesion. Both MTVpreand MTVmidwere predictive of LR by ROC (AUC = 0.71 and 0.76, respectively) and were significantly associated with LR on MVA (P = 0.004 andP = 7.1e-5, respectively). Among lesions at lower risk of LR based on MTVpre, higher MTVmidwas associated with LR (P = 0.001).

Conclusion

Per-lesion, larger MTVpreand MTVmidpredicted for increased risk of LR. MTVmidwas more highly predictive of LR than MTVpreand if validated may allow for further discrimination of high-risk lesions at mid-RT informing dose painting strategies.
Surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia—a retrospective comparative analysis
Authors: Szelerski Łukasz , Żarek Sławomir , Górski Radosław , Mochocki Karol , Górski Ryszard , Morasiewicz Piotr , Małdyk Paweł
Published: May 2020

Introduction

This study compared surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia.

Material and methods

In a retrospective comparative study, 75 patients were treated with the Ilizarov technique for aseptic posttraumatic pseudarthrosis of the tibia in the period 2000–2016. We compared them with the 51 patients from the control group, treated for tibial bone union disturbances using internal osteosynthesis methods, i.e., internal-fixation plates and intramedullary nails. The study groups were compared in terms of the rates of union, time to union, and the baseline-to-postoperative difference in lower leg deformity.

Results

Union rate in the Ilizarov group was 100% and the control group was 51.92% (p< 0.001). The median time to union suggests that patients from the Ilizarov group needed a shorter time to achieve bone union (203.00 days vs. 271.00 days) (p= 0.091). The effect size in the Ilizarov group was larger both in terms of reducing both limb deformity and shortening (it is worth noting, however, that the Ilizarov treatment was used in patients with higher baseline values of both these parameters). We observed no significant difference in terms of time to union between the group of patients with at least one risk factor for disturbance in fracture healing and the group with no risk factors. The following risk factors were considered: diabetes mellitus, corticosteroid therapy, smoking, alcohol dependence, and advanced lower-extremity vascular disease (p= 0.827).

Discussion

Our study demonstrated a high effectiveness of the Ilizarov method in the treatment of aseptic posttraumatic pseudarthroses of the tibia. The Ilizarov method seems to be worth considering in all cases where either the patient or the nature of injury is associated with additional risk factors and whenever there is a need for leg deformity correction or leg elongation.
Clinical and surgical aspects of congenital lobar over-inflation: a single center retrospective study
Authors: Abdel-Bary Mohamed , Abdel-Naser Mohamed , Okasha Ahmed , Zaki Mohammed , Abdel-Baseer Khaled
Published: May 2020

Background

Congenital lobar overinflation (CLOI) is one of the most important causes of infantile respiratory distress (RD). We aim to evaluate our experience in CLOI management emphasizing on clinical features, diagnostic modalities, surgery and outcomes.

Methods

This is a retrospective study for all CLOI cases undergoing surgical management at Qena University Hospital. Demographic data, clinical data, radiographic findings, surgery and postoperative follow-up were reviewed.

Results

A total of 37 neonates and infants with CLOI were presented to our center between January 2015 and January 2019; their mean age was 111.43 ± 65.19 days and 22 were males. All cases presented with RD; and cyanosis in 19 cases. 15 cases presented with recurrent pneumonia and fever. Diminished breath sounds on the affected side and wheezes were the main clinical findings in 30 and 22 cases respectively. On CXR, emphysema was detected in all cases. A confirmatory CT chest was done for all cases. Left upper lobe was affected in 23 cases, right middle lobe in 7 and right upper lobe in 7 cases.

Lobectomy was done in thirty-one cases; their mean age at surgery was 147.58 ± 81.49 days and 19 were males. Postoperative complications were noted in 5 cases and postoperative ventilation was required for 2 of them. No morbidity or mortality was reported. The follow-up duration ranged from 3 months to 1 year and all patients were doing well except one case that lost follow up after 3 months.

Conclusion

CLOI is a rare bronchopulmonary malformation that requires a high index of clinical suspicion, especially in persistent and recurrent infantile RD. CT chest is the most useful diagnostic modality. Early management of CLOI improves outcome and avoid life-threatening complications. Surgical management is the treatment of choice in our center without recorded mortality.
Difficult removal: a Swan-Ganz catheter coiled on the central venous catheter
Authors: Shen Jian , Ma Luyao , Huang He
Published: May 2020

Background

The Swan-Ganz catheter plays an important role in gaining understanding of cardiac pathophysiology and in the hemodynamic monitoring of critically ill patients. Difficult removal of the Swan-Ganz catheter is a rare but serious complication.

Case presentation

This case presents the difficult removal of a Swan-Ganz catheter in a 28-year-old female patient after cardiac surgery. Fluoroscopy and chest X-ray revealed that a portion of the Swan-Ganz catheter was coiled on the central venous catheter at the level of the superior vena cava. Under X-ray guidance, the central venous catheter was first removed, and then the Swan-Ganz catheter was successfully withdrawn through the percutaneous introducer sheath.

Conclusions

This case report provides an unreported reason for difficult removal and describes a successful solution. This report suggests that X-ray examinations may be necessary before removing the Swan-Ganz catheter.
Comparing a global high-resolution downscaled fossil fuel CO2 emission dataset to local inventory-based estimates over 14 global cities
Authors: Chen Jingwen , Zhao Fang , Zeng Ning , Oda Tomohiro
Published: May 2020

Background

Compilation of emission inventories (EIs) for cities is a whole new challenge to assess the subnational climate mitigation effort under the Paris Climate Agreement. Some cities have started compiling EIs, often following a global community protocol. However, EIs are often difficult to systematically examine because of the ways they were compiled (data collection and emission calculation) and reported (sector definition and direct vs consumption). In addition, such EI estimates are not readily applicable to objective evaluation using modeling and observations due to the lack of spatial emission extents. City emission estimates used in the science community are often based on downscaled gridded EIs, while the accuracy of the downscaled emissions at city level is not fully assessed.

Results

This study attempts to assess the utility of the downscaled emissions at city level. We collected EIs from 14 major global cities and compare them to the estimates from a global high-resolution fossil fuel CO2emission data product (ODIAC) commonly used in the science research community. We made necessary adjustments to the estimates to make our comparison as reasonable as possible. We found that the two methods produce very close area-wide emission estimates for Shanghai and Delhi (< 10% difference), and reach good consistency in half of the cities examined (< 30% difference). The ODIAC dataset exhibits a much higher emission compared to inventory estimates in Cape Town (+ 148%), Sao Paulo (+ 43%) and Beijing (+ 40%), possibly related to poor correlation between nightlight intensity with human activity, such as the high-emission and low-lighting industrial parks in developing countries. On the other hand, ODIAC shows lower estimates in Manhattan (− 62%), New York City (− 45%), Washington D.C. (− 42%) and Toronto (− 33%), all located in North America, which may be attributable to an underestimation of residential emissions from heating in ODIAC’s nightlight-based approach, and an overestimation of emission from ground transportation in registered vehicles statistics of inventory estimates.

Conclusions

The relatively good agreement suggests that the ODIAC data product could potentially be used as a first source for prior estimate of city-level CO2emission, which is valuable for atmosphere CO2inversion modeling and comparing with satellite CO2observations. Our compilation of in-boundary emission estimates for 14 cities contributes towards establishing an accurate inventory in-boundary global city carbon emission dataset, necessary for accountable local climate mitigation policies in the future.
Reliability of optic disc edema area in estimating the severity of papilledema in patients with POEMS syndrome
Authors: Liu Ling-shan , Zhang Xiao , Zhao Hao , Gao Xue-min , Zhou Dao-bin , Dai Rong-ping , Li Jian
Published: May 2020

Background

Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome is a rare paraneoplastic syndrome involving multisystem. Optic disc edema (ODE) is the most common ocular manifestation in patients with POEMS syndrome and serves as an independent prognostic factor. However, parameters previously used to estimate its severity were inconvenient and costly. This study was designed to bring forward a novel and practical parameter, optic disc edema area, to evaluate ODE in patients with this disease and applied it to assess effectiveness of lenalidomide combined with dexamethasone in respect of ODE.

Results

Forty-one treatment-naive patients with POEMS syndrome were enrolled in this single-center prospective study and treated with lenalidomide combined with dexamethasone. They received ocular examination to determine optic disc edema (ODE) area and other optic manifestations. Meanwhile, serum VEGF was measured before and after treatment. Among 41 enrolled patients, 38 received complete ocular examinations, and 25 of which had ODE at initial visit. Binocular mean ODE area of patients with ODE was significantly related to ODE grade (r = 0.620, p = 0.003) and peripapillary retinal thickness (r = 0.760, p < 0.001) before treatment. Serum VEGF was significantly higher in patients with ODE than their counterparts (p = 0.025) and positively correlated with binocular mean ODE area (r = 0.460, p = 0.036). After treatment, ODE area, along with serum VEGF, decreased markedly (p < 0.001).

Conclusion

ODE area was a reliable index to evaluate ODE severity and could precisely reflect ODE improvement through systemic treatment. Additionally, it was related to serum VEGF, a key factor in disease pathogenesis, suggesting its potential as an indicator of the overall severity of this disease.

Trial registration

Clinicaltrials, NCT01816620. Registered March 222,013.
Gastrointestinal manifestations in Satoyoshi syndrome: a systematic review
Authors: Solís-García del Pozo Julián , de Cabo Carlos , Solera Javier
Published: May 2020

Background

Satoyoshi syndrome (SS) [OMIM 600705; ORFHA 3130] is a multisystemic disease with a probable autoimmune basis, whose main symptoms are muscle spasms, alopecia, diarrhea and skeletal alterations. Chronic diarrhea may be severe and result in malnutrition, anemia, growth retardation, cachexia, disability and even death. However, to date, no review of the digestive symptoms has been carried out.

Methods

A search was performed in MEDLINE, Scopus and Web of Science databases. Cases of SS, without language or date restrictions, were recorded. Sixty-seven cases of SS were found up until December 2019. Thirty-nine cases described gastrointestinal manifestations.

Results

Chronic diarrhea was the main digestive symptom (92.3%). Other symptoms such as abdominal pain (15.4%), nausea (7.7%) and vomiting (7.7%), were less frequent. The D-xylose test was positive in 10 out of 12 patients, and 9 out of 13 cases showed a flattened oral glucose tolerance test suggesting carbohydrate malabsorption. Antinuclear antibodies were detected in 8 out of 16 cases. Antibodies to stomach or duodenum tissue lysates were also detected by Western blot. Histological data revealed predominantly lymphoplasmacytic inflammatory infiltrate that can affect any section of the digestive tract. In 6 out of 10 patients, diarrhea improved with a treatment regimen that included corticosteroids. Other treatments, such as methotrexate, carbohydrate restricted diets or otilonium bromide, improved digestive symptoms in isolated patients. Improvement of symptoms up to three years of follow-up has been described. None of the three patients who died had received corticosteroids or immunosuppressants.

Conclusion

Chronic diarrhea with malabsorption is one of the most disabling symptoms in SS. The early recognition of this disease is essential for immunosuppressive treatment and a better outcome.
Ideas for how informaticians can get involved with COVID-19 research
Authors: Moore Jason H. , Barnett Ian , Boland Mary Regina , Chen Yong , Demiris George , Gonzalez-Hernandez Graciela , Herman Daniel S. , Himes Blanca E. , Hubbard Rebecca A. , Kim Dokyoon , Morris Jeffrey S. , Mowery Danielle L. , Ritchie Marylyn D. , Shen Li , Urbanowicz Ryan , Holmes John H.
Published: May 2020

The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on population health and wellbeing. Biomedical informatics is central to COVID-19 research efforts and for the delivery of healthcare for COVID-19 patients. Critical to this effort is the participation of informaticians who typically work on other basic science or clinical problems. The goal of this editorial is to highlight some examples of COVID-19 research areas that could benefit from informatics expertise. Each research idea summarizes the COVID-19 application area, followed by an informatics methodology, approach, or technology that could make a contribution. It is our hope that this piece will motivate and make it easy for some informaticians to adopt COVID-19 research projects.
Supervised exercise protocol for lower limbs in subjects with chronic venous disease: an evaluator-blinded, randomized clinical trial
Authors: Volpe Esther Fernandes Tinoco , Resqueti Vanessa R. , da Silva Ana Aline Marcelino , Gualdi Lucien Peroni , Fregonezi Guilherme A. F.
Published: May 2020

Background

Chronic venous insufficiency (CVI) causes pathophysiological changes in the lower-limb muscles, particularly the calf muscles, and limits ankle range of motion (ROM). These changes reduce functional activities and decrease quality of life (QOL). Although several studies have shown the benefits of exercise (strengthening the calf muscles to improve calf-muscle pumping and QOL) in patients with CVI, few studies are randomized controlled trials. This has led to a weak indication of exercise for the treatment of patients with CVI. The aim of this study is to analyze the effects of a supervised exercise program to improve calf-muscle endurance as well as QOL in patients with CVI.

Methods/design

This is an evaluator-blind, randomized clinical trial with an 8-week duration and a follow-up evaluation at week 16. A pilot study with subjects with a CVI diagnosis will be performed to calculate sample size. The participants will be randomly allocated (1:1) into a treatment or a control group (usual care/no intervention). The treatment intervention consists of a bi-weekly supervised exercise program of the lower limbs that will include aerobic training, strengthening and cardiovascular exercises. The participants from both groups will participate in a health education lecture. Primary outcomes are changes in calf-muscle endurance and QOL score. Secondary outcomes are changes in exercise capacity, ankle ROM, electrical muscle activity and cardiac output. The first statistical comparison will be performed after 8 weeks’ intervention.

Discussion

Patients with CVI may have an impaired calf-muscle pump and decreased exercise capacity. A randomized controlled trial evaluating a supervised exercise program should provide much needed information on the management of CVI to promote health and independence.

Trial registration

This study was registered on the Brazilian Clinical Trials Database (REBEC) (RBR-57xtk7). The results will be disseminated at scientific events, presentations, and publications in peer-reviewed journals.
Spectrum of imaging findings in AIDS-related diffuse large B cell lymphoma
Authors: Nganga Edward Chege , Gitau Samuel
Published: May 2020

Lymphoma in HIV-infected patients is AIDS defining. This is the second most common AIDS defining malignancy after Kaposi’s sarcoma. Development of lymphoma in HIV patients is related to immunosuppression and high viral load. Co-infection with other lymphotrophic viruses especially EBV is also strongly associated with development of lymphoma in HIV patients. Despite advances in HAART therapy, incidence of diffuse large B cell lymphoma in HIV-infected patients remains significantly higher than in the general population.

Early diagnosis is challenging due to presence of opportunistic infections and atypical presentation of the lymphoma in this subset of patients. Atypical imaging findings are not unusual, and the diagnosis of lymphoma on imaging is on many occasions unexpected as the patient would ideally be initially investigated for presumed opportunistic infection.

Lymphoma treatment approaches in HIV patients are complicated by comorbidity with opportunistic infections and performance status of the patients. Treatment failure and early relapse are also common in AIDS-related lymphoma. This review article highlights the common and unusual multimodality imaging findings in HIV-associated lymphoma.
Role of MRI as first-line modality in the detection of previously undiagnosed otosclerosis: a single tertiary institute experience
Authors: Purohit Bela , Op de beeck Katya , Hermans Robert
Published: May 2020

Background

Otosclerosis causes conductive, sensorineural and mixed hearing loss (CHL, SNHL, MHL) and tinnitus in young adults. It is best diagnosed on high-resolution CT (HRCT). Occasionally, patients presenting with SNHL and/or tinnitus may undergo temporal bone MRI as the first investigation. In this study, we have described the role of MRI as the first-line modality in the detection of previously undiagnosed otosclerosis.

Using search words ‘MRI otosclerosis’ we found 15 cases in the PACS of our institute, (University Hospitals, KU Leuven, Belgium) from 2003 to 2018. Of these, 2 were known cases of otosclerosis, hence excluded from the study. The remaining 13 patients underwent MRI as first-line investigation for unilateral SNHL (8/13), bilateral SNHL (3/13), unilateral MHL (1/13) and bilateral pulsatile tinnitus (1/13). All MRI studies were reported by the same senior radiologist.

Results

Of these 13 cases, 12 were reported as showing MRI features suspicious for otosclerosis. The typical positive findings in these cases were intermediate T1 signal and post-contrast enhancement in the perilabyrinthine/pericochlear regions. Out of 13 patients, 9 underwent subsequent HRCT, confirming otosclerosis in all. The single MRI which was reported as normal initially showed otosclerosis on HRCT. Retrospective evaluation of this MRI study showed subtle positive findings of otosclerosis.

Conclusion

The end point of this study was to validate the subtle findings of otosclerosis on MRI, by comparison to the gold-standard modality HRCT. Our hypothesis is that in the appropriate clinical setting, familiarity with MRI features of otosclerosis would increase the diagnostic ‘catch’ in the first ‘net’ itself i.e. first-line MRI.
Existence of solutions of infinite system of nonlinear sequential fractional differential equations
Authors: Ahmadi Zahra , Lashkaripour Rahmatollah , Baghani Hamid , Heidarkhani Shapour , Caristi Giuseppe
Published: May 2020

In a recent paper (Filomat 32:4577–4586, 2018) the authors have investigated the existence and uniqueness of a solution for a nonlinear sequential fractional differential equation. To present an analytical improvement for Fazli–Nieto’s results with some conditions removed based on a new technique is the main objective of this paper. In addition, we introduce an infinite system of nonlinear sequential fractional differential equations and discuss the existence of a solution for them in the classical Banach sequence spaces$c_{0}$c0and$\ell_{p}$ℓpby applying the Darbo fixed point theorem. Moreover, the proposed method is applied to several examples to show the clarity and effectiveness.
CNN based lane detection with instance segmentation in edge-cloud computing
Authors: Wang Wei , Lin Hui , Wang Junshu
Published: May 2020

At present, the number of vehicle owners is increasing, and the cars with autonomous driving functions have attracted more and more attention. The lane detection combined with cloud computing can effectively solve the drawbacks of traditional lane detection relying on feature extraction and high definition, but it also faces the problem of excessive calculation. At the same time, cloud data processing combined with edge computing can effectively reduce the computing load of the central nodes. The traditional lane detection method is improved, and the current popular convolutional neural network (CNN) is used to build a dual model based on instance segmentation. In the image acquisition and processing processes, the distributed computing architecture provided by edge-cloud computing is used to improve data processing efficiency. The lane fitting process generates a variable matrix to achieve effective detection in the scenario of slope change, which improves the real-time performance of lane detection. The method proposed in this paper has achieved good recognition results for lanes in different scenarios, and the lane recognition efficiency is much better than other lane recognition models.
Evaluation of PET quantitation accuracy among multiple discovery IQ PET/CT systems via NEMA image quality test
Authors: Vallot Delphine , De Ponti Elena , Morzenti Sabrina , Gramek Anna , Pieczonka Anna , Llompart Gabriel Reynés , Siennicki Jakub , Deak Paul , Dutta Chiranjib , Uribe Jorge , Caselles Olivier
Published: May 2020

Introduction

Quantitative imaging biomarkers are becoming usual in oncology for assessing therapy response. The harmonization of image quantitation reporting has become of utmost importance due to the multi-center trials increase. The NEMA image quality test is often considered for the evaluation of quantitation and is more accurate with a radioactive solid phantom that reduces variability. The goal of this project is to determine the level of variability among imaging centers if acquisition and imaging protocol parameters are left to the center’s preference while all other parameters are fixed including the scanner type.

Methods

A NEMA-IQ phantom filled with radioactive 68Ge solid resin was imaged in five clinical sites throughout Europe. Sites reconstructed data with OSEM and BSREM algorithms applying the sites’ clinical parameters. Images were analyzed according with the NEMA-NU2-2012 standard using the manufacturer-provided NEMA tools to calculate contrast recovery (CR) and background variability (BV) for each sphere and the lung error (LE) estimation. In addition, a 18F-filled NEMA-IQ phantom was also evaluated to obtain a gauge for variability among centers when the sites were provided with identical specific instructions for acquisition and reconstruction protocol (the aggregate of data from 12 additional sites is presented).

Results

The data using the 68Ge solid phantom showed no statistical differences among different sites, proving a very good reproducibility among the PET center models even if dispersion of data is higher with OSEM compared to BSREM. Furthermore, BSREM shows better CR and comparable BV, while LE is slightly reduced. Two centers exhibit significant differences in CR and BV values for the 18F NEMA NU2-2012 experiments; these outlier results are explained.

Conclusion

The same PET system type from the various sites produced similar quantitative results, despite allowing each site to choose their clinical protocols with no restriction on data acquisition and reconstruction parameters. BSREM leads to lower dispersion of quantitative data among different sites. A solid radioactive phantom may be recommended to qualify the sites to perform quantitative imaging.
Species richness, forest types and regeneration of Schima in the subtropical forest ecosystem of Yunnan, southwestern China
Authors: Tang Cindy Q. , Han Peng-Bin , Li Shuaifeng , Shen Li-Qin , Huang Diao-Shun , Li Yun-Fang , Peng Ming-Chun , Wang Chong-Yun , Li Xiao-Shuang , Li Wei , Wang Wei , Zhang Zhi-Ying
Published: May 2020

Background

Schima genus of Theaceae is confined to subtropics and tropics of South, East and Southeast Asia. Thirteen species of Schima are distributed in subtropical China. Many of them appear as dominant canopy species in the subtropical forests. To date, Schima species richness distribution patterns of China have remained unknown. Meanwhile, there has been a longtime debate as to whether forests dominated by Schima species are early or late successional forests. We aim to clarify Schima species richness patterns and these species’ roles in the forest succession and regeneration dynamics of the subtropical ecosystem in Yunnan Province, China.

Method

We mapped Schima species richness distribution patterns in China. Based on 71 vegetation plots, we analyzed forest characteristics, population structure, and regeneration dynamics of Schima species in Yunnan.

Results

Yunnan was found to harbor the greatest richness and the highest rarity-weighted richness of Schima species in the subtropical regions of China. We classified five primary and six secondary forest types containing Schima species as one of dominants. Yunnan had the high floristic diversity and varying stand structure of forests containing Schima species. The Schima species studied generally had a sporadic regeneration type and a long life-span. Four species (Schima argentea, Schima villosa, Schima sinensis, Schima sericans) were shade-intolerant. But three species (Schima noronhae, Schima khasiana and Schima wallichii) were considered as bi-modal type species having shade-intolerant and shade-tolerant traits. Schima noronhae was seen to be a top dominant in late successional forests, while S. wallichii was found as a top-dominant in early or middle or late successional forests. S. khasiana, Schima villosa, Schima sinensis usually appeared as a top dominant in early or middle successional secondary forests, though they also presented as a second dominant in late-successional forests. Schima argentea and Schima sericans dominated only in the early or middle/seral successional forests. Schima species’ regeneration establishment depended mainly on forest canopy gap formation through moderate human and natural disturbances.

Conclusions

Yunnan has high species richness and rarity-weighted richness of Schima. Both moderate human and natural disturbances have provided regeneration niches for Schima species. Some of the Schima species studied as a second dominant (rare as the top-dominant) present in the late-successional forests. Some of them are more often as the top-dominant in early or middle successional forests, where as time goes by the dominance of Schima species would be replaced by their associated dominant taxa such as Castanopsis species.
A patient with post-Fontan operation underwent left hepatectomy and caudate lobectomy for hepatocellular carcinoma: a case report
Authors: Nemoto Satoshi , Ariizumi Shun-ichi , Kotera Yoshihito , Omori Akiko , Yamashita Shingo , Kato Taka-aki , Egawa Hiroto , Yamamoto Masakazu
Published: May 2020

Background

The Fontan procedure has been widely accepted for children with single ventricle physiology and guarantees survival rates of approximately 80% at age 20 years. However, there have been cases of Fontan-associated liver disease (FALD) caused due to congestion, along with recent reports of the development of hepatocellular carcinoma (HCC) in younger patients with FALD. The literature consists of only five previous case reports of patients who underwent hepatectomy for HCC due to poorer cardiac function and liver cirrhosis caused due to congestion.

Case presentation

The patient was a 37-year-old woman who presented with epigastralgia. Computed tomography (CT) revealed a liver tumor, 8 cm in diameter, in the caudate lobe. Liver damage was A, with an indocyanine green retention rate of 6% at 15 min. The levels of alpha-fetoprotein (AFP) and protein induced by vitamin K antagonists-II (PIVKA-II) were elevated to 81,663 ng/ml (normal < 10 ng/ml) and 238 mAU/ml (normal < 40 mAU/ml), respectively. Left ventricular ejection fraction was 56%, and central venous pressure (CVP) was 12 mmHg. Left hepatectomy and caudate lobe resection were successfully performed in the reverse Trendelenburg position which reduced the CVP. The total operation duration was 450 min, with a total blood loss of 3200 ml. The patient’s postoperative course was uneventful, and she is still alive 16 months after surgery.

Conclusions

First left hepatectomy with caudate lobectomy during reverse Trendelenburg position which reduced the CVP was performed in a patient with HCC and FALD.