bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic Underpinnings of Musculoskeletal Pain During Treatment With Aromatase Inhibitors for Breast Cancer: A Biological Pathway Analysis
Authors: Zhu Yehui , Koleck Theresa A. , Bender Catherine M. , Conley Yvette P.
Published: December 2019

Background:

Musculoskeletal pain (MSKP) is the most reported symptom during treatment with aromatase inhibitors (AIs) for breast cancer. The mechanisms underlying MSKP are multidimensional and not well understood. The goals of this biological pathway analysis were to (1) gain an understanding of the genetic variation and biological mechanisms underlying MSKP with AI therapy and (2) identify plausible biological pathways and candidate genes for future investigation.

Method:

Genes associated with MSKP during AI therapy or genes involved in drug metabolism of and response to AIs were identified from the literature. Studies published through February 2019 were queried in PubMed®. The genes identified from the literature were entered into QIAGEN’s Ingenuity® Pathway Analysis (IPA) software to generate canonical pathways, upstream regulators, and networks through a core analysis.

Results:

The 17 genes identified were ABCB1, ABCG1, CYP17A1, CYP19A1, CYP27B1, CYP2A6, CYP3A4, CYP3A5, ESR1, OATP1B1, OPG, RANKL, SLCO3A1, TCL1A, UGT2A1, UGT2B17, and VDR. These genes are involved in encoding bone-remodeling regulators, drug-metabolizing enzymes (cytochrome P450 family, UDP-glucuronosyltransferases family), or drug transporters (ATP-binding cassette transporters, organic anion transporters). Multiple plausible biological pathways (e.g., nicotine degradation, melatonin degradation) and candidate genes (e.g., NFKB, HSP90, AKT, ERK1/2, FOXA2) are proposed for future investigation based on the IPA results.

Conclusion:

Multiple genes and molecular-level etiologies may contribute to MSKP with AI therapy in women with breast cancer. Our innovative combination of gene identification from the literature plus biological pathway analysis allowed for the emergence of novel candidate genes and biological pathways for future investigations.
What it is like to be a pickpocket
Authors: Wachowski Witold M
Published: December 2019

This study aims to show the socio-cognitive engineering of the pickpocket craft from the point of view of cognitive ecology. Being a pickpocket has a wider, existential status; studying it goes beyond the field of cognitive sciences. My ambitions are more modest: I try to show that the question about what it is like to be someone like a pickpocket is also a question about the cognitive structure of his or her activity space. In this light, I analyze some aspects of the reality presented in the movie Pickpocket by Robert Bresson. From the ecological point of view, scenes from the old movie present pickpocketing techniques in the context of the opportunities and constraints of a given environment. I claim that studies like this require integrating certain conceptual tools, like distributed cognition approach, ecological psychology, and cognitive studies of design.
“Don’t Keep It a Secret”: E. Daniel Long and His Career in Music Education
Authors: Rawlings Jared R.
Published: December 2019

Music teachers are central to the effective implementation of the school curriculum; however, researchers know little about their careers in music education. In order to understand the work of music teachers, researchers must document experiences of those educators who may appear ordinary but who led extraordinary lives and careers. The purpose of this study was to create a biographical primary source on E. Daniel Long, one of the esteemed educators in American string music education during the second half of the twentieth century. Long’s memories of his life and teaching position with Ann Arbor Public Schools, alongside additional sources, were used to explore aspects of his career in music education. This article includes additional biographical information not previously documented in past interviews as well as his philosophical beliefs about teaching youth.
An efficient construction of key-dependent substitution box based on chaotic sine map
Authors: Usama Muhammad , Rehman Osama , Memon Imran , Rizvi Safdar
Published: December 2019

A substitution box is a core component of the popular symmetric-key algorithms. However, the major problem of the conventional substitution boxes is the statistic behavior, which is employed as a fixed-size lookup table. To solve the fixed-size lookup table problem, various substitution box construction methods were proposed with key control, but it is hard to enhance all cryptographic properties, for example, linear and differential probabilities. Thus, chaos is applied for key control in designing robust substitution boxes due to unpredictable and random-like behavior. Moreover, the confusion and diffusion properties of cryptography can be achieved by chaos. This article introduces an efficient construction of a key-dependent substitution box based on the mixing property of the chaotic sine map. The substitution box so constructed has very low differential and linear approximation probabilities. The experimental results confirmed that the proposed method to construct substitution box has acceptable cryptographic properties to resist against various cryptanalysis.
Trigger Digit Incidence After Carpal Tunnel Release: Reconstruction in Elongated Position Versus Traditional Carpal Tunnel Release
Authors: Esteban-Feliu Ignacio , Gallardo-Calero Irene , Barrera-Ochoa Sergi , Vidal-Tarrason Núria , Nuñez-Camarena Jorge , Lluch-Bergadà Alex
Published: December 2019

Background: The development of trigger digit after carpal tunnel syndrome release surgery has been widely reported. Lluch described reconstruction of the flexor retinaculum in elongated position to prevent such complication. Methods: We conducted a retrospective review to determine whether patients who undergo reconstruction in elongated position of the flexor retinaculum have a lower incidence of trigger digit postoperatively. In total, 1050 patients were included, 865 of whom had undergone traditional carpal tunnel release and 185 flexor retinaculum reconstruction. Results: No differences were found in the incidence of trigger digit after surgery (8.7% of the patients who underwent traditional release vs 11.9% in the reconstruction group). Neither difference was found when comparing mean time with the development of trigger digit. Conclusions: In the absence of randomized long-term studies comparing traditional release and reconstruction in elongated position after carpal tunnel release, given our results, we see no reason to favor reconstruction over standard carpal tunnel release as a means to prevent postoperative triggering of digits.
ADAPT technique in ischemic stroke treatment of M2 middle cerebral artery occlusions in comparison to M1 occlusions: Post hoc analysis of the PROMISE study
Authors: Navia Pedro , Schramm Peter , Fiehler Jens
Published: December 2019

Background/purpose

The benefit of endovascular thrombectomy in acute ischemic stroke (AIS) therapy of proximal large vessel occlusions (LVO) is established. However, there are few prospective studies evaluating the use of a direct aspiration first pass technique in distal vessel occlusions. This post hoc analysis of the PROMISE study examines the safety and effectiveness of the Penumbra System with the ACE68 and ACE64 Reperfusion Catheters for aspiration thrombectomy in the M1 and M2 segments of the middle cerebral artery.

Methods

PROMISE is a prospective, multicenter study that enrolled 204 patients with anterior circulation LVO AIS-treated frontline with ACE68/ACE64 catheters. We compared clinical and angiographic outcomes, complications, and mortality in patients with M1 and M2 occlusions. The association of M1 and M2 location and functional independence or mTICI 2b-3 reperfusion was described in univariable and multivariable analyses.

Results

One hundred sixty-one patients (124 M1 and 37 M2 locations) met the study criteria. Post procedure mTICI 2b-3 reperfusion (93% vs. 92%, p = 1.00), functional independence (57% vs. 70%, p = 0.18), symptomatic intracranial hemorrhage (1.6% vs. 2.7%, p = 0.55), device- or procedure-related serious adverse events at 30 days (4.0% vs. 8.1%, p = 0.39), and mortality at 90 days (6.6% vs. 2.7%, p = 0.69) were comparable between M1 and M2 occlusions. In multivariable analysis, lower age, lower baseline NIHSS, and shorter time from onset to admission were independent predictors of functional independence.

Conclusions

For frontline aspiration thrombectomy of stroke, use of large-bore ACE68/ACE64 catheters for treatment of M2 occlusions appeared as safe and effective as for M1 occlusions.
Clinical tests for assessing the presence and quality of the palmaris longus tendon: diagnostic accuracy of examination compared with ultrasound
Authors: Johnson Christine C. , Zusstone Esther , Miller Theodore T. , Nwawka O. Kenechi , Lee Steve K. , Wolfe Scott W.
Published: December 2019

Various clinical tests are used to evaluate the palmaris longus tendon, but their accuracy is unknown. We assessed the accuracy of clinical tests (Schaeffer’s, Thompson’s, Mishra-I, Mishra-II) against ultrasound as the reference standard. We hypothesized that Schaeffer’s was most accurate and that examination can reliably assess the palmaris longus tendon’s length. Ninety-six wrists were examined clinically and evaluated with ultrasound by radiologists who were blinded to examination results. We calculated diagnostic accuracy and agreement between length measurements. Sensitivity values were as follows: Schaeffer’s 94%, Mishra-I 100%, Mishra-II 100%, Thompson’s 72%. Specificity values were as follows: Schaeffer’s 94%, Mishra-I 83%, Mishra-II 89%, Thompson’s 91%. Intraclass correlation coefficient between palmaris longus tendon length measurement on examination and ultrasound was 0.54. Schaeffer’s test accurately detected this tendon with >90% sensitivity and specificity, but clinical examination less reliably measured palmaris longus tendon length. Ultrasound may be a useful adjunct to assess potential graft length preoperatively.

Level of evidence: I
Appreciation for food, an important concept in mindful eating: association with home and school education, attitude, behavior, and health status in Japanese elementary school children
Authors: Kawasaki Yui , Akamatsu Rie
Published: December 2019

Background:

Appreciating food is an important concept in mindful eating, mentioned by advocates of an expanded model of mindful eating in 2016. With the exception of Japan, this concept is not common in many countries.

Objective:

We aimed to describe the role that appreciation for food has in the health of children from two perspectives: 1) association between children’s appreciation for food and their backgrounds, such as home and school educational experiences related to food, and 2) association between their appreciation for food and outcomes, such as attitude toward food, eating behaviors, and health status.

Design:

Cross-sectional.

Methods:

Data were obtained from self-administered anonymous questionnaires sent to 2070 elementary school students in Tokyo, Japan, during October and December 2006. They contained several question items pertaining to the characteristics of participants: home and school educational experiences related to food, attitudes towards food (including level of appreciation for food), eating behaviors, and health status. T-test, Pearson’s correlation coefficient, and simple and multiple linear regression analyses were used to compare the total score of appreciation for food with other factors.

Results:

Surveys were completed by 1994 children (response rate: 96.3%) and significant correlations were indicated by gender, educational experiences at home and school, attitudes toward healthy food, recommended food preferences, breakfast consumption, and body mass index.

Conclusions:

We concluded that appreciation for food plays an important role in children’s health.
Do-It-Yourself Artificial Pancreas Systems: A Review of the Emerging Evidence and Insights for Healthcare Professionals
Authors: Jennings Peter , Hussain Sufyan
Published: December 2019

Application of artificial pancreas systems in type 1 diabetes (T1D) represents a change in approach to managing complex glucose and insulin dynamics using automated features with higher levels of safety, precision, and reliability than those afforded by manual adjustments. To date, limited commercial systems and more widely used open-source, hybrid closed loop, Do-It-Yourself Artificial Pancreas Systems (DIY APS) have been used in nontrial real-world management of T1D. The aims of this article are twofold. First, itsynthesizes the emerging literature on DIY APS and identifies a range of evidence including research, reviews, commentaries, and opinion pieces written by DIY APS users, healthcare professionals (HCPs), and researchers. It summarizes the emerging clinical evidence for DIY APS and provide insight into how the DIY APS movement began, has been disseminated throughout diabetes online communities, and is reshaping self-management of T1D in real-world settings. Second, the article provides commentaries that explore implications of DIY APS to healthcare practice. DIY APS are radically changing T1D management. Automating the process of frequently analyzing glucose readings and appropriately titrating insulin delivery is liberating people with T1D (PWD) from some of the demands of intensive management. Within this super-specialized area of T1D management, the expertise of DIY APS users has outstripped that of many HCPs. While educational, ethical, and legal constraints need to be resolved, HCPs still need to stay abreast of this rapidly developing area. Further research is needed to inform policy and practice relating to DIY APS. Meanwhile, HCPs continue to learn from PWD’s real-world experiences of building and using DIY APS to improve metabolic and psychological outcomes.
Translating Chagasic dilating cardiomyopathy to surgical therapies: An under published global challenge
Authors: Groom Zoe C , Zochios Vasileios , Protopapas Aristotle D
Published: December 2019

Chagas disease is a neglected parasitic anthropozoonosis of the Americas linked to social deprivation with no hope of eradication in the future. Having been the most common non-ischemic cause of dilating cardiomyopathy in Latin America, it now spreads beyond the geographical boundaries of its vector via imported and autochthonous transmission. We review the evidence on surgery in Chagasic heart failure and offer a brief narrative on the main aspects of translational management. There is very limited literature on surgery for Chagasic heart failure, especially assist devices and transplantation. This may be attributed to the often unsurmountable economic burden of this single-system parasymphatholytic heart failure to young sufferers who commonly have very limited access to the aforementioned procedures. Chagasic heart failure offers a so far neglected translational model of parasymphatholytic non-ischemic cardiac failure.
Does endometriosis have an effect on the survival of women with synchronous endometrial and ovarian cancer?
Authors: Celik Engin , Goksever Celik Hale , Sozen Hamdullah , Onder Semen , Baktiroglu Merve , Topuz Samet , Salihoglu Mehmet Yavuz
Published: December 2019

Purpose:

Synchronous endometrial and ovarian cancer is defined as the concurrent presence of ovarian cancer with endometrial cancer. We aimed to evaluate whether there is an effect of endometriosis on progression-free survival and overall survival of women with synchronous endometrial and ovarian cancer. We also compared these findings with the patients having endometrial-only tumors and ovarian-only tumors.

Methods:

The patients who underwent surgery for endometrioid or clear-cell endometrial-only tumors and/or ovarian-only tumors and synchronous endometrial and ovarian cancer between 2005 and 2016 were included in this cohort study. The effect of the presence of endometriosis on progression-free survival and overall survival in these women who met the criteria was determined using statistical methods. Women were also compared regarding their demographic, clinical, and pathological characteristics.

Results:

A total of 176 patients were included in this study. All histology types of tumors located in endometrium or ovary were endometrioid or clear-cell cancer. Endometriosis was present in 62 patients (35.2%), whereas adenomyosis was present in 44 patients (25%). Endometriosis was diagnosed more frequently in women with ovarian-only tumors and synchronous endometrial and ovarian cancer than those with endometrial-only tumors (59.2% vs 5.7%, p < 0.001 and 45.7% vs 5.7%, p < 0.001, respectively). The patients with endometriosis showed no significantly longer progression-free survival and overall survival (hazard ratio = 1.70; 95% confidence interval = 0.48–6.03; p = 0.408 and hazard ratio = 1.67; 95% confidence interval = 0.30–9.44; p = 0.562, respectively). The presence of endometriosis was a stronger predictor for progression-free survival and overall survival comparing with the presence of adenomyosis.

Conclusion:

The women with synchronous endometrial and ovarian cancer should be informed that endometriosis has no detrimental effect on progression-free survival and overall survival.
Fiction or non-fiction: Parent-reported book preferences of their preschoolers with autism spectrum disorder
Authors: Armstrong Rebecca M , Paynter Jessica , Westerveld Marleen F
Published: December 2019

Background and aims

Children’s early interactions with books are important for fostering development of oral language and emergent literacy skills. It is not known whether children diagnosed with autism spectrum disorder show different preferences for text types in the home environment prior to school entry. The current study aimed to: (i) investigate parent-reports of the favourite books of their children with autism spectrum disorder compared to typically developing children and (ii) identify whether there are differences in the reasons why books were preferred across the two groups.

Methods

Participants included children (aged 26–70 months) with autism spectrum disorder ( n =  41) and typically developing peers ( n =  164). Parent-reports of their child’s current favourite book/s were coded as fiction versus non-fiction and also category type. Parents also reported why the book was considered a favourite and this was coded.

Results

There were no differences between groups for fiction versus non-fiction, with both groups preferring fiction (>95% of responses). A strong category preference for animal topics across both groups was present. Significant group differences were found when asked to select specific reasons for favourite book preferences.

Conclusions

This study provides preliminary evidence of similarities between preschool children with autism spectrum disorder and typically developing peers’ preferences for fiction books during the early years.

Implications

It should not be assumed that children with autism spectrum disorder have different preferences for book types compared to typically developing children in the early years of development. Providing preschoolers with a range of book types during the preschool years will help to facilitate early language and emergent literacy skills.
Distribution Performance Analysis and Experimental Research on the Port Plate Pairs of Low Speed High Torque Seawater Hydraulic Motor
Authors: Wang Zhiqiang , Wu Shaofeng , Gao Dianrong , Wang Shuncai
Published: December 2019

The current research of seawater hydraulic motor mainly focused on piston motor and vane motor, but seldom regarded low speed high torque seawater hydraulic motor. Low speed high torque seawater hydraulic motor as a kind of energy conversion device and actuator plays an important role in seawater hydraulic transmission system. However, the physical and chemical properties of seawater, such as low viscosity, high causticity and poor lubrication, result in numerous problems. In this paper, the flow distribution characteristics of port plate pairs for the seawater hydraulic motor are investigated, and the leakage flow and power loss models of port plate pairs are established. Numerical simulations are carried out to examine the effects of water film, inlet pressure and rotating speed on the pressure distribution and leakage flow. And the friction and wear tests of port plate pairs are also carried out. Moreover, the test system of the seawater hydraulic motor is constructed and the performance of prototype with no-load or loading is conducted. The results indicate that the clearance of port plate pairs and inlet pressure have a significant effect on distribution characteristics, but the effect of rotating speed is not very obvious. The experimental results show that the minimum error rate can be maintained within 0.3% by the proposed flow model and the counter materials of 316L against carbon-fiber-reinforced polyetheretherketone (CFRPEEK) are suitable for the port plate pairs of seawater hydraulic motor. Finally, based on the seawater hydraulic experiment platform, the volumetric efficiency of no-load and loading are obtained that the maximum can achieve 94.71% and 90.14%, respectively. This research work may improve the flow distribution performance, lubrication and the friction and wear properties, enhance energy converting efficiency of port plate pair and provide theoretical and technical support for the design of high-performance water hydraulic components.
Broadband Ultrathin Transmission Quarter Waveplate with Rectangular Hole Array Based on Plasmonic Resonances
Authors: Wang Yu , Liu Yumin , Li Jing , Liu Chang , Yu Zhongyuan , Ye Han , Yu Li
Published: December 2019

The control of the polarization states of light plays an important role in modern optical systems. However, traditional polarization manipulating devices often have narrow bandwidth and their large size makes it difficult for them to achieve miniaturization and integration of optical systems. This work presents an ultrathin quarter waveplate with a periodic silver film 2 × 2 rectangular hole array with a thickness less than λ/50. Numerical simulation shows that the waveplate can efficiently transform a circular polarized wave into a linearly polarized one at the center of 1550 nm, and its bandwidth is 525 nm. Furthermore, the quarter waveplate can efficiently invert linear polarization into circular polarization at 1550 nm, which ellipticity is near unit. With an array of small holes on a metal film to enhance transmission, this structure can increase the transmission to 0.44. The broadband quarter waveplate can be used in communication system and near infrared band system, and be integrated with other optical devices at nanoscale to achieve polarization operation, detection, and sensing.
RETRACTED ARTICLE: Upregulating MicroRNA-410 or Downregulating Wnt-11 Increases Osteoblasts and Reduces Osteoclasts to Alleviate Osteonecrosis of the Femoral Head
Authors: Yin Yukun , Ding Lixiang , Hou Yu , Jiang Haoran , Zhang Ji , Dai Zhong , Zhang Genai
Published: December 2019

Background

Little is known regarding the functional role of microRNA-410 (miR-410) in osteonecrosis of the femoral head (ONFH); hence, the aim of the present study was to investigate miR-410 targeting Wnt-11 to modulate the osteogenic and osteoclastic mechanism in the prevention of ONFH.

Methods

Fifteen ONFH samples and 15 normal samples were gathered. The pathological changes of the femoral head, osteoblasts, and osteoclasts in the clinical samples were observed. The rat model of ONFH was injected with agomir-miR-410, Wnt-11-siRNA, or oe-Wnt-11. MiR-410; Wnt-11; osteoblast-related factors alkaline phosphatase (ALP), bone gamma-carboxyglutamate protein (BGLAP), and Collα1 expression; and osteoclast-related factors acid phosphatase 5 (ACP5), cathepsin K (CTSK), and MMP9, as well as Bcl-2 and Bax expression, were tested by RT-qPCR and western blot analysis. The osteogenic function index ALP and OCN together with osteoclast function index NTX-1 and CTX-1 in serum was tested by ELISA.

Results

MiR-410, ALP, BGLAP, and Collα1 degraded as well as Wnt-11, ACP5, CTSK, and MMP9 enhanced in ONFH tissues of the clinical samples. Upregulated miR-410 and downregulated Wnt-11 enhanced bone mineral density (BMD) and BV/TV of rats, heightened the BMD level of the femoral shaft, femoral head, and spinal column, and also raised the serum calcium and phosphorus levels of rats, while restrained apoptosis of osteocytes, elevated OCN, ALP, BGLAP, and Collα1 expression and declined ACP5, CTSK, NTX-1, CTX-1, and MMP9 expression in rats.

Conclusion

This study suggested that upregulating miR-410 or downregulating Wnt-11 increases osteoblasts and reduces osteoclasts to alleviate the occurrence of ONFH. Thus, miR-410 may serve as a potential target for the treatment of ONFH.
Wound area measurement with 3D transformation and smartphone images
Authors: Liu Chunhui , Fan Xingyu , Guo Zhizhi , Mo Zhongjun , Chang Eric I-Chao , Xu Yan
Published: December 2019

Background

Quantitative areas is of great measurement of wound significance in clinical trials, wound pathological analysis, and daily patient care. 2D methods cannot solve the problems caused by human body curvatures and different camera shooting angles. Our objective is to simply collect wound areas, accurately measure wound areas and overcome the shortcomings of 2D methods.

Results

We propose a method with 3D transformation to measure wound area on a human body surface, which combines structure from motion (SFM), least squares conformal mapping (LSCM), and image segmentation. The method captures 2D images of wound, which is surrounded by adhesive tape scale next to it, by smartphone and implements 3D reconstruction from the images based on SFM. Then it uses LSCM to unwrap the UV map of the 3D model. In the end, it utilizes image segmentation by interactive method for wound extraction and measurement. Our system yields state-of-the-art results on a dataset of 118 wounds on 54 patients, and performs with an accuracy of 0.97. The Pearson correlation, standardized regression coefficient and adjusted R square of our method are 0.999, 0.895 and 0.998 respectively.

Conclusions

A smartphone is used to capture wound images, which lowers costs, lessens dependence on hardware, and avoids the risk of infection. The quantitative calculation of the 3D wound area is realized, solving the challenges that 2D methods cannot and achieving a good accuracy.
Ketamine affects the integration of developmentally generated granule neurons in the adult stage
Authors: Zhao Zhanqiang , Li Bing , Wu Yuqing , Chen Xujun , Guo Yan , Shen Yang , Huang He
Published: December 2019

Background

Ketamine has been reported to cause neonatal neurotoxicity in a variety of developing animal models. Various studies have been conducted to study the mechanism of neurotoxicity for general anesthetic use during the neonatal period. Previous experiments have suggested that developmentally generated granule neurons in the hippocampus dentate gyrus (DG) supported hippocampus-dependent memory. Therefore, this study aimed to investigate whether ketamine affects the functional integration of developmentally generated granule neurons in the DG. For this purpose,the postnatal day 7 (PND-7) Sprague-Dawley (SD) rats were divided into the control group and the ketamine group (rats who received 4 injections of 40 mg/kg ketamine at 1 h intervals). To label dividing cells, BrdU was administered for three consecutive days after the ketamine exposure; NeuN+/BrdU+cells were observed by using immunofluorescence. To evaluate the developmentally generated granule neurons that support hippocampus-dependent memory, spatial reference memory was tested by using Morris Water Maze at 3 months old, after which the immunofluorescence was used to detect c-Fos expression in the NeuN+/BrdU+ cells. The expression of caspase-3 was measured by western blot to detect the apoptosis in the hippocampal DG.

Results

The present results showed that the neonatal ketamine exposure did not influence the survival rate of developmentally generated granule neurons at 2 and 3 months old, but ketamine interfered with the integration of these neurons into the hippocampal DG neural circuits and caused a deficit in hippocampal-dependent spatial reference memory tasks.

Conclusions

In summary, these findings may promote more studies to investigate the neurotoxicity of ketamine in the developing brain.
Spontaneous bladder rupture secondary to warfarin overdose: a case report
Authors: Sahin Taner , Oner Ufuk , Baser Omer , Kurtuncu Ismail
Published: December 2019

Background

Warfarin, a vitamin K antagonist, is a widely used medication for the treatment and prophylaxis of thromboembolic events. Patients with various clinical conditions due to warfarin overdose present to emergency departments. Although there may be serious bleeding due to a warfarin overdose, no bleeding may also be seen in some clinical conditions. Some of these bleedings may be life-threatening and result in death. Warfarin overdose and related cases of spontaneous bladder rupture are not frequently observed in the literature. We present a case of spontaneous bladder rupture due to warfarin overdose that was unexpectedly seen in a patient using warfarin for coronary artery disease and arrhythmia.

Case presentation

A 77-year-old Caucasian male patient was admitted to the emergency department with abdominal pain, haematuria, and a reduced volume of urine lasting for three days. The patient’s amount of urine was reduced, and he came to the hospital for the first time with this complaint. The patient had local bruises on his arms and legs. From the ultrasound, retrograde cystography and computed tomography images, it was thought that there was blood accumulation due to bladder rupture to the intraperitoneal region. Spontaneous bladder rupture secondary to warfarin overdose was considered for this patient who also had an international normalized ratio (INR) level of 13.4. After the INR level was normalized with vitamin K and a prothrombin complex concentrate, the patient underwent surgery. During the operation, a catheter was placed in the bladder, and the bladder mucosa and muscle were closed separately with a primary repair performed by a urologist. The patient was discharged on the 8th postoperative day without any complications.

Conclusion

In addition to the known findings of warfarin overdose in these patients presenting to the emergency department, we think that the emergency department staff should suspect bladder rupture, which is a fatal complication in the presence of signs such as oliguria, haematuria, anuria, abdominal pain, and syncope.
Laser Doppler blood flowmeter as a useful instrument for the early detection of lower extremity peripheral arterial disease in hemodialysis patients: an observational study
Authors: Ishii Takeo , Takabe Shizuka , Yanagawa Yuki , Ohshima Yuko , Kagawa Yasuhiro , Shibata Atsuko , Oyama Kunio
Published: December 2019

Background

A simpler method for detecting atherosclerosis obliterans is required in the clinical setting. Laser Doppler flowmetry (LDF) is easy to perform and can accurately detect deterioration in skin perfusion. We performed LDF for hemodialysis patients to determine the correlations between blood flow in the lower limbs and peripheral arterial disease (PAD).

Methods

This retrospective study included 128 hemodialysis patients. Patients were categorized into the non-PAD group (n = 106) and PAD group (n = 22), 14 early stage PAD patients were included in the PAD group. We conducted LDF for the plantar area and dorsal area of the foot and examined skin perfusion pressure (SPP) during dialysis.

Results

SPP-Dorsal Area values were 82.1 ± 22.0 mmHg in the non-PAD, and 59.1 ± 20.3 mmHg in PAD group, respectively (p < 0.05). The LDF-Plantar blood flow (Qb) values were 32.7 ± 15.5 mL/min in non-PAD group and 21.5 ± 11.3 mL/min in PAD group (p < 0.001). A total of 21 non-PAD patients underwent LDF before and during dialysis. The LDF-Plantar-Qb values were 36.5 ± 17.6 mL/min before dialysis and 29.6 ± 17.7 mL/min after dialysis (p < 0.05). We adjusted SPP and LDF for PAD using logistic regression, SPP-Dorsal-Area and LDF-P were significantly correlated with PAD (p < 0.05). The receiver-operating characteristic curve analysis indicated cut-off values of 20.0 mL/min for LDF-Plantar-Qb during dialysis.

Conclusion

LDF is a simple technique for sensitive detection of early-stage PAD. This assessment will help physicians identify early-stage PAD, including Fontaine stage II in clinical practice, thereby allowing prompt treatment.
Crescentic poststreptococcal acute glomerulonephritis accompanied by small vessel vasculitis: case report of an elderly male
Authors: Yano Keiko , Suzuki Hiroyuki , Oda Takashi , Ueda Yoshihiko , Tsukamoto Tatsuo , Muso Eri
Published: December 2019

Background

Poststreptococcal acute glomerulonephritis (PSAGN) in the elderly tends to have a severe clinical course and often presents with crescentic necrotizing glomerulonephritis in the renal biopsy. However, vasculitis lesions are unusual.

Case presentation

We present a 71-year-old man who was admitted to our hospital for a recurrent gout attack with a rapid decline of renal function. Low C3 levels and a high anti-streptolysin O titer were observed, while myeloperoxidase- and proteinase 3- antineutrophil cytoplasmic antibody (ANCA) were negative. In addition to cellular crescent and necrosis lesions, diffuse peritubular capillaritis and venulitis as well as small arteriole vasculitis in the glomerular hilus were also apparent. Although granular C3c deposits in the capillary wall and hump lesions were not found, immunofluorescent staining for nephritis-associated plasmin receptor (NAPlr) and in situ zymography for plasmin activity were both positive. We thus diagnosed PSAGN accompanied by small vessel vasculitis. Steroid therapy gradually improved the patient’s renal function, and hemodialysis was discontinued after 1 month.

Conclusions

In our case, streptococcus infection might have concurrently provoked vasculitis, and NAPlr staining was useful for confirming diagnosis.
Late-onset riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency (MADD): case reports and epidemiology of ETFDH gene mutations
Authors: Chen Wei , Zhang Youqiao , Ni Yifeng , Cai Shaoyu , Zheng Xin , Mastaglia Frank L. , Wu Jingshan
Published: December 2019

Background

Multiple acyl-CoA dehydrogenase deficiency (MADD) is a riboflavin-responsive lipid-storage myopathy caused by mutations in the EFTA, EFTB or ETFDH genes. We report a Chinese family of Southern Min origin with two affected siblings with late-onset riboflavin-responsive MADD due to a homozygous c.250G > A EFTDH mutation and review the genetic epidemiology of the c.250G > A mutation.

Case presentation

Both siblings presented with exercise-induced myalgia, progressive proximal muscle weakness and high levels of serum muscle enzymes and were initially diagnosed as polymyositis after a muscle biopsy. A repeat biopsy in one sibling subsequently showed features of lipid storage myopathy and genetic analysis identified a homozygous mutation (c.250G > A) in the ETFDH gene in both siblings and carriage of the same mutation by both parents. Glucocorticoid therapy led to improvement in muscle enzyme levels, but little change in muscle symptoms, and only after treatment with riboflavin was there marked improvement in exercise tolerance and muscle strength. The frequency and geographic distribution of the c.250G > A mutation were determined from a literature search for all previously reported cases of MADD with documented mutations. Our study found the c.250G > A mutation is the most common EFTDH mutation in riboflavin-responsive MADD (RR-MADD) and is most prevalent in China and South-East Asia where its epidemiology correlates with the distribution and migration patterns of the southern Min population in Southern China and neighbouring countries.

Conclusions

Mutations in ETFDH should be screened for in individuals with lipid-storage myopathy to identify patients who are responsive to riboflavin. The c.250G > A mutation should be suspected particularly in individuals of southern Min Chinese background.
Nutrient intakes and sources of fiber among children with low and high dietary fiber intake: the 2016 feeding infants and toddlers study (FITS), a cross-sectional survey
Authors: Finn Kristen , Jacquier Emma , Kineman Brian , Storm Heidi , Carvalho Ryan
Published: December 2019

Background

Increasing dietary fiber intake in children may improve overall diet quality. The purpose of this study was to compare nutrient intakes and sources of fiber between young children with low and high fiber intakes utilizing data from the Feeding Infants and Toddlers Study (FITS) 2016.

Methods

The FITS 2016 was a nationwide, cross sectional survey of caregivers designed to assess food and nutrient intakes, feeding behaviors, and dietary patterns among infants and young children living in the U.S. Energy adjusted macro and micronutrient intakes (nutrients/1000 kcals) of children with energy adjusted fiber intakes (g/1000 kcals) in the highest quartile were compared to those in the lowest quartile with paired t-tests. Sources of fiber for each quartile were ranked according to percent of total fiber intake.

Results

Children with fiber intakes in the highest quartile had significantly lower intakes of total fat (mean difference ranged from 7.4–9.6 g,p < 0.0005) and saturated fat (mean difference ranged from 4 to 5.8 g,p < 0.0005), and significantly higher intakes of vitamin B-6 (mean difference ranged from 0.3–0.4 mg,p < 0.0005), magnesium (mean difference ranged from 57.2–61.8 mg,p < 0.0005), iron (mean difference ranged from 2.2–3.7 mg,p < 0.0005), and potassium (mean difference ranged from 318.2 mg to 446.1 mg,p < 0.0005) compared to children in the lowest quartile across all age groups. Children in the highest quartile had higher intakes of nut butters, legumes, fruits, and vegetables and consumed a greater percentage of grains as whole grains than those in the lowest quartile.

Conclusion

Encouraging intake of fruits, vegetables, legumes, nut butters, and at least 75% of grains as whole grains may help young children improve dietary fiber intake and overall diet quality.
Efficacy of a group tobacco cessation behavioral intervention among tobacco users with concomitant mental illness in Kenya: protocol for a controlled clinical trial
Authors: Olando Yvonne , Kuria Mary , Mathai Muthoni , Huffman Mark D.
Published: December 2019

Background

The rate of tobacco use among people with mental illness is nearly twice that of the general population. Psychotropic medications for tobacco cessation are relatively expensive for most Kenyans. Behavioral counseling and group therapy are effective lower cost strategies to promote tobacco cessation, yet have not been studied in Kenya among individuals with concomitant mental illness.

Methods/design

One hundred tobacco users with mental illness who were part of an outpatient mental health program in Nairobi, Kenya were recruited and allocated into intervention and control groups of the study (50 users in intervention group and 50 users in control group). Participants allocated to the intervention group were invited to participate in 1 of 5 tobacco cessation groups. The intervention group received the 5As (Ask, Advise, Assess, Assist and Arrange) and tobacco cessation group behavioral intervention, which included strategies to manage cravings and withdrawal, stress and anxiety, and coping with depression due to withdrawal; assertiveness training and anger management; reasons to quit, benefits of quitting and different ways of quitting. Individuals allocated to the control group received usual care. The primary outcome was tobacco cessation at 24 weeks, measured through cotinine strips. Secondary outcomes included number of quit attempts and health-related quality of life.

Discussion

This study will provide evidence to evaluate the efficacy and safety of a tobacco cessation group behavioral intervention among individuals with mental illness in Kenya, and to inform national and regional practice and policy.

Trial registration

Trial registration number: NCT04013724.

Name of registry: ClinicalTrials.gov.

URL of registry: https://register.clinicaltrials.gov

Date of registration: 9 July 2019 (retrospectively registered).

Date of enrolment of the first participant to the trial: 5th September 2017.

Protocol version: 2.0.
Pharmacy-based interventions to increase vaccine uptake: report of a multidisciplinary stakeholders meeting
Authors: Ecarnot Fiona , Crepaldi Gaetano , Juvin Philippe , Grabenstein John , Del Giudice Giuseppe , Tan Litjen , O’Dwyer Susan , Esposito Susanna , Bosch Xavier , Gavazzi Gaetan , Papastergiou John , Gaillat Jacques , Johnson Robert , Fonzo Marco , Rossanese Andrea , Suitner Caterina , Barratt Jane , di Pasquale Alberta , Maggi Stefania , Michel Jean-Pierre
Published: December 2019

Background

Despite the existence of efficacious vaccines, the burden of vaccine-preventable diseases remains high and the potential health benefits of paediatric, adolescent and adult vaccination are not being achieved due to suboptimal vaccine coverage rates.

Main body of abstract

Based on emerging evidence that pharmacy-based vaccine interventions are feasible and effective, the European Interdisciplinary Council for Ageing (EICA) brought together stakeholders from the medical and pharmacy professions, the pharmaceutical industry, patient/ageing organisations and health authorities to consider the potential for pharmacy-based interventions to increase vaccine uptake. We report here the proceedings of this 3-day meeting held in March 2018 in San Servolo island, Venice, Italy, focussing firstly on examples from countries that have introduced pharmacy-based vaccination programmes, and secondly, listing the barriers and solutions proposed by the discussion groups.

Conclusions

A range of barriers to vaccine uptake have been identified, affecting all target groups, and in various countries and healthcare settings. Ease of accessibility is a potentially modifiable determinant in vaccine uptake, and thus, improving the diversity of settings where vaccines can be provided to adults, for example by enabling community pharmacists to vaccinate, may increase the number of available opportunities for vaccination.
Morphometric traits predict educational attainment independently of socioeconomic background
Authors: Valge Markus , Meitern Richard , Hõrak Peeter
Published: December 2019

Background

Aim of this study is to describe the relationship between anthropometric traits and educational attainment among Estonian schoolchildren born between 1937 and 1962. We asked whether height, cranial volume and face width (a testosterone-dependent trait), measured in childhood predict later educational attainment independently of each other, family socioeconomic position (SEP) and sex. Associations between morphometric traits and education and their interactions with biosocial variables are of scholarly importance because higher education is nearly universally associated with low fertility in women, and often with high fertility in men. Hence, morphometric traits associated with educational attainment are targeted by natural selection and describing the exact nature of these associations is relevant for understanding the current patterns of evolution of human body size.

Methods

Data on morphometric measurements and family background of 11,032 Estonian schoolchildren measured between seven and 19 years of age were obtained from the study performed by Juhan Aul between 1956 and 1969. Ordinal logistic regression was used for testing the effects of morphometric traits, biosocial variables and their interaction on the cumulative probability of obtaining education beyond primary level.

Results

Of biosocial variables, family SEP was the most important determinant of educational attainment, followed by the sex, rural vs urban origin and the number of siblings. No significant interactions with morphometric traits were detected, i.e., within each category of SEP, rural vs urban origin and sex, taller children and those with larger heads and relatively narrower faces were more likely to proceed to secondary and/or tertiary education. The effect of height on education was independent of cranial volume, indicating that taller children did not obtain more educations because their brains were larger than those of shorter children; heightper sewas important.

Conclusions

Our main finding – that adjusting for other morphometric traits and biosocial variables, morphometric traits still robustly predicted educational attainment, is relevant for understanding the current patterns of evolution of human body size. Our findings suggest that fecundity selection acting on educational attainment could be partly responsible for the concurrent selection for smaller stature and cranial volume in women and opposite trends in men.
Remote assessment via video evaluation (RAVVE): a pilot study to trial video-enabled peer feedback on clinical performance
Authors: Ho Kendall , Yao Christopher , Novak Lauscher Helen , Koehler Barry E. , Shojania Kamran , Jamal Shahin , Collins David , Kherani Raheem , Meneilly Graydon , Eva Kevin
Published: December 2019

Background

Video review processes for evaluation and coaching are often incorporated into medical education as a means to accurately capture physician-patient interactions. Compared to direct observation they offer the advantage of overcoming many logistical challenges. However, the suitability and viability of using video-based peer consultations for professional development requires further investigation. This study aims to explore the acceptability and feasibility of video-based peer feedback to support professional development and quality improvement in patient care.

Methods

Five rheumatologists each provided four videos of patient consultations. Peers evaluated the videos using five-point scales, providing annotations in the video recordings, and offering recommendations. The rheumatologists reviewed the videos of their own four patient interactions along with the feedback. They were asked to document if they would make practice changes based on the feedback. Focus groups were conducted and analysed to explore the effectiveness of video-based peer feedback in assisting physicians to improve clinical practice.

Results

Participants felt the video-based feedback provided accurate and detailed information in a more convenient, less intrusive manner than direct observation. Observations made through video review enabled participants to evaluate more detailed information than a chart review alone. Participants believed that reviewing recorded consultations allowed them to reflect on their practice and gain insight into alternative communication methods.

Conclusions

Video-based peer feedback and self-review of clinical performance is an acceptable and pragmatic approach to support professional development and improve clinical care among peer clinicians. Further investigation into the effectiveness of this approach is needed.