bluuebunny/crossref_metadata_2025 huggingface dataset:
Neoadjuvant chemotherapy combined with radical surgery for stage IB2/IIA2 cervical squamous cell carcinoma: a prospective, randomized controlled study of 35 patients
Authors: Jing Huang , Xiuhong Wu , Ying Yu , Zhenrong Liao , Xiyun Cheng , Deping Luo , Changmei Shen , Qi Wang , Tao Peng , Yiyun Pan
Published: July 2021

Objective

This study aimed to evaluate the clinical outcomes for patients with stage IB2/IIA2 cervical squamous cell carcinoma treated with neoadjuvant chemotherapy combined with radical surgery.

Methods

A total of 68 patients with cervical squamous cell carcinoma were randomly divided into the experimental group (n = 35) and the control group (n = 33). The patients in the experimental group received paclitaxel plus cisplatin neoadjuvant chemotherapy for two cycles, then underwent radical hysterectomy and bilateral adnexectomy at 2 weeks post-chemotherapy. The control group only underwent radical hysterectomy and bilateral adnexectomy after the diagnosis of cervical squamous cell carcinoma. The toxic and side effects of chemotherapy in the experimental group were observed. Also, the operation method, operation time, blood loss, grade of wound healing, complications, and postoperative pathology were noted in the two groups. Primary foci and pelvic lymph node recurrence and distant metastasis were observed, and 3-year and 5-year survival rates were calculated.

Results

Only one patient in the experiment had grade III bone marrow suppression; no other grade III and IV chemotherapy toxic reactions were observed. The operation was successfully completed in all patients. The operation time, intraoperative blood loss, placement of the ureteral catheter, bladder injury, ureteric injury, postoperative urinary tub, pelvic drainage tube indwelling time, anal exhaust time, postoperative complications, and metastatic ratio of lymph nodes were not significantly different between the two groups (P > 0.05). The number of dissected lymph nodes, deep myometrial invasion, and vascular tumor emboli showed a significant difference in the experimental group compared with the control group (P < 0.05). The 3-year disease-free survival (82.9% vs 81.9%), 5-year disease-free survival (71.4% vs 60.6%), 3-year overall survival (91.4% vs 87.8%), and 5-year overall survival (82.9% vs 75.6%) were not statistically significantly different between the experimental group and the control group (P > 0.05).

Conclusions

Neoadjuvant chemotherapy in IB2/IIA2 stage cervical squamous cell carcinoma showed low toxic side effects. Radical surgery after chemotherapy is safe and feasible. It plays a coordinating role in reducing the tumor infiltration depth of the deep muscle layer and the incidence of vascular tumor emboli, reducing the use of postoperative adjuvant therapy, and improving the quality of life of patients, but does not improve the 3-year/5-year survival rate.
Association of daily composition of physical activity and sedentary behaviour with incidence of cardiovascular disease in older adults
Authors: Yerramalla Manasa S. , McGregor Duncan E. , van Hees Vincent T. , Fayosse Aurore , Dugravot Aline , Tabak Adam G. , Chen Mathilde , Chastin Sebastien F. M. , Sabia Séverine
Published: July 2021

Background

Moderate-to-vigorous physical activity (MVPA) is proposed as key for cardiovascular diseases (CVD) prevention. At older ages, the role of sedentary behaviour (SB) and light intensity physical activity (LIPA) remains unclear. Evidence so far is based on studies examining movement behaviours as independent entities ignoring their co-dependency. This study examines the association between daily composition of objectively-assessed movement behaviours (MVPA, LIPA, SB) and incident CVD in older adults.

Methods

Whitehall II accelerometer sub-study participants free of CVD at baseline (N = 3319, 26.7% women, mean age = 68.9 years in 2012–2013) wore a wrist-accelerometer from which times in SB, LIPA, and MVPA during waking period were extracted over 7 days. Compositional Cox regression was used to estimate the hazard ratio (HR) for incident CVD for daily compositions of movement behaviours characterized by 10 (20 or 30) minutes greater duration in one movement behaviour accompanied by decrease in another behaviour, while keeping the third behaviour constant, compared to reference composition. Analyses were adjusted for sociodemographic, lifestyle, cardiometabolic risk factors and multimorbidity index.

Results

Of the 3319 participants, 299 had an incident CVD over a mean (SD) follow-up of 6.2 (1.3) years. Compared to daily movement behaviour composition with MVPA at recommended 21 min per day (150 min/week), composition with additional 10 min of MVPA and 10 min less SB was associated with smaller risk reduction – 8% (HR, 0.92; 95% CI, 0.87–0.99) – than the 14% increase in risk associated with a composition of similarly reduced time in MVPA and more time in SB (HR, 1.14; 95% CI, 1.02–1.27). For a given MVPA duration, the CVD risk did not differ as a function of LIPA and SB durations.

Conclusions

Among older adults, an increase in MVPA duration at the expense of time in either SB or LIPA was found associated with lower incidence of CVD. This study lends support to public health guidelines encouraging increase in MVPA or at least maintain MVPA at current duration.
A paradigm shift in cell-free approach: the emerging role of MSCs-derived exosomes in regenerative medicine
Authors: Moghadasi Soudeh , Elveny Marischa , Rahman Heshu Sulaiman , Suksatan Wanich , Jalil Abduladheem Turki , Abdelbasset Walid Kamal , Yumashev Alexei Valerievich , Shariatzadeh Siavash , Motavalli Roza , Behzad Farahnaz , Marofi Faroogh , Hassanzadeh Ali , Pathak Yashwant , Jarahian Mostafa
Published: July 2021

Recently, mesenchymal stem/stromal cells (MSCs) due to their pro-angiogenic, anti-apoptotic, and immunoregulatory competencies along with fewer ethical issues are presented as a rational strategy for regenerative medicine. Current reports have signified that the pleiotropic effects of MSCs are not related to their differentiation potentials, but rather are exerted through the release of soluble paracrine molecules. Being nano-sized, non-toxic, biocompatible, barely immunogenic, and owning targeting capability and organotropism, exosomes are considered nanocarriers for their possible use in diagnosis and therapy. Exosomes convey functional molecules such as long non-coding RNAs (lncRNAs) and micro-RNAs (miRNAs), proteins (e.g., chemokine and cytokine), and lipids from MSCs to the target cells. They participate in intercellular interaction procedures and enable the repair of damaged or diseased tissues and organs. Findings have evidenced that exosomes alone are liable for the beneficial influences of MSCs in a myriad of experimental models, suggesting that MSC- exosomes can be utilized to establish a novel cell-free therapeutic strategy for the treatment of varied human disorders, encompassing myocardial infarction (MI), CNS-related disorders, musculoskeletal disorders (e.g. arthritis), kidney diseases, liver diseases, lung diseases, as well as cutaneous wounds. Importantly, compared with MSCs, MSC- exosomes serve more steady entities and reduced safety risks concerning the injection of live cells, such as microvasculature occlusion risk. In the current review, we will discuss the therapeutic potential of MSC- exosomes as an innovative approach in the context of regenerative medicine and highlight the recent knowledge on MSC- exosomes in translational medicine, focusing on in vivo researches.
Risk factors and preventive strategies for unintentionally retained surgical sharps: a systematic review
Authors: Weprin Samuel , Crocerossa Fabio , Meyer Dielle , Maddra Kaitlyn , Valancy David , Osardu Reginald , Kang Hae Sung , Moore Robert H. , Carbonara Umberto , J. Kim Fernando , Autorino Riccardo
Published: July 2021

Background

A retained surgical item (RSI) is defined as a never-event and can have drastic consequences on patient, provider, and hospital. However, despite increased efforts, RSI events remain the number one sentinel event each year. Hard foreign bodies (e.g. surgical sharps) have experienced a relative increase in total RSI events over the past decade. Despite this, there is a lack of literature directed towards this category of RSI event. Here we provide a systematic review that focuses on hard RSIs and their unique challenges, impact, and strategies for prevention and management.

Methods

Multiple systematic reviews on hard RSI events were performed and reported using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the methodological quality of systematic reviews) guidelines. Database searches were limited to the last 10 years and included surgical “sharps,” a term encompassing needles, blades, instruments, wires, and fragments. Separate systematic review was performed for each subset of “sharps”. Reviewers applied reciprocal synthesis and refutational synthesis to summarize the evidence and create a qualitative overview.

Results

Increased vigilance and improved counting are not enough to eliminate hard RSI events. The accurate reporting of all RSI events and near miss events is a critical step in determining ways to prevent RSI events. The implementation of new technologies, such as barcode or RFID labelling, has been shown to improve patient safety, patient outcomes, and to reduce costs associated with retained soft items, while magnetic retrieval devices, sharp detectors and computer-assisted detection systems appear to be promising tools for increasing the success of metallic RSI recovery.

Conclusion

The entire healthcare system is negatively impacted by a RSI event. A proactive multimodal approach that focuses on improving team communication and institutional support system, standardizing reports and implementing new technologies is the most effective way to improve the management and prevention of RSI events.
EIF4A3-induced circ_0084615 contributes to the progression of colorectal cancer via miR-599/ONECUT2 pathway
Authors: Jiang Zhipeng , Tai Qinwen , Xie Xiaojun , Hou Zehui , Liu Wei , Yu Zhuomin , Liang Zhiqiang , Chen Shuang
Published: July 2021

Background

Colorectal cancer (CRC) is a common malignant tumor. Circular RNAs (circRNAs) have been reported to take part in the progression of CRC. However, the functions of circ_0084615 in CRC development are still undefined. In this study, we aimed to explore the functions and underlying mechanisms of circ_0084615 in CRC.

Methods

qRT-PCR, western blot assay and IHC assay were utilized for the levels of circ_0084615, miR-599, ONECUT2 or EIF4A3. 5-ethynyl-2’-deoxyuridine (EdU) assay and colony formation assay were conducted for cell proliferation ability. Wound-healing assay and transwell assay were applied to evaluate cell migration and invasion. Tube formation assay was used to analyze angiogenesis ability. RNA immunoprecipitation (RIP) assay, RNA pull down assay and dual-luciferase reporter assay were used to analyze the relationships of circ_0084615, miR-599, ONECUT2 and EIF4A3. Murine xenograft model assay was employed for the role of circ_0084615 in vivo.

Results

Circ_0084615 was elevated in CRC tissues and was linked to TNM stages, lymph node metastasis, differentiation and overall survival rate. Circ_0084615 knockdown inhibited CRC cell proliferation, migration, invasion and angiogenesis in vitro and hampered tumorigenesis in vivo. Circ_0084615 sponged miR-599 and miR-599 inhibition reversed circ_0084615 knockdown-mediated effects on CRC cell growth, motility and angiogenesis. ONECUT2 was identified as the target gene of miR-599. ONECUT2 overexpression recovered the effects of miR-599 on CRC malignant behaviors. Additionally, EIF4A3 induced circ_0084615 expression.

Conclusions

EIF4A3-induced circ_0084615 played an oncogenic role in CRC development via miR-599/ONECUT2 axis.
Emerging SARS-CoV-2 variants of concern and potential intervention approaches
Authors: Khateeb Jasmin , Li Yuchong , Zhang Haibo
Published: July 2021

The major variant of concerns (VOCs) have shared mutations in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike proteins, mostly on the S1 unit and resulted in higher transmissibility rate and affect viral virulence and clinical outcome. The spike protein mutations and other non-structural protein mutations in the VOCs may lead to escape approved vaccinations in certain extend. We will discuss these VOC mutations and discuss the need for combination therapeutic strategies targeting viral cycle and immune host responses.
GRIDSS2: comprehensive characterisation of somatic structural variation using single breakend variants and structural variant phasing
Authors: Cameron Daniel L. , Baber Jonathan , Shale Charles , Valle-Inclan Jose Espejo , Besselink Nicolle , van Hoeck Arne , Janssen Roel , Cuppen Edwin , Priestley Peter , Papenfuss Anthony T.
Published: July 2021

GRIDSS2 is the first structural variant caller to explicitly report single breakends—breakpoints in which only one side can be unambiguously determined. By treating single breakends as a fundamental genomic rearrangement signal on par with breakpoints, GRIDSS2 can explain 47% of somatic centromere copy number changes using single breakends to non-centromere sequence. On a cohort of 3782 deeply sequenced metastatic cancers, GRIDSS2 achieves an unprecedented 3.1% false negative rate and 3.3% false discovery rate and identifies a novel 32–100 bp duplication signature. GRIDSS2 simplifies complex rearrangement interpretation through phasing of structural variants with 16% of somatic calls phasable using paired-end sequencing.
Telomere-to-telomere assembly of a fish Y chromosome reveals the origin of a young sex chromosome pair
Authors: Xue Lingzhan , Gao Yu , Wu Meiying , Tian Tian , Fan Haiping , Huang Yongji , Huang Zhen , Li Dapeng , Xu Luohao
Published: July 2021

Background

The origin of sex chromosomes requires the establishment of recombination suppression between the proto-sex chromosomes. In many fish species, the sex chromosome pair is homomorphic with a recent origin, providing species for studying how and why recombination suppression evolved in the initial stages of sex chromosome differentiation, but this requires accurate sequence assembly of the X and Y (or Z and W) chromosomes, which may be difficult if they are recently diverged.

Results

Here we produce a haplotype-resolved genome assembly of zig-zag eel (Mastacembelus armatus), an aquaculture fish, at the chromosomal scale. The diploid assembly is nearly gap-free, and in most chromosomes, we resolve the centromeric and subtelomeric heterochromatic sequences. In particular, the Y chromosome, including its highly repetitive short arm, has zero gaps. Using resequencing data, we identify a ~7 Mb fully sex-linked region (SLR), spanning the sex chromosome centromere and almost entirely embedded in the pericentromeric heterochromatin. The SLRs on the X and Y chromosomes are almost identical in sequence and gene content, but both are repetitive and heterochromatic, consistent with zero or low recombination. We further identify an HMG-domain containing gene HMGN6 in the SLR as a candidate sex-determining gene that is expressed at the onset of testis development.

Conclusions

Our study supports the idea that preexisting regions of low recombination, such as pericentromeric regions, can give rise to SLR in the absence of structural variations between the proto-sex chromosomes.
Laparoscopic management of isolated metachronous adrenal metastases in a patient with esophageal cancer: a case report
Authors: Jindal Tarun , Sarwal Ankush , Pawar Pravin , Dhanalakshmi M. , Subedi Neeraj
Published: July 2021

Background

The presence of isolated metachronous adrenal metastasis in patients with esophageal cancer is rare. There is significant controversy regarding the management of such patients. Adrenal metastasectomy has been shown to be of benefit in some reports. Minimally invasive approach, although the gold standard for adrenalectomy, has not been used commonly in a postesophagectomy setting owing to the anticipated technical difficulties. We describe one such case wherein this approach helped in early recovery and long-term survival.

Case presentation

A 59-year-old male of Asian ethnicity presented with an isolated left adrenal nodule, 3 years after an Ivor Lewis esophagectomy for a lower esophageal adenocarcinoma. The biopsy of the nodule was suggestive of metastatic adenocarcinoma. The patient underwent laparoscopic excision of the left adrenal gland.

Conclusion

Adrenal metastasectomy, in postesophagectomy patients can provide good oncological control. Laparoscopic approach, though technically challenging, can provide results equivalent to those of open surgery, albeit with less morbidity.
Massive uterine fibroid: a diagnostic dilemma: a case report and review of the literature
Authors: Viva Wiesener , Juhi Dhanawat , Kristin Andresen , Micaela Mathiak , Marcus Both , Ibrahim Alkatout , Dirk Bauerschlag
Published: July 2021

Background

Fibroids of the uterus are the most common benign pelvic tumors in women worldwide. Their diagnosis is usually not missed because of the widespread and well-established use of ultrasound in gynecological clinics. Hence, the development of an unusually large myoma is a rare event, particularly in first-world countries such as Germany. It is even more uncommon that a myoma is misdiagnosed as a dietary failure.

Case presentation

Herein, we report the case of a Caucasian woman with a giant fibroid that reached a size of over 50 cm, growing slowly over the past 15 years, and was misdiagnosed as abdominal fat due to weight gain. We aim to discuss the factors that lead to the growth of such a huge tumoral mass, including misdiagnosis and treatment, and the psychological impact. Through this case, we intend to increase the awareness among general physicians and gynecologists. Although menstrual disorders incorporate several pathologies, adequate assessment remains the primary responsibility of health care providers. A literature review revealed approximately 60 cases of giant uterine fibroids.

Conclusion

The use of clinical and diagnostic devices, especially ultrasound, in this case, is indispensable. In conclusion, the growth of a giant fibroid can have disastrous effects on a woman’s health, including surgical trauma and psychological issues.
Rapid diagnostics for Gnomoniopsis smithogilvyi (syn. Gnomoniopsis castaneae) in chestnut nuts: new challenges by using LAMP and real-time PCR methods
Authors: Vettraino Anna Maria , Luchi Nicola , Rizzo Domenico , Pepori Alessia Lucia , Pecori Francesco , Santini Alberto
Published: July 2021

Nuts of the sweet chestnut (Castanea sativa) are a widely appreciated traditional food in Europe. In recent years producers and consumers reported a drop of nut quality due to the presence of rot diseases caused by Gnomoniopsis smithogilvyi. Early detection of this pathogen is fundamental to the economic viability of the chestnut industry. In the present study, we developed three molecular methods based on real-time portable LAMP, visual LAMP and qPCR assays for G. smithogilvyi. The molecular assays were specific for G. smithogilvyi and did not amplify the other 11 Gnomoniopsis species and 11 other fungal species commonly associated with chestnuts. The detection limit of both the qPCR and real-time portable LAMP (P-LAMP) assays was 0.128 pg/µL, while the visual LAMP (V-LAMP) assay enabled the detection up to 0.64 pg/µL. By using these newly developed molecular tools, the pathogen was detected in symptomatic and asymptomatic nuts, but not in leaves. The reliability of these molecular methods, including the P-LAMP assay, was particularly useful in detecting G. smithogilvyi of harvested nuts in field, even in the absence of rot symptoms.
J-ministernotomy for aortic valve replacement: a retrospective cohort study
Authors: Torky Mohammad A. , Arafat Amr A. , Fawzy Hosam F. , Taha Abdelhady M. , Wahby Ehab A. , Herijgers Paul
Published: July 2021

Background

The advantage of minimally invasive sternotomy (MS) over full sternotomy (FS) for isolated aortic valve replacement (AVR) is still controversial. We aimed to examine if J-shaped MS is a safe alternative to FS in patients undergoing primary isolated AVR. This study is a retrospective and restricted cohort study that included 137 patients who had primary isolated AVR from February 2013 to June 2015. Patients with previous cardiac operations, low ejection fraction (< 40%), infective endocarditis, EuroSCORE II predicted mortality > 10%, and patients who had inverted T or inverted C-MS or right anterior thoracotomy were excluded. Patients were grouped into the FS group (n=65) and MS group (n=72). Preoperative variables were comparable in both groups. The outcome was studied, balancing the groups by propensity score matching.

Results

Seven (9%) patients in the MS group were converted to FS. Cardiopulmonary bypass (98.5 ± 29.3 vs. 82.1 ± 13.95 min; p ≤ 0.001) and ischemic times (69.1 ± 23.8 vs. 59.6 ± 12.2 min; p = 0.001) were longer in MS. The MS group had a shorter duration of mechanical ventilation (10.1 ± 11.58 vs. 10.9 ± 6.43 h; p = 0.045), ICU stay (42.74 ± 40.5 vs. 44.9 ± 39.3; p = 0.01), less chest tube drainage (385.3 ± 248.6 vs. 635.9 ± 409.6 ml; p = 0.001), and lower narcotics use (25.14 ± 17.84 vs. 48.23 ± 125.68 mg; p < 0.001). No difference was found in postoperative heart block with permanent pacemaker insertion or atrial fibrillation between groups (p = 0.16 and 0.226, respectively). Stroke, renal failure, and mortality did not differ between the groups. Reintervention-free survival at 1, 3, and 4 years was not significantly different in both groups (p = 0.73).

Conclusion

J-ministernotomy could be a safe alternative to FS in isolated primary AVR. Besides the cosmetic advantage, it could have better clinical outcomes without added risk.
Hallucinations in the general population across the adult lifespan: prevalence and psychopathologic significance
Authors: Yates Kathryn , Lång Ulla , Peters Evyn M. , Wigman Johanna T. W. , McNicholas Fiona , Cannon Mary , DeVylder Jordan , Ramsay Hugh , Oh Hans , Kelleher Ian
Published: July 2021

Background

Community studies have found a relatively high prevalence of hallucinations, which are associated with a range of (psychotic and non-psychotic) mental disorders, as well as with suicidal ideation and behaviour. The literature on hallucinations in the general population has largely focused on adolescents and young adults.

Aims

We aimed to explore the prevalence and psychopathologic significance of hallucinations across the adult lifespan.

Method

Using the 1993, 2000, 2007 and 2014 cross-sectional Adult Psychiatric Morbidity Survey series (N = 33 637), we calculated the prevalence of past-year hallucinations in the general population ages 16 to ≥90 years. We used logistic regression to examine the relationship between hallucinations and a range of mental disorders, suicidal ideation and suicide attempts.

Results

The prevalence of past-year hallucinations varied across the adult lifespan, from a high of 7% in individuals aged 16–19 years, to a low of 3% in individuals aged ≥70 years. In all age groups, hallucinations were associated with increased risk for mental disorders, suicidal ideation and suicide attempts, but there was also evidence of significant age-related variation. In particular, hallucinations in older adults were less likely to be associated with a cooccurring mental disorder, suicidal ideation or suicide attempt compared with early adulthood and middle age.

Conclusions

Our findings highlight important life-course developmental features of hallucinations from early adulthood to old age.
SAKK 16/14: Durvalumab in Addition to Neoadjuvant Chemotherapy in Patients With Stage IIIA(N2) Non–Small-Cell Lung Cancer—A Multicenter Single-Arm Phase II Trial
Authors: Rothschild Sacha I. , Zippelius Alfred , Eboulet Eric I. , Savic Prince Spasenija , Betticher Daniel , Bettini Adrienne , Früh Martin , Joerger Markus , Lardinois Didier , Gelpke Hans , Mauti Laetitia A. , Britschgi Christian , Weder Walter , Peters Solange , Mark Michael , Cathomas Richard , Ochsenbein Adrian F. , Janthur Wolf-Dieter , Waibel Christine , Mach Nicolas , Froesch Patrizia , Buess Martin , Bohanes Pierre , Godar Gilles , Rusterholz Corinne , Gonzalez Michel , Pless Miklos ,   for the Swiss Group for Clinical Cancer Research (SAKK)
Published: July 2021

PURPOSE

For patients with resectable stage IIIA(N2) non–small-cell lung cancer, neoadjuvant chemotherapy with cisplatin and docetaxel followed by surgery resulted in a 1-year event-free survival (EFS) rate of 48% in the SAKK 16/00 trial and is an accepted standard of care. We investigated the additional benefit of perioperative treatment with durvalumab.

METHODS

Neoadjuvant treatment consisted of three cycles of cisplatin 100 mg/m2 and docetaxel 85 mg/m2 once every 3 weeks followed by two doses of durvalumab 750 mg once every 2 weeks. Durvalumab was continued for 1 year after surgery. The primary end point was 1-year EFS. The hypothesis for statistical considerations was an improvement of 1-year EFS from 48% to 65%.

RESULTS

Sixty-eight patients were enrolled, 67 were included in the full analysis set. Radiographic response rate was 43% (95% CI, 31 to 56) after neoadjuvant chemotherapy and 58% (95% CI, 45 to 71) after sequential neoadjuvant immunotherapy. Fifty-five patients were resected, of which 34 (62%) achieved a major pathologic response (MPR; ≤ 10% viable tumor cells) and 10 (18%) among them a complete pathologic response. Postoperative nodal downstaging (ypN0-1) was observed in 37 patients (67%). Fifty-one (93%) resected patients had an R0 resection. There was no significant effect of pretreatment PD-L1 expression on MPR or nodal downstaging. The 1-year EFS rate was 73% (two-sided 90% CI, 63 to 82). Median EFS and overall survival were not reached after 28.6 months of median follow-up. Fifty-nine (88%) patients had an adverse event grade ≥ 3 including two fatal adverse events that were judged not to be treatment-related.

CONCLUSION

The addition of perioperative durvalumab to neoadjuvant chemotherapy in patients with stage IIIA(N2) non–small-cell lung cancer is safe and exceeds historical data of chemotherapy alone with a high MPR and an encouraging 1-year EFS rate of 73%.
Effect of Intraoperative Arterial Hypotension on the Risk of Perioperative Stroke After Noncardiac Surgery: A Retrospective Multicenter Cohort Study
Authors: Wongtangman Karuna , Wachtendorf Luca J. , Blank Michael , Grabitz Stephanie D. , Linhardt Felix C. , Azimaraghi Omid , Raub Dana , Pham Stephanie , Kendale Samir M. , Low Ying H. , Houle Timothy T. , Eikermann Matthias , Pollard Richard J.
Published: July 2021

BACKGROUND:

Intraoperative cerebral blood flow is mainly determined by cerebral perfusion pressure and cerebral autoregulation of vasomotor tone. About 1% of patients undergoing noncardiac surgery develop ischemic stroke. We hypothesized that intraoperative hypotension within a range frequently observed in clinical practice is associated with an increased risk of perioperative ischemic stroke within 7 days after surgery.

METHODS:

Adult noncardiac surgical patients undergoing general anesthesia at Beth Israel Deaconess Medical Center and Massachusetts General Hospital between 2005 and 2017 were included in this retrospective cohort study. The primary exposure was intraoperative hypotension, defined as a decrease in mean arterial pressure (MAP) below 55 mm Hg, categorized into no intraoperative hypotension, short (<15 minutes, median [interquartile range {IQR}], 2 minutes [1–5 minutes]) and prolonged (≥15 minutes, median [IQR], 21 minutes [17–31 minutes]) durations. The primary outcome was a new diagnosis of early perioperative ischemic stroke within 7 days after surgery. In secondary analyses, we assessed the effect of a MAP decrease by >30% from baseline on perioperative stroke. Analyses were adjusted for the preoperative STRoke After Surgery (STRAS) prediction score, work relative value units, and duration of surgery.

RESULTS:

Among 358,391 included patients, a total of 1553 (0.4%) experienced an early perioperative ischemic stroke. About 42% and 3% of patients had a MAP of below 55 mm Hg for a short and a prolonged duration, and 49% and 29% had a MAP decrease by >30% from baseline for a short and a prolonged duration, respectively. In an adjusted analysis, neither a MAP <55 mm Hg (short duration: adjusted odds ratio [ORadj], 0.95; 95% confidence interval [CI], 0.85–1.07; P = .417 and prolonged duration: ORadj, 1.18; 95% CI, 0.91–1.55; P = .220) nor a MAP decrease >30% (short duration: ORadj, 0.97; 95% CI, 0.67–1.42; P = .883 and prolonged duration: ORadj, 1.30; 95% CI, 0.89–1.90; P = .176) was associated with early perioperative stroke. A high a priori stroke risk quantified based on preoperatively available risk factors (STRAS prediction score) was associated with longer intraoperative hypotension (adjusted incidence rate ratio, 1.04; 95% CI, 1.04–1.05; P < .001 per 5 points of the STRAS prediction score).

CONCLUSIONS:

This study found no evidence to conclude that intraoperative hypotension within the range studied was associated with early perioperative stroke within 7 days after surgery. These findings emphasize the importance of perioperative cerebral blood flow autoregulation to prevent ischemic stroke.
The Wisconsin Oneida and the WPA: Stories of Corn, Colonialism, and Revitalization
Authors: Webster Rebecca M.
Published: July 2021

Colonization efforts over time have changed Oneida relationships with corn drastically. This study examines that history through a collection of stories told by Oneida people for the Work Progress Administration (WPA) between 1938 and 1942. Furthermore, the people’s changing relationship with corn over time highlights the effects of removal, allotment, and assimilation on the Oneida within the American context. Finally, while change occurred, the WPA interviews uncover continuity in Oneida Country as members struggled to maintain their relationship with corn and other traditional foodways in the wake of colonialism.
Not Just Later, but Fewer: Novel Trends in Cohort Fertility in the Nordic Countries
Authors: Hellstrand Julia , Nisén Jessica , Miranda Vitor , Fallesen Peter , Dommermuth Lars , Myrskylä Mikko
Published: July 2021

With historically similar patterns of high and stable cohort fertility and high levels of gender equality, the Nordic countries of Sweden, Finland, Norway, Denmark, and Iceland are seen as forerunners in demographic behavior. Furthermore, Nordic fertility trends have strongly influenced fertility theories. However, the period fertility decline that started around 2010 in many countries with relatively high fertility is particularly pronounced in the Nordic countries, raising the question of whether Nordic cohort fertility will also decline and deviate from its historically stable pattern. Using harmonized data across the Nordic countries, we comprehensively describe this period decline and analyze the extent to which it is attributable to tempo or quantum effects. Two key results stand out. First, the decline is mostly attributable to first births but can be observed across all ages from 15 to the mid-30s. This is a reversal from the previous trend in which fertility rates in the early 30s increased relatively steadily in those countries in the period 1980–2010. Second, tempo explains only part of the decline. Forecasts indicate that the average Nordic cohort fertility will decline from 2 children for the 1970 cohort to around 1.8 children for the late 1980s cohorts. Finland diverges from the other countries in terms of its lower expected cohort fertility (below 1.6), and Denmark and Sweden diverge from Finland, Iceland, and Norway in terms of their slower cohort fertility decline. These findings suggest that the conceptualization of the Nordic model of high and stable fertility may need to be revised.
Women's Use of Long-Acting Reversible Contraception for Birth Timing and Birth Stopping
Authors: Eeckhaut Mieke C. W. , Rendall Michael S. , Zvavitch Polina
Published: July 2021

The use of long-acting reversible contraceptive (LARC) methods—intrauterine devices (IUDs) and implants—has recently expanded rapidly in the United States, and these methods together approach the contraceptive pill in current prevalence. Research on LARCs has analyzed their use to reduce unintended pregnancies but not their use to enable intended pregnancies. Knowledge of both is necessary to understand LARCs’ potential impacts on the reproductive life courses of U.S. women. We combine data from two nationally representative surveys to estimate women's likelihood and timing of subsequent reproductive events, including births resulting from an intended pregnancy up to nine years after discontinuing LARC use. We estimate that 62% of women will give birth, and 45% will give birth from an intended pregnancy. Additionally, 18% will have a new LARC inserted, and 13% will transition to sterilization. Most of these reproductive events occur within two years after discontinuing LARC use. Births from an intended pregnancy are especially common when no intervening switch to another contraceptive method occurs. We infer that women's motives for using LARC are varied but include the desire to postpone a birth, to postpone a decision about whether to have a(nother) birth, and to transition definitively to the completion of childbearing.
Care and Carelessness in the Anthropocene
Authors: Ross Daniel
Published: July 2021

This article proposes dividing Bernard Stiegler's work into three phases, and that a notion of care develops and deepens as these phases progress. To each of these phases there corresponds a particular relationship to Heidegger's thought: 1) the Heidegger of Being and Time who denies the role of technics in the opening of the possibility of authentic time; 2) as a thinker of the “they” who corrects Simondon's inability to think collective disindividuation while being himself unable to think a genuine collective individuation process; 3) the later Heidegger who indeed approaches the most mysterious and unsettling aspect of tekhnē and who foresees the most threatening aspect of Gestell as a world in which Dasein loses its privilege as the questioning being. Yet this third Heidegger also failed to reflect on what Stiegler puts at the heart of the thought of his third phase: the question of entropy, understood as describing fundamental but diverse thermodynamic, biological, and informational tendencies. For Stiegler, taking care in the Anthropocene necessarily entails reinscribing philosophical concepts, including that of Ereignis, in relation to entropy, anthropy, and the struggle against them. Beyond Heidegger, this also entails addressing the obsolescence and self-destructiveness of the current macroeconomic model.
Figures of Unwork and Ethics of Care
Authors: Graziano Valeria
Published: July 2021

The hypothesis of a post-work society has provoked a newfound interest in the role of imagination in political thinking, made explicit by many authors who turned to the literary genres of utopian and sci-fi writing to sketch possible scenarios of a jobless future. This article proposes instead another mode of constructing political narratives, that of figuration. It reclaims three specific figures to demonstrate how it might be possible to build a public sphere of “unwork.” The first is Bazlen, a fictional character of a writer who never wrote; the second is the collective figure of African American “othermothers”; and finally the third is Amy, the girl who gave flesh to Carol Gilligan's “ethics of care” proposition. Departing from these specific figures, the article tackles the problem of reimagining the labors (and pleasures) of social reproduction and creative action away from the work regime. It describes how processes of subjectivation sedimented in collective imaginary impact various modes of being together and naming social cooperation. The conclusions propose that the relationship between living labor and knowledge is a nexus that can escape the violence of capitalist relations only by understanding political action as a plural capacity of unwork.
A versatile, automated and high-throughput drug screening platform for zebrafish embryos
Authors: Lubin Alexandra , Otterstrom Jason , Hoade Yvette , Bjedov Ivana , Stead Eleanor , Whelan Matthew , Gestri Gaia , Paran Yael , Payne Elspeth
Published: July 2021

Zebrafish provide a unique opportunity for drug screening in living animals, with the fast-developing, transparent embryos allowing for relatively high-throughput, microscopy-based screens. However, the limited availability of rapid, flexible imaging and analysis platforms has limited the use of zebrafish in drug screens. We have developed an easy-to-use, customisable automated screening procedure suitable for high-throughput phenotype-based screens of live zebrafish. We utilised the WiScan® Hermes High Content Imaging System to rapidly acquire brightfield and fluorescent images of embryos, and the WiSoft® Athena Zebrafish Application for analysis, which harnesses an Artificial Intelligence-driven algorithm to automatically detect fish in brightfield images, identify anatomical structures, partition the animal into regions and exclusively select the desired side-oriented fish. Our initial validation combined structural analysis with fluorescence images to enumerate GFP-tagged haematopoietic stem and progenitor cells in the tails of embryos, which correlated with manual counts. We further validated this system to assess the effects of genetic mutations and X-ray irradiation in high content using a wide range of assays. Further, we performed simultaneous analysis of multiple cell types using dual fluorophores in high throughput. In summary, we demonstrate a broadly applicable and rapidly customisable platform for high-content screening in zebrafish.

This article has an associated First Person interview with the first author of the paper.
Cell wall damage attenuates root hair patterning and tissue morphogenesis mediated by the receptor kinase STRUBBELIG
Authors: Chaudhary Ajeet , Chen Xia , Leśniewska Barbara , Boikine Rodion , Gao Jin , Wolf Sebastian , Schneitz Kay
Published: July 2021

Cell wall remodeling is essential for the control of growth and development as well as the regulation of stress responses. However, the underlying cell wall monitoring mechanisms remain poorly understood. Regulation of root hair fate and flower development in Arabidopsis thaliana requires signaling mediated by the atypical receptor kinase STRUBBELIG (SUB). Furthermore, SUB is involved in cell wall integrity signaling and regulates the cellular response to reduced levels of cellulose, a central component of the cell wall. Here, we show that continuous exposure to sub-lethal doses of the cellulose biosynthesis inhibitor isoxaben results in altered root hair patterning and floral morphogenesis. Genetically impairing cellulose biosynthesis also results in root hair patterning defects. We further show that isoxaben exerts its developmental effects through the attenuation of SUB signaling. Our evidence indicates that downregulation of SUB is a multi-step process and involves changes in SUB complex architecture at the plasma membrane, enhanced removal of SUB from the cell surface, and downregulation of SUB transcript levels. The results provide molecular insight into how the cell wall regulates cell fate and tissue morphogenesis.
Elastic energy storage in seahorses leads to a unique suction flow dynamics compared with other actinopterygians
Authors: Avidan Corrine , Holzman Roi
Published: July 2021

Suction feeding is a dominant prey-capture strategy across actinopterygians, consisting of a rapid expansion of the mouth cavity that drives a flow of water containing the prey into the mouth. Suction feeding is a power-hungry behavior, involving the actuation of cranial muscles as well as the anterior third of the fish's swimming muscles. Seahorses, which have reduced swimming muscles, evolved a unique mechanism for elastic energy storage that powers their suction flows. This mechanism allows seahorses to achieve head rotation speeds that are 50 times faster than those of fish lacking such a mechanism. However, it is unclear how the dynamics of suction flows in seahorses differ from the conserved pattern observed across other actinopterygians, or how differences in snout length across seahorses affect these flows. Using flow visualization experiments, we show that seahorses generate suction flows that are 8 times faster than those of similar-sized fish, and that the temporal patterns of cranial kinematics and suction flows in seahorses differ from the conserved pattern observed across other actinopterygians. However, the spatial patterns retain the conserved actinopterygian characteristics, where suction flows impact a radially symmetric region of ∼1 gape diameter outside the mouth. Within seahorses, increases in snout length were associated with slower suction flows and faster head rotation speeds, resulting in a trade-off between pivot feeding and suction feeding. Overall, this study shows how the unique cranial kinematics in seahorses are manifested in their suction-feeding performance, and highlights the trade-offs associated with their unique morphology and mechanics.
Knowledge and attitude of secondary school students in Nakaseke, Uganda towards HIV transmission and treatment
Authors: Nabisubi Patricia , Kanyerezi Stephen , Kebirungi Grace , Mboowa Gerald
Published: July 2021

Background: One of the major health concerns in Nakaseke district, Uganda is the high prevalence of HIV/AIDS. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), as of March 2014, the prevalence rate of the disease in the district was estimated at about 8%, compared to the national average of 6.5%, making Nakaseke district have the sixth-highest prevalence rate of HIV/AIDS in the entire country. We set out to explore the knowledge and attitude of secondary school students in Nakaseke, Uganda on HIV transmission and treatment.

Methods: This was a cross sectional survey-based study with data collected during the month of February 2020. Data were analyzed using R programming language version 3.6.2.

Results: A total of 163 participants volunteered for the study, 53.37% males and 46.63% females with ages ranging from 12 – 20 years. Participants came from 5 senior classes (S1, S2, S3, S4 and S6). In total, 87.73% participants were aware of HIV/AIDS while 12.27% were not. The major source of information was through teachers/schools. 96.50% knew the mode of transmission of HIV/AIDS and 95.11% were conversant with HIV/AIDS prevention. 63.6% were aware of the terms DNA and genes whereas 36.36% were not.

Discussion: Generally, the students in Nakaseke district, Uganda had a high level of awareness of HIV/AIDS based on Bloom’s cut-off point. However, with regards to aspects such as the cause and modern prevention methods like taking prep and prevention of mother to child transmission were less known to them. Efforts to find a cure for HIV/AIDS are still in vain. Therefore, strong emphasis on up to date control and prevention methods should be implemented to fight the HIV/AIDS scourge.
Puncture needle with a hard plastic sheath and plastic wings minimizes repuncture attempts in ultrasound-guided paracentesis: a retrospective case-control study
Authors: Son Il Wan , Kim Suk , Hong Seung Baek , Lee Nam Kyung , Jeong Mi Ri , Han Sung Yong , Woo Hyun Young
Published: July 2021

Background: This study was performed to evaluate periprocedural factors, complications, and repuncture rate of the newly developed puncture needle and compare it with the routinely used puncture needle for ultrasound (US)-guided paracentesis.Methods: We retrospectively identified 137 patients who underwent US-guided paracentesis between July 2018 and March 2019. Among them, 82 patients underwent US-guided paracentesis with a newly developed puncture needle. The other 55 patients underwent US-guided paracentesis with a routinely used puncture needle. The periprocedural factors, complications, and repuncture rate were compared between the two groups using the Mann-Whitney U test and Fisher exact test. The repuncture-associated factors were assessed using logistic regression analysis.Results: There were no major or minor complications in either group. The rate of repuncture was significantly lower in the group using the newly developed puncture needle compared with the group using the routinely used puncture needle (p=0.01). The duration of the procedure was significantly shorter with the newly developed puncture needle compared with the routinely used puncture needle (p=0.01). In univariate analysis, the thickness of the abdominal wall (p=0.04) and the use of the newly developed puncture needle (p=0.01) were significantly associated with the rate of repuncture. In multivariate analysis, only the use of the newly developed puncture needle was significantly associated with the rate of repuncture.Conclusion: Using this novel puncture needle with a hard plastic sheath and plastic wings, the rate of repuncture and the duration of the procedure were decreased without complications of US-guided paracentesis.
Human reproductive systems: the wonder of life
Authors: Peate Ian
Published: July 2021

The female and male reproductive systems are considered in this article. While these two systems are very different, there are some fundamental issues that concern both systems, for example, the approach that the healthcare assistant and associate practitioner (HCA and AP) takes when offering care and support to people.

This article provides an overview of the reproductive systems, their location and their functions.

A glossary of terms has been provided and a range of multiple-choice questions is included, so as to aid learning and recall.
‘Hello, my name is …’: an exploratory case study of inter-professional student experiences in practice
Authors: Ban Sasha , Baker Katherine , Bradley Gemma , Derbyshire Julie , Elliott Cheryl , Haskin Marion , MacKnight Janice , Rosengarten Leah
Published: July 2021

Background:

The ‘Hello my name is …’ campaign emphasises the importance of compassionate care and focuses on health professionals introducing themselves to patients. Research has found that using names is key to providing individuals with a sense of belonging and can be vital in ensuring patient safety.

Objective:

To investigate the student experience of having ‘Hello my name is …’ printed on student uniforms and implement this campaign in practice.

Design:

A case study was used to capture the experiences of 40 multiprofessional healthcare students in practice. Participants were asked to complete a reflective diary during their first week in practice and attend a focus group with 4–8 other students.

Setting:

A higher education institution in the north east of England with students from adult, child and learning disability nursing, occupational therapy, physiotherapy and midwifery programmes, in a variety of clinical placements throughout the region.

Findings:

The implementation of the campaign and logo branding on the uniforms of students resulted in an increase in the number of times students were addressed by their name in practice. Participants reported that the study helped them to quickly develop a sense of belonging when on placement, and aided them in delivering compassionate care. Occasions when patient safety was improved were also reported.

Conclusion:

The use of names is a key feature in human relationships and the delivery of compassionate care, and the authors advocate use of the ‘Hello my name is …’ campaign for all health professionals.