bluuebunny/crossref_metadata_2025 huggingface dataset:
RSV prophylaxis use in high-risk infants in Western Australia, 2002-2013: a record linkage cohort study
Authors: Xu Ruomei , Fathima Parveen , Strunk Tobias , de Klerk Nicholas , Snelling Thomas L. , Richmond Peter C. , Keil Anthony D. , Moore Hannah C.
Published: October 2020

Background

The monoclonal antibody, palivizumab is licensed for use in high-risk infants to prevent severe illness caused by respiratory syncytial virus (RSV). The level of its use and compliance with current jurisdictional guidelines which were amended in 2010, is unknown. We determined the level of palivizumab use in a cohort of high-risk infants in Western Australia.

Methods

Using probabilistically linked administrative data, we conducted a birth cohort study within tertiary neonatal intensive care units (NICUs) born between 2002 and 2013. We described palivizumab use by patient characteristics, eligibility criteria according to guidelines over the period of study and identified predictors of its use.

Results

Of 24,329 infants admitted to tertiary NICUs, 271 (1.1%) were dispensed 744 palivizumab doses with 62.5% being dispensed to infants born 2010–2013. The median number of doses received was 2. A total of 2679 infants met at least one of three criteria for palivizumab (criteria 1: gestational age at birth < 28 weeks and chronic lung disease; criteria 2: gestational age < 28 weeks and Aboriginal; criteria 3: congenital heart disease not otherwise in criteria 1 or 2). The extent of palivizumab use differed across the 3 groups. Of 803 infants meeting criteria 1, 21.8% received at least 1 dose of palivizumab; 52.8% from 2010 onwards. From 174 infants meeting criteria 2, 14.4% received at least 1 dose; 43.1% from 2010 onwards and from 1804 births meeting criteria 3, only 3.7% received at least 1 dose; 5.4% from year of birth 2010 onwards). In adjusted analyses, being born after 2010, being extreme preterm, chronic lung disease, congenital lung disease and being born in autumn or winter were independent predictors of palivizumab use.

Conclusion

In this high-risk setting and notwithstanding the limitations of our data sources, the level of compliance of palivizumab use against current guidelines was low. Most doses were dispensed to infants meeting at least one high-risk criterion. Evidence of incomplete dosing is an important finding in light of recent developments of single dose monoclonal antibodies offering longer protection.
Evaluating the effectiveness of incentives to improve HIV prevention outcomes for young females in Eswatini: Sitakhela Likusasa impact evaluation protocol and baseline results
Authors: Gorgens Marelize , Longosz Andrew F. , Ketende Sosthenes , Nkambule Muziwethu , Dlamini Tengetile , Mabuza Mbuso , Sikwibele Kelvin , Tsododo Vimbai , Dlamini Mthokozisi , Dennis-Langa Futhie , Heard Wendy , Low Andrea , Harimurti Pandu , Wilson David , Mabuza Khanya , de Walque Damien
Published: October 2020

Background

Eswatini continues to have the highest prevalence of HIV in the world, and one of the highest HIV incidences among adult populations (aged 15–49). This analysis reports on both key elements of study design/protocol and baseline results from an impact evaluation of an intervention incentivizing (i) initiation, enrolment, attendance or completion of some form of education, and (ii) lower risk sexual behaviour.

Methods

The impact evaluation employs a two by two factorial design in which participants are enrolled in either the incentive for education arm (‘education treatment arm’ providing a conditional cash incentive) or the control arm (‘education control arm’). In each of these arms, 50% of participants were randomized to also be eligible for selection – three times a year – to participate in a conditional raffle conditional on testing negative for curable STIs (syphilis and Trichomonas vaginalis).

Results

Baseline recruitment and screening occurred in 2016 when a total of 6055 individuals were screened of which 4863 participated in the baseline survey, and 4819 individuals were randomized into one of the study arms. The baseline prevalence of HIV, Trichomonas vaginalis, and syphilis among adolescent girls and young women 8.20% (397/4840), 3.31% (150/4533) and 0.17% (8/4830) respectively.

Conclusions

An educational cash incentive and raffle incentive impact evaluation that addresses adolescent girls and young women who are in-education and out-of-education has the potential to reduce HIV risk in adolescent girls and young women in Eswatini.

Trial registration

Name of the registry: Pan African Clinical Trials Registry.

Trial registration number: PACTR201811609257043.

Date of registration: May 11, 2018 ‘Retrospectively registered’.

URL of trial registry record: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=4685
Scale validation for the identification of falsified hand sanitizer: public and regulatory authorities perspectives from United Arab Emirates
Authors: Jairoun Ammar Abdulrahman , Al-Hemyari Sabaa Saleh , Shahwan Moyad , El-Dahiyat Faris , Jamshed Shazia
Published: October 2020

Background

Since the time of declaration of global pandemic of COVID-19 by World Health Organization (WHO), falsified hand sanitizers surfaced regularly in markets, posing possible harm to public due to unlisted inclusion of methanol. The current research is an attempt to develop and validate a tool to document falsified hand sanitizer in the UAE community.

Method

A descriptive cross-sectional community-based study was conducted among 1280 randomly selected participants. Respondents were sent a web-based electronic link to the survey via email. Content validity, factor analyses and known group validity were used to develop and validate a new scale to identify falsified hand sanitizer. Test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs) were used to assess the reliability of the scale. SPSS version 24 was used to conduct data analysis.

Results

A total of 1280 participants were enrolled in the study. The content validity index (CVI) was 0.83 with the final scale of 12 items. The Kaiser-Meyer-Olkin (KMO) value was 0.788, with the Bartlett test of sphericity achieving statistical significance (p < 0.001). Our factor analysis revealed a 3-component model. The 3-factor solution was confirmed by PCFA analysis and had associations with good fit values. The PCFA for NFI was 0.970, CFI 0.978, and TLI 0.967. All values were in excess of 0.95, with RMSEA values below 0.06 at 0.03; all of these values indicated a good model fit. The Cronbach’s alpha was good overall (0.867). All factors had a Cronbach’s alpha value in excess of 0.70. The instrument demonstrated that every item met the IIC correlation standard ≥0.40. The scale displayed good overall ICC statistics of 0.867 (95% CI 0.856–0.877) with statistical significance (p < 0.001). The scale’s test-retest reliability was assessed through correlation of the falsified hand sanitizer identification score of respondents at the two time points. The test-retest correlation coefficient was 0.770 (p value < 0.01). Participants with post-graduate education were more likely to identify the falsified hand sanitizer compared to those with high school education. (p < 0.001).

Conclusions

This study developed and validated a new scale for the measurement of falsified hand sanitizer. This is expected to improve and promote collaboration between the health regulators and the public and hereby encourage customer satisfaction and participation.
The contribution of medical educational system of the College of Medicine, and Health Sciences of the University of Gondar in Ethiopia on the knowledge, attitudes, and practices of graduate students of Health Sciences in relation to the prevention and control of nosocomial infections during the academic year of 2018
Authors: Engda Tigist
Published: October 2020

Background

Nosocomial infection, also called a hospital-acquired infection, is an infection acquired during admitting patients in health care facilities. Nosocomial infection can be prevented and controlled by giving training to those responsible. This study aimed to assess the contribution of the medical education system on the knowledge, attitudes, and practices of the graduate students of health sciences about the prevention and control of nosocomial infection in the College of Medicine and Health Sciences at the University of Gondar in the Academic Year of 2018.

Method

An institution-based cross-sectional study was conducted among all graduate health science students posted in the different departments at the University of Gondar in the College of Medicine and Health Sciences from February to June 2018. A total of 422 study participants were included. Data were analyzed using SPSS version 20.

Results

Out of a total of 422 respondents, only 40% have taken training for infection prevention; out of which 39% had taken the training for a year ago. Moreover, only 35.5% have good knowledge of nosocomial infections as a result of the training; and only 32.5% have good understanding of the practical training given on prevention and control. Only 36% have good attitude towards its prevention and control.

Conclusion

The result shows that only a few of the respondents have taken the infection prevention training. Yet, a smaller proportion of them had good knowledge, attitude, and practice on nosocomial infections. Hence, the Medical Education System should give more attention to the training of the nosocomial infection control by developing different strategies to prepare the students on these issues before they start their clinical attachment.
Decision aids on breast conserving surgery for early stage breast cancer patients: a systematic review
Authors: Si Jing , Guo Rong , Lu Xiang , Han Chao , Xue Li , Xing Dan , Chen Caiping
Published: October 2020

Background

Breast cancer is a worldwide health concern. For early stage breast cancer patients, choosing the surgical method after diagnosis is always a dilemma. Decision aids designed for use by patients are tools which may help with surgical decision making for these patients.

Methods

We screened through MEDLINE, EMBASE, PubMed and Web of Science using the inclusion criteria which included (1) newly diagnosed patients with early stage breast cancer, (2) outcomes/results involving surgical options including breast conserving surgery. The search strategy used these key words or the combination of these words: “breast cancer”, “decision aid”, “decision making”, “decision support”, “breast conserving surgery”, “breast conserving therapy”.

Results

A total of 621 studies were identified, but only seven studies were included. Results were synthesized into narrative format. Various patterns of decision aids designed for use by patients were implemented. Mostly were educational materials via booklet, video or CDROM with or without assistance from surgeons. After decision aids, four studies showed that patients were more likely to change their original choices into mastectomy or modified radical instead of sticking to breast conserving surgery. Other results such as knowledge of breast cancer and treatments, decisional conflict and satisfaction, psychological changes after surgery and quality of life were all showed with a better trend in patients with decision aids in most studies.

Conclusion

Decision aids on breast conserving surgery made it easier for patient involvement in surgical decision making and improved decision-related outcomes in most early stage breast cancer patients. With more attention, improving procedures, and better interdisciplinary cooperation, more research is necessary for the improvement of decision aids. And we believe decision aids with agreed objective information are needed.
Neuroprotective effects of verbascoside against Alzheimer’s disease via the relief of endoplasmic reticulum stress in Aβ-exposed U251 cells and APP/PS1 mice
Authors: Wang Chunyue , Cai Xueying , Wang Ruochen , Zhai Siyu , Zhang Yongfeng , Hu Wenji , Zhang Yizhi , Wang Di
Published: October 2020

Background

Endoplasmic reticulum (ER) stress is involved in the progression of Alzheimer’s disease (AD). Verbascoside (VB), an active phenylethanoid glycoside that was first isolated from Verbascum sinuatum (the wavyleaf mullein), possesses anti-inflammatory, antioxidative, and anti-apoptotic effects. The purpose of this study was to elucidate the beneficial effects of VB in amyloid β (Aβ)1–42-damaged human glioma (U251) cells and in APPswe/PSEN1dE9 transgenic (APP/PS1) mice.

Methods

U251 cells were co-incubated with 10 μM of Aβ1-42 and treated with VB. The protective effects of VB were investigated by using 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide assay, flow cytometry, fluorescence staining, and transmission electron microscopy. APP/PS1 transgenic mice were treated for 6 weeks with VB. Learning and memory were evaluated using a Morris water maze test. Immunohistochemistry, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling, thioflavin-S staining, and proteomics analysis were performed to study the potential neuroprotective mechanism. Enzyme-linked immunosorbent assays and western blot were performed to analyze altered protein levels of brain lysates in APP/PS1 mice and/or Aβ1-42-damaged U251 cells.

Results

In Aβ1-42-damaged U251 cells, VB significantly improved cell viability, inhibited apoptosis, reduced calcium accumulation and the intracellular concentrations of reactive oxygen species, and improved the morphology of mitochondria and ER. In APP/PS1 mice, 6-week administration of VB significantly improved memory and cognition. VB inhibited apoptosis, reduced the deposition of Aβ, reduced the formation of neurofibrillary tangles formed by hyperphosphorylated tau protein, and downregulated the expression levels of 4-hydroxynonenal and mesencephalic astrocyte-derived neurotrophic factor in the brains of APP/PS1 mice. Proteomics analysis of mouse hippocampus suggested that the neuroprotective effect of VB may be related to the reduction of ER stress. This was indicated by the fact that VB inhibited the three branches of the unfolded protein response, thereby attenuating ER stress and preventing apoptosis.

Conclusions

The results confirmed that VB possesses significant neuroprotective effects, which are related to the reduction of ER stress. These findings support the status of VB as a potentially effective treatment for AD and warrant further research.
Socio-economic and demographic determinants of female genital mutilation in sub-Saharan Africa: analysis of data from demographic and health surveys
Authors: Ahinkorah Bright Opoku , Hagan John Elvis , Ameyaw Edward Kwabena , Seidu Abdul-Aziz , Budu Eugene , Sambah Francis , Yaya Sanni , Torgbenu Eric , Schack Thomas
Published: October 2020

Background

Owing to the severe repercussions associated with female genital mutilation (FGM) and its illicit status in many countries, the WHO, human rights organisations and governments of most sub-Saharan African countries have garnered concerted efforts to end the practice. This study examined the socioeconomic and demographic factors associated with FGM among women and their daughters in sub-Saharan Africa (SSA).

Methods

We used pooled data from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 12 countries in SSA. In this study, two different samples were considered. The first sample was made up of women aged 15–49 who responded to questions on whether they had undergone FGM. The second sample was made up of women aged 15–49 who had at least one daughter and responded to questions on whether their daughter(s) had undergone FGM. Both bivariate and multivariable analyses were performed using STATA version 13.0.

Results

The results showed that FGM among women and their daughters are significantly associated with household wealth index, with women in the richest wealth quintile (AOR, 0.51 CI 0.48–0.55) and their daughters (AOR, 0.64 CI 0.59–0.70) less likely to undergo FGM compared to those in the poorest wealth quintile. Across education, the odds of women and their daughters undergoing FGM decreased with increasing level of education as women with higher level of education had the lowest propensity of undergoing FGM (AOR, 0.62 CI 0.57–0.68) as well as their daughters (AOR, 0.32 CI 0.24–0.38). FGM among women and their daughters increased with age, with women aged 45–49 (AOR = 1.85, CI 1.73–1.99) and their daughters (AOR = 12.61, CI 10.86–14.64) more likely to undergo FGM. Whiles women in rural areas were less likely to undergo FGM (AOR = 0.81, CI 0.78–0.84), their daughters were more likely to undergo FGM (AOR = 1.09, CI 1.03–1.15). Married women (AOR = 1.67, CI 1.59–1.75) and their daughters (AOR = 8.24, CI 6.88–9.87) had the highest odds of undergoing FGM.

Conclusion

Based on the findings, there is the need to implement multifaceted interventions such as advocacy and educational strategies like focus group discussions, peer teaching, mentor–mentee programmes at both national and community levels in countries in SSA where FGM is practiced. Other legislative instruments, women capacity-building (e.g., entrepreneurial training), media advocacy and community dialogue could help address the challenges associated with FGM. Future studies could consider the determinants of intention to discontinue or continue the practice using more accurate measures in countries identified with low to high FGM prevalence.
Pulp repair response after the use of a dentin-pulp biostimulation membrane (BBio) in primary teeth: study protocol for a randomized clinical trial
Authors: Machado Maria Aparecida Andrade Moreira , Stafuzza Tássia Carina , Vitor Luciana Lourenço Ribeiro , da Costa Silgia Aparecida , da Costa Sirlene Maria , Neto Natalino Lourenço , Oliveira Thais Marchini
Published: October 2020

Background

Vital pulp therapy aims at maintaining the pulp tissue injured but vital. Thus, the use of capping materials that induce tissue regeneration is a great current trend. This study aims to evaluate clinically and radiographically the pulp repair after the use of dentin-pulp biostimulation membrane in primary teeth.

Methods

Four hundred and sixty-eight teeth from children aged between 5 and 9 years old, both genders, with deep caries lesion with pulp involvement, but no furcal impairment and any sign of necrosis will be selected. The vital pulp therapy will be performed with mineral trioxide aggregate (control group) and dentin-pulp biostimulation chitosan membrane (BBio group). The clinical and radiographic outcomes will be assessed at 12 and 24 months after treatment. The thickness of the dentin barrier will be verified through Image J2 software. The Wilcoxon signed rank test and Mann-Whitney test will respectively compare the intra- and intergroup clinical and radiographic outcomes. Paired t test and independent t test will respectively compare the intra- and intergroup radiographic measurements. The logistic regression will be applied, and the degrees of this association will be measured using odds ratio (OR) and 95% confidence interval (95% CI).

Discussion

Therefore, this study protocol aims at new perspectives of vital pulp therapy of primary teeth by employing new easy-handling, low-cost material to keep viable the pulp tissue capable of regenerating and maintain the physiological process of deciduous tooth exfoliation.

Trial registration

Brazilian Registry of Clinical Trials RBR-6vr58b. Registered on 17 February 2019.
Microbial upgrading of acetate into 2,3-butanediol and acetoin by E. coli W
Authors: Novak Katharina , Kutscha Regina , Pflügl Stefan
Published: October 2020

Background

Acetate is an abundant carbon source and its use as an alternative feedstock has great potential for the production of fuel and platform chemicals. Acetoin and 2,3-butanediol represent two of these potential platform chemicals.

Results

The aim of this study was to produce 2,3-butanediol and acetoin from acetate in Escherichia coli W. The key strategies to achieve this goal were: strain engineering, in detail the deletion of mixed-acid fermentation pathways E. coli W ΔldhA ΔadhE Δpta ΔfrdA 445_Ediss and the development of a new defined medium containing five amino acids and seven vitamins. Stepwise reduction of the media additives further revealed that diol production from acetate is mediated by the availability of aspartate. Other amino acids or TCA cycle intermediates did not enable growth on acetate. Cultivation under controlled conditions in batch and pulsed fed-batch experiments showed that aspartate was consumed before acetate, indicating that co-utilization is not a prerequisite for diol production. The addition of aspartate gave cultures a start-kick and was not required for feeding. Pulsed fed-batches resulted in the production of 1.43 g l−1 from aspartate and acetate and 1.16 g l−1 diols (2,3-butanediol and acetoin) from acetate alone. The yield reached 0.09 g diols per g acetate, which accounts for 26% of the theoretical maximum.

Conclusion

This study for the first time showed acetoin and 2,3-butanediol production from acetate as well as the use of chemically defined medium for product formation from acetate in E. coli. Hereby, we provide a solid base for process intensification and the investigation of other potential products.
Molecular characterization of the re-emerging West Nile virus in avian species and equids in Israel, 2018, and pathological description of the disease
Authors: Schvartz Gili , Farnoushi Yigal , Berkowitz Asaf , Edery Nir , Hahn Shelly , Steinman Amir , Lublin Avishai , Erster Oran
Published: October 2020

Background

In this report we describe the molecular and pathological characteristics of West Nile virus (WNV) infection that occurred during the summer and fall of 2018 in avian species and equines. WNV is reported in Israel since the 1950s, with occasional outbreaks leading to significant morbidity and mortality in birds, high infection in horses and humans, and sporadic fatalities in humans.

Methods

Animal and avian carcasses in a suitable condition were examined by post-mortem analysis. Tissue samples were examined for WNV by RT-qPCR and the viral load was quantified. Samples with sufficient material quality were further analyzed by Endpoint PCR and sequencing, which was used for phylogenetic analysis. Tissue samples from positive animals were used for culturing the virus in Vero and C6/36 cells.

Results

WNV RNA was detected in one yellow-legged gull (Larus michahellis), two long-eared owls (Asio otus), two domesticated geese (Anser anser), one pheasant (Phasianus colchicus), four hooded crows (Corvus cornix), three horses and one donkey. Pathological and histopathological findings were characteristic of viral infection. Molecular analysis and viral load quantification showed varying degrees of infection, ranging between 70–1.4 × 106 target copies per sample. Phylogenetic analysis of a 906-bp genomic segment showed that all samples belonged to Lineage 1 clade 1a, with the following partition: five samples from 2018 and one sample detected in 2016 were of Cluster 2 Eastern European, two of Cluster 2 Mediterranean and four of Cluster 4. Four of the positive samples was successfully propagated in C6/36 and Vero cell lines for further work.

Conclusions

WNV is constantly circulating in wild and domesticated birds and animals in Israel, necessitating constant surveillance in birds and equines. At least three WNV strains were circulating in the suspected birds and animals examined. Quantitative analysis showed that the viral load varies significantly between different organs and tissues of the infected animals.
Well-posedness and behaviors of solutions to an integrable evolution equation
Authors: Ming Sen , Lai Shaoyong , Su Yeqin
Published: October 2020

This work is devoted to investigating the local well-posedness for an integrable evolution equation and behaviors of its solutions, which possess blow-up criteria and persistence property. The existence and uniqueness of analytic solutions with analytic initial values are established. The solutions are analytic for both variables, globally in space and locally in time. The effects of coefficients λ and β on the solutions are given.
Oral contraceptive use and anterior cruciate ligament injury: comparison of active comparator new user cohort and case-control study designs
Authors: Herzog Mackenzie M. , Young Jessica C. , Lund Jennifer L. , Pate Virginia , Mack Christina D. , Marshall Stephen W.
Published: October 2020

Background

This study further investigates a protective association between oral contraceptive (OC) use and anterior cruciate ligament (ACL) injury noted in prior case-control studies.

Methods

Active comparator new user cohort analysis of women aged 13–45 years in the United States from the IBM MarketScan Commercial Claims and Encounters database who newly-initiated low-dose OCs (exposed) or underwent intrauterine device (IUD) insertion (comparison group) from 2000 to 2014. Women were followed for ACL injury starting 90 days after OC initiation or IUD insertion until OC or IUD discontinuation or end of continuous enrollment. Adjusted hazard ratios (adjHR) and 95% confidence intervals (CI) were estimated controlling for age. Secondary analysis replicated previously-published case-control studies assessing “ever” versus “never” OC use over 1- and 5-year periods among women who underwent ACL reconstruction compared to age-matched controls.

Results

In the cohort analysis, 2,370,286 women initiated OCs and 621,798 underwent IUD insertion. There were 3571 (0.15%) ACL injuries during an average 370.6 days of continuous OC use and 1620 (0.26%) during an average 590.5 days of IUD use. No difference in risk of ACL injury was observed between OC initiators and IUD users (adjHR = 0.95; 95%CI 0.89, 1.01). The case-control analysis replicated the slight protective association observed in prior studies over a 5-year period (OR = 0.90; 95%CI 0.85, 0.94).

Conclusions

This cohort study suggests no association between OC use and ACL injury, while the case-control study suggested bias from uncontrolled confounding and selection factors may have influenced previous findings that suggested a protective association between OC use and ACL injury.
Diagnostic value of 18F-FDG PET/MRI for staging in patients with endometrial cancer
Authors: Tsuyoshi Hideaki , Tsujikawa Tetsuya , Yamada Shizuka , Okazawa Hidehiko , Yoshida Yoshio
Published: October 2020

Background

Preoperative accurate assessment of endometrial cancer can assist in the planning of additional surgical options, and in predicting the prognosis. The aim of the present study was to evaluate the diagnostic potential of non-contrast PET/MRI with 18F-fluorodeoxyglucose (18F-FDG) for assessment in preoperative staging of endometrial cancer.

Methods

Thirty-six patients with biopsy-proven endometrial cancer underwent preoperative 18F-FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI) for initial staging. The diagnostic performance of 18F-FDG PET/MRI and ceMRI for assessing the extent of the primary tumor (T stage), and 18F-FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastasis, was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis.

Results

Accuracy for T status was 77.8 and 75.0% for 18F-FDG PET/MRI and ceMRI, respectively. Patient-based accuracy for detecting regional nodal and distant metastasis was 91.3 and 81.8% for 18F-FDG PET/MRI, and 87.0 and 81.8% for ceCT. None of these parameters was statistically significant (p > 0.05). Lesion-based sensitivity, specificity and accuracy for detecting regional nodal metastasis were 100, 96.9 and 97.0% for 18F-FDG PET/MRI, and 14.3, 97.6 and 93.3% for ceCT; sensitivity was statistically significant (p < 0.05).

Conclusions

Non-contrast 18F-FDG PET/MRI, which combines the individual advantages of PET and MRI, offers a high diagnostic value equivalent to that of ceMRI for assessment of the primary tumor, and equivalent to that of ceCT for the assessment of nodal and distant metastatic staging, in patients with endometrial cancer. These findings suggest that 18F-FDG PET/MRI might provide an alternative diagnostic strategy to conventional imaging modalities in the preoperative staging of endometrial cancer.
A decision model on the repair and maintenance of shipping containers
Authors: Hoffmann Niclas , Stahlbock Robert , Voß Stefan
Published: October 2020

The use of shipping containers for the transport of goods has become indispensable and a crucial factor for globalization by providing inexpensive and safe transport opportunities. It is expected that the number of globally operating containers will increase in the near future. Despite a high technical modernisation of the logistic chain, the container still faces a risk of damage at any time and any place within the transport chain. In principle, a container is taken out of service, when a damage is recognized. Different causes of damage exist and various types of damage could occur to the container, ranging from minor to substantial major ones that do not permit the continued proper use of the container. Thus, an individual decision on repair and maintenance (R&M) for each damaged container is necessary. Aside from technical aspects, it has to be decided from an economical perspective whether a repair should be performed. A profound decision should consider various criteria like, e.g., repair costs, lifespan of the container, future yields and possible sales price. Based on a regulatory, practical, and scientific view, this paper proposes a multi-criteria decision model for the economic decision on the R&M of a damaged container. Implemented in Microsoft Excel, this decision model is easily applicable. The user can deduce a first (limited) guidance for dealing with a respective damaged container based on its current state and general market conditions.
Not all that glitters is COVID! Differential diagnosis of FDG-avid interstitial lung disease in low-prevalence regions
Authors: Papa Annalisa , Pozzessere Chiara , Cicone Francesco , Rizzuto Fabiola , Cascini Giuseppe Lucio
Published: October 2020

Coronavirus disease-19 (COVID-19) is only one of the many possible infectious and non-infectious diseases that may occur with similar imaging features in patients undergoing [18F]-fluorodeoxyglucose (18FDG) monitoring, particularly in the most fragile oncologic patients. We briefly summarise some key radiological elements of differential diagnosis of interstitial lung diseases which, in our opinion, could be extremely useful for physicians reporting 18FDG PET/CT scans, not only during the COVID-19 pandemic, but also for their normal routine activity.
The association between waiting time and multidisciplinary pain treatment outcomes in patients with rheumatic conditions
Authors: Deslauriers Simon , Roy Jean-Sébastien , Bernatsky Sasha , Feldman Debbie E. , Pinard Anne Marie , Desmeules François , Fitzcharles Mary-Ann , Perreault Kadija
Published: October 2020

Background

Access to multidisciplinary pain treatment facilities (MPTF) is limited by extensive waiting time in many countries. However, there is a lack of knowledge about the impact of waiting time on clinical outcomes, particularly for patients with rheumatic conditions. This study examined the association between waiting time for MPTF and clinical outcomes in patients with rheumatic conditions.

Methods

Data were extracted from the Quebec Pain Registry, a large database of patients who received services in MPTF. The associations between waiting time (classified as < 2 months, 2–6 months and >  6 months) and change in pain interference, pain intensity and health-related quality of life, from the initial visit at the MPTF to the 6-month follow-up, were tested using generalized estimating equations.

Results

A total of 3230 patients with rheumatic conditions (mean age: 55.8 ± 14.0 years; 66% were women) were included in the analysis. Small significant differences in improvement between waiting time groups were revealed, with patients waiting less than 2 months having a larger improvement in all clinical outcomes compared to patients who waited 2–6 months or over 6 months before their initial visit (adjusted time X group effect p ≤ 0.001). Only patients waiting less than 2 months reached a clinically important improvement in pain interference (1.12/10), pain intensity (1.3/10) and physical and mental quality of life (3.9 and 3.7/100).

Conclusions

Longer delays experienced by patients before receiving services in MPTF were associated with statistically significant smaller improvements in pain interference, pain intensity and health-related quality of life; these differences were, however, not clinically significant. Based on these results, we advise that strategies are developed not only to reduce waiting times and mitigate their impacts on patients with rheumatic conditions, but also to improve treatment effectiveness in MPTF.
Skin microbiome of beluga whales: spatial, temporal, and health-related dynamics
Authors: Van Cise Amy M. , Wade Paul R. , Goertz Caroline E. C. , Burek-Huntington Kathy , Parsons Kim M. , Clauss Tonya , Hobbs Roderick C. , Apprill Amy
Published: October 2020

Background

Host-specific microbiomes play an important role in individual health and ecology; in marine mammals, epidermal microbiomes may be a protective barrier between the host and its aqueous environment. Understanding these epidermal-associated microbial communities, and their ecological- or health-driven variability, is the first step toward developing health indices for rapid assessment of individual or population health. In Cook Inlet, Alaska, an endangered population of beluga whales (Delphinapterus leucas) numbers fewer than 300 animals and continues to decline, despite more than a decade of conservation effort. Characterizing the epidermal microbiome of this species could provide insight into the ecology and health of this endangered population and allow the development of minimally invasive health indicators based on tissue samples.

Results

We sequenced the hypervariable IV region of bacterial and archaeal SSU rRNA genes from epidermal tissue samples collected from endangered Cook Inlet beluga whales (n = 33) and the nearest neighboring population in Bristol Bay (n = 39) between 2012 and 2018. We examined the sequences using amplicon sequence variant (ASV)-based analyses, and no ASVs were associated with all individuals, indicating a greater degree of epidermal microbiome variability among beluga whales than in previously studied cetacean species and suggesting the absence of a species-specific core microbiome. Epidermal microbiome composition differed significantly between populations and across sampling years. Comparing the microbiomes of Bristol Bay individuals of known health status revealed 11 ASVs associated with potential pathogens that differed in abundance between healthy individuals and those with skin lesions or dermatitis. Molting and non-molting individuals also differed significantly in microbial diversity and the abundance of potential pathogen-associated ASVs, indicating the importance of molting in maintaining skin health.

Conclusions

We provide novel insights into the dynamics of Alaskan beluga whale epidermal microbial communities. A core epidermal microbiome was not identified across all animals. We characterize microbial dynamics related to population, sampling year and health state including level of skin molting. The results of this study provide a basis for future work to understand the role of the skin microbiome in beluga whale health and to develop health indices for management of the endangered Cook Inlet beluga whales, and cetaceans more broadly.
Influence of architectural heritage on the identity and present-day value of American-designed universities’ campuses in Asia
Authors: Hong Yan
Published: October 2020

In this study, through case studies of campus architectural heritage, the preservation of architectural heritage on campuses is explored. In addition, the effects of architectural heritage preservation on the identity of campuses are investigated, and the corresponding effects on present-day value and spatial experience are analysed. The case studies involve early campuses planned in East Asia by Henry Murphy, and they feature American designs and building styles.

In this study, first, the characteristics of the campuses planned by Henry Murphy are analysed. Next, the characteristics of the preserved architectural heritage at Chosen Christian College are analysed. Finally, with a focus on the preservation of architectural heritage at Shanghai College, the value of architectural heritage and the spatial experience associated with campus development are analysed.

Chosen Christian College focused on maintaining the authenticity of buildings, and Shanghai College attempted to consolidate the identity of the campus through maximizing the spatial experience of the architectural heritage group and preserving architectural heritage. Thus, Shanghai College was more influenced by Henry Murphy’s master plan in the development and growth of the campus, and tried to carry on the design concept of the architect and the image of the campus. Conversely, Chosen Christian College was able to retain its original design over nearly a century with the use of all-stone buildings, as Henry Murphy proposed, but no significant trace of the early general plan remains.
Heterogeneity in clone dynamics within and adjacent to intestinal tumours identified by Dre-mediated lineage tracing
Authors: Thorsen Ann-Sofie , Khamis Doran , Kemp Richard , Colombé Mathilde , Lourenço Filipe C. , Morrissey Edward , Winton Douglas
Published: October 2020

Somatic models of tissue pathology commonly utilise induction of gene specific mutations in mice mediated by spatiotemporal regulation of Cre recombinase. Subsequent investigation of the onset and development of disease can be limited by the inability to track changing cellular behaviours over time. Here a lineage tracing approach based on ligand dependent activation of Dre recombinase that can be employed independently of Cre is described. The clonal biology of intestinal epithelium following Cre-mediated stabilisation of ß-catenin reveals that within tumours many new clones rapidly become extinct. Surviving clones show accelerated population of tumour glands compared to normal intestinal crypts but in a non-uniform manner indicating that intra-tumour glands follow heterogeneous dynamics. In tumour adjacent epithelium clone sizes are smaller than in the background epithelium as a whole. This suggests a zone of around 5 crypt diameters within which clone expansion is inhibited by tumours and that may facilitate their growth.
The role of hyoid muscles in biotremor production inChamaeleo calyptratus
Authors: Tegge Samuel M. , Anderson Christopher V. , Smith Michael E. , Huskey Steve
Published: October 2020

The production of biotremors has been described in veiled chameleons (Chamaeleo calyptratus), but the mechanism by which they are produced is unknown. We gathered muscle activation data via electromyography (EMG) with simultaneous recordings of biotremors using an accelerometer to test for the role of hyoid muscles in their production. We recorded mean biotremor frequency of 150.87 Hz for females and 136.01 Hz for males. The durations of activity and the latencies to onset and offset for the M. sternohyoideus profundus (SP), M. sternohyoideus superficialis (SS), Mm. mandibulohyoideus (MH), and Mm. levator scapulae (LS) were all significantly correlated with biotremor durations and biotremor onset and offset, respectively. Linear mixed-effect regression model comparisons of biotremor duration indicate that models containing either MH and/or SP and LS account or the most variation in the biotremor duration. Twitch times for the SP (100 ms) and the SS (132 ms) at field active body temperature, however, were individually too slow to produce the biotremors at the observed frequency without alteration after production by other anatomical structures. These results implicate the SP, SS, MH, and LS in the production of the biotremor, but the exact mechanism of production requires further study.
Evolution of Esophagectomy for Cancer Over 30 Years: Changes in Presentation, Management and Outcomes
Authors: Griffin S. Michael , Jones Rhys , Kamarajah Sivesh Kathir , Navidi Maziar , Wahed Shajahan , Immanuel Arul , Hayes Nick , Phillips Alexander W.
Published: October 2020

Background

Esophageal cancer has seen a considerable change in management and outcomes over the last 30 years. Historically, the overall prognosis has been regarded as poor; however, the use of multimodal treatment and the integration of enhanced recovery pathways have improved short- and long-term outcomes.

Objective

The aim of this study was to evaluate the changing trends in presentation, management, and outcomes for patients undergoing surgical treatment for esophageal cancer over 30 years from a single-center, high-volume unit in the UK.

Patients and Methods

Data from consecutive patients undergoing esophagectomy for cancer (adenocarcinoma or squamous cell carcinoma) between 1989 and 2018 from a single-center, high-volume unit were reviewed. Presentation method, management strategies, and outcomes were evaluated. Patients were grouped into successive 5-year cohorts for comparison and evaluation of changing trends.

Results

Between 1989 and 2018, 1486 patients underwent esophagectomy for cancer. Median age was 65 years (interquartile range [IQR] 59–71) and 1105 (75%) patients were male. Adenocarcinoma constituted 1105 (75%) patients, and overall median survival was 29 months (IQR 15–68). Patient presentation changed, with epigastric discomfort now the most common presentation (70%). An improvement in mortality from 5 to 2% (p < 0.001) was seen over the time period, and overall survival improved from 22 to 56 months (p < 0.001); however, morbidity increased from 54 to 68% (p = 0.004).

Conclusions

Long-term outcomes have significantly improved over the 30-year study period. In addition, mortality and length of stay have improved despite an increase in complications. The reasons for this are multifactorial and include the use of perioperative chemo(radio)therapy, the introduction of an enhanced recovery pathway, and improved patient selection.
Risk evaluation of fetal growth restriction by combined screening in early and mid-pregnancy
Authors: Wang Bo , Zhang Chunhua
Published: October 2020

Objectives: To assess risk of fetal growth restriction (FGR) by combined screening in early and mid-pregnancy.

Methods: Pregnant women who received prenatal examinations and delivered in our hospital from January 2015 to January 2019 were selected and retrospectively analyzed. All women completed two ultrasonographic examinations during pregnancy, i.e. Down’s screening during early pregnancy (11-13 + 6 weeks) and prenatal color Doppler screening during mid-pregnancy (20-24 weeks). A total of 33 FGR cases were screened out, and there were 1,507 normal pregnant women. The clinical, ultrasonographic and serological indices in early and mid-pregnancy were recorded. When the false positive rate was 5%, logistic regression analysis and receiver operating characteristic (ROC) curve were used to evaluate the influencing factors and predictive values of individual and combined indices for FGR in corresponding gestational weeks. The sensitivity and specificity of the optimal cutoff value of each index as well as the combination of optimal predictive indices were found by the area under ROC curve (AUC).

Results: When the false positive rate was 5% in the single-index screening during early pregnancy, the parity, BPD, AC, HC, and FL had statistical significances. Multivariate analysis showed that the parity and BPD had statistical significances. During mid-pregnancy, univariate analysis revealed that the parity, BMI, BPD, AC, HC, FL, UTA-PI, UTA-RI, UA-PI and UA-RI had statistical significances. BMI, AC, UTA-PI, UTA-RI, UA-PI and UA-RI had statistical significances in multivariate analysis. BMI, UTA-PI and UA-PI were risk factors for FGR, with UTA-PI being most dangerous. AUC for combined screening exceeded those for individual screenings. The best combined screening program was BPD in early pregnancy + BMI + AC + UTA-PI + UTA-RI + UA-PI + UA-RI in mid-pregnancy. The optimal cutoff value was 0.015, with the sensitivity of 83.1% and the specificity of 61.3%.

Conclusion: The predictive efficiency of combined FGR screening in early and mid-pregnancy surpasses that of simple mid-pregnancy screening. It is recommended to use the integrated screening program in early and mid-pregnancy to predict FGR.

doi: https://doi.org/-10.12669/pjms.36.7.1988

How to cite this:Wang B, Zhang C. Risk evaluation of fetal growth restriction by combined screening in early and mid-pregnancy. Pak J Med Sci. 2020;36(7):1708-1713. doi: https://doi.org/10.12669/pjms.36.7.1988

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Systemic inflammation is negatively associated with early post discharge growth following acute illness among severely malnourished children - a pilot study
Authors: Njunge James M. , Gonzales Gerard Bryan , Ngari Moses M. , Thitiri Johnstone , Bandsma Robert H.J. , Berkley James A.
Published: October 2020

Background: Rapid growth should occur among children with severe malnutrition (SM) when medically and nutritionally treated. Systemic inflammation (SI) is associated with death among children with SM and is negatively associated with linear growth. However, the relationship between SI and weight gain during therapeutic feeding following acute illness is unknown. We hypothesised that growth in the first 60 days post-hospital discharge is associated with SI among children with SM.

Methods: We conducted secondary analysis of data from HIV-uninfected children with SM (n=98) who survived and were not readmitted to hospital during one year of follow up. We examined the relationship between changes in absolute deficits in weight and mid-upper-arm circumference (MUAC) from enrolment at stabilisation to 60 days later and untargeted plasma proteome, targeted cytokines/chemokines, leptin, and soluble CD14 (sCD14) using multivariate regularized linear regression.

Results: The mean change in absolute deficit in weight and MUAC was -0.50kg (standard deviation; SD±0.69) and -1.20cm (SD±0.89), respectively, from enrolment to 60 days later. During the same period, mean weight and MUAC gain was 3.3g/kg/day (SD±2.4) and 0.22mm/day (SD±0.2), respectively. Enrolment inflammatory cytokines interleukin 17 alpha (IL17α), interleukin 2 (IL2), and serum amyloid P (SAP) were negatively associated with weight and MUAC gain. Lipopolysaccharide binding protein (LBP) and complement component 2 were negatively associated with weight gain only. Leptin was positively associated with weight gain. sCD14, beta-2 microglobulin (β2M), and macrophage inflammatory protein 1 beta (MIP1β) were negatively associated with MUAC gain only.

Conclusions: Early post-hospital discharge weight and MUAC gain were rapid and comparable to children with uncomplicated SM treated with similar diet in the community. Higher concentrations of SI markers were associated with less weight and MUAC gain, suggesting inflammation negatively impacts recovery from wasting. This finding warrants further research on the role of inflammation on growth among children with SM.