bluuebunny/crossref_metadata_2025 huggingface dataset:
Re-thinking Metronidazole: Anti-microbial Synergism of Hexane Extracts of Garcinia kola and Aframomum melegueta
Authors: Joy I. Odimegwu , Babatunde Asabisi , Mariam Sodeinde , Margaret O. Ilomuanya
Published: August 2020

Aims: This research evaluates knowledge, attitudes, and practice with regard to food poisoning treatment. It compares the antimicrobial effects of Garcinia kola (Gk) and Aframomum melegueta (Am) seeds with Metronidazole and Gentamicin as standards.

Study Design: A survey with questionnaires was carried out among community Pharmacists in Lagos, Nigeria on drug of choice for suspected food poisoning and the responses analyzed. Hexane extracts of Gk and Am seeds were used on selected microbials that cause food poisoning.

Place and Duration of Study: Department of Pharmacognosy; Phytochemistry Laboratory and Department of Pharmaceutics and Pharmaceutical Technology; Pharmaceutical Microbiology Laboratory, Faculty of Pharmacy. University of Lagos.

Methodology: Agar diffusion assays were carried out using and using Gk and Am with Metronidazole and Gentamicin as controls. Gas chromatography and Mass spectroscopy of the extracts was also carried out to ascertain the possible active phytocomponents.

Results: Our discovery on knowledge showed that 98.6% of the interviewed Pharmacists use Metronidazole for food poisoning treatment. 41.7% of the respondents prescribe Ciprofloxacin while 66.7% prescribed Tetracycline as adjunct medications. Gk and Am exerted powerful anti-microbial effects in a dose dependent manner. Gk on S. typhi showed 1.4-1.7 cm zone of inhibition (zi) at 200mg/ml and with E. coli, 1.2 cm at same concentration. Am with S. typhi showed1.2-1.8 cm and E. coli 1.5 cm zi at same concentration too, much better than Gk. Their mixture for the synergistic experiments had 2.0-2.2 cm and E. coli, 2.4 cm zi at 200 mg/ml, the best performance of the extracts as anti-infective agents against food poisoning. 19 compounds were discovered through GC/MS in Gk and 31 in Am. They each exerted more antimicrobial effects than Metronidazole and their mixture used for synergistic experiments compared favorably with Gentamicin.

Conclusion: Hexane extracts of Gk and Am are good alternatives for the treatment of food poisoning. The study encourages further drug discovery research in order to ascertain the particular bioactive compounds in the extracts responsible for their powerful antimicrobial actions. Metronidazole is not the drug of choice for food poisoning management.
Utilization of an Instructional Package on Patient Safety Culture to Enhance Knowledge of Nursing Students in Two Selected Universities in South-West, Nigeria
Authors: Christiana Emeghara, Obiageli , Okechukwu Emeghara , Christian C. C. Asonye , Olawale Oladapo Rasheed , Quamariyat Akinlawon Adekemi
Published: August 2020

Aims: The culture of keeping patients safe is a global issue which should be emphasized within the nursing profession. Despite exposure of nursing students to patient safety teachings, its knowledge among nursing students has been low. Re-emphasizing a positive culture of patient safety in classroom is essential in the training of nurses that will provide high quality care. This study was developed to assess the outcome of an instructional package on the knowledge of baccalaureate nursing trainees concerning patient safety culture in two chosen Universities in Southwest, Nigeria.

Study Design: The researchers adopted a two groups nonequivalent pre-test, and post-test quasi-experimental design.

Place and Duration of Study: Babcock University, Ogun State and Afe Babalola University, Ekiti State between March and April 2018.

Methodology: The study participants comprised 143 nursing students from Babcock University (experimental group) and Afe Babalola University (control group). A self-developed questionnaire was employed to obtain data on the knowledge of patient safety culture pre-intervention and two weeks post intervention. Data was examined using Statistical package for the social science (SPSS) and t-test was done at a significance level of P<0.05.

Results: Findings revealed experimental mean knowledge gain of 2.425, while control group mean knowledge gain was 0.110. Significant differences were found in the participants knowledge of patient safety culture between the experimental group and control group (P<0.001) and between knowledge of error reporting in the experimental group (P<0.001). 

Conclusion: Teaching sessions on patient safety culture can improve nursing students’ knowledge about patient safety. The findings of the study recommends that patient safety education should be reinforced in the curriculum of nursing schools, and that supplementary boosting sessions be executed periodically to ensure the  retention of learned materials.
Clinical Outcome of Intravascular Ultrasound Guided Left Main Coronary Intervention
Authors: Ezzelregal Mohamed , Testa Luca , Alashmawy Medhat , Elsaid Ayman , Kassem Hanan
Published: August 2020

Introduction: Intravascular ultrasound is a new imaging modality that facilitate the process of coronary intervention. The angiographic evaluation of left main lesions significance is always questionable, IVUS detect the significance, guide the procedure and some studies proves a benefit in mortality.

Objectives: To investigate whether intravascular ultrasound IVUS guided Left Main coronary intervention could improve clinical outcomes compared with angiographic-guided Left main coronary PCI.

Patients and Methods: This controlled study was carried out between June 2017 and June 2019, in Tanta university Hospital and San Donato Hospital, Milan, 83 patients eligible to Left Main coronary intervention divided into two groups, IVUS-guided group (n=19) and angiographic-guided group(n=64). The occurrence of major adverse cardiac events (MACE): death, non-fatal myocardial infarction, or target lesion revascularizations) were recorded 6 and18 Months of follow-up.

Results: The IVUS-guided group had a lower rate of 18-months MACE than the control group. The incidence of target lesion revascularization was lower in the IVUS-guided group than in the control group. The incidence of TLR after 6 months was not different between both groups (1 cases in IVUS group (5.3%), 6 cases in angiography group (9.4%) (P value 0.686) while the incidence of TLR after 18 months was significantly different between both groups (1 cases in IVUS group (5.3%), 17 cases in angiography group (26.6%) (P value 0.048), However, there were no differences in death, myocardial infarction, stent thrombosis and number of patients treated with CABG in the 2 groups.

Conclusion: The present study demonstrates that IVUS-guided LM angioplasty can improve 18 -months MACE events especially the incidence of target lesion revascularization.
Economic Analysis of Compressor Inlet Air Precooling Techniques of a Gas Turbine Operational in Nigerian Energy Utility Sector
Authors: Okafor Victor C.
Published: August 2020

Economic analysis of gas turbine compressor inlet air precooling is based on the economical evaluation (maintenance, operations and personnel costs) of the various precooling systems used to improve the performance of gas turbine operational in Nigeria energy utility sector. The precooling techniques studied are evaporative, vapour compression and vapour absorption precooling techniques. This study objectively compared the three precooling techniques taking into consideration the prevailing climatic conditions of Nigeria. The overall yearly cost for evaporative, vapour compression and vapour absorption precooling techniques are evaluated to be USD25501.31/KWh, USD69867.19/KWh and USD1184548.01/KWh respectively and the payback time is three years. The system profitability for evaporative, vapour compression and vapour absorption precooling systems are USD1785376.83/KWh, USD7198182.79/KWh and USD11103747.4/KWh respectively and the payback time is three and a half year. The Net Revenue of the systems is USD8782909.21/KWh, USD15888192.52/KWh and USD84947043.84/KWh respectively. In conclusion, it is recommended that evaporative precooling system should be used in dry and humid weather conditions (Northern region of Nigeria) but it must be ensured that water is in abundance and refrigeration precooling should be employed in the moderate climatic conditions (Southern Region of Nigeria).
ACTA2‐AS1 suppresses lung adenocarcinoma progression via sequestering miR‐378a‐3p and miR‐4428 to elevate SOX7 expression
Authors: Ying Kangtai , Wang Ling , Long Guangyan , Lian Chan , Chen Zhe , Lin Wei
Published: August 2020

Lung adenocarcinoma (LUAD) is the most common histological subtype of lung cancer. The abnormal expression of long noncoding RNAs (lncRNAs) can facilitate or suppress the development of malignant tumors. lncRNA actin alpha 2, smooth muscle antisense RNA 1 (ACTA2‐AS1) has been reported to function as a tumor suppressor in liver cancer, nevertheless, its influences on LUAD remain to be investigated. In this paper, ACTA2‐AS1 was identified as a downregulated lncRNA in LUAD samples and cells. Functionally, ACTA2‐AS1 overexpression restrained cell proliferation but accelerated cell apoptosis in LUAD. In addition, we determined the suppressive effect of ACTA2‐AS1 on LUAD cell invasion, migration, and epithelial–mesenchymal transition progress. Mechanistically, ACTA2‐AS1 exert functions as a competing endogenous RNA through serving as a sponge for microRNA‐378a‐3p (miR‐378a‐3p) and microRNA‐4428 (miR‐4428) to elevate SRY‐related high‐mobility group box 7 (SOX7) expression. Importantly, SOX7 silencing could recover the ACTA2‐AS1‐mediated cell functions. To summarize, ACTA2‐AS1 suppresses the malignant processes of LUAD cells through sequestering miR‐378a‐3p and miR‐4428 to augment SOX7 expression.
Application instrumentation for performance analysis and tuning with focus on energy efficiency
Authors: Vysocký Ondřej , Říha Lubomír , Bartolini Andrea
Published: August 2020

Profiling and tuning of parallel applications is an essential part of HPC. Analysis and elimination of application hot spots can be performed using many available tools, which also provides resource consumption measurements for instrumented parts of the code. Since complex applications show different behavior in each part of the code, it is essential to be able to insert instrumentation to analyse these parts. Because each performance analysis or autotuning tool can bring different insights into an application behavior, it is valuable to analyze and optimize an application using a variety of them. We present our on request inserted shared C/C++ API for the most common open‐source HPC performance analysis tools, which simplify the process of the manual instrumentation. Besides manual instrumentation, profiling libraries provide different methods for instrumentation. Of these, the binary patching is the most universal mechanism, and highly improves the user‐friendliness and robustness of the tool. We provide an overview of the most commonly used binary patching tools, and describe a workflow for how to use them to implement a binary instrumentation tool for any profiler or autotuner. We have also evaluated the minimum overhead of the manual and binary instrumentation.
Elastic modulus evolution of triaxially stressed mudstone at high temperature up to 400°C
Authors: Feng Zijun , Zhang Chao , Dong Fuke , Yang Dong
Published: August 2020

The elastic modulus is a key parameter in the constitutive equation of rock material, which changes with exterior conditions, including temperature. To study the evolution of the elastic modulus of the surrounding rock in some high‐temperature underground engineering works (eg, underground coal gasification, in situ pyrolysis of oil shale), a servo‐controlled rock testing machine was used in a study of the variation in elastic modulus of Jimsar mudstone (the roof stratum of Jimsar oil shale) when subjected to triaxial compression at high temperatures. The elastic modulus exhibited nonmonotonal variation when heated to 400°C while subjected to triaxial compression. This occurred in three stages. An empirical model involving piecewise linear function was used to quantitatively describe the relationship between elastic modulus and temperature. Elasticity increased between room temperature and 265°C, then weakened between 265 and 341°C, then increased at 341‐400°C, in accordance with the calculated result from the empirical model. Thermal expansion, thermal cracking, water loss, and structure reconstruction had a combined effect on the elastic modulus of the mudstone. The results will be helpful for understanding the mechanism of strata movement in some underground high‐temperature engineering operations.
Partitioning private and external benefits of crop pollination services
Authors: Lonsdorf Eric V. , Koh Insu , Ricketts Taylor
Published: August 2020

Ecosystem services (ES) provide a range of benefits to people, but landowners that produce ES are often separate from those receiving benefits. As a result, landowners bear the costs of managing ecosystems, but often share the benefits with others. Accounting for these private and external costs and benefits would improve the effectiveness of payments for ES management.

We develop a spatially explicit ES modelling approach to evaluate the alignment of private and external benefits resulting from habitat enhancement for pollinators. After testing the model on synthetic landscapes, we applied it to Yolo County, California, using information on crop type, value per acre and dependence on pollination. Detailed data on parcel ownership allowed us to distinguish private and external costs and benefits of enhancing habitat on any parcel.

We found that around 13% of the landowners would generate private benefits that exceed private costs, 47% would generate external benefits greater than private costs, and the remaining 40% would generate neither private nor external benefits greater than private costs. Landowners generating private net benefits had larger fields, more valuable crops and more pollinator‐dependent crops than the other owners.

These results reveal mis‐alignments between private and external incentives. Just over half of the Yolo County landowners' pollinator enhancements would produce external benefits, but only 25% of these would have private incentives to do so. We estimated that enhancements by those acting privately could increase the private net present value of crops by $495,309 and provide a total external benefit of $1,193,345. The remaining 47% of landowners’ enhancements generated $1,409,247 in additional net external benefits.

Accounting for heterogeneity in enhancement benefits due to ownership and crop characteristics allows one to distinguish contexts where enhancements should be managed by groups as a common‐pool resource or by individuals. Rather than fund a PES program to pay for enhancements, effort could be directed towards communicating with landowners about potential private benefits and facilitating common‐pool resource management. Overall, this analysis reveals the importance of partitioning private and external benefits of actions designed to provide ES.

A free Plain Language Summary can be found within the Supporting Information of this article.
History of Human Challenge Studies
Authors: Jamrozik Euzebiusz , Selgelid Michael J.
Published: August 2020

The intentional infection of human beings with pathogens with the aim of achieving benefits (chiefly, the prevention of more severe disease) has occurred for centuries; the (semi-)systematic testing and recording of such methods dates to the 18th Century in England.
Global Citizenship Education: Recognizing Diversity in a Global World
Authors: Akkari Abdeljalil , Maleq Kathrine
Published: August 2020

In this introductory chapter, we first examine how the concept of global citizenship education (GCE) has been brought to the forefront in international educational agendas, in particular in the 2030 Agenda for Sustainable Development. Second, we assess how social and political contexts are reshaping national-centric conceptions of citizenship and traditional models of civic identity. Third, we address the lack of conceptual clarity as well as the conceptual divides associated with it. Fourth, we point out the challenges in implementing GCE in national educational systems and briefly provide guidance regarding the choice of countries and topics covered in the book. KEY WORDS: Global citizenship education - International educational agendas – Sustainable Development Goals.
Women’s Rights, Democracy and Citizenship in Tunisia
Authors: Ouanada Halima
Published: August 2020

The gap between the role that women have played in Tunisian history and their current position in public and political life makes it difficult to address the issues of woman’s rights in relation to citizenship and democracy in Tunisia. Since the foundation of the ancient Phoenician-Punic city of Carthage, women have played a crucial role in the establishment of modern-day Tunisia endowed with a unique destiny. However, over the centuries, this role has often been obscured and undermined by politicized approaches to history with a deliberate attempt to conceal the women’s contribution. This chapter will examine the role of women in Tunisian society from the perspective of women’s identity, caught in a dichotomy between secular and religious worlds. Furthermore, we will examine women’s major contributions to the founding of Tunisia, providing an insight into the country’s current issues and challenges. We believe that the analysis of the role and place of women as citizens in the democratic process in Tunisia is thesine qua noncondition to better understand the persistent ambiguities, barriers and issues the country currently faces.
Global Citizenship Education in Canada and the U.S.: From Nation-Centric Multiculturalism to Youth Engagement
Authors: Ranco Sarah , Gilmer Alexis , Loomis Colleen
Published: August 2020

This chapter examines the historical and current uses of global citizenship education (GCE) in Canada and the U.S. in public schools from primary through secondary levels, with attention to Canada as well as similarities and differences within and across the two countries. We assess how social and political contexts have influenced the definition and operationalization of multiculturalism, civic studies, and global studies in curricula, noting that the neo-liberal perspective has focused on making people an economic powerhouse rather than socially concerned global citizens. In our examination of educational approaches that relate to GCE, we present decolonizing pedagogies, the multiculturalism approach in Canada, as well as culturally responsive and anti-racist pedagogies. To illustrate these issues, we offer an example in the Canadian context and raise the need to prevent GCE from becoming yet another tool for hegemony by the Global North on the Global South, as dominant groups have long defined citizenship. We conclude by proposing that to realize GCE in these two countries, teacher/practitioner and local, national, and international actors must engage youth, and in doing so, power imbalances that prohibit becoming global citizens will be addressed.
Global Citizenship Education in European Multicultural Contexts: Opportunities and Challenges
Authors: Radhouane Myriam , Maleq Kathrine
Published: August 2020

Deep societal changes resulting from globalization, increased cultural and ethnic diversity and the expansion of ICT (information and communication technology) have generated interest in the concept of global citizenship resulting in a growing body of literature on global citizenship education (GCE).

Despite its attractiveness, GCE appears nevertheless conceptually fragile and difficult to implement in national contexts. This chapter provides a comparative perspective on conceptions and current challenges for citizenship education in three European countries: France, Switzerland and England. We analyze how contents associated with global dimensions are integrated into educational policies and curricula, thereby highlighting the similarities and differences between contexts. We illustrate how France and England have brought citizenship education and the promotion of ‘national values’ to the forefront of the political agenda, with the specific aim of preventing radicalization.

Finally, we present considerations for the operationalization of GCE and argue that global citizenship may provide an opportunity to value multiple identities.
Citizenship, Social Exclusion and Education in Latin America: The Case of Brazil
Authors: Santiago Mylene , Akkari Abdeljalil
Published: August 2020

Latin America’s first encounter with the rest of the world happened over five centuries ago as a result of the European colonial conquest, characterized by the slave trade and the domination and exploitation of Indigenous Peoples. It was not until the late nineteenth century that Latin American Nation-States emerged in the quest for freedom, equality and access to citizenship. However, political instability and lengthy military dictatorships in the 1960s and 1970s provided limited and fragile access to citizenship.

First, this chapter analyzes the current state of education and citizenship in Latin America, after three decades of a gradual return to democracy. Our analysis suggests that citizenship is an unfinished agenda throughout the region. Minorities such as Afro-descendants and Indigenous Peoples have limited access to citizenship due to the social and educational exclusion they experience. Second, we review the main debates related to global citizenship and analyze how the concept of global citizenship is constructed in core education policies and curricula in Brazil. We conclude by examining the uncertain prospects of global citizenship education in Brazil and in the larger Latin American context.
Genome-based trait prediction in multi- environment breeding trials in groundnut
Authors: Pandey Manish K. , Chaudhari Sunil , Jarquin Diego , Janila Pasupuleti , Crossa Jose , Patil Sudam C. , Sundravadana Subramaniam , Khare Dhirendra , Bhat Ramesh S. , Radhakrishnan Thankappan , Hickey John M. , Varshney Rajeev K.
Published: August 2020

Key message

Comparative assessment identified naïve interaction model, and naïve and informed interaction GS models suitable for achieving higher prediction accuracy in groundnut keeping in mind the high genotype × environment interaction for complex traits.

Genomic selection (GS) can be an efficient and cost-effective breeding approach which captures both small- and large-effect genetic factors and therefore promises to achieve higher genetic gains for complex traits such as yield and oil content in groundnut. A training population was constituted with 340 elite lines followed by genotyping with 58 K ‘Axiom_Arachis’ SNP array and phenotyping for key agronomic traits at three locations in India. Four GS models were tested using three different random cross-validation schemes (CV0, CV1 and CV2). These models are: (1) model 1 (M1 = E + L) which includes the main effects of environment (E) and line (L); (2) model 2 (M2 = E + L + G) which includes the main effects of markers (G) in addition to E and L; (3) model 3 (M3 = E + L + G + GE), a naïve interaction model; and (4) model 4 (E + L + G + LE + GE), a naïve and informed interaction model. Prediction accuracy estimated for four models indicated clear advantage of the inclusion of marker information which was reflected in better prediction accuracy achieved with models M2, M3 and M4 as compared to M1 model. High prediction accuracies (> 0.600) were observed for days to 50% flowering, days to maturity, hundred seed weight, oleic acid, rust@90 days, rust@105 days and late leaf spot@90 days, while medium prediction accuracies (0.400–0.600) were obtained for pods/plant, shelling  %, and total yield/plant. Assessment of comparative prediction accuracy for different GS models to perform selection for untested genotypes, and unobserved and unevaluated environments provided greater insights on potential application of GS breeding in groundnut.
Parenting behaviour and paranoia: a network analysis and results from the National Comorbidity Survey-Adolescents (NCS-A)
Authors: Brown Poppy , Waite Felicity , Freeman Daniel
Published: August 2020

Purpose

Parenting behaviours—including the extent to which parents are protective, hostile, or caring—likely impacts whether a child develops a sense of vulnerability that carries forward into adulthood. Ideas of vulnerability are a contributory factor to the occurrence of paranoia. Our aim was to assess whether there is an association between specific parenting behaviours and paranoia.

Method

We examined cross-sectional associations of parenting and paranoia in an epidemiologically representative cohort of 10,148 adolescents (National Comorbidity Survey-Adolescents; NCS-A) and a second dataset of 1286 adults in Oxfordshire. Further, a network analysis was conducted with paranoia, parenting behaviours, and cognitive-affective variables (compassion, self-esteem, anxiety, and depression). Overprotectiveness, verbal abuse, physical abuse, and amount of care were assessed in mothers and fathers separately.

Results

Nearly all parenting variables were significantly associated with paranoia, with parental verbal and physical abuse showing the largest associations. For example, the odds of reporting paranoia was over four times higher for those in the adult sample reporting a lot of paternal verbal abuse, compared to those reporting none (OR = 4.12,p < 0.001, CI 2.47–6.85). Network analyses revealed high interconnectivity between paranoia, parenting behaviours, and cognitive-affective variables. Of the parenting variables, paranoia most strongly interacted with paternal abuse and maternal lack of care.

Conclusion

There are associations between participants’ self-reported experiences of parental behaviours and paranoia. Despite being associated with paranoia, cognitive-affective variables did not appear to mediate the relationship between parenting and paranoia, which is surprising. What might explain the link therefore remains to be determined.
Buckling of tower buildings on elastic foundation under compressive tip forces and self-weight
Authors: Ferretti Manuel , D’Annibale Francesco , Luongo Angelo
Published: August 2020

Buckling of uniformly and not uniformly compressed tower buildings, resting on Winkler type soil, is investigated. An equivalent beam is introduced, able to capture the essential behavior of the building. It is a 3D Timoshenko beam, modeled in the framework of a direct approach, whose constitutive law is derived via a homogenization procedure, which includes the effect of the column prestress. The continuous model is discretized via finite differences, and a linear bifurcation analysis is carried out by solving an algebraic eigenvalue problem. Numerical results are shown for sample problems, aimed at detecting the structural behavior, and illustrating the role of some mechanical parameters. Results supplied by the equivalent beam model are compared with those derived by finite element analyses, carried out on three-dimensional frames.
Recommendations for resuming elective hip and knee arthroplasty in the setting of the SARS-CoV-2 pandemic: the European Hip Society and European Knee Associates Survey of Members
Authors: Kort N. P. , Barrena E. Gómez , Bédard M. , Donell S. , Epinette J.-A. , Gomberg B. , Hirschmann M. T. , Indelli P. , Khosravi Ismail , Karachalios T. , Liebensteiner M. C. , Stuyts B. , Tandogan R. , Violante B. , Zagra L. , Thaler M.
Published: August 2020

Purpose

The COVID-19 pandemic has disrupted the health care system around the entire globe. A consensus is needed about resuming total hip and knee procedures. The European Hip Society (EHS) and the European Knee Association (EKA) formed a panel of experts that have produced a consensus statement on how the safe re-introduction of elective hip and knee arthroplasty should be undertaken.

Methods

A prospective online survey was done among members of EHS and EKA. The survey consisted of 27 questions. It includes basic information on demographics and details the participant’s agreement with each recommendation. The participant could choose among three options (agree, disagree, abstain). Recommendations focussed on pre-operative, peri-operative, and post-operative handling of patients and precautions.

Results

A total of 681 arthroplasty surgeons participated in the survey, with 479 fully completing the survey. The participants were from 44 countries and 6 continents. Apart from adhering to National and Local Guidelines, the recommendations concerned how to make elective arthroplasty safe for patients and staff.

Conclusion

The survey has shown good-to-excellent agreement of the participants with regards to the statements made in the recommendations for the safe return to elective arthroplasty following the first wave of the COVID-19 pandemic.
Satisfactory clinical outcome of operative and non-operative treatment of avulsion fracture of the hamstring origin with treatment selection based on extent of displacement: a systematic review
Authors: Nauta Hijleke J. A. , van der Made Anne D. , Tol Johannes L. , Reurink Gustaaf , Kerkhoffs Gino M.
Published: August 2020

Purpose

To compare outcome of operative and non-operative treatment of avulsion fractures of the hamstring origin, with minor (< 1.5 cm) and major (≥ 1.5 cm) displacement, and early (≤ 4 weeks) and delayed (> 4 weeks) surgery.

Methods

A systematic literature search was performed using PubMed, Cochrane, Embase, CINAHL and SPORTDiscus. A quality assessment was performed using the Physiotherapy Evidence Database (PEDro) scale.

Results

Eight studies with 90 patients (mean age: 16 years) were included. All studies had low methodological quality (PEDro score ≤ 5). Operative treatment yielded a return to preinjury activity rate (RTPA) of 87% (95% CI: 68–95), return to sports (RTS) rate of 100% (95% CI: 82–100), Harris hip score (HHS) of 99 (range 96–100) and a University of California Los Angeles activity scale (UCLA) score of 100%. Non-operative treatment yielded a RTPA rate of 100% (95% CI:68–100), RTS rate of 86% (95% CI: 69–94), HHS score of 99 (range 96–100), and non-union rate of 18% (95% CI: 9–34). All patients with minor displacement were treated non-operatively (RTPA: 100% [95% CI: 21–100], RTS: 100% [95% CI: 51–100]). For major displacement, operative treatment led to RTPA and RTS rates of 86% (95% CI: 65–95) and 100% (95% CI: 84–100), and 0% (0/1, 95% CI: 0–79) and 100% (95% CI: 51–100) for non-operative treatment. Early surgery yielded RTPA and RTS rates of 100% (95% CI: 34–100 & 57–100) compared to 100 (95% CI: 72–100) and 90% (95% CI: 60–98) for delayed repair.

Conclusion

All included studies have high risk of bias. There is only low level of evidence with a limited number of included patients to compare outcome of operative and non-operative treatment. Overall outcome was satisfactory. There is a treatment selection phenomenon based on displacement, with acceptable outcome in both groups. There is insufficient data to draw conclusions regarding timing of surgery.

Level of evidence

IV
Coalitions with limited coordination
Authors: Koutsougeras Leonidas C.
Published: August 2020

We study economies endowed with a market structure, where coalitions can form within each market but have no enforcement possibilities across markets. A standard cooperative game cannot be defined in this case. We develop a certain equilibrium notion which ties together the cores of the different markets. We provide an existence result and an application to economies with asymmetric information.
The Coevolution of Cellularity and Metabolism Following the Origin of Life
Authors: Takagi Yuta A. , Nguyen Diep H. , Wexler Tom B. , Goldman Aaron D.
Published: August 2020

The emergence of cellular organisms occurred sometime between the origin of life and the evolution of the last universal common ancestor and represents one of the major transitions in evolutionary history. Here we describe a series of artificial life simulations that reveal a close relationship between the evolution of cellularity, the evolution of metabolism, and the richness of the environment. When environments are rich in processing energy, a resource that the digital organisms require to both process their genomes and replicate, populations evolve toward a state of non-cellularity. But when processing energy is not readily available in the environment and organisms must produce their own processing energy from food puzzles, populations always evolve both a proficient metabolism and a high level of cellular impermeability. Even between these two environmental extremes, the population-averaged values of cellular impermeability and metabolic proficiency exhibit a very strong correlation with one another. Further investigations show that non-cellularity is selectively advantageous when environmental processing energy is abundant because it allows organisms to access the available energy, while cellularity is selectively advantageous when environmental processing energy is scarce because it affords organisms the genetic fidelity required to incrementally evolve efficient metabolisms. The selection pressures favoring either non-cellularity or cellularity can be reversed when the environment transitions from one of abundant processing energy to one of scarce processing energy. These results have important implications for when and why cellular organisms evolved following the origin of life.
Simple Wound Irrigation in the Postoperative Treatment for Surgically Drained Spontaneous Soft Tissue Abscesses: A Prospective, Randomized Controlled Trial
Authors: Oehme F. , Rühle A. , Börnert K. , Hempel S. , Link B.‐C. , Babst R. , Metzger J. , Beeres F. J.‐P.
Published: August 2020

Background

Soft tissue abscesses are among the most frequently encountered medical problems treated by different surgeons. Standard therapy remains incision and drainage with sterile saline irrigation during postoperative wound healing period. Aim of this prospective randomized controlled trial was to compare sterile irrigation versus nonsterile irrigation.

Study design

A single center randomized controlled trial was performed to investigate postoperative wound irrigation. The control group used sterile irrigation, and the intervention group used nonsterile irrigation. Primary endpoints were reinfection and reintervention rates, assessed during follow‐up controls for up to 2 years. Secondary endpoints were the duration of wound healing, inability to work, pain and quality of life.

Results

Between 04/2016 and 05/2017, 118 patients were randomized into two groups, with 61 allocated to the control‐ and 57 to the intervention group. Reinfection occurred in a total of 4 cases (6.6%) in the sterile protocol and 4 (7%) in the nonsterile protocol. Quality of life and pain values were comparable during the wound healing period, and patients treated according to the nonsterile irrigation protocol used significantly fewer wound care service teams. Despite equal wound persistence rates, a substantially shorter amount of time off from work was reported in the nonsterile protocol group (p value 0.086).

Conclusion

This prospective, randomized trial indicates that a nonsterile irrigation protocol for patients operated on for soft tissue abscesses is not inferior to the standard sterile protocol. Moreover, a nonsterile irrigation protocol leads to a shorter period of inability to work with comparable pain and quality of life scores during the wound healing period.
Long-Term Outcomes in Percutaneous Radiofrequency Ablation for Histologically Proven Colorectal Lung Metastasis
Authors: Zhong Jim , Palkhi Ebrahim , Ng Helen , Wang Kevin , Milton Richard , Chaudhuri Nilanjan , Lenton James , Smith Jonathan , Bhartia Bobby , Wah Tze Min
Published: August 2020

Introduction

To evaluate the long-term outcome of image-guided radiofrequency ablation (RFA) when treating histologically confirmed colorectal lung metastasis in terms of overall survival (OS), progression-free survival (PFS) and local tumour control (LTC).

Materials and Methods

Retrospective single-centre study. Consecutive RFA treatments of histologically proven lung colorectal metastases between 01/01/2008 and 31/12/14. The primary outcome was patient survival (OS and PFS). Secondary outcomes were local tumour progression (LTP) and complications. Prognostic factors associated with OS/ PFS were determined by univariate and multivariate analyses.

Results

Sixty patients (39 males: 21 females; median age 69 years) and 125 colorectal lung metastases were treated. Eighty percent (n = 48) also underwent lung surgery for lung metastases. Mean metastasis size (cm) was 1.4 ± 0.6 (range 0.3–4.0). Median number of RFA sessions was 1 (1–4). During follow-up (median 45.5 months), 45 patients died (75%). The estimated OS and PFS survival rates at 1, 3, 5, 7, 9 years were 96.7%, 74.7%, 44.1%, 27.5%, 16.3% (median OS, 52 months) and 66.7%, 31.2%, 25.9%, 21.2% and 5.9% (median PFS, 19 months). The LTC rate was 90% with 6 patients developing LTP with 1-, 2-, 3- and 4-year LTP rates of 3.3%, 8.3%, 10.0% and 10.0%. Progression-free interval < 1 year (P = 0.002, HR = 0.375) and total number of pulmonary metastases (≥ 3) treated (P = 0.037, HR = 0.480) were independent negative prognostic factors. Thirty-day mortality rate was 0% with no intra-procedural deaths.

Conclusion

The long-term OS and PFS following RFA for the treatment of histologically confirmed colorectal lung metastases demonstrate comparable oncological durability to surgery.
Radiomics in predicting treatment response in non-small-cell lung cancer: current status, challenges and future perspectives
Authors: Chetan Madhurima R. , Gleeson Fergus V.
Published: August 2020

Objectives

Radiomics is the extraction of quantitative data from medical imaging, which has the potential to characterise tumour phenotype. The radiomics approach has the capacity to construct predictive models for treatment response, essential for the pursuit of personalised medicine. In this literature review, we summarise the current status and evaluate the scientific and reporting quality of radiomics research in the prediction of treatment response in non-small-cell lung cancer (NSCLC).

Methods

A comprehensive literature search was conducted using the PubMed database. A total of 178 articles were screened for eligibility and 14 peer-reviewed articles were included. The radiomics quality score (RQS), a radiomics-specific quality metric emulating the TRIPOD guidelines, was used to assess scientific and reporting quality.

Results

Included studies reported several predictive markers including first-, second- and high-order features, such as kurtosis, grey-level uniformity and wavelet HLL mean respectively, as well as PET-based metabolic parameters. Quality assessment demonstrated a low median score of + 2.5 (range − 5 to + 9), mainly reflecting a lack of reproducibility and clinical evaluation. There was extensive heterogeneity between studies due to differences in patient population, cancer stage, treatment modality, follow-up timescales and radiomics workflow methodology.

Conclusions

Radiomics research has not yet been translated into clinical use. Efforts towards standardisation and collaboration are needed to identify reproducible radiomic predictors of response. Promising radiomic models must be externally validated and their impact evaluated within the clinical pathway before they can be implemented as a clinical decision-making tool to facilitate personalised treatment for patients with NSCLC.

Key Points

• The included studies reported several promising radiomic markers of treatment response in lung cancer; however, there was a lack of reproducibility between studies.

• Quality assessment using the radiomics quality score (RQS) demonstrated a low median total score of + 2.5 (range − 5 to + 9).

• Future radiomics research should focus on implementation of standardised radiomics features and software, together with external validation in a prospective setting.
Conservative management of abnormally invasive placenta complicated by local hyperfibrinolysis and beginning disseminated intravascular coagulation
Authors: Biele C. , Kaufner L. , Schwickert A. , Nonnenmacher A. , von Weizsäcker K. , Muallem M. Z. , Henrich W. , Braun T.
Published: August 2020

Introduction

Abnormally invasive placenta (AIP) is often associated with high maternal morbidity. In surgical treatment, caesarean hysterectomy or partial uterine resection may lead to high perioperative maternal blood loss. A conservative treatment by leaving the placenta in utero after caesarean delivery of the baby is an option to preserve fertility and to reduce peripartum hysterectomy-related morbidity. Nevertheless, due to increased placental coagulation activity as well as consumption of clotting factors, a disseminated intravascular coagulation (DIC)-like state with secondary late postpartum bleeding can occur.

Purpose

Systematic review after the presentation of a case of conservative management of placenta percreta with secondary partial uterine wall resection due to vaginal bleeding, complicated by local hyperfibrinolysis and consecutive systemic decrease in fibrinogen levels.

Methods

Systematic PubMed database search was done until August 2019 without any restriction of publication date or journal

Results

Among 58 publications, a total of 11 reported on DIC-like symptoms in the conservative management of AIP, in the median on day 59 postpartum. In most cases, emergency hysterectomy was performed, which led to an almost immediate normalization of coagulation status but was accompanied with high maternal blood loss. In two cases, fertility-preserving conservative management could be continued after successful medical therapy.

Conclusion

Based on these results, we suggest routinely monitoring of the coagulation parameters next to signs of infection in the postpartum check-ups during conservative management of AIP. Postpartum tranexamic acid oral dosage should be discussed when fibrinogen levels are decreasing and D-Dimers are increasing.
The PRIAMO study: age- and sex-related relationship between prodromal constipation and disease phenotype in early Parkinson’s disease
Authors: Picillo Marina , Palladino Raffaele , Erro Roberto , Alfano Rossella , Colosimo Carlo , Marconi Roberto , Antonini Angelo , Barone Paolo ,   on behalf of the PRIAMO study group, Antonini Angelo , Colosimo Carlo , Marconi Roberto , Morgante Letterio , Benincasa D. , Quatrale R. , Biguzzi S. , Braga M. , Ceravolo G. , Capecci M. , Meco G. , Caravona N. , Scala R. , De Falco F. A. , Pezzoli G. , De Gaspari D. , Bottacchi E. , Di Giovanni M. , Cannas A. , Floris G. , Gallerini S. , Grasso L. , Gaglio R. M. , Gurgone G. , Volpe G. , Zappulla S. , Ceravolo R. , Kiferle L. , Ramat S. , Meoni S. , Pisani A. , Moschella V. , Morgante F. , Savica R. , Pepe F. , Ciccarelli G. , Petretta V. , Giglia R. M. , Randisi M. G. , Iemolo F. , Avarello T. P. , Romeno M. , Santangelo G. , Stocchi F. , Sciortino G. , Sorbello V. , Nicoletti A. , Tiple D. , Fabbrini G. , Bentivoglio A. , Pontieri F. E. , Guidubaldi A. , Muoio R. , Toni V. , Del Dotto P. , Logi C. , Ciacci G. , Ulivelli M. , Perini M. , Lanfranchi S. , Griffini S. , Troianiello B. , Baratti M. , Amidei S. , Consoli D. , Iellamo M. , Cuomo T. , Scaglioni A. , Medici D. , Manfredi M. , Abbruzzese G. , Di Brigida G. , Cocco G. A. , Agnetti V. , Cossu G. , Deriu M. , Abrignani M. , Modica C. , Albani G. , Milan E. , Martinelli P. , Scaglione C. , Mucchiut M. , Zanini S. , Pennisi F. , Soliveri P , Albanese A. , Massimo Pederzoli , Bartolomei L. , Capus L. , Ferigo L. , Marano R. , Nastasi V. , Luciano R. , Maiello L. , Simone P. , Fogli D. , Lopiano L. , Pesare M. , Nordera G. , Pilleri E. , Scaravilli T. , Giaccaglini E. , Alesi C. , Petrone A. , Trianni G.
Published: August 2020

Objectives

To explore the impact of sex and age on relationship between prodromal constipation and disease phenotype in Parkinson’s disease at early stages.

Methods

A total of 385 Parkinson’s disease patients from the PRIAMO study were classified according to the presence of prodromal constipation and followed for 24 months. Multivariable mixed-effect models were applied. All analyses were performed separately for sex (64.1% men) and median age (different by sex: 67 years-old in men and 68 years-old in women).

Results

As for sex, prodromal constipation was associated with greater odds of attention/memory complaints and apathy symptoms in women only. As for age, prodromal constipation was associated with lower cognitive and higher apathy scores in older patients only.

Conclusions

Prodromal constipation anticipates lower cognitive performances and more severe apathy since the earliest stages in women and older patients. Sex- and age-related heterogeneity of prodromal markers of Parkinson’s disease may impact disease phenotype.
The spectrum of polypoidal choroidal vasculopathy in Caucasians: clinical characteristics and proposal of a classification
Authors: van Dijk Elon H. C. , Mohabati Danial , Veselinovic Simona , Chung Wing H. , Dijkman Greet , Boon Camiel J. F.
Published: August 2020

Purpose

To describe the clinical characteristics and outcome of polypoidal choroidal vasculopathy (PCV), also known as aneurysmal type 1 (sub-retinal pigment epithelium (RPE)) neovascularization, in Caucasian patients.

Methods

Single-centre study in 66 Caucasian patients with a diagnosis of PCV based on optical coherence tomography scan and indocyanine green angiography. Clinical characteristics and multimodal imaging were collected and assessed by an experienced retina specialist.

Results

This study involved 74 eyes of 66 patients with PCV, with a mean age at onset of 73 years and a female preponderance of 66%. The mean number of polypoidal lesions per eye was 1 (range: 1–5 lesions), out of which 75% was located in the macula and 19% in the peripapillary region. Of the 74 eyes, 37 eyes (50%) had PCV associated with a drusenoidal neovascular age-related macular degeneration (AMD) phenotype (PCV-AMD) and 18 eyes (24%) had PCV associated with non-polypoidal type 1 choroidal neovascularization/branching vascular network (PCV-BVN) without signs of drusenoidal AMD, while 19 eyes (26%) had idiopathic, isolated PCV (iPCV). The mean subfoveal choroidal thickness measured in 22 patients was 245 μm (range: 71–420 μm). In 51% of patients, the initially performed therapy showed good anatomical recovery (resolution of intra- and subretinal fluid).

Conclusions

A spectrum of PCV (aneurysmal type 1/sub-RPE neovascularization) can be seen in Caucasian patients. PCV associated with a drusenoidal neovascular AMD phenotype in Caucasians is phenotypically and presumably pathophysiologically more associated with neovascular AMD (PCV-AMD: type A PCV). However, this may not be the case for patients with PCV with non-polypoidal type 1 choroidal neovascularization or BVN and no signs of drusenoidal AMD (PCV-BVN: type B PCV), and for patients with idiopathic PCV without associated drusen or BVN (iPCV; type C PCV). Most patients have a thin choroid, even when drusen are absent. For the entire patient group, a moderate anatomical recovery was observed after treatment.