bluuebunny/crossref_metadata_2025 huggingface dataset:
Coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) influences delivery outcomes among women with obstetric referrals at the district level in Ghana
Authors: Amoakoh-Coleman Mary , Arhinful Daniel K. , Klipstein-Grobusch Kerstin , Ansah Evelyn K. , Koram Kwadwo A.
Published: June 2020

Background

The aim of the study was to determine the coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) and its relationship with delivery outcomes among obstetric referral cases at the district level of healthcare.

Methods

An implementation research within three districts of the Greater Accra region was conducted from May 2017 to February 2018, to assess the role of an enhanced inter-facility communication system on processes and outcomes of obstetric referrals. A cross-sectional analysis of the data on IPTp coverage as well as delivery outcomes for the period of study was conducted, for all the referrals ending up in deliveries. Primary outcomes were maternal and neonatal complications at delivery. IPTp coverage was determined as percentages and classified as adequate or inadequate. Associated factors were determined using Chi square. Odds ratios (OR, 95% CI) were estimated for predictors of adequate IPTp dose coverage for associations with delivery outcomes, with statistical significance set at p = 0.05.

Results

From a total of 460 obstetric referrals from 16 lower level facilities who delivered at the three district hospitals, only 223 (48.5%) received adequate (at least 3) doses of IPTp. The district, type of facility where ANC is attended, insurance status, marital status and number of antenatal clinic visits significantly affected IPTp doses received. Adjusted ORs show that adequate IPTp coverage was significantly associated with new-born complication [0.80 (0.65–0.98); p = 0.03], low birth weight [0.51 (0.38–0.68); p < 0.01], preterm delivery [0.71 (0.55–0.90); p = 0.01] and malaria as indication for referral [0.70 (0.56–0.87); p < 0.01]. Positive association with maternal complication at delivery was seen but was not significant.

Conclusion

IPTp coverage remains low in the study setting and is affected by type of health facility that ANC is received at, access to health insurance and number of times a woman attends ANC during pregnancy. This study also confirmed earlier findings that, as an intervention IPTp prevents bad outcomes of pregnancy, even among women with obstetric referrals. It is important to facilitate IPTp service delivery to pregnant women across the country, improve coverage of required doses and maximize the benefits to both mothers and newborns.
Prevalence and proportion of Plasmodium spp. triple mixed infections compared with double mixed infections: a systematic review and meta-analysis
Authors: Kotepui Manas , Kotepui Kwuntida Uthaisar , Milanez Giovanni D. , Masangkay Frederick R.
Published: June 2020

Background

Although mixed infection by two Plasmodium species has been recognized, mixed infection by three different Plasmodium species within one individual has not been clarified. This study sought to determine the pooled prevalence and proportion of triple mixed Plasmodium spp. infection compared with double mixed infection.

Methods

Articles from PubMed, Scopus, and Web of Science were searched for cross-sectional studies of triple mixed infection by Plasmodium species and then were retrieved and extracted. The pooled proportion and prevalence of triple mixed infection by Plasmodium species were subjected to random-effects analysis. The secondary outcomes were differences in the pooled proportion between triple mixed infection and double mixed infection by Plasmodium species reported in the included studies.

Results

Of 5621 identified studies, triple mixed infection data were available for 35 records, including 601 patients from 22 countries. The overall pooled prevalence of triple mixed infection was 4% (95% Confidence Interval (CI) 3–5%; I2 = 92.5%). The pooled proportion of triple mixed infection compared with double mixed infection was 12% (95% CI 9–18; I2 = 91%). Most of the included studies (29/35; 82.9%) presented a lower proportion of triple mixed infection than double mixed infection. Subgroup analysis demonstrated that the proportion of triple mixed infection was the highest in Oceania (23%; 95% CI 15–36%) and Europe (21%; 95% CI 5–86%), but the lowest in the USA (3%; 95% CI 2–4%). Moreover, the proportion of triple mixed infection was higher in residents (20%; 95% CI 14–29%) than in febrile patients (7%; 95% CI 4–13%), when compared with the proportion of double mixed infection. Subgroup analysis of the age groups demonstrated that, compared with the proportion of double mixed infection, triple mixed infection was lower in patients aged ≤ 5 years (OR = 0.27; 95% CI 0.13–0.56; I2 = 31%) and > 5 years (OR = 0.09; 95% CI 0.04–0.25, I2 = 78%).

Conclusions

The present study suggested that, in areas where triple mixed infection were endemic, PCR or molecular diagnosis for all residents in communities where malaria is submicroscopic can provide prevalence data and intervention measures, as well as prevent disease transmission and enhance malaria elimination efforts.
High expression of AMAP1, an ARF6 effector, is associated with elevated levels of PD-L1 and fibrosis of pancreatic cancer
Authors: Tsutaho Akio , Hashimoto Ari , Hashimoto Shigeru , Hata Soichiro , Kachi Shion , Hirano Satoshi , Sabe Hisataka
Published: June 2020

Background

Not merely the onset of immune evasion, but other factors, such as acidosis and fibrosis, are also major barriers in cancer therapeutics. Dense fibrosis is a hallmark of pancreatic ductal carcinoma (PDAC), in which hyperactivation of focal adhesion kinase (FAK) in tumor cells was shown to be crucial. Double mutations of KRAS/ TP53 are characteristic to PDAC. We previously showed that high protein expression of ARF6 and its downstream effector AMAP1, as well as processes involved in the ARF6 activation by cell surface tyrosine kinase receptors, are major targets of the KRAS/TP53 mutations to promote PDAC invasion, metastasis, and immune evasion. This notion was recaptured by KPC mouse model of human PDAC (LSL-Kras(G12D/+); LSL-Trp53(R172H/+)); Pdx-1-Cre). Mechanistically, the ARF6-AMAP1 pathway is primarily involved in cellular dynamics of PD-L1, β1-integrins, and E-cadherin; and hence modulates cell-adhesion properties when ARF6 is activated. Here, with an aim to understand whether the ARF6-AMAP1 pathway is critically involved in the elevated levels of PD-L1 and fibrosis of PDAC, we analyzed relationship between AMAP1 and these malignant phenotypes. Moreover, because the ARF6 pathway may closely be related to focal adhesion dynamics and hence to FAK, we also investigated whether AMAP1 employs FAK in fibrosis.

Methods

Clinical specimens, as well as KPC cells/tumors and their shAMAP1 or shFAK derivatives were analyzed.

Results

Elevated levels of PD-L1 and fibrosis correlated with poor outcome of our patient cohort, to be consistent with previous reports; in which high AMAP1 expression statistically correlated with the elevated PD-L1 and fibrosis. To be consistent, silencing of AMAP1 (shAMAP1) in KPC cells resulted in reduced PD-L1 expression and fibrosis in their tumors. On the other hand, shAMAP1 only slightly affected FAK activation in KPC cells, and phosphorylated FAK did not correlate with enhanced fibrosis or with poor outcome of our patients.

Conclusions

Together with our previous data, our results collectively indicated that the ARF6-AMAP1 pathway, empowered by the KRAS/TP53 mutations, is closely associated with elevated PD-L1 expression and fibrosis of human PDACs, to be recaptured in the KPC mouse model. The ARF6 pathway may promote fibrosis independent of FAK.
Best practice guidelines for management of spinal disorders in skeletal dysplasia
Authors: White Klane K. , Bober Michael B. , Cho Tae-Joon , Goldberg Michael J. , Hoover-Fong Julie , Irving Melita , Kamps Shawn E. , Mackenzie William G. , Raggio Cathleen , Spencer Samantha A. , Bompadre Viviana , Savarirayan Ravi ,   on behalf of the Skeletal Dysplasia Management Consortium
Published: June 2020

Background

Disorders of the spine present a common and difficult management concern in patients with skeletal dysplasia. Due to the rarity of these conditions however, the literature, largely consisting of small, single institution case series, is sparse in regard to well-designed studies to support clinical decision making in these situations.

Methods

Using the Delphi method, an international, multi-disciplinary group of individuals, with significant experience in the care of patients with skeletal dysplasia, convened to develop multi-disciplinary, “best practice” guidelines in the care of spinal disorders in patients with skeletal dysplasia.

Results

Starting with 33 statements, the group a developed a list of 31 “best practice” guidelines.

Conclusions

The guidelines are presented and discussed to provide context for clinicians in their decision making in this often-challenging realm of care.
Single-cell transcriptome and antigen-immunoglobin analysis reveals the diversity of B cells in non-small cell lung cancer
Authors: Chen Jian , Tan Yun , Sun Fenghuan , Hou Likun , Zhang Chi , Ge Tao , Yu Huansha , Wu Chunxiao , Zhu Yuming , Duan Liang , Wu Liang , Song Nan , Zhang Liping , Zhang Wei , Wang Di , Chen Chang , Wu Chunyan , Jiang Gening , Zhang Peng
Published: June 2020

Background

Malignant transformation and progression of cancer are driven by the co-evolution of cancer cells and their dysregulated tumor microenvironment (TME). Recent studies on immunotherapy demonstrate the efficacy in reverting the anti-tumoral function of T cells, highlighting the therapeutic potential in targeting certain cell types in TME. However, the functions of other immune cell types remain largely unexplored.

Results

We conduct a single-cell RNA-seq analysis of cells isolated from tumor tissue samples of non-small cell lung cancer (NSCLC) patients, and identify subtypes of tumor-infiltrated B cells and their diverse functions in the progression of NSCLC. Flow cytometry and immunohistochemistry experiments on two independent cohorts confirm the co-existence of the two major subtypes of B cells, namely the naïve-like and plasma-like B cells. The naïve-like B cells are decreased in advanced NSCLC, and their lower level is associated with poor prognosis. Co-culture of isolated naïve-like B cells from NSCLC patients with two lung cancer cell lines demonstrate that the naïve-like B cells suppress the growth of lung cancer cells by secreting four factors negatively regulating the cell growth. We also demonstrate that the plasma-like B cells inhibit cancer cell growth in the early stage of NSCLC, but promote cell growth in the advanced stage of NSCLC. The roles of the plasma-like B cell produced immunoglobulins, and their interacting proteins in the progression of NSCLC are further validated by proteomics data.

Conclusion

Our analysis reveals versatile functions of tumor-infiltrating B cells and their potential clinical implications in NSCLC.
The relationship between hyperuricemia and contrast-induced acute kidney injury undergoing primary percutaneous coronary intervention: secondary analysis protocol for the ATTEMPT RESCIND-1 study
Authors: Guo Wei , Song Feier , Chen Shiqun , Zhang Li , Sun Guoli , Liu Jin , Chen Jiyan , Liu Yong , Tan Ning ,   the RESCIND group
Published: June 2020

Background

Contrast-induced acute kidney injury (CI-AKI) contributes toward unfavorable clinical outcomes after primary percutaneous coronary intervention (pPCI). We will assess whether hyperuricemia is an independent predictor of CI-AKI and outcomes in patients undergoing pPCI.

Methods/design

Our study is a secondary analysis for the database from ATTEMPT study, enrolling 560 ST-segment elevation myocardial infarction (STEMI) patients undergoing pPCI. Patients will be divided into 2 groups according to the admission serum uric acid (SUA) level. Hyperuricemia will be defined as a SUA level > 7 mg/dL (417 mmol/L) in males and > 6 mg/dL (357 mmol/L) in females. The primary endpoint was CI-AKI, defined as > 25% or 0.5 mg/dL increase in serum creatinine from baseline during the first 48–72 h post-procedurally. Multivariate analyses for CI-AKI and long-term mortality will be performed using the logistic regression and Cox regression analyses, respectively.

Discussion

This study will determine the predictive value of hyperuricemia for the development of CI-AKI and outcomes in patients with STEMI undergoing pPCI. We predict that hyperuricemia will be associated with a risk of CI-AKI in patients with pPCI. Furthermore, after adjusting for other variables, long-term mortality after pPCI may be higher in those with hyperuricemia than in those with normouricemia. Results of this study may provide scientific evidence for the effect of hyperuricemia on CI-AKI and long-term outcomes, thereby offering the potential possibility of lowering SUA on the development of CI-AKI and outcomes.

Trial registration

ClinicalTrials.gov NCT02067195, Registered on 20 February 2014.
Life in mine tailings: microbial population structure across the bulk soil, rhizosphere, and roots of boreal species colonizing mine tailings in northwestern Québec
Authors: Gagnon Vanessa , Rodrigue-Morin Michaël , Tremblay Julien , Wasserscheid Jessica , Champagne Julie , Bellenger Jean-Philippe , Greer Charles W. , Roy Sébastien
Published: June 2020

Purpose

Mining activities have negative effects on soil characteristics and can result in low pH, high heavy metal content, and limited levels of essential nutrients. A tailings storage area located in northwestern Québec showed natural colonization by plants from the adjacent natural environment. The objective of the study was to determine the main edaphic parameters that structured microbial populations associated with the indigenous woody plants that had naturally colonized the site.

Methods

Microbial populations were studied in the bulk soil, the rhizosphere, and inside plant roots using Illumina sequencing, ordination analysis (i.e., redundancy analysis (RDA) and principal coordinates analysis (PCoA)), ternary plotting, and statistical analysis (MANOVA).

Results

The main variables that drove the microbial community patterns were plant species and the tailings pH. Indeed, the main bacterial classes were Gammaproteobacteria and Deltaproteobacteria in both the rhizosphere and root endosphere. Analysis revealed that some dominant operational taxonomic units (e.g., Pseudomonas sp., Acinetobacter sp., and Delftia sp.) were present in increased proportions in roots for each plant species under study. This study also revealed that many of the most abundant fungal genera (e.g., Claussenomyces, Eupenicillium, and Trichoderma) were more abundant in the rhizosphere than in the root endosphere.

Conclusions

This comprehensive study of the microbial community dynamics in the bulk soil, rhizosphere, and root endosphere of boreal trees and shrubs could be beneficial in facilitating the rehabilitation of disturbed ecosystems.
Rapid identification and detection of Vibrio parahaemolyticus via different types of modus operandi with LAMP method in vivo
Authors: Li Jun , Liu Jianfei , Fu Kaifei , Qin Kewei , Wu Chenglin , Yu Xiaojie , Zhou Shan , Zhou Lijun
Published: June 2020

Purpose

Vibrio parahaemolyticus, an easy-ignored food-borne pathogen, can cause bacterial outbreaks and human disease during early-stage infection. In this study, we aimed to evaluate the detection efficiency of loop-mediated isothermal amplification (LAMP) as an emerging technique to directly detect V. parahaemolyticus infection in mammalian hosts and assess its potential in clinical applications.

Methods

A LAMP assay was used for rapid identification of V. parahaemolyticus in a variety of mouse models in which animals were infected via the digestive tract, wounds, or through general infection, and the results were compared with routine analytical methods.

Results

Our results confirmed that the LAMP assay was capable of detecting V. parahaemolyticus in different mouse organs independent of the source of bacteria, although its sensitivity depended on the route of infection and the organ affected. Foodborne-derived V. parahaemolyticus was the most sensitive route, with the small intestine being the most sensitive organ. The LAMP assay indicated that V. parahaemolyticus that spread through the blood stream had the most serious consequences during early-stage infection. Positive LAMP results were identified in all blood samples from i.v. injected mice. Furthermore, the LAMP method could directly detect trace quantities of V. parahaemolyticus in fresh peripheral blood while conventional methods failed to do so, thereby shortening the time-to-result from days to minutes.

Conclusions

In this study, we demonstrated that the LAMP assay was effective in speeding up the detection of V. parahaemolyticus. Instead of being a secondary method to assist in the clinic, the LAMP assay has potential for use as the primary technique for rapid detection of V. parahaemolyticus in the future.
Arthroscopically-assisted reduction and pinning of a radial neck fracture in a child: a case report and review of the literature
Authors: Colozza Alessandra , Padovani Sara , Caruso Gaetano , Cavaciocchi Michele , Massari Leo
Published: June 2020

Background

Displaced radial neck fractures in children are challenging to treat. The age of the patient and the degree of angulation are the main criteria to consider when managing these fractures in children. Various surgical techniques have been described in the literature for both indirect and direct reduction and for fixation. However, the best treatment is still debated.

Case presentation

The case presented is of a 6-year-old Caucasian boy with an impacted and displaced radial neck fracture. With the patient in lateral position, under general anesthesia, elbow arthroscopy was performed to better visualize the articular surface and to assist with reduction and fixation. The fracture was reduced and fixed with a single K-wire under direct arthroscopic visualization. No associated lesions were found. An above-elbow cast was applied after surgery. The cast and K-wire were removed 3 weeks later. At the 3-month follow-up, the patient showed a full recovery with complete range of movement without any postoperative and radiographic complications.

Conclusion

Traditionally, surgery for displaced radial neck fractures in children is performed by closed reduction with percutaneous pinning or elastic intramedullary nail fixation under fluoroscopic guidance. Direct visualization of the articular surface via an open approach allows better reduction in complex fracture patterns but is related to a higher risk of complications: elbow stiffness, instability, or avascular necrosis. Elbow arthroscopy in children could be a valid alternative to open fixation surgery for displaced radial neck fractures without the complications associated with articular exposure, allowing the direct visualization of the fracture and reducing radiation exposure. Although technically demanding, we believe elbow arthroscopy should be considered an alternative option because it is effective in assisting reduction and fixation and enables the detection of associated joint lesions.
Multipoint channel charting-based radio resource management for V2V communications
Authors: Al-Tous Hanan , Ponnada Tushara , Studer Christoph , Tirkkonen Olav
Published: June 2020

We consider a multipoint channel charting (MPCC) algorithm for radio resource management (RRM) in vehicle-to-vehicle (V2V) and vehicle-to-infrastructure (V2I) communication systems. A massive MIMO (mMIMO) infrastructure network performs logical localization of vehicles to a MPCC, based on V2I communication signals. Combining logical distances given by channel charting with V2V measurements, the network trains a function to predict the quality of a direct V2V communication link from observed V2I communication signals. In MPCC, the network uses machine learning techniques to learn a logical radio map from V2I channel state information (CSI) samples transmitted from unknown locations. The network extracts CSI features, constructs a dissimilarity matrix between CSI samples, and performs dimensional reduction of the CSI feature space. Here, we use Laplacian Eigenmaps (LE) for dimensional reduction. The resulting MPCC is a two-dimensional map where the spatial distance between a pair of vehicles is closely approximated by the distance in the MPCC. In addition to V2I CSI, the network acquires V2V channel quality information for vehicles in the training set and develops a link quality predictor. MPCC provides a mapping for any vehicle location in the training set. To use MPCC for cognitive RRM of V2I and V2V communications, network management has to find logical MPCC locations for vehicles not in the training set, based on newly acquired V2I CSI measurements. For this, we develop an extension of LE-based MPCC to out-of-sample CSI samples. We evaluate the performance of link quality prediction for V2V communications in a mMIMO millimeter-wave scenario, in terms of the relative error of the predicted outage probability.
Patient and healthcare provider reported barriers and enablers to virtual or remote-only follow-up models for cardiovascular implantable electronic devices: protocol for a qualitative framework synthesis
Authors: Kelly Shannon E. , Clifford Tammy J. , Skidmore Becky , Birnie David , Parkash Ratika , Wells George A.
Published: June 2020

Background

Virtual care models are used to follow-up patients with cardiovascular implantable electronic devices (CIED), including pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapy. There is increasing interest in the expansion of virtual, or even remote-only, CIED care models to alleviate resource and economic burden to both patients and specialty device clinics and to maintain or improve equity and access to high-quality cardiovascular care. This qualitative framework synthesis aims to identify barriers and enablers to virtual care models from both the perspective of the patient and device clinics. How setting, context, equity factors or other aspects influence these factors, or satisfaction with care, will also be investigated.

Methods

We will perform a systematic literature search in MEDLINE, Embase, PsycINFO, CINAHL, Proquest Dissertations & Theses, other EBM Reviews, and trial registry databases. Screening will be completed by two independent review authors. Original research articles having a qualitative component (i.e., qualitative, mixed-, or multi-method) are eligible. Study populations of interest are (a) individuals with a CIED or (b) healthcare providers involved in any aspect of virtual or remote follow-up of patients with CIEDs. Eligibility will be restricted to studies published after January 1, 2000 in English or French. Data will be captured using standardized templates based on the domains and constructs of the Theoretical Domains Framework and the Warwick Patient Experiences Framework. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research will be applied to all included studies. The GRADE-CERQual approach will be applied to assess and summarize confidence in key findings. Reporting will follow the enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) statement. Detailed descriptive results will be presented, and summary of qualitative findings tables will be produced.

Discussion

While a number of trials have captured the clinical effectiveness and safety of virtual follow-up for CIEDs, there has been less attention given to factors affecting use and implementation of remote care by patients and healthcare providers or satisfaction with care. Results from this qualitative framework synthesis will provide important lived experience data from both patients and healthcare providers which will be essential to incorporate in clinical guidelines.

Systematic review registration

PROSPEROCRD42020160533.
Geotechnical investigations of an earthquake that triggered disastrous landslides in eastern Canada about 1020 cal BP
Authors: Wang Baolin
Published: June 2020

Geotechnical studies are carried out to investigate the location and magnitude of a prehistoric earthquake in eastern Canada. Previous studies identified 12 sensitive clay landslides of about 1020 cal BP in the Ottawa-Gatineau region, including one of the most disastrous slope failures in eastern Canada. The landslides were hypothesized to have been triggered by an earthquake. In the current study, three of those landslides are investigated to understand their failure mechanisms. The study sites form a triangle of lateral distances of about 38, 38 and 35 km. Micro-seismic surveys, cone penetrometer tests, vane shear tests, soil sampling and laboratory testing are conducted to collect geotechnical data. Slope stability models are constructed to calculate threshold ground accelerations required to trigger the landslides. The ground accelerations are used with Ground-Motion Prediction Equations to triangulate the earthquake. The results indicate an earthquake of a minimum moment magnitude of 5.9 near Eardley, Quebec.
Patient involvement in preparing health research peer-reviewed publications or results summaries: a systematic review and evidence-based recommendations
Authors: Arnstein Lauri , Wadsworth Anne Clare , Yamamoto Beverley Anne , Stephens Richard , Sehmi Kawaldip , Jones Rachel , Sargent Arabella , Gegeny Thomas , Woolley Karen L.
Published: June 2020

Background

There are increasing calls for patient involvement in sharing health research results, but no evidence-based recommendations to guide such involvement. Our objectives were to: (1) conduct a systematic review of the evidence on patient involvement in results sharing, (2) propose evidence-based recommendations to help maximize benefits and minimize risks of such involvement and (3) conduct this project with patient authors.

Methods

To avoid research waste, we verified that no systematic reviews were registered or published on this topic. We co-created, with patients, a PRISMA-P–compliant protocol. We included peer-reviewed publications reporting the effects of patient involvement in preparing peer-reviewed publications or results summaries from health research studies. We searched (9/10/2017) MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews, and secondary information sources (until 11/06/2018). We assessed the risk of bias in eligible publications and extracted data using standardized processes. To evaluate patient involvement in this project, we co-created a Patient Authorship Experience Tool.

Results

All nine eligible publications reported on patient involvement in preparing publications; none on preparing results summaries. Evidence quality was moderate. A qualitative synthesis of evidence indicated the benefits of patient involvement may outweigh the risks. We have proposed 21 evidence-based recommendations to help maximize the benefits and minimize the risks when involving patients as authors of peer-reviewed publications. The recommendations focus on practical actions patient and non-patient authors can take before (10 recommendations), during (7 recommendations) and after (4 recommendations) manuscript development. Using the Patient Authorship Experience Tool, both patient and non-patient authors rated their experience highly.

Conclusions

Based on a systematic review, we have proposed 21 evidence-based recommendations to help maximize the benefits and minimize the risks of involving patients as authors of peer-reviewed publications.
Divergent differentiation and variant morphology in invasive urothelial carcinomas – association with muscle-invasive disease
Authors: Santana Suelen Cunha , de Souza Maiara Ferreira , Amaral Maria Estela Pompeu , Athanazio Daniel Abensur
Published: June 2020

Introduction

To evaluate the frequency of divergent differentiations / variant morphology in urothelial carcinoma, and their association with muscle-invasive disease at diagnosis.

Methods

All consecutive cases of invasive urothelial carcinoma from a busy pathology laboratory were reviewed. Clinical and pathological data were recorded including data on divergent and variant morphologies and their percentage within the invasive component.

Results

Among 91 cases, 46 (51%) showed some form of divergent/variant morphology. The most common divergent morphology was squamous which was present in 18/46 (39% of cases with some divergent or variant morphology) followed by micropapillary (28%), plasmacytoid (20%) and poorly differentiated (17%). Only squamous differentiation was associated with higher rate with muscularis propria invasion.

Conclusions

Although common, squamous differentiation should be still recognized as a feature of aggressive disease.
Perceived organizational support and job satisfaction: a moderated mediation model of proactive personality and psychological empowerment
Authors: Maan Annum Tariq , Abid Ghulam , Butt Tahira Hassan , Ashfaq Fouzia , Ahmed Saira
Published: June 2020

Drawing on social exchange theory, the purpose of this study is to examine the mediating role of psychological empowerment and moderating role of proactive personality in the relationship between POS and job satisfaction. The data were collected from 936 employees working in various manufacturing and service sectors by using self-report survey questionnaires by employing time-lagged cross-sectional study design. The study findings demonstrate that POS positively influenced psychological empowerment and job satisfaction. Moreover, it is also revealed that the relationship between POS and job satisfaction is weaker when employees’ proactive personality is higher rather than lower. The findings of the current study pose a framework for organizational representatives of both service and manufacturing industries to strengthen individual psychological empowerment and job satisfaction by offering organizational support to those individuals who are less proactive.
The pattern of neonatal gastro-intestinal perforation in upper Egypt
Authors: Abo-Halawa Nezar Abd Elrouf , Negm Mohamed Ahmed , Fathy Mohamed
Published: June 2020

Background

Neonatal gastro-intestinal perforation [NGIP] is one of the major problems in pediatric surgical practice. Although the outcomes of neonatal surgery have improved markedly over the past decade the mortality rates of neonates with NGIP are still high. The aim of this study was to present the possible etiological factors, clinical findings, and operative procedures of NIP in our locality.

Results

A total of 34 neonates with NGIP were included in this study. The median age at presentation was (15.8 ± 7.0 SD) days. The median interval between presentation and surgical interference was (2.0 ± 1.1 SD).Necrotizing enterocolitis [NEC] was the commonest cause of neonatal gastro-intestinal perforation. The commonest site of perforation was the colon [11cases]. The overall mortality rate was 11 cases [32.4%]. The main cause of mortality was neonatal NEC [6 cases]. Eight cases [40 %] died out of 20 cases which the interval between the presentation and interference were more than one day.

Conclusions

Neonatal gastro-intestinal perforations are still associated with high mortality rate in our institutions, and delayed diagnosis with increased interval between the presentation and surgical intervention are associated with increased mortality. In our locality, although NEC is the commonest cause of NGIP, the iatrogenic cause is relatively higher than reported.
Can we prevent seasonal affective disorder (SAD) with melatonergic agents?
Authors: Zghoul Tarek
Published: June 2020

Seasonal affective disorder (SAD) is a recurrent form of major depression, particularly occurring in the winter months with a generally spontaneous remission in spring/summer. The predictable nature of this condition provides a potentially unique opportunity to prevent recurrence in sufferers of SAD. The Cochrane Review discussed here examines the evidence for melatonin and agomelatine in preventing SAD, putting its findings into their clinical context.
Minimizing Delays in the Breast Cancer Pathway by Integrating Breast Specialty Care Services at the Primary Health Care Level in Zambia
Authors: Songiso Mutumba , Pinder Leeya F. , Munalula Jabulani , Cabanes Anna , Rayne Sarah , Kapambwe Sharon , Shibemba Aaron , Parham Groesbeck P.
Published: June 2020

PURPOSE

In Zambia, more than two-thirds of female patients with breast cancer present with late-stage disease, leading to high mortality rates. Most of the underlying causes are associated with delays in symptom recognition and diagnosis. By implementing breast care specialty services at the primary health care level, we hypothesized that some of the delays could be minimized.

METHODS

In March 2018, we established a breast care specialty clinic for women with symptomatic disease within 1 of the 5 district hospitals in Lusaka. The clinic offers breast self-awareness education, clinical breast examination, breast ultrasound, ultrasound-guided breast biopsy, surgery, referral for chemoradiation, follow-up care, and electronic medical records.

RESULTS

Between March 2018 and April 2019, of 1,790 symptomatic women who presented to the clinic, 176 (10%) had clinical and/or ultrasound indications for histologic evaluation. Biopsy specimens were obtained using ultrasound-guided core-needle procedures, all of which were performed on the same day as the initial visit. Of the 176 women who underwent biopsy, 112 (64%) had pathologic findings compatible with a primary breast cancer, and of these, 42 (37%) were early-stage (stage I/II) disease. Surgery for early-stage cancers was performed at the district hospital within 2 weeks of the time of definitive pathologic diagnosis. Patients with advanced disease were referred to the national cancer center for multimodality therapy, within a similar time frame.

CONCLUSION

Breast care specialty services for symptomatic women were established in a district-level hospital in a resource-constrained setting in Africa. As a result, the following time intervals were minimized: initial presentation and performance of clinical diagnostics; receipt of a definitive pathologic diagnosis and initiation of surgery; receipt of a definitive pathologic diagnosis and referral.
Precise coordination of cell-ECM adhesion is essential for efficient melanoblast migration during development
Authors: Haage Amanda , Wagner Kelsey , Deng Wenjun , Venkatesh Bhavya , Mitchell Caitlin , Goodwin Katharine , Bogutz Aaron , Lefebvre Louis , Van Raamsdonk Catherine D. , Tanentzapf Guy
Published: June 2020

Melanoblasts disperse throughout the skin and populate hair follicles through long-range cell migration. During migration, cells undergo cycles of coordinated attachment and detachment from the extracellular matrix (ECM). Embryonic migration processes that require cell-ECM attachment are dependent on the integrin family of adhesion receptors. Precise regulation of integrin-mediated adhesion is important for many developmental migration events. However, the mechanisms that regulate integrin-mediated adhesion in vivo in melanoblasts are not well understood. Here, we show that autoinhibitory regulation of the integrin-associated adapter protein talin coordinates cell-ECM adhesion during melanoblast migration in vivo. Specifically, an autoinhibition-defective talin mutant strengthens and stabilizes integrin-based adhesions in melanocytes, which impinges on their ability to migrate. Mice with defective talin autoinhibition exhibit delays in melanoblast migration and pigmentation defects. Our results show that coordinated integrin-mediated cell-ECM attachment is essential for melanoblast migration and that talin autoinhibition is an important mechanism for fine-tuning cell-ECM adhesion during cell migration in development.
Comparison of 18F-FDG PET-MR and fecal biomarkers in the assessment of disease activity in patients with ulcerative colitis
Authors: Li Yan , Khamou Michael , Schaarschmidt Benedikt Michael , Umutlu Lale , Forsting Michael , Demircioglu Aydin , Haubold Johannes , Koch Anna Katharina , Bruckmann Nils-Martin , Sawicki Lino Morris , Herrmann Ken , Boone James Hunter , Langhorst Jost
Published: June 2020

Objective:

To compare the diagnostic performance of fecal biomarkers and 18F-fludeoxyglucose (18F-FDG) positron emmision tomography-MR (PET-MR) in the assessment of disease activity in patients with ulcerative colitis.

Methods:

This study was conducted under the framework of a single-center clinical trial (clinicaltrials.gov [NCT03781284]). N = 50 participants were enrolled. Fecal samples were collected before bowel preparation. All patients underwent whole-body 18F-FDG PET-MR followed by ileocolonoscopy within 24 h. Diagnostic performance of five fecal biomarkers (calprotectin, lactoferrin, polymorphonuclear leukocyte elastase, S100A12 and eosinophil-derived neurotoxin), MR morphological parameters (MRmorph), diffusion-weighted imaging and PET in detecting active disease determined by Rachmilewitz endoscopic activity index (EAI) were evaluated and compared with each other. Correlations between fecal biomarkers, PET and endoscopy were calculated.

Results:

According to EAI, n = 38 patients presented with endoscopically active disease (16 mild, 19 moderate and 3 severe). All five biomarkers, PET and MRmorph could differentiate endoscopically active disease from endoscopic remission without significant difference regarding their operating characteristics (accuracies between 0.673 for calprotectin and 0.898 for lactoferrin). In predicting endoscopically moderate to severe disease, PET showed the highest diagnostic performance (accuracy = 0.857) compared to calprotectin and lactoferrin (accuracy = 0.633 and 0.735). PET had also the strongest correlation with endoscopy (ρ = 0.685, p < 0.001), while within fecal biomarkers the levels of lactoferrin and eosinophil-derived neurotoxin correlated significantly with EAI (ρ = 0.423 and 0.528, both p < 0.05).

Conclusion:

Both fecal biomarkers and PET-MR were excellent non-invasive diagnostic tools in the assessment of disease activity in ulcerative colitis.

Advances in knowledge:

Both fecal biomarkers and PET-MR parameters are able to predict endoscopically active disease with comparable diagnostic performance. PET had the highest correlation with endoscopy and outperformed fecal biomarkers in differentiating moderate to severe from mild disease.
Molecular detection of chloramphenicol-florfenicol resistance (cfr) genes among linezolid resistant MRSA isolates in Sokoto State, Nigeria
Authors: Suleiman Shuaibu Adeiza , Onaolapo Josiah Ademola , Olayinka Busayo Olalekan
Published: June 2020

Objective: we investigated previous literatures for documentation of the trend in Sokoto, Nigeria and found none. We deemed it fit to determine the frequency of linezolid resistance mediated by cfr gene among MRSA isolates from Sokoto State-owned hospitals. Methods: Bacterial species identification was carried out with Microgen™ Staph-ID System kit (Microgen, Surrey, UK). Disc agar diffusion method (Modified Kirby-Bauer’s) following Clinical and Laboratory Standards Institute (CLSI 2018) guidelines was used in antimicrobial susceptibility testing. The results were interpreted and managed using WHONET 5.6 software (WHO, Switzerland). Oxacillin resistant screening agar base (ORSAB) culture was used to determine phenotypic methicillin resistance. Polymerase chain reaction (PCR) was carried out to determine the presence of cfr-gene. Results: A total of 81 S. aureus isolates were phenotypically identified. Of this number, 46.91% (38/81) were MRSA; Healthcare workers (39.5%), Outpatient (28.9%), In patient (21%), Security men and Cleaners (5.3% each). Importantly linezolid resistance rate among the MRSA isolates was 44.7%. Analysis of antimicrobial susceptibility profile also showed a multiple antibiotics resistance burden of MDR (5.9%), possible XDR (47.1%), XDR (41.1%) and PDR (5.9%) amongst LR-MRSA. About 52.9% (9/17) of LR-MRSA harbored the cfr gene. Conclusions: This is the first report to document cfr gene in LR-MRSA strains in Sokoto. The cfr gene was found among the studied LR-MRSA strains and if cfr-mediated linezolid resistance is not properly checked, its phenotypic expression may result in an outbreak of multiple antibiotic resistant strains.
Κατανάλωση, καταναλωτικές πρακτικές και καταναλωτισμός: Εννοιολογήσεις και η αναγκαιότητα της σημασιολογικής οριοθέτησης
Authors: Lallas Dimitris
Published: June 2020

Δεδομένων των ποικίλων εννοιολογήσεων των όρων «κατανάλωση» και «καταναλωτισμός», των ταυτίσεων/συγχύσεων και των αναλυτικών δυσχερειών που ανακύπτουν κατά τη μελέτη του καταναλωτικού φαινομένου, το άρθρο αυτό επιχειρεί την εννοιολόγηση της κατανάλωσης με όρους κοινωνικής πρακτικής και του καταναλωτισμού ως έθους και τρόπου ζωής στην υστεροκαπιταλιστική, καταναλωτική συνθήκη. Η προτεινόμενη (ιδεοτυπική) εννοιολόγηση των πρακτικών κατανάλωσης αποβλέπει στην αποφυγή εκ των προτέρων αρνητικών ή θετικών σημασιολογικών αποδόσεων και στην υποστήριξη τοπικά ευαίσθητων μελετών που αναδεικνύουν τα χαρακτηριστικά των πρακτικών αυτών και τις σχέσεις που συγκροτούνται μέσω αυτών με τον κόσμο των αντικειμένων, τον εαυτό, τους άλλους, τον φυσικό και κοινωνικό κόσμο, και βεβαίως με τον χρόνο και τον χώρο.
The emergence of the “jazz neighbourhood” of Kerameikos in recession Athens
Authors: Vavva Georgia
Published: June 2020

Η δημιουργία της «τζαζ γειτονιάς» του Κεραμεικού στην Αθήνα της κρίσηςTο άρθρο χαρτογραφεί τις αλλαγές που σχετίζονται με τις εργασιακές πρακτικές των ιδιοκτητών τζαζ μουσικών σκηνών και των επαγγελματιών μουσικών κατά την περίοδο της κρίσης, και τους τρόπους με τους οποίους αυτές οι πρακτικές γίνονται εμφανείς στην περιοχή του Κεραμεικού στην Αθήνα. Βασίζεται σε εθνογραφική έρευνα πεδίου, η οποία διενεργήθηκε το 2015-2017 ως μέρος της εθνομουσικολογικής διδακτορικής μου έρευνας, σχετικά με την Αθηναϊκή τζαζ σκηνή στην περίοδο μετά το 2010. Όπως υποστηρίζω, η αναστάτωση που προκλήθηκε τo 2010 σε αυτό που ο Appadurai ονομάζει financescape, προκάλεσε μία άνθιση των μουσικών συναυλιών μικρής κλίμακας και ταυτόχρονα οδήγησε στην ανάδειξη μιας παγκοσμιοποιημένης τοπικότητας. Στον Κεραμεικό αυτή η διαδικασία ενισχύθηκε περαιτέρω από τους επιβραδυμένους ρυθμούς του εξευγενισμού και, σε συνδυασμό με τις αλλαγές στις εργασιακές πρακτικές των μουσικών και των ιδιοκτητών των τζαζ σκηνών, είχε ως αποτέλεσμα να έρθουν κοντά δύο έννοιες, οι οποίες φαινομενικά ανήκουν σε αντικρουόμενα κοινωνικά φαντασιακά, αυτή της «τζαζ» και του «καφενείου», ενισχύοντας ακόμη περισσότερο την περιπλοκότητα του αστικού τοπίου της κρίσης.
Invest the city by doing businesses: Geographies of migrant entrepreneurs in the center of Athens
Authors: Polyzou Iris
Published: June 2020

Επενδύοντας στην πόλη μέσω επιχειρηματικών δραστηριοτήτων: Γεωγραφίες της μεταναστευτικής επιχειρηματικότητας στο κέντρο της ΑθήναςΣκοπός του άρθρου είναι η μελέτη της μεταναστευτικής επιχειρηματικότητας στην Αθήνα, από την κλίμακα του δήμου σε αυτήν του δρόμου. Η προσέγγιση του ζητήματος μέσα από διαφορετικές χωρικές κλίμακες στοχεύει στην ανάδειξη δύο θεματικών: πρώτον, στη συσχέτιση μεταξύ τόπου εγκατάστασης και χώρα προέλευσης των επιχειρηματιών στην Αθήνα και, δεύτερον, στην ανάλυση των χωροκοινωνικών πρακτικών που επιτρέπουν την εγκατάσταση και λειτουργία των εν λόγω επιχειρήσεων εντός του συγκεκριμένου πλαισίου τριών κεντρικών περιοχών, τα χρόνια που έπονται της οικονομικής κρίσης. Το άρθρο βασίζεται σε ερευνητικό πρόγραμμα που υλοποιήθηκε στην Γαλλική Σχολή Αθηνών μεταξύ 2015 και 2017.
The role of micro-enterprises in post-growth urban transitions: An inquiry in Athens and Barcelona
Authors: Koukoufikis Giorgos
Published: June 2020

Μετανάπτυξη, πόλη και ο ρόλος των μικροεπιχειρήσεων:Μια έρευνα στην Αθήνα και τη ΒαρκελώνηΤο παρόν άρθρο αποτελεί μια εμπειρική έρευνα που αξιολογεί τον ρόλο και την πιθανή επίδραση των μικροεπιχειρήσεων ως προς τον μετασχηματισμό των αστικών κοινωνικοοικονομικών συστημάτων στην κατεύθυνση της μετανάπτυξης. Η έρευνα πεδίου απευθύνθηκε σε «συμβατικές» πολύ μικρές επιχειρήσεις, οι οποίες λειτουργούν σε παραδοσιακούς τομείς της αγοράς και σε επιχειρήσεις που δραστηριοποιούνται στην κοινωνική και αλληλέγγυα οικονομία. Η Αθήνα και η Βαρκελώνη χρησιμοποιήθηκαν ως πόλεις-εργαστήρια για να τεκμηριώσουν τους παράγοντες που επηρέασαν τις στρατηγικές μικρο-επιχειρηματικής προσαρμογής στην οικονομική κρίση μετά το 2008, ώστε να ερευνηθεί σε ποιο βαθμό οι αφηγήσεις και οι πρακτικές αυτών μπορούν να αποτελέσουν ένδειξη ροπής προς έναν ευρύτερο κοινωνικοοικονομικό μετασχηματισμό. Τα αποτελέσματα δείχνουν ότι η κρίση και το αστικό περιβάλλον παρείχε ένα πλαίσιο για διαδικασίες διαμόρφωσης εναλλακτικών οικονομικών πρακτικών, στις οποίες οι μικροεπιχειρήσεις διαδραματίζουν σημαντικό ρόλο. Ωστόσο, για την κεφαλαιοποίηση και ενίσχυση της μετασχηματιστικής διαδικασίας, χρειάζεται κατάλληλο θεσμικό πλαίσιο και υλική υποστήριξη για την ενεργοποίηση περαιτέρω συλλογικών και ατομικών δράσεων.
Τhe symbolic economy of cities – new shapes of work and networking: Τhe role of traditional and emerging clusters of creativity in the Αthenian public space
Authors: Koutsari Maria , Demertzi Aggeliki
Published: June 2020

Η συμβολική οικονομία των πόλεων – νέες μορφές εργασίας και δικτύωσης: Ο ρόλος των παραδοσιακών και των αναδυόμενων clusters δημιουργικότητας στον αθηναϊκό αστικό χώροΣε αυτό το άρθρο εξετάζουμε τις αλλαγές στον αθηναϊκό αστικό χώρο που έγιναν υπό το φως της κρίσης καθώς και τις αλλαγές στις εργασιακές σχέσεις και τη συμβολική οικονομία της Αθήνας. Στα πρώτα κεφάλαια γίνεται θεωρητική επισκόπηση των διεθνών αλλαγών, του ρόλου του πολιτισμού στις αναπτυξιακές στρατηγικές και της συμβολικής οικονομίας. Επίσης, αναλύονται οι σύγχρονες αστικές πολιτικές και οι νέες μορφές εργασίας. Η περίπτωση του ιστορικού κέντρου της Αθήνας ως χώρου συγκέντρωσης δημιουργικών δραστηριοτήτων και ως αναπτυσσόμενου τουριστικού προορισμού έρχεται επίσης στο προσκήνιο. Το τελευταίο κεφάλαιο αφιερώνεται στην εν εξελίξει επιτόπια έρευνα που διεξάγεται προκειμένου να εξεταστούν τα παραδοσιακά και τα αναδυόμενα συμπλέγματα (επίκεντρα) δημιουργικότητας στο κέντρο της Αθήνας, τον τρόπο δομής, λειτουργίας και εγκατάστασης τους και την αλληλεπίδρασή τους με το «Αθηναϊκό Αστικό Εργοστάσιο».
The emergence of desperate optimists: Μanaging the start-up working life in times of crisis
Authors: Papageorgiou Antigoni
Published: June 2020

Η ανάδυση της γενιάς των «απελπιστικά αισιόδοξων»: Διαχείριση της εργασιακής ζωής στις νεοφυείς επιχειρήσεις στα χρόνια της κρίσηςΤο βάθεμα της ελληνικής κρίσης συνέβαλε στην αυξανόμενη προβολή συνεργατικών εργασιακών μονάδων όπως θερμοκοιτίδων και κόμβων επιχειρηματικότητας όπου φιλοξενούνται νεοφυείς επιχειρήσεις στο αθηναϊκό κέντρο. Λόγω περιορισμένων εργασιακών επιλογών νέοι υψηλών προσόντων δραστηριοποιούνται επιχειρηματικά. Το παρόν άρθρο εξερευνά τους τρόπους με τους οποίους οι νέοι αυτοί επιχειρηματίες διαχειρίζονται την επιχειρηματική τους εργασιακή ζωή, αναλύοντας τις διακριτές ποιότητες του εργασιακού τους βίου καθώς και τον τρόπο με τον οποίο δομούν τον επιχειρηματικό τους εαυτό. Η παρούσα ποιοτική έρευνα σκιαγραφεί έναν απαιτητικό εργασιακό βίο που στερείται ισορροπίας μεταξύ εργασίας και προσωπικής ζωής. Παρόλο, όμως, τον επισφαλή της χαρακτήρα, η επιχειρηματική καριέρα βιώνεται ως μια εξαιρετικά δημιουργική επιλογή που ανταμείβει τους νέους επιχειρηματίες τόσο σε επαγγελματικό όσο και σε προσωπικό επίπεδο. Ταυτόχρονα, το γεγονός ότι η επιχειρηματική τους δραστηριότητα υπαγορεύεται σε μεγάλο βαθμό από αναγκαιότητα αποσιωπάται, ενώ οι νέοι εργαζόμενοι παρουσιάζουν τους εαυτούς τους ως παθιασμένους και επίδοξους επιχειρηματίες. Το γεγονός ότι δραστηριοποιούνται εργασιακά και επιχειρηματικά από ένα συνεργατικό εργασιακό περιβάλλον συντηρεί και ενισχύει την ελπίδα, και βαθιά πεποίθησή τους ότι θα καταφέρουν να αμείβονται για αυτό που πραγματικά αγαπούν. Ως εκ τούτου, στην παρούσα συγκυρία, παρατηρούμε την ανάδυση μια νέας γενιάς εργαζόμενων, αυτής των «απελπιστικά αισιόδοξων». Μιας γενιάς που δέχεται με στωικότητα τις επισφαλείς συνθήκες εργασίας του, καλλιεργεί μια βαθιά και παθιασμένη σχέση με την εργασία και για αυτό δέχεται να αναλάβει το επιχειρηματικό ρίσκο με κάθε κόστος.