bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated With Law Enforcement Reporting in Patients Presenting for Medical Forensic Examinations
Authors: Downing Nancy R. , Adams Mollie , Bogue Richard J.
Published: August 2020

Law enforcement reporting following sexual assault is lower than for other violent crimes. Sexual assault nurse examiners (SANEs) provide care for patients in the acute period following sexual assault and are well-positioned to identify and address barriers to reporting. We examined data from medical forensic examination records documented by SANEs for a 5-year period (2011–2015). We examined 347 records of women 18 and older to identify factors associated with law enforcement reporting at the time of the exam using binomial logistic regression to construct odds ratios (OR). A total of 56.5% of patients in the sample reported to law enforcement. Patients who did not voluntarily consume alcohol were more likely to report than those who did (OR = 4.45; p = .001). Patients who were not students were more likely to report than students (OR = 3.24; p = .002). Patients who had a medical forensic exam within 32 hr of the assault were more likely to report than those having exams after 32 hr (OR = 2.68; p = .007). Patients who had anogenital and/or bodily injuries were more likely to report than those who had no injuries (OR = 2.50; p = .008). Patients who were penetrated (vaginally, orally, and/or anally) were more likely to report than those who were not penetrated (OR = 2.50; p = .056). Knowing the assailant, having multiple assailants, and patient and assailant race/ethnicity were not associated with different likelihood of reporting to law enforcement. SANEs and others who work with victims of sexual assault can use data to understand and address barriers to reporting.
Spark plug reliability improvement with regard to ceramic insulator form factor
Authors: Fryskowski Bernard
Published: August 2020

Ceramic insulators for spark plugs are important components responsible for the dielectric barrier to generate high-voltage pulses required to ignite the air–fuel mixture and for providing mechanical support to the center electrode. To ensure a high degree of reliability, many manufacturers apply corrugation patterns to the glazed upper part of an insulator to prevent flashover and parasitic discharges as well as to reduce the leakage current. The corrugation pattern design based mostly on simple cylindrical and conical shapes has changed very little over the years. This gives rise to the question whether an application of more sophisticated curves such as spherical, polynomial, or exponential can improve the surface resistance of a ribbed spark plug insulator. Quantitative analysis based on form factor and leakage distance calculations was used as a design method to optimize the shape of the spark plug insulator and its pollution performance. Furthermore, a novel concept of concave insulator corrugation patterns formed by quadratic and exponential functions was proposed and discussed as an alternative solution suitable for practical application. It was found that insulator ribs completed with supplementary concave corrugation ensure a longer leakage distance than conventional patterns. According to the results of calculations and measurements performed on three-dimensional printed samples, it was stated that the novel concave corrugation patterns can significantly increase the surface resistance of spark plug insulators.
Mental Health and Psychosocial Aspects of COVID-19 in India: The Challenges and Responses
Authors: Das Shankar
Published: August 2020

The first-ever global outbreak of COVID-19 has been intensely impacting humanity and continues to affect all segments of the population since its origin While dealing with such public health emergencies, the past experiences have testified generalised public fear and anxieties due to uncertainty, fatality, and lack of public health preparedness. The aim of the article is to explore the impact of this unprecedented environment on mental health of individuals and communities in its current magnitude. It will discuss at length some emerging concepts of the causal pathways of mental distress/disorders and suggest strategies to prevent and promote mental health in individuals during this crisis. For the general population at large, the mental health effects of COVID-19 are as important to address as are the physical health effects.
Asymptotic derivation of refined dynamic equations for a thin elastic annulus
Authors: Ege Nihal , Erbaş Barış , Kaplunov Julius
Published: August 2020

Low-frequency vibrations of a thin elastic annulus are considered. The dynamic equations of plane strain are subjected to asymptotic treatment beyond the leading-order approximation. The main peculiarity of the considered problem is a specific degeneration associated with the effect of the almost inextensible midline of the annulus, resulting in a few unexpected features of the mechanical behaviour. In particular, it is discovered that the leading-order even component of the circumferential stress is not uniform across the thickness, as is usually assumed, and can be determined only at the next order. The derived refined equations also govern vibrations of a cylindrical shell at the lowest cut-off frequencies. The two-term asymptotic formula obtained for the latter fully agrees with the expansion of the transcendental dispersion relation for plane strain but does not coincide in the second term with the prediction of the Kirchhoff–Love theory for thin shells.
Carpal tunnel syndrome in patients with arteriovenous fistula for haemodialysis: A narrative review of the current literature
Authors: Grant Yasmin , Freilich Simon , Horwitz Maxim D , Shemesh David , Crane Jeremy
Published: August 2020

The ideal choice of vascular access in patients requiring haemodialysis is an arteriovenous fistula. However, an important often under-reported complication encountered at follow-up is symptoms of tingling or numbness in the hand. This may represent carpal tunnel syndrome, impairment of the median nerve as it traverses through the carpal tunnel at the wrist by focal compression of this nerve. Contributory factors in the presence of an arteriovenous fistula may include venous hypertension and varying steal syndrome phenomena provoking micro-ischaemia. Studies that investigated the evolution of carpal tunnel syndrome in haemodialysis patients with an arteriovenous fistula revealed that the frequency of carpal tunnel syndrome associated with an arteriovenous fistula on haemodialysis ranged from 10.4% to 42.6%. An association between duration of haemodialysis with arteriovenous fistula and carpal tunnel syndrome development was also observed. Surgical release of carpal tunnel provided complete relief of paraesthesia in all treated patients in the examined, demonstrating an alleviation of symptoms and improved function of hand and quality of life in patients with an arteriovenous fistula. However, the aetiology and risk factors for development of carpal tunnel syndrome remain unclear and further studies should attempt to elucidate the pathophysiology of this occurrence in the presence of arteriovenous fistulas.
Comparison of MOG and AQP4 antibody seroprevalence in Korean adults with inflammatory demyelinating CNS diseases
Authors: Hyun Jae-Won , Lee Hye Lim , Jeong Woo Kyo , Lee Hye Jung , Shin Jong Hwa , Min Ju-Hong , Kim Byoung Joon , Kim Seung Woo , Shin Ha Young , Oh Jeeyoung , Kim Woojun , Shin Hyun-June , Oh Sun-Young , Kim Hyunjin , Lim Young-Min , Huh So-Young , Cho Eun Bin , Nam Tai-Seung , Lee Seung-Han , Kim Sun-Young , Kang Sa-Yoon , Han Suk Geun , Sohn Eun Hee , Baek Seol-Hee , Kim Byung-Jo , Lee Sang-Soo , Seok Jin Myoung , Hong Yoon-Ho , Oh Seong-il , Kim Jong Kuk , Shin Kyong Jin , Kwon Ohyun , Cho Joong-Yang , Bae Jong Seok , Kim So Yeon , Kim Yeseul , Lee Min Young , Kim Su-Hyun , Kim Ho Jin
Published: August 2020

We aimed to compare seroprevalence of anti-myelin oligodendrocyte glycoprotein (MOG) and anti-aquaporin-4 (AQP4) antibodies in Korean adults with inflammatory demyelinating diseases (IDDs) of the central nervous system (CNS), based on a multicenter nationwide database. Sera were analyzed using a live cell–based assay for MOG and AQP4 antibodies. Of 586 Korean adults with IDDs of the CNS, 36 (6.1%) and 185 (31.6%) tested positive for MOG and AQP4 antibodies, respectively. No participant showed double positivity. Seroprevalence of MOG antibodies was about five times lower than that of AQP4 antibodies in a large cohort of Korean adults with IDDs of the CNS.
Autofluorescence spectroscopy as a proxy for chronic white matter pathology
Authors: Morgan Megan L , Kaushik Deepak K , Stys Peter K , Caprariello Andrew V
Published: August 2020

Background:

The balance of tissue injury and repair ultimately determines outcomes of chronic neurological disorders, such as progressive multiple sclerosis (MS). However, the extent of pathology can be difficult to detect, particularly when it is insidious and/or offset by tissue regeneration.

Objectives:

The objective of this research is to evaluate whether tissue autofluorescence—typically a source of contamination—provides a surrogate marker of white matter injury.

Methods:

Tissue autofluorescence in autopsied specimens both experimental and clinical was characterized by spectral confocal microscopy and correlated to severity and chronicity as determined by standard histopathology.

Results:

Months after cuprizone (CPZ)-induced demyelination, despite robust remyelination, autofluorescent deposits progressively accumulated in regions of prior pathology. Autofluorescent deposits (likely reflecting myelin debris remnants) were conspicuously localized to white matter, proportional to lesion severity, and displayed differential fluorescence over time. Strikingly, similar features were apparent also in autopsied MS tissue.

Conclusion:

Autofluorescence spectroscopy illuminates prior and ongoing white matter injury. The accumulation of autofluorescence in proportion to the extent of progressive atrophy, despite robust remyelination in the CPZ brain, provides important proof-of-concept of a phenomenon (insidious ongoing damage masked by mechanisms of tissue repair) that we hypothesize is highly relevant to the progressive phase of MS.
A method for determining hydrogen–methane–nitrogen mixtures for laboratory tests of syngas-fuelled internal combustion engines
Authors: Gobbato Paolo , Masi Massimo , De Simio Luigi , Iannaccone Sabato
Published: August 2020

An original method for formulating surrogate fuels from actual syngas mixtures is presented and formalised. The method is the first example in the scientific literature of a rather complete tool for planning and setting up a laboratory syngas-fuelled engine test when some components of the syngas mixture are not available. Basically, the method allows a map to be built that provides the composition for a surrogate fuel once the composition of a syngas mixture is assigned, the components of a surrogate fuel are selected and the equivalence parameters are defined. The laminar flame speed, the energy density of the fuel–air mixture and the methane number are identified as equivalence parameters in the study. In particular, the proper laminar flame speed and energy density ensure that an engine fuelled by the surrogate mixture produces the same indicated power as it would when fuelled by the original syngas. Instead, the methane number allows for checking the fact that the tendency of the engine to knock is the same or greater than the knock tendency during syngas operation. In this article, the method is used to determine the hydrogen–methane–nitrogen mixtures corresponding to six five-component syngas mixtures, resulting from actual gasification processes. The laminar flame speed and methane number of each syngas mixture are estimated by means of simple original models aimed at either improving the predicting capabilities of existing models or allowing for a prompt application of the procedure. The results show that four of the six surrogate fuels are equally or more knock-prone than the original syngas mixtures, whereas only one of the two remaining surrogate fuels likely imposes a retardation of the spark advance in the final setup of the engine for actual syngas operation.
Direct angioplasty for acute ischemic stroke due to intracranial atherosclerotic stenosis-related large vessel occlusion
Authors: Zhang Guang , Ling Yeping , Zhu Shiyi , Wu Pei , Wang Chunlei , Qi Jingtao , Ji Zhiyong , Zheng Bingjie , Xu Shancai , Shi Huaizhang
Published: August 2020

Background

Intracranial artery atherosclerotic stenosis (ICAS) is among the causes of intracranial large artery occlusion (LVO). The optimal treatment strategy for patients with ischemic stroke due to ICAS-related LVO remains unclear. In this retrospective case series, we discussed our experience with direct angioplasty as frontline therapy for ICAS-related LVO.

Methods

We extracted data for patients who had a known pre-existing ICAS and undergone direct angioplasty as frontline therapy for ICAS-related LVO in the anterior circulation at our institution between January 2019 and December 2019. We analysed procedural details, the degree of reperfusion, functional outcomes, and complications. Successful reperfusion was defined as a modified Treatment in Cerebral Ischemia (mTICI) score of 2 b − 3. Functional outcomes at 90 days were assessed using modified Rankin Scale (mRS) scores (good outcome: mRS of 0–2).

Results

We analysed data for five patients (mean age: 51.6 ± 11 years). The mean time from symptom onset to recanalization was 371 ± 38.6 min. Occlusions involved the first segment of the middle cerebral artery in four patients and the intracranial internal carotid artery in one patient. Successful reperfusion was achieved in four (80%) patients. The remaining patient (20%) underwent intracranial stenting as rescue therapy, achieving a final mTICI of 2a. No re-occlusion was observed on follow-up images. Four patients (80%) achieved good outcomes at 90 days. There were no cases of symptomatic intracranial hemorrhage, although asymptomatic intracranial haemorrhage was observed in one patient.

Conclusion

Direct angioplasty may represent an alternative treatment strategy in patients with acute ischemic stroke due to known ICAS-related LVO.
Analysis and application of cleaning tool structure in negative pressure reverse circulating wellbore
Authors: Fang Qin , Liangliang Dong , Shiguo Tang , Qinglong Lei , Qing Zhu , Mei Yang , Xiaohua Zhu , Yukui Hong
Published: August 2020

Sediments frequently appear at the bottom of oil and gas wells in the bottom of carbonate rocks during completion or production, seriously affecting the productivity. In order to solve the wellbore cleaning problem, this article applies the Bernoulli equation theory method, the finite element method based on the standard turbulence model and the laboratory test to verify a kind of negative pressure wellbore cleaning tool which can establish local reverse circulation under the action of high-pressure water jet and salvage the bottom debris. Through the numerical analysis of the cleaning tool structure, it is found that the wall face diameter is at least two times of the nozzle hole diameter to effectively play the cleaning tool performance. If the total area of nozzle outlet is 48π mm2, the cleaning tool fishing capacity of six nozzle structures is improved the most. The analysis of the adaptability of the cleaning tool shows that the cleaning tool with an outer diameter of 104 mm is most suitable for the casing shaft with an inner diameter of 127.3 mm. The cleaning tool was applied to the field operation and successfully cleaned the wellbore, effectively increasing the wellbore productivity.
Factors Important in the Selection of a Rhinology/Skull Base Surgery Fellow: A National Survey of Fellowship Directors
Authors: Johnson Jared , Stathakios James , Chung Michael T. , Engel Ricardo , Folbe Adam
Published: August 2020

Background

The numbers of Rhinology/Skull Base Surgery fellowship programs and applicants have been increasing in recent years. However, little information is currently available with regards to the most important aspects of the application process.

Objective

The goal of this study was to determine the factors that Rhinology/Skull Base Surgery fellowship directors consider most important when selecting a fellow.

Methods

An anonymous, online survey was distributed to current Rhinology/Skull Base Surgery fellowship directors. 28 of 31 fellowship directors (90%) completed the survey. Respondents were asked to provide basic information regarding the program and to rank various selection factors they deem most important.

Results

For assessing the quality of an application, fellowship directors placed the highest value on LORs. Research experience and publications were also important considerations. The traditional strength of an applicant’s residency program was a factor, while medical school performance, USMLE scores, and OTE score did not play a significant role in the selection process. For subjective assessment of applicants, the most value was placed on faculty assessment of the applicant during their interview. Attention was also given to personality fit with the program and the perceived maturity and initiative of the applicant.

Conclusion

Numerous academic achievements and personal characteristics are given consideration in the Rhinology/Skull Base Surgery fellowship selection process, but recommendation from a trusted colleague and performance on interviews were viewed to be the most critical factors for fellowship programs in selecting applicants. This is consistent with studies that have explored the selection process for other otolaryngology fellowship programs.
Transcriptional re-programming in rat central nervous system two weeks after burn trauma: the impact of nephrilin treatment on the expression of oxidative stress-related genes
Authors: Mascarenhas Desmond D
Published: August 2020

Introduction:

Survivors of severe burns suffer lifetime neuroinflammatory consequences manifested by higher incidence of major depression and neurodegenerative disease. In a scald model, nephrilin peptide has previously been shown to protect rats from loss of lean body mass, kidney function and glycaemic control, complications that have also been shown to endure in burn patient populations. Nephrilin’s mechanism of action has been suggested to involve protection from excessive oxidative stress.

Methods:

Using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) amplification of transcripts in total RNA extracted from dorsal root ganglia of male rats 14 days after exposure to thermal insult, we query the relative levels of expression of 34 genes believed to be associated with oxidative stress biology in the central nervous system (CNS). We use these data to explore the central role of oxidative stress in astrogliosis, immunosuppression and mitochondrial homeostasis.

Results and Discussion:

Rats that received nephrilin treatment (4 mg/kg by subcutaneous bolus injection once daily for seven days after scald injury) showed significantly reduced elevations in gene expression of some key genes such as NOX2, GFAP, AQP4 and RAC1, but not of others such as NOX4, STEAP4, ARG1 and CCL2.

Conclusion:

The implications of these data with reference to nephrilin’s potential clinical utility for mitigating the enduring effects of burn trauma on the CNS are discussed. Nephrilin reduces the expression of some genes implicated in neurodegeneration after burn insult.

Lay Summary

Nephrilin peptide is a novel treatment for short- and long-term systemic effects of burn trauma. This study measures the capability of nephrilin to address post-traumatic neurodegenerative disease by looking at the expression of genes in the central nervous system, in a rat scald model. Nephrilin appears to have beneficial effects by reducing the expression of some key genes known to be relevant in neurodegenerative processes, but not others.
Managing Crises and Trauma in the Workplace
Authors: Lewis Gerald W.
Published: August 2020

Reactions to trauma/crisis in the workplace may have far reaching repercussions on the emotional as well as financial status of an organization. It is imperative to address these issues and situations as they occur.

Human resource, employee assistance, and occupational health professionals should: seek out and receive training in the area of managing trauma/crisis in the workplace; take responsibility for formulating policy and procedures with management; promote training programs that cover this topic for the organization; and use resources and other professionals that may have more/other experience in this area.

If individuals feel that their training is limited, they may want to contact an outside consultant to conduct the debriefmgs. However, the in-house staff will need to remain active and involved long after the outside consultant has left. Resolution of a crisis/trauma/disaster is not an event, but rather an ongoing process.
Hiring Practices and the Occupational Health Nurse Manager
Authors: Wachs Joy E.
Published: August 2020

In summary, the main purpose of the hiring process is to obtain job related information to match the most qualified applicant with the position. The process is designed to answer specific questions: Does the applicant have the experience, education, and skills necessary to successfully perform the job? Does the applicant share the values, mission, and goals of the health service? The nurse manager must develop and advertise a current job description, review applications, and interview with that job description in mind. An additional goal for the nurse manager is to create a process that is fair, objective, non-biased, and non-discriminatory, and that will result in a successful match between the new employee and the health service.
Evaluation of a Quality Assessment Manual
Authors: Walen Anna M.
Published: August 2020

Quality assurance in occupational health nursing is a social, political, and economic activity; it is a pathway to accountability, professionalism, and power. Obligations to employee, employer, and the profession are fulfilled in the achievement and maintenance of standards and the assurance of quality (Filios, 1991).
Performance Appraisal: A Motivational Tool
Authors: Wachs Joy E. , Lukes Eileen N.
Published: August 2020

To truly motivate employees, they must be challenged not only to improve, but to contribute significantly to the health service and the larger organization. Assisting employees to grow into their positions and gain competence in their work will result in satisfied employees who meet annual objectives and who are valuable assets to the company.
Evaluation of version of acetabular component following total hip replacement on conventional radiograph and computed tomography
Authors: Raj Manish , Jaiman Ashish , Chopra Rajesh Kumar
Published: August 2020

Background/Purpose:

Total hip replacement (THR) is considered as one of the most successful orthopedic procedures. However, improperly placed components can lead to instability and accelerated wear. Acetabular cup inclination can be very well accessed by anteroposterior pelvis X-rays; for acetabular version assessment, computed tomography (CT) scan is the gold standard. CT scan is not readily available at many centers and the surgeon has to rely on X-ray methods for evaluation of acetabular version to audit results and to predict behavior of the surgical intervention. This prospective study was undertaken to compare Woo and Morrey’s and ischiolateral methods of assessment of acetabular version on cross-table lateral radiographs with CT assessment and to assess the validity of radiographic methods with respect to CT scan method.

Material and methods:

A prospective follow-up study was conducted for 18 months’ duration (October 2016 to March 2018) on 30 adult patients who underwent THR surgery. Cross-table lateral radiograph was obtained at 3 and 6 weeks in the postoperative period. Two observers made each observation at two different points of time. CT scan was performed at 3 weeks. Version as measured by radiographs and CT scan was recorded.

Results:

The major overlap in the distribution of the values of the Woo and Morrey method suggests that there is no significant difference between the observations. Distribution of the values of the ischiolateral view and the CT scan value distributions have a very small overlap and hence suggest a strong significant difference between the two.

Conclusion:

In this study, Woo and Morrey’s method and ischiolateral method of assessment of acetabular version were compared with CT assessment. We found that in Woo and Morrey’s method, values were comparable to CT scan values, when put on regression line. However, in situation of change in patient positioning, namely hip stiffness in contralateral hip, measurement of component changed in series of radiography due to differences in pelvis tilt. So, in these circumstances, we can use ischiolateral method which can give consistent measurement. But it will not be in concordance with CT scan values and Woo and Morrey values, as represented in regression line. The high intra-class correlation coefficients for both intra- and inter-observer reliability indicated that the angle measured with these methods is consistent and reproducible for multiple observers. CT, however, be considered as gold standard for measurement owing to control over pelvic rotation and/or tilt/patient positioning.
Early Mentoring for Research and Academic Careers
Authors: Kichloo Asim
Published: August 2020

Research stands at the foreground of modern advances in medicine. Doing clinical research helps you become a good clinician, and doing good clinical work in turn makes you a better researcher. Being a good researcher and being a good clinician, most of the times, has one thing in common, a good mentor. When student at some point in medical school contemplates a research rotation, and this first rendezvous with the processes and, more important, the people involved in the project, determines how much interest one generates to carry forward in their medical career. This editorial focuses on the early mentoring for research and academic careers.
Expanding hermeneutic horizons: Working as multiple researchers and with multiple participants
Authors: Montague Jane , Phillips Eleanor , Holland Fiona , Archer Stephanie
Published: August 2020

The double hermeneutic is a central feature of interpretative phenomenological analysis (IPA). Typically, this has been considered in relation to individual researchers working with experiential accounts from individual participants. IPA has, however, frequently been applied by multiple researchers; a further layer of complexity occurs when individual or multiple researchers analyse data from group interactions. Little attention has been paid to hermeneutic considerations in these contexts. We present insights into our encounters with multiple hermeneutics as well as our application of the hermeneutic circle; we also consider implications for IPA research. Our multi-vocal approach to analysis requires us to work in a much more integrative manner than is generally represented in IPA literature. Explicitly attending to multiple hermeneutics in focus group situations provides additional insights into the social and cultural contexts within which participants’ experiences exist. This article discusses how the inclusion of multiple hermeneutics adds richness and robustness to IPA.
Broadening the GMO risk assessment in the EU for genome editing technologies in agriculture
Authors: Kawall Katharina , Cotter Janet , Then Christoph
Published: August 2020

Genome editing techniques, especially the CRISPR/Cas technology, increase the possibilities and the speed of altering genetic material in organisms. So-called genome editing is increasingly being used to achieve agriculturally relevant novel traits and/or genetic combinations in both plants and animals, although predominantly as proof of concept studies, with commercial growing or rearing so far limited to the U.S. and Canada. However, there are numerous reports of unintended effects such as off-target effects, unintended on-target effects and other unintended consequences arising from genome editing, summarised under the term genomic irregularities. Despite this, the searching for genomic irregularities is far from routine in these studies and protocols vary widely, particularly for off-target effects, leading to differences in the efficacy of detection of off-target effects. Here, we describe the range of specific unintended effects associated with genome editing. We examine the considerable possibilities to change the genome of plants and animals with SDN-1 and SDN-2 genome editing (i.e. without the insertion of genes conferring the novel trait) and show that genome editing techniques are able to produce a broad spectrum of novel traits that, thus far, were not possible to be obtained using conventional breeding techniques. We consider that the current EU risk assessment guidance for GMOs requires revision and broadening to capture all potential genomic irregularities arising from genome editing and suggest additional tools to assist the risk assessment of genome-edited plants and animals for the environment and food/animal feed in the EU.
Pertussis outbreak in southern Ethiopia: challenges of detection, management, and response
Authors: Mitiku Aychiluhim D. , Argaw Mesele D. , Desta Binyam F. , Tsegaye Zergu T. , Atsa Afework A. , Tefera Bekele B. , Teferi Ephrem , Rogers Deirdre , Beshir Ismael A. , Alemu Asrat G. , Ayesa Desta A. , Abate Derebe T. , Sendeku Agegnehu G. , Muloiwa Rudzani
Published: August 2020

Background

Despite the availability of effective vaccines, pertussis remains endemic with high fatality rates in low and middle-income countries (LMIC). This study aims to describe an outbreak of pertussis in a health district of Ethiopia. The study highlights the challenges faced by the health system in identifying pertussis cases and appropriately responding to the outbreak at the district level.

Methods

A descriptive cross-sectional study was conducted using data sourced from the District Public Health Emergency and Management (PHEM) surveillance service and outbreak management field reports. Stratified attack rates and fatality rates for pertussis are described. Systemic problems leading to the outbreak are explored and narrated. A modified CDC pertussis case definition was employed with a polymerase chain reaction used to confirm cases.

Results

From September 2018 to January 2019, 1840 suspected, probable, and confirmed pertussis cases and six deaths were identified. Pertussis cases ranged from 1 month to 51 years in age. An outbreak occurred in 14 out of the 24 villages of Dara Malo district. The overall attack rate was 1708 per 100,000 population with a fatality rate of 3.3 per 1000 pertussis cases. The highest attack rate of 12,689/100,000 was seen in infants. Among confirmed, probable and suspected pertussis cases, only 41.1% had completed the three-dose pertussis vaccine’s primary schedule. The household survey revealed a population coverage of 73.4 and 40.8% for Pentavalent vaccine dose one and three respectively. Investigations suggested the existence of a poor cold chain management system in the study area.

Conclusions

There is an urgent need to build capacity to strengthen routine vaccination services and improve the maintenance of the vaccine cold chain. Other LMICs are urged to take lessons learned from this outbreak to strengthen their own vaccination programs and capacitate health workers to manage local outbreaks.
The effects of spinach-derived thylakoid supplementation in combination with calorie restriction on anthropometric parameters and metabolic profiles in obese women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled clinical trial
Authors: Tabrizi Fatemeh Pourteymour Fard , Farhangi Mahdieh Abbasalizad , Vaezi Maryam , Hemmati Salar
Published: August 2020

Background

There is a promising outlook regarding the potential effect of spinach-derived thylakoids in the management of obesity and its associated metabolic disturbances. This research aimed to evaluate the effects of spinach-derived thylakoids supplementation combined with a calorie-restricted diet on anthropometric and metabolic profiles in obese women with the polycystic ovary syndrome (PCOS).

Methods

In a 12-week double-blind placebo-controlled randomized clinical trial, 48 females with obesity and PCOS were randomly allocated into either intervention (5 g/day thylakoid) or placebo (5 g/day cornstarch) groups along with calorie-restricted diets. Anthropometric measures, physical activity levels, dietary intakes, insulin resistance markers, as well as serum levels of insulin, fasting blood glucose (FBG), non-esterified fatty acids (NEFA), and sex hormones including dehydroepiandrosterone sulfate (DHEAS), follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), and free androgen index (FAI) were evaluated pre-and post-intervention.

Results

After the 12-week intervention, there were significant decreases in weight (− 6.97 ± 0.52 vs. -3.19 ± 0.72 kg;P < 0.001), waist circumference (− 7.78 ± 2.50 vs. -3.73 ± 1.40 cm;P < 0.001), fat mass (− 5.19 ± 0.53 vs. -1.36 ± 0.39 kg;P < 0.001), and insulin levels (− 5.40 ± 1.86 vs. -1.19 ± 0.85 μU/mL;P < 0.001) in the spinach-derived thylakoid group compared to the placebo group. Furthermore, insulin resistance markers and serum levels of testosterone decreased significantly in the thylakoid group compared to the placebo group (P < 0.05). The changes in other parameters did not show significant differences between the two groups.

Conclusions

Spinach-derived thylakoid supplementation resulted in more favorable improvements in anthropometric indices and insulin sensitivity compared to the calorie restriction alone.

Trial registration

The study was approved by the Ethics Committee of Research Vice-chancellor of Tabriz University of Medical Sciences, Tabriz, Iran, and was registered in the Iranian Registry of Clinical Trials (registration ID:IRCT20140907019082N9).
Androgen levels in the fetal cord blood of children born to women with polycystic ovary syndrome: a meta-analysis
Authors: Duan Changling , Pei Tianjiao , Li Yujing , Cao Qi , Chen Hanxiao , Fu Jing
Published: August 2020

Introduction

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in reproductive-aged women. It is reported that intrauterine exposure to hyperandrogenism may induce the development of PCOS and associated complications in later life. To analyze the intrauterine androgen levels in infants born to PCOS mothers, we evaluated the androgen levels in fetal cord blood through a meta-analysis of observational studies.

Material and methods

The following online databases were systematically searched: PubMed, EMBASE, Cochrane library databases and Web of Science up to December 2019. Human studies compared cord blood androgen levels, including testosterone (T) and androstenedione (ADION), in fetal cord blood of mothers with and without PCOS. Statistical analysis was performed in Review Manager, Version 5.3, with the inverse variance method based on a random-effects model.

Results

A total of 7 articles were scrutinized and a total of 570 samples including 268 female and 222 male infants were qualified for review. In the mass spectrograph (MS) subgroup, PCOS mothers showed no signs of increased T concentration in umbilical cord blood at birth (4 studies; hazard ratio [HR] = − 0.05; 95% confidence interval [CI] = [− 0.33,0.24]; I2 = 7%;P = 0.75; fixed-effects model). ADION level tends to be lower in daughters’ cord blood of PCOS mothers (3 studies; HR = -0.59; 95%CI = [− 1.00, − 0.19]; I2 = 0%;P = 0.004; fixed-effects model).

Conclusions

Fetal cord blood T level is not related to PCOS, while ADION levels tend to be lower in the cord blood of daughters born to mothers with PCOS.
Memantine ameliorates motor impairments and pathologies in a mouse model of neuromyelitis optica spectrum disorders
Authors: Yick Leung-Wah , Tang Chi-Ho , Ma Oscar Ka-Fai , Kwan Jason Shing-Cheong , Chan Koon-Ho
Published: August 2020

Background

Neuromyelitis optica spectrum disorders (NMOSD) are central nervous system (CNS) autoimmune inflammatory demyelinating diseases characterized by recurrent episodes of acute optic neuritis and transverse myelitis. Aquaporin-4 immunoglobulin G (AQP4-IgG) autoantibodies, which target the water channel aquaporin-4 (AQP4) on astrocytic membrane, are pathogenic in NMOSD. Glutamate excitotoxicity, which is triggered by internalization of AQP4-glutamate transporter complex after AQP4-IgG binding to astrocytes, is involved in early NMOSD pathophysiologies. We studied the effects of memantine, a N-methyl-D-aspartate (NMDA) receptor antagonist, on motor impairments and spinal cord pathologies in mice which received human AQP4-IgG.

Methods

Purified IgG from AQP4-IgG-seropositive NMOSD patients were passively transferred to adult C57BL/6 mice with disrupted blood-brain barrier. Memantine was administered by oral gavage. Motor impairments of the mice were assessed by beam walking test. Spinal cords of the mice were assessed by immunofluorescence and ELISA.

Results

Oral administration of memantine ameliorated the motor impairments induced by AQP4-IgG, no matter the treatment was initiated before (preventive) or after (therapeutic) disease flare. Memantine profoundly reduced AQP4 and astrocyte loss, and attenuated demyelination and axonal loss in the spinal cord of mice which had received AQP4-IgG. The protective effects of memantine were associated with inhibition of apoptosis and suppression of neuroinflammation, with decrease in microglia activation and neutrophil infiltration and reduction of increase in levels of proinflammatory cytokines including interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). In addition, memantine elevated growth factors including brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and vascular endothelial growth factor (VEGF) in the spinal cord.

Conclusions

Our findings support that glutamate excitotoxicity and neuroinflammation play important roles in complement-independent pathophysiology during early development of NMOSD lesions, and highlight the potential of oral memantine as a therapeutic agent in NMOSD acute attacks.
Correction to: Medium-scale traveling ionospheric disturbances by three-dimensional ionospheric GPS tomography
Authors: Chen C. H. , Saito A. , Lin C. H. , Yamamoto M. , Suzuki S. , Seemala G. K.
Published: August 2020

An amendment to this paper has been published and can be accessed via the original article.
Threat, hostility and violence in childhood and later psychotic disorder: population-based case–control study
Authors: Morgan Craig , Gayer-Anderson Charlotte , Beards Stephanie , Hubbard Kathryn , Mondelli Valeria , Di Forti Marta , Murray Robin M. , Pariante Carmine , Dazzan Paola , Craig Thomas J. , Reininghaus Ulrich , Fisher Helen L.
Published: August 2020

Background

A growing body of research suggests that childhood adversities are associated with later psychosis, broadly defined. However, there remain several gaps and unanswered questions. Most studies are of low-level psychotic experiences and findings cannot necessarily be extrapolated to psychotic disorders. Further, few studies have examined the effects of more fine-grained dimensions of adversity such as type, timing and severity.

Aims

Using detailed data from the Childhood Adversity and Psychosis (CAPsy) study, we sought to address these gaps and examine in detail associations between a range of childhood adversities and psychotic disorder.

Method

CAPsy is population-based first-episode psychosis case–control study in the UK. In a sample of 374 cases and 301 controls, we collected extensive data on childhood adversities, in particular household discord, various forms of abuse and bullying, and putative confounders, including family history of psychotic disorder, using validated, semi-structured instruments.

Results

We found strong evidence that all forms of childhood adversity were associated with around a two- to fourfold increased odds of psychotic disorder and that exposure to multiple adversities was associated with a linear increase in odds. We further found that severe forms of adversity, i.e. involving threat, hostility and violence, were most strongly associated with increased odds of disorder. More tentatively, we found that some adversities (e.g. bullying, sexual abuse) were more strongly associated with psychotic disorder if first occurrence was in adolescence.

Conclusions

Our findings extend previous research on childhood adversity and suggest a degree of specificity for severe adversities involving threat, hostility and violence.
Brigatinib Versus Crizotinib in Advanced ALK Inhibitor–Naive ALK-Positive Non–Small Cell Lung Cancer: Second Interim Analysis of the Phase III ALTA-1L Trial
Authors: Camidge D. Ross , Kim Hye Ryun , Ahn Myung-Ju , Yang James C. H. , Han Ji-Youn , Hochmair Maximilian J. , Lee Ki Hyeong , Delmonte Angelo , García Campelo Maria Rosario , Kim Dong-Wan , Griesinger Frank , Felip Enriqueta , Califano Raffaele , Spira Alexander , Gettinger Scott N. , Tiseo Marcello , Lin Huamao M. , Gupta Neeraj , Hanley Michael J. , Ni Quanhong , Zhang Pingkuan , Popat Sanjay
Published: August 2020

PURPOSE

Brigatinib, a next-generation anaplastic lymphoma kinase (ALK) inhibitor, demonstrated superior progression-free survival (PFS) and improved health-related quality of life (QoL) versus crizotinib in advanced ALK inhibitor–naive ALK-positive non–small cell lung cancer (NSCLC) at first interim analysis (99 events; median brigatinib follow-up, 11.0 months) in the open-label, phase III ALTA-1L trial (ClinicalTrials.gov identifier: NCT02737501 ). We report results of the second prespecified interim analysis (150 events).

METHODS

Patients with ALK inhibitor–naive advanced ALK-positive NSCLC were randomly assigned 1:1 to brigatinib 180 mg once daily (7-day lead-in at 90 mg once daily) or crizotinib 250 mg twice daily. The primary end point was PFS as assessed by blinded independent review committee (BIRC). Investigator-assessed efficacy, blood samples for pharmacokinetic assessments, and patient-reported outcomes were also collected.

RESULTS

Two hundred seventy-five patients were randomly assigned (brigatinib, n = 137; crizotinib, n = 138). With median follow-up of 24.9 months for brigatinib (150 PFS events), brigatinib showed consistent superiority in BIRC-assessed PFS versus crizotinib (hazard ratio [HR], 0.49 [95% CI, 0.35 to 0.68]; log-rank P < .0001; median, 24.0 v 11.0 months). Investigator-assessed PFS HR was 0.43 (95% CI, 0.31 to 0.61; median, 29.4 v 9.2 months). No new safety concerns emerged. Brigatinib delayed median time to worsening of global health status/QoL scores compared with crizotinib (HR, 0.70 [95% CI, 0.49 to 1.00]; log-rank P = .049). Brigatinib daily area under the plasma concentration–time curve was not a predictor of PFS (HR, 1.005 [95% CI, 0.98 to 1.031]; P = .69).

CONCLUSION

Brigatinib represents a once-daily ALK inhibitor with superior efficacy, tolerability, and QoL over crizotinib, making it a promising first-line treatment of ALK-positive NSCLC.
Hypofractionated Versus Conventional Fractionated Radiotherapy After Breast-Conserving Surgery in the Modern Treatment Era: A Multicenter, Randomized Controlled Trial From China
Authors: Wang Shu-Lian , Fang Hui , Hu Chen , Song Yong-Wen , Wang Wei-Hu , Jin Jing , Liu Yue-Ping , Ren Hua , Liu Juan , Li Gao-Feng , Du Xiang-Hui , Tang Yu , Jing Hao , Ma Yu-Chao , Huang Zhou , Chen Bo , Tang Yuan , Li Ning , Lu Ning-Ning , Qi Shu-Nan , Yang Yong , Sun Guang-Yi , Liu Xin-Fan , Li Ye-Xiong
Published: August 2020

PURPOSE

No randomized trials have compared hypofractionated radiotherapy (HFRT) with conventional fractionated radiotherapy (CFRT) after breast-conserving surgery in the Asian population. This study aimed to determine whether a 3.5-week schedule of HFRT is noninferior to a standard 6-week schedule of CFRT in China.

PATIENTS AND METHODS

Patients from 4 Chinese institutions who had undergone breast-conserving surgery and had T1-2N0-3 invasive breast cancers participated this study. Patients were randomly assigned (1:1) using a computer-generated central randomization schedule, without stratification, to receive whole-breast irradiation with or without nodal irradiation, followed by tumor-bed boost, either at a dose of 50 Gy in 25 fractions over 5 weeks with a boost of 10 Gy in five fractions over 1 week (CFRT) or 43.5 Gy in 15 fractions over 3 weeks with a boost of 8.7 Gy in three daily fractions (HFRT). The primary endpoint was 5-year local recurrence (LR), and a 5% margin of 5-year LR was used to establish noninferiority.

RESULTS

Between August 2010 and November 2015, 734 patients were assigned to the HFRT (n = 368) or CFRT (n = 366) group. At a median follow-up of 73.5 months (interquartile range, 60.5-91.4 months), the 5-year cumulative incidence of LR was 1.2% in the HFRT group and 2.0% in the CFRT group (hazard ratio, 0.62; 95% CI, 0.20 to 1.88; P = .017 for noninferiority). There were no significant differences in acute and late toxicities, except that the HFRT group had less grade 2-3 acute skin toxicity than the CFRT group ( P = .019).

CONCLUSION

CFRT and HFRT with a tumor-bed boost may have similar low LR and toxicity.
Management of Aromatase Inhibitor–Induced Musculoskeletal Symptoms
Authors: Gupta Arjun , Henry N. Lynn , Loprinzi Charles L.
Published: August 2020

Aromatase inhibitor–induced musculoskeletal symptoms (AIMSS) were first recognized as a distinct entity in 2001, 5 years after the approval of the first aromatase inhibitor, anastrozole. Musculoskeletal symptoms can severely affect patients’ quality of life and also lead to premature discontinuation of aromatase inhibitor therapy. Several interventions for managing AIMSS have been investigated in the last decade, with some demonstrating promise. This article provides an evidence-based summary to guide practicing oncologists in regard to the epidemiology, prevention, and treatment of AIMSS.
The UPRosome – decoding novel biological outputs of IRE1α function
Authors: Urra Hery , Pihán Philippe , Hetz Claudio
Published: August 2020

Different perturbations alter the function of the endoplasmic reticulum (ER), resulting in the accumulation of misfolded proteins in its lumen, a condition termed ER stress. To restore ER proteostasis, a highly conserved pathway is engaged, known as the unfolded protein response (UPR), triggering adaptive programs or apoptosis of terminally damaged cells. IRE1α (also known as ERN1), the most conserved UPR sensor, mediates the activation of responses to determine cell fate under ER stress. The complexity of IRE1α regulation and its signaling outputs is mediated in part by the assembly of a dynamic multi-protein complex, named the UPRosome, that regulates IRE1α activity and the crosstalk with other pathways. We discuss several studies identifying components of the UPRosome that have illuminated novel functions in cell death, autophagy, DNA damage, energy metabolism and cytoskeleton dynamics. Here, we provide a theoretical analysis to assess the biological significance of the UPRosome and present the results of a systematic bioinformatics analysis of the available IRE1α interactome data sets followed by functional enrichment clustering. This in silico approach decoded that IRE1α also interacts with proteins involved in the cell cycle, transport, differentiation, response to viral infection and immune response. Thus, defining the spectrum of IRE1α-binding partners will reveal novel signaling outputs and the relevance of the pathway to human diseases.