bluuebunny/crossref_metadata_2025 huggingface dataset:
Early recovery after surgery in elective obstetrics-gynaecology surgeries: prospective single-center pilot study
Authors: Jain Ritu V. , Jain Vaibhav
Published: May 2021

Background: Enhanced recovery after surgery (ERAS) programmes employed in elective colorectal, vascular, urologic and orthopaedic surgery has provided strong evidence for decreased hospital stay without increase in postoperative complications. The aim of the study was to explore role and benefits, if any, of ERAS/ERP (early recovery protocols) implemented in patients undergoing elective obstetrics-gynaecological surgeries.Methods: Prospective cohort of 48 consecutive patients undergoing elective obstetrics-gynaecological surgeries were included. ERP included early feeding, urinary catheter removal, mobilisation/physiotherapy, intravenous line removal and optimal oral analgesia. This was compared to control group of 50 patients undergoing similar operations prior to introduction of ERP, SPC group-standard perioperative care. Demographics and indications of surgeries were similar for both groups. The primary end-points were length of stay (LOS) and incidence of complications (Clavien-Dindo classification). Difference in means was tested using the t test assuming unequal variances. Statistical significance was defined as p<0.05.Results: Two groups, A (non-ERAS/SPC) and B (ERAS) were comparable with regards to demographics and indication of surgery. The mean time to solid diet, urinary catheter removal, mobilization, iv fluid removal and shift to oral analgesia was 2.57, 1.13 (p<0.00001), 1.99 ,1.03 (p<0.00268), 1.63, 1.2 (p<0.00001), 1.72, 1.14 (p<0.00001), 1.8, 1.37 (p<0.00001) days respectively. There were 31 and 21 complications in both groups, respectively (p<0.0097). Hospital stay was significantly shorter in the ERAS group, 2.87, 2.61 (p<0.0378).Conclusions: This pilot study shows that ERPs can be successfully implemented with significant shorter hospital stays without increase in postoperative complications in elective obstetrics-gynecology patients.
Clinico-histopathological and ultrasonographic correlation of abnormal uterine bleeding in perimenopausal and postmenopausal women
Authors: . Sharanya , Thomas Julie
Published: May 2021

Background: Abnormal uterine bleeding (AUB) accounts for one of the most common gynaecological problem, almost one third of total cases. The study was a prospective study done from December 2017 to November 2019. The histopathological reports of endometrial pattern as well as that of hysterectomy specimens were correlated with clinical diagnosis and ultrasonographic findings. The main objective was to study the correlation between clinical, ultrasonographic and histopathological correlation of AUB in perimenopausal, menopausal and postmenopausal women.Methods: Formal Permission was obtained from the administrator of St. Philomena’s hospital. Ethical clearance was obtained from institutional ethical review board of St. Philomena’s hospital. Informed consent was obtained from observational group and confidentiality was assured.  Data entry and analyses was done using the Statistical Package for Social Sciences (SPSS) for Windows software (version 20.0; SPSS Inc, Chicago).Results: A total number of 165 cases were studied. Maximum women were in the age group of 40-55 years 87.27%. Most common presentation of abnormal uterine bleeding is menorrhagia which accounts for 72.7% of women (120 women). The most common finding noted in USG was fibroid uterus which accounts for 44.2% of women (73 women). Most commonly observed histological pattern noted were proliferative (62.4%) followed by secretory endometrium (8.5%) and simple endometrial hyperplasia with atypia (8.5%).Conclusions: In conclusion, AUB is one of the most common condition for which patients seek advice in the gynaecological outpatient department. Analysis of histopathology of endometrium in abnormal uterine bleeding helps in management of patients and to know the pathological incidence of structural causes in AUB prior to surgery.
Clinical and sonographic features in infertile women with and without polycystic ovarian syndrome
Authors: Udofia Tenkeu A. , Jinadu Faosat O. , Ottun Abimbola T. , Olumodeji Ayokunle M.
Published: May 2021

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine cause of infertility affecting about 1 in 10 women of reproductive age. This study determined the proportion of infertile women with PCOS and compared clinical and sonographic features in infertile women with PCOS and without PCOS.Methods: This was a prospective comparative cross-sectional study at the Lagos State University Teaching Hospital over a 6 month period. One hundred and fifty two infertile women were recruited and had trans-vaginal ultrasonography for the presence and absence of polycystic ovaries. The diagnosis of PCOS was made using the Rotterdam criteria with other relevant socio-demographic and clinical data noted in the study proforma. Student t and chi-square tests were used as appropriate.Results: The prevalence of PCOS among infertile women was 32.9%. The mean age of infertile women diagnosed with PCOS and without PCOS was 33±4.90 and 32.71±5.00 years, respectively. Women with PCOS had significantly higher BMI than women without PCOS. Increased ovarian volume, peripheral follicular distribution and increased stromal echogenicity were observed in 60%, 74% and 94% of women with PCOS on trans-vaginal ultrasound compared to 11.8%, 2% and 2% of women without PCOS, respectively.Conclusions: The prevalence of PCOS among infertile women is high. Clinical characteristics of women with PCOS and women without PCOS are similar except in their BMI and features that constitute the diagnostic criteria for PCOS.
Single versus double intrauterine insemination to assess the relevance of double intrauterine insemination: a prospective, randomized multicentric study
Authors: Patil Deepak
Published: May 2021

Background: Intrauterine insemination (IUI) is a widely used tool as initial treatment option for infertile couples. Being a non-invasive, outpatient department (OPD) based procedure it serves as first modality of assisted reproductive technique. Overtime various modifications in stimulation protocol, sperm preparation techniques and variation in timing has been attempted to improve upon the success rates.Methods: We conducted a multicentric, prospective randomized study and assessment of data of double IUI at three tertiary care centers of armed forces. The data was evaluated to study the patient parameters and various factors affecting the success rate of IUI.Results: We found that duration of infertility, age of couple and body mass index (BMI) are inversely related to success of IUI cycles. Double IUI increases the success rate in borderline male factor infertility, ladies with normal BMI and in cases of secondary infertility with previous live issue. In donor IUI cycles there is a positive correlation with sperm parameters and benefit from double insemination.Conclusions: Double IUI can be offered to selected couples to improve upon the success rate of IUI cycle.
Effect of back massage on relieving pain during labour: a systemic review
Authors: Choudhary Suman , Jelly Prasuna , Mahala Prakash , Mery Amali
Published: May 2021

Managing labour pain is a challenging concern for nurses who involved in care of mothers during labour and child birth. Massage is a primordial method that has been generally employed during labour, however, relatively little study has been assumed examining the effects of massage on women during labour. The study insistent pain allied with labour may negatively impact mother further transforming to foetus, frequently varying the childbirth course. The techniques of health care humanisation mention that women in labour should have the chance to relieve their pain with pharmacological and non-pharmacological methods. The systemic review examines literature on effectiveness of back massage to relieve labour pain from 2013 to 2019. The electronic database reviewed for the systemic review included PubMed, Medline, nursing health journal, Google scholar etc by including relevant key words. Ten studies were included in the systemic review. The available literature on non-pharmacological method provides evidence as a back massage is effective to reduce labour pain. The aim of the present review is to examine the effect of back massage as a method to relieve labour pain and give comfort to mother. The experience of labour pain is different in women and it is affected by several psychological and physiological factors and its intensity may vary significantly. During labour majority of women need pain relief. Strategies of pain management include pharmacological and non-pharmacological intervention. Evidence suggests that non pharmacological methods are helpful to reduce labour pain. We identified 10 reviews out of 110 for inclusion within this review. All studies on back massages show that it is effective to relieve pain during labour.
Study of correlation between age with incidence of endometrial cancer and histopathological type
Authors: Bharaswadkar Ganesh
Published: May 2021

Endometrial carcinoma is one of the commonest Gynecological malignancy. Endometrioid type is the most common type associated with hyper-estrogenic state and has better prognosis. While non endometrioid type is less common, associated with elderly age and has dismal prognosis. Uterine cancer is most often observed in higher age group with average age at diagnosis of 60 years. It most often occurs in women over 50. 16 cases of endometrial carcinoma were collected from January 2018 until November 2020.The study evaluated the correlation of age with incidence and type of endometrial cancer by categorizing patients into different age groups and then analyzing them. The most affected age group was between 60-70 years and commonest type of endometrial cancer identified was Endometrioid type.
Stump tumors: clinical, histological and therapeutic aspects a case report
Authors: Moustaide Houda , Ziane Doha , Bzioui Ilias , Benkirane Saad
Published: May 2021

Smooth uterine muscle tumor of uncertain malignant potential (STUMP) belongs to a unique entity that is rare and known by its complexity.  Histology is the gold standard for the diagnosis. The aim of the study was to expose the latest researches in the field, about the clinical and radiological aspects to find a way to recognize these tumors way before surgery in order to discuss the best therapeutic strategy, by way of a clinical case report.
A case of intrauterine fetal demise with cord prolapse
Authors: Devi L. Thulasi , Prasad Gurusamy
Published: May 2021

A case of intrauterine fetal demise with cord prolapse, presenting to the labour room in active labour. Labour was uneventful; however, it reminds of importance of institutional deliveries, alert midwives, and importance of dedicated obstetric operation theatres and teams to prevent adverse maternal and neonatal outcome.
Postmenopausal endometrial carcinoma presenting as urinary incontinence: a case report
Authors: Agrawal Priti , Agrawal Rishi , Jain Jaswant , Lobo Anandi
Published: May 2021

Endometrial carcinoma (EC) most commonly presents with postmenopausal bleeding (PMB) or blood tinged vaginal discharge. Watery vaginal discharge is usually reported in fallopian tube malignancy. We reported a case of EC where she had profuse watery discharge from private part mimicking urine and so patient visited urologist for urinary incontinence and was later diagnosed as endometroid adenocarcinoma. A 73 year old female presented with history of passing urine involuntarily for last 3 months. Endometrial biopsy revealed endometrial endometroid adenocarcinoma-FIGO grade-2. FDG PET-CT scan revealed primary neoplastic pathology of uterus or endometrium with no lymphadenopathy. PMB or vaginal discharge in women with high risk factors like obesity, diabetes mellitus, unopposed oestrogen exposure needs prompt evaluation. PMB is highly suspicious of malignancy arising from cervix or uterus but copious watery discharge should also be evaluated thoroughly with ultrasound and confirmation of underlying malignancy with hysteroscopic guided endometrial sampling should be done.
Study on baseline characteristics and lipid profile abnormalities among type 2 diabetic patients attending urban diabetic care hospital, Bangladesh
Authors: Islam Shajedul , Islam Ariful , Bari Wasim , Islam Ariful , Islam Sifat Ul , Islam Mohammad Amirul
Published: May 2021

Background: Altered levels of serum glycated hemoglobin (HbA1c) and lipid profile are prevalent in patients having type 2 diabetic mellitus (T2DM). Aim of the study was to investigate the relationship between serum HbA1c and lipid profile in T2DM to predict diabetic dyslipidemia.Methods: A structured questionnaire was filled up by each study subject to collect data according to study protocol including age, gender, BMI, BP, residential status, socio-economic status, educational status, physical activity, dietary habit, smoking and duration of diabetes. We collected blood samples from 270 type-2 diabetes mellitus (T2DM) patients aged 30-65 years after overnight fasting (10-12 hours). Then blood samples collected from T2DM patients were used to measure serum levels of HbA1c, fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) were estimated by standard laboratory methods.Results: In this study, increased levels of fasting blood glucose (8.61 mmo/l), HbA1c (7.86%), TC (226.15 mg/dl), TG (193.34 mg/dl) and LDL (147.37 mg/dl), and decreased levels of HDL (40.36 mg/dl) were observed in T2DM patients. Moreover, the strong positive correlation of HbA1c levels with FBG, TC, TG, and LDL levels were found in this study. Besides, a very strong and significant negative correlation (R2=0.1822) between the serum levels of HbA1c and HDL were noted in this study.Conclusions: This study revealed a strong correlation between dyslipidemia and serum levels of HbA1c in T2DM patients.
CARACTERIZAÇÃO DE BARRAS DE CEREAIS ENRIQUECIDAS COM COCO OURICURI (Syagrus coronata)
Authors: Rodrigues Lima José Rafael , Santos Leite Kerolayne , Dos Santos Silva João Victor , Pereira Lopes Neto José Honório , Almeida Silva Joanna Beatriz
Published: May 2021

O presente trabalho teve como objetivo desenvolver barra de cereal adicionada de coco ouricuri (Syagrus coronata) e realizar análises físico-químicas e microbiológicas. A palmeira do coco ouricuri é predominantemente encontrada na região sertaneja, seu fruto possui tamanho aproximado de dois centímetros e são utilizados na produção de doces, como a cocada e também na produção de óleo. O uso do coco ouricuri na produção da barra de cereal, além de agregar valor nutricional à mesma, apresenta uma importância socioeconômica à região produtora, pois dessa maneira apresenta-se uma nova destinação para o fruto. Para a elaboração do produto, inicialmente os cocos foram coletados e higienizados. Na produção da barra de cereal fez-se a aglutinação do xarope (mel, xarope de glucose e óleo de coco) sob aquecimento, até atingir a concentração de 85-89 °BRIX. Logo em seguida, os ingredientes secos foram misturados ao xarope e foram obtidas 4 formulações com diferentes porcentagens de coco ouricuri 0, 10, 20 e 30% correspondendo a FP, F1, F2 e F3, respectivamente. Posteriormente, procedeu-se o corte e o resfriamento da massa, realizando em seguida os testes físico-químicos e microbiológicos. Quanto aos aspectos microbiológicos, as formulações apresentaram-se dentro dos requisitos exigidos pela legislação brasileira. Os resultados encontrados nas formulações adicionadas de coco ouricuri F1, F2 e F3 apresentaram valores de proteínas, lipídeos e cinzas compatíveis com a literatura. Conclui-se, que a utilização desse fruto na elaboração de barras de cereais é uma boa opção para difundir o seu uso na indústria alimentícia.
Produção de hidrolisado proteico de carne de palometa (Serrasalmus spilopleura) e avaliação das propriedades tecno-funcionais
Authors: Carricio Viero Rangieli , Fontoura da Silva Kassandra , Bueno Ribas Verônica , Mendes Furlan Valcenir Júnior , Salete Centenaro Graciela
Published: May 2021

O presente trabalho teve como objetivo elaborar um hidrolisado proteico de carne de palometa (Serrasalmus spilopleura) por via enzimática utilizando a enzima Alcalase, bem como realizar a caracterização físico-química e avaliar suas propriedades tecno-funcionais. O grau de hidrólise (GH) do hidrolisado proteico de palometa foi 17,4% e conteúdo proteico de 68,25±0,48%. O hidrolisado apresentou elevada solubilidade (acima de 79%) em diferentes pHs, capacidade de retenção de água máxima (5%) em pH 5,0 e 7,0, capacidade de formação de espuma de 50,0% e estabilidade de espuma de 45,7±2,08% após 60 min. O hidrolisado proteico de palometa não apresentou capacidade de formar emulsão e o teor de brancura (W) do produto foi de 87,89±0,08. Os resultados demonstram que o hidrolisado de músculo de palometa ​​apresentou boas propriedades de solubilidade e de formação de espuma, indicando possível uso em diferentes formulações alimentícias.
Inhibition of the fungus Colletotrichum lindemuthianum in the presence of different potassium sorbate concentrations
Authors: Engel Fernanda , Azeredo Coutinho Neto Antônio
Published: May 2021

One of the major problems of in vitro plant cultivation is caused by contaminations such asfungal, which represent great losses for plant cultivation laboratories. In view of the problem about contamination and gaps in efficient disinfection protocols, the present study aimed to evaluate the inhibition of the fungus Colletotrichum. lindemuthianum in the presence of the potassium sorbate food preservative at different concentrations (0 g L-1; 0.076 g. L-1; 0.15 g. L-1; 0.30 g. L-1; 0.45 g. L-1; 0.60 g. L-1 and 0.75 g. L-1). The analyses of the Percentage of Micelal Growth Inhibition (ICP) and the growth at 24 and 72 hours at different concentrations were quantified. It was observed that Potassium Sorbate was effective in the analysis of ICP at different concentrations in relation to control, with greater effectiveness for T4 to T7. The highest percentages of inhibition (T5 to T7) presenting an inhibition rate of mean mycelial growth of 17.5 % in relation to the control for the 72h period, indicating, therefore, that with further studies this preservative can be used to combat fungal microorganisms in vitro culture.
Expediente
Authors: Agrogeoambiental Revista
Published: May 2021

Expediente
The Women-Historians in F.W. Maitland’s Scientific School: Mary Bateson
Authors: Sidorova Tamara A.
Published: May 2021

Women-historians make up a small part of the scientific school of the outstanding British historian and lawyer F.W. Maitland (1850-1906). The gender profile of F.W. Maitland’s school was not the subject of special study. The women’s coming in the historical science of Great Britain in 1880-1890s was the result of a broad suffragist movement, granting women equal rights with men in higher education in national universities. The formation of “female” medieval studies was influenced by F.W. Maitland as a scholar and a professor of Cambridge University - his methodological approach, relevance with archival records as the main base of the historical studies, his fruitful publishing activities. Three prominent women-medievalists - Mary Bateson (1850-1906), Helen Maud Cam (1885-1968) and Bertha Haven Putnam (1872-1960), specialized in different spheres of the English medieval history, but in line with the teacher’s methodology, represented F.W. Maitland’s scientific school the most clearly. The scientific activity of Mary Bateson, a recognized and direct student of F.W. Maitland, one of the most famous British scientists in the field of medieval studies, is being investigated.
Migration and Identity in Contemporary Bulgarian Society
Authors: Nakova Albena I.
Published: May 2021

The article, based on the results of an empirical sociological study, examines the changes in the national identity of Bulgarian citizens under the influence of active migration processes within the EU. The started process of formation of su- pranational/European identity is substantiated. The exceptional dynamics of contemporary social processes, mass migratory movements in a world where borders are becoming more open and even practically absent (within the EU), and huge distances are covered in a very short time lead to significant changes in the identity of the Bulgarian citizens. New types of identity appear that are structurally and functionally different from the pre-existing ones, corresponding to the previous axiological paradigms. Constant process of movement from one society to another, and in particular from the new EU member states to the old member states within the “liquid migration”, leads to the transfer, assimilation and reconciliation of ideas, perceptions, understandings, values and behaviors that are typical for different societies, social groups and cultures. Bulgaria and Bulgarian citizens have been involved in these processes for three decades, with a gradually increasing intensity. Today the Bulgarian national identity is in constant transformation - the Bulgarian citizen becomes a European citizen, a citizen of the world. Thus, the specificity of social development logically leads to the formation of a supranational identity. On the other hand, when the change becomes permanent feature of society and radical changes occur over extremely short periods of time, it creates prerequisites for dissonance of identity. And sometimes, instead of the formation of a supranational identity, reverse processes of closure, localization, and regionalization are observed. It can be said that in modern Bulgarian society, the processes of European integration are accompanied by opposite processes of “atomization” of society and the “closure” of people into smaller, than national communities. The results of a national representative survey show that at this stage of development of the Bulgarian society, identification with the nation-state remains a key for Bulgarian citizens - more than half of the respondents identify themselves as citizens of Bulgaria. Almost one third of Bulgarian citizens, however, identify themselves with supranational structures (“citizen of Europe” and “citizen of the world”), which is an illustration of the processes of the formation of a supranational identity that have begun. And the identification of about one tenth of the respondents with their hometown, with the place where they were born, reflects the opposite trend of formation of local identity.
The Association Between Vitamin C Deficiency and Metabolic Syndrome Among Patients Who Developed Kidney Disease
Authors: Negesse Ayenew , Moges Beminet , kebede Tigest , Kifle Abiy , Alemayehu Dagim , Negesse Yilkal , Tesfaye Sisay , Fite Alemu
Published: May 2021

Introduction: Elevated albuminuria is an important outcome of diabetic complications and metabolic syndrome (MetS), the complex metabolic abnormalities manifested as glucose intolerance, hypertension, and dyslipidemia and enlarged waist circumference. These coexisting cardio-metabolic abnormalities are also associated with oxidative stress and low grade inflammation. Vitamin C (vitC) has long been recognized as hydrophilic antioxidant and blocker of oxidative stress which also has a protective role of MetS and kidney disease. Objective: The aim of this study was to identify the predictive effect of vitC deficiency on kidney disease among patients who developed metabolic syndrome. Method and procedures: To meet this objective, the National Health and Nutrition Examination Survey (NHANES) 2007-2008 data were used. NHANES represents the civilian, non-institutionalized US population data implemented for continuous system of monitoring health, nutritional status and well-being in the US. The predictive power of MetS on AU and vitC deficiency (vitC < 0.25 mg/dl) as effect modifier was assessed with binary logistic regression. Age, gender, race and BMI were used as covariates. Results: Among the respondents, 1.9% of the US population had risk of kidney damage, whereas 14.5 % of respondents had MetS. MetS was significantly positively correlated with AU (p < 0.01). Higher elevation of albuminuria creatinine ratio (ACR) was found in participants with VCD. The regression models developed in this study showed that the severity of kidney disease measured by ACR was increased among individuals who developed both VCD and MetS compared with individuals who developed MetS only (AOR=5.53; 95% CI: 2.73, 11.21). Increasing age and being African-American in race were independently associated with elevated AU. Conclusion: Specific considerations tailored to metabolic syndrome, vitamin C and kidney diseases measured by ACR screening and monitoring mechanisms at the community level is critical to tackle further medical complications. Moreover, the role of VitC fortified foods on prevention of kidney diseases among patients with MetS warrant further investigation.
Neural Timing Deficits Prevalent in Developmental Disorders, Aging, and Concussions Remediated Rapidly By Movement Discrimination Exercises
Authors: Lawton Teri , Shelley-Tremblay John , Huang Ming-Xiong
Published: May 2021

(1) Background: Substantial evidence that neural timing deficits are prevalent in developmental disorders, aging, and concussions resulting from a mild Traumatic Brain Injury (mTBI) is presented. We show that if timing deficits are remediated using low-level movement discrimination training, then high-level cognitive skills, including reading, attention, processing speed, and working memory improve substantially. (2) Methods: Two case studies are presented using MEG source imaging on an adult dyslexic, and a healthy older adult observed before and after training on movement discrimination two times/week for 8 weeks for adult dyslexic. (3) Results: We found improvements in reading, attention, processing speed, and working memory on neuropsychological tests. Substantial MEG signal increases in visual Motion Networks (V1, V3, MT, MST), Attention Networks (ACC, dlPFC, vlPFC and precuneous/ PCC areas) and Memory Networks (dlPFC). (4) Conclusions: Improving neural timing deficits before cognitive exercises to improve specific cognitive skills provides a rapid and effective method to improve cognitive skills. Improving the timing and sensitivity of low-level dorsal pathways, improving feedforward and feedback pathways, is essential to improve high-level cognitive skills. This adaptive training with substantial feedback shows cognitive transfer to tasks not trained on, significantly improving a person’s quality of life rapidly and effectively.
Porosity Prediction from Gravity Inversion with Constraints from Resistivity Data
Authors: Santos Fernando A. Monteiro , Represas Patricia
Published: May 2021

This work describes a method to carry out 2-D inversion of gravity data in terms of porosity and matrix density distribution using previous DC resistivity inversion results to constraint the fractional pore-water content in the rocks. The inversion is carried out using a controlled random search (CRS) algorithm for global optimization. The method was tested on synthetic data generated from a model representing a graben, and the results show that it can estimate accurate values of contrast-density and porosity. The method was also applied to gravity and dc experimental data collected in NE Portugal, showing results that agree quite well with the known geological information.
Optical Single Bragg Mirror Filters for Porous Silicon Multilayered Structure in Visible Wavelength Spectrum
Authors: Islam Md. Sakibul
Published: May 2021

A distributed bragg reflector is designed to get an optical reflectance on visible electromagnetic spectrum i.e. ~800 nm in this work. Device is realized based on Abele’s matrix for TE mode.
Method for optimal control of mechanical systems oscillations
Authors: Golubev Yury Filippovich
Published: May 2021

The problem of controlling oscillations in the vicinity of the equilibrium position of scleronomic mechanical systems with n degrees of freedom is solved. One degree of freedom is uncontrollable, and the rest are controlled by servos. A method is proposed for finding the optimal control of the oscillation amplitude of an uncontrollable degree of freedom by choosing the control of the law of change of other degrees of freedom. The controlled coordinates can include both position and cyclic coordinates. The effectiveness of the proposed method is demonstrated by the examples of specific oscillating systems.
On the Application of High-level Synthesis Technologies to the Circuit Implementation of Calculations
Authors: Andreev Sergey Sergeevich , Dbar Svetlana Alekseevna , Lacis Aleksey Ottovich , Plotkina Elena Aronovna
Published: May 2021

Many tasks in FPGA are one of the ways to overcome the current architectural crisis in the supercomputing industry. This path is deservedly considered one of the most promising directions, but at the same time one of the most difficult. In this paper, we investigated this particular problem.
Changes in 24-Hour Physical Activity Patterns and Walking Gait Biomechanics After Primary Total Hip Arthroplasty
Authors: Bahl Jasvir S. , Millar Stuart C. , Fraysse François , Arnold John B. , Taylor Mark , Callary Stuart , Solomon Lucian B. , Thewlis Dominic
Published: May 2021

Update

This article was updated on July 19, 2021, because of a previous error. On page 1172, in the Results section entitled “Sedentary Activity,” the sentence that had read “Postoperatively, 32% at 1 year and 14% at 2 years were sedentary for >11 hours per day.” now reads “Postoperatively, 32% at 1 year and 41% at 2 years were sedentary for >11 hours per day.”

Background:

Despite marked improvements in self-reported pain, perceived functional ability, and gait function following primary total hip arthroplasty (THA), it remains unclear whether these improvements translate into improved physical activity and sleep behaviors. The aim of this study was to determine the change in 24-hour activity profile (waking activities and sleep) and laboratory-based gait function from preoperatively to 2 years following the THA.

Methods:

Fifty-one patients undergoing primary THA at a single public hospital were recruited. All THAs were performed using a posterior surgical approach with the same prosthesis type. A wrist-worn accelerometer was used to capture 24-hour activity profiles preoperatively and at 1 and 2 years postoperatively. Three-dimensional gait analysis was performed to determine changes in temporospatial and kinematic parameters of the hip and pelvis.

Results:

Patients showed improvements in all temporospatial and kinematic parameters with time. Preoperatively, patients were sedentary or asleep for a mean time (and standard deviation) of 19.5 ± 2.2 hours per day. This remained unchanged up to 2 years postoperatively (19.6 ± 1.3 hours per day). Sleep efficiency remained suboptimal (<85%) at all time points and was worse at 2 years (77% ± 10%) compared with preoperatively (84% ± 5%). More than one-quarter of the sample were sedentary for >11 hours per day at 1 year (32%) and 2 years (41%), which was greater than the preoperative percentage (21%). Patients accumulated their activity performing light activities; however, patients performed less light activity at 2 years compared with preoperative levels. No significant differences (p = 0.935) were observed for moderate or vigorous activity across time.

Conclusions:

Together with improvements in self-reported pain and perceived physical function, patients had significantly improved gait function postoperatively. However, despite the opportunity for patients to be more physically active postoperatively, patients were more sedentary, slept worse, and performed less physical activity at 2 years compared with preoperative levels.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Dose-Dependent Early Postoperative Opioid Use Is Associated with Periprosthetic Joint Infection and Other Complications in Primary TJA
Authors: Chung Brian C. , Bouz Gabriel J. , Mayfield Cory K. , Nakata Haley , Christ Alexander B. , Oakes Daniel A. , Lieberman Jay R. , Heckmann Nathanael D.
Published: May 2021

Background:

Opioids are commonly prescribed for postoperative pain following total joint arthroplasty. Despite widespread use, few studies have examined the dose-dependent effect of perioperative opioid use on postoperative complications following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Therefore, we examined the dose-dependent relationship between opioid use and postoperative complications following primary THA and TKA.

Methods:

We queried the Premier Healthcare Database to identify adult patients who underwent primary elective THA or TKA from 2004 to 2014, and quantified opioid consumption within the first 3 postoperative days. Opioid consumption was standardized to morphine milligram equivalents (MMEs). Patients were divided into quintiles on the basis of MME exposure: <54, 54 to 82, 83 to 116, 117 to 172, and >172 MMEs. Primary outcomes included postoperative periprosthetic joint infection, pulmonary embolism, deep venous thrombosis, and pulmonary complications. Secondary outcomes included wound infection, wound dehiscence, and readmission within 30 and 90 days postoperatively. Univariate and multivariate analyses were performed to compare differences between groups and to account for confounders.

Results:

A total of 1,525,985 patients were identified. The mean age was 65.7 ± 10.8 years, 598,320 patients (39.2%) were male, and 1,174,314 patients (77.0%) were Caucasian. On multiple logistic regression analysis, increasing MME exposure was associated with a dose-dependent increased risk of postoperative complications. Compared with patients receiving <54 MMEs, exposure to >172 MMEs was associated with greater odds of periprosthetic joint infection (adjusted odds ratio [aOR], 1.37; 95% confidence interval [CI], 1.33 to 1.42), deep venous thromboembolism (aOR, 1.34; 95% CI, 1.30 to 1.38), pulmonary embolism (aOR, 1.29; 95% CI, 1.25 to 1.34), and pulmonary complications (aOR, 1.06; 95% CI, 1.05 to 1.08). Exposure to >172 MMEs was associated with increased risk of wound infection (aOR, 1.37; 95% CI, 1.33 to 1.41), wound dehiscence (aOR, 1.24; 95% CI, 1.19 to 1.31), and readmission within 30 (aOR, 1.21; 95% CI, 1.20 to 1.22) and 90 days (aOR, 1.20; 95% CI, 1.19 to 1.21).

Conclusions:

Increasing opioid use within the early postoperative period following THA or TKA was associated with a dose-dependent increased risk of periprosthetic joint infection and venous thromboembolic events.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Septic Dislocation of Hip After Cephalomedullary Nail Fixation of Intertrochanteric Fractures of Femur
Authors: Sridhar Michael S. , Pichiotino Erin R.
Published: May 2021

Case:

We describe 3 cases of septic hip arthritis with a dislocation after failed, cephalomedullary nail (CMN) fixation following fragility intertrochanteric (IT) hip fractures that were treated with antibiotic spacer placement.

Conclusion:

Septic hip arthritis and compromised hip abductors can contribute to dislocation of the hip after CMN for IT fractures. This case report presents a treatment plan to address this rare complication, not yet reported after CMN for IT fractures in the literature, to control infection and optimize function.
When Total Joint Arthroplasty After Septic Arthritis Can Be Safely Performed
Authors: Tan Timothy L. , Xu Chi , Kuo Feng-Chih , Ghanem Elie , George Jaiben , Shohat Noam , Chen Ji-Ying , Lee Mel S. , Higuera Carlos , Parvizi Javad
Published: May 2021

Background:

Patients undergoing total joint arthroplasty (TJA) following septic arthritis are at higher risk for developing periprosthetic joint infection (PJI). Minimal literature is available to guide surgeons on the optimal timing of TJA after completing treatment for prior native joint septic arthritis. This multicenter study aimed to determine the optimal timing of TJA after prior septic arthritis and to examine the role of preoperative serology in predicting patients at risk for developing PJI.

Methods:

A total of 207 TJAs were performed after prior septic arthritis from 2000 to 2017 at 5 institutions. Laboratory values, prior treatment, time from the initial infection, and other variables were recorded. Bivariate analyses were performed to identify the association between the time from septic arthritis to TJA and the risk of developing subsequent PJI. A subanalysis was performed between patients who underwent TJA in 1 setting (n = 97) compared with those who underwent 2-stage arthroplasties (n = 110). Receiver operating characteristic (ROC) curve analysis was performed for serum markers prior to TJA in predicting the risk of a subsequent PJI.

Results:

The overall PJI rate was 12.1%. Increasing time from septic arthritis treatment to TJA was not associated with a reduction of PJI, whether considering time as a continuous or categorical variable, for both surgical treatment cohorts (all p > 0.05). Although the ROC curve analysis found that the optimal threshold for timing of TJA from the initial treatment was 5.9 months, there was no difference in the PJI rate when the overall cohort was dichotomized by this threshold and when stratified by 1-stage compared with 2-stage TJA. There was no significant difference in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level prior to conversion TJA between patients who subsequently developed PJI and those who did not.

Conclusions:

Serum markers have limited value in predicting subsequent PJI in patients who undergo TJA after prior septic arthritis. There was no optimal interim period between septic arthritis treatment and subsequent TJA; thus, delaying a surgical procedure does not appear to reduce the risk of PJI.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Las nuevas modalidades de alojamiento turístico en Castilla-La Mancha: aparición, evolución y distribución territorial
Authors: Aparicio Guerrero Ana Eulalia , Serrano Gil Óscar , García Marchante Joaquín Saúl , Fernández Fernández María Cristina
Published: May 2021

La presente investigación se centra en el estudio de la implantación y crecimiento del alquiler vacacional en el espacio castellanomanchego, así como su incidencia geográfica, temporal y social, con el fin de valorar la magnitud del fenómeno. El objetivo general radica en el análisis detallado de la aparición, evolución y generalización en Castilla-La Mancha de las nuevas modalidades de alojamientos turísticos, apartamentos turísticos y viviendas de uso turístico en los últimos 25 años, considerando las posibles correlaciones positivas entre recursos patrimoniales, naturales y culturales, y la existencia de infraestructuras de alojamiento en determinados espacios de la región, tanto urbanos como rurales. Junto con la oferta tradicional de alojamientos en núcleos urbanos, en los últimos años la región ha experimentado un cambio significativo al alza de distintas modalidades de establecimientos relacionados con la importancia que va adquiriendo la práctica del turismo rural y de naturaleza y el turismo cultural y de centros urbanos.
RNA-Binding Protein IMP3 is a Novel Regulator of MEK1/ERK Signaling Pathway in the Progression of Colorectal Cancer through the Stabilization of MEKK1 mRNA
Authors: Zhang Meng , Zhao Senlin , Tan Cong , Gu Yanzi , He Xuefeng , Du Xiang , Li Dawei , Wei Ping
Published: May 2021

Background

MEK1/ERK signaling pathway plays an important role in most tumor progression, including colorectal cancer (CRC), however, MEK1-targeting therapy has little effective in treating CRC patients, indicating there may be a complex mechanism to activate MEK1/ERK signaling pathway except RAS activated mechanism.
Methods

To investigate the clinical significance of IMP3, we analyzed its expression levels in publicly available dataset and samples from Fudan University Shanghai Cancer Center. The effects of IMP3 on proliferation, migration, and invasion were determined by in vitro and in vivo experiments. To investigate the role of IMP3 in colon carcinogenesis, conditional IMP3 knockout C57BL/6 mice was generated. The IMP3/MEKK1/MEK/ERK signaling axis in CRC was screened and validated by RNA-sequencing, RNA immunoprecipitation, luciferase reporter and western blot assays.
Results

We find RNA binding protein IMP3 directly bind to MEKK1 mRNA 3’-UTR, which regulates its stability, promote MEKK1 expression and sequentially activates MEK1/ERK signaling. Functionally, IMP3 promote the malignant biological process of CRC cells via MEKK1/MEK1/ERK signaling pathway both in vitro and in vivo, Moreover, IMP3−/− mice show decreased the expression of MEKK1 as well as colorectal tumors compared with wild-type mice after treatment with azoxymethane/dextran sodium sulfate. Clinically, the expression of IMP3 and MEKK1 are positive correlated, and concomitant IMP3 and MEKK1 protein levels negatively correlate with metastasis in CRC patients. In addition, MEK1 inhibitor in combination with shRNA-IMP3 have a synergistic effect both in vitro and in vivo.
Conclusion

Our study demonstrates that IMP3 regulates MEKK1 in CRC, thus activating the MEK1/ERK signaling in the progression of colorectal cancer, Furthermore, these results provide new insights into potential applications for combining MEK1 inhibitors with other target therapy such as IMP3 in preclinical trials for CRC patients.
Impact of Perioperative Chemotherapy on Survival Outcomes Among Patients with Metastatic Colorectal Cancer to the Liver
Authors: Baidoun Firas , Merjaneh Zahi , Nanah Rama , Saad Anas M. , Abdel-Rahman Omar
Published: May 2021

IntroductionWhile surgical resection for primary tumor and distant metastases is recommended among individuals with resectable colorectal liver metastases, the role and timing of perioperative systemic therapy is not yet defined.Materials and MethodsThe National Cancer Database was queried for patients diagnosed with metastatic colorectal adenocarcinoma with isolated liver metastases between 2004 and 2016. We evaluated the overall survival (OS) based on the perioperative chemotherapy status using Kaplan-Meier estimates and multivariable cox regression analyses.ResultsA total of 6,883 patients with metastatic CRC and liver metastases were included, within which 6,042 (87.8%) were treated with surgery and chemotherapy, and 841(12.2%) were treated with surgery only. We found that patients who were treated with surgery and chemotherapy had better OS compared to patients who were treated with surgery only (median OS 42.9 months vs 6.4 months, P<0.001). On multivariable analysis, chemotherapy was associated with better OS (HR 0.30; 95% CI: 0.275 - 0.328; P<0.001).We also found that patients who received multiagent chemotherapy had better OS compared to patients who received single-agent chemotherapy (median OS 43.7 months vs 36.1 months, P<0.001), patients who received neoadjuvant chemotherapy had better OS compared to patients who received adjuvant chemotherapy (median OS 48.6 months vs 38.6 months, P<0.001).ConclusionPatients with CRC with isolated liver metastases who were treated with perioperative chemotherapy had significant improvement in OS compared to patients who didn’t receive chemotherapy. Also, neoadjuvant chemotherapy had better OS compared to adjuvant chemotherapy, and multiagent chemotherapy had better OS compared to single-agent chemotherapy.
Is the ABO Blood Group Associated With Increased Intraoperative Blood Loss in Cervical Surgery? A Cohort Study
Authors: Cao Jun-Xiong , Lin Lu , Ke Zhen-Yong , Jia Xiao-Jiong , Cheng Si
Published: May 2021

ObjectiveTo find out if the ABO blood group is associated with increased intraoperative blood loss in cervical surgery.MethodsA total of 126 patients who underwent cervical surgery under general anesthesia were included in this comparative study. Types of cervical surgery included anterior cervical corpectomy decompression and fusion (ACCF) and anterior cervical discectomy and fusion (ACDF). According to ABO blood group differences, the patients were divided into O and non-O blood groups. Intraoperative blood loss was assessed by external blood loss (EBL), Drop-Hct (hematocrit), and Drop-Hb (hemoglobin). This study collected indicators such as ABO blood group, preop Hct, preop Hb, postop Hct, postop Hb, history of hypertension, and etiology.ResultsThere were 22 patients in the O blood group and 104 in the non-O group. There were no significant differences in age between the two groups. Patients of blood group O showed a significantly higher Drop-Hb than in the non-O group (15(11.9-20.2) g/L and 8.5(6.5-11.0) g/L, p=0.001). Drop-Hct also showed a significant difference between the two groups (4.8 (3.3-6.9) (%) vs. 2.2 (1.6-2.8) (%), p=0.001). There was no association between group O and EBL (p=0.263). The ACCF subgroup included 54 patients. Patients with O blood had significantly higher Drop-Hct and Drop-Hb (p<0.05). In the ACDF subgroup (n=72), Drop-Hct and Drop-Hb of O blood patients increased significantly (p<0.05). ConclusionThe ABO blood group was associated with Drop-Hct and Drop-Hb. Consequently, blood group O may be a risk factor for increased intraoperative blood loss during anterior cervical surgery.
A Nomogram for Predicting the Risk of Tuberculosis Infection
Authors: Liu Huanqing , Li Tingting , Lyn Jun
Published: May 2021

Background: Tuberculosis (TB) has become one of the main causes of deaths worldwide. Because of certain conditions prevent the early TB diagnosis and treatment to some extent. This study aimed to develop a tuberculosis (TB) infection risk model and validate the ability of nomogram to predict risk for TB infection in a Chinese population.﻿Methods: A prediction model based on the training dataset of 272 patients was established. Minimum absolute shrinkage and selection operator regression model were adopted to optimize the feature selection of the TB infection risk model. Using multivariate logistic regression analysis, a predictive model combining the features selected in the minimum absolute shrinkage and the selected operator regression model was constructed. The ability of this predictive model to discriminate and calibrate TB infection risk and its utility in clinical settings were assessed via concordance index (C-index), calibration plot, area under time-dependent receiver operating characteristic curve (AUC), and decision curve analysis (DCA). The clinical practicality of nomogram was evaluated via net reclassification index (NRI) and integrated discrimination improvement (IDI). Bootstrapping validation allowed internal validation.Results: According to this predictive nomogram, the main predictors of TB infection risk were gender, age, smoking history, fever, hemoptysis, fatigue, emaciation, CD8, CD4/CD8, ESR, CRP, and abnormal liver function. The model exhibited superior risk calibration and discrimination with a C-index of 0.737 (95% CI: 0.685–0.789). The internal validation reached a C-index value of 0.688. The predictive model was able to produce an AUC of 0.729 (95% CI: 0.677–0.781). Analysis of the decision curve revealed the TB infection probability nomogram manifested its clinical usefulness on the condition that intervention was decided at the TB probability threshold of 13%. Moreover, results demonstrated that nomogram could be utilized as an effective prognostic tool according to NRI and IDI.Conclusion: The new TB probability nomogram for predicting TB infection risk developed herein that combines various factors, such gender, age, smoking history, fever, hemoptysis, fatigue, emaciation, CD8, CD4/CD8, ESR, CRP, and abnormal liver function is convenient and useful in predicting individual TB risks among patients.