bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel nomogram to predict the risk of anastomotic leakage in patients after oesophagectomy
Authors: Huang Chengya , Yao Haixia , Huang Qi , Lu Huijie , Xu Meiying , Wu Jingxiang
Published: April 2020

Background

Anastomotic leakage is a dangerous postoperative complication of oesophageal surgery. The present study aimed to develop a simple and practical scoring system to predict the risk of anastomotic leakage after oesophageal resection.

Methods

A consecutive series of 330 patients who underwent oesophageal cancer surgery from January 2016 to January 2018 at the Shanghai Chest Hospital were included to develop a prediction model. Anastomotic leakage was evaluated using oesophagography, computed tomography, or flexible endoscopy. Least absolute shrinkage and selection operator regression based on a generalized linear model was used to select variables for the anastomotic leakage risk model while avoiding overfitting. Multivariable logistic regression analysis was applied to build forest plots and a prediction model. The concordance index or the area under the curve was used to judge the discrimination, and calibration plots verified the consistency. Internal validation of the model was conducted, and the clinical usefulness and threshold screening of the model were evaluated by decision curve analysis.

Results

The factors included in the predictive nomogram included Sex, diabetes history, anastomotic type, reconstruction route, smoking history, CRP level and presence of cardiac arrhythmia. The model displayed a discrimination performance with a concordance index of 0.690 (95% confidence interval: 0.620–0.760) and good calibration. A concordance index value of 0.664 was maintained during the internal validation. The calibration curve showed good agreement between the actual observations and the predicted results.

Conclusion

The present prediction model, which requires only seven variables and includes Sex, diabetes history, anastomotic type, reconstruction route, smoking history, CRP level and presence of cardiac arrhythmia, may be useful for predicting anastomotic leakage in patients after oesophagectomy.
Utilization of clinical practice guideline on antimicrobial in China: an exploratory survey on multilevel determinants
Authors: Deng Qingwen , Liu Wenbin
Published: April 2020

Background

Nowadays, irrational use of antimicrobials has threatened public health. It’s necessary to expand the use of clinical practice guideline (CPG) on antimicrobial for facilitating the proper use of antimicrobial. However, the utilization status of CPG on antimicrobial and the influencing factors, especially the ones at the organizational level, remain largely unknown.

Methods

A cross-sectional questionnaire survey was conducted on a sample among physicians from 16 public hospitals in the eastern, central and western parts of China. A multilevel regression model was employed to examine factors associated with physicians’ utilization of CPG on antimicrobial.

Results

A total of 815 physicians were included in this study. About 80% of the surveyed physicians reported their adherence to the CPG on antimicrobial. Dimensions of “subjective norm”, “perceived risk” and “behavioral intention” from the domain of physician belief, a dimension of “ease of use” from the domain of CPG traits, and dimensions of “top management support” and “organization & implementation” from the domain of hospital practice were significantly associated with physicians’ utilization of CPG on antimicrobial. And except for working department, most demographics characteristics of the physician were not found to be significantly related to the CPG use. In addition, it also showed that region is a significant factor affecting physicians’ CPG use.

Conclusions

This study depicted the current status of CPG on antimicrobial and comprehensively identified its potential determinants not only from the three domains at the individual level, such as physician belief, but also from the location region at the organizational level. The results will provide a direct reference for the implementation of CPG on antimicrobial.
The benign c.344G > A: p.(Arg115His) variant in the LDLR gene interpreted from a pedigree-based genetic analysis of familial hypercholesterolemia
Authors: Hori Mika , Takahashi Atsushi , Son Cheol , Ogura Masatsune , Harada-Shiba Mariko
Published: April 2020

Background

We previously identified the c.344G > A: p.(Arg115His) variant in the low-density lipoprotein receptor (LDLR)gene, which was interpreted as “conflicting interpretations of pathogenicity” in ClinVar, based on a genetic analysis of patients with familial hypercholesterolemia (FH). However, whether this variant affects the pathophysiology of FH remains unclear. Therefore, our aim was to annotate the c.344G > A: p.(Arg115His) variant in theLDLRgene in FH. We present 2 families harboring the c.344G > A: p.(Arg115His) variant in theLDLRgene.

Methods

Genetic analyses were performed for the coding regions and the exon-intron boundary sequence of theLDLRand proprotein convertase subtilisin/kexin type 9 (PCSK9)genes in 2 FH families. Next, the family without pathogenic variants in theLDLRandPCSK9genes was screened by whole-exome sequencing. Detailed clinical and biochemical data were gathered from family members.

Results

In one family, the index case had biallelic c.1567G > A: p.(Val523Met) and c.344G > A: p.(Arg115His) variants in theLDLRgene, while the sibling had only the c.1567G > A: p.(Val523Met) variant in theLDLRgene. There was no difference in the FH phenotype between the siblings. In another family, the index case and the sibling had no pathogenic variants in theLDLR,PCSK9, and apolipoprotein B (APOB)genes, but the sibling’s wife with nonFH had the c.344G > A: p.(Arg115His) variant in theLDLRgene. The sibling and his wife had 4 children, including an unaffected child and an affected child who had the c.344G > A: p.(Arg115His) variant in theLDLRgene. In addition, the allele frequency of the c.344G > A: p.(Arg115His) variant (0.0023–0.0043) in Japanese and East Asian populations is relatively high compared with that of the otherLDLRpathogenic variants (0.0001–0.0008).

Conclusions

The c.344G > A: p.(Arg115His) variant in theLDLRgene is interpreted as benign in individuals with FH.
Prevalence and factors associated with depression among pregnant mothers in the West Shoa zone, Ethiopia: a community-based cross-sectional study
Authors: Tiki Takele , Taye Kefyalew , Duko Bereket
Published: April 2020

Background

Depression during pregnancy, the most prevalent mental health problem, can alter fetal development and has important consequences on the offspring’s physical and mental health. Evidence suggests increasing rates of prevalence of depression in low-income settings such as Ethiopia. However, there are a few studies on the topic with inconsistent results. Therefore, the aim of this study was to investigate the prevalence of antenatal depression and its correlates among pregnant women in Ethiopia.

Methods

A community-based cross-sectional study was conducted in the West Shoa zone, Oromia regional state, Ethiopia, from February 20, 2018, to March 20, 2018. Pregnant women were recruited by using cluster sampling techniques. Data on socio-demographic, obstetric, and psychosocial characteristics were collected by interviewer-administered questionnaire. Patient Health Questionnaire (PHQ-9) was used to assess depression during pregnancy. Bivariable and multivariable logistic regression analyses were fitted to identify correlates of depression. The level of statistical significance was declared at p value < 0.05.

Results

The mean age (± SD) of the pregnant women was 28.41 ± 5.9 years. The prevalence of depression during pregnancy was 32.3%. When we adjusted for possible confounding variables in the final model; those pregnant mothers with an average monthly income of less than 500 (18 USD) Ethiopian birr [AOR = 3.19, 95% CI (1.47, 6.96)], unplanned pregnancy [AOR = 1.52, 95% CI (1.04, 2.21)] and having history of abortion [AOR = 5.13, 95% CI (2.42, 10.85)] have higher odds of depression when compared to their counterparts.

Conclusion

The prevalence of depression during pregnancy was high. Strengthening the counseling service as well as increasing access and availability of modern contraceptive methods may reduce the rates of unplanned pregnancy in Ethiopia and this, in turn, plays a significant role in alleviating a resultant depression. Further, the integration of mental health services with existing maternal health care as well as strengthening the referral system among public health centers was warranted to minimize antenatal depression in the West Shoa zone health facilities.
High rumen degradable starch decreased goat milk fat via trans-10, cis-12 conjugated linoleic acid-mediated downregulation of lipogenesis genes, particularly, INSIG1
Authors: Zheng Lixin , Wu Shengru , Shen Jing , Han Xiaoying , Jin Chunjia , Chen Xiaodong , Zhao Shengguo , Cao Yangchun , Yao Junhu
Published: April 2020

Background

Starch is an important substance that supplies energy to ruminants. To provide sufficient energy for high-yielding dairy ruminants, they are typically fed starch-enriched diets. However, starch-enriched diets have been proven to increase the risk of milk fat depression (MFD) in dairy cows. The starch present in ruminant diets could be divided into rumen-degradable starch (RDS) and rumen escaped starch (RES) according to their different degradation sites (rumen or intestine). Goats and cows have different sensitivities to MFD. Data regarding the potential roles of RDS in milk fat synthesis in the mammary tissue of dairy goats and in regulating the occurrence of MFD are limited.

Results

Eighteen Guanzhong dairy goats (day in milk = 185 ± 12 d) with similar parity, weight, and milk yield were selected and randomly assigned to one of three groups (n = 6), which were fed an LRDS diet (Low RDS = 20.52%), MRDS diet (Medium RDS = 22.15%), or HRDS diet (High RDS = 24.88%) for 5 weeks. Compared with that of the LRDS group, the milk fat contents in the MRDS and HRDS groups significantly decreased. The yields of short-, medium- and long-chain fatty acids decreased in the HRDS group. Furthermore, increased RDS significantly decreased ruminal B. fibrisolvens and Pseudobutyrivibrio abundances and increased the trans-10, cis-12 conjugated linoleic acid (CLA) and trans-10 C18:1 contents in the rumen fluid.

A multiomics study revealed that the HRDS diet affected mammary lipid metabolism down-regulation of ACSS2, MVD, AGPS, SCD5, FADS2, CERCAM, SC5D, HSD17B7, HSD17B12, ATM, TP53RK, GDF1 and LOC102177400. Remarkably, the significant decrease of INSIG1, whose expression was depressed by trans-10, cis-12 CLA, could reduce the activity of SREBP and, consequently, downregulate the downstream gene expression of SREBF1.

Conclusions

HRDS-induced goat MFD resulted from the downregulation of genes involved in lipogenesis, particularly, INSIG1. Specifically, even though the total starch content and the concentrate-to-fiber ratio were the same as those of the high-RDS diet, the low and medium RDS diets did not cause MFD in lactating goats.
Low Quality of Reports on Blood Pressure in Patients Adrenalectomized for Unilateral Primary Aldosteronism
Authors: Lenders Jacques W M , Deinum Jaap , Passauer Jens , Januszewicz Andrezj , Chan On Ying A , Prejbisz Aleksander
Published: April 2020

Context

Adrenalectomy is the preferred treatment for unilateral primary aldosteronism but the results of long-term control of blood pressure (BP) are far from optimal. One possible explanation relates to the quality of the assessment of treatment effects on BP.

Purpose of the study

To examine the quality of reporting BP measurements in studies assessing the outcome of adrenalectomy on BP.

Methods

We conducted a systematic review searching 3 databases (PubMed, EMBASE, Web of Science) for articles published from January 1, 1990, onwards. Sixty-six studies, each reporting on more than 50 adrenalectomized patients, were eligible for full analysis.

Results

In 37 of the analyzed 66 studies (56.1%) BP values both before and after adrenalectomy were reported. In 19.7% (13/66) of the studies the method of BP measurement was described. The number of visits and number of BP recordings per visit on which BP results were based were reported in <15% of papers. The criteria for the diagnosis of hypertension were described in 72.7% (48/66) of the studies. The used definitions of improvement of BP control after adrenalectomy were variable, with 84.8% of the studies not providing any quantitative criteria to define reduction in BP.

Conclusion

We conclude that the quality of reporting on BP control after adrenalectomy for primary aldosteronism shows substantial deficiencies and inconsistencies, thus impacting negatively on accurate assessment of effects of adrenalectomy on BP control. Future studies should adhere to accepted recommendations of correct BP measurement and should provide detailed description of the methods used for BP measurement.
Novel Roles of Chloroquine and Hydroxychloroquine in Graves’ Orbitopathy Therapy by Targeting Orbital Fibroblasts
Authors: Guo Yan , Li Hai , Chen Xueying , Yang Huasheng , Guan Hongyu , He Xiaoying , Chen Yuxin , Pokharel Sunil , Xiao Haipeng , Li Yanbing
Published: April 2020

Context

Graves’ orbitopathy (GO) causes infiltrative exophthalmos by inducing excessive proliferation, adipogenesis, and glycosaminoglycan production in orbital fibroblasts (OFs). Interference with OF autophagy is a potential therapy for proptosis.

Objectives

Here, we aimed to evaluate the effects of chloroquine (CQ) and hydroxychloroquine (HCQ), the autophagy inhibitors commonly used in clinical practice, on OFs.

Design/Setting/Participants

OFs isolated from patients with GO (GO-OFs) or control individuals (non-GO-OFs) were cultured in proliferation medium (PM) or subjected to differentiation medium. OFs were treated with CQ or HCQ (0, 0.5, 2, and 10 μM), and subsequently examined in vitro.

Main Outcome Measures

CCK-8, EdU incorporation, and flow cytometry assays were used to assess cellular viability. Adipogenesis was assessed with Western blot analysis, real-time polymerase chain reaction (PCR) , and Oil Red O staining. Hyaluronan production was determined by real-time PCR and enzyme-linked immunosorbent assay. Autophagy flux was detected through red fluorescent protein (RFP)-green fluorescent protein (GFP)-LC3 fluorescence staining and Western blot analyses.

Results

CQ/HCQ halted proliferation and adipogenesis in GO-OFs in a concentration-dependent manner through blockage of autophagy, phenotypes that were not detected in non-GO-OFs. The inhibitory effect of CQ/HCQ on hyaluronan secretion of GO-OFs was also concentration dependent, mediated by downregulation of hyaluronan synthase 2 rather than hyaluronidases. Moreover, CQ (10 μM) induced GO-OF apoptosis without aggravating oxidative stress.

Conclusions

The antimalarials CQ/HCQ affect proliferation, adipogenesis, and hyaluronan generation in GO-OFs by inhibiting autophagy, providing evidence that they can be used to treat GO as autophagy inhibitors.
Responsible use of organoids in precision medicine: the need for active participant involvement
Authors: Lensink Michael A. , Jongsma Karin R. , Boers Sarah N. , Noordhoek Jacquelien J. , Beekman Jeffrey M. , Bredenoord Annelien L.
Published: April 2020

Organoids are three-dimensional multicellular structures grown in vitro from stem cells and which recapitulate some organ function. They are derivatives of living tissue that can be stored in biobanks for a multitude of research purposes. Biobank research on organoids derived from patients is highly promising for precision medicine, which aims to target treatment to individual patients. The dominant approach for protecting the interests of biobank participants emphasizes broad consent in combination with privacy protection and ex ante (predictive) ethics review. In this paradigm, participants are positioned as passive donors; however, organoid biobanking for precision medicine purposes raises challenges that we believe cannot be adequately addressed without more ongoing involvement of patient-participants. In this Spotlight, we argue why a shift from passive donation towards more active involvement is particularly crucial for biobank research on organoids aimed at precision medicine, and suggest some approaches appropriate to this context.
Multifaceted actions of Zeb2 in postnatal neurogenesis from the ventricular-subventricular zone to the olfactory bulb
Authors: Deryckere Astrid , Stappers Elke , Dries Ruben , Peyre Elise , van den Berghe Veronique , Conidi Andrea , Zampeta F. Isabella , Francis Annick , Bresseleers Marjolein , Stryjewska Agata , Vanlaer Ria , Maas Elke , Smal Ihor V. , van IJcken Wilfred F. J. , Grosveld Frank G. , Nguyen Laurent , Huylebroeck Danny , Seuntjens Eve
Published: April 2020

The transcription factor Zeb2 controls fate specification and subsequent differentiation and maturation of multiple cell types in various embryonic tissues. It binds many protein partners, including activated Smad proteins and the NuRD co-repressor complex. How Zeb2 subdomains support cell differentiation in various contexts has remained elusive. Here, we have studied the role of Zeb2 and its domains in neurogenesis and neural differentiation in the young postnatal ventricular-subventricular zone (V-SVZ), where neural stem cells generate olfactory bulb-destined interneurons. Conditional Zeb2 knockouts and separate acute loss- and gain-of-function approaches indicated that Zeb2 is essential to control apoptosis and neuronal differentiation of V-SVZ progenitors before and after birth, and identified Sox6 as Zeb2-dependent and potential downstream target gene. Zeb2 genetic inactivation impaired the differentiation potential of the V-SVZ niche in a cell-autonomous fashion. We also provide evidence that its normal function in the V-SVZ involves non-autonomous mechanisms as well. Additionally, we could demonstrate distinct roles for Zeb2 protein-binding domains, suggesting that Zeb2 partners co-determine neuronal output from the mouse V-SVZ in both quantitative and qualitative manners in early postnatal life.
Alkaline guts contribute to immunity during exposure to acidified seawater in the sea urchin larva
Authors: Stumpp Meike , Petersen Inga , Thoben Femke , Yan Jia-Jiun , Leippe Matthias , Hu Marian Y.
Published: April 2020

Larval stages of the abulacraria superphylum including echinoderms and hemichordates have highly alkaline midguts. To date the reason for the evolution of such extreme pH conditions in the gut of these organisms remains unknown. Here, we test the hypothesis that analogous to the acidic stomachs of vertebrates, these alkaline conditions may represent a first defensive barrier to protect from environmental pathogens.

pH-optimum curves for five different species of marine bacteria demonstrated a rapid decrease in proliferation rates by 50-60% between pH 8.5 and 9.5. Using the marine bacterium Vibrio diazotrophicus which elicits a coordinated immune response in the sea urchin larva of Strongylocentrotus purpuratus, we studied the physiological responses of the midgut pH regulatory machinery to this pathogen. Gastroscopic microelectrode measurements demonstrate a stimulation of midgut alkalization upon infection with V. diazotrophicus accompanied by an upregulation of acid-base transporter transcripts of the midgut. Pharmacological inhibition of midgut alkalization resulted in an increased mortality rate of larvae during Vibrio infection. Reductions in seawater pH resembling ocean acidification (OA) conditions lead to moderate reductions in midgut alkalization. However, these reductions in midgut pH do not affect the immune response and resilience of sea urchin larvae to a Vibrio infection under OA conditions.

Our study addressed the evolutionary benefits of the alkaline midgut of ambulacraria larval stages. The data indicate that alkaline conditions in the gut may serve as a first defensive barrier against environmental pathogens and that this mechanism can compensate for changes in seawater pH.
Exposure to hot temperatures during lactation stunted offspring growth and decreased the future reproductive performance of female offspring
Authors: Bao Meng-Huan , Chen Li-Bing , Hambly Catherine , Speakman John R. , Zhao Zhi-Jun
Published: April 2020

Among the important aspects of climate change, exposure to high temperatures (heat waves) is rapidly emerging as an important issue, in particular for female mammals during lactation. High temperatures adversely impact ability to dissipate heat, which has negative effects on reproductive output. The cumulative effects on growth of F1 offspring after weaning and future reproductive performance of offspring remain uncertain. In this study, the F1 mice that weaned from mothers lactating at 21°C and 32.5°C were housed at 21°C from day 19 till 56 of age; during which food intake and body mass were measured. The F1 adult females that had been weaned at the two temperatures were bred and then both exposed to 32.5°C during lactation. Energy intake, milk output and litter size and mass were determined. The F1 adults weaned at 32.5°C consumed less food and had lower body mass than their counterparts weaned at 21°C. Several visceral organs or reproductive tissues were significantly lower in mass in F1 weaned at 32.5°C than at 21°C. The exposure to 32.5°C significantly decreased energy intake, milk output and litter mass in F1 adult females during lactation. The F1 adult females weaned at 32.5°C produced less milk and raised lighter pups than those previously weaned at 21°C. The data suggest that transient exposure to hot temperature during lactation has long-lasting impacts on the offspring, including stunted growth and decreases in future reproductive performance when adult. This indicates that the offspring of females previously experiencing hot temperatures have a significant fitness disadvantage.
Using TENS to Enhance Therapeutic Exercise in Individuals with Knee Osteoarthritis
Authors: PIETROSIMONE BRIAN , LUC-HARKEY BRITTNEY A. , HARKEY MATTHEW S. , DAVIS-WILSON HOPE C. , PFEIFFER STEVEN J. , SCHWARTZ TODD A. , NISSMAN DANIEL , PADUA DARIN A. , BLACKBURN J TROY , SPANG JEFFERY T.
Published: April 2020

Transcutaneous electrical nerve stimulation (TENS) facilitates quadriceps voluntary activation in experimental settings. Augmenting therapeutic exercise (TE) with TENS may enhance the benefits of TE in individuals with knee osteoarthritis (KOA) and quadriceps voluntary activation failure (QVAF).

Purpose

This study aimed to determine the effect of TENS + TE on patient-reported function, quadriceps strength, and voluntary activation, as well as physical performance compared with sham TENS + TE (Sham) and TE alone in individuals with symptomatic KOA and QVAF.

Methods

Ninety individuals participated in a double-blinded randomized controlled trial. Everyone received 10 standardized TE sessions of physical therapy. TENS + TE and Sham groups applied the respective devices during all TE sessions and throughout activities of daily living over 4 wk. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC), quadriceps strength, and voluntary activation, as well as a 20-m walk test, chair-stand test, and stair-climb test were performed at baseline, after the 4-wk intervention (post 1) and at 8 wk after the start of the intervention (post 2). Mixed-effects models were used to determine between-group differences between baseline and post 1, as well as baseline and post 2.

Results

Improvements in WOMAC subscales, quadriceps strength, and voluntary activation, 20-m walk times, chair-stand repetitions, and stair-climb time were found at post 1 and post 2 compared with baseline for all groups (P < 0.05). WOMAC Pain and Stiffness improved in the TENS + TE group compared with TE alone at post 1 (P < 0.05); yet, no other between-group differences were found.

Conclusions

TE effectively improved patient-reported function, quadriceps strength, and voluntary activation, as well as physical performance in individuals with symptomatic KOA and QVAF, but augmenting TE with TENS did not improve the benefits of TE.
Case Report: Rare site for intraoral meningioma
Authors: Amer Hatem Wael , Hafed Layla , Ibrahim Sally , Shaker Shady
Published: April 2020

Extracranial meningioma is very rare with few cases reported, especially in the oral cavity. Its diagnosis is considered a challenge owing to the unusual site of occurrence.  We report, to the best of our knowledge, the first case of extra-cranial meningioma as a primary tumor in the hard palate with no detected intracranial extension. A 59-year-old Egyptian female patient presented with a 22-year history of a large painless swelling at the right side of the hard palate, which could not be seen on radiographs.  An incisional biopsy was taken and, after assessment with a panel of immunohistochemical markers, the lesion was diagnosed as extracranical grade I mengiothelial meningioma. The patient did not show up for surgical excision and follow-up was not performed because of the lose of contact with the patient. Intraoral meningioma is a rare tumor. Immuohistochemical markers are important for confirming this diagnosis.
Cervical spine clearance after blunt trauma: current state of the art
Authors: Moeri Michaël , Rothenfluh Dominique A. , Laux Christoph J. , Dominguez Dennis E.
Published: April 2020

No definite consensus exists for the clearance of the cervical spine (C-spine) after blunt trauma, despite many validated algorithms, recommendations and guidelines. We intend to answer the most relevant questions with which physicians are confronted when clearing C-spines after blunt trauma in emergency departments (EDs). To exclude significant C-spine injuries we designed an algorithm to be compatible with clinical practice, to simplify patient management and avoid unrewarding evaluation. We conducted an exploratory PubMed search including articles published from January 2000 to October 2018. Keywords used were “cervical spine”, “injury”, “clearance”, “Canadian C-spine Rule”, “CCR” and “national emergency x-radiography utilization study”. Clinical and experimental studies were included in a detailed review. We based our literature review on 33 articles. While answering fundamental triage questions from daily clinical practice, the current literature is discussed in detail. We designed an algorithm for the C-spine clearance suitable for any trauma centre with a high-quality multiplanar reconstruction computerized tomography (CT) scan continuously available. The high sensitivity of the Canadian C-spine Rule (CCR) prevents missing C-spine injuries while limiting the amount of unnecessary radiologic examinations. Plain radiographs were fully abandoned for C-spine clearance. A negative CT scan is sufficient to clear the majority of C-spine injuries and allows for collar removal. In case of motor symptoms or radio-clinical discrepancy, the advice of a specialized spine surgeon must be requested. Magnetic resonance imaging must not be routinely used. Neck pain despite negative imaging is not a reason to delay removal of stiff cervical collars.

Cite this article: EFORT Open Rev 2020;5:253-259. DOI: 10.1302/2058-5241.5.190047
Simple photonics-based system for Doppler frequency shift and angle of arrival measurement
Authors: Huang Chongjia , Chen Hao , Chan Erwin H. W.
Published: April 2020

A novel photonic approach for simultaneously measuring both the Doppler frequency shift (DFS) and the angle of arrival (AOA) of a microwave signal in a radar system is presented. It has the same structure as a fiber optic link consisting of a laser, an optical modulator and a photodetector. The incoming microwave signal and a reference signal are applied to the optical modulator. Beating of the echo and reference signal sidebands at the photodetector generates a low-frequency electrical signal. The DFS and the AOA can be determined from the frequency and the power of the low-frequency electrical signal measured on an electrical spectrum analyzer. The system has a very simple structure and is low-cost. It has a wide operating frequency range and a robust performance. Experimental results demonstrate a DFS measurement at around 15 GHz with errors of less than ±0.2 Hz, and a 0° to 90° AOA measurement with less than ±1° errors.
Indicação para exodontia de terceiros molares impactados: estudo transversal.
Authors: Silva Caio , Ferreira Victor Hugo , Lima Everaldo , Carneiro Suzana Celia , Leal Jefferson , Vasconcelos Belmiro
Published: April 2020

Introdução: a remoção de terceiros molares impactados assintomáticos tem sido objeto de considerável controvérsia. Diante disso, o presente estudo tem o propósito de verificar a indicação da remoção de terceiros molares inferiores por cirurgiões bucomaxilofaciais, após avaliarem imagens radiográficas. Métodos: trata-se de um estudo observacional do tipo transversal desenvolvido com profissionais participantes do XXIII Congresso Brasileiro de Cirurgia e Traumatologia Bucomaxilofacial (COBRAC 2015) realizado em Salvador/BA, no qual os participantes foram divididos em grupos de acordo com o nível de formação. Resultados: os resultados mostram que a maior parte dos cirurgiões bucomaxilofaciais tende a indicar a remoção dos terceiros molares impactados (TMIs) assintomáticos, sendo que essa tomada de de- cisão independe do nível de formação e não é influenciada pelo número de anos de experiência. Conclusões: pode-se concluir que não há evidências suficientes na literatura atual para determinar a remoção profilática de rotina de TMIs assintomáticos. A indicação ou não de remoção de TMIs assintomáticos deve levar em consideração a aceitação dos pacientes, bem como o conhecimento clínico do profissional para orientar a tomada de decisão.
Mioeptelioma de glândula salivar menor em palato: relato de caso
Authors: Torres Rafael , Motta Junior Joel , De Oliveira Marcelo Vinicius , Martins Valber , De Albuquerque Gustavo
Published: April 2020

Os mioepiteliomas são tumores raros que representam 1% dos tumores de glândulas salivares. Geralmente benigno, a glândula parótida é o local mais comum do tumor, seguido do palato e da glândula submandibular. Não há predomínio entre os sexos e a idade média é de 62 anos. Apresenta-se como uma massa de crescimento lento, geralmente encapsulado, indolor, o que leva a um atraso no diagnóstico. Sua variante maligna, ainda mais rara, caracteriza-se por invasão e destruição local, raramente sofrendo metástase. O objetivo do presente estudo é relatar um caso de mioepitelioma no palato de uma paciente do sexo feminino, apresentando um aumento de volume na região posterior do palato com evolução de 15 dias, de aproximadamente 2,5 cm em seu maior diâmetro, séssil, indolor, de consistência resiliente à palpação, apre- sentando mucosa de revestimento sem alteração e hipótese diagnóstica de adenoma pleomórfico. Realizou-se, em ambiente ambulatorial, a biópsia excisional da lesão, que apresentou aspecto transcirúrgico de múltiplas bolhas. A análise histopatológica chegou ao diagnóstico de mioepitelioma e não foi observada recidiva após dois anos. O mioepitelioma benigno é um tumor raro que, se tratado de forma correta, através da excisão cirúrgica, apresenta recidiva mínima.
Desafios terapêuticos do ceratocisto odontogênico: revisão de literatura e relato de caso utilizando a técnica de descompressão
Authors: RESCHKE LUÍSA , SCHIEFFERDECKER SÉRGIO ANTÔNIO , DIAS KELLY
Published: April 2020

Introdução: o ceratocisto odontogênico (CO) é uma lesão benigna que ocorre nos maxilares de maneira agressiva e infiltrativa. Frequentemente descoberto por exames de imagem, tem comportamento invasivo e recidivante. Devido às suas características, há dificuldades para se indicar a melhor terapêutica para essa patologia e, não há consenso sobre a melhor forma de tratamento. Métodos: revisão de literatura a partir de artigos originais publicados nos últimos 10 anos nas bases de dados Medline / PubMed, Cochrane, Embase e Bireme, com palavras-chave utilizadas de acordo com seus descritores específicos. Paralelamente, objetivou-se apresentar um caso clínico de descompressão de CO como alternativa de terapia. Resultados: do total de 08 artigos selecionados, foram identificados 01 revisão de literatura, 03 revisões sistemáticas de literatura, 03 estudos retrospectivos e 01 estudo de coorte, relatando e analisando diferentes modalidades de tratamento. Conclusões: considerando-se as possíveis comorbidades dos pacientes e limitações técnicas, sugere-se que lesões menores possam ser submetidas ao procedimento único de enucleação com combinação de um ou mais adjuvantes, e lesões extensas sejam submetidas à descompressão antes da cirurgia definitiva, restringindo-se a técnica de ressecção aos casos de lesões que não respondem à descompressão ou quando há fratura patológica.
Enfisema subcutâneo durante exodontia de terceiro molar: relato de três casos
Authors: TORRES RAFAEL , RIBEIRO ARIANY , CARVALHO HANNAH , DO NASCIMENTO SAULO , DE ALBUQUERQUE GUSTAVO , MARTINS VALBER , OLIVEIRA MARCELO , JUNIOR JOEL , TAVARES PAULO
Published: April 2020

Introdução: O enfisema subcutâneo é um acidente raro que acontece durante tratamentos odontológicos, no qual ocorre a passagem forçada de ar e/ou outros gases para o interior dos tecidos moles. Pode ter diversas causas; porém, as mais comuns decorrem do ar liberado durante o uso de turbinas de alta rotação ou seringas tríplices. Geralmente, o tratamento é sintomático, apresentando remissão espontânea ao longo do tempo. Porém, podem apresentar complicações, que evoluem para condições graves e colocam a vida do paciente em risco, sendo necessário um acompanhamento rigoroso até a sua completa regressão. Descrição: São relatados três casos clínicos de pacientes que desenvolveram enfisema subcutâneo durante o uso de turbina de alta rotação em procedimentos de extração de terceiro molar. Todos foram diagnosticados imediatamente durante as cirurgias, com quadros de aumento de volume facial e crepitação à palpação. Resultados: Os tratamentos realizados, que incluíram o uso de medicações anti-inflamatória e antibiótica associadas, ocorreram de forma satisfatória. Conclusão: Após um período de acompanhamento, observou-se completa remissão dos quadros, sem o surgimento de complicações. O correto planejamento cirúrgico é fundamental para evitar esse tipo de complicação.
Caso raro de extensa exostose maxilar e mandibular: relato de caso
Authors: COLOMBARI ANA BEATRIZ , COSTA FELIPPE , SEHN FELIPE , SVERZUT CÁSSIO , TRIVELLATO ALEXANDRE
Published: April 2020

Introdução: As exostoses e o tórus mandibular possuem etiologia incerta e multifatorial, mas acredita-se que fatores ambientais e genéticos estejam relacionados. Apresenta ocorrência maior no sexo masculino, com prevalência de 0,09 a 19% para as exostoses e 5 a 40% para os tórus mandibulares. Objetivo: Esse estudo relata um caso clínico de remoção cirúrgica de extensa exostose óssea em maxila e tórus mandibular. Relato de caso: O paciente compareceu ao serviço com queixa de impossibilidade da reabilitação protética. Após o exame clínico, observou-se arcada superior edêntula, com grande volume ósseo de aparência lobulada. Na arcada inferior, foi constatada protuberância óssea ao longo da superfície lingual na região de pré-molares, sendo indicada a remoção cirúrgica da exostose em maxila e tórus em mandíbula sob anestesia local. Não houve intercorrências no trans e pós-operatório. O exame histopatológico revelou fragmentos de tecido ósseo lamelar, com áreas predominantemente compactas nas regiões periféricas. Resultado: A remoção cirúrgica é o tratamento ideal para o tratamento dessa alteração, possibilitando a reabilitação dos maxilares. Conclusão: As exostoses são alterações fisiológicas comuns, que podem impossibilitar a reabilitação protética em pacientes, sendo indicada a cirurgia para a reabilitação dos maxilares.
Dynamics of Common Sterna hirundo and Little Tern Sternula albifrons populations along the Sava River in North-western Croatia between 2002 and 2019
Authors: Kralj Jelena , Martinović Miloš , Rubinić Tomica , Krnjeta Davor , Jurinović Luka
Published: April 2020

Between 2002 and 2019, monitoring of Common Tern Sterna hirundo and Little Tern Sternula albifrons along the Sava River near Zagreb, Croatia was conducted. Natura 2000 site “Sava kod Hrušćice” was designated to protect colony at river islands, with estimated population sizes of 100–150 pairs of Common and 20 pairs of the Little Tern. Flooding of the colony caused breeding failure in several years. Common Terns moved to breed on islands in gravel pits with a total population around 150 pairs, while Little Tern did not breed after 2010. In the last few years, terns have not bred at Hrušćica and the only colony inside the Natura 2000 site is situated on a breeding platform at Siromaja gravel pit. Channelling of rivers and hydropower plants are the main threats, changing natural dynamics of water level and causing reduction of gravel sediment in rivers.
37 years of Common Tern Sterna hirundo breeding at Sečovlje Salina
Authors: Škornik Iztok
Published: April 2020

Years ago, the Common Tern Sterna hirundo was known to nest in Slovenia along larger watercourses. Today it only breeds locally in artificially built nesting areas. On the seashore, its nesting was confirmed for the first time in 1983, when 9 pairs bred in the Sečovlje Saltpans. In the same year, we started mapping the breeders in the Sečovlje Saltpans, which has continued till this very day. Since 2010, we have been systematically collecting data on the number of fledged birds. In 1991, the number of breeding pairs increased, which coincides with the increase in other parts of the Mediterranean. Since 1991, the size of the breeding population has been quite stable, ranging from 30 to 70 pairs. The Common Tern’s breeding success in the Sečovlje Saltpans is poor, mainly due to precipitation (40% of all unsuccessful nests) and predation (35%). Long, dry periods without rainfall have a positive effect on the hatching and fledging success. Appropriate water management, artificial islands and access to nesting sites control can prevent the disturbance caused by visitors and, in part, predators such as foxes and martens. At the Sečovlje Saltpans, the Common Tern’s survival depends entirely on the active management. The expected climate change, with increasing sea level rise and consequently more frequent flooding of low-lying areas, further aggravates its existence and survival in the Sečovlje Saltpans.
Sıkıştırılmış yüksek plastisiteli kil bir zeminde hacim değişimi davranışının farklı başlangıç koşulları için incelenmesi
Authors: GENÇDAL Hazal Berrak , BERİLGEN Saadet Arzu , KILIÇ Havvanur
Published: April 2020

Bu çalışmada, yüksek plastisiteli bir kil zeminin
dolgu inşasında kullanıldığında, yapının hizmet ömrü boyunca farklı düşey gerilmeler
altında su ile karşılaşması durumunda meydana gelecek hacim değişimi davranışı üç
seri konsolidasyon deneyi ile incelenmiştir. Bu kapsamda konsolidasyon deneylerinde
kullanılan numuneler modifiye kompaksiyon yöntemi ile belirlenen optimum su
muhtevası (wopt=%18,7) ve bu değerin ıslak tarafında iki su
muhtevası (wopt+5= %23,7 ve wopt+7=%25,7)
ve %90 ve %95 rölatif kompaksiyon (R.K.) oranlarında sıkıştırılarak
hazırlanmıştır. 1. Seri konsolidasyon deneylerinde, zeminin sıkıştırıldığı su
muhtevası değerlerinde sulu (S-su ilaveli) ve susuz (N) olarak yüksek basınçlar
altında göstereceği kısa süreli oturma davranışı, 2. Seri konsolidasyon deneylerinde
(S50, S100, S200 ve S800), sırasıyla 50, 100, 200 ve 800 kPa değerlerinde su
ilave edilmesi ile göstereceği şişme davranışı,  3. Seri konsolidasyon deneylerinde (K) ise,
her bir yükleme kademesinde deformasyonların tamamen sönümlenmesi beklenerek göstereceği
uzun süreli oturma (krip) davranışı araştırılmıştır. Yapılan 1. ve 2. seri konsolidasyon
deneylerinde, su muhtevasının artması ile şişmeye olan eğilimin azaldığı ve oturmanın
arttığı görülmüştür. 3.seri konsolidasyon deneylerinde hiçbir numunede krip
davranışı görülmemiştir.
APPROACHES TO STRATEGIC ASSESSMENT OF THE PROSPECTS OF AFRICAN ELECTRICITY MARKETS FOR RUSSIAN COMPANIES
Authors: Mamonov A. O. , Tarasov I, V.
Published: April 2020

This article is devoted to development of methodological approaches to evalution of African energy markets’ strategic opportunities for Russian companies. The main research method in this paper is in-depth case study, which allows to test proposed approaches. The subject of case study is one of the largest African countries – Nigeria. A comprehensive analysis of nigerian energy market from the standpoint of quantitative indicators, technological and financial prospects, as well as the difficulties associated with entering the market, and the possibilities of overcoming them, is carried out. The long-term prospect of the feasibility of entering the energy markets within African countries has been identified.
Sunflowers genotypes agronomics features in the second harvest in Muzambinho (MG)
Authors: Expedito Lense Guilherme Henrique , Bócoli Fernanda Almeida , Alves Alberto Donizete
Published: April 2020

The sunflower (Helianthus annuus L.) is an oilseed crop with agronomic features that justify its tillage in the southeast of Brazil. The objective of this work was to evaluate the agronomic performance of sunflower genotypes tallaged in Muzambinho (MG) in the second harvest. It was adopted the randomized blocks design, with six genotypes (MULTISSOL, BRS G35, BRS G47, BRS G48, M734, and SYN 045) and four repetitions, totalizing 24 experimental plots with an area of 16.8 m2 on its plot. The plant population adopted was about 45000 plants ha-1. The obtained data were submitted to the analysis of variance and the Tukey test, by 5% of probability. There was variation in the agronomic performance of the genotypes to all evaluate parameters. The variety of MULTISSOL was the genotype that presented the larger precocity. The hybrid SYN 045 presented the longer cycle. The hybrid M734 is the genotype with a bigger weight of 1.000 achenes. The genotypes that provided the better yield of grains and oil were M734, SYN 045 and BRS G48. The biggest oil content in the achenes was observed in SYN 045 e BRS G48.
Sex and Gender Issues in Pain Management
Authors: Templeton Kimberly J.
Published: April 2020

➢ Differences exist between men and women in response to noxious stimuli.

➢ Sex-based differences in the perception of noxious stimuli and gender-based differences in the expression of, or behavioral response to, pain have been identified, but much of the current research is difficult to extrapolate to clinical settings.

➢ The response to opioids and the risks of misuse or addiction vary between men and women, although many studies of addiction do not assess data on the basis of sex or gender.
Prognostic factors in patients with thyroid carcinoma: a competing-risks analysis
Authors: Wang Junhu , Heng Lisong , Yang Jie , Tian Feng , Liang Xiaojun , Wang Xinwen
Published: April 2020

Background

Cox proportional-hazards models are widely used to describe survival trends and identify prognostic factors for thyroid carcinoma, but they have significant limitations and deficiencies. This study therefore used a competing-risks model to identify the significant prognostic factors for thyroid carcinoma.

Methods

We identified 38,444 eligible patients in the SEER (Surveillance, Epidemiology, and End Result) database. The potential prognostic factors for thyroid carcinoma were analyzed by competing-risks analysis using both univariate and multivariate analyses.

Results

The univariate analysis showed that age, sex, race, marital state, insurance status, tumor size, whether regional lymph nodes were examined, AJCC stage, histology, surgery status, radiation status, chemotherapy status, bone metastasis, brain metastasis, liver metastasis, and lung metastasis were prognostic factors for death caused by thyroid carcinoma. The multivariate analyses that comprised Cox regression analysis, the cause-specific hazard function analysis, and subdistribution hazard function (SD) analysis produced different results, identifying age, being unmarried, no regional lymph nodes examined, AJCC stages II, III, and IV, having follicular, medullary, and anaplastic carcinomas, no surgery, no radiation, liver metastasis, and lung metastasis as the significant risk factors for thyroid carcinoma, while being female and not receiving chemotherapy were protective factors. The results from the three multivariate models for being black, tumor size >1 cm, and brain metastasis were inconsistent.

Conclusion

This study had produced information about the significant prognostic factors for thyroid carcinoma using a competing-risks model that is more accurate than that obtained using Cox regression analysis. The SD model seems to be preferable for establishing a more accurate prognostic model of this disease aimed at guiding clinical treatments and improving prognoses.
Total laparoscopic versus open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a propensity score matching analysis with meta-analysis
Authors: Chen Ke , Pan Yu , Mou Yi-ping , Huang Chao-jie , Yan Jia-fei , Zhang Ren-chao , Zhang Miao-zun , Wang Guan-yu , Wang Xian-fa , Chen Qi-long
Published: April 2020

Background Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer mortality worldwide. Total laparoscopic pancreaticoduodenectomy (TLPD) have been used in the treatment of benign and low-grade diseases on the pancreatic head. It is necessary to expand the current knowledge on the feasibility and safety of TLPD for PDAC treatment. We aimed to assess the surgical and oncological outcomes of TLPD for patients with PDAC by comparing them with open pancreaticoduodenectomy (OPD). Methods Data regarding patients who underwent pancreaticoduodenectomy for PDAC treatment from January 2013 to January 2019 in our hospital were obtained. Baseline characteristics, intraoperative effects, postoperative recoveries, and survival outcomes were compared. To overcome selection bias, we performed a 1:1 match using propensity score matching (PSM) between TLPD and OPD. We also conducted a systematic review and meta-analysis. Results The original cohort included 276 patients (TLPD; 98 patients, OPD; 178 patients). After PSM, there were 89 patients in each group and the patient demographics were well matched. Of the 98 patients who underwent TLPD, 8 (8.2%) required conversions to laparotomies. Compared to OPD, TLPD could be performed with longer operative times, had less blood loss, and had lower overall morbidities. Regarding oncological and survival outcomes, there were no significant differences in tumor size, R0 resection rates and tumor stages between groups. However, TLPD had an advantage over OPD in terms of retrieved lymph nodes (21.9 ± 6.6 vs. 18.9 ± 5.4, p < 0.01). There were no statistically signiﬁcant differences between the groups in recurrence patterns, and the 3-year recurrence-free and overall survival rates were comparable between the two groups. Meta-analysis further confirmed that the TLPD were associated with longer operative times, less blood loss, shorter hospitalizations, lower morbidities, and a greater number of retrieved lymph nodes. Conclusions TLPD are feasible and oncologically safe procedures for PDAC treatments. Postoperative outcomes and long-term survival after TLPD are superior, or not inferior, to OPD, and could be a promising alternative to open surgery for PDAC treatments. Our findings should be further evaluated by multicenter or randomized controlled trials.
Ethnobotany as A Science of Preserving Traditional Knowledge: A Case Study of Herbal Uses of Plants in Trans-Himalaya (Ladakh), India
Authors: Haq Shiekh Marifatul , Calixto Eduardo Soares , Malik Zubair A. , Kunwar Ripu M.
Published: April 2020

The authors have requested that this preprint be withdrawn due to author disagreement.