bluuebunny/crossref_metadata_2025 huggingface dataset:
Can We Talk About Money? Financial Socialization Through Parent–Child Financial Discussion
Authors: LeBaron Ashley B. , Marks Loren D. , Rosa Christina M. , Hill E. Jeffrey
Published: February 2020

This multigenerational, qualitative research study explores family financial discussion processes that may lead to better financial preparation for emerging adults. Interviews were conducted with 90 emerging adults from three universities as well as 17 of their parents and 8 of their grandparents. Qualitative analyses revealed two major themes associated with family financial discussion processes. In parent-initiated discussions, principles were taught primarily through vertically structured (top-down) delivery. Three concepts reported across all three generations of respondents included (a) sharing financial experiences, (b) involving children in decisions, and (c) engaging in age-appropriate conversations. In child-initiated discussions, analyses revealed that financial principles were often taught in interactive, conversational, horizontal, and organic ways. Analyses identified two recurring concepts or contexts: (a) children asking financial questions and (b) child-initiated, age-appropriate conversations. These results highlight healthy processes for family financial discussion that may better prepare emerging adults for financial adulthood and reduce financial instability.
“My Friend with HIV Remains a Friend”: HIV/AIDS Stigma Reduction through Education in Secondary Schools—A Pilot Project in Buea, Cameroon
Authors: Jacobi Christoph Arnim , Atanga Pascal Nji , Bin Leonard Kum , Fru Akenji Jean Claude , Eppel Gerd , Mbome Victor Njie , Etonde Hannah Etongo Mbua , Bogner Johannes Richard , Malfertheiner Peter
Published: February 2020

The universal access to treatment and care for people living with HIV (PLWHIV) is still a major problem, especially in sub-Saharan Africa, where 70% of HIV-infected people live. Equally important is the fact that HIV/AIDS-related stigma is recognized to be a major obstacle to successfully control the spread of this disease. We devised a pilot project (titled “My friend with HIV remains a friend”) to fight the HIV/AIDS stigmatization through educating secondary school students by openly HIV-positive teachers. In a first step, we have measured the amount and type of stigma felt by the PLWHIV in Buea/Cameroon using the “The people living with HIV Stigma Index” from Joint United Nations Programme on HIV/AIDS. Gossiping and verbal insults were experienced by 90% of the interviewees, while 9% have experienced physical assaults. Using these data and material from the “Toolkit for action” from the “International Centre for the Research on Women,” the teachers educated the students on multiple aspects of HIV/AIDS and stigma. The teaching curriculum included role-plays, picture visualizations, drawing, and other forms of interactions like visits to HIV and AIDS treatment units. Before and after this intervention, the students undertook “True/False” examinations on HIV/AIDS and stigma. We compared these results with results from students from another school, who did not participate in this intervention. We were able to show that the students taking part in the intervention improved by almost 20% points in comparison to the other students. Their results did not change.
Ambedkar’s Educational Odyssey, 1913–1927
Authors: Krishnamurty J.
Published: February 2020

I have attempted to provide an accurate timeline for Ambedkar’s incredible educational achievements between 1913 and 1927. Although there is wealth of literature on Ambedkar’s life, ambiguities and errors abound. I have therefore examined afresh archival material and secondary sources.

Besides preparing several other manuscripts and papers in economics, Ambedkar secured his MSc and DSc degrees from London and published two major books, one on monetary policy and the other on fiscal policy. One was the basis on which he was awarded his Columbia PhD degree. It also appears that an earlier doctoral thesis draft prepared in 1917 was lost at sea. At the same time, he acquired his professional qualification as a lawyer, being called to the bar in 1920. Ambedkar’s relations with his supervisors were harmonious and he appears to have been treated well by them.

Ambedkar produced a large and varied body of original work under the most difficult of conditions. In the light of the above the fact which I also establish that he was not the first Indian to obtain a doctoral degree in economics pales into insignificance.
Bilateral Macular Holes in Adult Vitelliform Macular Dystrophy
Authors: Regan Kathleen A. , Gottlieb Justin L.
Published: February 2020

Purpose:

This report describes a case of bilateral macular holes (MHs) in adult vitelliform macular dystrophy (AVMD).

Methods:

A retrospective case report of a patient with AVMD and sequential onset of bilateral MHs is presented.

Results:

Bilateral MHs were observed after vitreomacular traction was identified on optical coherence tomography. Holes in both eyes were repaired with pars plana vitrectomy (PPV) with C3F8 (perfluoropropane) gas tamponade; only the right eye underwent internal limiting membrane peeling. In the right eye, 2 PPVs were required for hole closure. In both eyes, long-term atrophy of the retina and retinal pigment epithelium was observed.

Conclusions:

MHs in AVMD may be preceded by vitreomacular traction. Surgical repair with PPV and gas tamponade was successful. Retinal and retinal pigment epithelium atrophy developed postoperatively, but the patient’s vision still improved.
Myc-Miz-1 signaling promotes self-renewal of leukemia stem cells by repressing Cebpα and Cebpδ
Authors: Zhang Lei , Li Jing , Xu Hui , Shao Xianyu , Fu Li , Hou Ye , Hao Caiqing , Li Wenyan , Joshi Kanak , Wei Wei , Xu Yan , Zhang Feng , Dai Shaojun , Breslin, S.J. Peter W. , Zhang Jiwang , Zhang Jun
Published: February 2020

c-Myc (Myc hereafter) is found to be deregulated and/or amplified in most acute myeloid leukemias (AML). Almost all AML cells are dependent upon Myc for their proliferation and survival. Thus Myc has been proposed as a critical anti-AML target. Myc has Max-mediated trans-activational and Miz1-mediated trans-repressional activities. The role of Myc-Max-mediated trans-activation in the pathogenesis of AML has been well-studied; however the role of Myc-Miz1-mediated trans-repression in AML is still somewhat obscure. MycV394D is a mutant form of Myc which lacks trans-repressional activity due to a defect in its ability to interact with Miz1. We found that, compared to Myc, the oncogenic function of MycV394D is significantly impaired. The AML/myeloproliferative disorder which develops in mice receiving MycV394D-transduced hematopoietic stem/progenitor cells (HSPCs) is significantly delayed compared to mice receiving Myc-transduced HSPCs. Using a murine MLL-AF9 AML model, we found that AML cells expressing MycV394D (intrinsic Myc deleted) are partially differentiated and show reductions in both colony-forming ability in vitro and leukemogenic capacity in vivo. The reduced frequency of leukemia stem cells (LSCs) among MycV394D-AML cells and their reduced leukemogenic capacity during serial transplantation suggest that Myc-Miz1 interaction is required for the self-renewal of LSCs. In addition, we found that MycV394D-AML cells are more sensitive to chemotherapy than are Myc-AML cells. Mechanistically, we found that the Myc represses Miz1-mediated expression of Cebpα and Cebpδ, thus playing an important role in the pathogenesis of AML by maintaining the undifferentiated state and self-renewal capacity of LSCs.
Automatic Scallion Seedling Feeding Mechanism with an Asymmetrical High-order Transmission Gear Train
Authors: Zhao Xiong , Ye Jun , Chu Mengyan , Dai Li , Chen Jianneng
Published: February 2020

The current automatic scallion-transplanting machine is a complicated mechanism composed of two linkage mechanisms and two band carriers. It delivers seedlings inefficiently because of the movement limitations of the linkage mechanism. This paper proposes a new high-order non-circular gear train for an automatic scallion-seedling feeding mechanism. The proposed gear train has an asymmetrical transmission ratio; i.e., its transmission ratio varies. This allows the mechanism’s execution component to move in a long displacement and rotate in a large rotation angle. The long displacement enables the execution component to reach the designed working position, and the large rotation angle allows it to feed a scallion in the required pose. A mathematical model for calculating the asymmetrical transmission ratio was established according to the closure requirements and the full-cycle motion of the driven gear pitch curve. Then, the parameter-design model of the new seedling-feeding mechanism was established, based on precise pose points and trajectory-shape control points. Moreover, an aided-design program was developed to obtain the parameter-solution domain of the scallion-seedling feeding mechanism. The mechanism parameters, which met the seedling-feeding function, were optimized to determine the transmission ratio, using a program and a kinematic simulation. Finally, a prototype of the mechanism was produced, and a seedling-feeding experiment was carried out. One-thousand seedlings were tested at a rate of 100 seedlings per minute, and the statistical success rate was 93.4%. Thus, the automatic scallion-seedling feeding mechanism significantly improves the efficiency of automatically transplanting scallions.
Genotype-by-environment interaction in coast redwood outside natural distribution - search for environmental cues
Authors: Klápště Jaroslav , Meason Dean , Dungey Heidi S. , Telfer Emily J. , Silcock Paul , Rapley Simon
Published: February 2020

Background

Effective matching of genotypes and environments is required for the species to reach optimal productivity and act effectively for carbon sequestration. A common garden experiment across five different environments was undertaken to assess genotype x environment interaction (GxE) of coast redwood in order to understand the performance of genotypes across environments.

Results

The quantitative genetic analysis discovered no GxE between investigated environments for diameter at breast height (DBH). However, no genetic component was detected at one environment possibly due to stressful conditions. The implementation of universal response function allowed for the identification of important environmental factors affecting species productivity. Additionally, this approach enabled us to predict the performance of species across the New Zealand environmental conditions.

Conclusions

In combination with quantitative genetic analysis which identified genetically superior material, the URF model can directly identify the optimal geographical regions to maximize productivity. However, the finding of ideally uncorrelated climatic variables for species with narrow ecological amplitude is rather challenging, which complicates construction of informative URF model. This, along with a small number of tested environments, tended to overfit a prediction model which resulted in extreme predictions in untested environments.
Genome-wide association study (GWAS) reveals genetic loci of lead (Pb) tolerance during seedling establishment in rapeseed (Brassica napus L.)
Authors: Zhang Fugui , Xiao Xin , Xu Kun , Cheng Xi , Xie Ting , Hu Jihong , Wu Xiaoming
Published: February 2020

Background

Lead (Pb) pollution in soil has become one of the major environmental threats to plant growth and human health. Safe utilization of Pb contaminated soil by phytoremediation require Pb-tolerant rapeseed (Brassica napus L.) accessions. However, breeding of new B. napus cultivars tolerance to Pb stress has been restricted by limited knowledge on molecular mechanisms involved in Pb tolerance. This work was carried out to identify genetic loci related to Pb tolerance during seedling establishment in rapeseed.

Results

Pb tolerance, which was assessed by quantifying radicle length (RL) under 0 or 100 mg/L Pb stress condition, shown an extensive variation in 472 worldwide-collected rapeseed accessions. Based on the criterion of relative RL > 80%, six Pb-tolerant genotypes were selected. Four quantitative trait loci (QTLs) associated with Pb tolerance were identified by Genome-wide association study. The expression level of nine promising candidate genes, including GSTUs, BCATs, UBP13, TBR and HIPP01, located in these four QTL regions, were significantly higher or induced by Pb in Pb-tolerant accessions in comparison to Pb-sensitive accessions.

Conclusion

To our knowledge, this is the first study on Pb-tolerant germplasms and genomic loci in B. napus. The findings can provide valuable genetic resources for the breeding of Pb-tolerant B. napus cultivars and understanding of Pb tolerance mechanism in Brassica species.
Comparative transcriptome analysis of inbred lines and contrasting hybrids reveals overdominance mediate early biomass vigor in hybrid cotton
Authors: Shahzad Kashif , Zhang Xuexian , Guo Liping , Qi Tingxiang , Tang Huini , Zhang Meng , Zhang Bingbing , Wang Hailin , Qiao Xiuqin , Feng Juanjuan , Wu Jianyong , Xing Chaozhu
Published: February 2020

Background

Heterosis breeding is the most useful method for yield increase around the globe. Heterosis is an intriguing process to develop superior offspring to either parent in the desired character. The biomass vigor produced during seedling emergence stage has a direct influence on yield heterosis in plants. Unfortunately, the genetic basis of early biomass vigor in cotton is poorly understood.

Results

Three stable performing F1hybrids varying in yield heterosis named as high, medium and low hybrids with their inbred parents were used in this study. Phenotypically, these hybrids established noticeable biomass heterosis during the early stage of seedling growth in the field. Transcriptome analysis of root and leaf revealed that hybrids showed many differentially expressed genes (DEGs) relative to their parents, while the comparison of inbred parents showed limited number of DEGs indicating similarity in their genetic constitution. Further analysis indicated expression patterns of most DEGs were overdominant in both tissues of hybrids. According to GO results, functions of overdominance genes in leaf were enriched for chloroplast, membrane, and protein binding, whereas functions of overdominance genes in root were enriched for plasma membrane, extracellular region, and responses to stress. We found several genes of circadian rhythm pathway related to LATE ELONGATED HYPOCOTYL (LHY) showed downregulated overdominant expressions in both tissues of hybrids. In addition to circadian rhythm, several leaf genes related to Aux/IAA regulation, and many root genes involved in peroxidase activity also showed overdominant expressions in hybrids. Twelve genes involved in circadian rhythm plant were selected to perform qRT-PCR analysis to confirm the accuracy of RNA-seq results.

Conclusions

Through genome-wide comparative transcriptome analysis, we strongly predict that overdominance at gene expression level plays a pivotal role in early biomass vigor of hybrids. The combinational contribution of circadian rhythm and other metabolic process may control vigorous growth in hybrids. Our result provides an important foundation for dissecting molecular mechanisms of biomass vigor in hybrid cotton.
Conserved defense responses between maize and sorghum to Exserohilum turcicum
Authors: Zhang Xiaoyue , Fernandes Samuel B. , Kaiser Christopher , Adhikari Pragya , Brown Patrick J. , Mideros Santiago X. , Jamann Tiffany M.
Published: February 2020

Background

Exserohilum turcicumis an important pathogen of both sorghum and maize, causing sorghum leaf blight and northern corn leaf blight. Because the same pathogen can infect and cause major losses for two of the most important grain crops, it is an ideal pathosystem to study plant-pathogen evolution and investigate shared resistance mechanisms between the two plant species.To identify sorghum genes involved in theE. turcicumresponse, we conducted a genome-wide association study (GWAS).

Results

Using the sorghum conversion panel evaluated across three environments, we identified a total of 216 significant markers. Based on physical linkage with the significant markers, we detected a total of 113 unique candidate genes, some with known roles in plant defense. Also, we compared maize genes known to play a role in resistance toE. turcicumwith the association mapping results and found evidence of genes conferring resistance in both crops, providing evidence of shared resistance between maize and sorghum.

Conclusions

Using a genetics approach, we identified shared genetic regions conferring resistance toE. turcicumin both maize and sorghum. We identified several promising candidate genes for resistance to leaf blight in sorghum, including genes related to R-gene mediated resistance. We present significant advancements in the understanding of host resistance toE. turcicum, which is crucial to reduce losses due to this important pathogen.
Risk factors for pneumonia and influenza hospitalizations in long-term care facility residents: a retrospective cohort study
Authors: Moyo Patience , Zullo Andrew R. , McConeghy Kevin W. , Bosco Elliott , van Aalst Robertus , Chit Ayman , Gravenstein Stefan
Published: February 2020

Background

Older adults who reside in long-term care facilities (LTCFs) are at particularly high risk for infection, morbidity and mortality from pneumonia and influenza (P&I) compared to individuals of younger age and those living outside institutional settings. The risk factors for P&I hospitalizations that are specific to LTCFs remain poorly understood. Our objective was to evaluate the incidence of P&I hospitalization and associated person- and facility-level factors among post-acute (short-stay) and long-term (long-stay) care residents residing in LTCFs from 2013 to 2015.

Methods

In this retrospective cohort study, we used Medicare administrative claims linked to Minimum Data Set and LTCF-level data to identify short-stay (< 100 days, index = admission date) and long-stay (100+ days, index = day 100) residents who were followed from the index date until the first of hospitalization, LTCF discharge, Medicare disenrollment, or death. We measured incidence rates (IRs) for P&I hospitalization per 100,000 person-days, and estimated associations with baseline demographics, geriatric syndromes, clinical characteristics, and medication use using Cox regression models.

Results

We analyzed data from 1,118,054 short-stay and 593,443 long-stay residents. The crude 30-day IRs (95% CI) of hospitalizations with P&I in the principal position were 26.0 (25.4, 26.6) and 34.5 (33.6, 35.4) among short- and long-stay residents, respectively. The variables associated with P&I varied between short and long-stay residents, and common risk factors included: advanced age (85+ years), admission from an acute hospital, select cardiovascular and respiratory conditions, impaired functional status, and receipt of antibiotics or Beers criteria medications. Facility staffing and care quality measures were important risk factors among long-stay residents but not in short-stay residents.

Conclusions

Short-stay residents had lower crude 30- and 90-day incidence rates of P&I hospitalizations than long-stay LTCF residents. Differences in risk factors for P&I between short- and long-stay populations suggest the importance of considering distinct profiles of post-acute and long-term care residents in infection prevention and control strategies in LTCFs. These findings can help clinicians target interventions to subgroups of LTCF residents at highest P&I risk.
TB transmission is associated with prolonged stay in a low socio-economic, high burdened TB and HIV community in Cape Town, South Africa
Authors: Tadokera Rebecca , Bekker Linda-Gail , Kreiswirth Barry N. , Mathema Barun , Middelkoop Keren
Published: February 2020

Background

While several studies have assessed the associations between biological factors and tuberculosis (TB) transmission, our understanding of the associations between TB transmission and social and economic factors remains incomplete. We aimed to explore associations between community TB transmission and socio-economic factors within a high TB-HIV burdened setting.

Methods

We conducted a cross-sectional molecular epidemiology study among adult patients attending a routine TB clinic. Demographic and clinical data were extracted from TB registers and clinical folders; social and economic data were collected using interviewer-administered questionnaires; Mycobacterium tuberculosis isolates were genotyped and classified as clustered/non-clustered using IS6110-based Restriction Fragment Length Polymorphism. Composite “social” and “economic” scores were generated from social and economic data. Data were analyzed using StataCorp version 15.0 software. Stratified, bivariable analyses were performed using chi-squared. Wilcoxon signed rank tests; univariable and multivariable logistic regression models were developed to explore associations in the social, economic, traditional and composite TB risk factors with TB transmission.

Results

Of the 505 patient Mtb  strains, 348(69%) cases were classified as clustered and 157(31%) were non-clustered. Clustered cases were more likely to have lived longer in the study community, (odds ratio [OR] = 1.05, 95% Confidence interval [C.I]:1.02–1.09, p = 0.006); in the same house (OR = 1.04, C.I: 0.99–1.08, p = 0.06); and had increased household crowding conditions (i.e fewer rooms used for sleeping, OR = 0.45, C.I:0.21–0.95, p = 0.04). Although a higher proportion of clustered cases had a low economic score, no statistically significant association was found between clustering and either the economic score (p = 0.13) or social score (p = 0.26).

Conclusions

We report a novel association between Mtb transmission and prolonged stay within a high burdened community. Transmission was also associated with fewer rooms for sleeping in a household. Increased social interaction and prolonged residence in a high burdened community are important factors linked to Mtb transmission, possibly due to increased probability of higher effective contact rates. The possible importance of degrees of poverty within low socio-economic setting warrants further study.
Can the low and high b-value distribution influence the pseudodiffusion parameter derived from IVIM DWI in normal brain?
Authors: Hu Yu-Chuan , Yan Lin-Feng , Han Yu , Duan Shi-Jun , Sun Qian , Li Gang-Feng , Wang Wen , Wei Xiao-Cheng , Zheng Dan-Dan , Cui Guang-Bin
Published: February 2020

Background

Our study aims to reveal whether the low b-values distribution, high b-values upper limit, and the number of excitation (NEX) influence the accuracy of the intravoxel incoherent motion (IVIM) parameter derived from multi-b-value diffusion-weighted imaging (DWI) in the brain.

Methods

This prospective study was approved by the local Ethics Committee and informed consent was obtained from each participant. The five consecutive multi-b DWI with different b-value protocols (0–3500 s/mm2) were performed in 22 male healthy volunteers on a 3.0-T MRI system. The IVIM parameters from normal white matter (WM) and gray matter (GM) including slow diffusion coefficient (D), fast perfusion coefficient (D*) and perfusion fraction (f) were compared for differences among defined groups with different IVIM protocols by one-way ANOVA.

Results

The D* and f value of WM or GM in groups with less low b-values distribution (less than or equal to 5 b-values) were significantly lower than ones in any other group with more low b-values distribution (all P <  0.05), but no significant differences among groups with more low b-values distribution (P > 0.05). In addition, no significant differences in the D, D* and f value of WM or GM were found between group with one and more NEX of low b-values distribution (all P > 0.05). IVIM parameters in normal WM and GM strongly depended on the choice of the high b-value upper limit.

Conclusions

Metrics of IVIM parameters can be affected by low and high b value distribution. Eight low b-values distribution with high b-value upper limit of 800–1000 s/mm2 may be the relatively proper set when performing brain IVIM studies.
Respectful maternity care and associated factors among women who delivered at Harar hospitals, eastern Ethiopia: a cross-sectional study
Authors: Bante Agegnehu , Teji Kedir , Seyoum Berhanu , Mersha Abera
Published: February 2020

Background

In Ethiopia, approximately three-fourths of mothers do not deliver in health facilities. Disrespect and abuse during childbirth fallouts in underutilization of institutional delivery that upshots maternal morbidity and mortality. Thus, the ambition of this study was to assess respectful maternity care and associated factors in Harar hospitals, Eastern Ethiopia.

Methods

A facility-based cross-sectional study was conducted from April 01 to July 01, 2017. A total of 425 women, delivered at Harar town hospitals, were nominated using a systematic random sampling technique. A pretested and organized questionnaire was used to collect the data. After checking for completeness, the data were entered into EpiData version 3.1 and exported to SPSS version 22.0 for cleaning and analyses. Both bivariate and multivariable logistic regression was computed to identify factors associated with respectful maternity care. Statistical significance was declared at a P-value of < 0.05.

Results

Data were collected on 425 women. Overall, only 38.4% (95% CI: 33.7, 42.0%) of women received respectful maternity care. Delivering at private hospitals [AOR: 2.3, 95% CI: 1.25, 4.07], having ANC follow-up [AOR: 1.8, 95% CI: 1.10, 3.20], planned pregnancy [AOR: 3.0, 95% CI: 1.24, 7.34], labor attended by male provider [AOR: 1.8, 95% CI: 1.14, 2.77] and normal maternal outcome [AOR: 2.3, 95% CI: 1.13, 4.83] were significantly associated with respectful maternity care.

Conclusions

Only four out of ten women received respectful care during labor and delivery. Providing women-friendly, abusive free, timely and discriminative free care are the bases to improve the uptake of institutional delivery. Execution of respectful care advancement must be the business of all healthcare providers. Furthermore, to come up with a substantial reduction in maternal mortality, great emphasis should be given to make the service woman-centered.
Are perceived barriers to accessing health care associated with inadequate antenatal care visits among women of reproductive age in Rwanda?
Authors: Nisingizwe Marie Paul , Tuyisenge Germaine , Hategeka Celestin , Karim Mohammad Ehsanul
Published: February 2020

Background

Maternal and child mortality remain a global health concern despite different interventions that have been implemented to address this issue. Adequate antenatal care (ANC) is crucial in reducing maternal and neonatal morbidity and mortality. However, in Rwanda, there is still suboptimal utilization of ANC services. This study aims to assess the relationship between perceived barriers to accessing health care and inadequate ANC visits among women of reproductive age in Rwanda.

Methods

This study is cross-sectional using secondary data from the 2014–15 Rwanda demographic and health survey (RDHS). The study included 5876 women aged 15–49 years, and the primary outcome of the investigation was inadequate ANC visits defined as delayed first ANC visit and non-completion of at least four recommended visits during the pregnancy period. The primary exposure was perceived barriers to accessing health care, operationalized using the following 4 variables: distance to the health facility, getting money for treatment, not wanting to go alone and getting permission to go for treatment. A survey-weighted multivariable logistic regression analysis and backward elimination method based on Akaike information criterion (AIC) was used to select the final model. We conducted a number of sensitivity analyses using stratified and weighting propensity score methods and investigated the relationship between the outcome and each barrier to care separately.

Results

Of 5, 876 women included in the analysis, 53% (3132) aged 20 to 34 years, and 44% (2640) were in the lowest wealth index. Overall, 64% (2375) of women who perceived to have barriers to health care had inadequate ANC visits. In multivariable analysis, women who perceived to have barriers to health care had higher odds of having inadequate ANC visits (OR: 1.14; 95% CI: 0.99, 1.31). However, the association was borderline statistically significant. The findings from sensitivity analyses were consistent with the main analysis results.

Conclusion

The study suggests a positive association between perceived barriers to health care access and inadequate ANC visits. The findings speak to a need for interventions that focus on improving access to health care in Rwanda to increase uptake of ANC services.
Intramyometrial pregnancy after cryopreserved embryo transfer: a case report
Authors: Liu Yuan , Wu Yu
Published: February 2020

Background

Intramyometrial pregnancy is a rare subtype of ectopic pregnancy. The cases following IVF-ET were few reported in recent years. The etiological factors include previous uterine trauma like myomectomy, salpingectomy, dilatation and curettage, assisted reproductive technologies and adenomyosis. Early diagnosis is difficult to make due to its various manifestation. The medical treatment includes conservative management with surgical excision, aortic balloon occlusion, uterine artery embolization, MTX etc. Sometimes hysterectomy was performed due to delayed diagnosis.

Case presentation

In this article, we presented a case of a 28 years old woman who had cryopreserved embryo transfer with a history of right side salpingectomy. We suspected it a right adnexa ectopic pregnancy at the first place, especially the right fallopian interstitial or right uterus cornu due to ultrasonography and medical history. The product of conception was discovered embedded in the myometrium and protruding out from the right side of the posterior uterine wall, with seemingly no connection with uterine cavity nor fallopian tubes. The diagnosis of intramural pregnancy was made intraoperatively and validated after pathological report. The interventions were made early enough that exploratory laparoscopy, hysteroscopy and conservative surgical excision were successfully performed at 7 weeks’ gestation preserving the fertility.

Conclusions

It is important for clinicians to be aware of risk factors of intramural pregnancy and maintain an index of suspicion in ART treatment. Ultrasound and laparoscopy are essential managements for early diagnose which make conservative treatment possible and prevent life-threatening consequences.
What about the men? Perinatal experiences of men of color whose partners were at risk for preterm birth, a qualitative study
Authors: Edwards Brittany N. , McLemore Monica R. , Baltzell Kimberly , Hodgkin Allen , Nunez Olga , Franck Linda S.
Published: February 2020

Background

Preterm birth in the United States is associated with maternal clinical factors such as diabetes, hypertension and social factors including race, ethnicity, and socioeconomic status. In California, 8.7% of all live births are preterm, with African American and Black families experiencing the greatest burden. The impact of paternal factors on birth outcomes has been studied, but little is known about the experience of men of color (MOC). The purpose of this study was to explore the experiences of MOC who are partners to women at medical and social risk for preterm birth.

Methods

This study used a qualitative research design and focus group methods. The research was embedded within an existing study exploring experiences of women of color at risk for preterm birth conducted by the California Preterm Birth Initiative.

Results

Twelve MOC participated in the study and among them had 9 preterm children. Four themes emerged from thematic analysis of men’s experiences: (1) “Being the Rock”: Providing comfort and security; (2) “It’s a blessing all the way around”: Keeping faith during uncertainty; (3) “Tell me EVERYTHING”: Unmet needs during pregnancy and delivery; (4) “Like a guinea pig”: Frustration with the healthcare system. Participants identified many barriers to having a healthy pregnancy and birth including inadequate support for decision making, differential treatment, and discrimination.

Conclusions

This study shows novel and shared narratives regarding MOC experiences during pregnancy, birth, and postpartum periods. Healthcare providers have an essential role to acknowledge MOC, their experience of discrimination and mistrust, and to assess needs for support that can improve birth outcomes. As MOC and their families are at especially high social and medical risk for preterm birth, their voice and experience should be central in all future research on this topic.
The combination of CTCs and CEA can help guide the management of patients with SPNs suspected of being lung cancer
Authors: Zheng Jian , Ye Xiong , Liu Yanan , Zhao Yuxia , He Mudan , Xiao Hui
Published: February 2020

Objective

Solitary pulmonary nodules (SPNs) is a common radiographic finding and require further evaluation because of the possibility of lung cancer. This study aimed to determine the sensitivity and specificity of circulating tumour cells (CTCs) as a marker for the diagnosis of SPNs and the integration of CTCs, carcinoembryonic antigen (CEA) and imaging findings to improve the sensitivity and specificity of diagnosis in patients with SPNs suspected of being lung cancer.

Method

For the serum biomarker assay, the concentration of CEA was measured by an automated electrochemiluminescence analyzer. CTCs were collected from 6 ml of blood by the SE i-FISH method, which detects the gene copy number in eight chromosomes and the tumour-associated antigen CK18.

Results

With a threshold of 6 CTC units, the method showed a sensitivity of 67.1% and a specificity of 56.5% in the diagnosis of NSCLC, especially in the upper lobe, in which the diagnostic strength was the highest (P < 0.01). CTCs, CEA and nodule type had the highest diagnostic efficacy (area under the curve, 0.827; 95% confidence interval, 0.752–0.901) in patients with SPNs being suspected lung cancer. Combining CTCs (cut-off value 12 units) with CEA (1.78 ng/ml), the method showed a sensitivity of 77.8% and a specificity of 90% in the diagnosis of NSCLC, especially in the upper lobe, subsolid nodules and nodules ≥8 mm.

Conclusions

Our results demonstrated that CTCs are feasible diagnostic biomarkers in patients with SPNs, especially in the upper lobe. Furthermore, CTCs combined with CEA showed higher diagnostic efficacy in the upper lobe, subsolid nodules and nodules ≥8 mm.
Management of patients with early stage lung cancer – why do some patients not receive treatment with curative intent?
Authors: Lawrenson Ross , Lao Chunhuan , Brown Leonie , Moosa Lucia , Chepulis Lynne , Keenan Rawiri , Kidd Jacquie , Middleton Karen , Conaglen Paul , de Groot Charles , Aitken Denise , Wong Janice
Published: February 2020

Backgrounds

This study aims to understand the factors that influence whether patients receive potentially curative treatment for early stage lung cancer. A key question was whether indigenous Māori patients were less likely to receive treatment.

Methods

Patients included those diagnosed with early stage lung cancer in 2011–2018 and resident in the New Zealand Midland Cancer Network region. Logistic regression model was used to estimate the odds ratios of having curative surgery/ treatment. The Kaplan Meier method was used to examine the all-cause survival and Cox proportional hazard model was used to estimate the hazard ratio of death.

Results

In total 419/583 (71.9%) of patients with Stage I and II disease were treated with curative intent - 272 (46.7%) patients had curative surgery. Patients not receiving potentially curative treatment were older, were less likely to have non-small cell lung cancer (NSCLC), had poorer lung function and were more likely to have an ECOG performance status of 2+. Current smokers were less likely to be treated with surgery and more likely to receive treatment with radiotherapy and chemotherapy. Those who were treated with surgery had a 2-year survival of 87.8% (95% CI: 83.8–91.8%) and 5-year survival of 69.6% (95% CI: 63.2–76.0%). Stereotactic ablative body radiotherapy (SABR) has equivalent effect on survival compared to curative surgery (hazard ratio: 0.77, 95% CI: 0.37–1.61). After adjustment we could find no difference in treatment and survival between Māori and non-Māori.

Conclusions

The majority of patients with stage I and II lung cancer are managed with potentially curative treatment – mainly surgery and increasingly with SABR. The outcomes of those being diagnosed with stage I and II disease and receiving treatment is positive with 70% surviving 5 years.
Long-term outcomes and significance of preoperative lymphocyte-to-monocyte ratio as a prognostic indicator in patients with invasive pancreatic neoplasms after repeat pancreatectomy
Authors: Takano Shigetsugu , Yoshitomi Hideyuki , Kagawa Shingo , Furukawa Katsunori , Takayashiki Tsukasa , Kuboki Satoshi , Suzuki Daisuke , Sakai Nozomu , Mishima Takashi , Nakadai Eri , Miyazaki Masaru , Ohtsuka Masayuki
Published: February 2020

Background

Invasive pancreatic neoplasms have a high propensity for recurrence even after curative resection. Recently, patients who underwent pancreatectomy have an opportunity of undergoing secondary pancreatic resection, so-called “repeat pancreatectomy” to achieve curative operation and prolong their survival. We evaluated the long-term clinical outcomes and identified the prognostic factors, including systemic inflammation markers and the lymphocyte-to-monocyte ratio (LMR) of patients who underwent repeat pancreatectomy for invasive pancreatic tumors.

Methods

Twenty-eight consecutive patients with invasive pancreatic neoplasms (22 pancreatic ductal adenocarcinomas, 2 pancreatic acinar cell carcinomas, and 4 invasive intra-papillary mucinous carcinomas) with isolated local recurrence only in the remnant pancreas were analyzed retrospectively. To identify factors for the selection of optimal patients who should undergo repeat pancreatectomy, perioperative clinical parameters were analyzed by Cox proportional regression models.

Results

Of 28 patients, 12 patients experienced recurrence within 3 years after repeat pancreatectomy. Kaplan–Meier analysis showed that the median cancer-specific overall survival time of patients with invasive pancreatic neoplasms was 61 months, showing favorable outcomes. High preoperative LMR (LMR ≥ 3.3) (p = 0.022), no portal vein resection (p = 0.021), no arterial resection (p = 0.037), and pathological lymph node negative (p = 0.0057) were identified as favorable prognostic parameters on univariate analysis, and LMR ≥ 3.3 (p = 0.0005), and pathological lymph node negative (p = 0.018) on multivariate analysis.

Conclusions

Preoperative LMR is potentially a good indicator for selecting suitable patients to undergo repeat pancreatectomy in patients with isolated local recurrence of invasive pancreatic neoplasms.
Comparison of three classes of Marginal Risk Set Model in predicting infant mortality among newborn babies at Kigali University Teaching Hospital, Rwanda, 2016
Authors: Gatabazi Paul , Melesse Sileshi Fanta , Ramroop Shaun
Published: February 2020

Background

The Infant Mortality Rate (IMR) in Sub-Saharan Africa (SSA) remains the highest relatively to the rest of the world. In the past decade, the policy on reducing infant mortality in SSA was reinforced and both infant mortality and parental death decreased critically for some countries of SSA. The analysis of risk to death or attracting chronic disease may be done for helping medical practitioners and decision makers and for better preventing the infant mortality.

Methods

This study uses popular statistical methods of re-sampling and one selected model of multiple events analysis for measuring the survival outcomes for the infants born in 2016 at Kigali University Teaching Hospital (KUTH) in Rwanda, a country of SSA, amidst maternal and child’s socio-economic and clinical covariates. Dataset comprises the newborns with correct information on the covariates of interest. The Bootstrap Marginal Risk Set Model (BMRSM) and Jackknife Marginal Risk Set Model (JMRSM) for the available maternal and child’s socio-economic and clinical covariates were conducted and then compared to the outcome with Marginal Risk Set Model (MRSM). That was for measuring stability of the MRSM.

Results

The 2117 newborns had the correct information on all the covariates, 82 babies died along the study time, 69 stillborn babies were observed while 1966 were censored. Both BMRSM JMRSM and MRSM displayed the close results for significant covariates. The BMRSM displayed in some instance, relatively higher standard errors for non-significant covariates and this emphasized their insignificance in MRSM. The models revealed that female babies survive better than male babies. The risk is higher for babies whose parents are under 20 years old parents as compared to other parents’ age groups, the risk decreases as the APGAR increases, is lower for underweight babies than babies with normal weight and overweight and is lower for babies with normal circumference of head as compared to those with relatively small head.

Conclusion

The results of JMRSM were closer to MRSM than that of BMRSM. Newborns of mothers aged less than 20 years were at relatively higher risk of dying than those who their mothers were aged 20 years and above. Being abnormal in weight and head increased the risk of infant mortality. Avoidance of teenage pregnancy and provision of clinical care including an adequate dietary intake during pregnancy would reduce the IMR in Kigali.
Cognitive function in metformin exposed children, born to mothers with PCOS – follow-up of an RCT
Authors: Greger Hanne Klæboe , Hanem Liv Guro Engen , Østgård Heidi Furre , Vanky Eszter
Published: February 2020

Background

Metformin is widely used in pregnancy to treat gestational diabetes mellitus and polycystic ovary syndrome (PCOS). Association between PCOS and developmental delay in offspring, and larger head circumference of metformin-exposed newborns has been reported. The objective of this study was to explore whether metformin exposure in utero had any effect on offspring cognitive function.

Method

The current study is a follow-up of two randomized, placebo-controlled studies which were conducted at 11 public hospitals in Norway In the baseline studies (conducted in 2000–2003, and 2005–2009), participants were randomized to metformin 1700 and 2000 mg/d or placebo from first trimester to delivery. There was no intervention in the current study. We invited parents of 292 children to give permission for their children to participate; 93 children were included (mean age 7.7 years). The follow-up study was conducted in 2014–2016. The Wechsler Preschool and Primary Scale of Intelligence version III and the Wechsler Intelligence Scale for Children version IV were applied for cognitive assessment. Androstenedione and testosterone were measured in maternal blood samples at four time-points in pregnancy.

Results

We found no difference in mean, full scale IQ in metformin (100.0 (SD 13.2)) vs. placebo-exposed (100.9 (SD 10.1)) children. There was an association between metformin exposure in utero and borderline intellectual function of children (full scale IQ between 70 and 85). Free testosterone index in gestational week 19, and androstenedione in gestational week 36 correlated positively to full scale IQ.

Conclusions

We found no evidence of long-term effect of metformin on average child cognitive function. The increase of borderline intellectual functioning in metformin-exposed children must be interpreted with caution due to small sample size.

Trial registration

The baseline study was registered on 12 September 2005 at the US National Institute of Health (ClinicalTrials.gov) # NCT00159536.
Theory of mind, emotion recognition, delusions and the quality of the therapeutic relationship in patients with psychosis – a secondary analysis of a randomized-controlled therapy trial
Authors: Mehl Stephanie , Hesse Klaus , Schmidt Anna-Christine , Landsberg Martin W. , Soll Daniel , Bechdolf Andreas , Herrlich Jutta , Kircher Tilo , Klingberg Stefan , Müller Bernhard W. , Wiedemann Georg , Wittorf Andreas , Wölwer Wolfgang , Wagner Michael
Published: February 2020

Background

Cognitive models of psychosis postulate an important role of Theory of mind (ToM) in the formation and maintenance of delusions, but research on this plausible conjecture has gathered conflicting findings. In addition, it is still an open question whether problems in emotion recognition (ER) are associated with delusions. We examined the association of problems in ToM and ER with different aspects of delusions in a large sample of patients with psychosis enrolled in a therapy trial. This also enabled us to explore the possible impact of ToM and ER on one part of patients’ social life: the quality of their therapeutic relationship.

Methods

Patients with psychotic disorders and delusions and/or hallucinations (n = 185) and healthy controls (n = 48) completed a ToM picture sequencing task and an ER task. Subsequently, patients were enrolled in a randomized-controlled Cognitive Behavior Therapy (CBT) trial (ISRCTN29242879). Patients and therapists rated the quality of the therapeutic relationship during the first five sessions of therapy.

Results

In comparison to controls, patients were impaired in both ToM and ER. Patients with deficits in ER experienced more severe delusional distress, whereas ToM problems were not related to delusions. In addition, deficits in ER predicted a less favorable therapeutic relationship and interactional problems viewed by the therapist. Impaired ER also moderated (increased) the negative influence of delusions on the therapeutic relationship and interactional difficulties viewed by the therapist.

Conclusions

Cognitive models on the formation and maintenance of delusions should consider ER as a potential candidate that might be related to the formation and maintenance of delusional distress, whereas problems in ToM might not be directly related to delusions and secondary dimensions of delusions. In addition, problems in ER in patients with psychosis might have an impact on the quality of the therapeutic relationship and patients with problems in ER are more likely to be viewed as problematic by their therapists. Nevertheless, training ER might be a way to improve the quality of the therapeutic relationship and potentially the effectiveness of CBT or other interventions for patients with psychosis.