bluuebunny/crossref_metadata_2025 huggingface dataset:
The treatments and postoperative complications of esophageal cancer: a review
Authors: Xu Qi-Liang , Li Hua , Zhu Ye-Jing , Xu Geng
Published: July 2020

Esophageal cancer is still one of the most common cancers in the world. We review the appropriate treatments at different stages of esophageal cancer and also analyze the advantages and disadvantages of these treatments. The prognosis and recovery of different treatment regimens are further discussed. In particular, post-operative complications are the major causes of high mortality derived from the esophageal cancer. Therefore, we particularly discuss the main complications resulting in high mortality after surgery of esophageal cancer, and summarize their risk factors and treatment options.

Background

As the common cancer, the complications of esophageal cancer after surgery have been not obtained systematic treatment strategy, focusing on treatment regimens based on the different stages of esophageal cancers.

Methods and overview

This paper systematically summarizes the appropriate treatment strategies for different stages of esophageal cancers, and their advantages and disadvantages. We particularly focus on the postoperative survival rate of patients and postoperative complications, and discuss the causes of high mortality risk factors after surgery. The risk factors of death and corresponding treatment methods are further summarized in this study.

Conclusion

Postoperative complications is the main cause responsible for the hard cure of esophageal cancers. The existing literatures indicate that postoperative anastomotic fistula is one of the most important complications leading to death, while it has not received much attention yet. We suggest that anastomotic fistula should be detected and dealt with early by summarizing these literatures. It is, therefore, necessary to develop a set of methods to predict or check anastomotic fistula in advance.
Heart rupture repair during huge mediastinal mass resection – case report
Authors: Abdel Jail Riad , Abou Chaar Mohamad K. , Al-Qudah Obada , Abu Zahra Khalil , Al-Hussaini Maysa , Gharaibeh Azza
Published: July 2020

Background

Ventricular rupture is rarely described in the literature outside the context of myocardial infarction, infection or neoplasm. It is associated with a high mortality rate due to late presentation and delayed surgical intervention, which involves sutureless or sutured techniques. Comprehensive literature review failed to identify any case of intra-operative right ventricular heart rupture followed by myocardial repair and a complete recovery after a prolonged intensive care unit (ICU) stay.

Case presentation

A 57-year-old previously healthy gentleman presented complaining of a new onset shortness of breath for 2 months. A large mediastinal mass was found on chest imaging and biopsy revealed a thymoma. Patient received a neoadjuvant Cisplatin/Doxorubicin/Cyclophosphamide (CAP) regimen chemotherapy then sternotomy and thymectomy en bloc with anterior pericardium. Post-thymectomy, the patient continued to be hypotensive in recovery despite aggressive fluid resuscitation. He was sent back to theatre, aggressive fluid resuscitation continued, surgical site exploration was done by reopening the sternum, and the bleeding source was identified and controlled, but intraoperative asystole developed. During internal cardiac massage, the right ventricle ruptured with a 3 cm defect which was successfully repaired using a pericardial patch without a bypass machine due to unavailability at our cancer center. The patient remained dependent on mechanical ventilation through tracheostomy for a total of 2 months due to bilateral phrenic nerve paralysis, was discharged from ICU to the surgical floor 66 days after the operation and weaned off ventilator support after 85 days, adequate respiratory and physical rehabilitation followed. Patient is doing very well now with excellent performance, and free of tumor recurrence 30 months after surgery.

Conclusion

Right ventricular rupture is rarely described outside the context of myocardial infarction and valvular heart disease. Tumor proximity to the heart and neoadjuvant cardiotoxic chemotherapy are the proposed causes for precipitating the cardiac rupture in our case. Post-surgical patients who receive early physical rehabilitation and respiratory physiotherapy have improved survival and outcome.
Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China
Authors: Xu Jiqian , Yang Xiaobo , Yang Luyu , Zou Xiaojing , Wang Yaxin , Wu Yongran , Zhou Ting , Yuan Yin , Qi Hong , Fu Shouzhi , Liu Hong , Xia Jia’an , Xu Zhengqin , Yu Yuan , Li Ruiting , Ouyang Yaqi , Wang Rui , Ren Lehao , Hu Yingying , Xu Dan , Zhao Xin , Yuan Shiying , Zhang Dingyu , Shang You
Published: July 2020

Background

The global numbers of confirmed cases and deceased critically ill patients with COVID-19 are increasing. However, the clinical course, and the 60-day mortality and its predictors in critically ill patients have not been fully elucidated. The aim of this study is to identify the clinical course, and 60-day mortality and its predictors in critically ill patients with COVID-19.

Methods

Critically ill adult patients admitted to intensive care units (ICUs) from 3 hospitals in Wuhan, China, were included. Data on demographic information, preexisting comorbidities, laboratory findings at ICU admission, treatments, clinical outcomes, and results of SARS-CoV-2 RNA tests and of serum SARS-CoV-2 IgM were collected including the duration between symptom onset and negative conversion of SARS-CoV-2 RNA.

Results

Of 1748 patients with COVID-19, 239 (13.7%) critically ill patients were included. Complications included acute respiratory distress syndrome (ARDS) in 164 (68.6%) patients, coagulopathy in 150 (62.7%) patients, acute cardiac injury in 103 (43.1%) patients, and acute kidney injury (AKI) in 119 (49.8%) patients, which occurred 15.5 days, 17 days, 18.5 days, and 19 days after the symptom onset, respectively. The median duration of the negative conversion of SARS-CoV-2 RNA was 30 (range 6–81) days in 49 critically ill survivors that were identified. A total of 147 (61.5%) patients deceased by 60 days after ICU admission. The median duration between ICU admission and decease was 12 (range 3–36). Cox proportional-hazards regression analysis revealed that age older than 65 years, thrombocytopenia at ICU admission, ARDS, and AKI independently predicted the 60-day mortality.

Conclusions

Severe complications are common and the 60-day mortality of critically ill patients with COVID-19 is considerably high. The duration of the negative conversion of SARS-CoV-2 RNA and its association with the severity of critically ill patients with COVID-19 should be seriously considered and further studied.
Decoding the evolutionary response to prostate cancer therapy by plasma genome sequencing
Authors: Ramesh Naveen , Sei Emi , Tsai Pei Ching , Bai Shanshan , Zhao Yuehui , Troncoso Patricia , Corn Paul G. , Logothetis Christopher , Zurita Amado J. , Navin Nicholas E.
Published: July 2020

Background

Investigating genome evolution in response to therapy is difficult in human tissue samples. To address this challenge, we develop an unbiased whole-genome plasma DNA sequencing approach that concurrently measures genomic copy number and exome mutations from archival cryostored plasma samples. This approach is applied to study longitudinal blood plasma samples from prostate cancer patients, where longitudinal tissue biopsies from the bone and other metastatic sites have been challenging to collect.

Results

A molecular characterization of archival plasma DNA from 233 patients and genomic profiling of 101 patients identifies clinical correlations of aneuploid plasma DNA profiles with poor survival, increased plasma DNA concentrations, and lower plasma DNA size distributions. Deep-exome sequencing and genomic copy number profiling are performed on 23 patients, including 9 patients with matched metastatic tissues and 12 patients with serial plasma samples. These data show a high concordance in genomic alterations between the plasma DNA and metastatic tissue samples, suggesting the plasma DNA is highly representative of the tissue alterations. Longitudinal sequencing of 12 patients with 2–5 serial plasma samples reveals clonal dynamics and genome evolution in response to hormonal and chemotherapy. By performing an integrated evolutionary analysis, minor subclones are identified in 9 patients that expanded in response to therapy and harbored mutations associated with resistance.

Conclusions

This study provides an unbiased evolutionary approach to non-invasively delineate clonal dynamics and identify clones with mutations associated with resistance in prostate cancer.
Brief educational video plus telecare to enhance recovery for older emergency department patients with acute musculoskeletal pain: study protocol for the BETTER randomized controlled trial
Authors: Platts-Mills Timothy F. , McLean Samuel A. , Weinberger Morris , Stearns Sally C. , Bush Montika , Teresi Brittni B. , Hurka-Richardson Karen , Kroenke Kurt , Kerns Robert D. , Weaver Mark A. , Keefe Francis J.
Published: July 2020

Background

Chronic musculoskeletal pain (MSP) affects more than 40% of adults aged 50 years and older and is the leading cause of disability in the USA. Older adults with chronic MSP are at risk for analgesic-related side effects, long-term opioid use, and functional decline. Recognizing the burden of chronic MSP, reducing the transition from acute to chronic pain is a public health priority. In this paper, we report the protocol for the Brief EducaTional Tool to Enhance Recovery (BETTER) trial. This trial compares two versions of an intervention to usual care for preventing the transition from acute to chronic MSP among older adults in the emergency department (ED).

Methods

Three hundred sixty patients from the ED will be randomized to one of three arms: full intervention(an interactive educational video about pain medications and recovery-promoting behaviors, a telecare phone call from a nurse 48 to 72 h after discharge from the ED, and an electronic communication containing clinical information to the patient’s primary care provider);video-only intervention(the interactive educational video but no telecare or primary care provider communication); orusual care. Data collection will occur at baseline and at 1 week and 1, 3, 6, and 12 months after study enrollment. The primary outcome is a composite measure of pain severity and interference. Secondary outcomes include physical function, overall health, opioid use, healthcare utilization, and an assessment of the economic value of the intervention.

Discussion

This trial is the first patient-facing ED-based intervention aimed at helping older adults to better manage their MSP and reduce their risk of developing chronic pain. If effective, future studies will examine the effectiveness of implementation strategies.

Trial registration

ClinicalTrials.govNCT04118595. Registered on 8 October 2019.
What is the impact of fitness on injury risk during police academy training? A retrospective cohort study
Authors: Tomes Colin , Schram Ben , Pope Rodney , Orr Robin
Published: July 2020

Background

In the conduct of their daily duties, law enforcement officers (LEO) are often required to perform dynamic, physically demanding tasks with little or no notice, sometimes at maximal levels of exertion. Given these requirements, training for prospective LEOs must be rigorous enough to ensure that when trainees graduate, they are competent in their response to crisis and resilient enough to maintain this for the span of their career. Therefore, based on previously reported effectiveness of fitness testing in predicting injury risk in predominantly military settings, the aim of this study was to investigate relationships between a physical ability test (PAT) and risk of injury during police recruit training.

Methods

Retrospective PAT results and trainee injury records were obtained from a national police department and Mann-Whitney U tests were performed to investigate fitness differences between trainees who were, or were not, injured. Significant results were tested for effect size using Cliff’s delta (CD).

Results

Significant differences in mean performance between groups existed for the following PAT components: pushups (injured mean 32.94 ± 8.66 reps, uninjured mean 35.67 ± 9.04 reps, p = 0.01 CD + 0.11) and right-hand grip strength (injured mean 49.61 ± 12.51 kg, uninjured mean 52.12 ± 11.17 kg, p = 0.042 CD + 0.22) for all injuries; vertical jump height (injured mean 51.75 ± 7.54 cm, uninjured mean 55.06 ± 8.19 cm, p = 0.032 CD + 0.41) for lower limb injuries, and all measures of grip strength for trunk injury.

Conclusions

The results of this study suggest that a significant relationship between some PAT fitness components and injury risk exists during police recruit training.
Inter-agency collaboration factors affecting multidisciplinary workers’ ability to identify child maltreatment
Authors: Okato Ayumi , Hashimoto Tasuku , Tanaka Mami , Saito Naoki , Endo Mamiko , Okayama Jun , Ichihara Akiko , Eshima Saki , Handa Satoshi , Senda Masayoshi , Sato Yasunori , Watanabe Hiroyuki , Nakazato Michiko , Iyo Masaomi
Published: July 2020

Objectives

This study aimed to clarify the factors of successful inter-agency collaboration that affect multidisciplinary workers’ abilities to identify child maltreatment. A questionnaire-based survey was conducted; the contents of the questionnaire included the Collaboration Evaluation Scale we developed and the workers’ abilities to identify child maltreatment. In total, 277 individuals from various agencies in Japan participated in this study. To examine the factors of successful inter-agency collaboration affecting workers’ awareness of child maltreatment, we used hierarchical multiple regression analysis.

Results

The analysis showed the positive effect of “commitment with loyalty” on the workers’ awareness of child maltreatment-related information in all fields (β = .18–.31, p < .05), the effect of “strong leadership” on information about maltreated children and the home environment (β = .18, p < .05; β = .16, p < .05, respectively), and the effect of “resources” on the information about mothers’ information during pregnancy and of fathers’ feelings towards their children during the perinatal period (β = .17, p < .05; β = .22, p < .01, respectively). In conclusion, commitment with loyalty, strong leadership, and resources are factors of successful inter-agency collaboration that affects the ability of multidisciplinary workers to recognize signs of child maltreatment.
Systematic review supports the role of DNA methylation in the pathophysiology of preeclampsia: a call for analytical and methodological standardization
Authors: Cirkovic A. , Garovic V. , Milin Lazovic J. , Milicevic O. , Savic M. , Rajovic N. , Aleksic N. , Weissgerber T. , Stefanovic A. , Stanisavljevic D. , Milic N.
Published: July 2020

Background

Studies have recently examined the role of epigenetic mechanisms in preeclampsia pathophysiology. One commonly examined epigenetic process is DNA methylation. This heritable epigenetic marker is involved in many important cellular functions. The aim of this study was to establish the association between DNA methylation and preeclampsia and to critically appraise the roles of major study characteristics that can significantly impact the association between DNA methylation and preeclampsia.

Main body

A systematic review was performed by searching PubMed, Web of Science, and EMBASE for original research articles published over time, until May 31, 2019 in English. Eligible studies compared DNA methylation levels in pregnant women with vs. without preeclampsia. Ninety articles were included. Epigenome-wide studies identified hundreds of differentially methylated places/regions in preeclamptic patients. Hypomethylation was the predominant finding in studies analyzing placental tissue (14/19), while hypermethylation was detected in three studies that analyzed maternal white blood cells (3/3). In candidate gene studies, methylation alterations for a number of genes were found to be associated with preeclampsia. A greater number of differentially methylated genes was found when analyzing more severe preeclampsia (70/82), compared to studies analyzing less severe preeclampsia vs. controls (13/27). A high degree of heterogeneity existed among the studies in terms of methodological study characteristics including design (study design, definition of preeclampsia, control group, sample size, confounders), implementation (biological sample, DNA methylation method, purification of DNA extraction, and validation of methylation), analysis (analytical method, batch effect, genotyping, and gene expression), and data presentation (methylation quantification measure, measure of variability, reporting). Based on the results of this review, we provide recommendations for study design and analytical approach for further studies.

Conclusions

The findings from this review support the role of DNA methylation in the pathophysiology of preeclampsia. Establishing field-wide methodological and analytical standards may increase value and reduce waste, allowing researchers to gain additional insights into the role of DNA methylation in the pathophysiology of preeclampsia.
Variable observation window length blind equalization detector for underwater acoustic communication
Authors: Liu Zhiyong , Bai Fan , Tan Zhoumei
Published: July 2020

Aiming at the influence of underwater acoustic channel (UAC) profile difference on the performance of underwater acoustic communication, a variable observation window length blind equalization detector (VOWL-BED) is proposed in this paper. Compared with the existing methods, the observation window length (OWL) of the proposed VOWL-BED can be dynamically regulated on the basis of a given UAC profile and finally converge to the optimum OWL. We have verified the feasibility of the OWL regulation. The simulation results also demonstrate that the VOWL-BED can achieve better performance than the conventional invariable OWL blind equalization detector (IOWL-BED).
Crime and coronavirus: social distancing, lockdown, and the mobility elasticity of crime
Authors: Halford Eric , Dixon Anthony , Farrell Graham , Malleson Nicolas , Tilley Nick
Published: July 2020

Governments around the world restricted movement of people, using social distancing and lockdowns, to help stem the global coronavirus (COVID-19) pandemic. We examine crime effects for one UK police force area in comparison to 5-year averages. There is variation in the onset of change by crime type, some declining from the WHO ‘global pandemic’ announcement of 11 March, others later. By 1 week after the 23 March lockdown, all recorded crime had declined 41%, with variation: shoplifting (− 62%), theft (− 52%), domestic abuse (− 45%), theft from vehicle (− 43%), assault (− 36%), burglary dwelling (− 25%) and burglary non-dwelling (− 25%). We use Google Covid-19 Community Mobility Reports to calculate the mobility elasticity of crime for four crime types, finding shoplifting and other theft inelastic but responsive to reduced retail sector mobility (MEC = 0.84, 0.71 respectively), burglary dwelling elastic to increases in residential area mobility (− 1), with assault inelastic but responsive to reduced workplace mobility (0.56). We theorise that crime rate changes were primarily caused by those in mobility, suggesting a mobility theory of crime change in the pandemic. We identify implications for crime theory, policy and future research.
Correction to: Genome wide meta-analysis of cDNA datasets reveals new target gene signatures of colorectal cancer based on systems biology approach
Authors: Ilyas Umair , Zaman Shahiq uz , Altaf Reem , Nadeem Humaira , Muhammad Syed Aun
Published: July 2020

An amendment to this paper has been published and can be accessed via the original article.
Litter to glitter: promoting herbaceous groundcover and diversity in mid-southern USA oak forests using canopy disturbance and fire
Authors: Vander Yacht Andrew L. , Keyser Patrick D. , Barrioz Seth A. , Kwit Charles , Stambaugh Michael C. , Clatterbuck Wayne K. , Jacobs Ryan
Published: July 2020

Background

In oak-dominated communities throughout eastern North America, fire exclusion and subsequent woody encroachment has replaced the “glitter” of once robust and diverse wildflower and grass layers with leaf-litter dominance. Restoring the important herbaceous components of Eastern oak ecosystems could involve pairing heavy canopy disturbance with growing-season fire, but potential negative effects warrant research. Beginning with 20 ha replicates of closed-canopy forest at three sites across Tennessee and North Carolina, USA, we monitored groundcover response to combinations of thinning (none; light: 14 m2ha−1residual basal area; and heavy: 7 m2ha−1) and seasonal fire (none; March: pre leaf expansion; and October: pre leaf abscission) from 2008 to 2016.

Results

Before treatments, woody plants and leaf-litter-dominated groundcover and herbaceous plants were rare (<6% groundcover, 118 species). By 2016, herbaceous groundcover averaged 59% after heavy thinning and three biennial burns, and 359 herbaceous species were documented. Only 6% (23) of these species appeared negatively affected by applied disturbances. Across sites, thin-and-burn treatments increased graminoid groundcover 14-fold, forb groundcover 50-fold, herbaceous richness 9-fold, and herbaceous diversity 10-fold, relative to unmanaged stands. These increases were often greater where fire was repeatedly applied, and only after repeated fire was herbaceous response greater in heavily thinned stands relative to lightly thinned stands. Burn-only treatments rarely affected herbaceous metrics, and thin-and-burn treatments more than doubled woody groundcover. This suggests that canopy reduction, leaf-litter consumption, and pulses of bare ground were more related to positive herbaceous responses than to the control of woody competition in the understory. Fire season effects were not observed, but herbaceous response after less intense October fires was comparable to that following more intense March fires.

Conclusions

Our results conflict with warnings concerning the potential negative effects of disturbance on herbaceous diversity east of the prairie–woodland transition zone. Canopy disturbance and repeated fire, regardless of season, widely restored herbaceous groundcover and diversity in Eastern oak ecosystems. Herbaceous components were resilient to extended periods of fire exclusion, but current conservation programs often prioritize existing, high-quality sites. Our results suggest that such policies may overlook the tremendous restoration potential present in otherwise inconspicuous understories of closed-canopy oak forests throughout eastern North America.
Correction to: Rapid guide to the management of cardiac patients during the COVID-19 pandemic in Egypt: “a position statement of the Egyptian Society of Cardiology”
Authors: Shaheen Sameh , Awwad Omar , Shokry Khalid , Abdel-Hamid Magdy , El-Etriby Adel , Hasan-Ali Hosam , Shawky Islam , Magdy Ahmad , Nasr Gamila , Kabil Hamza , Elhadidy Amr , Zaki Mohamad , Hegab Ahmad
Published: July 2020

An amendment to this paper has been published and can be accessed via the original article.
Platelet count as a predictor of outcome of hospitalized patients with community-acquired pneumonia at Zagazig University Hospitals, Egypt
Authors: Ghoneim Adel H. A. , Mohammad Mohammad A. , Elghamrawy Mohammad A. , Embarak Sameh
Published: July 2020

Background

Platelets play an essential role in both coagulation system and the host immune defenses against infection including community-acquired pneumonia (CAP). This work aimed to study the possibility of using platelet count as an additional criterion to predict the outcome of hospitalized patients with CAP.

Results

This prospective cohort study included 250 patients hospitalized with CAP. According to platelet count at admission, 15 (6%) patients showed thrombocytopenia (group I) and 202 (80.8%) showed normal platelet count (group II), while 33 (13.2%) patients showed thrombocytosis (group III). CAP patients with thrombocytosis had more significant respiratory complications including lung abscess (p = 0.02), empyema (p < 0.001), and pleural effusion (p = 0.01). Severe sepsis and septic shock were significantly encountered among CAP patients with thrombocytopenia (p = 0.02 and 0.03, respectively). CAP patients with thrombocytopenia significantly needed mechanical ventilation either invasive (p = 0.017) or even non-invasive (p = 0.047). Both CAP patients with thrombocytopenia or thrombocytosis had significant 30 days readmission (p = 0.034) and significant 30 days mortality (p = 0.016) when compared to CAP patients with normal platelet count. Both thrombocytopenia (p = 0.012) and thrombocytosis (p = 0.029) were independent predictors of 30 days mortality among hospitalized patients with CAP.

Conclusions

Both thrombocytosis and thrombocytopenia are linked to adverse outcomes among hospitalized patients with CAP.
Fertility and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome Following Bariatric Surgery
Authors: Benito Estela , Gómez-Martin Jesús M , Vega-Piñero Belén , Priego Pablo , Galindo Julio , Escobar-Morreale Héctor F , Botella-Carretero José I
Published: July 2020

Context

Restoration of ovulation is quite common in women with polycystic ovary syndrome (PCOS) after surgically induced weight loss. Whether or not this results in an improvement of PCOS-associated infertility is uncertain.

Objective

To study fertility and gestational outcomes in women with PCOS after bariatric surgery.

Design

Unicenter cohort study.

Setting

Academic hospital.

Patients

Two hundred and sixteen premenopausal women were screened for PCOS before bariatric surgery. Women were followed-up after the intervention until mid-2019 regardless of having or not PCOS.

Interventions

All participants underwent bariatric surgery from 2005 to 2015.

Main outcome measures

Pregnancy and live birth rates in the PCOS and control groups.

Results

In women seeking fertility, pregnancy rates were 95.2% in PCOS and 76.9% in controls (P = 0.096) and live birth rates were 81.0% and 69.2%, respectively (P = 0.403). The time to achieve the first pregnancy after surgery was 34 ± 28 months in women with PCOS and 32 ± 25 months in controls. Albeit the mean birth weight was lower (P = 0.040) in newborns from women with PCOS (2763 ± 618 g) compared with those from controls (3155 ± 586 g), the number of newborns with low birth weight was similar in both groups (3 in the PCOS group and 1 in the controls, P = 0.137). Maternal (17.6% in PCOS and 22.2% in controls, P = 0.843) and neonatal (23.5% in PCOS and 14.8% in controls, P = 0.466) complications were rare, showing no differences between groups.

Conclusions

Pregnancy and fertility rates in very obese women with PCOS after bariatric surgery were high, with few maternal and neonatal complications.
Marked Increase in Incident Gynecomastia: A 20-Year National Registry Study, 1998 to 2017
Authors: Koch Trine , Bräuner Elvira V , Busch Alexander S , Hickey Martha , Juul Anders
Published: July 2020

Context

Gynecomastia, the proliferation of mammary glandular tissue in the male, is a frequent but little-studied condition. Available prevalence data are based on selected patient populations or autopsy cases with their inherent bias.

Objective

The objective of this work is to evaluate the age-related incidence and secular trends in gynecomastia in the general population.

Design

An observational, 20-year national registry study was conducted.

Setting

This population-based study used nationwide registry data.

Participants

Participants included all Danish males (age 0-80 years) with a first-time diagnosis of gynecomastia.

Main Outcome Measures

All Danish males (age 0-80 years) were followed up for incident diagnosis of gynecomastia in the Danish National Patient Registry from 1998 to 2017 using the International Codes of Diseases, 10th revision, and the Danish Health Care Classification System. Age-specific incidence rates were estimated. The hypothesis tested in this study was formulated prior to data collection.

Results

Overall, a total 17 601 males (age 0-80 years) were registered with an incident diagnosis of gynecomastia within the 20-year study period, corresponding to 880 new cases per year and an average 20-year incidence of 3.4 per 10 000 men (age 0-80 years). The average annual incidence was 6.5/10 000 in postpubertal males age 16 to 20 years and 4.6/10 000 in males age 61 to 80 years, with a respective 5- and 11-fold overall increase in these 2 age groups over the 20-year period.

Conclusions

The incidence of gynecomastia has dramatically increased over the last 20 years, implying that the endogenous or exogenous sex-steroid environment has changed, which is associated with other adverse health consequences in men such as an increased risk of prostate cancer, metabolic syndrome, type 2 diabetes, or cardiovascular disorders.
Ecdysone-dependent feedback regulation of prothoracicotropic hormone controls the timing of developmental maturation
Authors: Christensen Christian F. , Koyama Takashi , Nagy Stanislav , Danielsen E. Thomas , Texada Michael J. , Halberg Kenneth A. , Rewitz Kim
Published: July 2020

The activation of a neuroendocrine system that induces a surge in steroid production is a conserved initiator of the juvenile-to-adult transition in many animals. The trigger for maturation is the secretion of brain-derived neuropeptides, yet the mechanisms controlling the timely onset of this event remain ill-defined. Here, we show that a regulatory feedback circuit controlling the Drosophila neuropeptide Prothoracicotropic hormone (PTTH) triggers maturation onset. We identify the Ecdysone Receptor (EcR) in the PTTH-expressing neurons (PTTHn) as a regulator of developmental maturation onset. Loss of EcR in these PTTHn impairs PTTH signaling, which delays maturation. We find that the steroid ecdysone dose-dependently affects Ptth transcription, promoting its expression at lower concentrations and inhibiting it at higher concentrations. Our findings indicate the existence of a feedback circuit in which rising ecdysone levels trigger, via EcR activity in the PTTHn, the PTTH surge that generates the maturation-inducing ecdysone peak toward the end of larval development. Because steroid feedback is also known to control the vertebrate maturation-inducing hypothalamic-pituitary-gonadal axis, our findings suggest an overall conservation of the feedback-regulatory neuroendocrine circuitry that controls the timing of maturation initiation.
A mechanical approach to understanding the impact of the nematode Anguillicoloides crassus on the European eel swimbladder
Authors: Currie Helen A. L. , Martin Nicholas Flores , Garcia Gerardo Espindola , Davis Frances M. , Kemp Paul S.
Published: July 2020

One of the most detrimental factors in the drastic decline of the critically endangered European eel (Anguilla anguilla) was the inadvertent introduction of the invasive nematode Anguillicoides crassus. Infection primarily impacts the swimbladder, a gas-filled organ that enables the eel to control its depth in the water. A reduction in swimbladder function may be fatal for eel undergoing their spawning migration to the Sargasso Sea, a journey of over 5000 km. Although the physiological damage caused by this invasive parasite is well-studied through the use of quantifiable gross pathological indices, providing a good measure of the swimbladder health status; they cannot separate the role of mechanical and morphological damage. Our study examined the appropriateness of three commonly-used indices as a measure of mechanical damage by performing uniaxial tensile tests on swimbladder specimens obtained from an infected eel population. When the test results were compared to the gross pathological indices it was found that thickness correlated most strongly with mechanical damage, both confirming and, more importantly, explaining the counterintuitive findings of earlier work. In a damaged swimbladder, the immune response leads to a trade-off; increasing wall thickness raises the pressure required for organ rupture but decreases strength. The results indicate that for moderate infection the mechanical integrity of the swimbladder can be maintained. For severe infection, however, a reduction in mechanical integrity may reach a tipping point, impacting the successful completion of their oceanic migration.
Biomarkers of pituitary macroadenomas aggressive behaviour: a conventional MRI and DWI 3T study
Authors: Conficoni Alberto , Feraco Paola , Mazzatenta Diego , Zoli Matteo , Asioli Sofia , Zenesini Corrado , Fabbri Viscardo Paolo , Cellerini Martino , Bacci Antonella
Published: July 2020

Objective:

Pituitary macroadenomas (PAs) are usually defined as benign intracranial tumors. However, they may present local aggressive course. High Ki67 labelling index (LI) values have been related to an aggressive tumor behavior. A recent clinicopathological classification of PA based on local invasiveness and proliferation indexes, divided them in groups with different prognosis. We evaluated the utility of conventional MRI (cMRI) and diffusion-weighted imaging (DWI), in predicting the Ki67- LI according the clinicopathological classification.

Methods:

17 patients (12 M and 5 F) who underwent surgical removal of a PA were studied. cMRI features, quantification of T  1W and T  2W signal intensity, degree of contrast uptake (enhancement ratio, ER) and apparent diffusion coefficient (ADC) values were evaluated by using a 3 T scan. Statistics included Mann–Whitney test, Spearman’s test, and receiver operating characteristic analysis. A value of p ≤ 0.05 was considered significant for all the tests.

Results:

Negative correlations were observed between Ki-67 LI, ADCm (ρ = - 0.67, p value = 0.005) and ER values (ρ = −0.62; p = 0.008). ER values were significantly lower in the proliferative PA group (p = 0.028; p = 0.017). ADCm showed sensitivity and specificity of 90 and 85% respectively into predict Ki67-LI value. A value of ADCm ≤0, 711 x 10–6 mm2 emerged as a cut-off of a value of Ki67-LI ≥ 3%.

Conclusion:

Adding quantitative measures of ADC values to cMRI could be used routinely as a non-invasive marker of specific predictive biomarker of the proliferative activity of PA.

Advances in knowledge:

Routinely use of DWI on diagnostic work-up of pituitary adenomas may help in establish the likely biological aggressive lesions.
Multivessel endovascular therapy for undiagnosed vascular type Ehlers-Danlos syndrome. Successful percutaneous transcatheter coil embolization of hepatic artery pseudoaneurysm with stenting of right renal and iliac arteries in emergency setting
Authors: Moramarco Lorenzo Paolo , Capodaglio Carlo Alberto , Quaretti Pietro , Cionfoli Nicola , Fiorina Ilaria , Disabella Eliana , D'agostino Antonio Mauro , Urtis Mario , Arbustini Eloisa
Published: July 2020

Among Ehlers-Danlos syndromes, the vascular type is the most severe because of its vascular complications. Transcatheter embolization of medium-sized arteries has become the first-line therapy for life-threatening hemorrhage. Ongoing multiple lesions causing hemorrhagic or ischemic complications in the acute phase can challenge patient management. Multivessel endovascular treatment has never been reported. In this study, we report successful single-session treatment by coiling of a ruptured pseudoaneurysm of the hepatic artery with stenting of dissected right renal and iliac arteries in a 46-year-old female. Percutaneous transfemoral approach was gained and sealed with a plug-based closure device. Genetic disease was subsequently confirmed by molecular analysis.
Spectrophotometric analysis of the effectiveness of bleaching agents used for non-vital teeth bleaching
Authors: Santos Micheli Reis , De Carvalho Fabiola Bastos , Cangussu Maria Cristina Teixeira , Barros Lays Rocha , Trindade Renan Ferreira
Published: July 2020

Objectives: This study aimed to compare the efficiency of three different substances used for the bleaching of non-vital teeth. Methods: Forty bovine teeth were divided into five groups: three test groups (sodium perborate + 20% hydrogen peroxide – SPG; 37% carbamide peroxide – CPG; 35% hydrogen peroxide – HPG) and two control groups (CG1 and CG2). Teeth of the test groups were stained artificially with blood and bleached using the in-office and walking bleach techniques. The efficiency of the bleaching agents was evaluated objectively by comparing the color variables L*, a*, and b* measured spectrophotometrically according to the CIELab system. The data were analyzed by ANOVA and the Tukey test, adopting a 5% level of significance. Results: The results showed a reduction in lightness (L*) after staining and an increase after the bleaching sessions. The values of a* and b* increased after staining and decreased after the application of the bleaching substances. Conclusions: All substances used for non-vital tooth bleaching exhibited the same bleaching efficiency. No significant differences in this efficiency were observed between the bleaching techniques at the end of the experiment. However, in-office bleaching provided the same bleaching result as the walking bleach technique within a shorter period. Clinical significance: Given the increasing demand for esthetics, the use of different bleaching techniques and the variety of whitening agents, oral health professionals should offer evidence-based treatment, more efficient and in less time.
Severe Kala-azar and seric level of IL-6: case reports
Authors: Brito Gilmara da Rocha , Marreiros Aécio da Silva , Araujo Izael Francisco de Brito , Da Silva Júnior Raimundo Gerônimo , Sene Ingridi de Souza , Braz Débora Cavalcante
Published: July 2020

Introduction: IL-6 cytokine participates in the inflammatory process of systemic leishmaniasis and elevated levels are associated with active disease. Case reports: Three patients with different age groups and different severity scores, above 4 were reported, and IL-6 plasma concentrations and their association with disease severity were observed. Conclusion: Analysis suggests that only the score, has no sensitivity to classify, among others critically ill patients, those with imminent risk of death. IL-6 concentrations can allow this differentiation, considering that only fatal case, HBV/Leishmania coinfection, presented expressively higher level of the cytokine concentration.
Marketing communications
Authors: Grigoryan Ekaterina
Published: July 2020

The tutorial introduces the basic tools of marketing communications such as advertising, PR, sales promotion, personal selling, sponsoring, branding, and provides guidance on establishing, planning, budgeting, and performance evaluation. Special attention is paid to the peculiarities of formation of communicative policy and strategy of the enterprise. Presents the tasks for seminars: tests, practical situations, test questions.
Meets the requirements of Federal state educational standards of higher education of the latest generation and the programs of preparation of bachelors on directions 38.03.02 "Management" (profile "Management", "Marketing"), 38.03.05 "Business-Informatics", 38.03.06 "trading business" (specialization "Commerce"), etc.
For anyone interested in the issues of marketing communications: teachers, graduate students, researchers and practitioners.
Hydraulics
Authors: Vol'vak Sergey
Published: July 2020

Study guide corresponds to the program discipline "Hydraulics" and consists of two parts: "Hydraulics and hydraulic machines" and "the Dredging of agricultural processes".
This course focuses on the theory of hydraulics, design and operation of hydraulic machines, fans, compressors and other means of dredging of agricultural processes, provides information about the hydraulic drive, the basics of reclamation and mechanized irrigation and agricultural water supply, data on hydropneumatische in agriculture.
For students of all forms of education in field of study 35.03.06 "Agroengineering", as well as for graduate students, teachers and technical workers of agriculture.
The theoretical mortality risk of an asymptomatic patient with a negative SARS-CoV-2 test developing COVID-19 following elective orthopaedic surgery
Authors: Kader Nardeen , Clement Nick D. , Patel Vipul R. , Caplan Nick , Banaszkiewicz Paul , Kader Deiary
Published: July 2020

Aims

The risk to patients and healthcare workers of resuming elective orthopaedic surgery following the peak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been difficult to quantify. This has prompted governing bodies to adopt a cautious approach that may be impractical and financially unsustainable. The lack of evidence has made it impossible for surgeons to give patients an informed perspective of the consequences of elective surgery in the presence of SARS-CoV-2. This study aims to determine, for the UK population, the probability of a patient being admitted with an undetected SARS-CoV-2 infection and their resulting risk of death; taking into consideration the current disease prevalence, reverse transcription-polymerase chain reaction (RT-PCR) testing, and preassessment pathway.

Methods

The probability of SARS-CoV-2 infection with a false negative test was calculated using a lower-end RT-PCR sensitivity of 71%, specificity of 95%, and the UK disease prevalence of 0.24% reported in May 2020. Subsequently, a case fatality rate of 20.5% was applied as a worst-case scenario.

Results

The probability of SARS-CoV-2 infection with a false negative preoperative test was 0.07% (around 1 in 1,400). The risk of a patient with an undetected infection being admitted for surgery and subsequently dying from the coronavirus disease 2019 (COVID-19) is estimated at approximately 1 in 7,000. However, if an estimate of the current global infection fatality rate (1.04%) is applied, the risk of death would be around 1 in 140,000, at most. This calculation does not take into account the risk of nosocomial infection. Conversely, it does not factor in that patients will also be clinically assessed and asked to self-isolate prior to surgery.

Conclusion

Our estimation suggests that the risk of patients being inadvertently admitted with an undetected SARS-CoV-2 infection for elective orthopaedic surgery is relatively low. Accordingly, the risk of death following elective orthopaedic surgery is low, even when applying the worst-case fatality rate. Cite this article: Bone Joint J 2020;102-B(9):1256–1260.
Perbedaan Efektifitas antara Efedrin dengan Lidokain sebagai Premedikasi untuk Mengurangi Nyeri Lokal akibat Injeksi Propofol
Authors: Prihananto Bayu , Supraptomo R. Th. , Setijanto Eko , Santosa Sugeng Budi
Published: July 2020

Latar Belakang. Propofol merupakan agen induksi anestesi yang sering digunakan secara luas. Hal ini dikarenakan waktu pulih sadar pendek dengan kembalinya reflek-reflek kognitif, protektif dan psikomotor yang cepat. Propofol memiliki masalah lazim yang membuat pasien tidak nyaman karena nyeri pada lokasi injeksi. Berbagai metode sudah diteliti untuk mengurang nyeri dengan hasil yang berbeda-beda, yaitu dengan penggunaan obat lidokain, fentanil, metokloramid, atau modifikasi non-farmakologis dengan mendinginkan atau menghangatkan, mendilusi propofol, atau menyuntikkan pada vena yang besar. Obat lain yang dipakai untuk mengurangi nyeri tetapi masih jarang digunakan adalah efedrin. Penelitian ini ditujukan untuk mengetahui perbedaan efektifitas efedrin dengan lidokain sebagai premedikasi untuk mengurangi nyeri lokal akibat injeksi propofol.

Metode. Penelitian yang digunakan adalah penelitian quasi eksperimental. Subjek dalam penelitian merupakan pasien yang melakukan pembedahan menggunakan induksi propofol dengan kriteria tertentu. Pengambilan subjek dilakukan dengan teknik purposive sampling yang berjumlah 40 orang, kemudian dibagi menjadi dua kelompok perlakuan di Instalasi Bedah Sentral (I.B.S.) RSUD Dr. Moewardi Surakarta. Data yang diperoleh dianalisis menggunakan uji fisher exact.

Hasil: Dari hasil analisis data dengan 40 subjek penelitian yang dibagi menjadi dua kelompok perlakuan, didapatkan hasil perhitungan uji fisher exact adalah 0,661, maka H0 diterima karena p-value > 0,05.

Simpulan: Tidak ada perbedaan efektifitas antara efedrin 30 µg/kgBB intravena dengan lidokain 1 mg/kgBB intravena sebagai premedikasi dalam mengurangi nyeri akibat injeksi propofol.

Kata Kunci: Nyeri Propofol; Efedrin; Lidokain
Perdurability, families, and internationalization processes: approaches from business history in Latin America
Authors: Almaraz Alvarado Araceli
Published: July 2020

The main purpose of this text is to present an special issue with a set of researches that describes the history of companies, groups, and business families managed in Latin America from diverse approaches. Additionally, this article introduces the mid-range concept “durability of entrepreneurial process” as part of an agenda to business history in Latin America encouraging complementary methodologies and the theoretical debate. Economic and business history in Latin America has become open to a vigorous debate, strengthening. the analysis of sectors, large companies, national economic groups, longeval non-family business, and family-based companies as major lines of study. As emerging sublines, business historians in Latin America have also approached the study of internationalization, the evolution of organizational structures, the performance and corporate governance of businesses, women and business, and recently family succession andbusiness families in Latin America. In a much smaller proportion emerging research sublines, with great potential, have focused on small and medium-sized family businesses, immigration and ethnic descent-business. An agenda that more firmly promotes a theoretical and methodological proposal in business history studies in Latin America is urgent. The countries in which scholarship has progressed in these lines and sublines of research for over three decades are Colombia, Argentina, Mexico, Chile, Peru, Brazil, and Uruguay. The Latin America Congress of Economic History (CLADHE in Spanish) is the primary engine of discussions between economic and business historians which have held six events from 2007 and also, we must recognize the breach that the Business History Conference opened in their 2019 and 2020 meetings to discuss business history in Latin America. This presentation highlights contributions in this special issue about Mexican business groups and families, and the empirical and theoretical most relevant elements of the articles included about Argentina, Uruguay, Colombia, the Valencian SMEs in Latin America, and the political risks to invest in the region.