bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptomatic internal carotid artery stenosis in the presence of a persistent primary hypoglossal artery
Authors: Burgard Marie , Psathas Emmanouil , Mordasini Pasquale , Medlin Friedrich , Menth Markus , Egger Bernhard , Oscar Mayer Dieter
Published: November 2020

Objectives

Anatomic variations of the extracranial carotid artery are rare. Persistent primitive hypoglossal artery appears with a reported incidence between 0.03% and 0.2%. We report a case of recurrent transient ischemic attacks originating from proximal internal carotid artery stenosis associated with ipsilateral persistent primitive hypoglossal artery and give a review of the existing literature.

Methods

A 78-year-old patient with a medical history of two previous transient ischemic attacks consulted our emergency department with an acute left hemispheric stroke. Intravenous thrombolysis permitted complete resolution of symptoms. Concurrent Computed Tomography (CT) and Magnetic Resonance (MR) angiography revealed an unstable plaque causing 50% stenosis of the left internal carotid artery with a persistent primitive hypoglossal artery dominantly perfusing the posterior circulation, and bilateral hypoplastic vertebral arteries.

Results

Uneventful carotid artery stenting using a proximal protection device was performed, and the patient was discharged after 12 days. Six months follow-up was uneventful with a patent stent in the internal carotid artery.

Conclusions

Treatment of symptomatic carotid artery stenosis in the presence of persistent primitive hypoglossal artery is challenging. Management should be driven by patients’ co-morbidities, the anatomical localization of the lesions and local expertise. In the case of a high origin of the persistent primary hypoglossal artery, carotid artery stenting with the use of a proximal cerebral protection device is probably the preferred and simplest approach.
Stir: Poetic field works from the Distant Voices project
Authors: Crockett Thomas Phil
Published: November 2020

In this brief research note I discuss and share from, Stir (2020): a collection of poems that were written while I was the research associate on the Distant Voices project based at the University of Glasgow (2017–2021). These poems reflect on my experience of doing ethnographic research in carceral spaces, and are written from the perspective of an outsider with a pass that allowed access for a limited time only. The collection is open access and available to read online. The note situates my project within the context of poetic practice in the social sciences. Inspired primarily by feminist scholarship, I also draw on actor-network theory to describe my research process as one of ‘translation’. The note also touches on historical anxieties about the legitimacy of the approach and the sociological preference for ‘found poetry’. I reflect on some ethical and creative questions that arose for me in writing poetry as social research, including representing research participants, use of pronouns and authorial voice, and emotions and research. I also discuss the affordances of working creatively with ethnographic materials, and the role of poetry in pursuing social change.
Diagnostic accuracy of bi-parametric magnetic resonance imaging in suspected prostate cancer: Correlation of scan results with biopsy findings in a series of 266 patients
Authors: Moss Basil , Amin Suzanne , Muthukumara Withma , Khoory Christopher , Minshull-Beech Helen , Nambirajan Thiagarajan
Published: November 2020

Objectives:

This study aimed to determine the diagnostic accuracy of bi-parametric magnetic resonance imaging (bpMRI) for clinically significant (CS) prostate cancer (PCa), and to assess the suitability of a new diagnostic pathway using bpMRI and prostate-specific antigen density (PSAd) to determine the need for biopsy.

Methods:

A total of 386 patients referred to one UK cancer centre with suspected PCa across 12 months from 2017 to 2018 underwent bpMRI, with a Prostate Imaging Reporting and Data System (PIRADS) score assigned. Of these, 266 (69%) were biopsied, with 150 CS-PCa (a Gleason score of 7 or a Gleason score of 3 with core length ⩾5 mm) detected: a 57% diagnostic yield. Imaging, PSAd and biopsy results were collated, and a confusion matrix was calculated.

Results:

Twenty-three men with PIRADS 1 were biopsied, with two CS-PCa detected: PSAd M=0.19 ( SD=0.07). Twenty-one men with PIRADS 2 lesions were biopsied, with one CS-PCa detected: PSAd was 0.28. Seventy-five men with PIRADS 3 were biopsied, with 25 CS-PCa detected: PSAd M=0.26 ( SD=0.16). Fifty-seven men with PIRADS 4 were biopsied, with 46 CS-PCa detected: PSAd M=0.26 ( SD=0.16). Ninety men with PIRADS 5 were biopsied, with 83 CS-PCa detected: PSAd M=0.55 ( SD=0.63). Among the 266 biopsied patients, a pathway offering biopsy if PIRADS is ⩾3 or PSAd ⩾0.1 spares 11 (4.2%) biopsies compared to baseline practice, with a sensitivity of 100% and a specificity of 10.1%, for biopsy-detected CS-PCa. The diagnostic yield is 61.8%.

Conclusion:

BpMRI is comparable to multi-parametric MRI for assessing need for biopsy in suspected PCa, albeit with lower specificity. A diagnostic pathway using bpMRI and PSAd can be safely used to avoid biopsy in men at low risk, increasing diagnostic yield of biopsy while reducing overdiagnosis and avoiding the risks and costs associated with gadolinium contrast.

Level of evidence:

Level 4.
An ethics of pace in digital culture
Authors: Bailey Moya
Published: November 2020

As Elodie and 35,000 other Congolese children negotiate dangerous working conditions that impair their health, some Western consumers enjoy the fruits of their debilitating labor to fight for their own rights in the ableist infrastructure of the West. Americans and people around the world benefit from the cooling power of an aquifer in South Carolina, water that is in the ground traditionally stewarded by the Catawba, Pee Dee, Chicora, Edisto, Santee, Yamassee, and Chicora-Waccamaw who are all still present in South Carolina, as are many descendants of the Cherokee, despite also being devastated by European-born diseases like smallpox. What role should our studies of the digital play in addressing these problems in the global digital supply chain?
Causality and Blame Judgments of Negative Side Effects of Actions May Differ for Different Institutional Domains
Authors: Deviatko Inna F. , Gavrilov Kirill A.
Published: November 2020

Cognitive factors are known to influence lay assessments of causality and blame for negative side effects of intentional actions but specific social determinants of such assessments remain relatively unexplored. In a full-factorial, intraindividual experiment using two blocks of analogous vignettes constructed for two particular institutional action domains (“medical” and “corporate dress code”), we tested the propositions that causality and blame judgments differ between (a) domains and depend on (b) the type of action originator; (c) the type of damage; and (d) the “remoteness” of damage from the originator. Our data demonstrate a significant difference between two institutional action domains: actors in “medical”-related vignettes are generally estimated to be more causally effective and blameworthy than actors in “dress code”–related vignettes. In addition to the pronounced main effects of institutional domain as a factor influencing cause and blame judgments, we revealed few significant interaction effects of the latter with other experimental factors used for vignettes construction.
Manager Support for Wellness Champions: A Case Study for Consideration and Practice Implications
Authors: Mitchell Leah , Amaya Megan , Battista Lauren , Melnyk Bernadette , Andridge Rebecca , Kaye Gail
Published: November 2020

Background

Wellness champion networks are deemed an important component to workplace wellness programs. By encouraging colleagues to engage in healthy behaviors, champions can help improve employee health and well-being outcomes, while reducing healthcare costs and increasing productivity. However, little evidence exists regarding factors that impact the effectiveness of a wellness champion. This study examined the relationship between employee engagement in a workplace wellness champion program and the direct manager’s support of the wellness champion role.

Methods

A descriptive study was conducted with a 15-item cross-sectional survey that was developed and disseminated to 470 wellness champions at a large academic institution. Survey questions addressed manager/supervisor support for the wellness champion, manager/supervisor support for faculty and staff direct reports participating in wellness activities, and demographic questions.

Findings

One hundred and ninety-nine (42%) wellness champions responded to the survey and responded to at least half of the questions. Wellness champions who reported a high level of manager support for their role were more likely to have high levels of engagement in communicating wellness initiatives ( p = .0004), motivating and encouraging colleagues ( p < .0001), and planning wellness activities ( p = .04).

Conclusion/Application to Practice

Findings suggested that support wellness champions received from direct managers was a key determinant to their level of engagement in efforts to improve their colleagues’ health and well-being. As employers desire to impact the health and productivity of their employees and generate cost-savings, manager support of wellness champions is necessary to facilitate employee engagement in workplace wellness champion programs.
Silicosis
Authors: Reynolds Kimberly , Jerome John
Published: November 2020

Occupational exposures to dust with elevated levels of respirable crystalline silica in artificial stone increase workers’ risk for silicosis.
Incidence of and Risk Factors for Glenohumeral Osteoarthritis After Anterior Shoulder Instability: A US Population–Based Study With Average 15-Year Follow-up
Authors: Kruckeberg Bradley M. , Leland Devin P. , Bernard Christopher D. , Krych Aaron J. , Dahm Diane L. , Sanchez-Sotelo Joaquin , Camp Christopher L.
Published: November 2020

Background:

The rate of osteoarthritis (OA) in patients with a history of previous anterior shoulder instability (ASI) varies within the literature, with the majority of studies investigating rates after surgical stabilization. ASI appears to lead to increased rates of OA, although risk factors for developing OA in cohorts treated nonoperatively and operatively are not well-defined.

Purpose:

To determine the incidence of clinically symptomatic OA and identify potential risk factors for the development of OA in patients younger than 40 years with a known history of ASI.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

An established, geographically based database was used to identify patients in the United States who were younger than 40 years and were diagnosed with ASI between 1994 and 2014. Patient information, including demographic, imaging, and surgical details, was collected. Comparative analysis was performed between groups with and without OA at final follow-up as well as between patients who underwent surgical and nonsurgical management.

Results:

The study population consisted of 154 patients with a mean follow-up of 15.2 years (range, 5.1-29.8 years). The mean age at initial instability event was 20.9 years (95% CI, 19.9-22.0 years). Overall, 22.7% of patients developed clinically symptomatic glenohumeral OA. Multivariate analysis revealed that current or former smokers (odds ratio [OR], 4.3; 95% CI, 1.1-16.5; P = .030), hyperlaxity (OR, 10.1; 95% CI, 1.4-72.4; P = .020), laborer occupation (OR, 6.1; 95% CI, 1.02-36.1; P = .043), body mass index (BMI) (OR, 1.2; 95% CI, 1.03-1.3; P = .012), and age at initial instability (OR, 1.1; 95% CI, 1.02-1.2; P = .013) as potential independent risk factors when accounting for other demographic and clinical variables.

Conclusion:

In a US geographic population of patients younger than 40 years with ASI, approximately one-fourth of patients developed symptomatic OA at a mean follow-up of 15 years from their first instability event. When accounting for differences in patient demographic and clinical data, we noted a potentially increased risk for the development of OA in patients who are current or former smokers, have hyperlaxity, are laborers, have higher BMI, and have increased age at initial instability event. Smoking status, occupation, and BMI are modifiable factors that could potentially decrease risk for the development of symptomatic OA in these patients.
Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY
Authors: Chambers Earle C. , Heller Caroline , Fiori Kevin , McAuliff Kathleen , Rehm Colin D.
Published: November 2020

This study compared the prevalence of chronic pediatric health conditions for youth in public housing with youth not in public housing using clinical electronic health record (EHR) and housing data. Youth (ages 2-17 years) in a large urban health system were identified and categorized into two housing types—public housing (n = 10 770) and not in public housing (n = 84 883) by age (young childhood, middle childhood, young adolescence). The prevalence of some pediatric conditions was higher in public housing but varied by age. Disparities in health conditions among youth in public housing were more common in early adolescence: asthma (26.4 vs 18.6; P < .001); obesity (28.5 vs 24.6; P < .001); depression/anxiety (19.2 vs 17.3; P = .008); behavioral disorders (8.1 vs 5.3; P < .001). These results show that chronic pediatric conditions like asthma and obesity that lead to significant morbidity into adulthood are more common among youth living in public housing. However, this pattern is not consistent across all chronic conditions.
UTX maintains the functional integrity of the murine hematopoietic system by globally regulating aging-associated genes
Authors: Sera Yasuyuki , Nakata Yuichiro , Ueda Takeshi , Yamasaki Norimasa , Koide Shuhei , Kobayashi Hiroshi , Ikeda Ken-ichiro , Kobatake Kohei , Iwasaki Masayuki , Oda Hideaki , Wolff Linda , Kanai Akinori , Nagamachi Akiko , Inaba Toshiya , Sotomaru Yusuke , Ichinohe Tatsuo , Koizumi Miho , Miyakawa Yoshihiko , Honda Zen-ichiro , Iwama Atsushi , Suda Toshio , Takubo Keiyo , Honda Hiroaki
Published: November 2020

Epigenetic regulation is essential for the maintenance of the hematopoietic system, and its deregulation is implicated in hematopoietic disorders. In this study, UTX, a demethylase for lysine 27 on histone H3 (H3K27) and a component of COMPASS-like and SWI/SNF complexes, played an essential role in the hematopoietic system by globally regulating aging-associated genes. Utx-deficient (UtxΔ/Δ) mice exhibited myeloid skewing with dysplasia, extramedullary hematopoiesis, impaired hematopoietic reconstituting ability, and increased susceptibility to leukemia, which are the hallmarks of hematopoietic aging. RNA-sequencing (RNA-seq) analysis revealed that Utx deficiency converted the gene expression profiles of young hematopoietic stem-progenitor cells (HSPCs) to those of aged HSPCs. Utx expression in hematopoietic stem cells declined with age, and UtxΔ/Δ HSPCs exhibited increased expression of an aging-associated marker, accumulation of reactive oxygen species, and impaired repair of DNA double-strand breaks. Pathway and chromatin immunoprecipitation analyses coupled with RNA-seq data indicated that UTX contributed to hematopoietic homeostasis mainly by maintaining the expression of genes downregulated with aging via demethylase-dependent and -independent epigenetic programming. Of note, comparison of pathway changes in UtxΔ/Δ HSPCs, aged muscle stem cells, aged fibroblasts, and aged induced neurons showed substantial overlap, strongly suggesting common aging mechanisms among different tissue stem cells.
Widespread Permian granite magmatism in Lower Austroalpine units: significance for Permian rifting in the Eastern Alps
Authors: Yuan Sihua , Neubauer Franz , Liu Yongjiang , Genser Johann , Liu Boran , Yu Shengyao , Chang Ruihong , Guan Qingbin
Published: November 2020

The Grobgneis complex, located in the eastern Austroalpine unit of the Eastern Alps, exposes large volumes of pre-Alpine porphyric metagranites, sometimes associated with small gabbroic bodies. To better understand tectonic setting of the metagranites, we carried out detailed geochronological and geochemical investigations on the major part of the porphyric metagranites. LA–ICP–MS zircon U–Pb dating of three metagranites sampled from the Grobgneis complex provides the first reliable evidence for large volumes of Permian plutonism within the pre-Alpine basement of the Lower Austroalpine units. Concordant zircons from three samples yield ages at 272.2 ± 1.2 Ma, 268.6 ± 2.3 Ma and 267.6 ± 2.9 Ma interpreted to date the emplacement of the granite suite. In combination with published ages for other Permian Alpine magmatic bodies, the new U–Pb ages provide evidence of a temporally restricted period of plutonism (“Grobgneis”) in the Raabalpen basement Complex during the Middle Permian. Comparing the investigated basement with that of the West Carpathian basement, we argue that widespread Permian granite magmatism occurred in the Lower Austroalpine units. They belong to the high-K calc-alkaline to shoshonitic S-type series on the base of geochemical data. Zircon Hf isotopic compositions of the Grobgneis metagranites show εHf(t) values of − 4.37 to − 0.6, withTDM2model ages of 1.31–1.55 Ga, indicating that their protoliths were derived by the recycling of older continental crust. We suggest that the Permian granitic and gabbroic rocks are considered as rifted-related rocks in the Lower Austroalpine units and are contemporaneous with cover sediments.
Management of ureteric stone in pregnancy: a review
Authors: Thakur Avinash P. S. , Sharma Vivek , Ramasamy Vasantharaja , Choudhary Arpan , Patel Prashant , Singh Sangeeta , Parol Subeesh
Published: November 2020

Background

Urolithiasis in pregnancy is a major health concern and is one of the most common causes for non-obstetrical abdominal pain and subsequent hospital admission during pregnancy. The incidence of urinary calculi during pregnancy varies in the range of 1/200 to 1/2000. Acute ureteric colic in pregnancy is associated with significant potential risks to both mother and fetus. Significant anatomic and functional changes occur in pregnancy which not only lead to stone formation but also create diagnostic dilemma. The diagnosis of ureteric calculi can be incorrect in about 28% of pregnant patients.

Main body

Management of ureteric stone during pregnancy is remaining to be a challenge for the treating urologist. Because of the inability to use good imaging options for the diagnosis confirmation and more invasive approach for the treatment, management continues to be difficult. The main threats are preterm labor with delivery and premature rupture of membranes. Other pregnancy complications are obstructive uropathy, gestational diabetes mellitus, recurrent abortions and pre-eclampsia. Management of diagnosed ureteric stone is unique in the pregnant population and requires multi-disciplinary care. It should be individualized for each patient and moves preferably from conservative to invasive approaches sequentially. With continued advancements in endourological techniques, few definitive treatment options are also available for such patients.

Conclusion

There are several lacunae related with the diagnostic imaging, medical expulsive therapy, reliability of ureteral stent/percutaneous nephrostomy insertions and safety of ureteroscopy during pregnancy. Herein, we review the management of ureteric stone during pregnancy, the various diagnostic modalities and treatment options with their advantages and disadvantages. We also proposed our management algorithm to deal with such clinical scenario in this particular population.
Achieving large and distant ancestral genome inference by using an improved discrete quantum-behaved particle swarm optimization algorithm
Authors: Zhang Zhaojuan , Wang Wanliang , Xia Ruofan , Pan Gaofeng , Wang Jiandong , Tang Jijun
Published: November 2020

Background

Reconstructing ancestral genomes is one of the central problems presented in genome rearrangement analysis since finding the most likely true ancestor is of significant importance in phylogenetic reconstruction. Large scale genome rearrangements can provide essential insights into evolutionary processes. However, when the genomes are large and distant, classical median solvers have failed to adequately address these challenges due to the exponential increase of the search space. Consequently, solving ancestral genome inference problems constitutes a task of paramount importance that continues to challenge the current methods used in this area, whose difficulty is further increased by the ongoing rapid accumulation of whole-genome data.

Results

In response to these challenges, we provide two contributions for ancestral genome inference. First, an improved discrete quantum-behaved particle swarm optimization algorithm (IDQPSO) by averaging two of the fitness values is proposed to address the discrete search space. Second, we incorporate DCJ sorting into the IDQPSO (IDQPSO-Median). In comparison with the other methods, when the genomes are large and distant, IDQPSO-Median has the lowest median score, the highest adjacency accuracy, and the closest distance to the true ancestor. In addition, we have integrated our IDQPSO-Median approach with the GRAPPA framework. Our experiments show that this new phylogenetic method is very accurate and effective by using IDQPSO-Median.

Conclusions

Our experimental results demonstrate the advantages of IDQPSO-Median approach over the other methods when the genomes are large and distant. When our experimental results are evaluated in a comprehensive manner, it is clear that the IDQPSO-Median approach we propose achieves better scalability compared to existing algorithms. Moreover, our experimental results by using simulated and real datasets confirm that the IDQPSO-Median, when integrated with the GRAPPA framework, outperforms other heuristics in terms of accuracy, while also continuing to infer phylogenies that were equivalent or close to the true trees within 5 days of computation, which is far beyond the difficulty level that can be handled by GRAPPA.
Risk factors for hospital readmission in older adults within 30 days of discharge – a comparative retrospective study
Authors: Glans Maria , Kragh Ekstam Annika , Jakobsson Ulf , Bondesson Åsa , Midlöv Patrik
Published: November 2020

Background

The area of hospital readmission in older adults within 30 days of discharge is extensively researched but few studies look at the whole process. In this study we investigated risk factors related, not only to patient characteristics prior to and events during initial hospitalisation, but also to the processes of discharge, transition of care and follow-up. We aimed to identify patients at most risk of being readmitted as well as processes in greatest need of improvement, the goal being to find tools to help reduce early readmissions in this population.

Methods

This comparative retrospective study included 720 patients in total. Medical records were reviewed and variables concerning patient characteristics prior to and events during initial hospital stay, as well as those related to the processes of discharge, transition of care and follow-up, were collected in a standardised manner. Either a Student’s t-test, χ2-test or Fishers’ exact test was used for comparisons between groups. A multiple logistic regression analysis was conducted to identify variables associated with readmission.

Results

The final model showed increased odds of readmission in patients with a higher Charlson Co-morbidity Index (OR 1.12, p-value 0.002), excessive polypharmacy (OR 1.66, p-value 0.007) and living in the community with home care (OR 1.61, p-value 0.025). The odds of being readmitted within 30 days increased if the length of stay was 5 days or longer (OR 1.72, p-value 0.005) as well as if being discharged on a Friday (OR 1.88, p-value 0.003) or from a surgical unit (OR 2.09, p-value 0.001).

Conclusion

Patients of poor health, using 10 medications or more regularly and living in the community with home care, are at greater risk of being readmitted to hospital within 30 days of discharge. Readmissions occur more often after being discharged on a Friday or from a surgical unit. Our findings indicate patients at most risk of being readmitted as well as discharging routines in most need of improvement thus laying the ground for further studies as well as targeted actions to take in order to reduce hospital readmissions within 30 days in this population.
First patient management of COVID-19 in Changsha, China: a case report
Authors: Zhou Jian , Cao Ziqin , Wang Wanchun , Huang Kang , Zheng Fang , Xie Yuanlin , Jiang Dixuan , Zhou Zhiguo
Published: November 2020

Background

In December 2019, the novel coronavirus disease 2019 (COVID-19) emerged in Wuhan, Hubei Province, China. It rapidly spread and many cases were identified in multiple countries, posing a global health problem. Here, we report the first patient cured of COVID-19 infection in Changsha, China, and the symptoms, diagnosis, treatment, and management of this patient are all described in this report.

Case presentation

A 57-year-old woman developed cough and fever after returning to Changsha from Wuhan on January 9, 2020. She tested positive for COVID-19 infection, a diagnosis which was supported by chest CT. The patient was treated with lopinavir and ritonavir tablets and interferon alfa-2b injection. A low dose of glucocorticoids was used for a short period to control bilateral lung immune response, and this patient avoided being crushed by cytokine storms that might have occurred. The clinical condition of this patient improved, and a COVID-19 assay conducted on January 25, 2020 generated negative results. This patient recovered and was discharged on January 30, 2020.

Conclusions

Currently, there are numerous reports on COVID-19 infections focusing on the disease’s epidemiological and clinical characteristics. This case describes the symptoms, diagnosis, treatment, and management of a patient cured of COVID-19 infection, which may serve as reference for future cases, while further studies are needed.
The safety and outcomes of acutely ruptured intracranial aneurysms with incomplete occlusion after coiling: a case-control study
Authors: Yue Jianhe , Xie Yuan , Zhang Xiaolin , Jiang Yongxiang , Chen Weifu , Ma Ying , Cheng Yuan
Published: November 2020

Background

Incomplete aneurysmal occlusion is a common feature of immediate posttreatment angiography. The safety and outcomes of acutely ruptured intracranial aneurysms (RIAs) with incomplete occlusion after stent-assisted coiling (SAC) and no-stent coiling (NSC) have not been well clarified. Progressive occlusion of stents can promote the complete occlusion of intracranial aneurysms (IAs), but it remains to be determined if progressive occlusion in acutely RIAs with incomplete occlusion after coiling may be enhanced by protective stenting. This study aimed to evaluate the safety and outcomes of those aneurysms after SAC and NSC; And to discover whether the stents can promote progressive aneurysm occlusion in such lesions or not.

Methods

We reviewed 199 patients with acutely RIAs underwent endovascular coiling and developed incomplete occlusion in the past seven years. The patients’ clinical and imaging information were recorded and analyzed. Univariate and multivariate analyses were performed to determine the association of recurrence rate with potential risk factors.

Results

SAC group had wider aneurysms neck (3.471 mm vs 2.830 mm, P = 0.009) and smaller dome-to-neck ratio (1.536 vs 2.111, P = 0.001) than in NSC group. There was no significant difference between the two groups in total procedure-related complications rate (31.7% vs 23.5%, P = 0.195), procedure-related mortality (6.9% vs 2.0%, P = 0.170) and modified Rankin Scale (mRS) score at 6-month follow-up (P > 0.05). However, SAC group had significantly higher ischemic complications rate (21.8% vs 8.2%, P = 0.007) and complete occlusion rate (65.6% vs 48.3%, P = 0.020), and lower recurrence rate (15.6% vs 28.1%, P = 0.042) than NSC group based on 6-month follow-up angiograms. Additionally, Multivariable analysis showed NSC was an independent risk factor for aneurysm recurrence (Odds Ratio [OR]: 4.061; P = 0.018).

Conclusions

Acutely RIAs with incomplete occlusion after SAC is associated with higher complications rate and mortality, but has an acceptable safety profile and similar clinical outcome compared to NSC, as well as gives patients superior angiography outcome by progressive occlusion of stents.
Maternal and newborn healthcare practices: assessment of the uptake of lifesaving services in Hoima District, Uganda
Authors: Babughirana Geoffrey , Gerards Sanne , Mokori Alex , Nangosha Elisha , Kremers Stef , Gubbels Jessica
Published: November 2020

Background

The current maternal mortality ratio in Uganda is 336 maternal deaths per 100,000 live births. Infant mortality is 43 deaths per 1000 live births, with 42% of the mortality occurring during the neonatal period. This might be related to a weak health system in the country. This study aimed at assessing the uptake of lifesaving services during pregnancy and childbirth in Hoima District, Uganda.

Methods

The study used a cross-sectional quantitative design among 691 women with a child under 5 years. Households were randomly sampled from a list of all the villages in the district with the ENA for SMART software using the EPI methodology. Pre-coded questionnaires uploaded in the Open Data Kit were used for data collection. The data was cleaned and analysed using MS Excel and SPSS software. Descriptive results are presented.

Results

Of the 55.1% women attending at least four antenatal care (ANC) visits, only 24.3% had the first ANC within the first trimester. Moreover, ANC services generally was of poor quality, with only 0.4% meeting all the requirements for quality of ANC service. The highest contributors to this poor quality included poor uptake of iron-folic acid (adherence 28.8%), the six-required birth preparedness and complication readiness items (13.2%), and recognition of the seven danger signs of pregnancy (3.0%). Adherence to the seven essential newborn care actions was very low (0.5%), mainly caused by three practices: initiating breastfeeding within 1 h (59.9%), lack of postnatal care within 24 h (20.1%), and failure to recognize the 6 danger signs of the newborn (2.4%). Only 11.1% of the males participated in all maternal and newborn care requirements, by encouraging women to seek healthcare (39.9%), accompanying them to healthcare (36.9%), and HIV counselling and support services (26.2%).

Conclusion

The study reveals poor maternal and newborn practices throughout the continuum of care, from ANC and skilled birth attendance to newborn care during childbirth. With such poor results, it is not surprising that Hoima is sixth of 10 districts that have the highest numbers of deaths due to maternal mortality in Uganda.
Patterns of breast, prostate and cervical cancer incidence and mortality in Colombia: an administrative registry data analysis
Authors: Hernández Vargas Juliana Alexandra , Ramírez Barbosa Paula Ximena , Gil Quijano Ana Milena , Valbuena Ana María , Acuña Lizbeth , González Jaime Alberto
Published: November 2020

Background

Cancer is widely recognized as a global public health problem. Breast, prostate, and cervical cancer are among the most frequent types in developing countries. Assessing their incidence and mortality by regions and municipalities is important to guide evidence-based health policy. Our aim was to describe the incidence and mortality trends for breast, cervical, and prostate cancer across regions and municipalities in Colombia during 2018.

Methods

We performeda cross-sectional analysis with data from people with breast, prostate, or cervical cancer, reported to the National Administrative Cancer Registry during 2018. A descriptive analysis was performed. Age-standardized incidence and mortality rates were estimated at national, regional, and municipal levels. Finally, we identify the regions and municipalities with significantly higher or lower incidence and mortality rates compared to national estimations.

Results

Breast cancer was the most frequent type among all new cases and deaths in Colombia. Breast, prostate and cervical cancer incidence and mortality rates per 100,000 were: 18.69 (CI 95%: 18.15–19.25) and 10.48 (CI 95%: 10.07–10.91); 11.34 (CI 95%: 10.90–11.78) and 7.58 (CI 95%: 7.22–7.96); 5.93 (CI 95%: 5.62–6.25) and 4.31 (CI 95%: 4.05–4.58), respectively. Eastern region had both, incidence and mortality rates, significantly lower than national for all types of cancer. By municipalities, there was a heterogeneous pattern. Nonetheless, Agua de Dios (Cundinamarca), had one of the highest incidence rates for all types.

Conclusions

We observed clear differences in cancer incidence and mortality across regions and municipalities, depending on each type of cancer. Our findings are important to improve screening coverage, early detection, and treatment in the country.
Citrin deficiency mimicking mitochondrial depletion syndrome
Authors: Grünert S. C. , Schumann A. , Freisinger P. , Rosenbaum-Fabian S. , Schmidts M. , Mueller A. J. , Beck-Wödl S. , Haack T. B. , Schneider H. , Fuchs H. , Teufel U. , Gramer G. , Hannibal L. , Spiekerkoetter U.
Published: November 2020

Background

Neonatal intrahepatic cholestasis caused by citrin deficiency (CD) is a rare inborn error of metabolism due to variants in the SLC25A13 gene encoding the calcium-binding protein citrin. Citrin is an aspartate-glutamate carrier located within the inner mitochondrial membrane.

Case presentation

We report on two siblings of Romanian-Vietnamese ancestry with citrin deficiency. Patient 1 is a female who presented at age 8 weeks with cholestasis, elevated lactate levels and recurrent severe hypoglycemia. Diagnosis was made by whole exome sequencing and revealed compound heterozygosity for the frameshift variant c.852_855del, p.Met285Profs*2 and a novel deletion c.(69 + 1_70–1)_(212 + 1_231–1)del in SLC25A13. The girl responded well to dietary treatment with a lactose-free, MCT-enriched formula. Her younger brother (Patient 2) was born 1 year later and also found to be carrying the same gene variants. Dietary treatment from birth was able to completely prevent clinical manifestation until his current age of 4.5 months.

Conclusions

As CD is a well-treatable disorder it should be ruled out early in the differential diagnosis of neonatal cholestasis. Due to the combination of hepatopathy, lactic acidosis and recurrent hypoglycemia the clinical presentation of CD may resemble hepatic mitochondrial depletion syndrome.
Safety of the application of Rigidfix cross-pin system via different tibial tunnels for tibial fixation during anterior cruciate ligament reconstruction
Authors: Wang Jian , Fan Hua-qiang , Dai Wenli , Li Hong-Da , Fu Yang-pan , Liu Zhenhuang , Huang Chang-ming , Shi Zhanjun
Published: November 2020

Background

We investigate the safety of the application of the Rigidfix cross-pin system via different tibial tunnels in the tibial fixation during anterior cruciate ligament (ACL) reconstruction.

Methods

Five adult fresh cadaver knees were fixed with the Rigidfix cross-pins in the tibial fixation site during ACL reconstruction. Two different tibial tunnel groups were established: in group A, the tunnel external aperture was placed at the 25° angle of coronal section; in group B, the tunnel external aperture was placed at the 45° angle of coronal section. The guide was placed at the plane 0.5 mm below articular facet through the tibial tunnel, with three rotation positions set at 0°, 30°, and 60° slopes. The incidences of iatrogenic injuries at tibial plateau cartilage (TPC), medial collateral ligament (MCL), and patellar tendon in three different slope angles were calculated in groups A and B and the results were analyzed by using chi square test.

Results

The iatrogenic injuries at MCL, TPC, and patellar tendon could occur after the Rigidfix cross-pin system was placed 5 mm below tibial plateau cartilage for ACL reconstruction. The incidences of TPC injury (χ2 = 5.662, P = 0.017) and MCL injury (P = 0.048, Fisher exact probability method) were significantly lower in group A than in group B. However, the incidence of patellar tendon injury showed no significant difference between these two groups (χ2 = 0.120, P = 0.729).

Conclusions

When the Rigidfix cross-pin system is used for ACL reconstruction at the tibial fixation site, the external aperture of tibial tunnel should not be placed at the excessively posterosuperior site, to avoid MCL and TPC injuries.
Comparative gene expression profiling of mouse ovaries upon stimulation with natural equine chorionic gonadotropin (N-eCG) and tethered recombinant-eCG (R-eCG)
Authors: Min Kwan-Sik , Park Jong-Ju , Lee So-Yun , Byambaragchaa Munkhzaya , Kang Myung-Hwa
Published: November 2020

Background

Equine chorionic gonadotropin (eCG) induces super-ovulation in laboratory animals. Notwithstanding its extensive usage, limited information is available regarding the differences between the in vivo effects of natural eCG (N-eCG) and recombinant eCG (R-eCG). This study aimed to investigate the gene expression profiles of mouse ovaries upon stimulation with N-eCG and R-eCG produced from CHO-suspension (CHO-S) cells. R-eCG gene was constructed and transfected into CHO-S cells and quantified. Subsequently, we determined the metabolic clearance rate (MCR) of N-eCG and R-eCG up to 24 h after intravenous administration through the mice tail vein and identified differentially expressed genes in both ovarian tissues, via quantitative real-time PCR (qRT-PCR) and immunohistochemistry (IHC).

Results

R-eCG was markedly expressed initially after transfection and maintained until recovery on day 9. Glycan chains were substantially modified in R-eCG protein produced from CHO-S cells and eliminated through PNGase F treatment.

The MCR was higher for R-eCG than for N-eCG, and no significant difference was observed after 60 min. Notwithstanding their low concentrations, R-eCG and N-eCG were detected in the blood at 24 h post-injection. Microarray analysis of ovarian tissue revealed that 20 of 12,816 genes assessed therein were significantly up-regulated and 43 genes were down-regulated by > 2-fold in the group that received R-eCG (63 [0.49%] differentially regulated genes in total). The microarray results were concurrent with and hence validated by those of RT-PCR, qRT-PCR, and IHC analyses.

Conclusions

The present results indicate that R-eCG can be adequately produced through a cell-based expression system through post-translational modification of eCG and can induce ovulation in vivo. These results provide novel insights into the molecular mechanisms underlying the up- or down-regulation of specific ovarian genes and the production of R-eCG with enhanced biological activity in vivo.
Gastric canthariasis caused by invasion of mealworm beetle larvae in weaned pigs in large-scale farming
Authors: Gałęcki Remigiusz , Michalski Mirosław Mariusz , Wierzchosławski Karol , Bakuła Tadeusz
Published: November 2020

Background

Mealworm beetle T. molitor (Coleoptera: Tenebrionidae) (Linnaeus, 1758) is one of the most important cosmopolitan primary storage pests, scavenging on a variety of post-harvest grains and affecting the quality and safety of food and feed. In addition to being an important factor in feed hygiene, the insect can also be an epidemiological factor of canthariasis. Livestock infestations with T. molitor are rarely reported. This article describes T. molitor-caused canthariasis in pigs in large scale closed-cycle farming.

Results

In the spring, we registered a significantly increased mortality among weaned pigs. In autopsy, live 3–6 mm long T. molitor larvae were found in their stomachs, especially in the non-glandular oesophageal region, on average 2–3 larvae per 10 cm2 of gastric mucosa. Corrective actions reduced the number of deaths back to basal levels.

Conclusions

This is the first documented case of potentially lethal gastric canthariasis in weaned pigs, caused by invasion of T. molitor larvae. Although canthariasis caused by T. molitor has not been a significant problem in farm animals so far, our case indicates that the presence of mealworm beetles is a potential threat to animal welfare and health.
Trends in health workers’ compliance with outpatient malaria case-management guidelines across malaria epidemiological zones in Kenya, 2010–2016
Authors: Amboko Beatrice , Stepniewska Kasia , Macharia Peter M. , Machini Beatrice , Bejon Philip , Snow Robert W. , Zurovac Dejan
Published: November 2020

Background

Health workers' compliance with outpatient malaria case-management guidelines has been improving, specifically regarding the universal testing of suspected cases and the use of artemisinin-based combination therapy (ACT) only for positive results (i.e., ‘test and treat’). Whether the improvements in compliance with ‘test and treat’ guidelines are consistent across different malaria endemicity areas has not been examined.

Methods

Data from 11 national, cross-sectional, outpatient malaria case-management surveys undertaken in Kenya from 2010 to 2016 were analysed. Four primary indicators (i.e., ‘test and treat’) and eight secondary indicators of artemether-lumefantrine (AL) dosing, dispensing, and counselling were measured. Mixed logistic regression models were used to analyse the annual trends in compliance with the indicators across the different malaria endemicity areas (i.e., from highest to lowest risk being lake endemic, coast endemic, highland epidemic, semi-arid seasonal transmission, and low risk).

Results

Compliance with all four ‘test and treat’ indicators significantly increased in the area with the highest malaria risk (i.e., lake endemic) as follows: testing of febrile patients (OR = 1.71 annually; 95% CI = 1.51–1.93), AL treatment for test-positive patients (OR = 1.56; 95% CI = 1.26–1.92), no anti-malarial for test-negative patients (OR = 2.04; 95% CI = 1.65–2.54), and composite ‘test and treat’ compliance (OR = 1.80; 95% CI = 1.61–2.01). In the low risk areas, only compliance with test-negative results significantly increased (OR = 2.27; 95% CI = 1.61–3.19) while testing of febrile patients showed declining trends (OR = 0.89; 95% CI = 0.79–1.01). Administration of the first AL dose at the facility significantly increased in the areas of lake endemic (OR = 2.33; 95% CI = 1.76–3.10), coast endemic (OR = 5.02; 95% CI = 2.77–9.09) and semi-arid seasonal transmission (OR = 1.44; 95% CI = 1.02–2.04). In areas of the lowest risk of transmission and highland epidemic zone, none of the AL dosing, dispensing, and counselling tasks significantly changed over time.

Conclusions

There is variability in health workers' compliance with outpatient malaria case-management guidelines across different malaria-risk areas in Kenya. Major improvements in areas of the highest risk have not been seen in low-risk areas. Interventions to improve practices should be targeted geographically.
Comparative assessment of insecticide resistance phenotypes in two major malaria vectors, Anopheles funestus and Anopheles arabiensis in south-eastern Tanzania
Authors: Pinda Polius G. , Eichenberger Claudia , Ngowo Halfan S. , Msaky Dickson S. , Abbasi Said , Kihonda Japhet , Bwanaly Hamis , Okumu Fredros O.
Published: November 2020

Background

Long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS) have greatly reduced malaria transmission in sub-Saharan Africa, but are threatened by insecticide resistance. In south-eastern Tanzania, pyrethroid-resistant Anopheles funestus are now implicated in > 80% of malaria infections, even in villages where the species occurs at lower densities than the other vector, Anopheles arabiensis. This study compared the insecticide resistance phenotypes between the two malaria vectors in an area where pyrethroid-LLINs are widely used.

Methods

The study used the World Health Organization (WHO) assays with 1×, 5× and 10× insecticide doses to assess levels of resistance, followed by synergist bioassays to understand possible mechanisms of the observed resistance phenotypes. The tests involved adult mosquitoes collected from three villages across two districts in south-eastern Tanzania and included four insecticide classes.

Findings

At baseline doses (1×), both species were resistant to the two candidate pyrethroids (permethrin and deltamethrin), but susceptible to the organophosphate (pirimiphos-methyl). Anopheles funestus, but not An. arabiensis was also resistant to the carbamate (bendiocarb). Both species were resistant to DDT in all villages except in one village where An. arabiensis was susceptible. Anopheles funestus showed strong resistance to pyrethroids, surviving the 5× and 10× doses, while An. arabiensis reverted to susceptibility at the 5× dose. Pre-exposure to the synergist, piperonyl butoxide (PBO), enhanced the potency of the pyrethroids against both species and resulted in full susceptibility of An. arabiensis (> 98% mortality). However, for An. funestus from two villages, permethrin-associated mortalities after pre-exposure to PBO only exceeded 90% but not 98%.

Conclusions

In south-eastern Tanzania, where An. funestus dominates malaria transmission, the species also has much stronger resistance to pyrethroids than its counterpart, An. arabiensis, and can survive more classes of insecticides. The pyrethroid resistance in both species appears to be mostly metabolic and may be partially addressed using synergists, e.g. PBO. These findings may explain the continued persistence and dominance of An. funestus despite widespread use of pyrethroid-treated LLINs, and inform new intervention choices for such settings. In short and medium-term, these may include PBO-based LLINs or improved IRS with compounds to which the vectors are still susceptible.