bluuebunny/crossref_metadata_2025 huggingface dataset:
Lost bones: differential diagnosis of acro-osteolysis seen by the pediatric rheumatologist
Authors: Limenis Elizaveta , Stimec Jennifer , Kannu Peter , Laxer Ronald M.
Published: July 2021

Introduction

Acro-osteolysis is a radiographic finding which refers to bone resorption of the distal phalanges. Acro-osteolysis is associated with various conditions and its presence should prompt the clinician to search for the underlying etiology. The aim of this review is to discuss disorders with which acro-osteolysis is associated and their distinguishing features, with a focus on the pediatric population.

Methods

A targeted literature review was performed using the term “acro-osteolysis” in combination with other key terms. The primary search results were supplemented using reference citations. Articles published prior to the year 2000 were included if they described additional associations not encountered in the more recent literature.

Results

Genetic disorders (particularly primary hypertrophic osteoarthropathy and skeletal dysplasias) and rheumatic diseases (particularly psoriatic arthritis and systemic sclerosis) are the most frequently encountered conditions associated with acro-osteolysis in children. Hyperparathyroidism, neuropathy, local trauma and thermal injury, and spinal dysraphism should also be included in the differential diagnosis.

Conclusion

Although acro-osteolysis is uncommon, its presence should prompt the clinician to consider a differential diagnosis based on clinical and radiographic features.
A novel class III endogenous retrovirus with a class I envelope gene in African frogs with an intact genome and developmentally regulated transcripts in Xenopus tropicalis
Authors: Yedavalli Venkat R. K. , Patil Akash , Parrish Janay , Kozak Christine A.
Published: July 2021

Background

Retroviruses exist as exogenous infectious agents and as endogenous retroviruses (ERVs) integrated into host chromosomes. Such endogenous retroviruses (ERVs) are grouped into three classes roughly corresponding to the seven genera of infectious retroviruses: class I (gamma-, epsilonretroviruses), class II (alpha-, beta-, delta-, lentiretroviruses) and class III (spumaretroviruses). Some ERVs have counterparts among the known infectious retroviruses, while others represent paleovirological relics of extinct or undiscovered retroviruses.

Results

Here we identify an intact ERV in the Anuran amphibian, Xenopus tropicalis. XtERV-S has open reading frames (ORFs) for gag, pol (polymerase) and env (envelope) genes, with a small additional ORF in pol and a serine tRNA primer binding site. It has unusual features and domain relationships to known retroviruses. Analyses based on phylogeny and functional motifs establish that XtERV-S gag and pol genes are related to the ancient env-less class III ERV-L family but the surface subunit of env is unrelated to known retroviruses while its transmembrane subunit is class I-like. LTR constructs show transcriptional activity, and XtERV-S transcripts are detected in embryos after the maternal to zygotic mid-blastula transition and before the late tailbud stage. Tagged Gag protein shows typical subcellular localization. The presence of ORFs in all three protein-coding regions along with identical 5’ and 3’ LTRs (long terminal repeats) indicate this is a very recent germline acquisition. There are older, full-length, nonorthologous, defective copies in Xenopus laevis and the distantly related African bullfrog, Pyxicephalus adspersus. Additional older, internally deleted copies in X. tropicalis carry a 300 bp LTR substitution.

Conclusions

XtERV-S represents a genera-spanning member of the largely env-less class III ERV that has ancient and modern copies in Anurans. This provirus has an env ORF with a surface subunit unrelated to known retroviruses and a transmembrane subunit related to class I gammaretroviruses in sequence and organization, and is expressed in early embryogenesis. Additional XtERV-S-related but defective copies are present in X. tropicalis and other African frog taxa. XtERV-S is an unusual class III ERV variant, and it may represent an important transitional retroviral form that has been spreading in African frogs for tens of millions of years.
Do reverse total shoulder replacements have better clinical and functional outcomes than hemiarthroplasty for patients undergoing proximal humeral tumor resection using devitalized autograft composite reconstruction: a case-control study
Authors: Zuo Dongqing , Mu Haoran , Yang Qingbo , Sun Mengxiong , Shen Jiakang , Wang Hongsheng , Ma Xiaojun , Wang Chongren , Li Chuanping , Sun Wei , Cai Zhengdong
Published: July 2021

Objective

To compare the efficacy and prognosis of reverse total shoulder arthroplasty (rTSA) with shoulder hemiarthroplasty (SHA) using devitalized autograft or allograft composite reconstruction after proximal humeral tumor resection.

Methods

We retrospectively reviewed patients who underwent SHA (32) and rTSA (20) for tumor resections of the proximal humerus from January 2014 to July 2020. The clinical results included duration of the operation, intraoperative blood loss, bone union, visual analog scale (VAS) score, shoulder range of motion (ROM), American Shoulder and Elbow Surgeons (ASES) shoulder score, recurrence, and overall survival.

Results

Fifty-two patients were followed up for a mean of 30 months. Thirty-two patients were SHA with allograft-prosthetic composite (APC) reconstructions, while other 20 were rTSA with devitalized autograft-prosthetic composite reconstructions. At the end of the follow-up, 2 recurrence, 3 postoperative infections, and 4 subluxations occurred among the SHA patients. Two patients in the rTSA group had postoperative anterior dislocation and underwent revision surgery with surgical mesh, and 2 (2/20) had grade II scapular notching. The mean VAS score of the shoulder was 1.5 ± 0.8 in the rTSA group and 2.3 ± 1.2 in the SHA group (p < 0.05). The mean active forward flexion of the shoulder joint was 50.6 ± 6.0 in the SHA group and 100 ± 7.6 in the rTSA group (p < 0.05). The ASES shoulder score was 78 ± 3.0 in the rTSA group and 52 ± 5.6 in the SHA group (p < 0.05). The overall 3-year survival rate of all patients was 60.0%, and patients in the rTSA group showed better survival in terms of the mean 3-year OS than patients in the SHA group (p = 0.04).

Conclusion

rTSA with devitalized autograft-prosthetic composite can offer a reasonable reconstruction of the shoulder joint after Malawer type I tumor resection. Compared with patients who underwent SHA, patients who underwent rTSA present good outcomes, a better range of motion, better bone union, and no increase in instability rate in the mid-term.
Salvage of severe knee osteoarthritis: efficacy of tibial condylar valgus osteotomy versus open wedge high tibial osteotomy
Authors: Wang Xiaoyu , Shi Li , Zhang Rui , Wang Wenbo , Kong Lingchi , Zhao Haoyu , Xu Jia , Kang Qinglin
Published: July 2021

Introduction

To compare the clinical outcomes and the radiographic features between tibial condylar valgus osteotomy (TCVO) and open wedge high tibial osteotomy (OWHTO). New insight into the indication criteria for TCVO was also clarified for achieving satisfactory results.

Materials and methods

Sixty-three knees with medial-compartment osteoarthritis were retrospectively studied. Thirty-four knees with subluxated lateral joint and depression of the medial tibial plateau underwent TCVO and the rest underwent OWHTO. Among the 63 knees included, 27 knees with a pre-operative femorotibial angle (FTA) ≥ 185° were defined as severe varus (subgroup S, 15 in STCVO group and 12 in SHTO group). Lower limb alignment, intra-, and extra-articular congruency were evaluated according to the radiograph obtained before and 24 months after surgery. The visual analog scale (VAS) score and Hospital for Special Surgery (HSS) score were obtained to assess the clinical results. Opening angle and distance of the opening gap in each group were measured by intra-operative fluoroscopy.

Results

During the 2-year follow-up period, the mean HSS score increased from 70.3 to 81.4 in HTO group and 65.9 to 87.3 in TCVO group (p < 0.05). The mean VAS score decreased from 5.9 to 2.6 and 6.0 to 2.1, respectively (p < 0.01). Pre-operative FTA was restored to 172.9° in HTO group and 171.3° in TCVO group, and percentage of mechanical axis (%MA) was improved to 59.7% and 61.2%, respectively. Joint line convergence angle (JLCA) was slightly restored and medial tibial plateau depression (MTPD) was relatively the same before and after OWHTO, while these parameters improved greatly (from 6.4° to 1.2° and − 8.0° to 5.9°, p < 0.01) in TCVO group. More undercorrected knees were observed in SHTO group than STCVO group (58.3% and 13.3%, p < 0.05). Opening angle and distance of the opening gap were larger in TCVO group (19.1° and 14.0 mm) than those in OWHTO group (9.3° and 10.1 mm, p < 0.05).

Conclusion

Compared to OWHTO, TCVO had priority in treating advanced knee OA with intra-articular deformity. However, TCVO had a limited capacity to correct the varus angle. Besides, TCVO might be suitable for medial-compartment OA with a pre-operative FTA ≥ 185°.
Copy neutral absence of heterozygosity on chromosome 15 distal long arm: A surrogate marker for Prader–Willi/Angelman syndromes?
Authors: Ortega Veronica , Louie Raymond J. , Jones Melanie A. , Chaubey Alka , DuPont Barbara R. , Britt Allison , Ray Joseph , McLean Scott D. , Littlejohn Rebecca O. , Velagaleti Gopalrao
Published: July 2021

Background

Copy-neutral absence of heterozygosity (CN-AOH) observed on a single chromosome or part of a chromosome may be indicative of uniparental disomy (UPD) and may require additional testing when such chromosomes or chromosome regions are known to harbor imprinted genes.

Case presentation

Here we report 2 cases of neonates that presented to clinic with hypotonia, poor oral skills including inability to feed by mouth, weak cry, no response to noxious stimulation and vertical plantar creases (case 1) and hypotonia and respiratory distress (case 2). A preliminary chromosome analysis showed normal karyotypes in both cases while the high-resolution single nucleotide polymorphism (SNP) microarray showed copy neutral absence of heterozygosity involving chromosome 15 distal long arm. In case 1, the CN-AOH involved a 28.7 Mb block from genomic coordinates 73703619_102429049. In case 2, the CN-AOH involved a 15.3 Mb block from genomic coordinates 54729197_70057534. In both cases, methylation-specific PCR did not detect an unmethylated allele for the SNRPN gene suggesting either a deletion of paternal allele or maternal UPD for chromosome 15. Since microarray analysis did not show any copy number alterations on chromosome 15, a microdeletion was ruled out.

Conclusions

Based on our cases, we suggest that CN-AOH on chromosome 15, even if it does not involve the critical region of 15q12q13, should warrant additional studies for diagnosis of Prader–Willi/Angelman syndromes.
Decreased expression of the clock gene Bmal1 is involved in the pathogenesis of temporal lobe epilepsy
Authors: Wu Hao , Liu Yong , Liu Lishuo , Meng Qiang , Du Changwang , Li Kuo , Dong Shan , Zhang Yong , Li Huanfa , Zhang Hua
Published: July 2021

Clock genes not only regulate the circadian rhythm of physiological activities but also participate in the pathogenesis of many diseases. Previous studies have documented the abnormal expression of clock genes in epilepsy. However, the molecular mechanism of brain and muscle Arnt-like protein 1 (Bmal1), one of the core clock genes, in the epileptogenesis and seizures of temporal lobe epilepsy (TLE) remain unclear. We first investigated the levels of Bmal1 and other clock proteins in the hippocampus of subjects with epilepsy to define the function of Bmal1. The levels of Bmal1 were decreased during the latent and chronic phases in the experimental group compared with those in the control group. Knockout of Bmal1 in hippocampal dentate gyrus (DG) neurons of Bmal1flox/flox mice by Synapsin 1 (Syn1) promoter AAV (adeno-associated virus) lowered the threshold of seizures induced by pilocarpine administration. High-throughput sequencing analysis showed that PCDH19 (protocadherin 19), a gene associated with epilepsy, was regulated by Bmal1. PCDH19 expression was also decreased in the hippocampus of epileptic mice. Furthermore, the higher levels of Bmal1 and PCDH19 were detected in patients with no hippocampal sclerosis (no HS) than in patients with HS International League Against Epilepsy (ILAE) type I and III. Altogether, these data suggest that decreased expression of clock gene Bmal1 may participate in epileptogenesis and seizures via PCDH19 in TLE.
Protocol for a process evaluation of an external pilot cluster randomised controlled trial of a theory-based intervention to improve appropriate polypharmacy in older people in primary care: the PolyPrime study
Authors: Rankin Audrey , Molloy Gerard J. , Cadogan Cathal A. , Barry Heather E. , Gorman Ashleigh , Ryan Cristín , Ferrett Alan , McCarthy Pat , Gormley Gerard J. , Fahey Tom , Hughes Carmel M. ,   On behalf of the PolyPrime team
Published: July 2021

Background

The PolyPrime intervention is a theory-based intervention aimed at improving appropriate polypharmacy in older people (aged ≥65 years) in primary care. The intervention consists of an online video which demonstrates how general practitioners (GPs) can prescribe appropriate polypharmacy during a consultation with an older patient and a patient recall process, whereby patients are invited to scheduled medication review consultations with GPs. The aim of the process evaluation is to further examine the implementation of the PolyPrime intervention in primary care. This will involve investigating whether the PolyPrime intervention can be delivered as intended across two healthcare systems, how acceptable the intervention is to GPs, practice staff and patients, and to identify the intervention’s likely mechanisms of action.

Methods

The PolyPrime study is an external pilot cluster randomised controlled trial (cRCT) which aims to recruit 12 GP practices across Northern Ireland [NI] (n=6) and the six counties in the Republic of Ireland (ROI) that border NI (n=6). Practices have been randomised to intervention or usual care. An embedded process evaluation will assess intervention fidelity (i.e. was the intervention delivered as intended), acceptability of the intervention to GPs, practice staff and patients and potential mechanisms of action (i.e. what components of the intervention were perceived to be effective). Quantitative data will be collected from data collection forms completed by GPs and practice staff and a feedback questionnaire completed by patients from intervention arm practices, which will be analysed using descriptive statistics. Qualitative data will be collected through semi-structured interviews with GPs and practice staff and audio-recordings of medication review appointments from the intervention arm practices which will be transcribed and analysed using the framework method. Quantitative and qualitative data will be triangulated to provide an overall assessment of intervention fidelity, intervention acceptability, and mechanisms of action.

Discussion

This process evaluation will add to feasibility data from the pilot cRCT by providing evidence on the fidelity of implementing the intervention package across two healthcare systems, the acceptability of the intervention and potential mechanisms of action.

Trial registration

ClinicalTrials.govISRCTN41009897. Registered on 19 November 2019. ClinicalTrials.govNCT04181879. Registered 02 December 2019.
Intradermal acupuncture for rheumatoid arthritis: study protocol for a randomised controlled trial
Authors: Luo Huifang , Peng Jie , Ma Qing , Wei Zhihua , Lin Changsong , Zhang Mingying , Li Peiwu , Song Yang , Yang Xiangwei
Published: July 2021

Background

Rheumatoid arthritis (RA) is a common autoimmune disease that severely impacts quality of life. Currently available medications for the treatment of RA have adverse side effects. Emerging evidence suggests that intradermal acupuncture (IA) is feasible and safe for patients, but its application in RA patients has not been examined. Our study aims to explore the efficacy and safety of IA for the treatment of RA.

Methods

This study is a randomised, sham-controlled, patient-outcome assessor-statistician blind trial that aims to evaluate the effects of IA in patients with RA. We will recruit 132 patients aged ≥ 18 years with a diagnosis of RA. Patients will be randomly allocated with a 1:1 ratio to IA or sham IA groups. Both groups will receive basic treatment and nursing routines for RA. The experimental group will receive actual IA treatment, whereas the control group will receive sham IA treatment. All patients will receive one course of treatment (i.e., four consecutive treatment sessions with an intervening 1-day interval). Primary outcomes will be traditional Chinese medicine (TCM) syndromes before and after a treatment course and Health Assessment Questionnaire (HAQ) scores. Secondary outcomes will be disease activity score 28 (DAS28) and levels of serum C-reactive protein (CRP). Outcome measures will be collected pre- and post-treatment.

Discussion

This study aims to provide high-quality evidence for the efficacy and safety of IA for treating RA. In addition, the results will provide references for selection of acupoints for other syndromes in clinical practice.

Trial registration

Chinese Clinical Trial RegistryChiCTR2000038028. Registered on 8 September 2020.
Haplotype-resolved germline and somatic alterations in renal medullary carcinomas
Authors: Tan Kar-Tong , Kim Hyunji , Carrot-Zhang Jian , Zhang Yuxiang , Kim Won Jun , Kugener Guillaume , Wala Jeremiah A. , Howard Thomas P. , Chi Yueh-Yun , Beroukhim Rameen , Li Heng , Ha Gavin , Alper Seth L. , Perlman Elizabeth J. , Mullen Elizabeth A. , Hahn William C. , Meyerson Matthew , Hong Andrew L.
Published: July 2021

Background

Renal medullary carcinomas (RMCs) are rare kidney cancers that occur in adolescents and young adults of African ancestry. Although RMC is associated with the sickle cell trait and somatic loss of the tumor suppressor, SMARCB1, the ancestral origins of RMC remain unknown. Further, characterization of structural variants (SVs) involving SMARCB1 in RMC remains limited.

Methods

We used linked-read genome sequencing to reconstruct germline and somatic haplotypes in 15 unrelated patients with RMC registered on the Children’s Oncology Group (COG) AREN03B2 study between 2006 and 2017 or from our prior study. We performed fine-mapping of the HBB locus and assessed the germline for cancer predisposition genes. Subsequently, we assessed the tumor samples for mutations outside of SMARCB1 and integrated RNA sequencing to interrogate the structural variants at the SMARCB1 locus.

Results

We find that the haplotype of the sickle cell mutation in patients with RMC originated from three geographical regions in Africa. In addition, fine-mapping of the HBB locus identified the sickle cell mutation as the sole candidate variant. We further identify that the SMARCB1 structural variants are characterized by blunt or 1-bp homology events.

Conclusions

Our findings suggest that RMC does not arise from a single founder population and that the HbS allele is a strong candidate germline allele which confers risk for RMC. Furthermore, we find that the SVs that disrupt SMARCB1 function are likely repaired by non-homologous end-joining. These findings highlight how haplotype-based analyses using linked-read genome sequencing can be applied to identify potential risk variants in small and rare disease cohorts and provide nucleotide resolution to structural variants.
Multi-user hybrid precoding for mmWave massive MIMO systems with sub-connected structure
Authors: Du Jianhe , Wang Zekun , Zhang Yang , Guan Yalin , Jin Libiao
Published: July 2021

Hybrid precoding achieves a compromise between the sum rate and hardware complexity of millimeter wave (mmWave) massive multiple-input multiple-output (MIMO) systems.
However, most prior works on multi-user hybrid precoding only consider the full-connected structure. In this paper, a novel multi-user hybrid precoding algorithm is proposed for the sub-connected structure. Based on the improved successive interference cancellation (SIC), the analog precoding matrix optimization problem is decomposed into multiple analog precoding sub-matrix optimization problems. Further, a near-optimal analog precoder is designed through factorizing the precoding sub-matrix for each sub-array. Furthermore, digital precoding is designed according to the block diagonalization (BD) technology. Finally, the water-filling power allocation method is used to further improve the communication quality. The extensive simulation results demonstrate that the sum rate of the proposed algorithm is higher than the existing hybrid precoding methods with the sub-connected structure, and has higher energy efficiency compared with existing approaches. Moreover, the proposed algorithm is closer to the state-of-the-art optimization approach with the full-connected structure. In addition, the simulation results also verify the effectiveness of the proposed hybrid precoding design of the uniform planar array (UPA).
Consumer perceptions of food safety in animal source foods choice and consumption in Nairobi’s informal settlements
Authors: Bukachi Salome A. , Ngutu Mariah , Muthiru Ann W. , Lépine Aurélia , Kadiyala Suneetha , Domínguez-Salas Paula
Published: July 2021

Background

Animal-source foods (ASFs) are high-quality nutrient-dense products key to reducing stunting and micronutrient deficiencies. However, their consumption among the poorest households in urban informal settlements is low. Several drivers beyond price, including health considerations have been reported to drive ASF choice and consumption among consumers. This current study explores consumer perceptions of food safety associated with animal source foods (ASFs) consumption in urban informal settlements with a view to unpacking the health considerations driving their choice and consumption.

Methods

Coupled households with children 6–59 months formed the study sample. The Food Environments Working Group (FEWG) Framework of the Agriculture and Nutrition for Health academy (ANH) was used to guide the study which utilized qualitative methods namely, 60 in-depth interviews (IDIs), 19 focus group discussions, and 19 key informant interviews (KIIs) complemented by unstructured observations. Data were transcribed and analysed according to emerging themes.

Results

Consumer perceptions of food safety are driven by concerns about food production, processing, handling, storage and the health risks associated with consumption of the ASFs. For all the ASFs, lack of traceability of source, unhygienic environments in which they were sold and health risks around consuming too much or improperly cooked products were key perceptions from the community. To mitigate against food safety risks, consumers used strategies such as boiling the ASFs, purchasing their products from trusted retailers, avoiding vendors in unhygienic environments and reducing the amount and frequency of consumption of ASFs or totally avoiding their consumption.

These consumer perceptions are increasingly influencing the ASFs choice and consumption in low-income populations besides other drivers. Notably, given limited incomes that influence their purchasing power and the need for nutritious diets that included ASFs, the dilemma of quality vis-a-vis quantity persists and consumers still accessed and consumed these ASF products to supplement their diets.

Conclusions

To enhance food safety for ASFs, as well as assure consumer access to safe ASFs from informal markets, there is need to contextualize the value chain as informed by consumer perceptions on food safety as these influence their ASFs choice and consumption.
Revisiting level II sleep studies in the era of COVID-19: a theoretical economic decision model in patients with suspected obstructive sleep apnea
Authors: Ayas Najib T. , Jen Rachel , Baumann Brett
Published: July 2021

Background

The recent pandemic has made it more challenging to assess patients with suspected obstructive sleep apnea (OSA) with in laboratory polysomnography (PSG) due to concerns of patient and staff safety. The purpose of this study was to assess how Level II sleep studies (LII, full PSG in the home) might be utilized in diagnostic algorithms of suspected OSA using a theoretical decision model.

Methods

We examined four diagnostic algorithms for suspected OSA: an initial PSG approach, an initial LII approach, an initial Level III approach (LIII, limited channel home sleep study) followed by PSG if needed, and an initial LIII approach followed by LII if needed. Costs per patient assessed was calculated as a function of pretest OSA probability and a variety of other variables (e.g. costs of tests, failure rate of LIII/LII, sensitivity/specificity of LIII). The situation in British Columbia was used as a case study.

Results

The variation in cost per test was calculated for each algorithm as a function of the above variables. For British Columbia, initial LII was the least costly across a broad range of pretest OSA probabilities (< 0.80) while initial LIII followed by LII as needed was least costly at very high pretest probability (> 0.8). In patients with a pretest OSA probability of 0.5, costs per patient for initial PSG, initial LII, initial LIII followed by PSG, and initial LIII followed by LII were: $588, $417, $607, and $481 respectively.

Conclusions

Using a theoretical decision model, we developed a preliminary cost framework to assess the potential role of LII studies in OSA assessment. Across a broad range of patient pretest probabilities, initial LII studies may provide substantial cost advantages. LII studies might be especially useful during pandemics as they combine the extensive physiologic information characteristic of PSG with the ability to avoid in-laboratory stays. More empiric studies need to be done to test these different algorithms.
Quality of life assessments in clinical practice using either the EORTC-QLQ-C30 or the SEIOQL-DW: a randomized study
Authors: Kettis Åsa , Fagerlind Hanna , Frödin Jan-Erik , Glimelius Bengt , Ring Lena
Published: July 2021

Background

Effective patient-physician communication can improve patient understanding, agreement on treatment and adherence. This may, in turn, impact on clinical outcomes and patient quality of life (QoL). One way to improve communication is by using patient-reported outcome measures (PROMs). Heretofore, studies of the impact of using PROMs in clinical practice have mostly evaluated the use of standardized PROMs. However, there is reason to believe that individualized instruments may be more appropriate for this purpose.

The aim of this study is to compare the effectiveness of the standardized QoL-instrument, the European Organization for Research and Treatment of Cancer Quality of Life C-30 (EORTC-QOL-C30) and the individualized QoL instrument, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), in clinical practice.

Methods

In a prospective, open-label, controlled intervention study at two hospital out-patient clinics, 390 patients with gastrointestinal cancer were randomly assigned either to complete the EORTC-QOL-C30 or the SEIQoL-DW immediately before the consultation, with their responses being shared with their physician. This was repeated in 3–5 consultations over a period of 4–6 months. The primary outcome measure was patients’ health-related QoL, as measured by FACIT-G. Patients’ satisfaction with the consultation and survival were secondary outcomes.

Results

There was no significant difference between the groups with regard to study outcomes. Neither intervention instrument resulted in any significant changes in health-related QoL, or in any of the secondary outcomes, over time. This may reflect either a genuine lack of effect or sub-optimization of the intervention. Since there was no comparison to standard care an effect in terms of lack of deterioration over time cannot be excluded.

Conclusions

Future studies should focus on the implementation process, including the training of physicians to use the instruments and their motivation for doing so. The effects of situational use of standardized or individualized instruments should also be explored. The effectiveness of the different approaches may depend on contextual factors including physician and patient preferences.
Economic study for blend membrane production
Authors: El-Gendi A. , Abdallah H. , Amin A.
Published: July 2021

Background

In this work, an economic study for production reverse osmosis (RO) membrane from a blend of polyvinylchloride (PVC) with cellulose acetate (CA) was investigated. The model for predicting RO membrane performance was developed based on laboratory experimental data. The economic study was conducted to investigate the feasibility of producing blend RO polyvinylchloride/cellulose acetate (PVC/CA) membrane using a large-scale batch casting machine was developed and fabricated in workshop in the National Research Centre, Egypt.

Results

The cost of the prepared blend membrane using batch casting machine technique reached to 36 $/m2 for flat sheet polymeric membrane which was cheaper than the cost of sheets of commercial RO membranes. The original capital investment will be recovered in 7.5 years with estimation of machine lifetime 25 years.

Conclusions

The economic study revealed that the establishing small factories to produce blend membranes using the fabricated machine is a promising and will create a reasonable profit.
Fetal imaging of a rare case of dural sinus malformation: a case report
Authors: Kaushik Kavya S. , Acharya Ullas V. , Ananthasivan Rupa , Girishekar Bhavana , Kalidindi Priyanka , Patil Pooja G.
Published: July 2021

Background

Dural sinus malformations (DSM) are rare congenital anomalies, accounting for less than 2% of all intracranial vascular malformations. Fetal MRI plays an important role in the confirmation of the diagnosis, prognostication, and planning of treatment strategies. Here, we present a rare case of dural sinus malformation without thrombosis, diagnosed by prenatal ultrasound and fetal MRI. In addition to this, fetal intracranial 3D gradient recalled echo Dixon-based MRA was done which, to the best of our knowledge, is a first.

Case presentation

A 24-year-old multigravida with no known comorbidities underwent a routine second trimester anomaly scan in which an unusual posterior interhemispheric cyst was diagnosed. Further evaluation with fetal MRI revealed dilated posterior sinuses and torcula, normal internal jugular vein, and maintained flow voids with no mass effect. Fetal Dixon-based MRA and correlated Doppler revealed supply to the lesion by bilateral occipital arteries and posterior cerebral arteries. With these imaging features, a midline dural sinus malformation was diagnosed.

Conclusion

Dural sinus malformations should be considered in the differential diagnosis of unusual posterior fossa cystic lesions detected on antenatal ultrasound coupled with a colour Doppler examination. Prompt fetal MRI is essential to establish the diagnosis, identify intracranial complications and decide the postnatal treatment strategy, thereby possibly improving the postnatal outcome.
Cabergoline Stimulates Human Endometrial Stromal Cell Decidualization and Reverses Effects of Interleukin-1β In Vitro
Authors: Yu Jie , Berga Sarah L , Meng Qingying , Xia Mingjing , Kohout Trudy A , van Duin Marcel , Taylor Robert N
Published: July 2021

Context

Human embryonic implantation is regulated by neuroendocrine hormones, ovarian steroids, growth factors, and cytokines. Sympathetic innervation of the uterus also may play a role.

Objective

We tested the hypothesis that cabergoline (Cb), an agonist of type 2 dopamine receptors (DRD2), could influence endometrial decidualization in vitro.

Methods

Immunohistochemistry confirmed the presence of catecholaminergic neurons in human uterine tissue. DRD2 mRNA and protein expression in endometrial tissue and cells were validated by quantitative RT-PCR, cDNA microarrays, RNA sequencing, and Western blotting. Isolated human endometrial stromal cells (ESC) were subjected to dose-response and time-course experiments in the absence or presence of decidualizing hormones (10 nM estradiol, 100 nM progesterone, and 0.5 mM dibutyryl cAMP). In some cases, interleukin (IL)-1β (0.1 nM) was used as an inflammatory stimulus. Well-characterized in vitro biomarkers were quantified.

Results

DRD2 were maximally expressed in vivo in the mid-secretory phase of the cycle and upregulated in ESC in response to decidualizing hormones, as were classical (eg, prolactin) and emerging (eg, VEGF and connexin 43) differentiation biomarkers. Cabergoline treatment more than doubled decidual biomarker expression, whereas risperidone, a dopamine receptor antagonist, inhibited ESC differentiation by >50%. Cabergoline induced characteristic decidual morphology changes and blocked detrimental effects of IL-1β on decidual cytology.

Conclusion

Our results support the hypothesis that dopaminergic neurons modulate decidualization in situ. We postulate that dopamine agonists, like Cb, could be developed as therapeutic agents to enhance implantation in couples with inflammation-associated infertility.
Day-of-Surgery Gabapentinoids and Prolonged Opioid Use: A Retrospective Cohort Study of Medicare Patients Using Electronic Health Records
Authors: Young Jessica C. , Dasgupta Nabarun , Chidgey Brooke A. , Stürmer Til , Pate Virginia , Hudgens Michael , Jonsson Funk Michele
Published: July 2021

BACKGROUND:

While preoperative gabapentinoids are commonly used in surgical multimodal analgesia protocols, little is known regarding the effects this therapy has on prolonged postsurgical opioid use. In this observational study, we used data from a large integrated health care system to estimate the association between preoperative day-of-surgery gabapentinoids and the risk of prolonged postsurgical opioid use.

METHODS:

We identified adults age ≥65 years undergoing major therapeutic surgical procedures from a large integrated health care system from 2016 to 2019. Exposure to preoperative gabapentinoids on the day of surgery was measured using inpatient medication administration records, and the outcome of prolonged opioid use was measured using outpatient medication orders. We used stabilized inverse probability of treatment-weighted log-binomial regression to estimate risk ratios and 95% confidence intervals (CIs) of prolonged opioid use, comparing patients who received preoperative gabapentinoids to those who did not and adjusting for relevant clinical factors. The main analysis was conducted in the overall surgical population, and a secondary analysis was conducted among procedures where at least 30% of all patients received a preoperative gabapentinoid.

RESULTS:

Overall, 13,958 surgical patients met inclusion criteria, of whom 21.0% received preoperative gabapentinoids. The observed 90-day risk of prolonged opioid use following surgery was 0.91% (95% CI, 0.77–1.08). Preoperative gabapentinoid administration was not associated with a reduced risk of prolonged opioid use in the main analysis conducted in a broad surgical population (adjusted risk ratio [adjRR], 1.19 [95% CI, 0.67–2.12]) or in the secondary analysis conducted in patients undergoing colorectal resection, hip arthroplasty, knee arthroplasty, or hysterectomy (adjRR, 1.01 [95% CI, 0.30–3.33]).

CONCLUSIONS:

In a large integrated health system, we did not find evidence that preoperative gabapentinoids were associated with reduced risk of prolonged opioid use in patients undergoing a broad range of surgeries.
The RNA-binding protein Puf5 contributes to buffering of mRNA upon chromatin-mediated changes in nascent transcription
Authors: Kochan David Z. , Mawer Julia S. P. , Massen Jennifer , Tishinov Kiril , Parekh Swati , Graef Martin , Spang Anne , Tessarz Peter
Published: July 2021

Gene expression involves regulation of chromatin structure and transcription, as well as processing of the transcribed mRNA. While there are feedback mechanisms, it is not clear whether these include crosstalk between chromatin architecture and mRNA decay. To address this, we performed a genome-wide genetic screen using a Saccharomyces cerevisiae strain harbouring the H3K56A mutation, which is known to perturb chromatin structure and nascent transcription. We identified Puf5 (also known as Mpt5) as essential in an H3K56A background. Depletion of Puf5 in this background leads to downregulation of Puf5 targets. We suggest that Puf5 plays a role in post-transcriptional buffering of mRNAs, and support this by transcriptional shutoff experiments in which Puf5 mRNA targets are degraded slower in H3K56A cells compared to wild-type cells. Finally, we show that post-transcriptional buffering of Puf5 targets is widespread and does not occur only in an H3K56A mutant, but also in an H3K4R background, which leads to a global increase in nascent transcription. Our data suggest that Puf5 determines the fate of its mRNA targets in a context-dependent manner acting as an mRNA surveillance hub balancing deregulated nascent transcription to maintain physiological mRNA levels.
Olefination of Aldehydes with Ethyl Diazoacetate Catalyzed by Nitrogen-doped Carbon-supported Metal
Authors: Yasukawa Tomohiro , Kume Sanshiro , Yamashita Yasuhiro , Kobayashi Shū
Published: July 2021

Nitrogen-doped carbon-supported Co/Cu bimetallic catalysts were found to catalyze olefination of aldehydes with ethyl diazoacetate. In the presence of triaryl phosphine with electron-withdrawing groups, various aromatic aldehydes could be converted into unsaturated esters in good to high yields. The system is heterogeneous, allowing for recovery and reuse of the catalyst for several runs without significant loss of activity.
Chiral Vanadium(V)-catalyzed Oxidative Coupling of 4-Hydroxycarbazoles
Authors: Kamble Ganesh T , Salem Mohamed S H , Abe Tsukasa , Park Hanseok , Sako Makoto , Takizawa Shinobu , Sasai Hiroaki
Published: July 2021

Enantioselective oxidative couplings of 4-hydroxycarbazoles using a chiral dinuclear vanadium(V) complex have been achieved for the first time. Under the mild reaction conditions, the corresponding dimeric 4-hydroxycarbazoles were obtained in up to 90% ee.
Extension of the Linear Response Function of Electron Density to a Plane-wave Basis and the First Application to Periodic Surface Systems
Authors: Maruyama Tomohiro , Ohnari Jinta , Tada Kohei , Hinuma Yoyo , Kawakami Takashi , Yamanaka Shusuke , Okumura Mitsutaka
Published: July 2021

This paper proposed using the linear response function (LRF) of Kohn-Sham orbitals for checking the convergence regarding thickness in periodic slab-and-vacuum model calculations. The effectiveness was demonstrated using the alkaline earth metal oxide (001) surface. The calculated LRF decreases and converges to zero toward the opposite side of a slab. The proposed LRF scheme can be used as a guide to judge convergence of the slab thickness.
Cervical solitary fibrous tumor: case report and literature review
Authors: Yamada Camilla Akemi Felizardo , Narvaez Eduardo de Oliveira , Yamaki Vitor Nagai , Pfann Robert Zawadzki , Neville Iuri Santana , Amaral Lázaro Luís Faria do
Published: July 2021

Solitary fibrous tumors (SFTs) are rare neoplasms in the spinal canal. There are few studies addressing SFT/hemangiopericytomas with no distinctive clinical characteristics, no conclusive radiological findings or even a well-defined best treatment strategy. We described a rare case of cervical SFT/hemangiopericytomas in a young patient with spinal cord compression. There are many differential diagnoses for spinal dural-based masses of which meningiomas are the most common. Surgeons and oncologists should be aware of differentials of dural-based masses in the spinal cord for surgical decision making and to guide treatment.
A rare case: Spontaneous gastric fistula from a hydatid cyst of the liver
Authors: Onka Behyamet , Benmoula Fatima Zohra , Traore Wend-Yam Mohamed , Mohamed Daoud Ali , Khouchoua Selma , Nassar Ittimade , Moatassim Billah Nabil
Published: July 2021

The hydatid cyst is a worldwide anthropozoonosis, which constitutes a health issue in Northern Africa. It may involve any organ, but it mostly affects the liver. This often asymptomatic disease can lead to multiple complications. Among them, spontaneous fistulization of a hepatic hydatid cyst in the stomach is exceptional even in endemic countries. We report the case of a 38-year-old female with febrile biliary colics due to a hydatid cyst of the liver fistulized in the stomach. The diagnosis was established based upon different clinical, biological and mainly radiological features. She received surgical treatment with satisfactory postoperative outcome.
The March 2021 Thessaly earthquakes and their impact through the prism of a multi-hazard approach in disaster management
Authors: Mavroulis Spyridon , Mavrouli Maria , Carydis Panayotis , Agorastos Konstantinos , Lekkas Efthymis
Published: July 2021

In early March 2021, when Greece was struggling with the evolving third wave of the COVID-19 pandemic with the highest numbers of daily cases and fatalities from its initiation, Thessaly was struck by a seismic sequence, which included the 3 March, Mw = 6.3 mainshock, its strongest Mw = 6.1 aftershock the following day and numerous large aftershocks. The mainshock caused extensive damage to houses and infrastructure, while the aftershock aggravated damage and caused widespread concern among residents. Based on post-event field surveys in the affected area, it is concluded that the old unreinforced houses with load-bearing masonry walls in the northeastern part of the Thessaly basin suffered the most, while the recent constructions remained intact. As a result, hundreds of homeless were in need of immediate temporary sheltering, which immediately mobilized the Civil Protection authorities to manage the emergency situation. This emergency had something unique, which made its management a challenge: the implementation of the earthquake emergency response actions was incompatible with the measures to limit the further spread of the SARS-CoV-2 virus in the community during the evolving third pandemic wave. Many of the actions have been adapted to the unprecedented conditions through a prism of a multi-hazard approach to disaster management and their impact. Among others, more and different types of emergency shelters were used to prevent overcrowding, emergency supplies distribution processes were modified to prevent transmission through hands and surfaces, places for the identification and isolation of suspected COVID-19 cases were designated in emergency shelters and extensive and regular screening testing of the local population was conducted for the detection of SARS-CoV-2 virus. From the analysis of the daily reported COVID-19 cases in the earthquake-affected area during the pre- and post- disaster periods as well as from results of rapid testing during the post-disaster period, it was found that the viral load of the earthquake-affected villages was not increased, despite the difficult and unprecedented conditions. It can be suggested that the adaptation of the measures to the new conditions has worked beneficially to reduce the spread of the new virus among those affected and the involved staff. For this reason, this approach could be considered as good practice and important lesson learned, which can be applied to similar future compound emergencies in areas with similar geoenvironmental and epidemiological characteristics.
Το μάθημα της φυσικής αγωγής στη Μακεδονία κατά την περίοδο της Οθωμανικής Αυτοκρατορίας.
Authors: Μίλης Νικόλαος
Published: July 2021

Αντικείμενο της παρούσας ερευνητικής εργασίας είναι η μελέτη του μαθήματος της Φυσικής Αγωγής κατά την περίοδο της Οθωμανικής Αυτοκρατορίας στα διάφορα εκπαιδευτικά ιδρύματα στον ευρύτερο χώρο της Μακεδονίας. Το χρονικό πλαίσιο που εξετάζεται, αρχίζει περίπου από τα μέσα του 19ου αιώνα, περίοδος που ξεκινά η συστηματική εκπαίδευση στη Μακεδονία, έως το 1912-13 όπου η Μακεδονία μετά το τέλος των Βαλκανικών Πολέμων εντάσσεται εξ’ ολοκλήρου στο ελληνικό κράτος.
Who asked you? Young People and practitioners identify ways to facilitate access to mental health supports
Authors: Colleran Ann , O'Connor Anne , Hogan Michael J. , Harney Owen M. , Durand Hannah , Hanlon Michelle
Published: July 2021

Background: Despite representing the highest level of total population mental health burden, young people are the least likely to seek help from mental health services. It has been suggested that service design can influence the likelihood that young people will look for help, but little is known about how young people would like a service to be designed. This study addresses a gap in research regarding how mental health services can be designed to facilitate access for young people.                         

Methods: A collective intelligence, scenario-based design methodology was used to facilitate stakeholders to identify and prioritise ways to improve youth mental health services. In total, 74 15–17-year-olds from three geographically diverse schools in Ireland worked to identify barriers to help-seeking and to generate and prioritise options in response to barriers. Nine practitioners with experience of working in youth mental health services rated all options in terms of both potential impact on help-seeking and feasibility for service implementation.

Results: A total of 326 barriers across 15 themes were generated by youth stakeholders, along with 133 options in response to barriers. Through a process of voting, young people identified 30 options as the most impactful for improving access to mental health services. Of these options, 12 were also rated by practitioners as having both high potential impact and high feasibility. These 12 options focused on four areas: making services more familiar and welcoming; providing specialist mental health input in schools; improving parental understanding; and improving the visibility of appropriate supports.

Conclusions: The results of the current study inform mental health service innovation and development, in particular, by highlighting potentially impactful and feasible ways to adapt existing mental health services to improve young people’s help-seeking behaviour.