bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic management of idiopathic subglottic stenosis in pregnancy
Authors: Kanzara Todd , Rotman Anthony , Kinshuck Andrew , Al Yaghchi Chadwan , Tan Min Yi , Yu Christina , Sandu Guri 
Published: February 2021

Aims To describe the use of laser, endoscopic balloon dilatation with jet ventilation anaesthesia in the treatment of pregnant women with idiopathic subglottic stenosis. Materials and methods This is a case review of pregnant women with idiopathic subglottic stenosis, presenting to a tertiary referral centre with worsening breathlessness. Data were extracted from patient case notes. Results Four women underwent surgical management of subglottic stenosis in pregnancy. One patient required two procedures during the course of their pregnancy due to restenosis. All women had improvement in symptoms post-operatively and went on to deliver healthy babies at term. Conclusion Endoscopic balloon dilatation of idiopathic subglottic stenosis is a safe and viable treatment option in pregnancy and should be offered as first-line treatment in symptomatic women.
Clinical evaluation of preoperative embolization, vertebroplasty, and decompression in the treatment of aggressive vertebral hemangiomas
Authors: Xu Derong , Kong Meng , Zhu Kai , Han Xing , Zhang Wenwei , Zeng Xiangxu , Zhou Chuanli , Ma Xuexiao 
Published: February 2021

Objective: To evaluate the efficacy and safety of preoperative embolization and vertebroplasty in the treatment of aggressive hemangioma. Methods: A retrospective clinical review of patients diagnosed with aggressive vertebral hemangiomas was conducted. All the patients were assigned to three groups according to the treatment strategies: patients in Group A underwent embolization and decompression with internal fixation, patients in Group B underwent vertebroplasty and decompression with internal fixation, patients in Group C received all three treatments. Clinical indexes were compared within three groups. Results: There were 16 patients received embolization and decompression (Group A), 19 patients underwent decompression with vertebroplasty (Group B) and 16 patients in Group C. The operative duration of patients in group A (198.33 ± 38.43 min) were less than another two groups ( p = 0.001). The intraoperative blood loss of patients in group C was 713.33 ± 165.13 mL, which was significantly less than group A and group B ( p = 0.045). Patients in group C exhibited the lowest volume of drainage on POD 1 (178.33 ± 66.76 mL), which showed significant difference compared with group A (368.33 ± 191.15 mL, p = 0.01). There was no significant difference of preoperative and postoperative VAS and JOA score among three groups, as well as drainage on POD 2, total volume and hospital duration. Conclusion: Both embolization and vertebroplasty are efficient and safe measures to reduce blood loss in the surgical treatment of aggressive vertebral hemangiomas, combination of all three methods is also competent.
Effects of intermittent pneumatic compression on femoral vein peak venous velocity during active ankle exercise
Authors: Sakai Kenta , Takahira Naonobu , Tsuda Kouji , Akamine Akihiko 
Published: February 2021

Introduction: The risk of developing deep vein thrombosis (DVT) is high even after the period of bed rest following major general surgery including total joint arthroplasty (TJA). Mobile intermittent pneumatic compression (IPC) devices allow the application of IPC during postoperative exercise. Although ambulation included ankle movement, no reports have been made regarding the effects of IPC during exercise, including active ankle exercise (AAE), on venous flow. This study was performed to examine whether using a mobile IPC device can effectively augment the AAE-induced increase in peak velocity (PV). Methods: PV was measured by Doppler ultrasonography in the superficial femoral vein at rest, during AAE alone, during IPC alone, and during AAE with IPC in 20 healthy subjects in the sitting position. PV in AAE with IPC was measured with a mobile IPC device during AAE in the strong compression phase. AAE was interrupted from the end of the strong compression phase to minimize lower limb fatigue. Results: AAE with IPC (76.2 cm/s [95%CI, 69.0–83.4]) resulted in a significant increase in PV compared to either AAE or IPC alone (47.1 cm/s [95%CI, 38.7–55.6], p < 0.001 and 48.1 cm/s [95%CI, 43.7–52.4], p < 0.001, respectively). Discussion: Reduced calf muscle pump activity due to the decline in ambulation ability reduced venous flow. Therefore, use of a mobile IPC device during postoperative rehabilitation in hospital and activity including self-training in an inpatient ward may promote venous flow compared to postoperative exercise without IPC. Conclusion: Use of a mobile IPC device significantly increased the PV during AAE, and simultaneous AAE with IPC could be useful evidence for the prevention of DVT in clinical settings, including after TJA.
Molecular investigation of an outbreak associated with total parenteral nutrition contaminated with NDM-producing Leclercia adecarboxylata
Authors: Garza-González Elvira , Bocanegra-Ibarias Paola , Rodríguez-Noriega Eduardo , González-Díaz Esteban , Silva-Sanchez Jesús , Garza-Ramos Ulises , Contreras-Coronado-Tovar Iván Fernando , Santos-Hernández José Ecil , Gutiérrez-Bañuelos David , Mena-Ramirez Juan Pablo , Ramírez-De-los-Santos Saúl , Camacho-Ortiz Adrián , Morfín-Otero Rayo 
Published: February 2021

Abstract
Background
This study aimed to determine the epidemiological, microbiological, and molecular characteristics of an outbreak of carbapenem-resistant Leclercia adecarboxylata in three hospitals associated with the unintended use of contaminated total parental nutrition (TPN).

Methods
For 10 days, 25 patients who received intravenous TPN from the same batch of a formula developed sepsis and had blood cultures positive for L. adecarboxylata. Antimicrobial susceptibility and carbapenemase production were performed in 31 isolates, including one from an unopened bottle of TPN. Carbapenemase-encoding genes, extended-spectrum β-lactamase–encoding genes were screened by PCR, and plasmid profiles were determined. Horizontal transfer of carbapenem resistance was performed by solid mating. Clonal diversity was performed by pulsed-field gel electrophoresis. The resistome was explored by whole-genome sequencing on two selected strains, and comparative genomics was performed using Roary.

Results
All 31 isolates were resistant to aztreonam, cephalosporins, carbapenems, trimethoprim/sulfamethoxazole, and susceptible to gentamicin, tetracycline, and colistin. Lower susceptibility to levofloxacin (51.6%) and ciprofloxacin (22.6%) was observed. All the isolates were carbapenemase producers and positive for blaNDM-1, blaTEM-1B, and blaSHV-12 genes. One main lineage was detected (clone A, 83.9%; A1, 12.9%; A2, 3.2%). The blaNDM-1 gene is embedded in a Tn125-like element.
Genome analysis showed genes encoding resistance for aminoglycosides, quinolones, trimethoprim, colistin, phenicols, and sulphonamides and the presence of IncFII (Yp), IncHI2, and IncHI2A incompatibility groups. Comparative genomics showed a major phylogenetic relationship among L. adecarboxylata I1 and USDA-ARS-USMARC-60222 genomes, followed by our two selected strains.

Conclusion
We present epidemiological, microbiological, and molecular evidence of an outbreak of carbapenem-resistant L. adecarboxylata in three hospitals in western Mexico associated with the use of contaminated TPN.
‘Menstruation means impurity’: multilevel interventions are needed to break the menstrual taboo in Nepal
Authors: Thapa Subash , Aro Arja R. 
Published: February 2021

Abstract
Background
During their menstrual period, women are generally considered impure in Nepal; in the rural areas of the western part of the country, they are even banished to stay in sheds (called chhaupadi) during this time, which increases their vulnerability to a variety of health consequences. There is lack of clarity regarding the effectiveness of interventions that have been implemented to address menstrual taboo and improve menstrual hygiene and practices in Nepal (e.g., public awareness, community sensitization and legislation). In this paper, we discuss why menstruation management interventions, particularly those implemented to change the menstrual taboo might not work, and the opinions and experiences regarding the implementation of such interventions.

Main text
Anecdotal reports from the field and empirical studies suggest that interventions to address menstrual taboos have only been effective for short durations of time due to several reasons. First, local community stakeholders have been reluctant to take actions to abandon retrogressive menstrual practices in rural areas. Second, women who have stopped practising chhaupadi have faced stigma (e.g., fear of exclusion) and discrimination (e.g., blaming, physical and verbal abuse). Third, contextual factors, such as poverty and illiteracy, limit the effectiveness of such interventions. Fourth, community sensitization activities against chhaupadi have faced resistance from community leaders and traditional healers. Fifth, the law prohibiting chhaupadi has also faced implementation problems, including poor filing of complaints.

Conclusion
Multilevel, multisectoral interventions could be more effective than single-component interventions in breaking the prevailing menstrual taboo and in improving menstrual health and hygiene practices among young girls and women in the rural areas of Nepal. Moreover, interventions that have an active community mobilization component could be effective within local contexts and cultural groups.
Economic burden of moderate to severe burns and its association with health-related quality of life of Nigerian women
Authors: Chinweuba Anthonia U. , Chinweuba Ifunanya S. , Diorgu Faith C. , Ubochi Nneka E. , Ezeruigbo Chinwe S. , Wasini Kenneth B. , Nnabuenyi Anthonia I. 
Published: February 2021

Abstract
Background
Burns cases are frequent in Nigeria hospitals, however, literature on its economic burden and the association with health-related quality of life (HRQOL) of women in Nigeria is scarce. This study determined the burden of hospitalization after burns on women’s economic status and its associated HRQOL.

Methods
This was a three-month cross-sectional study of female patients ≥ 25 years, treated of mixed or full thickness burns in four teaching hospitals in south-east Nigeria, discharged between September–November, 2018. Study instruments were participants’ case notes for socio-demographic and disease history, interviewer-administered questionnaires, namely-economic-burden-of-burns questionnaire and English version of the EuroQol Five-Dimensions-Three-Level Health Questionnaire for Nigeria. Data were collected on second- or third-day post-discharge through home visits or phone calls. This lasted for 13 weeks.

Results
A total of seventy-three female patients with burn were successfully enrolled. Most participants were married, fairly educated, mainly traders or housewives. Thirty-four (46.6%) had subjective estimated family monthly income below NGN 50,000 (low economic status). Participants’ average monthly income reduced drastically after hospitalization. Their average family monthly income was NGN110,439 (USD307), while their average total expenses incurred during hospitalization was NGN691,093 (USD1,920). Almost all (93.2%) had at least one surgical intervention during management. Their average length of hospital stay was 35.4 days; eleven consequently lost their job. Many had moderate to severe economic burden of treatment; only eleven could bear all the treatment expenses independently. Anxiety/depression and pain/discomfort were common problems reported, However, these Euroqol dimensions varied according to their SES, education and occupation. Women in the low economic class were more inclined to poor HRQOL (Mean ± SD VAS = 53.33 ± 17.619) than women in high economic class (Mean ± SD VAS = 76.67 ± 21.794).

Conclusion
Burns places high level of economic burden on women and unfortunately, Nigerian government’s commitment to healthcare of burns patients is low. The long course of hospitalization and economic depletion impact negatively on the women’s HRQOL. Based on these findings, we recommend that government parastatals create special trust fund for burns treatment and the National Health Insurance Scheme be restructured for more accessibility.
A powerful qPCR-high resolution melting assay with taqman probe in Plasmodium species differentiation
Authors: Lamien-Meda Aline , Fuehrer Hans-Peter , Leitsch David , Noedl Harald 
Published: February 2021

Abstract
Background
The use of highly sensitive molecular tools in malaria diagnosis is currently largely restricted to research and epidemiological settings, but will ultimately be essential during elimination and potentially eradication. Accurate diagnosis and differentiation down to species levels, including the two Plasmodium ovale species and zoonotic variants of the disease, will be important for the understanding of changing epidemiological patterns of the disease.

Methods
A qPCR-high resolution melting (HRM) method was to detect and differentiate all human Plasmodium species with one forward and one reverse primer set. The HRM detection method was further refined using a hydrolysis probe to specifically discriminate Plasmodium falciparum.

Results
Out of the 113 samples tested with the developed HRM-qPCR- P. falciparum probe assay, 96 (85.0 %) single infections, 12 (10.6 %) mixed infections, and 5 (4.4 %) were Plasmodium negative. The results were concordant with those of the nested PCR at 98.2 %. The assay limit of detection was varied from 21.47 to 46.43 copies /µl, equivalent to 1–2.11 parasites/µl. All P. falciparum infections were confirmed with the associated Taqman probe.

Conclusions
Although the dependence on qPCR currently limits its deployment in resource-limited environments, this assay is highly sensitive and specific, easy to perform and convenient for Plasmodium mono-infection and may provide a novel tool for rapid and accurate malaria diagnosis also in epidemiological studies.
Uterine metabolic disorder induced by silica nanoparticles: biodistribution and bioactivity revealed by labeling with FITC
Authors: Duan Shuyin , Zhang Meihua , Li Junxia , Tian Jiaqi , Yin Haoyu , Wang Xietong , Zhang Lin 
Published: February 2021

AbstractExtensive application of nanomaterials has dramatically increased the risk of silica nanoparticle (SiNP, SiO2) exposure, yet their biological effect on reproduction has not been fully elucidated. By tracking the uterine biodistribution of SiNP in pregnant mice, this study was conducted to evaluate the biological effect of SiNP on reproduction. First, SiNP was conjugated with FITC, and then the FITC-SiNP was administrated to trophoblast (100 µg/mL, 24 h) in vitro and pregnant mice (0.25 mg/mouse, 2–24 h) in vivo. It was found that the FITC-SiNP was internalized by trophoblast and deposited in the uterus. The internalization of SiNP caused trophoblast dysfunction and apoptosis, while SiNP accumulation in the uterus induced diffuse inflammatory infiltration. The genome-wide alteration of gene expression was studied by high throughput sequencing analysis, where 75 genes were found to be dysregulated after SiNP exposure, among which ACOT2, SCD1, and CPT1A were demonstrated to regulate the biosynthesis of unsaturated fatty acids. Moreover, the suppression of unsaturated fatty acids caused mitochondrial overload of long-chain fatty acyl-CoA (LACoA), which further induced both trophoblast apoptosis and endometrial inflammation. In conclusion, the successful conjugation of FITC onto SiNP facilitated the tracking of SiNP in vitro and in vivo, while exposure to FITC-SiNP induced uterine metabolic disorder, which was regulated by the ACOT/CPT1A/SCD1 axis through the biosynthesis of unsaturated fatty acids signaling pathway.
High lymphocyte population-related predictive factors for a long-term response in non-small cell lung cancer patients treated with pemetrexed: a retrospective observational study
Authors: Sumiyoshi Issei , Okabe Takahiro , Togo Shinsaku , Takagi Haruhi , Motomura Hiroaki , Ochi Yusuke , Shimada Naoko , Haraguchi Mizuki , Shibayama Rina , Fujimoto Yuichi , Watanabe Junko , Iwai Moe , Kadoya Kotaro , Iwakami Shin-ichiro , Takahashi Kazuhisa 
Published: February 2021

Abstract
Background
Regimens combining pemetrexed (PEM) and immune checkpoint inhibitors (ICIs) targeting programmed cell death-1 (PD-1) or programmed death-ligand 1 (PD-L1) are widely used for the treatment of advanced non-squamous non-small-cell lung cancer (NSq-NSCLC). Recently, PEM was shown to induce immunogenic cell death (ICD) and to enhance immune-regulatory genes. Some patients demonstrate an extremely long-term response to PEM. It is possible that the continued response in these patients is dependent on not only the pharmacological induction of cytotoxic cell death but also antitumor immunity. However, factors that can predict outcomes associated with long-term PEM administration using blood test results have not yet been elucidated. We investigated the clinical characteristics and predictive factors in patients with advanced NSq-NSCLC who underwent long-term PEM maintenance therapy.

Methods
In total, 504 patients with advanced NSq-NSCLC who received PEM combination therapy/monotherapy (n = 414) or paclitaxel (PTX) combination therapy (n = 90) between January 2010 and November 2019 were recruited; 381 patients were retained for the final analysis. Patients treated with PEM (n = 301) were divided into subgroups according to the total cycles of PEM (≥ 17 [n = 25] for the long-term administration group and ≤ 16 [n = 276] for the intermediate/short-term group) and compared with another population (n = 80) treated with PTX combination regimen. We investigated clinical features and predictive biomarkers, focusing on immune-regulatory factors, absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), and PD-1 and PD-L1 expression, to predict long-term response to PEM.

Results
The long-term PEM administration group exhibited a higher ALC and a lower NLR than the shorter-term group did. Both these markers displayed greater association with progression-free survival and overall survival in the PEM combination therapy group than in the PTX combination therapy group. Increased PD-1 lymphocytes were associated with the long-term PEM response group, as PD-L1 expression in tumors was associated with a high incidence of immune-related adverse effects following ICI administration.

Conclusions
ALC, NLR, and PD-1 expression are PEM-mediated predictive biomarkers that are indirectly related to tumor immunity and can provide useful predictive information on the long-term response to PEM in patients with NSq-NSCLC.
Study of a nonlinear multi-terms boundary value problem of fractional pantograph differential equations
Authors: Bahar Ali Khan Muhammad , Abdeljawad Thabet , Shah Kamal , Ali Gohar , Khan Hasib , Khan Aziz 
Published: February 2021

AbstractIn this research work, a class of multi-term fractional pantograph differential equations (FODEs) subject to antiperiodic boundary conditions (APBCs) is considered. The ensuing problem involves proportional type delay terms and constitutes a subclass of delay differential equations known as pantograph. On using fixed point theorems due to Banach and Schaefer, some sufficient conditions are developed for the existence and uniqueness of the solution to the problem under investigation. Furthermore, due to the significance of stability analysis from a numerical and optimization point of view Ulam type stability and its various forms are studied. Here we mention different forms of stability: Hyers–Ulam (HU), generalized Hyers–Ulam (GHU), Hyers–Ulam Rassias (HUR) and generalized Hyers–Ulam–Rassias (GHUR). After the demonstration of our results, some pertinent examples are given.
Analyzing the contribution of crop diversification in improving household food security among wheat dominated rural households in Sinana District, Bale Zone, Ethiopia
Authors: Mengistu Dereje Derso , Degaga Degefa Tolossa , Tsehay Abraham Seyoum 
Published: February 2021

Abstract
Background
Agriculture is considered an important strategy for overcoming many of the emergencies faced by rural households in developing countries. In rural Ethiopia household access to food largely depends on what the household grows, either because they consume what they grow, or they purchase food with the income earned from what they grow. This study examines effect of crop diversification on food security and determinants of household food security among rural farm households of Sinana District, Oromia Regional state. The study uses a multi stage sampling procedure to select 384 sample households. Data were collected using a household survey, a focus group discussant (FGD), and key informant interviews. Ordinary least squares regression (OLS) and multinomial logistic regression model were used to analyze the data collected.

Results
We found that crop diversification had a positive and significant effect on household food security. Although crop diversification was positively associated with household food security, several other factors were found to be as or more important in increasing household food security. The education of the household head, access to irrigation system, livestock owned, total income, and remittance positively affected household food security. In contrast, age of household head and distance to nearest market were negatively associated with food security.

Conclusions
The study conclude that any effort to increase household food security should consider empowerment of farmers through adequate training and informal education, enhancing crop diversification, strengthening the rural infrastructural development (roads, market centers, and cooperatives).
Severe Bone Microarchitecture Impairment in Women With Pregnancy and Lactation-Associated Osteoporosis
Authors: Scioscia Maria Florencia , Vidal Maritza , Sarli Marcelo , Guelman Rodolfo , Danilowicz Karina , Mana Daniela , Longobardi Vanesa , Zanchetta María Belén 
Published: February 2021

Abstract

Context
Pregnancy- and lactation-associated osteoporosis (PLO) is a rare condition characterized by fragility fractures, mostly vertebral, during the third trimester of pregnancy or the early postpartum period.

Objective
The aim of this study was to evaluate bone microarchitecture in women with PLO to better understand the pathophysiology of this disease.

Methods
In this retrospective study, we included women with PLO referred to our bone center between November 2007 and July 2012. We assessed bone mineral density (BMD) by dual-energy x-ray absorptiometry, bone turnover markers, and bone microarchitecture by high-resolution peripheral quantitative computed tomography. Results were compared with a control group of healthy lactating women.

Results
Of the 7 primiparous patients with PLO, 6 suffered vertebral fractures and 1 developed a hip fracture during the seventh month of gestation. Fractures occurred within the eighth month of pregnancy and the fourth month post partum; vertebral fractures were multiple in 85.7%. Major or minor risk factors for osteoporosis were present in 86% of our patients. Trabecular density, number, and thickness were 34%, 20% and 22% lower than controls (P &lt; .01, P = .01, and P = .01, respectively). Cortical parameters were also deteriorated but to a lesser extent.

Conclusion
In comparison with healthy lactating women, patients with PLO presented severe deterioration of bone trabecular and cortical microarchitecture. This significant compromise may explain the occurrence of multiple fractures in these otherwise healthy young women. Further prospective studies are needed to determine whether bone microarchitecture might be able to be restored in the future.