bluuebunny/crossref_metadata_2025 huggingface dataset:
Microwave-induced hyperthermia in situ in the treatment of tumors of proximal humerus: long-term results with functionary sparing surgery
Authors: Pang Cheng-gang , Huang Zhi-fa , Ji Shao-lin , Zhang Hong , Zhao Yun-long , Hu Yong-cheng
Published: June 2023

Background

The present study aimed to evaluate the indications, feasibility, clinical effectiveness and complications of the treatment with microwave in situ inactivation followed by curettage and bone grafting assisted with internal fixation, for the proximal humerus tumors.

Methods

The clinical data of 49 patients with primary or metastatic tumor of the proximal humerus who received intraoperative microwave inactivation in situ with curettage and bone grafting in our hospital from May 2008 to April 2021 were retrospectively analyzed.

Results

There were 25 males and 24 females, with an average age of 57.6 ± 19.9 years (range, 20–81). All patients were followed up for 7 to 146 months, with an average period of 69.2 ± 39.8 months. Up to the last follow-up, 14 patients died. The 5-year overall survival was 67.3%, and 5-year tumor-specific survival was 71.4%. The 5-year tumor-specific survival rates were 100% for aggressive benign tumors or low potential malignancy tumors, 70.1% for primary malignancies, and 36.9% for metastatic tumors. The average preoperative MSTS, constant-Murley and VAS scores were 16.81 ± 3.85, 62.71 ± 12.56 and 6.75 ± 2.47, which were all significantly improved at 6 weeks after operation and at the final follow-up (P < 0.05).

Conclusions

Microwave inactivation in situ and curettage and bone grafting are a feasible treatment for tumors of proximal humeral, especially for malignant tumors and metastases, without the necessity of the replacement of the shoulder, with little trauma and good upper limb function, and with low local recurrence and distant metastasis.
Evaluation of primary wound healing and potential complications after perioperative infiltration with lidocaine without adrenaline in surgical incisions in dogs and cats
Authors: Herlofson Erica Anna Gumpert , Tavola Francesca , Engdahl Karolina Siri , Bergström Annika Filippa
Published: June 2023

Background

Pre-emptive local analgesia with the use of lidocaine is practised increasingly in veterinary medicine as part of applied multimodal analgesia, despite its controversial impact on wound healing. The purpose of this prospective, randomised, double-blinded, placebo-controlled clinical study was to evaluate if preoperative subcutaneous infiltration of lidocaine has a negative impact on primary wound healing of surgical incisions. Fifty-two companion animals (3 cats and 49 dogs) were enrolled in the study. The inclusion criteria were as follows: American Society of Anaesthesiologists (ASA) score I or II, a minimum body weight of 5 kg, and a planned incisional length of at least 4 cm. Surgical incisions were infiltrated subcutaneously with lidocaine without adrenaline or NaCl (placebo). Follow-up questionnaires for owners and veterinarians and thermography of the surgical wound were used to assess wound healing. Antimicrobial use was documented.

Results

There was no significant difference in either the total score or the individual assessment points between the treatment and the placebo group on the owner or the veterinary questionnaires in regard to primary wound healing (P > 0.05 for all comparisons). No significant difference was found between the thermography results of the treatment and placebo group (P = 0.78), and there was no significant correlation between the total score from the veterinary protocol and thermography results (Spearman’s correlation coefficient − 0.10, P = 0.51). Surgical site infections developed in 5/53 (9.4%) surgeries and its occurrence varied significantly between the treatment and the placebo group as all cases of infection were in the placebo group (P = 0.05).

Conclusion

The results of this study indicate that lidocaine used as a local anaesthetic did not affect wound healing in patients with ASA scores I-II. The results suggest that lidocaine infiltration in surgical incisions can be safely used to reduce pain.
Comparison of below‐knee and above‐knee amputations with demographic, comorbidity, and haematological parameters in patients who died
Authors: Hançerli Cafer Özgür , Doğan Necati
Published: June 2023

Background

This study aimed to establish mortality predictive parameters with a higher contribution to mortality by comparing the demographic data, comorbid factors, and haematological values of patients who underwent below‐knee and above‐knee amputation and had died during the follow‐up period.

Materials and methods

Between March 2014 and January 2022, 122 patients in a single centre who developed foot gangrene due to chronic diabetes and underwent below‐knee or above‐knee amputation were evaluated retrospectively. Patients who died of natural causes during the post‐operative period were included in the study. Those who were amputated below the knee were assigned to Group 1, and those who were amputated above the knee were assigned to Group 2. The patients' age, gender, side of amputation, comorbid diseases, American Society of Anaesthesiologists (ASA) score, Charlson comorbidity index (CCI), death time, and haematological values at the time of first admission were compared between the two groups and statistical analyses were performed.

Results

Group 1 (n = 50) and Group 2 (n = 37) had similar distributions in terms of age, gender, side of operation, number of comorbidities, and CCI (p > 0.05). Group 2's mean ASA score and c‐reactive protein (CRP) levels were statistically higher than those of Group 1 (p < 0.05). Death time, albumin value, and HbA1c levels were statistically lower in Group 2 than in Group 1 (p < 0.05). There were no significant differences between the groups in haemogram, white blood cells (WBC), lymphocytes, neutrophils, creatinine, and Na values at the time of first admission (p > 0.05).

Conclusion

A high ASA score, low albumin value, and high CRP value were significant predictors of high mortality. Creatinine levels and HbA1c values were quite ineffective in predicting mortality.

Level of evidence

Level 3, retrospective comparative study.
Patient communication and experiences in cancer clinical drug trials: a mixed-method study at a specialist clinical trials unit
Authors: Forbes Shepherd Rowan , Bradford Ashleigh , Lieschke Marian , Shackleton Kylie , Hyatt Amelia
Published: June 2023

Background

As cancer therapies increase in their complexity, effective communication among patients, physicians, and research staff is critical for optimal clinical trial management. Currently, we understand little about on-trial communication practices and patient trial experiences over time. This mixed-method study explored patient experiences of participating in a clinical drug trial at different time points, focussing on patient communication with trial staff.

Methods

Patients enrolled in clinical drug trials conducted at the Parkville Cancer Clinical Trials Unit were invited to complete a tailored online survey and/or a qualitative interview. Patients were recruited to three cohorts based on time since the first trial treatment: new (≥ 1 to ≤ 13 weeks), mid- (≥ 14 to ≤ 26 weeks), and long-term (≥ 52 weeks) trial patients. Descriptive statistics were calculated for survey responses. Interview data were analysed thematically with a team-based approach. Survey and interview data were integrated at the intepretation stage.

Results

From May to June 2021, 210 patients completed a survey (response rate 64%, 60% male), 20 completed interviews (60% male), and 18 completed both. More long-term trial patients (46%) participated than new (29%) and mid-trial patients (26%). Survey data showed high (> 90%) patient satisfaction with the provision of trial information and communication with trial staff across trial stages, and many reported trial experiences as above and beyond standard care. Interview data indicated that written trial information could be overwhelming, and verbal communication with the staff and physicians was highly valued, especially for enrolment and side effect management among long-term patients. Patients described the key points along the clinical trial trajectory that merit close attention: clear and well-communicated randomisation practices, reliable pathways for side effect reporting and prompt response from the trial staff, and end-of-trial transition management to avoid a sense of abandonment.

Conclusion

Patients reported high overall satisfaction with trial management but outlined key pinch points requiring improved communication practices. Establishing a range of effective communication practices among trial staff and physicians with patients in cancer clinical trials may have a wide range of positive effects on patient accrual, retention, and satisfaction.
The effect of combined β-lactoglobulin supplementation and resistance exercise training prior to limb immobilisation on muscle protein synthesis rates in healthy young adults: study protocol for a randomised controlled trial
Authors: Hughes Alix , Francis Thomas , Marjoram Lindsey , Rooney Jessica H. , Ellison-Hughes Georgina , Pollock Ross , Curtis Michael J. , Cape Angela , Larsen Mads , Phillips Bethan E. , Atherton Philip J. , Smith Kenneth , Witard Oliver C.
Published: June 2023

Background

The decline in skeletal muscle mass experienced following a short-term period (days to weeks) of muscle disuse is mediated by impaired rates of muscle protein synthesis (MPS). Previous RCTs of exercise or nutrition prehabilitation interventions designed to mitigate disuse-induced muscle atrophy have reported limited efficacy. Hence, the aim of this study is to investigate the impact of a complex prehabilitation intervention that combines β-lactoglobulin (a novel milk protein with a high leucine content) supplementation with resistance exercise training on disuse-induced changes in free-living integrated rates of MPS in healthy, young adults.

Methods/design

To address this aim, we will recruit 24 healthy young (18–45 years) males and females to conduct a parallel, double-blind, 2-arm, randomised placebo-controlled trial. The intervention group will combine a 7-day structured resistance exercise training programme with thrice daily dietary supplementation with 23 g of β-lactoglobulin. The placebo group will combine the same training programme with an energy-matched carbohydrate (dextrose) control. The study protocol will last 16 days for each participant. Day 1 will be a familiarisation session and days 2–4 will be the baseline period. Days 5–11 represent the ‘prehabilitation period’ whereby participants will combine resistance training with their assigned dietary supplementation regimen. Days 12–16 represent the muscle disuse-induced ‘immobilisation period’ whereby participants will have a single leg immobilised in a brace and continue their assigned dietary supplementation regimen only (i.e. no resistance training). The primary endpoint of this study is the measurement of free-living integrated rates of MPS using deuterium oxide tracer methodology. Measurements of MPS will be calculated at baseline, over the 7-day prehabilitation period and over the 5-day immobilisation period separately. Secondary endpoints include measurements of muscle mass and strength that will be collected on days 4 (baseline), 11 (end of prehabilitation) and 16 (end of immobilisation).

Discussion

This novel study will establish the impact of a bimodal prehabilitation strategy that combines ß-lactoglobulin supplementation and resistance exercise training in modulating MPS following a short-term period of muscle disuse. If successful, this complex intervention may be translated to clinical practice with application to patients scheduled to undergo, for example, hip or knee replacement surgery.

Trial registration

NCT05496452. Registered on August 10, 2022.

Protocol version: 16-12-2022/1
Differential target multiplexed spinal cord stimulation using a paddle-type lead placed at the appropriate site for neuropathic pain after spinal cord injury in patients with past spinal surgical histories: study protocol for an exploratory clinical trial
Authors: Tanei Takafumi , Maesawa Satoshi , Nishimura Yusuke , Nagashima Yoshitaka , Ishizaki Tomotaka , Ando Masahiko , Kuwatsuka Yachiyo , Hashizume Atsushi , Kurasawa Shimon , Saito Ryuta
Published: June 2023

Background

Neuropathic pain after spinal cord injury (SCI), both traumatic and non-traumatic, is refractory to various treatments. Spinal cord stimulation (SCS) is one of the neuromodulation therapies for neuropathic pain, although SCS has insufficient efficacy for neuropathic pain after SCI. The reasons are presumed to be inappropriate locations of SCS leads and conventional tonic stimulation itself does not have a sufficient analgesic effect for the pain. In patients with past spinal surgical histories, the cylinder-type leads are likely to be placed on the caudal side of the SCI because of surgical adhesions. Differential target multiplexed (DTM) stimulation is one of the latest new stimulation patterns that is superior to conventional stimulation.

Methods

A single-center, open-label, randomized, two-way crossover trial is planned to investigate the efficacy of SCS using DTM stimulation placing a paddle lead at the appropriate site for neuropathic pain after SCI in patients with spinal surgical histories. The paddle-type lead delivers energy more efficiently than a cylinder-type lead. This study consists of two steps: SCS trial (first step) and SCS system implantation (second step). The primary outcome is rates of achieving pain improvement with more than 33% reduction 3 months after SCS system implantation. The secondary outcomes are to be evaluated as follows: (1) effectiveness of DTM and tonic stimulations during the SCS trial; (2) changes of assessment items from 1 to 24 months; (3) relationships between the result of the SCS trial and the effects 3 months after SCS system implantation; (4) preoperative factors associated with a long-term effect, defined as continuing for more than 12 months; and (5) whether gait function improves from 1 to 24 months.

Discussion

A paddle-type lead placed on the rostral side of SCI and using DTM stimulation may provide significant pain relief for patients with intractable neuropathic pain after SCI in patients with past spinal surgical histories.

Trial registration

Japan Registry of Clinical Trials (jRCT) jRCT 1042220093. Registered on 21 November 2022, and last modified on 6 January 2023. jRCT is approved as a member of the Primary Registry Network of WHO ICTRP.
Three R2R3-MYB transcription factors from banana (Musa acuminata) activate structural anthocyanin biosynthesis genes as part of an MBW complex
Authors: Busche Mareike , Pucker Boas , Weisshaar Bernd , Stracke Ralf
Published: June 2023

Objective

Bananas are one of the most popular fruits in the world, providing food security and employment opportunities in several developing countries. Increasing the anthocyanin content of banana fruit could improve the health-promoting properties. Anthocyanin biosynthesis is largely regulated at the transcriptional level. However, relatively little is known about the transcriptional activation of anthocyanin biosynthesis in banana.

Results

We analysed the regulatory activity of three Musa acuminata MYBs that were predicted by bioinformatic analysis to transcriptionally regulate anthocyanin biosynthesis in banana. MaMYBA1, MaMYBA2 and MaMYBPA2 did not complement the anthocyanin-deficient phenotype of the Arabidopsis thaliana pap1/pap2 mutant. However, co-transfection experiments in A. thaliana protoplasts showed that MaMYBA1, MaMYBA2 and MaMYBPA2 function as components of a transcription factor complex with a bHLH and WD40 protein, the so called MBW complex, resulting in the activation of the A. thaliana ANTHOCYANIDIN SYNTHASE and DIHYDROFLAVONOL 4-REDUCTASE promoters. The activation potential of MaMYBA1, MaMYBA2 and MaMYBPA2 was increased when combined with the monocot Zea mays bHLH ZmR instead of the dicot AtEGL3. This work paves the path towards decoding the MBW complex-mediated transcriptional activation of anthocyanin biosynthesis in banana. It will also facilitate research towards increased anthocyanin content in banana and other monocot crops.
Recurrent diabetic myonecrosis in an African American woman with long-standing uncontrolled type 2 diabetes: a case report
Authors: Kurup Varsha , Nagoshi Ying , Rivera-Zengotita Marie , Maska Edlira
Published: June 2023

Background

Diabetic myonecrosis, also called diabetic muscle infarction, is an uncommon complication of uncontrolled diabetes mellitus and is frequently underdiagnosed. The objective of this case report is to highlight the challenges in the early diagnosis and treatment of this disease.

Case presentation

A 51-year-old African American woman with a long history of uncontrolled diabetes mellitus presented to her primary care physician with right thigh pain. A diagnosis of diabetes myonecrosis was made on the basis of magnetic resonance imaging, biopsy, and negative autoimmune panel. After failing conservative treatment, the patient was treated with prednisone with gradual improvement of her symptoms. However, she had a recurrence of myonecrosis almost one year after her original presentation, which was also treated with prednisone. The recurrence had a shorter course and the patient recovered well. Challenges to the treatment in this patient were her debilitating pain and her underlying chronic kidney disease.

Conclusions

A high index of suspicion for diabetic myonecrosis is necessary when a patient with diabetes presents with unilateral focal leg pain and swelling. Magnetic resonance imaging and biopsy can help confirm the diagnosis. Prednisone may be considered in patients who lack spontaneous regression with just rest. Educating healthcare professionals about this uncommon condition is of utmost importance in avoiding unnecessary testing and inappropriate treatment.
Avelumab in metastatic collecting duct carcinoma of the kidney: a case report
Authors: Pyrgidis Nikolaos , Sokolakis Ioannis , Haltmair Gena , Heller Vitus , Hatzichristodoulou Georgios
Published: June 2023

Background

Collecting duct carcinoma (CDC) of the kidney is associated with an aggressive course, limited response to treatment, and poor prognosis. Platinum-based chemotherapy is currently recommended as the first-line treatment in patients with metastatic CDC. Accumulating evidence supports the use of immunotherapy with checkpoint inhibitors as second-line therapy.

Case presentation

In this case report, we describe the first case of avelumab administration due to disease progression during chemotherapy with gemcitabine and cisplatin in a Caucasian, 71-year-old man presenting with multiple metastases due to CDC of the kidney. The patient initially responded well to four cycles of chemotherapy and his performance status improved. After two additional chemotherapy cycles, the patient presented with new bone and liver metastases (mixed response to chemotherapy with an overall 6-month progression-free survival). We offered him avelumab as a second-line treatment in this setting. The patient received a total of three cycles of avelumab. The disease remained stable (no new metastases during treatment with avelumab), and the patient developed no complications. To alleviate his symptoms, radiation therapy for the bone metastases was decided. Despite successful radiation of the bone lesions and further improvement of symptoms, the patient developed hospital-acquired pneumonia and died approximately ten months after the initial diagnosis of CDC.

Conclusions

Our findings suggest that the applied treatment modality with gemcitabine and cisplatin chemotherapy followed by avelumab was effective in terms of both progression-free survival and quality of life. Still, further studies assessing the use of avelumab in this setting are mandatory.
Clinical prognosis and related molecular features of hepatitis B-associated adolescent and young adult hepatocellular carcinoma
Authors: Lv Tao , Zhang Bo , Xu Xi , Jiang Chenhao , Zheng Daofeng , He Diao , Zhou Yongjie , Yang Jiayin
Published: June 2023

Background

Inattention has been given to the pathogenesis of adolescent and young adult (AYA) hepatocellular carcinoma (HCC). Due to the more advanced tumor progression and poorer prognosis of AYA-HCC, together with a better tolerance ability, noncirrhotic background, and a stronger willingness to treat AYA-HCC, clinical and molecular biology studies are urgent and necessary, especially for those with hepatitis B infection.

Methods

For clinical aspects, the overall survival, the recurrence-free survival, and the Cox analyses were performed. Then, functional analysis, gene clustering, metabolic-related analysis, immune infiltration and competing endogenous RNA (ceRNA) construction were carried out using whole transcriptome sequencing technique.

Results

Based on the clinical information of our HCC cohort, the overall survival and recurrence-free survival rates were worse in the AYA group than in the elderly group as previously described. According to our whole transcriptome sequencing results, functional analysis revealed that metabolism-related pathways as well as protein translation and endoplasmic reticulum processing were enriched. Then the hub metabolism-related genes were screened by metabolite–protein interactions (MPIs) and protein–protein interactions (PPIs). Fatty acid metabolism is a crucial component of metabolic pathways, abnormalities of which may be the reason for the worse prognosis of HBV-AYA HCC. Finally, the relationship of disrupted expression of metabolism-related genes with immune infiltration was also analyzed, and the lncRNA‒miRNA‒mRNA-related ceRNA network for HBV-AYA HCC was constructed, which may provide new cues for HBV-AHA HCC prevention.

Conclusion

The worse prognosis and recurrence rate of HBV-AYA HCC may be related to abnormalities in metabolism-related pathways, especially disorders of fatty acid metabolism.
The therapeutic potential of purified cannabidiol
Authors: O’Sullivan Saoirse Elizabeth , Jensen Sanne Skov , Nikolajsen Gitte Nykjaer , Bruun Heidi Ziegler , Bhuller Rhenu , Hoeng Julia
Published: June 2023

The use of cannabidiol (CBD) for therapeutic purposes is receiving considerable attention, with speculation that CBD can be useful in a wide range of conditions. Only one product, a purified form of plant-derived CBD in solution (Epidiolex), is approved for the treatment of seizures in patients with Lennox-Gastaut syndrome, Dravet syndrome, or tuberous sclerosis complex. Appraisal of the therapeutic evidence base for CBD is complicated by the fact that CBD products sometimes have additional phytochemicals (like tetrahydrocannabinol (THC)) present, which can make the identification of the active pharmaceutical ingredient (API) in positive studies difficult. The aim of the present review is to critically review clinical studies using purified CBD products only, in order to establish the upcoming indications for which purified CBD might be beneficial. The areas in which there is the most clinical evidence to support the use of CBD are in the treatment of anxiety (positive data in 7 uncontrolled studies and 17 randomised controlled trials (RCTs)), psychosis and schizophrenia (positive data in 1 uncontrolled study and 8 RCTs), PTSD (positive data in 2 uncontrolled studies and 4 RCTs) and substance abuse (positive data in 2 uncontrolled studies and 3 RCTs). Seven uncontrolled studies support the use of CBD to improve sleep quality, but this has only been verified in one small RCT. Limited evidence supports the use of CBD for the treatment of Parkinson’s (3 positive uncontrolled studies and 2 positive RCTs), autism (3 positive RCTs), smoking cessation (2 positive RCTs), graft-versus-host disease and intestinal permeability (1 positive RCT each). Current RCT evidence does not support the use of purified oral CBD in pain (at least as an acute analgesic) or for the treatment of COVID symptoms, cancer, Huntington’s or type 2 diabetes. In conclusion, published clinical evidence does support the use of purified CBD in multiple indications beyond epilepsy. However, the evidence base is limited by the number of trials only investigating the acute effects of CBD, testing CBD in healthy volunteers, or in very small patient numbers. Large confirmatory phase 3 trials are required in all indications.
3-Ketoacyl-ACP synthase III FabH1 is essential for branched-chain DSF family signals in Xanthomonas oryzae pv. oryzae
Authors: Yan Mingfeng , Yu Yonghong , Luo Lizhen , Huang Mei , Zhang Yuanyin , Su Jingtong , Zhang Wenbin , Ma Jincheng , Hu Zhe , Wang Haihong
Published: June 2023

The 3-ketoacyl-ACP synthase III (FabH), a key enzyme for bacteria growth, catalyses the last step of the initiation of bacterial fatty acid synthesis. Rice bacterial blight is caused by the pathogen Xanthomonas oryzae pv. oryzae (Xoo), which is widely studied as a model bacterium. Bioinformatics analysis showed that the X. oryzae pv. oryzae PXO99A genome encodes three FabH homologous proteins with unknown functions. In this study, we found that only PXO_02706 (fabH1) encodes a functional FabH, the key enzyme in the production of branched-chain fatty acid, which is essential for the branched-chain diffusible signal factor family signals in Xoo. Interestingly, we found that FabH1 is not essential for fatty acid biosynthesis in Xoo. Pathogenicity analysis showed that loss of fabH1 caused a significant decrease in virulence of Xoo. Genetic and phenotypic analyses revealed that fabH1 plays a key role in multiple Xoo virulence-related activities, including exopolysaccharide (EPS) production, biofilm formation, motility, and resistance to environmental stresses.
Vacuum-assisted closure therapy for an empyema with bronchopleural fistula with artificial dermis covering the bronchial stump
Authors: Matsumoto Akira , Shoji Tsuyoshi , Katakura Hiromichi
Published: June 2023

Background

Vacuum-assisted closure (VAC) therapy has recently been reported to be useful for treating empyema complicated by bronchopleural fistula (BPF). Since the pleural cavity must be closed to apply this treatment, various fistula closure methods for the fistula have been used in previous reports. We report a case in which VAC therapy could be applied more safely by simply covering the fistula with an artificial dermis.

Case presentation

A 72-year-old man who underwent thoracoscopic lower lobectomy of the right lung for squamous cell carcinoma pT1cN0 developed BPF on the postoperative day 22. First, infection control was achieved by open-window thoracostomy and antibiotic therapy. Subsequently, VAC therapy was applied by covering the fistula with an artificial dermis, and closure of the bronchial stump was completely achieved. Subsequently, the thoracostomy was closed surgically.

Conclusion

Covering the fistula with an artificial dermis allowed for the introduction of VAC therapy when treating empyema complicated by BPF.
Propagation of two-wave solitons depending on phase-velocity parameters of two higher-dimensional dual-mode models in nonlinear physics
Authors: Singh Shailendra , Saha Ray Santanu
Published: June 2023

Nonlinear evolution equations exhibit a variety of physical behaviours, which are clearly illustrated by their exact solutions. In this view, this article concerns the study of dual-mode (2 + 1)-dimensional Kadomtsev-Petviashvili and Zakharov-Kuznetsov equations. These models describe the propagation of two-wave solitons traveling simultaneously in the same direction and with mutual interaction dependent on an embedded phase-velocity parameter. The considered nonlinear evolution equations have been solved analytically for the first time using the Paul-Painlevé approach method. As a result, new abundant analytic solutions have been derived successfully for both the considered equations. The 3D dynamics of each of the solution has been plotted by opting suitable constant values. These graphs show the dark-soliton, bright-soliton, complex dual-mode bright-soliton, complex periodic-soliton and complex dual-mode dark-soliton solutions.
Development and Validation of Quality Measures for Testosterone Prescribing
Authors: Borzecki Ann M , Conti Jennifer , Reisman Joel I , Vimalananda Varsha , Nagy Michael W , Paluri Radhika , Linsky Amy M , McCullough Megan , Bhasin Shalender , Matsumoto Alvin M , Jasuja Guneet K
Published: June 2023

Context

Accurate measures to assess appropriateness of testosterone prescribing are needed to improve prescribing practices.

Objective

This work aimed to develop and validate quality measures around the initiation and monitoring of testosterone prescribing.

Methods

This retrospective cohort study comprised a national cohort of male patients receiving care in the Veterans Health Administration who initiated testosterone during January or February 2020. Using laboratory data and diagnostic codes, we developed 9 initiation and 7 monitoring measures. These were based on the current Endocrine Society guidelines supplemented by expert opinion and prior work. We chose measures that could be operationalized using national VA electronic health record (EHR) data. We assessed criterion validity for these 16 measures by manual review of 142 charts. Main outcome measures included positive and negative predictive values (PPVs, NPVs), overall accuracy (OA), and Matthews Correlation Coefficients (MCCs).

Results

We found high PPVs (>78%), NPVs (>98%), OA (≥94%), and MCCs (>0.85) for the 10 measures based on laboratory data (5 initiation and 5 monitoring). For the 6 measures relying on diagnostic codes, we similarly found high NPVs (100%) and OAs (≥98%). However, PPVs for measures of acute conditions occurring before testosterone initiation (ie, acute myocardial infarction or stroke) or new conditions occurring after initiation (ie, prostate or breast cancer) PPVs were much lower (0% to 50%) due to few or no cases.

Conclusion

We developed several valid EHR-based quality measures for assessing testosterone-prescribing practices. Deployment of these measures in health care systems can facilitate identification of quality gaps in testosterone-prescribing and improve care of men with hypogonadism.
Physiological assessment of the fetal body using MRI: current uses and potential directions
Authors: Gaunt Trevor , Sokolska Magdalena
Published: June 2023

MRI assessment of the fetus useing fast T2 weighted sequences is well established in defining alterations in fetal anatomy and structure, as a biomarker for disease and in some cases prognostication. To date, the physiological assessment of the fetus using advanced sequences to characterise tissue perfusion and microarchitecture has largely been unused. Current methods of assessing fetal organ function are invasive and carry inherent risk. Therefore the identification of imaging biomarkers of altered physiology in fetal disease, and their correlation with postnatal outcome, is therefore attractive. This review describes the techniques which show promise for such a task, and potential future directions.
The TRP Tutoring System in Education: System-Forming Factors
Authors: Ovchinnikov Yu. , Shpet V.
Published: June 2023

The problem of research and justification of its relevance. Introduction. The TRP in the USSR has not only become a historical chronicle in the upbringing and inculcation of physical qualities, but the ideological basis of the spiritual and moral development of society. There is a stage of continuity of the TRP of the USSR and the TRP of Russia in an updated conceptual framework. The mechanism of implementation of TRP in Russia is being improved in accordance with the digitalization of society, the creation of online services, taking into account the development of the region, mass physical culture and sports. The introduction of a new administrative unit of a tutor-teacher of the TRP of Russia in 2014 marked new approaches to the implementation of the complex and the creation of a tutoring system. The TRP tutoring system differs from tutoring in education as a whole, therefore, it requires the allocation of system-forming factors that will help identify problems and will contribute to the development of strategic and tactical tasks for the implementation of the TRP complex, health promotion, spiritual and moral forces in social development.

The social function of a student as a tutor in TRP is presented. Students of the Kuban State University of Physical Culture, Sports and Tourism not only personally take the TRP, but also promote it through various competitions, festivals, participation in the evaluation of TRP standards in secondary schools, regional testing centers. Regional peculiarities of the tutoring system development are shown on the example of Sochi. The authors note that in 2014, with the return of the TRP, a new administrative unit tutor appears on a legal basis, which made it possible to start building a tutoring system in the TRP complex, taking into account system-forming factors. The problem of the prospects for the development of the TRP is raised, taking into account its socio-orienting function in society.
Systemic and critical thinking as a competence of contemporary education
Authors: Minina Ol'ga
Published: June 2023

The article is devoted to students critical thinking skills’ development. Basing on the experiment, the author formulates a definition of the "critical thinking" concept and graphically presents its semantic composition. The article examines the invariant features of critical thinking and highlights the main strategies for its formation. They include: selecting and filtering information for the tasks set, evaluating information as "true" or "false", evaluating information as "implicit" or "explicit", identifying implicit manipulation strategies, systematizing the information selected according to established criteria, indicating correct relations between the facts highlighted, performing students’ own creative product of thought, reflection and the ability to argue their position. The author comes to the conclusion that these strategies should be taken into account when planning educational tasks with students of different ages.
Coping Mechanisms (Coping Behavior) as Forms of Adaptation Processes in Migrant Children
Authors: Makarova V. , Gur'eva V.
Published: June 2023

Integration into a new society of migrant children is always associated with problems of self-realization. Coping strategies are one of the main predicates of getting out of stressful situations, adequate ways to respond to the impact of society. The choice of adequate coping strategies, as productive ways of coping in the structure of social and psychological adaptation, contributes to successful socialization, the achievement of social and psychological integration, and the preservation of one’s own “I”.
Helicobacter pylori treatment - a review
Authors: Hurkała Kamil , Antonik Dominika , Denys Barbara , Góra Karolina , Zdziennicki Wojciech , Zimnicki Patryk , Lato Marta , Iberszer Konrad , Litwiniuk Maria , Zaniuk Marcin
Published: June 2023

In this review, current methods of treating Helicobacter pylori bacterial infection are discussed. H. pylori is one of the most common pathogens causing gastrointestinal discomfort. It is considered a major cause of peptic ulcer disease, stomach and duodenal cancer, and MALT lymphoma. The authors analyzed the results of clinical studies regarding the efficacy of various treatment regimens, such as quadruple therapy, triple therapy, therapy with probiotics, therapy with the addition of phytochemical compounds, and therapy with a single drug. In addition, indications for eradication therapy were discussed. The conclusions of the review indicate the need for an individualized approach to the treatment of H. pylori infection, taking into account the rapidly increasing antibiotic resistance and patient risk factors for eradication.
What impact does dialysis have on the patient's life and mental health?
Authors: Kułakowska Aleksandra , Kuc Monika , Lepczyński Bartłomiej , Kłakowicz Philip , Lechowski Sebastian
Published: June 2023

This essay looks into the effects of dialysis on patients' mental health and quality of life at the Department of Nephrology. We now live in a period when patients' mental health is receiving an increasing amount of attention in addition to their physical health. The progression of chronic kidney disease and how it is treated greatly affect the quality of life for dialysis users. Renal insufficiency consequently causes significant restrictions on patients' ability to engage in social, intellectual, and physical activities. Renal replacement therapy prolongs the lives of people with chronic kidney disease.
Premenstrual syndrome - theories and facts - something everyone should know
Authors: Świątek Gabriela , Środoń Maria , Sosnowska Weronika , Tkaczyk Rafał , Taracha Kalina , Tomczyk Jakub , Tomkiewicz Maciej , Brzozowska Aleksandra , Śwital Magdalena , Tokarski Michał
Published: June 2023

Premenstrual syndrome (PMS- Premenstrual Syndrome) is a group of cyclic somatic or psychological symptoms occurring during the luteal phase of the cycle and disappearing with the onset of menstruation. The purpose of this work is to draw attention to this important but often underestimated problem, trace its pathomechanism and identify treatment methods.

The interaction of many factors and predispositions is responsible for the occurrence of PMS/PMDD (PMDD- premenstrual dysphoric disorder). One of the most important is ovulatory cycles and cyclically repeated changes in ovarian hormone secretion- fluctuations in progesterone, estradiol and prolactin levels during the various phases of the cycle. The association of emotional disturbances, severe stress and disturbances in the neurotransmitter system of the central nervous system, as well as many other factors, mentioned in the article below, is described. Various methods are used to treat PMS/PMSS, ranging from less to more invasive, including lifestyle changes, cognitive-behavioral therapy, and pharmacotherapy and surgical treatment.  Currently, SSRIs-serotonin reuptake inhibitors-are considered the main therapy, as well as hormonal treatment-the two-pill.

A review of the literature shows that PMS/PMDD is a real problem that reduces quality of life and has a negative impact on family and social relationships. Increased public awareness and interest by physicians of many specialties in this problem will enable faster diagnosis and implementation of effective therapy, thereby minimizing the negative social impact.
Multidirectional pharmacological effects of saponins in light of clinical trials: a systematic review of literature
Authors: Galas Adam , Niemiec Rafał , Matysek Mikołaj , Olszanicka Anna , Kołodziejczyk Kacper , Hop Izabela , Branewska Justyna , Ostrowska Barbara , Imioło Jan , Maciąg Anna
Published: June 2023

Introduction: Saponins are secondary metabolites widely distributed in higher plants with multidirectional pharmacological effects. We distinguish between steroidal and triterpenoidal saponins, which are composed of glycone and aglycone. The varied medicinal properties of saponins are influenced by the presence of different substituents in the polycyclic aglycone, e.g. hydroxyls, hydroxymethyls, carboxyls and acyl groups, as well as the difference in bonding, composition and number of sugar chains. It is noteworthy that foods rich in these compounds can reduce the risk of developing various diseases, and the isolation of these compounds from the plant matrix provides new opportunities to create potential and effective drugs.

Purpose of the work: Conduct a literature review on the basis of available clinical studies on the pharmacological effects of saponins extracted from medicinal plants and their potential application in medicine.

Materials and methods: The work was based on a literature review of available medical publications from clinical trials conducted for the multidirectional therapeutic effects of saponins. Reports available in publications and scientific studies posted in medical information databases such as Pubmed and Google Scholar were summarised.

Results: Clinical studies confirm the pharmacological effect of saponins in the treatment of sports injuries and trauma, type II diabetes, abnormal glycemic state  fasting glucose, ischemic heart disease, pancytopenia and aplastic anemia.

Conclusions: With the advancement of scientific research on saponins, it is possible to use them to produce potential drugs and dietary supplements with pharmacological effects. However, before saponins can be used for medical treatment, further research on their efficacy and safety is needed.
Proposed Design Of Toy To Optimize The Brain Development Of Children Aged 3-5 Years Old
Authors: Astuti Rahmaniyah Dwi , Gandana William Elian , Pujiyanto Eko , Nurbi Rahma Sabilah
Published: June 2023

Children and games are inseparable, especially during their childhood which is known as the golden age. This is the phase when they experience a very fast and significant brain growth and development under the influence of several factors such as the sensory, motor, and cognitive aspects. Therefore, this study aims to design a safe toy without hazardous materials to maximize the brain development of children aged 3 to 5 years in the sensory, motor, and cognitive aspects. The design was based on the Nigel Cross principle normally used to analyze the consumer needs and this led to the production of three different toys which include the hand puppet, board game, and puzzle. The toys’ specifications and features were obtained from questionnaires distributed online and data analysis. The materials used include velboa fabric for hand puppets while Polylactic Acid (PLA) was used for both the board game and puzzles and they were selected based on the evaluations conducted by 3 competent production stakeholders. In conclusion, it was discovered that the design was able to provide solutions and breakthroughs needed to maximize the brains of children in their golden age.
Mental Workload Evaluation for PMM Outbound Student in X University (Unix) Using NASA-TLX Method
Authors: Isnaini Wildanul , Khoiri Halwa Annisa , Cahyaningtyas Putri
Published: June 2023

Program Mahasiswa Merdeka (PMM) is one of the MBKM program. This program allows student to study in different university and majors. It was attended by students of Engineering Faculty from UNIX in State and Private University throughout Indonesia. By participating PMM, the student have overload credits because they have to finish double credit from homebased and destination university. This condition affects the burden on students both physically and mentally. This mental burden of students has an impact on student achievement academically, so the mental burden analysis is needed. In this study, an evaluation of the mental workload was carried out using the NASA-TLX approach. The result found that in general 75% of students experienced a very high workload. The percentage of students who take PMM in State University as much as 50% is in the category of high mental workload and 50% is very high category. The percentage of students who take PMM in Private University is 25% in the very high category and 75% is in the high category. From this study, UNIX can have some consideration about providing the brief (tips and tricks) before PMM for student mental preparation and choosing the Private University for destination university.
Lighting Factor Analysis to Reduce Employee Eye Fatigue Using an Ergonomic Approach
Authors: Majid Nurul Janatim , Sokhibi Akh. , Tauhida Dina
Published: June 2023

PT Semen Gresik is a company that produces cement with various units, one of which is a production plan and control unit whose job is to plan and evaluate work processes. The problem that exists in the production plan and control office space is the intensity of the lighting in the office space is not under the SNI Lighting standard. 16-7062 2004 for an office space of 350 lux. This can cause eye fatigue which can affect the condition of employees at work. Measurement of eye fatigue using the Visual Fatigue Index (VFI) questionnaire. The subjects of this study were all employees of the production plan and control work unit of PT Semen Gresik. The results of the measurement of eye fatigue are 4 out of 5 employees who experience eye fatigue, and the results of the calculation of the need for lamps require 8 lamps with 36 watts of power and white/daylight color temperature to achieve room lighting standards.
A Study on the Technology Content Assessment Based on Aspects of Food Safety in the Food Ingredient Company
Authors: Aji Permadi Bayu , Wahyuni Hana Catur
Published: June 2023

Technological complexity assessment is one of ways to implement the continuous improvement process. This company is a food ingredient company that assure that their products do indeed meet customer requirements of food safety and quality. This study aims to assess the level of technological sophistication based on food safety aspects using technometric and AHP integration. Technological assessment is carried out on the production process of pregelatinized starch as premium and specialty product and its supporting processes within the company. The technometric approach will assess the level of sophistication of each technology component (technoware, humanware, infoware, and orgaware). And AHP is used to determine the contribution of each technology component. After that, computation of the technology contribution coefficient is done to determine the company’s technology level. The results showed that the highest to lowest value of the contribution of sophistication of each component of technology is orgaware with a sophistication value of 1.064, then infoware with a value of 1.047, followed by humanware 0.868, and lastly is the technoware component which is 0.692. The TCC value of the company is 0.909 which indicates that the company has a highly sophisticated technological with modern technology levels.
Common orthodontic indices and classification
Authors: Mohan Ashwini , Batley Haris Ahmed
Published: June 2023

An orthodontic index is a rating or categorizing system that assigns a numeric score or alphanumeric label to a person's occlusion. Indexing of malocclusions and their correction is important in epidemiology, diagnosis, communication between clinicians as well as with their patients, and assessing treatment outcome. Many useful indices have been put forward, but no one method appears to be equally suitable for the use of epidemiologists, public health programme planners and clinicians. This article describes the common clinical orthodontic indices and classifications used in the UK.

CPD/Clinical Relevance: Readers can gain an insight into the advantages and disadvantages of the commonly used orthodontic indices and classifications in the UK.
Comprehensive management of a child with multiple dens invaginatus
Authors: Premathilaka LKN , Vasantha S , Herath EMUCK
Published: June 2023

‘Dens invaginatus’ (DI) is a developmental anomaly of teeth, where an infolding of the enamel occurs into the dentine, creating a pocket or a dead space, as a result of the invagination of the enamel organ into the dental papilla prior to calcification. DI have been reported in 0.3–10% of the population. This case describes the comprehensive management of a 9-year-old child with multiple dens invaginatus.

CPD/Clinical Relevance: Early diagnosis and early intervention of DI is important to avoid dental caries, pulpitis and pulp death.