bluuebunny/crossref_metadata_2025 huggingface dataset:
Inverse design of layered periodic wave barriers based on deep learning
Authors: Liu Chen-Xu , Yu Gui-Lan
Published: May 2021

This study presents an approach based on deep learning to design layered periodic wave barriers with consideration of typical range of soil parameters. Three cases are considered where P wave and S wave exist separately or simultaneously. The deep learning model is composed of an autoencoder with a pretrained decoder which has three branches to output frequency attenuation domains for three different cases. A periodic activation function is used to improve the design accuracy, and condition variables are applied in the code layer of the autoencoder to meet the requirements of practical multi working conditions. Forty thousand sets of data are generated to train, validate, and test the model, and the designed results are highly consistent with the targets. The presented approach has great generality, feasibility, rapidity, and accuracy on designing layered periodic wave barriers which exhibit good performance in wave suppression in targeted frequency range.
Two-phase orthodontic treatment of two different types of tooth transposition in the same patient
Authors: Correa Marcelo Soares , Ellinger Correa Flávia N , de Freitas Karina Maria Salvatore , de Freitas Marcos Roberto , Garib Daniela Gamba , Janson Guilherme
Published: May 2021

Orthodontic treatment is thoroughly planned considering the patient’s facial and dental characteristics, the main complaint, treatment time and the orthodontist’s experience. Transposition is a form of ectopia, in which two adjacent teeth exchange positions in the dental arch. Transposition can be partial or complete. This article reports the treatment of a female patient with two kinds of tooth transposition managed in the mixed and permanent dentitions. A girl, aged eight years and three months, came to routine paediatric consultation with an ectopic permanent mandibular left lateral incisor in the mixed dentition. Radiographic analysis indicated partial transposition of the permanent mandibular left lateral incisor and canine (Md.L2.C), and development of a complete tooth transposition between the permanent maxillary right first pre-molar and canine (Mx.C.P1). The patient was treated in two phases. The first, in the mixed dentition, and the second, in the permanent dentition with a three-year follow-up between them. These challenging treatment approaches are described in detail, including the mechanics used. The key points of this treatment were early diagnosis of the ectopic mandibular lateral incisor, use of light forces and interphase patient follow-up. These determined the best time to start the second treatment phase, enabling achievement of aesthetic and functional outcomes, and the results remained stable one year after the end of orthodontic treatment.
Emission and performance of a micro gas turbine combustor fueled with ammonia-natural gas
Authors: Nozari Mohammadreza , Eidiattarzade Masoud , Tabejamaat Sadegh , Kankashvar Benyamin
Published: May 2021

Ammonia as a carbon-free fuel has great potentiality to be utilized in power generation sectors such as micro gas turbines (MGT) to mitigate carbon dioxide emission from combustion systems. It is also easy to store and transport at room temperature compared to hydrogen, and in liquid form has equal volumetric energy density to liquid hydrogen. However, some challenges regarding its NOx pollution and flame stabilization inhibit its usage in these areas which requires further studies. In the present study, thermal performance and NOx emission of an MGT combustor fueled with ammonia-natural gas blends has been analyzed numerically through chemical reactant networks (CRN). The combustor’s inlet conditions are at atmospheric conditions and diffusion flame is stabilized using air swirler. In the first part of the paper, the CRN model has been developed based on empirical and semi-empirical equations. Series of experiments have been carried out to find the required parameters for the CRN model. Also, the results of NOx emission and temperature distribution have been validated with the experimental results. In the second part, effects of ammonia addition to the natural gas fuel are studied for various ammonia percentages using the CRN. The results show that by increasing ammonia molar percentage in the fuel, NO emission rises dramatically and reaches up to 330 PPM, but after a certain threshold (about 12.5 molar percent of ammonia) further ammonia addition reduces NO emission. Moreover, the overall temperature of the combustor decreases with ammonia addition due to lower LHV (lower heating value) of ammonia relative to natural gas. However, the overall efficiency of the combustor does not change significantly. The results also reveal that most of the NO is produced in the primary and secondary zones of the combustor. NO2 is mostly created in the secondary zone of the combustor and comprises about 10% of total NOx emission.
Shabazz response to Noxolo
Authors: Shabazz Rashad
Published: May 2021

My response to Noxolo’s response to my 2019 lecture at the Royal Geographical Society.
The effect of professional ethics workshop with virtual follow-up on nurses moral distress
Authors: Ghahremani Ali , Esmaelzadeh Fatemeh , Khosravani Mahboobeh , Mohsenpour Mohaddeseh
Published: May 2021

Research objectives

Moral distress is a common phenomenon among nurses and can negatively affect their mental health and quality of the care. This study aimed to determine the effect of professional ethics workshop with virtual follow-up on the moral distress of nurses.

Methods

This experimental study was performed on 50 nurses in Ghaem Hospital, Mashhad, Iran. The intervention group received 8-hour professional ethics workshop and 4 weeks follow-up through social network. The moral distress was evaluated through the Moral Distress Scale-Revised at the beginning of the study, two weeks after the workshop and at the end of follow-up. Data were analyzed using SPSS21 by descriptive and statistical analysis.This study approved by Mashhad university Medical Ethics Committee and publishing ethics were also observed.

Results

The changes in the mean value of the frequency of moral distress in the intervention group was not significant, while these changes were significant in the control group ( p < 0.001, df = 2, f = 26.41) and had an upward trend. About intensity changes in the intervention group were significant ( p < 0.01, df = 2, f = 8.52) and had a downward trend, while it was not significant in the control group. Changes in the mean value of level of moral distress in the intervention group were not significant, while these changes were significant in the control group ( p < 0.01, df = 1, f = 16.8). The mean value of moral distress level decreased in the intervention and increased in control group.

Conclusion

The level of moral distress was increased in the control group due to increase in its frequency. This could be due to awareness of nurses regarding the concept of moral distress which caused them to pay more attention to this issue. Professional ethics workshop did not have effect on the frequency of moral distress, while it reduced the intensity and level of moral distress. Moreover, follow-up through social network reduced the frequency, intensity and the level of moral distress among nurses.
Community Concept Drawing: A Participatory Visual Method for Incorporating Local Knowledge into Conceptualization
Authors: McOmber Chesney , McNamara Katharine , McKune Sarah L.
Published: May 2021

Concepts can provide researchers and communities with common ground for communicating and building understandings about the world. However, researchers who engage with communities often encounter unexpected interpretations of concepts in the field. This article introduces Community Concept Drawing (CCD), a participatory visual method aimed at facilitating a deep understanding of how local communities make sense of complex concepts often central to social research. We present the methodological foundations, protocol, and utility of CCD while drawing examples from our case studies in Senegal, Nepal, Morocco, and Kenya to examine the concept of empowerment. While CCD was created to open opportunities for studying empowerment within the field of international development, this article concludes by offering applications for using CCD to examine other concepts in various fields of study.
Influence of coronavirus disease 2019 (COVID-19) on working flow, safety and efficacy outcome of mechanical thrombectomy for acute ischemic stroke with large vessel occlusion
Authors: Huo Xiaochuan , Raynald  , Sun Xuan , Mo Dapeng , Gao Feng , Ma Ning , Wang Yilong , Wang Yongjun , Miao Zhongrong
Published: May 2021

Aim

The epidemic of COVID-19 has greatly affect the world health care system, particular measures have been taken not only to provide safety for health care providers but also to maintain the treatment quality. We evaluate the effect of COVID-19 epidemic to acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) received endovascular treatment (EVT) in our institution.

Methods

AIS patients with LVO who underwent EVT in the period of January 1st to April 30th between 2015 and 2020 from our stroke center. The baseline characteristics, working flow time, safety and efficacy outcome and the hospitalization status were retrospectively reviewed, compared and analyzed.

Results

There is significant decline in the number of AIS patients with LVO treated compared with the previous year (36 Vs 72 patients) during the epidemic period. The door to puncture time was significantly prolong (225 minutes versus 115 minutes) as well as the length of hospital stay with increase of the hospitalization costs ( P < 0.05 for all). There is no significant difference on the safety and efficacy outcome, such recanalization rate, incidence of intracranial hemorrhage, functional independence and mortality during the epidemic ( P > 0.05 for all).

Conclusions

Prolongation of the working time flow during the COVID-19 epidemic did not influence the safety and efficacy of EVT in AIS patients with LVO. However, special policy and particular measures in this circumstances is still need to evolve to improve the treatment quality.
Staged angioplasty: A sensible approach to prevent hyperperfusion syndrome after carotid artery stenting? A meta-analysis
Authors: Zhao Bingyang , Jiang Xinzhao , Wang Pei , Zhao Zhongyu , Mang Jing , Xu Zhongxin
Published: May 2021

Objective

To investigate whether staged angioplasty (SAP) is a safe and effective treatment to prevent hyperperfusion syndrome after carotid artery stenting (CAS).

Methods

A systematic literature search was performed according to established criteria to identify eligible articles published before October 2020. Pooled dichotomous data were presented as odds ratios (OR) and corresponding 95% confidence intervals (CI) using random-effect models. The efficacy endpoints were hyperperfusion syndrome (HPS), hyperperfusion phenomenon (HPP), and intracerebral hemorrhage (ICH). The safety endpoint was post-procedural thromboembolic events. The feasibility of the procedure was assessed by device-related adverse events (vessel dissection and failed angioplasty) in SAP.

Results

Ten studies (1030 participants) were eligible. SAP was superior to regular CAS in preventing HPS (OR = 0.35, 95% CI 0.14–0.86, P = 0.02). There was no significant difference in the rate of thromboembolic events between the SAP group and the regular CAS group. The rates of vessel dissection and failed angioplasty with the use of a 3.0-mm-diameter balloon were 5.4% and 0.4%, respectively.

Conclusion

SAP may reduce the incidence of post-CAS HPS without increasing procedure-related complications. A 3.0-mm-diameter balloon used in SAP may be appropriate for Asian populations. However, the confounded study design and confused definitions of reporting items hinder the current recommendation of SAP in clinical use.
Clot-based radiomics features predict first pass effect in acute ischemic stroke
Authors: Sarioglu Orkun , Sarioglu Fatma C , Capar Ahmet E , Sokmez Demet FB , Mete Berna D , Belet Umit
Published: May 2021

Purpose

Our aim was to evaluate the performance of clot-based radiomics features (RFs) for predicting first pass effect (FPE) in patients with acute ischemic stroke (AIS). The secondary purpose was to search for any other variables associated with FPE.

Materials and methods

Patients who underwent mechanical thrombectomy (MT) for anterior circulation large vessel stroke in a single center were retrospectively reviewed. Patients were divided into two groups: FPE and non-FPE. Two observers extracted RFs from the clot on pretreatment noncontrast computed tomography (NCCT) images. Demographic, clinical, periprocedural, and RFs were compared between the groups and receiver operating characteristic (ROC) curves were constructed. Logistic regression analysis was used to determine the independent predictors of FPE.

Results

Fifty-two patients (27 female, 25 male; mean age 64.50 ± 15.15) who were treated by stent retrievers as the first option were included in the study. FPE was achieved in 25 patients (25/52, 48.1%). Twelve RFs were significantly different between patients with FPE and non-FPE. The long-run low gray-level emphasis (odds ratio = 44.24, p = 0.003) and the zone percentage (odds ratio = 16.88, p = 0.017) were found as independent predictors of FPE. Female sex and a baseline ASPECT score of >8.5 were the other independent variables to predict FPE. The diagnostic accuracy to predict FPE was observed as 83% when using all independent predictors in our predictive model.

Conclusions

Clot-based RFs on NCCT may help to estimate the success of the intended outcome of MT in patients with AIS.
Getting Extreme Poverty Narrated: Methodological Challenges of Interviewing Older Persons
Authors: Akram Owasim
Published: May 2021

Interviewing different groups involves different challenges and opportunities. Older persons living in extreme poverty are among those who warrant special methodological considerations. Building on the experiences of life-history interviews with extreme poor older persons in Bangladesh, this article contributes with a methodological reflection on the interview process from the start to the end. The article highlights the key practical, emotional, and ethical concerns that impact the interview process. Adopting an activist approach, it asserts that offering additional power and (or) agency to poor and vulnerable participants yields more benefit to research. The article challenges the traditional consent-seeking process as it remains short of protecting the participants fully. Period of silence appears to be crucial in interviews for which a researcher should devise schemes on how to manage and analyze silence as a non-textual interview content. The paper stresses on the need to frame plans and protocols for the researchers themselves as they can be exposed to mental, physical, or social harm. It recommends reformulation of the idea of accountability toward the research participants in relation to incentivisation, dissemination and reporting back to the community. Understanding all such nuances and careful dealing of micro-ethical aspects are crucial to succeed in an interview. The article can be particularly beneficial for early-stage researchers who conduct interviews with people living in extreme poverty, as it makes them more aware and prepared to deal with the possible challenges inherent in different stages of the interview process.
Reflections on Joint and Individual Interviews With Couples: A Multi-Level Interview Mode
Authors: Blake Sharon , Janssens Astrid , Ewing Jan , Barlow Anne
Published: May 2021

When researchers are interested in the experiences of couples, the mode of interview is typically considered a binary choice between separate individual interviews with each partner, or a joint interview with both partners together. That is, if interview mode is explicitly considered at all. In this article, we illustrate a reflective process undertaken to explore the role of interview mode in the production of knowledge. Our focus is the adoption of multi-level semi-structured interviews wherein couples were interviewed both jointly and individually in one visit. The paper is set out in two parts. In part one, the study context and how the mode of interview was conceptualized is considered, before describing the chosen multi-level interview design. In part two, how the mode of interview worked in practice is discussed. The triangulation of individual and dyadic level perspectives collected rich data. Despite the novelty of mode, the challenges encountered reflected familiar concerns with semi-structured interviews: characteristic match between interviewer and interviewee, recording tacit knowledge, moving beyond normative expression and balancing disclosure with interviewee well-being. The paper concludes with a consideration of our assumptions of what constitutes a “successful” interview and offers guiding reflective questions for researchers who are considering semi-structured interviews. Further research is needed to explore the impact of different interview modes.
A Numerical Study of the Effect of Particle Size on Particle Deposition on Turbine Vanes and Blades
Authors: Liu Zhengang , Diao Weinan , Liu Zhenxia , Zhang Fei
Published: May 2021

Particle deposition could decrease the aerodynamic performance and cooling efficiency of turbine vanes and blades. The particle motion in the flow and its temperature are two important factors affecting its deposition. The size of the particle influences both its motion and temperature. In this study, the motion of particles with the sizes from 1 to 20 μm in the first stage of a turbine are firstly numerically simulated with the steady method, then the particle deposition on the vanes and blades are numerically simulated with the unsteady method based on the critical viscosity model. It is discovered that the particle deposition on vanes mainly formed near the leading and trailing edge on the pressure surface, and the deposition area expands slowly to the whole pressure surface with the particle size increasing. For the particle deposition on blades, the deposition area moves from the entire pressure surface toward the tip with the particle size increasing due to the effect of rotation. For vanes, the particle capture efficiency increases with the particle size increasing since Stokes number and temperature of the particle both increase with its size. For blades, the particle capture efficiency increases firstly and then decreases with the particle size increasing.
Trigeminal neuralgia and genetics: A systematic review
Authors: Mannerak Mari Aaroe , Lashkarivand Aslan , Eide Per Kristian
Published: May 2021

Trigeminal neuralgia (TN) is a severe facial pain disease of unknown cause and unclear genetic background. To examine the existing knowledge about genetics in TN, we performed a systematic study asking about the prevalence of familial trigeminal neuralgia, and which genes that have been identified in human TN studies and in animal models of trigeminal pain. MedLine, Embase, Cochrane Library and Web of Science were searched from inception to January 2021. 71 studies were included in the systematic review. Currently, few studies provide information about the prevalence of familial TN; the available evidence indicates that about 1–2% of TN cases have the familial form. The available human studies propose the following genes to be possible contributors to development of TN: CACNA1A, CACNA1H, CACNA1F, KCNK1, TRAK1, SCN9A, SCN8A, SCN3A, SCN10A, SCN5A, NTRK1, GABRG1, MPZ gene, MAOA gene and SLC6A4. Their role in familial TN still needs to be addressed. The experimental animal studies suggest an emerging role of genetics in trigeminal pain, though the animal models may be more relevant for trigeminal neuropathic pain than TN per se. In summary, this systematic review suggests a more important role of genetic factors in TN pathogenesis than previously assumed.
Clinical Problem-Solving: Lower Extremity Weakness & Paresthesia in an Immunocompromised Patient With a Complex Cancer History
Authors: Stamm Brian , Yu Margaret , Adrissi Jennifer , Brooker Sarah M. , Hac Nicholas E.F. , Priyadarshini Shubadra , Dixit Karan
Published: May 2021

We present a case of new onset bilateral lower extremity weakness, paresthesia, urinary retention and bowel incontinence in a 51-year-old man. He had a complicated history of acute myelogenous leukemia with known central nervous system (CNS) and leptomeningeal involvement status post allogenic stem cell transplant complicated by chronic graft versus host disease (GVHD). We review the differential diagnosis as the physical exam and diagnostic results evolved. We also provide a review of the relevant literature supporting our favored diagnosis, as well as other competing diagnoses in this complicated case. The ultimate differential diagnosis included viral myelitis, treatment-related myelopathies, and CNS GVHD. The case provides a sobering reminder that even with an appropriate diagnostic workup, some cases remain refractory to therapeutic efforts. It also underscores the importance of a sensitive neurologic exam, given the significant clinico-radiological delay, and reviews the complex differential diagnosis for myelopathy.
Bilateral carotid webs
Authors: Essibayi Muhammed Amir , Nasr Deena , Lanzino Giuseppe
Published: May 2021

Carotid web is thought to be a focal intimal variant of fibromuscular dysplasia, which comprises a high risk of stroke because of blood stasis and subsequent coagulative reactions that occur distal to the web. These lesions generally involve the posterolateral wall of the carotid and their developmental pathogenesis is controversial. This case report describes a 51-year-old woman who presented to the hospital with sudden onset aphasia, right hemi-sensory loss, and right visual field cut. Magnetic resonance imaging (MRI) of the brain demonstrated a left middle cerebral artery (MCA) distribution embolic ischemic infarct with shelf-like linear filling defects in the carotid bulb bilaterally on a computed tomography angiography (CTA) of the head and neck consistent with bilateral carotid webs that were confirmed by catheter angiography. The carotid webs were projecting on the left posteriorly and on the right anteriorly into the inferior aspects of the bilateral proximal internal carotid arteries. The patient was started on clopidogrel and a high-intensity statin and remained on Plavix monotherapy for a 10-month follow up without a recurrent ischemic event.
Vitamin D regulation of the immune system and its implications for COVID-19: A mini review
Authors: Bui Linda , Zhu Zahra , Hawkins Stephanie , Cortez-Resendiz Alonso , Bellon Alfredo
Published: May 2021

The novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is at the origin of the current pandemic, predominantly manifests with severe respiratory symptoms and a heightened immune response. One characteristic of SARS-CoV-2 is its capacity to induce cytokine storm leading to acute respiratory distress syndrome. Consequently, agents with the ability to regulate the immune response, such as vitamin D, could become tools either for the prevention or the attenuation of the most severe consequences of the coronavirus disease 2019 (COVID-19). Vitamin D has shown antimicrobial as well as anti-inflammatory properties. While SARS-CoV-2 promotes the release of proinflammatory cytokines, vitamin D attenuates the release of at least some of these same molecules. Inflammatory cytokines have been associated with the clinical phenomena of COVID-19 and in particular with its most dangerous complications. Therefore, the goals of this article are as follows: first, present the numerous roles vitamin D plays in modulating the immune response; second, gather data currently available on COVID-19 clinical presentation and its relation to cytokines and similar molecules; third, expose what it is known about how coronaviruses elicit an inflammatory reaction; and fourth, discuss the potential contribution of vitamin D in reducing the risk and severity of COVID-19.
TLR4-MyD88-NF-κB signaling pathway contributes to the progression of secondary hepatic injury and fibrosis in hepatolithiasis
Authors: Fang Yuan , Zhou Lulu , Hu Xiaoxuan , Guo Jingyun , Liao Jinmao , Zhang Zheng
Published: May 2021

This paper focused on evaluating the effect of TLR4-MyD88-NF-κB signaling pathway in the progression of secondary hepatic injury and fibrosis in hepatolithiasis. The levels of inflammatory factors (IL-1β, IL-6, TNF-α) and serum biochemical values (ALT, AST, Tbil, Dbil, ALP, GGT) were detected by ELISA. IHC was used to detected the expression level of TLR4 in liver tissues of hepatolithiasis patients and mice. The pathological changes of liver tissue were observed by HE staining. The levels of MyD88, NF-κB, IκB, Laminin (LN), and chitosan enzyme 3-like protein 1 (CHI3L1) were detected by western blotting. In hepatolithiasis patients, the levels of TNF-α, IL-1β, and IL-6 were distinctly raised and proteins associated with TLR4-MyD88-NF-κB signaling pathway (such as TLR4, MyD88, NF-κB, and IκB) in liver tissues were significantly up-regulated. In Bile duct ligation (BDL) model of mice, the results showed that in addition to the significant increase of inflammatory factors, liver function indexes, and fibrosis indexes in BDL mice were also significantly up-regulated. Additionally, TLR4-MyD88-NF-κB signaling pathway was activated in BDL mice. After TLR4 knockdown in BDL mice, inflammatory factors, liver function indexes, and fibrosis indexes were significantly down-regulated. TLR4-MyD88-NF-κB signaling pathway proteins were restrained. TLR4-MyD88-NF-κB signaling pathway took part in the progression of secondary hepatic injury and fibrosis in hepatolithiasis. Inhibition of TLR4-MyD88-NF-κB signaling pathway can reduce the progression of secondary hepatic injury and fibrosis in hepatolithiasis.
Understanding the Importance of Fatherhood among Men Living with HIV in Ontario
Authors: Kyne Luke Thomas , Yudin Mark H. , Bekele Tsegaye , Loutfy Mona , Rourke Sean B. , Watson James , Nguemo Djiometio Joseph , Antoniou Tony , Globerman Jason , McGee Adam , Kennedy V. Logan
Published: May 2021

While pregnancy and motherhood have become paramount clinical issues for women living with HIV, parenting has received less attention among men living with HIV (MLWH). We conducted a secondary analysis of a cross-sectional study assessing fertility desires and intentions of MLWH using a 5-point Likert scale based on the question: “Being a father is important to me”. Logistic regression models were fit to calculate unadjusted and adjusted odds ratios (ORs) and confidence intervals (CIs) for significant correlates. Of the 276 respondents, 118 were heterosexual, 158 were gay, bisexual, 2-spirit, or queer (GBTQ), 55% had never parented before, and 65% wanted to parent. 191 (69%) respondents agreed that fatherhood was important to them. In unadjusted analyses, heterosexuality (OR 1.52; 95% CI 1.15 to 2.03), African/Caribbean/Black ethnicity (OR 1.57; 95% CI 1.12 to 2.19), African/Caribbean birthplace (OR 1.48; 95% CI 1.06 to 2.05), and history of parenting (OR 1.60; 95% CI 1.10 to 2.39) were significantly (p < 0.05) associated with importance of fatherhood. However, none of these variables were significant in adjusted analyses. From the unadjusted model, factors such as sexual orientation, ethnicity, and current parenthood may influence how MLWH value fatherhood, suggesting HIV and fatherhood is complex and must be explored further.
Laparoscopic nephrectomy: Moroccan experience of 68 cases
Authors: Bilgo Abdoulazizi , Saouli Amine , Karmouni Tarik , Khader Khalid El , Koutani Abdellatif , Andalousi Ahmed Iben Attya
Published: May 2021

Background

The aim of this study was to analyze the feasibility and the safety of laparoscopic nephrectomy in the treatment of pathologies of the upper urinary tract through the experience of the Urology B department.

Methods

We have retrospectively and monocentrally selected patients who underwent laparoscopic nephrectomy from January 2017 to December 2019. The collection was carried out on archived files, based on demographic, clinical and perioperative data. The primary endpoint was the occurrence of complications and secondarily the length of the operation and the length of hospital stay. The statistical analysis was carried out using the SPSS software.

Results

A total of 68 patients were included in our series. The average age of our patients was 57.8 years. There was a slight female predominance: 39 female patients (57.4%) for 29 male patients (42.6%). Indications for nephrectomy were dominated by renal tumor (33.82%) followed by lithiasis (16.17%) and non-functioning kidney (16.17%) at the same rank. During the study period, 31 (45.6%) simple nephrectomy, 26 (38.2%) total nephrectomy, 1 (1.5%) partial nephrectomy and 10 (14.7%) nephroureterectomy were performed in our department. In our series, the average operating time was 180 min. Estimated blood loss averaged 321.8 ml with extremes of a few milliliter to 1100 ml. Intraoperative complications were reported in 10 (14.7%) patients; conversion was necessary in 6 cases (8.82%). The postoperative follow-up was straightforward in 53 (77.94%) patients with an average hospital stay of 3.6 days. The rate of postoperative complications according to Clavien–Dindo was 22.1%. Histological examination of the nephrectomies carried out in our department revealed mainly chronic non-specific pyelonephritis in 24 (35.3%) patients, followed by renal cell carcinoma in 23 (33.82%) patients and urothelial carcinoma in 9 (13.2%) patients.

Conclusion

Laparoscopic nephrectomy appears to be an efficient and reliable technique. This technique has led to a significant improvement in operative morbidity, mainly represented by the length of hospital stay, operating time and blood loss.
Correction to: Glass-bottled drinking water: a time capsule to study the historic presence of hazardous chemicals using effect-based methods
Authors: Lundqvist Johan , Persson Kenneth M. , Oskarsson Agneta
Published: May 2021

An amendment to this paper has been published and can be accessed via the original article.
Prunus persica plant endogenous peptides PpPep1 and PpPep2 cause PTI-like transcriptome reprogramming in peach and enhance resistance to Xanthomonas arboricola pv. pruni
Authors: Foix Laura , Nadal Anna , Zagorščak Maja , Ramšak Živa , Esteve-Codina Anna , Gruden Kristina , Pla Maria
Published: May 2021

Background

Rosaceae species are economically highly relevant crops. Their cultivation systems are constrained by phytopathogens causing severe losses. Plants respond to invading pathogens through signaling mechanisms, a component of which are of them being plant elicitor peptides (Peps). Exogenous application of Peps activates defense mechanisms and reduces the symptoms of pathogen infection in various pathosystems. We have previously identified the Rosaceae Peps and showed, in an ex vivo system, that their topical application efficiently enhanced resistance to the bacterial pathogen Xanthomonas arboricola pv. pruni (Xap).

Results

Here we demonstrate the effectiveness of Prunus persica peptides PpPep1 and PpPep2 in protecting peach plants in vivo at nanomolar doses, with 40% reduction of the symptoms following Xap massive infection. We used deep sequencing to characterize the transcriptomic response of peach plants to preventive treatment with PpPep1 and PpPep2. The two peptides induced highly similar massive transcriptomic reprogramming in the plant. One hour, 1 day and 2 days after peptide application there were changes in expression in up to 8% of peach genes. We visualized the transcriptomics dynamics in a background knowledge network and detected the minor variations between plant responses to PpPep1 and PpPep2, which might explain their slightly different protective effects. By designing a P. persica Pep background knowledge network, comparison of our data and previously published immune response datasets was possible.

Conclusions

Topical application of P. persica Peps mimics the PTI natural response and protects plants against massive Xap infection. This makes them good candidates for deployment of natural, targeted and environmental-friendly strategies to enhance resistance in Prunus species and prevent important biotic diseases.
Genome-wide identification and expression analysis of the AT-hook Motif Nuclear Localized gene family in soybean
Authors: Wang Min , Chen Bowei , Zhou Wei , Xie Linan , Wang Lishan , Zhang Yonglan , Zhang Qingzhu
Published: May 2021

Background

Soybean is an important legume crop and has significant agricultural and economic value. Previous research has shown that the AT-Hook Motif Nuclear Localized (AHL) gene family is highly conserved in land plants, playing crucial roles in plant growth and development. To date, however, the AHL gene family has not been studied in soybean.

Results

To investigate the roles played by the AHL gene family in soybean, genome-wide identification, expression patterns and gene structures were performed to analyze. We identified a total of 63 AT-hook motif genes, which were characterized by the presence of the AT-hook motif and PPC domain in soybean. The AT-hook motif genes were distributed on 18 chromosomes and formed two distinct clades (A and B), as shown by phylogenetic analysis. All the AHL proteins were further classified into three types (I, II and III) based on the AT-hook motif. Type-I was belonged to Clade-A, while Type-II and Type-III were belonged to Clade-B. Our results also showed that the main type of duplication in the soybean AHL gene family was segmented duplication event.

To discern whether the AHL gene family was involved in stress response in soybean, we performed cis-acting elements analysis and found that AHL genes were associated with light responsiveness, anaerobic induction, MYB and gibberellin-responsiveness elements. This suggest that AHL genes may participate in plant development and mediate stress response. Moreover, a co-expression network analysis showed that the AHL genes were also involved in energy transduction, and the associated with the gibberellin pathway and nuclear entry signal pathways in soybean. Transcription analysis revealed that AHL genes in Jack and Williams82 have a common expression pattern and are mostly expressed in roots, showing greater sensitivity under drought and submergence stress. Hence, the AHL gene family mainly reacts on mediating stress responses in the roots and provide comprehensive information for further understanding of the AT-hook motif gene family-mediated stress response in soybean.

Conclusion

Sixty-three AT-hook motif genes were identified in the soybean genome. These genes formed into two distinct phylogenetic clades and belonged to three different types. Cis-acting elements and co-expression network analyses suggested that AHL genes participated in significant biological processes. This work provides important theoretical basis for the understanding of AHLs biological functions in soybean.
Short term cognitive function after sevoflurane anesthesia in patients suspect to obstructive sleep apnea syndrome: an observational study
Authors: Wagner Soeren , Sutter Lorenz , Wagenblast Fabian , Walther Andreas , Schiff Jan-Henrik
Published: May 2021

Background

The obstructive sleep apnea syndrome (OSAS) is characterized by intermittent cerebral hypoxia which can cause cognitive alterations. Likewise, hypoxia induced neurocognitive deficits are detectable after general anesthesia using volatile anesthetics.

The objective of this study was to evaluate the association between a moderate to high risk patients of OSAS and postoperative cognitive dysfunction after volatile anesthesia.

Methods

In this single center prospective, observational study between May 2013 and September 2013, 46 patients aged 55 to 80 years with an estimated hospital stay of at least 3 days undergoing surgery were enrolled. Patients were screened using the STOP-BANG test with score of 3 or higher indicating moderate to high risk of OSAS. The cognitive function was assessed using a neuropsychological assessment battery, including the DemTect test for cognitive impairment among other tests e.g. SKT memory, the day before surgery and within 2 days after extubation.

Results

Twenty-three of the 46 analyzed patients were identified with a moderate to high risk of OSAS. When comparing post- to preoperative phase a significant better performance for the SKT was found for both groups (p <  0.001). While the moderate to high risk group scores increased postoperative in the DemTect test, they decreased in the low risk group (p <  0.003). When comparing the changes between groups, the moderate to high risk patients showed significant better test result for DemTect testing after anaesthesia. This effect remained robust when adjusting for potential confounding variables using a two-factor ANOVA.

Conclusion

Compared to low risk, a moderate to high risk of OSAS based on the STOP-BANG score was associated with improved postoperative cognitive function measured by the DemTect test.

Trial registration

The study was approved by the local Ethics committee (Ethikkommission der Medizinischen Fakultät der Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany) (reference number:87_12 B) on 19.04.2012.
Immunohistochemical staining for IMP3 in patients with duodenal papilla tumors: assessment of the potential for diagnosing endoscopic resectability and predicting prognosis
Authors: Tanaka Hiroyuki , Kawashima Hiroki , Ohno Eizaburo , Ishikawa Takuya , Iida Tadashi , Ishikawa Eri , Furukawa Kazuhiro , Nakamura Masanao , Honda Takashi , Shimoyama Yoshie , Miyahara Ryoji , Kawabe Naoto , Kuzuya Teiji , Hashimoto Senju , Ishigami Masatoshi , Hirooka Yoshiki , Fujishiro Mitsuhiro
Published: May 2021

Background

Endoscopic papillectomy of duodenal papillary tumors (PT) is indicated for adenomas or well-differentiated adenocarcinomas that do not involve the sphincter of Oddi. However, there is currently no reliable pre-operative method to diagnose the infiltration in the sphincter of Oddi.’ Insulin-like growth factor 2 mRNA protein 3 (IMP3) staining is reportedly associated with advanced disease stage and clinical outcomes in many carcinomas. The aim of this retrospective study was to investigate the ability of diagnosing sphincter of Oddi involvement in PT and predicting the prognoses using IMP3 immunohistochemistry.

Methods

Twenty-five resected specimens from patients with PT and 24 biopsy specimens from the same patients excluding one were immunostained for IMP3. The percentage of positive cells in the tumor was evaluated and compared with the final pathological diagnosis and prognosis.

Results

The final pathological diagnoses were adenoma in 5 patients and adenocarcinoma in 20 patients (no sphincter of Oddi involvement in 5 and involvement in 15). The ability to diagnose sphincter of Oddi involvement based on the percentage of IMP3-positive cells in resected specimens and tissue biopsies was the area under the curve 0.8 and 0.78, respectively, of the receiver operating characteristic curve, and the accuracies were 80.0% and 75.0% (cutoff value: 10%), respectively. Moreover, patients with an IMP3-positive cell rate of ≥ 10% had a significantly worse prognosis (log-rank test P = 0.01).

Conclusion

IMP3 immunostaining of resected and biopsy specimens from PT patients enables the diagnosis of sphincter of Oddi involvement objectively and is also effective in predicting the prognosis.
Primary intestinal lymphangiectasia presenting as limb hemihyperplasia: a case report and literature review
Authors: Khayat Ammar A.
Published: May 2021

Background

Primary intestinal lymphangiectasia is an exceedingly rare disorder. Epidemiology is unknown. It usually presents with lower extremity swelling, diarrhea, ascites, and protein-losing enteropathy. Since the pathogenesis of edema is usually due to hypoalbuminemia; both extremities are typically involved. The edema can rarely be due to abnormal lymphatic circulation, causing lymphedema, which usually involves both extremities as well. Diagnosis is made by the constellation of clinical, biochemical, endoscopic, and histological findings. Treatment involves dietary modification, to reduce lymphatic dilation in response to dietary fat. Other pharmacologic (e.g., octreotide) and replacement measures may be indicated as well. The most serious long-term complication is intestinal lymphoma. Herein is a case of Primary intestinal lymphangiectasia presenting with unilateral lower limb swelling.

Case presentation

A 4-year-old boy presents with left foot swelling since the age of 4 months, in addition to intermittent diarrhea, and abdominal swelling. The foot swelling had been evaluated by different health care professionals in the past, and was mislabeled as either cellulitis, or congenital hemihyperplasia. Physical examination revealed mild ascites, and a non-pitting foot edema with a positive Stemmer’s sign (lymphedema). Blood work revealed hypoalbuminemia (albumin 2 g/dl), and hypogammaglobulinemia. Endoscopy showed dilated lacteals throughout the duodenum. Histopathologic examination revealed massively dilated lamina propria lymphatics in the duodenal biopsies. The patient was diagnosed with primary intestinal lymphangiectasia. He was treated with high-protein and low-fat diet, and supplemental formula high in medium chain triglycerides. On follow-up, the patient’s diarrhea completely resolved, and his ascites and edema improved significantly.

Conclusions

The presence of unilateral lower limb edema should not preclude the diagnosis of systemic disorders, and a high index of suspicion is required in atypical presentations. A good knowledge about Primary intestinal lymphangiectasia manifestations, and physical examination skills to differentiate edema or lymphedema from tissue overgrowth can significantly aid in the diagnosis.
Acceptability, feasibility, and impact of a pilot tuberculosis literacy and treatment counselling intervention: a mixed methods study
Authors: Law Stephanie , Seepamore Boitumelo , Oxlade Olivia , Sikhakhane Nondumiso , Dawood Halima , Chetty Sheldon , Padayatchi Nesri , Menzies Dick , Daftary Amrita
Published: May 2021

Background

There is a need for innovative strategies to improve TB testing uptake and patient retention along the continuum of TB care early-on in treatment without burdening under-resourced health systems. We used a mixed methods approach to develop and pilot test a tuberculosis literacy and counselling intervention at an urban clinic in KwaZulu Natal, South Africa, to improve TB testing uptake and retention in tuberculosis care.

Methods

We engaged in discussions with clinic staff to plan and develop the intervention, which was delivered by senior social work students who received one-week training. The intervention included: 1) group health talks with all patients attending the primary clinic; and 2) individual counselling sessions, using motivational interviewing techniques, with newly diagnosed tuberculosis patients. We compared social work students’ tuberculosis knowledge, attitudes, and practices before and after their training. We assessed the change in number of tuberculosis diagnostic tests performed after implementation via an interrupted time series analysis with a quasi-Poisson regression model. We compared pre- and post-intervention probabilities of treatment initiation and completion using regression analyses, adjusting for potential baseline confounders. We conducted focus groups with the students, as well as brief surveys and one-on-one interviews with patients, to assess acceptability, feasibility, and implementation.

Results

During the study period, 1226 individuals received tuberculosis diagnostic testing and 163 patients started tuberculosis treatment, of whom 84 (51.5%) received individual counselling. The number of diagnostic tuberculosis tests performed increased by 1.36 (95%CI 1.23–1.58) times post-intervention, adjusting for background calendar trend. Probabilities of TB treatment initiation and treatment completion increased by 10.1% (95%CI 1.5–21.3%) and 4.4% (95%CI -7.3-16.0%), respectively. Patients found the counselling sessions alleviated anxiety and increased treatment self-efficacy. Social work students felt the clinic staff were collaborative and highly supportive of the intervention, and that it improved patient engagement and adherence.

Conclusions

Engaging clinic staff in the development of an intervention ensures buy-in and collaboration. Education and counselling before and early-on in tuberculosis treatment can increase tuberculosis testing and treatment uptake. Training junior social workers can enable task-shifting in under-resourced settings, while addressing important service gaps in tuberculosis care.
Multiple pericardial hematomas: a case report and mini-review in multimodality imaging
Authors: Saboe Aninka , Sanjaya Ferdy , Soeriadi Raden Erwin Affandi , Maryani Euis , Kusumawardhani Nuraini Yasmin , Cool Charlotte Johanna , Astuti Astri
Published: May 2021

Background

Pericardial hematoma is blood accumulation in the pericardial space. Although rare, it could arise in various conditions, such as after cardiac surgery. Clinical diagnosis of pericardial hematoma is implausible; thus, cardiac imaging plays a pivotal role in identifying this condition. We presented a case of multiple pericardial hematomas, which was found as an incidental finding in post-cardiac surgery evaluation. We highlighted the diagnostic challenge and the key features of multi-modality cardiac imaging in pericardial hematoma evaluation.

Case presentation

An asymptomatic, 35-years old male, who underwent surgical closure of secundum atrial septal defect (ASD) one month ago, came for routine transthoracic echocardiography evaluation. An intrapericardiac hematoma was visualized at the right ventricle (RV) 's free wall side. Another mass with an indistinct border was visualized near the right atrium (RA). This mass was suspected as pericardial hematoma differential diagnosed with intracardiac thrombus. Cardiac computed tomography (CT) scan showed both masses have an attenuation of 30–40 HU; however, the mass's border at the RA side was still not clearly delineated. Mild superior vena cava (SVC) compression and multiple mediastinal lymphadenopathies were also detected. These findings are not typical for pericardial hematomas nor intracardiac thrombus; hence another additional differential diagnosis of pericardial neoplasm was considered. We pursued further cardiac imaging modalities because the patient refused to undergo an open biopsy. Single-photon emission computer tomography (SPECT)/CT with Technetium-99 m (Tc-99 m) macro-aggregated albumin (MAA) and Sestamibi showed filling defect without increased radioactivity, thus exclude the intracardiac thrombus. Cardiac magnetic resonance imaging (MRI) reveals intrapericardial masses with low intensity of T1 signal and heterogeneously high intensity on T2 signal weighted imaged and no evidence of gadolinium enhancement, which concluded the diagnosis as subacute pericardial hematomas. During follow-up, the patient remains asymptomatic, and after six months, the pericardial hematomas were resolved.

Conclusion

Pericardial hematoma should be considered as a cause of pericardial masses after cardiac surgery. When imaging findings are atypical, further multi-modality cardiac imaging must be pursued to establish the diagnosis. Careful and meticulous follow-up should be considered for an asymptomatic patient with stable hemodynamic.