bluuebunny/crossref_metadata_2025 huggingface dataset:
Nomogram to predict cause-specific mortality of patients with rectal adenocarcinoma undergoing surgery: a competing risk analysis
Authors: Zhang Xu , Xu Fengshuo , Bin Yadi , Liu Tianjie , Li Zhichao , Guo Dan , Li Yarui , Huang Qiao , Lyu Jun , He Shuixiang
Published: February 2022

Background

Rectal adenocarcinoma is one of major public health problems, severely threatening people’s health and life. Cox proportional hazard models have been applied in previous studies widely to analyze survival data. However, such models ignore competing risks and treat them as censored, resulting in excessive statistical errors. Therefore, a competing-risk model was applied with the aim of decreasing risk of bias and thereby obtaining more-accurate results and establishing a competing-risk nomogram for better guiding clinical practice.

Methods

A total of 22,879 rectal adenocarcinoma cases who underwent primary-site surgical resection were collected from the SEER (Surveillance, Epidemiology, and End Results) database. Death due to rectal adenocarcinoma (DRA) and death due to other causes (DOC) were two competing endpoint events in the competing-risk regression analysis. The cumulative incidence function for DRA and DOC at each time point was calculated. Gray’s test was applied in the univariate analysis and Gray’s proportional subdistribution hazard model was adopted in the multivariable analysis to recognize significant differences among groups and obtain significant factors that could affect patients’ prognosis. Next, A competing-risk nomogram was established predicting the cause-specific outcome of rectal adenocarcinoma cases. Finally, we plotted calibration curve and calculated concordance indexes (c-index) to evaluate the model performance.

Results

22,879 patients were included finally. The results showed that age, race, marital status, chemotherapy, AJCC stage, tumor size, and number of metastasis lymph nodes were significant prognostic factors for postoperative rectal adenocarcinoma patients. We further successfully constructed a competing-risk nomogram to predict the 1-year, 3-year, and 5-year cause-specific mortality of rectal adenocarcinoma patients. The calibration curve and C-index indicated that the competing-risk nomogram model had satisfactory prognostic ability.

Conclusion

Competing-risk analysis could help us obtain more-accurate results for rectal adenocarcinoma patients who had undergone surgery, which could definitely help clinicians obtain accurate prediction of the prognosis of patients and make better clinical decisions.
Linked nosocomial COVID-19 outbreak in three facilities for people with intellectual and developmental disabilities due to SARS-CoV-2 variant B.1.1.519 with spike mutation T478K in the Netherlands
Authors: Gorgels Koen M. F. , Dingemans Jozef , van der Veer Brian M. J. W. , Hackert Volker , Hensels Audrey Y. J. , den Heijer Casper D. J. , van Alphen Lieke B. , Savelkoul Paul H. M. , Hoebe Christian J. P. A.
Published: February 2022

Background

Individuals with intellectual and developmental disabilities (IDD) living in congregated settings have increased risk of COVID-19 infection and mortality. Little is known about variant B.1.1.519 with spike mutation T478K, dominant in Mexico. We describe a linked SARS-CoV-2 B.1.1.519 outbreak in three IDD facilities in the Netherlands.

Methods

Following notification of the index, subsequent cases were identified through serial PCR group testing. Positive specimens were submitted for whole-genome-sequencing. Clinical information was gathered through interviews with staff members of the three facilities.

Results

Attack rate (AR) in clients of the index facility was 92% (23/25), total AR in clients 45% (33/73) and in staff members 24% (8/34). 55% (18/33) of client cases were asymptomatic, versus 25% (2/8) of staff members. Five client cases (15%) were hospitalized, two died (6%). Sequencing yielded the same specific B.1.1.519 genotype in all three facilities. No significant difference in median viral load was established comparing the B.1.1.519 variant with other circulating variants. The index of the linked outbreak reported no travel history or link to suspected or confirmed cases suggesting regional surveillance. Observed peak regional prevalence of B.1.1.519 during the outbreak supports this.

Conclusion

AR, morbidity and mortality prior to control measures taking effect were high, probably related to the specific characteristics of the IDD setting and its clients. We assessed no evidence for intrinsic contributing properties of variant B.1.1.519. Our study argues for enhanced infection prevention protocols in the IDD setting, and prioritization of this group for vaccination against COVID-19.
Morphometry of cerebral arterial bifurcations harbouring aneurysms: a case-control study
Authors: Ćmiel-Smorzyk K. , Kawlewska E. , Wolański W. , Hebda A. , Ładziński P. , Kaspera W.
Published: February 2022

Background

Conclusions from studies evaluating vessel dimensions and their deviations from values resulting from the principle of minimum work (PMW) on the formation of intracranial aneurysms (IAs) are still inconclusive. Our study aimed to perform a morphometric analysis of cerebral arterial bifurcations harbouring aneurysms.

Methods

The study comprised 147 patients with basilar artery (BA) and middle cerebral artery (MCA) aneurysms and 106 patients constituting the control group. The following morphometric parameters were evaluated: the radii of vessels forming the bifurcation, the junction exponent, the values of the bifurcation angles (Φ1 and Φ2 angles between the parent vessel trunk axis and the larger or smaller branches, respectively; α angle, the total bifurcation angle) and the difference between the predicted optimal and observed branch angles.

Results

The analysed parameters for internal carotid artery (ICA) bifurcations were not significantly different among the groups. The MCA and BA bifurcation angles and the radii of the parent MCA and BA vessels with aneurysms were significantly higher than those of the control group. The differences between the predicted optimal and observed branch angles were significantly higher for BA and MCA bifurcations with aneurysms compared to the control group. The mean junction exponent for bifurcations in the circle of Willis (i.e., ICA and BA bifurcations, respectively) and MCA bifurcations with aneurysms was significantly lower than the theoretical optimum and did not significantly differ among the groups. In a multilevel multivariate logistic regression analysis, the branch angles and the radius from the parent vessel were significant independent predictors of the presence of an IA. The ROC analysis indicated that the α angle was the best performer in discriminating between aneurysmal and nonaneurysmal bifurcations.

Conclusions

The dimensions of the arteries forming the circle of Willis do not follow the PMW. Deviation from the energetically optimum geometry for bifurcations beyond the circle of Willis (particularly, a larger radius of the parent artery and a wider total bifurcation angle) may lead to the formation of IAs. Further studies are warranted to investigate the significance of vessel dimensions and the bifurcation angle on the magnitude of shear stress in the walls of arterial bifurcations.
Perception of pregnant women towards early antenatal visit in Fiji: a qualitative study
Authors: Maharaj Renita , Mohammadnezhad Masoud
Published: February 2022

Background

Antenatal Care (ANC) is an opportunity to provide care to prevent potential maternal and new born mortality and morbidity and reduce new born mortality and morbidity. There has been an increase in the number of women receiving early ANC over the last two decades, however, in many developing regions such as Fiji, women are still delaying initiation of ANC. Therefore, the aim of this study is primarily to explore reasons for delayed initiation of ANC appointments and to explore knowledge and perception of pregnant mothers towards early antenatal appointments in Fiji.

Methods

The study uses a qualitative approach. Data was collected among pregnant women more than 18 years of age after 12 weeks of gestation attending their first ANC clinic at the Ba Mission Hospital (BMH) from February 28 to April 2, 2020. Heterogenous purposeful sampling method was used to select 25 pregnant women for the study. A semi-structured open-ended questionnaire was used for face to face in-depth interviews. Data was analyzed manually using thematic content analysis after verbatim transcription of the interviews.

Results

The mean age of the participants was 25.8 ± 5.9 years (age range of 19–40 years). The average gestational age of those making a booking for a consultation was 5.4 ± 1.4 months with a range of 4 to 8 months. The majority of women were multigravida (64%) and multiparous (40%). The main themes that emerged from the study were: i) perception of early ANC booking; ii) perceived barriers of early ANC booking and; iii) enabling factors of early ANC booking. Even though pregnant women have a good knowledge of when to initiate ANC, the practice of early booking was influenced by many other factors.

Conclusions

The results of this study highlight the need to change the current booking system. Efforts are needed to attract the hard-to-reach women through outreach visits and increased communication between health care workers and the community with the use of community resources such as community health workers and traditional birth attendants. The media should be used to create awareness on timing and importance of early ANC visits at a community level.
Substance use in childhood and adolescence and its associations with quality of life and behavioral strengths and difficulties
Authors: Frobel Wiebke , Grafe Nico , Meigen Christof , Vogel Mandy , Hiemisch Andreas , Kiess Wieland , Poulain Tanja
Published: February 2022

Background

Substance use in childhood and adolescence continues to be a current health concern. The aims of the present study were to identify trends in the use of alcohol, cigarettes, and cannabis in children and adolescents in the last 10 years and to assess associations between substance use and quality of life and behavioral strengths and difficulties.

Methods

Substance use was examined in 1829 9- to 18-year-old German children and adolescents participating in the LIFE Child cohort study between 2011 and 2020. Quality of life was investigated using the KIDSCREEN-27 questionnaire. The Strength and Difficulties Questionnaire was used to assess behavioral strengths and difficulties. Associations were assessed using linear regression analyses. All effects were adjusted for age, gender, and family socio-economic status.

Results

38.44% of participants reported drinking alcohol at least sometimes. Smoking (6.23%) and the use of cannabis (3.94%) were less frequent. While we observed no significant changes in smoking between 2011 and 2021, the consumption of cannabis and the frequent consumption of alcohol has increased in this time period. Cigarette and cannabis use were associated with additional symptoms of hyperactivity/inattention and reduced prosocial behavior. For all three substances, usage was associated with more conduct problems. We also found significant associations between substance use and a lower quality of life in the areas of physical wellbeing, psychological wellbeing, parent relation and autonomy, and school environment. One noteworthy finding was that cigarette consumption and frequent alcohol use were associated with higher quality of life in terms of social support/peer group relations. Some significant interactions between substance use and child age indicated that associations between substance use and quality of life or behavioral difficulties were stronger in younger than in older children.

Conclusions

The results show that quality of life and behavioral difficulties are associated with substance use and should be considered when developing or implementing preventive measures to counter substance use. Furthermore, the findings indicate that substance use can be accompanied by improved peer relations. Therefore, the influence of peers, especially of peers who use these substances, should not be underestimated.
Does gender matter? The association between different digital media activities and adolescent well-being
Authors: Svensson Robert , Johnson Björn , Olsson Andreas
Published: February 2022

Background

Previous research on the relationship between social media use and well-being in adolescents has yielded inconsistent results. We addressed this issue by examining the association between various digital media activities, including a new and differentiated measure of social media use, and well-being (internalizing symptoms) in adolescent boys and girls.

Method

The sample was drawn from the four cross-sectional surveys from the Öckerö project (2016–2019) in eight municipalities in southern Sweden, consisting of 3957 adolescents in year 7 of compulsory education, aged 12–13. We measured the following digital media activities: playing games and three different activities of social media use (chatting, online sociability, and self-presentation). Our outcome measure was internalizing symptoms. Hypotheses were tested with linear regression analysis.

Results

Social media use and playing games were positively associated with internalizing symptoms. The effect of social media use was conditional on gender, indicating that social media use was only associated with internalizing symptoms for girls. Of the social media activities, only chatting and self-presentation (posting information about themselves) were positively associated with internalizing symptoms. Self-presentation was associated with internalizing symptoms only for girls.

Conclusion

Our study shows the importance of research going beyond studying the time spent on social media to examine how different kinds of social media activities are associated with well-being. Consistent with research in psychology, our results suggest that young girls posting information about themselves (i.e. self-presentation) might be especially vulnerable to display internalizing symptoms.
Middle-aged preparation for healthy aging: a qualitative study
Authors: Solhi Mahnaz , Pirouzeh Razieh , Zanjari Nasibeh
Published: February 2022

Background

Preparing for aging is investing resources in preparing to cope with the challenges that are expected to happen in older age. This will lead to an increase in the quality and well-being in aging. The present study was conducted to elucidate the preparation of the middle-aged people for healthy older age in Tehran, Iran.

Methods

The present study was performed with a qualitative approach and using semi-structured interviews with 23 Iranian middle-aged people (45 to 59 years old), selected by purposive sampling, and the interviews continued until theoretical saturation. Data were analyzed using the content analysis technique with MAXQDA 10 software.

Results

The preparation of the middle-aged people was examined in four main categories including staying healthy, financial perspective for the future, outlook on aging, and planning for use time productively. The middle-aged people paid more attention to Staying healthy than other dimensions and the saw their future financially as very dark. Outlook on aging and planning for use time productively dimensions were less considered by the subjects.

Discussion

Preparing for healthy aging is a multidimensional concept. The results of the study showed that the middle-aged studied in Iranian society rarely had the necessary preparation and planning to have healthy aging, also preparation is outside the individual behavioral factors and is more affected by the economic situation of the society. So, interventions and the country’s macro-policy are needed to plan for healthy aging these people.
Association between plasma sRAGE and emphysema according to the genotypes of AGER gene
Authors: Sin Sooim , Lim Myung-nam , Kim Jeeyoung , Bak So Hyeon , Kim Woo Jin
Published: February 2022

Background

Higher soluble receptor for advanced glycation end product (sRAGE) levels are considered to be associated with severe emphysema. However, the relationship remains uncertain when the advanced glycation end-product specific receptor (AGER) gene is involved. We aimed to analyse the association between sRAGE levels and emphysema according to the genotypes of rs2070600 in the AGER gene.

Methods

We genotyped rs2070600 and measured the plasma concentration of sRAGE in each participant. Emphysema was quantified based on the chest computed tomography findings. We compared sRAGE levels based on the presence or absence and severity of emphysema in each genotype. Multiple logistic and linear regression models were used for the analyses.

Results

A total of 436 participants were included in the study. Among them, 64.2% had chronic obstructive pulmonary disease and 34.2% had emphysema. Among the CC-genotyped participants, the sRAGE level was significantly higher in participants without emphysema than in those with emphysema (P < 0.001). In addition, sRAGE levels were negatively correlated with emphysema severity in CC-genotyped patients (r = − 0.268 P < 0.001). Multiple regression analysis revealed that sRAGE was an independent protective factor for the presence of emphysema (adjusted odds ratio, 0.24; 95% confidence interval (CI) 0.11–0.51) and severity of emphysema (β = − 3.28, 95% CI − 4.86 to − 1.70) in CC-genotyped participants.

Conclusion

Plasma sRAGE might be a biomarker with a protective effect on emphysema among CC-genotyped patients of rs2070600 on the AGER gene. This is important in determining the target group for the future prediction and treatment of emphysema.
Effect of archwire plane and archwire size on anterior teeth movement in sliding mechanics in customized labial orthodontics: a 3D finite element study
Authors: Wu Jianhua , Wang Xiaoting , Jiang Yiyang , Wu Zichen , Shen Qun , Chen Yucheng , Meng Qianjiao , Ye Niansong
Published: February 2022

Background

The aim of this study was to evaluate anterior teeth movement with different archwire planes and archwire sizes during space closure with and without miniscrew in sliding mechanics.

Methods

A 3D finite element method was applied to simulate anterior teeth retraction with and without miniscrew and power arm. Initial displacements and pressure stresses of periodontal tissue in anterior teeth were calculated after the teeth were applied with retraction forces with different archwire planes and archwire sizes.

Results

High archwire plane showed better torque control of anterior teeth in both sliding mechanics. With intramaxillary retraction, anterior teeth showed lingual tipping and extrusion movement, whereas larger-size archwires did not reduce it. In miniscrew sliding mechanics, anterior teeth showed labial tipping and intrusion movement. Compared with intramaxillary retraction, the retraction force produced less pressure stress on periodontal tissue in miniscrew sliding mechanics with long power arm.

Conclusions

Higher archwire plane is conducive to anterior teeth torque control. In order to achieve the bodily movement of the anterior teeth during space closure, it is more important to choose the appropriate method (miniscrew sliding mechanics with long power arm), instead of increasing the size of the archwire.
Quantitative influence and performance analysis of virtual reality laparoscopic surgical training system
Authors: Yu Peng , Pan Junjun , Wang Zhaoxue , Shen Yang , Li Jialun , Hao Aimin , Wang Haipeng
Published: February 2022

Background

Virtual reality (VR) surgery training has become a trend in clinical education. Many research papers validate the effectiveness of VR-based surgical simulators in training medical students. However, most existing articles employ subjective methods to study the residents’ surgical skills improvement. Few of them investigate how to improve the surgery skills on specific dimensions substantially.

Methods

Our paper resorts to physiological approaches to objectively study the quantitative influence and performance analysis of VR laparoscopic surgical training system for medical students. Fifty-one participants were recruited from a pool of medical students. They conducted four pre and post experiments in the training box. They were trained on VR-based laparoscopic surgery simulators (VRLS) in the middle of pre and post experiments. Their operation and physiological data (heart rate and electroencephalogram) are recorded during the pre and post experiments. The physiological data is used to compute cognitive load and flow experience quantitatively. Senior surgeons graded their performance using newly designed hybrid standards for fundamental tasks and Global operative assessment of laparoscopic skills (GOALS) standards for colon resection tasks. Finally, the participants were required to fill the questionnaires about their cognitive load and flow experience.

Results

After training on VRLS, the time of the experimental group to complete the same task could drop sharply (p < 0.01). The performance scores are enhanced significantly (p < 0.01). The performance and cognitive load computed from EEG are negatively correlated (p < 0.05).

Conclusion

The results show that the VRLS could highly improve medical students' performance and enable the participants to obtain flow experience with a lower cognitive load. Participants' performance is negatively correlated with cognitive load through quantitative physiological analysis. This might provide a new way of assessing skill acquirement.
Prevalence of podoconiosis and its associated factors in Gamo zone, Southern Ethiopia, 2021
Authors: Getachew Tamiru , Churko Chuchu
Published: February 2022

Background

Podoconiosis is a chronic non‐infectious preventable disease. Though not fatal, it may cause social, economic and physical disability. Ethiopia is projected to bear one‐fourth (25%) of the global burden of podoconiosis. Despite its huge economic impact and chronic morbidity and disability, podoconiosis seems to be neglected. Therefore, the aim of this study was to assess the prevalence of podoconiosis and its associated factors in Gamo zone, Southern Ethiopia.

Methods

A community based cross sectional study was conducted among 683 household members. A multistage sampling method was used to select study participants. Binary logistic regression model was fitted to identify factors associated with podoconiosis. Odds ratio with 95% confidence interval was computed to determine the level of significance; in multivariable analysis, variables with a P value less than 0.05 were considered as statistically significant.

Results

The prevalence of podoconiosis was 6.2% (95%CI: 4.3–8%). The significantly contributed factors for the prevalence of podoconiosis were wealth index (AOR = 0.249, 95%CI = 0.073–0.845), number of shoes owned (AOR = 6.199, 95% CI = 1.281–29.98), times when individual do not wear shoes (AOR = 2.448, 95%CI = 1.041–5.754), soap utilization during foot washing (AOR = 2.773, 95%CI = 1.210–6.355) and family history of leg swelling (AOR = 4.69, 95%CI = 2.215–9.935).

Conclusions

This study showed that there was significant burden of podoconiosis in the study area. Wealth index, times when individual do not wear shoes, number of shoes owned, soap utilization during foot washing, and family history of leg swelling were significantly associated with podoconiosis. It is recommended to practice secondary prevention which includes regular foot hygiene and wearing shoes, and the use of antiseptic soaks.
Antimicrobial activities of fungus comb extracts isolated from Indomalayan termite (Macrotermes gilvus Hagen) mound
Authors: Witasari Lucia Dhiantika , Wahyu Khairunnasa Wizdjanul , Anugrahani Bonifasia Junita , Kurniawan Dina Clarissa , Haryanto Aris , Nandika Dodi , Karlinasari Lina , Arinana Arinana , Batubara Irmanida , Santoso Djoko , Rachmayanti Yanti , Firmansyah Dikhi , Sudiana I Ketut , Hertanto Decsa Medika
Published: February 2022

Incorporating antimicrobial components into food packaging materials can prevent microbial contamination. Fungus combs could be an alternative source of natural antimicrobial agents. In this study, n-hexane, ethyl acetate, methanol, and water extracts were obtained from fungus combs isolated from Indomalayan termite (Macrotermes gilvus Hagen) mound. Their antibacterial and antifungal activities against food spoilage microorganisms including Escherichia coli ATCC 25922, Pseudomonas aeruginosaATCC 27853, Staphylococcus aureus ATCC 25923, Aspergillus flavus, and Aspergillus niger were evaluated by Kirby–Bauer disc diffusion and microdilution. Results showed that ethyl acetate extract formed the largest diameter inhibition zone for all tested bacteria and fungi, exhibited antibacterial activity against all tested bacteria with minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of 0.39 and 0.78 mg/mL, respectively, and suppressed A. flavus and A. niger with an MIC value of 0.78 mg/mL. This extract contained guaiacol and syringol, which were predicted as the main antimicrobial components in fungus comb. n-Hexane extract only inhibited Gram-positive bacteria. S. aureus ATCC 25923 was the most sensitive to all the extracts, and A. flavus was more sensitive than A. niger. All these fungus comb extracts exhibited antimicrobial activity against E. coli ATCC 25922, P. aeruginosa ATCC 27853, S. aureus ATCC 25923, A. flavus, and A. niger. This study revealed that fungus comb extracts, especially ethyl acetate, could be considered as a new antimicrobial agent.

Graphical Abstract
Mortality and its predictors among hospitalized patients with infections due to extended spectrum beta-lactamase (ESBL) Enterobacteriaceae in Malaysia: a retrospective observational study
Authors: Abubakar Usman , Tangiisuran Balamurugan , Elnaem Mohamed Hassan , Sulaiman Syed Azhar Syed , Khan Faiz Ullah
Published: February 2022

Background

Extended spectrum beta-lactamase (ESBL) pathogens are associated with morbidity and mortality. There is a paucity of data describing the treatments and outcomes of ESBL infections in Malaysia. This study evaluated the treatments, mortality and associated factors among patients hospitalized with infections due to ESBL positive enterobacteriaceae. This is a retrospective study conducted in a tertiary hospital from January 2018 to June 2020. Hospitalized patients with ESBL-positive enterobacteriaceae infections were included. A clinical pharmacist collected data by reviewing the patients’ electronic medical records. The data were analysed using both descriptive and inferential analyses.

Results

This analysis included 110 patients with a mean age of 62.1 ± 14.4 years. Klebsiella pneumoniae (53.6%) and Escherichia coli (40.9%) were the most prevalent pathogens among the 110 infections. Bacteremia (42.7%) was the most frequent diagnosis. The isolates were resistant to majority of penicillins and cephalosporins. However, over a third (39.3%) were susceptible to piperacillin–tazobactam, while carbapenem susceptibility was extremely high (≥ 99%). The most frequently used empiric and definitive antibiotics was piperacillin–tazobactam and meropenem, respectively. Less than a third (28.2%) of patients received active empiric antibiotics, and the mean duration before active antibiotics was 3.9 ± 2.7. Overall, hospital mortality rate was 13.6%, and mortality was significantly associated with ICU admission (AOR 8.75; 95% CI 1.05–72.75; P = 0.045) and diabetes mellitus (AOR 9.85; 95% CI 1.04–93.09; P = 0.046).

Conclusions

Carbapenems are the major antibiotics used to treat ESBL-positive enterobacteriaceae infections. Hospital mortality rate is relatively high and is significantly associated with  in patients admitted to ICU and those with diabetes mellitus. Antibiotic stewardship interventions are necessary to promote early administration of active antibiotics and to reduce overuse of carbapenem antibiotics.
Russia’s Radical Byron: Reexamining the “Decembrist Pushkin”
Authors: Wang Emily
Published: February 2022

Lord Byron’s reputation in Russia’s literary imagination might surprise those who remember him not only as a multifaceted poet or political commentator, but also as a sexual libertine. Following his death in Greece, the tempestuous Byron came to stand for both freedom and romanticism in Russia, especially for the poets who would become associated with the Decembrist Uprising, a failed attempt by liberal nobles to reform the absolutist state by military coup in 1825. Perhaps even more importantly, Byron also became identified with the primary candidate for the role of Russia’s national poet: Alexander Pushkin. Though much as been written about Pushkin’s “Byronic apprenticeship,” this article focuses on how Pushkin’s responses to the English poet led him to depart from—and even conflict with—a specifically political version of Byronism promoted by his contemporaries. In particular, it analyzes Russian poetic response to Byron’s death, including works by Pushkin, Ivan Kozlov, Wilhelm Küchelbecker, Kondraty Ryleev, and Dmitry Venevitnov. It also considers Pushkin’s “To the Sea” (1824), analyzing an extended polemic with Prince Pyotr Viazemsky about Byron’s political legacy that this poem initiates.
Does a suspensory lifestyle result in increased tensile strength? Organ-level material properties of sloth limb bones
Authors: Mossor Angela M. , Young Jesse W. , Butcher Michael T.
Published: February 2022

The material composition of vertebrate connective tissue is highly conserved across taxa. Existing data suggest that the compressive and tensile strength of limb bones are very similar despite marked variation in limb posture and locomotor patterns. However, the material properties of limb bone tissue from suspensory taxa have not been formally evaluated. Sloths are nearly obligatory in their use of below-branch suspensory locomotion and posture, thus placing their limb bones and associated soft tissue structures under routine tensile loading. It is possible that sloth limb bones are modified for enhanced tensile strength, perhaps at the expense of compressive strength. Forelimb and hindlimb bones of two-toed (Choloepus hoffmanni) and three-toed (Bradypus variegatus) sloths were tested in compression and bending to evaluate this hypothesis. Strength and elastic (Young's) modulus were similarly lower in sloth limb bones during both compression and bending, as compared with pronograde taxa. Ratios of peak bending strength to compressive strength additionally were elevated (sloths: 1.4–1.7; upright taxa: 0.6–1.2) for sloth limb bones. Overall, the material properties measured from the limb bones of tree sloths support our hypothesis of predicted function in a tensile limb system. Future studies should aim to directly test bones in tension to confirm indications of elevated axial tensile strength. Nevertheless, the results herein expand understanding of functional adaptation in mammalian tissue for a range of locomotor/postural behaviors that were previously unexplored.
Transarterial chemoembolization for hepatocellular carcinoma with vascular invasion
Authors: Miyayama Shiro , Arai Yasuaki , Matsui Osamu
Published: February 2022

Although the global guidelines only recommend systemic therapy for hepatocellular carcinoma with vascular invasion, various treatments are performed for it. Among them, transarterial chemoembolization (TACE) is the most frequent option; however, standard techniques have not been established. Conventional TACE (cTACE) has also been frequently performed for tumors invading the portal vein (PVTT), hepatic vein (HVTT), and bile duct (BDTT). In cTACE for PVTT, selective catheterization into the tumor-feeder is essential to avoid adverse effects. However, if it is unsuccessful, injection of embolic agents under balloon occlusion of the hepatic artery can improve the therapeutic effects and avoid hepatic infarction. When marked arterioportal shunts are demonstrated, embolization with gelatin sponge particles soaked with a chemotherapeutic solution is another option. Arteriovenous shunts accompanied by HVTT may cause systemic embolization due to migration of embolic agents, and occlusion of a shunt-draining hepatic vein using a balloon catheter can reduce the risk. BDTT is often accompanied by obstructive jaundice; therefore, endoscopic or percutaneous biliary drainage is required when the serum total bilirubin concentration is ≥3 mg dl−1. TACE should be performed as selectively as possible and attention should also be paid to the risk of obstructive jaundice and/or pancreatitis caused by sloughing of necrotized BDTT.
Comparison of surface- and voxel-based registration on the mandibular ramus for long-term three-dimensional assessment of condylar remodelling following orthognathic surgery
Authors: Holte Michael Boelstoft , Sæderup Henrik , Pinholt Else Marie
Published: February 2022

Objectives:

The purpose of the present study was to validate and compare the accuracy and reliability of surface- and voxel-based registration on the mandibular rami for long-term three-dimensional (3D) evaluation of condylar remodelling following Orthognathic Surgery.

Methods:

The mandible was 3D reconstructed from a pair of superimposed pre- and postoperative (two years) cone-beam computerized tomography scans and divided into the condyle, and 21 ramal regions. The accuracy of surface- and voxel-based registration was measured by the absolute mean surface distance of each region after alignment of the pre- and postoperative rami. To evaluate the reliability, mean absolute differences and intraclass correlation coefficients (ICC) were calculated at a 95% confidence interval on volumetric and surface distance measurements of two observers. Paired t-tests were applied to statistically evaluate whether the accuracy and reliability of surface- and voxel-based registration were significantly different (p < 0.05).

Results:

A total of twenty subjects (sixteen female; four male; mean age 27.6 years) with class II malocclusion and maxillomandibular retrognathia, who underwent bimaxillary surgery, were included. Surface-based registration was more accurate and reliable than voxel-based registration on the mandibular ramus two years post-surgery (p < 0.05). The interobserver reliability of using surface-based registration was excellent, ICC range [0.82–1.00]. For voxel-based registration, the interobserver reliability ranged from poor to excellent [0.00–0.98]. The measurement error introduced by applying surface-based registration for assessment of condylar remodelling was considered clinical irrelevant (1.83% and 0.18 mm), while the measurement error introduced by voxel-based registration was considered clinical relevant (5.44% and 0.52 mm).

Conclusions:

Surface-based registration was proven more accurate and reliable compared to voxel-based registration on the mandibular ramus for long-term 3D assessment of condylar remodelling following Orthognathic Surgery. However, importantly, the performance difference may be caused by an inappropriate reference structure, proposed in the literature, and applied in this study.
Υγρή βιοψία-μοριακή διάγνωση καρκίνου
Authors: Ντζιφά Αλίκη
Published: February 2022

Η υγρή βιοψία αποτελεί πολύτιμο εργαλείο για τη μοριακή διάγνωση του μη-μικροκυτταρικού καρκίνου του πνεύμονα (NSCLC). Η κλινική σημασία των EGFR μεταλλάξεων στο κυκλοφορούν καρκινικό DNA (circulating tumor DNA, ctDNA) έχει ήδη αποδειχθεί ενώ τα κυκλοφορούντα καρκινικά κύτταρα (circulating tumor cells, CTCs) αποτελούν μια μοναδική πηγή πληροφοριών του όγκου. Η χορήγηση θεραπείας με osimertinib σε ασθενείς που φέρουν τη μετάλλαξη Τ790Μ του γονιδίου EGFR έχει θετικά αποτελέσματα, όμως η εμφάνιση αντίστασης στη θεραπεία είναι αναπόφευκτη. Ο κύριος στόχος της διδακτορικής διατριβής ήταν η αξιολόγηση των μοριακών αλλαγών που παρατηρούνται στα CTCs και ctDNA σε επίπεδο γονιδιακής έκφρασης, DNA μεταλλάξεων και μεθυλίωσης DNA πριν και μετά τη θεραπεία με osimertinib και η περαιτέρω αξιολόγηση της ετερογένειάς τους και της κλινικής της σημασίας.Αρχικά, μελετήθηκε για πρώτη φορά η έκφραση των γονιδίων CK-8, CK-18, CK-19, VIM, TWIST-1, AXL, ALDH-1, PD-L1, PIM-1 και CD-45 στα CTCs 30 ασθενών με NSCLC πριν τη θεραπεία με osimertinib, μετά τον πρώτο κύκλο και στη πρόοδο νόσου (PD). Τα αποτελέσματα έδειξαν ότι αυξημένη παρουσία της VIM συνδέεται με το ρόλο της επιθηλιο-μεσεγχυματικής μετάβασης κατά τη διάρκεια της θεραπείας ενώ η αυξημένη έκφραση του PD-L1 στο PD υποδεικνύει ένα θεωρητικό υπόβαθρο για περαιτέρω αντιμετώπιση των ασθενών αυτών με ανοσοθεραπεία.Η ανίχνευση και ο ποσοτικός προσδιορισμός των EGFR μεταλλάξεων στο ctDNA πλάσματος και στα CTCs στο περιφερικό αίμα των ασθενών αυτών με την τεχνολογία crystal digital PCR έδειξε την ετερογένεια του όγκου σε επίπεδο μεταλλάξεων EGFR. Παράλληλα, αναλύθηκαν ταυτόσημα δείγματα ctDNA με την εγκεκριμένη από τον FDA μεθοδολογία cobas (Roche) και από την άμεση σύγκριση προέκυψαν υψηλά ποσοστά συμφωνίας. Επιπλέον, η άμεση σύγκριση της παρουσίας EGFR μεταλλάξεων στο ctDNA πλάσματος με τα αντίστοιχα δείγματα CTCs και ιστών αποκάλυψε την ύπαρξη μεγάλης ετερογένειας.Τέλος, πραγματοποιήθηκε για πρώτη φορά μελέτη μεθυλίωσης εννέα γονιδίων (RASSF1A, RASSF10, APC, WIF-1, BRMS1, SLFN11, RARβ, SHISA3, and FOXA1) στο ctDNA πλάσματος και σε αντίστοιχα δείγματα CTCs πριν και μετά τη θεραπεία με osimertinib. Τα αυξημένα ποσοστά μεθυλίωσης στο PD θα μπορούσαν να συσχετιστούν με την αντίσταση στο osimertinib ενώ οι διαφορές μεταξύ ctDNA και CTCs υποδεικνύουν τη σημασία της συνδυαστικής τους ανάλυσης.
Emotional intelligent in family business management
Authors: Τσιριμώκου Χρυσούλα
Published: February 2022

Οι οικογενειακές επιχειρήσεις αποτελούν αντικείμενο έρευνας και χάραξης πολιτικής εδώ και αρκετά χρόνια. Ωστόσο, ενώ το ελληνικό επιχειρηματικό τοπίο εξαρτάται σε μεγάλο βαθμό από τις οικογενειακές επιχειρήσεις, με το 80% των ιδιοκτητών να θεωρούν την επιχείρησή τους οικογενειακή, οι ενδογενείς παράγοντες που καθορίζουν την απόδοση και την ανταγωνιστικότητα αυτών των επιχειρήσεων ενδιαφέρουν ελάχιστα την ακαδημαϊκή κοινότητα και την ερευνητική κοινότητα. Η χρήση σύγχρονων εργαλείων για την αξιολόγηση των ποιοτικών χαρακτηριστικών της ανθρώπινης συμπεριφοράς των διευθυντών οικογενειακών επιχειρήσεων είναι απαραίτητη για τον εντοπισμό του αντίκτυπού τους στις επιδόσεις της διοίκησης. Επομένως, οι επιδόσεις αυτών των εταιρειών είναι τα σημεία όπου εντοπίζεται ένα σημαντικό ερευνητικό κενό, το οποίο οδηγεί στην κεντρική υπόθεση: «Εάν και σε ποιο βαθμό η συναισθηματική νοημοσύνη, ο μακιαβελισμός και ο οικονομικός οπορτουνισμός, επηρεάζουν τη διοίκηση και τη διαχείριση και τελικά την απόδοση της οικογένειας. επιχειρήσεις ". Η μεθοδολογική προσέγγιση για τεκμηριωμένη απάντηση στο ερώτημα συνίσταται στην υιοθέτηση σύγχρονων εργαλείων για τη διεξαγωγή πρωτογενούς έρευνας με ερωτηματολόγια σε πανελλήνιο δείγμα οικογενειακών επιχειρήσεων, τη δημιουργία βάσης δεδομένων και τη στατιστική επαγωγική ανάλυσή τους.
La importancia de adaptar las traducciones y comentarios de los Lieder al lector meta como propuesta didáctica para mejorar la formación de los alumnos de canto.
Authors: De Castro Goñi Ana Cristina
Published: February 2022

La traducción del Lied es una tarea que entraña muchas dificultades y en numerosas ocasiones se olvida la importancia del texto cuando se interpreta vocalmente. Es primordial para una correcta interpretación vocal de una obra musical que el intérprete conozca en profundidad lo que está cantando, ya que el compositor ha elegido este texto porque ha influido en su vida y ha decidido musicalizarlo. Por esta razón, es tan significativo traducir, comprender y analizar desde diferentes puntos la intencionalidad tanto del autor de la obra literaria como del compositor. La música puede transmitir, transportar palabras y convertirlas en melodía sirviéndose del texto, pero si no se comprende el texto ni se adapta al lector meta (alumnos de conservatorios o escuelas de música) al que va dirigido, no servirá para entender la intencionalidad final de los creadores, lo que ayuda a los alumnos de canto a mejorar su interpretación.
Morphing for Consumer Dynamics: Bandits Meet Hidden Markov Models
Authors: Liberali Gui , Ferecatu Alina
Published: February 2022

In this paper, the authors propose and validate a multiarmed bandit model that dynamically adapts website design to match a user's changing position in the purchase funnel.
A Rare Case of Benign Histiocytic Neoplasm of Cutaneous Rosai–Dorfman Disease: A Case Report and Literature Review
Authors: Mekheal Erinie , Roman Sherif , Kania Brooke , Mekheal Nader , Awasthi Sharon , Kumar Vinod , Maroules Michael
Published: February 2022

Rosai–Dorfman disease (RDD) is a rare disorder characterized by the proliferation of histiocytes in lymph nodes. It can occur anywhere in the body but commonly involves the cervical area of the neck. Its clinical presentation varies and patients with skin manifestations may develop papules, nodules, plaques, or pustules. Histologically, it typically presents with emperipolesis, where intact lymphocytes are found within histiocytes. The definitive treatment of RDD is not well established given the rarity of the disease and indeed skin lesions can regress spontaneously. Therapeutic treatment options include cryotherapy, radiation, or topical agents such as steroids or retinoids. Here we describe the case of a 24-year-old Hispanic female who presented with skin manifestations which proved to be histologically positive for Rosai–Dorfman disease. The patient clinically improved following the administration of intralesional steroids.
A Preoperative Spinal Education intervention for spinal fusion surgery designed using the Rehabilitation Treatment Specification System is safe and could reduce hospital length of stay, normalize expectations, and reduce anxiety
Authors: Edwards Rebecca , Gibson Jamie , Mungin-Jenkins Escye , Pickford Rashida , Lucas Jonathan D. , Jones Gareth D.
Published: February 2022

Aims

Psychoeducative prehabilitation to optimize surgical outcomes is relatively novel in spinal fusion surgery and, like most rehabilitation treatments, they are rarely well specified. Spinal fusion patients experience anxieties perioperatively about pain and immobility, which might prolong hospital length of stay (LOS). The aim of this prospective cohort study was to determine if a Preoperative Spinal Education (POSE) programme, specified using the Rehabilitation Treatment Specification System (RTSS) and designed to normalize expectations and reduce anxieties, was safe and reduced LOS.

Methods

POSE was offered to 150 prospective patients over ten months (December 2018 to November 2019) Some chose to attend (Attend-POSE) and some did not attend (DNA-POSE). A third independent retrospective group of 150 patients (mean age 57.9 years (SD 14.8), 50.6% female) received surgery prior to POSE (pre-POSE). POSE consisted of an in-person 60-minute education with accompanying literature, specified using the RTSS as psychoeducative treatment components designed to optimize cognitive/affective representations of thoughts/feelings, and normalize anxieties about surgery and its aftermath. Across-group age, sex, median LOS, perioperative complications, and readmission rates were assessed using appropriate statistical tests.

Results

In all, 65 (43%) patients (mean age 57.4 years (SD 18.2), 58.8% female) comprised the Attend-POSE, and 85 (57%) DNA-POSE (mean age 54.9 years (SD 15.8), 65.8% female). There were no significant between-group differences in age, sex, surgery type, complications, or readmission rates. Median LOS was statistically different across Pre-POSE (5 days ((interquartile range (IQR) 3 to 7)), Attend-POSE (3 (2 to 5)), and DNA-POSE (4 (3 to 7)), (p = 0.014). Pairwise comparisons showed statistically significant differences between Pre-POSE and Attend-POSE LOS (p = 0.011), but not between any other group comparison. In the Attend-POSE group, there was significant change toward greater surgical preparation, procedural familiarity, and less anxiety.

Conclusion

POSE was associated with a significant reduction in LOS for patients undergoing spinal fusion surgery. Patients reported being better prepared for, more familiar, and less anxious about their surgery. POSE did not affect complication or readmission rates, meaning its inclusion was safe. However, uptake (43%) was disappointing and future work should explore potential barriers and challenges to attending POSE. Cite this article: Bone Jt Open 2022;3(2):135–144.
SAÚDE E SEGURANÇA DE TRABALHADORES DA ATENÇÃO PRIMÁRIA DURANTE O PERÍODO DE PANDEMIA DO COVID-19: RIO GRANDE DO SUL/BRASIL
Authors: Suzane Beatriz Frantz Krug  , Bertelli Caroline , Bruna Rezende Martins  , Daiana Klein Weber Carissimi  , Ingre Paz  , Clauceane Venzke Zell  , Marcelo Carneiro
Published: February 2022

Introdução: Os profissionais da saúde estão entre a população exposta ao vírus da COVID-19 de forma direta, devido ao seu trabalho, na assistência e no cuidado que dispensam às pessoas infectadas. Objetivos: analisar aspectos da saúde e segurança de trabalhadores da Atenção Primária em municípios do sul do Brasil, no contexto da pandemia da COVID-19. Materiais e métodos: pesquisa quantitativa e transversal, realizada a partir de um estudo de base populacional. Os participantes foram profissionais de saúde da Atenção Primária de 13 municípios do interior do Rio Grande do Sul/Brasil. A coleta de dados ocorreu em 2020, através de um questionário previamente estruturado composto por 34 perguntas fechadas. As informações foram analisadas através do programa Jasp, onde avaliou-se frequências absolutas e relativas. Resultados: a análise evidenciou que os profissionais da Atenção Primária que compuseram este estudo têm condições laborais adequadas, bem como locais de trabalhos com condições favoráveis, no contexto da pandemia, isto é, possuem infraestrutura e equipamentos de proteção à saúde (EPI) em quantidade adequada. Foram mencionados a criação de novos fluxos pela gestão e o estabelecimento de novas rotinas durante os atendimentos em saúde. Devido à situação pandêmica, alguns profissionais precisaram afastar-se por contaminação, bem como, questões de saúde mental. Conclusões: Evidenciou-se a adesão dos trabalhadores às medidas de prevenção e o uso correto dos EPI durante a pandemia, bem como, a análise de diversos municípios possibilitou situações de trabalho distintas.
ASSOCIAÇÃO ENTRE HÁBITOS ALIMENTARES E DE VIDA DE IDOSOS HIPERTENSOS USUÁRIOS DE UMA FARMÁCIA MUNICIPAL
Authors: Lopes Vieira Letícia , Arcanjo de Freitas Leuânia , Veloso Dutra Luiza , Aparecida de Araujo Tânia , Martins Oliveira Isabela
Published: February 2022

Introdução: O estado nutricional dos idosos tem um papel importante para caracterizar a qualidade de vida e a saúde desta população que possui maior tendência as alterações fisiológicas e sociais, doenças crônicas como hipertensão arterial, uso de medicamentos, dificuldades com a alimentação e depressão. Objetivo: analisar a associação entre os hábitos alimentares e de vida de idosos hipertensos usuários de uma farmácia municipal. Metodologia: Os dados foram coletados, em uma farmácia pública do município de Visconde do Rio Branco-MG, com uma amostra de 180 idosos. Foi aplicado o questionário de frequência alimentar (QFA) para identificação dos hábitos alimentares e o questionário de caracterização durante entrevista com os idosos. Os dados foram registrados em planilha eletrônica e submetidos a uma análise estatística no Software Stata. Resultados: 73,8% (n=134) dos idosos eram do sexo feminino, 55,6 % (n=100) de 60 a 65 anos de idade, 88,3% (n=159) possuem renda mensal de um salário mínimo e 64,4% (n=116) nunca fizeram atividade física. Observou quanto a frequência do consumo alimentar que 50,3% são alimentos in natura, 14,3% ingredientes culinários, 7,1% de processados e 28,3% de ultraprocessados. Conclusões: os hábitos alimentares dos pacientes não estão saudáveis, pois foi verificado um predomínio de alimentos que não contribuem para a melhora do quadro da hipertensão. Além disso, os idosos que fumam consomem menos alimentos in natura e mais ultraprocessados e tomam mais medicamentos do que aqueles que não fumam. Sugere-se um acompanhamento nutricional envolto por políticas públicas que visem melhorar a qualidade de vida dessa parcela da população