bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions of orthopaedic medicine students and their supervisors about practice-based learning: an exploratory qualitative study
Authors: Nsubuga Muhamed , Opoka Robert O , Galukande Moses , Munabi Ian G. , Mubuuke Aloysius G. , Kiguli Sarah
Published: October 2022

Background

Practice-based learning is crucial in forming appropriate strategies for improving learning among the medical students that support the country’s understaffed health sector. Unsatisfactory learning consequently results in poor performance of students and poor quality of health care workforce in the long run. Exploring the perceptions about the current practice-based learning system and how to improve is thus vital. This study set out to explore the perceptions of Orthopaedic medicine students and their supervisors about practice-based learning at a tertiary training hospital.

Methods

This was an exploratory phenomenological qualitative study that involved in-depth interviews among 10 Orthopedic students during their rotation in the emergency ward of Mulago hospital and 6 of their supervisors. Interviews were audio-recorded, transcribed, and then imported into Atlas ti 8.3 for analysis. The data were coded and grouped into themes relating to perceptions of practice-based learning, general inductive analysis was used. The general inductive approach involved condensing the raw textual data into a brief and summary format. The summarized format was then analyzed to establish clear links between the perceptions of practice-based learning and the summary findings derived from the raw data.

Results

The mean age of the students was 23 ± 1.5 years. Four out of the six supervisors were Orthopaedic officers while the remaining two were principal Orthopaedic officers, four out of the six had a university degree while the other two were diploma holders. The main themes arising were hands-on skills, an unconducive learning environment, the best form of learning, and having an undefined training structure. Particularly, the perceptions included the presence of too many students on the wards during the rotation, frequent stock-outs of supplies for learning, and supervisors being overwhelmed caring for a large number of patients.

Conclusion

Barriers to satisfactory practice-based learning were overcrowding on the wards and insufficient training materials. To improve practice-based learning, adequate learning materials are required and the number of students enrolled needs to be appropriate for the student – supervisor ratio.
Consensus from an expert panel on how to identify and support food insecurity during pregnancy: A modified Delphi study
Authors: McKay Fiona H. , Zinga Julia , van der Pligt Paige
Published: October 2022

Background

Food insecurity and hunger during pregnancy have significant implications for the health of the mother and baby. Assisting clinicians when they encounter women who are experiencing hunger or food insecurity during their pregnancy will increase the opportunity for better birth and pregnancy outcomes. At present there are no guidelines for Australian clinicians on how to do this.

Methods

This study uses a modified Delphi technique, allowing diverse participation in the process, to create consensus on the ways to address and respond to food insecurity during pregnancy. This modified Delphi collected data via two rounds of consensus. The opinions collected from the first round were thematically categorised and grouped. The topics were integrated into the survey for the second round and circulated to participants. During the second round, priorities were scored by giving five points to the topic considered most important, and one point to the least important.

Results

Through two rounds of consultation, the panel achieved consensus on how to identify food insecurity during pregnancy, with some clear items of consensus related to interventions that could be implemented to address food insecurity during pregnancy. Experts achieved consensus on items that have importance at the institution and policy level, as well as services that exist in the community. The consensus across the spectrum of opportunities for assistance, from the clinical, to community-provided assistance, and on to government policy and practice demonstrate the complexity of this issue, and the multipronged approach that will be required to address it.

Conclusion

This is the first time such a consultation with experts on hunger and food insecurity during pregnancy has been conducted in Australia. Items that achieved consensus and the importance of the issue suggest several ways forward when working with pregnant women who are hungry and/or food insecure.
Effects of dulaglutide on endothelial progenitor cells and arterial elasticity in patients with type 2 diabetes mellitus
Authors: Xie Dandan , Li Yutong , Xu Murong , Zhao Xiaotong , Chen Mingwei
Published: October 2022

Background

Randomised controlled trial showed that dulaglutide can reduce the risk of atherosclerotic cardiovascular disease (ASCVD) in patients with type 2 diabetes mellitus (T2DM), but the underlying mechanisms remain unclear. This study aimed to investigate the effect of dulaglutide on the number and function of endothelial progenitor cells (EPCs) in the peripheral blood of patients with T2DM and its role in improving arterial elasticity, so as to determine potential mechanisms of preventive effect of dulaglutide on ASCVD.

Methods

Sixty patients with T2DM were treated with 1000 mg/day of metformin and randomly divided into two groups for 12 weeks: metformin monotherapy group (MET group, n = 30), and metformin combined with dulaglutide group (MET-DUL group, n = 30). Before and after treatment, the number of CD34+CD133+KDR+ EPCs and the brachial–ankle pulse wave velocity (baPWV) of the participants were measured, and EPC proliferation, adhesion, migration, and tubule formation were assessed in vitro.

Results

There were no significant differences in the number and function of EPCs and baPWV changes in MET group (P > 0.05). In MET-DUL group, nitric oxide (NO) levels and the number of EPCs increased after treatment (P < 0.05), while the levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), advanced glycation end products (AGEs), and baPWV decreased (P < 0.05). EPC proliferation, adhesion, migration, and tubule formation abilities were significantly enhanced (P < 0.05). Correlation analysis showed that in MET-DUL group, the changes in CRP, IL-6, TNF-α, and AGEs were negatively correlated with the number of EPCs and their proliferation and migration abilities (P < 0.05). Body weight, NO, CRP, and IL-6 levels were independent factors affecting the number of EPCs (P < 0.05). The changes in number of EPCs, proliferation and migration abilities of EPCs, and NO and IL-6 levels were independent influencing factors of baPWV changes (P < 0.05).

Conclusion

Dulaglutide can increase the number and function of EPCs in peripheral blood and improve arterial elasticity in patients with T2DM; it is accompanied by weight loss, inflammation reduction, and high NO levels. Dulaglutide regulation of EPCs may be a mechanism of cardiovascular protection.
Analysis of state portrayals of the risks of e-cigarette use and the cause of the EVALI outbreak
Authors: Katchmar Amanda , Shafer Paul , Siegel Michael
Published: October 2022

Introduction

In August 2019, an outbreak of “e-cigarette or vaping product use-associated lung injury” (EVALI) prompted many states and health organizations to warn against the use of electronic cigarettes, or e-cigarettes, due to the presumed link between e-cigarette use and the illness. However, it was later shown that vitamin E acetate, a component of some illicit vaporizable THC products, was the causative agent in this outbreak.

Methods

We conducted a series of cross-sectional surveys of the websites of all state departments of health to determine how they communicated the risk of e-cigarette use during and after the EVALI outbreak. We then paired this analysis with data from the 2016 through 2020 Behavioral Risk Factor Surveillance System to measure changes in cigarette and e-cigarette use.

Results

Website data from 24 states was available for analysis at all three time points of interest, and BRFSS data was only available for 8 of these states. We found that by January 2020, a majority of the states surveyed did not list vaporizable THC use as a cause of EVALI; however, differences in state messaging did not appear to be associated with changes in e-cigarette and cigarette use.

Conclusions

Given the number of states that did not appear to update their messaging regarding the cause of EVALI, we believe that states should re-evaluate this messaging to accurately communicate the risks of e-cigarette use.
Synchronous disease onset and flares in siblings with PFAPA
Authors: Dammeyer Kristen L. , Schneider Amanda , April Max M. , Kahn Philip J.
Published: October 2022

Background

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) is a clinical syndrome of unclear etiology. PFAPA has generally been considered a non-hereditary fever syndrome; however, this has been called into question with recent reports of family clustering. Few reports have been published describing siblings with PFAPA. To our knowledge, this is the first report of siblings with near simultaneous onset of disease followed by synchronous disease flares.

Case Presentation:

We describe the case of near simultaneous onset of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis in siblings followed by synchronous disease flares of clear frequency and nearly identical character. Flares were characterized predominantly by fever, aphthous ulceration, cervical lymphadenitis, and the absence of infection. The fever episodes demonstrated a robust response to glucocorticoids and recurred in the same staggered manner every four weeks, with complete absence of symptoms and normal growth and development between episodes. Nine months after onset, the older sibling, a 5-year-old female, underwent tonsillectomy resulting in dramatic resolution of episodes. At the same time, her 2-year-old sister experienced resolution of her fever episodes, though she did not undergo tonsillectomy herself.

Conclusion

This is an unusual case of simultaneous onset PFAPA followed by synchronous disease flares. PFAPA is an uncommon clinical syndrome, and it is rarely diagnosed in siblings. The etiology of PFAPA remains unclear. Though the disease is classically considered sporadic, there is a growing body of evidence to suggest that PFAPA may be heritable.
Cytogenetic profile of adult acute myeloid leukemia in Egypt: a single-center experience
Authors: Elnaggar Mohamed G. , Mosad Eman , Makboul Ahmed , Shafik Engy Adel
Published: October 2022

Background

Acute myeloid leukemia (AML) is a diverse disease characterized by the expansion of blasts of myeloid lineage. Cytogenetic testing is the cornerstone for risk stratification of AML patients. Geographical and environmental factors may play a very important role in the development of leukemia and several differences in genetic profile may be seen among different ethnicities. In our study, we evaluated cytogenetic findings of adult AML patients in South Egypt.

Methods

Cytogenetic testing (karyotyping and M-FISH) was performed for 120 adult patients with AML. Twenty metaphases were analyzed for each patient.

Results

In our study, the median age of AML patients was 36.5 years, with an age range between 18 and 86 years. 56.7% of patients had normal karyotypes and 43.3% of patients had clonal cytogenetic abnormalities. t (15;17) was the most detected structural abnormality, and + 8 was the most detected numerical abnormality. Regarding cytogenetic risk stratification, 65% of patients were in the intermediate-risk category.

Conclusion

The cytogenetic profile of AML patients in our locality showed some differences and some similarities with cytogenetic profiles in different Arab, Asian and Western countries. Further studies are needed using advanced techniques such as next-generation sequencing and optical genome mapping to elucidate more ethnic and geographic genetic heterogeneity among different countries.
Gene and cell therapies in China: booming landscape under dual-track regulation
Authors: Yin Chen , Gao Jianchao , Li Guanqiao , Hu Hongxi , Zhou Liyun , Lu Shuang , Chen Xiaoyuan
Published: October 2022

The booming of gene and cell therapy (GCT) worldwide in recent years has been observed, especially in the field of cancers. In order to provide the comprehensive GCT landscape in China with a focus on differential development pathways under the current dual-track regulation mode, we analyzed 953 clinical trials initiated by March 2021 including Investigational New Drugs (IND) registered trials and investigator-initiated trials (IITs). We classified GCT products into three categories and analyzed the clinical development by phases and regulation tracks, disease areas, indications, and targets. We found that CAR-T therapies from ex vivo category and stem and somatic cells from non-gene category are two most studied therapy types and GCT mostly focused on cancers. The number of IITs far exceeded IND-registered trials except for in vivo category. After 2017, when the cell therapy guideline issued, products of all categories boomed, especially the ex vivo categories. These data showed that current dual regulation tracks in China complemented each other and together facilitated the GCT development, especially after 2017. More consistent technical standards and risk-based regulation will help bring more GCT products to patients.
The effect innovation cloning to small business success: entrepreneurial perspective
Authors: Chaniago Harmon
Published: October 2022

It is challenging to run a business during the COVID-19 pandemic, because the owners and the small business leaders must be responsible for success. Leaders need to innovate and look for sources of innovation, including practical inventions, such as innovation cloning. In this study, innovation cloning consisting of creativity cloning and implementation cloning is analyzed for its relationship to business success, in the form of owner’s interest and financial performance perspectives. This study aims to reveal the role of innovation cloning, creativity cloning, and implementation cloning in achieving business success based on the owner’s interest and financial performance. The study uses an explanatory survey. The number of samples is 155 entrepreneurs/small business leaders in Bandung City, Indonesia.  Snowball  sampling is carried out to obtain the data. Data processing uses descriptive statistics and multiple regression with the help of SPSS and Amos 23 software. This study found that creativity cloning and implementation cloning affected the owner’s interest, and implementation cloning affected financial performance. In contrast, creativity cloning does not affect financial performance. Creativity cloning and implementation cloning are correlated with each other. Creativity cloning and implementation cloning are proved to be one unit of cloning innovation. The leader’s expertise in choosing the object to be cloned and adapting it to consumer needs will facilitate company goals. Utilizing innovation, cloning, and modifying it is a practical way for small businesses to succeed. This research needs to be continued to see if there is a continuous pattern in these findings so those findings can be generalized.
Alterations in the respiratory tract microbiome in COVID-19: current observations and potential significance
Authors: Merenstein Carter , Bushman Frederic D. , Collman Ronald G.
Published: October 2022

SARS-CoV-2 infection causes COVID-19 disease, which can result in consequences ranging from undetectable to fatal, focusing attention on the modulators of outcomes. The respiratory tract microbiome is thought to modulate the outcomes of infections such as influenza as well as acute lung injury, raising the question to what degree does the airway microbiome influence COVID-19? Here, we review the results of 56 studies examining COVID-19 and the respiratory tract microbiome, summarize the main generalizations, and point to useful avenues for further research. Although the results vary among studies, a few consistent findings stand out. The diversity of bacterial communities in the oropharynx typically declined with increasing disease severity. The relative abundance of Haemophilus and Neisseria also declined with severity. Multiple microbiome measures tracked with measures of systemic immune responses and COVID outcomes. For many of the conclusions drawn in these studies, the direction of causality is unknown—did an alteration in the microbiome result in increased COVID severity, did COVID severity alter the microbiome, or was some third factor the primary driver, such as medication use. Follow-up mechanistic studies can help answer these questions.
Development and validation of an English test measuring EFL learners’ critical thinking skills
Authors: Hirai Akiyo , Oka Hideaki , Kato Takeshi , Maeda Hiroki
Published: October 2022

Addressing the lack of English tests that measure critical thinking (CT) abilities of EFL learners, this study aims to develop an English Critical Thinking Test (ECTT) designed to measure the consistency, analysis, and inference CT skills. It is a follow-up to a pilot study to accumulate validity evidence for the use of the ECTT. A total of 262 Japanese EFL learners who were first-year college students took the ECTT, a Japanese Critical Thinking Test (JCTT), and an English proficiency test (EPT). The result of the internal structures of ECTT and JCTT revealed that both CT tests fit two-factor models better than three-factor models, with consistency as one factor and analysis and inference as the other factor. This implies that it is difficult to measure the CT skills’ hierarchical nature. However, the model that included the three tests fit the data well and indicated moderately high correlations between the ECTT and EPT (r= .64) and between the ECTT and JCTT (r= .55). In addition, we confirmed that the skills that test-takers needed most in solving questions in each of the three CT sections (i.e., consistency, analysis, and inference CT skills) of the ECTT were as intended. Based on these findings, the validation of the ECTT has been improved; ECTT can be used for EFL learners at upper secondary and university levels in Japan.
Accuracy of intraoral real-time navigation versus static, CAD/CAM-manufactured pilot drilling guides in dental implant surgery: an in vitro study
Authors: Stünkel Robert , Zeller Alexander-Nicolai , Bohne Thomas , Böhrnsen Florian , Wedi Edris , Raschke David , Kauffmann Philipp
Published: October 2022

Background

Nowadays, 3D planning and static for dynamic aids play an increasing role in oral rehabilitation of the masticatory apparatus with dental implants. The aim of this study is to compare the accuracy of implant placement using a 3D-printed drilling guide and an intraoral real-time dynamic navigation system.

Methods

A total of 60 implants were placed on 12 partially edentulous lower jaw models. 30 were placed with pilot drilling guides, the other half with dynamic navigation (DENACAM®). In addition, implant placement in interdental gaps and free-end situations were investigated. Accuracy was assessed by cone-beam computed tomography (CBCT).

Results

Both systems achieved clinically acceptable results, yet more accurate results regarding the offset of implant base and tip in several spatial dimensions were achieved using drilling guides (each p < 0.05). With regard to angulation, real-time navigation was more precise (p = 0.0016). Its inaccuracy was 3°; the template-guided systems was 4.6°. Median horizontal deviation was 0.52 mm at base and 0.75 mm at tip using DENACAM®. When using the pilot drill guide, horizontal deviation was 0.34 mm in the median and at the tip by 0.59 mm. Regarding angulation, it was found that the closer the drill hole was to the system's marker, the better navigation performed. The template did not show this trend (p = 0.0043; and p = 0.0022).

Conclusion

Considering the limitations of an in vitro study, dynamic navigation can be used be a tool for reliable and accurate implantation. However, further clinical studies need to follow in order to provide an evidence-based recommendation for use in vivo.
The role of extracellular vesicles in osteoarthritis treatment via microenvironment regulation
Authors: Yin Han , Li Muzhe , Tian Guangzhao , Ma Yang , Ning Chao , Yan Zineng , Wu Jiang , Ge Qian , Sui Xiang , Liu Shuyun , Zheng Jinxuan , Guo Weimin , Guo Quanyi
Published: October 2022

Osteoarthritis (OA) is a degenerative joint disease that is common among the middle-aged and older populations, causes patients to experience recurrent pain in their joints and negatively affects their quality of life. Currently, therapeutic options for patients with OA consist of medications to alleviate pain and treat the symptoms; however, due to typically poor outcomes, patients with advanced OA are unlikely to avoid joint replacement. In recent years, several studies have linked disrupted homeostasis of the joint cavity microenvironment to the development of OA. Recently, extracellular vesicles (EVs) have received increasing attention in the field of OA. EVs are natural nano-microcarrier materials with unique biological activity that are produced by cells through paracrine action. They are composed of lipid bilayers that contain physiologically active molecules, such as nucleic acids and proteins. Moreover, EVs may participate in local and distal intercellular and intracellular communication. EVs have also recently been shown to influence OA development by regulating biochemical factors in the OA microenvironmental. In this article, we first describe the microenvironment of OA. Then, we provide an overview of EVs, summarize the main types used for the treatment of OA, and describe their mechanisms. Next, we review clinical studies using EVs for OA treatment. Finally, the specific mechanism underlying the application of miRNA-enriched EVs in OA therapy is described.
Acute-onset chronic inflammatory demyelinating polyneuropathy complicating SARS-CoV-2 infection and Ad26.COV2.S vaccination: report of two cases
Authors: Fotiadou Aggeliki , Tsiptsios Dimitrios , Karatzetzou Stella , Kitmeridou Sofia , Iliopoulos Ioannis
Published: October 2022

Background

The spectrum of reported neurological sequelae associated with SARS-CoV-2 is continuously expanding, immune mediated neuropathies like Guillain–Barre syndrome (GBS) and exacerbations of preexisting chronic inflammatory demyelinating polyneuropathy (CIDP) being among them. However, respective cases of acute onset CIDP (A-CIDP) are rare.

Case presentation

We hereby report two cases of A-CIDP after COVID-19 infection and Ad26.COV2.S vaccination that presented with flaccid paraparesis and acroparesthesias (Case presentation 1; female, 52) and facial diplegia accompanied by acroparesthesias (Case presentation 2; male, 62), respectively. In both instances clinical, neurophysiological and CSF findings were indicative of acute inflammatory demyelinating polyneuropathy, thus both patients were initially treated with intravenous immunoglobulins resulting in clinical improvement. Nevertheless, the first patient relapsed 5 weeks after the initial episode, thus was diagnosed with GBS with treatment related fluctuations (GBS-TRF) and treated successfully with seven plasma exchange (PLEX) sessions. However, 11 weeks from symptom onset she relapsed again. Taking into account that the second relapse occurred more than 8 weeks after the first episode, the potential diagnosis of A-CIDP was reached and oral dexamethasone 40 mg/d for 4 consecutive days every 4 weeks was administered. With regards to the second patient, he relapsed > 8 weeks after the initial episode, thus was also diagnosed with A-CIDP and treated with 7 PLEX sessions followed by similar to the aforementioned corticosteroid therapy. On 2 month follow-up both patients exhibited remarkable clinical improvement.

Conclusions

Close surveillance of patients presenting with immune neuropathies in the context of SARS-CoV-2 infection or immunization is crucial for timely implementation of appropriate treatment. Prompt A-CIDP distinction from GBS-TRF is of paramount importance as treatment approach and prognosis between these two entities differ.
Effects of freeze-thaw cycles on physicochemical properties and structure of cooked crayfish (Procambarus clarkii)
Authors: Han Jiping , Sun Yingjie , Sun Rongxue , Zhang Tao , Wang Cheng , Jiang Ning
Published: October 2022

To explore the damage mechanisms of freeze-thaw cycles on cooked crayfish in frozen storage, changes in the physicochemical properties and structure of cooked crayfish during the freeze-thaw cycles were investigated. The physicochemical properties of cooked crayfish changed significantly after five freeze-thaw cycles. The moisture content, water holding capacity, pH, and textural properties were decreased, while the total color difference, drip loss, and protein and lipid oxidation were significantly increased (P < 0.05). LF-NMR and MRI verified the water loss, and SDS-PAGE showed denaturation/degradation of myofibrillar proteins (MPs). Multiple freeze-thaw cycles promoted the transition from α-helix to β-turn in the secondary structure, the unfolding of tertiary structure, and a significant change in the chemical forces of MPs. SEM results revealed a disruption in the microstructure of muscle fibers. Repeated freeze-thaw cycles reduced the moisture content and distorted the structure of MPs in cooked crayfish, resulting in the disruption of physicochemical properties and its structure.

Graphical Abstract
Cognitive and neurobehavioral patterns in a sample of Egyptian patients genetically diagnosed with Duchenne muscular dystrophy
Authors: Sayed Maha Mohamed , Fahmy Nagia Aly , El Habiby Mahmoud Mamdouh Mohamed , Elsayed Nermine Salah Eldin , El Bukhari Sara Mohamed Kamal Mohamed , Naguib Rehab Mohamed
Published: October 2022

Background

Children with Duchenne muscular dystrophy report a higher rate of cognitive and psychiatric disorders relative to general population. This study will describe and compare the psychiatric and cognitive problems in DMD patients with healthy controls.

Results

A statistically significant difference was found between the case and control groups regarding Total IQ (TIQ) with a mean of (82 ± 16) in cases compared to (94 ± 10) in controls, in which 58% of DMD boys had <90 TIQ and 40% less than 70. We also found that 58% of cases have delayed onset of speech, 38% have attention-deficit/hyperactivity disorder, 6% have autism spectrum disorder, 14% have anxiety disorders, and 22% have major depressive disorder. Ninety-two percent of cases had deletion mutations.

Conclusions

According to our results, we conclude that boys with DMD had a lower Total IQ and higher rate of psychiatric disorders than the general population. Also, school attendance and speech development are more affected in DMD patients compared to controls, with more speech delay and dropping out of school. So, the authors of this study recommend establishing cognitive and psychiatric screening as a routine in the evaluation and follow-up of DMD children.
Deauville score versus ratio Deauville score in the interpretation of interim 18F-FDG PET-CT and in prediction of outcome in children with FDG-avid extra-nodal lymphomas
Authors: Elhamady Hadeer Yousef , Mostafa Hosna Mohamed , Elsayed Huda Fathy , Abo-ElAzm Omnia Mohamed , Hussein Mohamed Hany
Published: October 2022

Background

Pediatric lymphoma is a common hematological neoplasm, representing the third most frequent childhood malignancy. 18F-fluoro-2-deoxyglucose–positron emission tomography has been found to be useful in lymphoma staging, prediction of prognosis and risk stratification of lymphoma patients. Although the interpretation of interim PET (after two cycles of chemotherapy) using the qualitative visual method of 5-point Deauville score has been widely accepted, semiquantitative methods of interpretation were evaluated by many studies and showed a better prediction of prognosis. The purpose of this study was to evaluate the prognostic role of the semiquantitative ratio Deauville score (rDS), defined as the ratio between target lesion and liver maximum standardized uptake values in children with FDG-avid extra-nodal lymphomas, undergoing interim FDG-PET/CT, and to compare it with the 5-point Deauville score (5p-DS).

Methods

This prospective study included 89 children with FDG-avid extra-nodal lymphoma. Interim PET was interpreted using both visual (5p-DS) and the semiquantitative method (rDS). The visual method depends on visual comparison of FDG uptake between lesions and liver as a reference organ for activity and considered lesions with activity higher than liver to be positive, while the semiquantitative method depends on making a ratio between the most active lesion and liver SUVmax. Receiver operating characteristic approach was applied to identify the optimal cut-point of rDS with respect to response to therapy and prognosis, and the prognostic significance of rDS was compared with 5p-DS.

Results

The ROC analysis for rDS as a predictor of progression showed an optimal cut-point of 1.25. Both 5p-DS and rDS were strong outcome predictors. Patients with negative 5p-DS and patients with rDS < 1.25 had a similar 3-year PFS (87%). Patients with a positive 5p-DS had a 3-year PFS of 67.4%, while patients with rDS > 1.25 had a 3-year PFS of 60%.

Conclusions

rDS could be suggested as an accurate prognostic factor in children with lymphoma undergoing interim FDG-PET/CT. However, larger studies with more homogenous sample regarding histopathological subtypes and chemotherapy lines are needed to confirm these data.
Arab healthcare professionals’ knowledge and perception of occupational therapy
Authors: Sarsak Hassan Izzeddin
Published: October 2022

Background

Occupational therapy (OT) services are not widespread and not well-represented or integrated into many healthcare settings. As a result, OT is not available at many clinical and rehabilitation institutions, which has led to both poor access and reduced knowledge and benefit from OT in many countries worldwide and in the Arab region.

Objective

To examine Arab healthcare professionals’ level of knowledge and perception of OT in an attempt to identify what action is required to enhance awareness and promote OT profession.

Methods

A descriptive online survey was conducted for healthcare professionals from different disciplines and Arab countries to obtain their knowledge and perceptions of OT.

Results

A total of 281 healthcare professionals completed the survey (57% were male). Of the total, only 96 (34.2%) have had worked with OT before, 144 (51.2%) were uncertain about the main domain of OT, 98 (34.9%) were not fully aware of the diverse OT healthcare work settings and different health conditions handled by OT, and 126 (44.8%) were not sure about the difference between OT and physical therapy (PT). Almost two third of the sample (187; 66.5%) were not satisfied with their knowledge of OT, 195 (69.4%) showed interest in learning further about OT, and 209 (74.4%) agreed that OT plays a vital role in the interdisciplinary rehabilitation team. There were significant associations between the participants’ knowledge of OT and their specialty (p = 0.01) and years of experience (p = 0.02).

Conclusion

Most Arab healthcare professionals perceive OT as playing a vital role in the interdisciplinary rehabilitation team. However, OT is not clearly understood and healthcare professionals are not well-educated about OT services and benefits. There is an emerging need to educate healthcare professionals on the focus areas of OT practice. Promoting and advocating for OT is key and crucial.
Deep physics-aware stochastic seismic inversion
Authors: Bürkle Paula Yamada , Azevedo Leonardo , Vellasco Marley
Published: October 2022

Seismic inversion allows the prediction of subsurface properties from seismic reflection data and is a key step in reservoir modeling and characterization. With the generalization of machine learning in geophysics, deep learning methods have been proposed as efficient seismic inversion methods. However, most of these methods lack a probabilistic approach to deal with the uncertainties inherent in the seismic inversion problem and/or rely on complete and representative training data, which often is partially or scarcely available. We have explored the ability of deep convolutional neural networks to extract meaningful and complex representations from spatially structured data, combined with geostatistical simulation, to efficiently invert poststack seismic data directly for high-resolution models of acoustic impedance. Our model incorporates physics constraints and sparse direct measurements while leveraging the use of imprecise but widely distributed indirect measurements as represented by the seismic data. The models generated with geostatistical simulation provide additional information with higher spatial resolution than the original seismic data and allow assessing uncertainty in the model predictions by generating multiple realizations of the subsurface properties. Our method can (1) provide an uncertainty assessment of the predictions, (2) model the complex and nonlinear relationship between data and model, (3) extend the seismic bandwidth at low and high ends of the frequency parameters spectrum, and (4) lessen the need for large, annotated training data. Our method is applied to a 1D synthetic example and a real 3D application example from a Brazilian reservoir. The predicted impedance models are compared with those obtained from a full iterative geostatistical seismic inversion. Our method allows retrieving similar models but has the advantage of generating alternative solutions in greater numbers, providing a larger exploration of the model parameter space in less time than the iterative geostatistical seismic inversion.
Handling missing data in well-log curves with a gated graph neural network
Authors: Jiang Chunbi , Zhang Dongxiao , Chen Shifeng
Published: October 2022

Well logging is a common method that is used to obtain the rock properties of a formation. It is relatively frequent, however, that log information is incomplete due to cost limitations or borehole problems. Existing models predict missing well logs from a fixed combination of other available well logs. However, the missing well logs vary from well to well. We have proposed using a gated graph neural network (GNN) to handle the missing values in well-log curves. It takes sequential data, predicting each missing measurement in the data not only using other available variables measured at the same depth but also available measurements of neighboring observations. Meanwhile, the missing well logs and available well logs could be any possible combinations as long as they are mutually exclusive. This approach has two advantages: (1) the gated GNN does not need to build a specific model for each missing measurement or from every possible combination of available measurements and (2) it can be integrated into the training process of the following predictive model to perform classification tasks. We evaluate the gated GNN model along with two other models: the GRAPE model and the multiple imputation by chained equations (MICE)-gated recurrent unit (GRU) model, on a data set from the North Sea to perform a missing feature imputation task and a lithofacies identification task. The GRAPE model also is a graph-based model, and it predicts values for each missing measurement from available variables measured at the same depth. The MICE-GRU model is a combination of the MICE algorithm and GRU, which handles the feature imputation procedure and the lithofacies identification procedure separately. Our experiments find that the gated GNN model outperforms the MICE algorithm and the GRAPE model on the missing feature imputation task. For the lithofacies identification task, the gated GNN model also provides comparable results to the MICE-GRU model, and they both outperform the GRAPE model.
Unsupervised deep learning for 3D interpolation of highly incomplete data
Authors: Saad Omar M. , Fomel Sergey , Abma Raymond , Chen Yangkang
Published: October 2022

We propose to denoise and reconstruct the 3D seismic data simultaneously using an unsupervised deep learning (DL) framework, which does not require any prior information about the seismic data and is free of labels. We use an iterative process to reconstruct the 3D highly incomplete seismic data. For each iteration, we use the DL framework to denoise the 3D seismic data and initially reconstruct the missing traces. Then, the projection onto convex sets (POCS) algorithm is used for further enhancement of the seismic data reconstruction. The output of the POCS is considered as the input for the DL network in the next iteration. We use a patching technique to extract 3D seismic patches. Because the proposed DL network consists of several fully connected layers, each extracted patch needs to be converted to a 1D vector. In addition, we use an attention mechanism to enhance the learning capability of the proposed DL network. We evaluate the performance of the proposed framework using several synthetic and field examples and find that the proposed method outperforms all benchmark methods.
Automated Ascertainment of Typhlitis From the Electronic Health Record
Authors: Miller Tamara P. , Li Yimei , Masino Aaron J. , Vallee Emma , Burrows Evanette , Ramos Mark , Alonzo Todd A. , Gerbing Robert , Castellino Sharon M. , Hawkins Douglas S. , Lash Timothy L. , Aplenc Richard , Grundmeier Robert W.
Published: October 2022

PURPOSE

Adverse events (AEs) on Children's Oncology Group (COG) trials are manually ascertained using Common Terminology Criteria for Adverse Events. Despite significant effort, we previously demonstrated that COG typhlitis reporting sensitivity was only 37% when compared with gold standard physician chart abstraction. This study tested an automated typhlitis identification algorithm using electronic health record data.

METHODS

Electronic health record data from children with leukemia age 0-22 years treated at a single institution from 2006 to 2019 were included. Patients were divided into derivation and validation cohorts. Rigorous chart abstraction of validation cohort patients established a gold standard AE data set. We created an automated algorithm to identify typhlitis matching Common Terminology Criteria for Adverse Events v5 that included antibiotics, neutropenia, and non-negated mention of typhlitis in a note. We iteratively refined the algorithm using the derivation cohort and then applied the algorithm to the validation cohort; performance was compared with the gold standard. For patients on trial AAML1031, COG AE report performance was compared with the gold standard.

RESULTS

The derivation cohort included 337 patients. The validation cohort included 270 patients (961 courses). Chart abstraction identified 16 courses with typhlitis. The algorithm identified 37 courses with typhlitis; 13 were true positives (sensitivity 81.3%, positive predictive value 35.1%). For patients on AAML1031, chart abstraction identified nine courses with typhlitis, and COG reporting correctly identified 4 (sensitivity 44.4%, positive predictive value 100.0%).

CONCLUSION

The automated algorithm identified true cases of typhlitis with higher sensitivity than COG reporting. The algorithm identified false positives but reduced the number of courses needing manual review by 96% (961 to 37) by detecting potential typhlitis. This algorithm could provide a useful screening tool to reduce manual effort required for typhlitis AE reporting.
Episodic Storytelling
Authors: D'Amore Maura
Published: October 2022

This essay maps the logistics and advantages of reading and teaching texts in their original installments as a means of theorizing seriality in the undergraduate literature classroom.
Psycho, Pharmaco and Sex therapy for the treatment of Premature Ejaculation
Authors: Bukhari Syeda Razia
Published: October 2022

Pakistani’s men with Premature ejaculation (PE) hardly prefer to go for treatment due to cultural barriers (men dominating society). This research objective is the gives knowledge about the effective treatment of premature ejaculation, how it can be effectively treated with the help of different techniques. Premature ejaculation (PE) is happened when a man has an orgasm and ejaculated earlier at the time of intercourse then he or his spouse would like. PE is a men sexual dysfunction that creates a significant anguish for men, partner and their relationships’. Premature ejaculation is not only one illness; it contains 4 subtypes with a unique psychological concern and problems (longtime, acquired, organic and subjective). PE men and couples are treated psychologically for sexual ability but also for self-esteem, performance anxiety and interpersonal disputes. Psychotherapy outcomes alone are hard to compare and to appreciate due to insufficient methodology (lacking control groups, limited sample sizes, poor results and insufficient monitoring). Rare researches, however, which overcome these methodological barriers, indicate that psychological intervention provides a promising treatment choice for men and partners. A detail literature review was done via an electronic database, “Cochrane library databases”, “PsychInfo”, and “PubMed” from June to July 2021. The most effective procedure for lifetime and acquired PE is pharmaco- and psychotherapy combination. Men and partners develop sexual abilities and resolve the intra-psychological, interpersonal and cognitive problems that trigger and sustain dysfunction.

doi: https://doi.org/10.12669/pjms.38.8.5217

How to cite this:Bukhari SR. Psycho, Pharmaco and Sex therapy for the treatment of Premature Ejaculation. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.5217

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Arthroscopic internal drainage of popliteal cysts with cyst wall resection in pediatric patients
Authors: Zhu Junxu , Xiang Dulei , Yang Shen , Xiang Liangbi , Liu Xinwei
Published: October 2022

Objectives: To evaluate the efficacy of arthroscopic internal drainage (AID) and cyst wall resection (CWR) in children with popliteal cysts.

Methods: This study included 16 pediatric patients with popliteal cysts and received arthroscopy using the double posteromedial (PM) portal system during June 2020 and June 2021 at The General Hospital of Northern Theater Command. Among these pediatric patients, 14 were males and two were females, with the mean age of nine years (range: 7-12 years). The left knee was affected in 12 cases, while the right knee was involved in the rest four cases. All patients underwent MR imaging before the procedure to assess whether there was intra-articular trauma and whether the popliteal cyst communicated with the knee-joint cavity. The MRI results showed that each patient had a simple popliteal cyst that involved a single knee joint without intra-articular trauma, which was classified as Grade-1 (n=3), Grade-2 (n =10) or Grade-3 (n =3) according to the Rauschning and Lindgren grading of knee joint symptoms. Arthroscopy was performed through anterolateral (AL) and PM portals to the knee joint for AID plus CWR, and the surgical outcomes were evaluated based on the Rauschning and Lindgren criteria.

Results: No major vascular or nerve injury occurred during the operation. Postoperative complications such as wound infection and lower-extremity deep venous thrombosis were not recorded in these patients. Complications involving the saphenous nerve or the great saphenous vein or pseudocyst formation were not observed during the follow-up period. All patients completed the follow-up ranging from 3-12 months and were identified to have grade-0 (n=15) and grade-1 (n=1) popliteal cysts based on the Rauschning and Lindgren criteria, indicating significant improvement compared with the preoperative levels (all p<0.05). Moreover, no recurrence was recorded after operation.

Conclusion: AID plus CWR is a minimally invasive and safe approach for pediatric patients with popliteal cysts to promote postoperative recovery and reduce the recurrence rate.

doi: https://doi.org/10.12669/pjms.38.8.5354

How to cite this:Zhu J, Xiang D, Yang S, Xiang L, Liu X. Arthroscopic internal drainage of popliteal cysts with cyst wall resection in pediatric patients. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.5354

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Breast surgery super-specialization: Impact on advanced surgical training and research
Authors: Ali Danish , Zeeshan Sana , Farooqi Nifasat , Vohra Lubna
Published: October 2022

The earliest records of breast cancer (BC) date back to 3,000 - 2,500 B.C., ever since multiple curative options have been explored. First known wide margin excision was performed around 1st Century AD and a prototype of the modern-day BC surgery, Halsted radical mastectomy, was performed in the 20th Century. BC is the most common cancer in Pakistan accounting for up to 14.5% of the total cancer incidences. Accredited breast surgery fellowships were established in the UK and USA in 2002 and 2003, respectively. In Pakistan, the movement was delayed and the two-year College of Physicians and Surgeons Pakistan (CPSP) accredited breast surgery fellowship program started in 2019. The increasing annual incidence and changes in demands have led to an increased percentage of General Surgery graduates taking up specialty training. PubMed search from 1990 to 2021 showed a rising trend in the number of breast cancer publications from Pakistan; from almost no papers before 1990 to 615 between 2012 to 2021. This remarkable surge in BC-related research can be explained by the commencement of fellowship programs in breast surgery and related fields. An increase in specialist training will yield better results in the management of patients, improve clinical trials and help produce more meaningful publications from the country.

doi: https://doi.org/10.12669/pjms.38.8.6045

How to cite this:Ali D, Zeeshan S, Farooqi N, Vohra L. Breast surgery super-specialization: Impact on advanced surgical training and research. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.6045

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.