bluuebunny/crossref_metadata_2025 huggingface dataset:
Sarcomas de partes moles nos membros, mais comuns e tão graves quanto os sarcomas ósseos
Authors: Voltan Karen , Baptista André Mathias , Etchebehere Maurício
Published: September 2020

Os sarcomas musculoesqueléticos são doenças raras que exigem atenção. Frequentemente, apresentam alto grau de malignidade ao diagnóstico e se subestimados podem evoluir de forma agressiva local e sistemicamente. Apresentam-se como sarcoma de partes moles e sarcomas ósseos, sendo os de partes moles quatro a cinco vezes mais comuns. A maioria dos sarcomas de partes moles ocorre nos membros. Os subtipos mais comuns nas crianças e adolescentes são o rabdomiossarcoma e o sarcoma sinovial, nos adultos o sarcoma pleomórfico indiferenciado, lipossarcoma, leiomiossarcoma, mixofibrossarcoma e sarcoma sinovial; todos de alto grau de malignidade histológica. Muitos sarcomas de partes moles são confundidos com tumores benignos de partes moles, 100 vezes mais comuns, por isso são ressecados sem o planejamento necessário, acarretando em amputação de um membro que poderia ter sido preservado. Como em todos os cânceres, o fator prognóstico mais importante é a doença metastática. Na sua vigência, a taxa de sobrevida global cai em torno de 20 a 30%. As taxas de sobrevida no geral são parecidas entre os sarcomas ósseos e de partes moles, portanto o sarcoma de partes moles, além de mais prevalente, mostra-se tão agressivo quanto os sarcomas ósseos, por isso merece muita atenção dos ortopedistas que frequentemente são a primeira linha de atendimento dos portadores destes tumores.
Falhas ósseas nas revisões de artroplastia total do joelho
Authors: Mozella Alan de Paula , Cobra Hugo Alexandre de Araújo Barros
Published: September 2020

O aumento do número de cirurgias de revisão de artroplastia total do joelho tem sido observado nos últimos anos, em todo o mundo, por diversas causas. Nos Estados Unidos, é estimado um aumento de 601% no número de artroplastias totais do joelho entre 2005 e 2030. Dentre os enormes desafios dessa cirurgia complexa, o adequado tratamento dos defeitos ósseos é essencial para a obtenção de resultados satisfatórios e duradouros. O adequado tratamento dos defeitos ósseos objetiva construir uma plataforma de suporte estável e duradoura para a implantação dos componentes protéticos definitivos e, se possível, com recomposição do estoque ósseo. Concomitantemente, possibilita o correto alinhamento dos componentes protéticos e do membro, assim como permite restabelecer a altura da interlinha articular e, dessa forma, restaurar a tensão de partes moles e distribuição de carga ao osso hospedeiro, gerando uma reconstrução articular com boa função, estável e indolor. Diversas são as opções para manejo dessas falhas ósseas, entre elas: cimento ósseo com ou sem reforço com parafusos, aumentos metálicos modulares, enxerto ósseo impactado, enxerto estrutural homólogo e, mais recentemente, cones metafisários de metal trabecular e sleeve metafisário. O objetivo do presente artigo foi reunir informações clássicas e inovações dos principais aspectos relativos ao tratamento das falhas ósseas durante as cirurgias de revisão de artroplastia total do joelho.
Análise mecânica após reforço femoral proximal com polimetilmetacrilato em orifícios duplos alternados
Authors: Freitas Anderson , Lessa Mariana de Medeiros , de Oliveira Saulo Pereira , Oliveira Pedro Félix Pereira de , Giordano Vincenzo , Shimano Antônio Carlos
Published: September 2020

Objetivo Avaliar, por meio de ensaio biomecânico, a carga máxima, a energia, e o deslocamento necessários para a ocorrência de fratura em modelos sintéticos de fêmures após a retirada de parafusos acanulados e a realização de técnica de reforço com polimetilmetacrilato (PMMA) em diferentes posições combinadas.

Métodos Foram utilizados 25 ossos sintéticos divididos em 4 grupos: o grupo controle (GC), com 10 modelos sem perfuração, e os grupos teste (A, B e C), com 5 modelos cada. Os grupos de teste foram fixados com parafusos acanulados pela técnica de Asnis, e tiveram a síntese removida e o preenchimento de dois dos orifícios formados por técnica de reforço com PMMA. A análise biomecânica foi realizada simulando queda sobre o grande trocânter utilizando máquina servo-hidráulica.

Resultados Todos os corpos de prova do GC e dos grupos A, B e C apresentaram fratura baso-cervical do colo femoral, exceto um modelo do grupo B, que apresentou fratura longitudinal. Foi utilizada uma média de 5,4 mL de PMMA no reforço dos grupos com preenchimento. Segundo a análise de variância (analysis of variance, ANOVA) e o teste de comparações múltiplas de Tukey, no nível de 5%, observou-se que o GC apresentou diferença significativa em relação aos grupos A e C nos seguintes parâmetros: carga máxima, energia até a fratura, e deslocamento.

Conclusão Observou-se que os grupos A e C, quando comparados ao GC, apresentaram diferenças significativas na observação do deslocamento, da carga máxima, e da energia até a fratura.
Síndrome do túnel do carpo aguda por trombose da artéria mediana: Relato de caso
Authors: Abdouni Yussef Ali , Brunelli João Pedro Farina , Munia Marco Antônio Soares
Published: September 2020

A síndrome do túnel do carpo é a neuropatia compressiva mais comum do membro superior, afetando ∼ 4% da população geral. O quadro clínico caracteriza-se por dor e, principalmente, parestesia no território do nervo mediano, de início insidioso e, nos casos mais graves, observa-se perda de força e atrofia da musculatura tenar. Trata-se de patologia extremamente comum na prática diária de cirurgia da mão, e na maior parte dos casos pode ser tratada com métodos conservadores. Apresentamos aqui um caso atípico de síndrome do túnel do carpo, de surgimento agudo, desencadeado pela trombose da artéria mediana persistente, quadro associado com embolização distal e hipoperfusão do membro.
Osteonecrose do cuneiforme intermédio: Relato de caso
Authors: Nunes Gustavo Araujo , de Souza Matheus Levy Almeida Taveira , Braga Bruno Maciel , Marcatti Mateus Martins , Bertolini Fabrício Melo , Oliveira Junior Otaviano de
Published: September 2020

A osteonecrose é uma doença que raramente afeta os ossos do pé. Quando presente, ela é mais comum no tálus e no navicular. Casos de osteonecrose do cuneiforme intermédio são extremamente raros, e após uma revisão bibliográfica minuciosa encontramos apenas cinco relatos na literatura, sendo todos eles em pacientes pediátricos. A seguir, apresentamos o caso de um paciente adulto com osteonecrose do cuneiforme intermédio resistente ao tratamento conservador. Portanto, propusemos uma abordagem cirúrgica com bom resultado. Nível de Evidência V; Estudos Terapêuticos; Opinião de Especialista.
Retorno ao esporte após osteotomia tibial alta com método de cunha de abertura
Authors: Nicolini Alexandre Pedro , Christiano Eduardo Suñe , Abdalla Rene Jorge , Cohen Moises , de Carvalho Rogério Teixeira
Published: September 2020

Objetivo Avaliar o retorno ao esporte em pacientes jovens e ativos praticantes de alguma modalidade esportiva submetidos a osteotomia tibial alta (OTA) com o método de cunha de abertura.

Métodos Foram analisados prospectivamente 12 pacientes submetidos ao procedimento de OTA utilizando-se método de cunha de abertura. Todos os pacientes estavam afastados do esporte. Foram utilizados os escores Lysholm, questionário International Knee Documentation Committee (IKDC, na sigla em inglês), escala analógica de dor e nível de retorno em comparação ao período pré-operatório. O tempo médio de seguimento foi de 12 meses.

Resultados Um paciente retornou ao esporte em nível muito abaixo do pré-operatório, oito pacientes retornaram em nível pouco abaixo, dois pacientes retornaram no mesmo nível e um paciente retornou em nível acima.

Conclusão A OTA com uso do método de cunha de adição como forma de tratamento para osteoartrose medial isolada demonstra resultados clínicos e funcionais favoráveis e permite o retorno ao esporte.
Effectiveness of Brief Educational Training on Medical Students' Attitude toward Suicide Prevention
Authors: Nebhinani Naresh , Kuppili Pooja Patnaik , Mamta  , Paul Karandeep
Published: September 2020

Objectives Medical students are future physicians, and their attitude toward suicide attempters can impact outcome of patient management and quality of care. This study aimed to assess the effects of brief educational intervention on medical students' attitude toward suicide prevention.

Materials and Methods The prospective study was conducted at a tertiary care center in northwestern India. The total enumeration method was employed to recruit 243 medical students. Attitude toward suicide prevention scale was applied before and after three hours’ training on management of suicide attempters and strategies for suicide prevention.

Statistical Analysis Mean, median, standard deviation, frequencies, and percentages were calculated through descriptive statistics. Mean values were compared before and after the intervention through paired sample student's t-test. Chi-square test or Fischer exact test was used to compare categorical variables and p ≤ 0.05 was set for level of significance.

Results Ten out of 14 attitudinal statements were significantly more favorable after imparting brief training on suicide prevention and management of suicide attempters. They reported lesser resentment, more responsible efforts, with greater competence and positive expectation associated with working for suicidal patients. They agreed on the need for multidisciplinary efforts for effective suicide prevention. After the intervention, they considered the possibility of suicidal ideas emerging due to the need for help, not for the purpose of attention-seeking, and instead of considering suicidal communication as individual's choice, they agreed on substantial preventability of suicide with comprehensive management. Their misconceptions were resolved to a greater extent.

Conclusion Brief educational intervention was found effective in improving their attitude toward suicide prevention. The medical curriculum should incorporate regular educational programs, suicide prevention and comprehensive assessment, and management of suicide attempters.
Corticobasal Degeneration Misdiagnosed As Musculoskeletal Disease: A Challenging Diagnosis of Higher-Level Gait Disease
Authors: Onder Halil
Published: September 2020

Gait disorders are common in the elderly as there are various causes of neurological and non-neurological conditions. On the other hand, most of the gait parameters do change with advancing age which is identified as age-related physiological changes in gait. At this point, the discrimination between age-related physiological changes and gait disorders may be strictly challenging. After identifying gait as an abnormal pattern, classification of it and making the responsible pathophysiology also require high-level expertise in this regard. Herein, we present a rare patient with corticobasal degeneration (CBD) who had admitted initially due to complaints of gait problems. Over a long time, the patient had received the misdiagnosis of gait abnormality due to musculoskeletal problems by multiple physicians. However, the detailed neurological exam showed a higher level gait disorder (HLGD). Further investigations at this point yielded the diagnosis of CBD.
An Unusual Occurrence of Trifluoperazine-Induced Nystagmus in Persistent Hallucinatory Disorder—A Case Report
Authors: Muthuramalingam Avin , Chandrasekaran Vigneshvar , Subramanian Karthick
Published: September 2020

Trifluoperazine is a conventional antipsychotic whose use has been limited with the arrival of relatively new atypical antipsychotics. However, conventional antipsychotics are utilized in the management of psychiatric illnesses comorbid with metabolic disorders such as diabetes or dyslipidemia. Though trifluoperazine has been known to cause extrapyramidal symptoms, rarely ophthalmic symptoms manifest. Here, we discuss the rare occurrence of newly-emergent nystagmus in an individual with persistent hallucinatory disorder and comorbid diabetes mellitus treated with trifluoperazine.
The Medical Treatment Planning and Decisions Act 2016: what is the role for allied health professionals?
Authors: Borthwick Aidan , Higgs Peter
Published: September 2020

Advance care planning is increasingly common practice in contemporary health care for individuals living with a chronic condition. Currently, limited research has been conducted into how newly adopted legislation in Victoria, Australia, facilitates advance care planning. The purpose of this study was to explore the uptake of the Medical Treatment Planning and Decisions Act 2016 in the primary care setting. The study also aimed to explore barriers that allied health professionals encounter when practicing advance care planning with patients. Four interdisciplinary focus groups and two in-depth interviews with participants were conducted and thematically analysed using an interpretivist inquiry paradigm. Analysis revealed two key themes: promoting client wellbeing and scope of practice. The data suggest that advance care planning by allied health professionals in the primary care setting is limited. Focussing on enhancing clients’ wellbeing was more important than the development of advanced care directives. Attempting to promote the wellbeing of patients may foster hesitation to commence advance care planning in primary care. This study demonstrated that knowledge of the fundamental legislative changes are evident among allied health professionals which provides a foundation for successful development of advance care planning post implementation of the new Act.
A mouse tissue atlas of small noncoding RNA
Authors: Isakova Alina , Fehlmann Tobias , Keller Andreas , Quake Stephen R.
Published: September 2020

Significance

We report a systematic unbiased analysis of small RNA molecule expression in 11 different tissues of the model organism mouse. We discovered uncharacterized noncoding RNA molecules and identified that ∼30% of total noncoding small RNA transcriptome are distributed across the body in a tissue-specific manner with some also being sexually dimorphic. Distinct distribution patterns of small RNA across the body suggest the existence of tissue-specific mechanisms involved in noncoding RNA processing.
Synergy between 15-lipoxygenase and secreted PLA
2
promotes inflammation by formation of TLR4 agonists from extracellular vesicles
Authors: Ha Van Thai , Lainšček Duško , Gesslbauer Bernd , Jarc-Jovičić Eva , Hyötyläinen Tuulia , Ilc Nejc , Lakota Katja , Tomšič Matija , van de Loo Fons A. J. , Bochkov Valery , Petan Toni , Jerala Roman , Manček-Keber Mateja
Published: September 2020

Significance

Oxidative stress, which accompanies sterile inflammation, induces release of extracellular vesicles (stressEVs), which activate Toll-like receptor 4 (TLR4), resulting in a pattern of gene expression distinct from response triggered by bacterial lipopolysaccharide. The synergy between 15-lipoxygenase and secreted phospholipase A
2
, both of which are induced by stress, is necessary for the formation of oxidized lysophospholipids, TLR4 endogenous agonists. Moreover, TLR4 was necessary for sPLA
2
promoted K/BxN serum-induced arthritis. As the formation of TLR4 agonists is enzyme driven, it provides an opportunity to inhibit these enzymes to limit sterile inflammation.
An integrated assessment of the global virtual water trade network of energy
Authors: Peer Rebecca A M , Chini Christopher M
Published: September 2020

The global trade of energy allows for the distribution of the world’s collective energy resources and, therefore, an increase in energy access. However, this network of trade also generates a network of virtually traded resources that have been used to produce energy commodities. An integrated database of energy trade water footprints is necessary to capture interrelated energy and water concerns of a globalized economy,and is also motivated by current climate and population trends. Here, we quantify and present the virtual water embedded in energy trade across the globe from 2012 to 2018, building on previous water footprinting and energy virtual water trade studies to create an integrated database. We use data from the United Nations Comtrade database and combine several literature estimates of water consumption of energy commodities to generate the global virtual water trade network. Results include a comprehensive database of virtual water trade for energy at the country level, greatly expanding the literature availability on virtual water trade. The total volume of virtual water trade increased 35% from 157 km3 in 2012 to 211 km3 in 2018. The global trade of oil and fuelwood are consistent drivers of virtual water trade over time, whereas coal, hydrocarbons, and charcoal collectively contribute less than 4% of total virtual water trade between 2012 and 2018. Electricity, despite a less dense trade network constrained by infrastructure, contributes notably to virtual water trade, driven largely by water use for hydroelectricity. This study develops an integrated assessment of previous virtual water studies to estimate global virtual water trade of energy, creating a platform for future global studies.
Wearable pressure sensor for athletes’ full-range motion signal monitoring
Authors: Kaiqiang Wu , Xingyang Li
Published: September 2020

In order to real-time grasp of various physiological signals of athletes during sports, a high-performance flexible pressure sensor that can monitor various physiological signals and human motion was designed. Porous polydimethylsiloxane (PDMS) foam prepared by the sacrificial template method and graphene as raw materials were used to prepare a flexible pressure sensor with wide working range (0–100 kPa), ultra-high sensitivity (the average sensitivity in the range of 0–30 kPa is 17.9 kPa−1, the sensitivity in the range of 30–100 kPa reaches 79 kPa−1), fast response ability (response time is 20 ms) and long-term work stability (more than 10 000 cycles). The excellent performance of this pressure sensor depends on the use of PDMS foam with a high elastic modulus and the graphene loading level is controlled to an appropriate ratio. Finally, we used the conductive porous PDMS foam based flexible pressure sensor to demonstrate accurate and real-time monitoring of athletes’ tiny physiological signals (including pulse and electrocardiograph signals), vocalization and facial emotions, as well as violent joint and limb movements (including joint bending, walking, squats, jogging, and jumping), showing the potential in coaching athletes.
Rising from the pandemic
Authors: Xin Ling
Published: September 2020

Physicists in China are beginning to return to the lab following the COVID-19 pandemic, but many of their projects face delays, as Ling Xin reports
Artificial stupidity
Authors: Harris Margaret
Published: September 2020

You Look Like a Thing and I Love You is a deft, informative and often screamingly funny primer on the ways that machine learning can (and often does) go wrong. And by "go wrong", author Janelle Shane isn't talking about machines becoming hyper-intelligent and overthrowing the puny humans who invented them.
Coronal mass ejection indicators could avoid satellite shutdown
Authors: Jarman Sam
Published: September 2020

Satellite operators could be doing more harm than good by shutting down their systems whenever a coronal mass ejection (CME) from the Sun is forecast to arrive at Earth.
The Digital Afterlife of Nineteenth-Century Black Writing: Response to Genealogies of Black Modernity
Authors: Senchyne Jonathan
Published: September 2020

This response to the forum on the nineteenth-century genealogies of Black modernity explores how nineteenth-century racial and publication contexts continue to shape the digital circulation and digital afterlife of authors. A born-digital publication of a work by George Moses Horton reveals how nineteenth-century racial paratexts re-emerge in metadata and algorithmic capitalism.

When Horton is hailed by a data marketing company seeking to claim him as an asset, when his writing is routed through or claimed by white editors and (re)printers (myself included), and when his work is circulated in networks and spaces far beyond his own, the nineteenth-century conditions that structured Horton’s life and writing are revealed to shape his digital afterlife.
ChemFLuo: a web-server for structure analysis and identification of fluorescent compounds
Authors: Yang Zi-Yi , Dong Jie , Yang Zhi-Jiang , Yin Mingzhu , Jiang Hong-Li , Lu Ai-Ping , Chen Xiang , Hou Ting-Jun , Cao Dong-Sheng
Published: September 2020

Background

Fluorescent detection methods are indispensable tools for chemical biology. However, the frequent appearance of potential fluorescent compound has greatly interfered with the recognition of compounds with genuine activity. Such fluorescence interference is especially difficult to identify as it is reproducible and possesses concentration-dependent characteristic. Therefore, the development of a credible screening tool to detect fluorescent compounds from chemical libraries is urgently needed in early stages of drug discovery.

Results

In this study, we developed a webserver ChemFLuo for fluorescent compound detection, based on two large and high-quality training datasets containing 4906 blue and 8632 green fluorescent compounds. These molecules were used to construct a group of prediction models based on the combination of three machine learning algorithms and seven types of molecular representations. The best blue fluorescence prediction model achieved with balanced accuracy (BA) = 0.858 and area under the receiver operating characteristic curve (AUC) = 0.931 for the validation set, and BA = 0.823 and AUC = 0.903 for the test set. The best green fluorescence prediction model achieved the prediction accuracy with BA = 0.810 and AUC = 0.887 for the validation set, and BA = 0.771 and AUC = 0.852 for the test set. Besides prediction model, 22 blue and 16 green representative fluorescent substructures were summarized for the screening of potential fluorescent compounds. The comparison with other fluorescence detection tools and theapplication to external validation sets and large molecule libraries have demonstrated the reliability of prediction model for fluorescent compound detection.

Conclusion

ChemFLuo is a public webserver to filter out compounds with undesirable fluorescent properties, which will benefit the design of high-quality chemical libraries for drug discovery. It is freely available at http://admet.scbdd.com/chemfluo/index/.
Personalized Reference Intervals in Laboratory Medicine: A New Model Based on Within-Subject Biological Variation
Authors: Coşkun Abdurrahman , Sandberg Sverre , Unsal Ibrahim , Cavusoglu Coskun , Serteser Mustafa , Kilercik Meltem , Aarsand Aasne K
Published: September 2020

Background

The concept of personalized medicine has received widespread attention in the last decade. However, personalized medicine depends on correct diagnosis and monitoring of patients, for which personalized reference intervals for laboratory tests may be beneficial. In this study, we propose a simple model to generate personalized reference intervals based on historical, previously analyzed results, and data on analytical and within-subject biological variation.

Methods

A model using estimates of analytical and within-subject biological variation and previous test results was developed. We modeled the effect of adding an increasing number of measurement results on the estimation of the personal reference interval. We then used laboratory test results from 784 adult patients (>18 years) considered to be in a steady-state condition to calculate personalized reference intervals for 27 commonly requested clinical chemistry and hematology measurands.

Results

Increasing the number of measurements had little impact on the total variation around the true homeostatic set point and using ≥3 previous measurement results delivered robust personalized reference intervals. The personalized reference intervals of the study participants were different from one another and, as expected, located within the common reference interval. However, in general they made up only a small proportion of the population-based reference interval.

Conclusions

Our study shows that, if using results from patients in steady state, only a few previous test results and reliable estimates of within-subject biological variation are required to calculate personalized reference intervals. This may be highly valuable for diagnosing patients as well as for follow-up and treatment.
Identification of the citrate exporter Cex1 ofYarrowia lipolytica
Authors: Erian Anna Maria , Egermeier Michael , Rassinger Alice , Marx Hans , Sauer Michael
Published: September 2020

Yarrowia lipolytica is a yeast with many talents, one of them being the production of citric acid. Although the citrate biosynthesis is well studied, little is known about the transport mechanism by which citrate is exported. To gain better insight into this mechanism, we set out to identify a transporter involved in citrate export of Y. lipolytica. A total of five proteins were selected for analysis based on their similarity to a known citrate exporter, but neither a citrate transport activity nor any other phenotypic function could be attributed to them. Differential gene expression analysis of two strains with a distinct citrate productivity revealed another three putative transporters, one of which is YALI0D20196p. Disrupting YALI0D20196g in Y. lipolytica abolished citrate production, while extrachromosomal expression enhanced citrate production 5.2-fold in a low producing wildtype. Furthermore, heterologous expression of YALI0D20196p in the non-citrate secreting yeast Saccharomyces cerevisiae facilitated citrate export. Likewise, expression of YALI0D20196p complemented the ability to secrete citrate in an export-deficient strain of Aspergillus niger, confirming a citrate export function of YALI0D20196p. This report on the identification of the first citrate exporter in Y. lipolytica, termed Cex1, represents a valuable starting point for further investigations of the complex transport processes in yeasts.
An infinitary axiomatization of dynamic topological logic
Authors: Chopoghloo Somayeh , Moniri Morteza
Published: September 2020

Dynamic topological logic ($\textsf{DTL}$) is a multi-modal logic that was introduced for reasoning about dynamic topological systems, i.e. structures of the form $\langle{\mathfrak{X}, f}\rangle $, where $\mathfrak{X}$ is a topological space and $f$ is a continuous function on it. The problem of finding a complete and natural axiomatization for this logic in the original tri-modal language has been open for more than one decade. In this paper, we give a natural axiomatization of $\textsf{DTL}$ and prove its strong completeness with respect to the class of all dynamic topological systems. Our proof system is infinitary in the sense that it contains an infinitary derivation rule with countably many premises and one conclusion. It should be remarked that $\textsf{DTL}$ is semantically non-compact, so no finitary proof system for this logic could be strongly complete. Moreover, we provide an infinitary axiomatic system for the logic ${\textsf{DTL}}_{\mathcal{A}}$, i.e. the $\textsf{DTL}$ of Alexandrov spaces, and show that it is strongly complete with respect to the class of all dynamical systems based on Alexandrov spaces.
Preventive Efficacy of Tenofovir/Emtricitabine Against Severe Acute Respiratory Syndrome Coronavirus 2 Among Pre-Exposure Prophylaxis Users
Authors: Ayerdi Oskar , Puerta Teresa , Clavo Petunia , Vera Mar , Ballesteros Juan , Fuentes Manuel Enrique , Estrada Vicente , Rodríguez Carmen , Del Romero Jorge ,   Sandoval Study Group, Del Romero Jorge , Rodríguez Carmen , Puerta Teresa , Clavo Petunia , Vera Mar , Ballesteros Juan , Lejarraga Clara , Fernández Nuria , Hurtado Estefanía , García Mónica , González Montserrat , Jerez Natividad , Alcudia Florencia , Jiménez Maria Teresa , Torres Elisa , de Domingo Iria , Lázaro Ruth , Raposo Montserrat , Ayerdi Oskar , Del Romero Jorge , Rodríguez Carmen , Puerta Teresa , Clavo Petunia , Vera Mar , Ballesteros Juan , Lejarraga Clara , Fernández Nuria , Hurtado Estefanía , García Mónica , González Montserrat , Jerez Natividad , Alcudia Florencia , Jiménez Maria Teresa , Torres Elisa , de Domingo Iria , Lázaro Ruth , Raposo Montserrat , Ayerdi Oskar
Published: September 2020

Background

The preventive effect that tenofovir/emtricitabine (FTC) could have against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in human immunodeficiency virus-negative people is unknown. The objective of this study was to analyze the seroprevalence and clinical manifestations of COVID-19 among users of pre-exposure prophylaxis (PrEP), disoproxil fumarate/FTC (TDF/FTC), or tenofovir alafenamide (TAF)/FTC and to compare it to that of a control group.

Methods

An observational descriptive study of the seroprevalence of antibodies for SARS-CoV-2 among men who have sex with men and transgender women without use of PrEP (Group 1; n = 250) and PrEP users with TDF/FTC (n = 409) or TAF/FTC (n = 91) (Group 2; n = 500) was conducted from May11, 2020 to June 27, 2020. All participants were provided with a structured questionnaire that collected information on the variables to be analyzed, and testing for immunoglobulin G antibodies to SARS-CoV-2 (chemiluminescent microparticle immunoassay) was then carried out.

Results

The seroprevalence of SARS-CoV-2 was 9.2% (95% confidence interval [CI], 5.9–13.5) in the group without PrEP and 15.0% (95% CI, 12.0–18.4) in the group with PrEP (P = .026). Among users of TDF/FTC it was 14.7% (95% CI, 11.4–18.5), and in users of TAF/FTC it was 16.5% (95% CI, 9.5–25.7) (P = .661). In those who tested positive for SARS-CoV-2 and receiving PrEP, 57.4% manifested symptoms, compared with 78.3% in the control group (P = .070). In users of TDF/FTC the figure was 53.3% and in users of TAF/FTC the figure was 73.3% (P = .100). The duration of symptoms was 11.5 days in the control group, 9.0 days in PrEP users (P = .116), 7.0 days in users of TDF/FTC, and 13.0 days in users of TAF/FTC (P = .100).

Conclusions

Users of PrEP, TDF/FTC, or TAF/FTC presented a higher seroprevalence to SARS-CoV-2 than the control group. No statistically significant differences were found in relation to clinical manifestations. The PrEP users should use the same prevention measures as those indicated for the general population.
BENCHMARKING OF A NEW AUTOMATIC CT RADIATION DOSE CALCULATOR
Authors: Akyea-Larbi Kofi Okyere , Tetteh Mercy Afadzi , Martinsen Anne Catrine T , Hasford Francis , Inkoom Stephen , Jensen Kristin
Published: September 2020

Information on patient radiation dose is essential to meet the radiation protection regulations and the demands of dose optimization. Vendors have developed different tools for patient dose assessment for radiological purposes. In this study, estimated effective doses derived from a new image-based software tool (DoseWatch, GE Healthcare) was benchmarked against the corresponding doses from a dose calculator (CT-Expo, SASCRAD) and a conversion coefficient method. Dose data from 150 adult patients (66 male and 84 female), who underwent CT head, abdominopelvic or chest examinations, were retrospectively collected using DoseWatch. Effective dose estimated by DoseWatch was significantly lower than that of CT-Expo and DLP-E (k) (p ≤ 0.001). For the organ doses, DoseWatch resulted in lower dose than CT-Expo for all the organs with the exception of testis (p ≤ 001) and eye lenses (p ≤ 0.026).
Failing: Nursing Student Perceptions and Insights for Success
Authors: Owen Amy McBeth
Published: September 2020

Nursing student success is important to students, faculty, higher education, and health care as the nursing shortage continues. However, baccalaureate nursing graduation rates average 80 to 84 (National League for Nursing, n.d.; Texas Center for Nursing Workforce Studies, 2017). Research exploring increased student success is attributed to competitive admission of students highly successful in prerequisite coursework. There is a gap in the literature regarding students’ experiences of failure in didactic nursing courses. This article explores why previously successful students experience didactic failure in BSN course.
An Empowerment Model for Individuals with Chronic Tinnitus
Authors: Dauman Nicolas , Dauman René
Published: September 2020

Objective:

This qualitative study sought to construct a model of empowerment for clinical implementation, based on the first-hand experience of a sample of individuals with chronic tinnitus.

Design:

The study was conducted in accordance with the inductive approach to data in classic grounded theory (GT). GT aims to build a model of behavior that accounts for the main concern of individuals and how they strive to resolve it. Twenty-one participants with chronic tinnitus (10 females, 11 males, age 31–85, mean: 57.6 years, mean duration of tinnitus: 12 years) were recruited through the patient association France Acouphènes and ENT consultations. Open-ended, tape-recorded interviews addressed the variation in the intrusiveness of tinnitus in daily life. A constant comparison analysis was undertaken to identify a core category and to distinguish stages in behavioral changes toward the tolerance of tinnitus.

Results:

Participants’ main concern was to limit the intrusiveness of tinnitus day in, day out. They continuously had to handle tinnitus-induced frustration, which was found to be the core category of the analysis accounting for how all the participants tried to deal with the condition. The more they managed to handle their frustration, the better they coped with the condition. Three behavior patterns were identified as facilitating the ongoing management of tinnitus-induced frustration: (1) searching for perspective upon tinnitus; (2) maintaining order in perception despite its interference; and (3) alleviating conflict arising from social interactions. A model of empowerment is presented that is based on four stages toward tolerance of tinnitus. They are dominated by lack of perspective upon tinnitus (circuit 1), preservation of energy through attempts to control its intrusiveness (circuit 2), attempts to detach oneself from the interference of tinnitus through constant activities (circuit 3), and self-induced relief through the fulfillment of meaningful goals (circuit 4).

Conclusion:

Tolerance of tinnitus requires finding balance between limiting one’s social participation and spontaneity in carrying out meaningful activities. Tolerance can be enhanced by the preservation of one’s energy and the mediating role of enjoyment through the fulfillment of gratifying goals. In patient counseling, it is essential to address the individual’s desire for direct relief from tinnitus through its elimination. Individuals should be made aware that such a desire will likely be thwarted, resulting in the worsening of intrusiveness. Improvement in tolerance is accompanied by the attenuation of niggling self-awareness, a change that is typical of full commitment with valued goals and that helps in alleviating the interference of tinnitus. By understanding the role of frustration, individuals may develop a sense of responsibility in dealing with disabling tinnitus.
Adherence to low-carbohydrate diet in relation to gastric cancer: findings from a case-control study in Iran
Authors: Toorang Fatemeh , Zendehdel Kazem , Sasanfar Bahareh , Hadji Maryam , Esmaillzade Ahmad
Published: September 2020

This study examined the association between adherence to low carbohydrate diet (LCD) and risk of gastric cancer (GC). This hospital-based case-control study was conducted in Iran Cancer Institute, Tehran, Iran between 2010 and 2012. Totally, 178 patients with GC and 276 apparently healthy controls participated in this study. Cases were histo-pathologically confirmed GC patients aged ≥40 years diagnosed with GC in the last year. Dietary intakes were assessed using a validated 146-item Diet History Questionnaire. We computed the LCD score trough the protocol explained by Halton. Patients with GC were older (60.8 vs. 53.2 years,
P
< 0.001) and more likely to be male (74.2 vs. 63.8%,
P
= 0.02), married (97.8 vs. 86.6%,
P
< 0.001) and illiterate (62.4% vs. 26.1%,
P
< 0.001) than controls. Before adjusting for covariates, adherence to LCD-diet was not associated with risk of GC [odds ratio (OR) 1.31; 95% confidence interval (CI) 0.82–2.09 for highest vs. lowest tertile;
P

trend < 0.26]. Adjustments for several potential confounders including H-pylori infection and BMI, participants in the highest tertile of LCD score were 7% more likely to have GC than those in the lowest tertile; however, it was not statistically significant (OR 1.07; 95% CI 0.59–1.95 for highest vs. lowest tertile;
P

trend < 0.79). No significant association was also seen between adherence to animal- or vegetable-based LCD diet and risk of GC. In conclusion, we failed to find any evidence on the association between consumption of LCD and odds of GC. Further studies, in particular of prospective design, are required to confirm these findings.
Corynebacterium Jeikeium Endocarditis
Authors: Gupta Rahul , Popli Tarun , Ranchal Purva , Khosla Jagjit , Aronow Wilbert S. , Frishman William H. , El Khoury Marc Y.
Published: September 2020

Corynebacterium jeikeium is a gram-positive, aerobic, pleomorphic, nonspore forming bacillus, commonly present on the skin surface. Infective endocarditis secondary to C. jeikeium most commonly affects left-sided heart valves and has a higher likelihood to require valve replacement compared to other Corynebacterium endocarditis. C. jeikeium endocarditis is extremely difficult to treat as it is characteristically resistant to penicillin, cephalosporins and aminoglycosides, and sensitivity to quinolones, macrolides, tetracyclines and rifampin is variable. Despite treatment, mortality rates as high as 33% have been reported. We hereby review the literature regarding the epidemiology, diagnosis and treatment of this deadly microorganism.
Dermatologists' Perceptions and Confidence in Cosmetic Care for Male Patients
Authors: Shah Payal , Cartron Alexander M. , Roman Jorge , Zampella John
Published: September 2020

BACKGROUND

Despite a growing interest in nonsurgical cosmetic procedures in men, the utilization of aesthetic treatments remains comparatively low, suggesting the presence of barriers to care.

OBJECTIVE

To describe barriers to cosmetic intervention for male patients from the perspective of dermatologists.

MATERIALS AND METHODS

An anonymous, online survey was distributed through a listserv made available by the American Academy of Dermatology.

RESULTS

Dermatologist respondents perceived a low utilization of cosmetic services in male patients (5%) and a lack of opportunity (72.3%) to provide such services. Respondents also perceived a lack of sufficient education/training (40.9%), experience (20.5%), and a lack of evidence in the field (20.5%) for dermatologists as potential barriers to cosmetic care for male patients. Presence of targeted messaging and in-office educational materials for male patients was found to be associated with increased utilization of cosmetic treatments by male patients (p = .012, p = .012, respectively). Dermatologists reported strong confidence in delivering various noninvasive cosmetic treatments to male patients.

CONCLUSION

Despite dermatologists' reported confidence in performing cosmetic procedures in men, many perceive insufficient education/training and experience with this population which may create barriers to cosmetic care for male patients. Increasing educational materials and targeted messaging to male patients may decrease barriers for patients to receive desired cosmetic care.
Common Dermatologic Procedures and the Associated Complications Unique to Skin of Color
Authors: Adotama Prince , Papac Nicole , Alexis Andrew , Wysong Ashley , Collins Lindsey
Published: September 2020

BACKGROUND

The skin of color (SOC) population in the United States continues to grow, and these patients are undergoing various cosmetic and surgical procedures at increasing rates. There is a paucity of data on the potential complications associated with surgical and cosmetic procedures in this patient population.

OBJECTIVE

We aim to educate dermatologic surgeons and clinicians on surgical and cosmetic procedures in patients of color and increase awareness of the potential complications unique to this patient population.

MATERIALS AND METHODS

A thorough PubMed literature search was performed to conduct this review.

RESULTS

There are a number of complications in SOC that require special attention, including keloids, postoperative infections, postinflammatory hyperpigmentation, and hypopigmentation. There are also various precautions to consider when performing cosmetic procedures, such as neurotoxin and filler injections, laser therapy, microneedling, and chemical peels.

CONCLUSION

Dermatologists should be aware of the potential cosmetic and surgical complications of this growing patient population to provide optimal evidence-based medical care.
Intranasal dexmedetomidine versus oral midazolam premedication to prevent emergence delirium in children undergoing strabismus surgery
Authors: Yao Yusheng , Sun Yang , Lin Jiancheng , Chen Wenjun , Lin Ying , Zheng Xiaochun
Published: September 2020

BACKGROUND

Dexmedetomidine is being used increasingly as a premedicant in the paediatric population. However, the effectiveness of pre-operative intranasal dexmedetomidine premedication, compared with oral midazolam, for emergence delirium is not well characterised.

OBJECTIVE

To identify the effectiveness of pre-operative intranasal dexmedetomidine for emergence delirium in the paediatric patient population following general anaesthesia.

DESIGN

A prospective, randomised, double-blind, parallel-group, placebo-controlled trial.

SETTING

Single university teaching hospital, from September 2013 to August 2014.

PATIENTS

One hundred and fifty-six patients undergoing anaesthesia for strabismus surgery were included in the study.

INTERVENTION

Patients were randomised in a 1 : 1 : 1 ratio to receive premedication with intranasal dexmedetomidine 2 μg kg−1 (the dexmedetomidine group), oral midazolam 0.5 mg kg−1 (the midazolam group), or 0.9% saline (the placebo group).

MAIN OUTCOME MEASURES

The primary outcome was the incidence of emergence delirium assessed by the Paediatric Anaesthesia Emergence Delirium scale. Secondary outcomes included the quality of the inhalational induction, emergence time, postoperative pain intensity, length of stay in the postanaesthesia care unit, the incidence of postoperative nausea or vomiting (PONV) and parents’ satisfaction.

RESULTS

The incidence of emergence delirium was lower in patients given dexmedetomidine compared with that in patients given midazolam (11.5 versus 44%, relative risk = 0.262, 95% confidence interval 0.116 to 0.592) or 0.9% saline (11.5 versus 49%, relative risk = 0.235, 95% confidence interval 0.105 to 0.525). Likewise, the incidence of PONV was lower in the dexmedetomidine group (3.8%) than that in the midazolam (22%; P = 0.006) or placebo (29.4%; P < 0.001) groups. However, there was no difference among the groups concerning postoperative pain scores and length of postanaesthesia care unit stay.

CONCLUSION

In paediatric patients undergoing strabismus surgery intranasal dexmedetomidine 2 μg kg−1 premedication decreases the incidence of emergence delirium and PONV, and improves parents’ satisfaction compared with oral midazolam.

TRIAL REGISTRATION

ClinicalTrials.gov (identifier: NCT01895023).
Metastasis of Lung Adenocarcinoma to the Lacrimal Sac
Authors: Eng Victor A. , Lin Jonathan H. , Mruthyunjaya Prithvi , Erickson Benjamin P.
Published: September 2020

The authors report an unusual case of lung adenocarcinoma metastasis to the lacrimal sac. A 61-year-old woman with stage IV non–small cell lung cancer presented with left facial pain and epiphora. She was found to have an elevated tear meniscus associated with a firm, fixed medial canthal mass. Orbital imaging demonstrated nodular enlargement of the lacrimal drainage apparatus. Biopsy of the lacrimal sac was performed, and it revealed a metastatic lung adenocarcinoma. The patient received targeted radiation therapy to the lacrimal sac, and her dose of maintenance chemotherapy was increased. The patient’s symptoms have since improved. This case of lung cancer involving the lacrimal sac highlights the importance of thorough oncologic surveillance, even with respect to locations atypical for metastatic spread.
Disability Severity and Home-Based Care Quality in Older Adults: The Mediating Effects of Social Support and Caregiver Competence
Authors: HUANG Wei , HE Bin , WANG Yu Huan , MA Wen Juan , ZHOU Jia
Published: September 2020

Background

The lack of adequate medical care, healthcare, and older adult care in remote, low-income, rural Kazakh areas of China is a particular concern that should be prioritized for improvement.

Purpose

This study was designed to explore the relationship between the variables of disability severity, social support, and caregiver competence and the quality of home-based care in a population of Kazakh older adults with disabilities and to analyze the path between severity of disability and quality of home-based care in this population.

Methods

A cross-sectional survey was conducted on 335 Kazakh older adults with disabilities living in Xinjiang, China, and their primary informal caregivers. Disability severity was assessed using the Activities of Daily Living Scale, caregiver competence was assessed using the Family Caregiver Task Inventory, social support was assessed using the Social Support Rating Scale, and home-based care quality was assessed using the Family Caregiving Consequences Inventory Scale. Path analysis was used to check the effects of other variables on the quality of home-based care.

Results

Significant correlations were found among disability severity, caregiver competence, social support, and home-based care quality. Disability severity was shown to have a 29.28% direct effect on home-based care quality and a 70.72% indirect effect through social support and caregiver competence.

Conclusions

The results of this study confirm that better social support and caregiver competence improves the quality of home-based care available to older adults with disabilities. Policymakers should give priority to improving the quality of care provided to community-dwelling older adults with severe disabilities. Furthermore, health management departments should provide informal caregiver training that teaches care and rehabilitation knowledge and skills to improve the competencies of caregivers.