bluuebunny/crossref_metadata_2025 huggingface dataset:
Variation in volumes and characteristics of ENT emergency visits during COVID-19 pandemic. Where are the patients?
Authors: Sapoutzi Marilia , Sideris Giorgos , Boumpa Eleni , Papadimitriou Nikolaos , Nikolopoulos Thomas , Delides Alexander
Published: June 2020

Purpose: The aim of this study is to analyze patterns and volumes of patients visiting ENT emergency departments during periods of community lockdowns given the newness of this situation and to assess the variation in numbers of visits and examine whether their reduction equally affects all categories of visit causation or whether it is limited to diseases not considered as emergencies.Methods: A retrospective descriptive study was conducted on prospectively collected registry data on patients of all age groups visited the emergency ENT department during the period of nationwide lockdown. Patients were grouped in 9 categories, according to the cause of visit the ENT emergency department.Results: A total of 201 patients visited the ENT emergency department. The retrospective analysis of the data during the same period in the years 2013 to 2019 showed a reduction of 73% in total visits (mean total visits number between 2013 to 2019 was 745.29 ± 20.0143). A statistically significant reduction in visitation was found in all categories studied with the exception of foreign body ingestion – aspiration.Conclusion: Patients with General ENT symptoms, mild epistaxis cases, otology cases, vertigo cases, uncomplicated infectious cases showed a statistically significant reduction in numbers and were treated empirically. Swallowing foreign body cases did not show statistically significant reduction. Limitation of movement and the lockdown itself, led to reduction of trauma cases. Surprisingly, there was also a reduction in oncology cases and an increase in numbers of these cases can be expected in the near future.
Protocol for a systematic review on the experience of informal caregivers for people with a moderate to advanced dementia within a domestic home setting
Authors: James Charles , Walshe Catherine , Froggatt Katherine
Published: June 2020

Background: The knowledge about the experience of informal caregivers who provide care to people with moderate to advanced dementia in a domestic home setting is limited. A consequence of long hours of caregiving in addition to dealing with normal challenges of daily living is their experience of a poor quality of life. Some of their experiences may be described in terms of a feeling of powerlessness to make changes during care provision. This feeling may also suggest an experience of moral distress. This protocol aims to explore these experiences.Methods: This review adopts a narrative synthesis approach. A search will be conducted for studies written in English language in the bibliographic databases MEDLINE Complete, CINAHL, EMBASE, PsycINFO, Web of Science, and Academic Search Complete covering periods from 1984 to present. The search terms will be related to dementia and caregivers, and the process will be focused on dementia at the moderate to the advanced stages. Reference lists of included papers will also be searched for additional relevant citations. Search terms and strategy will be checked by two independent reviewers. The identification of abstracts and full texts of studies will be done by the author, while the quality and the risk of bias will also be checked by the two independent reviewers. Discussion: Psychological distress is cited as an experience reported within informal caregiving. For the caregiver, it is associated with a negative impact on general health. To date, no synthesis exists on the specific experience of informal caregiving for people with moderate to advanced dementia within the domestic home setting. This review considers that variation of accounts contributes to how the informal caregivers’ general experience is explored in future research. This may enable gaps in current knowledge to be highlighted within the wider context of caregiving in the domestic home setting.Systematic review registrationThis review has been submitted for registration at PROSPERO (crd.york.ac.uk/prospero/).
Acute celiac artery occlusion secondary to blunt trauma: Two case reports
Authors: Li Hui , Zhao Yu , Xu Yan-an , Li Tao , Yang Jun , Hu Ping , Ai Tao
Published: June 2020

Background
Blunt celiac artery injury is extremely rare, but it is easy to ignore. The clinical manifestation of celiac artery injuries is usually atypical, so it is easy to fail to diagnose them.
Case presentation:
We report two cases of celiac artery occlusion after multiple trauma admitted, its mechanisms were motor vehicle collision and fall from height, respectively. The first patient was combined with severe liver injury, and the right hepatic arterial was embolized with coil assisted by the operation through the superior mesenteric artery. Both patients were managed with non-operation treatment, and no complications occurred during hospitalization.
Conclusions
For patients with celiac artery injury, conservative treatment is an important choice, but successful treatment still needs to be individualized based on the patient's condition.
The Prevalence and Impact on Patient Outcomes of Malnutrition Among Older Adults Presenting at an Irish Emergency Department: A Secondary Analysis of the OPTIMEND Trial
Authors: Griffin Anne , O´Neill Aoife , O´Connor Margaret , Ryan Damien , Tierney Audrey , Galvin Rose
Published: June 2020

BackgroundMalnutrition is common among older adults and is associated with adverse outcomes but remains undiagnosed on healthcare admissions. Older adults use emergency departments (EDs) more than any other age group. This study aimed to determine the prevalence and factors associated with malnutrition on admission and with adverse outcomes post-admission among older adults attending an Irish ED. MethodsSecondary analysis of data collected from a randomised trial exploring the impact of a dedicated team of health and social care professionals on the care of older adults in the ED. Nutritional status was determined using the Mini Nutritional Assessment- short form. Patient parameters and outcomes included health related quality of life, functional ability, frailty, hospital admissions, falls history and clinical outcomes at index visit, 30-day and 6-month follow up. Aggregate anonymised participant data linked from baseline to 30-days and 6-month follow-up were used for statistical analysis.ResultsAmong 353 older adults (mean age 79.6 years (SD=7.0); 59.2% (n=209) female) the prevalence of malnutrition was 7.6% (n=27) and ‘risk of malnutrition’ was 28% (n=99). At baseline, those who were malnourished had poorer quality of life scores, functional ability, were more frail, more likely to have been hospitalised or had a fall recently, had longer waiting times and were more likely to be discharged home from the ED than those who had normal nutrition status. At 30-days, those who were malnourished were more likely to have reported another hospital admission, a nursing home admission, reduced quality of life and functional decline than older adults who had normal nutrition status at the baseline ED visit. At 6-months, a reported further decline in functional ability was more likely among those who were malnourished compared to those who had normal nutritional status. ConclusionOver one-third of older adults admitted to an Irish ED are either malnourished or at risk of malnourishment. Malnutrition was associated with a longer stay in the ED, functional decline, poorer quality of life, increased risk of hospital admissions and a greater likelihood of admission to long-term care at 30 days. Trial registration: Protocol registered in ClinicalTrials.gov, ID: NCT03739515, first posted November 13, 2018. https://clinicaltrials.gov/ct2/show/NCT03739515
Floating Conditions of the Pads in Fluid Pivot Journal Bearing
Authors: Tuyen Vu Nguyen , Li Weiguang
Published: June 2020

Fluid pivot journal bearing (FPJB) used on the ships was selected as the object of the study in this paper. The ability to form a squeeze film following the recess area ratio of the pad is systematically investigated under the condition that the preload factor and the eccentricity ratio change. Three positions of the load’s characteristic for the moving conditions of boats on the water are considered. Numerical methods are used to calculate the dynamic lubrication in bearing. Equilibrium conditions of force and moment are used to determine the floating conditions of the pads. The results show that during working process, the pad directly applied by the external force satisfies the floating condition, while the remaining pads are satisfied only when the preload factor and eccentricity ratio increase. In the early stages, the pad mostly float on one side. Floating condition curves are constructed as the basis for determining the optimal recess area.
The impact of the cooling effect of urban parks on thermal comfort from the physiological and the psychological perspective
Authors: Aram Farshid , Solgi Ebrahim , García Ester Higueras , Mosavi Amir
Published: June 2020

Background: In densely populated urban centers, increased air temperature due to urban heat island (UHI) effect can undermine the thermal comfort and health of citizens. Research has shown that large urban parks can mitigate the effect of UHIs and improve thermal comfort, especially in the warmer months of the year when temperature changes are more noticeable. This study investigated the cooling effect intensity (CEI) of the Retiro Park in the center of Madrid at three different distances from its southern edge and the impact of this cooling effect on thermal comfort from physiological and psychological perspectives. This investigation was performed by measuring microclimate data and conducting a survey simultaneously during the summer days. Results: The results showed that the CEI of the park varies with distance from its edge. Because of this effect, air temperature within the 130m and 280m distance of the park was respectively 1.6°C and 0.9°C lower than the temperature at the 520m distance (the nearest heat island). After examining the effect of the park in terms of Physiological Equivalent Temperature (PET), it was found that the PET at the 130m and 280m distance of the park was 9.3% and 5.4% less than the PET in the heat island domain. More than 81% of the respondents (in all three areas) had a mental image of the park as the place where they would experience the highest level of outdoor thermal comfort, and this rate was higher in the areas closer to the park. The analysis of citizens’ responses about perceived thermal comfort (PTC) showed that citizens in areas with higher CEI had perceived a higher degree of thermal comfort from the psychological perspective. Conclusion: This study demonstrates the significant role of large urban parks located in the core of the populated cities in providing thermal comfort for citizens from both physiological and psychological perspectives.
In Vitro Evaluation of the Tension Band Suture Method for Proximal Humerus Fracture Treatment
Authors: Ishii Hideaki , Shintaku Takanori , Yoshizawa Shu , Sakamoto Misato , Kaneko Takao , Musha Yoshiro , Ikegami Hiroyasu
Published: June 2020

Background: Proximal humeral fractures are common, and more than half occur in patients over 65 years of age. Operative treatment may be recommended for displaced, complicated fractures; however, surgery may lead to displacement of the greater tuberosity or humeral head. Supplemental tension band sutures have been recommended to prevent such a complication. In this study, we investigate the best combination of suture, washer, and threading angle for proximal humeral fractures from a mechanical view.Methods: The mechanical durability of 18 combinations of suture materials (Fiberwire, Ethibond, and Surgilon), threading washers (ring washer, disc washer), and threading angles (15 or 45 degrees) were examined via a cyclic loading test. Results: The most durable combination in the cyclic loading test consisted of threading the Fiber Wire to the washer ring using only one hole (ring washer-1) at 45 degrees. In contrast, the most vulnerable combination was threading Ethibond to the washer disc at 15 degrees. Breakage of all suture materials occurred at the suture-washer interface, and no failure or loosening of the knots was observed. FiberWire gradually eroded until the loss of equilibrium; whereas the rupture of Ethibond and Surgilon occurred suddenly. Conclusions: From a mechanical viewpoint, we demonstrated that applying a supplemental tension band suture using FiberWire with a single-hole ring washer threaded at a wider angle is recommended.
Combination Lateral Orbitotomy and Orbit Decompression as a New Approach for the Treatment of Adhesion Cavernous Haemangioma in the Orbapex
Authors: Fang Chengyan , Liu Hai , Zhang Wenjia , Yang Zhongkun , Yang Yabing , Tao Tao , Hu Zhulin , Jiao Kangwei
Published: June 2020

Orbital cavernous haemangioma (OCH) is a benign, slow-growing lesion of intracranial space. Especially, lesions located at the tip of the angle to form adhesions to the optic nerve that remains extremely challenging. This study investigated the clinical features and combined treatment of patients with OCH who underwent orbital incision or decompression and incision. This was a retrospective observational study. Between September 2015 and August 2018, Cases with pathologically confirmed orbital cavernous haemangioma were treated with either of two eyelid incision approaches. The clinical features and treatment outcomes were compared between groups. Forty-three patients with unilateral haemangioma involving adhesion of the temporal and optic nerves were included in this study. Of the 43 patients, 60% were women; the mean age was 40.2 years (range, 25-71 years). The main complaints were painless progressive exophthalmos and visual impairment. Complete removal of the tumor was achieved in all patients who underwent a standard lateral opening. Visual acuity (VA) was stable in 21 patients (91%), whereas it worsened in 2 patients (8.6%). Complete tumor removal was achieved in all patients who underwent lateral decompression. Visual acuity was initially stable in 20 patients (100%); at one week postoperatively, visual acuity worsened in 1 patient (5%). Multivariable analysis showed that tumor location (p <���������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������
Cannabinoid Syndrome in the Pregnant Patient: Clinical Case and Literature Review
Authors: Flament Julien , Scius Nathan , Thonon Henri
Published: June 2020

Background:Cannabis use is on the rise. Several casesof cannabinoid syndrome, secondary to chronic cannabis intoxication, have been described worldwide, but few cases have described this entity in pregnant women. Case presentation: We describe a 29-year-old pregnant patient that had consumed cannabis and experienced uncontrolled vomiting. The use of hot baths, the rapid improvement in symptoms, and results of complementary examinations suggested a diagnosis of cannabinoid syndrome. The patient could return home and she continued her pregnancy and childbirth without peculiarities. Conclusion:Cannabinoid syndrome should be considered in the differential diagnosis of vomiting in pregnancy. Consumption of cannabis must be systematically included in the anamnesis. However, it seems to be somewhatunacceptable socially or medically. Consumption must be stopped to manage symptoms.
Preoperative predictors of enucleation time during en bloc no-touch holmium laser enucleation of the prostate
Authors: Lin Chun-Hsuan , Li Ching-Chia , Wu Wen-Jeng , Wen Sheng-Chen
Published: June 2020

Background

To evaluate preoperative predictors of enucleation time during en bloc no-touch holmium laser enucleation of the prostate (HoLEP)

Methods

We enrolled 135 patients with symptomatic benign prostatic hyperplasia (BPH) treated with en bloc no-touch HoLEP from July 2017 to March 2019 by a single surgeon. Preoperative, perioperative, and postoperative clinical variables were examined. Stepwise linear regression was performed to determine clinical variables associated with enucleation times.

Result

The average (range) enucleation time was 46.1 (12–220) minutes, and the overall operation time was 71 (18–250) minutes. History of anticoagulation, history of urinary tract infection (UTI), and increasing specimen weight were each significantly associated with increasing enucleation time. No category IV complications were recorded, and all complications were evenly distributed among the groups according to the HoLEP specimen weight.

Conclusion

En bloc no-touch HoLEP was found to be an efficient and reproducible surgical method for treating BPH. Prostatic gland size was significantly associated with increased enucleation times. Similarly, history of UTI and anticoagulation were correlated with increased operative time.
Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic: A cross-sectional study
Authors: Sarangi Bhakti , Reddy Venkat Sandeep , Oswal Jitendra S. , Malshe Nandini , Patil Ajinkya , Chakraborty Manojit , Lalwani Sanjay
Published: June 2020

Background: India saw the largest and the most stringent lockdown in the world when the number of COVID-19 cases reached around 550. With some early benefits in containing the surge and restricting the R0 of the virus, the current relaxation of lockdown norms has witnessed an exponential rise in positive cases. With scarcity of Pediatric data from the Indian subcontinent, early observations in the pandemic are pivotal in improving the understanding of physiologic behaviors, identifying risks, and guiding clinicians in assessing time-tested interventions and augmenting the awareness in the masses about the manifold clinical profiles of an evolving disease.Objective: To assess the epidemiological and clinical characteristics of children admitted with COVID-19 infection early in the pandemic.Study Design: A cross-sectional studyParticipants: Fifty children between one month and 18 years of age whose nasopharyngeal swab tested positive for SARS-CoV-2 by RT- PCR. Results: 28 (56%) children were male. 41 (82%) came from government declared containment zones with only one child having history of travel to affected area. Home overcrowding was observed in 33 (66%). Of the 50 children, 29 (58%) were asymptomatic while 20 (40%) and one (2%) had mild and moderate symptoms respectively. Fever, cough, and sore throat were the most common symptoms. 49 (98%) children had BCG scar. Leucopenia was seen in three (6%) only. Mean (SD) Neutrophil-Lymphocyte-Ratio (NLR) was 0.78 (0.48) while mean (SD) CRP was 10.98 (23.90). All 50 (100%) were cured. Conclusion: Our study reasserts the increasing pediatric burden of COVID-19 with all age groups affected and overcrowding as a risk factor for continued community transmission, thus beckoning that public health policies be directed to ensuring further preventive measures. It also re-iterates the milder disease pattern in children with COVID-19 in the initial phase of the pandemic with a high proportion of asymptomatic and mild illness. Though abnormal CRP values are synonymous with the illness in children; leucopenia may not be a consistent finding.
Informing the public health response to COVID-19 (and lessons learnt for future pandemics): a systematic review of risk factors for disease, severity, and mortality.
Authors: Flook Mary , Jackson Charlotte , Vasileiou Eleftheria , Simpson Colin R. , Muckian Marisa D. , Agrawal Utkarsh , McCowan Colin , Jia Yumeng , Murray Josie L.K. , Ritchie Lewis D. , Robertson Chris , Stock Sarah J. , Wang Xin , Woolhouse Mark E. J. , Sheikh Aziz , Stagg Helen R.
Published: June 2020

BackgroundSevere Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has challenged public health agencies globally. In order to effectively target government responses, it is critical to identify the individuals most at risk of coronavirus disease-19 (COVID-19), developing severe clinical signs, and mortality. We undertook a systematic review of the literature, to present the current status of scientific knowledge in these areas and describe the need for unified global approaches, moving forwards, as well as lessons learnt for future pandemics. MethodsMedline, Embase and Global Health were searched to the end of April 2020, as well as the Web of Science. Search terms were specific to the SARS-CoV-2 virus and COVID-19. Comparative studies of risk factors from any setting, population group and in any language were included. Titles, abstracts and full texts were screened by two reviewers and extracted in duplicate into a standardised form. Data were extracted on risk factors for COVID-19 disease, severe disease, or death and were narratively and descriptively synthesised. Results1,238 papers were identified post-deduplication. 33 met our inclusion criteria, of which 26 were from China. Six assessed the risk of contracting the disease, 20 the risk of having severe disease and ten the risk of dying. Age, gender and co-morbidities were commonly assessed as risk factors. The weight of evidence showed increasing age to be associated with severe disease and mortality, and general comorbidities with mortality. Only seven studies presented multivariable analyses and power was generally limited. A wide range of definitions were used for disease severity. ConclusionsThe volume of literature generated in the short time since the appearance of SARS-CoV-2 has been considerable. Many studies have sought to document the risk factors for COVID-19 disease, disease severity and mortality; age was the only risk factor based on robust studies and with a consistent body of evidence. Mechanistic studies are required to understand why age is such an important risk factor. At the start of pandemics, large, standardised, studies that use multivariable analyses are urgently needed so that the populations most at risk can be rapidly protected. This review was registered on PROSPERO as CRD42020177714.
Dodging COVID-19 infection: Low expression and localization of Angiotensin-Converting Enzyme 2 (ACE2) and Transmembrane Serine Protease 2 (TMPRSS2) in Mesenchymal Stem Cells derived from human umbilical cord (hUC-MSCs). 
Authors: Hernandez Jonathan J , Beaty Doyle E , Fruhwirth Logan L , Sloan J M , Chaves Ana P Lopez , Riordan Neil H
Published: June 2020

Mesenchymal stem cells derived from human umbilical cord (hUC-MSCs) have immunomodulatory properties that are of interest to treat novel coronavirus disease 2019 (COVID-19). Leng et al. recently reported that hUC-MSCs derived from one donor negatively expressed Angiotensin-Converting Enzyme 2 (ACE2), a key protein for viral infection along with Transmembrane Serine Protease 2 (TMPRSS2). In this report, the expression of ACE2 and TMPRSS2 was analyzed in 24 lots of hUC-MSCs derived from 24 different donors via quantitative polymerase chain reaction (qPCR), Western Blot, immunofluorescence and flow cytometry. hUC-MSCs had significantly lower ACE2 (p=0.002) and TMPRSS2 (p=0.008) expression compared with human lung tissue homogenates in Western blot analyses. Little to no expression of ACE2 or TMPRSS2 was observed in hUC-MSC by qPCR, and they were not observable with immunofluorescence in hUC-MSCs cell membranes. A double negative ACE2 and TMPRSS2 population percentage of 94.30% ±15.55 was obtained for hUC-MSCs via flow cytometry, with only 0.011% ACE2 and 10.91% TMPRSS2 observable positive populations. We have demonstrated negative expression of ACE2 and low expression of TMPRSS2 in 24 lots of hUC-MSCs. This has crucial implications for the design of future therapeutic options for COVID-19, since hUC-MSCs would have the ability to “dodge” viral infection to exert their immunomodulatory effects.
Downregulation of HBx Restrains Proliferation, Migration and Invasion of HepG2 Cells
Authors: Huang Chaoqun , Liu Wei , Zhao Xiaochuan , Zhao Libin , Wang Fuxiang
Published: June 2020

Background: Liver cancer is a frequent malignancy with high fatality. Hepatic B virus X protein (HBx) could promote theprogression of liver cancer. Meanwhile, aberrantly expressed XB130 was identified in liver cancer. However, relevant molecular mechanism is poorly studied. Our present study mainly investigated the mechanism of liver cancer.Methods: After microarray-based analyses in liver cancer tissues and the matched adjacent normal tissues, upregulated mRNA was screened out. Contents of HBx and XB130 in liver cancer tissues as well as cells HepG2 were examined by reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Western blot analysis. Correlation between HBx and XB130 was analyzed in HepG2 cells, followed by verification by RIP assay. After gain- and loss-of-function experiments, cellular proliferation, invasion, migration and colony formation ability were assessed using CCK-8, Transwell, wound healing experiment and colony formation assay.Results: Both HBx and XB130 expression was elevated in liver cancer, which was correlated with poor survival rate of liver cancer patients. Moreover, HBx and XB130 were positively correlated in HepG2 cells. RIP assay verified that HBx could bind to XB130. Loss of HBx hindered proliferation, and migration/invasion of HepG2 cells but promoted apoptosis, which was partially reversed by overexpressed XB130.Conclusion: The conclusion reached from the study offered an understanding of the role of HBx/XB130 played in liver cancer. Our study first reported the regulatory relation between HBx and XB130, which may be valuable to discover therapeutic targets for liver cancer treatment.
Serial Blood and Urine Drug Concentration Measurement in a Patient Withacute Intoxication Bytramadoland Zolpidem Resulting in Qt Prolongation: Case Report
Authors: Lee Bonggyu , Park Jungsoo , Kim Suncheun , Kim Dongwoo , Park Dongeun , Chang Hyejin , You Yeonho , Kang Changshin , Ahn Hongjoon , JEONG won joon
Published: June 2020

Background: QT prolongation is a well-known complication when tramadol or zolpidem is ingested in large amounts acutely. However, the blood drug concentration resulting in QT prolongation or tachyarrhythmia when tramadol and zolpidem are ingested simultaneously in large amounts has not yet been reported. We report a case of acute intoxication by tramadol and zolpidem resulting in QT prolongation in a patient in whomserial blood and urine tramadol and zolpidemconcentrationswere determined.Case presentation:A 38-year-old male patient presented tothe emergency medical centrebecause ofpoisoning from 3 g of tramadol and 50 mg of zolpidemat 3 h before hisemergency department(ED) visit.During supportive treatment, he developed QT prolongation without clinical manifestations. He was discharged five days after admission without any sequelae. We measured the blood and urine concentrations of tramadol and zolpidemat various time points, which revealed ablood tramadol concentration-dependent change in QTc intervals and increasing blood tramadol concentration at 8 h after the ED visit,with a sustainedlow zolpidem concentration.Tramadol and zolpidem are metabolized by the same enzyme, cytochrome P450 3A4.Therefore, competitive inhibition bya P450 3A4isoenzyme may lead to increases indrugtoxicity. The QT interval in patients acutely intoxicated bytramadol should be evaluated carefully, particularlywhen tramadol is co-ingested with other drugs.Conclusions:Considering the half-life of tramadolor zolpidem and potential for continued absorption of drugs remaining in the gastrointestinal tract, it is necessary to observe patients viacardiac monitoring for more than 36 hafteracute intoxication.The blood concentration of tramadol may increaseand result in QT prolongationeven afterappropriate initial treatment.
Exposure risk of patients with chronic infectious wounds during the COVID-19 outbreak and its countermeasures
Authors: Zhou Haiying , Jin Qianjun , lu hui
Published: June 2020

BACKGROUND

A large number of cases of pneumonia caused by novel β-coronavirus emerged in Hubei Province, China, at the end of 2019 and demonstrated great potential for transmission. At present, known independent risk factors include age, diabetes and other chronic diseases, which may be similar to the patients with chronic wound, thus we try to explore the clinical characteristics, prognostic factors and management recommendation of patients with chronic infective wounds during the COVID-19 epidemic period.

METHODS

In this single-center, retrospective observational study, we included all cases with chronic infective wounds that came to our hospital between the full outbreak of the COVID-19 in China (January 23, 2020) and the latest date prior to posting (20 April 2020). Demographic data, comorbidities, laboratory and imaging findings, consultation history and clinical outcomes (lesion cured, uncontrolled, amputated, etc. as of May 10, 2020) were collected for all individuals. Patients were subdivided into gangrene, traumatic infection and other types of soft tissue infection wound (including bedsores, gout ruptures, stab wounds and so on) according to the causes of wound and their disease-related information were compared group by group.

RESULTS

Among the total 81 patients with chronic infective wounds, 60% was male, with a mean age of 60.8 years (SD 18.6), including 38 (47%) patients with traumatic infection, 29 (36%) gangrene cases, and 14 (17%) other soft tissue infection wounds. Common comorbidities are hypertension (32%), diabetes (32%), cardiovascular disease (24%), and kidney injury (12%), and the patients with gangrenes have the most comorbidities. As of May 10, 2020, there were 78 patients discharged and their average stay time is 15.8 days(SD 14.2), while people still at the hospital is 39.7days(SD 8.7)much longer than the discharged and also has more comorbidities. But there is no significant difference in the hospitalization time of three types of wounds. And fortunately, none of all the patients were infected by coronavirus.

CONCLUSION

The majority of patients with chronic wounds are severely ill with high risk of infection and poor prognosis, therefore management of patients with chronic wounds should be improved.
Qualitative Assessments of Density and Background Parenchymal Enhancement on Contrast-Enhanced Spectral Mammography Associated with Breast Cancer Risk of High-Risk Women
Authors: Mao Ning , Yin Ping , Lin Fan , Wang Zhongyi , Yang Ping , Zhang Kun , Xie Haizhu , Wang Bin , Ma Heng
Published: June 2020

Background: To investigate the correlation between the risk of developing breast cancer for high-risk women and the density and background parenchymal enhancement (BPE) on contrast-enhanced spectral mammography (CESM).Methods: This retrospective study was approved by the Institutional Review Board of our hospital. Women at high risk, without breast cancer history and received CESM examination from July 2016 to December 2017 were retrospectively enrolled. Patients who developed breast cancer after CESM examination were classified as cancer cohorts, and women who did not develop breast cancer with maximized follow-up time were categorized as control cohorts. These two cohorts were one-to-one matched in age, family and/or genetic history of breast cancer, and BRCA status. The density and amount of BPE at CESM imaging were assessed. Conditional logistic regression was applied to evaluate the relationship between imaging features and breast cancer risk. Results: During the follow-up interval, 90 women at high risk with no history of breast cancer were diagnosed with breast cancer (invasive, n = 46; in situ, n = 44). During follow-up, women with mild, moderate or significant BPE were seven times more likely to be diagnosed with breast cancer than women with minimal BPE [P = 0.005; odds ratio (OR) = 7.0; 95% confidence interval(CI): 1.1-71.1]. Breast density was not significantly different between the two cohorts (P = 0.5). Conclusions: Increased BPE levels increase the risk of breast cancer among high-risk women.
Microwave-assisted hydrotropic pretreatment as a new and highly efficient way to cellulosic ethanol production from maize distillery stillage
Authors: Dawid Mikulski , Kłosowski Grzegorz
Published: June 2020

Background: The development of the second generation ethanol production technology requires new, highly effective methods of pretreatment of lignocellulosic biomass, which reduces lignin content, eliminates fermentation inhibitors, and makes the biomass susceptible to hydrolysis using cellulolytic enzymes. New pretreatment methods should be adapted to the processing of lignocellulosic waste biomass from various industries. One of the problems is the management of grain stillage, which is waste from the production of first generation ethanol.Results: The aim of the study was to assess the suitability of the combined use of microwave radiation and sodium cumene sulfonate under optimized process conditions for the preparation of maize stillage biomass as a raw material for the production of cellulosic ethanol. The key parameter guaranteeing a high level of lignin removal from biomass (ca. 44%) was the concentration of hydrotrope. The highest organic matter extraction from biomass (67.00±1.68%) was observed for 20% v/v sodium cumene sulfonate, ca. 117 PSI (microwave heating) and 30 min exposure time. Even at high biomass concentration (16% w/v) and a cellulose enzyme dose of about 4 FPU/g, maize stillage biomass subjected to microwave-assisted hydrotropic pretreatment was highly susceptible to enzymatic degradation, which resulted in 80% hydrolysis yield. The stillage biomass processed in this way is a very good raw material for the production of cellulosic ethanol. It is possible to obtain a fermentation medium with a very high glucose concentration (up to 80 g/L), without fermentation inhibitors (such as 5-HMF, furfural, lignin degradation products) and, as a consequence, to reach a very high level of sugar conversion to ethanol, even as much as 95% of theoretical yield.Conclusions: Microwave hydrotropic treatment with sodium cumene sulfonate is a very effective way to prepare waste maize stillage biomass for the production of cellulosic ethanol. The method provides a high level of enzymatic degradation of cellulose, leading to a medium with high content of released sugars suitable for bioconversion, which is in line with the assumptions of the second generation ethanol production technology.
Are closed campus policies associated with youth eating behaviours?
Authors: Patte Karen A , Cole Adam , Qian Wei , Magier Megan , Vine Michelle , Leatherdale Scott T.
Published: June 2020

Purpose The effectiveness of school nutrition regulations may be undermined by the food environment surrounding schools, particularly among adolescents, as they are less likely to eat lunch at school and have their own spending money. Given challenges in regulating the external food retail, policies where students are unable to leave the school property during the day have been suggested to improve student nutrition. The aim of this study was to examine whether closed campus policies (CCP) are associated with student eating behaviours. Methods The current study used student- and school-administrator survey data from 60,610 grade 9-12 students and 134 Canadian secondary schools participating in year 7 (2018/2019) of the COMPASS study. Multiple ordinal regression models tested school CCP as a predictor of weekday dietary behaviours (0-5 days), controlling for student- (grade, gender, spending money, ethnicity) and school-level (urbanicity, province, area median household income, school vending machines) covariates. Results A total of 16 schools reported CCP. Students who attended schools with CCP reported eating lunch purchased from fast food places or restaurants on fewer weekdays, but consumed sugar sweetened beverages (sodas/sports drinks or sweetened coffee/tea drinks) and snacks purchased from school vending machines on more weekdays, relative to students at schools with open campus policies. No significant differences in student reports of eating lunch brought from home, eating lunch purchased from the school cafeteria, or snacks purchased off-school campus were observed between schools with open and CCP. Conclusion CCP may help improve youth eating behaviour by reducing sugar sweetened beverages and lunch time fast food consumption on weekdays; however, students already purchasing food may shift from off-campus to within school options, highlighting the importance of ensuring healthy school food environments and encouraging students to bring home-prepared lunches. Future studies using experimental longitudinal designs are needed to determine the effect of school CCP on various health behaviours and outcomes.
Use of immune checkpoint inhibitors in patients with solid tumors and pre-existing autoimmune or inflammatory disease: real-word data.
Authors: Calvo Virginia , Fernández Marta Andrés , Lorduy Ana Collazo , Franco Fernando , Núñez Beatriz , Provencio Mariano
Published: June 2020

OBJECTIVE

Immune checkpoint inhibitors (ICI) are a cornerstone in cancer treatment but they can induce immune-related adverse events (irAEs). Furthermore, patients with pre-existing autoimmune and/or inflammatory disease (AID) have been excluded from clinical trials. The objective of this study is to evaluate the efficacy and safety of ICI in patients with cancer and AID.
METHODS

This is an observational, retrospective study carried out at the Medical Oncology Department of Hospital Universitario Puerta de Hierro, Majadahonda, Madrid between January 2016 and December 2018.
RESULTS

202 cancer patients treated with ICI were included, 15 (7, 4%) of them had pre-existing autoimmune diseases. The most frequent pre-existing AID were thyroid diseases (33.3%): autoimmune hypothyroidism, Graves Basedow disease and Hashimoto's thyroiditis. Three patients had psoriasis, two ANA + polyarthritis, one rheumatoid arthritis, another LADA (latent autoimmune diabetes in adults), another a systemic lupus erythematosus (SLE) and the last one, a polymyalgia rheumatica. In this series, the majority of patients (73.33%) did not experience any flare-up of their autoimmune disease. In patients who had AID flare-up, this was treated with corticosteroids. The most frequent cause of immunotherapy discontinuation was tumor progression (40%). 20% of patients had to discontinue immunotherapy due to toxicity.
CONCLUSIONS

In our series, AID flare or irAEs in patients with pre-existing AID who receive immunotherapy are not very common and can often be controlled without interrupting treatment. Prospective studies are needed to establish the incidence of irAEs in patients with preexisting autoimmune conditions, evaluate risk-benefits and elaborate management clinical guidelines in this population.
Research on Reliability of Nano Silver Tin Pulp in Flip Chip Solder Joint
Authors: Yang Hui , Wu Jihui
Published: June 2020

In order to improve the interconnect properties of nano-silver solders, we have developed a new tin-doped nano-silver paste (referred to as silver tin paste). The hard brittle phase Ag3Sn formed by the soldering of the silver tin paste acts as a second phase strengthening effect, which significantly improves the shear strength of the solder joint and has the potential to be widely used in the power electronics packaging industry. In this paper, the viscoplastic and elastic composite model is used to simulate the inelastic deformation behavior of flip chip nano silver tin solder joint under uniaxial shear load. The simulated stress-strain response curve agrees well with the experimentally measured data. The finite element method is used to simulate the interconnection state of flip chip solder joints under thermal cycling conditions. It can be seen that the inelastic strain of the silver tin solder joint has increased, and it can be inferred that as this strain increases further, the chip connection will be broken. The fatigue life of silver tin paste is predicted by the creep fatigue life model. Compared with the pure nano silver paste, the equivalent plastic strain of the silver tin paste is reduced and the fatigue life is significantly improved. It is indicated that the solder joint reliability of nano silver paste can be improved by tin doping. The analysis results provide reference data for the development of new nano solder.
T2 mapping evaluation of changes in cartilage matrix after PRP and HA injection therapy in knee osteoarthritis: a prospective, randomized, double blind, placebo controlled study
Authors: Vogrin Matjaz , Naranda Jakob , Gorenjak Mario , Bajec Tomaz , Mongus Domen , Pintaric Robert , Mijatovic Igor , Kelc Robi
Published: June 2020

BackgroundIn this study we focused on evaluating the effect of intra-articular platelet-rich plasma (PRP) and hyaluronic acid (HA) on the qualitative and quantitative properties of the articular cartilage in patients with knee osteoarthritis (OA).MethodsWe evaluated 264 patients undergoing treatment of moderate knee OA. Patients aged between 40 and 70 years were included with articular K-L stage ≤ 2. Patients were randomized into three groups and treated with three doses of intra-articular PRP, HA, or placebo injection. Patients were evaluated clinically and by using T2 mapping.ResultsBoth PRP (619.05 ± 243 ms; p = 2.7 × 10− 5) and HA (637.12 ± 273 ms; p = 1.×10− 4) group showed statistically significant lower post-application T2 relaxation times in comparison to the placebo group (859.80 ± 406 ms).Cartilage thickness increased significantly after PRP (2.41±0.87 vs. 2.58±0.97 mm, p=0.033) and HA (2.28±0.81 vs. 2.80±1.00 mm, p=1.8×10) applications. There was a significant decrease in WOMAC pain score by 30% (p=0,001) and the overall WOMAC score by 27 p=1.9×10-4%) in PRP group. The decrease in WOMAC pain score and the overall WOMAC score in the placebo group was similar to the results observed in the PRP group. In the HA group a significant decrease in WOMAC pain score by 14% (p=0,005) was observed only at the first follow-up, whereas no difference was observed at the second follow-up. ConclusionsT2 mapping of cartilage tissue may aid to monitor its properties after the intra-articular therapies in knee OA. However, there is a discrepancy between clinical findings and the results of T2 mapping, suggesting questionable grounds for applying intra-articular therapy.
Implication of regular pulmonary function evaluation in Duchenne muscular dystrophy
Authors: Lee Jang Woo , Kang Seong-Woong , Kim Eun Young , Choi Won Ah
Published: June 2020

Background

Various factors are considered when determining the need to initiate noninvasive ventilation (NIV), for example hypoventilatory symptoms, forced vital capacity (FVC), maximal inspiratory pressure (MIP), and end-tidal carbon dioxide. We aim to reveal the clinical importance of regular pulmonary function evaluation before the initiation of NIV by comparing Duchenne muscular dystrophy (DMD) patients with and without regular medical surveillance.
Methods

This retrospective study analyzes successful applications of NIV in our pulmonary rehabilitation center. We assigned 200 DMD patients, hospitalized between June 2006 and August 2019, to one of two groups, according to their follow-up status before NIV initiation. Group 1 (n = 102) had been followed-up regularly via the outpatient clinic at least twice a year. Group 2 (n = 98) was hypercapnic, either at the first visit, or re-visit after having missed the outpatient clinic appointment for more than one year.
Results

Significantly more patients were admitted via emergency room in group 2 (2.0% in group 1 and 28.6% in group 2). The patients’ age was higher in group 2 (18.3 ± 3.7 years in group and 21.2 ± 4.8 years in group 2). Ventilatory status evaluated by arterial blood gas analysis and transcutaneous continuous monitoring was better in group 1 than that of group 2. And all measures of pulmonary function, including FVC, peak cough flow, MIP, maximal expiratory pressure, and ventilatory status, were superior in group 1, too.
Conclusions

Regular follow-up before the onset of ventilatory insufficiency is crucial for the timely application of NIV, and appropriate NIV can exert a preventive effect on respiratory function deterioration.
PERCEPÇÃO DOS PASSAGEIROS NO ATENDIMENTO DE SUAS RECLAMAÇÕES: A POSIÇÃO DA AZUL LINHAS AÉREAS BRASILEIRAS
Authors: Marins Dayane Gonçalves , Souza Dantas José Carlos , Carvalho e Silva Erly Maria
Published: June 2020

RESUMO O presente estudo tem como objetivo analisar a percepção do passageiro no atendimento de suas reclamações realizadas no site Reclame Aqui sobre os principais serviços oferecidos pelo programa Experiência Azul. Relacionam-se transporte aéreo e turismo, discutem-se os conceitos presentes na qualidade em serviços, investiga-se e analisa a percepção dos passageiros no atendimento de suas reclamações. Para isso, lança-se mão da pesquisa documental com análise qualitativa a partir das reclamações selecionadas, utilizando o site Reclame Aqui. Como resultados principais identificou-se que os passageiros percebem como boa a qualidade do atendimento de suas reclamações, referentes aos principais serviços do programa Experiência Azul e que 84% dos passageiros voltariam a fazer negócios com a Azul. Espera-se que este trabalho contribua para a compreensão da importância de se utilizar ferramentas como o Reclame Aqui, no sentido de desenvolver práticas de hospitalidade em relação aos serviços prestados, na busca por melhoria na qualidade do que é oferecido ao usuário. Palavras-chave: Turismo; Transporte Aéreo; Qualidade em Serviços; Hospitalidade; Reclamações.
Práticas de Gestão de Pessoas no setor hoteleiro: um estudo em hotéis na cidade de Rondonópolis-MT
Authors: Castelhano Rafael Antônio , Cardoso André Luís Janzkovski
Published: June 2020

A gestão de pessoas tem se mostrado um departamento altamente relevante nas empresas, especialmente naquelas que atuam no setor de hospitalidade, com suas ações, estratégias e processos impactando diretamente nos resultados dessas empresas. Esta pesquisa, centrou-se na análise de fatores relacionados aos processos de gestão de pessoas em hotéis da cidade de Rondonópolis-MT. Os dados foram coletados com base em entrevistas com gestores do setor de recursos humanos de quatro dos principais hotéis. Os resultados indicam que algumas práticas relacionadas à cultura organizacional, ao bem-estar social, ao alinhamento com a estratégia e à gestão do conhecimento foram mais evidentes do que as práticas relacionadas ao uso da tecnologia e no desenvolvimento de líderes contrariando o que advogam alguns dos teóricos.
Práticas de Gestão do Conhecimento: Estudo de Caso em um Hotel Tradicional na Cidade do Natal (Rio Grande do Norte, Brasil)
Authors: Lima Daene Silva de Morais , Silva Jéssyca Rodrigues Henrique da
Published: June 2020

A gestão do conhecimento é uma estratégia empresarial que cada dia mais vem sendo utilizada como uma vantagem competitiva. Embora, o turismo seja uma atividade de informação intensiva, os estudos sobre a gestão do conhecimento neste campo ainda são incipientes. O presente estudo tem como objetivo analisar práticas de gestão do conhecimento aplicadas ao contexto de uma empresa hoteleira tradicional, localizada na cidade do Natal (Rio Grande do Norte-RN, Brasil). O hotel caracteriza-se como uma empresa consolidada na cidade, além de apresentar uma cultura peculiar e enraizada no cotidiano dos hóspedes e colaboradores. Em termos metodológicos, caracteriza-se como um estudo de caso, do tipo qualitativo. Os dados foram coletados junto ao gerente geral do empreendimento e analisados a partir da técnica de análise de conteúdo. Os resultados evidenciam que a gestão do conhecimento é de fato trabalhada na empresa, o que faz com que o mesmo venha conseguindo se consolidar ao longo dos anos, sem perder suas raízes e tradição. No entanto, sugere-se a necessidade de rever padrões intrínsecos a cultura organizacional, de modo que os colaboradores se sintam estimulados e envolvidos no processo de gestão do conhecimento e desenvolvimento de suas competências.