bluuebunny/crossref_metadata_2025 huggingface dataset:
Shape Factor of the Spinal Cord: A Possible Predictor of Surgical Outcome for Intradural Extramedullary Spinal Tumors in the Thoracic Spine
Authors: Matsumoto Yoshihiro , Saiwai Hirokazu , Iida Keiichiro , Okada Seiji , Endo Makoto , Setsu Nokitaka , Fujiwara Toshifumi , Kawaguchi Kenichi , Nakashima Yasuharu
Published: January 2021

Study Design:

Retrospective diagnostic analysis.

Objectives:

To establish a new predictor of surgical outcome after surgery for intradural extramedullary spinal tumor (IDEMT) in the thoracic spine, we introduced shape factor (SF), a mathematical description of the morphology of the spinal cord. SF was calculated by dividing object area by the square of perimeter.

Materials and Methods:

Forty-three consecutive patients with IDEMT, detected by magnetic resonance imaging at the thoracic level with myelopathic signs, were included. Preoperative transverse cross-sectional area (CSA) and perimeter of the spinal cord (perimeter) at the level of maximal compression were measured. SF was calculated as 4π × CSA/(perimeter)2. The association between clinicoradiological factors and surgical outcome of IDEMT was statistically analyzed.

Results:

Mean CSA, perimeter, and SF were 27.8 ± 15.8 mm2, 28.8 ± 6.1 mm, and 0.385 ± 0.14, respectively. A histogram distribution revealed that perimeter and SF, but not CSA, fit the normal distribution. The patients were subdivided into 2 groups according to postoperative modified Japanese Orthopedic Association Score (mJOA). [group F (favorable): n = 32, mJOA ≥ 9; group UF (unfavorable): n = 11, mJOA < 9). Group UF had significantly lower mean CSA and SF. In univariate analysis of possible predictive factors for IDEMT surgery, greater age, lower preoperative mJOA, and lower SF were significantly associated with unfavorable outcome. In multivariate analysis, lower SF was the only significant predictor of postoperative outcome (odds ratio = 2.66, 95% CI 1.10–6.39, p = 0.0115).

Conclusion:

Measurements of CSA and perimeter, followed by calculation of SF, may provide valuable quantitative information for the outcome of surgery for IDEMT.
Does surgical treatment increase the progression of spinal cord injury in patients with ossification of posterior longitudinal ligament of cervical spine? A systematic review and meta-analysis
Authors: Zhang Bi , Zhang Yufei , Ma Bin , Ma Junchi , Chen Xiaoyong , Li Junjie , Yuan Haifeng
Published: January 2021

Purpose:

The purpose of this study is to explore if the surgical treatment will accelerate the progression of spinal cord injury (SCI) in patients with cervical Ossification of the posterior longitudinal ligament (OPLL) and if surgery will have better curative effect than conservative treatment.

Methods:

An extensive search of literature was implemented in PubMed, EMBASE, and other online databases. The quality of the included articles was evaluated according to the Newcastle-Ottawa Quality Assessment Scale, as recommended by the Cochrane manual, and meta-analysis was performed using the review manage5.3 software.

Results:

No obvious statistical difference was observed in the rate of SCI progression (P > 0.05, OR 1.15 [0.66, 2.00]), cervical range of motion, (P > 0.05, weighted mean difference (WMD) 4.52 [−5.75, 14.79]), and Japanese Orthopedic Association scores before surgery (P > 0.05, WMD −2.78 [−7.87, 2.32]) between the surgical group and conservative treatment group. However the surgical group illustrated obviously higher neurofunctional recovery rate (P < 0.05, OR 6.07 [1.55, 23.78]) and postoperative JOA score of the surgery group (P < 0.05, WMD −0.77 [−1.21, −0.33]) than conservative group.

Conclusions:

Based on this meta-analysis, there is not enough evidence to indicate that surgery will accelerate the progress of SCI with OPLL. However, the superiority of surgical efficacy can be observed over conservative treatment in terms of relieving neurological symptoms.
Acute Tennis Injuries in the Recreational Tennis Player
Authors: Kaiser Peter , Stock Kerstin , Benedikt Stefan , Ellenbecker Todd , Kastenberger Tobias , Schmidle Gernot , Arora Rohit
Published: January 2021

Background:

Epidemiological studies on tennis injuries are mainly conducted in either elite professional or junior players. Injury patterns might differ in the recreational tennis player.

Purpose:

To investigate acute injuries in the recreational tennis–playing population with an additional focus on acute injuries that require surgical treatment.

Study Design:

Case series; Level of evidence, 4.

Methods:

A retrospective data analysis was conducted among patients who sustained an acute tennis injury between January 2013 and December 2018 and who had treatment administered at a single university hospital. Demographic data, diagnosis, body region of the trauma, injury mechanism, and treatment methods were recorded. Data were evaluated using descriptive statistics.

Results:

A total of 449 patients sustained 467 injuries (148 female, 301 male; mean age, 43.6 years; range, 8.2-84.4 years). The injuries occurred throughout the year, with an increased prevalence in the summer months. Injuries occurred in the lower extremity in 59%, the upper extremity in 30%, and the head and trunk in 11%. The main reason for an injury was a twist of a specific joint (n = 194) or a fall (n = 102). Harmless contusion or strains were the most common injury (49%). Ankle sprains were the most common serious injury, occurring in 11% of patients. Fractures occurred in 54 cases (12%). Overall, 9% of patients were treated surgically (fractures, n = 13; meniscal tears, n = 8; Achilles tendon ruptures, n = 6), and surgery was advised to another 1% who did not receive surgery at the study hospital.

Conclusion:

Typical acute injuries in recreational tennis players differ from acute injuries in elite and junior players, with an increased fracture occurrence. The main causes of acute tennis injuries are falls and twists, with 10% of injuries needing surgical treatment, mainly for fractures, meniscal tears, and Achilles tendon ruptures.
PGNMID in a patient with diabetes mellitus
Authors: Marques Joana , Cotovio Patrícia , Góis Mário , Sousa Helena , Nolasco Fernando
Published: January 2021

Diabetic nephropathy is a well known complication of diabetes mellitus and the leader cause of end -stage renal disease worldwide. Nonetheless, other forms of renal involvement can occur in diabetic population. Since it has prognostic and therapeutic implications, differentiating non-diabetic renal disease from diabetic nephropathy is of great importance. We report an 80-year-old man with well-controlled type 2 diabetes mellitus and hypertension, who presented with rapid deterioration of renal function, nephrotic proteinuria, microscopic hematuria and leukocyturia. The atypical clinical presentation prompted us to perform a kidney biopsy. A diagnosis of proliferative glomerulonephritis with monoclonal immunoglobulin deposits (light chain only variant) was made, with however some chronic histological aspects which made us took a conservative therapeutic attitude. We emphasize that other causes of chronic proteinuric kidney disease should be considered in patients with type 2 diabetes mellitus, based on clinical suspicion, absence of other organ damage and mostly if an atypical presentation is seen. We review the spectrum of monoclonal gammopathies of renal significance, focusing on this rare and newly describe entity.
Towards a sensory politics of the Anthropocene: Exploring activist-artistic approaches to politicizing air pollution
Authors: Landau Friederike , Toland Alexandra
Published: January 2021

In this paper, we investigate five activist-artistic approaches to argue for a sensory politics of the Anthropocene. Our aim is to highlight the affective and speculative potentials of art by examining how artists engage with the senses to make air pollution and its political implications visible, tangible, or otherwise experiential. The paper touches on widerreaching discourses on the politics of sensing, sensible politics, and sensory studies. Rather than situating air pollution within a policy framework, such as that of the international sustainable development goals, we locate our arguments within recent scholarship on postpolitics and the Anthropocene. Despite its epistemological slipperiness, we consider the Anthropocene to be a potent heuristic as well as a rich resource of ideas, data, and collaborative and antagonistic potential for artists working on issues of air pollution. The five case studies are each grounded in an explicit engagement with at least one of the five basic senses and include works by Amy Balkin, Hanna Husberg, Zane Cerpina and Stahl Stenslie, Lingling Zhang, Kitchen Budapest and Baltan Laboratories (NL). Clustered into three lines of argumentation, we demonstrate the ways in which these works contribute to the politicization of air: first, by framing air as a contested common good that problematizes the commodification of clean air; second, by integrating artistic research and environmental communication strategies; and third, by providing sensory experiences of the complicated constellations of agency and perception in the interscalar phenomenon of air pollution. Although our analysis is not exhaustive, three particularities could be identified in the works: an openness to other forms of knowledge and communication; a potent critique of the Anthropocene; and a radical questioning of ‘the political’. In conclusion, we argue that art can mobilize a sense of urgency and empowerment towards a multi-sensory politics of the Anthropocene.
Randomized, Comparative Study of Full- and Half-Dose Fluorescein Angiography
Authors: Patel Vaama , Syeda Sarah , Zeiter John , Nassiri Nariman , Kim Chaesik , Truhan Alan , Chapman Christopher , Adam Christopher , Parendo Anthony , Savage Mack , Abrams Gary
Published: January 2021

Purpose:

This study determines whether fluorescein angiography (FA) with a 250-mg dose of fluorescein (half dose) is equal in quality to the standard 500-mg dose of fluorescein (full dose) when using digital ultra-widefield (UWF) technology.

Methods:

In a randomized, prospective study using a UWF imaging system, FAs performed with half dose were compared with angiograms performed with full dose. Imaging studies were reviewed by 4 reviewers based on 6 characteristics: dye transit, macrovasculature, macula detail, microvasculature, leakage, and overall quality. The scores for macrovasculature, macula detail, microvasculature, and overall quality were converted to a fuzzy rating score to confirm results.

Results:

Seventy-nine FAs from 67 patients were reviewed for this study, including 12 patients who had both half-dose and full-dose FAs. Of all the factors studied, only microvasculature received a significantly different score between full dose and half dose that was confirmed by the fuzzy rating scale (3.79 vs 3.53; P = .04). Among those eyes that received both full and half dose, there was no significant difference in any of the 6 factors.

Conclusions:

In a UWF imaging system, aside from looking at fine microvascular abnormalities, the 250-mg dose of fluorescein provided similar results to a 500-mg dose. The images were not significantly different in overall quality.
Rice Loans and People’s Organisations in the Rural Philippines
Authors: Cloete Elene , Werner Pauline , Poole Samantha
Published: January 2021

This descriptive study introduces community-managed rice loans, as implemented by people’s organisations in the rural Philippines. Projects addressing low income and food shortages are by no means new to the development sector. Development agencies, nonprofit organisations, and local governments have implemented such projects to address immediate food shortages and threats of hunger. Less explored, however, is the potential of rice loans as intermediate solution, not only in terms of food provisioning but also in strengthening communities’ organisational structures and capabilities. This study explores such possibilities by focusing specifically on community-managed rice loans as implemented in the Philippines’ regions of Nueva Ecija and Isabela and supported by a local nonprofit, Outreach Philippines Incorporated (OPI). It discusses how rice loans provide communities with an alternative option for accessing affordable food and how these rice loans operate in the context of community development. The analysis of programme proposals identified three components integral to rice loans’ implementation and ongoing operations. These include specific organisational structures, clear operational processes, and well-defined policies and systems. We argue that these components are the building blocks of not only successful project implementation but also the strengthening of participating organisations’ project implementation and management capacity.
Roxadustat in treating anemia in dialysis patients (ROAD): protocol and rationale of a multicenter prospective observational cohort study
Authors: Zhang Yaling , Ren Song , Xue Hen , Wang Amanda Y , Zou Yang , Cai Yanrong , He Jingdong , Yuan Xiaoling , Jiang Feifei , Wei Jinxi , Yang Dongmei , He Dong , Hu Shide , Lei Min , Deng Fei , Chen Jin , Wang Xia , He Qiang , Li Guisen , Hong Daqing
Published: January 2021

Background

Roxadustat has been shown effective in treating patients with anemia due to chronic kidney disease. However, its long-term effect on clinical outcomes and socioeconomic burden and safety remains unclear.

Methods/Design

This is a multicenter, prospective, longitudinal observational cohort study assessing if Roxadustat improves prognosis in dialysis patients. Primary outcomes will be major adverse cardiovascular events (MACE), defined as composites of cardiovascular death, myocardial infarction, cerebral infarction, hospitalization because of heart failure; all-cause mortality, and annual economic costs in two years. The data will be collected via Research electronic data capture (REDCap) based database as well as software-based dialysis registry of Sichuan province. The primary outcomes for the ROAD study participants will be compared with those in the dialysis registry cohort. Data at baseline and study follow up will also be compared to assess the association between Roxadustat and long-term clinical outcomes.

Discussion

The main objective of this study is to the assess long-term association of Roxadustat on MACE, all-cause mortality, socio-economic burden, safety in dialysis patients, which will provide guidance for designing further large randomized controlled trials to investigate this clinic question.

Study registration

The study has been registered in Chinese Clinical Trials Registry (ROAD, ROxadustat in treating Anemia in Dialysis patients, registration number ChiCTR1900025765) and provincial observational cohort database (Renal disEAse observational CoHort database, REACH, ChiCTR1900024926), registered 07 September 2019,http://www.chictr.org.cn.
Lipoid Proteinosis presenting as beaded papules of the eyelid: report of three cases
Authors: Wei Zhenyu , Labbe Antoine , Liang Qingfeng
Published: January 2021

Background

Lipoid proteinosis (LP) is a rare multisystem inherited disease. We report here in three LP cases with beaded papules of the eyelid. Their clinical presentations, histological characteristics, and genetic findings are described and discussed.

Case presentation

A 12-year-old boy reported to our hospital with a complaint of ocular irritation, redness, and tearing for two years. He had a history of hoarseness since childhood. His younger brother (5 years old) also complained of hoarseness. Another patient, a 26-year-old woman, described many beaded papules on the edge of her eyelids since age 11 years. She additionally reported hoarseness since 4 years of age. Careful slit-lamp examination in these cases revealed waxy beaded papules on the margins of both eyelids and mild conjunctival congestion. Physical examination showed irregular, rugged scars on their facial skin. Genetic analysis showed the mutation located in exon 6 of the ECM1 gene.

Conclusions

Three LP cases first diagnosed by ophthalmologists are presented. The presence of eyelid papules should prompt the ophthalmologist to pay close attention to the patient’s voice. If there is a definite history of hoarseness, these patients should undergo gene sequence analysis. If necessary, otorhinolaryngology and dermatology consults may help confirm the diagnosis. Treatment is primarily symptomatic to improve patients’ quality of life.
Iris cyst after femtosecond laser-assisted cataract surgery: a case report
Authors: Wu Po-Ying , Wu Meng-Hsien , Wu Chi-Cheng , Sun Chi-Chin
Published: January 2021

Background

Secondary iris cysts are uncommon complication after cataract surgery. The reports of an iris cyst after conventional phacoemulsification surgery are scanty, let alone the iris cyst following femtosecond laser-assisted cataract surgery (FLACS). We herein report an unusual case of an iris cyst after an uneventful FLACS.

Case presentation

A 64-year-old man who was healthy underwent FLACS for a moderate cataract of his left eye. Shortly after surgery, he achieved 20/20 vision, but anterior bowing of temporal iris was noted on postoperative day 9 with a retro-pupillary iris cyst at temporal-inferior quadrant found after pupil dilatation. The cyst was confirmed by ultrasound bio-microscopy afterward. Four weeks later, argon laser cystotomy was performed, and the cyst disappeared 3 days later. The patient’s vision remained stable thereafter.

Conclusion

Although rare, secondary iris cyst may be one of the complications after FLACS. Argon laser cystotomy is effective in the management of post-FLACS iris cyst.
County‐level correlates of dental service utilization for low income pregnant women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program
Authors: Moss Mark E. , Grodner Andrew , Dasanayake Ananda P. , Beasley Cherry M.
Published: January 2021

Background

Dental care utilization for low income pregnant women is met with challenges in the traditional dentist-centered model of care. County-level measures provide insights for policy and roles for stakeholders that extend beyond the dentist-patient relationship. We examined county-level data to generate hypotheses about factors that influence utilization of dental services in North Carolina’s Medicaid for Pregnant Women (MPW) program.

Methods

County-level Medicaid utilization data for dental services for 2014–2016 were pooled to get mean county estimates of dental utilization in the MPW program. Descriptive statistics and multivariate regression models of dental utilization and county-level measures are presented. Data used were collected by NC Child and the Robert Wood Johnson Foundation’s County Health Rankings Reports. USDA Economic Research Service data were used to categorize counties in terms of Farming, Recreation, Persistent Poverty, and metro/non-metro status using Rural Urban Continuum Codes.

Results

Dental utilization ranged from 1–26% with a median of 8.5% across the 100 counties of North Carolina. Strong patterns linking utilization of dental services in the MPW program to contextual social measures of well-being emerged, specifically, increased reporting of child abuse and neglect, elevated infant mortality, poor quality of life, and worse ranking in years of potential life lost. Counties with persistent poverty had lower rates of dental utilization.

Conclusions

Utilization of dental services in the MPW program is generally low. Patterns identify the potential for enhancing community-clinical linkages to improve birth outcomes and care coordination for pregnant women to enhance dental utilization in this population.

Dental coverage in the Medicaid program in most states is administered separately from medical coverage. The separation of the funding mechanisms adds a further layer of complexity to care integration. Efforts to enhance dental care for pregnant women in the Medicaid program may benefit from policy that aligns incentives for care coordination within the community. Policy that extends the window of eligibility for dental benefits to 24 months after the birth of the child will help women complete the dental treatment that is needed. This also leverages the value of care coordination for community stakeholders from diverse child health sectors.
Predicting pathological complete response (pCR) after stereotactic ablative radiation therapy (SABR) of lung cancer using quantitative dynamic [18F]FDG PET and CT perfusion: a prospective exploratory clinical study
Authors: Yang Dae-Myoung , Palma David A. , Kwan Keith , Louie Alexander V. , Malthaner Richard , Fortin Dalilah , Rodrigues George B. , Yaremko Brian P. , Laba Joanna , Gaede Stewart , Warner Andrew , Inculet Richard , Lee Ting-Yim
Published: January 2021

Background

Stereotactic ablative radiation therapy (SABR) is effective in treating inoperable stage I non-small cell lung cancer (NSCLC), but imaging assessment of response after SABR is difficult. This prospective study aimed to develop a predictive model for true pathologic complete response (pCR) to SABR using imaging-based biomarkers from dynamic [18F]FDG-PET and CT Perfusion (CTP).

Methods

Twenty-six patients with early-stage NSCLC treated with SABR followed by surgical resection were included, as a pre-specified secondary analysis of a larger study. Dynamic [18F]FDG-PET and CTP were performed pre-SABR and 8-week post. Dynamic [18F]FDG-PET provided maximum and mean standardized uptake value (SUV) and kinetic parameters estimated using a previously developed flow-modified two-tissue compartment model while CTP measured blood flow, blood volume and vessel permeability surface product. Recursive partitioning analysis (RPA) was used to establish a predictive model with the measured PET and CTP imaging biomarkers for predicting pCR. The model was compared to current RECIST (Response Evaluation Criteria in Solid Tumours version 1.1) and PERCIST (PET Response Criteria in Solid Tumours version 1.0) criteria.

Results

RPA identified three response groups based on tumour blood volume before SABR (BVpre-SABR) and change in SUVmax (ΔSUVmax), the thresholds being BVpre-SABR = 9.3 mL/100 g and ΔSUVmax = − 48.9%. The highest true pCR rate of 92% was observed in the group with BVpre-SABR < 9.3 mL/100 g and ΔSUVmax < − 48.9% after SABR while the worst was observed in the group with BVpre-SABR ≥ 9.3 mL/100 g (0%). RPA model achieved excellent pCR prediction (Concordance: 0.92; P = 0.03). RECIST and PERCIST showed poor pCR prediction (Concordance: 0.54 and 0.58, respectively).

Conclusions

In this study, we developed a predictive model based on dynamic [18F]FDG-PET and CT Perfusion imaging that was significantly better than RECIST and PERCIST criteria to predict pCR of NSCLC to SABR. The model used BVpre-SABR and ΔSUVmax which correlates to tumour microvessel density and cell proliferation, respectively and warrants validation with larger sample size studies.

Trial registration

MISSILE-NSCLC, NCT02136355 (ClinicalTrials.gov). Registered May 8, 2014, https://clinicaltrials.gov/ct2/show/NCT02136355
Evaluation of different blood-feeding frequencies on Glossina palpalis gambiensis performance in a mass-rearing insectary
Authors: Camara Karifa , Ilboudo Kadidiata , Salou Ernest Wendemanegde , Gimonneau Geoffrey
Published: January 2021

Background

The main challenge to the successful mass-rearing of the tsetse fly in insectaries, especially in Africa, is a sustainable supply of high-quality blood meals. As such, the collection of high-quality blood in large quantities can be an important constraint to production. One possible strategy to lessen the impact of this constraint is to modify the blood-feeding frequency. In the study reported here, we evaluated the effect of three blood-feeding frequencies on the colony performance ofGlossina palpalis gambiensis, a riverine tsetse fly species.

Methods

The effect of three, four and six blood-feedings per week on female survival and productivity were evaluated over a 30-day period. Progeny emergence rate and flight ability were also evaluated.

Results

Female survival was significantly higher in flies fed four times per week (87%) than in those fed three (72%) and six times per week (78%;P< 0.05). Productivity was similar between flies fed four and six times per week (457 and 454 larvae) but significantly reduced in flies fed three times per week (280 larvae produced;P< 0.05). Both emergence rate and flight ability rate were also similar between flies fed four times per week (97 and 94%, respectively) and six times per week (96 and 97%, respectively), but they were significantly reduced when flies were fed three times per week (89 and 84%, respectively;P< 0.05).

Conclusions

Blood-feeding frequency could be reduced from six times per week to four times per week without affecting mass-rearing production and progeny quality. The implications of these results on tsetse mass-rearing production are discussed.

Graphical Abstract
Sex differences in the association of sphingolipids with age in Dutch and South-Asian Surinamese living in Amsterdam, the Netherlands
Authors: Muilwijk Mirthe , Callender Nardie , Goorden Susan , Vaz Frédéric M. , van Valkengoed Irene G. M.
Published: January 2021

Background

Men have a higher risk for cardiovascular disease (CVD) early in life, while women have a higher risk later in life. The sex-related differences in CVD risk, especially by age, could be related to sphingolipid metabolism. We compared plasma sphingolipid concentrations and its increase by age in men and women.

Methods

Plasma concentrations of 13 types of sphingolipids were measured by liquid chromatography-tandem mass spectrometry in a random subsample of 328 men and 372 women of Dutch and South-Asian Surinamese ethnic origin, participating in the HELIUS study. Sphingolipid concentrations were compared between men and women by age group (18–39, 40–55, and 56–70 years). Multiple linear regression was used to determine sex differences in age trends in sphingolipids stratified by ethnicity. Analyses were performed without adjustment and adjusted for body mass index (BMI) and waist circumference.

Results

At age 18–39 years, sphingolipid concentrations were lower in women than those in men, but at age 56–70 years this was reversed. At higher age, women showed higher concentrations than men. In line, we observed a more rapid increase of sphingolipid concentrations by age in women than in men. The observed sex differences were not explained by BMI or waist circumference. Patterns of sex differences were similar across ethnic groups, although the strength of associations differed.

Conclusions

Mean sphingolipid concentrations increase more rapidly with age in women than in men. Therefore, plasma lipid concentrations of sphingolipids, although lower in women than in men at younger age, are higher in women than in men at older age.
Experimental investigation on a novel approach for laser surface hardening modelling
Authors: Orazi L. , Rota A. , Reggiani B.
Published: January 2021

Laser surface hardening is rapidly growing in industrial applications due to its high flexibility, accuracy, cleanness and energy efficiency. However, the experimental process optimization can be a tricky task due to the number of involved parameters, thus suggesting for alternative approaches such as reliable numerical simulations. Conventional laser hardening models compute the achieved hardness on the basis of microstructure predictions due to carbon diffusion during the process heat thermal cycle. Nevertheless, this approach is very time consuming and not allows to simulate real complex products during laser treatments. To overcome this limitation, a novel simplified approach for laser surface hardening modelling is presented and discussed. The basic assumption consists in neglecting the austenite homogenization due to the short time and the insufficient carbon diffusion during the heating phase of the process. In the present work, this assumption is experimentally verified through nano-hardness measurements on C45 carbon steel samples both laser and oven treated by means of atomic force microscopy (AFM) technique.
An aberrant mediastinal medial basal segmental pulmonary artery (A7a) in a patient with lung cancer: a case report
Authors: Takase Yoshiaki , Tsubochi Hiroyoshi , Yamaki Ei , Kawashima Osamu
Published: January 2021

Background

Mediastinal branching of the A7a from the right main pulmonary artery (PA) is extremely rare. Herein, we report a patient with an aberrant mediastinal A7a who underwent right basal segmentectomy for lung cancer.

Case presentation

A 73-year-old man was referred to our department for a right lower lobe nodule measuring 18 mm in diameter on computed tomography (CT). Three-dimensional (3D) CT revealed mediastinal A7a branching from the right main PA. As the patient had undergone colectomy for advanced ascending colon cancer, the nodule was suspected to be a metastasis from the colon primary, and thus, basal segmentectomy of the right lung was performed. Intraoperatively, the A7a was observed behind the V4+5 and middle lobe bronchus. The pathological diagnosis was combined small cell carcinoma with an adenocarcinoma component (p-T1cN0M0, stage IA3). The patient subsequently received adjuvant chemotherapy for colon cancer. At 1-year postoperative follow-up, there was no evidence of disease.

Conclusion

This is the first report describing an aberrant mediastinal A7a branching from the right main PA. It is important to obtain accurate information about variations of the PA using 3D-CT for safe anatomical pulmonary resection.
Virtual reality simulation—the future of orthopaedic training? A systematic review and narrative analysis
Authors: Clarke Elinor
Published: January 2021

Background

Virtual reality (VR) simulation provides users with an immersive, 3D experience that can be used to allow surgical trainees to practice skills and operations in a safe yet realistic environment. The field of orthopaedics is yet to include VR in core teaching, despite its advantages as a teaching aid, particularly against current simulation tools. This study aims to conduct a systematic review to investigate the efficacy of VR in orthopaedic training, against current methods.

Methods

A systemic review of databases Medline, Embase and the Cochrane Library for randomized controlled trials focusing on VR training against conventional training in orthopaedic surgery was performed. Data synthesis was performed through narrative analysis due to the heterogeneous nature of the data.

Results

A total of 16 studies from 140 titles were identified, across 6 specialty areas. Four hundred and thirty-one participants were included. Control groups included VR, cadaver and benchtop simulators. Forty-seven outcomes were measured, focusing on skill and proficiency assessment. No outcomes focused on patient safety. Although significance between intervention and control was not always achieved, most studies found that the intervention outperformed the control.

Conclusion

VR provides a modern and immersive teaching tool that can develop skills and give confidence to trainees. This study demonstrates the potential for VR simulation as a training aid in orthopaedics and encourages its use alongside conventional teaching methods. However, long-term analysis of the results of VR training on surgical trainees has yet to be conducted. To provide conclusive justification for its inclusion in surgical training, this study recommends that future research follows trainees using VR into the operating room, to determine that VR teaches skills that are transferable onto actual surgeries, subsequently leading to better patient outcomes.
Effect of different single herbicide doses on sugar beet yield, quality and associated weeds
Authors: Abd El Lateef E. M. , Mekki B. B. , Abd El-Salam M. S. , El-Metwally I. M.
Published: January 2021

Background

The objective of this work is to identify the most proper herbicidal treatment on sugar beet to compare different single weed control herbicide doses on sugar beet traits and associated weeds as well as yield and quality under sandy soil conditions. Therefore, two field experiments were conducted during the winter seasons of 2017/2018 and 2018/2019 at the Experimental Farm of the National Research Centre, El-Beheira Governorate. Tigro at 1.0 and 0.750 l fed−1, Betasana-Trio at 0.675 and at 0.9 l fed−1, Select Super at 0.5 and 0.375 l fed−1 and Betanal MaxxPro at 0.5 l fed−1 besides the unweeded and hand weeded twice were used.

Results

The results showed that the herbicides Betasana-Trio at 0.9 l fed−1, Tigro at 1.0 l fed−1 and Betasana-Trio at 0.675 l fed−1 when sprayed twice could effectively and/or completely eliminate the broadleaved weeds associated with sugar beet plants. Moreover, the results indicated and confirmed that Tigro and Betasana-Trio herbicides are effective in controlling broadleaved weeds. Similar tendency was recorded for the narrow-leaved weeds, where Select Super or Betanal MaxxPro at 0.5 l fed−1 as well as Select Super at 0.375 l fed−1 could completely eliminate or minimize the narrow-leaved weeds associated with sugar beet plants. The greatest significant root length, root diameters and root yield plant−1 were recorded when hand weeding twice followed by Betanal MaxxPro at 0.5 l fed−1 without significant differences. Gross sugar % ranged between 12.08 and 15 .7% and extractable sugar % ranged between 8.97 and 13.8% for Betasana-Trio at 0.09 l fed−1 and Betanal MaxxPro at 0.5 l fed−1.

Conclusion

Betanal MaxxPro gave the highest values of root and biological yield ton fed−1. Betanal MaxxPro followed by hand weeding treatment twice resulted in the greatest sugar yield fed−1. The highest sugar yield resulted from the herbicidal treatment with Betanal MaxxPro or Tigro at 1.0 l fed−1, which gave the greatest gross and extractable sugar yield fed−1 and exceeded the hand weeding treatment by 10.4 and 7.8%.
Vascular endothelial growth factor in relation to the development of hepatocellular carcinoma in hepatitis C virus patients treated by direct-acting antivirals
Authors: ElGhandour Ahmed Mohamed , Bayoumy Essam Mohamed , Ibrahim Wesam Ahmed , Sayed Moataz Mohamed , Salama Ashraf Bekheet , Teama Nahla Mohamed , Salama Mohamed Magdy
Published: January 2021

Background

Hepatocellular carcinoma (HCC) comprises 5.6% of all cancers worldwide representing the sixth most common cancer. It is also the fourth most common cause of cancer-related mortality. Angiogenesis is a main factor in the development of HCC. Vascular endothelial growth factor (VEGF) is considered as the force for physiological and pathological angiogenesis, and overexpression of VEGF is prominent in HCC. We aimed to study the effect of direct-acting antivirals (DAAs) on VEGF considered as the key regulator of angiogenesis in HCC. This cross-sectional study involved fifty patients who were divided into two groups: group I—twenty-five chronic hepatitis C virus (HCV) patients as (cases) subjected to treatment with direct-acting antiviral drugs for 3 months; group II—twenty-five chronic HCV patients developed HCC as (controls). Serum VEGF level was measured in of group I at baseline, at end of treatment, and 3 months after the end of treatment by sofosbuvir 400 mg plus daclatasvir 60 mg for 3 months in the HCV patient group, also VEGF was assessed in group II with HCC.

Results

Serum VEGF was high in both groups, but it was higher in the HCC group with a statistically significant difference (p< 0.001), also serum VEGF in the HCV group decreased after 3 months at the end of DAA treatment from 209.5 ± 137.6 to 44.1 (31.8–55.3) mg/ml, and all patients who received DAAs achieved sustained virologic response (SVR).

Conclusion

We found that change in serum VEGF in HCV patients treated with DAAs in this study cannot explain the risk of HCC after treatment by DAAs.
Applications of polymer blends in drug delivery
Authors: Nyamweya Nasser N.
Published: January 2021

Background

Polymers are essential components of many drug delivery systems and biomedical products. Despite the utility of many currently available polymers, there exists a demand for materials with improved characteristics and functionality. Due to the extensive safety testing required for new excipient approval, the introduction and use of new polymers is considerably limited. The blending of currently approved polymers provides a valuable solution by which the limitations of individual polymers can be addressed.

Main body

Polymer blends combine two or more polymers resulting in improved, augmented, or customized properties and functionality which can result in significant advantages in drug delivery applications. This review discusses the rationale for the use of polymer blends and blend polymer-polymer interactions. It provides examples of their use in commercially marketed products and drug delivery systems. Examples of polymer blends in amorphous solid dispersions and biodegradable systems are also discussed. A classification scheme for polymer blends based on the level of material processing and interaction is presented.

Conclusion

The use of polymer blends represents a valuable and under-utilized resource in addressing a diverse range of drug delivery challenges. It is anticipated that new drug molecule development challenges such as bioavailability enhancement and the demand for enabling excipients will lead to increased applications of polymer blends in pharmaceutical products.

Graphical abstract
Donor-Acceptor Type [5]Helicene Derivative with Strong Circularly Polarized Luminescence
Authors: Kubo Hiromu , Hirose Takashi , Shimizu Daiki , Matsuda Kenji
Published: January 2021

Circularly polarized luminescence (CPL) of unsubstituted helicenes is weak due to their low fluorescence quantum yield (Φf) and small dissymmetry factor (gCPL). In this study, we designed and synthesized a donor-acceptor type [5]helicene, 5,10-dicyano-2,13-bis(3,4,5-tris(n-octyloxy)phenyl)[5]helicene. This helicene showed high fluorescence quantum yield (Φf = 0.63) and good |gCPL| (4.2 × 10−3) due to symmetry-allowed transition and its helical structure. Moreover, the helicene showed solvatofluorochromism while maintaining gCPL.
Check the diastolic blood pressure twice in aortic dissection as it is associated with prognosis
Authors: Sari Sezai , Sener Kemal , Calis Mustafa , Polat Mustafa , Kaya Adem , Yolcu Sadiye
Published: January 2021

Objective: In this study we aimed to determine the prediction level of admission diastolic blood pressure (DBP) on the prognosis and mortality in aortic dissection patients over 65 years old and under 65 years old.

Methods: We included 72 patients in this retrospective study and study groups were divided into two groups according to 65 age. Demographic data, dissection type (Stanford A-B), DBP, systolic blood pressure (SBP), mean arteriel pressure (MAP), heart rate (/min) main complaints, preoperative length of stay, hospitalisation clinic (clinic/intensive care unit), length of hospitaliisation, complications during hospitalisation (renal failure etc..) and the outcome (death/dischargement) results were noted. Preoperative lenth of stay, hospitalisation length, outcome and complications were compared between groups according to SBP, DBP, MAP and heart rate.

Results: Mean blood pressure values of the Stanford type B patients over 65 years old were higher than the other group (p<0.05). Fifty percent of patients under 65 years old were discharged but this ratio was 26.9% in the elder group. DBP was positively correlated with preoperative length of stay and hospitalisation length and negatively correlated with mortality. DBP under 65 mmHg was significantly related with high mortality (p<0.05). When the age and presentation time heart rate is added to each other, the values over 142 were significantly related with high mortality (p<0.05).

Conclusions: The presentation time vital signs especially the DBP may be helpful for emergency clinicians to predict the prognosis and outcome in aortic dissection patients which has high mortality ratio in patients over 65 years of age.

doi: https://doi.org/10.12669/pjms.37.2.2877

How to cite this:Sari S, Sener K, Calis M, Polat M, Kaya A, Yolcu S. Check the diastolic blood pressure twice in aortic dissection as it is associated with prognosis. Pak J Med Sci. 2021;37(2):339-344. doi: https://doi.org/10.12669/pjms.37.2.2877

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Recommendations for the development of Egyptian human biobanking ethical guidelines
Authors: Samir Abdelhafiz Ahmed , W. L. Ho Calvin , Chuan Voo Teck
Published: January 2021

Background: The development of biobanks is associated with the emergence of new ethical challenges. In Egypt, several biobanks have been established, but there are no specific local ethical guidelines to guide their work. The aim of this study is to develop recommendations for the Egyptian human biobanking ethical guidelines, which take into consideration the specific cultural and legal framework in Egypt.

Methods: We searched the literature for available biobanking ethical guidelines. Six themes were the concern of search, namely; informed consent, data protection, return of results, sharing of samples and data, community engagement, and stakeholder engagement. If a document refers to another guideline, the new source is identified and the previous step is repeated.

Results: Ten documents were identified, which were analyzed for the themes mentioned above. Guidelines and best practices were identified, and then compared with the published documents about ethical, legal and social issues (ELSI) related to biomedical research in Egypt to reach best recommendations.

Conclusions: We have proposed, by way of recommendations, key characteristics that a national ethics framework in Egypt could have. On informed consent, the practice of broad consent may be harmonized among biobanks in Egypt. Clear policies on return of research results, training requirements and availability of genetic counseling could also be instituted through the national framework. Additionally, such a framework should facilitate community and stakeholders engagement, which is important to secure trust and build consensus on contentious issues arising from sample and data sharing across borders and commercialization, among other concerns.
Engaging publics in biobanking and genetic research governance - a literature review towards informing practice in India
Authors: Warrier Prasanna , Ho Calvin Wai-Loon , Bull Susan , Vaz Mario , Vaz Manjulika
Published: January 2021

Background:There is growing interest in advancing biobanking and genetic research in many countries, including India. Concurrently, more importance is being placed on participatory approaches involving the public and other stakeholders in addressing ethical issues and policymaking as part of a broader governance approach. We analyse the tools, purposes, outcomes and limitations of engaging people towards biobanking and genetic research governance that have been undertaken worldwide, and explore their relevance to India.

Methods:Papers to be reviewed were identified through a targeted literature search carried out using ProQuest and PubMed. Retrieved papers were analysed with theRpackage forQualitative Data Analysisusing inductive coding and thematic analysis, guided by the Framework Method.

Results:Empirical studies on public and community engagement in the context of biobanking and or genetic research show a predominance towards the end of the last decade, spanning 2007 to 2019. Numerous strategies—including public meetings, community durbars, focus group discussions, interviews, deliberations, citizen-expert panels and community advisory boards—have been used to facilitate communication, consultation and collaboration with people, at the level of general and specific publics. Engagement allowed researchers to understand how people’s values, opinions and experiences related to the research process; and enabled participants to become partners within the conduct of research.

Conclusions: Constructs such as ‘co-production’, ‘engagement of knowledges’, ‘rules of engagement’ and ‘stewardship’ emerge as significant mechanisms that can address the ethical challenges and the governance of biobanking and genetic research in India. Given the inherent diversity of the Indian population and its varying cultural values and beliefs, there is a need to invest time and research funds for engagement as a continuum of participatory activity, involving communication, consultation and collaboration in relation to biobanking and genetic research. Further research into these findings is required to explore their effective employment within India
Application of Combined SWOT and AHP for Strategy Development: A Case of Slow Fashion Brand in Bandung, Indonesia
Authors:   Department of Continuing Education, University of Oxford, United Kingdom, Aldilax Dandy , Pfoertsch Waldemar ,   Business School, University of Pforzheim, Germany
Published: January 2021

Abstract. Raising global awareness in a sustainable environment intrigued many young designers and environmental activists to create environmentally friendly products. Slow fashion is a new solution to overcome issues caused by fast fashion, which promotes concern about the environment and sustainability of the products proven by materials, process, and disposal of the products. However, there is lack of empirical evidence about strategy development for Slow Fashion brand in Indonesia. This study aims to identify an appropriate strategy for slow fashion brand in Bandung, Indonesia. Bandung is one of the most creative cities in Indonesia, according to UNESCO, and be the main area of the research. Based on the result, researcher can determine several strategies for slow fashion brand in Indonesia. This research used quantitative approach through questionnaire filled during Forum Group Discussion (FGD). In developing the strategies, internal and external factors were carried out from environment scanning and discussion, then analyzed use hybrid methodology of SWOT-AHP. The result of the study concludes four strategies by considering both internal and external factors overall priority score. This study is important in understanding the most important factors to consider in developing strategies to grow a slow fashion brand in Indonesia. Keywords: Analytical Hierarchy Process , Slow Fashion, Strategic Planning , SWOT
Analysis of The Relationship Between Personal Competencies and Individual Work Performance with Job Specialization, Formalization, and Centralization as Moderators
Authors:   Faculty of Economic and Business, Universitas Sebelas Maret, Indonesia, Adihardja Hamdani Sulaeman , Hendarsjah Hidajat
Published: January 2021

Abstract. This research examines the impact of personal competencies on individual work performance when performing maintenance activities and examines job specialization, formalization, and centralization as moderator variables. For the analysis, we use questionnaires data from 741 respondents of maintenance officers in the Signalling and Telecommunication Departement at PT KAI (Persero). The results showed that personal competencies significantly affecting individual work performance with a correlation value of 0.001 ( <0.05), and other results related to job Specialization and Centralization as moderator variables demonstrated that these two variables could not be treated as moderators in strengthening the relationship between personal competencies and performance. The results showed correlation value of 0.847 ( >0.05) and 0. 173 (>0.05), respectively. This research's formalization variable was not used in the hypothesis testing stage as a moderator because it lacked instrument validity. This study recommends that maintenance officers have better individual work performance when management focuses on increasing the personal competencies or focuses on increasing competencies in work fields that require special skills by the scope of work they face. Keywords: Personal Competencies. Individual Work Performance. Job Specialization. Formalization. Centralization