bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of a standardized patient-based simulation in anaphylactic shock management for new graduate nurses
Authors: Ren Qi , Chen Fang , Zhang Huijuan , Tu Juanhua , Xu Xiaowei , Liu Caixia
Published: August 2022

Background

Patients may be endangered if new graduate nurses cannot recognize and manage anaphylactic shock. Consequently, enhancing the new graduate nurses’ understanding of their roles and responsibilities during the rescue of a patient with anaphylactic shock is important. However, due to its inherent limitations, traditional classroom-based teaching makes it difficult to explore the potential of the students. Although popular simulation teaching has several notable advantages, it has not been proven to be effective in training inexperienced nurses on anaphylactic shock. We investigated the effect of a standardized patient-based simulation on the behaviors of new graduate nurses’ during anaphylactic shock rescue to identify an effective and safe method for contemporary nursing education.

Methods

Except for the ill or pregnant, all the new graduate nurses were included in the study as students to undergo a standardized patient-based simulation conducted in the clinical skills center of a general hospital. The simulation training was designed to teach students to recognize the signs and symptoms of anaphylactic shock, place the patient in the correct position, stop the ongoing intravenous infusion of the antibiotic which triggers the anaphylactic shock, restart an intravenous infusion on a new infusion apparatus, give 100% oxygen via a nasal cannula or mask, preserve airway patency, call the rapid response team, and correctly administer the medications prescribed by the clinicians. Before and after the training, the instructors evaluated each student’s skills and behaviors using a clinical competency evaluation list. After the training, all students completed the Chinese version of the Simulation Design Scale (SDS) to demonstrate their satisfaction with the program and then participated in semi-structured interviews with their instructors.

Results

All 104 graduate nurses had a significant improvement on the 6 competencies of the clinical competency evaluation list after the simulation training (P < 0.001). The SDS scores revealed that the students were highly satisfied with all the aspects of the simulation training (the 20 satisfaction rates were all above 90.00%). During the semi-structured interviews, most of the new graduate nurses reported that simulation training in the management of anaphylactic shock was critical and would guide them in clinical practice.

Conclusion

Simulation training in anaphylactic shock is a potentially viable and effective method for teaching new graduate nurses to manage clinical incidents.
Barriers and motivation for presumptive tuberculosis case referral: qualitative analysis among operators of community medicine outlets in Ghana
Authors: Kwabla M.P , Klett-Tammen C. J. , Castell S.
Published: August 2022

Background

Community medicine outlets (CMOs) are the first point of call for individuals presenting with cough in Ghana. Although operators of CMOs comprising pharmacists and over-the-counter (OTC) medicine sellers largely support the public–private mix strategy which seeks to engage pharmacies in tuberculosis (TB) case detection, a significant proportion is not involved in TB referral services. The study explores the barriers to and motivation for presumptive TB case referral among CMO operators.

Methods

We used open- and close-ended questions nested in a telephone survey which assessed factors associated with presumptive TB case referral among CMO operators (n = 465). We interviewed participants using computer assisted telephone interviews and analysed the qualitative data using adjusted Mayring’s structured qualitative content analysis.

Results

Based on participants’ own experiences, non-referral was attributed to negative attitudes of presumed cases (48.2%) and inability to meet the financial demands of referred presumed cases (26.3%). Regarding their perception of barriers to TB referral for their professional colleagues, an assumed lack of TB training (44.5%) and an assumed negative attitude of operators (43.6%) were mentioned. From close-ended questions, most chosen barriers to referral were: the assumption of not having seen a presumptive TB case yet (31.8%), lack of TB training (22.2%) and no monetary motivation for operators (10.5%). Most operators (81.6%) view TB referral services as their social responsibility and feel self-motivated to refer cases in order to control the spread of TB in their communities. Of 152 further comments extracted as recommendations to improve referral, 101 (66.4%) of respondents would only refer with the availability of support systems in the form of TB training and making TB diagnostic testing more accessible.

Conclusion

Operators of CMOs are predominantly self-motivated to refer presumptive TB cases. Barriers to referral might be mitigated by providing more training to operators and specific financial support such as reimbursement of travel costs to presumptive cases.
Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension
Authors: Leppänen Helena , Kampman Olli , Autio Reija , Karolaakso Tino , Näppilä Turkka , Rissanen Päivi , Pirkola Sami
Published: August 2022

Background

Research in high-income countries has identified low socioeconomic status as a risk factor for disability pension (DP) due to common mental disorders (CMDs). Psychotherapy is an evidence-based treatment for the majority of CMDs along with medication and it is often targeted to prevent work disability. This study examines socioeconomic differences in the use of rehabilitative psychotherapy in Finland, where citizens have universal health coverage, but psychotherapy is partly dependent on personal finance.

Methods

The study subjects (N = 22,501) were all the Finnish citizens granted a DP due to CMD between 2010 and 2015 and a comparison group (N = 57,732) matched based on age, gender, and hospital district. Socioeconomic differences in psychotherapy use were studied using logistic regression models. Socioeconomic status was defined by education, income, and occupation. Age, gender, and family status were also examined.

Results

A lower level of education, lower occupational status (blue-collar worker), male gender, and older age, were associated with less frequent psychotherapy use, in both groups. Education was the strongest component of socioeconomic status associated with psychotherapy use, but the role of income was not straightforward. Unemployment when approaching DP, but not otherwise, was a risk factor for not receiving rehabilitative psychotherapy. Socioeconomic disparities were not any smaller among CMD patients approaching DP than in the comparison group.

Conclusion

This study demonstrates the disparity in the provision of psychotherapy for CMD patients, even on the verge of DP with an acute need for services. This disparity is partly related to a complex interplay of socioeconomic factors and the service system characteristics. Factors predisposing to unequal access to mental health services are presumably diverse and should be studied further.
Malaria-VisAnalytics: a tool for visual exploratory analysis of Brazilian public malaria data
Authors: Sironi Alberto Pietro , Bertoldo Juracy , Sampaio Vanderson , Coimbra Danilo , Rasella Davide , Barreto Marcos Ennes
Published: August 2022

Background

Data integration and visualisation techniques have been widely used in scientific research to allow the exploitation of large volumes of data and support highly complex or long-lasting research questions. Integration allows data from different sources to be aggregated into a single database comprising variables of interest for different types of studies. Visualisation allows large and complex data sets to be manipulated and interpreted in a more intuitive way.

Methods

Integration and visualisation techniques were applied in a malaria surveillance ecosystem to build an integrated database comprising notifications, deaths, vector control and climate data. This database is accessed through Malaria-VisAnalytics, a visual mining platform for descriptive and predictive analysis supporting decision and policy-making by governmental and health agents.

Results

Experimental and validation results have proved that the visual exploration and interaction mechanisms allow effective surveillance for rapid action in suspected outbreaks, as well as support a set of different research questions over integrated malaria electronic health records.

Conclusion

The integrated database and the visual mining platform (Malaria-VisAnalytics) allow different types of users to explore malaria-related data in a user-friendly interface. Summary data and key insights can be obtained through different techniques and dimensions. The case study on Manaus can serve as a reference for future replication in other municipalities. Finally, both the database and the visual mining platform can be extended with new data sources and functionalities to accommodate more complex scenarios (such as real-time data capture and analysis).
Clinical implication of the advanced lung cancer inflammation index in patients with right-sided colon cancer after complete mesocolic excision: a propensity score-matched analysis
Authors: Deng Yu , Sun Yanwu , Lin Yu , Huang Ying , Chi Pan
Published: August 2022

Background

This study aimed to assess the clinical implications of the advanced lung cancer inflammation index (ALI) in patients with right-sided colon cancer (RCC) after complete mesocolic excision (CME).

Methods

A total of 441 patients with RCC who underwent CME were included. The optimal cut-off value for the ALI was determined using the X-tile software. Logistic and Cox regression analyses were used to identify risk factors for postoperative complications and long-term outcomes. Predictive nomograms for overall survival (OS) and disease-free survival (DFS) were constructed after propensity score matching (PSM), and their performance was assessed using the net reclassification improvement index (NRI), integrated discrimination improvement index (IDI), and time-dependent receiver operating characteristic (time-ROC) curve analysis.

Results

The optimal preoperative ALI cut-off value was 36.3. After PSM, ASA classification 3/4, operative duration, and a low ALI were independently associated with postoperative complications in the multivariate analysis (all P<0.05). Cox regression analysis revealed that an age >60 years, a carbohydrate antigen 19-9 (CA19-9) level >37 U/mL, pathological N+ stage, and a low ALI were independently correlated with OS (all P<0.05). A CA19-9 level >37 U/mL, pathological N+ stage, lymphovascular invasion, and a low ALI were independent predictors of DFS (all P<0.05). Predictive nomograms for OS and DFS were constructed using PSM. Furthermore, a nomogram combined with the ALI was consistently superior to a non-ALI nomogram or the pathological tumor-node-metastasis classification based on the NRI, IDI, and time-ROC curve analysis after PSM (all P<0.05).

Conclusion

The ALI was an effective indicator for predicting short- and long-term outcomes in patients with RCC.
The human long noncoding RNAs CoroMarker, MALAT1, CDR1as, and LINC00460 in whole blood of individuals after controlled short-term exposure with ultrafine metal fume particles at workplace conditions, and in human macrophages in vitro
Authors: Scheurer Theresa , Steffens Jan , Markert Agnieszka , Du Marchie Sarvaas Miriam , Roderburg Christoph , Rink Lothar , Tacke Frank , Luedde Tom , Kraus Thomas , Baumann Ralf
Published: August 2022

Background

Short-term inhalation of occupationally relevant ultrafine zinc/copper (Zn/Cu) containing welding fumes has been shown to induce subclinical systemic inflammation, associated with an elevated risk for cardiovascular diseases. The involvement of noncoding RNAs (lncRNAs) in this setting is currently unknown. However, lncRNAs have been reported to fulfill essential roles in, e.g., cardiovascular diseases, inflammation, infectious diseases, and pollution-related lung disorders.

Methods

In this study, the specific lncRNAs levels of the 4 lncRNAs CoroMarker, MALAT1, CDR1as and LINC00460 were determined by RT-qPCR in THP-1 macrophages exposed to Zn/Cu metal fume suspensions for 1, 2, and 4 hours in vitro. Furthermore, 14 subjects were exposed to Zn/Cu containing welding fumes (at 2.5 mg/m3) for 6 hours. Before, 6, 10, and 29 hours after exposure start, whole blood cell lncRNAs levels were determined by RT-qPCR.

Results

In THP-1 macrophages, we observed a 2.3-fold increase of CDR1as at 1 h (Wilcoxonp = 0.03), a non-significant increase of CoroMarker at 1 h, and an increase of LINC00460 at 2 h (p = 0.03) and at 4 h (p = 0.06). In whole blood cells, we determined a non-significant upregulation of CDR1as at 6 h (p = 0.2), a significant downregulation of CoroMarker at 6 h (p = 0.04), and a significant upregulation of LINC00460 levels at 10 h (p = 0.04) and 29 h (p = 0.04). MALAT-1 remained unchanged in both settings.

Conclusion

The orientation of regulation of the lncRNAs is (except for CoroMarker) similar in the in vitro and in vivo experiments and in line with their described functions. Therefore, these results, e.g. the upregulation of the potential risk marker for cardiovascular diseases, CDR1as, contribute to understanding the underlying mechanisms of Zn/Cu-induced subclinical inflammation in metal workers.
Differential richness inference for 16S rRNA marker gene surveys
Authors: Kumar M. Senthil , Slud Eric V. , Hehnly Christine , Zhang Lijun , Broach James , Irizarry Rafael A. , Schiff Steven J. , Paulson Joseph N.
Published: August 2022

Background

Individual and environmental health outcomes are frequently linked to changes in the diversity of associated microbial communities. Thus, deriving health indicators based on microbiome diversity measures is essential. While microbiome data generated using high-throughput 16S rRNA marker gene surveys are appealing for this purpose, 16S surveys also generate a plethora of spurious microbial taxa.

Results

When this artificial inflation in the observed number of taxa is ignored, we find that changes in the abundance of detected taxa confound current methods for inferring differences in richness. Experimental evidence, theory-guided exploratory data analyses, and existing literature support the conclusion that most sub-genus discoveries are spurious artifacts of clustering 16S sequencing reads. We proceed to model a 16S survey’s systematic patterns of sub-genus taxa generation as a function of genus abundance to derive a robust control for false taxa accumulation. These controls unlock classical regression approaches for highly flexible differential richness inference at various levels of the surveyed microbial assemblage: from sample groups to specific taxa collections. The proposed methodology for differential richness inference is available through an R package,Prokounter.

Conclusions

False species discoveries bias richness estimation and confound differential richness inference. In the case of 16S microbiome surveys, supporting evidence indicate that most sub-genus taxa are spurious. Based on this finding, a flexible method is proposed and is shown to overcome the confounding problem noted with current approaches for differential richness inference.

Package availability:https://github.com/mskb01/prokounter
Impact of rapid molecular testing on diagnosis, treatment and management of community-acquired pneumonia in Norway: a pragmatic randomised controlled trial (CAPNOR)
Authors: Serigstad Sondre , Ritz Christian , Faurholt-Jepsen Daniel , Markussen Dagfinn , Ebbesen Marit H. , Kommedal Øyvind , Bjørneklett Rune O. , Heggelund Lars , Clark Tristan W. , van Werkhoven Cornelis H. , Knoop Siri T. , Ulvestad Elling , Grewal Harleen M. S. ,   The CAPNOR study group, Bjørneklett R. , Clark T. W. , Ebbesen M. , Faurholt-Jepsen D. , Grewal H. M. S. , Heggelund L. , Knoop S. T. , Kommedal Ø. , Markussen D. , Ravn P. , Ritz C. , Serigstad S. , Ulvestad E. , Van Werkhoven C. H.
Published: August 2022

Background

Community-acquired pneumonia (CAP) causes a large burden of disease. Due to difficulties in obtaining representative respiratory samples and insensitive standard microbiological methods, the microbiological aetiology of CAP is difficult to ascertain. With a few exceptions, standard-of-care diagnostics are too slow to influence initial decisions on antimicrobial therapy. The management of CAP is therefore largely based on empirical treatment guidelines. Empiric antimicrobial therapy is often initiated in the primary care setting, affecting diagnostic tests based on conventional bacterial culture in hospitalized patients. Implementing rapid molecular testing may improve both the proportion of positive tests and the time it takes to obtain test results. Both measures are important for initiation of pathogen-targeted antibiotics, involving rapid de-escalation or escalation of treatment, which may improve antimicrobial stewardship and potentially patient outcome.

Methods

Patients presenting to the emergency department of Haukeland University Hospital (HUH) in Bergen, Norway, will be screened for inclusion into a pragmatic randomised controlled trial (RCT). Eligible patients with a suspicion of CAP will be included and randomised to receive either standard-of-care methods (standard microbiological testing) or standard-of-care methods in addition to testing by the rapid and comprehensive real-time multiplex PCR panel, the BioFire® FilmArray® Pneumonia Panel plus (FAP plus) (bioMérieux S.A., Marcy-l’Etoile, France). The results of the FAP plus will be communicated directly to the treating staff within ~2 h of sampling.

Discussion

We will examine if rapid use of FAP plus panel in hospitalized patients with suspected CAP can improve both the time to and the proportion of patients receiving pathogen-directed treatment, thereby shortening the exposure to unnecessary antibiotics and the length of hospital admission, compared to the standard-of-care arm. The pragmatic design together with broad inclusion criteria and a straightforward intervention could make our results generalizable to other similar centres.

Trial registration

ClinicalTrials.govNCT04660084. Registered on December 9, 2020
Evaluation of the PhunkyFoods intervention on food literacy and cooking skills of children aged 7–9 years: a cluster randomised controlled trial in Yorkshire Primary Schools UK
Authors: Vaughan Karen L. , Cade Janet E. , Hetherington Marion M. , Cockroft Jennie E. , Heinen Mirjam M. , Rippin Holly , Evans Charlotte E. L.
Published: August 2022

Background

Childhood obesity rates more than double during primary school in England. Acquiring competent cooking skills is a key part of children’s education that can lead to improved knowledge of a healthy lifestyle and dietary behaviours. Evaluation of the impact of ‘PhunkyFoods’, a school-based food and nutrition education programme, will assess food literacy, cooking skills and dietary behaviour in primary-school children.

Methods

A cluster randomised controlled trial will be undertaken in 28 primary schools in North Yorkshire, UK, including a total population of children aged 7–9 years (n = 420). The trial has two arms: (a) the intervention group receiving PhunkyFoods programme (n = 210) and (b) the wait-list control group receiving the usual school curriculum (n = 210). The intervention ‘PhunkyFoods’ will be delivered by Purely Nutrition Ltd. The participating school staff are supported with training, policy development and access to resources to improve the delivery of nutrition education. Children participate through whole school assemblies, classroom activities, and after-school clubs about food preparation, cooking healthy meals and healthy living. Schools, parents and children have access to healthy meal recipes through the PhunkyFoods website. The primary outcomes are differences in food literacy and cooking skills scores between control and intervention arms after 12 months of the intervention and adjusted for baseline values. The secondary outcome is differences in fruit and vegetable intake between the arms after 12 months (adjusted for baseline). Treatment effects will be examined using mixed ANOVA and regression analysis. Primary analyses will adjust for baseline food literacy and cooking skills scores and secondary analysis will adjust for pre-specified baseline school and child level covariates.

Discussion

The PhunkyFoods programme is a flexible menu of options for schools to choose from, making this a highly complex intervention. Following Medical Research Council guidance, research perspectives will focus on effectiveness and theory-based approaches: to what extent the intervention produces the intended outcomes in real-world settings and what works in which circumstances.

Trial registration

ISRCTN ISRCTN68114155. Prospectively registered on 22 October 2021
Study protocol for a randomized trial on timely delivery versus expectant management in late preterm small for gestational age pregnancies with an abnormal umbilicocerebral ratio (UCR): the DRIGITAT study
Authors: Smies M. , Damhuis S. E. , Duijnhoven R. G. , Leemhuis A. G. , Gordijn S. J. , Ganzevoort W.
Published: August 2022

Background

The clinical inability to correctly identify late fetal growth restriction (FGR) within a group of fetuses who are identified as small for gestational age (SGA) is an everyday problem for all obstetrician-gynecologists. This leads to substantial overtreatment of healthy small fetuses but also inadequate detection of the growth-restricted fetuses that may benefit from timely delivery. Redistribution of the fetal circulation, signaled by an abnormal ratio of the Doppler velocity flow profiles of the umbilical artery and the middle cerebral artery, more specifically an increased umbilicocerebral ratio (UCR) (or its inverse: a decreased cerebroplacental ratio (CPR)), is an adaptation to chronic hypoxemia and nutritional scarcity with long-term consequences in survivors. The relevance of an abnormal UCR has been signaled extensively, and there is a general consensus that it is a signal of FGR, independent of size, with a strong association with poor outcomes. Yet, in the current literature, no comparisons of a monitoring-delivery strategy based on unfavorable UCR have been published. The objective of the Doppler Ratio In fetal Growth restriction Intervention Trial At (near) Term (DRIGITAT) is to evaluate if the timing of the delivery based on an abnormal UCR in late preterm fetuses identified as SGA improves neurodevelopmental outcomes at 2 years of age.

Methods

The DRIGITAT study is a national multicenter cohort study of women with singleton pregnancies between 32 and 37 weeks of gestation identified as SGA, with a nested randomized controlled trial (RCT) in case of an abnormal UCR (> 0.8). Recruiting centers are in The Netherlands. In the nested RCT, women are randomized to either immediate induction of labor or expectant management from 34 weeks in case of severely abnormal size (EFW or FAC < p3) and from 36 weeks in case of mildly abnormal size (EFW or FAC p3–p10). The primary outcome measure is the 7-point average difference in the composite cognitive score (CCS) and composite motor score (CMS) on the Bayley-3 at 2 years. Secondary outcome measures include a composite outcome of neonatal morbidity, perinatal mortality, mode of delivery, maternal quality of life, costs, and predictive value of serum biomarkers. Analyses will be by intention to treat. The required sample size is determined for the nested RCT as 185 patients.

Discussion

This study will provide insight into the diagnostic efficacy of UCR measurement in the evaluation of SGA fetuses in order to differentiate the healthy SGA fetus from the growth-restricted fetus and to determine if a fetus with abnormal UCR benefits from early delivery.

Trial registration

Healthcare Evaluation Netherlands NTR6663. Registered on 14 August 2017.
Effect of vibration associated with cryotherapy on vaccine-related pain and anxiety levels in adults: study protocol for a randomized clinical trial
Authors: da Cunha Lima Elaine Aparecida , Toledo Luana Vieira , Correia Marisa Dibbern Lopes , de Almeida Pereira Daniela , Caetano Renata Oliveira , Faria Thaís Bitencourt , Braga Luciene Muniz
Published: August 2022

Background

Vaccination is one of the most effective strategies for prevention and eradication of immunopreventable diseases, but community acceptance of vaccination can be influenced by different factors, such as pain and anxiety. The use of high-frequency vibration associated with cryotherapy has been used to manage pain and anxiety during the vaccination process in children, but studies with adults are still scarce. This study aims to evaluate the effect of high-frequency vibration associated with cryotherapy on the levels of self-reported pain and anxiety related to administration of the Influenza vaccine intramuscularly in adults.

Methods

A two-arm, parallel, randomized clinical trial conducted in a Brazilian Primary Health Care Unit is proposed. A sample of 350 adults will be randomly assigned to participate in the control group, receiving the vaccine intramuscularly according to the standard protocol of the service, or in the intervention group, receiving the vaccine by the same route and using a portable device of high frequency vibration associated with cryotherapy for 30 s before and during administration. The primary endpoints will be self-reported levels of pain, assessed before and after vaccine administration. Secondary endpoints will be levels of anxiety, satisfaction with vaccine administration, and discomfort caused by high frequency vibration and temperature of the frozen bag in contact with the skin. Self-reported levels of pain and anxiety will be compared before and after vaccination as well as between the control and intervention groups.

Discussion

By evaluating the effect of high-frequency vibration associated with cryotherapy on pain and anxiety levels, we expect to find evidence that will support nursing practice, in order to promote greater comfort and safety in the vaccination process and, consequently, greater compliance by the population, by minimizing its undesirable effects.

Trial registration

Human Research Ethics Committee Opinion Number: 5.138.564. Approved on December 2, 2021. Brazilian Registry of Clinical Trials (REBEC): Registration number RBR-5zgy25w. Registered on December 09, 2021.
Pasos Hacia La Salud II: study protocol for a randomized controlled trial of a theory- and technology-enhanced physical activity intervention for Latina women, compared to the original intervention
Authors: Mendoza-Vasconez Andrea S. , Benitez Tanya , Dunsiger Shira , Gans Kim M. , Hartman Sheri J. , Linke Sarah E. , Larsen Britta A. , Pekmezi Dorothy , Marcus Bess H.
Published: August 2022

Background

Latinas are at increased risk for many lifestyle-related chronic diseases and are one of the least physically active populations in the US Innovative strategies are needed to help Latinas achieve the health benefits associated with physical activity (PA). This manuscript describes the study protocol of the Pasos Hacia La Salud II Study, which builds upon our previous research to test an enhanced individually-tailored, text-message and website-delivered, Spanish-language intervention (enhanced intervention), in comparison to the original web-based Pasos Hacia La Salud Intervention (original intervention).

Methods

Sedentary Latinas between the ages of 18–65 will be recruited and will complete an orientation and baseline assessments. Participants will be subsequently randomized to the original intervention, or the Enhanced Intervention, which has greater targeting of theoretical constructs such as self-efficacy, enjoyment, and social support, and which uses text messages and more dynamic and refined website features to encourage increased website use. Using a linear mixed effects regression model, we will simultaneously estimate the intervention effects on mean accelerometer-measured hours/week of moderate-to-vigorous PA (MVPA) at 6, 12, 18, and 24 months, with a subject-specific intercept (intent-to-treat sample). Change in self-reported MVPA, measured via the 7-day Physical Activity Recall, will be assessed as a secondary outcome using a similar model. We will investigate potential mediators of the intervention effect using a multiple mediation approach, and potential moderators by evaluating potential interactions. As an exploratory outcome, we will study the differences (among both study arms) in cost, in US dollars, per minute increases in weekly mean MVPA.

Discussion

The original Pasos PA intervention showed efficacy in helping Latinas increase PA; we expect the Enhanced Intervention to help a larger proportion of participants to increase and maintain their PA long term. This web- and text-based enhanced intervention could have great reach and dissemination potential, which could be capitalized on in the future to help to advance health equity. Adaptations made in response to the COVID-19 pandemic are also described in this manuscript.

Trial registration

Clinical Trial Number: NCT03491592. First posted April 9, 2018.
Clear cell sarcoma of the kidney with inferior vena cava thrombus: a case report
Authors: Doya Leen Jamel , Alyousef Khaled , Oukan Majdy , Razzok Ali , Alshabab Basel Shek , AlEid Tarek , Saloum Rabab , Nasser Hassan
Published: August 2022

Background

Clear cell sarcoma of the kidney is an uncommon pediatric renal malignant neoplasm that is typically characterized in 2–3-year-olds by aggressive behavior and late relapses. Our literature review revealed fewer than ten previously reported cases of CCSK with inferior vena cava thrombus, with only five in the pediatric age group.

Case presentation

We report the case of a 14-year-old Syrian girl who complained of mild pain in the left lumbar region pain with hematuria. On physical examination, a mass was palpated in the left flank. Abdominal ultrasonography revealed a left renal mass (7 × 5 × 2 cm3), associated with dilatation of the left renal vein. Contrast abdominal computed tomography showed a mass measuring 7 × 5 × 3 cm3 with the presence of thrombus extending into the inferior cavity down to the right atrium that was initially diagnosed as Wilms’ tumor. Radical right nephrectomy with excision of the thrombus was undertaken. Histological immunostaining revealed a diagnosis of the tumor as clear cell sarcoma with vascular tumor thrombus extending to the inferior vena cava.

Conclusion

Clear cell sarcoma and Wilms’ tumor are similar in terms of typical age of appearance, clinical features, and histopathology, but with different methods of treatment and prognosis. The differential diagnosis of such masses is thus very important. We present the case of a patient with clear cell sarcoma with unusual age, with complete removal of the thromboses in the inferior vena cava and the right atrium.
Floristic composition, growth temperament and conservation status of woody plant species in the Cameroonian tropical rainforests
Authors: Kengne Olivier Clovis , Feukeng Samuel Severin Kenfack , Ngansop Eric Tchatchouang , Meyan-ya Raissa Gwladys Daghela , Zapfack Louis
Published: August 2022

Introduction

Cameroon’s tropical rainforests are nowadays strewn with rural forests maintained by local populations; however, these forests are not officially recognized in the non-permanent forest domain. Rural forests are non-delimited riparian areas within the dense moist forest, reserved for rural housing, agricultural activities and agroforestry practices, freely exploited by the local communities for their livelihood without them having any rights to artisanal and commercial logging. This study aimed at contributing to the flora knowledge and the conservation state of woody plant species in rainforests. The study was carried out in two rural forests located in the Eastern and Southern agroforestry zones of Cameroon.

Methods

The method adopted for floristic inventories combined a fixed area sampling unit and a variable area sampling unit. Woody individuals with diameter at breast height (dbh) < 3.2 cm were counted and shrubs of 3.2 ≤ dbh < 10 cm were measured to analyse the understorey, while trees with dbh ≥ 10 cm were measured and identified to characterize the canopy.

Results

In the Essiengbot-Mbankoho rural forest in Eastern Cameroon, 468 species belonging to 61 families were recorded in the understory while 227 species belonging to 53 families were identified at the canopy level. A total of 40 (7.68%) threatened species, 18 (3.45%) Near Threatened species and 408 (78.31%) Least Concern species were recorded. In the Nbgwassa-Opkweng rural forest in Southern Cameroon, 534 species belonging to 64 families were identified in the understory while 225 species belonging to 43 families were recorded in the canopy. A total of 54 (9.69%) threatened species, 25 (4.49%) Near Threatened species and 421 (75.58%) Least Concern species were identified in this forest. Shannon’s diversity indices were above five in the understories and canopies of both forests. Shade-bearer species were the most represented in the understories while the non-pioneer light-demanding and shade-bearer species were the most abundant in the canopies.

Conclusions

Despite the influence of slash-and-burn agriculture and subsistence farming practices, rural forests managed by local populations provide opportunities for preserving plant biodiversity. However, the presence of threatened species, pioneer species and non-pioneer light-demanding species in these forests is an indicator of moderate and man-induced disturbances that, in the absence of a forest management plan or sustainable management, may threaten this biodiversity. Legal management of rural forests could help in limiting the anthropogenic activities and pressures on community forests.
Flexural Behavior of Low Calcium Fly Ash Based Geopolymer Reinforced Concrete Beam
Authors: Alex Alexander Gladwin , Gebrehiwet Tewele Tsegay , Kemal Zeyneb , Subramanian Ramesh Babu
Published: August 2022

Pioneering studies have been conducted on alternative cementitious material in the manufacturing of conventional concrete to reduce carbon emission and improve the overall efficacy. However, there are limited studies on eco-friendly materials with low calcium fly ash. This study aims to examine the strength fly ash geopolymer concrete and reduce carbon emission. In this investigation, flexural test is done for conventional and geopolymer concrete (GPC) beam samples after the fulfillment of rest period and 24 h steam curing at 60 °C. The experimental results prove that the initial characteristics of both specimens are almost similar. When GPC specimens reached the service, yield, and failure stages, the load carrying capacity, deflection increased up to 21.5 and 8.75%, respectively and better load bearing capacity, moment resistance, and crack propagation were observed more than in conventional cement. Fresh property test results indicated the achievement of standard workability without the addition of any admixture. Our study show that low calcium based geopolymer can be used as an efficient material for the alternate of cement in cement-based industries with eco-friendly nature.
The role of sense of coherence and loneliness in borderline personality disorder traits: a longitudinal twin study
Authors: Skaug Eirunn , Czajkowski Nikolai O. , Waaktaar Trine , Torgersen Svenn
Published: August 2022

Background

Borderline personality disorder (BPD) implies having problems with identity and relations with other people. However, not much is known about whether these indications of BPD are present in adolescence, i.e., before personality disorders usually are diagnosed. In this study, we examined the prediction of an aspect of identity (i.e., sense of coherence [SOC]) and social relations (i.e., perceived loneliness) throughout adolescence on BPD traits in young adulthood. In addition, we examined to what degree the predictive ability could be attributed to genetic and environmental factors. We also examined whether life events in adolescence were related to BPD traits.

Methods

Three thousand three hundred ninety-one twins, consisting of seven national birth cohorts from Norway, participated in the study. SOC, loneliness and life events were measured three times throughout adolescence with self-report questionnaires, with 2 years in between measurements. BPD traits were measured at the end of adolescence around the age of 19 with a structured interview. Regression analyses were performed to examine the prediction of SOC, loneliness and life events on BPD traits. Cholesky decomposition models were then used to determine to what degree the associations were due to genetic and environmental influences.

Results

The prediction of SOC and loneliness on BPD traits increased from R = .25 (when measured 6 years prior to the assessment of BPD traits) to R = .45 (when measured shortly before the assessment of BPD traits). In addition, negative life events considered dependent on a person’s behavior were related to BPD traits. Negative independent and positive dependent life events did not contribute to the prediction of BPD traits. Cholesky decomposition models showed that SOC and loneliness were associated with BPD traits mainly due to shared genetic influences (i.e., the proportion due to genetic influences ranged from 71 to 86%). Adding negative dependent life events to the prediction of BPD traits did not change these percentages.

Conclusions

These findings indicate that the weaker SOC, the stronger feelings of loneliness, and the negative life events associated with BPD traits are mainly consequences of the genetic aspects of BPD traits, rather than having direct effects on levels of BPD symptoms.
Torque movement of the upper anterior teeth using a clear aligner in cases of extraction: a finite element study
Authors: Cheng Yuxun , Gao Jie , Fang Shishu , Wang Wei , Ma Yanning , Jin Zuolin
Published: August 2022

Background

Clear aligner treatment has become popular over recent years. It is necessary to identify methods by which we could avoid the bowing effect in extractions with clear aligner. The present study was to identify the appropriate method to design torque movement involving the upper anterior teeth of extraction cases, in order to maintain or improve the axis and torque of the upper anterior teeth with a clear aligner during movement and closure of the extraction space.

Results

As the height of the power ridge increased, the rotation angle of the upper central incisor in the sagittal direction decreased gradually and the location of the rotation center changed significantly; the rotation center moved in the apical direction and then changed to the crown side. The highest von-Mises stress of the upper central incisor root, periodontal ligaments, and alveolar bone, showed little change as the power ridge height increased. When the axial inclination of the upper central incisor was normal (U1-SN = 105°), the tendency of movement for the upper central incisor approached translation with a power ridge height of 0.7 mm (corresponding distorted angle: 5.8415). When the axial inclination of the upper central incisor was oversized (U1-SN = 110°), the axial inclination of the upper central incisor reduced to normal following completion of the anterior segment retraction with a power ridge of 0.4 mm (corresponding distorted angle: 3.4265).

Conclusion

Analysis indicates that pure palatal tipping movement of the upper anterior teeth is generated without torque control, thus resulting in the bowing effect. The required torque control of the upper anterior teeth with oversize axial inclination is weaker than that of the upper anterior teeth with normal axial inclination because limited torque loss is expected for oversize axial inclination teeth. Variation sensitivity of the rotation center should be considered carefully due to biological problems when designing translation of the upper anterior teeth with normal axial inclination.
Correcting magnification error in foveal avascular zone area measurements of optical coherence tomography angiography images with estimated axial length
Authors: Dutt Deepaysh D. C. S. , Yazar Seyhan , Charng Jason , Mackey David A. , Chen Fred K. , Sampson Danuta M.
Published: August 2022

Background

To generate and validate a method to estimate axial length estimated (ALest) from spherical equivalent (SE) and corneal curvature [keratometry (K)], and to determine if this ALest can replace actual axial length (ALact) for correcting transverse magnification error in optical coherence tomography angiography (OCTA) images using the Littmann-Bennett formula.

Methods

Data from 1301 participants of the Raine Study Gen2-20 year follow-up were divided into two datasets to generate (n = 650) and validate (n = 651) a relationship between AL, SE, and K. The developed formula was then applied to a separate dataset of 46 participants with AL, SE, and K measurements and OCTA images to estimate and compare the performance of ALest against ALact in correcting transverse magnification error in OCTA images when measuring the foveal avascular zone area (FAZA).

Results

The formula for ALest yielded the equation: ALest = 2.102K − 0.4125SE + 7.268, R2 = 0.794. There was good agreement between ALest and ALact for both study cohorts. The mean difference [standard deviation (SD)] between FAZA corrected with ALest and ALact was 0.002 (0.015) mm2 with the 95% limits of agreement (LoA) of − 0.027 to 0.031 mm2. In comparison, mean difference (SD) between FAZA uncorrected and corrected with ALact was − 0.005 (0.030) mm2, with 95% LoA of − 0.064 to 0.054 mm2.

Conclusions

ALact is more accurate than ALest and hence should be used preferentially in magnification error correction in the clinical setting. FAZA corrected with ALest is comparable to FAZA corrected with ALact, while FAZA measurements using images corrected with ALest have a greater accuracy than measurements on uncorrected images. Hence, in the absence of ALact, clinicians should use ALest to correct for magnification error as this provides for more accurate measurements of fundus parameters than uncorrected images.
Survival analysis of myopic regression after small incision lenticule extraction and femtosecond laser-assisted laser in situ keratomileusis for low to moderate myopia
Authors: Zhou Jihong , Gu Wei , Gao Yan , Wang Wenjuan , Zhang Fengju
Published: August 2022

Background

To report the predictive factors of myopic regression in patients who had undergone small incision lenticular extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileuses (FS-LASIK) after 3–12 months of follow-up.

Methods

This retrospective case series study recruited patients with a subjective sphere of − 1.00 to − 6.00 D myopia. SMILE was performed in 1629 eyes of 1629 patients with a subjective refraction spherical equivalent (SEQ) of − 4.57 ± 1.20 D and 1414 eyes of 1414 patients with a subjective SEQ of − 4.53 ± 1.26 D in FS-LASIK. Refractive outcomes were recorded at 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. Predictors affecting myopic regression and other covariates were estimated with a Cox proportional hazard (Cox PH) model for the two surgical methods.

Results

At 12 months, no significant difference was evident in the efficacy (P = 0.934), predictability (P = 0.733), or stability (P = 0.66) between FS-LASIK and SMILE. The survival rates were 83.7% in the FS-LASIK group and 88.1% in the SMILE group. Multivariate analysis by the Cox PH model revealed a similar probability of postoperative myopic regression with SMILE or FS-LASIK (P = 0.630). Predictors of myopic regression included preoperative higher-order aberration root mean square with 3 mm pupil diameter (pre-HOA-RMS3) (P = 0.004), anterior chamber depth (ACD) (P = 0.015), pre-subjective sphere (P = 0.016), corneal diameter (P = 0.016), optical zone (OZ) (P = 0.02), and predicted depth of ablation (DA) (P = 0.003).

Conclusion

SMILE and FS-LASIK had a similar risk of myopic regression for low to moderate myopia. Pre-HOA-RMS3, ACD, pre-subjective sphere, corneal diameter, OZ, and predicted DA were predictors of myopic regression.
Surgical treatment of pediatric intractable frontal lobe epilepsy due to malformation of cortical development
Authors: Yu Hao , Lv Qiang , Liu Qingzhu , Wang Shuang , Ji Taoyun , Wang Ruofan , Wang Wen , Wang Dongming , Jiang Yuwu , Liu Xiaoyan , Cai Lixin
Published: August 2022

Background

Malformation of cortical development (MCD) is a common cause of intractable epilepsy in children. In this study, the effectiveness of frontal lobe epilepsy (FLE) surgery in children with intractable epilepsy due to MCD was assessed and its prognostic factors were studied.

Methods

Seventy-six patients with intractable FLE who received epilepsy surgery between January 2016 and March 2018 in Peking University First Hospital were recruited in this study. All the resected brain tissues were demonstrated to be MCD. All patients were followed up for at least 3 years. The clinical data and prognosis were analyzed retrospectively. Univariate and multivariate analyses were performed to investigate the correlations between clinical variables and prognostic outcome (Engel classification).

Results

Sixty (78.9%) patients had Engel class I postoperative outcome. The mean age at surgery was 6.00 ± 4.24 years. Sixty-six patients (86.8%) had daily seizures, 40.2% of the patients had epileptic spasm, and 33% of the patients had extensive interictal EEG abnormalities, which, however, could not provide any helpful information for localizing epileptogenic zones. About 29% of the patients had normal MRI findings even by experienced radiologists, and 26% of the patients had epileptogenic lesion involving adjacent lobes. There was a significant correlation between acute postoperative seizure (APOS) and prognosis (P < 0.05): APOS predicted poor prognosis. There was a significant correlation between pathology and prognosis (P < 0.05): FCD IA and FCD IIB were correlated with a good outcome. Both variables with a significance level of P < 0.05 during univariate analysis, including pathology and APOS, were included in multivariate analysis, which were significant independent predictors of prognosis.

Conclusions

The clinical manifestations of pediatric intractable FLE due to MCD are more complicated than those in adults. Multidisplinary presurgical evaluation in pediatric epilepsy is mandatory. The surgical outcome of pediatric FLE due to MCD could reach a seizure-free rate of 78.9% with the follow-up of at least 3 years. The post-operative pathology and APOS may be related to the prognosis of surgery in this group of pediatric patients.