bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the experiences of operating room health care professionals' from the challenges of the COVID-19 pandemic
Authors: Mohammadi Fateme , Tehranineshat Banafsheh , Bijani Mostafa , Oshvandi Khodayar , Badiyepeymaiejahromi Zohreh
Published: December 2021

Background

The operating room nurses have encountered several challenges during the current COVID-19 Pandemic, which subsequently impact their clinical performance. The present study aimed to investigate the experiences of operating room health care professionals' regarding the COVID-19 pandemic challenges in southern Iran.

Methods

This is a descriptive qualitative study. The required data were collected using in-depth and semi-structured interviews. Accordingly, 19 operating room health care professions were included in this study through purposive sampling. The data were collected from February 2020 to August 2021 and then analyzed using the Granheim and Lundman’s method.

Results

Three main themes and 9 sub-themes were presented in this study. They included: 1- Challenges of applying protocols and standards of care in the COVID-19 pandemic in the operating room (lack of specific guidelines regarding care protocols and standards for crisis management of Covid-19 in the operating room and impossibility of keeping social distance in the operating room). 2- Professional challenges (tedious and hard work, professional burnout, lack of adequate support by the managers and lack of personal protective equipment). 3-Psychological crises (indescribable anxiety and worry, parenting stress, and weakened resilience).

Conclusion

Based on the findings of the present study, it was indicated that lack of a specific guideline in the COVID-19 pandemic led to a sense of indecision and confusion among operating room staff. In this regard, performing tedious tasks, feelings of tiredness and exhaustion, lack of support by the authorities, and lack of access to adequate facilities and equipment were reported as the professional challenges of the healthcare staff in the current COVID-19 pandemic, which consequently affected the quality of care and patient’s safety. It seems that hospital officials can use the results reported in this study for efficient planning and effective management during the COVID-19 pandemic.
Spontaneous enterocutaneous fistula in a patient with femoral hernia: a case report
Authors: Chalise Anup , Rajbhandari Ashish Prasad , Kathayat Lok Bahadur , Koirala Rabin
Published: December 2021

Background

Enterocutaneous fistula commonly occurs in the post-operative setting. However, a handful of cases have been reported to occur secondary to strangulation of hernia, mostly femoral due to the narrow femoral ring through which this type of hernia passes through.

Case presentation

We encountered a case of spontaneous fecal fistula, which occurred in the setting of an incarcerated femoral hernia. The patient did not develop peritonism, or obstruction, throughout the course of the disease. The hernia ruptured on day 7 of incarceration. Exploratory laparotomy under epidural anesthesia revealed a femoral hernia with ileum as content, arising approximately 20 cm from the
ileocecal junction. Reduction of the contents was done, and a resection performed along with repair of the hernia.

Conclusion

As very few literature describe the formation of spontaneous fecal fistula, we discuss the presentation in this report.
“Does this dental mob do eyes too?”: perceptions and attitudes toward dental services among Aboriginal Australian adults living in remote Kimberley communities
Authors: Patel Jilen , Durey Angela , Naoum Steven , Kruger Estie , Slack-Smith Linda
Published: December 2021

Background

Australian Aboriginal and Torres Strait Islander people continue to experience significant disparities in oral health and there remains an urgent need to improve services to rural and remote communities. Quantitative research has typically been used to highlight the disease burden and severity experienced by those living in remote communities, but this data does little to explore the lived reality and psychosocial nuances that impact on care. The Kimberley region of Western Australia is home to over 150 Aboriginal communities spread out across 400,000 square kilometres. The success and sustainability of oral health services to these remote communities relies on respect and reciprocity achieved through shared knowledge, decision making and involvement of Aboriginal people in discussions around oral health services and their delivery. This, study aimed to investigate the perceptions and attitudes toward dental services among Aboriginal Australian families living in remote Kimberley communities.

Methods

Semi-structured interviews and yarning circles were carried out following purposive sampling of Aboriginal adults living in the East Kimberley region of Western Australia. Interviews were recorded, transcribed, and analysed guided by a constructivist grounded theory approach.

Results

In total, 80 community members participated in the yarning process. Enablers to care included: promotion of existing services, integration with primary health services, using mobile dental services and volunteers to extend care. Barriers to care included transportation, cost of treatment, the complexity of appointment systems and shame associated with health-seeking behaviours.

Conclusions

Reassessing the prevailing operative model of dental care to remote Aboriginal communities is warranted to better address the overwhelming structural barriers that impact on oral health. Integration with existing primary health services and schools, the use of mobile units to extend care and increasing community engagement through clinical yarning are recommended in improving the current state of dental services to communities in the Kimberley.
The influence of change on sense of coherence on dental services use among adolescents: a two-year prospective follow-up study
Authors: da Silva Araújo Júnior Carlos Augusto , Rebelo Vieira Janete Maria , Rebelo Maria Augusta Bessa , Herkrath Fernando José , Herkrath Ana Paula Corrêa de Queiroz , de Queiroz Adriana Corrêa , Pereira Juliana Vianna , Vettore Mario Vianna
Published: December 2021

Background

To investigate the influence of change on sense of coherence (SOC) on dental services use in adolescents over a two-year period.

Methods

A prospective follow-up study was conducted involving 334 12-year-old adolescents from public schools in the city of Manaus, Amazonas, Brazil. The predictors of use of dental services in the last 12 months were selected according to the Andersen’s behavioural theoretical model. The predisposing factors included sex, self-reported skin colour and SOC. The enabling factors were dental insurance, monthly family income and parents/guardians schooling. Dental pain, perceived oral health status, dental caries and gingival status were used to assess need factors. Multivariable Poisson regression with robust variance was used to estimate incidence-rate ratios (IRR) and 95% confidence intervals between the independent variables and use of dental services.

Results

Adolescent’s SOC scores decreased significantly between baseline and one-year follow-up. SOC decline decreased the likelihood of using dental services in the last 12 months (IRR = 0.96 95%CI 0.92–0.99). Dental caries (IRR = 1.03 95%CI 1.01–1.04) and gingival bleeding (IRR = 1.01 95%CI 1.01–1.02) remained associated with use of dental services in the last 12 months. Adolescents with dental pain were more likely to have visited a dentist in the last year (IRR = 1.03, 95%CI 1.01–1.06).

Conclusion

SOC decrease over one-year period was a meaningful factor of dental services use among 12-year-old adolescents. Dental pain and clinical conditions were also relevant factors that can influence use of dental services in this group.
Help-seeking behaviour and associated factors among women who experienced physical and sexual violence in Ethiopia: evidence from the 2016 Ethiopia Demographic and Health Survey
Authors: Handebo Simegnew , Kassie Ayenew , Nigusie Adane
Published: December 2021

Background

Violence against women remains devastatingly pervasive and remained unchanged over the past decade. Violence against women is preventable and help-seeking of women subjected to violence is an entry point. So, this study assessed help-seeking behaviour and associated factors among women who experienced physical and sexual violence in Ethiopia.

Method

Using the 2016 Ethiopia Demographic and Health Surveys (EDHS), this paper analyzes the determinants of help-seeking behavior of women subjected to violence in Ethiopia. EDHS used a two-stage stratified cluster sampling technique. From 642 communities, a total of 1540 (weighted) reproductive age women were included in the analysis. Simple descriptive, bivariable and multivariable logistic regression analysis were employed. Statistical significance was set at a p-value of less than 0.05.

Results

Only 22.5% of the women who experienced violence sought help. Being aged 30 and above, working in sales, or an agricultural job, being in the richest wealth quintile, and experiencing severe violence were associated with increased help-seeking behaviour. Living in a rural area, having a husband who attended primary, secondary, and higher education, having a husband working in a professional job and agriculture were factors associated with lower odds of help-seeking behaviour.

Conclusion

In Ethiopia below one-fourth of women who were subject to violence sought help. Socio-demographic factors and severity of the violence were associated with help-seeking. Preventing child marriages and reducing poverty as well as increased employment and education for women enhance help-seeking behaviour by the women. Interventions could include creating awareness, law enforcement, and support for victims.
A systematic approach to the disclosure of genomic findings in clinical practice and research: a proposed framework with colored matrix and decision-making pathways
Authors: Matsui Kenji , Yamamoto Keiichiro , Tashiro Shimon , Ibuki Tomohide
Published: December 2021

Background

Whether and how to disclose genomic findings obtained in the course of genomic clinical practice and medical research has been a controversial global bioethical issue over the past two decades. Although several recommendations and judgment tools for the disclosure of genomic findings have been proposed, none are sufficiently systematic or inclusive or even consistent with each other. In order to approach the disclosure/non-disclosure practice in an ethical manner, optimal and easy-to-use tools for supporting the judgment of physicians/researchers in genomic medicine are necessary.

Methods

The bioethics literature on this topic was analyzed to parse and deconstruct the somewhat overlapping and therefore ill-defined key concepts of genomic findings, such as incidental, primary, secondary, and other findings. Based on the deconstruction and conceptual analyses of these findings, we then defined key parameters from which to identify the strength of duty to disclose (SDD) for a genomic finding. These analyses were then applied to develop a framework with the SDD matrix and systematic decision-making pathways for the disclosure of genomic findings.

Results

The following six major parameters (axes), along with sub-axes, were identified: Axis 1 (settings and institutions where findings emerge); Axis 2 (presence or absence of intention and anticipatability in discovery); Axis 3 (maximal actionability at the time of discovery); Axis 4 (net medical importance); Axis 5 (expertise of treating physician/researcher); and Axis 6 (preferences of individual patients/research subjects for disclosure). For Axes 1 to 4, a colored SDD matrix for genomic findings was developed in which levels of obligation for disclosing a finding can be categorized. For Axes 5 and 6, systematic decision-making pathways were developed via the SDD matrix.

Conclusion

We analyzed the SDD of genomic findings and developed subsequent systematic decision-making pathways of whether and how to disclose genomic findings to patients/research subjects and their relatives in an ethical manner. Our comprehensive framework may help physicians and researchers in genomic medicine make consistent ethical judgments regarding the disclosure of genomic findings.
Users’ perception on factors contributing to electronic medical records systems use: a focus group discussion study in healthcare facilities setting in Kenya
Authors: Ngugi Philomena N. , Were Martin C. , Babic Ankica
Published: December 2021

Background

Electronic medical records systems (EMRs) adoption in healthcare to facilitate work processes have become common in many countries. Although EMRs are associated with quality patient care, patient safety, and cost reduction, their adoption rates are comparatively low. Understanding factors associated with the use of the implemented EMRs are critical for advancing successful implementations and scale-up sustainable initiatives. The aim of this study was to explore end users’ perceptions and experiences on factors facilitating and hindering EMRs use in healthcare facilities in Kenya, a low- and middle-income country.

Methods

Two focus group discussions were conducted with EMRs users (n = 20) each representing a healthcare facility determined by the performance of the EMRs implementation. Content analysis was performed on the transcribed data and relevant themes derived.

Results

Six thematic categories for both facilitators and barriers emerged, and these related to (1) system functionalities; (2) training; (3) technical support; (4) human factors; (5) infrastructure, and (6) EMRs operation mode. The identified facilitators included: easiness of use and learning of the system complemented by EMRs upgrades, efficiency of EMRs in patient data management, responsive information technology (IT) and collegial support, and user training. The identified barriers included: frequent power blackouts, inadequate computers, retrospective data entry EMRs operation mode, lack of continuous training on system upgrades, and delayed IT support.

Conclusions

Users generally believed that the EMRs improved the work process, with multiple factors identified as facilitators and barriers to their use. Most users perceived system functionalities and training as motivators to EMRs use, while infrastructural issues posed as the greatest barrier. No specific EMRs use facilitators and/or barriers could be attributed to facility performance levels. Continuous evaluations are necessary to assess improvements of the identified factors as well as determine emerging issues.
The Hippo signaling pathway in leukemia: function, interaction, and carcinogenesis
Authors: Noorbakhsh Negar , Hayatmoghadam Bentolhoda , Jamali Marzieh , Golmohammadi Maryam , Kavianpour Maria
Published: December 2021

Cancer can be considered as a communication disease between and within cells; nevertheless, there is no effective therapy for the condition, and this disease is typically identified at its late stage. Chemotherapy, radiation, and molecular-targeted treatment are typically ineffective against cancer cells. A better grasp of the processes of carcinogenesis, aggressiveness, metastasis, treatment resistance, detection of the illness at an earlier stage, and obtaining a better therapeutic response will be made possible. Researchers have discovered that cancerous mutations mainly affect signaling pathways. The Hippo pathway, as one of the main signaling pathways of a cell, has a unique ability to cause cancer. In order to treat cancer, a complete understanding of the Hippo signaling system will be required. On the other hand, interaction with other pathways like Wnt, TGF-β, AMPK, Notch, JNK, mTOR, and Ras/MAP kinase pathways can contribute to carcinogenesis. Phosphorylation of oncogene YAP and TAZ could lead to leukemogenesis, which this process could be regulated via other signaling pathways. This review article aimed to shed light on how the Hippo pathway interacts with other cellular signaling networks and its functions in leukemia.
Cordycepin augments the chemosensitivity of osteosarcoma to cisplatin by activating AMPK and suppressing the AKT signaling pathway
Authors: Li Hong-Bo , Chen Jun-Kai , Su Ze-Xin , Jin Qing-Lin , Deng Li-Wen , Huang Gang , Shen Jing-Nan
Published: December 2021

Background

Osteosarcoma is the most common primary bone tumor in children and adolescents. However, some patients with osteosarcoma develop resistance to chemotherapy, leading to a poor clinical prognosis. Hence, effective therapeutic agents that can improve the response to chemotherapy drugs to improve the prognosis of patients with osteosarcoma are urgently needed. Cordycepin has recently emerged as a promising antitumor drug candidate. This study aims to explore the effect of cordycepin in suppressing osteosarcoma in vivo and in vitro and the synergistic effect of cordycepin combined with cisplatin and to demonstrate the underlying molecular mechanism.

Methods

CCK-8 assay was performed to investigate the inhibition effect of cordycepin combined with cisplatin in osteosarcoma cell lines. The colony formation and invasion abilities were measured by colony formation assay and Transwell assay. Osteosarcoma cells apoptosis was detected by flow cytometry. Western blot analysis were used to detect the expression of cell apoptosis-related proteins and AMPK and AKT/mTOR signaling pathway-related proteins. Finally, we performed the in vivo animal model to further explore whether cordycepin and cisplatin exert synergistic antitumor effects.

Results

Notably, we found that treatment with cordycepin inhibited cell proliferation, invasion, and induced apoptosis in osteosarcoma cells in vitro and in vivo. Moreover, the combination of cordycepin and cisplatin led to marked inhibition of osteosarcoma cell proliferation and invasion and promoted osteosarcoma cell apoptosis in vitro and in vivo. Mechanistically, we demonstrated that cordycepin enhanced the sensitivity of osteosarcoma cells to cisplatin by activating AMPK and inhibiting the AKT/mTOR signaling pathway.

Conclusions

In brief, this study provides comprehensive evidence that cordycepin inhibits osteosarcoma cell growth and invasion and induces osteosarcoma cell apoptosis by activating AMPK and inhibiting the AKT/mTOR signaling pathway and enhances the sensitivity of osteosarcoma cells to cisplatin, suggesting that cordycepin is a promising treatment for osteosarcoma.
The role of cancer stromal fibroblasts in mediating the effects of tobacco-induced cancer cell growth
Authors: Cao Zai-Zai , Ao Yin-Jie , Zhou Shui-Hong
Published: December 2021

Tobacco products cause a variety of cancers, nicotine and carcinogens are two major factors to link the tobacco products and various cancers. The mechanism of tobacco inducing carcinogenesis and promoting cancer progression have been studied for a long time. However, mainstream studies just focus on the mutagenic characteristics of tobacco product and its properties to induce carcinogenesis of epithelial cells. In the past decades, people began to aware of the significant role of tumor stroma in cancer development and progression. Fibroblasts, which is associated with various cancer in all stage of disease progression, are the dominant cell type in the tumor microenvironment. While only a few studies explore the crosstalk between tobacco-induced fibroblasts and surrounding epithelial cells. Our purpose is to systematically review the effects of tobacco products on fibroblasts and further discuss how these effects affect the development of cancer cells.
Conjoint analysis of circulating tumor cells and solid tumors for exploring potential prognostic markers and constructing a robust novel predictive signature for breast cancer
Authors: Li Xuan , Sun Hefen , Liu Qiqi , Liu Yang , Hou Yifeng , Jin Wei
Published: December 2021

Background

Distance metastasis is the leading cause of death for breast cancer patients, and circulating tumor cells (CTCs) play a key role in cancer metastasis. There have been few studies on CTCs at the molecular level due to their rarity, and the heterogeneity of CTCs may provide special information for solid tumor analysis.

Methods

In this study, we used the gene expression and clinical information of single-cell RNA-seq data of CTCs of breast cancer and discovered a cluster of epithelial cells that had more aggressive characteristics. The differentially expressed genes (DEGs) between the identified epithelial cells cluster and others from single-CTCs were selected for further analysis in bulk sequence data of solid breast cancers.

Results

Eighteen genes closely related to the specific CTC epithelial phenotype and breast cancer patient prognosis were identified. Among these 18 genes, we selected the GARS gene, which has not been studied in breast cancer, for functional research and confirmed that it may be a potential oncogene in breast cancer. A risk score was established by the 18 genes, and a high-risk score was strongly associated with a high metastasis rate and poor survival prognosis in breast cancer. The high-risk score group was related to a defective immune infiltration environment in breast cancer, and the immune checkpoint therapy response rate was lower in this group. The drug-sensitive analysis shows that the high-risk score patients may be more sensitive to AKT-mTOR and the cyclin-dependent kinase (CDK) pathways drugs than low-risk score patients.

Conclusions

Our 18-gene risk score shows good prognostic and predictive values and might be a personalized prognostic marker or therapy guide marker in breast cancer patients.
Physiotherapy using a free-standing robotic exoskeleton for patients with spinal cord injury: a feasibility study
Authors: Postol Nicola , Spratt Neil J. , Bivard Andrew , Marquez Jodie
Published: December 2021

Background

Evidence is emerging for the use of overground lower limb robotic exoskeletons in the rehabilitation of people with spinal cord injury (SCI), with suggested benefits for gait speed, bladder and bowel function, pain management and spasticity. To date, research has focused on devices that require the user to support themselves with a walking aid. This often precludes use by those with severe trunk, postural or upper limb deficits and places the user in a suboptimal, flexed standing position. Free-standing exoskeletons enable people with higher level injuries to exercise in an upright position. This study aimed to evaluate the feasibility of therapy with a free-standing exoskeleton for those with SCI, and to determine the potential health-related benefits of this intervention.

Methods

This 12-week intervention study with 12-week waitlist control and 12-week follow up, provided people with SCI scoring < 5 on the mobility section of the spinal cord independence measure (SCIM-III) twice weekly therapy in the REX (Rex Bionics, Auckland, NZ), a free-standing lower limb robotic exoskeleton. The primary outcome measure of interest was function, as measured on the SCIM-III. A battery of secondary outcomes was included. Participants also completed a survey on their perceptions of this treatment modality, to determine acceptability.

Results

Forty-one potential participants were screened for eligibility. Two females (one ASIA A, one ASIA C) and one male (ASIA B) completed all 24 intervention sessions, and the follow up assessment. One participant showed positive trends in function, fatigue, quality of life and mood during the intervention phase. Grip and quadriceps strength, and lower limb motor function improved in another. Two improved their percentage of lean body mass during the intervention phase. Remaining results were varied across patients, time points and outcomes. The intervention was highly acceptable to all participants.

Conclusion

With three of 41 potential participants being eligible and completing this study, our results show that there are potential benefits of exercise in a free-standing exoskeleton for people with severe mobility impairment due to SCI, for a small subset of patients. Further research is warranted to determine those most likely to benefit, and the type of benefit depending on the patient characteristics.

Trial registration The trial was registered prospectively on 20 April 2018 at www.anzctr.org.au/ (ACTRN12618000626268)
Identifying and modulating distinct tremor states through peripheral nerve stimulation in Parkinsonian rest tremor
Authors: Arruda Beatriz S. , Reis Carolina , Sermon James J. , Pogosyan Alek , Brown Peter , Cagnan Hayriye
Published: December 2021

Background

Resting tremor is one of the most common symptoms of Parkinson’s disease. Despite its high prevalence, resting tremor may not be as effectively treated with dopaminergic medication as other symptoms, and surgical treatments such as deep brain stimulation, which are effective in reducing tremor, have limited availability. Therefore, there is a clinical need for non-invasive interventions in order to provide tremor relief to a larger number of people with Parkinson’s disease. Here, we explore whether peripheral nerve stimulation can modulate resting tremor, and under what circumstances this might lead to tremor suppression.

Methods

We studied 10 people with Parkinson’s disease and rest tremor, to whom we delivered brief electrical pulses non-invasively to the median nerve of the most tremulous hand. Stimulation was phase-locked to limb acceleration in the axis with the biggest tremor-related excursion.

Results

We demonstrated that rest tremor in the hand could change from one pattern of oscillation to another in space. Median nerve stimulation was able to significantly reduce (− 36%) and amplify (117%) tremor when delivered at a certain phase. When the peripheral manifestation of tremor spontaneously changed, stimulation timing-dependent change in tremor severity could also alter during phase-locked peripheral nerve stimulation.

Conclusions

These results highlight that phase-locked peripheral nerve stimulation has the potential to reduce tremor. However, there can be multiple independent tremor oscillation patterns even within the same limb. Parameters of peripheral stimulation such as stimulation phase may need to be adjusted continuously in order to sustain systematic suppression of tremor amplitude.
Patient, carer, and staff perceptions of robotics in motor rehabilitation: a systematic review and qualitative meta-synthesis
Authors: Laparidou Despina , Curtis Ffion , Akanuwe Joseph , Goher Khaled , Niroshan Siriwardena A. , Kucukyilmaz Ayse
Published: December 2021

Background

In recent years, robotic rehabilitation devices have often been used for motor training. However, to date, no systematic reviews of qualitative studies exploring the end-user experiences of robotic devices in motor rehabilitation have been published. The aim of this study was to review end-users’ (patients, carers and healthcare professionals) experiences with robotic devices in motor rehabilitation, by conducting a systematic review and thematic meta-synthesis of qualitative studies concerning the users’ experiences with such robotic devices.

Methods

Qualitative studies and mixed-methods studies with a qualitative element were eligible for inclusion. Nine electronic databases were searched from inception to August 2020, supplemented with internet searches and forward and backward citation tracking from the included studies and review articles. Data were synthesised thematically following the Thomas and Harden approach. The CASP Qualitative Checklist was used to assess the quality of the included studies of this review.

Results

The search strategy identified a total of 13,556 citations and after removing duplicates and excluding citations based on title and abstract, and full text screening, 30 studies were included. All studies were considered of acceptable quality. We developed six analytical themes: logistic barriers; technological challenges; appeal and engagement; supportive interactions and relationships; benefits for physical, psychological, and social function(ing); and expanding and sustaining therapeutic options.

Conclusions

Despite experiencing technological and logistic challenges, participants found robotic devices acceptable, useful and beneficial (physically, psychologically, and socially), as well as fun and interesting. Having supportive relationships with significant others and positive therapeutic relationships with healthcare staff were considered the foundation for successful rehabilitation and recovery.
Dramatic radiotherapy response of a giant T4 cutaneous squamous cell carcinoma of the scalp with extensive bone destruction: a case report
Authors: Gruber Isabella , Koelbl Oliver
Published: December 2021

Background

Patients with large cutaneous squamous cell carcinoma of the scalp are a treatment challenge. We report a case of dramatic radiotherapy response of a patient with a giant cutaneous squamous cell carcinoma of the scalp with extensive skull destruction and suspected infiltration of the dura mater and superior sagittal sinus. This case is the first report of this kind in the literature that shows that large bone defects can heal with the resolution of tumor and inflammation by secondary intention without surgical reconstruction. We want to put an end to concerns about radiocurability of tumors with extensive bone involvement, and show sustained complete response after definitive radiotherapy and programmed cell death protein-1 inhibiting antibody therapy.

Case presentation

A 74-year-old White man presented with a 7.2 × 6.8 × 5.5 cm painless tumor on the right parietal region of the scalp. Medical imaging revealed widespread destruction of the skull and suspected infiltration of the dura mater and superior sagittal sinus. Biopsies showed cutaneous squamous cell carcinoma (cT4a cN0 cM0, stage IVA). The patient was treated with a total dose of 60 Gy, at 2 Gy per daily fraction with volumetric modulated arc therapy using 6 megavoltage photons. The biologically effective dose (alpha/beta 10 Gy) was 72 Gy. The tumor response correlated with dose received. The patient had a massive tumor necrosis secondary to tumor shrinkage after 18 fractions (36 Gy, biologically effective dose 43.2 Gy). Leakage of cerebrospinal fluid did not occur. Radiotherapy did not hamper the patient’s quality of life. The patient had a clear regression of the initial tumor on the final day of radiotherapy. The bone defect healed by secondary intention without surgical interventions. The patient achieved a complete response with a good cosmetic result after 82 days follow-up. He started a programmed cell death protein-1 inhibiting antibody therapy with cemiplimab 2 months after radiotherapy, and is now at 10 months follow-up without evidence of recurrence.

Conclusion

Definitive radiotherapy is a safe and highly effective therapy for giant tumors of the scalp with extensive bone destruction. We report a sustained complete response with a good cosmetic result after secondary wound healing.
Q estimation based on the logarithmic spectral area double difference
Authors: Cheng Wanli , Wang Shoudong , Zhou Chen , Yang Liuqing
Published: December 2021

The Q factor is an essential parameter describing the characteristics of medium absorption within a material during wave propagation. When a seismic wave propagates within the attenuating media, its amplitude decreases and frequency band narrows, resulting in a variation in its logarithmic spectral area. Based on these effects, we calculate the logarithmic spectral area difference (LSAD) before and after attenuation and set a division point to divide the LSAD into two parts. We then compute the difference between the two LSADs to derive a new Q-estimation formula based on computation of the logarithmic spectral area double difference. To improve the noise robustness of the Q estimation, we select multiple division points to calculate the Q factors and consider their average value as our final estimate. We then compare and analyze the noise robustness and bandwidth sensitivity of our technique with other commonly used methods. These results demonstrate that our approach is the most accurate and robust, and least sensitive to the frequency band when processing noisy synthetic seismograms. Finally, we apply our methodology to field vertical seismic profile and seismic reflection data, further illustrating the effectiveness of this method to estimate the Q factor.
Nonsurgical Management of Thyroid Nodules: The Role of Ablative Therapies
Authors: Stan Marius N , Papaleontiou Maria , Schmitz John J , Castro M Regina
Published: December 2021

Context

After a thorough evaluation most thyroid nodules are deemed of no clinical consequence and can be observed. However, when they are compressive, toxic, or involved by papillary thyroid carcinoma surgery or radioactive iodine (RAI) (if toxic) are the treatments of choice. Both interventions can lead to hypothyroidism and other adverse outcomes (eg, scar, dysphonia, logistical limitation with RAI). Active surveillance might be used for papillary thyroid microcarcinoma (PTMC) initially, but anxiety leads many cases to surgery later. Several ablative therapies have thus evolved over the last few years aimed at treating these nodules while avoiding described risks.

Cases

We present 4 cases of thyroid lesions causing concern (compressive symptoms, thyrotoxicosis, anxiety with active surveillance of PTMC). The common denominator is patients’ attempt to preserve thyroid function, bringing into focus percutaneous ethanol injection (PEI) and thermal ablation techniques (radiofrequency ablation [RFA] being the most common). We discuss the evidence supporting these approaches and compare them with standard therapy, where evidence exists. We discuss additional considerations for the utilization of these therapies, their side-effects, and conclude with a simplified description of how these procedures are performed.

Conclusion

Thermal ablation, particularly RFA, is becoming an attractive option for managing a subgroup of solid thyroid nodules, while PEI has a role in managing thyroid cysts and a select group of PTMC. Their role in the algorithm of thyroid nodule management is still being refined and technical expertise will be essential to reproduce the reported results into everyday practice.
Hypothalamic Kisspeptin Neurons and the Control of Homeostasis
Authors: Rønnekleiv Oline K , Qiu Jian , Kelly Martin J
Published: December 2021

Hypothalamic kisspeptin (Kiss1) neurons provide indispensable excitatory transmission to gonadotropin-releasing hormone (GnRH) neurons for the coordinated release of gonadotropins, estrous cyclicity, and ovulation. But maintaining reproductive functions is metabolically demanding so there must be a coordination with multiple homeostatic functions, and it is apparent that Kiss1 neurons play that role. There are 2 distinct populations of hypothalamic Kiss1 neurons, namely arcuate nucleus (Kiss1ARH) neurons and anteroventral periventricular and periventricular nucleus (Kiss1AVPV/PeN) neurons in rodents, both of which excite GnRH neurons via kisspeptin release but are differentially regulated by ovarian steroids. Estradiol (E2) increases the expression of kisspeptin in Kiss1AVPV/PeN neurons but decreases its expression in Kiss1ARH neurons. Also, Kiss1ARH neurons coexpress glutamate and Kiss1AVPV/PeN neurons coexpress gamma aminobutyric acid (GABA), both of which are upregulated by E2 in females. Also, Kiss1ARH neurons express critical metabolic hormone receptors, and these neurons are excited by insulin and leptin during the fed state. Moreover, Kiss1ARH neurons project to and excite the anorexigenic proopiomelanocortin neurons but inhibit the orexigenic neuropeptide Y/Agouti-related peptide neurons, highlighting their role in regulating feeding behavior. Kiss1ARH and Kiss1AVPV/PeN neurons also project to the preautonomic paraventricular nucleus (satiety) neurons and the dorsomedial nucleus (energy expenditure) neurons to differentially regulate their function via glutamate and GABA release, respectively. Therefore, this review will address not only how Kiss1 neurons govern GnRH release, but how they control other homeostatic functions through their peptidergic, glutamatergic and GABAergic synaptic connections, providing further evidence that Kiss1 neurons are the key neurons coordinating energy states with reproduction.
Bone Age Maturation and Growth Outcomes in Young Children with CAH Treated with Hydrocortisone Suspension
Authors: Al-Rayess Heba , Addo O Yaw , Palzer Elise , Jaber Mu’taz , Fleissner Kristin , Hodges James , Brundage Richard , Miller Bradley S , Sarafoglou Kyriakie
Published: December 2021

Background

Young children with congenital adrenal hyperplasia (CAH) require small doses (0.1-1.25 mg) of hydrocortisone (HC) to control excess androgen production and avoid the negative effects of overtreatment. The smallest commercially available HC formulation, before the recent US Food and Drug Administration approval of HC granules, was a scored 5-mg tablet. The options to achieve small doses were limited to using a pharmacy-compounded suspension, which the CAH Clinical Practice Guidelines recommended against, or splitting tablets into quarters or eighths, or dissolving tablets into water.

Methods

Cross-sectional chart review of 130 children with classic CAH treated with tablets vs a pharmacy-compounded alcohol-free hydrocortisone suspension to compare growth, weight, skeletal maturation, total daily HC dose, and exposure over the first 4 years of life.

Results

No significant differences were found in height, weight, or body mass index z-scores at 4 years, and in predicted adult height, before or after adjusting for age at diagnosis and sex. Bone age z-scores averaged 2.8 SDs lower for patients on HC suspension compared with HC tablets (P < 0.001) after adjusting for age at diagnosis and sex. The suspension group received 30.4% lower (P > 0.001) average cumulative HC doses by their fourth birthday.

Conclusions

Our data indicate that treatment with alcohol-free HC suspension decreased androgen exposure as shown by lower bone age z-scores, allowed lower average and cumulative daily HC dose compared to HC tablets, and generated no significant differences in SDS in growth parameters in children with CAH at 4 years of age. Longitudinal studies of treating with smaller HC doses during childhood are needed.
Analysis of Penrose’s Second Argument Formalised in DTK System
Authors: Corradini Antonella , Galvan Sergio
Published: December 2021

This article aims to examine Koellner’s reconstruction of Penrose’s second argument – a reconstruction that uses the DTK system to deal with Gödel’s disjunction issues. Koellner states that Penrose’s argument is unsound, because it contains two illegitimate steps. He contends that the formulas to which the T-intro and K-intro rules apply are both indeterminate. However, we intend to show that we can correctly interpret the formulas on the set of arithmetic formulas, and that, as a consequence, the two steps become legitimate. Nevertheless, the argument remains partially inconclusive. More precisely, the argument does not reach a result that shows there is no formalism capable of deriving all the true arithmetic propositions known to man. Instead, it shows that, if such formalism exists, there is at least one true non-arithmetic proposition known to the human mind that we cannot derive from the formalism in question. Finally, we reflect on the idealised character of the DTK system. These reflections highlight the limits of human knowledge, and, at the same time, its irreducibility to computation.
S5-Style Non-Standard Modalities in a Hypersequent Framework
Authors: Petrukhin Yaroslav
Published: December 2021

The aim of the paper is to present some non-standard modalities (such as non-contingency, contingency, essence and accident) based on S5-models in a framework of cut-free hypersequent calculi. We also study negated modalities, i.e. negated necessity and negated possibility, which produce paraconsistent and paracomplete negations respectively. As a basis for our calculi, we use Restall's cut-free hypersequent calculus for S5. We modify its rules for the above-mentioned modalities and prove strong soundness and completeness theorems by a Hintikka-style argument. As a consequence, we obtain a cut admissibility theorem. Finally, we present a constructive syntactic proof of cut elimination theorem.
History of Relating Logic. The Origin and Research Directions
Authors: Klonowski Mateusz
Published: December 2021

In this paper, we present the history of and the research directions in relating logic. For this purpose we will describe Epstein's Programme, which postulates accounting for the content of sentences in logical research. We will focus on analysing the content relationship and Epstein's logics that are based on it, which are special cases of relating logic. Moreover, the set-assignment semantics will be discussed. Next, the Torunian Programme of Relating Semantics will be presented; this programme explores the various non-logical relationships in logical research, including those which are content-related. We will present a general description of relating logic and semantics as well as the most prominent issues regarding the Torunian Programme, including some of its special cases and the results achieved to date.
Dynamic Probabilistic Entailment. Improving on Adams' Dynamic Entailment Relation
Authors: Van Rooij Robert , Mirabile Patricia
Published: December 2021

The inferences of contraposition (A ⇒ C ∴ ¬C ⇒ ¬A), the hypothetical syllogism (A ⇒ B, B ⇒ C ∴ A ⇒ C), and others are widely seen as unacceptable for counterfactual conditionals. Adams convincingly argued, however, that these inferences are unacceptable for indicative conditionals as well. He argued that an indicative conditional of form A ⇒ C has assertability conditions instead of truth conditions, and that their assertability ‘goes with’ the conditional probability p(C|A). To account for inferences, Adams developed the notion of probabilistic entailment as an extension of classical entailment. This combined approach (correctly) predicts that contraposition and the hypothetical syllogism are invalid inferences. Perhaps less well-known, however, is that the approach also predicts that the unconditional counterparts of these inferences, e.g., modus tollens (A ⇒ C, ¬C ∴ ¬A), and iterated modus ponens (A ⇒ B, B ⇒ C, A ∴ C) are predicted to be valid. We will argue both by example and by calling to the results from a behavioral experiment (N = 159) that these latter predictions are incorrect if the unconditional premises in these inferences are seen as new information. Then we will discuss Adams’ (1998) dynamic probabilistic entailment relation, and argue that it is problematic. Finally, it will be shown how his dynamic entailment relation can be improved such that the incongruence predicted by Adams’ original system concerning conditionals and their unconditional counterparts are overcome. Finally, it will be argued that the idea behind this new notion of entailment is of more general relevance.
Family practices, deportability and administrative violence: an ethnographic study on asylum seekers’ family life in the Swedish migration context
Authors: Andreasson Jesper , Herz Marcus
Published: December 2021

Utilising data gathered through ethnographic fieldwork this article investigates (a) how asylum seekers portray family life in relation to their decision to flee their country of origin, and (b) how asylum seekers’ ways of doing family life intersect with the Swedish migration context. Analytically, the article leans on sociologically informed theories of family practices and a conceptual discussion on deportability. The results show how family life among the participants is reconstituted both in terms of geographical closeness and distance, and in terms of ideas about a previous family life in the country of origin and hopes for a possible future in Sweden. The insecurity and the strains placed on people and their family bonds by current migration policies, and the risk of deportation, are interpreted as a specific form of administrative violence that cuts into family practices, serving to maintain physical and emotional distance between family members and break down social bonds.
Impact of L-carnitine supplementation on the in vitro developmental competence and cryotolerance of buffalo embryos
Authors: El-Sokary Mohamed M. M. , El-Naby Al-Shimaa Al-H. H. , El Hameed Amal R. Abd , Mahmoud Karima Gh. M. , Scholkamy T. H.
Published: December 2021

Background and Aim: Despite many trials, buffalo embryos have poor cryosurvivability because of their high lipid content. L-carnitine was found to be a lipid-reducing agent when added to oocyte and embryo culture media. The study aimed to determine the most effective concentration of L-carnitine to improve the oocyte developmental competence and cryotolerance of buffalo embryos.

Materials and Methods: In vitro maturation and embryo culture media were supplemented with four concentrations of L-carnitine: 0 (control), 0.25, 0.5, and 1 mM. Good-quality embryos on 7 days were vitrified using mixtures of dimethyl sulfoxide and ethylene glycol at two concentrations (3.5 and 7 M).

Results: The result showed that the cleavage and morula rates were significantly (p<0.05) higher in the 0.5 mM group. Blastocyst rates were significantly (p<0.05) higher at both 0.5 and 1 mM. The rates of viable embryos directly after thawing were significantly (p<0.05) increased in the 0.5 mM group. No significant difference was found in embryos cultured for 24 h after warming among all the groups.

Conclusion: The addition of L-carnitine at a concentration of 0.5 mM to the culture media improves the oocyte developmental competence and cryotolerance of buffalo embryos directly after warming but not after 24 h of culture. Nevertheless, further studies must identify how L-carnitine exerts its beneficial micromechanisms.
Increasing the Learning Result of Early Mathematics Odd and Even Numbers through Montessori "Cards and Counters" Activity: A Quasi-experimental Study
Authors: Darnis Syefriani , Dodd Jaime
Published: December 2021

Purpose – This study aims to obtain information about the effect of using the Montessori cards and counters’ mathematics activity on learning the result of odd and even numbers of 1 to 10 to the kindergarten students at the age of 4 to 5 years.Design/methods/approach – Quantitative research with a quasi-experimental model of non-equivalent control group design was carried out by applying conventional methods (lectures and giving questions by worksheets) to the control group and applying the Montessori learning model through the use of Cards and Counters apparatus in the experimental group with 30 samples of students, divided into two classes (control class and experiment class) at Kalyca Azzahra School, West Java, Indonesia.Findings – The result showed that students who used the Montessori Mathematics cards and counters achieved higher mathematics odd and even numbers are learning results than those who were not taught with the Montessori approach.Research implications/limitations – This research design used pre-test and post-test. Thus, the treatment results can be more accurate because they can be compared before and after treatment.Practical implications – The use of the Montessori apparatus becomes necessary in introducing early mathematics to children and attracting children’s attention to learn and facilitate teachers in teaching mathematics. Displaying the concrete objects as a medium will help teachers in teaching early mathematics to children. The cards and counters allow children to verify their understanding of the concept by matching the qualitative, concrete, quantitative, or abstract before slowly removing the concrete altogether.Originality/value – This research contributes to understanding learning strategies used in Early Mathematics, Odd and Even Numbers. The Montessori apparatus becomes more natural to understand it by the child’s cognitive development effortlessly.

Paper type Research paper