bluuebunny/crossref_metadata_2025 huggingface dataset:
Fostering Inclusive Recruitment Interviews with Intelligent Digital Humans
Authors: Salvetti Fernando , Bertagni Barbara , Contardo Ianna
Published: May 2024

This article is about an intelligent digital human model enhanced by artificial intelligence, designed to meet the requirements from a multinational company in need of training for their human resources personnel on bias-free recruitment interviews. We have been creating a new generation of avatars with social intelligence, who are capable not only of presenting a wide variety of topics in a dynamic and engaging manner, but also of interacting with the audience and communicating emotions and moods. We have been customizing avatars for role plays, building them as real interlocutors who facilitate training in how to handle difficult conversations by including aspects such as non-verbal communication, different communication styles, and diversity and inclusion. Practicing conversations with avatars accelerates learning from experience without the risks associated with learning in the field. At the end of each interview, timely feedback is provided so learners can determine how to improve their performance. These digital humans are able to perform like realistic human beings, challenging the interviewer both at a verbal and para-verbal level, as well on the cognitive and the emotional levels – making it easy for the interviewer to get trapped into biases and false assumptions. The key message is this: diversity and inclusion best practices are first of all about mindset.
Fostering Diversity and Inclusion in Medicine: Collaborating with Extended Reality and Medical Simulation in the Metaverse
Authors: Salvetti Fernando , Gardner Roxane , Rudolph Jenny , Minehart Rebecca , Bertagni Barbara , Contardo Ianna
Published: May 2024

Metaverse is a term used to describe a hypothetical shared virtual space where people can interact with a computer-generated environment and each other, and there are multiple metaverses currently being developed by various companies and organizations. Cooperation in the metaverse is at the core of the ongoing digital revolution that impacts the way we design and deliver overall education and training. Medical simulation is a powerful way to deliver education and training, based on the use of technology and other techniques to recreate clinical scenarios for the purpose of teaching and training healthcare professionals and students. This article is about how to involve learners in a metaverse within the medical simulation field. The key questions that we address are as follows: What is the metaverse today? What will it look like in a few years? How do we enhance medical simulation based on cooperation in the metaverse? How do we engage learners with diversity and inclusion?
Collaborative Learning of Macroeconomics Through the Lens of Universal Design for Learning (UDL)
Authors: Ganguli Subhadra
Published: May 2024

The paper shows that implementation of Universal Design for Learning (UDL) for collaborative learning through teams in a Macroeconomics course can help to transform students’ educational experience to become lifelong learners. The UDL uses a portfolio of assessments in the course and team presentation happens to be one of them. In this paper students form teams through self-selection exercise and work in teams throughout the semester to produce and present research outcomes of analyzing macroeconomic policy in a globally connected world. The presentation requires students to apply their learning of country specific macroeconomic issues on global policy decisions. This enables transforming classroom learning into an immersive experience for future career choices of students developing transferable skills in the process.
Certainty-Based Self-Assessment in Higher Education
Authors: Remesal Ana , García-Mínguez Patricio , Domínguez Judit , Corral María José
Published: May 2024

This study explores students’ behavior in response to a study-learning system during one semester at university, based on the certainty-based marking strategy. The learning support system pursues to encourage diagnostic formative self-assessment. In total, 258 students complete the full study program and respond to an additional sociodemographic questionnaire. An exploratory study was performed. Two individual variables were considered for basic statistical analysis: gender and prior academic experience. Results show progression of students’ confident responses, especially by the third trial. No differences were found with respect to gender. In contrast, strong differences were found related to prior academic experience. These latter results must be taken carefully, in expectance of further research to look for connections with other individual variables.
Stanley Milgram’s Obedience Studies: An Ethical and Methodological Assessment
Authors: Russell Nestar
Published: May 2024

With the opening of Milgram’s personal archive, from the mid-1990s there has been a “second wave” of literature on the Obedience Studies. Some of this literature convincingly suggests Milgram’s research is so ethically and methodologically problematic that it does not deserve the enormous attention it receives. At the other end of the spectrum, some scholars argue there is still much to be learnt from these experiments. With such divergent (contradictory?) views, what is one to believe? After reviewing this literature, this article addresses two questions: are the Obedience Studies unethical and do they remain methodologically valid? This article concludes that although the Obedience Studies are, for many reasons, highly unethical, they remain methodologically valid. It also concludes that it is because of Milgram’s unethical practices that his research remains so relevant to the world beyond his laboratory walls.
Engineering Dimeric EGFR-directed IgA Antibodies Reveals a Central Role of CD147 during Neutrophil-mediated Tumor Cell Killing of Head and Neck Squamous Cancer Cells
Authors: Zwick Anabel , Braun Felix Leon , Weber Lennert Jochen , Linder Manuel , Linxweiler Maximilian , Lohse Stefan
Published: May 2024

Human IgA Abs engage neutrophils for cancer immunotherapy more effectively than IgG Abs. Previous studies demonstrated that engineering approaches improved biochemical and functional properties. In this study, we report a novel, to our knowledge, IgA2 Ab against the epidermal growth factor receptor generated by protein engineering and polymerization. The resulting molecule demonstrated a covalent linkage of L and H chains and an effective polymerization by the joining chain. The engineered dimer outperformed its monomeric variant in functional experiments on Fab-mediated modes of action and binding to the Fc receptor. The capacity to engage neutrophils for Ab-dependent cell-mediated cytotoxicity (ADCC) of adherent growing target cancer cells was cell line dependent. Although the engineered dimer displayed a long-term efficacy against the vulva carcinoma cell line A431, there was a notable in-efficacy against human papillomavirus (HPV)− head and neck squamous cell carcinoma (HNSCC) cell lines. However, the highly engineered IgA Abs triggered a neutrophil-mediated cytotoxicity against HPV+ HNSCC cell lines. Short-term ADCC efficacy correlated with the target cells’ epidermal growth factor receptor expression and the ability of cancer cell–conditioned media to enhance the CD147 surface level on neutrophils. Notably, the HPV+ HNSCC cell lines demonstrated a significant increment in releasing soluble CD147 and a reduced induction of membranous CD147 on neutrophils compared with HPV− cells. Although membranous CD147 on neutrophils may impair proper IgA–Fc receptor binding, soluble CD147 enhanced the IgA–neutrophil-mediated ADCC in a dose-dependent manner. Thus, engineering IgA Abs and impedance-based ADCC assays provided valuable information regarding the target–effector cell interaction and identified CD147 as a putative critical parameter for neutrophil-mediated cytotoxicity.
UMA DOAÇÃO CENTENÁRIA. O MISTÉRIO DAS AMOSTRAS BRASILEIRAS NA COLEÇÃO GEOLÓGICA DO “REAL COLLEGIO CARLO ALBERTO DI MONCALIERI”, TURIM, ITÁLIA
Authors: Pane Vittorio , Fernandes Antonio Carlos Sequeira , Silva Rafael Costa da
Published: May 2024

A centennial donation. The mystery of the Brazilian samples in the geological collection of the Real Collegio di Moncalieri, Turin, Italy. A curatorial investigation conducted at the geological collections of the Real Collegio Carlo Alberto in Moncalieri, Turin, Italy, revealed the presence of minerals and rocks from Brazil that were once part of the former Serviço Geológico e Mineralógico do Brasil (Brazilian Geological and Mineralogical Survey). Twenty-eight samples were identified through typed labels in Portuguese, indicating the association with the “Serviço Geológico e Mineralógico do Brasil,” sequential numbers assigned within a collection, sample identification, and the respective locality of origin. The absence of primary documentation raises questions about the origin of the Brazilian collection at the Real Collegio. However, further investigation into the annual reports of the Brazilian survey uncovered that, in 1927, a collection of 140 minerals was dispatched to the Brazilian embassy in Rome. No additional information in subsequent reports regarding the dispatch of collections to Italy by the Brazilian survey led the authors to conclude that the samples sent to the Brazilian embassy in Rome in 1927 are the same collection discovered at the Real Collegio Carlo Alberto in Moncalieri. Keywords: Mineralogical colection, Real Collegio Carlo Alberto, Brazilian Geological and Mineralogical Survey
Complete revascularization in coronary artery bypass grafting with coronary artery endarterectomy: updated findings from Vietnam
Authors: Nguyen Huu Cong , Doan Hung Quoc , Ngo Linh Hai T. , Nguyen Uoc Huu , Vo Long Hoang , Le Thanh Ngoc
Published: May 2024

We examined the technique and early outcomes of coronary artery bypass graft surgery (CABG) with endarterectomy. In 2023, the single-center database identified 24 severe coronary disease patients undergoing CABG with coronary artery endarterectomy. The patients were in a selected cohort with a minimum of three grafts for the three main vessels. Patients’ mean age was 63.8 years. The mean number of grafts was 4.3. A coronary endarterectomy (CE) was performed on the right coronary artery in 45.8% of patients, the left anterior descending artery in 29.1%, the circumflex artery in 16.6%, and the diagonal artery in 29.1%. Aortic cross-clamp took 147.2 minutes, perfusion 180.9 minutes, mechanical ventilation 18.9 hours, and intensive care unit stay 4.8 days. Our in-hospital mortality rate was 8.3% with no technical complications. To achieve complete revascularization in patients with extensive coronary artery disease, CE should be considered an acceptable adjunct to CABG.
Comparative Evaluation of Antitumor Chinese Patent Medicine Injections Based on Evidence-Based Medicine and Markov Model
Authors: Yang Jing , Wang Yan-Peng , Yu Wen-Gong , Guan Yu-Yao , Amponsah Prince Emmanuel Opoku , Tang Xian-Shuai , Sun Ying-Zi , Zheng Lei
Published: May 2024

Objective:

The objective of this study was to explore the safety, efficacy, economy, and other aspects of frequently-used antitumor Chinese patent medicine injections through a comprehensive evaluation of evidence-based medical research to provide scientific information and decision-making basis for drug selection, rational drug use, public awareness of safe drug use, and medical insurance.

Materials and Methods:

The names of five frequently used antitumor Chinese patent medicine injections were used as search terms, including the compound Sophora flavescens injection, Kangai injection, Aidi injection, Kanglaite injection, and Brucea javanica oil emulsion injection. Relevant evidence-based medical research was extracted from the databases. A descriptive evaluation was conducted, and the Markov model was used for the cost-benefit analysis. Finally, the above injections are ranked by comprehensive scores using the multi-criteria decision analysis and Delphi method.

Results:

The five injections had their own advantages in enhancing the effectiveness of anti-tumor treatments, improving the quality of life for cancer patients, and reducing the incidence of adverse reactions. From the perspective of economy and other attributes, compound S. flavescens was superior to B. javanica oil, Aidi, Kangai, and Kanglaite. After a comprehensive evaluation of the above five injections, the compound S. flavescens injection received the highest score.

Conclusions:

Compound S. flavescens, Kangai, Aidi, B. javanica oil, and Kanglaite have their own advantages in effectiveness and no significant difference in safety. Compound S. flavescens injection has the highest comprehensive score. Clinical attention should be paid to monitoring the initial stage of medication and special groups.
Alteration of T-cell and monocyte subsets in patients with immune thrombocytopenia: glucocorticoids versus immunosuppressant drugs
Authors: Nafady Asmaa , Nafady-Hego Hanaa , Shhata Nada A , El Khalek Fatma A , Ahmed Shimaa A , Elsaied Abdelrahman A
Published: May 2024

Background

Several therapy approaches are currently in use, each focusing on a different element of primary immune thrombocytopenia (ITP) pathogenesis. Human T-lymphocytes and monocytes are heterogeneous and play an important role in autoimmune diseases. However, the distribution and function of mononuclear cells remain unclear in ITP after therapy.

Aim

To evaluate the effect of glucocorticoid hormones and other immunosuppressant drugs in patients with ITP on lymphocyte and monocyte subsets and correlate changes between drug responders and nonresponders.

Patients and methods

A randomized cross-sectional case–control study was conducted on 130 participants, who were divided into two groups: 50 patients with ITP and 80 healthy controls. The patients were randomly treated with either steroids, azathioprine, or revolade in the Department of Internal Medicine of Qena University Hospital between April 2021 and April 2022. The research was conducted at the Department of Clinical Pathology of Qena University Hospital.

Results

Treatment with steroids, azathioprine, or revolade showed increased CD3-expressing cells and improved platelets and platelet/lymphocyte ratios. Steroid therapy also increased hemoglobin levels, leukocyte numbers, neutrophil counts, monocyte counts, and monocyte–lymphocyte ratios. Leukocyte count was increased by azathioprine treatment, whereas leukocyte, neutrophil, and monocyte/lymphocyte counts were increased by revolade treatment. Azithromycin and revolade therapy decreased CD14 count and increased CD16 fraction. Azithromycin treatment increased CD4 cells, whereas steroid treatment boosted CD8 cells. Additionally, in comparison with controls, patients had considerably less classical monocytes. However, patients had significantly more nonclassical monocytes and intermediate than controls did. Nonclassical and intermediate monocytes showed a significant reduction. Treatment responders were much older than nonresponders. The hazard ratio of monocyte/lymphocyte ratio was 0.002 (95% confidence interval: 0–0.55) and for neutrophil/lymphocyte ratio was 1.82 (95% confidence interval: 1.04–3.16), with P values of 0.04 and 0.03, respectively.

Conclusion

The modification of monocytes and lymphocytes in ITP following treatment can provide insight into the significance of these cells and the likelihood of using it to monitor patients while they are receiving treatment.
Semiquantitative measurements of standardized uptake value in assessment of response and outcomes in patients with lymphoma
Authors: Al-Agizy Hagar A , Tawfek Eman A , Abd El-Ghany Ashraf E , Ahmed Mohamed E , Hebesh Eman H , Gohar Suzy F
Published: May 2024

Objectives

To evaluate the accuracy of semiquantitative measurements of standardized uptake value (ΔSUVmax) in the assessment of response to treatment in patients with lymphoma.

Background

Positron emission tomography (PET) with 2-[18 F]-fluoro-2-deoxy-D-glucose is an essential tool for accurate staging and early and late therapy response assessments in all 2-[18 F]-fluoro-2-deoxy-D-glucose -avid histologies.

Patients and methods

The study included 73 patients diagnosed as having diffuse large B-cell lymphoma or Hodgkin’s disease. PET/CT examinations were performed at baseline (PET0), then after 2 cycles of chemotherapy (PET 2), and after 4 cycles of chemotherapy (PET4). PET scans were analyzed according to Deauville five-point scale, and cutoff values for changes in the maximum standardized uptake value (SUVmax). The change in activity (ΔSUV) from initial (SUVmax1) to later scans (SUVmax2) was calculated. Biopsy was also taken when PET4 was visually positive but delta SUVmax was negative or in case of new lesions if other sites have improved.

Results

In comparison with the results of biopsy, ΔSUV0-2 had 80% sensitivity, 94.1% specificity, and 90.91% accuracy, with significant P value of 0.001. Moreover, ΔSUV0–4 had sensitivity of 80%, specificity of 100%, and accuracy of 95.45%, with high agreement k(P) 0.861 with significant P value less than 0.001. On the contrary, the visual five-point scale analysis specificity was 17.65% and accuracy was 36.36%, with insignificant P value less than 0.321. Neither the Deauville criteria nor ΔSUVmax was significantly associated with time to progression and overall survival.

Conclusion

ΔSUVmax is comparable to biopsy and significantly more accurate than Deauville criteria in response assessment to chemotherapy.
Diagnostic value and biological significance of CD71 in lymphoid disorders
Authors: Mahmoud Maged S , Eldeen Taghreed M K , Fahmy Marwa A E S
Published: May 2024

Background

The CD71 expression is tightly regulated by intracellular iron level, cell proliferation, or erythropoiesis at levels of receptor recycling, as well as transcriptional or posttranscriptional control. In the previous studies, CD71 was expressed by most of acute leukemia and chronic granulocytic leukemia in blast crisis with a variable density of expression. Only few studies have observed CD71 as a diagnostic and prognostic marker in cases of acute lymphocytic leukemia (ALL) as a type of acute leukemia. Therefore, our study aimed to evaluate the diagnostic and biological significance of CD71 in lymphoid disorders.

Aim and objectives

This study aimed to evaluate the diagnostic value and biological significance of CD71 in lymphoid disorders.

Patients and methods

The present research was carried out on 60 patients diagnosed with lymphoid disorders (benign lymphocytosis, ALL, CLL, lymphoma, and multiple myeloma) who presented to Assiut University Hospital from July 2020 till July 2021.

Results

CD71 expression was significantly higher in acute disorders (immature cell-type tumors of malignant lymphoid disorders) than in benign lymphocytosis and chronic disorders (immature cell-type tumors of malignant lymphoid disorders), with strong relation with the positivity of CD34 and TdT.

Conclusion

CD71 helps to differentiate between lymphoid disorders and further helps in discriminating the differentiation status of ALL. High expression of CD71 might reflect a much more aggressive and immature cell type. However, further prospective investigations are needed to document the possible relation of CD71 with response to treatment and relapse rate. Moreover, high expression of CD71 with clonal evolution in leukemia may predict the possibility of being an important molecular target in future therapy of acute leukemia.
Clinical utility of red blood cell distribution width in patients with systemic lupus erythematosus
Authors: Elbadry Haridy Alaa A M , Abd-Elwahab Nadia M , Abdou Madleen Adel A , Abd Elsamea Mona H
Published: May 2024

Aim

To investigate the value of red blood cell distribution width (RDW) as a biomarker of activity in patients with systemic lupus erythematosus (SLE) and its relationship with disease activity and severity.

Patients and methods

A total of 50 patients with SLE and 46 healthy controls were included. Complete blood count (CBC), antinuclear antibodies, antidouble-stranded DNA antibodies, complement 3, systemic lupus erythematosus disease activity index, and Systemic Lupus International Collaborating Clinics/American college of rheumatology damage index were assessed in patients with SLE.

Results

The mean age of SLE was 31.12 ± 8.68 years, and the majority of studied participants were females. RDW was significantly higher in patients with SLE compared with healthy controls (15.42 ± 2 vs. 13.57 ± 0.78; P=0.000). In patients with active SLE, the RDW was significantly higher than in those with inactive disease (15.86 ± 2.25 vs. 14.38 ± 1.78; P=0.032). At a cutoff value of greater than 14.6, RDW can indicate active SLE disease with sensitivity and specificity of 65.7 and 60.0%, respectively. The area under the curve was 0.692, with P=0.033.

Conclusion

The RDW was significantly high in patients with SLE compared with healthy controls, and these high levels were associated with disease activity.
Predictive utility of plasma fibrinogen level in B-cell lymphoma: a single-center cohort study
Authors: Tarek Nada , Younes Soha , Suliman Marwa A , Ibrahim Gehan A
Published: May 2024

Background

Recent reports have demonstrated an association between high fibrinogen levels and the prognosis of patients with B-cell lymphoma; still, the current evidence is inconclusive. Thus, we assessed the association between plasma fibrinogen level and the treatment response of B-cell lymphoma patients.

Patients and methods

In this descriptive cohort study, newly diagnosed B-cell lymphoma patients who attended a tertiary hospital were included and followed up after treatment. Plasma fibrinogen level was assessed at baseline and at6 months after treatment.

Results

Twenty-six patients were included. The pretreatment fibrinogen level (496.9 ± 177.2) was significantly higher than the posttreatment (357.9 ± 165.7) (P<0.05). Cases with response to treatment had significantly lower fibrinogen levels (pretreatment and posttreatment) than cases without response to treatment (P<0.05). The plasma pretreatment fibrinogen had significant predictive value for response to treatment at a cutoff level less than or equal to 597 mg/dl, with a sensitivity of 100% and specificity of 57.1%. Likewise, the posttreatment fibrinogen had significant predictive value for response to treatment at a cutoff level less than or equal to 342 mg/dl, with a sensitivity of 91.7% and specificity of 71.4%.

Conclusion

Fibrinogen is a simple, affordable, and highly sensitive biomarker for patients with B-cell lymphoma. Elevate plasma fibrinogen is associated with worse clinical outcomes in patients with B-cell lymphoma. Further multicentric studies with larger sample sizes and longer duration of follow-ups are required to validate these findings.
Predictors of survival in the Egyptian patients with primary myelofibrosis: a single-center prospective cohort study
Authors: Abdallah Ghada E M , Aziz Maha A , Nafady Howaida , Thabet Marwa , Hussein Safinaz
Published: May 2024

Background

Primary myelofibrosis (PMF) is a clonal hematological myeloproliferative neoplasm distinguished by poor prognosis and reduced life expectancy. This study aimed to detect the overall survival (OS) in patients with PMF and assess the factors affecting clinical outcomes.

Aim

To assess factors affecting OS in patients with PMF.

Design and Methods

A prospective cohort study included 73 patients with PMF. The dynamic international prognostic scoring system (DIPSS) score was calculated for risk stratification. Age, DIPSS score, excess circulating blast,JAK2 V617Fmutation, bleeding, and thrombosis complications were correlated with OS.

Results

The median age of our participants at diagnosis was 55 years. TheJAK2 V617Fmutation was positive in 26 (35%) patients. Our patients were classified according to the DIPSS score into intermediate-1, with 21 (28.77%); intermediate-2, with 43 (58.9%) patients; and high, with nine (12.33%) patients. The Kaplan–Meier curve was used to calculate time-to-death curves, which were compared by the log-rank tests. The Cox regression test was done to recognize risk factors for the OS. Age and excess peripheral blast cells were negative predictors of survival outcome (P=0.012 and 0.005, respectively).

Conclusion

Advanced age and excess peripheral blast cells are predictors of inferior survival outcomes in patients with PMF.
Polymorphisms of the DNA repair genes (APE1, XPD, and RAD51) and the risk of developing cytogenetic abnormalities in a cohort of Egyptian patients with newly diagnosed AML
Authors: El-Noshokaty Essam H , Ebid Gamal T , Ayoub Mahmoud A , Gawdat Rania M
Published: May 2024

Background

Genetic alterations of the DNA repair genes might decrease the efficiency of DNA repair mechanisms and increase susceptibility to cancers such as acute myeloid leukemia (AML).

Objectives

The purpose of the present study was to detect the association of APE1Asp148Glu; rs1130409, XPD Lys751Gln;rs13181 & RAD51 G135C;rs1801320 polymorphisms with the risk of developing abnormal cytogenetics in a sample of newly diagnosed AML Egyptian patients.

Methods:

The target genetic polymorphisms were determined by polymerase chain reaction and restriction fragment length polymorphism (PCR –RFLP) in 101 AML blood samples comprising 70 cases with normal cytogenetics and 31 cases with abnormal cytogenetics.

Results:

The genotypic variants of APE1Asp148Glu; rs1130409 polymorphism (T/G,G/G,T/G+G/G) were significantly associated with cytogenetic abnormalities than normal cytogenetics in the studied de novo AML cases {P-0.022,OR:3.463,95%CI:1.199-10.002;P-0.042,OR:3.85,95%CI:1.049-14.124;P-0.01,OR:3.568,95%CI:1.299-9.797}, respectively. The combined APE1 mutants (T/G+G/G) were more likely to be associated with t(15;17){P-value0.02,OR:10.08,95%CI:1.23-82.41}. The association of XPD Lys751Gln combined mutants (A/C+C/C) and RAD1 G135C(G/C+C/C) in AML cases with abnormal cytogenetics were not significantly different from those with normal cytogenetics.

Conclusions:

APE1Asp148Glu; rs1130409 polymorphism in AML may be associated with the development of favourable cytogenetic abnormalities, especially t(15; 17) .This association might affect AML prognosis but further large sample studies including AML cases with adverse cytogenetics should be performed.
Prognostic value of serum vimentin in adult Egyptian patients with acute lymphoblastic leukemia
Authors: Naguib Meleak Mary G , El-Metwally Reham A , Azzazi Mohamed O , Moussa Mohamed M , El-Ghammaz Amro M S , Mohamed Haydi S
Published: May 2024

Background

Vimentin is a type III intermediate filament protein that is normally expressed in mesenchymal cells. Vimentin is recognized as a marker of epithelial–mesenchymal transition. It is overexpressed in cancer cells such as breast cancer, prostate cancer, melanoma, and gastrointestinal cancers. It plays an important role in tumor growth, invasion, and metastatic progression. Its role in hematological malignancy is still under investigation.

Aim

To measure serum vimentin level in the peripheral blood of adult patients with acute lymphoblastic leukemia (ALL) and correlating it with clinical outcome and prognosis of the disease.

Patients and methods

Serum vimentin was measured using enzyme-linked immunosorbent assay in 40 patients with ALL recruited from the hematology unit and compared with 20 healthy controls, with follow-up of 12 months.

Results

Vimentin levels were significantly higher in patients with ALL than in controls (P<0.001). Vimentin levels were also positively correlated with high white blood cell count (P=0.030).

Patients were divided into two groups using the median value of their vimentin (18 ng) into high vimentin group and low vimentin group. We found that patients with high vimentin level have shorter median overall survival than patients with low vimentin level (5.18 vs. 6.73 months) but with no statistical significance detected (P=0.598). Regarding disease-free survival, the patients with high vimentin level has shorter disease-free survival than patients with low vimentin level (1.67 vs. 7 months), with no statistical significance (P=0.588).

Conclusion

Vimentin is overexpressed in patients with ALL and associated with poor clinical outcome.
Hypotension, Tachypnea, and Stridor Following Radial PCI
Authors: Ghosh Anindya , Chatterjee Krishnarpan , Khanna Roopali , Kapoor Aditya
Published: May 2024

The radial artery route is being increasingly used by interventional cardiologists as a default access site for both diagnostic and interventional coronary procedures, and although rare, serious complications can occur. We herein report a potentially catastrophic complication of radial percutaneous coronary intervention (PCI) in the form of a large mediastinal and retro-left-atrial hematoma from possible subclavian artery injury with tracheal compression and stridor in a 60-year-old female presenting with anteroseptal myocardial infarction having undergone PCI of the left anterior descending artery through right radial access and then planned for a second stage PCI of the right coronary artery. The patient was managed conservatively with close hemodynamic and echocardiographic monitoring, inotrope support, and blood transfusions. Transradial PCI, despite having a better safety profile in terms of bleeding compared to transfemoral PCI, is not without complications. Manipulation of hydrophilic guidewires as well as diagnostic catheters while performing radial procedures can cause injury to conduit vessels, potentially leading to intrathoracic, axillary, and arm hematomas may remain undetectable in the cath lab, presenting late and can pose a diagnostic and management challenge. Decision to proceed toward repeat interventional/surgical/”wait and watch” strategy should be guided by the patient's clinical status and noninvasive imaging.
Successful Surgical Embolectomy for a Rapidly Deteriorating Patient with Pulmonary Embolism and Hemorrhagic Stroke
Authors: Nasri Mohamad Salim Mohamad Kousay , Abdelghani Mohamed Salah , Carr Cornelia S. , Wani Mohd Lateef , Al-Hijji Mohammed
Published: May 2024

Pulmonary embolism (PE) is a life-threatening condition. High-risk PE is defined as pulmonary embolism with either hemodynamic collapse, persistent hypotension, and/or organ hypoperfusion. The overall mortality rate associated with high-risk PE remains at approximately 30%.

Intermediate–high risk PE is a new term introduced to identify hemodynamically stable PE patients with evidence of right ventricular dysfunction.

Thrombolytics therapy is the first choice for treatment of high-risk PE with hemodynamic instability; however, in a patient who failed thrombolytics or have contraindication to thrombolytics, thrombus removal either with open surgical or catheter embolectomy is a good alternative.

We report a case of a patient who presented with hemorrhagic stroke complicated by intermediate–high-risk PE that rapidly deteriorated before undergoing successful surgical embolectomy.
Administration of Protamine Through Radial Arterial Access
Authors: Goyal Priyanka , Joshi Sandeep , Raut Monish S.
Published: May 2024

Protamine is mainly used to reverse the anticoagulant effect of heparin after cardiopulmonary bypass (CPB). Unfortunately, it is associated with adverse clinical reactions ranging from minor cardiopulmonary instability to fatal cardiovascular collapse. In the present prospective observational study, effects of protamine administration through peripheral intra-arterial route, i.e., radial artery, were investigated.
Surgical Removal of Broken and Inflated Percutaneous Transluminal Coronary Angioplasty Balloon Catheter
Authors: Subash S. , Nandakumar M. N. , Placid Siroraj , Cherian Vijay Thomas , Palangadan Shaji
Published: May 2024

An entrapment and breakage of coronary angioplasty catheter during coronary intervention is a rare but serious complication. Percutaneous transluminal coronary angioplasty (PTCA) catheter got entrapped and broken inside the left anterior descending artery (LAD) in a 58-year-old male patient. The whole length of the PTCA catheter was retrieved through an arteriotomy incision in LAD along with reversed saphenous vein graft to LAD, under cardiopulmonary bypass and cardioplegic arrest. We discuss here the various percutaneous retrieval techniques and surgical management of entrapped broken PTCA catheter and also the role of transesophageal echocardiography intraoperatively.
A Rare Co-existent Case of Splenic Microfilariasis and Pancreatic Solid Pseudopapillary Epithelial Neoplasm - A Double Jeopardy!
Authors: Kini Sangeeta , Kamat Rima N , Janjal Sneha , Desai Heena M
Published: May 2024

Filariasis is a major public health concern in tropical and subtropical countries like India with Wuchereria bancrofti accounting for 90% of lymphatic filariasis. Rarely observed are extra lymphatic manifestations caused by interaction of immune system with microfilaria and their diffusible products. Among various organs involved, splenic involvement is a rare extra lymphatic manifestation of filariasis and can masquerade clinicoradiologically as metastasis when associated with a known malignancy or as a primary malignancy like lymphoma. Hereby, we present an unusual case of coincidence of splenic filariasis with pancreatic solid pseudopapillary epithelial neoplasm in a 20-year-old woman associated with peripheral blood eosinophilia.
A Study on Nature of Violence Against Doctors in Tertiary Care Centers in Karnataka, India: A Cross-Sectional Study
Authors: Nayanar Bharath Sekhar , Fareed Nusrath , Battur Hemanth , Praveena Jaseela
Published: May 2024

Background:

Over the previous decades, violence against physicians has risen. To comprehend the issue connected with it, we need to know the nature of violence and doctor’s views on the current state of safety at their disposal. The purpose of the study was to assess the incidence and nature of violence against doctors in tertiary health care centers in Karnataka, India.

Objectives:

The objectives were to collect data from three tertiary care centers, evaluate the incidence of violence against doctors in tertiary care centers, and evaluate the nature of violence against doctors in tertiary care centers.

Methods:

From the list of all tertiary care centers in Dakshina Kannada, three tertiary care hospitals were randomly chosen. Approval of the Ethical Committee from the Institutional Ethics Committee (IEC) of KVG Dental College and permission from chosen hospitals were obtained. A pre-validated questionnaire was handed over to the available physicians and surgeons in these hospitals to be filled. The total number of participants in the study was 330.

Results:

Nearly half (48.02% of physicians) reported experiencing violence during working hours. The Department of Obstetrics and Gynaecology recorded 43.2% of instances, while surgery, medicine, and other departments reported 23.6%, 22.8%, and 10.4%, respectively.

Conclusions:

Violence against physicians continues to be a huge issue that must be addressed through decisive measures by the police and hospitals. This impacts the healthcare system in the nation and often cripples it owing to the loss of human resources and working hours.
Traumatic Dental Injuries and their Association with Demographics and Other Predisposing Risk Factors in School Children Aged between 8-13 Years: A Descriptive, Cross-Sectional Study
Authors: Bellamkonda Pavani , Varghese Eby , Alasabi Asim Nasser , Alshehri Nasser Mohammed , Bhandary Srikala , Krishnan Ramesh , Babu Suresh J , Swarnalatha C , Nayyar Abhishek S.
Published: May 2024

Background:

Traumatic dental injuries are most commonly seen in school age children. This not only affects physical, but, also, the psychological and social well-being of a child. The aim of the present study was to assess the prevalence of traumatic dental injuries in school children aged between 8 and 13 years and their association with the demographics and other predisposing risk factors.

Materials and Methods:

The present study was conducted as a cross-sectional study design on 1500 school children aged between 8 and 13 years. Apart from clinical examination, all the participants were asked to complete a questionnaire related to the injuries sustained. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 21.0 (IBM, Chicago). Pearson’s Chi-square (Χ²) test was used for categorical data analysis and distribution to determine the association between categorical variables, while P < 0.05 was considered statistically significant.

Results:

The prevalence of traumatic dental injuries in the present study was calculated at 9.7%. Also, the occurrence of such injuries was found to be higher in the age group of 8–11 years with 10 years being the peak age of incidence for sustaining such injuries. Again, crown fracture involving enamel was found to be the most common type of injury sustained, while proclination observed in relation to upper anterior teeth, and incompetent lips were found to be the independent, significant risk predictors associated with the frequency and severity of such injuries.

Conclusions:

The results obtained in the present study suggested a high prevalence of traumatic dental injuries in school children aged between 8 and 13 years highlighting the need for conducting educational programs, for increasing knowledge and awareness of parents, school children and school faculty in this regard to save the affected child patients from the more dreaded sequelae including complete loss of tooth structure, and social and emotional trauma.
Comparison of Knowledge, Attitude, and Practices of Nursing Staff Regarding Cervical Cancer Screening at Various Levels of Health Care Facilities in Western India
Authors: Kaushal Rashmi , Patel Mamta , Bhardwaj Pankaj , Gupta Manoj , Mathur Deepti , Dash Girish Chandra , Shekhar Shashank
Published: May 2024

Background:

Cervical cancer is a public health problem, and nursing personnel are crucial for successful implementation of low-cost cervical cancer screening approaches in low-resource settings. The following study assessed and compared the knowledge, attitude, and practices regarding cervical cancer and its screening among female nursing staff at different levels of health care facilities in western Rajasthan, India.

Methodology:

An anonymous pre-validated, structured questionnaire was used as the study tool among 233 female nursing personnel of primary, secondary, and tertiary care health facilities. Multiple logistic regression was performed to determine the association between level of knowledge with level of health care and other demographic variables.

Results:

The nursing staff of the tertiary care health facility demonstrated significantly higher knowledge compared to those working at primary and secondary levels [adjusted odds ratio (95% confidence interval) 11.01 (3.80–32.40)]. At tertiary care, the practices of the nursing professionals were not found significantly associated with any socio-demographic variable including age, marital status, or level of health care facility.

Conclusion:

The overall knowledge of cervical cancer was poor, especially among staff nurses at primary and secondary levels of health care. In order to implement a successful population-based screening program in India, it is important to update the nursing curriculum and start in-service trainings at primary and secondary levels of health care facilities.
Effect of Structured Exercise-Based Intervention on Upper Quadrant Dysfunction among Fish Processing Workers with Work-Related Musculoskeletal Disorders
Authors: V Rajesh N. Gundmi , Gangahanumaiah Somu , Maiya Arun G. , Guddattu Vasudeva
Published: May 2024

Background:

Musculoskeletal disorders (MSDs) are one of the major causes of morbidity, which affect particularly the upper quadrant in industrial settings and so upset the quality of life (QoL). The influence of the protocol of exercise-based programs at the workplace on the well-being of the worker is contradictory. The objective of the study was to find the effect of the structured exercise-based intervention on upper quadrant dysfunction among fish processing workers with work-related MSDs.

Methods:

The intervention group (n = 91) participated in an individually tailored structured exercise-based intervention (SEBI) program for three months, which consisted of stretching, strengthening, and active exercises. The control group (n = 93) was instructed to continue routine daily activities. The outcome measures of the cluster-randomized controlled trial were Neck Disability Index (NDI), Disabilities of Arm, Shoulder, and Hand (DASH), Visual Analog Scale (VAS), and Short Form-36, used to evaluate at baseline, eighth, and twelfth week. The data were analyzed by repeated analysis of variance and Student’s t-tests.

Results:

The results for the overall perception of upper quadrant dysfunction showed statistically significant differences (P < 0.0001) for NDI, DASH, and VAS. Further, we obtained a significant difference in QoL between the intervention and control groups for physical and psychological health sub-domains.

Conclusion:

SEBI effectively enhanced the general health of fish processing workers by showing improvements in the measures of NDI, DASH, VAS, and QoL. Hence, SEBI can be recommended in the fish processing industries to achieve potential impact on upper quadrant dysfunction and improve the QoL.
Maternal Experiences during Pregnancy, Delivery, and Breastfeeding Practices: A Community-based Analytical Cross-sectional Study
Authors: Shanmugam Jeevithan , Kumar Mohan , Jayaraj Naveen P. , Rajan Palanivel
Published: May 2024

Background:

Evidence on variation in the information provided to mothers during antenatal and postnatal periods, its influence on breastfeeding awareness, and practice in urban and rural settings of India is scarce. The aim of the study was to assess the variation in mothers experience during pregnancy, delivery, and maternity period across settings and its influence on breastfeeding practices in the first six months of infants’ life.

Methods:

A community-based analytical cross-sectional study was carried out in urban and rural settings of Coimbatore, Tamil Nadu, among 800 mothers who had delivered between one year and six months before the date of the survey using simple random sampling.

Results:

The proportion of mothers with less than four antenatal visits were significantly higher in urban areas (urban vs rural, 11.4% vs 6.2%). The mean scores for positive experiences during pregnancy (MD −0.99, 95% CI −1.31 to −0.69), experiences during birth and maternity period (MD −0.59, 95% CI −0.83 to −0.35) were significantly lower in the urban areas compared to rural areas. The prevalence of exclusive breastfeeding was 75.8% and 85.0% in urban and rural areas, respectively. Mothers not satisfied with experiences during delivery and maternity period (OR 1.69, 95% CI 1.18 to 2.42) and from urban areas (OR 1.81, 95% CI 1.27 to 2.59) were at significantly increased risk of nonexclusive breastfeeding.

Conclusion:

The present study showed that mothers from urban areas were not provided with appropriate, adequate, and timely information by the healthcare providers. It is the need of the hour to train and motivate healthcare providers regarding maternal awareness of antenatal, intranatal, and postnatal care practices including breastfeeding and infant care.
General Practitioners’ Experience of Remote Consultations by Telephone in the General Practice Setting during the COVID-19 Pandemic
Authors: Mahmood Sajid , Ahmed Kashif , Khan Majid , Perveen Tahira , Ali Zafar
Published: May 2024

The coronavirus disease 2019 (COVID 19) pandemic brought substantial changes in the way doctors used to interact with patients. In the general practice, consultation over the phone has become a norm now. However, it is not well known how this new mode of consultation affected clinicians’ practices. Objective of this study was to find out if doctors working in the general practices were trained enough for telephonic consultation and how this new mode of consultation affected their clinical practice in general. It was an online survey. Information was gathered by using an online questionnaire which was sent electronically to general practitioners (GPs) and general practitioner speciality trainees (GPSTs) working in the general practices based in Leicestershire. Data were analyzed by using software SPSS. Descriptive characteristics of participants were reported in terms of numbers and percentages, whereas Chi square test was run to assess if there is a difference between GPs and GPSTs in terms of their experience of remote consultations by telephone. The questionnaire response rate was 69.3% (n = 133/192). Of the total, 54.1% (n = 72/133) of participants were women. About 36% (n = 48/133) of the participants were GPSTs, whereas 64% (n = 85/133) were qualified GPs. Not having enough training for phone consultation, technical issues during consultation, inadequate supervision framework, difficulties in building therapeutic alliance with patients, making diagnosis and risk assessment, and increased duration of consultation were identified as issues. Similarly, concerns around patients’ confidentiality and medico legal issues were highlighted. GPs and GPSTs reported similar difficulties. In conclusion, lack of training for the telephonic consultation has been identified as a unanimous issue along with other challenges to phone consultations. There is an urgent need to take measures to make telephone consultation more successful, enjoyable, and safe for patient care by addressing identified issues. Larger studies with representative samples are needed to increase generalizability of our findings.
Symptomatic improvement following resection of cystic pineal lesions
Authors: Porto Guilherme B.F. , Alshareef Mohammed A. , Lowe Stephen R. , Chatterjee Arindam R. , Welsh Cynthia T. , Carroll Steven , Patel Sunil J.
Published: May 2024

Introduction:

Pineal cysts have proven to be a challenging pathology for neurosurgeons. Due to occasional nonspecific symptoms, as well as a wide range of possible morphology and diagnoses, literature is scarce, and little evidence-based management guidelines exist.

Methods:

We present a retrospective review of 38 patients who underwent a surgical resection of a pineal lesion in a single center by a single surgeon between 2012 and 2018. Symptoms, imaging characteristics of the lesion, pathology report, and postoperative radiographic and clinical outcomes were collected.

Results:

Thirty-eight patients were selected. The most common preoperative symptoms included headaches (97%), visual disturbances (89%), cognitive disturbances (58%), and nausea/vomiting (53%). Preoperative radiographic measures showed no relationship to the pathological diagnosis of pineal cyst or pineocytoma (P > 0.05) except for mass effect on the tectal plate that was associated with pineocytoma (P < 0.05). Lesion pathology breakdown: 23 (60%) – World Health Organization Grade I pineocytoma, 14 (37%) – simple pineal cysts, and 1 (3%) – pineal parenchymal tumor of intermediate differentiation. The mean follow-up was 24 months. Headaches and visual disturbances were relieved in 78% and 58% of patients, respectively. Cognitive disturbances were found to be correlated with pineal cyst (P < 0.01). Patients with hyperintense fluid-attenuated inversion recovery signal and enhancement on preoperative magnetic resonance imaging were found to be at higher risk of not experiencing full symptom resolution (P < 0.05). Finally, if no symptom resolution occurred, then higher chance of patients not returning to work was seen (P < 0.05).

Conclusion:

Albeit challenging to treat, careful examination of presurgical imaging findings and surgical resection of appropriately selected pineal lesions can lead to significant relief of preoperative symptoms and overall meaningful improvement.