bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnitude, pattern and management outcome of intestinal obstruction among non-traumatic acute abdomen surgical admissions in Arba Minch General Hospital, Southern Ethiopia
Authors: Atalay Mulatie , Gebremickael Abinet , Demissie Solomon , Derso Yonas
Published: June 2021

Background

Intestinal obstruction is defined as a blockage or partial blockage of the passage of the intestinal contents. It is a potentially risky surgical emergency associated with high morbidity and mortality. Its pattern differs from country to country and even from place to place within a country. Therefore, this study aimed to find out the magnitude, pattern and management outcome of intestinal obstruction in Arba Minch General Hospital.

Methods

A retrospective cross-sectional study was conducted in Arba Minch General hospital from January 09, 2015, to November 09, 2018. The data collection period was from December 15, 2018, to February 09, 2019. A simple random technique was applied to select 801 study participants. Then, the required data entered into Epi Info version 7.2.1.0 and exported to the statistical package for the social sciences software package version 20 for analysis. The binary logistic regression analysis has been done to determine crude statistical associations between independent variables and dependent variables. Linearity, Multivariate normality and multicollinearity were checked between independent and dependent variables by using scatter plot and Q–Q plot respectively. Variables with a p-value of less than 0.25 in the binary logistic regression analysis were entered into multivariable logistic regression. Statistical significance factors were identified based on a p-value of < 0.05 and with a 95% confidence interval.

Result

This study revealed that the overall magnitude of intestinal obstruction was 40.60% with 95% CI (34.95–45.95). The magnitude of unfavorable management outcomes and deaths during the study period were 22.3% with 95% CI (18.00–27.00) and 7.1% with 95% CI (4.00–10.00) respectively. Persistent tachycardia 10.3 (3.28–32.42), Dehydration 13.7 (3.34–56.56), elevated serum creatinine 10.2 (1.89–54.94), gangrenous small bowel volvulus 2.7 (1.27–5.84), ischemic bowel 3.4 (1.17–9.81) and perforated bowl 7.68 (2.96–19.93) were significantly associated with the management outcome of intestinal obstruction.

Conclusion and recommendation

Intestinal obstruction was the most common among all acute abdomen cases and its management outcome highly associated with dehydration. Adequate early preoperative resuscitation and proper post-operative care with appropriate surgical techniques and wound care with sterile techniques would help to reduce further mortality. This could be achieved by increasing public awareness of health-seeking behavior. Moreover, health facilities capable of handling patients with small bowel obstruction should be available within the reach of the community.
X-linked congenital adrenal hypoplasia: a case presentation
Authors: Ouyang Hong , Chen Bo , Wu Na , Li Ling , Du Runyu , Qian Meichen , Yu Wenshu , He Yujing , Liu Xinyan
Published: June 2021

Background

Most patients with congenital adrenal hypoplasia (AHC) develop symptoms during infantile and juvenile periods, with varying clinical manifestations. AHC is a disease that is easily misdiagnosed as Addison’s disease or congenital adrenal hyperplasia (CAH). There was also a significant time difference between the age at which patients developed symptoms and the age at which they were diagnosed with AHC. Most patients showed early symptoms during infantile and juvenile periods, but were diagnosed with AHC many years later.

Case presentation

We are currently reporting a male patient who developed systemic pigmentation at age 2 and was initially diagnosed with Addison’s disease. At 22 years of age, he experienced a slipped capital femoral epiphysis (SCFE), a disease mostly seen in adolescents aged 8–15 years, an important cause of which is endocrine disorder. Testes evaluated using color Doppler Ultrasonography suggested microcalcifications. Further genetic testing and auxiliary examinations revealed that the patient had hypogonadotropic hypogonadism (HH) and DAX-1 gene disorders, at which time he was diagnosed with AHC complicated by HH. He was given hormone replacement therapy, followed by regular outpatient review to adjust the medication.

Conclusions

The typical early symptoms of AHC are hyperpigmentation and ion disturbance during infantile and juvenile periods, while few patients with AHC develop puberty disorders as early symptoms. AHC is prone to being misdiagnosed as Addison’s disease, and then gradually develops the symptoms of HH in adolescence. The definitive diagnosis of AHC ultimately is based on the patient’s clinical presentation, laboratory results and genetic testing results.
Effectiveness of photon-initiated photoacoustic streaming in root canal models with different diameters or tapers
Authors: Wen Cheng , Kong Yuanyuan , Zhao Jian , Li Yang , Shen Ya , Yang Xuechao , Jiang Qianzhou
Published: June 2021

Background

This study aimed to compare the use of photon-initiated photoacoustic streaming (PIPS) and conventional needle irrigation (CNI) in conjunction with different concentrations of sodium hypochlorite (NaOCl) to removeEnterococcus faecalis(E. faecalis) suspended bacteria and biofilms from root canal systems with different diameters or tapers.

Methods

Artificial root canal samples (n = 480) were randomly divided into three groups (n = 160/group). The canals were prepared to fit file sizes #10/.02, #25/.02, or #25/.06. The size #10/.02 group was incubated for seven days. The size #25/.02 or #25/.06 group was incubated for 2 days. A stable biological model ofE. faecalisinfection was established. The root canals were washed with distilled water or with 1%, 2%, or 5.25% NaOCl combined with CNI or PIPS. Bacterial suspensions and biofilms were assessed using an ATP assay kit and fluorescence microscopy. Image-Pro Plus was used to analyse the average fluorescence intensity to determine the most suitable root canal irrigation solution.

Results

In the CNI and PIPS groups, the ATP value of the 5.25% NaOCl subgroup was the lowest, followed by that of the 2% and 1% NaOCl subgroups. The ATP value of the distilled water subgroup was the highest (P < 0.05). When the root canal taper was 0.02, the ATP value of the #10/.02 + PIPS group was significantly lower than that of the #25/.02 + CNI group (P < 0.05). The average fluorescence intensity of the #10/.02 + PIPS group was lower than that of the #25/.02 + CNI group (P < 0.05). When the apical diameter was #25, the ATP value of the 0.02 taper in the PIPS group was lower than that of the 0.06 taper in the CNI group (P < 0.05), and the average fluorescence intensity of the 0.02 taper + PIPS group was lower than that of the 0.06 taper + CNI group (P < 0.05). PIPS combined with 2% and 5.25% NaOCl effectively improved the long-term antibacterial effect after irrigation and re-culture for 6 h.

Conclusions

Compared with CNI, PIPS has greater ability to remove bacteria in root canals with a small preparation diameter and a small taper. PIPS with 2% and 5.25% NaOCl exhibited superior antibacterial and bacteriostatic effects.
Modified laparoscopic lateral suspension with a five-arm mesh in pelvic organ prolapse surgery
Authors: Akbaba Eren , Sezgin Burak
Published: June 2021

Background

Laparoscopic lateral suspension (LLS) is a laparoscopic technique used to treat pelvic organ prolapse (POP) in apical and anterior compartment defect with the use of a synthetic T-shaped mesh graft. The posterior compartment is repaired using a second mesh or a procedure along with LLS, such as posterior colporrhaphy. The aim of this study was to evaluate the clinical results of LLS for POP using a five-arm mesh instead of a T-shaped mesh graft to repair the defect of the posterior compartment in addition to the apical and anterior compartments.

Methods

Data from 37 patients with a diagnosis of advanced-stage (≥ 3) POP undergoing LLS with the use of a five-arm mesh were retrospectively analysed. Pre-operative and post-operative examinations and, surgical outcomes were determined. The results of measurements and examinations, reoperation rates, erosion rates, lower urinary tract symptoms, and complications were analysed. The Prolapse Quality of Life Questionnaire (P-QOL) was also used.

Results

The median post-operative follow-up was 20 (13–34) months. There was a significant improvement in POP-Q scores in all treated compartments, with overall objective cure rates of 94.5% for the apical compartment, 86.4% for the anterior compartment, and 91.8% for the posterior compartment. The median operative time was 96 (76–112) minutes. The median length of hospitalization was 2 (1–3) days. A significant improvement in vaginal bulge, urinary urgency, incomplete voiding, urinary frequency, and constipation was observed after surgery. The sexuality among patients increased from 13 (35.1%) preoperatively to 22 (59.4%) post-operatively. De novo stress urinary incontinence developed in 7 (18.9%) patients. The P-QOL scores improved significantly after surgery.

Conclusions

In advanced-stage POP patients, the posterior compartment damage can also be repaired in LLS with the use of a single five-arm mesh without the need for an additional procedure, and the recurrence rate can be reduced.
Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020
Authors: Klamroth-Marganska Verena , Gemperle Michael , Ballmer Thomas , Grylka-Baeschlin Susanne , Pehlke-Milde Jessica , Gantschnig Brigitte E.
Published: June 2021

Background

The COVID-19 pandemic impedes therapy and care activities. Tele-health, i.e., the provision of health care at a distance (HCD), is a promising way to fill the supply gap. However, facilitators and barriers influence the use and experience of HCD for occupational therapists (OTs) and midwives.

We identified use of services and appraisal of experiences of Switzerland-based OTs and midwives regarding the provision of HCD during the lockdown as it pertains to the COVID-19 pandemic in spring 2020. 1. Hypothesis: Profession, age in years, and area of work have a significant and meaningful influence over whether HCD is provided. 2. Hypothesis: Profession, age in years, area of work, possibility of reimbursement by health insurance, and application used have a significant and meaningful influence on the experience of HCD.

Methods

In a cross-sectional survey, 5755 OTs and midwives were contacted to fill out an online questionnaire with 13 questions regarding demographic information, use of HCD, and experiences while providing the service. Eleven potential facilitators and barriers and areas where there was desire for support were identified.

Results

The questionnaire was completed by 1269 health professionals (response rate 22.5%). 73.4% of responding OTs (n = 431) and midwives (n = 501) provided HCD during the COVID-19 pandemic lockdown. Profession and area of work had a significant influence on whether HCD was provided. Age only had a significant influence on the use of videotelephony, SMS, and chat services.

OTs experienced HCD significantly more positively than midwives (log odds = 1.3; p ≤ .01). Video-telephony (log odds = 1.1; p ≤ .01) and use of phone (log odds = 0.8; p = .01) were positive predictors for positive experience, while use of SMS (log odds = − 0.33; p = .02) was a negative predictor.

Among OTs, 67.5% experienced HCD as positive or mostly positive, while 27.0% experienced it as negative or mostly negative. Among midwives, 39.5% experienced it as positive or mostly positive, while 57.5% experienced it as negative or mostly negative. Most respondents desired support concerning reimbursement by health insurance (70.8%), followed by law and data protection (60.4%).

Conclusions

HCD during the early COVID-19 pandemic was generally perceived as positive by OTs and midwives. There is need for training opportunities in connection with HCD during the COVID-19 pandemic.
Epidemiology, haematology and molecular characterization of haemoprotozoon and rickettsial organisms causing infections in cattle of Jammu region, North India
Authors: Kaur Rabjot , Yadav Anish , Rafiqi Shafiya I. , Godara Rajesh , Sudan Vikrant , Chakraborty D. , Katoch Rajesh
Published: June 2021

Background

The present study was aimed at establishing the prevalence, epidemiology and molecular characterization of major haemoprotozoons (Babesia and Theileria) and rickettsia (Anaplasma) of cattle in Jammu region (North India) using microscopy and Polymerase Chain Reaction (PCR). Hematology, microscopy and PCR based prevalence studies were undertaken with 278 whole blood samples from cattle. Molecular prevalence studies were followed by genetic characterization of the isolates of Babesia, Anaplasma and Theileria spp. based on 18S rRNA, 16S rRNA and Tams1 gene, respectively. The data related to metrology and epidemiological variables like temperature, rainfall, season, age and type of livestock rearing was analyzed and correlated with occurrence of disease by statistical methods.

Results

The prevalence based on microscopy was 12.9% (36/278) whereas PCR recorded 30.22% (84/278) animals positive for haemoparasitic infections. All the samples found positive by microscopy were also recorded positive by PCR. Thus the study revealed prevalence of Babesia bigemina, Anaplasma marginale and Theileria annulata to be 9.7, 16.5 and 0.7% respectively. The metrological and epidemiological variables made inroads for the propagation of vector ticks and occurrence of infection. Haematological alterations predominantly related to decrease in haemoglobin, red blood cell count and packed cell volume were evident in diseased animals and collaterally affected the productivity. Further the genetic characterization of Babesia bigemina. (MN566925.1, MN567603, MN566924.1), Anaplasma marginale. (MH733242.1, MN567602.1) and Theileria annulata (MT113479) provided a representative data of the isolates circulating in the region and their proximity with available sequences across the world.

Conclusions

Despite holding much significance to the animal sector, comprehensive disease mapping has yet not been undertaken in several parts of India. The present study provides a blue print of disease mapping, epidemiological correlations and genomic diversity of Babesia bigemina, Anaplasma marginale and Theileria annulata circulating in the region.
Functional interplay between long non-coding RNAs and the Wnt signaling cascade in osteosarcoma
Authors: He Jieyu , Ling Lin , Liu Zhongyue , Ren Xiaolei , Wan Lu , Tu Chao , Li Zhihong
Published: June 2021

Osteosarcoma is a common and highly malignant bone tumor among children, adolescents and young adults. However, the underlying molecular mechanisms remain largely unexplored. LncRNAs are transcripts with no or limited protein-coding capacity in human genomes, and have been demonstrated to play crucial functions in initiation, progression, therapeutic resistance, recurrence and metastasis of tumor. Considerable studies revealed a dysregulated lncRNA expression pattern in osteosarcoma, which may act as oncogenes or suppressors to regulate osteosarcoma progression. Wnt signaling pathway is an important cascade in tumorigenesis by modulation of pleiotropic biological functions including cell proliferation, apoptosis, differentiation, stemness, genetic stability and chemoresistance. Hyperactivation or deficiency of key effectors in Wnt cascade is a common event in many osteosarcoma patients. Recently, increasing evidences have suggested that lncRNAs could interplay with component of Wnt pathway, and thereby contribute to osteosarcoma onset, progression and dissemination. In this review, we briefly summarize Wnt signaling-related lncRNAs in osteosarcoma progression, aiming to gain insights into their underlying crosstalk as well as clinical application in osteosarcoma therapeutic modalities.
Biomedical signals and machine learning in amyotrophic lateral sclerosis: a systematic review
Authors: Fernandes Felipe , Barbalho Ingridy , Barros Daniele , Valentim Ricardo , Teixeira César , Henriques Jorge , Gil Paulo , Dourado Júnior Mário
Published: June 2021

Introduction

The use of machine learning (ML) techniques in healthcare encompasses an emerging concept that envisages vast contributions to the tackling of rare diseases. In this scenario, amyotrophic lateral sclerosis (ALS) involves complexities that are yet not demystified. In ALS, the biomedical signals present themselves as potential biomarkers that, when used in tandem with smart algorithms, can be useful to applications within the context of the disease.

Methods

This Systematic Literature Review (SLR) consists of searching for and investigating primary studies that use ML techniques and biomedical signals related to ALS. Following the definition and execution of the SLR protocol, 18 articles met the inclusion, exclusion, and quality assessment criteria, and answered the SLR research questions.

Discussions

Based on the results, we identified three classes of ML applications combined with biomedical signals in the context of ALS: diagnosis (72.22%), communication (22.22%), and survival prediction (5.56%).

Conclusions

Distinct algorithmic models and biomedical signals have been reported and present promising approaches, regardless of their classes. In summary, this SLR provides an overview of the primary studies analyzed as well as directions for the construction and evolution of technology-based research within the scope of ALS.
The role of personal factors in quality of life among Iranian women with vaginismus: a path analysis
Authors: Velayati Atefeh , Jahanian Sadatmahalleh Shahideh , Ziaei Saeideh , Kazemnejad Anoshirvan
Published: June 2021

Background

The aim of this study was to provide a path model for assessing the direct and/or indirect effects of psychological/behavioral parameters on health-related quality of life among women with vaginismus.

Methods

A cross-sectional study was conducted on a sample of 236 women with vaginismus disorder attending to sex clinics in Tehran, Iran from April 2017 to March 2018. Data were collected using a demographic questionnaire, the marital satisfaction scale, the hospital anxiety and depression scale, the rosenberg self-esteem scale, the body image concern inventory, the short-form health survey (SF-12) and the female sexual quality of life questionnaire. In addition to descriptive statistical data, the fitness of the proposed model was investigated using path analysis.

Results

The results of path analysis demonstrated that the final model had a good fit to the data (Chi-Square/degrees of freedom (Normed Chi2) = 2.12, root mean square error of approximation = 0.069, goodness fit index = 0.99, both comparative fit index = 0.99 and Tucker–Lewis index = 0.96). In this model, anxiety and depression significantly predicted health-related quality of life as measured by the SF-12.

Conclusions

Anxiety and depression are important components in predicting health-related quality of life among those suffering from vaginismus.
Effect of mistletoe extract on tumor response in neoadjuvant chemoradiotherapy for rectal cancer: a cohort study
Authors: Baek Jeong-Heum , Jeon Youngbae , Han Kyoung-Won , Jung Dong Hae , Kim Kyung-Ok
Published: June 2021

Background

Mistletoe extract, used as a complementary chemotherapeutic agent for cancer patients, has anticancer effects against various malignancies. The aim of the present study was to evaluate the effect of mistletoe extract (Abnoba Viscum Q®) on tumor responses to neoadjuvant chemoradiotherapy (NCRT) for locally advanced rectal cancer.

Methods

This study included patients with rectal cancer who underwent NCRT between January 2018 and July 2020. In the mistletoe group (MG), the patients were administered Abnoba Viscum Q® subcutaneously during chemoradiotherapy—maintained just before surgery. Patient demographics, clinical outcomes, histopathological outcomes, and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) assay results were compared between the MG and non-mistletoe group (NMG). Two rectal cancer cell lines (SNU-503 and SNU-503R80Gy) were treated with Abnoba Viscum Q® to assess its mechanistic effects in vivo.

Results

Overall, the study included 52 patients (MG: n = 15; NMG: n = 37). Baseline demographics between the two groups were similar, except carbohydrate antigen 19-9 levels and tumor location from the anal verge. There was no difference in the clinical stage between the two groups. A better tumor response in the MG, relative to the NMG, was observed with respect to tumor regression grade (TRG), T stage, and overall tumor–node–metastasis stage. Tumor response was significantly better in the MG than in the NMG in terms of pathologic complete response rate (53.3% vs. 21.6%, P = 0.044), good TRG response (66.7% vs. 32.4%, P = 0.024), T downstaging (86.7% vs. 43.2%, P = 0.004), and overall downstaging (86.7% vs. 56.8%, P = 0.040). The toxicities during NCRT were minimal in both groups. More apoptotic cells were noted in MG samples than in the NMG samples on TUNEL staining. Cleaved caspase-3 level following treatment with Abnoba Viscum Q® was higher in SNU-503R80Gy cells than in SNU-503 cells.

Conclusion

Patients treated with chemoradiation combined with mistletoe extract showed better outcomes than patients not treated with mistletoe extract in terms of tumor responses. This diversity in treatment may improve the efficacy of NCRT, leading to better oncologic outcomes. Prospective and randomized studies with long-term follow-up are warranted to confirm and extend these results.
A 10-year longitudinal evaluation of science policy interventions to promote sex and gender in health research
Authors: Haverfield Jenna , Tannenbaum Cara
Published: June 2021

Background

Over the past decade, the Canadian Institutes of Health Research (CIHR) has implemented multicomponent interventions to increase the uptake of sex and gender in grant applications. Interventions included mandatory reporting on applicant forms, development of resources for applicants and evaluators, and grant review requirements. Here, we aim to inform science policy implementation by describing the 10-year outcomes and lessons learned from these interventions.

Methods

This is a prospective longitudinal study. The population is all applicants across 15 investigator-initiated CIHR competitions from 2011 to 2019 and grant evaluators from 2018 to 2019. Quantitative data were derived from applicants’ and grant evaluators’ mandatory reporting of sex and gender integration in the grants management database. The application was the unit of analysis. Trends in sex and gender uptake in applications were plotted over time, stratified by research area. Univariate logistic regression was used to assess associations between the sex of the applicant and the uptake of sex and gender, and the latter with funding success. Qualitative review of the quality and appropriateness of evaluators’ comments informed the development of discipline-specific training to peer review committee members. Feedback was compiled from a subset of evaluators on the perceived usefulness of the educational materials using a brief questionnaire.

Results

Since 2011, 39,390 applications were submitted. The proportion that reported integration of sex rose from 22 to 83%, and gender from 12 to 33%. Population health research applications paid the greatest attention to gender (82%). Across every competition, applications with female principal investigators were more likely to integrate sex (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.50–1.63) and gender (OR 2.40, 95% CI 2.29–2.51) than those who identified as male. Since 2018, applications that scored highly for the integration of sex (OR 1.92, 95% CI 1.50–2.50) and gender (OR 2.53, 95% CI 1.83–3.50) were more likely to be funded. Qualitative observations revealed persistent conflation of the terms sex and gender. Eighty-six percent of evaluators appreciated the tailored discipline-specific coaching.

Conclusions

A number of policy interventions improved sex and gender uptake in grant applications, with higher success rates observed over time for applications that integrated sex and gender. Other funders’ action plans around sex and gender integration may be informed from our experiences of the timing, type and targets of the different interventions, specifically those directed at evaluators.
Cost-effectiveness analysis of oral nutritional supplements with nutritional counselling in head and neck cancer patients undergoing radiotherapy
Authors: Martin Beatrice , Cereda Emanuele , Caccialanza Riccardo , Pedrazzoli Paolo , Tarricone Rosanna , Ciani Oriana
Published: June 2021

Objective

There is limited evidence regarding the economic effects of nutrition support in cancer patients. This study aims at investigating the cost-effectiveness profile of systematic oral nutritional supplementation (ONS) in head and neck cancer (HNC) patients undergoing radiotherapy (RT) and receiving nutritional counseling.

Methods

A cost-effectiveness analysis based on a RCT was performed to estimate direct medical costs, life years gained (LYG) and Quality-Adjusted Life Years (QALY) for nutritional counseling with or without ONS at 5-month and 6-year follow up time. Value of information analysis was performed to value the expected gain from reducing uncertainty through further data collection.

Results

ONS with nutritional counseling produced higher QALY than nutritional counseling alone (0.291 ± 0.087 vs 0.288 ± 0.087), however the difference was not significant (0.0027, P = 0.84). Mean costs were €987.60 vs €996.09, respectively in the treatment and control group (-€8.96, P = 0.98). The Incremental Cost Effectiveness Ratio (ICER) was -€3,277/QALY, with 55.4% probabilities of being cost-effective at a cost-effectiveness threshold of €30,000/QALY. The Expected Incremental Benefit was €95.16 and the Population Expected Value of Perfect Information was €8.6 million, implying that additional research is likely to be worthwhile. At a median 6-year follow up, the treatment group had a significantly better survival rate when adjusting for late effect (P = 0.039).

Conclusion

Our findings provide the first evidence to inform decisions about funding and reimbursement of ONS in combination with nutritional counseling in HNC patients undergoing RT. ONS may improve quality of cancer care at no additional costs, however further research on the cost-effectiveness of nutritional supplementation is recommended.

Trial Registration: ClinicalTrials.gov: NCT02055833. Registered 5th February 2014 https://clinicaltrials.gov/ct2/show/NCT02055833
Outcome of mitral valve repair or replacement for non-ischemic mitral regurgitation: a systematic review and meta-analysis
Authors: Fan Qianqian , Li Xiaoguang , Cao Guilan , Yu Puliang , Zhang Fengxiao
Published: June 2021

Background

Mitral regurgitation (MR) is a rather common valvular heart disease. The aim of this systematic review and meta-analysis was to compare the outcomes, and complications of mitral valve (MV) replacement with surgical MV repair of non-ischemic MR (NIMR)

Methods

MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until October, 2020. Studies were eligible for inclusion if they included patients with MR and reported early (30-day or in-hospital) or late all-cause mortality. For each study, data on all-cause mortality and incidence of reoperation and operative complications in both groups were used to generate odds ratios (ORs) or hazard ratios (HRs). This study is registered with PROSPERO, CRD42018089608.

Results

The literature search yielded 4834 studies, of which 20 studies, including a total of 21,898 patients with NIMR, were included. The pooled analysis showed that lower age, less female inclusion and incident of hypertension, significantly higher rates of diabetes and atrial fibrillation in the MV replacement group than MV repair group. No significant differences in the rates of pre-operative left ventricle ejection fraction (LVEF) and heart failure were observed between groups. The number of patients in the MV repair group was lower than in the MV replacement group. We found that there were significantly increased risks of mortality associated with replacement of MR. Moreover, the rate of re-operation and post-operative MR in the MV repair group was lower than in the MV replacement group.

Conclusions

In patients with NIMR, MV repair achieves higher survival and leads to fewer complications than surgical MV replacement. In light of these results, we suggest that MV repair surgery should be a priority for NIMR patients.
Impact of frontline treatment approach on outcomes of myeloid blast phase CML
Authors: Saxena Kapil , Jabbour Elias , Issa Ghayas , Sasaki Koji , Ravandi Farhad , Maiti Abhishek , Daver Naval , Kadia Tapan , DiNardo Courtney D. , Konopleva Marina , Cortes Jorge E. , Yilmaz Musa , Chien Kelly , Pierce Sherry , Kantarjian Hagop , Short Nicholas J.
Published: June 2021

Background

The natural course of untreated chronic myeloid leukemia (CML) is progression to an aggressive blast phase. Even in the current era of BCR-ABL1 tyrosine kinase inhibitors (TKIs), the outcomes of blast phase CML remain poor with no consensus frontline treatment approach.

Methods

We retrospectively analyzed the response rates and survival outcomes of 104 consecutive patients with myeloid blast phase CML (CML-MBP) treated from 2000 to 2019 based on 4 different frontline treatment approaches: intensive chemotherapy (IC) + TKI (n = 20), hypomethylating agent (HMA) + TKI (n = 20), TKI alone (n = 56), or IC alone (n = 8). We also evaluated the impact of TKI selection and subsequent allogeneic stem cell transplant (ASCT) on patient outcomes.

Results

Response rates were similar between patients treated with IC + TKI and HMA + TKI. Compared to treatment with TKI alone, treatment with IC/HMA + TKI resulted in a higher rate of complete remission (CR) or CR with incomplete count recovery (CRi) (57.5% vs 33.9%, p < 0.05), a higher complete cytogenetic response rate (45% vs 10.7%, p < 0.001), and more patients proceeding to ASCT (32.5% vs 10.7%, p < 0.01). With a median follow-up of 6.7 years, long-term outcomes were similar between the IC + TKI and HMA + TKI groups. Combination therapy with IC/HMA + TKI was superior to therapy with TKI alone, including when analysis was limited to those treated with a 2nd/3rd-generation TKI. When using a 2nd/3rd-generation TKI, IC/HMA + TKI led to lower 5-year cumulative incidence of relapse (CIR; 44% vs 86%, p < 0.05) and superior 5-year event-free survival (EFS; 28% vs 0%, p < 0.05) and overall survival (OS; 34% vs 8%, p = 0.23) compared to TKI alone. Among patients who received IC/HMA + TKI, EFS and OS was superior for patients who received a 2nd/3rd generation TKI compared to those who received imatinib-based therapy. In a landmark analysis, 5-year OS was higher for patients who proceeded to ASCT (58% vs 22%, p = 0.12).

Conclusions

Compared to patients treated with TKI alone for CML-MBP, treatment with IC + TKI or HMA + TKI led to improved response rates, CIR, EFS, and OS, particularly for patients who received a 2nd/3rd-generation TKI. Combination therapy with IC + TKI or HMA + TKI, rather than a TKI alone, should be considered the optimal treatment strategy for patients with CML-MBP.
Nonlocal and multiple-point fractional boundary value problem in the frame of a generalized Hilfer derivative
Authors: Shatanawi Wasfi , Boutiara Abdellatif , Abdo Mohammed S. , Jeelani Mdi B. , Abodayeh Kamaleldin
Published: June 2021

The aim of this manuscript is to handle the nonlocal boundary value problem for a specific kind of nonlinear fractional differential equations involving aξ-Hilfer derivative. The used fractional operator is generated by the kernel of the kind$k(\vartheta,s)=\xi (\vartheta )-\xi (s)$k(ϑ,s)=ξ(ϑ)−ξ(s)and the operator of differentiation${ D}_{\xi } = ( \frac{1}{\xi ^{\prime }(\vartheta )}\frac{d}{d\vartheta } ) $Dξ=(1ξ′(ϑ)ddϑ). The existence and uniqueness of solutions are established for the considered system. Our perspective relies on the properties of the generalized Hilfer derivative and the implementation of Krasnoselskii’s fixed point approach and Banach’s contraction principle with respect to the Bielecki norm to obtain the uniqueness of solution on a bounded domain in a Banach space. Besides, we discuss the Ulam–Hyers stability criteria for the main fractional system. Finally, some examples are given to illustrate the viability of the main theories.
Friction and contact temperature in dry rolling-sliding contacts with MoS2-bonded and a-C:H:Zr DLC coatings
Authors: Hofmann Stefan , Yilmaz Mustafa , Maier Enzo , Lohner Thomas , Stahl Karsten
Published: June 2021

Gearboxes are usually lubricated with oil or grease to reduce friction and wear and to dissipate heat. However, gearbox applications that cannot be lubricated with oil or grease, for example in the space or food industry, are commonly lubricated with solid lubricants. Especially solid lubricants with a lamellar sliding mechanism like graphite and molybdenum disulfide (MoS2) or diamond-like carbon (DLC) coatings can enable very low coefficients of friction. This study investigates the friction and temperature behavior of surface coatings in rolling-sliding contacts for the application in dry lubricated gears. In an experimental setup on a twin-disk test rig, case-hardened steel 16MnCr5E (AISI5115) is considered as substrate material together with an amorphous, hydrogenated, and metal-containing a-C:H:Zr DLC coating (ZrCg) and a MoS2-bonded coating (MoS2-BoC). The friction curves show reduced coefficients of friction and a significantly increased operating area for both surface coatings. Due to the sufficient electrical insulation of the MoS2-BoC, the application of thin-film temperature measurement-known from lubricated contacts-was successfully transfered to dry rolling-sliding contacts. The results of the contact temperature measurements reveal pronounced thermal insulation with MoS2-BoC, which can interefere the sliding mechanism of MoS2 by accelerated oxidation. The study shows that the application of dry lubricated gears under ambient air conditions is challenging as the tribological and thermal behavior requires tailored surface coatings.
Myasthenic crisis appearing after resection of intracardiac ectopic thymoma with superior vena cava syndrome
Authors: Takebayashi Satoshi , Yoshikawa Yasuji , Morita Masato , Nagashima Ryotaro , Nakazono Yuichi , Miyamoto Shinji
Published: June 2021

Background

We describe herein an extremely rare case of intracardiac ectopic thymoma—only two pure cases have been reported to date—associated with myasthenia gravis, an infrequent complication of ectopic thymoma.

Case presentation

A 71-year-old woman with superior vena cava syndrome was found to have a large mass mainly located in the right atrium. Tumor resection under cardiopulmonary bypass was performed. The pathological diagnosis was type AB ectopic thymoma. The postoperative course was complicated by progressive respiratory failure, and she was diagnosed with myasthenic crisis based on clinical signs and the edrophonium test. The patient recovered and was weaned from prolonged mechanical ventilation after receiving intravenous immunoglobulin, and was subsequently discharged uneventfully.

Conclusions

This is the first report of myasthenic crisis due to intracardiac ectopic thymoma. Residual thymoma is a risk factor for the development of post-thymectomy myasthenia gravis, and long-term follow-up is required.
Pattern and prevalence of neuropsychiatric lupus: a retrospective study from a tertiary level hospital in Bangladesh
Authors: Hossain Fahima , Hawlader Mohammad Delwer Hossain , Mitra Dipak Kumar , Nabi Mohammad Hayatun , Rahman Md. Mujibur
Published: June 2021

Background

Neuropsychiatric systemic lupus erythematosus (NPSLE) is well known for its varying presentations and poor outcomes, but little is evident about its distribution and characteristics among the Bangladeshi population. This study aimed to assess the pattern and prevalence of neuropsychiatric symptoms in female systemic lupus erythematosus (SLE) patients of Bangladesh. A retrospective study was conducted at a tertiary care hospital in Dhaka, Bangladesh, between January and December 2018. One hundred female SLE patients were included in the study purposively. Data were collected on sociodemographic and clinical characteristics of diagnosed SLE cases visiting the SLE clinic and indoor medicine department. Neuropsychiatric (NP) syndromes were defined according to the widely accepted American College of Rheumatology (ACR) nomenclature and case definitions.

Results

A total of 244 NP events were identified in fifty-five patients. Headache was the most frequent symptom (55%), followed by cognitive dysfunction (50%), anxiety (49%), psychosis (43%), seizure (23%), depression (17%), and cerebrovascular disease (ischemic type, 7%). The NP manifestations were more prevalent among urban residents (58.2%), younger patients (41.8%), and patients with graduate-level education (34.5%). Besides, young age at diagnosis (p = 0.038), Raynaud’s phenomenon (p = 0.015), other organ involvement (p < 0.001), and time of NPSLE development (p < 0.001) were found to be significantly associated with the development of these manifestations.

Conclusion

NP damage is prevalent among Bangladeshi female SLE patients (55%) with headache and cognitive dysfunction being the most common symptoms. Routine screening for neuropsychiatric symptoms among suspected SLE cases and further evaluation with a larger population are warranted.
Collagen fiber membrane-derived chemically and mechanically durable superhydrophobic membrane for high-performance emulsion separation
Authors: Li Huifang , Zheng Wan , Xiao Hanzhong , Hao Baicun , Wang Yujia , Huang Xin , Shi Bi
Published: June 2021

Developing high-performance separation membrane with good durability is a highly desired while challenging issue. Herein, we reported the successful fabrication of chemically and mechanically durable superhydrophobic membrane that was prepared by embedding UiO-66 as size-sieving sites within the supramolecular fiber structure of collagen fiber membrane (CFM), followed by the polydimethylsiloxane (PDMS) coating. The as-prepared CFM/UiO-66(12)/PDMS membrane featured capillary effect-enhanced separation flux and homogeneous porous channels guaranteed high separation efficiency. When utilized as double-layer separation membranes, this new type of composite membranes separated various surfactant stabilized water-in-oil microemulsions and nanoemulsions, with the separation efficiency high up to 99.993 % and the flux as high as 973.3 L m− 2 h− 1. Compared with commercial polytetrafluoro ethylene (PTFE) membrane, the advantage of the double-layer CFM/UiO-66(12)/PDMS membranes in separation flux was evident, which exhibited one order of magnitude higher than that of commercial PTFE membrane. The CFM/UiO-66(12)/PDMS membrane was acid-alkali tolerant, UV-aging resistant and reusable for emulsion separation. Notably, the CFM/UiO-66(12)/PDMS membrane was mechanically durable against strong mechanical abrasion, which was still capable of separating diverse water-in-oil emulsions after the abrasion with sandpaper and assembled as double-layer separation membranes. We anticipate that the combination of CFM and metal organic frameworks (MOFs) is an effective strategy for fabricating high-performance separation membrane with high mechanical and chemical durability.

Graphical Abstract
Virtual screenings of the bioactive constituents of tea, prickly chaff, catechu, lemon, black pepper, and synthetic compounds with the main protease (Mpro) and human angiotensin-converting enzyme 2 (ACE 2) of SARS-CoV-2
Authors: Emon Nazim Uddin , Alam Md. Munsur , Akter Irin , Akhter Saima , Sneha Anjuman Ara , Irtiza Md. , Afroj Marufa , Munni Arifa , Chowdhury Masruba Hossen , Hossain Summiya
Published: June 2021

Background

COVID-19 has mutation capability, and there are no specific drug therapies that are available to fight or inhibit the proteins of this virus. The present study aims to investigate the binding affinity of the bioactive and synthetic compounds with the main protease (Mpro) enzymes and angiotensin-converting enzyme 2 (ACE 2) by computational approach. PASS prediction, pharmacokinetics, and toxicological properties prediction studies were performed through the Google PASS prediction and Swiss ADME/T website. Besides, molecular docking studies were accomplished by BIOVIA Discovery Studio 2020, UCSF Chimera, and PyRx autodock vina.

Results

The docking scores were inferred and the selected compounds showed results varying from −3.2 to −9.8 (kcal/mol). Theaflavin scored the highest docking score to the 5REB, 6VW1, and 1R42 enzymes and showed the binding affinity as −6.3 kcal/mol, −9.8 kcal/mol, and −8.6 kcal/mol, respectively. Again, kaempferol showed the best binding affinity to the 7BQY (−7.1 kcal/mol) and 6Y2FB (−6.6 kcal/mol) enzymes. All the chemical constituents showed better probability in action in pass prediction analysis. Besides, no ligands (except theaflavin) have any conflict with Lipinski’s rules of five, which authorized the drug probability of these ligands.

Conclusion

Therefore, the selected compounds could be considered a potential herbal treatment source against SARS-CoV-2.
The role of ultrasound-guided transthoracic Tru-Cut core biopsy in the diagnosis peripheral thorax lesion
Authors: Mohamed Maha Fathy , Laz Nabila Ibraheem , Kamel Khaled Mahmoud , Mahmoud Raghda Yaser
Published: June 2021

Background

The nature of opaque lesions such as effusions, atelectasis, masses, and consolidations can be clarified by sonography. This study investigated the sensitivity and accuracy of ultrasound-guided percutaneous core needle biopsy in different thoracic tumors (lung, pleural, chest wall, and mediastinal).

Results

Sixty patients underwent ultrasound-guided percutaneous transthoracic core biopsy of peripheral thoracic masses with a Tru-Cut needle with a big bore. Twenty masses were in the lung, seventeen lesions were in the pleura, ten masses were in the mediastinum, eleven were enlarged palpable lymph nodes, and two masses were in chest wall. The sensitivity, PPV, and accuracy for detection of chest tumors in the chest wall, mediastinum, lung, and pleura were 100% for all, and in LN 88.9, 100, and 90.9%, respectively. The overall diagnostic performance of sonar-guided Tru-Cut needle biopsy in diagnosis was 97.78% sensitivity, 98.18% accuracy, and 100% PPV.

Conclusion

Tru-Cut needle percutaneous transthoracic core biopsy is a convenient and sensitive process in obtaining samples under ultrasound guidance for exact histological diagnosis of thoracic tumors. The diagnostic efficiency is high, and the technique can also be used in outpatients, which is relatively simple.

Trial registration

NCT, NCT04741958 Registered 5 February 2021, retrospectively registered,
Morphology, internal architectures, and formation mechanisms of mega-pockmarks on the northwestern South China Sea margin
Authors: Lu Yintao , Xu Xiaoyong , Luan Xiwu , Jiang Shu , Ran Weimin , Yang Taotao , Lyu Fuliang , Zhou Yingfang , Yang Zhili
Published: June 2021

Pockmarks, as depression morphology related to fluid escape on the seafloor, are revealed by 3D seismic data on the northwestern South China Sea (SCS) margin. The pockmarks can be classified into two groups based on their various shapes in plan view: the circular group and the elongating group. These pockmarks in the study area could be defined as mega-pockmarks because their maximum diameters can reach to 7.5 km. They commonly develop more than one crater, which are called the central crater and the secondary crater. The seismic data illuminated their complicated internal architectures in the subsurface, as well as their evolution periods, such as the initiation stage, mature stage, and abandonment stage. According to the buried structures and their genesis mechanism, mega-pockmarks could be classified into linear faults-associated pockmarks and volcano-associated pockmarks. The linear fault-associated pockmarks root on the top Middle Miocene, where the linear faults are distributed. The linear faults on the top of fluid reservoir in Middle Miocene act as conduits for fluid seepage. The fluid seepage is driven by the break of balance between the hydrostatic and pore pressure. When the fluid seepage initiates, they will migrate along the linear faults, making the linear feature of pockmarks on the seafloor. Thermogenic gas from deep intervals and biogenic gas from shallow intervals may be fluid sources for the genesis of pockmarks. However, the volcanic activities control the genesis and evolution of volcano-associated pockmarks. Volcano-associated pockmarks root on the craters of volcanoes. The volcanoes underneath the pockmarks provide volcanic hydrothermal solutions, such as phreatomagmatic eruptions through the volcanic craters. The confined fluid seepages make the pockmarks exhibit a more circular shape on the seafloor. Long-term, multiepisode fluid expulsions generate the complicated internal architecture that leads to multicratered mega-pockmarks on the northwestern margin of SCS.
Τα δημοτικά τραγούδια των Πομάκων της Θράκης στο πλαίσιο της βαλκανικής μουσικής παράδοσης
Authors: Κόκκας Νικόλαος
Published: June 2021

Η διατριβή παρουσιάζει την εξέλιξη της ταυτότητας των Πομάκων σε συνάρτηση με την παραδοσιακή τους μουσική και τα δημοτικά τους τραγούδια. Αναλύεται επίσης η αφηγηματική και ποιητική τέχνη, τα μουσικά όργανα και η ερμηνεία των τραγουδιών και σκιαγραφούνται εξέχουσες μορφές λαϊκών Πομάκων ερμηνευτών. Γίνεται συγκριτική μελέτη της θεματολογίας και των μοτίβων των τραγουδιών που έχουν καταγραφεί στο ελληνικό και στο βουλγαρικό τμήμα της Ροδόπης αλλά και σε άλλα μέρη των Βαλκανίων. Διερευνώνται επίσης οι δυνατότητες εκπαιδευτικής αξιοποίησης των δημοτικών τραγουδιών των Πομάκων στα μειονοτικά σχολεία, αλλά και σε δημόσια σχολεία.
Η συμμετοχή των λαϊκών στη διοίκηση των επιμέρους Ορθόδοξων Εκκλησιών.
Authors: Χαμάκος Νικόλαος
Published: June 2021

Αντικείμενο της παροούσας μελέτης είναι η συμμετοχή των λαϊκών στη Διοίκηση των επιμέρους Ορθόδοξων Εκκλησιών. Στο πλαίσιο αυτό παρουσιάζονται, αναλύονται και αποτιμώνται κριτικά οι σχετικές ρυθμίσεις των πρεσβυγενών Πατριαρχείων (Οικουμενικό Πατριαρχείο Κωνσταντινουπόλεως, Πατριαρχεία Αλεξανδρείας, Αντιοχείας και Ιεροσολύμων), των νεώτερων Πατριαρχείων (Πατριαρχεία Ρωσίας, Σερβίας, Ρουμανίας Βουλγαρίας και Γεωργίας), των αυτοκέφαλων Εκκλησιών (Εκκλησίες Κύπρου, Ελλάδας, Πολωνίας, Αλβανίας, Τσεχίας και Σλοβακίας και Ουκρανίας ) και των αυτόνομων Εκκλησιών (Εκκλησιες Φινλανδίας και Εσθονίας).
Η σχέση της μουσικής εκπαίδευσης με τις φωνολογικές και αναγνωστικές δεξιότητες μαθητών προσχολικής και πρώτης σχολικής ηλικίας
Authors: Tsesmeli Styliani Ν. , Sotiropoulou Εleni , Ntente Εleni
Published: June 2021

The aim of the study was to evaluate the effect of the training of morphological awareness of spelling words by 27 students following 4th and 6th grades of a primary school. They were compared with a group of 26 classmates who did not take part in the intervention. All students were assessed via standardized tests of spelling and reading comprehension and non-standardized tests of analogy and meaning of compounds. The intervention included a pre-test, an educational program and a post-test. Experimental material entailed compound words categorized into two conditions of morphophonological transparency (transparent/ non-transparent) and two conditions of compositionality (Modern Greek/Ancient Greek morphemes). Results showed that the systematic exercise of the morphological structure of words improved students' spelling performance in every compound type. Considerably, non-transparent items entailing ancient morphemes received the highest gains, where students presented the lowest performance before intervention. These findings underline the importance of morphological awareness in the acquisition of spelling of morphologically complex vocabulary, whose teaching is important in the highest grades of primary school.