bluuebunny/crossref_metadata_2025 huggingface dataset:
Communication skills training in advance care planning: a survey among medical students at the University of Antwerp
Authors: van de Wiel Mick , Bombeke Katrien , Janssens Annelies
Published: August 2022

Background

Palliative care (PC) is a strongly emerging discipline worldwide. Despite efforts to integrate this important topic in the medical curriculum in Belgium, still little time is spent on PC and its implementation during theoretical and practical training.

Materials & methods

We had two cohorts of second master’s year MD students at the University of Antwerp complete a survey compromising a custom-built PC knowledge test and a self-confidence assessment of communicative skills used in end-of-life conversations. We evaluated students’ self-confidence regarding end-of-life-conversations before and after a PC training program. We also explored whether the PC classes enabled the students to adequately reflect on factors that might influence end-of-life conversations with an open-end question about the potential implications of the COVID-19 pandemic on advance care planning (ACP) conversations. Finally, we compared the results of the respondents having enjoyed face-to-face training (cohort 1) with those having received online training only (cohort 2, COVID-19 pandemic).

Results

Although the respondents in both cohorts indicated that the overall curriculum did not pay enough attention to PC training, their average scores on the theoretical questions were good. Feeling confident about their communicative skills in general, they indicated to be less confident when it came to communications concerning PC and ACP in particular. The COVID-19 pandemic was initially equally deemed to impede and facilitate ACP and end-of-life conversations, but after the ACP training class more respondents saw the pandemic as an opportunity to broach end-of-life issues. Finally, we found no differences in scores between online and regular classroom teaching.

Conclusion

Students experience a lack of confidence in communication skills used in end-of-life conversations and ACP. To help improve skills and competencies in conducting end-of-life conversations, it is recommended to have medical students assess PC/ACP training programs regularly and to modify the curriculum and course content based on these outcomes and current developments.
The direct cost incurred by patients and caregivers in diagnosing and managing prostate cancer in Ghana
Authors: Wiafe Ebenezer , Mensah Kofi Boamah , Appiah Kwaku Addai Arhin , Oosthuizen Frasia , Bangalee Varsha
Published: August 2022

Background

Over the years, the prevalence of prostate cancer (PCa) has been on the increase. Poor prognosis has been a reflection of increased advance-staged diagnosis and inadequate financial assistance. The prioritization of resources cannot be effective enough to factor in the unexpected economic burden resulting from ill health unless health economic approaches are utilized to estimate the cost of diseases including PCa. With the absence of data on the cost of PCa in Ghana, and the evidence of the benefits of PCa cost-of-illness studies on cancer financing, it has become imperative to investigate the direct health cost of PCa on patients and careers. Hence, we investigate the cost of PCa diagnosis and management, the availability and prices of PCa medications, and the affordability of PCa care in Ghana.

Methods

The prevalence approach to cost-of-illness studies was adopted in this study through a random selection of two (2) hospitals, four (4) private laboratories, and ten (10) private community pharmacies in the Ashanti Region of Ghana. The diagnostic and management cost of PCa was investigated through the application of validated data collection instruments to representatives of the selected hospitals and laboratories. The availability and prices of PCa medications were studied with the administration of a validated tool to representatives of the selected pharmacies. The data were analyzed with Microsoft Excel Spreadsheet and the affordability of care was assessed considering the 2021 Ghana National Daily Minimum Wage (GNDMW).

Results

The cost of diagnosing non-metastatic and metastatic PCa were respectively estimated at GHC 1686.00 ($ 290.58) and GHC 6876.00 ($ 1185.09). Radical prostatectomy, as a management option, was estimated at GHC 2150.00 ($ 370.56) higher than Extended Beam Radiotherapy (GHC 2150.00: $ 370.56). The mean PCa drug availability for the sampled pharmacies around the public hospital, all the sampled pharmacies, and around the private hospital were respectively 61.54, 51.54, and 41.54%. None of the sampled drugs at the stated strengths had a 100% availability. A 6-month androgen deprivation therapy employing goserelin was GHC 3000.00 ($ 517.05). The median drug price ratio (MDPR) was 0.72 - 15.38, with generic bicalutamide 150 mg tablets as the cheapest and generic flutamide 250 mg tablets as the most expensive.

Conclusion

The diagnostic and management cost of PCa currently overwhelms the average Ghanaian because the minimum daily wage in 2021 is GHC 12.53 ($ 0.46). A higher economic burden was associated with metastatic PCa and hence, the need for strategies to improve early detection. Also, the inclusion of PCa management in the National Health Insurance Scheme would lessen the financial burden of the disease on patients and careers, and improve management outcomes.
A method for labelling lesions for machine learning and some new observations on osteochondrosis in computed tomographic scans of four pig joints
Authors: Olstad Kristin , Gangsei Lars Erik , Kongsro Jørgen
Published: August 2022

Background

Osteochondrosis is a major cause of leg weakness in pigs. Selection against osteochondrosis is currently based on manual scoring of computed tomographic (CT) scans for the presence of osteochondrosis manifesta lesions. It would be advantageous if osteochondrosis could be diagnosed automatically, through artificial intelligence methods using machine learning. The aim of this study was to describe a method for labelling articular osteochondrosis lesions in CT scans of four pig joints to guide development of future machine learning algorithms, and to report new observations made during the labelling process. The shoulder, elbow, stifle and hock joints were evaluated in CT scans of 201 pigs.

Results

Six thousand two hundred fifty osteochondrosis manifesta and cyst-like lesions were labelled in 201 pigs representing a total volume of 211,721.83 mm3. The per-joint prevalence of osteochondrosis ranged from 64.7% in the hock to 100% in the stifle joint. The lowest number of lesions was found in the hock joint at 208 lesions, and the highest number of lesions was found in the stifle joint at 4306 lesions. The mean volume per lesion ranged from 26.21 mm3 in the shoulder to 42.06 mm3 in the elbow joint. Pigs with the highest number of lesions had small lesions, whereas pigs with few lesions frequently had large lesions, that have the potential to become clinically significant. In the stifle joint, lesion number had a moderate negative correlation with mean lesion volume at r = − 0.54, p < 0.001.

Conclusions

The described labelling method is an important step towards developing a machine learning algorithm that will enable automated diagnosis of osteochondrosis manifesta and cyst-like lesions. Both lesion number and volume should be considered during breeding selection. The apparent inverse relationship between lesion number and volume warrants further investigation.
Refining index to measure physical activity inequality: which group of the population is the most vulnerable?
Authors: Widyastari Dyah Anantalia , Khanawapee Aunyarat , Charoenrom Wanisara , Saonuam Pairoj , Katewongsa Piyawat
Published: August 2022

Background

The existing body of research mostly discusses inequality in physical activity (PA) based on the difference in the level of moderate-to-vigorous physical activity (MVPA). Evidence is lacking on the quantified inequality measures (e.g., how big the inequality is, and the distribution) in order to identify the most vulnerable groups of a population. This study measured PA inequality among Thai adults by using three parameters to construct an inequality index: (1) Proportion of the population with sufficient MVPA; (2) Cumulative minutes of MVPA; and (3) The Gini coefficient.

Methods

This study employed three rounds of data from Thailand’s Surveillance on Physical Activity (SPA) 2019–2021. In each round, over 6,000 individuals age 18–64 years were selected as nationally-representative samples, and were included in the analysis. PA inequality was constructed by using three parameters, with a combination of the three as the final measure, to identify the sub-groups of the Thai adults who are most vulnerable: groups with the least MVPA, highest insufficiency, and highest inequality index (Gini).

Results

Covid-19 containment measures have widened the gap in PA inequality, as shown by a declining proportion of the population meeting the recommended guidelines, from 74.3% in 2019 to 56.7% in 2020 and 65.5% in 2021. PA inequality existed in all sub-populations. However, by combining three parameters, the most vulnerable groups during the Covid-19 epidemic were identified as follows: (1) Those with no income; (2) The unemployed; (3) Those who have no access to PA facilities; (4) Older adults aged 60 + years; and (5) Those earning < 3,500 baht per month. Further, residents of Bangkok, young adults aged 18–24, individuals who attained primary level education or less, those who had no exposure to a PA awareness campaign and those who have a debilitating chronic disease also had elevated risk of PA insufficiency.

Conclusion

A concerning level of PA inequality existed in all sub-populations. The use of combined indicators in measuring PA inequality should aid in determining the most vulnerable groups of the population with a refined procedure. This method can be applied in many settings since the baseline data used to measure inequality (i.e., percent sufficient and cumulative minutes of MVPA) are widely available.
The effects of coconut oil on the cardiometabolic profile: a systematic review and meta-analysis of randomized clinical trials
Authors: Duarte Ana Cláudia , Spiazzi Bernardo Frison , Zingano Carolina Pires , Merello Eduarda Nunes , Wayerbacher Laura Fink , Teixeira Paula Portal , Farenzena Laura Penso , de Araujo Carina , Amazarray Carmen Raya , Colpani Verônica , Gerchman Fernando
Published: August 2022

Background

Despite having a 92% concentration of saturated fatty acid composition, leading to an apparently unfavorable lipid profile, body weight and glycemic effect, coconut oil is consumed worldwide. Thus, we conducted an updated systematic review and meta-analysis of randomized clinical trials (RCTs) to analyze the effect of coconut oil intake on different cardiometabolic outcomes.

Methods

We searched Medline, Embase, and LILACS for RCTs conducted prior to April 2022. We included RCTs that compared effects of coconut oil intake with other substances on anthropometric and metabolic profiles in adults published in all languages, and excluded non-randomized trials and short follow-up studies. Risk of bias was assessed with the RoB 2 tool and certainty of evidence with GRADE. Where possible, we performed meta-analyses using a random-effects model.

Results

We included seven studies in the meta-analysis (n = 515; 50% females, follow up from 4 weeks to 2 years). The amount of coconut oil consumed varied and is expressed differently among studies: 12 to 30 ml of coconut oil/day (n = 5), as part of the amount of SFAs or total daily consumed fat (n = 1), a variation of 6 to 54.4 g/day (n = 5), or as part of the total caloric energy intake (15 to 21%) (n = 6). Coconut oil intake did not significantly decrease body weight (MD -0.24 kg, 95% CI -0.83 kg to 0.34 kg), waist circumference (MD -0.64 cm, 95% CI -1.69 cm to 0.41 cm), and % body fat (-0.10%, 95% CI -0.56% to 0.36%), low-density lipoprotein cholesterol (LDL-C) (MD -1.67 mg/dL, 95% CI -6.93 to 3.59 mg/dL), and triglyceride (TG) levels (MD -0.24 mg/dL, 95% CI -5.52 to 5.04 mg/dL). However, coconut oil intake was associated with a small increase in high-density lipoprotein cholesterol (HDL-C) (MD 3.28 mg/dL, 95% CI 0.66 to 5.90 mg/dL). Overall risk of bias was high, and certainty of evidence was very-low. Study limitations include the heterogeneity of intervention methods, in addition to small samples and short follow-ups, which undermine the effects of dietary intervention in metabolic parameters.

Conclusions

Coconut oil intake revealed no clinically relevant improvement in lipid profile and body composition compared to other oils/fats. Strategies to advise the public on the consumption of other oils, not coconut oil, due to proven cardiometabolic benefits should be implemented.

Registration

PROSPERO CRD42018081461.
lncRNA polymorphism affects the prognosis of gastric cancer
Authors: Lyu Yanping , Yang Shuangfeng , Lyu Xuejie , Wang Yuan-Liang , Ji Shumi , Kang Shuling , Jiang Yu , Xiang Jianjun , He Chenzhou , Li Peixin , Liu Baoying , Wu Chuancheng
Published: August 2022

Background

Previous studies have found that lncRNA polymorphisms are associated with the prognosis of gastric cancer (GC), but the specific roles of many lncRNA polymorphism sites in gastric cancer are still unclear. Our study aims to deeply explore the relationship between genetic polymorphism of lncRNA and the prognosis of GC.

Methods

The genotypes of candidate SNP locus were detected by Sequenom Mass ARRAY SNP. We deeply analyzed the association of lncRNA polymorphisms with GC prognosis by univariate and multivariate Cox regression, stratified analysis, conjoint analysis, and log-rank test.

Results

We found that mutations at rs2579878 and rs10036719 loci reduced the risk of poor prognosis of GC. Stratified analysis showed that rs2795025, rs10036719, and rs12516079 polymorphisms were all associated with tumor prognosis. In addition, conjoint analyses showed that the interaction between these two polymorphic sites (rs2795025 and rs12516079) could increase the risk of poor prognosis. Multivariate analysis also found that the AG/AA genotype of rs10036719 and AG genotype of rs12516079 were independent prognostic factors. Moreover, the high expression of both CCDC26 and LINC02122 were shown to be associated with the poor survival status of GC patients.

Conclusions

We find that the genetic polymorphism of lncRNA plays a role in the development of GC and is closely related to the survival time of patients. It could serve as a predictor of the prognosis of GC.
Intra-bone marrow injection of magnesium isoglyrrhizinate inhibits inflammation and delays osteoarthritis progression through the NF-κB pathway
Authors: Chen Rong , Li Xiangwei , Sun Zhibo , Yin Junyi , Hu Xiaowei , Deng Jingwen , Liu Xinghui
Published: August 2022

Objective

Osteoarthritis (OA) presents cartilage damage in addition to chronic inflammation. However, self-recovery of damaged cartilage in an inflammatory environment is not possible. Mesenchymal stem cells (MSCs) in the bone marrow are a source of regenerative repair of damaged cartilage. To date, whether intra-luminal administration of the bone marrow can delay the progression of OA is still unknown. This study, therefore, aimed to explore the role of intra-bone marrow injection of Magnesium isoglycyrrhizinate (MgIG) in delaying the OA progression and to investigate the underlying mechanism.

Methods

Rabbit OA models were established using the anterior cruciate ligament transection method while a catheter was implanted into the bone marrow cavity. 1 week after surgery, MgIG treatment was started once a week for 4 weeks. The cartilage degradation was analyzed using hematoxylin–eosin staining, Masson’s trichrome staining and Alcian blue staining. Additionally, the pro-inflammatory factors and cartilage regeneration genes involved in the cartilage degeneration and the underlying mechanisms in OA were detected using enzyme-linked immunosorbent assay, quantitative real-time PCR (qRT-PCR) and Western blotting.

Results

The results of histological staining revealed that intra-bone marrow injection of MgIG reduced degeneration and erosion of articular cartilage, substantially reducing the Osteoarthritis Research Society International scores. Furthermore, the productions of inflammatory cytokines in the bone marrow cavity and articular cavity such as interleukin-1β(IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) were inhibited upon the treatment of MgIG. At the same time, the expression of alkaline phosphate, tartrate-resistant acid phosphatase-5b (TRAP-5b) and C-telopeptides of type II collagen (CTX-II) in the blood also decreased and was positively correlated. On the contrary, cartilage-related genes in the bone marrow cavity such as type II collagen (Col II), Aggrecan (AGN), and SRY-box 9 (SOX9) were up-regulated, while matrix metalloproteinase-3 (MMP-3) was down-regulated. Mechanistically, MgIG was found to exert an anti-inflammatory effect and impart protection to the cartilage by inhibiting the NF-κB pathway.

Conclusion

Intra-bone marrow injection of MgIG might inhibit the activation of the NF-κB pathway in the progression of OA to exert an anti-inflammatory effect in the bone marrow cavity and articular cavity, thereby promoting cartilage regeneration of MSCs in the bone marrow, making it a potential new therapeutic intervention for the treatment of OA.
Femoral artery variation was found during V-A ECMO catheterization
Authors: Du Liwen , Zhu Leilei , Shi Yongwei , Liu Peng , Xun Kai
Published: August 2022

Background

High bifurcation of the deep femoral artery (DFA) is rare in clinical practice, and patients with this variation are less likely to receive venoarterial extracorporeal membrane oxygenation (V-A ECMO) treatment. Therefore, the method by which V-A ECMO is introduced in patients with vascular variation is very important.

Case presentation

A 52-year-old male patient had ST elevation myocardial infarction due to coronary heart disease. Angiography showed tripartite coronary artery lesions, and coronary artery stenting supported by V-A ECMO was needed. Vascular evaluation before ECMO catheterization revealed high bifurcation of the bilateral DFA located at the inguinal ligament. After discussion, the perfusion cannula was placed in the left superficial femoral artery (SFA) towards the heart, and the distal perfusion catheter (DPC) was placed in the left SFA towards the distal end. Nevertheless, after the patient's heart recovered, necrosis of the toe of the left lower limb still occurred.

Conclusion

Common femoral artery assessment must be performed before V-A ECMO for patients with high bifurcation of the DFA. Incision catheterization and DPC placement are recommended. After decannulation, arterial repair under direct visualisation is recommended, and rigorous distal vascular assessment and management are needed.
Comparative analysis of cancer cell responses to targeted radionuclide therapy (TRT) and external beam radiotherapy (EBRT)
Authors: Grzmil Michal , Boersema Paul , Sharma Ashish , Blanc Alain , Imobersteg Stefan , Pruschy Martin , Picotti Paola , Schibli Roger , Behe Martin
Published: August 2022

The vast majority of our knowledge regarding cancer radiobiology and the activation of radioresistance mechanisms emerged from studies using external beam radiation therapy (EBRT). Yet, less is known about the cancer response to internal targeted radionuclide therapy (TRT). Our comparative phosphoproteomics analyzed cellular responses to TRT with lutetium-177-labeled minigastrin analogue [177Lu]Lu-PP-F11N (β-emitter) and EBRT (ɣ-rays) in CCKBR-positive cancer cells. Activation of DNA damage response by p53 was induced by both types of radiotherapy, whereas TRT robustly increased activation of signaling pathways including epidermal growth factor receptor (EGFR), mitogen-activated protein kinases (MAPKs) or integrin receptor. Inhibition of EGFR or integrin signaling sensitized cancer cells to radiolabeled minigastrin. In vivo, EGFR inhibitor erlotinib increased therapeutic response to [177Lu]Lu-PP-F11N and median survival of A431/CCKBR-tumor bearing nude mice. In summary, our study explores a complex scenario of cancer responses to different types of irradiation and pinpoints the radiosensitizing strategy, based on the targeting survival pathways, which are activated by TRT.
Treatment of myelodysplastic syndromes in the era of precision medicine and immunomodulatory drugs: a focus on higher-risk disease
Authors: Mohty Razan , Al Hamed Rama , Bazarbachi Ali , Brissot Eolia , Nagler Arnon , Zeidan Amer , Mohty Mohamad
Published: August 2022

Myelodysplastic syndromes (MDS) are a heterogeneous clonal disease of myeloid neoplasms characterized by ineffective hematopoiesis, variable degree of cytopenias, and an increased risk of progression to acute myeloid leukemia (AML). Molecular and genetic characterization of MDS has led to a better understanding of the disease pathophysiology and is leading to the development of novel therapies. Targeted and immune therapies have shown promising results in different hematologic malignancies. However, their potential use in MDS is yet to be fully defined. Here, we review the most recent advances in therapeutic approaches in MDS, focusing on higher-risk disease. Allogeneic hematopoietic cell transplantation is beyond the scope of this article.
Ischemic and hemorrhagic abdominal complications in COVID-19 patients: experience from the first Italian wave
Authors: Bonaffini Pietro Andrea , Franco Paolo Niccolò , Bonanomi Alice , Giaccherini Cinzia , Valle Clarissa , Marra Paolo , Norsa Lorenzo , Marchetti Marina , Falanga Anna , Sironi Sandro
Published: August 2022

Purpose

To report ischemic and haemorrhagic abdominal complications in a series of COVID-19 patients. To correlate these complications with lung involvement, laboratory tests, comorbidities, and anticoagulant treatment.

Methods

We retrospectively included 30 COVID-19 patients who undergone abdomen CECT for abdominal pain, between March 16 and May 19, 2020. Ischemic and haemorrhagic complications were compared with lung involvement (early, progressive, peak or absorption stage), blood coagulation values, anticoagulant therapy, comorbidities, and presence of pulmonary embolism (PE).

Results

Ischemic complications were documented in 10 patients (7 receiving anticoagulant therapy, 70%): 6/10 small bowel ischemia (1 concomitant obstruction, 1 perforation) and 4/10 ischemic colitis. Main mesenteric vessels were patent except for 1 superior mesenteric vein thrombosis. Two ischemia cases also presented splenic infarctions. Bleeding complications were found in 20 patients (all receiving anticoagulant treatments), half with active bleeding: hematomas in soft tissues (15) and retroperitoneum (2) and gastro-intestinal bleeding (3). Platelet and lymphocyte were within the normal range. d-Dimer was significantly higher in ischemic cases (p < 0.001). Most of the patients had severe lung disease (45% peak, 29% absorption), two patients PE.

Conclusions

Ischemic and haemorrhagic abdominal complications may occur in COVID-19 patients, particularly associated to extended lung disease. CT plays a key role in the diagnosis of these potentially life- threatening conditions.
An exploratory study of associations between the ICD-11 personality disorder model and eating pathology
Authors: Stricker Johannes , Barthels Friederike , Müller Romina , Pietrowsky Reinhard
Published: August 2022

Background

Recently, the International Classification of Diseases 11th Revision (ICD-11) has introduced a paradigm shift in personality disorder conceptualization. The novel ICD-11 personality disorder model comprises a dimensional assessment of personality dysfunction and five maladaptive personality trait domains. Maladaptive personality plays a central role in eating pathology. Yet, relations between the ICD-11 personality disorder model and eating pathology are, to date, unclear. Thus, this study aimed to explore the bivariate, incremental, and interactive associations of the ICD-11 personality disorder model components with eating pathology domains.

Methods

A predominantly female (85%) sample of 888 German-speaking community adults completed validated self-report measures of personality dysfunction, the ICD-11 personality trait domains, and five eating pathology domains (drive for thinness, bulimia, body dissatisfaction, orthorexia, binge eating). Bivariate and hierarchical regressions models were used to investigate bivariate, incremental, and interactive relations between the ICD-11 personality disorder model components and eating pathology.

Results

Personality dysfunction and the ICD-11 personality trait domains showed statistically significant bivariate relations with eating pathology. Additionally, personality dysfunction and most ICD-11 personality trait domains displayed incremental links with eating pathology. Finally, the relations of the ICD-11 personality trait domains with eating pathology were largely independent of the severity of personality dysfunction.

Conclusions

This study indicated that all ICD-11 personality disorder model components are uniquely linked to eating pathology. Beyond maladaptive personality trait domains, the strong and incremental relations of personality dysfunction with eating pathology have potential implications for theory building. Further research using longitudinal designs is needed to evaluate causal links between the ICD-11 personality disorder model components and eating pathology.
Correction: SCCWRP workshop series
Authors:   Microplastics and Nanoplastics
Published: August 2022

An amendment to this paper has been published and can be accessed via the original article.
Right-to-left ventricle ratio determined by machine learning algorithms on CT pulmonary angiography images predicts prolonged ICU length of stay in operated chronic thromboembolic pulmonary hypertension
Authors: Shikhare Sumer , Balki Indranil , Shi Yuliang , Kavanagh John , Donahoe Laura , Xu Wei , Rozenberg Dmitry , de Perrot Marc , McInnis Micheal
Published: August 2022

Objective:

Right-to-left ventricle diameter ratio (dRV/dLV) on CT pulmonary angiography (CTPA) is a predictor of outcomes in non-operated chronic thromboembolic pulmonary hypertension (CTEPH) patients. The purpose of this study is to evaluate the performance of a novel machine learning (ML) algorithm for dRV/dLV measurement in operated CTEPH patients and its association with post-operative outcomes.

Methods:

This retrospective study reviewed consecutive CTEPH patients who underwent pulmonary endarterectomy between 2013 and 2017. ML calculated dRV/dLV on pre-operative CTPA and compared with manual measures. Associations of dRV/dLV with patient characteristics and post-operative outcomes were evaluated including intensive care (ICU) and hospital length of stay (LOS) using multivariable linear regression analysis. Prolonged LOS was defined as greater than median.

Results:

ML segmented the ventricles in 99/125 (79%) patients. The most common cause of failure was misidentification of the moderator band as the interventricular septum (7.9%). Mean dRV/dLV by ML was 1.4 ± 0.4 and strongly correlated with manual measures (r = 0.9–0.96 p < 0.0001). dRV/dLV was moderately correlated with measures of pulmonary hypertension on right heart catheterization and RV dilatation on echocardiogram (r = 0.5–0.6, p < 0.0001). dRV/dLV ≥ 1.2 was associated with proximal Jamieson type disease (p = 0.032), longer cardiopulmonary bypass (p = 0.037), aortic cross-clamp (p = 0.022) and circulatory arrest (p < 0.001) at surgery and dRV/dLV ≥ 1.6 with post-operative ECMO (p = 0.006). dRV/dLV was independently associated with prolonged ICU LOS (OR = 3.79, 95% CI 1.1–13.06, p = 0.035).

Conclusion:

dRV/dLV was associated with CTEPH severity and independently associated with prolonged ICU LOS. This CT parameter may therefore assist in perioperative planning. Further refinement of the ML algorithm or CTPA technique is required to avoid errors in ventricular segmentation.

Advances in knowledge:

Automated right-to-left ventricle ratio measurement by machine learning is feasible and is independently associated with outcome after pulmonary endarterectomy.
Diagnostic accuracy of palpation and ultrasonography for diagnosing infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis
Authors: van den Bunder Fenne AIM , Derikx Joep PM , Kiblawi Rim , van Rijn Rick R , Dingemann Jens
Published: August 2022

Objective:

Although infantile hypertrophic pyloric stenosis (IHPS) is a well-known disease, there is no systematic review regarding the optimal diagnostic strategy. We conducted a systematic review and meta-analysis to obtain diagnostic accuracy of all methods to diagnose IHPS.

Methods:

According to the Preferred Reported Items for Systematic Reviews and Meta-Analysis guidelines, we searched MEDLINE and Embase to identify studies reporting sensitivity and specificity of all methods used to diagnose IHPS. Inclusion criteria were infants with suspicion of/or diagnosed with IHPS who underwent pyloromyotomy or had clinical follow-up. A random-effects model was used to obtain pooled estimates of sensitivity, specificity and area under the receiver operating characteristic curve.

Results:

After screening 5364 studies, we included 43 studies with in total 6085 infants (n = 4241 IHPS; n = 1844 controls). The diagnostic sensitivity of palpation ranged from 10.0 to 93.4% and decreased over time. Different parameters for ultrasonography were found. Most used parameters were pyloric muscle thickness (PMT) ≥ 3 mm (pooled sensitivity 97.6% and specificity 98.8%), PMT ≥ 4 mm (pooled sensitivity 94.0% and specificity 98.0%) or a combination of PMT ≥ 4 mm and/or pyloric canal length ≥16 mm (pooled sensitivity 94.0% and specificity 91.7%). The AUC showed high diagnostic accuracy (0.997, 0.966 and 0.981 respectively), but large heterogeneity exists. Due to the large differences in cut-off values no meta-analysis could be conducted for pyloric canal length and pyloric diameter.

Conclusion:

Palpation has limited sensitivity in diagnosing IHPS. We showed that ultrasonography has highest diagnostic accuracy to diagnose IHPS and we advise to use PMT ≥ 3 mm as cut-off.

Advances in knowledge:

This is the first systematic review and meta-analysis on diagnosing IHPS, which summarizes the available literature and may be used as a guideline.
Automated detection of dental restorations using deep learning on panoramic radiographs
Authors: Çelik Berrin , Çelik Mahmut Emin
Published: August 2022

Objectives:

Automatically detecting dental conditions using Artificial intelligence (AI) and reporting it visually are now a need for treatment planning and dental health management. This work presents a comprehensive computer-aided detection system to detect dental restorations.

Methods:

The state-of-art ten different deep-learning detection models were used including R-CNN, Faster R-CNN, SSD, YOLOv3, and RetinaNet as detectors. ResNet-50, ResNet-101, XCeption-101, VGG16, and DarkNet53 were integrated as backbone and feature extractor in addition to efficient approaches such Side-Aware Boundary Localization, cascaded structures and simple model frameworks like Libra and Dynamic. Total 684 objects in panoramic radiographs were used to detect available three classes, namely, dental restorations, denture and implant. Each model was evaluated by mean average precision (mAP), average recall (AR), and precision-recall curve using Common Objects in Context (COCO) detection evaluation metrics.

Results:

mAP varied between 0.755 and 0.973 for ten models explored while AR ranges between 0.605 and 0.771. Faster R-CNN RegnetX provided the best detection performance with mAP of 0.973 and AR of 0.771. Area under precision-recall curve was 0.952. Precision-recall curve indicated that errors were mainly dominated by localization confusions.

Conclusions:

Results showed that the proposed AI-based computer-aided system had great potential with reliable, accurate performance detecting dental restorations, denture and implant in panoramic radiographs. As training models with more data and standardization in reporting, AI-based solutions will be implemented to dental clinics for daily use soon.
A resposta educacional dos municípios à Covid-19: Diversidade, trajetória e desigualdades
Authors: Lazzarotti Diniz Costa Bruno , Brandão Lucas
Published: August 2022

O artigo analisa as modalidades de respostas educacionais das redes municipais de educação diante da interdição, em virtude da pandemia de Covid-19, das atividades escolares presenciais, os padrões de resposta e, particularmente, em que medida as variações na qualidade e amplitude dessas estratégias tendem a reproduzir ou aprofundar as desigualdades educacionais existentes. O objetivo foi operacionalizado pela análise dos dados de resposta a questionários aplicados pelo censo educacional, agregadas em um indicador sintético. O comportamento do indicador foi analisado levando-se em conta o legado das políticas educacionais prévias – medido pelo Índice de Desenvolvimento da Educação Básica (Ideb) municipal –, o contexto socioeconômico em que foram implementadas – o nível socioeconômico médio dos estudantes da rede –, a diversidade regional brasileira e o porte populacional dos municípios. Os resultados apontam que, de fato, nos municípios de nível socioeconômico mais alto e com trajetória educacional mais exitosa, as alternativas ao fechamento das escolas tenderam a ser mais abrangentes e diversificadas, sugerindo o risco de que esse seja mais um vetor de aprofundamento das desigualdades educacionais.
Modelling the impact of emigration upon social and economic development of the Carpathian region of Ukraine
Authors: Levytska Olha , Mulska Olha , Shushkova Yulia , Ivaniuk Ulana , Vasyltsiv Taras , Krupin Vitaliy , Ivanova Liliya
Published: August 2022

Population migration activity in the Carpathian region of Ukraine is currently high in intensity and scale compared to the national average. This situation is caused by subjective factors (lower living standards and quality of life, employment problems, escalation of armed conflict in the east) and objective factors (globalization and increasing population mobility, development of transnational corporations, digitalization of the economy, simplification of border-crossing procedures). The aim of the research is to model and visualize the impact of population migration on the social and economic development of the Carpathian region of Ukraine and to determine an optimal value and critical range of external migration for the region. Based on the modelling, assuming that socio-economic development of the Carpathian region corresponds to the level of integral coefficient for Poland in 2018 (calculated using a multiplicative approach), the acceptable level of external migration was determined. It is 0.850 for Lviv region (actual migration level was 1.479 in 2018); 0.653 for Chernivtsi region (0.695); and 1.488 for Zakarpattya region (2.149). The critical range of the intensity of external population migration is 0.723–1.264 for Lviv region, 0.499–0.578 for Chernivtsi region, 0.006–0.008 for Ivano Frankivsk region, and 0.479–0.769 for Zakarpattya region.
The problem of knowledge about health and its relationship with magic at the beginning of this human civilization
Authors: Sytnik-Czetwertyński Janusz
Published: August 2022

One of the common features of primitive cultures and civilizations is the complete integration of magic and medicine. The symbol is tribal shamans playing both the role of a priest and a medic. In addition to practices that may have some justification, such as when the treatment is carried out with the help of plants known today for their therapeutic qualities, spells and practices characteristic of occult ceremonies are used. Magic even replaces the diagnosis here – it is the omens that are supposed to indicate the real state of the patient. History shows that the unification of magic and medicine is devastating for the latter.
COVID-19 vaccination in pregnant and lactating women
Authors: Kaziród Karolina , Kuryło Weronika , Brzuszkiewicz Kinga , Miturski Andrzej , Semczuk-Sikora Anna
Published: August 2022

Introduction: The COVID-19 pandemic significantly changed the lifestyle of pregnant women. Pregnant women with COVID-19 are more likely to suffer from severe disease, as well as unfavorable pregnancy and childbirth. Currently, there is no causal treatment for this disease available, so attention should be paid to preventing infection with vaccines.

Aim of the study: A review of the literature on the influence of COVID-19 vaccines on the course of pregnancy and summary of recommendations regarding the use of COVID-19 vaccines during pregnancy and breastfeeding.

 State of knwoledge: Three types of COVID-19 vaccines are most commonly used: mRNA vaccines, vector vaccines as well as subunit vaccines. In preclinical developmental and reproductive toxicity studies in animal models, there were no alarming safety signals, and observations of vaccinated pregnant women did not reveal any complications with respect to the course of pregnancy and development of the fetus. No cases of neonatal death have been reported in the first 28 days after birth. Most of the side effects following vaccination, such as injection site pain or tenderness, fatigue, fever or muscle pain, were moderate and resolved within 24 hours. The current research results confirm a positive immune response in pregnant women. Moreover, it is important that the presence of antibodies in the umbilical cord blood makes it possible to protect and reduce the risk of SARS-CoV-2 infection of the newborn.

Summary: All pregnant women, irrespective of trimester, and breastfeeding mothers are advised to administer a booster dose of the COVID-19 vaccine within an appropriate period of time after the primary vaccination schedule.
Pregnant woman infected with SARS-COV-2 – diagnosis and treatment
Authors: Borowik Joanna , Kaziród Karolina , Miturski Andrzej , Semczuk-Sikora Anna
Published: August 2022

Introduction: COVID-19 is an infection caused by the new SARS-CoV-2 virus. In pregnant women with COVID-19, compared to non-pregnant women, there is an increased risk of a severe course of the infection. Pregnant women are more often hospitalized in the Intensive Care Unit and require mechanical ventilation. In the course of COVID-19 infection, pregnant women have a greater risk of miscarriage, premature birth or having a baby with low birth weight, compared to their healthy pregnancy peers.

The aim of the study: To present, based on the available literature, the principles of management of a pregnant woman infected with SARS-CoV-2 virus.

State of knowledge: The evidence of infection is the detection of the virus in the clinical specimen confirmed by PCR. Chest computer tomography can be useful in diagnosis, especially when the PCR test result is negative. Particular attention should be paid to pharmacological treatment, which should be both effective and safe for the fetus. Certain antiviral and anti-inflammatory drugs as well as anticoagulants drugs are used in COVID-19 therapy. Oxygen and fluid therapy is also important. The condition of the fetus should be monitored regularly. It is recommended to measure the fetal heart rate, perform cardiotocography, pregnancy ultrasound and assess the volume of amniotic fluid. The decision about the time and method of delivery should be made individually on the basis of obstetric indications and the maternal-fetal condition.

Summary: The therapy of a pregnant patient infected with SARS-CoV-2 should be adjusted individually depending on the woman's health condition. In therapeutic interventions, the welfare of both the mother and the fetus should be taken into account.
Small intestinal bacterial overgrowth - small intestine, big struggle
Authors: Dembowska Aleksandra , Dubaj Maciej , Bigosiński Karol
Published: August 2022

The gut microbiota plays an important role in the proper functioning of the human body. The microbes present in the intestines are important for the correct functioning of the digestive tract as well as other, often distant, organs of the human body. Unfavorable conditions may lead to an imbalance of intestinal microorganisms, leading to unfavorable consequences.

Under physiological conditions, the large intestine is inhabited by a significant amount of bacteria, while the small intestine contains only a small amount of them. The appearance of pathological conditions in the gastrointestinal tract may lead to the colonization of the small intestine by an excessive amount of bacteria, which, in combination with gastrointestinal symptoms, is called small intestinal bacterial overgrowth. The most common symptoms associated with this disease are abdominal pain, diarrhea, and gas.

It is difficult to diagnose this disease due to the lack of specific symptoms and imperfect diagnostic methods. The highest quality test is the microbiological test, however, due to the invasiveness of the method and the difficulties with precise collection of the material, less invasive tests are used, primarily the hydrogen breath test.

The mainstay of treatment of bacterial overgrowth is antibiotic therapy, which aims to reduce the amount of bacteria to the extent that the patient does not feel the disease. It is also important to eat a diet rich in fiber and low in fermenting oligo-, di- and monosaccharides and polyols.

Patients with the small intestinal bacterial overgrowth rarely develop symptoms of a severe course of the disease, however, due to the unpleasant symptoms and relatively easy treatment methods, the disease should be included in the differential diagnosis in people with risk factors and present symptoms.
Regionalizm jako nieredukowalny aspekt działalności bibliotecznej – na przykładzie poczynań Pedagogicznej Biblioteki Wojewódzkiej w Opolu
Authors: Kawoń-Noga Dagmara
Published: August 2022

REGIONALISM AS AN IRREDUCIBLE ASPECT OF LIBRARY ACTIVITY: A CASE STUDY OF THE ACTIVITIES OF THE REGIONAL PEDAGOGICAL LIBRARY IN OPOLE The article presents selected projects of a regional nature undertaken by the Regional Pedagogical Library in Opole. It offers theoretical discussions of regionalism, regional education and the little homeland; a general typology of library projects that fit in with the issues in question; and a characterization of three areas of activity: the publication of the socio- -cultural periodical Strony [Pages], the organization of Mother Language Day in Opole Silesia and the cooperation with the Goethe Institute in Kraków.
Zagadnienia regionalizmu w działalności bibliograficznej Pedagogicznej Biblioteki Wojewódzkiej w Opolu
Authors: Kowalska Iwona , Zacłona Anna
Published: August 2022

THE ISSUES OF REGIONALISM IN THE BIBLIOGRAPHIC RESEARCH OF THE REGIONAL PEDAGOGICAL LIBRARY IN OPOLE The article discusses the progress on a specialist regional bibliography of education in Opole and demonstrates the directions of its development. Since 2000, a specialist bibliography has been in preparation at the Regional Pedagogical Library in Opole, entitled Oświata na Śląsku Opolskim [Education in Opole Silesia], which currently features ten thousand bibliographic entries. The bibliography records writings on the history and development of state and private education in the Opole region, and materials on education policy in Opole Silesia. It contains documents pertaining to educational and upbringing institutions (e.g. children’s homes, psychological counselling centres, and teacher training centres). Information about teachers is also recorded (biographies, teaching career, academic or artistic output). Similarly, bibliographic information related to students is collected. The data are entered in accordance with a regional classification which comprises fourteen main categories. The bibliographical research in progress at the Regional Pedagogical Library in Opole which aims to produce a bibliographical record of education in the region has also been documented in books published in 2011, 2018 and 2021 under the editorship of Iwona Kowalska and Anna Zacłona. Another bibliographic database discussed in the article is OMNIBUS, which features over 120 thousand entries in various areas of research, published in ca. 450 periodicals, especially in the fields of pedagogy, methods of teaching of various subjects, psychology, sociology as well as journals in literary studies, socio-cultural studies, popular science and library studies.
Świat jako ziemia obiecana. Lokalne wspólnoty jako miejsca wzajemnego gospodarowania ziemią w ujęciu Józefa Tischnera
Authors: Kozak Magdalena
Published: August 2022

THE WORLD AS A PROMISED LAND: LOCAL COMMUNITIES AS PLACES OF MUTUAL MANAGEMENT OF LAND ACCORDING TO JÓZEF TISCHNER The article is meant as an introduction to the idea of community according to the Kraków philosopher, Fr Józef Tischner, based in particular on his work entitled Filozofia dramatu [The Philosophy of Drama]. How does Tischner understand the community and what kinds of communities does he focus on in his thinking about man? What is the significance of mutuality and responsibility and why must every community rely on a clearly defined system of values? What threats does the community face and how does corrosion and ultimate collapse of communities take place? While discussing the idea of community, Tischner refers to the land under our feet as a promised land, but also a land that has been granted to man. We, people, are given control of it as a space to be managed wisely and responsibly. A home, a workplace, a church or a cemetery are only selected examples of how land can be managed, which constitute special places in human life and shape our identity at the same time.
Konferencje z cyklu Człowiek potrzebuje korzeni i skrzydeł jako forma popularyzacji wiedzy o regionie
Authors: Marcol Anna
Published: August 2022

THE CONFERENCE SERIES ENTITLED MAN NEEDS ROOTS AND WINGS AS A FORM OF PROMOTION OF REGIONAL KNOWLEDGE The promotion of regional matters is an important activity of the Józef Lompa Regional Pedagogical Library in Katowice. Since 2011 it has organized, in cooperation with the Regional In-Service Teacher Training Centre “Metis” in Katowice, a series of conferences entitled Man Needs Roots and Wings aimed at a wide range of teachers, librarians and regionalists. Each conference centres around a different topic and institutions whose activities fit in with the issues discussed in individual meetings are invited to cooperate. The speakers in clude established scholars as well as practitioners who provide information on how to popularize knowledge about the region among students. Ten conferences in the series took place in 2011 -2020. Their topics often focused on important anniversaries and celebrations: “Little homelands: culture – education – development”, “The media as a factor shaping the culture of the region”, “The region in the senses”, “In search of forgotten authorities”, “Year of Remembrance of the Victims of the 1945 Upper Silesian Tragedy”, “Year of Remembrance of the Victims of the Wujek Coal Mine Massacre”, “The homeland ought to be loved and respected: how to teach children so that they remember when they grow up”, “Polish scouts’ service to Independent Poland”, “Centenary of the Silesian Uprisings: 1919 -1920 -1921”, “From agglomeration to metropolis”.
A Biphasic COVID-19 Clinical Course in Anti-CD20 Treated Patients: Case Series and Review of the Literature
Authors: Bigman-Peer Noa , Peer Eyal , Pertzov Barak , Kramer Mordechai , Segal Gad , Eliakim-Raz Noa
Published: August 2022

We describe four cases of COVID-19 infection during the Omicron wave, in patients treated with anti-CD20 monoclonal antibodies. All cases follow a similar biphasic clinical course consisting of respiratory deterioration, which occurred a few weeks after convalescence from initial mild to asymptomatic infection. Possible explanations are discussed.