bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical features and outcomes of four atypical hemolytic uremic syndrome cases at a single institution in Miyazaki Prefecture from 2015 to 2019
Authors: Kawano Noriaki , Abe Tomohiro , Ikeda Naoko , Nagahiro Yuri , Kawano Sayaka , Tochigi Taro , Nakaike Takashi , Yamashita Kiyoshi , Kubo Keisuke , Yamanaka Atsushi , Terasaka Sohshi , Marutsuka Kousuke , Mashiba Koichi , Kikuchi Ikuo , Shimoda Kazuya , Matsumoto Masanori , Ochiai Hidenobu
Published: April 2022

Background

Although atypical hemolytic uremic syndrome (aHUS) is a life-threatening clinical entity that was characterized by thrombotic microangiopathy (TMA) with the activation of the complement system and the efficient treatment of eculizumab, the clinical features of aHUS have been unclear because of the rare incidence.

Case presentation

We retrospectively analyzed 4 aHUS cases at a single institution during 2015–2019. Here, we presented 4 aHUS cases with renal transplantation (one case), influenza/acute interstitial pneumonia/disseminated intravascular coagulation (two cases), and severe fever with thrombocytopenia syndrome (one case), respectively. Initial clinical symptoms were microangiopathic hemolytic anemia (four cases), renal dysfunction (four cases), thrombocytopenia (four cases), and pulmonary hemorrhage (three cases) consisted with TMA features. Subsequent further examinations ruled out thrombotic thrombocytopenic purpura, Shiga toxin-producing E.coli-induced hemolytic uremic syndrome, and secondary TMA. Taken these findings together, we made the clinical diagnosis of aHUS. Furthermore, all cases also presented the high levels of plasma soluble C5b-9 (871.1 ng/ml, 1144.3 ng/ml, 929.2 ng/ml, and 337.5 ng/ml), suggesting persistent activation of complementary system. Regarding the treatment, plasma exchange (PE) (four cases) and eculizumab (two cases) therapy were administered for aHUS cases. Consequently, case 2 and case 4 were still alive with 768 days and 235 days, respectively. The other two cases were dead at 34 days and 13 days, respectively. Finally, although the previous reported genetic pathogenetic mutations were not detected in our cases, multiple genetic variants of complement factors were detected as CFH (H402Y, E936D), and THBD (A473V) in case 1, CFH (V62I, H402Y, V837I) in case 2, and CFH (H402Y, E 936D) and THBD (A473V) in case 3, CFH (V62I, H402Y, E936D) and THBD (473V) in case 4, respectively.

Conclusions

Because of still high mortality in our study, an urgent diagnosis of aHUS and subsequent immediate treatment including PE and eculizumab should be essential in clinical practice. Furthermore, the multiple genetic variants and the triggers may be related to one of the pathogenesis of aHUS. Thus, we assume that such a case-oriented study would be highly useful to the physicians who directly care for aHUS cases in clinical practice.
Remdesivir administration for Japanese COVID-19 patients undergoing maintenance hemodialysis: a retrospective observation with six case reports
Authors: Ito Jun , Kimura Moritsugu , Toya Tomoyuki , Isozumi Konomi , Kawaji Atsuro , Isozaki Yudai , Fukagawa Masafumi
Published: April 2022

Background

The mortality rate of novel coronaviral disease (COVID-19) patients undergoing dialysis is considerably higher than that of patients with normal kidney function. As of August 2021, only remdesivir has been approved in Japan as an antiviral drug for the treatment of COVID-19. However, in cases of kidney failure, remdesivir administration should be considered only if the therapeutic benefits outweigh the risks because of concern about the accumulation of its solubilizing excipient sulfobutylether-beta-cyclodextrin and subsequent renal tubular injury or liver injury. Recently, reports from overseas indicating the safety of the use of remdesivir for COVID-19 patients on dialysis have been gathered.

Case presentation

From June 2021, in our hospital, we started the administration of remdesivir to patients with moderate cases of COVID-19 undergoing hemodialysis, with careful consideration of the dosage and timing. Since then, six out of seven COVID-19 patients on hemodialysis who had received remdesivir have completely recovered. In a patient who died, the initial dose of remdesivir was administered after the case developed into severe COVID-19. All six patients who were able to start receiving remdesivir immediately at the stage of moderate COVID-19 recovered and were discharged without the need for mechanical ventilation. While, two out of four patients before May 2021 who had not been administered remdesivir at admission became severe, transferred to another tertiary hospital, and died. During and after remdesivir administration, no increase in serum transaminase to five times or more of the normal upper limit was observed in any of the cases. There were no other adverse drug reactions, such as infusion reaction, gastrointestinal symptoms, or anemia.

Conclusions

We were able to administer remdesivir to six Japanese patients with moderate COVID-19 on hemodialysis safely. It is expected that the safe use of remdesivir will bring an increase in treatment options for moderate cases of COVID-19 in dialysis patients as well as subsequent improvement in treatment outcomes. However, to confirm the efficacy and safety of such use, further careful observation in more cases is required.
Carrier RNA is a key factor affecting fully integrated short tandem repeats profiling in challenging forensic samples models
Authors: El-Shorbagy Haidan M. , El-Liethy Shereen S. , Moussa Mona K. , Elghor Akmal A.
Published: April 2022

Background

Short tandem repeats (STRs) are used today to provide discriminatory power for DNA fingerprinting. The present results showed that different factors may affect STR profiles in challenging samples including DNA quantity, DNA quality, PCR inhibitors and storage time. In the present study, blood stain samples were applied on two types of fabrics (black cotton and denim) to compare the efficiency of two different DNA-extraction methods (automated magnetic based beads method (EZ1), and manual organic method), with and without adding carrier RNA molecules, and to assess the quality and quantity of the extracted DNA and their capabilities for producing reportable STR-profiles in the presence of PCR inhibitors at two different storage times.

Results

Carrier RNA caused a dramatic increase in DNA recovery from black cotton or denim using EZ1 in contrast to organic method. EZ1 was found to be preferred than organic, especially when a time passed over, while organic method was preferred when samples are available in small quantities. In addition, using carrier RNA within the organic method steps showed no improvement in STR profiling. EZ1 with carrier RNA was preferred for bloodstained samples on fabrics with textile dyes (black dye or denim indigo), especially when stored for a long time.

Conclusions

Denim was found to be more problematic than black cotton due to presence of challenging inhibitors (indigo dye). DNA concentration, storage time and types of fabrics are key factors for choosing the appropriate extraction method for reportable STR profile. Using EZ1 with carrier RNA gives less dropout profile than not using it, or when using organic method even in presence or absence of carrier RNA. Anyway, innovation of more sensitive, more robust analytical protocols could result in a better understanding of these inhibitory samples.
Hyperbaric oxygen therapy as a conservative approach for osteoradionecrosis of the jaw in an osteoporotic patient receiving oral bisphosphonate therapy: a case report
Authors: Shudo Atsushi
Published: April 2022

Background

Osteoradionecrosis of the jaw (ORNJ) is a well-known chronic side effect of radiotherapy (RT) for head and neck malignancies. Osteonecrosis of the jaw (ONJ), similar pathology to ORNJ, may be induced by bisphosphonate (BP) therapy and is known as BP-related ONJ (BRONJ). Although differences exist between ORNJ and BRONJ in terms of clinical features and management methods, ONJ in a patient with history of both RT and BP therapy is categorized as ORNJ in the diagnostic criteria, despite the possibility that the ONJ may be affected by BP considering the pharmacology and mechanism of action. To date, management of ORNJ with a history of BP therapy has been scarcely discussed.

Case presentation

We report here our experience of serious ORNJ in an 82-year-old osteoporotic woman receiving oral BP therapy. She had undergone partial maxillectomy to treat left maxillary gingival cancer and had received RT of 60 Gy as postoperative treatment. She had a history of osteoporosis, for which she had been administered BP for 8 years and 5 months. A bony sequestrum 45 × 25 mm in size was found at the site of the mandibular ramus, and the clinical diagnosis was ORNJ. We administered hyperbaric oxygen therapy (HBOT), scheduled for 3–5 days per week in 2 courses, 35 times. After HBOT, we performed sequestrectomy avoiding invasive surgery such as mandibulectomy. After the surgical procedure the wound healed completely. Bone regeneration was confirmed by computed tomography postoperatively. There have been no signs of recurrence as of 4 years after the operation.

Conclusions

We undertook a multimodality approach with HBOT and conservative surgery and achieved a satisfactory outcome. HBOT may be worthy of consideration as a conservative approach for ORNJ in patients receiving BP therapy, leading to the possibility of avoiding invasive surgery such as mandibulectomy.
A protocol for periprosthetic joint infections from the Northern Infection Network for Joint Arthroplasty (NINJA) in the Netherlands
Authors: Zijlstra W. P. , Ploegmakers J. J. W. , Kampinga G. A. , Toren-Wielema M. L. , Ettema H. B. , Knobben B. A. S. , Jutte P. C. , Wouthuyzen-Bakker M. ,   the Northern Infection Network for Joint Arthroplasty (NINJA), Moujahid A. Al , Doorn P. F. , ten Have B. L. E. F. , Mithoe G. , Pirii L. E. , Vlasveld I. N. , Stevens M. , van Vonderen M. G. A. , de Vries A. J.
Published: April 2022

Periprosthetic joint infection (PJI) is a devastating complication of joint arthroplasty surgery. Treatment success depends on accurate diagnostics, adequate surgical experience and interdisciplinary consultation between orthopedic surgeons, plastic surgeons, infectious disease specialists and medical microbiologists. For this purpose, we initiated the Northern Infection Network for Joint Arthroplasty (NINJA) in the Netherlands in 2014. The establishment of a mutual diagnostic and treatment protocol for PJI in our region has enabled mutual understanding, has supported agreement on how to treat specific patients, and has led to clarity for smaller hospitals in our region for when to refer patients without jeopardizing important initial treatment locally. Furthermore, a mutual PJI patient database has enabled the improvement of our protocol, based on medicine-based evidence from our scientific data. In this paper we describe our NINJA protocol.

Level of evidence: III
3D self-potential tomography of seafloor massive sulfide deposits using an autonomous underwater vehicle
Authors: Su Zhaoyang , Tao Chunhui , Shen Jinsong , Revil André , Zhu Zhongmin , Deng Xianming , Nie Zuofu , Li Qianyu , Liu Long , Wu Tao , Zhou Jianping , Chen Dong
Published: April 2022

Seafloor massive sulfide (SMS) deposits contain abundant metals, such as Cu, Zn, Au, and Ag, which are of growing economic interest. Currently, the exploration of SMS deposits has entered into a new stage of resource assessment, so we need a geophysical method to rapidly obtain the 3D structure of these SMS deposits. We report here a self-potential (SP) survey performed with an autonomous underwater vehicle (AUV) at the Yuhuang hydrothermal field on the ultraslow-spreading Southwest Indian Ridge with a water depth ranging from 1300 m to 2200 m. The electric-field sensors are attached to the tail of the AUV to record the electric field approximately 50 m above the seafloor. The electric field strength is observed to reach an amplitude of 0.6 mV/m at this known SMS deposit. SP tomography is used to obtain the 3D structure of the ore body, and benchmark numerical tests are first performed on synthetic cases to optimize the inversion algorithm parameters to estimate the ore location. The 3D SP tomography reveals a south-sloping ore body, which is 100 m long in the north–south direction and nearly 200 m long in the east–west direction. The vertical extent of the ore body is approximately 100 m. These results suggest that an AUV-based SP survey and tomography are potentially useful exploration methods to characterize the geometry of SMS deposits. This method may play an important role in resource assessment in concert with other geophysical methods, such as magnetic and induced-polarization surveys.
Characterizing near-surface structures at the Ostia archaeological site based on instantaneous-phase coherency inversion
Authors: Liu Jianhuan , Ghose Ranajit , Draganov Deyan
Published: April 2022

Traditional least-squares full-waveform inversion (FWI) suffers from severe local minima problems in the case of the presence of strongly dispersive surface waves. In addition, recorded wavefields are often characterized by amplitude errors due to varying source coupling and incorrect 3D-to-2D geometric-spreading correction. Thus, least-squares FWI is considered less suitable for near-surface applications. We introduce an amplitude-unbiased coherency measure as a misfit function that can be incorporated into FWI. Such coherency has been used previously in phase-weighted stacking to enhance weak but coherent signals. The benefit of this amplitude-unbiased misfit function is that it can extract information uniformly for all seismic signals (surface waves, reflections, and scattered waves). Using the adjoint-state method, we show how to calculate the gradient of this new misfit function. We validate the robustness of the new approach using checkerboard tests and synthetic data contaminated by random noise. We then apply the new FWI approach to a field data set acquired at an archaeological site located in Ostia, Italy. The goal of this survey is to map the unexcavated archaeological remains with high resolution. We identify a known tumulus in the FWI results. The instantaneous-phase coherency FWI results also establish that the shallow subsurface under the survey lines is quite heterogeneous. The instantaneous-phase coherency FWI of near-surface data can be a promising tool to image shallow small-scale objects buried under shallow soil covers, as found at archaeological sites.
The First Pilot Study of an Interactive, 360° Augmented Reality Visualization Platform for Neurosurgical Patient Education: A Case Series
Authors: Lee Jonathan J. , Klepcha Maxim , Wong Marcus , Dang Phuong N. , Sadrameli Saeed S. , Britz Gavin W.
Published: April 2022

BACKGROUND:

Interactive technologies are increasingly being used for patient education. Augmented reality (AR) is the technology of superimposing digital content on the reality that the user observes.

OBJECTIVE:

To evaluate a brand new, commercial prototype of a 360° AR visualization platform (360 ARVP) to enhance patient education for neurosurgical patients.

METHODS:

This pilot study was a single-center, single-provider study that took place in the clinic setting of the senior author. Patients were given the opportunity to use the 360 ARVP (Surgical Theater) concurrently with the neurosurgeon. All patients completed a survey on their experience with the 360 ARVP immediately after use.

RESULTS:

A total of 24 patients participated in the study. All patients (19 [79.2%] strongly agreed and 5 [20.8%] agreed) reported that using the 360 ARVP system helped improve understanding of their medical condition. The total percentage of patients who either agreed or strongly agreed that experiencing the 360 ARVP helped improve their comfort levels and that they felt included in decisions about their treatment was 95.8%. When asked to rate their level of understanding of their treatment plans on a 0 to 10 scale, the difference in means for the patients' ratings before and after the use of 360 ARVP was statistically significant (P < .0017)

CONCLUSION:

This pilot study demonstrates that AR can be used as an adjunctive tool for patient education. Patients found that the 360 ARVP increased their understanding of their medical conditions and improved their comfort level with the proposed treatments.
Odours of cancerous mouse congeners: detection and attractiveness
Authors: Gouzerh Flora , Buatois Bruno , Hervé Maxime R. , Mancini Maicol , Maraver Antonio , Dormont Laurent , Thomas Frédéric , Ganem Guila
Published: April 2022

Chemical communication plays a major role in social interactions. Cancer, by inducing changes in body odours, may alter interactions between individuals. In the framework of research targeting non-invasive methods to detect early stages of cancer development, this study asked whether untrained mice could detect odour changes in cancerous congeners. If yes, were they able to detect cancer at an early developmental stage? Did it influence female preference? Did variations in volatile organic components of the odour source paralleled mice behavioural responses? We used transgenic mice strains developing or not lung cancer upon antibiotic ingestion. We sampled soiled bedding of cancerous mice (CC) and not cancerous mice (NC), at three experimental conditions: before (T0), early stage (T2) and late stage (T12) of cancer development. Habituation/generalisation and two-way preference tests were performed where soiled beddings of CC and NC mice were presented to wild-derived mice. The composition and relative concentration of volatile organic components (VOC) in the two stimuli types were analysed. Females did not show directional preference at any of the experimental conditions, suggesting that cancer did not influence their choice behaviour. Males did not discriminate between CC and NC stimuli at T0 but did so at T2 and T12, indicating that wild-derived mice could detect cancer at an early stage of development. Finally, although the VOC bouquet differed between CC and NC it did not seem to parallel the observed behavioural response suggesting that other types of odorant components might be involved in behavioural discrimination between CC and NC mice.
Stool is a sensitive and noninvasive source of DNA for monitoring expansion in repeat expansion disease mouse models
Authors: Zhao Xiaonan , McHugh Cassandra , Coffey Sydney R. , Jimenez Diego Antonio , Adams Elizabeth , Carroll Jeffrey B. , Usdin Karen
Published: April 2022

Repeat expansion diseases are a large group of human genetic disorders caused by expansion of a specific short tandem repeat tract. Expansion in somatic cells affects age of onset and disease severity in some of these disorders. However, alleles in DNA derived from blood, a commonly used source of DNA, usually show much less expansion than disease-relevant cells in the central nervous system in both humans and mouse models. Here we examined the extent of expansion in different DNA sources from mouse models of the fragile X-related disorders, Huntington's disease, spinocerebellar ataxia type 1 and spinocerebellar ataxia type 2. We found that DNA isolated from stool is a much better indicator of somatic expansion than DNA from blood. As stool is a sensitive and noninvasive source of DNA, it can be useful for studies of factors affecting the risk of expansion, or the monitoring of treatments aimed at reducing expansion in preclinical trials, as it would allow expansions to be examined longitudinally in the same animal and allow significant changes in expansion to be observed much earlier than is possible with other DNA sources.
Can extreme returns predict the cross-section of expected returns in the Brazilian market?
Authors: Marques Naielly Lopes , Klotzle Marcelo Cabus , Pinto Antonio Carlos Figueiredo , Silva Paulo Vitor Jordão da Gama
Published: April 2022

This article extends the evidence of maximum (MAX) and minimum (MIN) daily return effects on stock performance to the Brazilian market. Our sample includes data on daily and monthly stock returns of the firms listed on the Brazilian stock exchange between January 2001 and December 2018. To test whether extreme returns can predict the cross-section of expected returns, we perform univariate and bivariate portfolio analyses and the Fama-MacBeth regression. The results suggest a negative (positive) relationship between MAX (MIN) and the cross-section of future stock returns, which supports the hypothesis that idiosyncratic lottery-like payoffs are priced in equilibrium. This work is of interest to investors seeking insight into how to analyze high-risk and reward opportunities in the Brazilian stock market.
Novel methods for post-manufacturing and in-field testing of VLSI circuits/systems
Authors: Σισμάνογλου Παναγιώτης
Published: April 2022

Στην εργασία αυτή, αναλύουμε και αξιολογούμε τις ήδη γνωστές μεθόδους συμπίεσης δεδομένων δοκιμής για εργοστασιακό έλεγχο και τους μηχανισμούς που ενσωματώνονται στα κυκλώματα για τον έλεγχό τους στο πεδίο της εφαρμογής με στόχο την αύξηση της αξιοπιστίας τους. Προτείνουμε μια νέα μέθοδο συμπίεσης δεδομένων δοκιμής η οποία βασίζεται σε πίνακα. Στόχος της προτεινόμενης μεθόδου είναι η μείωση του όγκου των δεδομένων δοκιμής και του χρόνου εφαρμογής του ελέγχου ορθής λειτουργίας. Επίσης, αναλύουμε τα χαρακτηριστικά της διαδικασίας ελέγχου και προτείνουμε νέες τεχνικές για την αύξηση της αποδοτικότητας της προτεινόμενης μεθόδου, ως προς τον όγκο των δεδομένων που αποθηκεύονται στην εξωτερική μονάδα ελέγχου, το κόστος υλοποίησής της και κατανάλωση ισχύος. Στη συνέχεια επεκτείνουμε την έρευνά μας στους μηχανισμούς εφαρμογής του ελέγχου στο πεδίο της εφαρμογής και αναλύουμε το κόστος υλοποίησής τους, την παρεμβατικότητα εφαρμογής του ελέγχου στην κανονική λειτουργία του συστήματος και τα επίπεδα αξιοπιστίας που επιτυγχάνονται ως προς τη συχνότητα εφαρμογής του ελέγχου. Επιπλέον, προτείνεται ένας τροποποιημένος ενσωματωμένος μηχανισμός ελέγχου, ο οποίος έχει σχεδιαστεί κατάλληλα ώστε να υποστηρίζει τη διακοπή και τη συνέχιση της διαδικασίας εφαρμογής του ελέγχου σε οποιαδήποτε χρονική στιγμή. Επιπλέον, προτείνουμε μια νέα κυψελίδα αποθήκευσης τιμής για τη μείωση των παροδικών σφαλμάτων του κυκλώματος λόγω λειτουργίας σε περιβάλλον υψηλής ακτινοβολίας. Η αύξηση της συχνότητα εφαρμογής του ελέγχου για την ανίχνευση μόνιμων σφαλμάτων και η αντιμετώπιση παροδικών σφαλμάτων κατά την κανονική λειτουργία, αυξάνουν σημαντικά την αξιοπιστία των κυκλωμάτων.
Ο ρόλος των νευροπεπτιδίων στη φλεγμονή των εντερικών νευρικών πλεγμάτων σε ασθενείς με νόσο Crohn
Authors: Γκλαβάς Αντώνιος
Published: April 2022

Υπόβαθρο και Σκοπός: Ο κίνδυνος μετεγχειρητικής υποτροπής έπειτα από ειλεοκολική εκτομή για νόσο Crohn (NC) είναι υψηλός. Η μυεντερική πλεγματίτιδα τους εγγύς ορίου εκτομής θεωρείται ένας αναγνωρισμένος παράγοντας κινδύνου. Ο πρωταρχικός σκοπός αυτής της μελέτης ήταν η διερεύνηση της συσχέτισης των επιπέδων έκφρασης του νευροπεπτιδίου P (NPY), του αγγειοδραστικού εντερικού πεπτιδίου (VIP), και της ουσίας P (SP) με την παρουσία και τη βαρύτητα της πλεγματίτιδας στο εγγύς όριο εκτομής. Δευτερεύοντες στόχοι ήταν η εκτίμηση της προγνωστικής αξίας της ανοσοϊστοχημικής έκφρασης των συγκεκριμένων νευροπεπτιδίων και η αναγνώριση παραγόντων κινδύνου για μετεγχειρητική υποτροπή. Υλικά και Μεθοδολογία: Πραγματοποιήθηκε αναδρομική, μονοκεντρική μελέτη ασθενών με ΝC που υποβλήθηκαν σε ειλεοκολική εκτομή από τον Ιανουάριο 2010 έως και τον Δεκέμβριο 2016. Καταγράφηκαν τα δημογραφικά, κλινικά και χειρουργικά δεδομένα των ασθενών, όπως επίσης και η ύπαρξη ενδοσκοπικής, κλινικής και χειρουργικής υποτροπής. Η αξιολόγηση της παρουσίας και βαρύτητας της πλεγματίτιδας έγινε με χρώση αιματοξυλίνης-ηωσίνης, ξεχωριστά για το μυεντερικό και υποβλεννογόνιο πλέγμα. Η χρώση Giemsa χρησιμοποιήθηκε για την εκτίμηση της συμμετοχής μαστοκυττάρων. Η ανίχνευση Τ λεμφοκυττάρων και των ΝΡΥ-, VIP- και SP-εργικών νευρώνων πραγματοποιήθηκε με ανοσοϊστοχημικές μεθόδους. Η ανοσοέκφραση των πεπτιδίων ποσοτικοποιήθηκε χρησιμοποιώντας πρόγραμμα ψηφιακής ανάλυσης εικόνας. Αποτελέσματα: Συμπεριλήφθηκαν 79 ασθενείς (44 άνδρες) με διάμεση ηλικία τα 35 έτη και διάμεση παρακολούθηση 71 μηνών. Μυεντερική και υποβλεννογόνια πλεγματίτιδα διαπιστώθηκε στο 83.5% και 73.4% των περιπτώσεων, αντίστοιχα. Δεν ανιχνεύθηκε συσχέτιση μεταξύ της ανοσοέκφρασης των NPY, VIP και SP και της παρουσίας ή της βαρύτητας της πλεγματίτιδας. Παρομοίως, ο αριθμός των εμπλεκόμενων Τ λεμφοκυττάρων ή μαστοκυττάρων δεν συσχετίστηκε με την έκφραση των συγκεκριμένων νευροπεπτιδίων. Από τη μονοπαραγοντική και πολυπαραγοντική ανάλυση επιβίωσης (παλινδρόμηση αναλογικών κινδύνων Cox), το κάπνισμα (hazard ratio [HR] 4.07, 95% confidence interval [CI] 2.08–7.94, p<0,001), η μέτρια (HR 3.68, 95%CI 1.06–12.73, p=0.040) και σοβαρή μυεντερική πλεγματίτιδα (HR 7.36, 95%CI 1.12–48.30, p=0.037) αναδείχθηκαν ανεξάρτητοι παράγοντες κινδύνου για ενδοσκοπική υποτροπή, ενώ το κάπνισμα (HR 2.78, 95%CI 1.01–7.67, p=0.049), η σοβαρή μυεντερική πλεγματίτιδα (HR 20.09, 95%CI 1.09–368.28, p=0.044) και το θετικό εγγύς όριο εκτομής (HR 3.45, 95%CI 1.33–8.96, p=0.011) για κλινική υποτροπή. Συμπεράσματα: Στην παρούσα μελέτη δεν αναγνωρίστηκε κάποια συσχέτιση μεταξύ της πλεγματίτιδας και της έκφρασης συγκεκριμένων νευροπεπτιδίων. Το κάπνισμα, η μυεντερική πλεγματίτιδα και το θετικό εγγύς όριο εκτομής αναδείχθηκαν ως ανεξάρτητοι παράγοντες κινδύνου για μετεγχειρητική υποτροπή.
Temporomandibular joint (TMJ) disorders prevalence and awareness of appropriate clinical practices, among Al-Madinah community in Saudi Arabia
Authors: Alolayan Albraa , Alsayed Shayma S. , Salamah Ruwaa M. , Ali Khadija M. , Alsousi Mashael , Elsayed Shadia
Published: April 2022

Background:  Painful temporomandibular joint disorders (TMDs) are of musculoskeletal origin and are considered the most common cause of non-odontogenic pain in the orofacial region.  The purpose of this study was to investigate the prevalence and awareness of temporomandibular joint (TMJ) disorders in Almadinah Almunawwarah community.

Methods: An observational cross-sectional study with convenience sampling was conducted. A translated Arabic version of Fonseca's questionnaire was employed. The questionnaire asked about the participant's personal information, if they thought they had TMDs, and who to visit for therapy if necessary. These were followed by 10 items from Fonseca's questionnaire, each with a three-point scale.

Results: The questionnaire was completed by 598 people. Females made up 57.1% of the participants. TMDs were present in 61% of the population, with varying degrees of severity. Males (44.3%) were less affected than females (55.7%). The difference, however, was not statistically significant (P = 0.354). Out of the 61% TMDs Positive patients, 74.1% had mild TMDs symptoms, while 20.8% and 5.1%, respectively, had moderate and severe TMDs symptoms (P = 0.05). The severity of the symptoms was unaffected by demographic data (P > 0.05). Only 40% seek care, with 64.6% selecting for a dentist and 24.6% preferring for an orthopaedic specialist (P= 0.008).

Conclusions: Participants from Al-Madinah had a greater prevalence of mild TMDs. The majority of the participants had no idea who to go to for treatment. The findings of this study highlight the importance of educational activities to enhance public awareness. Fonseca's Anamnestic Index could also be considered as a useful instrument for early identification and measuring the severity of TMDs in the general population.
Applicability of open science practices to completed research projects from different disciplines and research paradigms
Authors: Schneider Jürgen
Published: April 2022

The purpose of this data collection was to uncover the extent to which communities have emerged that cultivate a shared understanding of open science. In a cross-sectional survey, we assessed the applicability of 13 open science practices over different disciplines and research paradigms. Focusing on completed research projects, participants were able to draw informed evaluations concerning the applicability of open science practices. The total sample is N=295 researchers, with approximately equal numbers from six broad disciplines (between 42 and 52 participants per discipline). The survey included an attention check.
Seroprevalence and risk factors of SARS-CoV-2 infection in an urban informal settlement in Nairobi, Kenya, December 2020
Authors: Munywoki Patrick K , Nasimiyu Caroline , Alando Moshe Dayan , Otieno Nancy , Ombok Cynthia , Njoroge Ruth , Kikwai Gilbert , Odhiambo, Dennis , Osita Mike Powel , Ouma Alice , Odour Clifford , Juma Bonventure , Ochieng Caroline A , Mutisya Immaculate , Ngere Isaac , Dawa Jeanette , Osoro Eric , Njenga M Kariuki , Bigogo Godfrey , Munyua Peninah , Lo Terrence Q , Hunsperger Elizabeth , Herman-Roloff Amy
Published: April 2022

Introduction: Urban informal settlements may be disproportionately affected by the COVID-19 pandemic due to overcrowding and other socioeconomic challenges that make adoption and implementation of public health mitigation measures difficult. We conducted a seroprevalence survey in the Kibera informal settlement, Nairobi, Kenya, to determine the extent of SARS-CoV-2 infection.

Methods: Members of randomly selected households from an existing population-based infectious disease surveillance (PBIDS) provided blood specimens between 27th November and 5th December 2020. The specimens were tested for antibodies to the SARS-CoV-2 spike protein. Seroprevalence estimates were weighted by age and sex distribution of the PBIDS population and accounted for household clustering. Multivariable logistic regression was used to identify risk factors for individual seropositivity.  

Results: Consent was obtained from 523 individuals in 175 households, yielding 511 serum specimens that were tested. The overall weighted seroprevalence was 43.3% (95% CI, 37.4 – 49.5%) and did not vary by sex. Of the sampled households, 122(69.7%) had at least one seropositive individual. The individual seroprevalence increased by age from 7.6% (95% CI, 2.4 – 21.3%) among children (<5 years), 32.7% (95% CI, 22.9 – 44.4%) among children 5 – 9 years, 41.8% (95% CI, 33.0 – 51.1%) for those 10-19 years, and 54.9%(46.2 – 63.3%) for adults (≥20 years). Relative to those from medium-sized households (3 and 4 individuals), participants from large (≥5 persons) households had significantly increased odds of being seropositive, aOR, 1.98(95% CI, 1.17 – 1.58), while those from small-sized households (≤2 individuals) had increased odds but not statistically significant, aOR, 2.31 (95% CI, 0.93 – 5.74). 

Conclusion: In densely populated urban settings, close to half of the individuals had an infection to SARS-CoV-2 after eight months of the COVID-19 pandemic in Kenya. This highlights the importance to prioritize mitigation measures, including COVID-19 vaccine distribution, in the crowded, low socioeconomic settings.
Green synthesis and characterization of zinc oxide nanoparticles using bush tea (Athrixia phylicoides DC) natural extract: assessment of the synthesis process.
Authors: Kaningini Gabriel Amani , Azizi Shohreh , Nyoni Hlengilizwe , Mudau Fhatuwani Nixwel , Mohale Keletso Cecilia , Maaza Malik
Published: April 2022

Background: Nanoparticles are globally synthesized for their antimicrobial, anti-inflammatory, wound healing, catalytic, magnetic, optical, and electronic properties that have put them at the forefront of a wide variety of studies. Among them, zinc oxide (ZnO) has received much consideration due to its technological and medicinal applications. In this study, we report on the synthesis process of ZnO nanoparticles using Athrixia phylicoides DC natural extract as a reducing agent.  

Methods: Liquid chromatography–mass spectrometry (LC-MS) was used to identify the compounds responsible for the synthesis of ZnO nanoparticles. Structural, morphological and optical properties of the synthesized nanoparticles have been characterized through X-ray diffraction (XRD), Ultraviolet-visible spectroscopy (UV-Vis), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS).  

Results: LC-MS results showed that different flavonoids and polyphenols, as well as Coumarin, an aromatic compound, reacted with the precursor to form ZnO nanoparticles. XRD and UV-Vis analysis confirmed the synthesis of ZnO nanoparticles, with a spherical shape showed in SEM images. The quasi-spherical ZnO crystals had an average crystallite size of 24 nm. EDS and FTIR analysis confirmed that the powders were pure with no other phase or impurity.  

Conclusions: This study successfully demonstrated that the natural plant extract of A. phylicoides DC. can be used in the bio-reduction of zinc nitrate hexahydrate to prepare pure ZnO nanoparticles, thus, extending the use of this plant to an industrial level.
Orthogonal decompositions in growth curve models
Authors: Klein Daniel , Žežula Ivan
Published: April 2022

The article shows advantage of orthogonal decompositions in the standard and extended growth curve models. Using this, distribution of estimators of ρ and σ2 in the standard GCM with uniform correlation structure is derived. Also, equivalence of Hu and von Rosen conditions in the extended GCM under mild conditions is shown.
Estimating the Size of Branch-and-Bound Trees
Authors: Hendel Gregor , Anderson Daniel , Le Bodic Pierre , Pfetsch Marc E.
Published: April 2022

This paper investigates the problem of estimating the size of branch-and-bound (B&B) trees for solving mixed-integer programs. We first prove that the size of the B&B tree cannot be approximated within a factor of 2 for general binary programs, unless [Formula: see text]. Second, we review measures of progress of the B&B search, such as the well-known gap and the often-overlooked tree weight, and propose a new measure, which we call leaf frequency. We study two simple ways to transform these progress measures into B&B tree-size estimates, either as a direct projection or via double-exponential smoothing, a standard time-series forecasting technique. We then combine different progress measures and their trends into nontrivial estimates using machine learning techniques, which yield more precise estimates than any individual measure. The best method that we have identified uses all individual measures as features of a random forest model. In a large computational study, we train and validate all methods on the publicly available MIPLIB and Coral general purpose benchmark sets. On average, the best method estimates B&B tree sizes within a factor of 3 on the set of unseen test instances, even during the early stage of the search, and improves in accuracy as the search progresses. It also achieves a factor of 2 over the entire search on each of the six additional sets of homogeneous instances that we tested. All techniques are available in version 7 of the branch-and-cut framework SCIP.

Summary of Contribution: This manuscript develops a method for online estimation of the size of branch-and-bound trees, thereby combining methods of mixed-integer programming and machine learning. We show that high-quality estimations can be obtained using the presented techniques. The methods are also useful in everyday use of branch-and-bound algorithms to obtain approximate search-completion information. The manuscript is accompanied by an extensive online supplement comprising the code used for our simulations and an implementation of all discussed methods in the academic solver SCIP, together with the tools and instructions to train estimators for custom instance sets.
Stochastic Planning and Scheduling with Logic-Based Benders Decomposition
Authors: Elçi Özgün , Hooker John
Published: April 2022

We apply logic-based Benders decomposition (LBBD) to two-stage stochastic planning and scheduling problems in which the second stage is a scheduling task. We solve the master problem with mixed integer/linear programming and the subproblem with constraint programming. As Benders cuts, we use simple no-good cuts as well as analytic logic-based cuts we develop for this application. We find that LBBD is computationally superior to the integer L-shaped method. In particular, a branch-and-check variant of LBBD can be faster by several orders of magnitude, allowing significantly larger instances to be solved. This is due primarily to computational overhead incurred by the integer L-shaped method while generating classic Benders cuts from a continuous relaxation of an integer programming subproblem. To our knowledge, this is the first application of LBBD to two-stage stochastic optimization with a scheduling second-stage problem and the first comparison of LBBD with the integer L-shaped method. The results suggest that LBBD could be a promising approach to other stochastic and robust optimization problems with integer or combinatorial recourse.

Summary of Contribution: We study an important class of optimization problems, namely, two-stage stochastic programs with integer recourse, which are known to be extremely difficult to solve in general. We focus on an application in which the second-stage problem is a scheduling problem, a first in the literature to the best of our knowledge. Our study exemplifies how one can exploit the combinatorial structure of the scheduling problem to derive novel analytic Benders cuts and use them within a branch-and-check algorithm. The proposed algorithm solves instances that are intractable for commercial solvers and state-of-the-art decomposition-based methods, such as the integer L-shaped method. We believe that our study will inspire further research in the use of hybrid logic-based optimization methods for solving stochastic combinatorial optimization problems.
A multidisciplinary learning approach: a narrative review
Authors: Hulse Anna Louise
Published: April 2022

Advanced nursing/clinical practice has emerged worldwide in response to the demands of changing complex healthcare needs and ageing populations, and the need to improve services and outcomes, decrease waiting times and reduce overall healthcare cost. A reduction in medical practitioners' working hours has meant other healthcare disciplines have to develop medical skills. Evidence suggests there are global differences in the advanced nursing/clinical practice role definition, expectations and scope of practice. Education and training for role development varies around the world. Part 1 of this review, which explores international approaches to advanced practice, examines literature findings that look at learner experiences of training and preparation and highlights a gap in educational research in this field. A small-scale cross-sectional mixed methods study that was subsequently undertaken will be discussed in part 2.
Improving patient safety by learning from the experiences of others
Authors: Tingle John
Published: April 2022

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses ways of approaching the myriad of patient safety reports that are published and looks at some useful publications
Exploring the complexity of student nurse relationships with adolescent patients when placing nasogastric tubes
Authors: Haskayne Allison , Hill Barry , Davies Barbara
Published: April 2022

This article aims to explore the complexity of student nurse relationships with adolescent patients when placing nasogastric tubes. The potential inter-connectiveness of this relationship is debated within this article and an evaluation of current practice identifies potential implications for both patients and nursing care.
Combined use of progressive tension suture and negative pressure wound therapy in large torso degloving wounds
Authors: Netto Fernando AC Spencer , Becker Mariana J , Bertoldi Ayessa , Shiroma Henriqué S , Barreto Hemanuelli , Ribeiro Marcelo Augusto Fontenelle
Published: April 2022

Objective:

To demonstrate the associated use of progressive tension sutures (PTS) with negative pressure wound therapy (NPWT) in large torso degloving wounds.

Methods:

This is a case report of two patients with large torso degloving wounds caused by trauma, both of whom were treated with combined PTS and NPWT. Statistics related to wound treatment responses are presented.

Results:

Initial wound area for Patient 1 was 2400cm2 and 900cm2 for Patient 2. Within 21 and 12 days, respectively, using the combined method, the following data were observed: wound reduction of 94% and 99%, respectively; a closing speed rate of 98cm2/day and 75cm2/day, respectively; and a closing percentage of 4.45% per day and 8.25% per day, respectively.

Conclusion:

The use of combined PTS and NPWT techniques may be useful in the treatment of traumatic degloving injuries, reducing the wound area and facilitating reconstruction.
Hydro-responsive wound dressings for treating hard-to-heal wounds: a narrative review of the clinical evidence—part 2
Authors: Rippon Mark G , Forster Jan , Rogers Alan A
Published: April 2022

This narrative clinical review summarises the key evidence in support for the use of a hydro-responsive wound dressing, HydroTac (HRWD-2, PAUL HARTMANN AG, Germany) to address key aspects associated with the treatment of both acute and hard-to-heal wounds. This review demonstrates how HRWD-2 can be used in general to address the challenges presented by a wide range of wound types and skin injuries. It highlights the ability of HRWD-2 to regulate an optimal moist wound environment that promotes wound progression and healing. Key aspects covered in this review include the dressing's ability to: promote certain phases of the wound healing response (for example, re-epithelialisation) address the concepts and needs for wound progression as set out in the TIME wound management framework provide an optimal hydration level reduce tissue trauma and pain at dressing change.
The effects of negative pressure wound therapy on wounds with cerebrospinal fluid leakages
Authors: Nangole Ferdinand Wanjala , Agak George
Published: April 2022

Objective:

Negative pressure wound therapy (NPWT) has been widely used for a variety of wounds with good outcomes. However, it is contraindicated in the management of wounds with cerebrospinal fluid (CSF) leakages. The reason is the fear of a sudden shift of CSF fluid as a result of suction leading to brain herniation or coning. There is a paucity of data to either support or negate such claims. We aimed to determine the effect of NPWT in the management of patients with wounds with CSF leakages.

Method:

This was a longitudinal prospective study of patients having wounds with CSF leakages managed with NPWT in our institute. Outcome measures evaluated were changes in the level of consciousness, Glasgow Coma Scale (GCS) score, length of hospital stay, mean effluent collected, time taken for the wounds to heal/close and complications related to NPWT.

Results:

A total of 12 patients with wounds that had CSF leakage were managed with NPWT over two years. Of the patients, nine had wounds in communication with the brain, with three patients having spinal cord wounds. The average effluent collected on the first day of applying NPWT was 510ml, and by the third day this had fallen to approximately 200ml. The mean time taken for wounds to close was 12.3 days. There was no evidence of herniation nor any other morbidities or mortalities reported in any of our patients.

Conclusion:

NPWT, as indicated in this series, had a beneficial effect in the management of wounds with CSF leakage. NPWT, once applied to the wound, caused a tamponade effect that resulted in stoppage of the leakage of the CSF and did not lead to suction of the fluid, as previously thought. The dressings ensured an airtight system, preventing communication between the wound and the external environment, thus reducing sepsis while awaiting definitive wound closure.
Pain control with punch grafting in ulcers with underlying arteriolosclerosis
Authors: Quintana-Castanedo Lucía , Conde-Montero Elena , Recarte-Marín Lorena , Peral-Vázquez Alicia , Pérez-Jerónimo Laura , de la Cueva-Dobao Pablo
Published: April 2022

Objective:

Martorell hypertensive ischaemic ulcers are often misdiagnosed and can be a clinical and therapeutic challenge. Controversy exists regarding both their underlying triggers and the type of treatment that should be carried out. This study was designed to compare the effectiveness of punch grafting and conventional therapy in pain reduction.

Method:

A single-centre retrospective study was performed, including 40 patients with a clinical diagnosis of a Martorell ulcer or post-traumatic ulcer secondary to arteriolopathy in the elderly, who were treated with punch grafting (n= 24) or conventional medical treatment (n=16).

Results:

There was a statistically and clinically significant reduction in pain after punch grafting. The minimal overall reduction was of three points in visual analogue pain scores. Of the patients who received punch grafting, 80% reported a VAS pain score of 0 at the third follow-up, in contrast with the 44% (n=4) patients who were treated without punch grafting. The mean time to epithelialisation was 82.1 days in patients who received conventional treatment and 43.5 days in those who received punch grafts.

Conclusion:

Punch grafting is a simple, validated and cost-effective technique that can be performed on an outpatient basis, promotes wound healing and reduces pain. It may control pain and stimulate epithelialisation even if the wound does not present with optimum wound bed characteristics for graft taking. Pain reduction and faster epithelialisation are associated with improvements in patients' quality of life.
Solifenacin and Mirabegron Monotherapies Versus Combination Therapy in Overactive Bladder: A Prospective Observational Study
Authors: Mahapatra Sanjay Kumar , Dash Rinu Rani , Rath Bhabagrahi , Hota Prajit Saswat
Published: April 2022

Overactive bladder (OAB) is a common medical condition, especially in the elderly population, that affects the quality of life. The primary treatment of OAB is a combination of behavioural measures and widely used anti-muscarinic drug therapy like solifenacin, which brings about significant side effects, thereby affecting the quality of life adversely. Mirabegron, a recently approved drug for treatment of OAB is a β3 - adrenergic agonist, which relaxes the detrusor muscle. With this background, the current study was done to compare the efficacy and safety of solifenacin, mirabegron and combination of low doses of solifenacin and mirabegron on various parameters of OAB. A total no. of 70 patients with OAB symptoms coming to urology OPD were included in this study and they were divided into 3 groups - Group 1: 24 patients receiving solifenacin 10mg/day, Group 2: 23 patients receiving solifenacin 5mg/day plus mirabegron 25mg/day, Group 3: 23 patients receiving mirabegron 50 mg/day. Patients were assessed for change in mean numbers of micturition, urgency, incontinence per 24 hour and quality of life using Patient Perception of Bladder Control (PPBC) Questionnaire. They were followed up after 4 weeks and 12 weeks and change in the above parameters from baseline were noted. Patients receiving combination therapy achieved a significant reduction in urgency, frequency, nocturia and urge incontinence and decrease in side effects when compared with solifenacin and mirabegron alone. Combination therapy with solifenacin and mirabegron significantly improved quality of life and reduced side effects like dry mouth, blurred vision, constipation in OAB patients in comparison to solifenacin and mirabegron monotherapy.