bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and Sonographic Classification of Neurofibromas in Children with Neurofibromatosis Type 1 – A Cluster Analysis
Authors: García-Martínez Francisco Javier , Alfageme Fernando , Duat-Rodríguez Anna , Andrés Esteban Eva María , Hernández-Martín Angela
Published: November 2021

Purpose High-frequency ultrasound allows the accurate identification of neurofibromas in neurofibromatosis type 1 (NF1). This study aimed to analyze the ultrasound features of neurofibromas in children with NF1, to establish a classification based on the clinical and sonographic patterns of the different types of neurofibromas, and to evaluate the interobserver correlation coefficient (κ) of this classification.

Materials and Methods In this prospective, single referral center observational study, clinical and ultrasound findings of neurofibromas in children diagnosed with NF 1 were analyzed. To identify the ultrasound patterns, a cluster analysis allowing the inclusion of both clinical and ultrasound data was designed. The κ coefficient was calculated using 9 external evaluators.

Results 265 ultrasound scans were performed on a total of 242 neurofibromas from 108 children diagnosed with NF1. Cluster analysis allowed the identification of 9 patterns (Snedecorʼs F, P < 0.001) classified as “classic” cutaneous neurofibroma, blue-red neurofibroma, pseudoatrophic neurofibroma, nodular subcutaneous neurofibroma, diffuse subcutaneous neurofibroma, congenital cutaneous neurofibroma, congenital plexiform neurofibroma, congenital diffuse and plexiform neurofibroma, and subfascial neurofibroma. The κ coefficient of the interobserver ratings was 0.82.

Conclusion Patterns identified in the cluster analysis allow neurofibromas to be classified with a very high interobserver correlation.
„Erst sah ich doppelt und dann fiel mein linkes Auge zu“
Authors: Heckelmann Jan , Dafotakis Manuel
Published: November 2021

Der 60-jährige Patient stellte sich mit schmerzlos aufgetretenen vertikal-versetzten Doppelbildern beim Blick nach oben und rechts in unserer Notaufnahme vor. Als Vorerkrankungen bestanden ein mäßig eingestellter Diabetes mellitus Typ 1 sowie ein im Jahre 2015 kurativ behandeltes Schilddrüsenkarzinom. Eine zu diesem Zeitpunkt durchgeführte Diagnostik mittels CCT und CT-Angiographie ergab einen unauffälligen Befund.
Wie viel Quantität braucht Qualität?
Authors: Roßius Sabrina
Published: November 2021

Pflegepersonal endlich richtig bemessen: Das ist ein Vorhaben, das trotz großer Bemühungen immer wieder scheitert. Warum es sich lohnt, an einem Instrument zu arbeiten, lesen Sie hier.
Gemeinsam mehr erreichen
Authors: Roßius Sabrina , Hunger Sebastian
Published: November 2021

Solidarität und Miteinander für ein übergeordnetes Ziel: eine bessere Versorgung von Patienten und gute Rahmenbedingungen für Pflegefachkräfte. Lesen Sie, warum Verbandsarbeit als tragende Säule der Gesellschaft Sinn stiftet und den persönlichen Horizont erweitert.
Gestationsdiabetes
Authors: Fard Delnaz , Brodowski Lars , von Kaisenberg Constantin S.
Published: November 2021

Ziel: Review der Literatur zu Schwangeren mit Gestationsdiabetes, die ein erhöhtes peripartales Risiko aufweisen, welches im Rahmen des geburtshilflichen Managements Beachtung finden sollte.

Methodik: Systematische Literaturrecherche.

Ergebnisse: Als Gestationsdiabetes wird ein erstmals in der Schwangerschaft auftretender bzw. diagnostizierter Diabetes bezeichnet. Die Pathophysiologie und das Risikoprofil entsprechen dem des Diabetes mellitus Typ 2. Eine entscheidende Rolle spielen dabei, neben einer genetischen Disposition, der mütterliche Body-Mass-Index, der Lebensstil sowie frühere Schwangerschaften mit Gestationsdiabetes. Die Diagnosestellung erfolgt durch einen 75 g oralen Glukosetoleranztest, meist bei 24–28 Schwangerschaftswochen. Die Folgen für die Mutter sind vor allem die schwangerschaftsinduzierte Hypertonie und Präeklampsie sowie im Verlauf die erhöhte Inzidenz für kardiovaskuläre Ereignisse. Intrapartal zeigen sich zudem eine erhöhte Sectio-Rate bei fetalem Large for gestational age und ein erhöhtes Risiko für höhergradige Geburtsverletzungen und atone Nachblutungen. Die Therapie schließt sowohl die Lifestyle-Modifikation als auch die medikamentöse Therapie mit Insulin ein.

Schlussfolgerungen: Durch die frühzeitige Diagnosestellung durch adäquate Testverfahren und konsequent eingeleitete Therapien kann das peripartale maternale und fetale Risiko reduziert werden.
Synthesis of 1,3,4-Oxadiazoles by Iodine-Mediated Oxidative Cyclization of Methyl Ketones with 4-Phenylsemicarbazide
Authors: Leng Yuting , Wu Yangjie , Zhang Shanshan , Liu Chuang , Wu Xiaojun , Li Wen , Li He , Wang Shiwei
Published: November 2021

An efficient one-pot method has been developed to access 5-amino-2-(het)aroyl-1,3,4-oxadiazoles through I2/DMSO-promoted oxidative cyclization of 4-phenylsemicarbazide with (het)aryl methyl ketones under mild conditions. This reaction proceeds smoothly with a wide range of methyl ketones containing various functional groups to give the corresponding products in moderate yields under mild conditions.
Magnetic Resonance Morphometry of Normal Cerebral Aqueduct in South Indian Population
Authors: Raveendranath Veeramani , Dash Prafulla Kumar , Kavitha Thangaraj , Nagarajan Krishnan
Published: November 2021

Introduction Cerebral aqueduct (of Sylvius) connects the third and fourth ventricles of the brain, and the shape of the aqueduct varies. The aim of the study is to assess the morphometry of the cerebral aqueduct in normal south Indian adult population and to look for pattern by shape, if any.

Materials and Methods One hundred and fifty normal brain MR images (75 males and 75 females) using 3D heavily T2-weighted sequence were analyzed for various normal parameters of cerebral aqueduct. Mean and standard deviation were calculated. Based on the shape of the aqueduct, an attempt was made to classify them. Unpaired t-test was used to assess any significant difference between age groups and gender. The intraclass coefficient correlation was used to analyze the interobserver variability.

Results The mean value of the length of the cranial and caudal part of aqueduct in males were 0.69 cm and 0.86 cm and in females 0.65 cm and 0.80 cm, respectively. The length was more in males, and it was statistically significant (p = 0.006 and 0.02). There are four types of cerebral aqueduct based on shape.

Conclusion MRI is considered as the investigation of choice for preoperative planning of brain operative procedures. The MR morphometric evaluation of cerebral aqueduct provides precise knowledge about the anatomy and may be of help in the diagnosis and treatment by endoscopic neurosurgery.
Benign Fibrous Histiocytoma of the Sacrum: A Rare Scenario
Authors: Acharya Ashish , Grewal Sarvpreet Singh , Paul Sudhakar B John
Published: November 2021

Benign fibrous histiocytoma (BFH) of bone is quite rare, and here we report the second case of such tumor originating from sacrum, with the first being reported in an 18-year-old female. The overlapping clinical, radiological, and histopathological findings make it a difficult diagnosis along with the fact that it is a rare diagnosis. In this case report, we present the diagnostic difficulties and optimal treatment for such cases. A 46-year-old male w presented to OPD with complaint of numbness in left foot since 1 month, and intermittent urinary incontinence for 2 weeks. On examination, the straight leg raising test was positive of left side, extensor hallucis longus (EHL) was weak in both lower limbs, and bilateral ankle jerks were diminished. MRI showed well-defined lobulated solid mass lesion, which is T1 hypointense and T2 hyperintense and homogeneously involving the S1 vertebral body, with involvement of the right sacral ala, and right sacral foramen seen at S1 and S2 levels extending into the spinal canal till L4 level. Excision through a posterior midline incision was performed taking care to preserve the traversing nerves. Postoperatively, remarkable improvement in pain with no major residual neurological deficit was observed. Patient was followed-up till 9 months; patient’s incontinence improved over a period of 3 months and has stayed the same until the last follow-up.
Surgical Management of Parapharyngeal Tumors: Our Experience
Authors: Joshi Poonam , Joshi Kamal Deep , Nair Sudhir , Bhati Muddasir , Nair Deepa , Bal Munita , Joshi Amit , Mummudi Naveen , Tuljapurkar Vidisha , Chaukar Devendra A. , Chaturvedi Pankaj
Published: November 2021

Context Tumors of parapharyngeal space (PPS) are rare and histologically diverse. The management of these tumors requires diligent assessment and planning with due consideration of various anatomical and pathological aspects of the lesion.

Aims This retrospective study aims to present our experiences in the clinical and pathological aspects of PPS tumors with a critical evaluation of management.

Settings and Design Retrospective analytical study.

Methods and Material The electronic medical records of 60 cases of PPS tumors, managed surgically from 2007 to 2017, were reviewed and analyzed using SPSS 22 software. The mean follow-up duration was 44 months.

Results The mean age was 45 years with a male-to-female ratio of 1.7 (38:22). The majority of the tumors were benign (71.7%) and the most common presentation being upper neck mass or oropharyngeal mass. Histologically, neurogenic tumors were most common (43.3%) PPS tumors, followed by tumors of salivary gland origin. Magnetic resonance imaging was used as a diagnostic modality in 70% of cases, and computed tomography scan and positron emission tomography/CT were used in 26.7 and 3.3% of cases, respectively. In our study, the diagnostic accuracy of fine-needle aspiration cytology was 71% for benign and 47% for malignant lesions. The most common approach for surgery used was transcervical (72%).

Conclusion The study reveals that cranial nerve palsy is the most common complication associated with PPS tumors. Completely resected, malignant tumors originating within PPS have a good prognosis, as compared with tumors extending or metastasized to PPS.
Adult Soft Tissue Sarcoma: A Prospective Observational Real-World Data
Authors: Shivarudraiah Shivashankara Mathighatta , Viswanath Sundaram , Pandalanghat Suresh , Soneji Dharmesh , Kumar Manish , Patel Amol , Guleria Bupesh , Pathi Nikhil , Sud Rahul , Pathak Abhishek , Rathore Anvesh
Published: November 2021

Introduction There is a lacuna of prospective studies on soft tissue sarcoma (STS) from the Indian subcontinent in published literature.

Objectives We conducted this study to describe the clinical profile and outcomes of STS in North India.

Materials and Methods This is a single-center, prospective, observational study conducted from October 2017 to September 2019. All consecutive patients aged ≥18 years with histopathological diagnosis of STS were enrolled. The study end points included overall response rate, progression-free survival (PFS), and overall survival (OS).

Results A total of 140 patients were included with a median duration of follow-up of 14 months (range: 1–25 months). The median age of patients was 45 years. The median duration of symptoms before diagnosis was 5 months (range: 1–18 months). The most common histopathologic subtype was undifferentiated pleomorphic STS (22%). Of 105 localized patients, 21 received neoadjuvant therapy with external beam radiotherapy and/or doxorubicin-based chemotherapy and reported partial response in 38% (8/21) of the patients; the remaining 62% (13/21) of the patients had stable disease. Neoadjuvant therapy resulted in nonsignificantly higher complete resection rates with relative risk of 2.37 (p = 0.19). Of the remaining 35 metastatic STS patients, 31 received chemotherapy and reported partial response in 39.1% (n = 9/23), stable disease in 30.4% (n = 7/23), and disease progression in 30.4% (n = 7/23) of the patients. For localized STS patients, 1-year disease-free survival (DFS) and OS rates were 87.6 ±3.5 and 95.3 ± 2.3%, respectively. The median OS for metastatic STS patients was 23.90 months (95% confidence interval [CI]: 7.43–40.36). Among metastatic STS, median OS was not reached for those who underwent curative resection versus 12.66 months (95% CI: 9.28–16.04) for those who received systemic therapy alone.

Conclusion Median age of 45 years is a decade earlier than seen in the Western population. Neoadjuvant therapy improved complete resection rates, though it was statistically nonsignificant. Curative resection among metastatic STS patients improves survival.
Post-Denosumab-Treated Giant Cell Tumor of Bone: A Retrospective Histomorphological and Immunohistochemical Study
Authors: Kamble Anvesh , Hui Monalisa , Rao K. Nageshwara , Ramakrishna N. , Chandrasekhar P. , Uppin Shantveer G. , Sadashivudu G.
Published: November 2021

Introduction Giant cell tumors of bone (GCTBs) are treated with surgery with or without local adjuvants. Denosumab is a human monoclonal antibody that has recently emerged to be effective in treating unresectable and recurrent GCTBs.

Objective In this study, we analyzed the histomorphological changes in GCTB following treatment with denosumab. The expression of histone mutation H3.3G34W by immunohistochemistry (IHC) using mutant specific antibody was also determined.

Materials and Methods Of the total 109 GCTBs encountered during the study period, 14 cases with neoadjuvant denosumab therapy were analyzed retrospectively. The post-treatment changes on histopathology were examined on routine hematoxylin and eosin-stained sections. IHC was done using antihistone H3.3G34 antibodies. Statistical analysis was limited to descriptive statistics. No hypothesis testing was performed.

Results All these cases except three showed fibrosis with areas of hyalinization, prominent newly formed woven bone along with spindle cells in short fascicles and storiform pattern. There was complete absence and marked reduction in osteoclast-like giant cells in six and five patients, respectively. Only three patients showed a substantial amount of residual osteoclast-like giant cells. IHC with antihistone H3.3G34W antibody showed unequivocal nuclear positivity in the mononuclear cells in nine cases. The mononuclear cells rimming and entrapped within the woven bone were also positive on IHC. The spindle cells in the benign fibrous histiocytoma-like areas and septa of aneurysmal bone cyst-like areas also retained nuclear staining.

Conclusion Awareness of post-denosumab-related histopathological changes are necessary to avoid misdiagnosis as fibroosseous lesion and low-grade central osteosarcoma. Expression of mutant-specific H3.3 G34W antibody suggests that the neoplastic stromal cells are largely retained after denosumab therapy. The positive staining of cells both within and those rimming the newly formed woven bone point toward osteoblastic phenotype of the neoplastic stromal cells.
Clinical and Postoperative Outcomes of Cancer Surgeries during the COVID-19 Pandemic: A Comparative Study with its Pre-COVID Surgical Audit at Five Major Tertiary Care Hospitals’ Cancer Departments in India
Authors: Heroor Anil , Talwar Rajnish , Joshi Rama , Nayak Sandeep , Naik B. Niranjan , Tiwari Alok , Jain Sushil Kumar , Kapoor Rajeev , Jagad Vijay , Bansal Naval , Gangadhara Bharath , Bora Rashmi , Verma Harish , Nambiar Yadhukrishnan , Patil Akshay , Singhavi Hitesh
Published: November 2021

Introduction There has been an exponential rise in number of coronavirus disease 2019 (COVID-19)-positive infections since March 23, 2020. However, cancer management cannot take a backseat.

Objective The aim of this study was to identify any difference in the complication and mortality rates for the cancer patients operated during the ongoing COVID-19 pandemic.

Materials and Methods This was a retrospective study of a prospectively maintained database of five centers situated in different parts of India. Variables such as demographics, intraoperative, and postoperative complications were compared between COVID-19 (group A—March 23, 2020–May 22, 2020) and pre-COVID time period (group B—January 1 to January 31, 2020).

Results One-hundred sixty-eight cancer surgeries were performed in group B as compared with 148 patients who underwent oncosurgeries in group A. Sixty-two percent lesser cancer surgeries were performed in the COVID-19 period as compared with the specific pre-COVID-19 period. There was no significant difference in age group, gender, comorbidities, and type of cancer surgeries. Except for the duration of surgery, all other intraoperative parameters like blood loss and intraoperative parameters were similar in both the groups. Minimally invasive procedures were significantly lesser in group A. Postoperative parameters including period of intensive care unit stay, rate of infection, need for the change of antibiotics, and culture growth were similar for both the groups. While minor complication like Clavien-Dindo classification type 2 was significantly higher for group A, all other complication rates were similar in the groups. Also, postoperatively no COVID-19-related symptoms were encountered in the study group. A subset analysis was done among the study groups between those tested preoperatively for COVID-19 versus those untested showed no difference in intraoperative and postoperative parameters. No health-care worker was infected from the patient during the time period of this study.

Conclusion Our study shows that there is no significant difference in the incidence of postoperative morbidity and mortality rates in surgeries performed during COVID-19 pandemic as compared with non-COVID-19 time period.
A Retrospective Cohort Study of Upfront Nilotinib in Chronic Myeloid Leukemia: A Single-Center Experience
Authors: Singh Reema , Kapoor Jyotsna , Ahmed Rayaz , Mehta Pallavi , Khushoo Vishvdeep , Agrawal Pragya , Bhurani Dinesh , Agrawal Narendra
Published: November 2021

Context Nilotinib is a second-generation BCR-ABL1 tyrosine kinase inhibitor used in the treatment of chronic myeloid leukemia (CML).

Aims We aim to evaluate the responses and safety of upfront Nilotinib therapy in Indian CML patients.

Setting and Design We retrospectively reviewed the medical records of CML patients who received Nilotinib as an upfront treatment at our center between January 1, 2011 and October 15, 2019.The follow-up was taken till March 31, 2020.

Results Forty One patients (n = 36 chronic phase and five accelerated-phase CML) received frontline Nilotinib. Median age was 39 years (21–63) with male-to-female ratio of 1.1: 1. At 3 months, 96.9% patients achieved BCR-ABL of ≤10% at international scale. By the end of 12 months, 71.5% patients achieved major molecular response (BCR-ABL ≤0.1%) and 91.4% patients achieved complete cytogenetic response assessed by BCR-ABL polymerase chain reaction of ≤1%. Common toxicities observed were weight gain, thrombocytopenia, corrected QT prolongation, and elevated serum amylase in 14 (34.1%), 7(17.07%), 4(9.7%), and 4(9.7%) patients, respectively. Overall, five patients had loss of response with further progression and death in three patients. At a median of 43.7 months, 38 patients survived with estimated 3 year event-free survival and overall survival of 65 ± 9 and 93 ± 5%.

Conclusion This study showed remarkable good response with upfront Nilotinib in Indian patients with CML.
Evaluating the Effect of Health Education Intervention on the Health Beliefs and Behaviors of First-Degree Female Relatives of Breast Cancer Patients
Authors: Olgun Sule , Dizer Berna
Published: November 2021

Background Breast cancer risk increases by 80% in the presence of BRCA1 and BRCA2 gene mutations in the same family. In particular, a woman whose sister or mother has breast cancer has a 2- to 5-fold higher risk of developing breast cancer compared with other women. For this reason, recommendations should have been made regarding breast cancer prevention and/or early detection for women with first-degree family history of breast cancer.

Aim The aim of this study was to evaluate the effect of health education, which was provided to first-degree female relatives of breast cancer patients, on their health beliefs and behaviors.

Study Design and Methods The study sample included 50 women with a first-degree relative being treated for breast cancer in the chemotherapy and radiotherapy unit of a university hospital. A one-group pretest-posttest design was used. The pretest consisted of the health belief model scale and a questionnaire regarding the women's sociodemographic information and breast cancer screening behaviors. After the pretest, the patients received health education regarding breast cancer risk factors and screening methods. The posttest was conducted 3 weeks after the education using the same assessment tools.

Results After education, there were statistically significant increases in rates of practicing breast self-examination, having clinical breast examinations, and undergoing breast ultrasound/mammography compared with pretest results.

Conclusions Health workers should possess knowledge and experience about breast cancer which will enable them to effectively undertake an educational role, especially for high-risk groups such as women with first-degree family history of breast cancer.
Factors Affecting Short-Term Outcome of Critically Ill Children with Malignancies Admitted in Pediatric Intensive Care Unit: A Retrospective Observational Study
Authors: Aggarwal Priyanka , Kumar Ishan , Rao Sunil Kumar , Pradhap K , Gupta Vineeta
Published: November 2021

Introduction Pediatric cancer contributes <1% of all malignancies. Childhood cancer survival has improved dramatically with the use of more intensive chemotherapy regimens, better stratification, and improvement in supportive care with enhanced facilities in pediatric intensive care unit (PICU).

Objective The aim of this study was to identify the risk factors responsible for poor outcome in critically ill children with malignancies admitted in PICU.

Materials and Methods Sixty-four children with a primary diagnosis of malignancy admitted in PICU with disease or treatment related complications were enrolled retrospectively. The short-term outcome, that is, shifting from PICU to ward, was assessed in relation to the presence of febrile neutropenia, organ failure, hepatitis, acute renal failure as well as requirement of inotropes and mechanical ventilation. Death was considered as an adverse outcome in this study.

Results The mean age of study population was 6.25 ± 3.91 and M:F ratio 2.4:1. The majority of children had hematological malignancies (81.25%), that is, pre-B acute lymphoblastic leukemia (ALL) (45.3%), non-Hodgkin lymphoma (21.3%), acute myeloid leukemia (12.5%), T ALL (10.9%), and Hodgkin lymphoma (3.1%). Few children also had retinoblastoma (4.7%) and Langerhans cell histiocytosis (1.6%). The mean duration of PICU stay was 3.16 ± 2.31 days. Sepsis (37.5%) was the most common indication for PICU admission, followed by metabolic disturbance (26.6%), respiratory failure (17.2%), neurological complaints (15.6%), and anaphylactic shock (3.1%). Children requiring mechanical ventilation (p < 0.001), inotrope support (p < 0.001), having acute renal failure (p = 0.001), and >1 organ failure (p < 0.001) were associated with adverse outcome. The overall survival at the time of discharge from PICU was 64%.

Conclusion In the context of low- and middle-income countries, optimal resource utilization by early identification of risk factors for clinical deterioration is required to allow timely admission to PICU and delivery of life-saving therapy to salvageable patients.
Challenges of Implementing Artificial Intelligence in Interventional Radiology
Authors: Mazaheri Sina , Loya Mohammed F. , Newsome Janice , Lungren Mathew , Gichoya Judy Wawira
Published: November 2021

Artificial intelligence (AI) and deep learning (DL) remains a hot topic in medicine. DL is a subcategory of machine learning that takes advantage of multiple layers of interconnected neurons capable of analyzing immense amounts of data and “learning” patterns and offering predictions. It appears to be poised to fundamentally transform and help advance the field of diagnostic radiology, as heralded by numerous published use cases and number of FDA-cleared products. On the other hand, while multiple publications have touched upon many great hypothetical use cases of AI in interventional radiology (IR), the actual implementation of AI in IR clinical practice has been slow compared with the diagnostic world. In this article, we set out to examine a few challenges contributing to this scarcity of AI applications in IR, including inherent specialty challenges, regulatory hurdles, intellectual property, raising capital, and ethics. Owing to the complexities involved in implementing AI in IR, it is likely that IR will be one of the late beneficiaries of AI. In the meantime, it would be worthwhile to continuously engage in defining clinically relevant use cases and focus our limited resources on those that would benefit our patients the most.
Chronic Paronychia of Great Toe Treated with Excision of Nail Plate along with Surrounding Tissue and Split Thickness Skin Graft: An Observational Prospective Study
Authors: Panda Radharaman
Published: November 2021

Paronychia is an inflammatory condition of alongside of nail of toe or finger. It is seen commonly in housewives and housemaids. Paronychia may be acute or chronic. Majority of patients with acute paronychia respond well to nonsurgical treatment. Patients with chronic paronychia of great toe do not respond to nonsurgical treatment. Patients suffer from chronic pain in finger or toe. Many treatment methods are available for chronic paronychia of great toe. All have merits, demerits, and different outcomes. This study is conducted to find out the outcome of a modified surgical technique in chronic paronychia of great toe of patients. This is a method adopted with a little modification of existing method.

This study was conducted among 50 patients of chronic paronychia of great toe, who were between 15 to 55 years of age, from December 2019 to December 2020. These patients were operated and kept on follow-up for 1 year and observed for different outcomes likes skin graft take off, complete wound healing of operated area, relief from chronic pain of great toe, acceptance of cosmetic appearance, and recurrence of disease. Clinical data was recorded in case record form by examining the patient, asking questions to them, and conducting descriptive analysis. Results in terms of skin graft take off, complete wound healing of operated area, relief from chronic pain of great toe, acceptance of cosmetic appearance, and recurrence of disease were assessed during follow-up period. Postoperative result showed that 98% of patients had complete wound healing and complete graft take up, acceptance of cosmetic appearance was 94%, recurrence was 2%, and 90% were relieved from chronic pain of disease great toe. It was concluded that this was a better method for treatment of chronic paronychia of great toe.
A Comparative Study between the Use of Negative Pressure Wound Therapy and Silver-Releasing Foam Dressings in the Management of Diabetic Ulcers
Authors: Taliat George , D'Souza Clement
Published: November 2021

Introduction Diabetic foot ulcers are one among the most commonly encountered complication of diabetes mellitus tackled by the surgical department worldwide. Negative pressure wound therapy (NPWT) and silver-releasing foam dressings are effective modalities for the treatment of ulcers. This study compares the two treatment modalities.

Methods Sixty adult patients admitted with diabetic foot ulcers undergoing NPWT (vacuum-assisted closure [VAC]) or silver-releasing foam dressing (Biatain Ag) treatment were included in the study. Patients undergoing either of the treatment modalities were observed and followed up on a weekly basis prospectively. Wounds were routinely examined for the size of ulcer in area (cm2) and time taken for wound healing. Patients were also assessed qualitatively by means of a questionnaire to find out patient satisfaction and compliance.

Results Time taken for wound healing among Biatain Ag group was found to be 24±9.483 days compared with only 19.73±7.575 days in the VAC group. Decrease in size ulcer measured in area was found to be 38.79% in Biatain Ag group, whereas in the VAC group it was found to be 26.56%. Patients were satisfied with both modalities of treatment; however, patient compliance was better for the Biatain Ag Group due to decrease in restriction of mobility and decrease in cost.

Conclusion Overall, both modalities of treatment were found to be comparable and can be used with similar efficacy. It can be concluded that silver-releasing foam dressing can act as a beneficial alternative to NPWT in the treatment of diabetic ulcers.
Tuberculosis is still the most Common Cause of Mediastinal and Intra-abdominal Lymphadenopathy by EUS-FNA in India
Authors: Behera Manas Kumar , Narayan Jimmy , Agarwal Shobhit , Mishra Debakanta , Reddy Pruthvi , Singh Ayaskanta , Pati Girish Kumar , Sahu Manoj Kumar
Published: November 2021

Background Lymph nodal tuberculosis is reported to occur in 4% to 7% of all tuberculosis, and mediastinal lymphadenopathy accounts for 10% of lymph nodal tuberculosis but the diagnosis still remains a challenge due to inaccessibility to these sites. There is a scarcity of recent data from India about the etiology of intra-abdominal and mediastinal lymphadenopathy despite being frequently detected in cross-sectional imaging.

Methods A retrospective study was conducted after reviewing hospital records over a period of 3 years from December 2017 to December 2020 who underwent endoscopic ultrasonography (EUS). A total of 126 patients with mediastinal and/or intra-abdominal lymphadenopathy detected by cross-sectional imaging were examined for clinical features, EUS, and histopathology records.

Results The mean age of patients was 53.12 ± 14.15 years. Seventy-one patients (56%) had intra-abdominal lymph nodes and 55 (44%) had mediastinal lymph nodes. The average number of needle passes was 2.35 ± 0.58 (range: 2–4). The majority of patients had tubercular etiology (53.2%) followed by metastatic (26.2%). Other etiologies were reactive (4.8%), lymphoma (4.8%), sarcoidosis (3.2%), and GIST (1.6%). No diagnosis could be ascertained in 6.3% of patients. The EUS features that favored tubercular etiology over metastatic were heterogeneous echotexture (72% vs. 30%), irregular shape (78% vs. 12%), indistinct borders (81% vs. 30%) and calcification (43% vs. 15%). Partial anechoic area and hyperechoic area were seen in 21% and 64% of tubercular patients, respectively. EUS only had sensitivity and specificity of 63% and 84%, respectively, and EUS FNA had a very high sensitivity and specificity of 93% and 100%, respectively.

Conclusion Tuberculosis is still the most common cause of lymph nodes. EUS FNA had a very high sensitivity and specificity of 93% and 100%, respectively, for the diagnosis of mediastinal and intra-abdominal lymphadenopathy.
Losses, hopes, and expectations for sustainable futures after COVID
Authors: Lewandowsky Stephan , Facer Keri , Ecker Ullrich K. H.
Published: November 2021

The COVID-19 pandemic has caused immense distress but also created opportunity for radical change. Two main avenues for recovery from the pandemic have been discussed: A “back to normal” that foregrounds economic recovery, and a sustainable and progressive “build back better” approach that seeks to address global problems such as inequality and climate change. The article reports two experiments conducted on representative British and American samples (N = 600 andN = 800, respectively, for the two experiments) that show that people in both countries overall prefer a progressive future to a return to normal, although that preference is stronger on the political left and center-left with ambivalence prevailing on the right. However, irrespective of political leanings, people consider a return to normal more likely than a progressive future. People also mistakenly believe that others want the progressive scenarios less, and the return to normal more, than they actually do. The divergence between what people want and what they think others want represents an instance of pluralistic ignorance, which arises when public discourse is not reflecting people’s actual opinions. Publicizing public opinion is thus crucial to facilitate a future with broad support. In additional open-ended items, participants cited working from home, reduced commuting, and a collective sense of civility as worth retaining post pandemic.
Queering the web archive: A xenofeminist approach to gender, function, language and culture in the London French Special Collection
Authors: Huc-Hepher Saskia
Published: November 2021

Based on the author’s experience of curating a collection of migrant community web objects within the UK Web Archive, this paper combines conceptual interrogation with empirical analysis. The central premise is that the incorporation of multilingual, diasporic micro-archives serves to queer the anglophone UK Web Archive, or “patriarchive”, by dismantling steadfast binaries and implicit postcolonial hegemonies. The article challenges Jacques Derrida’s contention that themal d’archiveis the result of the archive’s ‘troubling’ duality, and posits, on the contrary, that such boundary-crossings are the very incarnation of a positive, transgressive form of xenofeminism (XF). From the dualism at the origin of the archive itself, to that comprised in the concept of genre/gender, and from the spatiotemporal in-betweenness of the archived diasporic (web)site to the translanguaging present therein, the article demonstrates how the diasporic micro-archive is the embodiment of a non-binary, trans-inclusive XF ideology. Taking French migrant women’s blogs preserved in the London French Special Collection as a primary source and examining their transformation over time, the paper explores how blog repurposing can be apprehended as a technomaterialist XF act and how the blogs’ increasing multimodal translanguaging bears witness to a form of culturo-linguistic transitioning that transcends binary hybridity.
A deep-learning model for predictive archaeology and archaeological community detection
Authors: Resler Abraham , Yeshurun Reuven , Natalio Filipe , Giryes Raja
Published: November 2021

Deep learning is a powerful tool for exploring large datasets and discovering new patterns. This work presents an account of a metric learning-based deep convolutional neural network (CNN) applied to an archaeological dataset. The proposed account speaks of three stages: training, testing/validating, and community detection. Several thousand artefact images, ranging from the Lower Palaeolithic period (1.4 million years ago) to the Late Islamic period (fourteenth century AD), were used to train the model (i.e., the CNN), to discern artefacts by site and period. After training, it attained a comparable accuracy to archaeologists in various periods. In order to test the model, it was called to identify new query images according to similarities with known (training) images. Validation blinding experiments showed that while archaeologists performed as well as the model within their field of expertise, they fell behind concerning other periods. Lastly, a community detection algorithm based on the confusion matrix data was used to discern affiliations across sites. A case-study on Levantine Natufian artefacts demonstrated the algorithm’s capacity to discern meaningful connections. As such, the model has the potential to reveal yet unknown patterns in archaeological data.
Univariate and multivariable forecasting models for ultra-short-term wind power prediction based on the similar day and LSTM network
Authors: Xu Hai-Yan , Chang Yu-Qing , Wang Fu-Li , Wang Shu , Yao Yuan
Published: November 2021

High-precision wind power prediction is an important method to ensure the safety and stability of wind power integration. However, because of the intermittent and uncontrollable nature of wind speed sequences, the wind power prediction has become a difficult task. Given this, this paper studies the prediction of wind power from three aspects. First, combining a similar day with long short-term memory is proposed to predict ultra-short-term wind power, and the improved gray correlation analysis method is used to select a similar day. In addition, to study the influence of weather data on the accuracy of the prediction model, a univariable prediction model and a multivariable prediction model are proposed to predict ultra-short-term wind power, and their performances are compared. The experimental results show that all of the above studies help improve ultra-short-term wind power prediction accuracy. Finally, the uncertainty prediction (confidence interval) of wind power is estimated by the nonparametric kernel density estimation based on the Bootstrap-Kernel density method on the result of deterministic prediction, and the upper and lower limits of wind power fluctuation are given at a certain level of confidence. The research results can provide decision-makers with accurate data changes in risk analysis and reliability assessment.
Symptoms of anxiety, depression and fear in healthcare workers and non-healthcare workers undergoing outpatient COVID-19 testing in an urban Australian setting
Authors: Brennan M. E. , Marinovich M. L. , Verdonk B. , Vukasovic M. , Coggins A.
Published: November 2021

This study assessed symptoms of anxiety, depression and fear of COVID-19 in members of the general community and healthcare workers (HCWs) attending for COVID testing. This cross-sectional study was conducted in a public hospital COVID-19 testing clinic (June–September 2020) using self-administered questionnaires (i.e. the Hospital Anxiety and Depression Scale (HADS) and the Fear of COVID-19 Scale). In all, 430 participants who met the criteria for COVID-19 testing with nasopharyngeal and throat swabs completed the questionnaires. The mean (±s.d.) age of participants was 37.6 ± 12.6 years. HCWs made up 35.1% of the sample. Overall, the mean (±s.d.) score for anxiety was 6.09 ± 4.41 and ‘case’ prevalence (any severity) was 151/430 (35.1%), higher than normative population scores. Higher anxiety was found in women (P = 0.001) and in clients who had previously been tested for coronavirus (P = 0.03). HCWs had lower anxiety scores than members of the general community (P = 0.001). For depression, the mean (±s.d.) score was 4.18 ± 3.60, with a ‘case’ prevalence (any severity) of 82/430 (19.1%), similar to normative population scores. Women reported a higher level of COVID-19 fear (P = 0.001), as did people with a lower education level (P = 0.001). A greater psychological impact of COVID-19 was observed in women, people undergoing repeat testing and participants reporting lower levels of educational attainment. HCWs had fewer symptoms of anxiety and depression than non-HCWs attending the same clinic for COVID-19 testing. This information can be used to plan mental health interventions in primary care and testing settings during this and future pandemics.
Probing the adsorption behavior and free energy landscape of single-stranded DNA oligonucleotides on single-layer MoS2 with molecular dynamics
Authors: Saikia Nabanita
Published: November 2021

Interfacing single-stranded DNA (ssDNA) with 2D transition metal dichalcogenides are important for numerous technological advancements. However, the molecular mechanism of this process, including the nature of intermolecular association and conformational details of the self-assembled hybrids is still not well understood. Here, atomistic molecular dynamics simulation is employed to study the distinct adsorption behavior of ssDNA on a single-layer MoS2 in aqueous environment. The ssDNA sequences [T10, G10, A10, C10, U10, (GT)5, and (AC)5] are chosen on the basis that short ssDNA segments can undergo a spontaneous conformational change upon adsorption and allow efficient sampling of the conformational landscape. Differences in hybridization is attributed to the inherent molecular recognition ability of the bases. While the binding appears to be primarily driven by energetically favorable van der Waals π-stacking interactions, equilibrium structures are modulated by the ssDNA conformational changes. The poly-purines demonstrate two concurrently competing π-stacking interactions: nucleobase–nucleobase (intramolecular) and nucleobase–MoS2 (intermolecular). The poly-pyrimidines, on the other hand, reveal enhanced π-stacking interactions, thereby maximizing the number of contacts. The results provide new molecular-level understanding of ssDNA adsorption on the MoS2 surface and facilitate future studies in design of functional DNA/MoS2 structure-based platforms for DNA sequencing, biosensing (optical, electrochemical, and electronic), and drug delivery.
Temperature and creatine kinase changes during a 10d taper period in sprinters
Authors: Korman Paweł , Kusy Krzysztof , Kantanista Adam , Straburzyńska-Lupa Anna , Zieliński Jacek
Published: November 2021

Objective. The aim of this prospective cohort study, performed during a 10 d training camp, was to analyze the effect of a series of successive speed-power training sessions on the concurrent circadian changes in resting leg skin temperature and blood creatine kinase (CK) levels and to determine the correlation between them. Approach. Seventeen elite sprinters, aged 22–31 years, were examined. Every morning and evening, capillary blood samples were drawn to assay CK levels. Lower limb skin temperature was measured simultaneously, and thermal images were taken using an infrared camera. Main results. From the first day of the training camp, the base temperature levels began to drop to obtain a significant reduction from the 6th day (male) and from the 8th day (female) to the end of the camp. Simultaneously, CK levels increased in the male group from 8th to the end of the camp, but it did not change significantly in females. Regarding the circadian rhythm, the CK levels always rose during the day and declined during the night. The temperature decreased during the day and increased during the night until the 6th day. After that, the temperature changed oppositely till the end of camp, i.e. it increased during the day and decreased during the night. This could suggest that the training microcycle should last about a week because after this time there may be a disturbance in the temperature circadian rhythm and a significant CK accumulation Significance. Multi-day speed-power training induced a progressive reduction in resting skin temperature and an elevation in CK levels. It also altered the circadian rhythm of the body skin temperature, which may indicate that after about 6 d of regular exercise, physiological deregulation may occur.
The attachment length in orificed hollow cathodes
Authors: Wordingham C J , Taunay P-Y C R , Choueiri E Y
Published: November 2021

A first-principles approach to obtain the attachment length within a hollow cathode with a constrictive orifice, and its scaling with internal cathode pressure, is developed. This parameter, defined herein as the plasma density decay length scale upstream of (away from) the cathode orifice, is critical because it controls the utilization of the hollow cathode insert and influences cathode life. A two-dimensional framework is developed from the ambipolar diffusion equation for the insert-region plasma. A closed-form solution for the plasma density is obtained using standard partial differential equation techniques by applying an approximate boundary condition at the cathode orifice plane. This approach also yields the attachment length and electron temperature without reliance on measured plasma property data or complex computational models. The predicted plasma density profile is validated against measurements from the NSTAR discharge cathode, and calculated electron temperatures and attachment lengths agree with published values. Nondimensionalization of the governing equations reveals that the solution depends almost exclusively on the neutral pressure-diameter product in the insert plasma region. Evaluation of analytical results over a wide range of input parameters yields scaling relations for the variation of the attachment length and electron temperature with the pressure-diameter product. For the range of orifice-to-insert diameter ratio studied, the influence of orifice size is shown to be small except through its effect on insert pressure, and the attachment length is shown to be proportional to the insert inner radius, suggesting high-pressure cathodes should be constructed with larger-diameter inserts.
Scalar and Dirac quasinormal modes of scalar-tensor-Gauss-Bonnet black holes *
Authors: Wang Tong-Zheng , Qian Wei-Liang , Zapata Juan Fernando Zapata , Lin Kai
Published: November 2021

This study explores the scalar and Dirac quasinormal modes pertaining to a class of black hole solutions in the scalar-tensor-Gauss-Bonnet theory. The black hole metrics in question are novel analytic solutions recently derived in the extended version of the theory, which effectively follows at the level of the action of string theory. Owing to the existence of a nonlinear electromagnetic field, the black hole solution possesses a nonvanishing magnetic charge. In particular, the metric is capable of describing black holes with distinct characteristics by assuming different values of the ADM mass and the magnetic charge. This study investigates the scalar and Dirac perturbations in these black hole spacetimes; in particular, we focus on two different types of solutions, based on distinct horizon structures. The properties of the complex frequencies of the obtained dissipative oscillations are investigated, and the stability of the metric is subsequently addressed. We also elaborate on the possible implications of this study.
Features of a negative ionization wave development preceding the full breakdown in a long capillary tube wrapped with a continuous or fine-sectioned grounded electrode
Authors: Akishev Yu S , Karalnik V B , Petryakov A V
Published: November 2021

The experimental results on the study of negative ionization wave propagating along a long capillary tube are presented. The ionization wave was initiated by high-voltage pulse of negative polarity. The propagation of this surface ionization wave precedes and influences the establishment of complete electric breakdown within the tube. The spreading of this wave is accompanied by the surface charge deposition. The usage of the fine-sectioned outer electrode allows one to find out the general features of a negative ionization wave. The main of them is the tight correlation between local currents determining the formation of local surface charge and visual discharge images taken by the fast camera characterizing the pace of the ionization wave propagation.
“Electrical wind” in CO2–laser mixtures at superatmospheric pressures
Authors: Kozlov B A , Makhanko D S
Published: November 2021

This article presents the results of “electrical wind” investigations in CO2–laser mixtures at superatmospheric (1–12 atm) pressures. It is established that for a fixed value of the unipolar corona discharge current, the gas flow velocity does not depend on the pressure, but is determined by the chemical composition of the working mixture. The maximum values of the “electrical wind” velocity are achieved in carbon dioxide and molecular nitrogen and their values are 3.2 and 2.9 ms−1. In typical laser mixtures CO2:N2:He = 1:1:1 – 1:1:3 the velocity of the “electrical wind ” are in the range from 2.5 to 1.5 ms−.