bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical studies in times of a pandemic – Concepts of digital teaching for Orthopaedics and Trauma at German universities
Authors: Mielke Anna-Maria , Mohamed Ghanem , Back David Alexander , Digitalisierung AG , Lehre AG , Fröhlich Susanne , Seemann Ricarda Johanna
Published: May 2022

Background: Due to the Covid-19 pandemic, on-site classroom teaching became limited at most German medical universities. This caused a sudden demand for digital teaching concepts. How the transfer from classroom to digital teaching or digitally assisted teaching was conducted was decided by each university and/or department individually. As a surgical discipline, Orthopaedics and Trauma have a particular focus on hands-on teaching as well as direct contact to patients. Therefore, specific challenges in designing digital teaching concepts were expected to arise. Aim of this study was to evaluate medical teaching at German universities one year into the pandemic as well as to identify potentials and pitfalls in order to develop possible optimization approaches.Methods: A questionnaire with 17 items was designed and sent to the professors in charge of organising the teaching in Orthopaedics and Trauma at each medical university. A differentiation between Orthopaedics and Trauma was not made to allow a general overview. We collected the answers and conducted a qualitative analysis.Results: We received 24 replies. Each university reported a substantial reduction of their classroom teaching and efforts to transfer their teaching to digital formats. Three sites were able to switch to digital teaching concepts completely, whereas others tried to enable classroom and bedside teaching at least for students of higher edcuational levels.The online platforms used varied depending on the university as well as the format it was supposed to support. Conclusion: One year into the pandemic significant differences concerning the proportions of classroom and digital teaching for Orthopaedics and Trauma can be observed. Simultaneously huge differences in concepts used to create digital teaching are present. Since a complete suspense of classroom teaching was never mandatory, several universities developed hygiene concepts to enable hands-on and bedside teaching. Despite these differences, some similarities were observed: the lack of time and personnel to generate adequate teaching material was reported as the leading challenge by all participants of this study.
Intracranial, intratumoral implantation of drug-releasing microdevices in patients with high grade gliomas is feasible, safe, and may predict tumor response to systemic chemotherapy
Authors: Peruzzi Pierpaolo , Dominas Christine , Fell Geoffrey , Blitz Sarah , Bernstock Joshua , Dawood Hassan , Triggs Daniel , Ahn Sebastian , Bhagavatula Sharat , Tatarova Zuzana , Pannel Michael , Truman Kyla , Ball Anna , Chiocca E. , Ligon Keith , Wen Patrick , Jonas Oliver
Published: May 2022

The lack of reliable predictive biomarkers to guide effective therapy is a major obstacle for the advancement of therapy for high grade gliomas (HGG), and particularly glioblastoma (GBM), one of the few cancers whose prognosis has not improved over the past several decades. With this pilot clinical trial we provide first in human evidence that drug-releasing intratumoral microdevices (IMD) can be safely and effectively used to obtain patient-specific, high throughput molecular and histopathological data to inform selection of drugs based on their observed antitumor effect in situ. The use of IMD is seamlessly integrated in standard surgical practice during tumor resection. None of the six enrolled patients experienced adverse events related to the IMD, and the retrieved tissue was usable for downstream analysis for 11 out of 12 retrieved specimens. Molecular analysis of the specimens provided, for the first time in humans, preliminary evidence of the robustness of the readout, with strong correlation between IMD analysis and clinic-radiological responses to temozolomide. From an investigational aspect, the amount of information obtained with IMD allows unprecedented characterization of tissue effects of any drugs of interest, within the physiological context of the intact tumor.
Identifying congenital generalized lipodystrophy using deep learning- DEEPLIPO
Authors: Olegario Natália Bitar da Cunha , Neto Joel Sotero da Cunha , Barbosa Paulo Cirillo Souza , Pinheiro Plácido Rogério , Landim Pedro Lino Azevêdo , Montenegro Ana Paula Dias Rangel , Fernandes Virginia Oliveira , de Albuquerque Victor Hugo Costa , Duarte João Batista Furlan , Lima Grayce Ellen da Cruz Paiva , Junior Renan Magalhães Montenegro
Published: May 2022

Congenital Generalized Lipodystrophy (CGL) is a rare autosomal recessive disease characterized by near complete absence of functional adipose tissue from birth. CGL diagnosis can be based on clinical data including acromegaloid features, acanthosis nigricans, reduction of total body fat, muscular hypertrophy, and protrusion of the umbilical scar. The identification and knowledge of CGL by the health care professionals is crucial once it is associated with severe and precocious cardiometabolic complications and poor outcome. Image processing by deep learning algorithms have been implemented in medicine and the application into routine clinical practice is feasible. Therefore, the aim of this study was to identify congenital generalized lipodystrophy phenotype using deep learning. A deep learning approach model using convolutional neural network was presented as a detailed experiment with evaluation steps undertaken to test the effectiveness. These experiments were based on CGL patient’s photography database. The dataset consists of two main categories (training and testing) and three subcategories containing photos of patients with CGL, individuals with malnutrition and eutrophic individuals with athletic build. A total of 337 images of individuals of different ages, children and adults were carefully chosen from internet open access database and photographic records of stored images of medical records of a reference center for inherited lipodystrophies. For validation, the dataset was partitioned into four parts, keeping the same proportion of the three subcategories in each part. The 4-fold cross-validation technique was applied, using 75% (3 parts) of the data as training and 25% (1 part) as a test. Following the technique, 4 tests were performed, changing the parts that were used as training and testing until each part was used exactly once as validation data. As a result, a mean accuracy, sensitivity, and specificity were obtained with values ​​of [90.85% ± 2.20%], [90.63% ± 3.53%] and [91.41% ± 1.10%], respectively. In conclusion, this study presented for the first time a deep learning model able to identify congenital generalized lipodystrophy phenotype with excellent accuracy, sensitivity and specificity, possibly being a strategic tool for detecting this disease.
Heterospecific Immunity Help to Sustain an Effective BK-virus Immune Response and Prevent BK-virus-associated Nephropathy
Authors: Dekeyser Manon , de Herve Marie-Ghislaine de Goër , Hendel-chavez Houria , Boutin Emmanuelle , Herr Florence , Lhotte Romain , Taupin Jean-Luc , Taoufik Yassine , Durrbach Antoine
Published: May 2022

BK-virus-associated nephropathy (BKvAN) is a major complication in kidney transplant recipients, associated with a higher level of BK-virus (BKv) replication and leading to poor graft survival. In a large cohort of kidney transplant recipients with various BKv reactivation levels, we found that BKvAN was associated with a low BKv-specific memory CD8 T-cell functionality and an exhausted-like phenotype. This severe lymphocyte impairment was associated with a low level of class II HLA mismatches. In vitro experiments showed that allogeneic CD4 T cells partly restored BKv-specific memory CD8 T-cell responses. Our results suggest that in kidney transplant recipient, allogeneic CD4 T cells may provide a heterospecific help that maintain an effective BKv-specific memory CD8 T-cell response, and allows a better control of BKv replication in the kidney graft.
Frequency-swept feedback interferometry for non-cooperative-target ranging with the stand-off distance of hundred meters
Authors: Wang Yifan , Xu Xin , Dai Zongren , Hua Ziyu , Lin Chenxiao , Hou Yubin , Zhang Qian , Wang Pu , Tan Yidong
Published: May 2022

Frequency-swept interferometry (FSI) is a powerful ranging method with high precision and immunity to ambient light. However, the stand-off distance of the current FSI-based ranging system for non-cooperative targets is relatively short, because the weak echo power cannot provide the needed signal-to-noise ratio (SNR). Here, we report a ranging method combining FSI and the laser feedback technique. Compared with the conventional FSI, the interference between the weak echo signal and the local oscillator occurs in the laser cavity, which makes the signal enhanced spontaneously and then provides a satisfying SNR. In experiments, the detection limit of the echo power is less than 0.1fW, with 230µW output in total. Based on the enhancement from the laser feedback technique, the system achieves a non-cooperative target ranging hundreds of meters away in space without extra optical amplifiers. On the other hand, a large stand-off distance makes the system sensitive to environmental disturbance, which degrades the ranging precision. To correct it, a compensation device is proposed to correct the unwanted optical-path-length drifts. Owing to the high sensitivity and the validity of the compensation, the standard deviation in 10 measurements is better than 0.07mm, targeting an aluminum sheet at about 152m. Generally, hundred-meter range, high relative precision, and low photon consumption predict a novel technical scheme for laser ranging, and demonstrate new capabilities that promise to enable a wide range of scientific and industrial applications.
Mapping of Health Resources in Lower Manya Krobo Municipality in the Eastern Region of Ghana
Authors: Ansoumane BERETE , Enos Juliana , Acheampong Gideon , Augustine Kumah , Berete Karinkan
Published: May 2022

Background: Variations in the distribution of health facilities have resulted in differences in health outcomes within the administrative districts of Ghana of which the Lower Manya Krobo Municipality (LMKM) is no exception. Aim: The primary objective of this study was to examine the distribution of health care resources in the Lower Manya Krobo Municipality in the Eastern Region of Ghana. Methods: A single case study approach was adopted, involving all health resources, facilities, and their supporting service centers in the LMKM. All functional health facilities in the municipality during the time of the study were included in the study. The study partly utilized records of generated coordinates using the Geo-positioning system (GPS) of other resources and services. Results: The Municipality had a total of 16 health facilities and 29 supporting centers. There were 285 clinical health workers in the municipality. Odumase and Akuse, had higher percentages of clinical health personnel. The population per single health worker ratio for the whole municipality was found to be 13201:1. Agomanya had the highest number of facilities and support centers. The population per health facility ratio was 15,086 per facility.Conclusion: The study demonstrated disparities in the distribution of health facilities across the municipality. There is a need to ensure the distribution of all health resources corresponds to the population size and the health needs of the Lower Manya Krobo Municipality.
A mathematical model and numerical simulation for SARS-CoV-2 dynamics
Authors: Amoddeo Antonino
Published: May 2022

Since its outbreak the corona virus-19 disease has been particularly aggressive for the lower respiratory tract, and lungs in particular. The dynamics of the abnormal immune response leading to lung damage with fatal outcomes is not yet fully understood. We present a mathematical model describing the dynamics of corona virus disease-19 starting from virus seeding inside the human respiratory tract, taking into account its interaction with the components of the innate immune system as classically and alternatively activated macrophages, interleukin-6 and-10. The numerical simulations have been performed for two different parameter values related to the pro-inflammatory interleukin, searching for a correlation among components dynamics during the early stage of infection, in particular pro-and anti-inflammatory polarizations of the immune response. We found that in the initial stage of infection the immune machinery is unable to stop or weaken the virus progression. Also an abnormal anti-inflammatory interleukin response is predicted, induced by the disease progression and clinically associated to tissue damages. The numerical results well reproduce experimental results found in literature.
Development and Validation of a Nomogram for Evaluating the Prognosis of Immunotherapy plus Antiangiogenic Therapy in Non-small Cell Lung Cancer
Authors: Huang Hao , Chen Yao , Weng Xuezi , Li Sirou , Zhang Lin , Chen Peisong
Published: May 2022

Background: With the combination therapy of PD-1/PD-L1 antibody and antiangiogenic drugs used widely in clinic, a novel method to estimate the prognosis of patients is needed. We aimed to develop a nomogram to examine prognosis of anti-PD-1/PD-L1 antibody plus bevacizumab in non-small cell lung cancer (NSCLC) patients.Methods: We developed a nomogram using the cohort involving 204 NSCLC patients who treated with immunotherapy and anti-angiogenesis therapy. The nomogram was validated under the same conditions in another cohort with 69 patients. Prognostic factors were assessed using Cox regression analysis. The nomogram was internally validated using bootstrap resampling and then externally validated. Performance was assessed using concordance index, calibration curve and decision curve analysis. Clinical utility was evaluated using receiver operation characteristic curve.Results: Pleural metastasis (P=0.001, HR=2.980, 95%CI=1.521-5.837), ANC (P<0.001, HR=5.139, 95%CI=2.081-12.691), ALC (P=0.010, HR=0.331, 95%CI=0.142-0.771), B cells (P=0.005, HR=0.329, 95%CI=0.151-0.714), Treg cells (P=0.002, HR=2.934, 95%CI=1.478-5.826) were independent prognostic factors. The calibration curves showed a good consistency and the C-index of nomogram were 0.808, 0.741 in training and external validation cohort, respectively. The area under the curve (AUC) in receiver operation characteristic curves (ROC) are 0.833 (P<0.001) and 0.908 (P<0.001), respectively.Conclusion: We build an accurate and convenient nomogram to predict long-time overall survival (OS) of NSCLC patients treated with PD-1/PD-L1 antibody and antiangiogenic drugs and validated this nomogram. The nomogram might be helpful to clinicians to estimate long-time OS of NSCLC patients treated with PD-1/PD-L1 antibody and antiangiogenic drugs.
[18F]F13640: a selective agonist PET radiopharmaceutical for imaging functional 5-HT1A receptors in humans
Authors: Courault Pierre , Lancelot Sophie , Costes Nicolas , Colom Matthieu , Bars Didier Le , Redoute Jérôme , Gobert Florent , Dailler Frédéric , Isal Sibel , Iecker Thibaut , Newman-Tancredi Adrian , Merida Inés , Zimmer Luc
Published: May 2022

Purpose:F13640 (a.k.a. befiradol, NLX-112) is a highly selective 5-HT1A receptor ligand that was selected as a PET radiopharmaceutical-candidate based on animal studies. Due to its high efficacy agonist properties, [18F]F13640 binds preferentially to functional 5-HT1A receptors, which are coupled to intracellular G-proteins. Here we characterize brain labeling of 5-HT1A receptors by [18F]F13640 in humans and describe a simplified model for its quantification.Methods:PET/CT and PET-MRI scans were conducted in a total of 13 healthy male volunteers (29 ± 9 years old), with arterial input functions (AIF) and test-retest protocol. Several kinetic models were compared (one tissue compartment model, two-tissue compartment model and Logan); two models with reference region were also evaluated: simplified reference tissue model (SRTM) and the Logan reference model (LREF).Results:[18F]F13640 showed high uptake values in raphe nuclei and cortical regions. SRTM and LREF models showed excellent correlation with kinetic models using AIF. Considering test-retest parameters and the prolonged binding kinetics of [18F]F13640, better reproducibility and reliability were found with the LREF method. Cerebellum white matter and frontal lobe white matter stand out as suitable reference regions.Conclusion:The favorable brain labeling and kinetic profile of [18F]F13640, its high receptor specificity and its high efficacy agonist properties open new perspectives for studying functionally active 5-HT1A receptors, unlike previous radiopharmaceuticals that act as antagonists. [18F]F13640’s kinetic properties allow injection out of the PET scanner with delayed acquisitions, facilitating the design of innovative longitudinal protocols in neurology and psychiatry.Trial Registration EudraCT 2017-002722-21
DOA Estimation Algorithm Based on Spread Spectrum Sequence in Low Signal-to-Noise Ratio
Authors: Zhang Wenbo , Zhou Feng , Zhang Baosheng , Ji Xiaofeng , Li Xuanze
Published: May 2022

Spread spectrum communication is a common communication method in underwater communication. Based on the space-time processor received by the array, it can filter the signals arriving along each path separately. Combined with the diversity of space-time clusters, it can effectively improve the communication system's reliability. The core problem of the space-time processor is the direction of arrival (DOA) and signal source number estimation. Based on the good self-coherence of the spread spectrum sequence. This paper proposes a multiple signal classification algorithm (MUSIC) for accurate DOA estimation. However, since the MUSIC algorithm uses the received signal’s covariance matrix for DOA estimation, the number of sources needs to be predicted in advance. Under a low signal-to-noise ratio (SNR), the signal eigenvalues and the noise eigenvalues of the covariance matrix differ slightly, which makes signal source number estimation difficult. To address this issue, a singular value decomposition method using the delay structure information of the array element is proposed to estimate the number of sources of the spreading sequence under a low SNR. Through simulation experiments, the effectiveness of our DOA estimation algorithm is validated under a low SNR.
Flap-making patterns and corneal characteristics influence OBL occurrence in FS-LASIK
Authors: He HEXI , Li Shi-Ming , Zhai Changbin , Zhang Li , Wang Yue , Song Xiumei , Wang Yi
Published: May 2022

Background: To investigate the incidence and risk factors of opaque bubble layer (OBL) during the creation of a laser in suit keratomileusis (LASIK) flap with the Visumax 500kHZ femtosecond laser for myopia correction.Methods: This prospective study included 167 eyes of 86 patients (mean age: 27.5±6.1 years) undergoing bilateral FS-LASIK for myopia/myopic astigmatism by the same surgeon from April 2020 to August 2020. Preoperative data on refraction, central corneal thickness (CCT), and keratometry as well as intraoperative data were included for analysis. A new flap-making pattern creating an offset between flap-cut and side-cut was adopted to compare with the traditional pattern. The operation video of flap formation was analyzed to identify the existence and type of OBL. The area covered by OBL and the ratio of OBL to flap were calculated using Image J software. Results: Among 167 eyes, 54 eyes (32.3%) developed OBLs, consisting of 31 as hard OBL coexisting with soft OBL, and 23 as soft OBL alone. The OBL incidence was significantly reduced in eyes with the new flap-making pattern compared with the traditional pattern (13.8% vs. 52.5%, P<0.001). Hard OBLs had larger area ratios than soft OBLs (14.3±8.3% vs. 1.1±1.8%, P<0.001). Univariate analyses revealed that eyes with more myopia, thicker CCT, and traditional flap-making patterns were more likely to develop OBLs. Multivariate analysis further confirmed that more myopia, thicker CCT, and traditional flap-making pattern were risk factors for OBLs. A Larger corneal diameter was associated with a higher incidence of hard OBL when applying the traditional flap-making process. Conclusion: More myopia, thicker CCT, and larger corneal diameter were risk factors for OBL development during flap creation, whereas a flap-making pattern with an offset between flap-cut and side-cut could reduce the incidence of OBL.
Altered methylation pattern in EXOC4 is associated with stroke outcome: an Epigenome- Wide Association Study
Authors: Cullell Natalia , Soriano-Tárraga Carolina , Gallego-Fábrega Cristina , Cárcel-Márquez Jara , Muiño Elena , Llucià-Carol Laia , Lledós Miquel , Esteller Manel , Moura Manuel Castro , Montaner Joan , Rosell Anna , Delgado Pilar , Martí-Fábregas Joan , Krupinski Jerzy , Roquer Jaume , Jiménez-Conde Jordi , Fernández-Cadenas Israel
Published: May 2022

Background and PurposeThe neurological course after stroke is highly variable and is determined by demographic, clinical, and genetic factors. However, other heritable factors such as epigenetic DNA methylation could play a role in neurological changes after stroke.MethodsWe performed a three-stage epigenome-wide association study (EWAS) to evaluate DNA methylation associated with the difference between the National Institutes of Health Stroke Scale (NIHSS) at baseline and at discharge (ΔNIHSS) in ischemic stroke patients. DNA methylation data in the Discovery (n = 643) and Replication (n = 62) Cohorts were interrogated with the 450K and EPIC BeadChip. Nominal CpG-sites from the Discovery (p-value < 10-06) were also evaluated in a meta-analysis of the Discovery and Replication cohorts, using a random-fixed effect model. Specific cell type methylation was assessed using EpiDISH. We integrated the methylation data with 1305 plasma protein expression levels measured by SOMAscan and measured RNA expression with RT-PCR in a subgroup of 13 subjects. Results The meta-analysis revealed an epigenome-wide significant association in EXOC4 (p-value = 8.4x10-08) and in MERTK (p-value = 1.56x10-07). Only the methylation in EXOC4 was also associated in the Discovery and in the Replication cohort (p-value = 1.14x10-06 and p-value = 1.3x10-02, respectively). EXOC4 methylation negatively correlated with the long-term outcome (coefficient = -4.91) and showed a tendency towards a decrease in EXOC4 expression (rho = -0.469, p-value = 0.091). Pathway enrichment from the meta-analysis revealed significant associations related with the exocytic process. Seventy-nine plasma proteins were differentially expressed in association with EXOC4 methylation. Pathway analysis of these proteins showed an enrichment in Natural Killer cell activation.ConclusionsDNA methylation of EXOC4 is associated with a worse neurological course after stroke. Pathway analysis suggests that the exocytic pathway could be a potential biological mechanism underlying this association.
Discrimination of serum metabolomics profiles in infants with sepsis, based on liquid chromatography-mass spectrometer
Authors: Wang Li , Cha Xinyi , Zhang Zhongxiao , Qian Jihong
Published: May 2022

Background: Sepsis is one of the most important problems to be addressed in pediatrics, characterized by insidious onset, rapid progression, and high rates of severe infection and even mortality. There is an urgent clinical need for sensitive and robust biomarkers to assist in the early diagnosis of infant sepsis.Methods: We used serum metabonomics approach based on liquid chromatography-mass spectrometry to analyze the samples from 30 infants with sepsis at an early stage and 30 infants with noninfectious diseases. Multivariate statistical analysis was used to screen for differential metabolites and receiver operating characteristic (ROC) curves were generated to find potential biomarkers. Subsequently, the relationship between potential biomarkers and classical infection indicators (CRP and PCT) was analyzed with Spearman's correlation coefficient. Lastly, metabolic pathway analysis was performed to explore the metabolic and signaling pathways associated with the differential metabolites.Results: Seven lipid metabolites (phosphatidic acid (PA), phosphatidyl ethanolamine (PE (16:0/18:2(9Z,12Z))), cytidine 5'-diphosphocholine (CDP-CHO), pubescenol, sphingomyelin (SM (d18:0/16:1(9Z))), prolylhydroxyproline and phosphorylcholine(P-CHO)) significantly different were identified between the sepsis group and control group. ROC curve analysis showed that pubescenol (Area Under the Curve (AUC) = 0.814) and prolylhydroxyproline (AUC = 0.832) have potential diagnostic values for infant sepsis. The AUC value of the diagnostic model constructed using the two biomarkers was 0.888 (CI: 0.807, 0.969). Pubescenol, PE and prolylhydroxyproline were found to be correlated with CRP and PCT levels, and CDP-CHO with PCT levels. Pathway analysis indicated that glycerophospholipid metabolism and phenylalanine, tyrosine, and tryptophan biosynthetic pathways played important roles in infant sepsis. Network analysis showed that these differential metabolites were associated with extracellular signal-regulated kinase/mitogen-activated protein kinase, nuclear factor-κB, AMP-activated protein kinase, mammalian target of rapamycin, and other classical inflammatory and metabolic signaling pathways. Conclusion: This study identified serum metabolite profiles and potential lipid biomarkers in infants with sepsis. These findings will help improve the early diagnosis of sepsis in infants.
WITHDRAWN: The effect of a group counselling program to reduce the level of future anxiety and psychological stress among gifted students
Authors: Mahasneh Ahmad M. , Mhaiat Fatin A. , Abood Mohammad H.
Published: May 2022

Background: This study explores the effect of a group counselling program in reducing the level of future anxiety and psychological stress among a sample of gifted students.Methods: With a counselling program consisting of 15 sessions, a future anxiety scale, and psychological stress scale. The study sample was divided into two groups, the control group (N= 30), not included in counselling sessions, and the experimental group (N= 30) included in the counselling program.Results: The results showed a statistical analysis of differences between the experimental group and the control group recorded a lower level of future anxiety and psychological stress in the experimental group.
Exoscopic vs. microscopic transsphenoidal surgery for Cushing’s disease: A retrospective single-center study on 388 patients
Authors: Sumisławski Piotr , Piffko Andras , Huckhagel Torge , Ryba Alice , Burkhardt Till , Aberle Jens , Saeger Wolfgang , Flitsch Jörg , Rotermund Roman
Published: May 2022

Background
Microscopic or endoscopic transsphenoidal surgery represent the standard treatment for Cushing’s disease (CD). At our institution a new exoscopic approach was implemented. After proof of the general use for transsphenoidal pituitary surgery, the aim of this study was to compare the exoscopic 4K3D video microscope with the microscopic transsphenoidal surgery for patients with CD.
Methods
We conducted a retrospective analysis on 388 patients with CD treated in our medical center via microscopic transsphenoidal surgery (MTS) between January 2008 and July 2019 or via exoscopic transsphenoidal surgery (ExTS) between May 2019 and May 2021. Parameters investigated included histology, pre- and postoperative MRI with tumor size, pre- and postoperative ACTH and cortisol levels, duration of surgery, perioperative and postoperative complications as well as clinical outcome.
Results
Patients who underwent ExTS in CD experienced a lower incidence of SIADH/Diabetes insipidus (p = 0.0164), a higher rate of remission (p = 0.0422) and a shorter duration of surgery (p < 0.0001) compared to MTS. However, there was no significant difference regarding new postoperative pituitary insufficiency and intraoperative CSF space opening.
Conclusions
We found that ExTS had multiple benefits compared to MTS for tumor resection in case of CD. These results are in line with our previous publication on the general applicability of an exoscope in pituitary surgery. To our knowledge, this is the first clinical study proving the superiority of ExTS in CD. These results are promising, nevertheless further studies comparing exoscopic with the endoscopic approach are necessary to finally evaluate the utility of the new technique.
[68Ga]Ga-Prostate-specific membrane antigen PET/CT in ovarian tumours: potential to differentiate benign and malignant tumours before surgery. A preliminary report
Authors: Kunikowska Jolanta , Bizoń Magdalena , Pełka Kacper , Derlatka Paweł , Olszewski Maciej , Królicki Leszek
Published: May 2022

Purpose Ovarian cancer is usually diagnosed in an advanced stage of disease due to the absence of specific symptoms and a lack of sensitive diagnostic methods. Prostate‑specific membrane antigen (PSMA) is expressed on prostate cancer cells, but can be found in other tumours such as ovarian cancer. The aim of this pilot study was to evaluate the feasibility of using [ 68 Ga]Ga-PSMA-11 PET/CT in detection of ovarian neoplasm before surgical treatment. Material and methods: Eight women with mean age of 56.0±16.2 years were included in the study. All patients underwent transvaginal ultrasound followed by CT scan of the chest and abdomen as qualification for surgery. Within a 1-week interval, PET/CT was performed on a Siemens Biograph scanner, 60 min after injection of 2 MBq/kg [ 68 Ga]Ga-PSMA-11. Results: In three cases (37.5%) the [ 68 Ga]Ga-PSMA-11 PET/CT was positive, whereas histological examination confirmed two serous ovarian cancer cases and one ovarian borderline tumour. The SUVmax in the serous ovarian cancer was 8.7 and 4.1, and in the borderline ovarian tumour it was 13.8. No correlation was found between antigen CA 125 level and [ 68 Ga]Ga-PSMA expression. Range of tumour SUVmax was not correlated with stage of disease. The remaining 62.5% (5/8) were negative in [ 68 Ga]Ga-PSMA-11 PET/CT and histopathology confirmed benign pelvic tumour. Conclusion The initial experience supports the potential to use [ 68 Ga]Ga-PSMA-11 in ovarian cancer to differentiate malignant and benign tumours before surgery. This study was approved by the Ethical Committee of the Medical University of Warsaw (KB/2/A/2018).
Development and characterization of microsatellite primers for Triops granarius (Branchiopoda: Notostraca) using MiSeq technology
Authors: Ahmed Lina , Al-Najjar Yousef , Cramer Emily R. A. , Thareja Gaurav , Suhre Karsten , Chen Kuei-Chiu
Published: May 2022

Background: Next-generation sequencing technology has allowed for the rapid development of microsatellites, neutral polymorphic markers that can be used for the analysis of population structure. Methods and Results: In this study, we performed whole-genome sequencing using the Illumina MiSeq system and de novo assembly to design microsatellite primers for Triops granarius populations in Qatar. The developed microsatellites are suitable for future studies of genetic structuring among geographically isolated freshwater pools. A total of 23 different primer pairs produced typical microsatellite results, with each pair successfully amplified in up to 40 individuals. Only five of the loci produced a significant departure from Hardy-Weinberg equilibrium. Conclusion: These HWE deviation results could be attributed to several factors. The homozygosity of rare alleles in certain individuals could have inflated the impact from the frequencies of these alleles in the population. Additionally, the Wahlund effect often found in substructured populations, may have also contributed to the deviations.
Single molecule analyses of Salmonella translocated effector proteins reveal targeting to and dynamics in host cell endomembranes
Authors: Göser Vera , Schulte Marc , Scharte Felix , Franzkoch Rico , Liss Viktoria , Psathaki Olympia , Hensel Michael
Published: May 2022

Bacterial pathogens deliver proteins in temporal and spatial coordinated manner to manipulate mammalian host cells. The facultative intracellular pathogen Salmonella enterica remodels the host endosomal system for survival and proliferation inside host cells. The pathogen resides in a membrane-bound compartment termed Salmonella-containing vacuole (SCV). By Salmonella-induced fusions of host endomembranes, the SCV is connected with extensive tubular structures termed Salmonella-induced filaments (SIF). The intracellular lifestyle of Salmonella critically depends on effector molecules translocated by the SPI2-encoded type III secretion system (SPI2-T3SS) into host cells. A subset of these effectors is associated with, or integral in SCV and SIF membranes. It remained to be determined how SPI2-T3SS effectors reach their subcellular destination, and how these effectors interact with endomembranes remodeled by Salmonella. We deployed self-labeling enzyme (SLE) tags as novel approach to label translocated effector proteins in living host cells, and analyzed their dynamics on single molecule level. We found that SPI2-T3SS effector proteins diffuse in membranes of SIF with mobility comparable to membrane-integral host proteins in endomembranes. Dynamics differed between various effector proteins investigated and was dependent on membrane architecture of SIF. In the early infection, we observed host endosomal vesicles associated with Salmonella effector proteins. Effector-positive vesicles continuously fused with SCV and SIF membranes, providing a route of effector delivery by SPI2-T3SS translocation, interaction with endosomal vesicles, and ultimately fusion with the continuum of SCV/SIF membranes. This novel mechanism controls membrane deformation and vesicular fusion to generate the specific intracellular niche for bacterial survival and proliferation.
Evidence-based practice in well-child care
Authors: De Schipper JJ , Hermans AJM , Jaarsma ADC , Noordik FW , Reijneveld SA
Published: May 2022

Purpose: Evidence-based practice (EBP) significantly improves the quality of healthcare, but its use in community pediatrics has not yet been proven. We aimed to assess how Dutch community pediatricians use scientific findings and apply evidence-based practice in everyday well-child care.Methods: We interviewed a purposive sample of 14 community pediatricians in the Netherlands regarding their professional activities in daily practice, focusing on instances in which their professional knowledge was insufficient to address the issue at hand. We transcribed the interviews verbatim, and coded them using ATLAS.ti software. We structured the information using template analysis. Results: Community pediatricians relied largely on guidelines of their own profession. If these were not sufficient, they first consulted other medical specialists or colleagues, or used different sources that they considered reliable. They only rarely performed an EBP-search, and if so, only for somatic problems. For psychosocial problems they used a strategy of extensive interaction with clients and members of multidisciplinary teams. We identified five barriers to performing an EBP-search: (1) a conviction that not every community pediatrician needs to be able to perform an EBP-search; (2) a conviction that an EBP-search is not suitable for psychosocial problems; (3) lack of confidence in one’s own abilities to perform an EBP-search; (4) limited access to literature; (5) lack of time. Conclusions: Community pediatricians rely on professional guidelines; this indicates a need to keep these up-to-date and user-friendly. Furthermore, pediatricians should be better trained in performing EBP-searches, and in working in multidisciplinary teams, especially for psychosocial problems.
Incidence, Risk Factors, Prevention and Treatment of Postmastectomy Pain Syndrome in Breast Cancer: a Multicenter Study
Authors: Kong Xiangyi , Yang Qinheng , Ouyang Liquan , Liu Qiang , Dong Hao , Wang Zhongzhao , Fang Yi , Wang Jing , Ren Yinpeng
Published: May 2022

Postmastectomy pain syndrome (PMPS) is a common postoperative condition after breast cancer surgery, The aim of this study was to investigate the incidence rate and risk factors of PMPS, and to propose prevention and treatment methods. The study included 1790 postoperative breast cancer patients from three hospitals from 2017 to 2021, of which 302 (13.0%) patients with PMPS were included in the study. Age, breast surgery type, axillary surgery type and radiotherapy are the risk factors of PMPS. Age, radiotherapy and chemotherapy affect the pain degree of PMPS during movement. For breast cancer patients with high risk factors, pain should be actively prevented during perioperative period. Oral pharmacological agents, multidisciplinary combination therapy, local anesthetics and regional anesthesia are the most common treatment of PMPS.
Evaluation of Effectiveness of Dexamethasone versus Hydrocortisone in Reducing Hospital Length, Peak Expiratory Flow,Oxidative Stress Factors and Inflammatory Mediators in Chronic Obstructive Pulmonary Disease (COPD) Exacerbation Patients: A Randomized Controlled Trial
Authors: Moslem Sedaghattalab , Hossein Doustimotlagh Amir , Afrasiabifar Ardashir , ahad hosseini
Published: May 2022

Background: Corticosteroids are routinely used in management of chronic obstructive pulmonary disease (COPD) exacerbation. The main goal of present study was to compare the efficacy of hydrocortisone(HCT) and dexamethasone (DXM).Methods: Adult COPD patients entered the present randomized clinical trial.All patients received standard treatment on admission and then divided into 2 groups of intravenous HCT and sdyspnea, cough and general wellbeing on a 1-10 scale.Blood pressure and peripheral edema (as main corticosteroids side effects) measured and scaled 1-4 by researcher. Baseline parameters such as O2 saturation, arterial blood gas parameters, white blood cell (WBC) count, malondialdehide (MDA) level, serum potassium level and c-reactive peptide (CRP) were compared on admission and discharge day using SPSS 22. Results: 70 patients were randomly divided in 2 equal groups with 35 patients. The baseline characteristics of the two groups were similar (p < 0.05). Comparison of treatment outcomes showed a significant increase of edema in HCT group (p = 0.009). There was a significant improvement of Peak Expiratory Flow (P= 0.02, Mean 1.1 Lit/sec in DXM group vs 0.9 Lit/Sec in HCT group) and dyspnea (p = 0.01) in DXM group. There were no significant differences between the two medications regarding drug side effects on admission and discharge day after treatment. Conclusion: It seems that DXM is more effective than HCT andhave less side effects in treatment of COPD exacerbation.Trial registration: This study has been retrospectively registered in Iranian Registry of Clinical Trials at 2021-11-10, with registration reference: IRCT20200818048447N1. http://www.irct.ir/
A Rare Case of Telangiectasia Macularis Eruptive Perstans in a Toddler
Authors: Shah Rohan R. , Schwartz Robert A. , Patel Aman M , Lambert W. Clark
Published: May 2022

Telangiectasia macularis eruptive perstans is an uncommon, cutaneous form of benign mast cell disease rarely delineated in children and tends to be overlooked because of its rarity and common presentation as blanchable, reddish-brown telangiectatic macules. It is a form of cutaneous mastocytosis that is differentiated from other forms such as urticaria pigmentosa, solitary mastocytoma, and diffuse or systemic mastocytosis by its refractory nature and lack of systemic association. Skin biopsy specimens often require special stains (c-Kit, Giemsa, toluidine blue) to detect the fibroblast-appearing non-cuboidal perivascular mast cells and to distinguish it from a normal skin biopsy specimen. Currently no standard cure exists for mastocytosis, but some cases may be self-limited and the lesions are generally refractory to treatment. This condition has almost exclusively affected adults, but we report a unique case of telangiectasia macularis eruptive perstans in a child. Pediatric patients with this condition may be at greater risk of developing a systemic mastocytosis so appropriate precautions should be conveyed.
Effect of early pelvic floor muscle exercises (Kegel’s) after Robotic Prostatectomy in Prostate cancer patients
Authors: Chitre Ankita , Kulkarni Jagdeesh
Published: May 2022

Post Prostatectomy Urinary incontinence (PPUI) due to open or robotic surgery has a negative impact on the patient’s psycho-social well-being and leads to altered quality of life [1]. Sphincteric incompetence overall remains the primary cause of PPUI, believed due to direct damage and manipulation intraoperatively [9]. Pelvic ﬂoor muscle (PFM) rehabilitation appears to be beneﬁcial at hastening return of continence [3]. Hence, there is a need to re-educate or strengthen the pelvic ﬂoor muscles. Aim & Objectives: To study the return of continence, time duration required for the pelvic ﬂoor muscles to regain strength and endurance, thereby, leading to urinary continence and its effect on quality of life after Kegel's exercises on post robotic prostatectomy patients. Methodology: Pelvic ﬂoor muscle grading, 24 hour pad test, and International Prostate symptom scoring (IPSS) had been used to assess the effect in incontinence status at 3 and 6 weeks post operatively. Results & Analysis: 69 patients were screened between the duration of 3 year i.e. 2017-2020. 4 patients had incontinence 3 months post-surgery. Whereas, 65 patients gained continence. Conclusion: There is an effect of early Kegel’s exercise, the patients gains good pelvic floor muscle strength, show a reduction in dribbling or leakage of urine and there is an improvement in the quality of life after Robotic Prostatectomy in Prostate cancer patients after 6 weeks of surgery. 94.20 % of the patients have shown a have gained continence by 3 months post robotic prostatectomy following a regular exercise regime of Kegel’s exercise.
Estimates of prevalence of anti-SARS-CoV-2 antibodies among blood donors in South Africa in March 2022
Authors: Bingham Jeremy , Cable Russel , Coleman Charl , Glatt Tanya Nadia , Grebe Eduard , Mhlanga Laurette , Nyano Cynthia , Pieterson Nadia , Swanevelder Ronel , Swarts Avril , Sykes Wendy , Berg Karin van den , Vermeulen Marion , Welte Alex
Published: May 2022

In line with previous instalments of analysis from this ongoing study to monitor ‘Covid Seroprevalence’ among blood donors in South Africa, we report on an analysis of 3395 samples obtained in mid-March 2022 from all provinces of South Africa – a timepoint just after the fourth (primarily omicron) wave of infections. As in our previous analyses, we see no evidence of age and sex dependence of prevalence, but significant variation by race. Differences between provinces have largely disappeared, as prevalence appears to have saturated. In contrast to previous estimates from this study, which reported only prevalence of anti-nucleocapsid antibodies, this present work also reports results from testing for anti-spike antibodies. This addition allows us to categorise those donors whose only antibodies are from vaccination. Our race-weighted national extrapolation is that 98% of South Africans have some antibodies, noting that 10% have anti-spike antibodies but not anti-nucleocapsid antibodies - a reasonable proxy for having both 1) been vaccinated and 2) avoided infection.
Long Duration and Increase in Pediatric Complicated Appendicitis During the Period of Lockdown in April 2022 in Shanghai
Authors: Li Hui , Xu Weijue , Huang Xiong , Li Qingxing , Wu Yibo
Published: May 2022

Objective: The Corona Virus Disease 2019 (COVID-19) has tremendously transformed medical care worldwide, and elective surgery has been affected. The aim of the current study was to determine whether complicated appendicitis rates in children were influenced by the lockdown in April 2022 in Puxi region of Shanghai due to COVID-19.Background: The progression of acute appendicitis from simple to complicated is affected by the presentation timeliness. In the context of city-mandated control, the influences of lockdown in Puxi April on children suffering from acute appendicitis will be investigated in this study. Methods: The medical records of all children presenting in 2 hospitals with acute appendicitis between April 1 and April 30, 2022 (The first lockdown month in Puxi region) were reviewed and analyzed as the lockdown group. Moreover, the medical records of the latest 2 years of acute appendicitis in the same period were reviewed and analyzed as the control group. In addition, the clinical and laboratory parameters, treatment ways, intraoperative and pathological findings, and postoperative outcomes were analyzed.Results: A total of 22 children were diagnosed with acute appendicitis in the first month of the lockdown period in 2 hospitals. Compared with a 2-year control cohort of acute appendicitis, we observed a longer mean duration of symptoms (67.2±77.6 vs 31.9±34.7 h, P=0.01) and higher rate (72.73% vs 43.75%, P=0.038) in children with complicated appendicitis and a long operation time (92.5±35.46 vs 71.25±34.44 min, P=0.03), as well as a higher CRP (61.82±49.75 vs 23.43±28.19 mg/dL, P<0.001) and serum bilirubin (19.07±11.07 vs 10.74±4.37 umol/L, P<0.0001). The mean length of stay was longer in the lockdown group than that in the control group (10.77±5.37 vs 7.70±3.74 d, P=0.0072). The admission WBC and neutrophil percentage had no significant differences, the mean number of hospital or clinic visits had no differences, and the interval between diagnosis and operation has no statistical differences (5.28±2.94 vs 3.73±3.11 h, P=0.076). However, the overall conservative treatment cases, postoperative morbidity and mortality did not change.Conclusions: The lockdown affected the symptoms’ duration time of pediatric acute appendicitis. The children in the lockdown period demonstrated higher complicated appendicitis compared with the historical controls, as well as longer mean length of hospital stay.
Morphological characteristics and yield of Opuntia stricta and Nopalea cochenillifera in integrated crop systems with caatinga trees
Authors: Neto Clemente Fernandes dos Santos , Silva Rodrigo Gregório da , Maranhão Samuel Rocha , Barreto Cleber Medeiros , Lopes Marcos Neves , Cândido Magno José Duarte
Published: May 2022

The objective was to evaluate the structural and production characteristics of Opuntia stricta (Cactus pear Orelha de Elefante Mexicana) and Nopalea cochenillifera (Cactus pear Miúda) under different arrangements of caatinga trees. The study was carried out at the Teaching, Research and Extension Unit (UEPE) of the Federal Institute of Education, Science and Technology of Ceará (IFCE), Limoeiro do Norte Campus, state of Ceará. The experimental area consisted of nine systems, arranged in strips of Caatinga trees (woody component), with dimensions of 6.0 x 100.0 m, directed in the north-south direction. Among the tree strips, Opuntia stricta and Nopalea cochenillifera were implanted in plots, according to the following treatments: cactus pear grown under 46.15% woody cover (ICS46; 1,418 trees per hectare), cactus pear grown under 30.00% woody cover (ICS30; 925 trees per hectare) and cactus pear grown under 17.64% woody cover (ICS18; 524 trees per hectare). The experimental design was completely randomized, in a split-plot arrangement. Mean canopy height (H), number of cladodes per linear meter (NC) and total forage biomass (TFB) were evaluated, considering the east, center and west positions. The lowest H and NC was found for Nopalea cochenillifera in the east position. Nopalea cochenillifera and Opuntia stricta cultivated in system ICS46 had the lowest TFB in the center position. The silvopastoral systems ICS30 and ICS18 can be adopted without negatively affecting the structural and productive characteristics of cactus pears Opuntia stricta and Nopalea cochenillifera.