bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of rectal neuroendocrine tumours by transanal endoscopic microsurgery
Authors: Lie Jessica J. , Yoon Hyea Min , Karimuddin Ahmer A. , Raval Manoj J. , Phang P. Terry , Ghuman Amandeep , Lee Lik Hang , Stuart Heather , Brown Carl J.
Published: February 2023

Aim

The objective of this study was to evaluate the safety and effectiveness of transanal endoscopic microsurgery for rectal neuroendocrine tumours.

Method

A retrospective cohort study of all pathology‐confirmed rectal neuroendocrine tumours treated by transanal endoscopic microsurgery from April 2007 to December 2020 at a tertiary care centre was performed. Demographic, clinical, radiographic and pathological data were collected. Characteristics of patients with recurrence were examined. Descriptive statistics were performed.

Results

There were 58 patients treated by transanal endoscopic microsurgery excision. Referrals were for primary excision (15, 25.9%), completion re‐excision after incomplete endoscopic removal (38, 65.5%) or locally recurrent rectal neuroendocrine tumours (5, 8.6%). The mean age of patients was 56.4 ± 11.9 years and 26 patients were women (44.8%). Mean tumour size was 7.4 ± 3.8 mm (range 1.0–15.0 mm). Most (86.4%) were Grade 1 tumours. Mean operative time was 37.2 ± 17.2 min and 56 patients (96.6%) were discharged on the same day. All patients had negative margins on final pathology. Of the 38 patients who were referred for completion re‐excision after incomplete endoscopic removal, eight (21.1%) had residual tumour on final pathology. Three recurrences were diagnosed at 2.1, 4.5 and 12.5 years after excision. All recurrences were from Grade 1 or 2 primary tumours, less than 2 cm, and diagnosed radiographically.

Conclusion

To date, this is the largest North American study looking at transanal endoscopic microsurgery for rectal neuroendocrine tumours. This technique is effective in managing primary, incompletely excised and recurrent tumours with good clinical and oncological outcomes.
The diagnostic potential of plasma SCUBE‐1 concentration for pulmonary embolism: A pilot study
Authors: Xiao Lu , Wang Minlian , Yang Sicong , Li Shulin , Huang Qijun , Xu Lan , Li Yazhen , Fu Yingyun
Published: February 2023

Introduction

This study aimed to investigate the potential application of plasma signal peptide‐complement C1r/C1s, Uegf and Bmp1‐epidermal growth factor domain‐containing protein 1 (SCUBE‐1) as a biomarker in the diagnosis of pulmonary embolism (PE).

Methods

This cross‐sectional study enrolled 177 patients who underwent PE diagnostic test and 87 healthy controls. The results of CT pulmonary angiogram (CTPA) were used as reference standards for PE diagnosis. The levels of SCUBE‐1 and D‐dimer in participants' plasma were detected with enzyme‐linked immunosorbent assay and compared among patients with confirmed PE, suspicious PE and healthy controls. The diagnostic values were analysed using receiver operating characteristic (ROC) curve analysis. In addition, differences in plasma SCUBE‐1 levels were compared among patients with different risk stratifications.

Results

The plasma SCUBE‐1 concentration levels in patients with CTPA confirmed PE (14.28 ± 7.74 ng/ml) was significantly higher than those in the suspicious patients (11.11 ± 4.48 ng/ml) and in healthy control (4.40 ± 3.23 ng/ml) (P < 0.01). ROC curve analysis showed that at the cut‐off of 7.789 ng/ml, SCUBE‐1 has significant diagnostic value in differentiating PE patients from healthy control (AUC = 0.919, sensitivity = 81.25%, specificity = 92.13%), and the performance is more accurate than D‐dimer (cut‐off 273.4 ng/ml, AUC = 0.648, sensitivity = 65.75%, specificity = 67.42%). The combination of D‐dimer with SCUBE‐1 did not further improve the diagnostic value. However, SCUBE‐1 did not show significant diagnostic value in identifying PE among suspicious patients There was no significant difference in SCUBE‐1 level among different risk groups (P > 0.05).

Conclusion

We believe that SCUBE‐1 could be a potential coagulation‐related marker for the diagnosis of PE.
Empagliflozin versus sitagliptin for ameliorating intrahepatic lipid content and tissue‐specific insulin sensitivity in patients with early‐stage type 2 diabetes with non‐alcoholic fatty liver disease: A prospective randomized study
Authors: Hiruma Shigenori , Shigiyama Fumika , Kumashiro Naoki
Published: February 2023

Aim

To compare the effects of sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors and dipeptidyl peptidase‐4 inhibitors on ectopic fat accumulation and tissue‐specific insulin sensitivity.

Materials and Methods

This randomized controlled trial enrolled 44 patients with type 2 diabetes (T2D) and non‐alcoholic fatty liver disease (NAFLD). They were randomly assigned to receive either empagliflozin 10 mg/day or sitagliptin 100 mg/day for 12 weeks. The primary endpoint was the change in intrahepatic lipid content (IHL) measured using proton magnetic resonance spectroscopy (1H‐MRS). The secondary endpoints included intramuscular and extramuscular lipid content seen in 1H‐MRS, body composition seen through dual‐energy X‐ray absorptiometry and tissue‐specific insulin sensitivity shown through hyperinsulinaemic‐euglycaemic clamp using stable isotopic glucose. Liver biopsy samples were pathologically evaluated at baseline.

Results

At baseline, the mean duration of diabetes, HbA1c level and IHL were 3.7 years, 7.2% and 20.9%, respectively. The median NAFLD activity score was 3.0. IHL was significantly more decreased in the empagliflozin group than that in the sitagliptin group (between‐group difference was −5.2% ± 1.1% and −1.9% ± 1.2%, respectively, (95% confidence interval); −3.3 (−6.5, −0.1), P = .044). However, there were no significant between‐group differences in the change of insulin sensitivity in the liver, muscle or adipose tissues. Interestingly, hepatic insulin sensitivity was significantly increased only in the empagliflozin group and was significantly negatively associated with the change in IHL.

Conclusions

Empagliflozin significantly improves hepatic steatosis compared with sitagliptin, and this may protect against subsequent hepatic insulin resistance. Early administration of SGLT2 inhibitors is preferable for T2D patients with NAFLD.
Ranked soft sets
Authors: Santos‐García Gustavo , Alcantud José Carlos R.
Published: February 2023

This article defines ranked soft sets and establishes their fundamental theory. This new model of uncertain knowledge is a non‐numerical yet powerful improvement of soft sets. The model relies on a qualitative improvement of the basic parameterized description posed by soft sets. We define relations between ranked soft sets and some existing models (N‐soft sets, fuzzy soft sets, probabilistic soft sets) that enhance the soft set spirit with the help of additional quantities. Primary contributions to their development include set‐theoretic operations and representation theorems, at a theoretical level; and scores and aggregation operators, at a practical level. Finally we design a multi‐person decision‐making strategy for data in the form of ranked soft sets that takes advantage of these elements.
Interaction network among de novo purine nucleotide biosynthesis enzymes in Escherichia coli
Authors: Gedeon Antoine , Karimova Gouzel , Ayoub Nour , Dairou Julien , Giai Gianetto Quentin , Vichier‐Guerre Sophie , Vidalain Pierre‐Olivier , Ladant Daniel , Munier‐Lehmann Hélène
Published: February 2023

In human cells, de novo purine nucleotide biosynthesis is known to be regulated through the formation of a metabolon called purinosome. Here, we employed a bacterial two‐hybrid approach to characterize the protein–protein interactions network among the corresponding enzymes of Escherichia coli. Our study revealed a dense network of binary interactions that connect most purine nucleotide biosynthesis enzymes. Notably, PurK, an exclusive prokaryotic enzyme, appears as one of the central hubs of this network. We further showed that modifications in PurK, which disrupted several interactions in the network, affected the purine nucleotide pools and altered the bacterial fitness. Our data suggest that the bacterial de novo purine nucleotide biosynthesis enzymes can assemble in a supramolecular complex and that proper interactions among the components of this complex can contribute to bacterial fitness.
The Kuchi‐kara Taberu index as a predictive marker of oral intake recovery in patients with aspiration pneumonia
Authors: Otsubo Hisanori , Okita Ikumi , Suzuki Madoka , Nakanishi Sayaka , Asai Hitoshi , Inaoka Pleiades T.
Published: February 2023

Aim

In recent years, the Kuchi‐kara Taberu (KT) index has been used as a new tool for the evaluation of dysphagia; however, its predictive ability remains unknown. This study was conducted to examine the validity of oral intake recovery prediction using the KT index in patients with aspiration pneumonia.

Methods

The subjects were older inpatients admitted to an acute‐care hospital for the treatment of aspiration pneumonia. A logistic regression analysis was conducted to clarify factors significantly associated with oral intake recovery. In addition, cut‐off values of the predictors were calculated using a receiver operating characteristic curve analysis with the area under the curve (P < 0.05).

Results

A total of 124 patients (mean age 84.3 ± 7.9 years old, 70 males, 54 females) were enrolled in this study and divided into two groups at discharge: the oral intake group (62.1%) and the non‐oral intake group (37.9%). The significant predictors of the recovery of oral intake were the pre‐treatment period, treatment period, and the total score of the KT index; the respective odds ratios were 1.082 (95% confidence interval [CI] 1.013–1.156), 1.018 (1.003–1.033) and 0.850 (0.780–0.927), and the respective areas under the curve were 0.407 (95% CI 0.300–0.515), 0.304 (0.208–0.399), and 0.732 (0.640–0.824). The cut‐off value of the total score of the KT index was 30. The model showed 85.7% sensitivity and 57.4% specificity.

Conclusion

The KT index is suggested to be a valid variable for predicting whether or not a patient with aspiration pneumonia can recover their oral intake ability during acute‐care hospitalization. Geriatr Gerontol Int 2023; 23: 221–226.
Uncovering microstructure and composition susceptibility of high permittivity ceramic granules to plasma‐induced arc breakdown
Authors: Grey John K. , Yang Pin , Dickens Sara M. , Rodriguez Mark A. , Vreeland David E.
Published: February 2023

Effective diversion of surge currents is vital to prevent unwanted damage to sensitive electronics. Among the most successful and efficient strategies relies on a dielectric stimulated arc breakdown mechanism with high permittivity ceramic granules in a spark‐gap geometry. Although generally regarded as a self‐healing process, substantial energy deposition may occur that, over time, diminishes the ability to withstand repeated electrical assaults. We investigate the susceptibility of lead–magnesium–niobate–lead titanate (PMN–PT) granule microstructure and composition changes following many exposures to high voltage impulses resulting in arc breakdown. Scanning electron microscopy and energy‐dispersive spectroscopy mapping reveal a broad range of thermal and mechanical defects entailing thermal reduction of constituent PMN–PT metal ions and recasting due to rapid eruption of volatile species. Additionally, evidence of local melting and microcracking are apparent that can have deleterious impact on the proper function of the granules, namely, the ability to concentrate electric fields across air gaps to establish and sustain discharge pathways. We propose that the localized nature of damage and stochasticity associated with the dielectric stimulated breakdown mechanism may allow granules to maintain functionality provided no permanent conduction paths are established.
Low‐temperature synthesis one‐dimensional Ag2CO3/SnFe2O4Z‐scheme with excellent visible‐light photoactivity
Authors: Su Xiaoli , Wang Aihui , Xu Linyuan , Zhang Wei , Guo Fumin , Zhang Dafeng , Pu Xipeng , Cai Peiqing
Published: February 2023

In this study, Ag2CO3/SnFe2O4 (Ag2CO3/SFO) photocatalyst was prepared by a simple hydrothermal‐ultrasonic method for the efficient degradation of ciprofloxacin and phenol. The SFO nanoparticles were attached on the surface of Ag2CO3 rods synthesized by a low‐temperature precipitation method, resulting a unique 1D/0D morphology, which increased the number of active sites. Due to introduction of magnetic SFO, Ag2CO3/SFO exhibited excellent magnetic recovery performance. When the mass fraction of SFO was 5%, the degradation efficiency of composite photocatalyst was the highest, the degradation rate for ciprofloxacin was 6.5 and 1.5 times higher than pure SFO and Ag2CO3, respectively. The improved photoactivity of Ag2CO3/SFO should be attributed to the construction of heterojunction with tight interface, which boosts the separation and transfer of photoinduced electron and hole pairs. On the basis of experimental results, a possible Z‐scheme photocatalytic mechanism was discussed. Additionally, the excellent photostability of Ag2CO3/SFO was proved by a cycle experiment.
Electrocardiogram abnormalities and renal impairment in patients with type 2 diabetes mellitus: A healthcare facilities‐based cross‐sectional study in Dang district of Nepal
Authors: Khanal Mahesh Kumar , Bhandari Pratiksha , Dhungana Raja Ram , Gurung Yadav , Rawal Lal B. , Pandey Gyanendra , Bhandari Madan , Bhuiyan Rijwan , Devkota Surya , de Courten Maximilian , de Courten Barbora
Published: February 2023

Aims/Introduction

The global burden of diabetes mellitus is rising substantially, with a further increase in cardiovascular and kidney disease burden. These public health problems are highly prevalent in low‐ and middle‐income countries, including Nepal. However, there is limited evidence on cardiac and renal conditions among patients with type 2 diabetes mellitus. We determined the status of electrocardiogram (ECG) abnormalities and renal impairment among patients with type 2 diabetes mellitus in Nepal.

Methods

We carried out a cross‐sectional study in Tulsipur Sub‐Metropolitan City of Nepal using a multistage stratified sampling technique to recruit patients with type 2 diabetes mellitus. We used World Health Organization stepwise approach to surveillance (WHO STEPS) questionnaires and carried out resting ECG to collect data of 345 patients with type 2 diabetes mellitus. Logistic regression analysis assessed the factors associated with ECG abnormalities and renal impairment.

Results

The study showed that 6.1% of participants had major ECG abnormalities (95% confidence interval [CI] 3.8–8.6%), which were associated with hypertension (P = 0.01%) and low socioeconomic status (P = 0.01). The proportion of major and/or minor ECG abnormalities was 47.8% (95% CI 40.5–51%), and were significantly associated with age (odds ratio [OR] 1.04, 95% CI 1.01–1.07), higher education (OR 3.50, 95% CI 1.31–9.33), unemployment (OR 3.02, 95% CI 1.08–8.48), body mass index (OR 1.09, 95% CI 1.02–1.17) and duration of type 2 diabetes mellitus >5 years (OR 2.42, 95% CI 1.19–4.93). The proportion of renal impairment was 3.5% (95% CI 1.5–4.5%) which was associated with older age (OR 1.08, 95% CI 1.00–1.17) and hypertension (OR 12.12, 95% CI 1.07–138.22).

Conclusion

A significant proportion of patients with type 2 diabetes mellitus had ECG abnormalities and renal impairment, which were significantly associated with hypertension. Therefore, hypertension management and early screening are essential to prevent future cardiorenal complications among patients with type 2 diabetes mellitus.
Sleep duration and food intake in people with type 2 diabetes mellitus and factors affecting confectionery intake
Authors: Akiyama Tomoaki , Yamakawa Tadashi , Orime Kazuki , Suzuki Jun , Sakamoto Rika , Matsuura‐Shinoda Minori , Shigematsu Erina , Takahashi Kenichiro , Kaneshiro Mizuki , Asakura Taro , Tanaka Shunichi , Kawata Takehiro , Yamada Yoshihiko , Isozaki Tetsuo , Takahashi Atsushi , Osada Uru Nezu , Kadonosono Kazuaki , Terauchi Yasuo
Published: February 2023

Aims/Introduction

We carried out a cross‐sectional study of people with type 2 diabetes mellitus to elucidate the association between sleep duration and food intake.

Materials and Methods

Overall, 2,887 participants with type 2 diabetes mellitus (mean age 63.0 years; 61.1% men; mean glycated hemoglobin level 7.5%) were included in this study. The participants' self‐reported dietary habits and sleep duration were evaluated using a brief self‐administered dietary history questionnaire and Pittsburgh Sleep Quality Index, respectively. The participants were categorized into the following four groups based on sleep duration: <6, 6–6.9, 7–7.9 (reference) and ≥8 h.

Results

No significant differences were observed between the groups regarding energy intake (kcal/day), absolute intake (g/day) or relative intake (% energy) of carbohydrates, total fat, proteins and fibers. However, confectionery intake was higher in the <6 h group and lower in the ≥8 h group than in the reference group after adjustment for confounding factors. In multivariate analysis, sleep durations <6 h and ≥8 h significantly correlated with increased (95% confidence interval 0.55 to 3.6; P = 0.0078) and decreased (95% confidence interval −4.0 to −0.32; P = 0.021) confectionery intake, respectively. Confectionery intake was positively correlated with female sex, glycated hemoglobin level and dyslipidemia, whereas it was negatively correlated with alcohol consumption and current smoking status.

Conclusions

Short sleep duration is associated with high confectionery intake in people with type 2 diabetes mellitus; this might disturb their glycemic control. Therefore, short sleepers with type 2 diabetes mellitus could improve their glycemic control by avoiding confectionery intake and maintaining adequate sleep duration.
Recognizing and addressing how gender shapes young people's experiences of image‐based sexual harassment and abuse in educational settings
Authors: Ringrose Jessica , Regehr Kaitlyn
Published: February 2023

This paper explores findings from a study with 150 young people (aged 12‐21) across England, which employed qualitative focus groups and arts‐based methods to investigate young people's experiences of digital image‐sharing practices. In this paper, we explore how gendered pressures to send nudes experienced by girls is a form of Image‐Based Sexual Harassment (IBSH) and how pressures upon boys to secure nudes and prove they have them by sharing them non‐consensually is Image‐Based Sexual Abuse (IBSA). In addition, we argue boys’ sending nudes (dick pics) non‐consensually is a form of image based sexual harassment, which can be compounded by harassment of girls to send nudes back. We look at the gendered nature of combined practices of Image‐Based Sexual Harassment and Abuse (IBSHA) and how sexual double standards create sexual shaming and victim blaming for girls who experience IBSHA. We also explore young people's perspectives on their digital sex and relationship education and their suggestions for improvement. We conclude by arguing that schooling policies and practices would benefit from adopting the conceptual framework of IBSHA. We suggest this would be a good first step in better supporting young people in managing and negotiating digital gendered and sexualized consent, harms, and risks.
Comparison of axillary and inguinal temperature with rectal temperature in dogs at a veterinary teaching hospital
Authors: Zakari F. O. , Omontese B. O.
Published: February 2023

Objectives

The objective of the study was to determine the agreement between rectal, axillary and inguinal temperatures and to estimate the accuracy of these measurements in detecting hyperthermia and hypothermia in dogs presented at a veterinary teaching hospital in the tropical Guinea Savannah zone.

Materials and Methods

Prospectively, body temperature was measured in 610 dogs, using digital thermometry in the axillary, inguinal and rectal regions.

Results

Overall, axillary and inguinal temperatures significantly underestimated rectal temperature, with a mean difference of −0.39 ± 0.02°C (95% confidence interval: −0.43 to −0.35; limit of agreement: −1.27 to 0.49) and − 0.34 ± 0.02°C (95% confidence interval, −0.37 to −0.30; limit of agreement: −1.15 to 0.47), respectively. The limits of agreement of axillary and inguinal temperatures were wide and above the pre‐determined maximal acceptable difference of ±0.50°C recommended for clinical significance of rectal temperature in dogs. Bland–Altman plots showed that the confidence intervals of the mean differences of axillary and inguinal temperatures did not include the value zero, thereby indicating that the tested methods lack agreement with rectal temperature. Sensitivity and specificity for the detection of hyperthermia with axillary temperature were 72.1% and 30.5%, respectively. In contrast, sensitivity and specificity for the detection of hyperthermia with inguinal temperature were 77.9% and 26.2%, respectively. The magnitude of disagreement between axillary, inguinal and rectal temperatures was affected by age, breed and sex being slightly lower in mature, non‐native breed and female dogs.

Clinical Significance

Axillary and inguinal temperature measurements in dogs significantly underestimated rectal temperature measurements by −0.39 ± 0.02°C and −0.34 ± 0.02°C, respectively. The results indicate that axillary and inguinal temperatures should not be used as a replacement for rectal temperature due to the wide limits of agreement. In addition, axillary and inguinal temperatures may not be suitable in detecting hyperthermia because the sensitivity were lower than the required set‐point of 90.0% for clinical identification of hyperthermia.
Swapping Gender Traditionalism: Christianity, Buddhism, and Gender Ideology in South Korea
Authors: JEON NANUM
Published: February 2023

South Korea provides an ideal setting for studying religion and gender because Western and local religions are both prominent, and Confucianist beliefs still shape gender norms. Using the 2018 Korean General Social Survey, this study examines the extent to which two dimensions of gender traditionalism in South Korea–Confucian patriarchal ideology (i.e., belief in the subordination of women for Confucian patriarchy) and separate spheres ideology (i.e., belief that men are better suited to work and women to domestic responsibilities)—vary across Buddhists, Catholics, Protestants, and the nonaffiliated. The findings show that Christians have the lowest endorsement for Confucian patriarchal ideology while supporting separate spheres ideology as much as Buddhists, who are most gender traditional in both dimensions. The results illustrate the dynamics between religion and gender norms in South Korea's context, demonstrating how Christianity combines Western modernization with gender‐essentialist traditionalism, while Buddhism maintains Confucian patriarchal values.
Assessment of heavy metal and organic pollution of a salmonid ecosystem: Case of the Oued Guigou River, Middle Atlas (Morocco)
Authors: Zerkani Saida , Abba El Hassan , Hachi Touria , Zine Nasser‐Eddine
Published: February 2023

The present study focused on evaluating the quality of the Oued Guigou River located in Middle Atlas (Morocco) by studying relevant physicochemical and metallic parameters. Samples for determining the organic matter and trace metal elements trapped in water samples were collected at upstream of Oued Guigou between December 2020 and April 2021. The samples were analysed for physicochemical quality, while the trace metal elements (lead, zinc, copper, chromium, iron, nickel, calcium and magnesium) were determined using ICP‐AES analysis. The results indicated significant organic pollution, as well as standard deviation and average changes in the values of the studied metals, most likely attributable to domestic effluents. The metal content in particular exhibited high values exceeding the recommended Moroccan standard limits, suggesting domestic and agricultural pollution is a potential threat to both the receiving rivers and their associated lakes and reservoirs.
Re‐examining the relationship between moral distress and moral agency in nursing
Authors: Morley Georgina , Sankary Lauren R.
Published: February 2023

In recent years, the phenomenon of moral distress has been critically examined—and for a good reason. There have been a number of different definitions suggested, some that claimed to be consistent with the original definition but in fact referred to different epistemological states. In this paper, we re‐examine moral distress by exploring its relationship with moral agency. We critically examine three conceptions of moral agency and argue that two of these conceptions risk placing nurses' values at the center of moral action when it ought to be the patient's values that shape nurses' obligations. We propose that the conception of moral agency advanced by Aimee Milliken which re‐centers patient values, should be more broadly accepted within nursing. We utilize a case example to demonstrate a situation in which the values of a patient's parents (surrogates) justifiably constrained nurses' moral agency, creating moral distress. Through an examination of constraints on nurse agency in this case, we illustrate the problematic nature of ‘narrow' moral distress and the value of re‐considering moral distress.  Finally, we provide an action‐oriented proposal identifying mediating steps that we argue have utility for nurses (and other healthcare professionals) to mediate between experiences of narrow moral distress and the exercise of moral agency.
The impact of psychosocial training on staff attitudes towards people living with dementia: A systematic review
Authors: McKenna Megan , Brown Laura JE , Muller Claire , Vikram Anvita , Berry Katherine
Published: February 2023

Background

As the prevalence of dementia increases, the need for appropriately trained and skilled care teams also increases. Staff attitudes towards people living with dementia have a significant impact on caregiving behaviours and staff and resident outcomes. Training within care settings is a potential way of improving staff attitudes towards residents in their care.

Objectives

This review aimed to (i) assess the effectiveness of psychosocial training in improving care staff attitudes towards dementia; and (ii) examine the content and focus of training.

Method

The review was conducted following PRISMA guidance and the protocol was registered on PROSPERO prior to conducting the review. A comprehensive search of peer‐reviewed literature was undertaken using CINAHL, Medline and PsycINFO from inception to March 2021. All papers were evaluated using a quality appraisal tool.

Results

Ten studies met inclusion criteria and were of variable quality. However, six studies found significant improvements in staff attitudes towards dementia following staff training. The studies varied in terms of training focus and included behavioural, communication and cognitive‐based approaches.

Conclusions

Staff training could be an effective method of improving staff attitudes towards dementia in care settings. Further research adopting high‐quality randomised controlled designs to further explore staff attitudes following psychosocial training would make a valuable contribution to the literature base.
A large single‐center experience in management of pediatric intussusception
Authors: Elzeneini Wael M. A. , Cusick Eleri
Published: February 2023

Background

The objective of this study was to present the results of a comprehensive single‐center study of the management and outcome of intussusception over a 10‐year period and to review the recent literature.

Methods

A retrospective analysis was carried out of all children less than 16 years old, admitted with intussusception to our tertiary center between January 2007 and December 2016. Air enema was attempted routinely, with primary surgery reserved for selected cases. If air enema failed, open surgery was performed. The data collected included age, enema reduction rate, need for laparotomy, detail of bowel resection, hospital stay, and complications noted.

Results

One hundred and ninety‐one children presented with intussusception, totaling 200 admissions. One hundred and seventy‐four patients (87%) underwent air enema. There was a complete reduction in 66% of these cases and a perforation rate of 1.1%. Twenty‐six patients (13%) underwent primary surgery. Of the 59 patients with incomplete enema reduction, 50.8% required bowel resection while 49.2% required only manual reduction. Bowel resection was necessitated in 26% of total admissions and 61.2% of those requiring surgery. Hospital stays ranged from 3–97 days (median 7 days). There were four complications (2%).

Conclusion

This comprehensive study reveals a higher rate of surgical intervention and bowel resection than was anticipated from selective series in published literature. Institutional variation in outcome is likely multifactorial but incomplete data make comparisons difficult.
Association between fetal echogenic and/or dilated bowel and adverse perinatal outcomes
Authors: Al Jobeer Haifa , Al Dossari Maha , Babic Inas
Published: February 2023

Background

Echogenic and/or dilated bowel is uncommonly encountered on prenatal ultrasound and may represent either a panel of differential diagnoses or a transient normal variant with excellent outcome. Prenatal differentiation between the two entities remains uncertain. Here, we aimed to review prenatal cases associated with echogenic and/or dilated bowel and analyze their prospective perinatal outcomes.

Methods

This was a retrospective cohort study, carried out at a single center. All relevant data was retrieved from the hospital electronic records. Bowel echogenicity is defined as grade 0–3, in relation to the surrounding liver or bone echogenicity. Bowel dilatation is defined as the largest diameter >7 mm with the length >15 mm.

Results

Out of 59 cases with prenatal echogenic and or dilated bowel, 32 cases were analyzed, and 10/32 (31%) neonates among all categories showed intestine related pathologies that required postnatal care. Two out of 19 (11%) cases with echogenic bowel and one out of three (34%) cases with bowel dilatation revealed structural abnormality that required postnatal surgery. All cases were in stable conditions upon discharge from the hospital. There were no cases of perinatal death associated with bowel abnormalities.

Conclusion

Echogenic bowel in isolation carries a low risk for structural bowel anomalies that require surgery. Dilated bowel represents an increased risk for intestinal obstruction. Combination of two ultrasonographic features, echogenicity and dilatation of the intestine should be considered as a suspicious sign of a genetic syndrome which may alter bowel function but may not require surgery.
Variations in ERP data quality across paradigms, participants, and scoring procedures
Authors: Zhang Guanghui , Luck Steven J.
Published: February 2023

Although it is widely accepted that data quality for event‐related potential (ERP) components varies considerably across studies and across participants within a study, ERP data quality has not received much systematic analysis. The present study used a recently developed metric of ERP data quality— the standardized measurement error (SME)—to examine how data quality varies across different ERP paradigms, across individual participants, and across different procedures for quantifying amplitude and latency values. The EEG recordings were taken from the ERP CORE, which includes data from 40 neurotypical college students for seven widely studied ERP components: P3b, N170, mismatch negativity, N400, error‐related negativity, N2pc, and lateralized readiness potential. Large differences in data quality were observed across the different ERP components, and very large differences in data quality were observed across participants. Data quality also varied depending on the algorithm used to quantify the amplitude and especially the latency of a given ERP component. These results provide an initial set of benchmark values that can be used for comparison with previous and future ERP studies. They also provide useful information for predicting effect sizes and statistical power in future studies, even with different numbers of trials. More broadly, this study provides a general approach that could be used to determine which specific experimental designs, data collection procedures, and data processing algorithms lead to the best data quality.
GnRH agonists: Updating fixed‐time artificial insemination protocols in sows
Authors: Falceto María Victoria , Suárez‐Usbeck Andrés , Tejedor María Teresa , Ausejo Raquel , Garrido Ana María , Mitjana Olga
Published: February 2023

Protocols for fixed‐time artificial insemination (FTAI) in swine reproduction can help increase genetic improvement and production efficiency. Different gonadotropin‐releasing hormone (GnRH) agonists have been developed to gain better control of follicular development, timing, and ovulation quality; therefore, they have been extensively used in FTAI protocols. This literature review resumes the most important characteristics of the physiology of follicular development and ovulation in sows, followed by a discussion about the hormonal alternatives available to induce ovulation (human chorionic gonadotropin, hCG; porcine luteinizing hormone, LH and GnRH agonists). Also, ovulation induction failures with GnRH agonists are described. Finally, current FTAI protocols with GnRH agonists are resumed and discussed. FTAI with GnRH agonists has proven to be an efficient, successful reproductive protocol that can be implemented in pig farms due to better knowledge of an endocrine system that regulates follicular development and ovulation and increased availability of several GnRH agonists that allow more efficient reproductive swine programs.
Using machine learning algorithms to investigate factors associated with complete edentulism among older adults in the United States
Authors: Oladayo Abimbola M. , Miyuraj Harishchandra Hikkaduwa Withanage , Zeng Erliang , Caplan Daniel J. , Butali Azeez , Marchini Leonardo
Published: February 2023

Aims

Edentulism is an incapacitating condition, and its prevalence is unequal among different population groups in the United States (US) despite its declining prevalence. This study aimed to investigate the current prevalence, apply Machine Learning (ML) Algorithms to investigate factors associated with complete tooth loss among older US adults, and compare the performance of the models.

Methods

The cross‐sectional 2020 Behavioral Risk Factor Surveillance System (BRFSS) data was used to evaluate the prevalence and factors associated with edentulism. ML models were developed to identify factors associated with edentulism utilizing seven ML algorithms. The performance of these models was compared using the area under the receiver operating characteristic curve (AUC).

Results

An overall prevalence of 11.9% was reported. The AdaBoost algorithm (AUC = 84.9%) showed the best performance. Analysis showed that the last dental visit, educational attainment, smoking, difficulty walking, and general health status were among the top factors associated with complete edentulism.

Conclusion

Findings from our study support the declining prevalence of complete edentulism in older adults in the US and show that it is possible to develop a high‐performing ML model to investigate the most important factors associated with edentulism using nationally representative data.
BK virus genotypes and humoral response in kidney transplant recipients with BKV associated nephropathy
Authors: Gras Julien , Nere Marie Laure , Peraldi Marie Noëlle , Bonnet‐Madin Lucie , Salmona Maud , Taupin Jean Luc , Desgrandchamps François , Verine Jérôme , Brochot Etienne , Amara Ali , Molina Jean Michel , Delaugerre Constance
Published: February 2023

Background

Among kidney transplant recipients (KTR) with BK virus associated nephropathy (BKVN), BKV genotypes’ evolution and anti‐BKV humoral response are not well established. We aim to analyze BKV replication and genetic evolution following transplantation, and characterize concomitant anti‐BKV‐VP1 humoral response.

Methods

We retrospectively analyzed 32 cases of biopsy‐proven BKVN. Stored plasma and kidney biopsies were tested for BKV viral load, and VP1 sequencing performed on positive samples. BKV–VP1 genotype‐specific neutralizing antibodies (NAbs) titers were determined at transplantation and BKVN.

Results

At the time of BKVN diagnosis, BKV viral load was 8.2 log10IU/106 cells and 5.4 log10IU/mL in kidney and plasma, respectively. VP1 sequencing identified the same BKV‐subtype in both compartments in 31/32 cases. At the time of transplantation, 8/20 (40%) of biopsies tested positive for BKV detection, whereas concomitant BKV viremia was negative. VP1 sequencing identified a different subtype compared to BKVN in 5/6 of these samples. This was confirmed following transplantation: 8 patients had a BKV+ biopsy before BKV viremia, and VP1 sequencing identified a different subtype compared to BKVN in all of them. After the onset of BKV viremia and prior to BKVN diagnosis, the BKV subtype in BKV+ plasma and kidney biopsy was the same as the one isolated at BKVN. BKV–VP1 NAbs titers were significantly higher at the time of BKVN compared to transplantation (p = .0031), with similar titers across genotypes.

Conclusion

Altogether, our data suggest that among some KTR with BKVN, the BKV genotype from the donor may not be responsible for BKVN pathogenesis.

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Density of antibiotic use and infectious complications in pediatric allogeneic hematopoietic cell transplantation
Authors: Andrew Eden C. , Khaw Seong Lin , Hanna Diane , Conyers Rachel , Fleming Jacqueline , Hughes David , Toro Claudia , Wang Stacie Shiqi , Weerdenburg Heather , Anderson Sally , Cole Theresa , Haeusler Gabrielle M
Published: February 2023

Background

Antibiotics, while an essential component of supportive care in allogeneic hematopoietic cell transplantation (allo‐HCT), can have adverse effects and select for antibiotic resistance. Understanding of patterns of use will inform antimicrobial stewardship (AMS) interventions.

Methods

Retrospective, single‐center cohort of children undergoing first allo‐HCT (n = 125). Antibiotic prescription and infection data were included from the date conditioning was commenced until 30 days post allo‐HCT. Antibiotic use was reported as length of therapy (LOT) (number of days a patient received an antibiotic) and days of therapy DOT (aggregating all antibiotics prescribed per day). Infections were classified as microbiologically documented infection (MDI) or clinically documented infections.

Results

At least one course of antibiotics was administered to 124 (99%) patients. The LOT was 636 per 1000 patient days and DOT was 959 per 1000 patient days. The median duration of cumulative antibiotic exposure per patient was 24 days (interquartile range [IQR] 20–30 days). There were 131 days of fever per 1000 patient days with patients febrile for a median of 4 days (IQR 1–7 days). Piperacillin–tazobactam was used for 116 (94%) of patients with an LOT of 532 per 1000 patient days. A total of 119 MDI episodes occurred in 74 (59%) patients, including blood stream infection in 30 (24%) and a proven/probable invasive fungal infection in 4 (3%).

Conclusion

Pediatric HCT patients receive prolonged courses of broad‐spectrum antibiotics relative to the frequency of fever and bacterial infections. This study has identified opportunities for AMS intervention to improve outcomes for our HCT patients.

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Incompatible red blood cell transfusion for hemolytic disease of the fetus and newborn secondary to anti‐U: A case report
Authors: Badawi Maha A. , Al‐Wassia Heidi
Published: February 2023

Background

Hemolytic disease of the fetus and newborn (HDFN) is a challenging condition that may necessitate the need for intrauterine or neonatal transfusion. The ability to provide compatible blood depends on antibody identification and antigen prevalence. We describe the case of a newborn that was affected by HDFN secondary to a high‐prevalence antigen of unknown specificity.

Study Design and Methods

A 29‐year‐old mother underwent emergency cesarean section for fetal distress. The newborn had severe anemia and hyperbilirubinemia. Antibody screening and identification on maternal plasma revealed pan reactivity with negative autocontrol. The cord sample had the same pattern with positive Direct Antiglobulin Test. Incompatible group O red blood cells were transfused to the newborn with no complications.

Results

Testing the maternal sample at a reference laboratory revealed the presence of anti‐U at a high titer.

Discussion

In life‐threatening conditions, it may be necessary to transfuse incompatible units. In patients who require transfusion in the presence of an identified antibody against a high‐prevalence antigen, sources for rare blood should be explored. These include autologous donations for adults, collecting blood from relatives (including mothers), and fresh or frozen units from rare donors through rare donor registries.
Calibration of a novel rebound tonometer (Tono‐Vera® vet) in the porcine eye
Authors: Mills Erinn P. , Liu Chin‐Chi , Emelogu Ugochi , Carter Renee T. , Camacho‐Luna Pilar , Lewin Andrew Christopher
Published: February 2023

Objective

Porcine models of ocular disease are becoming increasingly utilized. A recently commercialized ocular tonometer, the Reichert Tono‐Vera® Vet, has not been evaluated for use in pigs. The purpose of this study was to calibrate this device for use in porcine eyes and to determine which settings are most appropriate for use in pigs.

Procedure

The anterior chambers of five freshly enucleated normal porcine eyes were cannulated then connected to a reservoir of balanced salt solution and a physiologic monitor. Triplicate measurements were obtained with the four available settings: dog, cat, horse, and rabbit at intraocular pressures ranging from 5– to 80 mmHg. Bland–Altman analysis was utilized to determine bias and 95% limits of agreement for each setting.

Results

There was a strong positive linear regression trend for all settings (dogr2 = 0.986, horser2 = 0.947, catr2 = 0.977, and rabbitr2 = 0.982). The linear regression equations for the dog, horse, cat, and rabbit setting were y = 1.0168x – 2.6128, y = 0.8743x – 3.4959, y = 0.9394x – 7.3188, and y = 1.1082x – 3.4077. The average bias and 95% limits of agreement for dog, horse, cat, and rabbit settings were − 2.00, −8.32, −9.58, and 0.57 mmHg, and (−7.52, 3.53), (−19.00, 2.37), (−16.66, −2.50), and (−7.79, 8.93), in mmHg.

Conclusion

The Tono‐Vera® Vet dog setting was most accurate and precise setting compared to true intraocular pressures. This setting is likely to be appropriate for in vivo use in pigs, with the appropriate correction formula applied.
In-situ Empirical Characterization of Constructive Typologies and Vulnerability Factors of Historical Nuclei, as a Prerequisite for the Construction of Suitable Experimental and Numerical Models - Case of the Dellys Kasbah
Authors: Bougdal Kamal , Cherif Nabila
Published: February 2023

This article aims to characterize empirically the constructive typologies of the Kasbah of Dellys, Algeria and the damage associated with them following the 2003 earthquake.

Visual recognition is essential as a prerequisite for the definition of experimental programs and simulation tools based on the typological characteristics of these discrete structures.

From the corollary of the data collected, there are categories of vulnerabilities involving building scales ranging from masonry apparatus to built aggregates and structural components. To this end, an adapted theoretical experimental protocol is outlined, combining several methods and levels of urbanfabric, structures and material investigations in accordance with the heritage character and the progress of research on weak masonry structures.
¿Museos para la comunidad?
Authors: Da Silva Catela Gilda Verónica Ludmila
Published: February 2023

En este texto voy a plantear tres dimensiones de la relación espacio público y museos; patrimonio y comunidades. Primero trazaré un recorrido sobre la relación museo-patrimonio en torno a las definiciones más consagradas, en segundo lugar realizaré una breve génesis de las posturas que a lo largo de las décadas se construyeron en torno a los debates de la UNESCO. Para esto me enfocaré en las definiciones de lo patrimoniable y sus implicancias e impacto en las perspectivas dadas a los Museos. Finalmente, recorreré dilemas y potencialidades al hablar de la relación museo/comunidad, a partir de la experiencia concreta del Museo de Antropología de Córdoba, Argentina. Para esto, anclaré la mirada en torno al saber y las relaciones de poder que se establecen en las definiciones sobre lo que se incluye o excluye en los museos, para visibilizar la relación asimétrica que se teje con las comunidades. Las preguntas de las cuales parto de manera transversal, plantean: ¿Cómo se construye el saber en los museos? ¿Quiénes lo construyen? ¿Para qué y para quienes?
Real-Time Simulation of Ground Vehicles on Deformable Terrain
Authors: Serban Radu , Taves Jay , Zhou Zhenhao
Published: February 2023

Sophisticated modeling and simulation, based on rigid and flexible multibody dynamics, are nowadays a standard procedure in the design and analysis of vehicle systems and are widely adopted for on-road driving. Off-road driving for both terrestrial wheeled and tracked vehicles, as well as wheeled and legged robots and rovers for extra-terrestrial exploration pose additional modeling and simulation challenges, a primary one being that of the vehicle–terrain interaction, modeling of deformable terrain, and terramechanics in general. Techniques for modeling deformable terrain span an entire range varying in complexity, representation accuracy, and ensuing computational effort. While formulations such as fully resolved granular dynamics, continuum representation of granular material, or finite element can provide a high level of accuracy, they do so at a significant cost, even when the implementation leverages parallel computing and/or hardware accelerators. Real-time or faster than real-time terramechanics is a highly desired capability (in applications such as training of autonomous vehicles and robotic systems) or critical capability (in applications such as human-in-the-loop or hardware-in-the-loop). We present a real-time capable deformable soil implementation, extended from the soil contact model (SCM) developed at the German Aerospace Center which in turn can be viewed as a generalization of the Bekker-Wong and Janosi-Hanamoto semi-empirical models for soil interaction with arbitrary three-dimensional shapes and arbitrary contact patches. This SCM implementation is available, alongside more computationally intensive deformable soil representations, in the open-source multiphysics package Chrono. We describe the overall implementation and the features of the Chrono SCM model, the efficient underlying data structures, the current multicore parallelization aspects, and its scalability properties for concurrent simulation of multiple vehicles on deformable terrain.