bluuebunny/crossref_metadata_2025 huggingface dataset:
Elective neck dissection versus elective neck irradiation in cT3/4N0 maxillary sinus squamous cell carcinoma: a propensity score matching analysis
Authors: Chen Min , Gu Hefeng , Xuan Guihong , Ma Lan , Tu Sunyu , Li Min
Published: April 2024

Background

Maxillary sinus squamous cell carcinoma (MS-SCC) is an infrequent malignancy, and determining the optimal neck management for patients with cT3/4N0 MS-SCC remains a topic of ongoing debate. The purpose of this study was to compare the prognoses and quality of life outcomes of patients who underwent either elective neck dissection (END) or elective neck irradiation (ENI) for cT3/4N0 MS-SCC.

Methods

In this retrospective study, we enrolled patients with surgically treated cT3/4N0 MS-SCC, and the impact of different neck management strategies on regional control and disease-specific survival was compared using propensity score matching. The effect of surgical intervention on quality of life was evaluated using the Mann-Whitney U test.

Results

Of the 120 patients included, 36 underwent END. After propensity score matching, our analysis indicated that END did not lead to superior outcomes than ENI, as demonstrated by comparable rates of regional control (p = 0.990) and disease-specific survival (p = 0.999). However, in the 70 returned questionnaires, patients who underwent END reported higher scores in the domains of appearance, chewing, and speech than did patients who underwent ENI.

Conclusions

Our findings suggest that while END and ENI contribute to similar prognoses, END yields superior functional outcomes.
GSDMD/Drp1 signaling pathway mediates hippocampal synaptic damage and neural oscillation abnormalities in a mouse model of sepsis-associated encephalopathy
Authors: Fu Qun , Zhang Yi-Bao , Shi Chang-Xi , Jiang Ming , Lu Kai , Fu Zi-Hui , Ruan Jia-Ping , Wu Jing , Gu Xiao-Ping
Published: April 2024

Background

Gasdermin D (GSDMD)-mediated pyroptotic cell death is implicated in the pathogenesis of cognitive deficits in sepsis-associated encephalopathy (SAE), yet the underlying mechanisms remain largely unclear. Dynamin-related protein 1 (Drp1) facilitates mitochondrial fission and ensures quality control to maintain cellular homeostasis during infection. This study aimed to investigate the potential role of the GSDMD/Drp1 signaling pathway in cognitive impairments in a mouse model of SAE.

Methods

C57BL/6 male mice were subjected to cecal ligation and puncture (CLP) to establish an animal model of SAE. In the interventional study, mice were treated with the GSDMD inhibitor necrosulfonamide (NSA) or the Drp1 inhibitor mitochondrial division inhibitor-1 (Mdivi-1). Surviving mice underwent behavioral tests, and hippocampal tissues were harvested for histological analysis and biochemical assays at corresponding time points. Haematoxylin-eosin staining and TUNEL assays were used to evaluate neuronal damage. Golgi staining was used to detect synaptic dendritic spine density. Additionally, transmission electron microscopy was performed to assess mitochondrial and synaptic morphology in the hippocampus. Local field potential recordings were conducted to detect network oscillations in the hippocampus.

Results

CLP induced the activation of GSDMD, an upregulation of Drp1, leading to associated mitochondrial impairment, neuroinflammation, as well as neuronal and synaptic damage. Consequently, these effects resulted in a reduction in neural oscillations in the hippocampus and significant learning and memory deficits in the mice. Notably, treatment with NSA or Mdivi-1 effectively prevented these GSDMD-mediated abnormalities.

Conclusions

Our data indicate that the GSDMD/Drp1 signaling pathway is involved in cognitive deficits in a mouse model of SAE. Inhibiting GSDMD or Drp1 emerges as a potential therapeutic strategy to alleviate the observed synaptic damages and network oscillations abnormalities in the hippocampus of SAE mice.
Current practices of craniospinal irradiation techniques in Turkey: a comprehensive dosimetric analysis
Authors: Şenkesen Öznur , Tezcanlı Evrim , Alkaya Fadime , İspir Burçin , Çatlı Serap , Yeşil Abdullah , Bezirganoglu Ebrar , Turan Sezgi , Köksal Canan , Güray Gülay , Hacıislamoğlu Emel , Durmuş İsmail Faruk , Çavdar Şeyma , Aksu Telat , Çolak Nurten , Küçükmorkoç Esra , Doğan Mustafa , Ercan Tülay , Karaköse Fatih , Alpan Vildan , Ceylan Cemile , Poyraz Gökhan , Nalbant Nilgül , Kınay Şeyda , İpek Servet , Kayalılar Namık , Tatlı Hamza , Zhu Mingyao
Published: April 2024

Objective

This study evaluates various craniospinal irradiation (CSI) techniques used in Turkish centers to understand their advantages, disadvantages and overall effectiveness, with a focus on enhancing dose distribution.

Methods

Anonymized CT scans of adult and pediatric patients, alongside target volumes and organ-at-risk (OAR) structures, were shared with 25 local radiotherapy centers. They were tasked to develop optimal treatment plans delivering 36 Gy in 20 fractions with 95% PTV coverage, while minimizing OAR exposure. The same CT data was sent to a US proton therapy center for comparison. Various planning systems and treatment techniques (3D conformal RT, IMRT, VMAT, tomotherapy) were utilized. Elekta Proknow software was used to analyze parameters, assess dose distributions, mean doses, conformity index (CI), and homogeneity index (HI) for both target volumes and OARs. Comparisons were made against proton therapy.

Results

All techniques consistently achieved excellent PTV coverage (V95 > 98%) for both adult and pediatric patients. Tomotherapy closely approached ideal Dmean doses for all PTVs, while 3D-CRT had higher Dmean for PTV_brain. Tomotherapy excelled in CI and HI for PTVs. IMRT resulted in lower pediatric heart, kidney, parotid, and eye doses, while 3D-CRT achieved the lowest adult lung doses. Tomotherapy approached proton therapy doses for adult kidneys and thyroid, while IMRT excelled for adult heart, kidney, parotid, esophagus, and eyes.

Conclusion

Modern radiotherapy techniques offer improved target coverage and OAR protection. However, 3D techniques are continued to be used for CSI. Notably, proton therapy stands out as the most efficient approach, closely followed by Tomotherapy in terms of achieving superior target coverage and OAR protection.
Mid-term clinical outcomes of totally endoscopic repair for mitral regurgitation in Barlow’s disease
Authors: Zhang Lin , Cui Huimin , Shen Hong , Li Dong , Li Lianggang , Shen Hua , Jiang Shengli
Published: April 2024

Objective

This study aimed to confirm the safety and feasibility of totally endoscopic repair for mitral regurgitation (MR) in Barlow’s disease.

Methods

From June 2018 to December 2022, 21 consecutive Barlow’s disease patients (aged 33 ± 12 years; 57.1% male) underwent totally endoscopic mitral valve (MV) repair with leaflets folding, multiple artificial chordae implantation and ring annuloplasty. The safety and feasibility of this technique was evaluated by its mid-term clinical outcomes.

Results

There was no operative death or complications. The mean cardiopulmonary bypass (CPB) time was 190 ± 41 (128–267) min, and the aortic cross-clamp time was 145 ± 32 (66–200) min. The average number of artificial chordae implantation was 2.9 ± 0.7 (1–4) pairs. The mean MV coaptation length was 1.4 ± 0.3 (0.8–1.8) cm, and the median transvalvular gradient was 1 [interquartile range (IQR), 1–2] mmHg. During a median follow-up time of 24 (IQR, 10–38) months, all patients showed persistent effective valve function with no significant MR or systolic anterior motion.

Conclusions

Totally endoscopic repair was a safe, effective, and reproducible procedure with satisfied mid-term clinical outcomes for MR in Barlow’s disease. However, further randomized and long-term follow-up studies were warranted to determine its clinical effects.
Sex-related differences in outcome of thoracic aortic surgery
Authors: Jiang Hongxue , Xu Hongjie , Xu Zhiyun
Published: April 2024

Background

Sex-related dissimilarities’ influence on outcomes following thoracic aortic surgery is poorly understood. Our aim is to examine sex-related disparities in patients undergoing thoracic aortic aneurysm (TAA).

Methods

A total of 455 cases undergoing thoracic aortic aneurysm (TAA) surgery were consecutively enrolled between December 2009 and December 2015 in a Chinese hospital. Primary outcomes, including overall mortality and related risk factors, were evaluated. Cox regression is utilized to recognize the independent risk factor of these consequences.

Results

Females, compared to males, had greater indexed aortic diameters and higher aortic transvalvular pressure differences. For the location of aortic aneurysms, females had a higher rate of aortic arch involvement, while males had a higher rate of root involvement. Females underwent less frequent complex proximal aortic operations compared with males (29.5% versus 46.9%; p < 0.001). Women and men both had a lower rate of aortic transvalvular pressure difference and LV volume index 7 days after thoracic aortic surgery. The overall mortality for the women’s groups (11%) was suggestively greater compared to 4.9% for the men’s groups (p = 0.026). Renal failure and aortic arch involvement were the main risk factors associated with males’ survival, while maximum indexed aortic diameter and cross-clamp time were the risk factors associated with females’ survival.

Conclusions

The outcome after TAA surgery was less favorable in women with significantly increased overall mortality. It highlights the need to focus on implementing personalized surgery strategies and gender-specific guidelines in treating female patients following TAA surgery.
Repair of a fistula between the aorta and right ventricular outflow tract secondary to infective endocarditis of a unicuspid aortic valve and previously repaired ventricular septal defect
Authors: Karsan Rickesh B. , O’Sullivan Katie E. , Lockhart Christopher J. , Austin Christopher
Published: April 2024

Background

Infective endocarditis of the aortic valve can result in a wide range of destructive pathology beyond the valve leaflets and annulus which require careful surgical planning to provide appropriate debridement and reconstruction. Failure to do so can result in a failure of surgical treatment, recurrent infection and cardiac failure with concomitant high morbidity and mortality.

Case report

We describe the case of a 45-year-old male with previous patch repair of a ventricular septal defect, who was diagnosed with sub-acute bacterial endocarditis of the native aortic valve and developed a new fistula from the aorta to the right ventricular outflow tract which. This was managed surgically.

Conclusion

This unique case highlights another spectrum of infective endocarditis with a unique approach to repair and management.
Evaluation of network-guided random forest for disease gene discovery
Authors: Hu Jianchang , Szymczak Silke
Published: April 2024

Background

Gene network information is believed to be beneficial for disease module and pathway identification, but has not been explicitly utilized in the standard random forest (RF) algorithm for gene expression data analysis. We investigate the performance of a network-guided RF where the network information is summarized into a sampling probability of predictor variables which is further used in the construction of the RF.

Results

Our simulation results suggest that network-guided RF does not provide better disease prediction than the standard RF. In terms of disease gene discovery, if disease genes form module(s), network-guided RF identifies them more accurately. In addition, when disease status is independent from genes in the given network, spurious gene selection results can occur when using network information, especially on hub genes. Our empirical analysis on two balanced microarray and RNA-Seq breast cancer datasets from The Cancer Genome Atlas (TCGA) for classification of progesterone receptor (PR) status also demonstrates that network-guided RF can identify genes from PGR-related pathways, which leads to a better connected module of identified genes.

Conclusions

Gene networks can provide additional information to aid the gene expression analysis for disease module and pathway identification. But they need to be used with caution and validation on the results need to be carried out to guard against spurious gene selection. More robust approaches to incorporate such information into RF construction also warrant further study.
Impact of SGLT-2 inhibitors on modifiable cardiovascular risk factors in Romanian patients with type 2 diabetes mellitus
Authors: Gherbon Adriana , Frandes Mirela , Dîrpeş Darius , Timar Romulus , Timar Bogdan
Published: April 2024

Background

Modifiable cardiovascular risk factors are high blood pressure, smoking, diabetes, sedentary lifestyle, obesity, and hypercholesterolemia.

Aim

To investigate the impact of sodium-glucose 2 co-transporter inhibitors (SGLT-2i) on modifiable cardiovascular risk factors in Romanian patients diagnosed with type 2 diabetes mellitus (T2DM).

Method

A retrospective study was conducted on 200 Romanian patients with T2DM who were being treated with SGLT-2i, either Dapagliflozin or Empagliflozin. Collected data included demographic characteristics, such as weight, body mass index (BMI), fasting blood glucose (FBG), creatinine, glycated hemoglobin (HbA1c), abdominal circumference (AC), urine albumin-to‐creatinine ratio (UACR), systolic blood pressure (SBP), diastolic blood pressure (DBP), C-reactive protein (CRP) and N-terminal pro b-type natriuretic peptide (NT-proBNP). The patients were observed for one year after being treated with SGLT-2i.

Results

The mean value of FBG decreased from 180.00 mg% (IQR: 154.50–207.00) to 130.00 mg% (IQR: 117.50–150.00) (p < 0.001), and the mean of HbA1c values decreased from 8.40% (IQR: 7.98-9.15%) to 7.30% (IQR: 6.90-7.95%) (p < 0.001). We also obtained significant positive effects on body weight, i.e., the weight decreased from 90.50 kg (82.00-106.50) to 89.00 kg (77.50–100.00) (p = 0.018), BMI from 32.87 kg/m2 (29.24–36.45) to 31.00 kg/m2 (27.74–34.71) (p < 0.001) and AC from 107.05 (± 16.39) to 102.50 (± 15.11) (p = 0.042). The UACR decreased from 23.98 mg/g (19.76–36.85) to 19.39 mg/g (1.30-24.29) (p < 0.001). Initially, the median value for SBP was 140.00mmgHg (130.00-160.00), and for DBP was 80.00 mmgHg (72.00–90.00), and one year after treatment, the medium value was 120.00 mmgHg (115.50–130.00) for SBP (p < 0.001), and 72.00 mmgHg (70.00–78.00) for DBP (p < 0.001) The mean CRP values decreased from 68.00 mg/dL (56.25–80.25) to 34.00 mg/dL (28.12–40.12) (p < 0.001), and the mean NT-proBNP decreased from 146.00pg/mL (122.50-170.50) to 136.00 pg/mL (112.50-160.50) (p = 0.005).

Conclusion

Treatment with SGLT-2i in Romanian patients with T2DM has beneficial effects on modifiable cardiovascular risk factors.
Can resistance training improve throwing performance in handball players? A Systematic review and meta-analysis
Authors: Hadjisavvas Stelios , Efstathiou Michalis A. , Themistocleous Irene-Chrysovalanto , Daskalaki Katerina , Malliou Paraskevi , Lewis Jeremy , Stefanakis Manos
Published: April 2024

Background

Throwing is one of the most important movement in handball. Throwing performance is crucial for success in handball.

Objective

Τo investigate the level of evidence for the effect of resistance training (RT) on throwing performance in handball players.

Methods

Systematic searches of Pubmed, Medline complete, Cinahl, Sport Discus and Scopus were undertaken for peer reviewed articles published between 18 March 1995 to 18 March 2023. Randomized, controlled, clinical studies, written in English, aiming to investigate the effect at least one modality of RT on throwing performance (velocity or/and accuracy) in handball players were considered for inclusion in the study. The eligible studies were assessed for methodological quality using the Physical Therapy Evidence Database (PEDRO) scale. The Best Evidence Synthesis (BES) approach was used for synthesizing and reporting the results. Furthermore, the random-effects model was used for the meta-analysis and the Q-statistic was used to test the null hypothesis that all studies in the analysis share a common effect size.

Results

One hundred ninety-eight studies were identified, of which 30 were included. A total of 727 handball players (males = 388, females = 292) were included. 28 of the 30 studies were rated as high methodological quality studies (PEDRO score > 70%) while the rest of the studies were rated as moderate methodological quality studies (PEDRO score ≤ 60%). The mean effect size for the effectiveness of resistance training (RT) in improving jumping throw, running throw, and standing throw velocity were 1.128 (95% CI 0.457 – 1.798), 1.756 (95% CI 1.111 – 2.400), and 1.098 (95% CI 0.689 – 1.507) correspondingly. Traditional weight training using barbells in mostly compound lifts yielded the most significant and robust results. Other RT modalities such as elastic bands, medicine balls, core training and ballistic training showed no significant results or positive effects due to the limited number of the studies.

Conclusion

Strong evidence exists only for the effectiveness of RT using barbells in increasing throwing velocity. In contrast, the remaining RT modalities, while yielding positive results, have limited support due to limited number of studies and the high heterogeneity between studies. Furthermore, there is insufficient evidence to support various forms of RT in increasing throw distance. Finally, medicine ball training and elastic band training demonstrated no benefits in improving throwing accuracy.

Trial registration

PROSPERO ID: CRD42023393574.
Healers that hurt: a scoping review of media reports of cases of rape in healthcare settings
Authors: Okonji Adaobi Margaret , Ishola Adeyinka G. , Ayamolowo Love Bukola , Femi-Akinlosotu Omowumi M. , Mapayi Boladale , Folayan Morenike Oluwatoyin
Published: April 2024

Background

Sexual assault occurring within healthcare settings represents a significant breach of public trust. This scoping review aimed to highlight the profile of people raped, those who committed the rape within the health facilities, and the legal actions taken to resolved cases.

Methods

Media-reported data on incidents of rape in healthcare settings were collected. The search was conducted in May and June 2023, focusing on English-language publications with accessible full texts. Reports that lacked information on the survivors or incidents that occurred outside of healthcare settings were excluded. Descriptive statistics were used to summarize the categories of the collected publications, and graphical representations were employed for visualization purposes.

Results

A total of 62 cases were retrieved, originating from Africa (n = 17; 27.4%), Europe (n = 14; 22.6%), Southeast Asia (n = 14; 22.6%), the Americas (n = 11; 17.7%), the Western Pacific Region (n = 5; 8.1%) and Eastern Mediterranean region (n = 1; 1.6%). In addition, 69 individuals were implicated in 59 cases. They were 31 doctors (44.9%), 17 (24.6%) nurses, four (5.8%) nurse/healthcare assistants, three (4.3%) cleaners/ward boy, two (2.9%) traditional medical doctors, and two (2.9%) security guards. Others included six (8.7%) staff members without designations and one (1.4%) ambulance driver. All perpetrators were male, ranging in age from 22 to 67 years. There were 66 victims identified in the 62 cases with age ranging from 2 to 92 years. Except for one case, all victims were female, and all but one case were patients. Most assaults occurred in consulting rooms/clinics (n = 21; 31.8%), 16 (24.2%) happened under sedation, and six (9.1%) were repeatedly raped, Survivors typically reported the cases the police (n = 12; 19.4%), family/friends (n = 11; 17.7%) or to hospital authorities (n = 10; 16.1%). Out of the 69 perpetrators, 19 (30.6%) were imprisoned with sentences ranging from 12 months to an indefinite period and one (1.6%) received a death sentence.

Conclusion

The raping of patients by healthcare providers within healthcare settings calls for urgent and extensive measures. Stakeholders in healthcare management need to prioritize raising awareness about the problem, implement robust prevention and reporting strategies, and create healthcare environments that are safe, respectful, and supportive for all individuals seeking care.
Controlling factors of latitudinal distribution of dissolved organic matter in the upper layers of the Indian Ocean
Authors: Shigemitsu M. , Sasaoka K. , Wakita M. , Yokokawa T. , Hashioka T. , Arulananthan K. , Murata A.
Published: April 2024

We studied chromophoric (CDOM) and fluorescent (FDOM) dissolved organic matter (DOM) and dissolved organic carbon in surface waters to determine the factors controlling the geographical distribution of DOM along two meridional transects in the Indian Ocean. For CDOM, we calculated the absorption coefficients, spectral slope, and absorption coefficient ratio from the observed absorption spectra. For FDOM, we calculated the biological (BIX) and humification (HIX) indices from the excitation emission matrices (EEMs); parallel factor analysis of the EEMs identified three fluorescent components, i.e., two humic-like and one protein-like. Using these DOM parameters, a factor analysis extracted fewer latent variables than the observed variables to account for the geographical distributions. We obtained three factors (F1, F2, and F3), which explained ~ 84% of the variance in the observed data. From the factor loadings, F1, F2, and F3 were interpreted as the effects of net primary production-derived DOM and its horizontal transport, photodegradation, and vertical transport by physical processes. We characterized seven marine biogeochemical provinces by factor scores. F1 scores gradually decreased from the northernmost to the Antarctic province, with a small maximum around the subtropical front. F2 scores were highest in the subtropical province and decreased in both the northward and southward directions. F3 scores were high in the Antarctic and northernmost provinces, and lowest in the subtropical province. Only BIX was insufficiently explained by these factors. BIX was highest in the northern part of the subtropical province, where photodegradation of DOM was the most intense. This suggests that the possible interaction between photodegradation, autochthonous production, and reworking by heterotrophic bacteria of DOM occurs in the subtropical province.
Bundle branch reentrant ventricular tachycardia in a patient with Fabry disease
Authors: Beladel Wassim , Abdelali Mehdi , Cheikhna Oussama , Hasni Karim , El Minaoui Mohamed
Published: April 2024

Background

Bundle branch reentrant ventricular tachycardia is a unique type of VT that employs both bundles and the ventricular septum as integral components of a re-entrant circuit. It is usually observed in dilated cardiomyopathy, and its circuit depends exclusively on the specialized conduction system.

Case presentation

A 67-year-old man with a history of Fabry disease, and atrial fibrillation ablation, was admitted for a wide QRS tachycardia at 150 bpm, with an LBBB. Pharmacological therapy failed to stop the arrhythmia. Intracardiac recordings confirm the diagnosis. His Bundle recordings are essential, and Atrioventricular (AV) dissociation is typically present. The method used to induce left BBRVT is right ventricle apex stimulation. An electrophysiological study showed an AV dissociation a long HV sequence and a similar QRS morphology between VT and sinus rhythm. An overdrive stopped it. The same arrhythmia reappears and is restored to sinus rhythm by electrical cardioversion. We decided to implant an Implantable Cardiac defibrillator (ICD) with a backup pacing for secondary prevention and to ablate the right bundle branch.

Conclusion

BBRVT is a rare entity that is underreported. Pharmacological therapy is usually inefficient. An ICD is recommended for secondary prevention and can provide backup pacing, frequently required after catheter ablation to prevent the development of AV block or an excessive prolonged HV interval. Catheter ablation of the bundle branch is the first-line therapy.
Clinical and laboratory spectrum of hereditary angioedema in a group of Egyptian children: a cross sectional study
Authors: Almalky Mohamed , El Shabrawy Reham M. , Gheetah Najeeb Ali Mohammed , Elkady Hossam Moustafa , Osman Naglaa S. , Shoman Walaa , Baz Eman Gamal
Published: April 2024

Background

Hereditary angioedema (HAE) is a hereditary illness represented by repeated bouts of submucosal or subcutaneous edema. Types of HAE includes; HAE with deficient C1-inhibitor (type 1), HAE with dysfunctional C1-inhibitor (type 2), and HAE with normal C1-inhibitor. Data on the epidemiology of HAE in Egypt are limited. Therefore, we aimed to characterize HAE in Egyptian children, identify the morbidity, and clarify HAE's different clinical and laboratory presentations.

Methods

In this cross-sectional study, we enrolled pediatric patients diagnosed with HAE according to the international hereditary angioedema WAO/EAACI guidelines. We gathered laboratory data on patients' mean serum C1 esterase inhibitor (C1-INH) level and activity, C4, and IgE levels.

Results

We included 18 HAE patients (14 females and 4 males). They were between the ages of 6 and 18 years. The mean age upon confirmation of diagnosis was 8.4 ± 2.4 years. The mean time required to correctly diagnose HAE was 3.2 ± 1.8 years. We detected type I in 15 cases and type II in three cases. Eleven patients had a family member with HAE. In terms of previous misdiagnoses, 50% of patients were diagnosed with allergic angioedema. The median annual frequency of episodes was 17. The mean HAE attack time was 2.9 ± 1.5 days. Edema was most typically found in the face and abdomen. Trauma was the main triggering factor. We detected a significant direct relationship between severity of attack and C1-INH activity level.

Conclusions

This research adds a considerable clinical information about children with HAE. According to current results, there is a considerable underdiagnosis of HAE in Egypt. The detection and management of HAE can be improved by screening the relatives of HAE patients.
Cannonball Pulmonary Metastases as Initial Presentation of Hepatocellular Carcinoma: A Case Report and Literature Review
Authors: Ibarra-Sifuentes Héctor Raúl , Canales-Azcona Gustavo Abraham , Gómez-Arredondo Jaqueline Isabel , Rodríguez-Álvarez Carlos Javier
Published: April 2024

Background

Hepatocellular carcinoma is a major public health problem, as is considered the fastest growing cause of cancer-related death. Cannonball metastases as an initial finding in hepatocellular carcinoma are considered a rare phenomenon.

Case Presentation

A 59-year-old man presented to the outpatient clinic for subacute cough, asthenia, and involuntary weight loss. Chest X-ray showed multiple, round, bilateral pulmonary solid lesions. Contrast-enhanced computed tomography of the chest and abdomen revealed multiple bilateral, contrast-enhanced pulmonary nodules known as "cannonball" lesions and a heterogeneous lesion located in the right lobe of the liver with retroperitoneal lymphadenopathy. A biopsy was performed, and the histopathological result was compatible with metastatic poorly differentiated hepatocellular carcinoma. Due to the advanced stage of the disease, the patient received palliative care and expired two months later.

Conclusion

Cannonball metastases in hepatocellular carcinoma are considered a rare finding and represents a poor prognosis. It is important to awaken the interest of clinicians in a timely diagnosis, as well as a possible suspicion of hepatocellular carcinoma in patients with this radiographic pattern.
Iron springs, environmental changes, accelerated weathering and cave development in quartz sandstone in the Blue Mountains, New South Wales, Australia: preliminary studies
Authors: Rowling Jill
Published: April 2024

After a series of extreme weather events (drought, bushfires and floods), iron flocs were seen at ephemeral springs in quartz sandstone in the Blue Mountains National Park, New South Wales, Australia. Naturally burnt areas allowed better viewing of small sandstone caves. This paper discusses some of the processes operating within the quartz sandstone, leading to the attractive and unusual shapes, and how extreme weather led to the mobilisation and redeposition of iron minerals.
Museu como espaço não formal para o ensino de ciências: uma revisão integrativa
Authors: Silva de Melo Charlline Vládia , Sales Gilvandenys Leite , Junior Antônio de Lisboa Coutinho , Morano Domingos Antônio Clemente Maria Silvio , Cerqueira Gilberto Santos
Published: April 2024

Locais não formais de educação são espaços nos quais diversas práticas de ensino têm a oportunidade de ocorrer. Neste estudo, exploramos o uso de museus como ferramentas de ensino de ciências, com um foco específico na anatomia humana. Nosso objetivo foi avaliar o potencial pedagógico dos museus para o ensino e determinar se eles permitem a criação de experiências significativas e multidisciplinares. Utilizamos uma metodologia de Revisão Integrativa (RI) que abrange o período de 2012 a 2022. Durante esse processo, buscamos identificar artigos científicos em Língua Portuguesa disponíveis em repositórios digitais, a fim de descrever as abordagens adotadas. Os resultados dessa pesquisa revelaram um total de 392 artigos, no entanto apenas 15 deles foram considerados elegíveis. Essa seleção foi baseada na capacidade dos artigos de apresentar uma interconexão sólida entre teoria e prática no contexto da relação entre museus, ensino de ciências e anatomia. Constatamos que há uma escassez de estudos que se aprofundem nesse modelo pedagógico de ensino por meio de exposições ou objetos expositivos em museus de ciências. Essa abordagem ainda é predominantemente limitada a contextos universitários, em que, muitas vezes,  apresenta-se de maneira passiva na integração com o ensino básico e com a comunidade em geral. Como conclusão, destacamos a necessidade de uma maior exploração e desenvolvimento desse potencial pedagógico.
Tradução do conhecimento nas condições crônicas não transmissíveis: visão de usuários e profissionais da atenção primária à saúde
Authors: Bezerra da Silva Rávila Suênia , Fernandes Junior Gilson Carlos , Araújo Dantas Loren Aryelly , Dantas Ribeiro Rebeca Izabel , Queiroz de Medeiros Anna Cecília , Sureira Thaiz Mattos , Magalhães Adriana Gomes
Published: April 2024

As condições crônicas não transmissíveis (CCNTs) são doenças causadas por inúmeros fatores causais, necessitando o emprego de ações voltadas não apenas para o indivíduo, mas também para os aspectos sociais, econômicos e culturais, visando a minimizar suas repercussões na qualidade de vida dos usuários. Assim, o presente trabalho buscou investigar de que forma ocorre a TC sobre CCNTs na visão de usuários e profissionais da APS. Trata-se de um estudo observacional, descritivo e transversal, com abordagem quantitativa, realizado na V Unidade Regional da Saúde Pública localizada na Região de Saúde Trairi e Potengi –RN. Para a coleta de dados, foram utilizados questionários semiestruturados, direcionados aos profissionais e aos usuários. Os resultados foram apresentados por meio de estatística. Entre os 113 participantes, 58 eram profissionais de saúde e 55 usuários da APS, a maioria era do sexo feminino. A maior parte dos profissionais afirmou não utilizar as plataformas digitais para se comunicar com usuários, no entanto, entre os que utilizavam, o aplicativo de mensagens WhatsApp foi o mais citado. Já os usuários relataram buscar informações indo presencialmente até a unidade básica e por meio do Agente comentário de saúde, a maior parte recebeu orientações sobre CCNTs e conseguiu compreender a linguagem adotada pelo profissional de saúde, sem apresentar dificuldades. Sendo assim, a utilização da comunicação com uma linguagem de forma clara e de fácil entendimento é essencial, pois favorece a troca de informações e possibilita a geração de resultados positivos.
Arquitetas mulheres e o ensino da história da arquitetura moderna: um relato de experiência na monitoria de Teoria e História da Arquitetura 3
Authors: Miyasaki Julia Santos , Chacon Maria Beatriz de Andrade Furtado
Published: April 2024

Este artigo trata de um relato de experiência da Monitoria da disciplina de Teoria e História da Arquitetura III, lotada no 5º semestre do Curso de Arquitetura e Urbanismo, nos semestres 2022.2 e 2023.1. A disciplina foi ministrada por Julia Miyasaki nos turnos vespertino e noturno, que também foi a supervisora da Monitoria. A discente selecionada foi Beatriz Chacon, por meio do Edital 17/2022. Ao longo do período de duração da Monitoria, foram realizadas atividades que visavam a promover a introdução da aluna à docência, bem como desenvolver atividades com o objetivo de viabilizar o estudo e conhecimento da produção de arquitetas atuantes em contexto internacional entre os séculos XIX e XX. Entre as atividades desenvolvidas pela Monitora, destaca-se uma pesquisa cujo objetivo era atualizar a bibliografia da disciplina sobre o tema supracitado. A seguir, será apresentado um relato descritivo de algumas atividades realizadas pela Monitora, bem como os resultados advindos dessa pesquisa.
Uma experiência de extensão universitária curricularizada no curso de arquitetura e urbanismo da Unichristus – estudo preliminar para o novo quarto coletivo para instituição recanto do sagrado coração
Authors: Gaspar Maia Rebeca , Resende Ribeiro Matheus Gabriel , Araújo Veloso Lara , Ribeiro Ferreira Ediny
Published: April 2024

O presente artigo diz respeito ao relato de experiência acerca do desenvolvimento de Estudo Preliminar para projeto arquitetônico de reforma de um espaço existente para adequação ao uso de quarto coletivo no Recanto Sagrado Coração. A partir de visitas no local e de conversas com profissionais que atuam no abrigo, foi identificada a demanda de criação de um novo quarto coletivo para as moradoras do espaço. Viu-se a necessidade de atuar nessa demanda por meio de disciplina específica e totalmente extensionista de 120h chamada Projeto Extensionista. O desenvolvimento do projeto de reforma objetiva a ampliação da quantidade de leitos existentes na instituição, levando em consideração a reforma de um ambiente existente e subutilizado, e transformá-lo em um lugar amplo, funcional e confortável para as moradoras e os funcionários do Recanto. Apesar da existência de uma disciplina totalmente extensionista, para alcançar esse objetivo, foram organizadas ações em diversas outras disciplinas, como atividades de levantamento, desenho As Built, relatórios de conforto ambiental, pesquisa semiestruturada para aferir a satisfação das moradoras sobre o espaço físico, desenvolvimento de programa de necessidades, proposta projetual, modelagem e renderização, além de memorial descritivo do projeto. Em conjunto, todas essas disciplinas implementaram uma ação de extensão curricularizada no Curso de Arquitetura e Urbanismo da Unichristus.
Enoxaparin sodium combined with magnesium sulfate in the treatment of severe preeclampsia
Authors: Lu Dawei , Yu Jie , Sang Lin
Published: April 2024

Objective: To observe the treatment of severe preeclampsia in newborns with enoxaparin sodium combined with magnesium sulfate.

Methods: A retrospective analysis was conducted on the clinical data of 80 patients with severe preeclampsia admitted to Hefei Second People’s Hospital, China from January 2019 to December 2020. Treatment records showed that 40 cases received magnesium sulfate treatment (single group), and 40 cases received enoxaparin sodium combined with magnesium sulfate treatment (combination group). Levels of D-dimer, soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PLGF), Apgar scores of newborns delivered before and after treatment were compared. Gestation weeks and incidence of adverse reactions were analyzed.

Results: After treatment, levels of D-dimer, sfit-1 and adverse reactions in the combination group were significantly lower than those in the single group (P<0.05), and the level of PLGF, newborn Apgar score and length of gestation were significantly higher than those in the single group (P<0.05).

Conclusion: Compared to magnesium sulfate alone, the combination of enoxaparin sodium and magnesium sulfate in the treatment of pregnant women with severe preeclampsia can more effectively regulate the cytokine level of patients, improve pregnancy outcome, and improve neonatal Apgar score. The incidence of adverse reactions is low, making it a safe and efficient treatment modality.

doi: https://doi.org/10.12669/pjms.40.5.9001

How to cite this: Lu D, Yu J, Sang L. Enoxaparin sodium combined with magnesium sulfate in the treatment of severe preeclampsia. Pak J Med Sci. 2024;40(5):870-874. doi: https://doi.org/10.12669/pjms.40.5.9001

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Learning from the Radical Behavioral Challenge
Authors: von Kriegstein Hasko
Published: April 2024

I (mostly) accept Ancell’s argument that my proposal for dealing with the radical behavioral challenge entails what he calls ‘the excessive recusal problem’. I argue that this is no reason to reject my proposal, but rather an opportunity for further reflection on what behavioral and normative ethicists can learn from each other. I make some suggestions for future lines of inquiry for both fields.
Zasada archiwalnej reprezentacji podstawowych organizacji partyjnych (POP) PZPR – założenia teoretyczne i realizacja praktyczna ze szczególnym uwzględnieniem województwa lubelskiego
Authors: Czarnota Tomasz
Published: April 2024

Zasada reprezentacji POP (organizacji skupiających członków PZPR pracujących w określonych zakładach lub zamieszkujących na danym terenie) była rozwiązaniem przyjętym na początku lat 60. w archiwach Komitetów Wojewódzkich PZPR, wiążącym się z kształtowaniem narastającego zasobu archiwalnego partii. Wprowadzenie jej w życie miało na celu przyspieszenie opracowywania jej akt i włączenie ich do obiegu naukowego, a także zachowanie akt najbardziej wartościowych informacyjnie i wyeliminowanie tych o niskiej wartości, które ponadto, stanowiąc dokumentację masową, mogły szybko stać się źródłem problemów z powierzchnią magazynową w archiwach. Jej istotą było wyselekcjonowanie takich POP, które – z uwagi na ulokowanie w zakładach pracy odzwierciedlających specyfikę warunków społeczno-gospodarczych itd.. danego terenu – w swojej dokumentacji utrwalały informacje dla niego nader charakterystyczne. W drugiej połowie lat 80. było ich ponad 7 tys. w całym kraju. Zasadę reprezentacji POP wprowadzono między innymi w województwie lubelskim. Przez circa dekadę jej podtrzymywanie przebiegało dość sprawnie, ale od drugiej połowy lat 70. system zaczął objawiać dysfunkcje, tj. nieaktualizowanie wykazu reprezentatywnych POP odpowiednio do zachodzących zmian (np. ogólnej liczebności POP w województwie), opóźnieniach i niewywiązywaniu się z przekazywania akt do Archiwum KW PZPR w Lublinie. W rezultacie w latach 80. były tam akta tylko 69 reprezentatywnych POP, a powinny tam wówczas trafiać przynajmniej około 250, spośród których faktycznie wytypowanych było tylko 146. Akta reprezentatywnych POP początkowo stanowiły grupę zespołów w zasobie Archiwum, a w 1987 r. wskutek odgórnej decyzji włączono je do zespołów komitetów gminnych, miejsko-gminnych i miejskich. Przez brak należytej staranności do tegoż Archiwum ostatecznie wcale nie dotarły akta wielu tych POP, zwłaszcza z drugiej połowy lat 80.
The Impact of E-Cigarettes on Oral Injuries and Bone Fractures
Authors: Głogowska Karen , Wojtas Mikołaj , Piątkiewicz Julia , Krzyżanowska Maria , Kapica Marcin , Nowak Gabriela , Żmijewska Aleksandra , Sztybór Mateusz , Maleszewska Monika  , Kopacz Wojciech
Published: April 2024

Introduction
The rising prevalence of electronic cigarette (e-cigarette) use has prompted concerns regarding its potential health implications. While much attention has focused on respiratory and cardiovascular effects, injuries, oral trauma, and bone fractures linked to e-cigarette use have received less scrutiny. This paper aims to comprehensively review the landscape of injuries, oral trauma, and bone fractures induced by e-cigarettes, shedding light on this underexplored facet of e-cigarette-related harm.
Material and Methods
This literature review has analyzed 16 papers. Inclusion criteria: researches and case reports published after 2015. PubMed and Google Scholar has been searched to identify the papers.
 Analysis of the Literature
Existing literature suggests a growing incidence of injuries, oral trauma, and bone fractures associated with e-cigarette use, albeit with limited systematic investigation. Mechanisms underlying these injuries range from device malfunctions to inadvertent impacts during use. Case reports highlight a spectrum of injuries, including oral burns, dental trauma, and skeletal fractures, often involving the face and mouth regions.
Conclusions
Despite the lack of comprehensive epidemiological data emerging evidence underscores the need for heightened awareness and preventive measures to mitigate e-cigarette-related injuries. Enhanced education, regulation of e-cigarette devices, and promotion of safer usage practices are crucial steps towards reducing the burden of e-cigarette-related harm on oral and skeletal health.
Tekstowy świat oryginału i przekładu – konfrontacyjna lektura dwutekstów medialnych (perspektywa dydaktyka)
Authors: Pstyga Alicja
Published: April 2024

THE TEXTUAL WORLD OF THE ORIGINAL TEXT AND ITS TRANSLATION. THE COM­PARATIVE READING OF MEDIA TEXTS FROM A TEACHING PERSPECTIVE
From the perspective of a researcher and educator, the comparative reading of media texts – original texts and their translations – calls for making an attempt to investigate relations between the reality presented in them. The translator’s (and the editor’s or publisher’s) choices modify the original text in both its content and form and influence the perception of the translated text. Using examples of media texts in Russian and their translations into Polish, the author demonstrates that possible deviations from the original textual reality are important from the point of view of the interpretation and competence of the receiver. From the perspective of teaching the translation of media texts, attention should be paid to the specificity of media texts as well as to the specificity of their translations.
Emergencia temprana de la referencia temporal en la comunicación multimodal entre madre-niño
Authors: Muñetón Ayala Mercedes Amparo
Published: April 2024

El objetivo de este estudio es observar cómo las madres y los niños (12 a 36 meses) usan la referencia verbal y gestual (señalamiento) para indicar objetos que están tanto presentes como ausentes en el espacio y en el tiempo. Para ello, vamos a acotar varios conceptos: referencia verbal y gestual, referencia temporal y comunicación multimodal.
Retos en la formación del fonoaudiólogo en el abordaje de la modalidad
Authors: Duarte-Valderrama Adriana
Published: April 2024

El presente documento pretende reflexionar acerca de la formación de fonoau- diólogos en el abordaje de la modalidad escrita (código escrito que involucra tanto los procesos de lectura como de escritura), tanto en el eje disciplinar como en el profesional.
Debt Derisking
Authors: Cutura Jannic , Parise Gianpaolo , Schrimpf Andreas
Published: April 2024

We examine how corporate bond fund managers manipulate portfolio risk in response to incentives. We find that liquidity risk concerns drive the allocation decisions of underperforming funds, whereas tournament incentives are of secondary importance. This leads laggard fund managers to trade off yield for liquidity while holding the exposure to other sources of risk constant. The documented derisking is stronger for managers with shorter tenure and is reinforced by a more concave flow to performance sensitivity and by periods of market stress. Derisking meaningfully supports ex post laggard fund returns. Flexible net asset values (swing pricing) may, however, reduce derisking incentives and create moral hazard.

This paper was accepted by Agostino Capponi, finance.

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2022.03406 .
Strategic Responses to Algorithmic Recommendations: Evidence from Hotel Pricing
Authors: Garcia Daniel , Tolvanen Juha , Wagner Alexander K.
Published: April 2024

We study the interaction between algorithmic advice and human decisions using high-resolution hotel-room pricing data. We document that price setting frictions, arising from adjustment costs of human decision makers, induce a conflict of interest with the algorithmic advisor. A model of advice with costly price adjustments shows that, in equilibrium, algorithmic price recommendations are strategically biased and lead to suboptimal pricing by human decision makers. We quantify the losses from the strategic bias in recommendations using as structural model and estimate the potential benefits that would result from a shift to fully automated algorithmic pricing.

This paper was accepted by Axel Ockenfels, special issue on the human-algorithm connection.

Funding: D. Garcia gratefully acknowledges that this research was funded in part by the Austrian Science Fund [Grant FWF-FG6]. A. K. Wagner gratefully acknowledges financial support from the Anniversary Fund of the Oesterreichische Nationalbank [Project 18878].

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2022.03740 .
Indication and surgical approach for reconstruction with endoprosthesis in bone-associated soft tissue sarcomas: Appropriate case management is vital
Authors: Öztürk Recep
Published: April 2024

It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas (STS) have unique features in terms of indication, surgical approach and follow-up, in terms of the management of these cases. Some STS are associated with bone and major neurovascular structures. Bone-associated STS are generally relatively large and relatively deep-seated. Additionally, the tendency for metastasis is high. In some cases, the decision about which structures to resect is difficult. These cases are often accompanied by poor oncological and surgical outcomes. Management of cases should be done by a multidisciplinary team in advanced centers specialized in this field. The surgical team must have sufficient knowledge and experience in the field of limb-sparing surgery. Preoperative evaluation and especially good planning of bone and soft tissue reconstruction are vital.
Pain management in chronic pancreatitis
Authors: Nag Deb Sanjay , Swain Bhanu Pratap , Anand Rishi , Barman Tapas Kumar , Vatsala
Published: April 2024

Pain in chronic pancreatitis (CP) is difficult to manage. Many patients suffer from inadequate pain relief, completely incapacitating them in their daily activities. Historically, despite their well-known adverse effects, opioids have been the pillar of treatment regimens in painful CP. The management is now gradually evolving with a better understanding of the underlying pathophysiology of CP-related pain. Clinicians should follow a holistic approach to the management of CP-associated pain, which must involve lifestyle changes that are coupled with analgesic medications and other pain-relieving interventions. Furthermore, there is no easy cure for vanquishing CP-associated pain. Each patient must be evaluated on a case-by-case basis by a multidisciplinary team to decide which treatment option is best suited for that individual.