bluuebunny/crossref_metadata_2025 huggingface dataset:
The modern Russian pharmaceutical market: consumer attitudes towards distance retailing of medicines
Authors: Lobuteva Liudmila , Lobuteva Alisa , Zakharova Oksana , Kartashova Oxana , Kocheva Natalia
Published: April 2022

Background

In Russia, remote retail trade of over-the-counter (OTC) medicines was legalised. According to statistics as of April 2020, consumer demand in the categories of “online pharmacies” increased by 803%.

Methods

The study was conducted in two stages by cross-sectional method using a structured questionnaire in the central region of Russia: 1st stage - July-August 2020; 2nd stage - February-March 2021. The results of the study were obtained using qualitative (method of discussions in focus groups) and quantitative methods (survey) of sociological research, logical and statistical analysis. The representativeness of the data was ensured by a sufficient sample size including 1194 consumers (with confidence probability = 0.95 and confidence interval ≤ 0.05).

Results

The number of respondents fully supporting the legalisation of online trade in medicines increased. Consumer attitudes towards online commerce depend on the age group of the respondents. 1.5 times more respondents over 46 years (12.1%) are strongly against distance selling of medicines compared to survey participants aged 18 to 25 years (7.8%). Six months after the first survey, no respondent strongly opposed the sale of prescription medicines through the internet, whereas in the first survey half of consumers held this view. The percentage of respondents who considered pharmaceutical counselling when purchasing medicines online as extremely important decreased by a factor of 4 over time (10.9%) M (08.2020) = 3.66 (0.992); M (03. 2021) = 3.17 (0.981) t = 7.66 (p < 0.05). Consumers consider accessibility for people with disabilities (80.3%) to be the most significant advantage of distance selling medicines.

Conclusion

Consumer demand for the purchase of medicines online will grow as this type of sale has undeniable advantages. However, some risks remain when buying medicines online.
Pulmonary sclerosing pneumocytoma: clinical features and prognosis
Authors: Zheng Quan , Zhou Jian , Li Guangchen , Man Shulei , Lin Zhangyu , Wang Tengyong , Chen Boran , Lin Feng
Published: April 2022

Background

Pulmonary sclerosing pneumocytoma is a kind of rare benign pulmonary tumor with potential malignancy. The clinical features, risk factors for prognosis, and optimal treatment have not been identified yet. This study aimed to investigate the clinical features and prognosis of pulmonary sclerosing pneumocytoma.

Methods

We retrospectively performed a review of pulmonary sclerosing pneumocytoma patients in West China Hospital from 2009 to 2019. The basic characteristics, treatment regimens, operation detail, postoperative variables, and follow-up time were recorded for each case. Differences in features between patients undergoing lobectomy and segmentectomy were compared. We also performed a case review and summarized reported clinical features in former studies.

Results

Altogether 61 pulmonary sclerosing pneumocytoma patients were retrospectively reviewed. Fifty-six patients were female and 5 were male. The patients’ median age was 51 (23-73). Seven (11.48%) patients had smoking history. Twenty tumors were located in the right lung [upper lobe (n = 7), middle (n = 2), and lower (n = 11)] and 41 in the left [upper (n = 12) and lower (n = 29)]. The median tumor size was 2 (0.9-7) cm. Thirty-six (59.02%) patients underwent sublobectomy (segmentectomy or wedge resection) whereas 25 (40.98%) underwent lobectomy. All patients recovered uneventfully, and no perioperative mortality was identified. Sublobectomy showed a trend towards reduced chest tube duration and shorter postoperative hospital stays compared with lobectomy.

Conclusions

The findings showed good prognosis of pulmonary sclerosing pneumocytoma and proved its benign characteristics. Sublobectomy showed advanced efficacy regarding chest tube duration and postoperative hospital stay compared with lobectomy.
Using affected embryos to establish linkage phase in preimplantation genetic testing for thalassemia
Authors: Ou Zhanhui , Deng Yu , Liang Yunhao , Chen Zhiheng , Sun Ling
Published: April 2022

Background

This study aimed to evaluate the ability of next-generation sequencing (NGS) to conduct preimplantation genetic testing (PGT) for thalassemia using affected embryos.

Methods

This study included data from 36 couples who underwent PGT for thalassemia without probands and relative pedigrees. NGS results were compared with prenatal diagnosis results.

Results

Thirty-six couples (29 α-thalassemia and 7 β-thalassemia) underwent 41 PGT cycles (31 α-thalassemia and 10 β-thalassemia). Analysis using NGS produced conclusive results for all biopsied blastocysts (100%, 217/217). One hundred and sixty (73.7%, 160/217) were unaffected by thalassemia. Preimplantation genetic testing for aneuploidy revealed that 112 (70.0%, 112/160) were euploid. Single blastocysts were transferred into the uteri of 34 women (53 frozen embryo transfer [FET] cycles). Thirty-two cycles resulted in clinical pregnancies, with a clinical pregnancy rate of 60.1% (32/53) per FET cycle. Twenty-two cycles (22 couples) resulted in 23 live births, with a live birth rate of 43.4% (23/53; 3 cycles were ongoing pregnancies). All 25 embryos’ prenatal diagnosis results and/or thalassemia gene analyses after delivery were concordant with the NGS-PGT results. Seven embryos (21.9%, 7/32) were miscarried before 12 weeks’ gestation, and the abortion villus in four showed a normal karyotype and thalassemia results consistent with the NGS-PGT results. Aborted fetus samples from 3 cycles were not available because the pregnancy lasted less than 5 weeks.

Conclusion

NGS can be used to conduct PGT for thalassemia using affected embryos as a reference.

Trial registration

Retrospectively registered.
Improvement of 1,3-propanediol production from crude glycerol by co-cultivation of anaerobic and facultative microbes under non-strictly anaerobic conditions
Authors: Sun Yaqin , Liang Lingyun , Zheng Yafeng , Han Jindong , Xiu Zhilong
Published: April 2022

Background

Natural microbial consortia could efficiently produce 1,3-propanediol (1,3-PDO), a most promising bulk biochemical derived from glycerol that can be used as a monomer in the synthesis of polytrimethylene terephthalate (PTT). While natural microbial communities are made up of a diverse range of microbes with frequently unknown functions, the construction of synthetic microbial consortia allows for the creation of more defined systems with lower complexity.

Results

In this study, the synthetic microbial consortia were constructed by combining facultative microbes of Klebsiella pneumoniae DUT2 (KP) and/or Escherichia coli DUT3 (EC) cultures with the strictly anaerobic microbe of Clostridium butyricum DUT1 (CB) cultures under micro-aerobic conditions. The function of EC and KP during the fermentation process was to deplete oxygen and create an anaerobic environment for CB. Furthermore, KP competes with CB for the consumption of crude glycerol and the production of 1,3-PDO. The interaction of commensalism and competition resulted in the construction of synthetic microbial consortia capable of efficiently converting crude glycerol to 1,3-PDO even under micro-aerobic conditions. In a batch fermentation, the synthetic CB:KP co-culture at an initial abundance ratio of 92.5:7.5, yielded a maximum 1,3-PDO concentration of 52.08 g/L, with a yield of 0.49 g/g and a productivity of 1.80 g/(L.h), which increased by 10%, 9%, and 12%, respectively, when compared to the CB mono-culture under strictly anaerobic conditions. The final 1,3-PDO concentration, yield, and productivity by the synthetic CB:KP consortia increased by 16%, 19%, and 84%, respectively, when compared to the KP mono-culture. At an initial abundance ratio of 85:7.5:7.5, the synthetic CB:KP:EC co-culture achieved the highest 1,3-PDO flux of 49.17%, while 7.43%, 5.77%, 3.15% 4.24%, and 2.13% of flux was distributed to butyric acid, acetic acid, lactic acid, ethanol, and succinic acid pathways. In a fed-batch fermentation, the synthetic CB:KP:EC co-culture demonstrated a maximum 1,3-PDO concentration of 77.68 g/L with a yield of 0.51 g/g which is 30% and 13% higher than the production by the CB mono-culture at 0.02 vvm (nitrogen volume/culture volume/min) N2 supply. The initial abundance of CB, which is guaranteed to be at least 85%, enables efficient 1,3-PDO production from crude glycerol via the development of synthetic microbial consortia.

Conclusion

The synthetic microbial consortia demonstrated excellent performance on 1,3-propanediol production under micro-aerobic conditions through the interaction of commensalism and competition. The experimental results demonstrated the potential benefit of using synthetic microbial consortia to produce 1,3-propanediol from crude glycerol.
Utility of biomarkers in predicting complications and in-hospital mortality in patients with COVID-19
Authors: Ali Noman , Kapadia Nazir Najeeb , Aymen Dure , Baig Noor
Published: April 2022

Objectives: To determine the association between the laboratory biomarkers (C-reactive protein (CRP), Ferritin, lactate dehydrogenase (LDH), Procalcitonin, and D-dimer) with complications and in-hospital mortality in COVID-19 patients.

Methods: This single-center, cross-sectional study was conducted at the Department of Emergency Medicine of Aga Khan University Hospital from April 01, 2020, to July 31, 2020. Descriptive statistics were presented as Mean±SD and Median along with Range. The frequencies and percentages were calculated for all categorical variables. Univariate and multivariate analysis was carried out to evaluate the significant association between the laboratory biomarkers and in-hospital mortality.

Results: A total of 310 adult COVID positive patients were included. The most common complication was acute respiratory distress syndrome (ARDS) (37.1%), followed by myocardial injury (MI) (10.7%), deep vein thrombosis (DVT) (0.6%), and pulmonary embolism (PE) (0.3%). In-hospital mortality was 15.2%. In univariate analysis, it was observed that increased values of all biomarkers were significantly associated with the prediction of in-hospital mortality using binary logistic regression analysis (OR > 1.0, P <0.05). In multivariate analysis, increased levels of LDH and D-dimer at admission were significantly associated with increased odds of mortality (P <0.05).

Conclusion: Serum CRP, ferritin, Procalcitonin, LDH, and D-dimer levels at the time of admission can predict complications like ARDS and MI and also predict mortality in COVID-19 infection. Serum LDH and D-dimer are the best amongst them for predicting mortality.

doi: https://doi.org/10.12669/pjms.38.5.5165

How to cite this:Ali N, Kapadia NN, Aymen D, Baig N. Utility of biomarkers in predicting complications and inhospital mortality in patients with COVID-19. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.5165

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.
Burden of Congenital and Hereditary Anomalies in Hazara Population of Khyber Pakhtunkhwa, Pakistan
Authors: Bibi Anisa , Naqvi Syeda Farwa , Syed Amman , Zainab Shah , Sohail Khadija , Malik Sajid
Published: April 2022

Background and Objectives: In Pakistan, there is high incidence of congenital and hereditary anomalies (CA) which are a leading cause of infant mortality and morbidity. In order to elucidate the burden and biodemographic correlates of CA, this study was aimed to report the prevalence-pattern and phenotypic attributes of CA in the Hazara population of Khyber Pakhtunkhwa, Pakistan.

Methods: In a retrospective cross-sectional study, subjects/families with CA were recruited from district hospitals and community centers. Phenotypic and descriptive data were obtained; pedigrees were analyzed and parental and biodemographic attributes were recorded.

Results: A total of 1,189 independent subjects and/or families with CA were ascertained. The malformations were grouped into nine major and 95 minor categories. Neurological disorder had the highest representation (n=486; proportion=0.409; 95% CI=0.381-0.437), followed by limb defects (n=292; proportion=0.246, 95% CI=0.221-0.270), musculoskeletal defects, sensorineural/ear defects, blood disorders, eye/visual impairments, ectodermal anomalies, and congenital heart defects. In this cohort, sporadic cases were 65% and familial 35%. Parental consanguinity was significantly higher in isolated cases compared to syndromic, and in familial cases compared to sporadic. Further, speech apraxia and epilepsy were most common associations among the syndromic cases. The assessment of variables like demography, parental consanguinity, familial/sporadic nature, and pedigree structures showed conspicuous heterogeneity among the major and minor categories of CA.

Conclusions: The trend of CA and high incidence of sporadic cases observed in this cohort indicate that nongenetic factors may play a significant role in their etiology which could be minimized by improving the healthcare system.

doi: https://doi.org/10.12669/pjms.38.5.5486

How to cite this:Bibi A, Naqvi SF, Syed A, Zainab S, Sohail K, Malik S. Burden of Congenital and Hereditary Anomalies in Hazara Population of Khyber Pakhtunkhwa, Pakistan. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.5486

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.
Formation of preparedness for professional activity by ICT means
Authors: Senkivska L.
Published: April 2022

The article considers the current state of the problem of forming the readiness of future professionals for professional activities by ICT. The author proved that the training of future specialists in pedagogical specialties in the application of ICT requires a slightly different view of this complex creative process, which requires constant dynamic updating and application of the most effective and diverse methods of higher education.
The role of digital technologies in education
Authors: Senkivska L.
Published: April 2022

The article analyzes the role of digital technologies in the educational process. It is determined that digital technologies allow to focus the educational process not only on meeting the requirements of professional and educational standards, but on the formation of professional culture of the future specialist, the desire for continuous self-improvement through information services and technologies.
Securing the API economy
Authors: Spencer Travis
Published: April 2022

Application programming interfaces (APIs) are an example of technological advances that continue to play a vital role in our digital experience. But while APIs present ample opportunity for growth, managing user data creates an increased responsibility to ensure the safety of API-enabled transactions, and data breaches aren't made easier by the presence of APIs in an app's software architecture.
Is a staged reloading protocol effective to time the removal of circular frames?
Authors: Sadekar Vilas , Watts Arun T. , Moulder Elizabeth , Souroullas Panayiotis , Hadland Yvonne , Barron Elizabeth , Muir Ross , Sharma Hemant K.
Published: April 2022

Aims

The timing of when to remove a circular frame is crucial; early removal results in refracture or deformity, while late removal increases the patient morbidity and delay in return to work. This study was designed to assess the effectiveness of a staged reloading protocol. We report the incidence of mechanical failure following both single-stage and two stage reloading protocols and analyze the associated risk factors.

Methods

We identified consecutive patients from our departmental database. Both trauma and elective cases were included, of all ages, frame types, and pathologies who underwent circular frame treatment. Our protocol is either a single-stage or two-stage process implemented by defunctioning the frame, in order to progressively increase the weightbearing load through the bone, and promote full loading prior to frame removal. Before progression, through the process we monitor patients for any increase in pain and assess radiographs for deformity or refracture.

Results

There were 244 frames (230 patients) included in the analyses, of which 90 were Ilizarov type frames and 154 were hexapods. There were 149 frames which underwent single-stage reloading and 95 frames which underwent a two-stage reloading protocol. Mechanical failure occurred after frame removal in 13 frames (5%), which suffered refracture. There were no cases of change in alignment. There was no difference between refracture patients who underwent single-stage or two-stage reloading protocols (p = 0.772). In all, 14 patients had failure prevented through identification with the reloading protocol.

Conclusion

Our reloading protocol is a simple and effective way to confirm the timing of frame removal and minimize the rate of mechanical failure. Similar failure rates occurred between patients undergoing single-stage and two-stage reloading protocols. If the surgeon is confident with clinical and radiological assessment, it may be possible to progress directly to stage two and decrease frame time and patient morbidity. Cite this article: Bone Jt Open 2022;3(5):359–366.
Giant celiac artery aneurysm – a rare experience
Authors: Mulpuri V B , Gupta V , Kumarasamy S , Gupta P
Published: April 2022

Giant celiac artery aneurysm is a rare entity. We describe a case of a 45-year-old male with chronic kidney disease who presented with abdominal pain for the past 6 months. CT showed a celiac artery aneurysm of size 6×6.2cm involving the common hepatic artery and compressing the portal vein posteriorly. During the procedure the supra celiac aorta was exposed, and the neck of the aneurysm was identified. After taking control of branches of the celiac and common hepatic arteries, the neck of the aneurysm was clamped and divided. In view of diminished flow in the hepatic arteries aorto hepatic bypass was done using PTFE graft from supra celiac aorta to right hepatic artery; as there was retrograde flow from the left hepatic artery it was ligated. Post operatively the patient's liver functions were normal, and he was followed up by Doppler sonography which detected good flow in the hepatic artery distal to anastomosis. Celiac artery aneurysms are rare, and management options vary from the endovascular to surgery; regardless of the approach used, revascularisation is needed if there is no adequate collateral flow.
The persistent challenges faced by vascular surgery services during the UK coronavirus pandemic: a snapshot qualitative survey
Authors: Nandhra S , Benson RA ,   The Vascular and Endovascular Research Network (VERN) COVER Study Collaborative
Published: April 2022

Introduction

The coronavirus (COVID-19) pandemic continues to affect the NHS. The Vascular and Endovascular Research Network (VERN) COvid Vascular sERvice (COVER) study has prospectively shown the significant global impact of the COVID-19 pandemic on vascular surgery. The aim of this study is to investigate the way in which this second wave has affected surgeons’ ability to treat patients with urgent vascular conditions, using contemporaneous snapshot data from 30 UK vascular centres.

Methods

This is a contemporary (18–28 January 2021) re-run of the Tier 1 COVER survey. This used closed and open questions, related to centres’ provision of common vascular services, threshold for treatment, imaging, screening, staff and theatre availability, multidisciplinary team input, clinics, personal protective equipment, vaccination policies and case-backlogs. The survey was disseminated to clinicians via email. A service reduction score was calculated.

Results

Forty-two complete responses were received from 30 vascular centres (England, Northern Ireland, Scotland and Wales). Overall, 56.7% of units are performing only urgent procedures. The threshold for abdominal aortic aneurysm (AAA) repair has increased in the majority of UK centres (60%). One in six AAA screening programmes have stopped all screening activity: 30% having a significantly reduced programme and only half running as normal. Waiting lists are increasing for AAA, lower limb revascularisation and venous disease.

Conclusion

Overall, these data suggest that vascular care in the NHS is facing unprecedented pressures due to COVID-19. Vascular stakeholders will have to urgently address these issues in the coming months.

Study registration number

ISRCTN 80453162 (registered prospectively).
Synchronous mucosal and intraosseous oral cavity carcinomas: a case of rare occult second primary malignancy
Authors: Uddin M , Lim LC , Goodall A , Padaki P , Anjum K
Published: April 2022

Secondary primary malignancies within the head and neck region are well documented. Within this group, synchronous tumours with an index oral cancer are usually found in the oropharyngeal or laryngeal sites. We present a rare case of an index squamous cell carcinoma in the tongue with a synchronous primary intraosseous squamous cell carcinoma. We discuss the challenges associated with investigation, diagnosis and subsequent management. Treatment aims remain the same; namely, eradicating the disease using surgery, radiotherapy, chemotherapy or a combination of these modalities. It is important to acknowledge the unpredictable pattern of tumour presentation and the need to maintain a high index of suspicion.
Radiolucent foreign bodies presenting as inflammatory bowel disease: the case of an ingested plastic straw disguising as Crohn’s
Authors: Wadham B , Connolly T , Ledda V , Satchidanand RY
Published: April 2022

More than 80% of ingested foreign bodies are thought to pass spontaneously in the faeces, with fewer than 1% requiring surgical intervention. ‘Missed’ gastrointestinal foreign bodies are rare and often due to the lack of an obtainable history in patients with communication difficulties or radiolucent foreign bodies. We present the rare case of a 27-year-old woman with severe learning difficulties and a complex surgical history who presented with a 2-year history of increasing abdominal discomfort due to a ‘missed’ foreign body. Initially diagnosed as Crohn’s disease, this case highlights the value of oral contrast enhancement imaging in patients who do not fit a ‘classical’ inflammatory bowel disease presentation.
Outcomes of emergency laparoscopy in the elderly
Authors: Mercer SJ , Body S , Carter NC , Van Boxel GI , Knight BC
Published: April 2022

Introduction

This paper assessed the association between operative approach and postoperative in-hospital mortality in elderly patients undergoing emergency abdominal surgery. Patients undergoing emergency laparotomy have high morbidity and mortality rates. One-third of patients requiring emergency surgery are over 75 years old, and their in-hospital mortality rate exceeds 17%. Fewer than 20% of emergency abdominal operations in the UK are attempted laparoscopically, and only 10% are completed laparoscopically. Little is known about how laparoscopic emergency surgery in the elderly might affect outcomes.

Methods

An observational UK study was performed using the prospectively maintained National Emergency Laparotomy Audit (NELA) database. Operative approach, NELA risk-prediction score and in-hospital mortality were recorded. The effect of operative approach on in-hospital mortality was analysed, both on a national basis and in a high-volume laparoscopic centre.

Results

A total of 47,667 patients were included in the study, of whom 15,068 were over 75 years of age. Nationally, surgery was completed by the laparoscopic approach in 7.8% of patients aged over 75; both crude mortality (9.2%) and risk-adjusted mortality (7.1%) were significantly reduced (p<0.0001). In our unit, surgery was completed laparoscopically in 48.4% of patients aged over 75; both crude mortality (6.6%) and risk-adjusted mortality (3.3%) were significantly reduced (p<0.0001).

Conclusion

Laparoscopy in emergency surgery has been shown in this study to significantly reduce in-hospital mortality in elderly patients and should be embraced in every centre dealing with emergency abdominal surgery.
Development and evaluation of an objective laparoscopic assessment tool: LapPass®
Authors: Fong ML , Leeder P , Dexter S , Menzies D , Sedman P , Francis N
Published: April 2022

Introduction

Laparoscopic surgery is technically challenging and assessment of competency is necessary to ensure patient safety and guide training. We report on the development of LapPass®, an accessible objective simulation assessment tool with credentialing potential. We provide a preliminary evaluation of its usability and aspects of validity.

Methods

The domains of LapPass® were defined through a consensus process by the executive council of the Association of Laparoscopic Surgeons of Great Britain and Ireland (ALSGBI). A survey of both assessors and trainees was used to test for usability, face and content validity of LapPass®. Internal consistency was tested with Cronbach’s alpha, and a composite marker of validity and usability was obtained.

Results

LapPass® was developed to consist of four tasks: (1) grasping and manipulation, (2) simulated appendicectomy, (3) cutting a disk and (4) intracorporeal suturing. A total of 76 participants contributed to the evaluation of LapPass®: 13 assessors and 63 trainees. For assessors, Cronbach’s alpha for usability of tasks 1–4 was 0.84, 0.84, 0.76 and 0.86, whereas validity was 0.80, 0.85, 0.88, 0.95, respectively. For trainees, Cronbach’s alpha was 0.75, 0.77, 0.80 and 0.85 for usability, and 0.79, 093, 0.87 and 0.91 for validity. Consensus was that each task was usable and had face and content validity, with median scores of 4.0 or higher (interquartile range 0.0–1.0).

Conclusion

LapPass® has potential for the objective assessment of basic laparoscopic skills but further research is required to explore its predictive capabilities in a clinical setting.
Which lesions with a radiological or core biopsy diagnosis of fibroadenoma should be excised?
Authors: Lee AHS , James J , Whisker L , Rakha EA , Ellis IO
Published: April 2022

Introduction

A recent Association of Breast Surgery summary statement on fibroadenoma management recommends excision only for cellular fibroepithelial lesions and rapidly growing lesions with a core biopsy diagnosis of fibroadenoma; persistent pain is a relative indication for excision.

Methods

This retrospective study looked at the impact this approach would have on the diagnosis of phyllodes tumours.

Results

From 2014 to 2018, there were 1,058 core biopsy diagnoses of fibroadenoma; 112 lesions were excised, of which 98 were fibroadenomas, 4 were hamartomas and 10 were phyllodes tumours. In this group, an excision diagnosis of phyllodes tumour was associated with size more than 40 mm, age more than 40 years and radiological suspicion of phyllodes tumour or carcinoma. One hundred and sixty-six excised fibroepithelial lesions with no previous core biopsy included eight phyllodes tumours; in this group, rapid growth was associated with phyllodes tumour diagnosis. Twelve of the 26 fibroepithelial lesions classified as B3 (cellular fibroepithelial lesion or phyllodes tumour) were diagnosed as phyllodes tumours on excision. Using a combination of radiological, clinical and pathological features it was possible to create an excision policy that would recommend excision of 22 of the 31 phyllodes tumours in this period. Eight of the nine ‘missed’ phyllodes tumours were benign.

Conclusion

The Association of Breast Surgery summary statement will reduce the number of fibroadenomas excised, but may also result in delayed diagnosis of some phyllodes tumours. Appropriate safety netting advice should be provided to identify rapidly growing lesions.
Metachronous isolated inferior vena cava tumour thrombus in renal cell cancer: a rare aftermath
Authors: Kumar S , Akif S , Parmar K , Singh P , Thummala Y , Panda I , Gupta K
Published: April 2022

Renal cell cancer (RCC) accounts for 3% of all solid malignancies. Synchronous tumour thrombus in the renal vein or inferior vena cava is reported in 4–10% cases and is a surgical challenge. Contemporary imaging modalities that are used to define the presence and extent of venous thrombus include colour Doppler, contrast-enhanced computed tomography and magnetic resonance venography. Surgical management depends upon the degree of tumour thrombus. We report isolated recurrence of RCC in the inferior vena cava 2 years after radical nephrectomy, and discuss its pathophysiology and management.
Solitary jejunal diverticulum: a rare unexpected cause of chronic pneumoperitoneum
Authors: Fouad M , Appleton B , Young T
Published: April 2022

Jejunal diverticula are a rare acquired herniation of the mucosa and submucosa through the muscularis propria. They are asymptomatic in the majority of cases; however, they can present with non-specific abdominal symptoms and rarely complicate leading to acute abdomen. Perforation usually results in symptoms and signs of acute peritonitis and it is not an identifiable aetiology of chronic pneumoperitoneum. Computed tomography scanning may identify intestinal wall oedema, air bubbles travelling through the mesentery, free intra-abdominal air and/or fluid. Radiological diagnosis requires a high index of suspicion of such pathology. We report a case of an isolated jejunal diverticulum as a cause for aseptic chronic pneumoperitoneum.
CORESS Feedback: Cases from the Confidential Reporting System for Surgery
Authors: Smith F CT
Published: April 2022

CORESS is an independent charity, supported by the AXA Health, the MDU and the WPA Benevolent Foundation

We are grateful to those who have provided the material for these reports. The online reporting form is available on the website ( www.coress.org.uk ), which also includes previous Feedback reports. Published cases will be acknowledged by a Certificate of Contribution, which may be included in the contributor’s record of continuing professional development or may form part of appraisal or annual review of competence progression (ARCP) portfolio documentation. Trainee contributions are particularly welcome.
Vladimiro Caposso e a distopia pós-revolucionária: considerações sobre o romance Predadores, de Pepetela
Authors: Dias Mariana Sousa
Published: April 2022

São recorrentes, na contemporaneidade, debates voltados aos rumos sociopolíticos e identitários em espaços outrora coloniais, principalmente quando pensamos nações referenciadas por processos tardios de independência. Diante da vasta abrangência de campos como os estudos culturais e o pós-colonialismo, interessa-nos pesquisar, em especial a oposição entre o homem novo angolano, idealizado durante as lutas de libertação, frente à ascensão do novo homem angolano, forjado a partir de valores capitalistas, no romance “Predadores”, de 2005. Os tensionamentos delineados pela conjugação utopia-distopia, ou seja, homem novo-novo homem, traduzem, em boa medida, não somente as problemáticas enfrentadas por Angola na atualidade, mas o elemento central da atuação literária de Pepetela: a busca por identificações a serem pensadas a partir das falhas que marcam os dois modelos subjetivos – bem como as interpretações e adaptações realizadas a partir de tais perfis. A trajetória de “aperfeiçoamento” da personagem até a total amoralidade torna-se uma síntese para a desconstrução das utopias, da revolução e, em especial, da nação projetada. Ironicamente, de acordo com lógica mercadológica, temos em Vladimiro uma figura de aparente sucesso, visto que conseguiu adaptar-se totalmente à lei do mais forte, segundo os paradigmas neoliberais. Sua derrocada, entretanto, ocorre justamente devido às crises inerentes ao sistema que o colocou no topo dos jogos de corrupção e de apropriação dos bens públicos pelo poder privado. Para estudarmos a obra, recorreremos em especial a Fanon (1979, 2008), Frade (2007) e Mudimbe (2012).
Entre a literatura e a música: A tradução intersemiótica de Johnny vai à guerra pela banda Metallica
Authors: Gonçalves Davi , Perek Luiz Eduardo
Published: April 2022

O presente artigo tem como objetivo analisar o livro Johnny vai à guerra, escrito por Dalton Trumbo, e suas relações com a letra da música “One” da banda Metallica. Nele, exploramos a trajetória vivenciada pelo personagem ficcional Joe, ex-combatente da Segunda Guerra Mundial, que sofreu graves consequências decorrentes do campo de batalha. Mais amplamente, o trabalho se debruça sobre os impactos que a guerra pode causar na vida de milhões de jovens, investigando as críticas realizadas no romance e na música em relação ao horror da guerra. Partindo de conceitos ligados ao estresse pós-traumático, indefinição entre sonho e realidade e estabelecendo paralelos teóricos entre o Discurso do método, de René Descartes, e a tradução intersemiótica com base nas contribuições de Julio Plaza, investigamos algumas particularidades da obra de partida – o livro – e da obra de chegada – a música. Em nossos achados concluímos que a música da banda Metallica opera como uma continuação da história escrita por Trumbo: uma contribuição para seu enriquecimento. Além disso, e já que a análise trata de mídias distintas, torna-se evidente que cada uma dessas formas de registro compreende diferentes questões e diferentes nuances, as quais somente podem ser comparadas e contrastadas se seus atributos específicos forem levados em consideração.
Apresentação - Dias inertes, noites (in)sones, melodias ao amanhecer
Authors: Evangelista Neto João , Barberena Ricardo
Published: April 2022

Apresentação - Dias inertes, noites (in)sones, melodias ao amanhecer
May 2022 Imaging Case of the Month: Asymmetric Apical Opacity–Diagnostic Considerations
Authors:   Mayo Clinic Arizona, Scottsdale, AZ USA, Gotway Michael
Published: April 2022

No abstract available. Article truncated after 150 words. Clinical History: A 64–year–old woman presented to the emergency room with complaints of right arm pain for 2 months accompanied by subjective low-grade intermittent fevers. The patient’s past medical history was unremarkable and she had never had surgery. She had been a smoker for most of her life, at least 25-pack-years. She denied allergies, admitted to moderate daily alcohol use, and denied illicit drug use. The patient’s physical examination showed no clear focal abnormalities and she was afebrile. She did have some right scapular tenderness to palpation, although there were no abnormal skin changes over this region. Her pulse rate and blood pressure were within normal limits, and her room air oxygen saturation was 96%. Basic laboratory data, including a complete blood count and electrolytes were largely within the normal range. The patient’s white blood cell count was technically abnormal at 9.7 x109 (normal, 3.4 - 9.6 x …
Scholarly publication, open access and the commons
Authors: Ballantyne Neil
Published: April 2022

The article argues that social work academics, especially critical and radical social work academics, ought to contribute to alternative, open and more collective approaches to academic publication. The prevailing problematic of price gouging, that is, for-profit publishers enclosing scholarly articles behind paywalls, is discussed, along with mainstream liberal responses in the form of open access initiatives that aim to reorient the business models of for-profit publishers towards payment for publication. Mainstream approaches analyse the problem of achieving open access as one of oligopoly and market failure. Other more critical perspectives are introduced, along with the notion of the commons as a site of struggle within higher education. A brief case study of a collective, community-driven approach to transitioning the Aotearoa New Zealand Social Work journal to open access is offered, before concluding with an assessment of open access as just one part of a wider platform of anti-capitalist struggle within higher education.
Sacred precincts in the Neolithic of the Near East?
Authors: Cartolano Mattia
Published: April 2022

The interpretations of unusual or special archaeological contexts in the Near Eastern Neolithic that might suggest the appearance of the first forms of religious belief in early sedentary communities have commonly been associated with magic practices or other concepts related to ritual performance or symbolism. The present work proposes alternative perspectives that focus on the term “sacred” as outlined by three renowned anthropologists: Girard, Durkheim and Eliade. This paper also discusses interpretative views on the development of symbolic and ritual forms in early Holocene societies in the Near East. It is argued that the sacred in the Neolithic is an externally manifested prosocial reality that is gradually adopted via mimetic practices. A number of Neolithic archaeological examples will be presented and analysed in light of mimetic theory and other key anthropological concepts. 
How to Create “Administrative” Iconographies? The Bestiary of the Sasanian Glyptic
Authors: Poinsot Delphine
Published: April 2022

This study focuses on the bestiary of Iran in late antiquity, in an administrative context of sealing (seals and bullae) and within an administration characterized by a close relationship with the Zoroastrian Church. Its objective is to understand how man's interrelationship with his environment enters into the production of images of an administrative nature. This study therefore compares the bestiary as represented in the glyptic, what we know about fauna in the Sasanian period and human-animal relations, and what we know about Iran's beliefs in late antiquity, particularly through Zoroastrian texts. This confrontation makes it possible to determine what, in iconography, is or is not related to man's relationship with his natural environment. From there, we try to understand the semantic value attached to this relationship, or whether it is to be sought outside this relationship. It appears that the level of human interaction with animals is inversely proportional to the use of the animal as a bestiary's image: the closer an animal is to humans (domestication, breeding), the less visible it is in the seals. In this context, we see an over-representation of wildlife. However, a low level of interaction does not prevent the creation of images that reflect the observation and knowledge of wildlife and domestic fauna during the Sasanian period. Since the images of the bestiary are used in an administrative context, the animals selected belong mainly to the semantic field of royalty and Zoroastrianism, even if they probably do not have a single interpretation. Sometimes these semantic fields are in contradiction, and we find, in the reality of fauna, elements that adapt one to the other.
Writing and Social Diversity in Late Bronze Age Ugarit
Authors: Boyes Philip
Published: April 2022

Writing at Ugarit has received a great deal of scholarly attention for the wide range of languages and writing systems used, and especially for the city’s distinctive alphabetic cuneiform script which accounts for around half of the inscribed material from the site. The vast majority of the rest is in the Akkadian language and logo-syllabic cuneiform script. This written material is, justifiably, usually seen as scribal, in that the vast majority stems from the state bureaucracy and from professional writers formally trained in a curriculum derived from the Mesopotamian cuneiform tradition. However, by using the blanket term ‘scribe’ we risk obscuring potential diversity in who used writing and why. This paper will explore the extent to which we can identify social diversity within writing practices at Ugarit and will focus in particular on three main areas: gender and women’s literacy; social mobility and writing outside the traditional literate establishment; and the relationship between writing and possible minority communities within Ugaritian society.
Immunogenetics of primary hyperaldosteronism: fundamental studies and their clinical prospects
Authors: Eristavi S. K. , Platonova N. M. , Troshina E. A.
Published: April 2022

Primary hyperaldosteronism (PHA) is the most common form of endocrine hypertension. Until recently, the reason for the development of this condition was believed to be the presence of genetic mutations, however, many studies declare that the disease can be polyetiologic, be the result of genetic mutations and autoimmune triggers or cell clusters of aldosterone-producing cells diffusely located in the adrenal gland at the zona glonerulosa, zona fasculata, zona reticularis, as well as directly under the adrenal capsule. Recently, the actions of autoantibodies to type 1 angiotensin II receptors have been described in patients with renal transplant rejection, with preeclampsia, and with primary hyperaldosteronism. The diagnostic role of antibodies in both forms of PHA (aldosterone-producing adenoma and bilateral hyperaldosteronism) requires clarification. Diagnosis and confirmation of the focus of aldosterone hypersecretion is a multi-stage procedure that requires a long time and economic costs. The relevance of timely diagnosis of primary hyperaldosteronism is to reduce medical and social losses. This work summarizes the knowledge about genetic mutations and presents all the original studies devoted to autoantibodies in PHA, as well as discusses the diagnostic capabilities and limitations of the available methods of primary and differential diagnosis of the disease and the prospects for therapy.
The daily dose of testosterone-replacement therapy dependence from the body mass index in FtM transgender PATIENTS
Authors: Sergeeva L. Y. , Babenko A. Yu.
Published: April 2022

BACKGROUND: The basis for the management of transgender patients is the use of various hormonal correction schemes necessary for changing the hormonal sex and, possibly, further preparation for surgical correction. Currently, the choice of the starting dose and the scheme is carried out empirically, which lengthens the period of selection of therapy and increases the risk of its complications. Taking into account the individual characteristics of the patient can help in optimizing therapy.

AIM: Investigate Factors Affecting the Daily Demand for Testosterone Ester Blends in Transgender Men

MATERIALS AND METHODS: This study is a case-control observational study. Patients included prior to initiation of testosterone replacement therapy. The analysis of factors interrelated with the daily requirement of testosterone preparations was carried out. Among the factors of interest, the body mass index (BMI), the results of blood tests for total testosterone and the functional state of the liver and kidneys are considered. Testosterone replacement therapy (TRT) regimens were evaluated in transgender men. For the calculation, we used the formulas for BMI and the average daily dose of testosterone. Based on the data obtained, conclusions were drawn that allow determining the necessary TRT scheme in different trans-gender men at an early stage of hormonal correction.

RESULTS: Our study included 58 transgender FtM patients who were prescribed testosterone preparations with an identical composition. We found a positive correlation between BMI and testosterone dose in patients of group II (p = 0.04).

CONCLUSION: In the conclusion, the obtained schemes of hormonal sex reassignment with a minimum risk of possible complications are presented. Our results demonstrated a relationship between BMI in overweight and obese patients and the need for TRT. For patients with a BMI of 25 to 29 kg / m2, the interval between injections of a mixture of testosterone esters does not differ significantly from that in the group with a BMI below 25 kg / m2 and averages once every 18 days, and in the group with a BMI ≥ 30 kg / m2 tested testosterone ester preparations should be prescribed once every 2 weeks (14 days).
Dysglycemia in COVID-19 and Type 2 Diabetes Mellitus: Peculiarities of the Glycemic Profile in Hospitalized Patients and the Role of Steroid-Induced Disorders
Authors: Strongin L. G. , Nekrasova T. A. , Belikina D. V. , Korneva K. G. , Petrov A. V.
Published: April 2022

BACKGROUND: There is a lack of data on the features of dysglycemia in hospitalized patients with COVID-19 and concomitant diabetes mellitus (DM) confirmed by continuous glucose monitoring (CGM).

AIM: to study the glycemic profile in hospitalized patients with COVID-19 and type 2 diabetes mellitus by continuous glucose monitoring and the role of steroid therapy in dysglycemiadevelopment.

MATERIALS AND METHODS: We examined 21 patients with COVID-19 and DM 2 and 21 patients with DM 2 without COVID-19 (control group) using a professional 4–7-day CGM. We also compared two subgroups of patients with COVID-19 and DM 2: 1) patients received systemic glucocorticosteroids (GCS) during CGM and 2) patients in whomCGMwas performed after discontinuation of GCS.

RESULTS: Compared with controls, patients with COVID-19 and DM2 had lesser values of glycemic «time in range» (32.7 ± 20.40 vs 48.0 ± 15.60%, p = 0.026) andhigher parameters of mean glycemia (p <0.05) but similar proportion of patients with episodes of hypoglycemia (33.3% vs 38.1%, p = 0.75). Patients who received dexamethasone during CGM were characterized by higher hyperglycemia and the absence of episodes of hypoglycemia. In patients who hadCGM after dexamethasone discontinuation, hyperglycemia was less pronounced, but 60% of them had episodes of hypoglycemia, often nocturnal, clinically significant and not detected by routine methods.

CONCLUSION: Patients with COVID-19 and DM 2had severe and persistent hyperglycemia but a third of them hadalso episodes of hypoglycemia. During therapy with dexamethasone, they had the most pronounced hyperglycemia without episodes of hypoglycemia. In patients who underwent CGM after discontinuation of dexamethasone, hyperglycemia was less pronounced but 60% of them have episodes of hypoglycemia, often nocturnal, clinically significant and not diagnosed by routine methods. It would be advisable to recommend at least a 5–6-fold study of the blood glucose level (with its obligatory assessment at night) even for stable patients with COVID-19 and DM 2after the end of GCS treatment.
Telomere pathology in ontogenesis in patients with Turner syndrome
Authors: Mikheev R. K. , Grigoryan O. R. , Pankratova M. S. , Andreeva E. N. , Sheremetyeva E. V. , Absatarova Yu. S. , Mokrysheva N. G.
Published: April 2022

According to present medical databases there many trials to provide in vivo researches in vivo to confirm/refute shortening process of telomeres among patients with Turner syndrome. Despite the successful clinical experience of providing such patients with Turner syndrome, a lot of omics (proteomic and metabolomic) aspects still stay unclear. Main disadvantages of most researches are small volume and minimized mathematical correlation with chronic disease (coronary heart disease, essential hypertension, cardiovascular malformations). Finally, organization of international prospective multi-centered researches in vivo including patients with mosaic cariotype and co-operation between physicians and biologists are optimal solutions for this present problem.