bluuebunny/crossref_metadata_2025 huggingface dataset:
In situ evaluation of European eel counts and length estimates accuracy from an acoustic camera (ARIS)
Authors: Lagarde Raphaël , Peyre Jason , Amilhat Elsa , Mercader Manon , Prellwitz François , Simon Gaël , Faliex Elisabeth
Published: November 2020

Despite the increasing use of acoustic cameras in fish ecology and fisheries studies, the quantification of biases associated with this method have received little attention. In this note, we used data collected from an ARIS acoustic camera, positioned in a channel linking a lagoon to the sea, to quantify differences in European eel (Anguilla anguilla) counts and size estimates made by two experienced operators. Count estimates made from 58 videos were highly consistent between the two operators (R2 = 0.99), although statistically different. Compared to the known sizes for the 82 eels, sizes estimated manually from video were underestimated. The resulting mean error percentages were significantly different between the two operators (−3.9% ± 8.5 (SD) and −6.6% ± 8.9). This error percentage was significantly influenced by the known size of the eels but not by the detection range. Our results highlighted the importance of taking into account the biases in counts and size estimates in fish ecology and fisheries studies based on acoustic cameras. These biases have to be quantified and, if possible, corrected using similar protocols as described in this study, when multiple operators analyse acoustic videos or when comparing the results from different studies.
Uncovering the diversity of monogeneans (Platyhelminthes) on endemic cypriniform fishes of the Balkan Peninsula: new species of Dactylogyrus and comments on their phylogeny and host-parasite associations in a biogeographic context
Authors: Řehulková Eva , Benovics Michal , Šimková Andrea
Published: November 2020

Seven new species of Dactylogyrus Diesing, 1850 (Dactylogyridae) are described from the gills of seven endemic species of cyprinoids (Cyprinidae, Leuciscidae) inhabiting the Balkan Peninsula: Dactylogyrus romuli n. sp. from Luciobarbus albanicus (Greece), Dactylogyrus remi n. sp. from Luciobarbus graecus (Greece), Dactylogyrus recisus n. sp. from Pachychilon macedonicum (Greece), Dactylogyrus octopus n. sp. from Tropidophoxinellus spartiaticus (Greece), Dactylogyrus vukicae n. sp. from Delminichthys adspersus (Bosnia and Herzegovina), Dactylogyrus leptus n. sp. from Chondrostoma knerii (Bosnia and Herzegovina), and Dactylogyrus sandai n. sp. from Telestes karsticus (Croatia). To delineate species boundaries, we used an integrative taxonomic approach combining morphological and genetic data. With these tools, we illustrate that some species of monogeneans considered as cryptic might be designated as pseudocryptic (morphologically similar, not easily differentiated) after a posteriori detailed morphological examination, as happened with D. romuli n. sp. and D. remi n. sp. Thus, for accurate species characterization, it is particularly important to acquire both morphological and molecular data from the same individual specimens, ideally along with illustrations of taxonomically important structures directly taken from hologenophores. Using phylogenetic reconstruction, we investigated the phylogenetic position of newly described Dactylogyrus species within Dactylogyrus species from Balkan cyprinoids with regard to morphological characteristics, host range, and geographical distribution.
A Feasibility Pilot Study on the Use of Telemedicine for
the Examination of the Knee Joint
Authors: Scheidt Sebastian , Kehrer Michael , Welle Kristian , Wimmer Matthias D. , Jaenisch Max , Goost Hans , Wirtz Dieter Christian , Burger Christof , Kabir Koroush
Published: November 2020

Background In times of a pandemic threat, such as COVID-19, and the need
for reduced direct doctor-patient contact, internet-based telemedicine has
attracted more and more attention as a surrogate service. Suspending the
diagnosis and treatment of non-virus related diseases for longer periods of time
is not a viable option since this would only exacerbate problems on the patient
and national level. The need for alternative treatment modalities increased
rather quickly. So far, telemedical applications have mainly focused on
teleradiological diagnosis, follow-up and monitoring of psychiatric and internal
diseases, as well as geriatric patient care. As far as these authors are aware,
orthopaedic physical examination of the knee joint, including trauma work-up,
has not been the subject of any studies to date. This feasibility study explores
how video consultation can be designed and implemented in the context of history
taking and physical examination in knee joint complaints.

Material and Method 21 patient actors (PA) with simulated complaints of
the knee joint were examined individually for each diagnosis, first via video
consultation and then directly by a specialist (SP). One PA group has a medical
background, the other was made up of laypersons. The time was measured for both
types of consultation. The physician documented the detected symptoms, the
quality of implementation of the self-examination steps, and the derived
diagnosis on an assessment form. After completion of both consultation sessions,
the PAs were handed a questionnaire on the respective examination modality.

Results With the video consultation the examination lasted 8.63 (± 2.5)
minutes on average and with the regular consultation in person 5.63 (± 1.7)
minutes (p < 0.001). For the group with medical background the examination
lasted 7.67 (± 1.4) minutes on average, while for the lay group the video
consultation took 9.7 (± 3.1) minutes (p = 0.049). With increased age, the video
consultation was prolonged (p = 0.032; r = 0.47). The mean value for
self-examination of leg axis, gait pattern and degrees of freedom was 9.32
(± 0.4) of 10 points. The following functional tests resulted in lower mean
values (points): Payr 7.2 (± 2.3), Merke 5.9 (± 2.8), no-touch Lachmann 6.4
(± 2.7), gravity sign-recurvatum 6.7 (± 2.4). The mean grade by the PAs for the
feasibility of self-examination was 2.43 (± 0.98) out of 5 points.

Conclusion The video consultation for musculoskeletal complaints of the
knee joint allows exploratory remote examination and helps to minimise the
number of patients in hospitals and practices. It takes longer for the physician
to perform and does not permit functional testing for ligament injuries of the
knee joint. In its present form, telemedical examination is not able to fully
replace personal consultation.
Die neue generalistische Pflegeausbildung – Chance für die psychiatrische Pflege?
Authors: Rau Fritz-Stefan
Published: November 2020

Ist die Ausbildung in der psychiatrischen Pflege durch das Pflegeberufegesetz attraktiver und zukunftsfähiger geworden? Unser Autor erläutert die Eckpunkte des reformierten Bildungswegs, beleuchtet Potenziale und Fallstricke und zieht ein fundiertes Resümee.
Umsetzung von Behandlungskontinuität im Versorgungsalltag – ein Vergleich zwischen zwei psychiatrischen Kliniken
1
Authors: Assheuer Michaela , Beine Karl , Mehl Claudia , Kellner Michael , Agelink Marcus , Sieberer Marcel , de Cruppé Werner , Geraedts Max
Published: November 2020

Ziel der Studie Die starre Trennung von ambulanter und stationärer Versorgung im deutschen Gesundheitssystem verhindert eine Behandlungskontinuität, obwohl sie sich für psychiatrische Patienten als sehr wichtig erwiesen hat. Die vorliegende Studie analysiert die Behandlungskontinuität einer Modellklinik mit einem Gesamtbudget nach § 64b SGB V und konstantem Behandlungspersonal über alle Settings hinweg im Vergleich zu einer Kontrollklinik mit Regelfinanzierung ohne ein solches Team.

Methodik In einer prospektiven Kohortenstudie mit einem Beobachtungszeitraum von 20 Monaten wurden Daten zur Behandlungskontinuität von 220 Patienten der Modellklinik und 215 Patienten der Kontrollklinik erhoben.

Ergebnisse Die Modellklinik erreichte eine signifikant höhere Behandlungskontinuität als die Kontrollklinik, sowohl während der stationären Behandlung zum Zeitpunkt der Rekrutierung als auch in allen Settings während des Beobachtungszeitraums.

Schlussfolgerung Ein Gesamtbudget kann die notwendigen Voraussetzungen für eine flexiblere psychiatrische Versorgung und eine bessere Umsetzung der Behandlungskontinuität schaffen.
Das Virus und die Digitalisierung: Treibt Corona die digitale Evolution des deutschen Gesundheitswesens voran?
Authors: Straub Christoph
Published: November 2020

Mit dem Digitale-Versorgung-Gesetz öffnete die Bundesregierung den Weg für einen deutlichen Schub bei der Digitalisierung des Gesundheitswesens. Durch die Corona-Krise hatte es einen weiteren starken Impuls in diese Richtung gegeben. Dennoch sorgt der sprunghafte Anstieg der digitalen Möglichkeiten mitunter auch für Unsicherheit unter Patientinnen und Patienten wie Ärztinnen und Ärzten. Besonders die Mediziner artikulieren einen großen Informationsbedarf. Diesen zu decken, ist auch im Sinne der Krankenkassen. Denn es kommt nicht nur auf den Nutzen digitaler Gesundheitsanwendungen an, sie müssen auch tatsächlich implementiert werden, damit alle Beteiligten, nicht zuletzt die Patienten, davon profitieren.
Risikoanalyse im Krankenhaus – Die Pandemie als unterschätztes Risiko?!
Authors: Müller Anna
Published: November 2020

Eine Pandemie, wie die durch das Coronavirus, kann in Deutschland nicht als unterschätztes Risiko bewertet werden, da mit dem nationalen Pandemieplan bereits Maßnahmen zur Vorsorge definiert werden. Jedoch zeigt die Risikoanalyse, dass weitaus mehr Risiken und Auswirkungen infolge des Virus auftreten können, welche teilweise bisher nicht berücksichtigt wurden. Anhand von erkennbaren Auswirkungen und dem Ansatz der Business Impact Analyse nach der DIN EN ISO 22301 werden einzelne Risiken aufgeführt. Schlussfolgernd ist festzuhalten, dass die Risiken einer Pandemie vielfältig sind, die Vorsorge bisher nur grundlegende Maßnahmen umfasst und eine verbesserte Vorsorge den Schaden und damit die Kosten reduzieren kann.
Führung: eminenz- oder evidenzbasiert?
Authors: Ebner Markus
Published: November 2020

Das PERMA-Modell gilt als Standard für Potenzialentfaltung. Jeder Buchstabe von PERMA steht für eine Voraussetzung, die Menschen brauchen, um ihr volles Potenzial auszuschöpfen. Dabei ist jeder einzelne Aspekt messbar und beeinflussbar – mit großem Nutzen für die Praxis.
Der „Hilfsverein für Nerven- und Gemütskranke in Württemberg“ – Zur Geschichte poststationärer Begleitung psychisch Kranker, 1895–1975
Authors: Luigart Sylvia , Kanis-Seyfried Uta , Reichelt Bernd , Müller Thomas
Published: November 2020

Dieser psychiatriehistorische Beitrag gibt einleitend einen Überblick über die Entwicklung der psychiatrischen Hilfsvereine in Deutschland und beschreibt in der Folge Geschichte und Tätigkeitsprofil des genannten Hilfsvereins in Württemberg von dessen Gründung bis ca. 1975. Hierfür wurde das Archiv des bis heute existierenden, inzwischen für ganz Baden-Württemberg zuständigen, Vereins ausgewertet. Der Hilfsverein nahm seit seiner Gründung eine zentrale Position in der poststationären Begleitung und Unterstützung von psychisch kranken Menschen ein. Bis 1945 stand die Einzelfall- und Angehörigen-Unterstützung im Vordergrund. Mit dem Ausbau der sozialpsychiatrischen Versorgungsstrukturen, beginnend Ende der 1960er-Jahre, verlagerte sich der Fokus der Arbeit auf die Unterstützung von Projektarbeit. Die Geschichte des Hilfsvereins weist hierbei deutliche Zäsuren auf, wie auch Anpassungen an politischen Wandel sowie Veränderungen durch die Entwicklung des psychiatrischen Versorgungssystems.
An Unusual Case of Iron-Deficiency Anemia: The Culprit Hides in the Aorta
Authors: Lock Guntram , Bertram Mathias , Oelckers Michael , Bitz Ulrich , Zipfel Burkhart , Jacobsen Frank
Published: November 2020

In a 72-year-old patient with anemia (Hb 7 g/dl), duodenoscopy exhibited an area of polypous irregular-looking mucosa. Histology revealed duodenal infiltration by epithelioid tumor cells, immunhistochemically positive for endothelial cell markers (CD34, CD31, ERG). Ultrasonography showed thrombotic material in the otherwise unremarkable abdominal aorta with some uptake of contrast bubbles on CEUS. Histological and clinical diagnosis assumed an epithelioid angiosarcoma of the thoraco-abdominal aorta at the level of the visceral and renal arteries with duodenal metastases.

To prevent further shedding of tumor cells and aortic rupture, a branched stent-graft was placed into the thoraco-abdominal aorta. Palliative chemotherapy with gemcitabine and docetaxel was started, leading to a partial remission after 6 cycles. Three months later, however, there was a progress of the duodenal masses with new pulmonal and osseous metastases. Thirteen months after the initial diagnosis, death occured due to a hemorrhagic shock caused by a hematothorax.

Aortic tumors are exceedingly rare, with only slightly more than 220 cases reported so far. In most cases, diagnosis is made either at autopsy or after an emergency operation for embolic complications like embolic intestinal ischemia. With an overall median survival of 8 months, prognosis is very poor.

This case sensitizes for the correct sonographic interpretation of aortic “thrombi” in an otherwise normally appearing aorta, possibly with the aid of CEUS. Besides, it demonstrates the relatively early and uncommon diagnosis of an aortic angiosarcoma by the combination of endoscopy, immunohistochemistry, and ultrasonography.
Shining Light on the Light-Bearing Element: A Brief Review of Photomediated C–H Phosphorylation Reactions
Authors: Li Chao-Jun , Ung Sosthène P.-M. , Mechrouk Victoria Atica
Published: November 2020

Organophosphorus compounds have numerous useful applications, from versatile ligands and nucleophiles in the case of trivalent organophosphorus species to therapeutics, agrochemicals and material additives for pentavalent species. Although phosphorus chemistry is a fairly mature field, the construction of C–P(V) bonds relies heavily on either prefunctionalized substrates such as alkyl or aryl halides, or requires previously oxidized bonds such as C=N or C=O, leading to potential sustainability issues when looking at the overall synthetic route. In light of the recent advances in photochemistry, using photons as a reagent can provide better alternatives for phosphorylations by unlocking radical mechanisms and providing interesting redox pathways. This review will showcase the different photomediated phosphorylation procedures available for converting C–H bonds into C–P(V) bonds.

1 Introduction

1.1 Organophosphorus Compounds

1.2 Phosphorylation: Construction of C–P(V) Bonds

1.3 Photochemistry as an Alternative to Classical Phosphorylations

2 Ionic Mechanisms Involving Nucleophilic Additions

3 Mechanisms Involving Radical Intermediates

3.1 Mechanisms Involving Reactive Carbon Radicals

3.2 Mechanisms Involving Phosphorus Radicals

3.2.1 Photoredox: Direct Creation of Phosphorus Radicals

3.2.2 Photoredox: Indirect Creation of Phosphorus Radicals

3.2.3 Dual Catalysis

3.3 Photolytic Cleavage

4 Conclusion and Outlook
Recent Advances in Metal-Catalyzed, Electrochemical Coupling Reactions of sp2 Halides/Boronic Acids and sp3 Centers
Authors: Gale-Day Zachary J.
Published: November 2020

Traditionally, metal-catalyzed cross-coupling reactions rely on stable but expensive metals, such as palladium. However, the recent development of synthetic organic electrochemistry allows for in situ redox manipulations, expanding the use of cheaper, abundant and sustainable metals, such as nickel and copper as efficient cross-coupling catalysts. This short review covers the recent advances in metal-catalyzed electrochemical coupling reactions, with a focus on reactions of sp2 electrophiles and nucleophiles with sp3 coupling partners to form both C–C and C–heteroatom bonds.

1 Introduction

2 Nickel-Catalyzed C–C sp2–sp3 Coupling Reactions

3 Coupling of Aryl Groups with Heteroatomic Nuclei

4 Conclusion
Vitamin B12-Catalyzed Dicarbofunctionalization of Bromoalkenes Under Visible Light Irradiation
Authors: Smoleń Sabina , Wincenciuk Aleksandra , Gryko Dorota , Drapała Olga
Published: November 2020

Vitamin B12 plays a crucial role in enzymatic transformations. This natural compound proved also useful as a catalyst in numerous organic reactions. Commercial availability and lower cost than precious metal complexes, make cobalamin an attractive candidate for a broader use as a benign Co-catalyst. Herein, the vitamin B12-catalyzed dicarbofuntionalization of bromoalkenes with electrophilic olefins is reported leading to substituted pyrrolidines and piperidines in decent yields after only 15 minutes under light irradiation.
Endoscopic Endonasal Odontoidectomy with Nasopharyngeal Flap Reconstruction
Authors: London Nyall R. , Mohyeldin Ahmed , Carrau Ricardo L. , Prevedello Daniel M.
Published: November 2020

Objective This study aimed to demonstrate the nuances in preoperative management, surgical technique, and reconstruction for an endoscopic endonasal odontoidectomy.

Design Assembly of an operative video demonstrating technique for endoscopic endonasal odontoidectomy.

Setting this study is a comprehensive skull base team at a tertiary care center.

Participant The patient is a 53-year-old male, with basilar invagination and myelopathy, who underwent cervical fusion, 6 years back, without ventral decompression at an outside hospital. He presented to our clinic with persistent myelopathy and generalized weakness, thus an endoscopic endonasal odontoidectomy for brainstem decompression was recommended.

Main Outcome Measures Preoperative computed tomography (CT) angiography and intraoperative CT navigation demonstrated normal carotid artery anatomic localization. An inverted U-shaped mucosal flap was reflected inferiorly and preserved. The C1 arch was identified and resected with a high speed drill. The resultant diseased soft tissue arising from retropulsion of the odontoid process was then removed and the odontoid process identified. This bone was removed centrally until a thin cap remained. After removal of the cap, the underlying ligamentous tissue was removed until dural pulsations were appreciated and brainstem decompression achieved. Hemostasis was attained and the mucosal flap mobilized into position.

Results Postoperative CT imaging demonstrated resolution of basilar invagination and brainstem decompression (Fig. 1). The patient improved both in arm dexterity and ambulation after surgery and the reconstruction demonstrated appropriate healing on nasal endoscopy 2 months postoperatively.

Conclusions This operative video demonstrates nuances in endoscopic endonasal odontoidectomy. This case also demonstrates that ventral decompression after long-term cervical fusion can improve myelopathy and that fusion in the setting of bony ventral compression, rather than rheumatoid panus, may not reduce over time with fusion only.

The link to the video can be found at: https://youtu.be/370FFuBA89Y.
Percutaneous Reconstruction of the Ulnar Collateral Ligament of the Metacarpophalangeal Joint of the Thumb: Technique and Results
Authors: Herrera Juan Manuel , Herrera Lucas , Rotella Pablo , Cantero Téllez Raquel , Castellanos Jimena , Vázquez Fernando
Published: November 2020

Objectives The present study aims to describe a new percutaneous technique for the reconstruction of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb with a tendon graft, and to evaluate the functional outcomes and stability six months postoperatively.

Material and methods The percutaneous ligamentoplasty technique was performed with a palmaris longus tendon graft and tenodesis screws in 6 patients with ulnar instability of the thumb (> 30° degrees of radial deviation) for more than 6 weeks. Range of motion, grip strength, and pinch strength (lateral/key pinch, tip pinch, and palmar pinch) were assessed in comparison to the contralateral limb, as well as the Quick Disabilities of the Arm, Shoulder and Hand (DASH) score.

Results At 6 months, the joint movement was of 100%, the grip strength was of 94.8%, the key pinch was of 95%, the palmar pinch was of 85.7%, and the tip pinch was of 93.5% compared to the contralateral limb. The internal tilt was of 14° compared to 9° at the contralateral limb. The Quick DASH score decreased from 24.2 to 2.6 points.

Conclusion We devised this versatile surgical procedure to obtain early mobility with the advantages related to the percutaneous techniques.
Xantoma del tendón de aquiles bilateral: Debut de xantomatosis cerebrotendinosa
Authors: Fernández-Ruiz María Dolores , Moril-Peñalver Lorena , Sevilla-Monllor Alexandra , García-Ortiz María Tíscar , Lizaur-Utrilla Alejandro , López-Prats Fernando
Published: November 2020

Objetivo Presentación de un inusual caso de xantomatosis cerebrotendinosa en un paciente de edad cuya primera manifestación fueron xantomas bilaterales del tendón de Aquiles.

Material y métodos Mujer de 62 años, que presenta tumoraciones, que presenta tumoraciones sólidas y polilobuladas, en la cara posterior de ambos tendones de Aquiles de 8 años de evolución. El diagnóstico se realizó mediante el hallazgo de hiperlipidemia y estudio genético. Se realió la exóresis quirúrgica parcial de las tumoraciones.

Resultados A los 5 años de la cirugía del pie izquierdo y 4 años del pie derecho la paciente estaba asintomática. Presentaba una fuerza para la flexión plantar bilateral de 5/5, pudiendo caminar y subir escaleras sin molestias. Presentaba una escala AOFAS de 85 y 90 puntos en el pie izquierdo y derecho, respectivamente. No hubo recidivas.

Discusión Los xantomas son depósitos de colesterol en el tejido conectivo de la piel, tendones o fascia, como resultado de una hiperlipoproteinemia. La importancia del caso radica en su sospecha diagnóstica, ya que la xantomatosis cerebrotendinosa suele manifestarse en pacientes de menos de 30 años de edad y en los que se ha recomendado la resección radical de las tumoraciones, e incluso del tendón, debido a las frecuentes recidivas.

Conclusión En pacientes de mayor edad con lesiones que infiltran el tendón, se puede optar por un tratamiento menos agresivo con un buen resultado clínico.

Nivel de evidencia IV
Artroplastia de resección de hombro como salvamento para infecciones recalcitrantes. Estado actual de la técnica a propósito de dos casos
Authors: Arbeloa-Gutierrez Lucas , Arenas-Miquelez Antonio
Published: November 2020

Introducción y Objetivos La artroplastia de resección de hombro (ARH) se presenta como una técnica obsoleta y una opción no válida en la actualidad, debido a la evolución de las técnicas quirúrgicas y de los implantes. Pero, como consecuencia del aumento exponencial del uso de artroplastias de hombro, están aumentando en paralelo el número de fracasos e infecciones, con necesidad de revisión y rescate. Es por ello que, en determinadas situaciones y pacientes, esa técnica vuelve a ser una opción necesaria como salvataje, aunque tiene un alto coste funcional. El objetivo de nuestro trabajo, es presentar dos casos de artroplastia de resección de hombro como una opción válida de tratamiento en la actualidad y la revisión de la literatura.

Casos Se presentan dos casos de ARH como tratamiento de rescate, en un caso de osteomielitis crónica de cabeza humeral y un caso de infección de hemiartroplastia de hombro. Ambos pacientes se encontraban sin dolor y libres de infección con un seguimiento de más de 30 meses. En un caso la funcionalidad fue limitada con un Constant de 45 pero el otro caso la funcionalidad fue aceptable con un Constant de 67.

Conclusiones La ARH sigue siendo una técnica útil tras el fracaso de procedimientos de revisión, para resolver infecciones protésicas recalcitrantes u osteomielitis. Los resultados funcionales son pobres, por lo que debe reservarse para pacientes con baja demanda funcional y como salvataje, tras agotar otras opciones.
A Rare Cause of Facial Paralysis in Children: A Case of Ramsay Hunt Syndrome
Authors: Çiçek Muharrem , Kılıç Zeynep , Mercen Yezdanşer , Karaoğlan Emel , Öztarhan Kazım
Published: November 2020

Peripheral facial paralysis in children can have many causes including trauma, otitis media, head and neck tumors, congenital anomalies, viral infections, as well as metabolic and genetic factors. One cause of peripheral facial paralysis is Ramsay Hunt syndrome (RHS), which is also known as herpes zoster oticus, affecting the seventh and eighth cranial nerves. It is characterized by inner ear dysfunction, periauricular pain, and peripheral facial paralysis accompanied by the presence of an erythematous vesicular rash around the ear pinna and outer ear canal or in the oral mucosa. RHS is very rare in children when compared with its prevalence in adults. A 13-year-old male with no prior medical history applied to the pediatric emergency department after having first developed a vesicular rash on the left ear pinna and pain around the left ear, which was followed 1 day later by the development of ipsilateral facial asymmetry. The patient was hospitalized and simultaneously started on 2 mg/kg/d methylprednisolone for 10 days (followed by a 15-day taper), 100 mg/kg/d intravenous ceftriaxone twice per day (stopped on day 10), 30 mg/kg/d intravenous acyclovir three times per day (stopped on day 21), ciprofloxacin ear drops, tobramycin eye drops, ointment, and artificial tear drops with eye patching. However, only a minimal improvement was observed in the patient's peripheral facial paralysis by day 21. When compared with the prevalence in adults, RHS is very rare in children, which is why reports of pediatric RHS are limited in the literature. Therefore, additional studies are needed to provide information about the pathophysiology, diagnosis, and treatment of pediatric RHS.
Detection of Streptococcus pneumoniae in Urine by Loop-Mediated Isothermal Amplification
Authors: Cima-Cabal María Dolores , Vázquez-Espinosa Emma , Vazquez Fernando , García-Suárez María del Mar
Published: November 2020

Objective To assess the loop-mediated isothermal amplification (LAMP) to detect cell-free DNA from Streptococcus pneumoniae in urine samples from children with pneumococcal pneumonia.

Methods LAMP reactions using four primers (backward inner primer, forward inner primer, B3, and F3) targeting conserved regions of the S. pneumoniae ply gene and DNA from the recombinant plasmid pTrc99A-ply were optimized for temperature (65°C) and MgSO4 concentration (8 mM) conditions. Urine samples from 71 patients with symptoms of pneumonia and from 17 healthy children were tested side by side using the isothermal methodology LAMP and the commercial urinary antigen test, BinaxNOW S. pneumoniae assay. Percentages of sensitivity, specificity, positive predictive value (PPV), negative predictive value, and positive (LR) were calculated to compare both tests.

Results The specificity of the LAMP reaction was confirmed against several species of bacteria and yeast that can cause pneumonia or urine infections. The suitability of the LAMP assay was evaluated in urine samples from 71 patients and 17 healthy children. All patients (100%) with confirmed pneumococcal pneumonia were positive for the LAMP assay. Among patients with possible/probable pneumonia, 74.1% were identified as positive using the LAMP test. Notably, a higher specificity (95.4%), PPV (94.1%) and positive LR (21.7) were found compared with the urinary antigen test.

Conclusion The presence of S. pneumoniae cell-free DNA in urine samples of pediatric patients can be used as a specific diagnostic biomarker for community-acquired pneumonia by using the LAMP methodology.
Knowledge, Attitude, Behavior, and Stress Related to COVID-19 among Undergraduate Health Care Students in Jordan
Authors: Mustafa Ruba M. , Alrabadi Nasr N. , Alshali Ruwaida Z. , Khader Yousef S. , Ahmad Dana M.
Published: November 2020

Objectives This study aimed to assess knowledge, attitude, and infection control measures related to the coronavirus disease 2019 (COVID-19) pandemic outbreak among Jordanian health care students. Besides, their social behavior and stress level regarding COVID-19 infection were assessed.

Materials and Methods An online questionnaire was distributed to medical, dental, pharmacy, nursing, and applied health science students in Jordan during the COVID-19 outbreak quarantine in March 2020. The questionnaire comprised 38 questions assessing demographic data, knowledge, attitude, risk perception, and stress level toward COVID-19. Questions regarding infection control measures and social behavior after the quarantine were also included.

Statistical Analysis Independent samples t-test, one-way analysis of variance (ANOVA), and chi-square at a significance level of 5% were used for data analysis.

Results A total number of 935 responses were collected. The knowledge score of 55.72% of participants was satisfactory and it was higher for the clinical years’ students compared with the basic years’ students (p = 0.000) (descending order: sixth year > fifth year > fourth year > third year > first year > second year). Also, knowledge scores were significantly higher for medical and dental students than other disciplines (descending order: medicine, dentistry, pharmacy, nursing/applied) (p = 0.000). The social media (89.1%) and TV or radio (69.5%) were mainly routes through which participants heard about COVID-19. Moderate and justifiable feelings about COVID-19 were found in the majority of the participants.

Conclusion Although the majority of students showed good knowledge scores, few of them appeared to have a serious lack of knowledge. Therefore, proper education and mentoring are necessary for students before reopening the university campuses.
Burnout among Plastic Surgery Residents in India: An Observational Study
Authors: Panse Nikhil , Panse Smita , Ravi Swaminathan , Mankar Hemant , Karanjkar Ankur , Sahasrabudhe Parag
Published: November 2020

Introduction Burnout syndrome can be defined as emotional exhaustion, depersonalization, and perceived lack of personal accomplishment, all of which lead to decreased effectiveness at work. The Medscape burnout and depression report of 2018 suggests that the burnout range across various specialties ranges from 23 to 48%. There are no studies to assess the burnout among plastic surgery residents in India. This study is an attempt to assess the same.

Materials and Methods An online survey was conducted in March and April 2019 for plastic surgery residents across India. Various parameters including those related to gender, year of the curriculum, hobbies, exercise, and marital status were assessed. There were multiple sections in the survey, which included the demographic details, stress-related variables, and the abbreviated Maslach Burnout Inventory. The abbreviated Maslach Burnout Inventory is a validated scale that has been used to assess the burnout among plastic surgery residents in India. The three subscales, emotional exhaustion, depersonalization, and personal accomplishment were measured on a Likert scale. Univariable and multivariable analysis of factors associated with burnout was performed.

Results Of the 185 respondents, 48.4% experienced moderate-to-high burnout. Of these, 25% (n = 46) were above the 75th centile of the overall burnout score, indicating severe burnout. Insufficient faculty involvement, insufficient time allotted for formalized teaching, conflict with colleagues, and lack of adequate support staff correlated with resident burnout on multivariate analysis. Residents who pursued their hobbies or performed physical activities for exercise had significantly lesser burnout.

Conclusion The incidence of burnout in plastic surgery residents surveyed in our study was 48.4%. The faculty of the departments and the residents themselves, as well as the governing bodies, all have a role to play to address the issue of burnout among residents. Dedicated and persistent efforts toward improving physical and psychological well-being of plastic surgery residents will positively impact not only the well-being of the residents but also the quality of patient care.
Abiotrophia defectiva as a Rare Causative Agent of Periprosthetic Total Knee Arthroplasty Infections: A Case Report and Literature Review
Authors: Kocazeybek Emre , Demirel Mehmet , Ersin Mehmet , Ergin Omer Naci , Sadic Betul , Yavuz Serap Simsek , Asik Mehmet
Published: November 2020

We present a case of Abiotrophia defectiva in a prosthetic knee infection following total knee replacement for the first time. A 69-year-old female was prediagnosed with prosthetic knee infection, and a two-stage revision arthroplasty was applied. A. defectiva was cultured by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) from the synovial fluid aspirates. Penicillin G and gentamicin had been administered. One year postoperatively, a scintigraphy showed no recurrence. A. defectiva may be missed in culture negative patients with knee or hip arthroplasty. They should be carefully evaluated if they have undergone recent dental procedures.
Introducing the “SOAC Wrist”: Scaphotrapeziotrapezoid Osteoarthritis Advanced Collapse
Authors: Oliveira Ricardo Kaempf de , Aita Márcio , Brunelli João , Carratalá Vicente , Delgado Pedro J
Published: November 2020

Despite being the second most common osteoarthritis of the wrist, little is known about scaphotrapeziotrapezoid osteoarthritis. Not all patients with this type of osteoarthritis have symptoms, and, even in those symptomatic patients, the intensity of the complaint is not proportional to the severity of the degeneration. In symptomatic patients, when the conservative treatment fails, grading classifications to help define the surgical treatment are solely based on the joint characteristics, and fail to assess the rest of the carpus.

In general, most carpal degenerative processes show the same evolution pattern, which varies according to the initial injury, along with the type of deformity and the inherent instabilities. Thus, we hypothesize that the degenerative evolution due to primary osteoarthritis of the scaphotrapeziotrapezoid joint also follows a logical evolutionary sequence, similar to the one that occurs in cases of scapholunate advanced collapse (SLAC), scaphoid nonunion advanced collapse (SNAC), scaphoid malunion advanced collapse (SMAC), and scaphoid chondrocalcinosis advanced collapse (SCAC), thus resulting in scaphotrapeziotrapezoid osteoarthritis advanced collapse (SOAC). We have divided the SOAC into three groups, and considered that their treatment shall be guided by the evolutionary stage of the disease, and not by the surgeon's preferred technique.
Image of the Month: High Pressure Distal Colostogram in a Patient with an Anorectal Malformation
Authors: Apte Anisha , Brisighelli Giulia , McKenna Elise , Levitt Marc A.
Published: November 2020

An adequately performed high pressure distal colostogram is crucial to plan surgery in male patients born with anorectal malformations. We present two male patients that underwent a divided sigmoid colostomy with distal mucus fistula in the neonatal period and at 6 months of age underwent a high pressure distal colostogram. In the discussion, we will give some tricks beyond the known rules: how to correctly interpret a high pressure distal colostogram, how to identify the level of a recto-urinary fistula, and how to accurately plan the surgical approach.
Clorpactin: An Alternative Irrigation Method for Total Knee Arthroplasty Joint Infection Revisions
Authors: Kotecki Keith , Bradford Michael S.
Published: November 2020

Different combinations of irrigation solutions have been used in attempt to eradicate microorganisms for the prevention and treatment of prosthetic joint infections (PJIs). Clorpactin WCS-90 was evaluated as an alternative irrigation intraoperative technique for the treatment of PJI using both debridement, antibiotics, and implant retention (DAIR) and 2-stage total knee arthroplasty (TKA) procedures. We retrospectively reviewed PJIs irrigated with Clorpactin between January 2015 and January 2020. We found 13 patients who underwent a DAIR procedure for an acutely infected primary TKA, 18 patients underwent a 2-stage procedure for a chronically infected primary TKA, two patients underwent a DAIR procedure for an acutely infected revision TKA, and 18 patients underwent a 2-stage procedure for a chronically infected revision TKA. The odds of reinfection and need for additional surgery were analyzed at a mean follow-up of 20 to 26 months between groups. Only one patient (7.69%) became reinfected in the acute infected primary TKA group, three patients (16.67%) in the chronic infected primary TKA group, 0 patients (0%) in the acute infected revision TKA group, and six patients (33.33%) in the chronic infected revision TKA group. When the acute primary TKA infection group was compared with the chronic revision TKA infection group, the odds of reinfection (Chi-square test [χ2] = 21.7, df 3, p < 0.001) and odds of additional surgery (χ2 = 13.6, df 3, p < 0.003) were significantly higher for the chronic revision TKA infection group. Overall, the reinfection rate for DAIR revisions was 6.67% (range = 0–7.69) and 2-stage revisions was 25.00% (range = 16.67–33.33). The use of Clorpactin WCS-90 irrigation prior to wound closure is a useful option for the treatment of acute and chronic knee PJIs. Our study provides evidence that infection eradication with the use of Clorpactin is comparable to other irrigation methods and surgical techniques in reported literature.
Patellotrochlea Index in Normal Healthy Knees
Authors: Middleton Simon , Bajada Stefan , Powell Roy , Nelson Adam , Mandalia Vipul
Published: November 2020

Patella alta is a common and significant abnormality responsible for many patellofemoral joint-related conditions. Many methods of patella height measurements are described; however, patellotrochear index (PTI) is the most logical method as it measures the direct relation between patella and trochlea. The aim of this study is to investigate PTI in normal healthy asymptomatic volunteers to understand the patellofemoral relation in normal knees. Twenty-five healthy volunteers underwent magnetic resonance imaging (MRI) scans of both knees. Two observers independently measured PTI on two different occasions at 6-week interval. Statistical analysis was performed to identify intra- and interobserver correlation between two observers and the mean value of PTI. Agreement analysis was performed according to Bland and Altman. Comparisons of means were made using paired t-tests. The mean age of 25 healthy volunteers was 21.28 years (19–23) with a male:female ratio of 14:11. The overall mean PTI value of all observations was 36.8% and pooled standard deviation (SD) 11.5%. Intraclass correlation (ICC) testing showed “good” interobserver ICC between two observers for PTI for both first (0.80) and second (0.84) set of measurements. There was “excellent” intraobserver correlation for two sets of measurements of PTI made by each first (0.96) and second (0.91) observer. Intraobserver repeatability for PTI was ± 0.07 and ± 0.1, respectively, for the first and second observer. Interobserver repeatability for PTI was ± 0.159 and ± 0.133, respectively, for the first and second set of measurements. Analysis of individual measurements of patella and trochlear articular cartilage revealed that the largest repeatability values were for trochlea measurements. The study reports that the average PTI in asymptomatic healthy knee utilizing current clinical MRI scanning conditions is 36.8%. This provides surgeons with a gold standard normal PTI value, which can serve as a target value in clinical diagnosis as well as surgical correction of patella height. There is good to excellent intra- and interobserver correlation with limited variability in assessing patella height using PTI on MRI scan.
Mosaic Trisomy 16 Associated with Left Lung Agenesis, Abnormal Left Arm, and Right Pulmonary Artery Stenosis: Expanding the Phenotype and Review of the Literature
Authors: Nguyen Hoang H. , Umapathi Krishna Kishore , Bokowski John W. , Hogan Kelsey , Hart Alexa , Li Mindy H.
Published: November 2020

Trisomy 16 is the most common autosomal trisomy found in spontaneous abortions with mosaic versions seen in survivors. However, surviving children have multiple congenital defects and are at risk of growth and developmental delay. We report an additional case of mosaic trisomy 16 diagnosed by amniocentesis and confirmed after birth. Our patient is the first documented case of living mosaic trisomy 16 with the malformation constellation of lung agenesis, left pulmonary artery agenesis, congenital heart defects, and ipsilateral radial ray and limb abnormalities, expanding the phenotype of this rare condition. Additionally, this individual's unique combination of lung and cardiac defects caused morbidities that were challenging to manage and complicated family counseling as well.
Expression of Cyclin D1 in Hyperplasia and Carcinoma of Endometrium and Its Correlation with Histologic Grade, Tumor Type, and Clinicopathological Features
Authors: Sangwan Karuna , Garg Monika , Pathak Nayana , Bharti Lavleen
Published: November 2020

Background Endometrial carcinoma is often preceded by characteristic histopathologic lesions known as endometrial hyperplasia. Estrogen, p53, PTEN, and overexpression of cyclin D1 appear to be involved in the development of endometrial carcinogenesis.

Design We evaluated and compared the expression profile of cyclin D1 expressions in 50 endometrial samples submitted as either endometrial curetting (n = 34) or hysterectomy (n = 16) specimens, which were diagnosed as simple hyperplasia (n = 10), complex hyperplasia (n = 06), atypical hyperplasia (n = 04), and endometrial carcinoma (n = 20). Ten cases of normal proliferative and secretory endometrium were selected as controls. Breast cancer with known cyclin D1 expression was selected as a positive control in each immunohistochemistry run.

Results Cyclin D1 was significantly overexpressed in glands with complex hyperplasia and endometrial adenocarcinoma compared with proliferative or secretory endometrium and simple hyperplasia. A statistical difference was found in the extent of cyclin D1 positivity of simple hyperplasia and carcinoma of the endometrium (p < 0.005). No statistical difference was seen between complex hyperplasia and carcinoma and clinicopathologic parameters in endometrioid carcinomas. All cases of clear cell carcinoma and serous carcinoma showed cyclin D1 immunoreactivity. Significant statistical difference was seen between cyclin D1 expression and only one clinicopathologic parameter, i.e., menopausal status in endometrial carcinomas

Conclusion Cyclin D1 over expression may be an early event in endometrial carcinogenesis and cyclin D1 over expression may be an informative biomarker to recognize subsets of endometrial lesions that may be precancerous and therefore amenable to surgical therapy.
Efficacy of Pooled Serum Internal Quality Control in Comparison with Commercial Internal Quality Control in Clinical Biochemistry Laboratory
Authors: Kulkarni Sweta , Pierre Shema Alain , Kaliaperumal Ramachandran
Published: November 2020

Introduction With increasing automation in clinical laboratories, the requirements for quality control (QC) material have greatly increased in order to monitor performance. The constant use of commercial control material is not economically feasible for many countries because of nonavailability or the high-cost of those materials. Therefore, preparation and use of in-house QC serum will be a very cost-effective measure with respect to laboratory needs.

Materials and Methods In-house internal quality control from leftover serum samples of master health checkup subjects, which have been screened negative for HIV, HCV and HBsAg antibodies was pooled in a glass jar with ethanediol as preservative and kept in deep freezer at − 20°C. From the pooled serum, 100 microliter thirty aliquots were prepared. Every day along with commercial internal QC (IQC), one aliquot of pooled serum was analyzed for 30 days for the following parameters: plasma glucose, blood urea, serum creatinine, total cholesterol, triglycerides (TGL), high-density lipoprotein, calcium, total protein, albumin, total bilirubin, AST, ALT, ALP, amylase. After getting 30 values for each parameter, mean, standard deviation (SD) and CV% were calculated for both IQC commercial sample and pooled serum sample.

Results The mean, SD, and CV% of glucose, cholesterol, TGL, calcium, alanine aminotransaminase (ALT), aspartate aminotransferase (AST), amylase, and alkaline phosphatase (ALP) were statistically significant between pooled serum and commercial QC.

Conclusion In-house QC prepared from pooled serum is better than commercial internal QC. The biochemical parameters were stable in pooled serum due to less matrix effect; also, variation was less in pooled serum IQC.
Effectiveness of Sample Pooling Strategies for SARS-CoV-2 Mass Screening by RT-PCR: A Scoping Review
Authors: Deka Sangeeta , Kalita Deepjyoti
Published: November 2020

The ongoing COVID-19 pandemic has hugely impacted the economy of many countries, and there is an acute shortage of diagnostic resources. With the exponential increase in the number of cases and necessity to screen large number of people, there is a steep increase in the demand for diagnostic kits. Pooled-sample testing is a promising strategy to screen a large population rapidly with limited resources. The aim of this work was to compile a cohesive literature review of the effectiveness and accuracy of pooled-sample testing in the detection of SARS-CoV-2 and critically analyze its limitations. Medline, Google Scholar, Embase, and preprint servers (e.g., bioRxiv) were searched for literature on pooled testing for diagnosis of COVID-19, and out of initial 60 articles/reports, nine original articles were retained. Optimal pool size (number of samples in a pool) seemed to be dependent on factors like prevalence or rate of positivity in community. In low-prevalence localities pool size of around 30 seemed to be effective as observed by some authors. All the researchers had found significant reduction in number of tests (depending on pool size, stages, and pooling design), leading to conservation of resources. Pooling can be done with extracted RNA eluate or directly with patient’s sample before extraction. This leads to further reduction in consumables, time and manpower. Risk of false negativity in samples with high-threshold cycle (i.e., low-viral load) value was a concern. Some researchers suggest adding few additional cycles to lower the chances of missing positive cases with low-Ct value. Lower limit of detection (LoD) of RT-PCR kits, that is, sensitivity of kits was another factor to consider. Thus, in a country like India, given the economic benefit and scarcity of resources, pooling strategy can be very effective, especially in low-prevalence areas and in low-risk contacts.
Leclercia adecarboxylata Causing Spontaneous Bacterial Peritonitis in a Child with Nephrotic Syndrome: A Case Report and Review of Literature
Authors: Hassan Ijas , Gupta Parakriti , Ray Pallab , Tiewsoh Karalanglin
Published: November 2020

Infection is an important complication of childhood nephrotic syndrome (NS) and spontaneous bacterial peritonitis (SBP) is a frequently encountered one. We present a 7-year-old boy with NS who had decreased urine output, generalized body swelling, and abdominal pain. Urine analysis showed proteinuria of 50 mg/m2/d. Ascitic tap showed total leukocyte count of 100 cells/mm3, sugar of 67 mg/dL, and protein of 1.1 g/dL. Gram stain revealed gram-negative bacilli with pus cells and culture grown Leclercia adecarboxylata (LAD). LAD was identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) with an identification score of 2.0. The organism showed good susceptibility to common antibiotics. The boy had no direct contact with livestock and the source of infection remains speculative. Devitalized skin because of massive edema seems to be the most plausible site of entry for the organism. Our patient was started on ceftriaxone and improved. LAD is a rare opportunistic pathogen, which belongs to Enterobacteriaceae and usually causes soft tissue infections. As far as we know, this is the first case where it has caused peritonitis in a child with NS. We also reviewed other pediatric cases.