bluuebunny/crossref_metadata_2025 huggingface dataset:
Using formalin embalmed cadavers to teach fracture identification with ultrasound
Authors: Weston Michael , Elmer Dallin , McIntosh Scott , Lundgreen Mason Nena
Published: July 2020

Background

Ultrasound is being utilized more frequently to diagnose fractures in bone and track fracture reduction quickly, and without radiation exposure in the ED. Realistic and practical methods of teaching sonographic fracture identification to medical trainees are needed. The objective of this study is to determine the feasibility of using formalin-embalmed human cadavers in teaching medical trainees to use ultrasound to identify synthetic fractures in tibia, radius, and metacarpal bones.

Methods

First-year medical students attended an orientation presentation and a 15-min scanning workshop, to evaluate fractures in cadaver bones with an instructor. Next participants independently scanned bones to determine if a fracture was present. Questionnaires were given that assessed participant self-confidence and ability to evaluate still ultrasound images for fracture and differentiate between tissue layers before, after, and 5 months following training.

Results

Participants were collectively able to scan and differentiate between fractured and unfractured bone in 75% of 186 total bone scanning attempts (tibia: 81% correct, metacarpal: 68% correct, radius: 76% correct). When evaluating still ultrasound images for fracture, participants’ scores rose significantly following training from an average score of 77.4 to 91.1% (p = 0.001). Five months post-training, scores fell slightly, to an average of 89.8% (p = 0.325).

Conclusions

Ultrasound images of formalin-embalmed cadaveric fractures are of sufficient quality to use in teaching fracture identification to medical trainees. With only 15 minutes of scanning experience, medical trainees can learn to independently scan and significantly increase their ability to identify fractures in still ultrasound images.
Determinants of subnational disparities in antenatal care utilisation: a spatial analysis of demographic and health survey data in Kenya
Authors: Wairoto Kefa G. , Joseph Noel K. , Macharia Peter M. , Okiro Emelda A.
Published: July 2020

Background

The spatial variation in antenatal care (ANC) utilisation is likely associated with disparities observed in maternal and neonatal deaths. Most maternal deaths are preventable through services offered during ANC; however, estimates of ANC coverage at lower decision-making units (sub-county) is mostly lacking. In this study, we aimed to estimate the coverage of at least four ANC (ANC4) visits at the sub-county level using the 2014 Kenya Demographic and Health Survey (KDHS 2014) and identify factors associated with ANC utilisation in Kenya.

Methods

Data from the KDHS 2014 was used to compute sub-county estimates of ANC4 using small area estimation (SAE) techniques which relied on spatial relatedness to yield precise and reliable estimates at each of the 295 sub-counties. Hierarchical mixed-effect logistic regression was used to identify factors influencing ANC4 utilisation. Sub-county estimates of factors significantly associated with ANC utilisation were produced using SAE techniques and mapped to visualise disparities.

Results

The coverage of ANC4 across sub-counties was heterogeneous, ranging from a low of 17% in Mandera West sub-county to over 77% in Nakuru Town West and Ruiru sub-counties. Thirty-one per cent of the 295 sub-counties had coverage of less than 50%. Maternal education, household wealth, place of delivery, marital status, age at first marriage, and birth order were all associated with ANC utilisation. The areas with low ANC4 utilisation rates corresponded to areas of low socioeconomic status, fewer educated women and a small number of health facility deliveries.

Conclusion

Suboptimal coverage of ANC4 and its heterogeneity at sub-county level calls for urgent, focused and localised approaches to improve access to antenatal care services. Policy formulation and resources allocation should rely on data-driven strategies to guide national and county governments achieve equity in access and utilisation of health interventions.
Long non-coding RNA NORAD exhaustion represses prostate cancer progression through inhibiting TRIP13 expression via competitively binding to miR-495-3p
Authors: Chen Fengling , Liu Ling , Wang Shuya
Published: July 2020

Background

Prostate cancer (PCa) is a malignant heterogeneous tumor that threatens men’s health. Long non-coding RNA activated by DNA damage (NORAD) and microRNA-495-3p (miR-495-3p) have been revealed to be concerned with the tumorigenesis and progression of diverse cancers. Nevertheless, the regulatory mechanism between NORAD and miR-495-3p in PCa is unclear.

Methods

The expression of NORAD, miR-495-3p, and thyroid hormone receptor interactor 13 (TRIP13) mRNA was detected with quantitative real-time polymerase chain reaction (qRT-PCR). The levels of Bcl-2, Bax, Cleaved-casp-3, TRIP13, cyclin D1, and PCNA were detected through western blot analysis. The proliferation, apoptosis, migration, and invasion of PCa cells were assessed through 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT), flow cytometry, or transwell assays. The relationship between NORAD or TRIP13 and miR-495-3p was confirmed via dual-luciferase reporter, RIP, or RNA pull-down assays.

Results

NORAD and TRIP13 were upregulated while miR-495-3p was downregulated in PCa tissues and cells. Both NORAD silencing and miR-495-3p upregulation accelerated cell apoptosis and curbed cell proliferation, migration, and invasion in PCa cells. Also, NORAD silencing repressed tumor growth in vivo. Notably, NORAD modulated TRIP13 expression by competitively binding to miR-495-3p. Furthermore, miR-495-3p repression reversed NORAD knockdown-mediated effects on the malignant behaviors of PCa cells. Moreover, TRIP13 enhancement overturned the effects of miR-495-3p overexpression on the proliferation, apoptosis, migration, and invasion of PCa cells.

Conclusion

NORAD depletion inhibited PCa advancement via the miR-495-3p/ TRIP13 axis, which provided a potential tactic for PCa treatment.
Characterization of a multicenter pediatric-hydrocephalus shunt biobank
Authors: Gluski Jacob , Zajciw Paul , Hariharan Prashant , Morgan Amanda , Morales Diego M. , Jea Andrew , Whitehead William , Marupudi Neena , Ham Steven , Sood Sandeep , McAllister James P. , Limbrick David D. , Harris Carolyn A.
Published: July 2020

Background

Pediatric hydrocephalus is a devastating and costly disease. The mainstay of treatment is still surgical shunting of cerebrospinal fluid (CSF). These shunts fail at a high rate and impose a significant burden on patients, their families and society. The relationship between clinical decision making and shunt failure is poorly understood and multifaceted, but catheter occlusion remains the most frequent cause of shunt complications. In order to investigate factors that affect shunt failure, we have established the Wayne State University (WSU) shunt biobank.

Methods

To date, four hospital centers have contributed various components of failed shunts and CSF from patients diagnosed with hydrocephalus before adulthood. The hardware samples are transported in paraformaldehyde and transferred to phosphate-buffered saline with sodium azide upon deposit into the biobank. Once in the bank, they are then available for study. Informed consent is obtained by the local center before corresponding clinical data are entered into a REDCap database. Data such as hydrocephalus etiology and details of shunt revision history. All data are entered under a coded identifier.

Results

293 shunt samples were collected from 228 pediatric patients starting from May 2015 to September 2019. We saw a significant difference in the number of revisions per patient between centers (Kruskal–Wallis H test, p value < 0.001). The leading etiology at all centers was post-hemorrhagic hydrocephalus, a fisher’s exact test showed there to be statistically significant differences in etiology between center (p = 0.01). Regression showed age (p < 0.01), race (p = 0.038) and hospital-center (p < 0.001) to explain significant variance in the number of revisions. Our model accounted for 31.9% of the variance in revisions. Generalized linear modeling showed hydrocephalus etiology (p < 0.001), age (p < 0.001), weight and physician (p < 0.001) to impact the number of ventricular obstructions.

Conclusion

The retrospective analysis identified that differences exist between currently enrolled centers, although further work is needed before clinically actionable recommendations can be made. Moreover, the variables collected from this chart review explain a meaningful amount of variance in the number of revision surgeries. Future work will expand on the contribution of different site-specific and patient-specific factors to identify potential cause and effect relationships.
Unexpected endometrial malacoplakia related to abortion and placental rests retention: a case report
Authors: d’Amati Antonio , Bellitti Emilio , Resta Leonardo
Published: July 2020

Background

Malacoplakia is a rare chronic inflammatory disease. The name derives from the Greek “μαλακός” meaning “soft” and “πλάξ” meaning “plaque”, describing its usual macroscopic presentation as a friable yellow soft plaque. It was first described by von Hansemann in 1901 and by Michaelis and Gutmann in 1902. The urinary system is the most commonly involved site. Female genital tract involvement is extremely rare. Treatment is prevalently based on antibiotics with surgical intervention sometimes necessary. Prognosis is usually good, but relapse may frequently occur.

Case presentation

This report illustrates the first case of endometrial malacoplakia in a 40 years-old patient who received endometrial curettage due to the retention of placental rests following an abortion. After conspicuous vaginal sero-hematic secretions, the patient received a further curettage. The histological examination did not show any retention of chorionic rests, but an endometrial and myometrial infiltration of histiocytes with large granular cytoplasm within a chronic inflammatory background. Immunoreactivity for CK-pool was negative, while CD68 immunostaining was strongly positive.

Conclusions

Malacoplakia of endometrium is an extremely rare condition, with few cases reported in the whole international literature. In this paper, we present the first case associated to an abortion followed by endometrial curettage procedures. This rare disease should always be attentively examined, considering, among differential diagnoses, uterine neoplasms or physiological conditions such as cumulus of foamy macrophages in the endometrium.
Prognostic value of a three-dimensional dynamic quantitative analysis system to measure facial motion in acute facial paralysis patients
Authors: Zhao Yang , Feng Guodong , Wu Haiyan , Aodeng Surita , Tian Xu , Volk Gerd Fabian , Guntinas-Lichius Orlando , Gao Zhiqiang
Published: July 2020

Background

To investigate the prognostic value of a three-dimensional dynamic quantitative analysis system to measure facial motion (3D ASFM) in acute facial palsy patients and compare it with subjective grading methods and electroneurography.

Methods

We continuously recruited 37 patients with acute (< 1 month) Bell’s palsy. An integrated evaluation of facial palsy was performed for each patient. The integrated evaluation included the House-Brackmann grading system (H-BGS), Sunnybrook Facial Grading System (SFGS), electroneurography and three-dimensional objective measurements. Then, the entire set of evaluations were repeated for each patient 1 month later. The patients were followed up monthly until recovery or for up to more than 6 months. We adopted the SFGS and H-BGS as the representative subjective grading system and final criteria for recovery. Poor recovery was defined as an SFGS score less than 70 or H-BGS score higher than II.

Results

Multiple regression analysis was performed to find the best prognostic indicators. In less than 1 month from onset, ENoG had the highest prognostic value. However, in the second month from onset, the results of SFGS and 3D ASFM were identified as the best prognostic parameters, and a prediction formula with a determination coefficient of 0.673 was established. The receiver operating characteristic curves revealed that a gross score of the 3D ASFM less than 31 in the first evaluation and 49 in the second evaluation had higher sensitivity and specificity to predict poor recovery.

Conclusions

In different phases of Bell’s palsy, the best predictor of prognosis is different. ENOG is the most effective predictor of the prognosis in the first month after onset. In the second month after onset, the combination of SFGS and 3D ADSM is considered to be the best prognostic predictor.
Validation and psychometric properties of the community assessment inventory in Iranian persons who use drug
Authors: Salari Nader , Jalali Amir , Abdam Behzad , Abdi Alireza , Daryoushi Hooman
Published: July 2020

Objective

Social support is a key factor in the treatment and rehabilitation process of persons who use drug (PWUD). This highlights the need for a valid and reliable tool for assessing social support. The cultural and psychometric properties of community assessment inventory (CAI) in PWUDs under methadone therapy were examined in Iran in 2019.

Methods

The study was carried out as a validation and methodological study. At first, the original tool was translated into Farsi using forward-backward method. After ensuring face validity and content validity, construct reliability of the tool was supported using explorative and confirmatory factor analysis (EFA & CFA) using a sample group of 392 participants. The participants were selected through convenient-quota sampling from 24 drug clinics. Reliability of the questionnaire was supported using Pearson correlation coefficient and internal consistency based on Cronbach’s alpha.

Results

To determine content validity of the tool, CVI and CVR of it were obtained, which were on average equal to 0.79 and 0.59 respectively. The EFA supported correlation of the 37itmes of the tool (KMO = 0.975, Chi-square = 15,051.6, Pvalue=0.0001). The main indices of the model, based on CFA were higher than 0.9, which support goodness of fit of the model (χ2/DF = 2.98, CFI = 0.91, NFI, TLI = 0.905 GF = 0.92, REMSEA = 0.07, R2 = 0.99). Reliability of the tool based on internal consistency (Cronbach’s alpha) for the subscales were in 0.8–0.95 interval and equal to 0.85 for the whole tool.

Conclusion

As the results showed, CAI had acceptable indices for Iranian PWUDs under methadone therapy. The tool can be used for assessing social support level in the study population. It is a reliable and valid tool for studies in pertinent fields.
What is the impact of a novel MED12 variant on syndromic conotruncal heart defects? Analysis of case report on two male sibs
Authors: Amodeo Silvia , Vitrano Giuseppe , Guardino Melania , Paci Giuseppe , Corselli Fulvio , Antona Vincenzo , Barrano Giuseppe , Magliozzi Monia , Novelli Antonio , Venezia Renato , Corsello Giovanni
Published: July 2020

Background

Syndromic congenital heart disease accounts for 30% of cases and can be determined by genetic, environmental or multifactorial causes. In many cases the etiology remains uncertain. Many known genes are responsible for specific morphopathogenetic mechanisms during the development of the heart whose alteration can determine specific phenotypes of cardiac malformations.

Case presentation

We report on two cases of association of conotruncal heart defect with facial dysmorphisms in sibs. In both cases the malformations’ identification occurred by ultrasound in the prenatal period. It was followed by prenatal invasive diagnosis. The genetic analysis revealed no rearrangements in Array-CGH test, while gene panel sequencing identified a new hemizygous variant of uncertain significance (c.887G > A; p.Arg296Gln) in the MED12 gene, located on the X chromosome and inherited from the healthy mother.

Conclusion

No other reports about the involvement of MED12 gene in syndromic conotruncal heart defects are actually available from the literature and the international genomic databases. This novel variant is a likely pathogenic variant of uncertain significance and it could broaden the spectrum of genes involved in the development of congenital heart diseases and the phenotypic range of MED12-related disorders.
Aggressive refractory pemphigus vulgaris that responded to plasmapheresis: a case report
Authors: Khaddour Hiba Hasan , Zaher Diana , Kassem Triak , Hasan Ahmad
Published: July 2020

Background

Pemphigus vulgaris is an autoimmune disorder that involves intraepithelial blistering and sores of the skin and mucous membranes. The average age of onset is between 50 and 70 years. Pemphigus rarely occurs in children. It correlates with the level of circulating autoantibodies; therapeutic plasma exchange is hypothesized to remove pathogenic autoantibodies, and this is necessary in refractory severe cases.

Case presentation

A 14-year-old Asian girl came to our hospital with blisters and erosions all over her body and in the oral mucosa. She was diagnosed with pemphigus vulgaris by skin biopsy about 3 months before hospitalization. She was admitted to the intensive care unit due to aggressively worsening symptoms, extensive lesions, dehydration, and electrolyte imbalance secondary to excess fluid loss from the skin wounds and sepsis secondary to infection of the exposed wounds. She did not respond to prednisone and azathioprine therapy but was successfully treated with plasmapheresis.

Conclusion

The purpose of this case report is to describe an aggressive presentation of pemphigus vulgaris, especially because the onset of the disease in our patient was at an early age. The disease rarely begins in childhood, and this case report highlights the importance of plasmapheresis as a useful intervention in patients with pemphigus vulgaris who are not responding to conventional therapy, taking into account that there is a paucity of studies showing the effectiveness of plasmapheresis in inducing partial or complete remission in young patients.
Effectiveness of exergames for improving mobility and balance in older adults: a systematic review and meta-analysis
Authors: Pacheco T. B. F. , de Medeiros C. S. P. , de Oliveira V. H. B. , Vieira E. R. , de Cavalcanti F. A. C.
Published: July 2020

Background

Exergaming is a fun, engaging, and interactive form of exercising that may help overcome some of the traditional exercise barriers and help improve adherence on the part of older adults, providing therapeutic applications for balance recovery and functional mobility. The purpose of this systematic review is to summarize the effects of exergames on mobility and balance in older adults.

Methods

The PRISMA guidelines for systematic reviews were followed. The following databases were searched from inception to August 2019: Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PEDro, CINAHL, and INSPEC. We selected randomized controlled trials that assessed the effects of exergames on balance or mobility of older adults without neurological conditions, in comparison to no intervention or health education. Two review authors independently screened the trials’ titles and abstracts and identified trials for inclusion according to the eligibility criteria. An almost perfect agreement between the authors was observed with respect to interrater reliability of trial selection (kappa = 0.84; P < 0.001). We performed descriptive analysis of the quantitative data to summarize the evidence. Meta-analysis was carried out using RevMan. A random effects model was used to compute the pooled prevalence with 95% confidence intervals.

Results

After screening 822 records, 12 trials comparing exergames with no intervention were included. A total of 1520 older adults participated in the studies, with a mean age of 76 ± 6 years for the experimental group and 76 ± 5 years for the control group. Quantitative synthesis showed significant improvements in balance and mobility based on the center of pressure sway (SMD = − 0.89; 95%CI = − 1.26 to − 0.51; P = 0.0001; I2 = 58%), Berg Balance Scale (MD = 2.15; 95%CI = 1.77 to 2.56; P = 0.0001; I2 = 96%), and on Timed Up and Go test (MD = − 2.48; 95%CI = − 3.83 to − 1.12; P = 0.0003; I2 = 0).

Conclusions

Exergames improved balance and mobility in older adults without neurological disorders and motivate patients to keep performing balance exercises. High quality studies with standardized assessment protocols are necessary to improve the strength of the evidence.
On generalized fractional integral inequalities for the monotone weighted Chebyshev functionals
Authors: Rahman Gauhar , Nisar Kottakkaran Sooppy , Ghanbari Behzad , Abdeljawad Thabet
Published: July 2020

In this paper, we establish the generalized Riemann–Liouville (RL) fractional integrals in the sense of another increasing, positive, monotone, and measurable function Ψ. We determine certain new double-weighted type fractional integral inequalities by utilizing the said integrals. We also give some of the new particular inequalities of the main result. Note that we can form various types of new inequalities of fractional integrals by employing conditions on the function Ψ given in the paper. We present some corollaries as particular cases of the main results.
Topological degree theory and Caputo–Hadamard fractional boundary value problems
Authors: Amara Abdelkader , Etemad Sina , Rezapour Shahram
Published: July 2020

We study two hybrid and non-hybrid fractional boundary value problems via the Caputo–Hadamard type derivatives. We seek the existence criteria for these two problems separately. By utilizing the generalized Dhage’s theorem, we derive desired results for an integral structure of solutions for the hybrid problems. Also by considering the special case as a non-hybrid boundary value problem (BVP), we establish other results based on the existing tools in the topological degree theory. In the end of the article, we examine our theoretical results by presenting some numerical examples to show the applicability of the analytical findings.
Existence results of fractional delta–nabla difference equations via mixed boundary conditions
Authors: Reunsumrit Jiraporn , Sitthiwirattham Thanin
Published: July 2020

In this article, we purpose existence results for a fractional delta–nabla difference equations with mixed boundary conditions by using Banach contraction principle and Schauder’s fixed point theorem. Our problem contains a nonlinear function involving fractional delta and nabla differences. Moreover, our problem contains different orders in four fractional delta differences, four fractional nabla differences, one fractional delta sum, and one fractional nabla sum. Finally, we present some illustrative examples.
A multimodal intervention to improve hand hygiene compliance in peripheral wards of a tertiary care university centre: a cluster randomised controlled trial
Authors: Aghdassi Seven Johannes Sam , Schröder Christin , Lemke Elke , Behnke Michael , Fliss Patricia Manuela , Plotzki Carolin , Wenk Janina , Gastmeier Petra , Kramer Tobias Siegfried
Published: July 2020

Background

Interventions to improve hand hygiene (HH) compliance are a key element in the practice infection prevention and control. It was our objective to assess the effect of a multimodal intervention on HH compliance at a tertiary care university hospital. As a secondary objective, we investigated the effect of the intervention on the occurrence of device-associated bloodstream infections.

Methods

We performed a single centre cluster randomised controlled trial at a university hospital in Germany. Twenty peripheral wards were invited to participate and randomly assigned to either the intervention (n = 10) or control group (n = 10). Quarterly, specifically trained student employees conducted direct compliance observations in all twenty wards. The intervention entailed dissemination of teaching materials on aseptic procedures, equipment with flexibly mountable alcoholic hand rub dispensers, and quarterly feedback on HH compliance.

Results

In total, 21,424 HH opportunities were observed. Overall, compliance did not change significantly in either group (intervention group: 59% vs. 61% (1482 HH actions for 2494 HH opportunities vs. 5033 HH actions for 8215 HH opportunities), odds ratio (OR) 1.08 (95% confidence interval (CI95) 0.88, 1.33)); control group: 59% vs. 60% (1457 HH actions for 2484 HH opportunities vs. 4948 HH actions for 8231 HH opportunities), OR 1.06 (CI95 0.84, 1.35)). Compliance prior to aseptic procedures improved significantly in the intervention group from 44% (168 HH actions for 380 HH opportunities) to 53% (764 HH actions for 1452 HH opportunities) (OR 1.40 (CI95 1.04, 1.89), p = 0.03), while no significant increase was noted in the control group. In the intervention group, significantly fewer device-associated bloodstream infections per 1000 patient-days occurred than in the control group (84 vs. 123, incidence rate ratio 0.61 (CI95 0.46, 0.81), p < 0.01).

Conclusions

The lack of a significant overall improvement of HH compliance demonstrated that comprehensive implementation of HH interventions in multiple wards simultaneously is difficult. However, through targeted intervention measures, we were able to significantly increase HH compliance before aseptic procedures.
Spatial estimation of soil erosion using RUSLE modeling: a case study of Dolakha district, Nepal
Authors: Thapa Pawan
Published: July 2020

Background

Soil erosion causes topsoil loss, which decreases fertility in agricultural land. Spatial estimation of soil erosion essential for an agriculture-dependent country like Nepal for developing its control plans. This study evaluated impacts on Dolakha using the Revised Universal Soil Loss Equation (RUSLE) model; analyses the effect of land use and land cover (LULC) on soil erosion.

Results

The soil erosion rate categorized into six classes based on the erosion severity, and 5.01% of the areas found under extreme severe erosion risk (> 80 Mg ha−1 year−1) addressed by decision-makers for reducing its rate and consequences. Followed by 10% classified between high and severe range from 10 to 80 Mg ha−1 year−1. While 15% and 70% of areas remained in a moderate and low-risk zone, respectively. Result suggests the area of the north-eastern part suffers from a high soil erosion risk due to steep slope.

Conclusions

The result produces a spatial distribution of soil erosion over Dolakha, which applied for conservation and management planning processes, at the policy level, by land-use planners and decision-makers.
Social innovation for health: engaging communities to address infectious diseases
Authors: Dako-Gyeke Phyllis , Amazigo Uche V. , Halpaap Beatrice , Manderson Lenore
Published: July 2020

Universal health coverage emphasises the value of the community-based delivery of health services to ensure that underserved populations have access to care. In areas where infectious diseases are endemic, there are often few resources and limited capacity, and the introduction of effective and accessible strategies require innovation. In this special issue, the contributing authors emphasise the power of local responses to the circumstances that underpin diseases of poverty, and highlight the methodological and programme innovations necessary to support and sustain these responses. Through case studies, the authors illustrate how social innovations can address health inequities, and they identify the role of academics in the Social Innovation in Health Initiative to support this approach.
Orbital Rosai-Dorfman disease initially diagnosed as IgG4-related disease: a case report
Authors: Iyengar Nishanth S. , Golub Danielle , McQuinn Michelle W. , Hill Travis , Tang Karen , Gardner Sharon L. , Harter David H. , Sen Chandranath , Staffenberg David A. , Thomas Kristen , Elkin Zachary , Belinsky Irina , William Christopher
Published: July 2020

Inflammatory orbital lesions include a broad list of diagnoses, many of them with overlapping clinical and radiographic features. They often present a diagnostic conundrum, even to the most experienced orbital specialist, thus placing considerable weight on surgical biopsy and histopathological analysis. However, histopathological diagnosis is also inherently challenging due to the rarity of these lesions and the overlaps in histologic appearance among distinct disease entities. We herein present the case of an adolescent male with a subacutely progressive orbital mass that generated a significant diagnostic dilemma. Early orbital biopsy was consistent with a benign fibro-inflammatory lesion, but corticosteroid therapy was ineffective in halting disease progression. After an initial substantial surgical debulking, histopathological analysis revealed several key features consistent with IgG4-related disease (IgG4-RD), a systemic fibro-inflammatory process typically accompanied by multifocal tumor-like lesions. Surprisingly, within months, there was clear evidence of clinical and radiographic disease progression despite second-line rituximab treatment, prompting a second surgical debulking. This final specimen displayed distinctive features of Rosai-Dorfman disease (RDD), a systemic inflammatory disease characterized by uncontrolled histiocytic proliferation. Interestingly, certain features of this re-excision specimen were still reminiscent of IgG4-RD, which not only reflects the difficulty in differentiating RDD from IgG4-RD in select cases, but also illustrates that these diagnoses may exist along a spectrum that likely reflects a common underlying pathogenetic mechanism. This case emphasizes the importance of surgical biopsy or resection and histopathological analysis in diagnosing—and, ultimately, treating—rare, systemic inflammatory diseases involving the orbit, and, furthermore, highlights the shared histopathological features between RDD and IgG4-RD.
Clinical outcomes with a new design in multifocal intraocular lens: a pilot study
Authors: Alió Jorge L. , Yébana Pilar , Cantó Mario , Plaza Ana B. , Vega Alfredo , Alió del Barrio Jorge L. , Lugo Francisco
Published: July 2020

Purpose

To evaluate the clinical and visual outcomes, quality of near vision and the influence of photic phenomena in patients bilaterally implanted with a new Precizon Presbyopic multifocal intraocular lens (IOL).

Methods

In this prospective consecutive case series, 20 eyes of 10 patients were included (mean age 63.80 ± 12.55 years). Uncorrected and corrected visual acuity (far, intermediate and near), subjective refraction, binocular defocus curve, contrast sensitivity (CSV-1000) and quality of vision and satisfaction questionnaires were measured. The follow-up was 12 months after surgery.

Results

At 12 months after surgery, uncorrected distance visual acuity (UDVA) improved with surgery (p = 0.001) with a value of 0.08 ± 0.08 logMAR. Uncorrected near visual acuity (UNVA) was 0.22 ± 0.12 logMAR and distance corrected near visual acuity (DCNVA) was 0.16 ± 0.13 logMAR. Intermediate distance visual acuity (UIVA) was 0.22 ± 0.10 logMAR. Contrast sensitivity outcomes were similar to normal population in photopic conditions and slightly reduced in mesopic conditions of lighting. Defocus curve showed that this multifocal IOL was able to provide a visual acuity (VA) equal or better to 0.16 logMAR between defocus levels of + 1.00 to − 2.50 D. Good patient satisfaction was obtained in quality of vision and satisfaction questionnaires outcomes.

Conclusions

The Precizon Presbyopic NVA IOL (OPHTEC BV) provides good visual outcomes. This multifocal IOL provides a high percentage of spectacle independence due to good VA at far, intermediate and near distances and satisfactory contrast sensitivity. High patient satisfaction was observed in quality of vision and satisfaction questionnaires with a low percentage of patients manifesting photic phenomena.
Fertility patients’ use and perceptions of online fertility educational material
Authors: Jones Claire Ann , Mehta Chaula , Zwingerman Rhonda , Liu Kimberly E.
Published: July 2020

Background

Online educational information is highly sought out by patients with infertility. This study aims to assess patient-reported usage and helpfulness of fertility educational material on a clinic website and social media accounts.

Methods

Educational material was created on common fertility topics in text and video format and posted on the clinic website and social media accounts. At the first consultation for infertility, patients were provided with a postcard directing them to material online. At the first follow-up appointment, patients were invited to fill out a survey assessing whether patients viewed the online educational material and if they found the information helpful.

Results

98.4% (251/255) of patients completed the survey, of which 42.6% (106/249) looked at the online material. Of those who viewed the online information, 99.1% (115/116) found the information helpful or somewhat helpful and 67.6% (73/108) found reading the material online better prepared them for making fertility decisions at their doctor’s appointment

Conclusion

Patients found online fertility information on the clinic website and social media accounts useful for making fertility treatment decisions. Providing online educational material has the potential to improve patient care by empowering patients with the knowledge to make more informed treatment decisions, and improving the quality of the time spent with the physician.
Visual processing of color and shape in people with leprosy
Authors: Soares Perla Figueredo Carreiro , Andrade Michael Jackson Oliveira , Andrade Sefora Luana Evangelista , Santos Natanael Antonio
Published: July 2020

The aim of this study was to analyze the contrast sensitivity of spatial luminance and the color discrimination thresholds of the protan, deutan, and tritan axes of people with leprosy. This study included 8 subjects with leprosy (M = 4, W = 4, M = 33.38 ± 8.7) and 8 healthy subjects (M = 4, W = 4, M = 30.89 ± 5.8). The contrast sensitivity was evaluated by the Metropsis software version 11.0 with vertical sinusoidal grids of frequencies of 0.2, 0.5, 1, 5, 10, and 16 cycles per degree of visual angle (cpd) and color vision by the desaturated Lanthony D15 tests and the trivector and ellipse protocols of the Cambridge Color Test. The results showed significant differences between the groups in the processing of spatial frequencies of 0.2 (U= 14;p= .018); 5.0 (U= 45.0;p= .001); 10.0 (U= 45.0;p= .001), and 16.0 (U= 45.0;p= .001) cpd. The difference in color recognition through D15d (U= 4.0;p= .002). Ellipse 2 (U= 10.0;p= .012) and ellipse 3 (U= 9.0;p= .009) were discriminated against. Overall, the results indicate that leprosy changes the visual processing of low, medium, and high spatial frequencies, as well as the sensitivity of the short wavelength (tritan line of confusion) and long (protan line of confusion) cones.
Correction to: Endophytic colonization of tomato plants by the entomopathogenic fungus
Beauveria bassiana
for controlling the South American tomato pinworm,
Tuta absoluta
Authors: Silva Ana Carolina Loreti , Silva Gerson Adriano , Abib Pedro Henrique Nogueira , Carolino Aline Teixeira , Samuels Richard Ian
Published: July 2020

An amendment to this paper has been published and can be accessed via the original article.
The Gilets Jaunes
Authors: Galí Marta Camell , Polleri Matteo , Puletti Federico
Published: July 2020

This contribution is dedicated to an in-depth look at the cycle of the Gilets Jaunes protests that marked the French and European political landscape between November 2018 and the beginning of 2020. An unexpected social and political phenomenon, this movement accompanied the presidency of Emmanuel Macron and influenced his political agenda. Through “co-research” work done in direct contact with the movement, the essay analyzes the social and geographical composition of the participants, the political context in which it emerged, and its forms of organization and struggle. It argues that by subverting the frustration of social and geographical declassing, the Gilets Jaunes managed to constitute an unprecedented case of democratic counter-power.
The Climate of Roundabouts
Authors: Chédikian Élodie , Guillibert Paul , Lassere Davide Gallo
Published: July 2020

We argue that the Gilets Jaunes have contributed to the radicalization of climate justice by claiming ecological and territorial autonomy. The political centrality of social reproduction in the movement, as well as its quasi-insurrectional forms of struggle, have created a space that recon figures the terrain of political ecology in France, producing effects of “Gilet Jauneification.”
«ВЕРБЛЮЖЬИ» АНТИТЕЛА: ОСОБЕННОСТИ ИХ СТРОЕНИЯ, ПОЛУЧЕНИЕ И ПРИМЕНЕНИЕ
Authors: Andreev Alexey Alekseevich , Lopina Nadezhda Petrovna , Bordina Galina Evgenievna , Nekrasova Elizaveta Georgievna
Published: July 2020

В статье представлен аналитический обзор научной литературы на тему «верблюжьих» антител, их открытия, структурных отличий от классических иммуноглобулинов и их применения в генной инженерии, биологических исследованиях и в медицине, в частности, в онкологической терапии.
ОСОБЕННОСТИ КРОВООБРАЩЕНИЯ В ВЕРХНИХ КОНЕЧНОСТЯХ ПРИ ДОЗИРОВАННОЙ ВЕЛОЭРГОМЕТРИИ
Authors: Nikolaeva Tatyana Mikhaylovna , Golubeva Elena Konstantinovna
Published: July 2020

Проведено исследование интенсивности кровотока в сегменте «плечо-предплечье» при дозированной физической нагрузке на велоэогометре. Для изучения особенностей регионального кровообращения использовался метод реовазографии. Выявлено снижение тонуса артериальных сосудов верхних конечностей и увеличение кровенаполнения при мощности физической нагрузки, составляющей 2 Вт/кг.
Polymorphism and expression of the Dvl3 gene in the etiology of depressive disorder
Authors: Zajączkowska Marlena , Talarowska Monika , Szemraj Janusz , Gałecki Piotr
Published: July 2020

Cel pracy

Celem tej pracy było zbadanie roli genu Dvl3 w etiologii zaburzeń depresyjnych poprzez porównanie ekspresji genu Dvl3 na poziomie mRNA i białka jak i polimorfizmu w locus rs 1969253 w obrębie intronu genu Dvl3 u pacjentów z depresją w odniesieniu do osób zdrowych oraz poszukiwanie zmiennych klinicznych mających związek z polimorfizmem lub ekspresją badanego genu.

Metoda

Badaniami objęto grupę 181 osób z rozpoznaniem zaburzeń depresyjnych nawracających lub epizodu depresyjnego. Grupę kontrolną stanowiły 102 zdrowe osoby. Od wszystkich uczestników pobrano próbki krwi obwodowej celem pomiaru poziomu ekspresji genu Dvl3 na poziomie mRNA i białka jak i polimorfizmu w locus rs 1969253. Od pacjentów zebrano przy włączeniu do badania dane dotyczące płci, wieku, przebiegu choroby a także zbadano natężenie objawów depresyjnych za pomocą Skali Depresji Hamiltona. Uzyskane dane opracowano statystycznie.

Wyniki

U pacjentów z depresją stwierdzono istotne statystycznie obniżenie ekspresji Dvl3 na poziomie mRNA i białka względem zdrowych uczestników. Na ekspresję genu Dvl3 u pacjentów z depresją nie miały wpływu płeć, wiek, liczba epizodów, nasilenie objawów, czas trwania choroby lczy wiek wystąpienia pierwszego epizodu. Ocena polimorfizmu w locus rs 1969253 wykazała, że osoby z genotypem CA i CC miały ponad trzykrotnie wyższe ryzyko zachorowania na depresję w porównaniu z osobami o genotypie AA (OR = 3,3 ,% CI = 1,56-6,99). Nie obserwowano natomiast zależności między badanym polimorfizmem a analizowanymi zmiennymi klinicznymi

Wnioski

Zmiany ekspresji i polimorfizm genu Dvl3 mogą mieć istotny związek z mechanizmami patogenetycznymi występującymi w przebiegu zaburzeń depresyjnych.
The program of psychological and breastfeeding support “Maternity step by step”: an example of effective solution for the prevention, diagnostics and treatment of prenatal and postpartum depression
Authors: Chrzan-Dętkoś Magdalena , Pietkiewicz Agnieszka , Żołnowska Joanna , Pizuńska Daria
Published: July 2020

Cel pracy

Depresja poporodowa dotyka około 13 – 20% kobiet, depresja w okresie ciąży – 19% kobiet ciężarnych. W Polsce brakuje oferty pomocy dla tej grupy osób. W artykule zaprezentowano elementy pilotażowego programu „Macierzyństwo krok po kroku”, finansowanego przez gminę Miasto Gdańsk. Celem programu było zapewnienia gdańszczanom specjalistycznej opieki laktacyjnej i psychologicznej w okresie ciąży i w pierwszym roku życia dziecka.

Metoda

Badaniem objęto trzy grupy kobiet: 36 matek biorących udział w konsultacjach psychologicznych i terapii krótkoterminowej, 123 kobiet korzystających z porad laktacyjnych oraz 104 osoby z grupy kontrolnej. Do ewaluacji wykorzystano m.in. autorskie ankiety, Kwestionariusz Oceny Zdrowia Psychicznego GHQ – 28 Goldberga (Makowska & Merecz, 2011) oraz Parental Stress Index - 3rd version (Abidin, 1995).

Wyniki

Wyniki. Przeprowadzona ewaluacja wykazała istotne obniżenie symptomów zaburzeń zdrowia psychicznego zarówno w grupie kobiet korzystających z interwencji psychologicznej jak i z porad laktacyjnych. W grupie kobiet korzystających z interwencji psychologicznej zaobserwowano istotne obniżenie stresu rodzicielskiego.

Wnioski

Przeprowadzone analizy pokazują, że wdrożony program charakteryzuje się wysoką skutecznością. Program może być odpowiedzią na planowane zmiany w standardach opieki okołoporodowej i kontynuowany w kolejnych latach.
Implementation of the European Psychiatric Association (EPA) guidance on forensic psychiatry in Poland. Current state and required measures
Authors: Heitzman Janusz , Gosek Paweł , Luks Małgorzata , Pilszyk Anna , Kotowska Justyna , Pacholski Marek
Published: July 2020

Cel pracy i metoda: W artykule omówiono kluczowe aspekty wytycznych Europejskiego Towarzystwa Psychiatrycznego w zakresie psychiatrii sądowej - European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders. Wyniki: Autorzy zwracają uwagę na rozbieżności pomiędzy rekomendacjami wynikającymi z wytycznych a praktyką kliniczną i obecnymi rozwiązaniami systemowymi. Omówiono podstawowe trudności związane z implementacją wytycznych w praktyce klinicznej w Polsce w zakresie pełnienia roli biegłego przez lekarzy psychiatrów i psychologów, oceny i zarządzania ryzykiem, lecznictwa psychiatrycznego w zakładach karnych, realizacji środków zabezpieczających w warunkach ambulatoryjnych i szpitalnych, skuteczności oddziaływań farmakologicznych i pozafarmakologicznych. Wnioski: Mamy nadzieję, że omówienie treści wytycznych przyczyni się do pogłębienia wiedzy klinicystów w zakresie pracy w charakterze biegłych sądowych i osób odpowiedzialnych za realizację środka zabezpieczającego w naszym kraju. W oparciu o doświadczenie kliniczne zaproponowano rozwiązania umożliwiające implementację wytycznych, a tym samym poprawę jakości sprawowanej opieki nad chorującymi psychicznie sprawcami czynów zabronionych.
Does pop-culture affect perception of medical procedures? Report on knowledge and attitude towards electroconvulsive therapy among Polish students
Authors: Kramarczyk Krzysztof , Ćwiek Aleksandra , Kurczab Bartłomiej , Czok Marcelina , Bratek Agnieszka , Kucia Krzysztof
Published: July 2020

Cel pracy

Terapia elektrowstrząsowa (EW, ang. electroconvulsive therapy) jest jedną z najbardziej stygmatyzowanych i kontrowersyjnych form leczenia stosowanych w psychiatrii. Pomimo faktu, że z biegiem lat liczba wskazań do jej wykonywania spadła, wciąż cechuje ją dobry efekt terapeutyczny. Ponadto jej skuteczność w wielu jednostkach chorobowych przewyższa skuteczność leczenia farmakologicznego. Ponadto EW jest leczeniem bezpiecznym z kilkoma efektami ubocznymi, z których najważniejszym jest przejściowa utrata pamięci. Celem badania było sprawdzenie poziomu wiedzy ogólnej oraz stosunku polskich studentów, w tym również studentów kierunków medycznych, do terapii elektrowstrząsowej. Oprócz tego zbadano wpływ popkultury na opinię społeczną na temat EW.

Metoda

W tym celu zankietowano 1370 studentów za pomocą kwestionariusza autorskiego, złożonego z pytań o dane demograficzne, pytań szczegółowych dotyczących EW, jak również pytań o wpływ popkultury na odbiór społeczny tej procedury medycznej. Respondenci zostali przyporządkowani do czterech podgrup, w zależności od kierunków studiów: kierunki humanistyczne, techniczne, kierunek lekarski oraz inne kierunki nauk o zdrowiu.

Wyniki

Uzyskane dane wskazują że wiedza na temat elektrowstrząsów wśród polskich studentów stoi na bardzo niskim poziomie. W wielu przypadkach terapia ta jest uważana za bolesną, nieskuteczną, a nawet nielegalną.

Wnioski

Duży wpływ na takie postrzeganie tej terapii ma popkultura, a zwłaszcza przemysł filmowy, który kreuje negatywne opinie na temat opisywanej procedury. Ponadto wielu respondentów deklaruje, że głównym źródłem ich wiedzy jest telewizja lub Internet, gdzie informacje są często nierzetelne.
Mania induced by antidepressants – characteristics and specific phenomena in children and adolescents
Authors: Stawicka Elżbieta , Wolańczyk Tomasz
Published: July 2020

Zjawisko manii indukowanej, czyli epizodu maniakalnego związanego ze stosowaniem farmakoterapii (w szczególności lekami przeciwdepresyjnymi) jest szczegółowo zdefiniowane i opisane w grupach pacjentów dorosłych. Potwierdzony został negatywny wpływ wystąpienia powyższego zjawiska na przebieg choroby afektywnej dwubiegunowej. W grupie dzieci i młodzieży jest to temat nadal słabo poznany i opisywany stosunkowo od niedawna ze względu na kontrowersje wokół samej diagnozy choroby afektywnej dwubiegunowej o wczesnym początku. Autorzy pracy przedstawią przegląd aktualnych badań na ten temat począwszy od opisów przypadków, poprzez badania otwarte kończąc na badaniach randomizowanych. Ponieważ wyniki prac nie są jednoznaczne, omówione zostały również główne problemy, które uniemożliwiają formułowanie obiektywnych wniosków oraz najważniejsze kierunki dalszych badań. Zaprezentowano także aktualne hipotezy na temat etiologii epizodu manii indukowanej u dzieci i młodzieży służące systematyzacji problemu oraz stanowiące pomoc diagnostyczną w codziennej pracy klinicznej. W grupie dzieci i młodzieży zjawisko manii indukowanej wymaga różnicowania w zależności od diagnozy pierwotnej, gdyż podobnie jak w badaniach u dorosłych wydaje się występować częściej u pacjentów z chorobą afektywną dwubiegunową niż w innych zaburzeniach psychicznych. Ponadto, można przyjąć, że na obecnym etapie wiedzy samo zjawisko występowania manii indukowanej u dzieci i młodzieży nie podlega dyskusjom, aczkolwiek określenie skali zjawiska wymaga dalszych badań.
SARS-CoV-2 pandemic and the population with dementia. Recommendations under the auspices of the Polish Psychiatric Association
Authors: Łuc Mateusz , Szcześniak Dorota , Trypka Elżbieta , Mazurek Justyna , Rymaszewska Joanna
Published: July 2020

SARS-CoV-2 stanowi szczególne zagrożenie dla osób w wieku podeszłym oraz z wieloma schorzeniami towarzyszącymi. W przypadku osób żyjących z otępieniem przestrzeganie zaleceń sanitarnych oraz niezbędna fizyczna izolacja mogą mieć daleko idące negatywne konsekwencje związane z ograniczeniem kontynuacji dostosowanej do ich potrzeb opieki, wsparcia oraz leczenia. Zalecenia związane z pandemią SARS-CoV-2 uwzględniać muszą nie tylko medyczne konsekwencje braku dostępu do opieki lekarskiej, lecz również ich długofalowe efekty oraz progresję choroby zgodnie z koncepcją zdrowia społecznego. Potrzebny jest również dopasowany do grupy seniorów, w tym osób z otępieniem, plan postępowania w zakresie psychoedukacji opiekunów nieformalnych. Przedstawione zalecenia, przygotowane pod patronatem PTP, dla osób mieszkających samodzielnie, z rodziną oraz w placówkach opieki długoterminowej mają na celu zwrócenie uwagi na kluczowe kwestie epidemiologiczne możliwe do zaplanowania przez personel medyczny w ramach organizacji opieki nad pacjentem. Równie ważne są jednak potrzeby psychiczne i społeczne pacjentów, których realizacja jest szczególnie istotna w dobie obostrzeń związanych z czynnościami dnia codziennego. Dalsze monitorowanie sytuacji epidemiologicznej oraz doniesień naukowych związanych z pandemią SARS-CoV-2 jest konieczne w celu weryfikacji i aktualizacji wytycznych.
Editorial
Authors: Dudek Dominika , Sobański Jerzy , Klasa Katarzyna
Published: July 2020

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