bluuebunny/crossref_metadata_2025 huggingface dataset:
A two-step method for paroxysmal atrial fibrillation event detection based on machine learning
Authors: Wang Ya'nan , Liu Sen , Jia Haijun , Deng Xintao , Li Chunpu , Wang Aiguo , Yang Cuiwei
Published: July 2022

Detection of atrial fibrillation (AF) events is significant for early clinical diagnosis and appropriate intervention. However, in existing detection algorithms for paroxysmal AF (AFp), the location of AF starting and ending points in AFp is not concerned. To achieve an accurate identification of AFp events in the long-term dynamic electrocardiograms (ECGs), this paper proposes a two-step method based on machine learning. In the first step, based on features extracted from the calculated R-to-R intervals (RR intervals, the cycle of heart beat), the rhythm type of the ECG signal is first classified into three classes (AFp rhythm, persistent AF (AFf) rhythm, and non-atrial fibrillation (non-AF, N) rhythm) using support vector machine (SVM). In the second step, the starting and ending points for AF episodes of AFp rhythms predicted in the first step are further located based on heartbeat classification. By training a deep convolutional neural network with phased training, the segmented beats of AFp rhythms are divided into AF beats and non-AF beats to determine the beginning and end of any AF episode. The proposed two-step method is trained and tested on the 4th China Physiological Signal Challenge 2021 databases. A final score U of 1.9310 is obtained on the unpublished test set maintained by the challenge organizers, which demonstrates the advantage of the two-step method in AFp event detection. The work is useful for assessing AF burden index for AFp patients.
Adaptive decision support model for sustainable transport system using fuzzy AHP and dynamical Dijkstra simulations
Authors: Ma Xinlei , Chen Wen , Gao Zhan , Yang Tao
Published: July 2022

Concerning decisions for modern public transportation project, the lack of consensus between stakeholders and foreseeability of future transportation requirements might cause poor sustainability of the project. Unfortunately, many decision models give decision opinions without the test of the sustainability. Therefore, a dynamical Dijkstra simulation model is proposed to simulate the real traffic flows. In the model, the cost of the road connections is dynamically updated according to the change of the passenger flows. Then a combined decision support model using fuzzy AHP and dynamical Dijkstra simulation tests is designed. The combined model is capable of analyzing and creating consensus among different stakeholder participants in a transport development problem. The application of FAHP and dynamical Dijkstra ensures that the consensus creation is not only based on the FAHP decision making process but also on the response of the simulated execution of the decisions by dynamical Dijkstra. Thus, the decision makers by FAHP can firstly make their initial preferences in transportation planning, given the pairwise comparison matrices and generate the related weight for the traffic control parameters. And the dynamical Dijkstra simulations test the plan's setting and gives a response to iteratively adjust the FAHP matrices and parameters. The combined model is tested in different scenarios. And the results show that by the application of the proposed model, decision-makers can be more aware of the conflicts of interests among the involved groups, and they can pay more attention to possible violations causing by the change of traffic environment, including the citizen numbers, the construction cost, the roll cost, and etc., to get a more sustainable plan.
La construcción historiográfica de la «generación deshabitada»: una mirada desde las antologías poéticas
Authors: Iravedra Araceli
Published: July 2022

Este artículo parte de la consideración de las antologías como documentos historiográficos de primer orden para el estudio de la poesía española contemporánea, y como instrumentos privilegiados para orientarnos en la realidad poética de constitución más reciente. De ahí que nuestro trabajo se proponga examinar el relato crítico, tal y como ha sido construido por las antologías, de la penúltima generación de poetas españoles, una generación de manifestación tardía que aún desvela su frágil afianzamiento historiográfico veinte años después de su eclosión. La revisión de los principales florilegios atenidos a los poetas de la generación referida permitirá perseguir el modo en que se ha ido gestando desde su mismo comienzo ese relato. Y su atento análisis crítico conducirá a poner en cuestión algunos de sus fundamentos, señalar curiosas contradicciones y matizar los tópicos más reiterados a la hora de caracterizar a la por algunos llamada «generación deshabitada» o «generación de 2000».
Sobre la pervivencia del anecdotario zoológico griego en La Diana o Arte de la caza de Nicolás Fernández de Moratín
Authors: Silva Sánchez Tomás
Published: July 2022

La mención de Opiano en el Canto primero ha sugerido una posible conexión entre La Diana o Arte de la caza de Nicolás Fernández de Moratín y los Cynegetica de Opiano de Apamea, poema griego sobre caza del s. III d. C. Reforzaría esta hipótesis la presencia en ambas obras de anécdotas idénticas o muy similares sobre los animales objeto de caza. Algunas anécdotas remiten a la paradoxografía, género para el que el contenido zoológico era materia primordial y cuyo estilo compositivo influyó en los Cynegetica. El objetivo de nuestro trabajo es tratar de clarificar la relación entre Opiano y Moratín y, además, comprobar en qué medida el anecdotario zoológico griego pervive en La Diana o Arte de la caza, y si en esa pervivencia laten aún los rasgos de estilo propios de la antigua paradoxografía.
Exploring the Reliability of a Cross-Cultural Model for Digital Games: A Systematic Review
Authors: Kuo Yu-Tung , Kuo Yu-Chun , Whittinghill David M.
Published: July 2022

In recent years, the game industry has become one of the most popular and competitive industries. To quickly expand game markets and attract more game players and consumers, a variety of types of games are developed by the companies and developers. Cross-region games are also common in the current game markets. Consequently, a multi-national competition across different cultures or countries is inevitable. For successful expansion of game market, the existence of cultural differences of game players with various cultural backgrounds is one of the notable issues we cannot ignore. Even though there are studies focusing on the relevant cultural differences, there are no study summarizing the past findings. Additionally, no powerful norm has yet been defined, therefore this paper will investigate whether it is feasible to apply the Hofstedes’ Cultural Dimensions Theory, often utilized in Management, to game industries and to be a reliable guidance for game design and development for cross-culture game players.
Understanding Online Learning Readiness among University Students: A Bibliometric Analysis
Authors: Hassan Abuhassna  , Freed Awae  , Kawthar Bayoumi  , Diaya Uddeen Alzitawi  , Ahmed H Alsharif  , Noraffandy Yahaya
Published: July 2022

Many learners and educators have challenges accepting online education due to the non-traditional educational style. Additionally, many learners are not familiar with utilizing online learning platforms for educational purposes due to their lack of readiness. Therefore, this research comprehensively examines online learning readiness by conducting a bibliometric analysis. This study expanded all research from 2010 to 2020 by utilizing the similarities visualization software (Vosviewer). A sum of 1371 publications were analyzed as documented in the Scopus database in July 2021, identifying the most compelling subjects covered by the journal. Findings demonstrate several significant research concerns (E-learning readiness, ICT education, Technology Acceptance Model TAM). Several emerging topics have been identified (Digital learning, online learning environments, self-directed learning). The research presents a roadmap for potential researchers, concentrating on critical areas where success is possible.
Dynamic Background Subtraction in Video Surveillance Using Color-Histogram and Fuzzy C-Means Algorithm with Cosine Similarity
Authors: Yasir Maryam A. , Yossra Hussain Ali
Published: July 2022

The background subtraction is a leading technique adopted for detecting the moving objects in video surveillance systems. Various background subtraction models have been applied to tackle different challenges in many surveillance environments.

In this paper, we propose a model of pixel-based color-histogram and Fuzzy C-means (FCM) to obtain the background model using cosine similarity (CS) to measure the closeness between the current pixel and the background model and eventually determine the background and foreground pixel according to a tuned threshold. The performance of this model is benchmarked on CDnet2014 dynamic scenes dataset using statistical metrics. The results show a better performance against the state-of the art background subtraction models.
Energized IOT Sensor through RF Harvesting Energy
Authors: Chaari Mohamed Zied , Al-Rahimi Rashid , Aghzout Otman
Published: July 2022

Wireless Power Collecting (WPC) present the future in powering and energizing intelligent Internet of Things (IoT) electronics devices. This chapter studies and utilizes a circuit to powering wirelessly IoT devices. The WPC offer a best technique to help researchers and engineers of modern societies to build cell blocks. The concept is to energy any IoT devices and sensors wirelessly from Radio Frequency (RF) power strength in the same areas that may be hard to achieve or potentially hazardous. We implemented the RF harvesting technology with IoT devices to increase the efficiency of sensors. The idea of this system is to power up and self-energize any IoT sensors wirelessly. This work studies two different topologies of a rectangular patch antenna and different RF harvesting circuit voltage multiplier configurations using a microwave power station as the input RF source. This work aims to utilize the wireless power transmission technique in the smart house solution. The proposed prototype gets all technical parameters to generate enough electricity to power up the bulbs 5 W wirelessly at a gap distance around a five meters. Finally, we test the RF rectifier circuit coupled with a twin patch antenna that can self-energize the bulb, eventually devices work without batteries.
Technology-Based Tools for an Online, a Collaborative Learning Experience in Fashion Design
Authors: Guedes Graça , Buest Andreana
Published: July 2022

This paper analyses the results obtained from an online learning experience, in which fashion professionals and students were invited to explore and use a set of technology-based tools to develop their projects. It was expected that these tools and resources would potentiate and create a contextualized online learning experience in fashion design, helping learners to think and learn with each other, to bring ideas to life while interacting with data and information that were made available to them. A set of tools and resources were researched, identified, and allocated with specific fashion-design tasks. Participants were then asked to resolve these tasks resorting to the tools and resources presented and exploring beyond them, experimenting with potential uses in fashion design projects. The aim was also to understand if learners would acknowledge their potential to create a learning community, through connectivity and shared goals, helping them to develop their projects and stimulating reflective-thinking and self-determined capabilities, needed in the fashion professional environment. The results demonstrated that although learners recognised the potentiality of these tools for their fashion design projects, by convenience or lack of technological skills, they resorted to traditional methods of developing and communicating their projects. The results also demonstrated that like any technology adopted for educational purposes in the past, technologies-based tools, collaborative and mobile technologies require a further discussion about their limitations and potentialities and further experimentation by the fashion design sector.
A New Curriculum for Sustainable Fashion at Textile Universities in Europe – Preliminary Results of the European Project Fashion Diet
Authors: Blaga Mirela , Grundmeier Anne Marie , Höfer Dirk , Kazlacheva Zlatina , Köksal Deniz , Strähle Jochen , Zlatev Zlatin
Published: July 2022

The strong demand for a transformation of the textile and fashion industry towards sustainability requires a continuous implementation of the guiding principle of Education for Sustainable Development (ESD) in education and industry [1, 2]. In a first step of the European research project "Sustainable fashion curriculum at textile Universities in Europe - Development, Implementation and Evaluation of a Teaching Module for Educators" (Fashion DIET) a continuing education module shall be created to implement ESD as a guiding principle in university teaching. The research-based teaching and learning materials are delivered through an e-learning portal.
From Y to Z: A Cross-Generational Study of Green Purchasing Behaviour
Authors: Bernardes João , Nogueira Mafalda , Marques António Dinis
Published: July 2022

This study presents the results of a work-in-progress analysis and synthesis of the body of knowledge so far produced about green/sustainable consumption among Gen-Y (also known as Millennials) and Gen-Z consumers [1,2]. The main purpose of this paper is to provide a cross-generational, and comparative, quantitative analysis of Gen Y and Gen Z’s green purchasing behaviour, through a questionnaire with a sample of 2.000 respondents (n=1.000 per generation). To safeguard comparison criteria between generations the same survey was employed and the same dimensions will be analysed: Awareness, Financial availability, Personal benefits, Subjective norm and Trust, which may positively or negatively influence ‘green’ purchasing behaviour. Results show that not all dimensions have the same influence on the ‘green’ purchasing behavior for Gen Y and Gen Z. Despite both generations acknowledging the importance of consuming ‘green’, Gen Z presented stronger attitude and belief in being ‘green’, when compared to Gen Y. Hopefully, conclusions from this study can guide the development of marketing strategies to captivate both generations in engaging in a more environmental lifestyle.
Co-Creation and its Relationship with the Supply Chain: A Theoretical Approach
Authors: Martins Paulo , Miguel Rui , Pina Liliana , Lucas José , Pereira Madalena
Published: July 2022

The purpose of this paper is to understand which the best methods are to interconnect co-creation and supply chains in the fashion business. For this theoretical study was considered published work. The most interesting contents reviewed where from the 2000’s on. A research was made having into account scientific papers from journals as this is still a theme that hasn’t been much studied. A review of the sales methodology of several brands/suppliers working on the supply chain was also made to contextualize sourcing possibilities. This paper will be divided in three parts. First it will be made a literature review to understand how supply chains work, secondly about co-creation and third will be made a contextualization about practices in other concepts and suppliers. This theoretical research made the author raise a series of concerns and possibilities that could make this study being developed empirically, in the future to access the manufacturers’ opinion over the best practices that can be applied. This study could be a plus for future investigators in the fashion field as well as brands and fashion designers, to understand how co-creation can simplify its relationship with its supply chain. As for the limitations there was no opportunity for an empirical study to be made with the focus on manufacturers, although this could be important for the future. Also, it would be interesting to better understand the positive and negative impacts of the co-creation development and implementation in fashion, namely on the supply chain and manufacturing industries of fashion products as this has been barely studied.
Research of Modern Technologies of Wastewater Treatment of Food Products Combined with Ozonation and Hydrogen Peroxide
Authors: Tsytlishvili Kateryna , Rashkevich Nina , Poltavska Dana
Published: July 2022

The paper presents studies of the process of purification of model wastewater, which contained high concentrations of animal proteins, fats and hydrocarbons. The model wastewater solution was treated by biosorption treatment in a bioreactor; with pre-ozonation (O3) and biosorption purification in the bioreactor and in the variant with pre-treatment with ozonation and hydrogen peroxide – by the method of AOPs (O3/H2O2) or the process «Peroxon». The efficiency of cleaning by chemical oxygen consumption when using the AOPs method reached (97-98) %, disinfection – up to 100 %.
Female Firefighters’ Body Weight and Stature: A Comparison between Two Portuguese Fire Brigades
Authors: Moraes Anna S.P. , Carvalho Miguel A. , Boldt Rachel S. , Ferreira Fernando B.N. , Ashdown Susan , Griffin Linsey
Published: July 2022

Anthropometric data are essential for applying ergonomic principles to the design of a wide range of products and are paramount when developing personal protective equipment. In the case of occupations that deal with extreme circumstances, as is the case of firefighting, a proper fit and sizing of personal protective equipment is related not only with work performance and comfort but also with protection level. The increase in the number of female firefighters have raised the discussion about the barriers and challenges faced by women in firefighting. Issues with the fit of personal protective equipment commonly appear among physical and psychological stressors encountered by female firefighters. The need to provide gender-specific protective equipment for such professionals is highlighted by many studies. Furthermore, significant anthropometric differences among specialized occupational groups have also been found. However, anthropometric databases on firefighters are still very limited. Aiming to fulfill this shortcoming as well as to understand if Portuguese firefighters’ protective equipment is adjusted to their anthropometrics, a study designated as Size FF Portugal – Anthropometric Study of Portuguese Firefighters is currently underway. This paper presents a preliminary comparison of anthropometric data of female firefighters from two different fire brigades located in the North of Portugal. Stature and body weight measurements of 30 participants were analyzed using both descriptive and inferential statistics. Results show that there were not statistically significant differences on the average stature nor on the average body weight of female firefighters from both brigades. Moreover, significant differences were not found when comparing their types of commitment for both considered measurements. However, the comparison of stature data of female firefighters with two available anthropometric databases of the Portuguese population presented statistically significant differences. These results corroborate similar research and highlight the relevance of the on-going study. A discussion regarding the results is presented, taking into consideration the current stage of the study and its limitations.
Study of Short-Term Effects on the Soil of Disposable Protective Face Masks Used in the COVID-19 Pandemic
Authors: Leonova Nataliia , Loboichenko Valentyna , Divizinyuk Mykhailo , Shevchenko Roman
Published: July 2022

The paper analyzes the impact of personal protective equipment used by the population as a result of the COVID-19 pandemic on the environment. The scale of the additional amount of waste generated as a result of the use of protective face masks, etc. is noted. The globality of the existing problem and its multiparametric impact on the components of the environment are indicated. The short-term effect of a number of disposable protective face masks on the condition of soil by chemical component has been studied. The dependence of leaching of heavy metals from masks on soil acidity was experimentally analyzed, the dynamics of mobile phosphorus and potassium in soil samples was studied. It is shown that the presence of masks in the soil leads to exceeding the standard for zinc content, while for copper content and manganese content exceeding the standard is not observed in the study period, for lead there are fluctuations in content beyond standard value. The need for long-term research on the impact of face masks on the environment, and in particular soils, was noted.
Insect pest complexes associated with wheat and canola crops in the Canadian Prairies Ecozone: pest risk in response to variable climates using bioclimatic models
Authors: Weiss R.M. , Vankosky M.A. , Olfert O.
Published: July 2022

Wheat, Triticum aestivum Linnaeus (Poaceae), and canola, Brassica napus Linnaeus (Brassicaceae), yield is at risk from insects, weeds, and pathogens. Insects must adapt to both seasonal and annual weather patterns and are known to respond to climate with changes in their distribution and relative abundance. Subsequently, risk to crop production also changes. Models that account for multiple species can serve to assess risk and address those risks proactively by monitoring, detecting, and managing insect pests. Bioclimatic models, developed individually for nine insect pests, were used to create a model to estimate risk to canola and wheat crops associated with the activity of multiple pest species. Once developed, the multiple-species model was used to analyse how crop risk responds to variation in temperature and precipitation across the prairies. For this analysis, we compared insect response and subsequent risk (a measure of the number of co-occurring pest species) to canola and wheat in current climate conditions and six incremental scenarios (warmer, cooler, drier, wetter, cooler and wetter, and warmer and drier). Results of the multiple-species model predict how pest complexes respond to climate conditions. The model will help increase risk awareness associated with insect pests.
Cerambycid pheromones affect catches ofPhymatodes aeneus(Coleoptera: Cerambycidae) andThanasimus undatulus(Coleoptera: Cleridae) in ethanol-baited multiple-funnel traps in the Pacific Northwest, United States of America
Authors: Miller Daniel R. , Crowe Christopher M. , Dickinson Darci M. , Willhite Elizabeth A.
Published: July 2022

In 2012, we evaluated the effects of hardwood cerambycid pheromones (syn-2,3-hexanediol, 3-hydroxyhexan-2-one, and 3-hydroxyoctan-2-one) on catches of bark and woodboring beetles in ethanol-baited multiple-funnel traps in two field trials in Oregon and Washington, United States of America. Catches ofPhymatodes aeneusLeConte (Coleoptera: Cerambycidae) in ethanol-baited traps increased with the addition of 3-hydroxyhexan-2-one lures or the 3,2-hydroxyketone lure blend (3-hydroxyhexan-2-one + 3-hydroxyoctan-2-one). Catches of the predatorThanasimus undatulus(Say) (Coleoptera: Cleridae) in ethanol-baited traps increased with the addition of 3-hydroxyhexan-2-one lures but notsyn-2,3-hexanediol lures or 3-hydroxyoctan-2-one lures. The 3,2-hydroxyketone lure blend decreased catches of the corthyline ambrosia beetle,Gnathotrichus sulcatus(LeConte) (Coleoptera: Curculionidae), but not the xyleborine ambrosia beetle,Xyleborinus saxesenii(Ratzeburg), (Coleoptera: Curculionidae). Catches ofPtilinus basalisLeConte (Coleoptera: Anobiidae) in ethanol-baited traps increased with the addition of the 3,2-hydroxyketone lure blend.
Prevalence, characterization, antimicrobial susceptibility pattern and factors associated with group B Streptococci (Streptococcus agalactiae) from clinical and non- clinical sources in South-East Nigeria
Authors: Dozie-Nwakile Ogechukwu C. , Nwakile Calistus D. , Uchendu Ikenna K. , Okoroiwu Henshaw U. , Onyemelukwe Ngozi F.
Published: July 2022

Many years ago most human infections caused by aerobic Streptococci, were attributed to Lancefield groups A and D or to the so called non-groupable viridans Streptococci. The first human isolates of the group B Streptococci (GBS) were isolated from the vagina of post-partum women. This study is aimed at assessing GBS colonization of some clinical and common non-clinical surfaces. This study utilized a total of 615 samples (300 clinicals and 315 non-clinicals). Samples were from neonates and women who were respectively seen at the Institute of Child Health, of the University of Nigeria Teaching Hospital and Amblim Reference Laboratory in Enugu. The 300 clinical samples were cultured from 119 pregnant and 79 non-pregnant women, 52 neonates and 25 infertile couples (50 individuals; 7 primary and 18 secondary infertility). All samples were cultured on a modified Islam medium and identification carried out using standard bacteriological methods. Characterizations of the GBS isolates were carried out using sodium hippurate reactions, aesculin reactions, Christie, Atkin Muchin – Patterson (CAMP) test and definite hydrolysis on blood agar. The overall GBS isolation of 15.8% was observed in the clinical and non-clinical surfaces assessed. For the clinical subjects, GBS colonization of 11.9%, 7.6%, 9.6% and 17.0% were observed in the pregnant women, non-pregnant women, neonates and couples admitted for infertility. Prevalence of GBS isolation on inflamed cattle udder and milk products were 4.0% and 83.3%, respectively. Gestational period was associated with GBS colonization in pregnant women. All the GBS isolates were susceptible to penicillin and methicillin while all were resistant to streptomycin, tetracycline and sulphafurazole. GBS colonization of vagina was found and this poses a risk for neonatal sepsis.
FOXM1 and β-catenin in meningiomas
Authors: Ibrahim Riham A. , Shash Lobna S. , Elgohary Shimaa A.
Published: July 2022

Objectives

Forkhead box protein M1 (FOXM1) is a recently recognized biologic marker of increased cell proliferation and poor clinical outcomes in meningiomas. Alterations of Wnt signaling pathway, involving β-catenin, is one of FOXM1 key mechanisms and plays a pivotal role in meningioma progression. In this study, we aimed to analyze the expression of FOXM1, β-catenin, and Ki-67 in meningiomas of different WHO grades and correlated such expression with proliferation indices and tumor recurrence. This would delineate any potential predictive/prognostic value of these markers and investigate their eligibility as targets in meningioma therapy.

Materials and methods

We studied the immunohistochemical expression of FOXM1, β-catenin, and Ki-67 in 91 meningiomas: 43 WHO grade I, 34 WHO grade II, and 14 WHO grade III meningiomas.

Results

A statistically significant higher FOXM1 expression was reported with increasing WHO meningioma grade. β-catenin expression was lower in meningiomas WHO grade II/III than WHO grade I, and a significant association between lower β-catenin expression and tumor recurrence was detected. Increased FOXM1 expression correlated with tumor recurrence probability, increased proliferation indices, and lower β-catenin expression.

Conclusion

The study highlighted the patterns of FOXM1 and β-catenin in meningiomas. There was a trend for FOXM1 upregulation in high-grade and aggressive meningiomas, suggesting its consideration as a therapeutic target in cases with poor response to current management options. We also emphasize the potential roles of β-catenin in meningioma progression and recurrence.
Stromal immunohistochemistry of the smooth muscle actin expression in indolent versus aggressive basal cell carcinoma
Authors: Said Abeer , Abdelhamied Hala , Kamel Radwa O.M. , Elsebaei Hoda
Published: July 2022

Background

Basal cell carcinoma (BCC) is often locally aggressive but rarely metastasizes. Detection of aggressive BCCs at an early stage is mandatory to avoid localized destruction, which causes disabilities to patients; several factors are associated with a more aggressive clinical course. Actin, which is found exclusively in normal epithelial cells, is substantially responsible for cell motility. The actin expression of some cancers may be changed, allowing for more aggressive invasion.

Objective

To evaluate the relevance of alpha-smooth muscle actin (α-SMA) as a BCC aggressiveness marker, regarding its expression in tumor cells as well as the surrounding stroma.

Patients and methods

This cross-sectional descriptive study was carried out on skin biopsies that were obtained from 36 patients with BCC for routine histopathological and immunohistochemical study to evaluate the reactivity of α-SMA.

Results

The reactivity of α-SMA was noticed in 88.9% of BCC cases. Tumoral α-SMA positivity was found in 63.2% of indolent BCCs and in 76.5% of aggressive BCCs. Stromal reactivity was found in 31.6% of indolent BCC cases and in 76.5% of aggressive BCC cases. There was a statistically significant difference between the indolent and aggressive groups in terms of stromal positive α-SMA. However, there was no statistically significant difference between the indolent and aggressive groups in terms of the intensity of expression of tumoral α-SMA.

Conclusion

Our study findings suggested that stromal α-SMA expression is an accurate and reliable marker of aggressiveness in BCC.
Implication of CD74 and vascular endothelial growth factor (VEGF) immunohistochemical expression on epithelioid mesothelioma progression
Authors: Abou Gabal Hoda H. , Jassim Mona S. , Soliman Doaa A. , Ellithy Mahmoud A.A. , Saad Amr S. , Abd El Khalek Safaa M.M.
Published: July 2022

Background

Malignant pleural mesothelioma (MPM) is is one of most aggressive tumors with dismal prognosis. This poor prognosis necessitates deep understanding of different signaling pathway in order to improve prognostic prediction and therapeutic options. Macrophage migration inhibitory factor (MIF) and its receptor CD74 are found to be associated with poor prognosis in mesothelioma. However, this is still not well studied. Besides, the underlying mechanism of its action is in need for more understanding. Playing on immune checkpoints as well as angiogenesis are two of its potential mechanisms of action. Serum VEGF levels is one of the highest circulating markers in mesothelioma with correlation with poor prognosis. This study aimed at evaluating the expression of VEGF and CD74 on stored retrospective 50 paraffin embedded mesothelioma specimens. In 44 out of 50 of the cases, the relationship between both markers’ expression as well as tumor response to chemotherapy Gemcitabine and platinum combination was also studied. The study also elucidated the effect of VEGF and CD74 on the progression free survival (PFS) and overall survival (OS) of the studied patients.

Patients and Methods

Tissues were immunohistochemically stained for VEGF and CD74. The former was scored from 0 to 3 represent the percentage of cytoplasmic positively of stained tumour cells. The latter was scored in the tumor and the stroma in a sem-iquantitative manner using the histoscore method. Then after, Both CD74 and VEGF markers were furtherly categorized into none (0)/low (1) vs medium (2)/high expression (3) for statistical purposes.

Results

Poor response to gemcitabine and cisplatin chemotherapy was correlated with combined med/high expression of CD74-TS (P=0.03). High CD74 (T) and (S) as well as high VEGF expression were significantly correlated with short overall survival. Significant correlation is found between VEGF and each of CD74 (T) and CD74 (S) immunohistochemical expression levels.

Conclusion

High expression of CD74 T&S are inversely correlated with OS and response to Chemotherapy with Gemcytabine and cisplatin in mesothelioma patients.
Differential E-cadherin expression in helicobacter-related gastric pathology
Authors: Allithy Amal N. , Baig Habeeb A. , Darwish Anas A. , Al-Harbi Ghadeer A.M. , Alaa Edin Hala S.E.
Published: July 2022

Background and aims

E-cadherin plays an important role in the maintenance of cell–cell adhesion. Loss of E-cadherin expression is fundamental in the development of many epithelial malignancies. Helicobacter pylori (H. pylori) is an important etiological factor in the development of many gastric diseases, including gastritis, peptic ulcer disease, and gastric carcinoma. In this study, we related different histopathological findings to the absence and presence of helicobacter infection, and investigated E-cadherin expression in H. pylori-negative and H. pylori-positive gastritis. This study aimed to find the prevalence of H. pylori colonization in chronic gastritis patients and its association with different histomorphological changes of chronic gastritis. Also, we aimed to evaluate E-cadherin expression in chronic gastritis as a prestage in the development of gastric carcinoma, and its relation to H. pylori.

Materials and methods

In total, 40 cases of gastritis samples were obtained by endoscopy; hematoxylin and eosin staining, Giemsa stain, and E-cadherin immunostain were done; we related different histopathological findings to the absence and presence of helicobacter infection. Also, we reported the changes in E-cadherin expression in relation to histopathological findings of chronic gastritis, and investigated E-cadherin expression in H. pylori-negative and H. pylori-positive gastritis.

Results

H. pylori was seen in 62.5% of cases. There was a statistically significant correlation between the presence of H. pylori and increase of the severity of chronic inflammation, neutrophilic activity, and presence of glandular atrophy (P=0.05, 0.003, and 0.04), respectively. Also, there was a significant decrease in E-cadherin expression with the increase in the severity of chronic inflammation, neutrophilic activity, and presence of glandular atrophy (P=0.04, 0.05, and 0.03), respectively. A statistically significant correlation between the presence of H. pylori and decrease in E-cadherin expression was found (P=0.01).

Conclusion

In chronic gastritis, there is high prevalence of H. pylori infection and decrease in E-cadherin expression. Also, there is an increase in the severity of chronic gastritis with the increase in the prevalence of H. pylori and this is associated with a decrease in E-cadherin expression, which precedes gastric carcinoma.
Predictive value of Ki67 for complete pathological response to neoadjuvant chemotherapy in patients with breast cancer
Authors: Abd El Khalek Safaa M.M. , Mohammed Mona Q.R. , Hafez Fatma S.S.
Published: July 2022

Background

Neoadjuvant chemotherapy is an essential therapeutic approach for patients with breast cancer, with the goal of improving pathological complete response rate (pCR) by decreasing staging and evaluating treatment response for prognostic purposes. Proliferation index estimated by Ki67 has a significant effect on tumor prognosis with a cutoff value of 30%. However, data are still insufficient about the predictive cutoff value for pCR after neoadjuvant chemotherapy. The objective of this study was to evaluate the pathologic response after neoadjuvant chemotherapy in patients with breast cancer, to examine the effect of Ki67 index on the rate of pathologic response with the estimation of the proper predictive cutoff value. We also studied the correlation of the pCR rate with different prognostic histopathological parameters.

Patients and methods

The study included 84 patients with breast cancer who received neoadjuvant chemotherapy. Baseline Ki67 immunohistochemical expression was evaluated.

Results

Overall, 25% of the patients achieved pCR. The optimal cutoff point for Ki67 was 25%. There is a significant correlation between pCR and tumor-infiltrating lymphocytes (TILs), T stage before therapy, lymph node metastasis, and postmenopausal state. Linear regression analysis showed that Ki67 and TILs were associated with an increased rate of pCR after neoadjuvant therapy with a highly significant correlation.

Conclusion

In patients with breast cancer, Ki67 expression with a cutoff threshold of 25% could be used to predict the probability of achieving a complete response to neoadjuvant therapy. TILs are strongly associated with pCR.
Thoracoscopic pericardial patch repair of iatrogenic major bronchial injury during oesophagectomy
Authors: Gadiyaram Srikanth , Nachiappan Murugappan
Published: July 2022

Tracheobronchial injuries are rare but dreaded and potentially lethal complications of oesophagectomy. The reported literature on tracheobronchial injuries in thoraco-laparoscopic oesophagectomy is sparse. They may be detected either intraoperatively or in the post-operative period. Those tracheobronchial injuries detected intraoperatively usually need conversion to an open procedure for appropriate management. The surgical approaches and the methods employed for closure depend on the size and location of the rent. The methods of surgical repair include primary closure, gastric patch closure, pericardial patch, pleural patch, pedicled intercostal muscle flap, dural graft and synthetic polytetrafluoroethylene grafts. Herein, we report a thoracoscopic repair of a major bronchial injury encountered in a patient during thoracoscopic oesophagectomy using a pericardial patch. To the best of our knowledge, this is the first report of a thoracoscopic repair of a bronchial injury using a pericardial patch.
Double common bile duct with cholelithiasis
Authors: Lian Tianming , Liu Gaomin , Zhang Yaoming
Published: July 2022

Double common bile duct is a rare congenital anomaly among biliary anomalies. The anomaly has an important clinical implication because of its association with biliary tract obstruction. In addition, if one of the two common bile ducts is mistaken for the cystic duct during surgery, residual stones and bile duct injury are likely to occur. Here, we report a case of double choledochal variation (Type Vb) with choledochal calculi. An 82-year-old woman was admitted to the hospital due to mild pain in the upper abdomen accompanied by vomiting for 3 days. Magnetic resonance imaging suggested common bile duct lithiasis, variation of the common bile duct and moderate biliary tract dilation. Laparoscopy combined with choledochoscopic lithotomy was performed for choledocholithotomy. During the operation, left and right choledocholithotomy was performed, and all the gallstones were removed via choledochoscope. The patient’s post-operative recovery was good, and no recurrence of cholelith had been observed at the time of writing.
Magnitude, determinants, and impact of treatment lag in West syndrome: A prospective observational study
Authors: Anbarasu Abinaya , Sahu Jitendra Kumar , Sankhyan Naveen , Singhi Pratibha
Published: July 2022

Abstract

Aim:

Early recognition and initiation of standard therapy are crucial for the management of West syndrome. The study aimed to assess the magnitude, potential determinants, and impact of treatment lag impact on short-term therapeutic outcomes.

Materials and Methods:

The study design was prospective, observational, and data were ascertained through personal interviews with caregivers and reviewing medical records according to a pre-structured questionnaire. We defined short-term therapeutic response as the cessation of epileptic spasms commencing within 14 days of initiation of hormonal therapy and sustained for ≥28 days.

Results:

Of 82 consecutively enrolled children with West syndrome, the median treatment lag was 90 days (95% confidence interval [CI]: 110–198 days). The significant determinants of treatment lag in our study were as follows: the preexisting developmental delay, educational status of the parents, and qualification of the first practitioner visited. Our study showed that a shorter treatment lag (<1 month) was associated with a favorable cessation of epileptic spasms (85% vs. 15%; P = 0.011).

Conclusion:

We observed a significant treatment lag in children with West syndrome. The lead time to treatment emerged as a potentially modifiable risk factor for short-term therapeutic response with hormonal therapy.
Primary intracranial Ewing’s sarcoma/peripheral primitive neuroectodermal tumor in pediatric age group: A comprehensive review of literature
Authors: Elbaroody Mohammad , Abdullah Ahmed
Published: July 2022

Abstract

Background:

Ewing’s sarcoma (ES) forms about 1% of pediatric malignancies, and primary intracranial ES is an extremely rare entity.

Materials and Methods:

We report a case of primary Ewing’s sarcoma/peripheral primitive neuroectodermal tumor (ES/pPNET) in the posterior temporal-occipital region with an extension down into posterior fossa managed by gross total resection (GTR), and the skull was reconstructed using a titanium mesh followed by chemotherapy and 28 sessions of radiotherapy. The child is doing well 2 years after surgery with no recurrence in the last imaging. We reviewed the literature for 74 pediatric ES/pPNET cases reported in the last quarter of the century, focussing on surgical treatment, adjuvant therapy, and reported outcomes.

Results:

Most patients (81.1%) did not develop neither recurrence nor metastasis during the follow-up, and 55 patients (74.3%) were alive and free of disease at the last follow-up, and 19 patients were dead (25.7%). The mean time of survival was 12.679 months (95% confidence interval: 9.632–15.725).

Conclusion:

Primary intracranial ES/pPNET is an extremely rare tumor in the pediatric age group. Maximum safe resection followed by chemotherapy and radiotherapy is the cornerstone for the best outcome. Follow-up is recommended for the detection of recurrence or metastasis.
A Study on Behavioral Disorders, Academic Difficulties, and Parental Handling Patterns in Children with Epilepsy
Authors: Singh Rashmi , Sawant Neena , Vaswani Rajwanti
Published: July 2022

Abstract

Background:

Various psychiatric comorbidities have been reported in children with epilepsy (CWE), but Indian data on the same are lacking.

Aim:

This study was undertaken with the aim to find the prevalence and type of behavioral problems in CWE, academic difficulties, and parental handling patterns.

Materials and Methods:

Sixty-five patients of CWE and 65 controls were recruited after ethics approval and parent consent. All children were interviewed and diagnosed for psychopathology as per ICD-10 criteria, along with Strength and Difficulties Questionnaire. Parental handling questionnaire was used to assess the patterns of care or control among parents. Academic difficulties were assessed using open- and closed-ended questions.

Results:

Behavioral disorders were seen in 44.6% of CWE when compared with 12% of the control group. Hyperkinetic disorders were significant in CWE. Conduct and oppositional defiant disorders were not so prevalent. On Strength and Difficulties Questionnaire, a significant difference was seen on domains of hyperactivity and prosocial behavior in CWE when compared with controls, whereas emotional, conduct, peer problems, and total difficulty scores revealed no significant differences in both the groups. Academic difficulties were more in CWE, although absenteeism was not seen in both the groups. Parents of CWE had significant scores on care and control domains and were more overprotective and rigid in their behaviors when compared with the control group parents.

Conclusion:

Significant behavioral disorders are seen in CWE, which entails the need to have a multidisciplinary approach for early diagnosis and better control of symptoms. Parental awareness and appropriate parenting need to be emphasized for better prognosis in CWE.
Clinical Profile, Evaluation of Imaging Guidelines, and Management of Pediatric Traumatic Brain Injury at a Tertiary Care Center in India: A Review of 269 Patients
Authors: Roy Joanna M. , Balasubramaniam Srikant , Barve Pandurang S. , Nadkarni Trimurti D.
Published: July 2022

Abstract

Background:

Traumatic brain injury (TBI) is associated with considerable morbidity and mortality in the pediatric population. Literature regarding management of TBI in children is scarce in the Indian setting. Our study aims to bridge the existing literary gap.

Materials and Methods:

This study is a retrospective analysis of 269 children below 12 years of age presenting to a tertiary care hospital in India with head injury between January 2018 and January 2021. Pearson’s χ2 test, Kruskal–Wallis test, and Mann–Whitney U-test were used for statistical analysis.

Results:

The mean age of children admitted with head injury was 4.7 years. TBI was mild in 92.2% of children. A fall from height was the most common cause of injury (81.8%). The most common finding on computed tomography (CT) was skull fracture in 38%. Ten children (3.8%) required neurosurgical intervention. The median duration of hospital stay was 4 days. Statistically significant differences in median duration of hospital stay were obtained based on skull fracture and Glasgow Coma Scale on arrival. About 43.1% (n = 116) of children received a CT scan despite lack of indication as per NICE (National Institute of Health Care and Excellence) guidelines, and positive findings were obtained in 47.4% (n = 55). Prophylactic anticonvulsants were given to 39.8% of children (n = 107), of which 86.8% (n = 92) had positive findings. Fourteen children (13.2%) with a normal CT scan received anticonvulsants due to the presence of seizures following head injury.

Conclusion:

Strict implementation of guidelines issued by NICE would have led to non-detection of intracranial injury in many patients. A modification of this guideline to suit the Indian perspective may be necessary. The use of anticonvulsants in children following head injury needs further characterization.
Pulse methylprednisolone plus low-dose prednisolone versus low-dose prednisolone alone for treatment of children with West syndrome: A single-center, open-label randomized controlled trial
Authors: Kumari Nisha , Nanda Sanjiv , Kaushik Jaya Shankar , Bala Kiran
Published: July 2022

Abstract

Background:

There are preliminary reports of the benefit of additional pulse methylprednisolone (MP) to oral prednisolone in the treatment of West syndrome.

Aim:

To compare the efficacy and safety of intravenous pulse MP followed by low-dose prednisolone versus low-dose prednisolone alone for children with West syndrome.

Materials and Methods:

This randomized, open-labeled, controlled clinical trial was conducted among children aged two months to 30 months with a diagnosis of West syndrome. They were randomized to either of pulse MP (30 mg/kg for 3 days) followed by low-dose prednisolone (2 mg/kg) [n = 26] or low-dose prednisolone (2 mg/kg) alone [n = 24] for four weeks.

Results:

The efficacy of pulse MP was comparable with oral prednisolone in terms of spasms cessation (11 [45.8%] vs. 7 [26.9%]; RRR [95% confidence interval [CI]: 0.74 [0.47–1.14]; P = 0.24), more than 50% spasms reduction (16 [66.6%] vs. 11 [42.3%]; RRR [95% CI]: 0.57 [0.31–1.12]; P = 0.09), more than 90% reduction (11 [42.8%] vs. 7 [26.9%]; RRR [95% CI]: 0.74 [0.47–1.14]; P = 0.24), and primary electroclinical remission (5 [20.8%] vs. 2 [7.6%]; RRR [95% CI]: 0.85 [0.68–1.08]; P = 0.21). The adverse effect profile was comparable in the two groups.

Conclusion:

Pulse MP therapy followed by oral prednisolone in low-dose (2 mg/kg) was as effective as low-dose prednisolone (2 mg/kg) therapy alone in West syndrome. Although pulse MP did not result in any adverse outcome, routine use of the same before initiation of oral prednisolone needs further studies with a larger sample size; longer follow-,up and comparative trial with high dose steroids (4 mg/kg).