Isotopologue pattern based data mining for selenium species from HILIC-ESI-Orbitrap-MS-derived spectra

Automated and specific picking of selenium-containing molecular entities has not been an obvious option for software tools associated with electrospray high-resolution mass spectrometry (MS). In our study, a comprehensive pattern matching approach based on intra-isotopologue distance and isotopologue ratio data was critically evaluated in terms of reproducibility and selenium isotope selection on three samples, including selenized Torula yeast and the selenium hyperaccumulator plant Cardamine violifolia. Hydrophilic interaction liquid chromatography was applied to provide a one-step separation for water soluble metabolites to put an end to the need for either orthogonal setups or poor retention on reversed phase chromatography. Assistance from inductively coupled plasma-MS was taken only for chromatographic verification purposes, and the involvement of absolute mass defect (MD) data in selenometabolite-specific screening was assessed by multivariate statistical tools. High focus was placed on screening efficiency and on the validation of discovered selenized molecules to avoid reporting of artefacts. From the >1000 molecular entries detected, selenium-containing molecules were picked up with a recovery rate of >88% and a false positive rate of <10%. Isotop(ologu)e pairs of 78Se-80Se and 80Se-82Se proved to be the most performant in the detection. On the basis of accurate mass information and hypothetical deamination processes, elemental composition could be proposed for 72 species out of the 75 selenium species encountered without taking into account selenocompound databases. Absolute MD data were used to significantly differentiate a potentially sample-specific subgroup of false positive molecular entities from non-selenized and selenized entities.

Effect of 3D Printing Process Parameters on Damping Characteristic of Cantilever Beams Fabricated Using Material Extrusion

The present paper aims to investigate the process parameters and damping behaviour of the acrylonitrile butadiene styrene (ABS) cantilever beam manufactured using material extrusion (MEX). The research outcome could guide the manufacture of MEX structures to suit specific operating scenarios such as energy absorption and artificially controlled vibration responses. Our research used an experimental approach to examine the interdependencies between process parameters (nozzle size, infill density and pattern) and the damping behaviour (first-order modal damping ratio and loss factor). The impact test was carried out to obtain the damping ratio from the accelerometer. A dynamic mechanical analysis was performed for the loss factor measurement. The paper used statistical analysis to reveal significant dependencies between the process parameters and the damping behaviour. The regression models were also utilised to evaluate the mentioned statistical findings. The multiple third-order polynomials were developed to represent the relation between process parameters and modal damping ratio using stiffness as the mediation variable. The obtained results showed that the infill density affected the damping behaviour significantly. Higher infill density yielded a lower damping ratio. Nozzle size also showed a notable effect on damping. A high damping ratio was observed at a significantly low value of nozzle size. The results were confirmed using the theoretical analysis based on the underlying causes due to porosity in the MEX structure.

Outcomes after Prehospital Cricothyrotomy

BACKGROUND

Prehospital surgical cricothyrotomies and complications from placement are an important and under-evaluated topic for both the military and civilian prehospital populations. This study uses the Department of Defense Trauma Registry to identify complications and the incidence of complications in prehospital combat surgical cricothyrotomies.

METHODS

A secondary analysis of previously described prehospital-based dataset from the Department of Defense Trauma Registry (DODTR) was performed. Casualties who had a prehospital cricothyrotomy performed were isolated and assessed for documented airway injuries and surgical procedures after hospital admission.

RESULTS

There were 25,8976 casualties in the original dataset, of which 251 met inclusion for this analysis. The median age was 25 and most (98%) were male. Explosives were most frequent (55%) followed by firearm (33%) mechanisms. Most were host nation partner forces (35%) and humanitarian (32%) casualties. The median injury severity score was 24. The most frequent seriously injured body region was the head/neck (61%). Most (61%) were discharged alive. Within the 251, 14% had a complication noted, most commonly requiring tracheostomy revision (5%).

CONCLUSIONS

Cricothyrotomies are rarely performed, but when they are performed and the casualty survives long enough to reach a military treatment facility with surgical capabilities, the incidence of near-term and long-term complications is high. A better understanding of outcomes associated with this procedure will enable more targeted training and technology development.

Clinical Pattern and Outcome of Burn Injury in Children in AaBet Trauma Center Addis Ababa Ethiopia: Prospective Study

Introduction

Burn injuries are among the most prevalent health conditions worldwide that happen mainly in children, military, and victims of fire accidents. The previous literature had general limitations in that it focused on the retrospective study design, which can be prone to incomplete data or lack the full evidence of the problem, however, this study is a prospective study that gives a clue to the possible determinant factors of burn injury in pediatrics.

Objectives

The purpose of this study was to assess the clinical pattern and outcome of burn injury in children at the AaBet trauma center in Addis Ababa, Ethiopia, between July 2016 and July 2020.

Methods

An institutional-based prospective study was conducted in an AaBet trauma center. The study participants were chosen using a systematic random sampling method and followed for 4 years to determine their clinical outcomes after burn injury. A pretested observational check list was used to collect the data. The collected data were coded, entered Epi-data version 4.6, and exported to SPSS version 26 for descriptive and inferential analysis. A binary logistic regression model was used to identify factors associated with burn injury on the adjusted odd ratio with a 95% confidence interval at a p-value of  < .05.

Results

A total of 256 patients were recruited for this study. Scald burns accounted for 50.8% of the injury mechanisms, with 93.8% of the incidents occurring in private residences. Second-degree burns were the most common presentation of the victims (83%). Lower limbs were the most frequently burned body part (47%). Over 70% of the victims had 20% of their body surface area burned. Intentional burns accounted for 1.2% of all burn victims. The length of the hospital stay ranged from 1 day to 164 days with a mean stay of 24.73 days. Eight patients (3.1%) died during the study period.

Conclusion and recommendation

Pediatric burn incidences showed no significant discrepancies between males and females. Scald and open flame are the common causes of burn injury. Most incidents occurred in indoor settings, and most of the victims had not received first aid at home. Most patients left the hospital with no or minimal complications. Only 3.1% of the patients died. Patients who had burn-associated injuries were 98.8% less likely to be alive than those who had no associated injuries at all. For all governmental and non-governmental bodies, it is highly recommended to give priority to preventive measures and education on the need for appropriate prehospital care.

Outcomes after Prehospital Cricothyrotomy

BACKGROUND

Prehospital surgical cricothyrotomies and complications from placement are an important and under-evaluated topic for both the military and civilian prehospital populations. This study uses the Department of Defense Trauma Registry to identify complications and the incidence of complications in prehospital combat surgical cricothyrotomies.

METHODS

A secondary analysis of previously described prehospital-based dataset from the Department of Defense Trauma Registry (DODTR) was performed. Casualties who had a prehospital cricothyrotomy performed were isolated and assessed for documented airway injuries and surgical procedures after hospital admission.

RESULTS

There were 25,8976 casualties in the original dataset, of which 251 met inclusion for this analysis. The median age was 25 and most (98%) were male. Explosives were most frequent (55%) followed by firearm (33%) mechanisms. Most were host nation partner forces (35%) and humanitarian (32%) casualties. The median injury severity score was 24. The most frequent seriously injured body region was the head/neck (61%). Most (61%) were discharged alive. Within the 251, 14% had a complication noted, most commonly requiring tracheostomy revision (5%).

CONCLUSIONS

Cricothyrotomies are rarely performed, but when they are performed and the casualty survives long enough to reach a military treatment facility with surgical capabilities, the incidence of near-term and long-term complications is high. A better understanding of outcomes associated with this procedure will enable more targeted training and technology development.

Systematic Literature Review of the Prevalence, Pattern, and Determinant of Multimorbidity Among Older Adults in Nigeria

Introduction

Multimorbidity is a rising health issue globally and it is likely to become challenging in developing countries like Nigeria as they experience economic, demographic, and epidemiological transition. Yet, evidence of prevalence and patterns of multimorbidity, and their determinants, are scarce. This study aims to systematically review studies of the prevalence, patterns, and determinants of multimorbidity in Nigeria.

Methods

Studies were identified by searching 5 electronic databases (PubMed, Web of Science, CINAHL, PsycINFO, Africa Index Medicus/Global Index Medicus). Multimorbidity as well as other versions of it was used to search. The prevalence and determinants were also searched. According to preestablished inclusion criteria, and using different search strategies, 6 articles were included. The quality and risk of bias were assessed using Joanna Briggs Institute appraisal tool for prevalence studies. Two researchers assessed the eligibility of studies for inclusion. The protocol was registered on PROSPERO Ref no. CRD42021273222. The overall prevalence, pattern, and determinants were analyzed.

Results

We identified 6 eligible publications describing studies that included a total of 3332 (men 47.5%, women 52.5%) patients from 4 states plus the federal capital territory Abuja. The multimorbidity prevalence ranges from 27% to 74% among elderly Nigerians. Cardiovascular together with metabolic and/or musculoskeletal conditions were the frequent patterns of multimorbidity. A positive association was observed between age and multimorbidity in most studies. Other factors associated with multimorbidity were female gender, low education status, poor monthly income/unemployment, hospitalization, medical visits, and emergency services.

Conclusion

There has been a growing need for more applied health services research to understand better and manage multimorbidity in developed countries. The scarcity of studies in our review reveals that multimorbidity is not a priority area of research in Nigeria, and this will continue to hinder policy development in that area.

Prevalence, Pattern, and Reasons for Self-Medication: A Community-Based Cross-Sectional Study From Central India

Introduction Self-medication is an important public health problem, with varied prevalence across the world. The high prevalence of self-medication in India is one of the important factors contributing to the development of antimicrobial resistance. Self-medication without medical guidance can lead to inappropriate, incorrect, or undue therapy, missed diagnosis, delays in appropriate treatment, pathogen resistance, and increased morbidity. The growing trend of self-medication can be attributed to various factors like the urge for self-care, sympathy toward sick family members, inaccessible health services and nonavailability of drugs, time and financial constraints, ignorance, misbeliefs, extensive advertisement and availability of drugs in places other than drug shops. Methodology The present community-based descriptive cross-sectional study was conducted in an urban field practice area of a tertiary health care center (UHTC) in Central India. Individuals above 18 years of age and present at home at the time of the house-to-house survey comprised the study participants. A total of 400 participants were enrolled in the study. Data were collected using a predesigned and pretested questionnaire by the face-to-face interview technique. Results The prevalence of self-medication in the area was 60 % (240). The most widely used drugs for self-medication were analgesics (159; 66.25%) and antipyretics (142; 59.16%). Common ailments for which self-medication was used frequently were fever, body aches, common cold, and cough. It was observed that female participants were twice more likely to self-medicate as compared to male participants (Odds Ratio (OR): 2.04; Prevalence (p) = 0.014, Confidence Interval (CI) 95% = 1.15-3.62). Additionally, those having education above the high school level had more chances of self-medicating than those educated less than high school (OR: 1.25; p≤0.014, CI 95%=1.05-1.50). The commonest reasons for resorting to self-medication as per the findings of the present study are that it saves time and the condition was not serious enough to warrant a physician's consultation.

The trend and pattern of adult mortality in South-Central Ethiopia: analysis using the 2008-2019 data from Butajira Health and Demographic Surveillance System

Background

Understanding context-specific temporal trends in mortality is essential for setting health policy priorities.

Objective

To investigate the trends and distribution of deaths due to communicable and non-communicable diseases and external causes in South-Central Ethiopia.

Method

All adult deaths captured by the Butajira Health and Demographic Surveillance System between January 2008 and December 2019 were included. A verbal autopsy method of collecting cause of death data was used. Physician review and a computerised algorithm, InterVA, were used to determine the cause of death. Coding was undertaken using the World Health Organization's International Classification of Diseases. Trends in adult mortality rate and proportional mortality were estimated by major cause of death categories. Significant trends were analysed using the Mann–Kendall statistical test with a significance set at P < 0.05. Deaths were also disaggregated by age, sex, and residence.

Results

There were 1,612 deaths in 279,681 person-years; 811 (50.3%) were females. The median age at death was 65 years. The proportional adult mortality and adult mortality rates (per 1000 person-years) attributed to communicable diseases, non-communicable diseases, and external causes were 31.1%, 58.9%, and 6.0%, and 1.9, 3.4, and 0.4, respectively. Adult mortality due to communicable diseases showed a declining trend (tau, the measure of the strength and direction of association, = −0.52; P < 0.05), whereas the trend increased for non-communicable diseases (tau = 0.67, P < 0.05) and external causes (tau = 0.29, P > 0.05). Moreover, death rates were pronounced in the 65+ age group and rural areas but comparable among males and females.

Conclusion

The trend in deaths due to communicable diseases declined but increased for non-communicable diseases and external causes with significant public health burdens. These findings will provide essential input in formulating health policy reforms to reduce premature mortality.

Pattern and predictors of medication use among adults in southwestern Nigeria: A community-based cross-sectional study

Population-based drug utilization studies are scanty in Nigeria. The aim was to determine the pattern and predictors of medication use among adults in the communities of Southwestern Nigeria. A cross-sectional study was conducted among adults selected by multi-stage sampling from Oyo State communities. The questionnaires, adapted from the WHO Students' Drug Use Questionnaire and previous studies, were pretested and interviewer administered. The respondents' socio-demographic characteristics, the pattern of medication use, prescribers, and sources of drug acquisition were obtained. Binary logistic regression was used to determine the predictor of medications used. Of the 999 respondents, 501 resided in rural communities while 498 dwelled in urban areas. The mean (±SD) age of the respondents was 38 ± 15 years. The median (range)% prevalence of medication use were as follows: lifetime use, 58.2 (17.7-81.0); current use, 31.2 (8.9-65.9); and past use, 20.3 (9.2-28.9). Medications were mainly obtained from patent medicine stores, median (range%), 71 (65-80). The commonly used drugs were paracetamol, 626 (67.6); nonsteroidal anti-inflammatory drugs, 174 (18.8); artemether/lumefantrine, 422 (68.2); ampicillin/cloxacillin, 220 (48.6); and chlorpheniramine, 59 (39.9). Factors predictive of current medication use, adjusted odd ratio (95% confidence interval) were as follows: antimalarial [male, 0.7 (0.5, 0.9)]; antibacterial [male, 0.6 (0.4-0.9)]; analgesics [married, 1.5 (1.1-2.2); presence of health facilities, 0.5 (0.3-0.7); and shorter distance to health facility, 1.5 (1.1-2.1)]. Antimalarials, antibacterial, and analgesics were commonly used and inappropriately obtained by adults in Southwestern Nigeria. Factors predictive of current medication use were gender, marital status, the presence of health facilities, and distance to health facilities. There is a need for more extensive countrywide medication use studies and enlightenment programs to ensure the appropriate use of medications.

Dysbiotic Gut Microbiota Modulation by Aronia Fruits Extract Administration

The administration of chokeberry extract in vitro in the GIS1 system was evaluated for the modulation capacity of the dysbiotic pattern resulting from the consumption of stevia. The microbial pattern determined by molecular method, the metabolomic one (fatty acids), the evolution of the antioxidant status, and the cytotoxic effect were determined comparatively for six months. This study presented for the first time that Aronia extract has a strong antimicrobial effect but also a presence of new organic acids that can be used as a biomarker. The functional supplement had the impact of a gradual increase in antioxidant status (DPPH scavenging activity) for up to three months and a subsequent decrease correlated with the reduction of the microbial load (especially for Enterobacteriaceae). The effect on metabolomic activity was specific, with butyric acid being generally unaffected (0.6-0.8 mg/mL) by the antimicrobial effect manifested after three months of administration. The pH was strongly acidic, corresponding to the constant presence of maximum values for acetic and lactic acid. The non-selective elimination of a part of the microbiota could also be correlated with a decrease in metabolomic efficiency. The results in the GIS1 system indicated for the first time that the controlled use of this extract had a pronounced antimicrobial and cytotoxic effect. This has helped to correct the dysbiotic pattern that results after the long-term use of sweeteners based on an increase of 0.2 log UFC/mL for favorable strains.

Comprehensive profile and natural history of pediatric patients with spinal muscular atrophy: A large retrospective study from China

Background

There is a large population of people with spinal muscular atrophy (SMA) in China, and new disease-modifying therapies have become available recently. However, comprehensive data on the management and profile of treatment-naive SMA patients in China are still lacking.

Methods

As a retrospective study, a large cohort of treatment-naive patients with clinical and genetic diagnoses of 5q SMA were enrolled, ranging from neonatal to 18 years old, from the Neurology Department of Children's Hospital of Fudan University between January 2013 and December 2020. The data regarding their clinical presentations, genetic defects, motor function assessment results, and follow ups were reviewed.

Results

We enrolled 392 SMA patients (male: female = 189: 203): 1a = 46, 1b = 44, 1c = 31, 2a = 119, 2b = 56, 3a = 52, 3b = 14, from 27 of the 34 administrative districts in China, and 389 patients harbored homozygous deletion of exon 7 in the SMN1 gene (99.2%). The median age of onset was 0.08 (range: 0-0.30), 0.25 (0.06-0.60), 0.42 (0.08-1.50), 0.67 (0.07-5.08), 1.0 (0.40-1.83), 1.5 (1.00-3.00), and 4.04 (1.80-12.00) years old for SMA 1a, 1b, 1c, 2a, 2b, 3a, and 3b patients, while the median age of first assessment was 0.25 (0.08-2.60), 0.42 (0.17-1.90), 0.80 (0.17-4.5), 2.50 (0.5-15.83), 2.92 (1.08-13.42), 4.25 (1.58-17.33), and 7.34 (3.67-14.00) years old, respectively. Patients were followed up with for up to 15.8 years. The median event-free survival time was 7 months, 15 months, and indeterminate in SMA 1a, 1b, and 1c patients (p < 0.0001), with a better survival situation for higher SMN2 copies (p = 0.0171). The median age of sitting loss was 5.75 years and 13.5 years in SMA 2a and 2b (p = 0.0214) and that of ambulation loss was 9.0 years and undefined in SMA 3a and 3b (p = 0.0072). Cox regression analysis showed that higher SMN2 copies indicated better remaining ambulation in SMA 3. The median time to develop orthopedic deformities was 4.5, 5.2, and 10.1 years in SMAs 1c, 2, and 3, respectively (p < 0.0001), with a possible trend of better preservation of joint function for patients under regular rehabilitation (p = 0.8668).

Conclusion

Our study elucidated insight into the comprehensive management and profile of different types of SMA patients in China, providing a clinical basis for assessing the efficacy of new therapies.

Morphological Pattern of Building Clusters in Cold Regions: Evidence from Harbin

The rapidly changing global conditions of the environment and climate have resulted in higher requirements for urban design. Significant annual temperature variations and large day/night temperature differences in cold-region cities leads to high energy consumption. Therefore, it is challenging to achieve low energy consumption in cold-region cities. Urban morphology focuses on the physical elements of urban areas, reflecting the relationship between the city and its environment and the city's response to natural climatic conditions. Building clusters are common in cold regions due to the extreme climate. Thus, it is crucial to study the energy performance of cities by considering urban morphology. This study focuses on four morphological patterns of building clusters: point, linear, courtyard, and mixed patterns. A case study is conducted in Harbin, a cold-region city in China. Samples of the four morphological patterns are extracted, and GIS analysis and manual labeling are used to analyze the dominant morphological patterns of building clusters in cold regions. Average nearest-neighbor analysis is used to obtain quantitative results and determine the prevalence of different morphological patterns of building clusters in cold regions. This process can be used to determine the dominant patterns of urban building clusters and provide a scientific basis for selecting the morphological patterns of new building clusters in cold regions.

Patterns and Determinants of Multimorbidity in Older Adults: Study in Health-Ecological Perspective

(1) Background: Multimorbidity has become one of the key issues in the public health sector. This study aims to explore the patterns and health-ecological factors of multimorbidity in China to propose policy recommendations for the management of chronic diseases in the elderly. (2) Methods: A multi-stage random sampling method was used to conduct a questionnaire survey on 3637 older adults aged 60 and older in Shanxi, China. Association rule mining analysis (ARM) and network analysis were applied to analyze the patterns of multimorbidity. The health-ecological model was adopted to explore the potential associated factors of multimorbidity in a multidimensional perspective. A hierarchical multiple logistic model was employed to investigate the association strengths reflected by adjusted odds ratios and 95% confidence. (3) Results: Multimorbidity occurred in 20.95% of the respondents. The graph of network analysis showed that there were 6 combinations of chronic diseases with strong association strengths and 14 with moderate association strengths. The results of the ARM were similar to the network analysis; six dyadic chronic disease combinations and six triadic ones were obtained. Hierarchical multiple logistic regression indicated that innate personal traits (age, history of genetics, and body mass index), behavioral lifestyle (physical activity levels and medication adherence), interpersonal network (marital status), and socioeconomic status (educational level) were the common predictors of multimorbidity for older adults, among which, having no family history was found to be a relative determinant as a protective factor for multimorbidity after controlling the other covariates. (4) Conclusions: multimorbidity was prevalent in older adults and most disease combinations are associated with hypertension, followed by diabetes. This shows that diabetes and hypertension have a high prevalence among older adults and have a wide range of associations with other chronic diseases. Exploring the patterns and associated factors of multimorbidity will help the country prevent complications and avoid the unnecessary use of the health service, adopting an integrated approach to managing multimorbidity rather than an individual disease-specific approach and implementing different strategies according to the location of residence.

Pattern of expression of CDX2 in colorectal cancer and its role in prognosis

Background

CDX2, a nuclear protein, is essential for the proliferation and development of intestinal epithelial cells and is frequently down-regulated during tumorigenesis. We have evaluated the pattern of CDX2 expression in all stages of colorectal cancer (CRC) and its association with prognosis.

Methods

We performed CDX2 staining by immunohistochemistry (IHC) on the available biopsy blocks of patients of CRC registered in our institute from January 2014 to January 2018. CDX2 scoring was done using the semi-quantitative method.

Results

A total of 286 patients were registered during the study period, of which only 110 biopsy blocks were available for staining. Of 110 patients, 77 (70%) had colon cancer and 33 (30%) had rectal cancer. The median age was 54.2 years, with 62 (56.4%) being male and 48 (43.6%) female with a male to female ratio of 1.3:1. In the study cohort, 33 (30%) patients had stage II disease, 30 (27.3%) had stage III, and 47 (42.7%) had stage IV. Seventy-three (66.4%) were positive for CDX2 and 37 (33.4%) were negative. Loss of CDX2 expression was significantly associated with advanced stage, rectal site, poor grade of differentiation, and presence of lymphovascular invasion. With a median follow-up of 16 months, progression-free survival (PFS) at 2 years was 30% for CDX2-negative patients compared to 67% for CDX2-positive patients (P = 0.009), whereas the overall survival (OS) at 2 years was 46% for CDX2-negative versus 77% for CDX2-positive patients (P = 0.01).

Conclusion

Loss of CDX2 expression is associated with advanced stage, higher tumor grade, presence of LVSI, worse PFS, and OS and thereby functions as a poor prognostic factor in CRC.

Evolutionary loss of shell pigmentation, pattern, and eye structure in deep-sea snails in the dysphotic zone

Adaptations to habitats lacking light, such as the reduction or loss of eyes and pigmentation, have fascinated biologists for centuries, yet have rarely been studied in the deep sea, the earth's oldest and largest light-limited habitat. Here, we investigate the evolutionary loss of shell pigmentation, pattern, and eye structure across a family of deep-sea gastropods (Solariellidae). We show that within our phylogenetic framework, loss of these traits evolves without reversal, at different rates (faster for shell traits than eye structure), and over different depth ranges. Using a Bayesian approach, we find support for correlated evolution of trait loss with increasing depth within the dysphotic region. A transition to trait loss occurs for pattern and eye structure at 400-500 m and for pigmentation at 600-700 m. We also show that one of the sighted, shallow-water species, Ilanga navakaensis, which may represent the "best-case" scenario for vision for the family, likely has poor spatial acuity and contrast sensitivity. We therefore propose that pigmentation and pattern are not used for intraspecific communication but are important for camouflage from visual predators, and that the low-resolution vision of solariellids is likely to require high light intensity for basic visual tasks, such as detecting predators.

Fluid-Mediated Fabrication of Complex Assemblies

This Perspective accounts for recent progress in the directed control of interfacial fluid flows harnessed to assemble architected soft materials. We are focusing on the paradigmatic problem of free-surface flows in curable elastomers. These elastomers are initially liquid and cure into elastic solids whose shape is imparted by concomitant and competing phenomena: flow-induced deformations and curing. Particular attention is given to the role of capillary forces in these systems. Originating from the cohesive nature of liquids and thus favoring smooth interfaces, capillary forces can also promote the destabilization of interfaces, e.g., into droplets. In turn, such mechanical instabilities tend to grow into regular patterns, e.g., forming hexagonal lattices. We discuss how the universality, robustness, and ultimate regularity of these out-of-equilibrium processes could serve as a basis for new fabrication paradigms, where instabilities are directed to generate target architected solids obtained without each element laid in place by direct mechanized intervention.

Resemblance of the Recurrence Patterns in Primary Systemic, Primary Surgery and Secondary Oncoplastic Surgery

PURPOSE

Surgical interventions tend to have an effect on the generation of recurrences in tumor patients due to the anesthesia involved as well as tissue damage and subsequent inflammation. This can also be found in patients with breast cancer.

METHODS

In this multicenter study, we investigated data of 632 patients with breast cancer and the subsequent diagnosis of a recurrence. The patient data were acquired from 1 January 2006 to 31 December 2019 in eight different centers in Germany. The data sets were separated into those with primary surgery, primary systemic therapy with subsequent surgery, and reconstructive surgery. Three different starting points for observation were defined: the date of diagnosis, the date of first surgery, and the date of reconstructive surgery, if applicable. The observational period was divided into steps of six months and maxima of recurrences were compared. Furthermore, the variance was calculated using the difference of the distribution in percent.

RESULTS

The descriptive analysis showed no resemblance between the groups. The variance of the difference of the recurrence rates analysis using the surgical date as the starting point showed similarities in the age subgroup.

CONCLUSION

Our clinical analysis shows different metastatic behavior in different analysis and treatment regimes. These findings justify further investigations on a larger database. These results may possibly identify an improved follow-up setting depending on tumor stage, biology, treatment, and patient factors (i.e., age, …).

Pattern of astigmatism using partial coherence interferometry in patients of different age groups undergoing cataract surgery

BACKGROUND

Astigmatism is a refractive error that accounts for 70% of refractive errors in the elderly population. It is important to be aware of the distribution, extent, and type of astigmatism in patients undergoing cataract surgery to guide in reducing postoperative spectacle dependency.

AIM

To study the demography, amount, and pattern of astigmatism using partial coherence interferometry in patients of different age groups undergoing cataract surgery.

MATERIALS AND METHODS

A cross-sectional observational study. Keratometry and demography data were collected for patients planned for cataract surgery at a tertiary care center between January 2018 and December 2019. It was done with noncontact partial coherence interferometry in patients above 50 years undergoing cataract surgery.

RESULTS

Out of 385 patients, 216 (56%) were males and 169 (44%) were females. Astigmatism was more common in males than females (P = 0.00). Against-the-rule (ATR) astigmatism was found in 262 cases (68%), while with-the-rule (WTR) astigmatism was seen in 87 cases (23%). ATR was more common than WTR (P = 0.00). The number of patients with ATR seems to be increased with aging eyes and was more common between 61 and 70 years of age group (P = 0.00). The total amount of astigmatism increased with increasing age (P = 0.00029) which was found to be significant. Frthermore, there was a gradual change of WTR to ATR astigmatism with aging eyes.

CONCLUSION

Two hundred and sixty-two cases (68%) had ATR astigmatism mainly seen in the age group of 61-70 years. Majority had astigmatism up to 1.0 D that can be easily managed by simple cost-effective keratorefractive procedures like on-axis incision, opposite clear corneal incision, and limbal relaxing incisions.

Dermoscopy as an efficient aid to diagnose pigmentary and vascular component of periorbital melanosis: A cross-sectional study

INTRODUCTION

Periorbital melanosis (POM) has a significant impact on quality of life. There is a dearth of literature regarding POM, especially in Asian population. Accurate classification of POM is contributory to the choice of therapy. The aim of this study was to assess the role of dermoscopy in etiologic classification of POM.

METHODS

Two hundred and fifty adult patients (age > 18 years) of POM were enrolled over a period of 2 years. POM was classified clinically and re-evaluated based on their dermoscopic findings (pattern of pigmentary and vascular involvement, surface changes).

RESULTS

Pigmented, vascular, structural, and mixed types of POM represented 6.4%, 4.8%, 0.4%, and 88.4%, respectively. Dermoscopy was found to be statistically more accurate in classifying pigmentary and vascular types of POM as compared to clinical examination with the naked eyes (p- value <0.05). Patchy or post-inflammatory pigmentation was the most common pigmentary pattern on dermoscopy (53.8%) followed by pseudoreticular (37.1%) and mixed pattern (9.1%). 80.4% patients had vascular involvement of which the most common vascular pattern was telangiectasia (58.8%). Wrinkling or increased skin laxity as a cause of shadow effect was found in 52% patients. Diffuse erythema and scaling suggestive of subtle inflammation was detected in 47.6% patients on dermoscopy.

CONCLUSION

Dermoscopy as a diagnostic modality is more accurate in detecting pigmentary and vascular causes of POM and subtle signs of active inflammation in the form of erythema and scaling which is difficult to detect clinically. The major limitations of this study were lack of correlation of dermoscopic findings with the histological findings and the absence of any control group for comparison.

The Pattern of Unintentional Injuries and Poisoning Among Children Admitted to King Abdulaziz Medical City, Jeddah, From 2014 to 2018 in Saudi Arabia: A Cross-Sectional Study

Background Unintentional injuries and poisoning among children are prevalent and severe causes of hospitalization and impairment. The number of accidental injuries among children increases every year, leading to a huge burden on communities and health institutions. Methods This study is a retrospective analytical cross-sectional study. Charts from January 2014 to December 2018 were reviewed to estimate the epidemiological distribution and types of unintentional injuries among children aged 14 years or younger, including newborns, who were admitted to King Abdulaziz Medical City (KAMC), Jeddah, Saudi Arabia. Results In this study, 353 children were included. Patients were those admitted to King Abdulaziz Medical City (KAMC), Jeddah, due to unintentional injuries and whose age varies from birth to 14 years. Most of the injured children were males (60.1%), but interestingly more female patients suffered from fracture injuries than males. The most common injury was found to be falling (38.5%), followed by road traffic accidents (RTA) (26.1%). The frequency of different types of injuries varied among different age groups. Infants' injuries were mainly falling (50%), while RTA was the most common injury among adolescents (94.7%). Moreover, the head and neck area was the most affected site contributing 39.1% of all sites. Outcomes of the accidental injuries were assessed as full recovery, disability, or death. Conclusion This study showed the proportion of unintentional injuries among children from birth to 14 years old in KAMC, Jeddah, Saudi Arabia. Overall, the most prevalent type of injury found in our study was falling. Moreover, injuries were more common among male patients. We concluded that most injuries could be avoided if parents or children's guardians practiced protective strategies mainly by ensuring a safe and clear environment for the children.

Study of pattern of foods given to the infants during weaning period in an urban field practice area in Vijayapura

Background

The first 2 years of life are a critical period for a child's growth and development. Exclusive breastfeeding for 6 months and continued breastfeeding with safe, appropriate, and adequate feeding are recommended as a global health policy in both developing and developed countries.

Objective

The objective was to study the pattern of foods given to the infants during the weaning period in an urban field practice area in Vijayapura.

Materials and methods

The mothers of infants (aged 6-12 months) were interviewed by using predesigned and pretested questionnaires regarding different types of foods given to their infants and also about their immunization status, incidence of diarrhea and acute respiratory infection (ARI).

Results

A total of 95 mothers with infants aged between 6 and 12 months were enrolled in the study during the period of 1 month. Majority of the infants were fed with milk (animal) as a type of complementary food.

Conclusion

Poor complementary feeding practices were observed in urban areas, and urgent health education and demonstration of weaning foods in the community play a major role in preventing diseases.

Pattern of presentation of paediatric endocrine disorders in a Nigerian tertiary institution: an 11-year survey

OBJECTIVES

There is need to generate epidemiological data regarding paediatric endocrine disorders (PEDs) in sub-Saharan Africa, since little attention has been given endocrine disorders in children in this sub-region over the years. The aim of the study was to determine the sociodemographic characteristics of children with endocrine disorders in our paediatric endocrinology clinic, as well as the pattern of presentation of these disorders.

METHODS

This study included paediatric patients who presented to the endocrine clinic over an 11-year period. Data of patients seen during the study period were retrieved from the case notes and were analyzed using SPSS version 23.

RESULTS

A total of 188 patients were seen over the study period, with an almost equal male:female ratio. Five of the patients (2.7%) could not be classified into any gender because of genital ambiguity. The age of the patients at diagnosis ranged from 0 to 18 years of age with a median age of 9.03 (9.94) years. All the 14 subdivisions of paediatric endocrine disorders were documented among the patients, with thyroid disorders ranking highest among the PEDs seen. Type 1 diabetes mellitus, obesity and pubertal disorders were the most prevalent PEDs (in descending order), after thyroid disorders. Congenital hypothyroidism accounted for 14.3% of patients with thyroid disorders.

CONCLUSIONS

Thyroid disorders, type 1 diabetes mellitus and obesity rank highest among the PEDs in our locality. There is the need to create awareness among healthcare workers and the general public regarding these disorders, in order to improve appropriate and timely presentation of patients to the clinic.

Perceptions and Patterns of Dietary Supplements' Use during COVID-19 among Undergraduate Female Students in Saudi Arabia

(1) Background: During the COVID-19 pandemic, the use of Dietary Supplements (DSs) has increased for health promotion purposes. Few data records were found on the safe use of DSs among university students in Saudi Arabia, during COVID-19. This study aimed to assess the perceptions and patterns of DSs during COVID-19 among students at a selected female university. (2) Methods: A descriptive cross-section design was used. A convenient sample of undergraduate students (n = 651) were recruited via email, to fill in an online validated questionnaire: The nutrition and intake of DSs during COVID-19. Data were analyzed using descriptive and inferential statistics. (3) Results: Among the 509 students who did not have chronic diseases, 85% of them had taken DSs. About 35.5% of the students had not changed their dietary habits since the beginning of COVID-19, but 78.6% thought that they needed to improve their immunity by taking DSs. Half of the students 51.2% believed that healthy habits may reduce the chance of being infected with COVID-19. The most used DSs were vitamin C (84.3%), followed by honey (65.3%), and vitamin D (47.7%). At the top of students’ references for DSs was personal judgment or previous knowledge of the benefits (27.3%). (4) Conclusion: The usage and patterns of DSs were impacted by the COVID-19 pandemic. Taking DSs without a doctor’s prescription may lead to several complications. DSs users should be educated effectively about the proper use of DSs as an external supplementation.

Analysis of Injury Patterns in Men's Football between the English League and the Spanish League

BACKGROUND

Injuries in professional football lead to reduced team performance and large financial losses. The aim of this study was to analyse injuries in the two best team competitions in the world (LaLiga and Premier League), establishing similarities and differences, as well as determining injury causation patterns.

METHODS

A total of 277 on-field injuries requiring a substitution were analysed (142 in the Spanish league and 135 in the English league). The analysis was performed using traditional statistical tests (frequency analysis, chi-square test) with SPSS 25 and a T-Patterns sequence analysis with THEME 5.0.

RESULTS

In the Spanish league, there were a similar number of injuries in the first part of the season as in the second part of the season, while in the English league, they are more frequent in the first part of the season. In the Spanish league, injuries are more frequent in the first half of the match, while in the English league, they are more frequent in the second half. The type of player most frequently injured was the defender. Most of the injuries occurred without the presence of an opponent. The accumulated minutes during the season affect injuries of the muscular type.

CONCLUSIONS

The most common type of injury in both leagues was a strain, followed by a sprain and a contusion. Although common injury patterns can be established between the two leagues, there are notable differences. One of the factors is determined by the English league calendar (many matches at Christmas). In Spain, there were more muscular injuries that were not caused by the opponent, while in England there were more tackling injuries. Age is a risk factor in the Spanish league. In this league, there is a moderately significant relationship between the number of injuries and the points won.

Patterns of premenstrual syndrome in collegiate women: A cross-sectional study

Premenstrual syndrome (PMS) has a wide variety of symptoms. The classification of these symptoms into several patterns is useful for more effective tailor-made treatment. Therefore, our study aimed to examine the patterns of PMS by analyzing multiple factors to identify the characteristics of each pattern. This is a cross-sectional study. A total of 165 women (18.9 ± 1.0 years) were investigated by using of questionnaire about PMS, nutrition, physical activity, and other lifestyle traits. Then, the factor analysis was performed to classify the premenstrual symptoms, that is, the pattern of PMS. Additionally, logistic regression analysis was performed to identify the characteristics of each pattern, adjusted for age, body mass index, sleep duration, and caffeine intake. As the result, PMS was classified into 3 patterns. The type related to psychological symptoms such as depression, physiological symptoms, such as abdominal pain, and intermingled type, were labeled as affected, somatic, and mixed types, respectively. From the result of logistic regression analysis, self-rating depression scale scoring was marginally associated with affective type (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 0.99-1.16), physical activity was significantly associated with the mixed type (OR: 1.13, 95% CI: 1.00-1.28), and physical activity (OR: 1.20, 95% CI: 1.05-1.36) and some nutrients (OR: 0.56-1.00) were significantly associated with the somatic type. Understanding PMS and management of these complicated symptoms has been difficult. From the results of this study, the complicated symptoms were categorized into simpler patterns. Our findings may contribute to the understanding and possible management adjusted for each categorized case of PMS.

Sign Language Recognition Method Based on Palm Definition Model and Multiple Classification

Technologies for pattern recognition are used in various fields. One of the most relevant and important directions is the use of pattern recognition technology, such as gesture recognition, in socially significant tasks, to develop automatic sign language interpretation systems in real time. More than 5% of the world's population-about 430 million people, including 34 million children-are deaf-mute and not always able to use the services of a living sign language interpreter. Almost 80% of people with a disabling hearing loss live in low- and middle-income countries. The development of low-cost systems of automatic sign language interpretation, without the use of expensive sensors and unique cameras, would improve the lives of people with disabilities, contributing to their unhindered integration into society. To this end, in order to find an optimal solution to the problem, this article analyzes suitable methods of gesture recognition in the context of their use in automatic gesture recognition systems, to further determine the most optimal methods. From the analysis, an algorithm based on the palm definition model and linear models for recognizing the shapes of numbers and letters of the Kazakh sign language are proposed. The advantage of the proposed algorithm is that it fully recognizes 41 letters of the 42 in the Kazakh sign alphabet. Until this time, only Russian letters in the Kazakh alphabet have been recognized. In addition, a unified function has been integrated into our system to configure the frame depth map mode, which has improved recognition performance and can be used to create a multimodal database of video data of gesture words for the gesture recognition system.

Chiral Lead-Free Double Perovskite Single-Crystalline Microwire Arrays for Anisotropic Second-Harmonic Generation

Halide double perovskites present a new branch for versatile optoelectronic devices because of their huge structural compatibility and environmental friendliness, whereas nonlinear optics (NLO) devices remain blank for this fascinating family. Simultaneously, the precise patterning of single-crystalline perovskite microwire arrays remains a challenge for the integration of NLO devices. Herein, we designed lead-free chiral 2D double perovskites with the nonsymmetrical structure presenting second-harmonic generation (SHG). Furthermore, perovskite single-crystalline arrays with regulated geometry, pure orientation, and high crystallinity are prepared using the capillary-bridge confined assembly technique. The efficient SHG originates from the asymmetric crystal structure and high crystallinity of the microwire arrays. Compared with their polycrystalline thin-film counterparts, linearly polarized SHG and a higher SHG conversion efficiency are demonstrated based on microwire arrays. The results not only expand the applications of lead-free double perovskites in the NLO-integrated fields but also provide a viable way for lead-free optoelectronic devices.

Formation of Nano-Fibrous Patterns on Aluminum Substrates via Photolithographic Fabrication of Electrospun Photosensitive Polyimide Fibrous Membranes

The formation of polymeric micro-patterns on various substrates via a photolithography procedure has been widely used in semiconductor fabrication. Standard polymer patterns are usually fabricated via photosensitive polymer varnishes, in which large amounts of potentially harmful solvents with weight ratios over 50 wt% have to be removed. In the current work, a novel pattern-formation methodology via solvent-free electrospun photosensitive polymeric fibrous membranes (NFMs) instead of the conventional photosensitive solutions as the starting photoresists was proposed and practiced. For this purpose, a series of preimidized negative auto-photosensitive polyimide (PSPI) resins were first prepared via the two-step chemical imidization procedure from the copolymerization reactions of 3,3',4,4'-benzophenonetetracarboxylic- dianhydride (BTDA) and two ortho-methyl-substituted aromatic diamines, including 3,3',5,5'-tetramethyl-4,4'-diaminodiphenylmethane (TMMDA) and 3,7-diamino-2,8-dimethyl- dibenzothiophene sulfone (TSN). The derived homopolymer PI-1 (BTDA-TMMDA) and the copolymers, including SPI-2~SPI-6, with the molar ratio of 5~25% for TSN in the diamine units, showed good solubility in polar solvents. Then, a series of PSPI NFMs were fabricated via standard electrospinning procedure with the developed PSPI solutions in N,N-dimethylacetamide (DMAc) with a solid content of 25 wt% as the starting materials. The derived PSPI NFMs showed good thermal stability with 5% weight loss temperatures higher than 500 °C in nitrogen. Meanwhile, the derived PSPIs showed good photosensitivity to the ultraviolet (UV) emitting wavelengths of i-line (365 nm), g-line (405 nm) and h-line (436 nm) of the high-pressure mercury lamps in both forms of transparent films and opaque NFMs. Fine micro-patterns with a line width of around 100 μm were directly obtained from the representative SPI-4 NFM via standard photolithography procedure.

Rhythmic Spatial Self-Organization of Bacterial Colonies

Bacteria display a remarkable capacity to organize themselves in space and time within biofilms. Traditionally, the spatial organization of biofilms has been dissected vertically; however, biofilms can exhibit complex, temporally structured, two-dimensional radial patterns while spreading on a surface. Kahl and colleagues report a ring pattern that indicates the alternating redox metabolism of P. aeruginosa biofilms under light/dark cycles. Does the presence of a rhythmic, daily phenotype imply a circadian rhythm? Here, we highlight several examples of rhythmic patterns reported in the literature for surface-colonizing multicellular assemblies and discuss the conceptual requirements for proving the presence of a prokaryotic circadian clock behind pattern formation.

Pattern of Orthopedic Injuries Related to Road Traffic Accidents Among Patients Managed at the Emergency Department in Black Lion Hospital, Addis Ababa, Ethiopia, 2021

Background

Studies showed that each year people lose their life on the road and many people are disabled. The majority of this disability was caused by orthopedic injury related to road traffic accidents. However, in the context of Ethiopia, studies ascribed to orthopedic injuries related to road traffic accidents are limited. The study aimed to assess the pattern of orthopedic injuries related to road traffic accidents among patients managed at the emergency department of Black Lion Hospital.

Methods

An institutional-based cross-sectional study was conducted on 354 victims of road traffic accidents with orthopedic injuries who were visiting the Emergency department of Black Lion Hospital. Patient charts were selected by systematic random sampling technique and the data was entered into Epi-data version 4.4.2.2 and exported to the static package for social science window version 26, and descriptive statistics were used for analysis.

Results

The study reveals that males were mostly injured persons (71.7%) with the age group of 13-24 were the most injured. Passenger car accounts 36.3% of causes of injury followed by motorbikes (27.4%) and lower limbs were the most common anatomic site of injuries (47.9). Of all injury types, a fracture is the most common one with 71.1%, especially lower limb fracture (42.1%). More than half victims (59.5%) had open wounds, and almost half of the study subjects (51.8%) experience Road traffic accidents while they are crossing or walking along the way.

Conclusion

Orthopedic injuries related to road traffic accidents are the main cause of death and disability in many individuals, especially in reproductive age groups. Therefore, policy-makers should be aware of different patterns of orthopedic injuries associated with a victim of road traffic accidents to have an appropriate and sustainable capacity to manage the orthopedic injuries.

Pattern and prognostic value of lymph node metastasis in sinonasal mucosal melanoma

OBJECTIVE

To analyze the pattern of lymph node (LN) metastasis and its effect on prognosis in sinonasal mucosal melanoma (SNMM).

METHODS

This retrospective study was conducted based on the Surveillance, Epidemiology, and End Results (SEER) Program data. Survival outcomes were analyzed using the Kaplan-Meier method. Factors were compared between groups using log-rank test and Fisher's exact test, and prognostic factors were screened using the Cox proportional hazards model. Propensity score matching (PSM) was conducted to examine the treatment differences after accounting for sex, age, race, T stage, N stage, and M stage.

RESULTS

Level I (57.1%) and level II (53.6%) nodes were the most common sites of lymph node metastasis, followed by level III (17.9%) and IV (17.9%) nodes. T stage, M stage, and tumor size were associated with LN metastasis. The 5-year overall survival rates for patients without and with LN metastasis were 35.2% and 5.3%, respectively.

CONCLUSIONS

Level I and II lymph nodes may be the sentinel nodes of SNMM, Advanced T stage and increasing tumor size could promote LN metastasis. LN metastasis may promote distant metastasis and remains an important prognostic factor for patients with SNMM.

Is there an Influence of Match and Mismatch of Venous Drainage Pattern on AVM Hemorrhagic Presentation?

Objective

To analyze whether there is an influence of match and mismatch of venous drainage patterns on arteriovenous malformation (AVM) hemorrhagic presentation.

Methods

Consecutive 161 patients of AVM between 2014 and 2017 were retrospectively reviewed. Venous drainage was considered deep or superficial. Match of venous drainage pattern was defined as a superficial AVM with only superficial venous drainage or a deep AVM with deep venous drainage. Mismatch of venous drainage pattern was defined as a superficial AVM involving a deep venous drainage. Univariate analysis was used to assess the influence of match and mismatch of venous drainage pattern on AVM hemorrhagic presentation.

Results

AVM location and venous drainage were matched in 116 patients, including superficial location with superficial venous drainage or deep location with deep venous drainage, and were mismatched in 45 patients, including superficial location with deep venous drainage. The rupture proportion of mismatch venous drainage pattern was statistically comparable to that of deep location with deep drainage (P = 0.819). However, superficial location with deep venous drainage was statistically associated with a higher rupture percentage than that of superficial location with superficial venous drainage (P = 0.003).

Conclusions

Mismatch venous drainage pattern or an exclusively deep venous drainage is associated with an initial clinical presentation with an AVM hemorrhage.

Pattern of childhood injury in a tertiary centre

INTRODUCTION

Childhood injury and death have been projected to be a disease of public health significance, however, the trend in many developing countries of which Nigeria is one is still unknown. We, therefore, examine the pattern of childhood traumatic injury in our institution.

MATERIALS AND METHODS

The information of patients aged 16 years and below who presented with trauma was extracted from the trauma registry of the emergency units of University College Hospital, Ibadan, from 2015 to 2020. Data were analysed using the SPSS version 20.

RESULTS

A total of 3146 children were managed for trauma in the accident and emergency departments of the hospital. Most of them were males (61.2%) and within the under-five age group (36.4%). The majority of the injuries were secondary to fall (41.8%). Male child was more likely to be involved in any mechanism of injury and children between 11 and 16 years were commonly involved in machine hand injury (80%). Following intervention in the accident and emergency department, 44.1% were discharged in the emergency units, 21.5% required admission into the specialist ward, 6.0% died, 5.0% discharged against medical advice and 2.6% were referred.

CONCLUSION

The burden of childhood injury is becoming significant thus demands more attention.

Patterns of Sexually Transmitted Co-infections and Associated Factors Among Men Who Have Sex With Men: A Cross-Sectional Study in Shenyang, China

Background

Men who have sex with men (MSM) are disproportionately affected by sexually transmitted infections (STIs). We sought to describe patterns of sexually transmitted co-infections and explore factors associated with increased acquisition of STIs among MSM.

Methods

We enrolled MSM in Shenyang, China, between July and December 2020 to test for four STIs, including human papillomavirus (HPV), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Treponema pallidum (TP). Data regarding demographic and behavioral characteristics of participants were collected through a self-administered digital questionnaire. We adopted the ordinal logistic regression model to identify factors associated with acquiring more STIs.

Results

Overall, 177 participants with completed test results for all four STIs were analyzed. These participants had a median age of 29.0 (interquartile range: 23.0-38.0) years. The prevalence of STI co-infections was 23.7% [42/177; 95% confidence interval (CI), 17.8%-30.8%], among which HPV/CT (47.1%) and HPV/CT/NG (50.0%) co-infection were the predominant types among participants with dual and multiple infections, respectively. Participants who had a higher educational background [adjusted odds ratio (aOR), 0.46; 95% CI, 0.24-0.85; P = 0.014] and had a history of STIs (aOR, 2.53; 95% CI, 1.24-5.18; P = 0.011) were positively associated with acquiring more STIs.

Conclusions

MSM in Shenyang suffer a substantial burden of sexually transmitted co-infections. An optimized multi-STI integration strategy targeting prevention, surveillance, screening, and treatment is warranted to reduce the prevalence of sexually transmitted co-infections, especially in less-educated MSM.

Quantification and Pattern of Central Compartment Lymph Nodes in pN1a Papillary Thyroid Cancer Patients

Background: The background is to investigate the results of central compartment lymphadenectomy for pN1a papillary thyroid carcinoma (PTC) with regard to quantification and pattern of resected lymph nodes thereby providing basis for future compartment VI surgical intervention. Methods: The study comprised 443 pN1a PTC patients whose clinicopathological characteristics and central compartment lymphadenectomy results were compared and correlated with the primary thyroid cancer and lymph node metastasis (LNM) features. Ultimately, multivariate analysis was conducted to identify statistically significant impact factors for a high metastatic ratio (MR). Results: Dissected lymph nodes (DLNs) were more frequently identified in right level VI than left (P < .05) although there was no difference in in the number of resected metastatic lymph nodes (MLNs). Male sex, multifocality, extrathyroidal extension (ETE), and fewer DLNs were related to a high MR. There was a positive correlation between DLN and MLN, and a negative correlation between DLN and MR. Disease multifocality and ETE were identified more frequently in the left than the right thyroid lobe. Conclusion: The outcome of central compartment lymphadenectomy in pN1a PTC patients is associated with several factors, and a thorough dissection of lymph nodes improves the rate of metastatic lymph node resection.

Prevalence and Pattern of Paediatric dermatoses among children in Aminu Kano teaching Hospital Kano, Nigeria

INTRODUCTION

Skin disorders are common among children, most especially the infections and infestations as the immunity is not fully developed during childhood. Skin disorders are among common causes of morbidity in developing countries of Sub-Saharan Africa.Skin disorders are major cause of concern among children. This study aimed to document the prevalence of skin diseases among children who attended the paediatric outpatient clinic of the Aminu Kano Teaching Hospital (AKTH) Kano, Nigeria.

METHODS

It was a cross-sectional study. The study population included children aged between 6 weeks and 14years from the study area who attend Paediatric Out Patient Department (POPD) clinics recruited consecutively. Data obtained from the patients included age, gender, clinical features, socio-economic class and diagnosis.

RESULT

Two hundred and twenty-three children aged 6weeks to 14years were enrolled into the study. The mean age of the children was 84.42+ 40.12. There were 110 males (49.3%) and 113 females (50.7%) with Male to female ratio 1:1.1. Fifty-five children (24.7%) had skin disorders. There were 14 specific diagnosis made. The leading categories were infections accounting for 18.3% of the skin disorders (p < 0.001). Seborrheic dermatitis was the commonest specific diagnosis found among 3.1% of the children.

CONCLUSION

Prevalence of skin disorders among children attending POPD of Aminiu Kano Teaching Hospital is 24.7%. Infections and infestations were the commonest category of skin disorders found.

Associations of Plasma Fatty Acid Patterns During Pregnancy With Gestational Diabetes Mellitus

Background

Limited studies have explored the difference of fatty acid profile between women with and without gestational diabetes mellitus (GDM), and the results were inconsistent. Individual fatty acids tend to be interrelated because of the shared food sources and metabolic pathways. Thus, whether fatty acid patters during pregnancy were related to GDM odds needs further exploration.

Objective

To identify plasma fatty acid patters during pregnancy and their associations with odds of GDM.

Methods

A hospital-based case-control study including 217 GDM cases and 217 matched controls was carried out in urban Wuhan, China from August 2012 to April 2015. All the participants were enrolled at the time of GDM screening and provided fasting blood samples with informed consent. We measured plasma concentrations of fatty acids by gas chromatography-mass spectrometry, and derived potential fatty acid patterns (FAPs) through principal components analysis. Conditional logistic regression and restricted cubic spline model were used to evaluate the associations between individual fatty acids or FAPs and odds of GDM.

Results

Twenty individual fatty acids with relative concentrations ≥0.05% were included in the analyses. Compared with control group, GDM group had significantly higher concentrations of total fatty acids, 24:1n-9, and relatively lower levels of 14:0, 15:0, 17:0, 18:0, 24:0, 16:1n-7, 20:1n-9,18:3n-6, 20:2n-6, 18:3n-3, 20:3n-3, 22:5n-3. Two novel patterns of fatty acids were identified to be associated with lower odds of GDM: (1) relatively higher odd-chain fatty acids, 14:0, 18:0, 18:3n-3, 20:2n-6, 20:3n-6 and lower 24:1n-9 and 18:2n-6 [adjusted odds ratio (OR) (95% confidence interval) (CI) for quartiles 4 vs. 1: 0.42 (0.23-0.76), P-trend = 0.002], (2) relatively higher n-3 polyunsaturated fatty acids, 24:0, 18:3n-6 and lower 16:0 and 20:4n-6 [adjusted OR (95% CI) for quartiles 4 vs. 1: 0.48 (0.26-0.90), P-trend = 0.018].

Conclusion

Our findings suggested that two novel FAPs were inversely associated with GDM odds. The combination of circulating fatty acids could be a more significant marker of GDM development than individual fatty acids or their subgroups.

Chirality of Fingerprints: Pattern- and Curvature-Induced Emerging Chiroptical Properties of Elastomeric Grating Meta-Skin

Fingerprint-inspired elastomeric grating meta-skin (EGMS) is herein fabricated to investigate the chirality of fingerprints. The EGMS is made by a facile nanoimprinting method with a diffraction grating as a template using polydimethylsiloxane, followed by gold deposition. The chirality of the surface is caused by symmetry breaking, induced by the pattern (P) and curvature (T). Furthermore, the chiroptical properties of EGMS are reconfigurable through the control of the skew angle (θ), which is the angle between P and T. The chiroptical properties of a fingerprint are also shown and interpreted in this perspective. On the basis of the results, we suggest the strategy to impart chirality on the surface, which is reconfigurable by controlling P and T. It will be a useful method to produce chirality in membranes, thin films, metasurfaces, and 2D nanomaterials, as well as advance biometric recognition.

Multimorbidity patterns and association with mortality in 0.5 million Chinese adults

BACKGROUND

Few studies have assessed the relationship between multimorbidity patterns and mortality risk in the Chinese population. We aimed to identify multimorbidity patterns and examined the associations of multimorbidity patterns and the number of chronic diseases with the risk of mortality among Chinese middle-aged and older adults.

METHODS

We used data from the China Kadoorie Biobank and included 512,723 participants aged 30 to 79 years. Multimorbidity was defined as the presence of two or more of the 15 chronic diseases collected by self-report or physical examination at baseline. Multimorbidity patterns were identified using hierarchical cluster analysis. Cox regression was used to estimate the associations of multimorbidity patterns and the number of chronic diseases with all-cause and cause-specific mortality.

RESULTS

Overall, 15.8% of participants had multimorbidity. The prevalence of multimorbidity increased with age and was higher in urban than rural participants. Four multimorbidity patterns were identified, including cardiometabolic multimorbidity (diabetes, coronary heart disease, stroke, and hypertension), respiratory multimorbidity (tuberculosis, asthma, and chronic obstructive pulmonary disease), gastrointestinal and hepatorenal multimorbidity (gallstone disease, chronic kidney disease, cirrhosis, peptic ulcer, and cancer), and mental and arthritis multimorbidity (neurasthenia, psychiatric disorder, and rheumatoid arthritis). During a median of 10.8 years of follow-up, 49,371 deaths occurred. Compared with participants without multimorbidity, cardiometabolic multimorbidity (hazard ratios [HR] = 2.20, 95% confidence intervals [CI]: 2.14 - 2.26) and respiratory multimorbidity (HR = 2.13, 95% CI:1.97 - 2.31) demonstrated relatively higher risks of mortality, followed by gastrointestinal and hepatorenal multimorbidity (HR = 1.33, 95% CI:1.22 - 1.46). The mortality risk increased by 36% (HR = 1.36, 95% CI: 1.35 - 1.37) with every additional disease.

CONCLUSION

Cardiometabolic multimorbidity and respiratory multimorbidity posed the highest threat on mortality risk and deserved particular attention in Chinese adults.

A review of harmonization methods for studying dietary patterns

Data harmonization is the process by which each of the variables from different research studies are standardized to similar units resulting in comparable datasets. These data may be integrated for more powerful and accurate examination and prediction of outcomes for use in the intelligent and smart electronic health software programs and systems. Prospective harmonization is performed when researchers create guidelines for gathering and managing the data before data collection begins. In contrast, retrospective harmonization is performed by pooling previously collected data from various studies using expert domain knowledge to identify and translate variables. In nutritional epidemiology, dietary data harmonization is often necessary to construct the nutrient and food databases necessary to answer complex research questions and develop effective public health policy. In this paper, we review methods for effective data harmonization, including developing a harmonization plan, which common standards already exist for harmonization, and defining variables needed to harmonize datasets. Currently, several large-scale studies maintain harmonized nutrient databases, especially in Europe, and steps have been proposed to inform the retrospective harmonization process. As an example, data harmonization methods are applied to several U.S longitudinal diet datasets. Based on our review, considerations for future dietary data harmonization include user agreements for sharing private data among participating studies, defining variables and data dictionaries that accurately map variables among studies, and the use of secure data storage servers to maintain privacy. These considerations establish necessary components of harmonized data for smart health applications which can promote healthier eating and provide greater insights into the effect of dietary patterns on health.

Toward an Anthropometric Pattern in Elite Male Handball

We investigated the anthropometric characteristics associated with specific handball skills in competition. The body anthropometric profiles differ significantly among the playing positions in handball due to the specific tasks. The aim of this study is to identify the anthropometric patterns for each playing position by collecting data from elite male handball players. To determine the anthropometric profile of the elite handball players for each playing position, we used descriptive statistics for every indicator in order to identify the optimal patterns for elite handball players from the top-four ranked teams at the most important competitions over a period of 18 years (2004-2021). Over time, the anthropometric indices evolved: the average height increased (from 190 to 192.6 cm) but less than weight increased (from 90.5 to 95.28 kg), and these affected the body mass index (increase from 25.2 to 25.67). The novelty of our study is that we identified an anthropometric pattern for each playing position and for all teams in elite male handball. Our study also covered a period of 18 years to give our results more accuracy and reliability.

Identification of Social Engagement Indicators Associated With Autism Spectrum Disorder Using a Game-Based Mobile App: Comparative Study of Gaze Fixation and Visual Scanning Methods

BACKGROUND

Autism spectrum disorder (ASD) is a widespread neurodevelopmental condition with a range of potential causes and symptoms. Standard diagnostic mechanisms for ASD, which involve lengthy parent questionnaires and clinical observation, often result in long waiting times for results. Recent advances in computer vision and mobile technology hold potential for speeding up the diagnostic process by enabling computational analysis of behavioral and social impairments from home videos. Such techniques can improve objectivity and contribute quantitatively to the diagnostic process.

OBJECTIVE

In this work, we evaluate whether home videos collected from a game-based mobile app can be used to provide diagnostic insights into ASD. To the best of our knowledge, this is the first study attempting to identify potential social indicators of ASD from mobile phone videos without the use of eye-tracking hardware, manual annotations, and structured scenarios or clinical environments.

METHODS

Here, we used a mobile health app to collect over 11 hours of video footage depicting 95 children engaged in gameplay in a natural home environment. We used automated data set annotations to analyze two social indicators that have previously been shown to differ between children with ASD and their neurotypical (NT) peers: (1) gaze fixation patterns, which represent regions of an individual's visual focus and (2) visual scanning methods, which refer to the ways in which individuals scan their surrounding environment. We compared the gaze fixation and visual scanning methods used by children during a 90-second gameplay video to identify statistically significant differences between the 2 cohorts; we then trained a long short-term memory (LSTM) neural network to determine if gaze indicators could be predictive of ASD.

RESULTS

Our results show that gaze fixation patterns differ between the 2 cohorts; specifically, we could identify 1 statistically significant region of fixation (P<.001). In addition, we also demonstrate that there are unique visual scanning patterns that exist for individuals with ASD when compared to NT children (P<.001). A deep learning model trained on coarse gaze fixation annotations demonstrates mild predictive power in identifying ASD.

CONCLUSIONS

Ultimately, our study demonstrates that heterogeneous video data sets collected from mobile devices hold potential for quantifying visual patterns and providing insights into ASD. We show the importance of automated labeling techniques in generating large-scale data sets while simultaneously preserving the privacy of participants, and we demonstrate that specific social engagement indicators associated with ASD can be identified and characterized using such data.

Fully-printed metamaterial-type flexible wings with controllable flight characteristics

Insect wings are an outstanding example of how a proper interplay of rigid and flexible materials enables an intricate flapping flight accompanied by sound. The understanding of the aerodynamics and acoustics of insect wings has enabled the development of man-made flying robotic vehicles and explained basic mechanisms of sound generation by natural flyers. This work proposes the concept of artificial wings with a periodic pattern, inspired by metamaterials, and explores how the pattern geometry can be used to control the aerodynamic and acoustic characteristics of a wing. For this, we analyzed bio-inspired wings with anisotropic honeycomb patterns flapping at a low frequency and developed a multi-parameter optimization procedure to tune the pattern design in order to increase lift and simultaneously to manipulate the produced sound. Our analysis is based on the finite-element solution to a transient three-dimensional fluid-structure interactions problem. The two-way coupling is described by incompressible Navier-Stokes equations for viscous air and structural equations of motion for a wing undergoing large deformations. We 3D-printed three wing samples and validated their robustness and dynamics experimentally. Importantly, we showed that the proposed wings can sustain long-term resonance excitation that opens a possibility to implement resonance-type flights inherent to certain natural flyers. Our results confirm the feasibility of metamaterial patterns to control the flapping flight dynamics and can open new perspectives for applications of 3D-printed patterned wings, e.g. in the design of drones with target sound.

Cancer cell migration on straight, wavy, loop and grid microfibre patterns

Cell migration plays an important role in physiological and pathological processes where the fibrillar morphology of extracellular matrices (ECM) could regulate the migration dynamics. To mimic the morphological characteristics of fibrillar matrix structures, low-voltage continuous electrospinning was adapted to construct straight, wavy, looped and gridded fibre patterns made of polystyrene (of fibre diameter ca. 3 μm). Cells were free to explore their different shapes in response to the directly-adhered fibre, as well as to the neighbouring patterns. For all the patterns studied, analysing cellular migration dynamics of MDA-MB-231 (a highly migratory breast cancer cell line) demonstrated two interesting findings: first, although cells dynamically adjust their shapes and migration trajectories in response to different fibrillar environments, their average step speed is minimally affected by the fibre global pattern; secondly, a switch in behaviour was observed when the pattern features approach the upper limit of the cell body's minor axis, reflecting that cells' ability to divert from an existing fibre track is limited by the size along the cell body's minor axis. It is therefore concluded that the upper limit of cell body's minor axis might act as a guide for the design of microfibre patterns for different purposes of cell migration.

Identifying Frames of the COVID-19 Infodemic: Thematic Analysis of Misinformation Stories Across Media

Background

The word "infodemic" refers to the deluge of false information about an event, and it is a global challenge for today's society. The sheer volume of misinformation circulating during the COVID-19 pandemic has been harmful to people around the world. Therefore, it is important to study different aspects of misinformation related to the pandemic.

Objective

This paper aimed to identify the main subthemes related to COVID-19 misinformation on various platforms, from traditional outlets to social media. This paper aimed to place these subthemes into categories, track the changes, and explore patterns in prevalence, over time, across different platforms and contexts.

Methods

From a theoretical perspective, this research was rooted in framing theory; it also employed thematic analysis to identify the main themes and subthemes related to COVID-19 misinformation. The data were collected from 8 fact-checking websites that formed a sample of 127 pieces of false COVID-19 news published from January 1, 2020 to March 30, 2020.

Results

The findings revealed 4 main themes (attribution, impact, protection and solutions, and politics) and 19 unique subthemes within those themes related to COVID-19 misinformation. Governmental and political organizations (institutional level) and administrators and politicians (individual level) were the 2 most frequent subthemes, followed by origination and source, home remedies, fake statistics, treatments, drugs, and pseudoscience, among others. Results indicate that the prevalence of misinformation subthemes had altered over time between January 2020 and March 2020. For instance, false stories about the origin and source of the virus were frequent initially (January). Misinformation regarding home remedies became a prominent subtheme in the middle (February), while false information related to government organizations and politicians became popular later (March). Although conspiracy theory web pages and social media outlets were the primary sources of misinformation, surprisingly, results revealed trusted platforms such as official government outlets and news organizations were also avenues for creating COVID-19 misinformation.

Conclusions

The identified themes in this study reflect some of the information attitudes and behaviors, such as denial, uncertainty, consequences, and solution-seeking, that provided rich information grounds to create different types of misinformation during the COVID-19 pandemic. Some themes also indicate that the application of effective communication strategies and the creation of timely content were used to persuade human minds with false stories in different phases of the crisis. The findings of this study can be beneficial for communication officers, information professionals, and policy makers to combat misinformation in future global health crises or related events.

Pattern of Antibiotic Prescriptions in Chinese Children, A Cross-Sectional Survey From 17 Hospitals Located Across 10 Provinces of China

Objectives

Use of Broad-spectrum antibiotics is related closely to increasing antimicrobial resistance. Reports on antibiotic prescriptions for Chinese children were rare. We described the prescribing patterns of antibiotic prescriptions for Chinese children from 2017 to 2019 based on the Anatomical Therapeutic Chemical Classification (ATC classification); the Access, Watch, and Reserve (AWaRe) classification from the World Health Organization (WHO), and the Management of Antibiotic Classification in China.

Methods

A 1-day point-prevalence survey (PPSs) on antibiotics prescribing for Chinese children was conducted in hospitalized children from 17 centers in 10 Chinese provinces from 1 September 2017 to 30 November 2019.

Results

A total of 4,982 antibiotic prescriptions for Chinese children were included in the analysis. There were 76 types of antibiotic agents in total, 22 (28.9%) of which accounted for 90% of all antibiotic prescriptions. The top-three antibiotics prescribed for children were azithromycin (684, 13.7%), ceftriaxone (508, 10.2%) and latamoxef (403, 8.1%). Third-generation cephalosporins (1,913, 38.4%) were the most commonly prescribed antibiotic classes. On the basis of the AWaRe classification, the Watch group antibiotics accounted for 76.3% and Access group antibiotics accounted for 12.1% of all antibiotic prescriptions. On the basis of the China classification, we showed that 26.5% of antibiotic prescriptions were in the Unrestricted group, 53.6% in the Restricted group, and 14.5% in the Special group.

Conclusion

The proportion of antibiotics included in the Watch group and the Special group was high in children in China. The AWaRe classification and China classification for antibiotic prescriptions could be used to supply detailed data for antibiotic stewardship as a simple metric.

Frequency, Pattern, and Treatment of Hand Fractures in Children and Adolescents: A 27-Year Review of 4356 Pediatric Hand Fractures

Background: The frequency, pattern, and treatment of pediatric hand fractures are rarely reported. We sought to review our institution's experience in the management of pediatric hand fractures. Methods: A retrospective review of children and adolescents (younger than 18 years) treated for hand fractures between January 1990 and June 2017 was preformed. Fractures were categorized into metacarpal, proximal/middle phalanx, distal phalanx, or intra-articular metacarpophalangeal (MCP)/proximal interphalangeal (PIP)/distal interphalangeal (DIP) fractures. Patients were categorized into 3 age groups (0-5, 6-11, and 12-17 years). Results: A total of 4356 patients were treated for hand fractures at a mean ± SD age of 12.2 ± 3.5 years. Most fractures occurred in patients aged 12 to 17 years (n = 2775, 64%), followed by patients aged 6 to 11 years (n = 1347, 31%). Only 234 (5%) fractures occurred in children younger than 5 years. Most fractures occurred in the proximal/middle phalanx (48%), followed by metacarpal (33%), distal phalangeal (12%), and intra-articular MCP/PIP/DIP joints (7%). Proximal/middle phalangeal fractures were the most common in all age groups. About 58% of intra-articular MCP/PIP/DIP fractures in patients aged between 0 and 5 years required open reduction ± fixation, and the remaining 42% fractures were amenable to closed reduction. In patients older than 5 years, about 70% of these fractures were amenable to closed reduction. All age groups included, most metacarpal (93%), proximal/middle phalangeal (92%), and distal phalangeal (86%) fractures were amenable to closed reduction alone. Conclusions: The frequency, pattern, and treatment of hand fractures vary among different age groups. Understanding the pattern of these fractures helps making the right diagnosis and guides choosing the appropriate treatment.

Partisan Differences in Legislators' Discussion of Vaccination on Twitter During the COVID-19 Era: Natural Language Processing Analysis

BACKGROUND

The COVID-19 era has been characterized by the politicization of health-related topics. This is especially concerning given evidence that politicized discussion of vaccination may contribute to vaccine hesitancy. No research, however, has examined the content and politicization of legislator communication with the public about vaccination during the COVID-19 era.

OBJECTIVE

The aim of this study was to examine vaccine-related tweets produced by state and federal legislators during the COVID-19 era to (1) describe the content of vaccine-related tweets; (2) examine the differences in vaccine-related tweet content between Democrats and Republicans; and (3) quantify (and describe trends over time in) partisan differences in vaccine-related communication.

METHODS

We abstracted all vaccine-related tweets produced by state and federal legislators between February 01, 2020, and December 11, 2020. We used latent Dirichlet allocation to define the tweet topics and used descriptive statistics to describe differences by party in the use of topics and changes in political polarization over time.

RESULTS

We included 14,519 tweets generated by 1463 state legislators and 521 federal legislators. Republicans were more likely to use words (eg, "record time," "launched," and "innovation") and topics (eg, Operation Warp Speed success) that were focused on the successful development of a SARS-CoV-2 vaccine. Democrats used a broader range of words (eg, "anti-vaxxers," "flu," and "free") and topics (eg, vaccine prioritization, influenza, and antivaxxers) that were more aligned with public health messaging related to the vaccine. Polarization increased over most of the study period.

CONCLUSIONS

Republican and Democratic legislators used different language in their Twitter conversations about vaccination during the COVID-19 era, leading to increased political polarization of vaccine-related tweets. These communication patterns have the potential to contribute to vaccine hesitancy.

Pattern-based approach to gastritis and gastropathy

Histological investigation of non-neoplastic endoscopic biopsies of gastric mucosa is one of the most common tasks most pathologists have to face on daily basis. Although the most common clinical question is still being whether Helicobacter organisms are found, pathologists have to bear in mind the whole spectrum of causes and associated morphological patterns of gastritides and gastropathies, governed by characteristic combinations of various types of inflammatory infiltrate, alterative and reactive changes of epithelial component, vascular response, and variability of stromal composition. The association of histopathologic pattern with supposed etiology can be sometimes proved by direct detection of the cause of morphologic changes in the investigated endoscopic sample.

Pattern-based approach to duodenitis and duodenopathy

Duodenum is currently the most popular site to obtain samples of intestinal mucosa for recognition of a disorder leading to malabsorption. Although there are significant overlaps between histological findings described in various non-neoplastic diseases of the duodenum, recognition of one of the six basic morphologic patterns, namely coeliac disease-like pattern, active chronic duodenitis, acute GvHD-like pattern, enteritis with predominant eosinophilic infiltration, enteritis with predominant infiltration by macrophages, and non-inflammatory enteropathy, usually allows diagnostic separation, especially if subtle histological details, clinical setting and serological investigation are taken into account.