Mean Length Research Articles

Older Adults in CCRCs: Their Social Engagement, Processes and Solutions

ABSTRACT As the older adult population continues to grow, the demand for Continuing Care Retirement Communities (CCRCs) is increasing in the United States. Older adults living in CCRCs may, however, experience social isolation and loneliness if they lack meaningful and sustained social engagement – seen as the quintessence of fulfilled human living. To date, the social engagement preferences and priorities of older adults who live in CCRCs remain under researched. We therefore utilized participatory action research to explore the social engagement goals, processes and solutions of older adults living in CCRCs. An Interpretive Phenomenological Analysis (IPA) approach was adopted to explore the perspectives of 25 older adults living in a CCRC (females = 75%; mean age = 85; mean length of stay = 4.3 years). Thematic analysis of interview data identified three main themes, in addition to subthemes, critical to maintaining social wellbeing in a CCRC: 1) meaningful engagement with CCRC committees and clubs, and contributions to community led by those who live there; 2) opportunities and challenges associated with resilient living, as well as end-of life concerns; and 3) a sense of belonging and connectedness contributing to social community and health wellness. The findings suggest that the social engagement of older adults who live in a CCRC can be enhanced by introducing and promoting initiatives that bring joy, a sense of purpose, belonging, and fulfillment. This engagement needs to align with individuals’ preferences and priorities to ensure satisfying lives and a sense of community.

Satisfactory 2-year outcome of minimal invasive hybrid stabilization with double treated screws for unstable osteoporotic spinal fractures.

This study evaluates whether the fracture level alters the outcomes of minimally invasive hybrid stabilization (MIHS) with double-threaded, uncemented polyaxial screws for unstable osteoporotic vertebral fractures. This prospective cohort study included 73 patients (71.23% females, mean age: 79.9 ± 8.8 years) with unstable OF 3-4 fractures treated by MIHS between Nov 2015-Jan 2018. Patient characteristics, operative data, clinical outcomes, complications, radiological outcomes, and midterm (24-month) follow-up regarding functionality, pain, and quality of life were analyzed. Patients had thoracolumbar (71.23%), thoracic (10.97%), and lumbar (17.8%) fractures. Operative time was < 120min in 73.97% of patients, with blood loss < 500ml in 97.25% of cases. No in-hospital mortality was recorded. Spine-associated complications occurred in 15.07% of patients, while 36.98% of patients had urinary tract infections (n = 12), pneumonia (n = 5), and electrolyte disturbances (n = 9). The mean length of hospital stay was 13.38 ± 7.20 days. Clinically-relevant screw loosening occurred in 1.7% of screws, and secondary adjacent fractures were diagnosed in 5.48% of patients. The alpha-angle improved significantly postoperatively (mean change: 5.4°) and remained stable for 24 months. The beta-angle improved significantly from 16.3° ± 7.5 to 10.8° ± 5.6 postoperatively but increased slightly to 14.1° ± 6.2 at midterm follow-up. Although no differences were seen regarding baseline data, clinical outcomes, and complications, fracture level significantly altered the COMI score at 24 months with no effect on pain score or quality-of-life. MIHS using polyaxial screws is a safe treatment for single-level osteoporotic spinal fractures. Fracture level did not alter radiological reduction loss; however, it significantly altered patients' function at 24 months.

The Association of Conventional Therapy Associated with Somatosensory Interactive Game Enhances the Effects of Early Pulmonary Rehabilitation for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial.

Objective: This study aimed to evaluate the effect of somatosensory interactive games in combination with pulmonary rehabilitation programs (PRPs) on exercise tolerance, balance function, pulmonary function, inflammatory markers, and healthcare utilization in individuals with acute exacerbation of chronic obstructive pulmonary disease over 12 months. Design: In a randomized controlled trial, 80 patients were divided into two groups. The control group participated in a lasted 30 minutes daily program composed of postural training for 10 minutes, limb movement for 10 minutes, and breathing exercises for 10 minutes based on regular oxygen therapy and medication. The experimental group received a once-daily, 20-minute somatosensory interactive game session based on the control group. Patients began treatment within 48 hours after admission and lasted for 6 weeks. Results: The time × group interactions on 6-minute walk distance (6MWD) and Brief Balance Evaluation Systems Test (Brief-BESTest) between the two groups were significant (P < 0.001). At the postintervention and each time point of follow-up, the 6-minute walk distance (6MWD) and Brief-BESTest of the intervention group were significantly higher than those of the control group (P < 0.05). The effects of time factor on forced expiratory volume in one second and forced vital capacity were statistically significant (P < 0.05). The 6MWD and Brief-BESTest of the intervention group peaked 3 months after the intervention and were higher than the control group within 12 months. C-reactive protein and procalcitonin were similar between the groups before and after intervention (P > 0.05). The readmission rates and mean length of time spent in the hospital were comparable between the groups at 12 months (P > 0.05). Conclusions: The addition of somatosensory interactive games based on a PRP was safe and feasible, and this benefit persisted for 12 months, peaked at 3 months after the intervention, and then gradually decreased.

The "what" and "when" of language input to children: Linguistic and temporal predictors of vocabulary in 3-year-olds.

The quantity, quality, and complexity of language input are important for children's language development. This study examined how the detailed timing of this input relates to children's vocabulary at 3 years of age in 64 mother-child dyads (male = 28; female = 36; White = 69%, Black = 31%). Acoustical analysis of turn taking in mother-child dialogue found that more consistently timed maternal responses (lower response latency variability) were associated (r = .42, p < .001) with higher vocabulary (Peabody Picture Vocabulary Test, third edition) scores. In mothers with consistently timed responses, the complexity (mean length of utterance) of their child-directed speech significantly predicted (r = .53, p = .002) their children's vocabulary. This suggests that predictably timed contingent maternal responses provide an important learning cue that supports language development beyond the content of language input itself. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

ANALYSIS OF OSSIFICATION CENTRES OF THE RADIAL DIAPHYSIS IN FETUSES OF 20-32 WEEKS OF GESTATION

The aim of the study – to investigate the characteristics of ossification of the right andleft radial diaphysis in fetuses of 20-32 weeks’ gestation.Materials and methods. Computed tomography scans of 52 human fetuses at 20-32 weeksof gestation were analyzed to study the characteristics of ossification of the radial bones inhuman fetuses. The results of the study were statistically analyzed in Excel. Student’s t-testfor independent variables and univariate analysis of variance were used to compare means.Results. In human fetuses of 20-32 weeks of gestation, the mean length of ossificationof the right radius increases from 19.63±0.19 mm to 40.87±0.09 mm, and the left radiusincreases from 20.43±0.18 mm to 41.62±0.28 mm, according to the quadratic equation: y= 1.7152 x age – 13.152 (R2 = 0.9825). When analyzing the proximal transverse diameterof the diaphysis of the radius, its increase occurs according to the following quadraticequation: y = 0.2354 x age-1.6858 (R² = 0.9797). In the analysis, the transverse diameterof the middle part of the radius diaphysis increases according to the following quadraticequation: y = 0.1388 x age – 1.0613 (R² = 0.9832). When analyzed, the transversediameter of the distal part of the radial diaphysis increases according to the followingquadratic equation: y = 0.1491 x age – 1.1459 (R² = 0.9847).Conclusion. The obtained morphometric data on ossification of the radial diaphysis can beconsidered normal for the studied 20-32 weeks of gestation and can be used for assessmentof fetal age and for ultrasound diagnosis of congenital pathologies of the upper extremity.

Treatment of Fourth Metatarsal Brachymetatarsia Using Distraction Osteogenesis with External Fixator: Surgical Techniques, Outcomes and Complications.

Surgical technique in distraction osteogenesis for the treatment of brachymetatarsia can influence the final prognosis. However, there are currently no standardized guidelines for surgical procedures and complication management. The aim of this study is to investigate the effect of bone lengthening with external fixation by minimally invasive osteotomy based on Ilizarov technique in the treatment of congenital brachymetatarsia. A retrospective study was conducted on patients with congenital brachymetatarsia treated by metatarsal lengthening, from June 2017 to December 2020. There were 11 patients with 17 shorted fourth metatarsals, including 10 females and 1 male, with age of 24.6 ± 4.5 years (16-31 years). Six patients were bilaterally involved. Orthofix external fixator mini track was installed through dorsal approach and the fourth MTP joints were temporarily fixed by Kirschner wire. Bone lengthening was performed after a minimally invasive osteotomy at the proximal metatarsals. American Orthopedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal (MTP-IP) scores, metatarsal length, complications were recorded. Statistical comparison was performed using the paired t-student test for pre- and postoperative AOFAS MTP-IP scores. Patients were followed up for 55 ± 10.8 months. The mean length of the fourth metatarsal bone was 49.9 ± 2.9 mm preoperatively. The mean metatarsal shortage was 18.8 ± 3.1 mm. The mean lengthening achieved was 19.8 ± 3.3 mm, with a lengthening ratio of 39.7% ± 6.6%. The lengthened callus ossified completely at 3-4 months after operation. All patients were satisfied with the results of lengthening. The AOFAS scores were improved significantly from 83.7 ± 4.2 preoperatively to 93.2 ± 2.7 postoperatively (t = -10.27, p < 0.001). One patient with traumatic metatarsophalangeal joint subluxation was treated by joint reduction and Kirschner wire fixation. One patient had metatarsophalangeal joint release and Kirschner wire fixation due to flexion contracture. Pin tract infections were controlled by wound care and antibiotics in 6 patients. All patients had no nonunion, necrosis of toes, and sensory disturbance of toes. Metatarsal lengthening by minimally invasive osteotomy with external fixator had satisfactory results in the treatment of congenital brachymetatarsia.

Neuropathic component of chronic musculoskeletal pain in patients with post-COVID-19: A cross-sectional study

Objectives: This study aimed to evaluate the neuropathic component of chronic musculoskeletal pain in post-coronavirus disease 2019 (COVID-19) and examine the relationship between neuropathic pain and clinical and demographic characteristics. Patients and methods: This cross-sectional study included 163 adult patients (85 females, 78 males; mean age: 41.7±4.3 years; range, 22 to 50 years) with post-COVID-19 musculoskeletal pain between February 1, 2021, and April 30, 2021. Demographic and clinical characteristics, including age, sex, affected site, duration, and severity of post-COVID-19 musculoskeletal pain using the Visual Analog Scale (VAS), as well as a neuropathic component of pain using the Leeds assessment of neuropathic symptoms and signs (LANSS), were collected. The most common post-COVID-19 symptoms, presence of hospitalization, and length of hospital stay during active COVID-19 infection were recorded from the patient records. Results: The mean duration and severity of pain were 7.85±1.53 months and 5.09±1.95, respectively. Half of the patients were hospitalized, and the mean length of hospital stay was 12.15±18.06 days. The most common pain sites were upper and lower back pain, followed by leg and arm pain. A total of 92 (56.4%) patients had previously received pharmacological or nonpharmacological treatment for post-COVID-19 musculoskeletal pain. Based on the LANSS (scores &gt;12), 31 (19%) patients had neuropathic pain. There was a significant correlation between the presence of neuropathic pain and pulmonary involvement/symptoms. The presence and length of hospital stay were correlated with LANNS scores (p&lt;0.05). The frequency, LANSS scores, and VAS-pain scores of the patients with and without neuropathic pain were similar between male and female patients (p&gt;0.05). Conclusion: The neuropathic component of chronic musculoskeletal pain may be common, as one-fifth of our patients had neuropathic pain as assessed by the LANNS. Therefore, the awareness of post-COVID-19 chronic neuropathic musculoskeletal pain should be increased. We believe that focusing on the identification of pain phenotypes would provide adequate and tailored chronic neuropathic musculoskeletal pain management in the post-COVID-19 period.

Impact of a financial incentive on early rehabilitation and outcomes in ICU patients: a retrospective database study in Japan

BackgroundEarly mobilisation of intensive care unit (ICU) patients has been recommended in clinical practice guidelines. Therefore, the Japanese universal health insurance system introduced an additional fee for early mobilisation and/or...

Risk factors for prolonged length of hospital stay following elective hip replacement surgery: a retrospective longitudinal observational study

ObjectivesOur aim was to identify which patients are likely to stay in hospital longer following total hip replacement surgery.DesignLongitudinal, observational study used routinely collected data.SettingData were collected from an NHS...

Long term results with medpor® reconstruction of the anterior skull base at a single institute

Objectives To evaluate a technique of multi-layered CSF repair following endonasal anterior skull base surgery using medpor graft. Design Retrospective review of consecutive case series from a single centre. Subjects 68 cases of repair of CSF leaks utilising medpor identified from a larger prospectively maintained database of endonasal endoscopic procedures at our centre. Methods Retrospective review of a database of consecutive anterior skull base cases from 2016–2022, and further data collection from electronic hospital records. Results During follow up there were 7 cases of post-op CSF leak (10.3%). There were no radiological complications, and no cases of medpor removal or extrusion. Rates of infection were low, there were 3 (4.4%) cases of confirmed bacterial meningitis within our cohort. The mean length of stay was 4.7 days (median 3 days), with 16 cases discharged on the first post-operative day. Conclusions Our experience of using medpor in anterior skull base reconstruction demonstrates that medpor is a readily available, easily handled, and reliable graft option with relatively low rates of infection and post-op CSF leak. Its use reduces the use of autologous graft materials and the associated donor site morbidity. Our long term follow up data further demonstrates the safety and efficacy of this technique.

The Levator Veli Palatini: Are all Segments Created Equal?

The levator veli palatini (LVP) muscle has two segments with distinct roles in velopharyngeal function. Previous research suggests longer extravelar segments with shorter intravelar segments may lead to a more advantageous mechanism for velopharyngeal closure. The purpose of this study was to examine whether the distribution of the LVP intravelar and extravelar segments differs between children with cleft palate with and without VPI and controls. The study included 97 children: 37 with cleft palate +/- lip with VPI, 37 controls, and 19 with cleft palate with normal resonance. Measures included mean LVP length, mean extravelar LVP length, and intravelar LVP length. Overall mean LVP length was similar (P = .267) between controls and children with cleft palate (with and without VPI). However, there was a significant difference (P < .001) between group for both intravelar and extravelar LVP lengths: the intravelar segment was significantly longer in those with VPI compared to controls and children with cleft palate and normal resonance; and the extravelar segment was significantly shorter in those with VPI compared to controls and children with cleft palate and normal resonance. Results from this study demonstrate a significant difference between the distribution of the functional segments of the LVP among children with VPI, with a more disadvantageous distribution of the muscle segments among those with VPI.

National 30-Day Readmission Trends in IBD 2014-2020-Are We Aiming for Improvement?

Background: Inflammatory bowel disease (IBD) prevalence in Eastern Europe is increasing. The 30-day readmission rate is a crucial quality metric in healthcare, reflecting the effectiveness of initial treatment and the continuity of care post-discharge; however, such parameters are rarely analyzed. The aim of this study was to explore the trends in 30-day readmissions among patients with inflammatory bowel disease in Latvia between 2014 and 2020. Methods: This is a retrospective trends study in IBD-ulcerative colitis and Crohn's disease (UC and CD)-patients in Latvia between 2014 and 2020, involving all IBD patients identified in the National Health service database in the International Classification of Diseases-10 (ICD) classification (K50.X and K51.X) and having at least one prescription for IBD diagnoses. We assessed all IBD-related hospitalizations (discharge ICD codes K50X and K51X), as well as hospitalizations potentially related to IBD comorbidities. We analyzed hospitalization trends and obtained the 30 day all-cause readmission rate, disease specific readmission rate and readmission proportion for specific calendar years. Trends in readmissions and the mean length of stay (LOS) for CD and UC were calculated. Results: Despite a decrease in admission rates observed in 2020, the total number of readmissions for CD and UC has increased. Female patients prevailed through the study period and were significantly older than male patients in both the CD and UC groups, p < 0.05. We noted that there was no trend for 30 day all-cause readmission rate for CD (p > 0.05); however, there was a statistically significant trend for 30 day all-cause readmission for UC patients (p-trend = 0.018) in the period from 2014 to 2019. There was a statistically significant trend for CD-specific readmission rate (p < 0.05); however, no statistically significant trend was observed for UC-specific readmission (p > 0.05). An exploratory analysis did not reveal any statistically significant differences between treated and not-treated IBD patients (p > 0.05). The increasing trend is statistically significant over the period 2014-2018 (p < 0.05); however, the trend interrupts in 2020, which can be associated with the COVID-19 global pandemic and the related changes in admission flows where the gastroenterology capacity was reallocated to accommodate increasing numbers of COVID-19 patients. More studies are needed to evaluate the long-term impact of COVID-19 pandemic and 30-day readmissions. No significant dynamics were observed in the mean total hospitalization costs over the 2014-2020 period.

The reference curves of percentile for the length and head circumference of infants aged 0–1 year in Hainan Province, China

We first established percentile reference curves for infant length and head circumference in Hainan Province based on gender and age in months and compared them with the 2022 national standards and World Health Organization (WHO) standards. This cross-sectional survey involved 2736 infants (1471 boys and 1265 girls) in 18 cities and counties in Hainan Province. Standardized instruments were used to measure head circumference and length. Reference values for Hainan infants' length and head circumference were determined using the LMS method. Curves were generated using the LMS Chart Maker software. According to the newly established reference curves, the length and head circumference of Hainan infants exhibited a consistent trend of steady growth. However, the average head circumference was below the 2022 national reference values and WHO standards. The mean length was lower than the new national reference values but roughly consistent with the WHO standards. Differences exist in infant length and head circumference in Hainan compared to national and global averages. To enhance infant length and head circumference growth, the health department should encourage exclusive breastfeeding for the first 6 months, ensure infants' sleep needs at night, and promote the regularity of vitamin D supplementation during the perinatal period.

Impella 5.5 Support for Delayed Surgical Ventricular Septal Defect Repair-A Paradigm Shift?

Ventricular septal defects (VSDs) remain a rare but life-threatening complication of myocardial infarction. Although the incidence has decreased due to better treatment options, the mortality rate remains high. The timing of VSD repair remains critical to outcome. The use of mechanical circulatory support is rarely described in the literature, although it may help to delay repair to allow tissue stabilization. While Impella is currently considered contraindicated due to the potential worsening of the right-to-left shunt and possible systemic embolization of necrotic debris, there is no comprehensive evidence for this. Therefore, we aimed to analyze whether the use of Impella 5.5 as a first choice for patients undergoing VSD repair should be considered for discussion. This retrospective study analyses four consecutive patients who underwent delayed ventricular septal repair after prior implantation of Impella 5.5 (Abiomed Inc., Danvers, Massachusetts, United States). A total of 75% of patients (n = 3) presented with acute right heart failure prior to implantation with a mean systolic pulmonary artery pressure of 64 ± 3.0 mmHg. Implantation was performed under local anesthesia in three cases. The mean time to surgery was 9.8 ± 3.1 days. All patients remained on the Impella 5.5 device postoperatively. Weaning from Impella 5.5 was successful in 75% (n = 3). The mean length of stay in the intensive care unit was 22.3 ± 7.5 days. Preoperative implantation of the Impella 5.5 device is a safe and feasible option for patients undergoing VSD repair. Outcomes may be improved by performing Impella implantation under local anesthesia and continuing Impella support after VSD repair. However, it is important to note that these patients represent a high-risk cohort and the mortality rate remains high.

The Relationship between the Length/Width of the Face and the Length/Width of the Crown of the Permanent Upper Central Incisors.

Background: The face, with its attractiveness, is positively connected with self-esteem and interpersonal relationships, and the maxillary central incisors are the most noticeable teeth and crucial for smile aesthetics. The aim of this study is to examine facial and permanent upper central incisors' clinical crown dimensions and their correlations to establish whether there is a relationship between the length/width of the face and the length/width of the clinical crown of the permanent upper central incisors. Methods: This study included 100 subjects (43 males and 57 females) with a mean age of 17.5 ± 3.4 years before orthodontic treatment. Facial length and width were measured using a cephalometer by the same orthodontist and the upper central incisors' clinical crown lengths and widths were measured using a sliding calliper by the same dental student. Data were analysed using SPSS version 29.0, presenting descriptive statistics for age, facial and upper central incisor crown dimensions, and indices. Pearson's correlation coefficient assessed the relationship between facial features and the upper central incisors' crown. The significance level was p ≤ 0.05. Results: Males exhibit a slightly higher mean value of the face length (11.6 ± 0.8 cm) compared to females' face length (11.2 ± 1.1 cm) and a statistically significant (p < 0.05) higher mean value of the face width (11.7 ± 0.8 cm) compared to females (11.1 ± 0.6 cm). The facial index shows no statistically significant gender difference (males: 99.1 ± 8.4; females: 101.2 ± 11.9, p > 0.05). The upper central incisor crown dimensions are without statistically significant differences between gender and tooth side: males have mean value clinical crown lengths of 10.2 ± 1.1 mm (left) and 10.1 mm ± 1.2 (right) while females have 9.9 ± 1.0 mm (left) and 9.8 ± 0.7 mm (right). Clinical crown widths are also comparable (males: left 9.0 ± 0.7, right 8.9 ± 0.6 and females: left 8.8 ± 0.7, right 8.8 ± 0.7), with no statistically significant differences observed. The tooth index shows no statistically significant difference but there is a statistically significant (p < 0.05) correlation between the facial index and tooth index. Conclusions: Knowledge of the presented data is important for diagnosis and treatment planning and may be useful for restorative dentists, orthodontists, prosthodontists, and maxillofacial surgeons to achieve an aesthetic result. Clinically, our study supports the development of more personalized treatment plans.

Analyzing Runs of Homozygosity Reveals Patterns of Selection in German Brown Cattle.

An increasing trend in ancestral and classical inbreeding coefficients as well as inbreeding depression for longevity were found in the German Brown population. In addition, the proportion of US Brown Swiss genes is steadily increasing in German Browns. Therefore, the aim of the present study was to analyze the presence and genomic localization of runs of homozygosity (ROH) in order to evaluate their associations with the proportion of US Brown Swiss genes and survival rates of cows to higher lactations. Genotype data were sampled in 2364 German Browns from 258 herds. The final data set included 49,693 autosomal SNPs. We identified on average 35.996 ± 7.498 ROH per individual with a mean length of 8.323 ± 1.181 Mb. The genomic inbreeding coefficient FROH was 0.122 ± 0.032 and it decreased to 0.074, 0.031 and 0.006, when genomic homozygous segments > 8 Mb (FROH>8), >16 Mb (FROH>16) and >32 Mb (FROH>32) were considered. New inbreeding showed the highest correlation with FROH>32, whereas ancestral inbreeding coefficients had the lowest correlations with FROH>32. The correlation between the classical inbreeding coefficient and FROH was 0.572. We found significantly lower FROH, FROH>4, FROH>8 and FIS for US Brown Swiss proportions <60% compared to >80%. Cows surviving to the 2nd, 4th, 6th, 8th, and 10th lactation had lower genomic inbreeding for FROH and up to FROH>32, which was due to a lower number of ROH and a shorter average length of ROH. The strongest ROH island and consensus ROH shared by 50% of the animals was found on BTA 6 at 85-88 Mb. The genes located in this genomic region were associated with longevity (NPFFR2 and ADAMTS3), udder health and morphology (SLC4A4, NPFFR2, GC and RASSF6), milk production, milk protein percentage, coagulation properties of milk and milking speed (CSN3). On BTA 2, a ROH island was detected only in animals with <60% US Brown Swiss genes. Genes within this region are predominantly important for dual-purpose cattle breeds including Original Browns. For cows reaching more than 9 lactations, an exclusive ROH island was identified on BTA 7 with genes assumed to be associated with longevity. The analysis indicated that genomic homozygous regions important for Original Browns are still present and also ROH containing genes affecting longevity may have been identified. The breeding of German Browns should prevent any further increase in genomic inbreeding and run a breeding program with balanced weights on production, robustness and longevity.

Fungal Peptidomelanin: A Novel Biopolymer for the Chelation of Heavy Metals.

Melanin is an amorphous, highly heterogeneous polymer found across all kingdoms of life. Although the properties of melanin can greatly vary, most forms are insoluble and strongly absorb light, appearing dark brown to black. Here, we describe a water-soluble form of melanin (peptidomelanin) secreted by the spores of Aspergillus niger (strain: melanoliber) during germination. Peptidomelanin is composed of an insoluble L-DOPA core polymer that is solubilized via short, copolymerized heterogeneous peptide chains forming a "corona" with a mean amino acid length of 2.6 ± 2.3. Based on in vitro experiments, we propose a biochemical copolymerization mechanism involving the hydroxylation of tyrosynylated peptides. Peptidomelanin is capable of chelating heavy metals such as lead, mercury, and uranium (as uranyl) in large quantities. Preliminary data indicates that peptidomelanin may have applications for the remediation of heavy metals in situ, including in agricultural settings.

Antipsychotic Drug Poisoning in Children Under 12 Years Old in Loghman-Hakim Hospital During 2016-2022

Background: Unintentional pediatric poisoning with antipsychotic medications represents an important clinical entity. This study aimed to evaluate the epidemiology, clinical manifestations, and outcomes of antipsychotic poisoning among children presenting to a referral hospital.Methods: This descriptive, cross-sectional study reviewed medical records of children &lt;12 years old hospitalized for antipsychotic drug poisoning at Loghman Hakim Hospital in Tehran from 2015-2016. Data extracted included demographic details, agent and dose ingested, clinical findings, treatments administered, and patient dispositions.Results: 141 cases were identified, comprising 2.3% of all pediatric poisonings. Patient ages ranged from 6 months to 12 years (mean 5.5 years), with a male predominance (52.5%). The most common offending agents were risperidone (53.2%) and olanzapine (13.4%). Unintentional exposures accounted for 72.3% of cases. Central nervous system (CNS) effects like somnolence (61.7%) and dysarthria (19.1%) were most prevalent. Significant toxicity was infrequent; no fatalities occurred. Mean length of stay was 2 days for uncomplicated admissions. Conclusion: Antipsychotic poisoning in children chiefly involves atypical agents with a largely benign course. Risperidone predominated due to prescribing patterns. Somnolence represented the principal clinical manifestation. With reasonable supportive care, favorable outcomes are achievable in the pediatric population.

An alternative bronchoscopic transparenchymal nodule access by “invisible tunnel” technique under electromagnetic navigation without the transbronchial access tool

BackgroundThe diagnosis of peripheral pulmonary lesions (PPL) is still challenging. We describe a novel method for sampling PPL without bronchial signs by creating invisible tunnel under electromagnetic navigation without the transbronchial access tool (TABT).MethodsDuring electromagnetic navigation, we adjust the angle of the edge extended working channel catheter based on the real-time position of the lesion in relation to the locating guide rather than preset route. A biopsy brush or biopsy forceps is used to punch a hole in the bronchial wall. A locating guide is then re-inserted to real-time navigate through the lung parenchyma to the lesion. Safety and feasibility of this method was analyzed.ResultsA total of 32 patients who underwent electromagnetic navigation bronchoscopy were retrieved. The mean size of the lesion is 23.1 mm. The mean operative time of all patients was 12.4 min. Ten of the patients did not have a direct airway to the lesion, thus creating an invisible tunnel. For them, the length of the tunnel from the bronchial wall POE to the lesion was 11–30 mm, with a mean length of 16.9 mm and a mean operation time of 14.1 min. Adequate samples were obtained from 32 patients (100%), and the diagnostic yield was 87.5% (28/32). Diagnostic yield of with create the invisible tunnel TBAT was 90% (9/10), and one patient undergone pneumothorax after operation.ConclusionsThis method is feasible and safe as a novel approach sampling pulmonary lesions without bronchial signs, and it further improves current tunnel technique.

Are Written Syntax Features Related to Writing Quality? An Examination of Spanish and English Compositions by Bilingual Children.

There is limited research on the writing of young Spanish-English bilinguals and their writing in both languages. In the current study, we addressed whether written syntax features differed by language (English and Spanish) and varied as a function of grade level, English learner status, and instructional program (dual or English immersion). We also examined whether Spanish and English syntax features were related cross-linguistically and related to writing quality within languages and whether these relations to writing quality were moderated by grade level, English learner status, and instructional program. We examined written syntax features of Spanish and English essays by simultaneous and emergent bilinguals in Grades 1, 2, and 3 in either Spanish-English dual immersion or English immersion instruction in the United States (N = 278). Essays were scored for quality and evaluated for mean length of T-units, number of verbs, number of noun agreement words, and number of subject agreement words accurately conjugated. Written syntax features significantly differed by language and varied as a function of grade level, English learner status, and instructional program. Grades 2 and 3 wrote longer utterances, more verbs, and greater noun agreement accuracy than Grade 1. Syntax features were related to writing quality within languages, but Spanish relations were weaker for English learners than non-English learners and for dual immersion students than English immersion students. Our findings suggest written syntax features may be useful for evaluation of English-Spanish simultaneous and emergent bilinguals' writing. https://doi.org/10.23641/asha.25927366.