Mean Total Area Research Articles

535 Influence of Covid-19 Pandemic Conditions on the Features of Pediatric Minor Burn Injuries

Abstract Introduction Majority of pediatric burns are minor injuries. Social life changes due to Covid-19 pandemic may have influenced their characteristics. We compared the features of pediatric burn cases which were treated as outpatients at our center before and during Covid-19 pandemic. Methods The records of 658 patients were reviewed. The study group was evaluated in two groups; Group I: patients-treated between March 2018 and February 2020 (pre-pandemic) (n=350), Group II: patients-treated between March 2020 and February 2022(Pandemic) (n=308). Data collected for each case were age; sex; insurance status, place of residence; burn-causes, extent of burns; body-site affected; time and environment where the injury occurred, time-interval between occurrence of injury and admissions to the burn-center; (mean± SE, p<.05). Results Mean age (years) was 4,32±0,24 for Group I, it was 4,32±0,18 for Group II; male:female ratio was 0,87:1 in Group I, it was 1,1: 1 in Group II; mean total surface area burned was 1,94±0,14 % (min:0,5, max:16) in Group I, and it was 1,98±0,26% (min:0,1 max: 16,1) in Group II (p>.05). Most of the patients were from urban areas and were covered by social security system in both groups (p>.05). Injuries occurred between 06:00 and 18:00 in 63,7% of Group I and in 62,6% of Group II (p>.05). The most common scenario was the domestic environment for both groups with a rise in rates of outdoor-burns Group II (p<.05) and this rise was observed during the ‘new normal’ period, but not during the ‘lock-down’(p< .05). The most common burn-cause was the scalds for both groups (p >.05). Hands, trunk, head and neck regions were less frequently involved in group II (p<.05). Rates of direct admission were similar for both, but children in Group II were more frequently brought to our burn center on the day of injury (p<.05). Conclusions The decrease in injuries to hands, trunk, head and neck, and the increase in admissions on the day of injury were remarkable during pandemic period. These results may be clues for enhanced care-giver precautions against injuries during ‘stay home’ days. Increased frequency of outdoor burns during ‘new normal’ may indicate the negative effects of this new unfamiliar social life on care-giver watchfulness. However, increased admissions on the day of the injury may be influenced both by the changing social conditions of care-givers and the uninterrupted service of our burn center while others were serving for covid-19 patients rather than burn victims. Applicability of Research to Practice This study helped to make recommendations for evidence-based interventions to decrease factors associated with pediatric minor burn injuries before, during and after pandemic

Pharmacokinetics comparison of vardenafil as administered by an intranasal spray formulation vs a 10-mg oral tablet.

Oral vardenafil (VDF) tablet is an effective treatment for erectile dysfunction (ED), but intranasal administration with a suitable formulation can lead to a faster onset of action and offer more convenient planning for ED treatment. The primary purpose of the present pilot clinical study was to determine whether intranasal VDF with an alcohol-based formulation can result in more "user-friendly pharmacokinetics" as compared with oral tablet administration. This single-dose randomized crossover study was conducted in 12 healthy young volunteers receiving VDF as a 10-mg oral tablet or 3.38-mg intranasal spray. Multiple blood concentrations were obtained, and VDF concentrations were determined with a liquid chromatography-tandem mass spectrometry assay. Pharmacokinetic parameters following each treatment were compared and adverse events assessed. Pharmacokinetic parameters were obtained: apparent elimination rate constant, elimination half-life, peak concentration, peak time, total area under the curve, and relative bioavailability. Although mean apparent elimination rate constant, elimination half-life, peak concentration, and total area under the curve were similar between intranasal and oral administration, the median peak time from intranasal was much shorter (10vs 58minutes, P < .001, Mann-Whitney U test). The variability of the pharmacokinetic parameters was also less with intranasal than oral administration. The relative bioavailability of intranasal to oral was 1.67. Intranasal VDF caused transient but tolerable local nasal reactions in 50% of subjects. Other adverse events (eg, headache) were similar between the treatments. The incidence of adverse events was, however, significantly less in the second treatment after initial exposure to VDF. No serious adverse events were noted. Intranasal VDF potentially offers a more timely and lower dose for the treatment of ED in patients who can tolerate the transient local adverse reactions. The strength of this study is its randomized crossover design. Because the study was conducted in 12 healthy young subjects, the results may not reflect those observed in elderly patients who may be likely taking VDF for ED. Nevertheless, the changes of pharmacokinetic parameters in the present study are likely a reflection of the differences between intranasal and oral administration of the formulations. Our study indicated that the present VDF formulation, when administered intranasally, can achieve a more rapid but similar plasma concentration with only about one-third dose when compared with the oral administration.

Management of Through-and-Through Oromandibular Defects after Segmental Mandibulectomy with Fibula Osteocutaneous Flap.

Oromandibular defects involving the external skin are a reconstructive challenge. This study aimed to evaluate the use of the fibula osteocutaneous free flap (FOCFF) for through-and-through oromandibular defects by comparing the surgical outcomes and complications of different techniques to close the external skin defect. A retrospective analysis was conducted of patients who underwent reconstruction of through-and-through oromandibular defects after oncologic segmental mandibulectomy between January 2011 and December 2014. Five groups were analyzed according to the method of external skin coverage: primary closure, locoregional flaps, deepithelialized double-skin paddle FOCFF (deEpi-FOCFF), division of the skin paddle for double-skin paddle FOCFF (div-FOCFF), and a simultaneous second free flap. Intraoperative and postoperative outcomes along with complications were analyzed between groups. A total of 323 patients were included. The mean total defect area requiring a simultaneous second free flap was larger in comparison to other groups (p < 0.001). Reconstructions performed with div-FOCFF had a higher number of perforators per flap when compared with deEpi-FOCFF (p < 0.001). External defects closed with another free flap exhibited higher intraoperative time for the reconstructive segment in comparison to other groups (p < 0.05). The overall rate of complications was comparable between groups (24%, p = 0.129). The FFOCF is a reliable alternative to harvesting multiple simultaneous free flaps for through-and-through oromandibular defects. The authors recommend appropriate curation of the surgical plan based on individual patient characteristics and reconstructive requirements.

Tissue amount and diagnostic yield of a novel franseen EUS-FNB and a standard EUS-FNA needle-A randomized controlled study in solid pancreatic lesions.

Several types of needles are available for EUS-guided tissue sampling of pancreatic lesions. Whereas fine-needle aspiration (FNA) needles typically provide cytological samples, fine-needle biopsy (FNB) needles are designed to obtain microcores with preserved tissue architecture. The aim of this study was to compare tissue amount and diagnostic yield between a modified Franseen-type FNB needle (TopGain; Medi-Globe GmbH, Grassau, Germany) and a standard FNA needle. We performed a prospective, multicenter randomized controlled study between June 2020 and September 2021, including patients with a solid pancreatic lesion referred for EUS-guided tissue sampling at 3 centers in Denmark. The patients were randomized 1:1 to either FNA needle or the novel FNB needle. Primary outcomes included the number of obtained tissue microcores and total and diagnostic tissue area. Sixty-four patients were included. The median number of tissue microcores procured per pass was significantly higher in the FNB group compared with FNA (3 vs. 2, P < 0.001). Similarly, the mean total tissue area (2.74 vs. 0.44 mm2, P < 0.001) and mean diagnostic tissue area (1.74 vs. 0.28 mm2, P < 0.001) were more than 6-fold larger in the FNB samples compared with FNA. The median number of passes needed for a diagnostic sample was 1 for the FNB needle and 2 for FNA needle (P = 0.12). The novel FNB needle provided a higher percentage of samples of excellent quality (P = 0.002). The novel Franseen-type FNB needle seems to be significantly superior to a conventional FNA needle. The results of this study underline excellent performance of crown-cut needles.

The effects of cytomegalovirus on brain structure following sport-related concussion.

The neurotrophic herpes virus cytomegalovirus is a known cause of neuropathology in utero and in immunocompromised populations. Cytomegalovirus is reactivated by stress and inflammation, possibly explaining the emerging evidence linking it to subtle brain changes in the context of more minor disturbances of immune function. Even mild forms of traumatic brain injury, including sport-related concussion, are major physiological stressors that produce neuroinflammation. In theory, concussion could predispose to the reactivation of cytomegalovirus and amplify the effects of physical injury on brain structure. However, to our knowledge this hypothesis remains untested. This study evaluated the effect of cytomegalovirus serostatus on white and grey matter structure in a prospective study of athletes with concussion and matched contact-sport controls. Athletes who sustained concussion (n = 88) completed MRI at 1, 8, 15 and 45 days post-injury; matched uninjured athletes (n = 73) completed similar visits. Cytomegalovirus serostatus was determined by measuring serum IgG antibodies (n = 30 concussed athletes and n = 21 controls were seropositive). Inverse probability of treatment weighting was used to adjust for confounding factors between athletes with and without cytomegalovirus. White matter microstructure was assessed using diffusion kurtosis imaging metrics in regions previously shown to be sensitive to concussion. T1-weighted images were used to quantify mean cortical thickness and total surface area. Concussion-related symptoms, psychological distress, and serum concentration of C-reactive protein at 1 day post-injury were included as exploratory outcomes. Planned contrasts compared the effects of cytomegalovirus seropositivity in athletes with concussion and controls, separately. There was a significant effect of cytomegalovirus on axial and radial kurtosis in athletes with concussion but not controls. Cytomegalovirus positive athletes with concussion showed greater axial (P = 0.007, d = 0.44) and radial (P = 0.010, d = 0.41) kurtosis than cytomegalovirus negative athletes with concussion. Similarly, there was a significant association of cytomegalovirus with cortical thickness in athletes with concussion but not controls. Cytomegalovirus positive athletes with concussion had reduced mean cortical thickness of the right hemisphere (P = 0.009, d = 0.42) compared with cytomegalovirus negative athletes with concussion and showed a similar trend for the left hemisphere (P = 0.036, d = 0.33). There was no significant effect of cytomegalovirus on kurtosis fractional anisotropy, surface area, symptoms and C-reactive protein. The results raise the possibility that cytomegalovirus infection contributes to structural brain abnormalities in the aftermath of concussion perhaps via an amplification of concussion-associated neuroinflammation. More work is needed to identify the biological pathways underlying this process and to clarify the clinical relevance of this putative viral effect.

Effect of prenatal diaphragmatic hernia on pulmonary arterial morphology.

Congenital diaphragmatic hernia (CDH) is a major cause of severe lung hypoplasia and pulmonary hypertension in the newborn. While the pulmonary hypertension is thought to result from abnormal vascular development and arterial vasoreactivity, the anatomical changes in vascular development are unclear. We have examined the 3D structure of the pulmonary arterial tree in rabbits with a surgically induced diaphragmatic hernia (DH). Fetal rabbits (n= 6) had a left-sided DH created at gestational day 23 (GD23), delivered at GD30, and briefly ventilated; sham-operated litter mates (n= 5) acted as controls. At postmortem the pulmonary arteries were filled with a radio-opaque resin before the lungs were scanned using computed tomography (CT). The 3D reconstructed images were analyzed based on vascular branching hierarchy using the software Avizo 2020.2. DH significantly reduced median number of arteries (2,579 (8440) versus 576 (442), p= .017), artery numbers per arterial generation, mean total arterial volume (43.5± 8.4 vs. 19.9± 3.1μl, p= .020) and mean total arterial cross-sectional area (82.5± 2.3 vs. 28.2± 6.2 mm2 , p=.036). Mean arterial radius was increased in DH kittens between the eighth and sixth branching generation and mean arterial length between the sixth and 28th branching generation. A DH in kittens resulted in threefold reduction in pulmonary arterial cross-sectional area, primarily due to reduced arterial branching. Thus, the reduction in arterial cross-sectional area could be a major contributor to pulmonary hypertension infants with CDH.

Differences in left and right carotid plaque vulnerability in patients with bilateral carotid plaques: a CARE-II study

Background and purposeAtherosclerosis is a very complex process influenced by various systemic and local factors. Therefore, in patients with bilateral carotid plaques (BCPs), there may be differences in carotid plaque...

Acute kidney injury in burns in the intensive care unit: A retrospective research.

Acute kidney injury (AKI) is one of the common complications, associated with high mortality and morbidity in patients with burn injuries. This study aimed to determine the frequency of AKI development, its affective factors, and mortality rates according to kidney disease improving global outcomes (KDIGO) criteria in the burn patients. The study included patients who are hospitalized for at least 48 h and aged >18 years, whereas patients with a renal transplant, chronic renal failure, undergoing hemodialysis, <18 years of age, with a glomerular filtration rate of <15 on admission, and toxic epidermal necrolysis was excluded from the study. KDIGO criteria were used to evaluate the occurrence of AKI. Burn mech-anism, total body surface area, inhalation injury respiratory tract burn, fluid replacement at 72 h with Parkland Formula, mechanical ventilator support, inotrope/vasopressor support, intensive care unit, lenght of stay, mortality, abbreviated burn severity index (ABSI), acute physiology, and chronic health evaluation II (APACHE II) ve Sequential organ failure assessment (SOFA) were recorded. A total of 48 patients were included in our study, of which 26 (54.2%) developed AKI (+), whereas 22 (45.8%) did not (-). The mean total burn surface area was 47.30% in the AKI (+) group and 19.88% in the AKI (-) group. Mean scores of ABSI, II (APACHE II), and SOFA, the mechanical ventilation and inotrope/vasopressor support and the presence of sepsis were significantly higher in the AKI (+). No mortality was determined in the AKI (-) group, whereas 34.6% in the AKI (+) group which was significantly high. AKI was related to high morbidity and mortality in patients with burns. Using KDIGOs, classification in daily fol-low-up is useful in early diagnosis.

The effect of mirror therapy on joint movement, pain and functionality in acute upper limb burns

ObjectiveMirror therapy is aimed at developing a normal proprioceptive perception for the area with pain or movement restriction by making use of the person's monitoring of the healthy side movements thanks to the mirror's reflective feature. The aim of this study is to investigate the effect of mirror therapy on joint range of motion, pain and functionality in acute upper extremity burn injuries. MethodsDemographic and burn-specific data of individuals with upper extremity burns were recorded. Individuals were divided into two groups. Standard treatment was applied to the first group, and mirror treatment in addition to the standard treatment was applied to the second group for 30 sessions, 5 days a week for 6 weeks. In the standard treatment program, passive, active-assisted and active ROM, strengthening, stretching, resistant and functional exercises were applied. In the mirror therapy group, active exercises were performed on the healthy side by covering the burn area in the mirror box. Before and after the treatment, joint range of motion(ROM) was evaluated with Universal Goniometer, pain intensity was evaluated with Visual Analog Scale and upper extremity functions were evaluated with QuickDASH. ResultsA total of 32 (23 Male, 9 Female) individuals between the ages of 18–65 were included. The mean total burn surface area was 12.93 ± 9.80 in the standard treatment and 6.12 ± 2.96 in the mirror treatment. The groups were similar in terms of ROM change (p > 0.05). The pretest/posttest pain scores of both the standard therapy and mirror therapy groups were similar (p > 0.05). There was no statistically significant difference in terms of pretest and posttest QuickDASH scores according to the groups (p > 0.05). The difference between the pretest/posttest QuickDASH scores of both Standard treatment and Mirror treatment groups was statistically significant. ConclusionThis study showed that the standard physiotherapy and rehabilitation program applied in the acute period in upper extremity burns and the mirror treatment applied in addition to this program provide similar improvements in joint range of motion and pain.

First clinical experience of high-power ablation of atrial fibrillation with a novel contact force-sensing gold-tip catheter

BackgroundContact force (CF)-sensing catheters are commonly used in the field of radiofrequency (RF) ablation to treat atrial fibrillation (AF). Increasing ablation power (e.g., 50 W) has been suggested as a method to reduce procedure times whilst creating safe and lasting lesions.MethodsWe report the first clinical evidence of a 50 W point-by-point RF ablation in 25 consecutive patients with symptomatic AF using a novel CF-sensing catheter with a gold tip (AlCath Force, Biotronik). We collected and analyzed procedural and ablation parameters. The safety and efficacy of the catheter were evaluated.ResultsAltogether, 985 RF lesions in 25 patients were created with a mean number of 39.4 ± 16.3 lesions per patient. The total skin-to-skin procedure time was 116.1 ± 35.1 min, and the mean total area dose product was 10.9 ± 5.1 Gy*cm2. The mean RF time per procedure was 13.2 ± 6.6 min. The mean RF time per lesion was 20.2 ± 8.4 s. The mean CF was 15.7 ± 7.6 g. We observed a mean force time integral of 274.7 ± 11.1 gs (range: 53 to 496 gs). Acute procedural success, defined as entrance and exit block in all pulmonary veins, could be obtained in all cases. No procedure- or device-related serious adverse events were observed. No audible steam pops occurred. Optical inspection of the catheter after the procedure showed neither charring nor clotting.ConclusionsWe provide the first evidence for the safety and efficacy of 50 W ablation using the AlCath Force gold-tip catheter. These data must be supported by a larger multi-center study.

Choriocapillaris flow deficit in a pachychoroid spectrum disease using en face optical coherence tomography angiography averaging.

To investigate the choriocapillaris changes associated with pachychoroid pigment epitheliopathy (PPE) in comparison with healthy eyes. Nine 3 × 3 mm macular optical coherence tomography angiography images were acquired in patients with PPE and age-matched healthy participants. Multiple en face image averaging of the choriocapillaris was binarized for quantitative image analysis of the flow voids. In PPE eyes, we evaluated the presence of pachyvessels and the association between the location of the choriocapillaris flow deficit and pachyvessels. Thirty-two eyes with PPE and 30 eyes of healthy participants were included. In PPE eyes, the mean total area (1.16 ± 0.18 vs. 0.91 ± 0.16, p < 0.001) and average size of the flow voids (790 ± 144 vs. 520 ± 138; p < 0.001) were significantly larger than those in control eyes. Composite images of the choriocapillaris and choroid showed choriocapillaris flow deficits just above and outside the pachyvessels. The mean proportion of the flow void area overlying the pachyvessels against the whole flow void area of the choriocapillaris was 21.3% ± 10.2% (9.38%-44.42%) in PPE eyes. In PPE eyes, the blood flow area of the choriocapillaris decreased diffusely within the macular area compared to control eyes, and the choriocapillaris flow deficit was not necessarily related to pachyvessel location.

Smallholder farmers and forest landscape restoration in sub-Saharan Africa: Evidence from Central Malawi

Malawi is a sub-Saharan African country at the forefront of the contemporary forest landscape restoration movement that places local smallholder farmers and resources users at the center of restoration actions. However, the manifestations of farmer-led bottom-up restoration efforts at individual and collective levels, and how they add up to landscape-scale restoration outcomes remain understudied. We analyze the nature of restoration efforts across interlocked forest and agricultural landscapes, estimate the extent of farmlands under restoration, and examine the contextual drivers and barriers of restoration. We use a mixed-methods approach combining a multivariate Tobit regression model and a Poisson model based on a 2019 household survey (N = 480 households), and qualitative insights from seven focus group discussions from Malawi’s Dedza and Ntchisi Districts. The estimated mean total area of restored farmlands per household was 1.10 ( ± 0.76) and 1.07 ( ± 0.72) acres, representing, on average, about 54 % and 43 % of the total household landholdings in Dedza and Ntchisi, respectively. Results also indicate restoration diversification and intensification patterns whereby farmers generally combine two or more land-management practices based on complementarities in achieving specific livelihoods, food security, and ecological goals of restoration, and on compatibility regarding labor and other inputs demand. Land configuration mattered. Land plots that were spatially consolidated and tenure-secured were associated with higher restoration efforts. Also, women restoration efforts are limited by their inadequate access to productive inputs. Therefore, restoration policies should center on strategies that improve land-ownership security while minimizing fragmentation within landholdings and promote gender-responsive interventions. Drivers of collective resources restoration include strong local leadership; perceived tangible benefits for firewood, NTFPs, and timber resources; secure rights to collect firewood and free access to grazing areas; and perceived balanced among payoffs for energy needs, climate change adaptation, and ecological goals. These can inform restoration programs involving collective actions and their governance.

Visual Field Parameters and Pupil Size Measured through and Compared between Colored Contact Lenses and Clear Contact Lenses: A Prospective Comparative Pilot Study in Asian Population

Objective: To compare visual field (VF) parameters and pupil size as measured through colored and clear contact lenses (CL) in Asian population.Materials and Methods: Demographic data and CL prescription data were recorded during the baseline visit. Visual acuity and autorefraction were evaluated while patients wore clear CL, followed by slit-lamp examination and intraocular pressure measurements after CL removal. During the second visit, subjects were given dark browncolored CL with their same prescription. Visual acuity and autorefraction were measured. Pupil size and VF tests were measured twice with the clear CL and the colored CL. Measurements through colored and clear CL were compared.Results: Twenty-one volunteers (mean age: 31 years) were recruited. Refractive error varied from 0.00 to -7.00 diopters. Mean horizontal meridian measured through clear and colored CL was 134.8±7.8° and 133.3±4.7°, respectively. Mean vertical meridian measured through clear and colored CL was 100.1±3.8° and 100.4±2.5°. Mean total VF area measured through clear and colored contact lenses was 9,890.9±822.8° and 9,882.7±528.1°. There was no significant difference between clear and colored CL groups for horizontal meridian, vertical meridian, total VF area, or pupil size.Conclusion: There was no significant difference in any evaluated parameters between clear and colored CL.

CT attenuation of the medial coronoid process is reduced in dogs with medial coronoid disease but independent of arthroscopic disease severity.

To compare the attenuation of the medial coronoid process (MCP) in dogs with and without arthroscopically confirmed evidence of medial coronoid disease (MCD). The database at our institution was searched for cases with thoracic limb lameness, diagnosed with MCD by arthroscopic examination that had CT as part of their investigation and compared with a control group of elbow joints from cadavers euthanized for reasons unrelated to MCD. A total of 84 elbow joints were included that met these criteria. Following CT, a standardized measurement of the MCP was obtained from apex to base and the mean attenuation, SD, and total area were recorded. A comparative measurement was obtained from the proximal radial cortex at the level of the nutrient foramen. Elbow joint arthroscopy was carried out using standard portals, and the modified Outerbridge score was (MOS) used to score elbow joint cartilage. Descriptive and inferential statistics were carried out using MLwiN and R. Attenuation of the MCP was reduced in dogs with MCD compared with those with no MCD (P < .002). No significant differences were observed in the attenuation between categories of severity (MOS). There was good inter- and intraobserver agreement between measurements (intraclass correlation coefficient = 0.89 and 0.95, respectively). MCP attenuation is reduced in dogs with MCD compared with dogs with no evidence of MCD. This finding may be a useful tool for early detection of MCD, but there is no relationship with arthroscopic lesion severity.

Contribution of the genomic and nutritional differentiation to the spatial distribution of bacterial colonies.

Colony growth is a common phenomenon of structured populations dispersed in nature; nevertheless, studies on the spatial distribution of colonies are largely insufficient. Here, we performed a systematic survey to address the questions of whether and how the spatial distribution of colonies was influenced by the genome and environment. Six Escherichia coli strains carrying either the wild-type or reduced genomes and eight media of varied nutritional richness were used to evaluate the genomic and environmental impacts, respectively. The genome size and nutritional variation contributed to the mean size and total area but not the variation and shape of size distribution of the colonies formed within the identical space and of equivalent spatial density. The spatial analysis by means of the Voronoi diagram found that the Voronoi correlation remained nearly constant in common, in comparison to the Voronoi response decreasing in correlation to genome reduction and nutritional enrichment. Growth analysis at the single colony level revealed positive correlations of the relative growth rate to both the maximal colony size and the Voronoi area, regardless of the genomic and nutritional variety. This result indicated fast growth for the large space assigned and supported homeostasis in the Voronoi correlation. Taken together, the spatial distribution of colonies might benefit efficient clonal growth. Although the mechanisms remain unclear, the findings provide quantitative insights into the genomic and environmental contributions to the growth and distribution of spatially or geographically isolated populations.

Factors Affecting Postoperative Lung Functions in Patients Undergoing Lobectomy for Non-Small Cell Lung Cancer.

Background and Objectives: The estimation of lung function impairment after pulmonary lobectomy for primary non-small cell lung cancer (NSCLC) has been of great interest since the reduction of respiratory function might severely affect a patient’s quality of life. The perioperative factors that may have an influence on widening the gap between the postoperative measured lung function and predicted postoperative lung function were our greatest concern. We aimed to analyze the perioperative patient factors that may influence postoperative lung function in patients undergoing pulmonary lobectomy. Materials and Methods: A retrospective study was conducted using the medical records of 199 patients who underwent lobectomy for lung cancer between July 2017 and May 2020. After comparing the achieved postoperative forced expiratory volume in 1 s (FEV1) and predicted postoperative (ppo) FEV1, patients were divided into two groups: group A (n = 127), who had preserved pulmonary lung function; and group B (n = 72), who had decreased pulmonary lung function. Primary endpoints included location of pulmonary resection, preoperative performance status, body mass index (BMI) on admission, total muscle area, and muscle index. Results In group A, the proportion of normal weighted patients was significantly higher than that in group B (67.7% vs. 47.2%, p = 0.003). Conversely, the proportion of overweight patients was significantly higher in group B than in group A (47.2% vs. 28.3%, p = 0.003). Group B had a significantly high incidence of upper lobe resection (p = 0.012). The mean total muscle area in group A was higher than that in group B, but the difference was not statistically significant. Conclusions: A greater decrease in postoperative lung function than in ppo FEV1 was associated with BMI and the location of pulmonary resection in patients who underwent lobectomy. Postoperative physiologic changes due to high BMI and the resection of upper lobes need to be discussed to prevent postoperative morbidities.

Abstract 236: Evaluation Of The Radiation Safety And Protection Practices At The Cardiac Catheterization Unit Of The Cairo University Hospital.

Introduction: Cardiac Catheterization laboratories are one of the most hazardous places to work in. The aim of this study is to evaluate the radiation safety in the cardiac catheterization unit at the Cairo University Hospital in Egypt. Hypothesis: We hypothesize that the employees of the Cath labs are overexposed to radiation. Methods: We conducted a cross-sectional observational descriptive study at two Cath labs at the Cairo University Hospital in 2019. The participants were nine cardiologists, six nurses, three technicians, and seven hundred patients. The study was conducted over seven months in three phases. Phase I (Thre months), we measured the real-life radiation exposure for the participants in the Cath lab of our department. Phase II (Four weeks), educational lectures about radioprotection and the hazards of radiation exposure were given. Phase III (Three months) The operators were motivated to use maximally the radiation protection shields that are fixed to the table and the ceiling, and radiation doses were re-meausred. Results: The total cumulative radiation doses in Phase I ranged from 2.7mSv to 6.5mSv (mean=4.29±1.26), 0.5mSv to 5.5mSv (mean=2.7±1.7), and 0.7 mSv to 4 mSv (mean=2.9±1.9), while in Phase III ranged from 2.1mSv to 5.5 mSv (mean=3.48±1.26), 0.6 mSv to 4.8 mSv (mean=2.4±1.5), and 0.8 mSv to 5.8 mSv (mean=4±2.8); for the cardiologists, the nurses and the technicians respectively. There was a statistically significant difference between the two phases in the mean total cumulative radiation doses received by the cardiologists (P value=0.013), and the mean total dose area product for the patients (P value= &lt;0.001). Conclusion: The staff compliance with radiation protection standards during cardiac catheterization was insufficient. However, the exposure to radiation to the operators and the patients was significantly lowered after we educated the staff and applied out the methods of radiation protection. To the best of our knowledge, it is the first study to clarify the role of radiation protection on reducing the received radiation doses by the working personnel and patients in the region of Africa. The challenges we faced were huge to introduce then implement the basics of radiation safety and protection practices in our hospital.

Sexual Dimorphism in Body Size and Wing Loading for Three Cicada Species

Abstract Sexual dimorphism in body size has been observed for many insect species. However, whether dimorphism influences the flight performance for closely related insects or between the genders of conspecifics has seldom been examined. Wing loading (i.e., body mass/total wing area, WL = M/A) is an important indicator of flight efficiency and maneuverability. We examined the potential for sexual dimorphism and interspecific differences in wing loading for three cicada species (Cryptotympana atrata, Meimuna mongolica, and Platypleura kaempferi) and tested the hypothesis that females have higher WLs than males possibly because they must carry the extra weight of eggs. There were significant dimorphic differences in body mass and WL for each of the three species. However, there were no significant dimorphic differences in total wing area for C. atrata and M. mongolica, whereas P. kaempferi females had larger mean total wing area than males. Among the three cicada species, males had lower WLs (and by inference, greater maneuverability) than females. In addition, the M vs. A scaling exponent (i.e., α) was numerically significantly greater than unity (i.e., α &amp;gt; 1). Thus, WL should scale with respect to M with α &amp;gt; 1, which accounts for why females have a larger WL than males. We interpret these results to indicate that gender dimorphism in body size and flight performance likely reflect selection on traits affecting reproductive success that, in turn, likely depend on flight maneuverability.

Ultrasound-guided lymph node sampling: accuracy of FNAC, end-cutting (Franseen), and side-cutting (Temno) needle biopsy techniques

To compare technical success, diagnostic accuracy, and histological yield of fine-needle aspiration cytology (FNAC), side-cutting (Temno) needle biopsy, and end-cutting (Franseen) needle biopsy for ultrasound-guided sampling of groin and axillary lymph nodes. A total of 270 abnormal groin and axillary nodes were sampled using one of the three techniques. Nodes with a maximum length of <2.5cm underwent FNAC or Franseen biopsy, while nodes >2.5cm underwent Temno biopsy. Mean size of nodes sampled by FNAC (21.2mm) and Franseen (19.7mm) were similar while nodes sampled by Temno were larger (34.4mm, p<0.0001). Technical success rates of FNAC (82/93, 88%), Franseen (105/111, 95%), and Temno (59/66, 89%) biopsies were similar (p>0.05 for all). Lymphoid tissue yield by FNAC (mean total area 1.51mm2) was less than that by Franseen (7.14mm2, p=0.002) or Temno biopsy (19.44mm2, p<0.0001). Diagnostic accuracy for malignancy was lower for FNAC (22/30, 73%) than Franseen (25/26, 96%, p=0.02) or Temno biopsy (32/32, 100%, p=0.002). For malignant nodes, determining the likely organ of origin was also lower for FNAC (7/30, 23%) than Franseen (19/26, 73%, p=0.0002) or Temno biopsy (29/32, 91%, p<0.0001), with a similar pattern observed in the identification of lymphoma. For similarly sized nodes, Franseen biopsy provided more lymphoid material, a higher diagnostic accuracy for malignancy including lymphoma, and better identification of the likely organ of origin than FNAC. Routine use of Franseen biopsy is advocated rather than FNAC for percutaneous sampling of lymph nodes not suitable for side-cutting needle biopsy.

Making white spots disappear! Do minimally invasive treatments improve incisor opacities in children with molar-incisor hypomineralisation?

Children with molar-incisor hypomineralisation (MIH) frequently seek aesthetic treatment for incisor opacities. Surprisingly, few studies have evaluated the clinical success of such interventions. To quantify the effectiveness of minimally invasive treatments in reducing enamel opacity visibility in children with MIH. This in vitro study used digital clinical images of 23 children aged 8-16years with MIH who underwent microabrasion and/or resin infiltration for the management of incisor opacities. Standard images were taken pre-treatment and 6months post-treatment. Image software (Image-Pro Plus® V7) was employed to convert 24-bit RGB images to 16-bit greyscale and 145× magnification. Measurement repeatability was assessed using intra-class correlation coefficients (ICCs). Post-treatment changes in visible opacity area (mm2 ) and brightness (greyscale value) were tested using the Wilcoxon signed-rank test for related samples. The mean total opacity surface area significantly reduced from 14.3mm2 (SD=7.5) to 9.4mm2 (SD=9.0) post-treatment. The proportion of tooth surface affected by the opacity also significantly reduced from 22.5% (SD=10.5) to 14.7% (SD=12.7). The mean maximum opacity brightness significantly reduced from 53066 greyscale value (SD=4740) to 49040 (SD=3796). ICC was good/excellent (0.75-1.0). Minimally invasive treatment is effective in reducing the size and brightness of discrete incisor opacities. Future research should compare objective findings with patient-reported outcomes.