Small Sample Group Research Articles

A Retrospective Report of Carprofen Administration as Post-Operative Analgesia Reveals Negative Effects of Recommended Doses.

Effective pain management in laboratory animals is crucial for both animal welfare and the reliability of scientific research. We retrospectively examined the effects of carprofen as post-operative analgesia in Sprague Dawley rats following stereotactic surgery. Our data indicate that administering carprofen twice daily (5 mg/kg), as currently recommended by Die Gesellschaft für Versuchstierkunde/Society for Laboratory Animal Science (GV-SOLAS), led to adverse effects such as reduced food and water intake, disrupted fecal excretion, and abdominal bloating consistent with peritonitis. Continued administration exacerbated these symptoms, with post-mortem findings of intestinal obstructions and ulcers. However, when the frequency was reduced to once daily, such adverse symptoms were not observed. These results are based on incidental data collected from various neuroscientific experiments, resulting in small and uneven sample groups across various experimental cohorts. The inherent imbalances in these groups present challenges for statistical interpretation. While the findings suggest that less frequent carprofen use may reduce adverse effects, the surgical interventions and concurrent use of other drugs in these experiments likely exacerbated these outcomes. Further investigation into the interactions between carprofen, surgical stress, and other perioperative factors is needed to refine analgesia protocols in laboratory animals. Despite these limitations, these observations contribute to understanding analgesia protocols and may assist in improving animal welfare practices.

Effect of Simple Oral Dental Extraction on Systemic Serum Amyloid A Concentrations in Horses.

The translocation of gingival commensals resulting in measurable systemic inflammation has been described in humans and non-equine veterinary species with dental disorders, particularly periodontal disease. Routine odontoplasty does not result in increased serum amyloid A (SAA) concentration in horses, but a measurable increase in SAA concentration in horses undergoing dental extractions could suggest that local inflammation resulting from more severe dental disease has potential for wider, systemic consequences that warrants further study. To determine whether SAA increases in horses undergoing simple, oral extraction of non-fractured cheek teeth with and without periodontal disease. Prospective cohort study. SAA was measured using a stall-side test in horses undergoing simple oral extraction of cheek teeth with intact clinical crowns at baseline (T = 0), 24 h (T = 24) and 48 h (T = 48) post-extraction. Eight horses and 4 ponies aged between 4 and 23 years underwent cheek tooth extraction. A statistically significant difference in SAA concentration was noted between groups with and without periodontal disease at both 24 h (p = 0.004) and 48 h (p = 0.043). At 24h, the median SAA concentration was 135mg/L (range: 0-260mg/L; IQR: 77.5-174mg/L) in horses with periodontal disease and 27.5mg/L (range: 0-47mg/L; IQR: 4.8-43.5mg/L) in horses without periodontal disease. At 48h, median SAA concentration was 264mg/L (range: 236-440mg/L; IQR: 245.5-300.5mg/L) in horses with periodontal disease and 0mg/L (range = 0-41mg/L; IQR: 0-21.8mg/L) in horses without periodontal disease. Small sample group. Horses undergoing extraction of fractured cheek teeth were not included. Extraction of non-fractured cheek teeth does not result in a remarkable increase in SAA, except in horses with periodontal disease. These results suggest that periodontal disease in horses is associated with a local inflammatory response, which in turn drives the development of systemic inflammation, resulting in detectable increases in inflammatory markers when diseased periodontal tissues are disturbed.

Exploring the relationship between lipid metabolism and cognition in individuals living with stable-phase Schizophrenia: a small cross-sectional study using Olink proteomics analysis

BackgroundCognitive impairment is a core symptom of schizophrenia. Metabolic abnormalities impact cognition, and although the influence of blood lipids on cognition has been documented, it remains unclear. We conducted a small cross-sectional study to investigate the relationship between blood lipids and cognition in patients with stable-phase schizophrenia. Using Olink proteomics, we explored the potential mechanisms through which blood lipids might affect cognition from an inflammatory perspective.MethodsA total of 107 patients with stable-phase schizophrenia and cognitive impairment were strictly included. Comprehensive data collection included basic patient information, blood glucose, blood lipids, and body mass index. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and the MATRICS Consensus Cognitive Battery (MCCB). After controlling for confounding factors, we identified differential metabolic indicators between patients with mild and severe cognitive impairment and conducted correlation and regression analyses. Furthermore, we matched two small sample groups of patients with lipid metabolism abnormalities and used Olink proteomics to analyze inflammation-related differential proteins, aiming to further explore the association between lipid metabolism abnormalities and cognition.ResultsThe proportion of patients with severe cognitive impairment (SCI) was 34.58%. Compared to patients with mild cognitive impairment (MCI), those with SCI performed worse in the Attention/Alertness (t = 2.668, p = 0.009) and Working Memory (t = 2.496, p = 0.014) cognitive dimensions. Blood lipid metabolism indicators were correlated with cognitive function, specifically showing that higher levels of TG (r = -0.447, p < 0.001), TC (r = -0.307, p = 0.002), and LDL-C (r = -0.607, p < 0.001) were associated with poorer overall cognitive function. Further regression analysis indicated that TG (OR = 5.578, P = 0.003) and LDL-C (OR = 5.425, P = 0.001) may be risk factors for exacerbating cognitive impairment in individuals with stable-phase schizophrenia. Proteomics analysis revealed that, compared to individuals with stable-phase schizophrenia and normal lipid metabolism, those with hyperlipidemia had elevated levels of 10 inflammatory proteins and decreased levels of 2 inflammatory proteins in plasma, with these changes correlating with cognitive function. The differential proteins were primarily involved in pathways such as cytokine-cytokine receptor interaction, chemokine signaling pathway, and IL-17 signaling pathway.ConclusionBlood lipids are associated with cognitive function in individuals with stable-phase schizophrenia, with higher levels of TG, TC, and LDL-C correlating with poorer overall cognitive performance. TG and LDL-C may be risk factors for exacerbating cognitive impairment in these patients. From an inflammatory perspective, lipid metabolism abnormalities might influence cognition by activating or downregulating related proteins, or through pathways such as cytokine-cytokine receptor interaction, chemokine signaling pathway, and IL-17 signaling pathway.

New insights on the Western production of Ionian cups type B2

Ionian cups are a ceramic class widely spread in the Mediterranean basin from the second half of the VII century BCE and even more throughout the VI century and a little beyond. Initially imported from Eastern Greece, they were successively produced also in the West, in the colonies and in the indigenous hinterland.This research is a recent development of a study started about a decade ago aimed at identifying the production area of Ionian cups type B2 found in various archaeological contexts in central-eastern Sicily (Italy). Here we focus on 30 items from Gela, a Greek colony located along the southern coast of Sicily, where cups of type B2 and their variants exceed 600 specimens. Mineralogical-petrographic and chemical investigations have been performed through polarized optical microscopy, X-ray powder diffraction (XRPD) and portable X-ray fluorescence (pXRF) aiming at: i) assessing if the examined findings were locally manufactured; or ii) if, on the contrary, they can be considered imports in Gela from another specialized production site or area.Results revealed three different petro-chemical groups corresponding to as many provenance areas. Specifically, the main group, including most of the examined samples, display characteristics similar to those of Ionian cups from the other investigated Sicilian sites whose workshops could be located in the Strait of Messina area. Conversely, a small group of samples can be attributed to a local production, while another minor group indicates a Greek provenance.

Rescue Stenting of Isolated Middle Cerebral Artery (MCA) Dissections (MCAD) with Antithrombogenic Coated Stents and Mono-Antiplatelet Therapy (MAPT).

Objective: Acute ischemic stroke (AIS) is a leading cause of death, but isolated middle cerebral artery dissection (MCAD) is rarely reported. The aim of this article is to sum up the current information on this pathology and to explore the technical aspects of its endovascular treatment with emphasis on novel coated, antithrombogenic stents and antiplatelet management. Another part of this article offers our experience with the problematics represented by a small sample group of patients with an MCAD diagnosis who were treated in our center. Methods: We conducted literature research and a retrospective review of patients treated for anterior circulation AIS at our comprehensive stroke center from January 2022 to March 2024. The cohort included 16 patients diagnosed with isolated MCAD, 9 received antithrombogenic coated stents, while 7 received bare metal stents. Pharmacological management of coated stents involved the use of Cangrelor for acute antiplatelet therapy, transitioning to oral Ticagrelor. Results: Among the 16 patients treated, those with antithrombogenic coated stents showed no major complications and had a lower incidence of intracranial hemorrhage compared to the bare metal stent group. The average National Institutes of Health Stroke Scale (NIHSS) score at discharge improved in both groups. Functional outcomes and mortality rates were slightly better in the coated stent group, but no statistical significance was proven. Conclusions: Antithrombogenic coated stents, in conjunction with MAPT, demonstrated a safe and effective option for treating isolated MCAD. These stents offer promising potential for improved outcomes and reduced complications compared to traditional treatments. Further multicentric studies with larger cohorts are recommended to validate these findings.

Safeguarding, uncertainty and new possibilities: an appreciative inquiry into personal adviser’s relational practice with care leavers

Purpose An appreciative inquiry process was collaboratively undertaken with an inner city local authority and personal advisors where systemic social work practice was embedded. The purpose of this study is to explore how systemic social work principles could be integrated into the support of young adults leaving the care system, especially when safeguarding concerns exist. Design/methodology/approach Three fortnightly, reflecting team-style, appreciative inquiry workshops explored the integration into practice of systemic concepts under the themes of safeguarding, uncertainty and new possibilities. Findings Within the contexts of the organisation, other agencies and the relationship, six paired themes emerged: learning and navigating; positioning and risk-taking; and feeling and engaging. Core systemic concepts, such as self-reflexivity and mutual influence, can enable personal advisers to use themselves and their relationship with care leavers as a context for change. Considering responses to risk from different family member positions may support holding greater levels of uncertainty. Seeing resilience as a process rather than a personal attribute enabled personal advisors to think about how they connected with care leavers through shared life experiences, fostering narratives of hopes and dreams where new possibilities abound. Research limitations/implications Appreciative inquiry is generally seen as a defined model for implementing large organisational changes; this study comprised a small sample group, and the model’s application was less defined. Originality/value A gap exists in the extensive care leaver research, addressing safeguarding and working systemically. A conceptual model for practice is offered, with potential utility in developing further systemically informed training and supervision for practitioners. A less structured and more relationally engaged model for appreciative inquiry is presented.

Small Sample Size and Group Homogeneity: A Crucial Ingredient to Inter-Group Bias.

Applying a recently developed framework for the study of sample-based person impressions to the level of group impressions resulted in convergent evidence for a highly robust judgment process. How stimulus traits mapped on the resulting group impressions was subject to two distinct moderators, diagnosticity of traits, and the amplifying impact of early sample truncation. Three indices of diagnosticity-negative valence, extremity, and distance to other traits in a density framework-determined participants' decision to truncate trait sampling early and hence the final group judgments. When trait samples were negative and extreme and when the distance between high-density traits was small, early truncation of the trait samples fostered high group homogeneity and polarized impressions. Granting that mental representations of in-groups and out-groups rely on systematically different samples, our sampling approach can account for various inter-group biases: out-group homogeneity, out-group polarization and (because negative traits are more diagnostic) out-group derogation.

The Game-based Learning (GbL) Platform with Generative AI to Enhance Digital and Technology Literacy Skills

The GbL platform, or game-based learning platform, with generative AI is a research tool initiated from the combination of game-based learning concepts and generative artificial intelligence technology; thereby, this platform is intended to be used as a guideline for the instruction management, in which learners can respond and interact with the real-time activities by means of gamification. The objectives of this research are (1) to study and synthesize the conceptual framework of the GbL platform with generative AI to enhance digital and technology literacy skills, (2) to develop the architecture of the GbL platform with generative AI to enhance digital and technology literacy skills, and (3) to study the results of the development of the GbL platform with generative AI to enhance digital and technology literacy skills. The results of this research show that (1) the overall elements suitability of the architecture of the GbL platform with generative AI is at the highest level (Mean = 4.51, SD = 0.48), and (2) the overall suitability of the architecture of the GbL platform with generative AI is at the highest level (Mean = 4.59, SD = 0.41). Nevertheless, there are still some research gaps in this study; that is, this study was conducted with quite a small sample group and it focuses mainly on the results of evaluation on the architecture of the GbL platform. Therefore, this research is regarded merely as a pilot study designated for feasibility study to further develop the GbL platform that can be put in practical use in the future.

Experiences of Lactating Mothers on Breastfeeding and Additional Food Practices

The rate of exclusive breastfeeding and additional food practices rate remained low in Nepal. It's quite surprising, given the active promotion of breastfeeding and additional food practices by individuals, family members, communities, health institutions, hospital NGOs, INGOs, and the government. Nevertheless, we should continue to spread awareness about the importance of exclusive breastfeeding and healthy food practices for infants. The main objective of this study was to explore the experience of lactating mothers, who often struggle to manage additional food practices for their babies. The study was based on narrative theory and included a small sample group of two mothers, who shared their experiences of breastfeeding. Despite the challenges, the mothers in the study remained committed to providing their babies with the best possible nutrition and care. By sharing their stories, they hope to help other mothers who may be facing similar difficulties. During the research, a qualitative-descriptive research design was adopted, and purposive sampling was used to select participants. The data was gathered using verbatim audio recordings of in-depth interviews, and interview transcriptions were analyzed using the qualitative content analysis approach. It was found that all participants were still breastfeeding at the time of the interview. The analysis of the interview transcriptions generated 46 nodes, 8 sub-themes, and 2 key themes. The two key themes that emerged were "Challenge and support for breastfeeding" and "Nutrition and additional food practices." The research provided valuable insights into the experiences of breastfeeding mothers and the factors that impact their feeding practices. Our findings show that these mothers adopt positive practices such as feeding colostrum, exclusively breastfeeding, timely introduction of additional foods, and continuing to breastfeed. To ensure that more mothers have successful breastfeeding journeys, it is crucial to increase public awareness and support for breastfeeding through education, social support, and laws that promote it. Additionally, involving family members in the process can significantly contribute to the success of breastfeeding.

The Experiences of the Managed: case management in the Aotearoa New Zealand prison system

In 2011, the Department of Corrections/Ara Poutama Aotearoa (Corrections) began a series of initiatives aimed at reducing reoffending, including introducing case management. In 2016 Corrections stated that case management had led to improvements in four areas: the assessment of prisoner needs; prisoner motivation to complete activities; scheduling of programmes; and levels of reintegration support. Using in-depth qualitative interviews of seven men formerly in prison in Aotearoa New Zealand, this study explores the perceptions that the formerly imprisoned have of case management, and examines the four improvements identified by Corrections. While based on a small and unique sample group, the study provides interesting indicative insights into case management in the prisons of Aotearoa New Zealand.

Abstract Number ‐ 37: A Clinical Multicenter Experience of Novel Tenzing Delivery Catheter for Thrombectomy in Acute Stroke

Introduction Mechanical thrombectomy has become the standard of care to treat acute ischemic stroke patients with large vessel occlusions. Device performance and physician technique have developed since early trials proving the efficacy of the procedure1‐3. One of these techniques, direct aspiration first pass technique (ADAPT)4involves navigating a large‐bore catheter to the face of the clot and initiating suction. Navigating large‐bore catheters through intracranial neurovasculature has been accomplished using microcatheters and/or guidewires. Due to the large sizes of these aspiration catheters, the microcatheters used to help deliver the aspiration catheters into the brain form a “ledge” between the disparate lumens and prevent progression of the aspiration catheter into the distal neurovasculature and increase the risk of damaging arteries during advancement. A novel navigation support catheter, the Tenzing Delivery Catheter, has shown promising benchtop performance assisting large‐bore aspiration catheter delivery to the occlusion sitein vitro5. It demonstrated superior performance over traditional microcatheter/guidewire techniques in delivering the aspiration catheter to the occlusion in this model. While limited initial clinical experience from examining a small sample group appears to confirm this observation, a cumulative, large‐scale analysis of experience using the Tenzing catheter in clinical practice to further examine its safety, efficacy, and usability has not yet been performed. With that in mind, this study serves as an initial multicenter first‐experience investigation to assess the aforementioned factors and determine the utilization potential of Tenzing catheters. Methods This study was conducted via retrospective chart review across three institutions. Patients included in the study are 18 years old or older, underwent a thrombectomy procedure between January 1, 2020 and July 31, 2022, and whose procedures involved the use of the Tenzing delivery catheter system. Our primary outcome measures were success in delivering aspiration catheter, post treatment thrombus, and perioperative complications. Results In our sample size of n = 95, inclusive of patients from multiple institutions, it was found that in 96% of cases, the Tenzing catheter was successfully delivered to the occlusion site and successful reperfusion (mTICI less than or equal to 2b) was achieved in 90% of cases.In the majority of cases, the Tenzing delivery catheter was used to deliver an aspiration catheter to a middle cerebral artery occlusion (75%). Tenzing was advanced past the occlusion location (identified as the angiographic limit of contrast) in 59% of cases. Secondary emboli were observed 11% of the time. Other procedural complications were observed in 8% of patients while none was seen in 74%. On average, the median NIHSS decreased from 17 pre‐treatment to 10 post‐treatment. Conclusions Based on these findings, we conclude that the Tenzing Delivery Catheter is a safe and efficacious instrument in thrombectomy procedures. Given its high rate of revascularization and delivery success with few complications as demonstrated in this multicenter study.Future studies with larger patient volume are necessary to evaluate this important delivery catheter as it is used more frequently around the world.

Research on migraine time-series features classification based on small-sample functional magnetic resonance imaging data

The extraction of neuroimaging features of migraine patients and the design of identification models are of great significance for the auxiliary diagnosis of related diseases. Compared with the commonly used image features, this study directly uses time-series signals to characterize the functional state of the brain in migraine patients and healthy controls, which can effectively utilize the temporal information and reduce the computational effort of classification model training. Firstly, Group Independent Component Analysis and Dictionary Learning were used to segment different brain areas for small-sample groups and then the regional average time-series signals were extracted. Next, the extracted time series were divided equally into multiple subseries to expand the model input sample. Finally, the time series were modeled using a bi-directional long-short term memory network to learn the pre-and-post temporal information within each time series to characterize the periodic brain state changes to improve the diagnostic accuracy of migraine. The results showed that the classification accuracy of migraine patients and healthy controls was 96.94%, the area under the curve was 0.98, and the computation time was relatively shorter. The experiments indicate that the method in this paper has strong applicability, and the combination of time-series feature extraction and bi-directional long-short term memory network model can be better used for the classification and diagnosis of migraine. This work provides a new idea for the lightweight diagnostic model based on small-sample neuroimaging data, and contributes to the exploration of the neural discrimination mechanism of related diseases.

UNDERSTANDING THE IMPACT OF DIRECT AND INDIRECT ADVERTISING ON CONSUMER BEHAVIOR

In order to achieve company objectives, marketing is the strategic process of discovering, promoting, and providing value to customers. It includes a variety of activities like as market research, product development, promotion, and sales, all with the goal of increasing consumer awareness, interest, and loyalty. In today's competitive industry, effective marketing is critical for businesses to engage with their target audience and generate growth. To do so, understanding the distinction between direct and indirect marketing - and tailoring it to their target audience- is vital for businesses to optimize the effectiveness of marketing efforts. Marketing is essential and in the digital age understanding the dynamic between the two advertising methods is of growing relevance, thus making this study of importance. The present study aims to investigate the effectiveness of direct and indirect advertising in persuading consumer behavior. It was conducted using a small sample group belonging to the upper socio-economic background from New Delhi, NCR and Gurgaon, Haryana. Using a questionnaire, their preferences on direct (Billboards, Youtube and Offers) and indirect (Social media, Celebrity endorsement and Product Placement) were analyzed. It was found that direct advertising was rewarded more informative, creative and influential in comparison.

Специфика речевой межполушарной асимметрии при афазических расстройствах и ее влияние на количественные показатели речевой перцепции и динамику афазии

Introduction. In neuropsychological practice the dichotic listening task has been widely used for more than 50 years as a valid test for determining the laterality of auditory speech asymmetry. Theoretical analysis. Most of the studies of the dichotic listening task in aphasia are characterized by small sample groups, a wide demographic features of them, lack attention to the type and aphasia severity, a size of local brain damage as well. Without taking into account these important factors it is difficult to answer to some questions: 1. whether the vector of auditory speech asymmetry is determined by the age, type and aphasia severity; 2. whether the laterality of auditory speech asymmetry affects the dynamics of aphasia recovery. The aim of the study: the connection between quantitative parameters of the dichotic listening task and the dynamics of aphasia regression. Empirical analysis. Material. The study involved patients (N = 109) with traumatic and post-stroke efferent motor (50.7 ± 10.1 years) and acoustic mnestic (54.4 ± 8.2 years) aphasia of mild and moderate severity of speech disorders. Methods. Kimura’s dichotic listening task modified by B. S. Kotik; the quantitative assessment of speech in aphasia L. S. Tsvetkova, T. V. Akhutina, N. M. Pylaeva. The speech assessment was carried out twice: before and after a 6-week course of speech rehabilitation. Results. Between efferent motor and acoustic mnestic aphasia groups the difference in the laterality of ear superiority was revealed. The efferent motor aphasia group shows the ambidextrous pattern in auditory perception. The dichotic listening task efficiency increases with a burst of the left ear productivity and vice versa with the right ear. The acoustic mnestic aphasia group presents a pronounced effect of the right ear suppression. Its productivity is significantly lower than the productivity of the left ear and the same indicator of the efferent motor aphasia group. The effectiveness of the dichotic listening task in the acoustic mnestic aphasia group does not exhibit a correlation with the parameters of productivity of the right or left ear. The aphasia groups vary in the dynamics of aphasia regression. In the acoustic mnestic aphasia group, this dynamics was 2.5 times higher than in the efferent motor aphasia group. Conclusion. The right hemisphere laterality in auditory speech perception correlates positively with the dynamics of aphasia regression. Further research should find an answer to the question of the constellations of significant factors and their hierarchical relationships that could determine the positive dynamics of recovery of aphasic disorders.

Comparison of the Optimized Intraocular Lens Constants Calculated by Automated and Manifest Refraction for Korean

Purpose: To derive the optimized intraocular lens (IOL) constants from automated and manifest refraction after cataract surgery in Korean patients, and to evaluate whether there is a difference in optimized IOL constants according to the refraction method.Methods: This retrospective multicenter cohort study enrolled 4,103 eyes of 4,103 patients who underwent phacoemulsification and in-the-bag IOL implantation at 18 institutes. Optimized IOL constants for the SRK/T, Holladay, Hoffer Q, and Haigis formulas were calculated via autorefraction or manifest refraction of samples using the same biometry and IOL. The IOL constants derived from autorefraction and manifest refraction were compared.Results: Of the 4,103 eyes, the majority (62.9%) were measured with an IOLMaster 500 followed by an IOLMaster 700 (15.2%). A total of 33 types of IOLs were used, and the Tecnis ZCB00 was the most frequently used (53.0%). There was no statistically significant difference in IOL constants derived from autorefraction and manifest refraction when IOL constants were optimized with a large number of study subjects. On the other hand, optimized IOL constants derived from autorefraction were significantly smaller than those from manifest refraction when the number of subjects was small.Conclusions: It became possible to use the IOL constants optimized from Koreans to calculate the IOL power. However, if the IOL constant is optimized using autorefraction in a small sample group, the IOL constant tends to be small, which may lead to refractive error after surgery.

Psoriasis-Related Stigma: Is There More to Uncover?

Abstract Background: Psoriasis is a common, inflammatory immune-mediated dermatosis, occurring in patients of all ages, sexes, and races, associating significant comorbidities. One such comorbidity is represented by psychological disorders, which negatively influence the clinical course of the disease. The purpose of our study is to offer a first glimpse into the stigmatization of Romanian psoriasis patients, as well as their potential anxious or depressive manifestations. Materials and methods: The present study is based on an adapted questionnaire previously used to estimate stigmatizing attitudes in the general population, mirrored to reflect the patients’ experience in social situations such as shaking hands, maintaining friendship, kissing, or intercourse. GAD7 and PHQ8 scales were used to screen for anxiety or depression traits in the same patients. Results: Our study group consisted of 12 psoriasis patients, with a mean age of 46.75 years. While few patients reported feeling discriminated against in social contexts, 16.66% presented with mild depressive symptoms recorded by PHQ8 and 24.99% presented mild anxiety manifestations according to their GAD7 scores. Conclusion: In spite of the small sample group, our study outlines a tendency for depressive and anxious manifestations in patients with psoriasis.

Placental pathological findings in coronavirus disease 2019: Perinatal outcomes

IntroductionPlacental alterations caused by severe acute respiratory coronavirus-2 (SARS-CoV-2) infection have already been described, but most studies used small sample groups and the difference according to the severity of the disease has not been verified. Our objective was to describe placental alterations in patients with coronavirus disease 2019 (COVID-19) and analyze the association of pathological placental findings with the clinical parameters of COVID-19 and perinatal results. MethodsThis was a nested study within a prospective cohort study involving 109 symptomatic pregnant women with COVID-19. The prevalence of observed placental alterations was described, and the associations of pathological findings with the clinical parameters of COVID-19 severity and with perinatal outcomes were assessed. ResultsThe frequency of types of placental features was poor maternal vascular perfusion in 45% of cases, poor fetal vascular perfusion in 33.9%, hematogenous origin infection in 32.1%, and morphological changes corresponding to ascending infection in 21.1%. Hematogenous infection differed significantly according to COVID-19 severity (p = 0.008), with a prevalence ratio (PR) of 1.74 (95% confidence interval, 1.02–2.98) in the moderate COVID-19 group compared to the mild COVID-19 group. Among the perinatal outcomes, there was an unexpected inverse association between prematurity and placental infection of hematogenous origin, with lower rates of prematurity among cases with inflammation of hematogenous origin (p = 0.029). DiscussionModerate SARS-Cov-2 infection presented a higher prevalence of placental pathological findings. There was no association of placental findings with adverse perinatal outcomes.

Detection of circulating Influenza A and B virus by real-time reverse transcriptase polymerase chain reaction at a tertiary care center in Chennai, Tamil Nadu, India

Objective: The aim of this study was to determine the proportion of influenza-like illnesses (ILIs) caused by influenza A and influenza A H1N1 and to determine the proportion of influenza B in a smaller group of samples with ILIs and influenza A H1N1 negative by qualitative real-time reverse transcriptase polymerase chain reaction (RT-PCR) using TaqMan-based assay at a tertiary health-care center in Chennai, Tamil Nadu. Material and Methods: Laboratory samples of participants from all age groups who had ILIs were included in this study. The study was conducted from January 2018 to January 2019 at a tertiary health-care center in Chennai, Tamil Nadu. The sample size of the study was 1755. This is a cross-sectional study. RNA extraction was performed using QIAamp Viral RNA Mini Kit (Qiagen, U.S.A) as per the manufacturer instructions. The assay is a TaqMan®-based real-time detection of circulating novel influenza A H1N1 and H3N2. Real-time PCR for influenza B virus was performed in influenza A H1N1-negative patients using artus Infl/H1 LC/RG RT-PCR kit (Cat 4523003, Qiagen, Germany). Samples that had a crossing threshold value 15–35 cycles were considered positive. Results: The majority of the participants were in the pediatric and young adult age group (&lt;30 years) (41%). The incidence of influenza was in the range of 32.34–41% up to 60 years. Beyond 60 years, the frequency of detection reduced to 25.9%, and in those above 71 years, it was 22.3%. About 45.4% (n = 798) were positive for influenza A, of which 32.7% (n = 575) were positive for influenza A H1N1. Both influenza A H1N1 and influenza A other than H1N1 incidence started to rise in September and spiked between October and December. Among patients with persistent ILI, screening for influenza B was done in 48 samples. Among 48 samples, 18% (n = 8) had influenza B. Conclusion: The need for increased vaccination is demonstrated through the high influenza A H1N1 positivity rate among pediatric patients with ILIs. Detection of influenza B among influenza A H1N1-negative individuals demonstrates the need for influenza B screening. Incidence of influenza is highest in cooler months. The implementation of vaccination against influenza before the beginning of the cooler seasons could possibly reduce the burden of influenza on the health-care system. The importance of surveillance for the continued screening of influenza could be expanded in the private sector as a majority of the disease burden is observed in that sector.

Clinicopathologic predictors of central lymph node metastases in clinical node-negative papillary thyroid microcarcinoma: a systematic review and meta-analysis

BackgroundThe presence of central lymph node metastases (CLNM) has been suggested as a risk factor for poorer prognosis and recurrence in papillary thyroid microcarcinoma (PTMC). However, the clinicopathologic factors for CLNM in clinical node-negative (CN0) PTMC were not well defined. This study aimed to perform a systematic review and meta-analysis to investigate the significant clinicopathologic predictors of CLNM in CN0 PTMC.MethodsA systematic literature search was performed in PubMed, Embase, Cochrane Library, and Web of Science. Case-control studies on the association of clinicopathologic risk factors with CLNM in CN0 PTMC were included.ResultsThirteen eligible studies involving 6068 patients with CN0 PTMC were included. From the pooled analyses, male (odds ratio [OR]: 2.07, 95% CI: 1.49–2.87, P < 0.001), multifocality (OR: 1.88, 95% CI: 1.54–2.29, P < 0.001), tumor size > 5 mm (OR: 1.84, 95% CI: 1.55–2.18, P < 0.001), and extrathyroidal extension (OR: 1.96, 95% CI: 1.30–2.95, P = 0.001) are significantly associated with increased risk of CLNM in CN0 PTMC. A sample size with a cutoff point of 200 was identified as the source of heterogeneity for sex according to meta-regression (t = 3.18, P = 0.033). Then, the subgroup analysis of male was performed, which illustrated that male increased the risk of CLNM in the small sample group (SG) and the large sample group (LG) by 6.11-folds and 2.01-folds, respectively (SG: OR, 6.11, 95% CI, 3.16–11.81, P < 0.001; LG: OR, 2.01, 95% CI, 1.65–2.46, P < 0.001).ConclusionsMale, multifocality, tumor size > 5 mm, and extrathyroidal extension may be reliable clinical predictors of CLNM in CN0 PTMC. Moreover, prophylactic central lymph node dissection should be considered in surgical decision-making for CN0 PTMC patients, who are male, multifocal, with tumor size > 5 mm, and with extrathyroidal extension.Trial registrationCRD42021242211 (PROSPERO)

A BIBLIOMETRIC AND CONTENT ANALYSIS OF CRITICAL THINKING IN PRIMARY EDUCATION

Critical thinking is an effective skill that allows students to be successful in the continually changing world by playing a role in their thinking development. Although the significance of critical thinking in primary education has been discussed in many studies, the number of studies conducted on the subject is limited. This study aims to systematically review and analyse the literature by taking a holistic approach to previous studies in order to clearly identify the gaps in the field and the steps to be taken for future studies. In this context, two different analysis methods were employed in the study. This review aims to reveal information that has not been fully captured or evaluated previously, including information related to important sources, documents, countries, and keywords used in the field. According to the results obtained from the study, the country with the highest publication performance is the United States of America, and the most cited publication source is the Journal of Thinking Skills and Creativity. The most frequently studied concepts in the documents are identified as 21st century skills, assessment, creativity, learning, teaching, teacher, education, and primary school. Another result obtained reveals that articles on critical thinking, which increased between 2015 and 2020, mostly discussed critical thinking in the fields of mathematics and science education. Studies that examine the development of critical thinking skills through the implementation of different teaching methods are particularly in the majority. According to the analysis results of the article methodologies, it is revealed that the majority are based on the qualitative research approach, the criterion sampling method is used with small sample groups, and the most preferred data collection tool is the document. In addition to revealing the current status regarding the research tendencies of critical thinking in primary education, these results have the potential to guide researchers, countries and primary school teachers working in the field.