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Introduction: The war caused huge devastation to rehabilitation centers in Mosul City, leading to a significant gap in rehabilitation services, which was further compounded by the COVID-19 pandemic. Objectives: We sought to incorporate simple and safe clinical exercises by utilizing common household items, thereby maximizing effectiveness through a combination of psychological simulation and physical impact while ensuring safety, and evaluate its efficacy as a home telerehabilitation program (HTRP) for participants with spinal cord injury (SCI) following a 4- to 5-year rehabilitation interruption. Methods: Eighteen volunteers, including 13 with SCI (injuries sustained 53.4-55 months prior), were split into an experimental group (Exp., n = 8), a first control group (first Con., n = 5), and a second control group of healthy individuals (second Con., n = 5), averaging 21.2 years old. The HTRP focused on muscles and whole-body joints, conducted with five weekly sessions gradually increasing from 45 to 120 min, with sufficient rest. Assessments occurred every 3 months. Results: The Friedman test indicated no significant effect of HTRP on weight, body mass index, 3 of 4 anthropometric measures, and 4 of 19 muscle strength tests, p > 0.05, and small effect sizes (ES). However, significant effects were observed in pelvic strength (p < 0.001, ES = 0.73), exceeding control groups (first Con. 1.6%, second Con. 1.0%). Muscle strength in the lower extremities, head, and trunk showed significant improvements (p < 0.05, ES = 18.3-81.8%), it is indicating functional enhancement despite morphological weaknesses, particularly in individuals with SCI. Conclusion: The HTRP demonstrated weak effects on muscle morphology but strong effects on functionality, highlighting its potential for long-term management and improvement of muscle functional outcomes in individuals with SCI, even after prolonged rehabilitation interruptions.
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Composição Corporal , COVID-19 , Estudos de Viabilidade , Força Muscular , Traumatismos da Medula Espinal , Telerreabilitação , Humanos , Traumatismos da Medula Espinal/reabilitação , Força Muscular/fisiologia , Masculino , Feminino , Adulto , Iraque , SARS-CoV-2 , Adulto Jovem , Antropometria , Sobreviventes , Serviços de Assistência Domiciliar/organização & administraçãoRESUMO
Introduction: The significance of comprehensive investigations specifically addressing the characteristics and implications of nervous system injuries (NSIs) and particularly war-related spinal cord injuries (SCI) remain limited. Iraq lacks comprehensive survey studies for quality of life for people after SCI. The objective of this work was to identify the number of NSIs and mortality of those injured during the Islamic State of Iraq and Syria (ISIS) war in Iraq and analyze events specifically as sociodemographic variables to assess quality of life healthy, psychological, and social disorders from onset of injury till the involving. Methods: A survey-based descriptive study, and analytical retrospective at community-based of Nineveh Governorate, in Iraq. The participants were 34 survivors of ISIS war with SCIs, ages between 9 and 60 years, and 7 females (20.59%) and 27 males (79.41%) as registered in Nineveh Center of Disability Rehabilitation. Data collection was conducted using Telephone Video Interviews and respondents' health information. Protocol-specific questions and some psychological and social scales (PTSD) (DSM-IV), (TAS-20), (SWLS), and (MSPSS) were also used. Results: There were 2,990 NSIs with the highest rate of injuries occurring from 2017 to 2018, and the SCIs were 267 injuries (8.93%), and (70.59%) at level T the mortalities were 57 cases, all participants suffered from physical and psychological chronic complications, while the results of the PTSD, GPC, and SWLS were at a moderate level. Conclusions: In urban warfare, there's a rise in NSIs, notably SCIs influenced by the type of weaponry. The survivors face significant physical, psychological, social, and financial burdens. More research is crucial to understanding their situations and developing strategies to alleviate their health, social, and financial challenges.
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Qualidade de Vida , Traumatismos da Medula Espinal , Sobreviventes , Humanos , Feminino , Masculino , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/psicologia , Adulto , Pessoa de Meia-Idade , Adolescente , Iraque/epidemiologia , Síria , Adulto Jovem , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos , Estudos Retrospectivos , Criança , Guerra , Inquéritos e Questionários , Fatores SociodemográficosRESUMO
Cases of Goiter related to iodine deficiency in cross-breed goat kids in Basrah, Iraq are very scarce, and little information has been provided; therefore, the present study highlighted a clinical case of goat kids suffering from Goiter due to iodine deficiency with hematological and biochemical evaluation. The study examined 44 cross-breed goat kids, 1-3 months old (males and females), who showed painless palpable enlargement on one side of the cranio-ventral neck region or near the throat rejoin with weakness and alopecia. Ten clinically healthy kids of the same age were considered a control group. This study's diseased and control group was subjected to complete clinical examinations. Diseased animals show painless palpable and visible enlarged thyroid glands with or without enlargement of the neck, sparse hair coats with little alopecia, slow growth rate, irregular appetite or unwillingness to suck, weakness, and emaciation. Furthermore, the presence of thyroid thrill during palpation of jugular furrow was also detected. Moreover, diseased goat kids show no significant difference in body temperature; however, a significant increase was encountered in respiratory rate with a significant decrease in heart rate. On the other hand, no significant changes have been detected in the hematological analysis between diseased goat kids and the control group concerning the chemical analysis between the diseased cross-breed goat kids and the control group; the results of the present study indicated a significant increase in TSH, whereas, T3, T4, FT4, glucose level, Vit. E (α-tocopherol) and serum glutathione peroxides were lowered in diseased cross-breed goat kids compared with the control group. In contrast, a significant hyper- cholesterolemia was indicated in diseased animals than in the control group. It was concluded that Goiter in kids could reflect harm effects terminated mostly with death. Therefore, improving the maternal diet is an important reason to reduce the development of the disease.
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Bócio , Iodo , Masculino , Feminino , Animais , Cabras , Iraque/epidemiologia , AlopeciaRESUMO
In the southern region of Iraq, Peste des petits ruminants (PPR) has been identified and diagnosed. The study was done on (300) local sheep breeds of varying ages and sexes exhibiting PPR symptoms, while (25), healthy sheep breeds served as the control group. Additionally, the diagnosis of PPRV was confirmed by PCR. Infected sheep exhibit a variety of clinical symptoms. However, DNA sequencing was used to detect genetic links and genetic variation, and the results revealed a closed genetic relationship with the NCBI BLAST PPRV India isolate (GU014574.1) at total genetic variation (0.02-0.01%). Results indicate a large rise in PCV and ESR in conjunction with leukocytopenia and lymphocytopenia, a significant difference in clotting factor indices, and a significant increase in ALT, AST, and CK. In addition, there was a substantial variation in acute phase response. Postmortem examinations revealed various erosive lesions on the upper and lower gums, severe hemorrhagic enteritis, particularly of the small intestine, and obvious congestion of the lungs. Histopathological changes revealed an obvious flattening of the intestinal mucosa as well as an enlargement of the villi. In addition to a granuloma in the sub-mucosa, chronic inflammatory cells, primarily lymphocytes, were seen invading the mucosa. It has been determined that the sickness was circulating in the southern region of Iraq and severely afflicted sheep, which might result in significant economic losses owing to the detrimental effects of the virus that causes the disease on the various bodily parts.
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Doenças das Cabras , Peste dos Pequenos Ruminantes , Vírus da Peste dos Pequenos Ruminantes , Doenças dos Ovinos , Ovinos , Animais , Peste dos Pequenos Ruminantes/diagnóstico , Peste dos Pequenos Ruminantes/epidemiologia , Peste dos Pequenos Ruminantes/patologia , Vírus da Peste dos Pequenos Ruminantes/genética , Iraque/epidemiologia , Cabras , Doenças dos Ovinos/epidemiologia , Doenças das Cabras/diagnósticoRESUMO
Friendships can positively impact students' academic performance and grade point average (GPA) by providing emotional support and reducing stress, thereby leading to improved focus and better concentration on studies. Peer connections and friendships often result in collaborative learning and the exchange of academic ideas, improving comprehension and retention of course materials, ultimately leading to higher GPAs. In contrast, negative friendships or excessive social distractions can adversely affect GPA, which highlights the importance of striking a fine balance between social connections and academic responsibilities. This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. It involved a thorough electronic search on PubMed, Ebsco, and Web of Science databases with no time restrictions. We considered studies from various parts of the world, which examined friendships and relations within the academic setting. This review delved into the substantial impact of friendships in academic settings. Friendships foster a supportive environment for collaboration and knowledge-sharing, ultimately enhancing motivation, reducing stress, and improving GPA, thereby contributing to a successful academic experience. While disparities were noted across studies due to geographical variations, study designs, and outcome measures, the majority of them revealed a positive correlation between friendship and academic performance. Some studies highlighted gender-related differences, with male friendships often proving beneficial for academic performance, though this is not a universal rule, as the quality of friendships mostly depends on compatibility rather than gender. To sum up, the extensive review of research underscores the pivotal role of friendships in academic settings, which act as crucial support systems for collaboration, knowledge-sharing, and motivation among students, leading to enhanced academic performance. Despite regional and methodological variations, a consistent positive correlation between friendship and academic success was observed across diverse studies.
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Brucellosis is an important contagious disease affecting most domestic and mature animals. Since the impact of IL-1ß in B. abortus invasion and survival remains elusive, the current study sought to elucidate the actual roles of these potent cytokines in the modulation of the initial immune response to Brucella infection. Therefore, this study aimed to detect Brucella abortus in the placenta of aborted women and cows and estimate the expression of the interleukin 1ß (IL1ß) gene associated with immune response mechanisms to Brucella abortus infection. The detection of Brucella abortus was performed by Rose Bengal Test (RBT) and Polymerase Chain Reaction based AlkB gene (AlkB-PCR) in the sera and placenta samples of aborted women and cows, respectively. The overall percentage of Brucella abortus infection was 13.1% and 5% as determined by RBT and AlkB-PCR in aborted women's sera and placentas, respectively. On the other hand, the overall percentage rates of Brucella abortus infection in the sera and placentas from aborted cows were 30% and 11% as estimated by RBT and AlkB-PCR, respectively. The results of RBT demonstrated that the association between Brucella abortus and abortion in cows was statistically significant. On the other hand, it was found that the association between Brucella abortus and abortion in women was not significant. Moreover, according to the results of AlkB-based PCR, the association between Brucella abortus and abortion was statistically significant in aborted cows, while it was not significant in aborted women. The sensitivity, specificity, and accuracy of RBT were calculated as 60.00, 53.85, and 54.55%, respectively. Moreover, positive and negative predictive values were reported as 14.33% and 91.28%, respectively. Regarding RBT for aborted cows, the sensitivity, specificity, and accuracy of the test were 81.82%, 57.78%, and 62.49%, respectively. The positive predictive value was reported as 32.08%, while the negative predictive value was reported as 92.88%. Quantitative PCR (qPCR) was carried out for the evaluation of Interleukin 1 Beta (IL1ß) gene expression. The qPCR result was presented as a fold change in gene expression. A significant increment of IL1ß gene expression was observed in aborted women (114.905±99.661) and cows (22.454 ±18.528), compared to non-aborted women (4.953±5.564) and cows (2.033±1.845). Statistical comparison of IL1ß gene expression between aborted women and cows illustrated a non-significant increment in IL1ß gene expression in aborted women (114.905±99.661), compared to aborted cows (22.454 ±18.528).
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Brucelose Bovina , Brucelose , Doenças dos Bovinos , Interleucina-1beta , Animais , Bovinos , Feminino , Humanos , Gravidez , Aborto Animal , Brucella abortus , Brucelose/genética , Brucelose Bovina/genética , Interleucina-1beta/genética , Placenta/metabolismo , Rosa Bengala , Aborto EspontâneoRESUMO
te public knowledge of stroke, but the impact in Nigeria is notwell known. This study assessed stroke-related knowledge andattitudes among university students in Nigeria, where health stud-ies are parts of college curricula. This was a cross-sectional studyof students at three universities in Northeast Nigeria. Using ques-tionnaire survey, we assessed biographical data and participantknowledge of the primary site, warning signs and risk factors ofstroke. Responses were graded on a knowledge score, where ≥2.5points indicated adequate knowledge. Data were analyzed with theSPSS version 21 program. We studied 824 participants, 67.1%males. Males were older than females (mean age ± SD: 27.42±5.58years versus 26.27±5.31 years; P = 0.009; 95% CI: 0.29 1.99)and 14.5% participants had stroke lectures during general studies.Major sources of stroke knowledge were personal discussions(44.6%) and internet websites (24.5%). Only 15.7% participantscorrectly identified the brain as the primary site of stroke, whileknowledge of one or more stroke warning signs and risk factorswere noted in 42.2% and 49.6%, respectively. Mean knowledgescore was 1.08 ± 0.99. Adequate knowledge of stroke was noted in13.2% participants, and was higher in females (17.7% versus10.7%; P = 0.01). Logistic regression analysis showed significantassociations between adequate knowledge of stroke with femalesex (OR 1.8; 95% CI: 1.2 2.8; P = 0.008) and a history of strokein close relatives (OR 1.7; 95% CI: 1.1 2.6; P = 0.025) but notwith age, academic discipline or stroke lectures. University stu-dents in Northeast Nigeria have low knowledge of stroke, which isworse in males. Although health issues are taught at universities,little is taught on stroke, suggesting a need to prioritize strokeknowledge in the universities little is taught on stroke, suggeting a need to prioritize stroke knowlegde in the university curriculum .
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Humanos , Masculino , Feminino , Adolescente , Adulto , Acidente Vascular Cerebral , Estudantes de Saúde Pública , Serviços de Saúde para Estudantes , Conhecimento do Paciente sobre a Medicação , Infarto do MiocárdioRESUMO
BACKGROUND: Not many studies have investigated the knowledge outcomes among medical students with regards to contact lenses (CL). Thus, in this study, we aim to assess the attitude and awareness of CL use and the associated factors among medical students of King Faisal University (KFU), Al Ahsa, Saudi Arabia. METHODS: This a cross-sectional study that based developed based on a designed questionnaire that was composed of 31 questions with a maximum score of 57 points. We have also conducted a linear regression model to explore the possible important factors that may affect the level of knowledge and awareness about contact lenses care. RESULTS: A total of 208 participants were included in this study, with a mean age of 21.0 ± 1.9, and 56.3% (n = 117) of them being females. The total mean knowledge score in our study was 30.1 ± 7.74, which was higher in females (31.5 ± 7.09) than in male participants (28.7 ± 7.69). The results of the linear regression model showed that being female (E = -0.37; 95%CI = -0.65- -0.10; P = 0.007), using contact lenses (E = 0.56; 95%CI = 0.29 - 0.82; P < 0.001), and in the third year (E = 0.66; 95%CI = 0.19- 1.13; P = 0.007) is significantly correlated with having higher knowledge scores about using CLs. CONCLUSION: Female participants had higher total mean knowledge scores than males. We recommend that further educational campaigns should be inaugurated to raise awareness about taking care of CLs and enhancing the related practices of wearing them.
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PURPOSE: Clarithromycin is commonly prescribed for H. pylori infection. Domain V mutations are responsible for clarithromycin resistance. This study was aimed to characterize the clarithromycin resistance and its associated mutations in clinical isolates of H. pylori in Pakistan. MATERIALS AND METHODS: Infection was diagnosed in 93 patients' biopsies using culture, rapid urease test, 16S rRNA, and vacA gene multiplex PCR. Clarithromycin resistance was assessed by the agar dilution method. Mutations were detected by PCR-RFLP using 46 (1.4 kb) domain V fragments. Sequencing was executed for 13 domain V fragments, of which 12 showed unusual amplicon size (1.2 kb) and 01 had a new MboII RFLP pattern. RESULTS: A total of 48 (83%) strains were obtained from 58 (62.3%) PCR H. pylori-positive samples. Resistance (MIC ≥ 0.001 mg/mL) and intermediate resistance phenotype (MIC = 0.0005 mg/mL) was observed in 22 (46%), and 10 (21%) isolates, respectively. The primary resistance was found in 23 (39.6%) samples. PCR-RFLP detected A2142G, A2143G, and double mutations in 19, 04, and 01 resistant strain, respectively. Sequencing of 10 amplicons obtained from intermediated resistant strains and 03 amplicons from resistant strains showed 138 new mutations. Among them, T2182C was also seen in 04 intermediated resistant isolates, whereas A2142G, A2143G, and A2143C were observed in resistant isolates. The new MboII RFLP pattern in an intermediated resistant strains was due to A1761G mutation. CONCLUSION: H. pylori domain V mutations showed extensive diversity. Multiple mutations in domain V may give endurance to H. pylori against clarithromycin. Further investigations on the molecular mechanism of antibiotic resistance in H. pylori seem crucial at this stage.
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Nerve growth factor (NGF), a critical mediator of nociception, is a novel analgesic therapeutic target. Bedinvetmab, a canine monoclonal antibody (mAb), binds NGF and inhibits its interaction with tropomyosin receptor kinase A (trkA) and p75 neurotrophin receptor (p75NTR) receptors. The objective of three integrated laboratory studies was to demonstrate the safety of bedinvetmab in adult laboratory Beagle dogs. Daily health, veterinary, clinical pathology, systemic exposure, and anti-drug antibody evaluations were performed. Study 1 additionally included electrocardiography, neurologic, and ophthalmic assessments, and radiographic monitoring of joints of the appendicular skeleton. Study 2 evaluated T-lymphocyte-dependent immune function. Study 3 evaluated the safety of short-term concurrent administration of carprofen, a nonsteroidal anti-inflammatory drug (NSAID), with bedinvetmab. Studies 1 and 3 included terminal pathology and histopathology evaluations. Study designs and procedures included directed complementary morphologic and functional evaluations of a literature- and in vitro-based list of potential safety issues related to the NGF signaling pathway and characteristics engineered into this mAb. Screening-level general procedures evaluated effects associated with mAbs that target and inhibit soluble agonist cytokines. There were no treatment-related adverse changes in clinical evaluations, clinical neurological and ophthalmic examinations, joints, immune morphology or function, and no effects of short-term concurrent NSAID usage. Treatment-emergent immunogenicity was not observed. Bedinvetmab (1 mg/kg SC monthly; 3× and 10× dose multiples) was well tolerated in normal laboratory Beagle dogs for 6 months and with 2 weeks' concurrent NSAID administration.
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Laboratórios , Fator de Crescimento Neural , Animais , Anticorpos Monoclonais/efeitos adversos , Cães , Receptor de Fator de Crescimento Neural , Transdução de SinaisRESUMO
Primary amebic meningoencephalitis is a rare, usually fatal disease, caused by Naegleria fowleri. This case highlights the challenging clinicopathologic diagnosis in a 13-year-old boy who swam in freshwater in northern Florida where a previous case had exposure to a body of water on the same property in 2009.
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BACKGROUND: HIV-infected (HIV+) donor to HIV+ recipient (HIV D+/R+) transplantation might improve access to transplantation for people living with HIV. However, it remains unknown whether transplant candidates living with HIV will accept the currently unknown risks of HIV D+/R+ transplantation. METHODS: We surveyed transplant candidates living with HIV from 9 US transplant centers regarding willingness to accept HIV+ donor organs. RESULTS: Among 116 participants, the median age was 55 years, 68% were men, and 78% were African American. Most were willing to accept HIV+ living donor organs (87%), HIV+ deceased donor organs (84%), and increased infectious risk donor organs (70%). Some (30%) were concerned about HIV superinfection; even among these respondents, 71% were willing to accept an HIV D+ organ. Respondents from centers that had already performed a transplant under an HIV D+/R+ transplantation research protocol were more willing to accept HIV+ deceased donor organs (89% vs. 71%, P = 0.04). Respondents who chose not to enroll in an HIV D+/R+ transplantation research protocol were less likely to believe that HIV D+/R+ transplantation was safe (45% vs. 77%, P = 0.02), and that HIV D+ organs would work similar to HIV D- organs (55% vs. 77%, P = 0.04), but more likely to believe they would receive an infection other than HIV from an HIV D+ organ (64% vs. 13%, P < 0.01). CONCLUSIONS: Willingness to accept HIV D+ organs among transplant candidates living with HIV does not seem to be a major barrier to HIV D+/R+ transplantation and may increase with growing HIV D+/R+ transplantation experience.
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Infecções por HIV/virologia , HIV-1 , Doadores de Tecidos , Transplantados , Transplantes/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transplante de Órgãos , Fatores de Risco , Transplantes/microbiologiaRESUMO
BACKGROUND: Peroral cholangioscopy (POCS) of indeterminate biliary strictures aims to achieve a diagnosis through visual examination and/or by obtaining targeted biopsies under direct visualization. In this large, prospective, multinational, real-life experience of POCS-guided evaluation of indeterminate biliary strictures, we evaluated the performance of POCS in this difficult-to-manage patient population. METHODS: This prospective registry enrolled patients, with indeterminate biliary strictures across 20 centers in Asia, the Middle East, and Africa. The primary end points were the ability to visualize the lesion, obtain histological sampling when intended, and an assessment of the diagnostic accuracy of POCS for malignant strictures. Patients were followed for 6 months after POCS or until a definitive malignant diagnosis was made, whichever occurred first. RESULTS: 289 patients underwent 290 POCS procedures with intent to biopsy in 182 cases. The stricture/filling defect was successfully visualized in 286/290 (98.6â%), providing a visual diagnostic impression in 253/290 (87.2â%) and obtaining adequate biopsies in 169/182 (92.9â%). Procedure-related adverse events occurred in 5/289 patients (1.7â%). POCS influenced patient management principally by elucidating filling defects or the causes of bile duct stricture or dilation. The visual impression of malignancy showed 86.7â% sensitivity, 71.2â% specificity, 65.8â% positive and 89.4â% negative predictive value, and 77.2â% overall accuracy compared with final diagnosis. Histological POCS-guided samples showed 75.3â% sensitivity, 100â% specificity, 100â% positive and 77.1â% negative predictive value, and 86.5â% overall accuracy. CONCLUSION: In this large, real-life, prospective series, POCS was demonstrated to be an effective and safe intervention guiding the management of patients with indeterminate biliary strictures.
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Colestase , Endoscopia do Sistema Digestório , Ásia , Colestase/etiologia , Constrição Patológica/etiologia , Humanos , Sistema de RegistrosRESUMO
BACKGROUND: Owing to the rising population of the Kingdom of Saudi Arabia, the need for family physicians is growing. The number of family physicians who would be available in the health service in future is dependent on the attitudes of medical students because their choice of specialty is a major factor in satisfying this demand. The aim of the study was to evaluate the attitudes of medical students to family medicine as a future career. MATERIALS AND METHODS: This cross-sectional study was conducted at King Saud Bin Abdulaziz University for Health Sciences. A total of 308 students were randomly selected from problem-based learning groups. Data were collected using a 25-item validated questionnaire, and Excel and SPSS were used for data entry and analysis. Mean and standard deviation were used to describe numerical data and frequencies and percentages to describe categorical data. P < 0.05 was considered statistically significant. RESULTS: A total of 308 medical students, 201 (65.3%) of whom were male, completed the questionnaire. Majority of the students (229 [74.3%]) agreed that family physicians make important contributions to medicine although family medicine was one of the least preferred specialties of the students. CONCLUSIONS: Most students were aware of the importance of family medicine; however, only a few of them chose this specialty. Further studies should be conducted to identify the factors that influence medical students' decisions in their choice of family medicine as a future career.
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BACKGROUND: Peroral cholangioscopy (POCS) can be useful for difficult bile duct stone clearance. Large prospective multinational data on POCS-guided lithotripsy for clearing difficult bile duct stones in a single session of endoscopic retrograde cholangiopancreatography (ERCP) are missing. METHODS: Patients with difficult bile duct stones (defined as one or more of: largest stone diameter ≥â15âmm, failed prior attempt at stone clearance, impacted, multiple, hepatic duct location, or located above a stricture) were enrolled at 17 centers in 10 countries. The principal endpoint was stone clearance in a single ERCP procedure using POCS. RESULTS : 156 patients underwent 174 sessions of POCS-guided electrohydraulic or laser lithotripsy. Stone clearance had failed in a previous ERCP using traditional techniques in 124/156 patients (80â%), while 32â/156 patients (21â%) were referred directly to POCS-guided therapy based on preprocedural assessment of the difficulty of stone clearance. In 101/156 patients (65â%), there were impacted stones. POCS-guided stone clearance was achieved in a single POCS procedure in 125â/156 patients (80â%, 95â% confidence interval [CI] 73â%â-â86â%), and was significantly more likely for stones ≤â30âmm compared with >â30âmm (odds ratio 7.9, 95â%CI 2.4â-â26.2; Pâ=â0.002). Serious adverse events occurred in 3/156 patients (1.9â%, 95â%CI 0.4â%â-â5.5â%), and included pancreatitis, perforation due to laser lithotripsy, and cholangitis (nâ=â1 each), all resolved within 1 week. CONCLUSION: POCS-guided lithotripsy is highly effective for clearance of difficult bile duct stones in a single procedure and successfully salvages most prior treatment failures. It may also be considered first-line therapy for patients with difficult choledocholithiasis to avoid serial procedures.
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Colangiopancreatografia Retrógrada Endoscópica , Cálculos Biliares/cirurgia , Litotripsia/métodos , Cirurgia Endoscópica por Orifício Natural , Idoso , Feminino , Cálculos Biliares/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sistema de Registros , Resultado do TratamentoRESUMO
The above article, published in print in the Jan 2018 issue of the Journal of Child Psychology & Psychiatry and online in Wiley Online Library (wileyonlinelibrary.com), has been retracted by the JCPP Editor-in-Chief, Edmund Sonuga-Barke, and John Wiley & Sons. Following a series of communications from readers highlighting concerns about the paper (now published on the journal website), the journal editors requested that the authors send them the raw data from the trial. In response the authors informed the editors that; (i) the electronic data base had been lost following a computer outage and (ii) that they could send only 95 out of 120 hard-copy participant data sheets as one site had closed and was no longer contactable. The substantial data loss in and of itself posed a serious difficulty in verifying the correctness of the data presented in the paper. The JCPP then analysed the data from the 95 cases itself. A number of significant discrepancies emerged between the re-analysis and the findings reported in the paper both in terms of means and standard deviations of key outcome variables across the trial. These involved very substantial differences that we judged to be extremely unlikely to have arisen due to variations in composition of the original and re-analysed samples. We also discovered previously unidentified/reported problems with missing data and recording irregularities regarding changes in treatment regimen and subject identifiers. As a result of these issues the Editors no longer have confidence in the findings reported in the original paper. Based on all these matters combined and following published guidance from the Committee on Publishing Ethics (COPE) and Wiley's Best Practice Guidelines on Publishing Ethics, we have decided that the only course of action available to us is to retract the paper.
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The main objective of this paper is to investigate an accurate numerical method for solving a biological fractional model via Atangana-Baleanu fractional derivative. We focused our attention on linear and nonlinear Fisher's equations. We use the spectral collocation method based on the Chebyshev approximations. This method reduced the nonlinear equations to a system of ordinary differential equations by using the properties of Chebyshev polynomials and then solved them by using the finite difference method. This is the first time that this method is used to solve nonlinear equations in Atangana-Baleanu sense. We present the effectiveness and accuracy of the proposed method by computing the absolute error and the residual error functions. The results show that the given procedure is an easy and efficient tool to investigate the solution of nonlinear equations with local and non-local singular kernels.
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BACKGROUND: With passage of the HIV Organ Policy Equity (HOPE) Act, people living with HIV (PLWH) can donate organs to PLWH awaiting transplant. Understanding knowledge and attitudes regarding organ donation among PLWH in the United States is critical to implementing the HOPE Act. METHODS: PLWH were surveyed regarding their knowledge, attitudes, and beliefs about organ donation and transplantation at an urban academic HIV clinic in Baltimore, MD, between August 2016 and October 2016. Responses were compared using Fisher exact and χ tests. RESULTS: Among 114 survey respondents, median age was 55 years, 47.8% were female, and 91.2% were African American. Most were willing to be deceased donors (79.8%) or living donors (62.3%). Most (80.7%) were aware of the US organ shortage; however, only 24.6% knew about the HOPE Act, and only 21.1% were registered donors. Respondents who trusted the medical system or thought their organs would function adequately in recipients were more likely to be willing to be deceased donors (P < 0.001). Respondents who were concerned about surgery, worse health postdonation, or need for changes in HIV treatment because of donation were less likely to be willing to be living donors (P < 0.05 for all). Most believed that PLWH should be permitted to donate (90.4%) and that using HIV+ donor organs for transplant would reduce discrimination against PLWH (72.8%). CONCLUSIONS: Many of the PLWH surveyed expressed willingness to be organ donors. However, knowledge about the HOPE Act and donor registration was low, highlighting a need to increase outreach.