Gadeeriksen5772
The Covid-19 pandemic launched the use of online courses in Chinese medical schools during February 2020. To evaluate the state of gross anatomy education in China during the pandemic, a nationwide survey was conducted through convenience sampling by email or respondent invitations on social media. A total of 359 questionnaires were received from the respondents. The first response from a given school was included in the study to represent that school, thus, 77 questionnaires were used for analyses. Schools represented were from all provinces in mainland China as well as Hong Kong and Macao. The survey found that before the pandemic, 74.0% and 33.8% of the 77 schools conducted online theoretical and practical sessions, respectively, on gross anatomy, and 36 (46.8% of 77) had temporarily suspended practical sessions at the time the survey was conducted. Body donation programs were also affected with 26.0% and 27.3% of the 77 schools having suspended donation programs or saw a decreased number of donations. During the pandemic, 40.3% of the 77 schools kept or initiated the implementation of active learning, and online assessment was continued in 49.4% of the 77 medical schools. Another 26 (33.8%) schools initiated online assessment during the pandemic. A total of 359 answers were included for the analysis of the "teachers' perception of the online teaching experience." Over half (51.0%) of the 359 responded teachers were very statisfied or satisfied with the effectiveness of online teaching during the pandemic. A total of 36.2% of these respondents preferred to implement online teaching of theoretical sessions after the pandemic, and 89 (24.8%) teachers were keen to return to traditional face-to-face anatomy education.
Tenofovir disoproxil fumarate (TDF) is frequently used for treatment of and prophylaxis against reactivation of hepatitis B virus (HBV) after liver transplant (LT). Because TDF can lead to renal impairment and a decrease in bone mineral density (BMD), the prodrug tenofovir alafenamide (TAF) may be considered a viable alternative with fewer adverse effects. Only limited information is available about the use of TAF for LT recipients. We report a European single-center experience with TAF as treatment for LT patients.
This retrospective analysis involved 29 LT recipients receiving standard immunosuppressants (mainly calcineurin inhibitors). Demographic and clinical data were documented at baseline upon switch to TAF and at various time points thereafter.
None of the patients experienced HBV reactivation after the switch to TAF. Liver and renal function remained stable. Drug levels of immunosuppressive agents did not change significantly after the switch. After 1year, 22 patients were still taking TAF; two patients had been lost to follow-up; one patient had died; and four patients had discontinued therapy because of TAF-related adverse effects. No serious adverse effects were reported.
Tenofovir alafenamide exhibits high antiviral efficacy and a good safety profile for LT recipients. Still, the safety and tolerability of TAF for organ transplant patients should be evaluated in larger cohorts.
Tenofovir alafenamide exhibits high antiviral efficacy and a good safety profile for LT recipients. Still, the safety and tolerability of TAF for organ transplant patients should be evaluated in larger cohorts.
Sleep medicine is an under-recognised medical specialty in Pakistan and obstructive sleep apnoea (OSA) often goes unnoticed. Final year medical students and junior doctors are the primary medical contact to elicit patient history and physical examination. We aimed to measure the current knowledge of OSA amongst the final year medical students and junior doctors at four university teaching hospitals across three large Pakistani cities.
Cross-sectional survey of final year medical students and junior doctors rotating through medical wards of four university teaching hospitals were conducted during August-October 2019. The knowledge section of the OSA knowledge and attitude (OSAKA) questionnaire was used. Descriptive statistics were used to present the data with Chi-Square test and independent samples student t-test to compare the differences between individual items and mean scores of the participants, respectively.
A total 282 final year medical students and 204 junior doctors completed the survey yieldial students and junior doctors from a sample of four university teaching hospitals in three large cities of Pakistan have limited knowledge about the diagnosis and management of OSA. The observed limited knowledge of OSA may contribute towards under-diagnosis of this increasingly prevalent medical condition.Broad ligament pregnancies are rare and are often misdiagnosed, leading to serious consequences. In our hospital, we have treated six broad ligament pregnancies since 2000. They were diagnosed and operated on promptly, and treatment was successful. Ultrasound can detect early ectopic pregnancies promptly and effectively, avoiding advanced ectopic pregnancies. Early broad ligament pregnancies should be operated on promptly, and laparoscopic therapy is preferable. During the operation, attention must be paid to avoid massive bleeding and protect the ureter, because the ectopic gestational sac is located near the uterine artery and the ureter.
The present study compared the treatment changes in the upper airway, hyoid bone position and craniofacial morphology between two groups of children with skeletal class II malocclusion treated with the headgear activator (HGA) and Herbst appliance (Herbst).
Orthodontic population from the Faculty of Dentistry of the University of Hong Kong.
Thirty-four skeletal class II patients treated with the HGA (17 patients, mean age 10.6±1.5years) and the Herbst (17 patients, mean age 11.0±1.4years) were matched for sex, age, overjet, skeletal class and mandibular divergence. The patients received lateral cephalometric radiographs (LCRs) at the beginning of treatment (T
), after treatment (T
) and at follow-up (T
). In the HGA group, patients underwent LCRs 7months before the beginning of treatment (T
), which were used as growth reference for intra-group comparison. Paired Student's t tests were used for intra- and inter-group comparisons (α=.05).
Treatment changes (T
-T
) did not differ significantly between the groups. However, at follow-up (T
-T
) the Herbst group showed a smaller increase than the HGA group in the vertical position of the hyoid bone relative to the Frankfort plane (P=.013) and mandibular plane (P=.013).
There were no significant differences in the upper airway, hyoid bone position and craniofacial morphology between the groups at the end of treatment. However, the Herbst may provide better long-term control of the vertical position of the hyoid bone than the HGA in children with skeletal class II malocclusion.
There were no significant differences in the upper airway, hyoid bone position and craniofacial morphology between the groups at the end of treatment. However, the Herbst may provide better long-term control of the vertical position of the hyoid bone than the HGA in children with skeletal class II malocclusion.
Treatment of patients with hemophilia has advanced over the past decades, but it is unknown whether this has resulted in a normal life expectancy in the Netherlands.
This observational cohort study aimed to assess all-cause and cause-specific mortality in patients with hemophilia in the Netherlands between 2001 and 2018 and to compare mortality and life expectancy with previous survival assessments from 1973 onward.
All 1066 patients with hemophilia who participated in a nationwide survey in 2001 were followed until July 2018.
Information on 1031 individuals (97%) was available, of whom 142 (14%) deceased during follow-up. Compared with the general Dutch male population, mortality of patients with hemophilia was still increased (standardized mortality ratio 1.4, 95% confidence interval 1.2-1.7). Intracranial bleeding and malignancies were the most common causes of death. Estimated median life expectancy of patients with hemophilia was 77years, 6years lower than the median life expectancy of the general Dutch male population (83years). R-848 Over the past 45years, death rates of patients with hemophilia have consistently decreased, approaching the survival experience of the general population. Over the past decades, mortality due to human immunodeficiency virus and hepatitis C virus infections has decreased, death due to intracranial hemorrhages has increased, and death due to ischemic heart disease has remained consistently low over time.
Survival in patients with hemophilia in the Netherlands has improved over time but is still lower than that of the general population.
Survival in patients with hemophilia in the Netherlands has improved over time but is still lower than that of the general population.Modulation of the reactivity of metallofullerenes is critical for production of metallofullerene derivatives with desired properties and functionalities. In this study, we investigate the effects of reduction and oxidation on the reactivity and regioselectivity in Diels-Alder reaction of metallofullerene La@C82 by means of density functional theory calculations. Because of the enhanced electron-deficiency characteristic upon oxidation, the oxidized metallofullerene exhibits higher thermodynamic and kinetic reactivity as compared with neutral La@C82 . The regioselectivity in the reaction of La@C82 with cylcopentadiene is remarkably changed after oxidation of the metallofullerene, which is explained in terms of the changes in the geometrical structure and the electronic structure of the metallofullerene. Quantitative analysis based on the activation-strain model demonstrates that the low activation energy barrier for the reaction of the cation La@C82+ with cyclopentadiene originates from small strain energy and large interaction energy between the reactants. Energy decomposition analysis on the transition states of the reactions reveals that the exchange-repulsion interaction energy is one of the critical factors that determine the kinetic reactivity of the metallofullerene. This study not only provides new theoretical insights on how to modulate the reactivity of metallofullerenes, but also offers guideline for future experimental synthesis of new metallofullerene derivatives.
Traboulsi syndrome is a rare disorder characterized by ectopia lentis and facial dysmorphism (large beaked nose), which was only reported in 18 individuals to date. It is caused by homozygous/compound heterozygous variants in the aspartate/asparagine-β-hydroxylase (ASPH) gene, which hydroxylates the aspartic acid and asparagine in epidermal growth factor-like domains of various proteins.
Whole-exome and Sanger sequencing were used to identify the disease-causing gene of the patient in a consanguineous Chinese family. Domain analysis was applied to predict the impact of the variant on ASPH protein.
Through exome and Sanger sequencing, we identified a novel homozygous ASPH variant (NM_004318.4c.1910del/NP_004309.2 p.(Asn637MetfsTer15)) in the patient, which may lead to blockage of the ASPH function through truncating the AspH oxygenase domain of the ASPH protein and/or nonsense-mediated decay of the ASPH transcript. This is the first report of Traboulsi syndrome in a Chinese patient who was combined with ventricular septal defect, lung bullae, and recurrent spontaneous pneumothorax.
