Explore the vast range of titles available.

Back ground An impalement-related injury to the oral cavity is common in pediatric patients at emergency department. A computed tomography evaluation is not always suitable in these cases. Herein, we aimed to present oral sonography findings from six pediatric patients presenting with impalement-related injury to the oral cavity. Case series All included patients were younger than 4 years and sustained injuries with a toothbrush, chopstick, water gun, and fork to the tonsils, submandibular gland area, uvula, and under the tongue. Conclusion Ultrasound imaging appeared useful in helping diagnose impalement-related injuries lateral to the midline.

We review the current status of knowledge concerning the early phases of star formation during cosmic dawn. This includes the first generations of stars forming in the lowest mass dark matter halos in which cooling and condensation of gas with primordial composition is possible at very high redshift ( z > 20 ), namely metal-free Population III stars, and the first generation of massive black holes forming at such early epochs, the so-called black hole seeds. The formation of black hole seeds as end states of the collapse of Population III stars, or via direct collapse scenarios, is discussed. In particular, special emphasis is given to the physics of supermassive stars as potential precursors of direct collapse black holes, in light of recent results of stellar evolution models, and of numerical simulations of the early stages of galaxy formation. Furthermore, we discuss the role of the cosmic radiation produced by the early generation of stars and black holes at high redshift in the process of reionization.

ObjectiveTo define patterns of spread through the order of lower motor neuron involvement (first, second or third order), relationships between interval or sites of affected areas from onset to involvement of a second region, and prognosis, including 5 year survival, normal preservation of motor function at onset of respiratory symptoms and cumulative occurrence of each region and direction of spread.Method150 patients with sporadic amyotrophic lateral sclerosis (ALS) underwent follow-up at 3 month intervals until the appearance of respiratory symptoms. Symptom appearances were determined using the revised version of the ALS Functional Rating Scale.ResultMedian survival with combined type onset (two regions simultaneously) was shorter (18 months) than with bulbar onset (26 months, p=0.01). The interval from onset to involvement of the second region correlated significantly with survival, independent of particular combinations. 5 year survival rate was 21% for lower limb onset, 18% for upper limb onset and 16% for bulbar onset. No patient with a rapid spread pattern (two regions within 3 months from onset) survived >5 years. Early manifestations of bulbar symptoms within 1 year were associated with worse survival (p<0.001) although no significant difference in survival was seen between groups with and without bulbar symptoms (p=0.51). In terms of cumulative occurrence, symptoms spread longitudinally to adjacent regions. Bulbar function remained preserved in 27%, lower limb function in 10% and upper limb function in 2.7%.ConclusionThe interval between onset and involvement of the second region is an important predictor of survival. The data support the contiguous anatomical propagation of lower motor neuron involvement in sporadic ALS.

Purpose: The characteristics of patients with severe COVID-19 pneumonia who underwent direct hemoperfusion using polymyxin B-immobilized fiber column (PMX-DHP), in addition to steroids and immunomodulators, remain unclear. Patients and Methods: We conducted a retrospective observational study on 31 patients with severe COVID-19 pneumonia treated with PMX-DHP in an intensive care unit (ICU) from December 2020 to September 2021. Results: Outcomes 28 days after admission to the ICU were 20 in the survival group and 11 in the death group. Parameters significantly different between the survival and death group before PMX-DHP were percentage of invasive mechanical ventilation (25% vs 72.7%, P = 0.0209), PaP[O.sub.2]/[F.sub.I][O.sub.2] (P/F) ratio (104.5 vs 75, P = 0.0317), and sequential organ failure assessment (SOFA) score (2 vs 3, P = 0.0356). Invasive mechanical ventilation avoidance rate was significantly different between the survival (100%) and death group (0%) (P = 0.0012). P/F ratio, respiratory ratio (RR), and lymphocyte counts improved significantly after PMX-DHP for all patients. The lymphocyte counts changed significantly in the survival (P < 0.0001), but not the death group (P = 0.7927). Conclusion: PMX-DHP, in addition to steroids and immunomodulators, may improve oxygenation and alleviate tachypnea by modulating the lymphocyte numbers and levels of various mediator against severe COVID-19 pneumonia. It may be better to perform PMX-DHP before multi organ dysfunction and lung injury has progressed. Furthermore, the early increase in lymphocyte counts after PMX-DHP might be an indicate a positive outcome. Keywords: IL-6, lymphocyte, P/F ratio, respiratory rate, SOFA

The standard theory of cosmic structure formation posits that the present-day rich structure of the universe developed through gravitational amplification of tiny matter density fluctuations left over from the Big Bang. Recent observations of the cosmic microwave background, large-scale structure, and distant supernovae determined the energy content of the universe and the basic statistics of the initial density field with great accuracy. It has become possible to make accurate predictions for the formation and nonlinear growth of structure through early to the present epochs. We review recent progress in the theory of structure formation in the early universe. Results from state-of-the-art computer simulations are presented. Finally, we discuss prospects for future observations of the first generation of stars, black holes, and galaxies.

Radiologists are often unfamiliar with anorectal malformations and have limited knowledge of the surgical procedures for their repair. In this article, we provide a comprehensible description of the surgical procedures for radiologists, review previous literature, and summarise the incidence of the complications. Moreover, we detail major postoperative complications consequent to the use of various imaging techniques, including anorectal prolapse, anal stenosis, urethral injury, posterior urethral diverticulum, neurogenic bladder, adhesion of reconstructed vagina, leakage from suture lines, and trocar site hernia. Knowledge of these complications and surgical procedures is important to radiologists for diagnosis and determination of a treatment strategy.

This paper evaluated the performance and durability of leading structural shading materials to be used in the Super Containerized Living Units (Super-CLU’s) project. Fifteen unique shading fabrics were tested in five different experiments in order to evaluate their strength, resistance to wind, abrasion, and heat and to assess their heat transmissivity and breathability. A current United States Navy material was used as a control material for the evaluation of the other tested materials. Samples of each fabric were first tensile tested in both their warp and weft orientation to create an ‘as-received’ baseline condition. Then, additional samples of each fabric were exposed to wind, abrasion, or heat and subsequently tensile tested in order to show the degradation in tensile strength as compared to the as-received samples. The heat transmissivity and breathability testing was conducted separately.

We tested the hypothesis that personality plays a role in cancer outcome in a population-based prospective cohort study in Japan. In July 1990, 41 442 residents of Japan completed a short form of the Eysenck Personality Questionnaire-Revised and a questionnaire on various health habits, and between January 1993 and December 1997, 890 incident cases of cancer were identified among them. These 890 cases were followed up until March 2001, and a total of 356 deaths from all causes was identified among them. Cox proportional-hazards regression was used to estimate the hazard ratio (HR) of death according to four score levels on each of four personality subscales (extraversion, neuroticism, psychoticism, and lie), with adjustment for potential confounding factors. Multivariable HRs of deaths from all causes for individuals in the highest score level on each personality subscale compared with those at the lowest level were 1.0 for extraversion (95% CI=0.8–1.4; Trend P =0.73), 1.1 for neuroticism (0.8–1.6; Trend P =0.24), 1.2 for psychoticism (0.9–1.6; Trend P =0.29), and 1.0 for lie (0.7–1.5; Trend P =0.90). The data obtained in this population-based prospective cohort study in Japan do not support the hypothesis that personality is associated with cancer survival.

To obtain a history of occupational exposure in the workplace, the questionnaire is one of the main sources of information. The aim of this study was to develop an online questionnaire using the REDCap data management platform based on the Work-Related Cancer Surveillance Guidelines, reported by the Brazilian National Cancer Institute. Several issues were taken into consideration for its routine application. It should be simple, easy, capable of being applied in a short time and used in the clinical setting of collecting information on the occupational history of the cancer patient. Consequently, this could enable the compulsory notification of work-related cancer. The questionnaire was developed based on questions about the use of and exposure to carcinogenic factors at work and due to smoking. An entirely electronic version of the cancer patient interview was performed using tablets. The online questionnaire was applied at the Barretos Cancer Hospital, Barretos, to newly diagnosed patients from July 2016 to 2018. A total of 1063 patients were included, and 550 indicated positively when asked “Do you work, or have you worked with this substance and/or in this function?/job?” Of these potentially notified patients, 38 subsequently had compulsorily reported work-related cancer. Another important result of this study was the creation and development of a website. In conclusion, we developed an online tool that could facilitate hospital routines, contributing to generating data for the compulsory notification of work-related cancer and triggering investigations and surveillance actions in Brazil.