Search

Abstract Background Metanephric adenoma is a rare benign renal tumor of the kidney, uncommonly observed in children. It is often misdiagnosed preoperatively as a malignant neoplasm, leading to an unnecessary nephrectomy. The challenge is to make the right diagnosis preoperatively and therefore manage it with conservative surgery. We report a case of a child with metanephric adenoma who underwent nephron-sparing surgery. Case presentation A renal tumor was discovered fortuitously in an 18-month-old Caucasian girl with several congenital malformations. Investigations showed a 28 × 27 × 27 mm left renal mass centrally located, well defined, nonvascularized, with no calcifications and which compressed the adjacent renal tissue. Furthermore, there were no signs of metastasis. The decision of a multidisciplinary meeting was to perform a computed tomography (CT)-scan-guided biopsy. Histologic examination concluded it was a metanephric adenoma. We performed a left open partial nephrectomy via a flank retroperitoneal incision. The final histopathological examination confirmed the diagnosis. The postoperative course was uneventful. Conclusion Preoperative diagnosis of metanephric adenoma is challenging. Because of the high probability of unnecessary radical nephrectomy, preoperative biopsy can be safe and determining to guide a more conservative approach so nephron-sparing surgery can be performed.

Abstract Introduction Acute appendicitis and blunt abdominal trauma may co-exist, imposing a dilemma of whether there is only coincidence or there is a cause to effect relationship. The etiopathogenesis of this rare association remains obscure. Pneumoperitoneum has rarely been described in patients with acute perforative appendicitis following abdominal trauma. Case presentation We report a rare case of acute perforated appendicitis after blunt abdominal trauma in an 8-year-old boy revealed by a pneumoperitoneum. We also reviewed the literature on this rare condition to assess the specificity of pneumoperitoneum in the diagnosis and to understand its etiopathogenesis. Conclusion Abdominal pain and fever several days after an abdominal trauma may be a sign of post-traumatic appendicitis in the pediatric population. Pneumoperitoneum is not specific of post-traumatic appendicitis but it can be a protective sign, since it will lead to immediate laparotomy in patients with an unrecognized surgical abdomen.

Background: Pediatric female urethral injury is rare and the management remains non consensual. Patients presenting at a later stage with obliterate strictures have limited surgical options for repair. The aim was to report an original endosurgical procedure to recreate the urethra after a complete urethral rupture Case presentation: A 6-year-old girl was operated for a ruptured bladder. The attempt to catheterize the urethra failed. We decided to put a suprapubic cystostomy. Cystourethrography, performed 3 weeks postoperatively, showed a complete urethral rupture. The patient was lost to follow-up for 2 years. When returned, the decision was to perform urethra realignment endoscopically with a suprapubic and transurethral approaches. When brought in by the cystostomy, the endoscope showed a normal bladder wall and a stricture of the bladder neck. When introduced by the remaining urethra, it showed a dead-end 1- cm urethra. The intervention consisted on drilling the way from the meatus, to reach the bladder, while controlling the procedure by suprapubic cystoscopy. The result was a urethral path of 1.5cm permitting a normal voiding behavior after the closure of the suprapubic opening. Conlusion: Post traumatic urethral injury in girls is difficult to deal with. Surgical ingenuity and more preservative techniques are necessary and go along with maintaining an acceptable urinary function.

Abstract Background Pediatric spontaneous bile duct perforation is one of the rare causes of acute abdomen in infants. With a highly variable presentation, diagnosis and treatment can prove challenging. We report a case of spontaneous common hepatic duct perforation mistaken for appendicular peritonitis. Case presentation An otherwise healthy 3-year-old boy presented to the emergency department with complaints of abdominal pain, distention, bilious vomiting, and fever evolving for 4 days. Preoperative ultrasound was suggestive of appendicular peritonitis. Laparotomy revealed abundant biliary fluid, a distended gallbladder with thickened and inflammatory wall, and a macroscopically normal appendix. Intraoperative cholangiography showed a leak of contrast from the anterior wall of the common hepatic duct, 2–3 mm below the upper biliary confluence and 2 cm above the junction of the cystic duct to the common hepatic duct. A cholecystostomy was performed, and two external intraabdominal drains were placed. A retrograde cholangiogram was performed on postoperative day 21 showing no extravasation of contrast product. The patient was discharged on postoperative day 25. Conclusion Spontaneous perforation of the common hepatic duct is a rare phenomenon. It should be considered as a differential diagnosis in pediatric patients that present with unexplained peritonitis. The optimal method of diagnosis and management remains controversial.

Purpose: Acquired hypoganglionosis or aganglionosis after surgery for Hirschsprung's disease is a littler described situation. To investigate and describe the mechanism of acquired aganglionosis or hypoganglionosis following sugery in the pulled-through bowel which had been previously confirmed as ganglionated. Case report: A full-term boy initially presented with polymalformatif syndrome and dwarfism. The symptoms started at birth with abdominal distension and failure to pass meconium in the first 48 hours of life which was relieved by the use of a rectal tube. At the age of 4 months he developed abdominal distention and acute bowel obstruction. He was operated on and during surgery a narrow distal recto-sigmoid transition zone was found. A diverting right transverse colostomy was done. A barium enema was done and showed a recto-sigmoid transition zone. A rectal biopsy suction was performed and showed aganglionic segment. At the age of 8 months, a Soave pull-through procedure was performed. Ganglion cells were documented in the pull-through segment. The recurrent symptom patterns of abdominal distention constipation, and failure to thrive developed. Another contrast enema was performed two years later and shows massive colonic dilation with a rectosigmoid zone of transition. A redo Soave pull-through was done. Histology concluded to a hypoganglionosis. The CD56 staining was positive confirming aganglionosis. After surgery and during follow-up the boy was in a good condition, without abdominal distention. Conclusion: The cause of acquired aganglionosis or hypoganglionosis could be secondary to destruction of neuroganglionic cells due to secondary hypoxemia. That's why this diagnosis should be considered when recurrent obstructive symptoms appear several months following pull-through for HD.

Artificial intelligence methods, especially deep learning, have seen increasing application in analysing personality and occupational data to identify individuals with psychological and neurological disorders. Currently, there is a great need for effectively processing mental healthcare with the integration of artificial intelligence such as machine learning and deep learning. The paper addresses the pressing need for accurate and efficient methods for diagnosing psychiatric disorders, which are often complex and multifaceted. By exploiting the power of convolutional neural networks (CNN), we propose a novel CNN-based natural language processing method without removing stop words for predicting psychiatric diagnoses capable of accurately classifying individuals based on their psychological data. Our proposal is based on keeping a richer linguistic and semantic context to accurately predict psychiatric diagnosis. The experiment involves two datasets: one gathered from a private clinic and the other from Kaggle, called the Human Stress Dataset. The outcomes from the first dataset demonstrate a remarkable accuracy rate of 98.51% when employing CNN, showcasing their superior performance compared to the standard machine learning techniques such as logistic regression, k-nearest neighbours and support vector machines. With the second dataset, our model achieved an impressive area under the receiver operating characteristic curve (AUROC) of 0.87. This result surpasses those achieved by existing state-of-the-art methods, further highlighting the efficacy of our CNN-based approach in discerning subtle nuances within the data and making accurate predictions. Moreover, we have compared our model with three other programs on the same dataset and the accuracy reached 78.52%. The results are promising to aid parents or clinicians in early and rapidly predicting the ill individual.

Over the past two decades, there has been a growing interest in the role of universities in developing generic skills, in addition to disciplinary ones, to help students adapt to a changing workplace. The need to develop these skills is particularly critical for healthcare students who must face challenges in health systems. This scoping study, following Arksey and O'Malley's ([2005]. Scoping studies: Towards a methodological framework. "International Journal of Social Research Methodology, 8"(1), 19-32. https://doi.org/10.1080/1364557032000119616) method provides an overview of the scientific literature on generic skills in health studies. The definitions, categorizations, and measurement tools from 43 articles were mapped and summarized and gaps were identified. Definitions and terms were varied but overall, generic skills are considered cross-disciplinary and cross-professional. Nevertheless, the term skill itself was not defined. The lack of consensus on categorization and assessment led us to propose a typology to group all the skills mentioned into four categories: personal, ideas and object-related, interpersonal and community-related skills. One conclusion is that generic skills are valued foremost in relation to labor market demands with an emphasis on skills such as knowledge, communication, and planning over ethical and citizenship skills that are essential for future healthcare professionals. It is imperative to consider generic skills that are necessary to face the complex challenges of today's world.

The title compound, [Zn2(C6H8O4)2(C10H9N3)2]·3H2O or {Zn2[(C5H4N)2NH]2[μ-(CH2)4(COO)2]2}·3H2O, was separated from the solvothermal reaction of zinc(II) sulfate heptahydrate, 2,2′-dipyridylamine and sodium adipate. The dinuclear metal complex has a centrosymmetric structure, with the ZnII atom adopting a highly distorted octahedral coordination sphere composed of four oxygen atoms from bridging adipato ligands and two pyridine nitrogen atoms. In the crystal, the title compound aggregates into a tri-periodic supramolecular structure through intermolecular hydrogen-bonding networks of the form O—H...O and N—H...O.

The title coordination polymer, [Co(N3)2(C9H8N2)]n, was synthesized solvothermally. The CoII atom exhibits a distorted octahedral [CoN6] coordination geometry with a bidentate 8-aminoquinoline ligand and four azide ligands. Bridging azide ligands result in chains extending along [100]. N—H...N hydrogen bonds join the chains to give an extended structure with sheets parallel to (002).

Through a qualitative research with in-depth interviews with Tunisian travellers and netnography on travel related blogs, we aim to investigate how connected technologies modified imaginaries in the travel experience through the (non)sharing behaviour. Findings demonstrate a related expressed paradoxical behaviour swinging between 'self-promotion' and 'evil eye': the former being the desire to be socially visible and included, and the latter is the fear of being jinxed by others. Accordingly, we identify five different travellers' profiles. We conclude that paradoxical social imaginaries of both worldviews can coexist within the travel experience, leading to an incredible complexity and a continuous oscillation between both. [ABSTRACT FROM AUTHOR]

Introduction/purpose: The aim of the paper is to prove the existence of solutions for a special case of the sixth-order boundary value problem. Methods: The Leray-Schauder fixed point theorem is used in order to determine lower and upper bound solutions. Results: Lower and upper bound solutions have been found. Conclusions: The sixth-order boundary value problem admits solutions.

The Emergency Department (ED) plays an important role in the healthcare field, due to the nature of the services it provides, especially for patients with urgent cases. Therefore, good management of ED is very important in improving the quality of services. Good management depends on the effective use of material and human resources. One of the most common problems that the ED suffers from is the long waiting period and the length of the patient’s stay. Many researchers have proposed many solutions to reduce waiting time and length of stay (LOS). One of the best solutions for resource optimization is modeling and simulation based on inputs such as patient length of stay and door-to-doctor time (DTDT). In this study, the ED was modeled using a Coloured Petri Net, and to determine the number of resources needed, genetic algorithms were used. This study was conducted in the ED of Hassani Abdelkader Hospital in Sidi Bel Abbes, and several simulation models were evaluated, which reduced the waiting time and the length of stay for the patient.

This paper summarizes the arguments and counterarguments within the scientific discussion on the issue of electronic advertising in Saudi Arabia. The main purpose of this research is to explore the impact of internet advertising on companies’ visits to stores through an exploratory study. The systematization of literary sources and approaches for solving electronic advertising problems indicates that new mediating and moderating variables could have an impact on the relation between Internet advertising and visits to stores. In this research, the disposition to visit the point of sale is assimilated as a mediating construct rather than an implication with the product as a moderating variable. The relevance of this scientific problem decision is that this investigation of the consequences of electronic advertising for offline customer comportment in Saudi Arabia is unprecedented research that seeks to address this interesting question. The investigation of the role of online advertising and the impact of mediating and moderating variables on the visit to the store in the paper was carried out in the following logical sequence: the data were collected via an electronic survey. Of the 500 randomly selected Internet users in Saudi Arabia, only 350 responses were valid. This research used a structural equation model and multigroup analysis to examine the direct and indirect influences of variables. This paper presents the results of an empirical analysis that revealed a positive relation between internet advertising and visits to points of sale. The disposition to visit the point of sale mediates the relationship between Internet advertising and concrete visits to the store. The effect of the product moderates the effect of internet advertising on the disposition to visit the point of sale in Saudi Arabia. The research empirically confirms and theoretically proves that Saudi shoppers fine online advertising to be attractive when this advertising must have some actions and concepts flash. Therefore, Saudi directors should follow this form and use an effective mixture of content and animation. The e-shoppers who are involved are persons who have little engagement; for this reason, they are simply concerned about the tools of the publicity communication.

Since the primitive ages, the vegetal world has contained a vast array of species, generating various biologically active compounds with diverse chemical frameworks. Throughout the centuries, medicinal and aromatic plants maintained their importance, and the interest in these herbs has been continuously growing leading to the significant promise for their application in therapeutic medicine, destined to overcome many difficult illnesses and considered important reservoirs of drug candidates and primary compounds. This review aimed to examine and give an outline of Juniperus oxycedrus which is regarded as among the plant species that have many biological activities and contains many valuable bioactive compounds, forming a huge interest for researchers. We studied the ethnobotany, phytochemistry, chemical applications, pharmacological, and food control properties of Juniperus oxycedrus to help provide easier access to information for future and potential research. Ethnobotanical inspection revealed the utilization of Juniperus oxycedrus for addressing various health conditions, while the pharmacological investigations indicated that Juniperus oxycedrus demonstrated noteworthy diabetic suppression, redox damage-reducing, inflammation-inhibiting, germ-fighting, cell growth-regulating, antibacterial, and antiviral properties. Supplementary research should focus on its phytochemical composition, and thorough exploration is needed to confirm its potential as a food preservative and its clinical potential in the observed therapeutic effects.

This current research explores the health benefits of pink pepper (Schinus terebinthifolius Raddi) leaves linked to damage associated with diabetes in diabetic mice. An interesting increase in blood glycemia, total cholesterol, low-density lipoprotein, hepatic malondialdehyde (MDA), peroxide (H2O2), and renal advanced glycated end products (AGE) in comparison with the non-diabetic mice was observed. Additionally, a decrease in the high-density lipoprotein cholesterol level and antioxidant enzymes namely catalase, glutathione reductase, glutathione peroxidase, as well as superoxide dismutase in mice with hyperglycemia was appreciated, as well. The treatment with Schinus terebinthifolius Raddi methanolic extract (STME) from leaves (150 and 250 mg kg−1) for 21 days reduced markedly blood glucose, TC, LDL, hepatic malondialdehyde (MDA), H2O2 and AGE levels in kidneys of mice with abnormally glucose level; it elevated serum HDL degree and boosted the activity of hepatic redox-regulating enzymes in diabetic mice. These findings exhibit the capacity of the STME to mitigate diabetes-related hyperglycemia. The data proposed that the administration of Schinus terebinthifolius Raddi leaves extract can be useful in preventing alterations and dysfunction caused by glycation, oxidative stress, and hyperlipidemia in the pathology of diabetes. The overall results imply that phytochemical compounds of Schinus terebinthifolius Raddi leaves may represent a promising therapeutic opportunity in the search for new anti-diabetic treatments.

AbstractThis research endeavors to explore the impact of entrepreneurial coaching on the performance of start-ups. Employing a quantitative research methodology, data were gathered through a questionnaire-based survey. Analysis of the data was conducted using SmartPLS (Partial Least Squares) software, allowing for the assessment of discriminant validity and testing our conceptual model. The outcomes of this investigation present compelling evidence supporting the notion that entrepreneurial coaching significantly influences the performance of recently established businesses. Findings from this study contribute significantly to enhancing our comprehension of the intricate relationship between coaching, entrepreneurial support, and the outcomes of new business creation. The results reveal a substantive connection between the provision of entrepreneurial support and the positive performance outcomes of newly formed enterprises. These findings carry practical implications for various stakeholders invested in fostering the growth of start-ups. Entrepreneurs can gain valuable insights into the positive impact of receiving coaching, encouraging them to seek and leverage such support. Support organizations can use these findings to refine their strategies and tailor their coaching programs to optimize outcomes for new businesses. Policymakers can benefit from understanding the tangible benefits of entrepreneurial coaching, informing the development of policies that foster a conducive environment for start-up success.

Employing vision-based hand gesture recognition for the interaction and communication of disabled individuals is highly beneficial. The hands and gestures of this category of people have a distinctive aspect, requiring the adaptation of a deep learning vision-based system with a dedicated dataset for each individual. To achieve this objective, the paper presents a novel approach for training gesture classification using few-shot samples. More specifically, the gesture classifiers are fine-tuned segments of a pre-trained deep network. The global framework consists of two modules. The first one is a base feature learner and a hand detector trained with normal people hand’s images; this module results in a hand detector ad hoc model. The second module is a learner sub-classifier; it is the leverage of the convolution layers of the hand detector feature extractor. It builds a shallow CNN trained with few-shot samples for gesture classification. The proposed approach enables the reuse of segments of a pre-trained feature extractor to build a new sub-classification model. The results obtained by varying the size of the training dataset have demonstrated the efficiency of our method compared to the ones of the literature.

Environmental toxins, particularly liposoluble compounds that accumulate in adipose tissues, present a risk for newborns, not only through breastfeeding but also through artificial milks. These compounds pass into breast milk, potentially exposing infants to harmful substances. In a monocentric observational study carried out in the Charleroi region, we employed liquid chromatography coupled with mass spectrometry to analyze the presence of environmental toxins in milk for newborns. Out of 39 breast milk and 12 artificial milk samples analyzed, 15 and six contained at least one pesticide, respectively, with nine different pesticides identified from a panel of 54 substances tested. The study found an association between the consumption of fresh produce and a higher presence of pesticides in breast milk. This.highlights the broader issue of environmental toxin exposure for infants, regardless of the feeding method. The results underline the need for a comprehensive approach when considering the establishment of breast milk banks and the safety of artificial milk, especially in the context of potential risks to premature newborns. Our findings not only validate the analysis technique for detecting toxins in breast milk but also suggest the necessity for a larger prospective study to explore these risks in the future.

Background & Objectives American foulbrood (AFB), caused by the highly virulent, spore-forming bacterium Paenibacillus larvae, poses a significant threat to honey bee brood. The widespread use of antibiotics not only fails to effectively combat the disease but also raises concerns regarding honey safety. The current computational study was attempted to identify a novel therapeutic drug target against P. larvae, a causative agent of American foulbrood disease in honey bee. Methods We investigated effective novel drug targets through a comprehensive in silico pan-proteome and hierarchal subtractive sequence analysis. In total, 14 strains of P. larvae genomes were used to identify core genes. Subsequently, the core proteome was systematically narrowed down to a single protein predicted as the potential drug target. Alphafold software was then employed to predict the 3D structure of the potential drug target. Structural docking was carried out between a library of phytochemicals derived from traditional Chinese flora (n > 36,000) and the potential receptor using Autodock tool 1.5.6. Finally, molecular dynamics (MD) simulation study was conducted using GROMACS to assess the stability of the best-docked ligand. Results Proteome mining led to the identification of Ketoacyl-ACP synthase III as a highly promising therapeutic target, making it a prime candidate for inhibitor screening. The subsequent virtual screening and MD simulation analyses further affirmed the selection of ZINC95910054 as a potent inhibitor, with the lowest binding energy. This finding presents significant promise in the battle against P. larvae. Conclusions Computer aided drug design provides a novel approach for managing American foulbrood in honey bee populations, potentially mitigating its detrimental effects on both bee colonies and the honey industry.