Relationship between Pneumonia and the Thymus Gland in Children with COVID-19: A Volumetric Computed Tomography Study

Objective Many studies showed that less-severe disease symptoms and fewer mortality rates have been reported in pediatric novel coronavirus disease 2019 (COVID-19) patients. In this study, we aimed to reveal the relationship between the volume of thymus gland, which provides T lymphocyte maturation in children, with the severity of lung involvement and blood laboratory values in pediatric patients with COVID-19 infection. Methods Thymus density and thymus and cardiac volumes were measured in pediatric COVID-19 patients and a control group that underwent thoracic tomography for reasons other than infection. Thymus/heart ratios were calculated to index the thymus volumes of the patients to their body dimensions. The severity of pneumonia was demonstrated by proportioning the involved lung parenchymal volume to the total lung volume in patients with typical involvement in thoracic tomography. The relationship between volumetric and blood laboratory values was statistically evaluated. Results Thymus density (p = 0.015) and thymus/heart ratio (p = 0.04) significantly differed between patients with COVID-19 infection and the control group. A correlation was observed between the pneumonia involvement rate and C-reactive protein (CRP) (k: 0.451, p = 0.08) and white blood cell (WBC; k: 0.419, p = 0.015) values in the thoracic tomography of the COVID-19 group. Conclusion The thymus gland is enlarged as an indicator of activation in COVID-19 infection. We hope that our study will guide new studies on the prognostic value of thymus size in lymphopenic patients with severe disease.

The accidentology of sport in France through the prism of the legitimacy theory: A first multilevel quantitative approach

In many so-called developed countries, participation to at least one physical activity or sport is a mass phenomenon. More, the combination of a high involvement rate and omnivorousness/voraciousness results in a very high volume of practice and lead to a significant volume of accidents. Academic studies have shown the importance of socio-demographic characteristics, such as age and sex, the mode of practice and the physical activity or sport itself in the occurrence of accidents. However, it is also necessary to take into account certain cultural dimensions of investment in sport, and more particularly the legitimate definition of risk specific to each activity. Since commitment and risk-taking are characteristic of young men, we tested the hypothesis that there are more accidents in physical activity or sports in which young men are statistically over-represented. This study evaluated this hypothesis using a sample of 29,000 reported physical activity or sports for a sample of 7,424 practitioners (national survey of the Ministry of Sports in France, people aged 15 and over). We used a multilevel cross classified logistic regression. The results show first a strong effect of the variable concerning the overrepresentation of young men in a physical activity or sport. Secondary, other results are more usual with the effect of modes of practice involved (high frequency, club and competition) and of the physical activity or sport itself (example of alpine skiing) and a single sociodemographic characteristic (the under 30 yo). Conversely, some results are more original, showing the non-effect of sex taken independently. These results provide essential information for taking into account the cultural dimension in sport-related prevention and for the management of the teams responsible for administering it.

Sacroiliitis in children and adolescents with familial Mediterranean fever

Background Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent episodes of fever and serositis. Sacroiliitis can be observed in some FMF patients. This study aimed to compare the demographic, clinical, and laboratory findings, and treatment in children with FMF and sacroiliitis, and children with juvenile spondyloarthropathy (JSpA). Methods In total, 1687 pediatric FMF patients that were followed-up between May 2010 and June 2020 were evaluated retrospectively. Among them, those with sacroiliitis (n = 63) were included in the study and compared to patients with JSpA (n = 102). Results The study included 63 FMF patients with sacroiliitis (38 males [60.3%] and 25 females [39.7%]) with a mean age of 15.2 ± 4.1 years. Mean age at symptom onset was 7.2 ± 5.05 years and mean age at diagnosis was 9.74 ± 4.67 years. The most common mutation in the FMF patients was M694V/M694V (n = 22). Patients were diagnosed with sacroiliitis with a mean of 12 months (range: 6–36 months) after the diagnosis of FMF. Among the FMF patients, 28 (44.4%) had enthesitis, 23 (36.5%) had heel pain, and 11 (17.4%) had low back pain. The study also included 102 JSpA patients (90 males [88.2%] and 12 females [11.8%]). Mean age of patients with JSpA was 16.1 ± 2.8 years. As compared to 102 JSpA patients, patients with FMF and sacroiliitis had higher acute phase reactants, whereas HLA-B27 positivity rate was lower. In addition, axial involvement rate was higher in the JSpA patients. Conclusion Sacroiliitis is a common co-morbidity in FMF patients. The phenotypic features of these patients are different from patients with JSpA.

Evaluation of Robot Professor Technology in Teaching and Business

In this paper the Robot technology development will be evaluated in teaching and business. Impacts hypothesis of robot’s applications are discussed in addition to the types of the robots with time line. The results of this study show the advantages and disadvantages of using the Robot teacher in classroom and business and it shows that the Robot teacher performance is not like the human teacher due to the senses that owned by human being. Robot impacts minimizes the employment worldwide and it is predicted that around 800 million of global workers will lose their jobs in 2030. The results show that impacts hypothesis is minimized through improving the performance of robot technology by using AI Artificial Intelligence, also the Robot applications in the global health system have contributed effectively and successfully to prevention of the spread of the coronavirus pandemic. The Sophia Robot with AI improvements, behaves with good feelings, senses and debating friendly and it is approved by UNDP on 2018. In this study, it is concluded that the robot is not like human being, although developing human-like robot is still out of reach. Also, AI is the best tool for enhancing the Robot technology and increase the employment involvement rate in near future, which is one of the future challenges and studies proposed in this research, industry 4.

Orbitopalpebral and ocular sarcoidosis: what does the ophthalmologist need to know

Sarcoidosis is a chronic multisystemic disease of unknown aetiology, characterised by non-caseating granulomas. Ocular involvement rate ranges from 30% to 60% among individuals with sarcoidosis, and can vary widely, making the diagnosis a challenge to the ophthalmologist. Cutaneous manifestations occur in about 22% of sarcoidosis cases, but eyelid involvement is rare. Eyelid swelling and nodules are the most frequent forms of eyelid involvement, but other findings have been reported. The joint analysis of clinical history, ancillary exams and compatible biopsy is needed for the diagnosis, as well as the exclusion of other possible conditions. This review aims to describe the different forms of presentations, the clinical reasoning and treatment options for ocular, eyelid and orbital sarcoidosis.

Robotic pancreaticoduodenectomy provides better histopathological outcomes as compared to its open counterpart: a meta-analysis

The aim of this meta-analysis was to evaluate whether robotic pancreaticoduodenectomy (PD) may provide better clinical and pathologic outcomes compared to its open counterpart. The Pubmed, EMBASE, and Cochrane Library were systematically searched. Overall postoperative morbidity and resection margin involvement rate were the primary endpoints. Secondary endpoints included operating time, estimated blood loss (EBL), incisional surgical site infection (SSI) rate, length of hospital stay (LOS), and number of lymph nodes harvested. Twenty-four studies totaling 12,579 patients (2,175 robotic PD and 10,404 open PD were included. Overall postoperative mortality did not significantly differ [OR (95%CI) = 0.86 (0.74, 1.01); p = 0.06]. Resection margin involvement rate was significantly lower in robotic PD [15.6% vs. 19.9%; OR (95%CI) = 0.64 (0.41, 1.00); p = 0.05; NNT = 23]. Operating time was significantly longer in robotic PD [MD (95%CI) = 75.17 (48.05, 102.28); p < 0.00001]. EBL was significantly decreased in robotic PD [MD (95%CI) = − 191.35 (− 238.12, − 144.59); p < 0.00001]. Number of lymph nodes harvested was significantly higher in robotic PD [MD (95%CI) = 2.88 (1.12, 4.65); p = 0.001]. This meta-analysis found that robotic PD provides better histopathological outcomes as compared to open PD at the cost of longer operating time. Furthermore, robotic PD did not have any detrimental impact on clinical outcomes, with lower wound infection rates.

PsART-ID inception cohort: clinical characteristics, treatment choices and outcomes of patients with psoriatic arthritis

Objectives Our aim is to understand clinical characteristics, real-life treatment strategies, outcomes of early PsA patients and determine the differences between the inception and established PsA cohorts. Methods PsArt-ID (Psoriatic Arthritis- International Database) is a multicentre registry. From that registry, patients with a diagnosis of PsA up to 6 months were classified as the inception cohort (n==388). Two periods were identified for the established cohort: Patients with PsA diagnosis within 5–10 years (n = 328), ≥10 years (n = 326). Demographic, clinical characteristics, treatment strategies, outcomes were determined for the inception cohort and compared with the established cohorts. Results The mean (s.d.) age of the inception cohort was 44.7 (13.3) and 167/388 (43.0%) of the patients were male. Polyarticular and mono-oligoarticular presentations were comparable in the inception and established cohorts. Axial involvement rate was higher in the cohort of patients with PsA ≥10 years compared with the inception cohort (34.8% vs 27.7%). As well as dactylitis and nail involvement (P = 0.004, P = 0.001 respectively). Both enthesitis, deformity rates were lower in the inception cohort. Overall, 13% of patients in the inception group had a deformity. MTX was the most commonly prescribed treatment for all cohorts with 10.7% of the early PsA patients were given anti-TNF agents after 16 months. Conclusion The real-life experience in PsA patients showed no significant differences in the disease pattern rates except for the axial involvement. The dactylitis, nail involvement rates had increased significantly after 10 years from the diagnosis and the enthesitis, deformity had an increasing trend over time.

Tumor volume is more reliable to predict nodal metastasis in non-small cell lung cancer of 3 cm or less in diameter

Background In this study, we sought to evaluate the correlation between TV, GTD, and lymph node metastases in NSCLC patients with tumors ≤ 3.0 cm. Methods We retrospectively analyzed the relationship between the clinicopathologic variables and lymph node involvement in 285 NSCLC patients with tumors ≤ 3.0 cm who accepted curative surgical resection. The TVs were semi-automatically measured by a software and optimal cutoff points obtained using X-tile software. The relationship between GTD and TV were described using non-linear regression. The correlation between GTD, TV, and N stages were analyzed using the Pearson correlation coefficient. The One-Way ANOVA was used to compare the GTD and TV of different lymph node stage groups. Results The relationship between GTD and TV accorded with the exponential growth model:y = 0.113e1.455x (y = TV, x = GTD). TV for patients with node metastases (4.782.83 cm3) was significantly greater for those without metastases (3.572.62 cm3) (P<0.001). However, there were no obvious GTD differences in cases with or without lymph node metastases (P = 0.054). We divided all cases into three TV groups using the two cutoff values (0.9 cm3 and 3.9 cm3) and there was an obvious difference in the lymphatic involvement rate between the groups (P<0.001). The tendency to metastasize was greater with higher TV especially when the TV was >0.9–14.2 cm3 (P = 0.010). Conclusions For NSCLC tumors ≤ 3.0 cm, TV is a more sensitive marker than GTD in predicting the positive lymph node metastases. The likelihood for metastasis increases with an increasing TV especially when GTD is > 2.0–3.0 cm.

Modeling Impacts of Speed Reduction on Traffic Efficiency on Expressway Uphill Sections

Road geometric design is a key factor impacting driving safety and efficiency. In highway profile design, speed reduction is used to determine critical length of grade. Previous research generally concentrated on the relationship between speed reduction and crash involvement rate to establish the recommended value. Limited research results have been reported at this point concerning speed reduction and traffic efficiency. This study aims to fill the gap by investigating tolerable speed reduction with different vertical slopes considering traffic efficiency. Firstly, appropriate experimental sections were determined after field survey. Traffic data including vehicle count, timely speed, vehicle type, and headway time were then collected on an expressway in Shaanxi Province. The associated traffic efficiency was derived from traffic volume and average speed. After this, the modeling between speed reduction and traffic efficiency was processed with different slopes. The correlation between speed reduction and traffic efficiency was therefore verified. Finally, the prediction model of optimum speed reduction concerning traffic efficiency under different vertical slopes was introduced. It was found that the critical length of grade can be longer with traffic efficiency as the major design control incorporated with slopes of 3–3.5%. The existing regulation in critical length of grade at 3.5–5% can benefit both safety and efficiency. The findings can provide a reference for vertical alignment design, leading to high-efficiency road systems.

Conversion of Optic Neuritis to Relapsing Remitting Multiple Sclerosis: A Retrospective Comorbidity Cohort Study

Objective: The aim of the study was to determine the risk of multiple sclerosis (MS) conversion after optic neuritis (ON) and to identify the predictive factors on conversion in Turkish patients. Methods: Patients whose first clinical attacks had been ON were included in the study. The primary end point was the diagnosis of clinical relapse-remitting MS. Result: Except for the bilateral involvement rate, the clinical and demographic characteristics of the cohort are similar to Western studies. Though one-third of the patients with ON had bilateral involvement, bilateral involvement reduces the risk of conversion. Also, active lesions at the initial cranial magnetic resonance imagination increase the conversion rate. Conclusion: This research confirms previous findings and contributes additional evidence that if the patients have unilateral involvement and active lesions, they should be closely monitored. Moreover, our research supports the hypothesis that risk factors may be affected by racial, environmental, and genetic factors.