Comparison of Verbal Explanations, Graphics, and Film Presentations for Increasing Parental Satisfaction with Lumbar Puncture Performance in Children with Febrile Seizure

AbstractObjective: The present study aimed to determine the effect of training parents by film, poster or graphics, and verbal explanation, on the enhancement of their satisfaction with the performance of this procedure.Materials and Methods: This cross-sectional quasi-experimental study was conducted on the children with febrile seizures referred to the Emergency and Pediatric Wards of hospitals affiliated with Mashhad University of Medical Sciences. They were LP candidates; nonetheless, their parents did not consent to the performance of this procedure. The children were randomly assigned to three groups. In the first group, videos of the location and method of LP were presented to the parents. The second group received this information via posters, and the parents in the third group were given a verbal explanation. Results: The children included 49 (4.54%) females with a mean age of 15 months. There was a significant relationship between the reason for parental refusal of LP and their final satisfaction (P=0.022). There was a significant relationship between parents' satisfaction with the performance of LP and their education (P=0.029). The film method had the lowest chance of success, and the verbal explanation method enjoyed the most remarkable success in enhancing parental satisfaction (P= 0.013).Conclusion: Although the use of posters and videos was less effective than verbal explanation, it increased the satisfaction of LP in some parents. In fact, it is more beneficial to try to alter parental misperceptions of LP in non-emergency situations

Multigene Next-Generation Sequencing Panel Identifies Pathogenic Variants in Patients with Unknown Subtype of Epidermolysis Bullosa: Subclassification with Prognostic Implications

Purpose: Epidermolysis bullosa (EB), the prototype of heritable blistering diseases, is caused by mutations in as many as 19 distinct genes. In this study, we evaluated the molecular basis of EB in 93 families, many of them of unknown subtype. Methods: A next generation sequencing panel covering 21 EB-related genes was developed, and mutation profiles, together with clinical features, were used to classify the patients into distinct clinical categories. Results: A total of 72 pathogenic or likely pathogenic variants in 68 families were identified in 11 of the EB-associated candidate genes, most of them (75%) being homozygous consistent with considerable consanguinity in the cohort. Approximately half of the mutations (48.6%) were previously unreported. Refined analysis of the types of mutations with addition of variants of unknown significance suspected of causing clinically consistent disease in several patients allowed subclassification of patients into different subcategories of EB in 76 of 91 families, with prognostic implications. A genetically challenging case with homozygous loss-of-function pathogenic mutations in two different EB-associated genes resulting in different subtypes was identified. In addition, secondary findings included identification of known pathogenic variants in DSP associated with arrhythmogenic right ventricular cardiomyopathy. Conclusion: Utilization of next generation sequencing panel of EB-associated genes allowed diagnostic subclassification in the neonates particularly in families of unknown subtype, with prognostication of the overall long-term outcome of the disease

Comparative evaluation of fracture and defect in reciproc and rotary files in severe curved root canals

Introduction: Root canal instrumentation is an important phase in root canal therapy. Since success in endodontic treatment depends on file defect and fracture, the aim of this study was to compare the evaluation of defect and fracture in rotary and reciproc files in severe curved root canals. Materials &Methods: In this experimental study, 60 mesial canals of human closed apex molars with more than 30° canal curvature were randomly divided into two groups. In first group M-two rotary files number# 15, 20, and 25 and in second group R25 reciproc file were used for filing, respectively. A ×8 magnifier was applied to evaluate the defect or fracture presence in each side and if it were observed, a new file would be replaced. Therefore, the number of prepared canals with each file and fractured or defective files and the place of fracture in root canal were recorded. Kaplan Meier curve and log rank test were done by using SPSS v.22. Results: In rotary group, seven and two files were fractured and defected, respectively and four files were fractured and no defect was observed in reciproc group. Although the mean of the number of prepared canals until fracture or defect in rotary and reciproc groups was 3.3 and 7.06, respectively, there were no significant differences between two systems. All file’s fractures occurred in apical regions. Conclusion: The results showed that there was no significant difference in defects or fractures of rotary and reciproc systems. Reciproc instruments can be more effective than rotary ones because the root canal preparation in rotary instruments is longer than in reciproc system

Brain tumor segmentation based on deep learning and an attention mechanism using MRI multi-modalities brain images

Brain tumor localization and segmentation from magnetic resonance imaging (MRI) are hard and important tasks for several applications in the field of medical analysis. As each brain imaging modality gives unique and key details related to each part of the tumor, many recent approaches used four modalities T1, T1c, T2, and FLAIR. Although many of them obtained a promising segmentation result on the BRATS 2018 dataset, they suffer from a complex structure that needs more time to train and test. So, in this paper, to obtain a flexible and effective brain tumor segmentation system, first, we propose a preprocessing approach to work only on a small part of the image rather than the whole part of the image. This method leads to a decrease in computing time and overcomes the overfitting problems in a Cascade Deep Learning model. In the second step, as we are dealing with a smaller part of brain images in each slice, a simple and efficient Cascade Convolutional Neural Network (C-ConvNet/C-CNN) is proposed. This C-CNN model mines both local and global features in two different routes. Also, to improve the brain tumor segmentation accuracy compared with the state-of-the-art models, a novel Distance-Wise Attention (DWA) mechanism is introduced. The DWA mechanism considers the effect of the center location of the tumor and the brain inside the model. Comprehensive experiments are conducted on the BRATS 2018 dataset and show that the proposed model obtains competitive results: the proposed method achieves a mean whole tumor, enhancing tumor, and tumor core dice scores of 0.9203, 0.9113 and 0.8726 respectively. Other quantitative and qualitative assessments are presented and discussed

AMPNet: Attention as Message Passing for Graph Neural Networks

Graph Neural Networks (GNNs) have emerged as a powerful representation learning framework for graph-structured data. A key limitation of conventional GNNs is their representation of each node with a singular feature vector, potentially overlooking intricate details about individual node features. Here, we propose an Attention-based Message-Passing layer for GNNs (AMPNet) that encodes individual features per node and models feature-level interactions through cross-node attention during message-passing steps. We demonstrate the abilities of AMPNet through extensive benchmarking on real-world biological systems such as fMRI brain activity recordings and spatial genomic data, improving over existing baselines by 20% on fMRI signal reconstruction, and further improving another 8% with positional embedding added. Finally, we validate the ability of AMPNet to uncover meaningful feature-level interactions through case studies on biological systems. We anticipate that our architecture will be highly applicable to graph-structured data where node entities encompass rich feature-level information.Comment: 16 pages (12 + 4 pages appendix). 5 figures and 7 table

Field Quantization for Radiative Decay of Plasmons in Finite and Infinite Geometries

We investigate field quantization in high-curvature geometries. The models and calculations can help with understanding the elastic and inelastic scattering of photons and electrons in nanostructures and probe-like metallic domains. The results find important applications in high-resolution photonic and electronic modalities of scanning probe microscopy, nano-optics, plasmonics, and quantum sensing. Quasistatic formulation, leading to nonretarded quantities, is employed and justified on the basis of the nanoscale, here subwavelength, dimensions of the considered domains of interest. Within the quasistatic framework, we represent the nanostructure material domains with frequency-dependent dielectric functions. Quantities associated with the normal modes of the electronic systems, the nonretarded plasmon dispersion relations, eigenmodes, and fields are then calculated for several geometric entities of use in nanoscience and nanotechnology. From the classical energy of the charge density oscillations in the modeled nanoparticle, we then derive the Hamiltonian of the system, which is used for quantization. The quantized plasmon field is obtained and, employing an interaction Hamiltonian derived from the first-order perturbation theory within the hydrodynamic model of an electron gas, we obtain an analytical expression for the radiative decay rate of the plasmons. The established treatment is applied to multiple geometries to investigate the quantized charge density oscillations on their bounding surfaces. Specifically, using one sheet of a two-sheeted hyperboloid of revolution, paraboloid of revolution, and cylindrical domains, all with one infinite dimension, and the finite spheroidal and toroidal domains are treated. In addition to a comparison of the paraboloidal and hyperboloidal results, interesting similarities are observed for the paraboloidal domains with respect to the surface modes and radiation patterns of a prolate spheroid, a finite geometric domain highly suitable for modeling of nanoparticles such as quantum dots. The prolate and oblate spheroidal calculations are validated by comparison to the spherical case, which is obtained as a special case of a spheroid. In addition to calculating the potential and field distributions, and dispersion relations, we study the angular intensity and the relation between the emission angle with the rate of radiative decay. The various morphologies are compared for their plasmon dispersion properties, field distributions, and radiative decay rates, which are shown to be consistent. For the specific case of a nanoring, modeled in the toroidal geometry, significant complexity arises due to an inherent coupling among the various modes. Within reasonable approximations to decouple the modes, we study the radiative decay channel for a vacuum bounded single solid nanoring by quantizing the fields associated with charge density oscillations on the nanoring surface. Further suggestions are made for future studies. The obtained results are relevant to other material domains that model a nanostructure such as a probe tip, quantum dot, or nanoantenna

Plasmon Dispersion in a Multilayer Solid Torus in Terms of Three-Term Vector Recurrence Relations and Matrix Continued Fractions

Toroidal confinement, which has played a crucial role in magnetized plasmas and Tokamak physics, is emerging as an effective means to obtain useful electronic and optical response in solids. In particular, excitation of surface plasmons in metal nanorings by photons or electrons finds important applications due to the engendered field distribution and electromagnetic energy confinement. However, in contrast to the case of a plasma, often the solid nanorings are multilayered and/or embedded in a medium. The non-simply connected geometry of the torus results in surface modes that are not linearly independent. A three-term difference equation was recently shown to arise when seeking the nonretarded plasmon dispersion relations for a stratified solid torus (Garapati et al 2017 Phys. Rev. B 95 165422). The reported generalized plasmon dispersion relations are here investigated in terms of the involved matrix continued fractions and their convergence properties including the determinant forms of the dispersion relations obtained for computing the plasmon eigenmodes. We also present the intricacies of the derivation and properties of the Green\u27s function employed to solve the three term amplitude equation that determines the response of the toroidal structure to arbitrary external excitations

Developing “Family Integrated Treatment” for Autistic Disorders and Comparing its Efficacy on Decreasing Parenting Stress of Parents of Autistic Children with “Little Bird” Method

Introduction: Autism is one of the most famous neuro-developmental disorders and increases parental stresses. On the other hand, decrease of parental stress has positive effect on child response to treatment. So, the main goal of this study was to develop a family education program for parents of children with autism, which is effective on decreasing their parental stress. Materials and Methods: The first part of the study was a qualitative research of three categories of information resulted from deep interviews with 11 specialists, semi-structured interviews with 30 parents and review of 101 articles. The second part was an experimental research on two intervention, and one control groups, with three examination stages: before, after and one-month fallow-up. To fulfill this goal, 42 parents were selected from the parents of autistic children who received services in Tehran Autism Center, Iran, during the study period, and then, were divided randomly to tree groups. The material used for this section of study was Parental Stress Index (PSI). The results were analyzed using covariate analysis and analysis of variance techniques via SPSS20 software. Results: Our family integrated treatment method for autistic disorders was more efficient on decreasing reinforcing (P = 0.032), mood (P = 0.010), acceptability (P = 0.013), and adaptability (P = 0.004), and total score of child stress (P = 0.004). In addition, it showed significant effect on competence (P = 0.002), depression (P = 0.001), social isolation (P = 0.002), attachment (P < 0.001), role restriction (P =0.001), parental health (P = 0.003), and total score of parental stress (P < 0.001), and also on PSI-total score (P < 0.001), in comparison with 2 other groups. Conclusion: In comparison with previous parental training programs like little bird program which mostly focuses on stress of child domain, family integrated treatment method pays attention to special needs of every single family and its comprehensiveness; and is effective on decreasing parental domain of stress as well