bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Computer Vision Syndrome and Personal Risk Factors among Employees of Commercial Bank of Ethiopia in Addis Ababa, Ethiopia
Authors: Derbew Haile , Nega Ansha , Tefera Worku , Zafu Tekie , Tsehaye Kenfe , Haile Kebede , Temesgen Belsity
Published: May 2021

Background. Computer vision syndrome (CVS) is an amalgam of visual symptoms caused by continued use of computers. Worldwide, up to 70 million workers are at risk for computer vision syndrome resulting in reduced productivity at work and reduced quality of life. Bank employees are among the risky workers with unknown magnitude of the syndrome. Therefore, the main aim of this study was to determine the prevalence of CVS and its associated personal factors among employees of Commercial Bank of Ethiopia. Methods. A total of three hundred and fifty-nine bank workers participated in the study between February and March 2018. A self-administered structured questionnaire was used to collect sociodemographic data, CVS symptoms, and its personal factors. Snellen chart tool was used to measure blurred vision. Data entry and analysis were performed via Epi Info™ 7 and Statistical Package for the Social Sciences (SPSS) version 21. Binary logistic regression and multivariable logistic regression were performed to assess the association and control the potential confounders. Result. The prevalence of computer vision syndrome in the last 12 months among the total study subjects, 359 (98% response rate), was 262 (74.6%) (95% confidence interval [CI] = 70.1, 79.5). Risk factors that could not be intervened with were sex (AOR: 1.8; 95% CI (1–3)) and age group (AOR: 3.11; 95% CI (1.2–8)). Causal factors that could be intervened with were use of electronic materials outside work (AOR: 3.11; 95% CI (1.15–8.36). Protective factor that could be intervened with was habit of taking a break (AOR: 0.44; 95% CI (0.3–0.8)). Conclusion and Recommendation. Three-fours of the employees were at risk. Sex, age, habit of taking a break, and use of electronic materials outside work environment were significantly associated with the presence of CVS. Remedial actions need to be considered at individual level.
Ordering of Transformed Recorded Electroencephalography (EEG) Signals by a Novel Precede Operator
Authors: Ahmad Fuad Amirul Aizad , Ahmad Tahir
Published: May 2021

Recorded electroencephalography (EEG) signals can be represented as square matrices, which have been extensively analyzed using mathematical methods to extract invaluable information concerning brain functions in terms of observed electrical potentials; such information is critical for diagnosing brain disorders. Several studies have revealed that certain such square matrices—in particular, those related to so-called “elementary EEG signals”—exhibit properties similar to those of prime numbers in which every square EEG matrix can be regarded as a composite of these signals. A new approach to ordering square matrices is pivotal to extending the idea of square matrices as composite numbers. In this paper, several ordering concepts are investigated and a new technique for ordering matrices is introduced. Finally, some properties of this matrix order are presented, and the potential applications of this technique to analyzing EEG signals are discussed.
Increased TNF-α Initiates Cytoplasmic Vacuolization in Whole Blood Coculture with Dengue Virus
Authors: Satria Rahmat Dani , Huang Tzu-Wen , Jhan Ming-Kai , Shen Ting-Jing , Tseng Po-Chun , Wang Yun-Ting , Yang Zhen-Yu , Hsing Chung-Hsi , Lin Chiou-Feng
Published: May 2021

During the acute febrile phase of dengue virus (DENV) infection, viremia can cause severe systemic immune responses accompanied by hematologic disorders. This study investigated the potential induction and mechanism of the cytopathic effects of DENV on peripheral blood cells ex vivo. At one day postinfection, there was viral nonstructural protein NS1 but no further virus replication measured in the whole blood culture. Notably, DENV exposure caused significant vacuolization in monocytic phagocytes. With a minor change in the complete blood cell count, except for a minor increase in neutrophils and a significant decrease in monocytes, the immune profiling assay identified several changes, particularly a significant reduction in CD14-positive monocytes as well as CD11c-positive dendritic cells. Abnormal production of TNF-α was highly associated with the induction of vacuolization. Manipulating TNF-α expression resulted in cytopathogenic effects. These results demonstrate the potential hematological damage caused by ex vivo DENV-induced TNF-α.
Algorithms for a Generalized Multipolar Neutrosophic Soft Set with Information Measures to Solve Medical Diagnoses and Decision-Making Problems
Authors: Zulqarnain Rana Muhammad , Garg Harish , Siddique Imran , Ali Rifaqat , Alsubie Abdelaziz , Hamadneh Nawaf N. , Khan Ilyas
Published: May 2021

The aim of this paper is to propose the generalized version of the multipolar neutrosophic soft set with operations and basic properties. Here, we define the AND, OR, Truth-Favorite, and False-Favorite operators along with their properties. Also, we define the necessity and possibility of operations for them. Later on, to extend it to solve the decision-making problems, we define some information measures such as distance, similarity, and correlation coefficient for the generalized multipolar neutrosophic soft set. Several desirable properties and their relationship between them are derived. Finally, based on these information measures, a decision-making algorithm is stated under the neutrosophic environment to tackle the uncertain and vague information. The applicability of the proposed algorithm is demonstrated through a case study of the medical-diagnosis and the decision-making problems. A comparative analysis with several existing studies reveals the effectiveness of the approach.
Prevalence of Gastrointestinal Helminthiasis in Horses and Donkeys of Hawassa District, Southern Ethiopia
Authors: Mathewos Mesfin , Girma Dawit , Fesseha Haben , Yirgalem Metages , Eshetu Eyob
Published: May 2021

Background. Gastrointestinal helminth parasite infection is a major influencing factor against the profitability of working equines all over the world. Methods. A cross-sectional study was conducted to determine the prevalence of gastrointestinal tract (GI) helminths and assess the associated risk factors in donkeys and horses in the Hawassa district. A total of 214 fecal samples were collected from randomly selected equines (112 donkeys and 102 horses) and examined for the presence of eggs of GI helminths using standard coprological techniques. Results. According to the current study, the prevalence of GI helminths in equine was 78.5% (168/214) and the highest prevalence was reported in donkeys 92% (103/112) as compared to horses 63% (65/102). Out of 168 positive samples, the different species of parasites were identified, namely, Strongyle species 120 (56.1%), Strongyloides westeri 76 (35.5%), Parascaris equorum 54 (25.2%), Anoplocephala perfoliata 34 (15.8%), Oxyuris equi 20 (9.3%), Fasciola hepatica 18 (8.8%), Gastrodiscus species 12 (5.6%), and Dictyocaulus arnfieldi 4 (1.8%). There was a strong association between the prevalence of GI helminths and factors such as the species of equine, body condition scores, and feed type (

p

 < 0.05). However, no significant association (

p

 > 0.05) was observed between the prevalence of GI helminths and putative risk factors such as age, sex, housing, and water source. The coproculture performed on 30 pooled fecal samples revealed that Cyathostomes species, Strongylus vulgaris, and Strongylus edentatus were the major helminth parasites of donkeys and horses. Conclusion. The frequency of gastrointestinal helminths in equine species was high, especially in donkeys. Hence, strategic deworming using broad-spectrum antihelminthic drugs and a rotational grazing program should be implemented to control and prevent the diseases.
The Preparation and Identification of Characteristic Flavour Compounds of Maillard Reaction Products of Protein Hydrolysate from Grass Carp (Ctenopharyngodon idella) Bone
Authors: Li Yunliang , Wang Xiaojing , Yang Xue , Ruan Siyu , Zhou Anqi , Huang Shanfeng , Ma Haile
Published: May 2021

This study aims at preparing the Maillard reaction products of protein hydrolysate from grass carp (Ctenopharyngodon idella) bone and identifying its characteristic flavour compounds. Meanwhile, bioactivities and amino acids composition of hydrolysates and its Maillard reaction products were compared with the thermal degradation reaction as one positive control. Single factor experiment was applied to optimize the enzymolysis parameters of grass carp bone protein using flavourzyme, under which the highest degree of hydrolysis (40.1%) was obtained. According to the response surface methodology, the top predicted value (70.45%) of degree of graft of Maillard reaction was obtained with initial pH of 7.07, temperature of 118.33°C, and time of 1.75 h. Moreover, the results of Maillard reaction products illustrated a significant increase in DPPH radical scavenging activity (p<0.05) compared to that of hydrolysate and its thermal degradation products, which was accompanied by the decreased ACE inhibitory activity. Besides, the umami-sweet taste amino acid ratio in free amino acids of Maillard reaction products climbed considerably compared to those of hydrolysate and its thermal degradation products, which proved that Maillard reaction is an effective way to improve the flavour taste of protein hydrolysate. The GC-MS results showed that 37, 40, and 62 kinds of volatile compounds were detected in hydrolysate, thermal degradation products, and Maillard reaction products, respectively. The Maillard reaction products contained more flavour volatile compounds of aldehydes, alcohol, ketone, pyrazine, and other compounds that contribute to pleasant aromas. These results suggested that the grass carp bone protein hydrolysate after Maillard reaction could potentially have a wide range of applications as antioxidant and flavour substances.
Research on Efficiency of Animation Enterprises Based on Two-Stage DEA Network System Model of Sharing Input Resources
Authors: Zhang Shuo , Yang Xuemei , Zhang Jian , Liao Mengjie , Qi Lin
Published: May 2021

This research constructs a two-stage DEA network system model of shared input resources to evaluate the efficiency of animation companies: the first-stage efficiency to reflect the production quantity and the second-stage efficiency to reflect the production quality of animation products, where the quality of animation products is judged based on the market recognition of the animation products. The overall efficiency in the research model is used to describe the development of animation enterprises. According to the result, it is concluded that the overall efficiency of the surveyed animation companies and the efficiency of each sub-stage have shown an upward trend, which is in line with the growth of the company's development.
Negative Video Capsule Endoscopy Had a High Negative Predictive Value for Small Bowel Lesions, but Diagnostic Capability May Be Lower in Young Patients with Overt Bleeding
Authors: Khamplod Sipawath , Limsrivilai Julajak , Kaosombatwattana Uayporn , Pausawasdi Nonthalee , Charatcharoenwitthaya Phunchai , Pongprasobchai Supot , Leelakusolvong Somchai
Published: May 2021

Background. Patients with potential small bowel bleeding (PSBB) who have negative results of video capsule endoscopy (VCE), clinical course, rate of rebleeding, and missed lesions with their predictors are essential for further management decision. Methods. This retrospective study included patients presenting with PSBB who had negative VCE findings between January 2008 and December 2016. All patients had to have at least two years of follow-up data to be included. Patients with <2 years of follow-up in their medical record were interviewed by telephone to determine if any unrecorded rebleeding episodes occurred. Results. One hundred forty-two patients were included. The mean age was 60.9 years, and 52.8% were male. Eighty-one patients presented with overt bleeding. The median duration of follow-up was 5.08 years. During the follow-up period, 30 patients experienced rebleeding. The cumulative rate of rebleeding at 1, 2, and 5 years was 10.0%, 14.3%, and 22.4%, respectively. Multivariate analysis showed nonsteroidal anti-inflammatory drugs (NSAIDs) and presentation of overt bleeding to be independent predictors of rebleeding. There were only nine small bowel lesions (6.3%) missed by VCE. These nine patients, compared with others, were significantly younger and tended to present with overt bleeding. Conclusion. Rebleeding was not uncommon in PSBB after negative VCE; however, the rate of missing small bowel lesions was low. Nonetheless, further investigations may be considered in young patients who present with overt bleeding.
Examining the Bus Ridership Demand: Application of Spatio-Temporal Panel Models
Authors: Rahman Moshiur , Yasmin Shamsunnahar , Faghih-Imani Ahmadreza , Eluru Naveen
Published: May 2021

An important tool to evaluate the influence of these public transit investments on transit ridership is the application of statistical models. Drawing on stop-level boarding and alighting data for the Greater Orlando region, the current study estimates spatial panel models that accommodate for the impact of spatial and temporal observed and unobserved factors on transit ridership. Specifically, two spatial models, Spatial Error Model and Spatial Lag Model, are estimated for boarding and alighting separately by employing several exogenous variables including stop-level attributes, transportation and transit infrastructure variables, built environment and land use attributes, and sociodemographic and socioeconomic variables in the vicinity of the stop along with spatial and spatiotemporal lagged variables. The model estimation results are further augmented by a validation exercise. These models are expected to provide feedback to agencies on the benefits of public transit investments while also providing lessons to improve the investment process.
Involvement of Dendritic Cells and Th17 Cells in Induced Tertiary Lymphoid Structures in a Chronic Beryllium Disease Mouse Model
Authors: KleinJan Alex , van Nimwegen Menno , Leman Karolina , Wen Ke-xin , Boon Louis , Hendriks Rudi W.
Published: May 2021

Rationale. Sarcoidosis is a systemic inflammatory disorder characterized by the presence of granulomas in various organs, most commonly in the lungs. Although the ethology is unknown, sarcoidosis is thought to be mediated by T helper (Th)1 and Th17 lymphocytes. Chronic airway exposure to beryllium metal leads to chronic beryllium disease (CBD), which shares similarities with pulmonary sarcoidosis. Objective. To study airway pathophysiology and the role of dendritic cells (DCs) and IL-17 receptor (IL-17R) signals in a mouse model for CBD. Methods. Here, we present a CBD mouse model in which mice were exposed to beryllium during three weeks. We also exposed IL-17R-deficient mice and mice in which DCs were depleted. Results. Eight weeks after the initial beryllium exposure, an inflammatory response was detected in the lungs. Mice displayed inflammation of the lower airways that included focal dense infiltrates, granuloma-like foci, and tertiary lymphoid structure (TLS) containing T cells, B cells, and germinal centers. Alveolar cell analysis showed significantly increased numbers of CD4+ T cells expressing IFNγ, IL-17, or both cytokines. The pathogenic role of IL-17R signals was demonstrated in IL-17R-deficient mice, which had strongly reduced lung inflammation and TLS development following beryllium exposure. In CBD mice, pulmonary DC subsets including CD103+ conventional DCs (cDCs), CD11b+ cDCs, and monocyte-derived DCs (moDCs) were also prominently increased. We used diphtheria toxin receptor-mediated targeted cell ablation to conditionally deplete DCs and found that DCs are essential for the maintenance of TLS in CBD. Furthermore, the presence of antinuclear autoantibodies in the serum of CBD mice showed that CBD had characteristics of autoimmune disease. Conclusions. We generated a translational model of sarcoidosis driven by beryllium and show that DCs and IL-17R signals play a pathophysiological role in CBD development as well as in established CBD in vivo.
Numerical Well Test Analysis of Condensate Dropout Effects in Dual-Permeability Model of Naturally Fractured Gas Condensate Reservoirs: Case Studies in the South of Iran
Authors: Safari-Beidokhti Mohsen , Hashemi Abdolnabi , Abdollahi Reza , Hematpur Hamed , Esfandyari Hamid
Published: May 2021

Naturally fractured reservoirs (NFR) represent an important percentage of worldwide hydrocarbon reserves and production. The performance of naturally fractured gas condensate reservoirs would be more complicated regarding both rock and fluid effects. In contrast to the dual-porosity model, dual-porosity/dual-permeability (dual-permeability) model is considered as a modified model, in which flow to the wellbore occurs through both matrix and fracture systems. Fluid flow in gas condensate reservoirs usually demonstrates intricate flow behavior when the flowing bottom-hole pressure falls below the dew point. Accordingly, different regions with different characteristics are formed within the reservoir. These regions can be recognized by pressure transient analysis. Consequently, distinguishing between reservoir effects and fluid effects is challenging in these specific reservoirs and needs numerical simulation. The main objective of this paper is to examine the effect of condensate banking on the pressure behavior of lean and rich gas condensate NFRs through a simulation approach. Subsequently, evaluation of early-time characteristics of the pressure transient data is provided through a single well compositional simulation model. Then, drawdown, buildup, and multirate tests are conducted to establish the condition in which the flowing bottom-hole pressure drops below the dew point causing retrograde condensation. The simulation results are confirmed through well test analysis in both Iranian naturally fractured rich and lean gas condensate fields. Interpretations of simulation analysis revealed that the richer gas is more prone to condensation. When the pressure drops below the dew point, the pressure derivative curves in the rich gas system encounter a more shift to the right, and the trough becomes more pronounced as compared to the lean one.
Gamification and Machine Learning Inspired Approach for Classroom Engagement and Learning
Authors: Duggal Kavisha , Gupta Lovi Raj , Singh Parminder
Published: May 2021

Technology has enhanced the scope and span of the teaching and learning process but somehow it could not enhance the self-motivation and engagement among the students to the same scale. The lack of self-motivation and intermittent engagement is one of the prime challenges faced by educators today. Perplexing tasks for the faculty are to embroil students during the lecture. This work paves new ways to scale up the enticement using artificial intelligence and machine learning. The intelligent framework proposed here is built on yet another novel methodology used globally for user engagement and is termed gamification. The primary objective of the present research work is to negate the issue of disengagement by designing and implementing a gamified framework on 120 students from higher education that will include student engagement, enticement, and motivation. Generally, mechanisms are designed for specific courses, whereas the gamified system proposed is an open-ended method irrespective of course and the program being studied, and this framework has endeavored on multiple courses. To enhance the utility of the gamified framework, ANFIS model is utilized for smart decision-making concerning rewards distribution that is directly proportional to the number of coins gained by the students. As an outcome, better participation of a group of students under the proposed intelligent gamified system is reported as compared to the control group thus endorsing the success of the model.
The Efficacy and Predictors of Using GPi-DBS to Treat Early-Onset Dystonia: An Individual Patient Analysis
Authors: Chen Wenxiu , Fan Houyou , Lu Guohui
Published: May 2021

Objective. To compare the efficacy in patients with different genotypes, identify the potential predictive factors, and summarize the complications of globus pallidus deep brain stimulation (GPi-DBS) treating early-onset dystonia. Methods. Three electronic databases (PubMed, Embase, and Cochrane databases) were searched with no publication data restriction. The primary outcomes were the improvements in Burke–Fahn–Marsden Dystonia Rating Scale motor (BFMDRS-M) and disability (BFMDRS-D) score. Pearson’s correlation coefficients and a metaregression analysis were used to identify the potential predictive factors. This article was registered in Prospero (CRD42020188527). Results. Fifty-four studies (231 patients) were included. Patients showed significant improvement rate in BFMDRS-M (60.6%,

p
<
0.001

) and BFMDRS-D (57.5%,

p
<
0.001

) scores after treatment with GPi-DBS. BFMDRS-M score improved greater in the DYT-1-positive (

p
=
0.001

) and DYT-11-positive (

p
=
0.008

) patients compared to DYT-6-positive patients. BFMDRS-D score improved greater in the DYT-11 (+) compared to DYT-6 (+) patients (

p
=
0.010

). The relative change of BFMDRS-M (

p
=
0.002

) and BFMDRS-D (

p
=
0.010

) scores was negatively correlated with preoperative BFMDRS-M score. In the metaregression analysis, the best predictive model showed that preoperative BFMDRS-M, disease duration (

p
=
0.047

), and the age at symptom onset (

p
=
0.027

) were important. Conclusion. Patients with early-onset dystonia have a significant effect after GPi-DBS treatment, and DYT-1 (+) and DYT-11 (+) patients are better candidates for GPi-DBS. Lower preoperative score, later age of onset, and an earlier age at surgery probably predict better clinical outcomes.
Design of an Adaptive Boost Energy-Saving Fuzzy Control System Driven by the Finite State Machine
Authors: Ren Wen , Wen Xia , Lai Sencai
Published: May 2021

Aiming at the challenging problem of the traditional warp knitting machine electronic jacquard control system with complex structure of multiple circuit boards layered cascade, such as large physical space occupation, high power consumption, and independent high-voltage power supply voltage, we proposed an embedded circuit and control strategy design for the piezoelectric jacquard needle (PJN) with adaptive boost and energy recovery functions. Firstly, the electromechanical dynamics model of PJN was established. Secondly, the fuzzy PI double closed-loop control algorithm driven by a finite state machine is proposed. Thirdly, with the help of a Metal-Oxide-Semiconductor Field-Effect Transistor (MOSFET), the PJN is integrated with the drive circuit. The drive circuit of PJN uses an energy storage inductor to replace the current limiting resistor of the traditional drive circuit, which can not only limit the forward charging current of the PJN and reduce energy loss but also can use the energy absorbed from the low-voltage power supply to adaptively boost the power supply of the PJN to the high voltage required for working conditions. The simulation results show that the new PJN drive circuit has an adaptive self-boost function. The PWM signal modulated by the fuzzy PI double closed-loop control algorithm can efficiently and accurately control the adaptive boost power supply and the voltage across the PJN. The mode of the circuit can be correctly switched through the sequential logic of the finite state machine and realize the energy recovery function.
Study on Rock Burst Early Warning in the Working Face of Deep Coal Mines Based on the Law of Gas Emission
Authors: Zhang Qinghua , He Shudong
Published: May 2021

This study is aimed at predicting rock burst disasters in high gas mines. First, the distribution law and correlation of gas and stress in the F15-17‐11111 working face of Pingdingshan No. 13 Mine were analyzed based on the coupling relationship between gas emission and stress in the working face. Next, the relationship between gas emission and stress distribution was revealed, and an early warning method of rock burst in the deep mine working face based on the law of gas emission was proposed and applied to the F15-17‐11111 working face. Finally, the critical value of the gas concentration indicator for rock burst early warning in the F15-17‐11111 working face was determined as 0.05%. The following research results were obtained. The gas emission and the mining stress in the F15-17‐11111 working face are negatively correlated. Mechanically, their correlation satisfies the typical coupling. Besides, the critical value of the gas concentration indicator determined by the proposed early warning method boasts high accuracy in predicting rock burst disasters. It can be used as an early warning method for underground rock burst disasters to promote the safety of working face mining. The research results provide reference and guidance for the monitoring and early warning of rock burst disasters in deep high gas mines.
β
-Stability in
q
-th Moment of Neutral Impulsive Stochastic Functional Differential Equations with Markovian Switching
Authors: Mchiri Lassaad , Rhaima Mohamed
Published: May 2021

In this paper, we investigate the

β

-stability in q-th moment for neutral impulsive stochastic functional differential equations with Markovian switching (NISFDEwMS). Moreover,

β

-stability in q-th moment is studied by using the Lyapunov techniques and a new Razumikhin-type theorem to prove our result. Finally, we check the main result by a numerical example.
Analysis of Three-Dimensional Morphological Differences in the Mandible between Skeletal Class I and Class II with CBCT Fixed-Point Measurement Method
Authors: Dong Qiang , Shi HaoYu , Jia Qi , Tian Yueyi , Zhi Keqian , Zhang Lu
Published: May 2021

This study was aimed at determining the three-dimensional differences in the mandible morphology between skeletal class I and II patients, at exploring the pathogenic mechanisms and morphological characteristics of skeletal class II, and at providing clinical references. The subjects were assigned to two groups according to the size of ANB angle: skeletal class I (

2

°

<
ANB
 
angle
<

5

°

) and skeletal class II (

5

°

<
ANB
 
angle
<

8

°

). After cone-beam computed tomography (CBCT) scanning, 31 landmarks and 25 measurement items were determined by In Vivo Dental 5.1 software (Anatomage, CA) for statistical analysis. The results were as follows: Co-Go, Go-Me, and CdM-CdD in skeletal class II cases were smaller than those in skeletal class I, and GoR-Me-GoL, GoR-Me-CoL, and, Ig-Men were larger than those in skeletal class I cases. In conclusion, there were significant differences in the three-dimensional morphology of the mandible between skeletal class I and class II patients. The vertical growth of the ramus, the horizontal growth of the mandibular body, and the condyle in skeletal class II patients were smaller than those in skeletal class I cases. In skeletal class II, the growth of the anterior part of the mandible in the vertical direction was larger than that in skeletal class I, and the shape of the mandible was more extended.
Myopic Peripapillary Pits with Spatially Corresponding Localized Visual Field Defects: A Progressive Japanese and a Cross-Sectional European Case
Authors: Kita Yoshiyuki , Holló Gábor , Narita Fumihiro , Kita Ritsuko , Hirakata Akito
Published: May 2021

We report 2 peripapillary pit cases, in which the isolated visual field defects spatially correspond to the pit-related retinal nerve fiber layer and optical coherence tomography (OCT) angiography (OCTA) perfusion damage areas. A high myopic eye of a 39-year-old Japanese male patient, and a moderate myopic eye of a 47-years old Caucasian female patient were evaluated with OCT, OCTA, and visual field testing for peripapillary pits and spatially corresponding localized visual field defects. In the Japanese patient a temporal and in the Caucasian patient an inferotemporal peripapillary pit was confirmed, both spatially associated with a myopic peripapillary atrophy area. In both cases, the retinal nerve fibers herniated into the pit. En face OCT and OCTA revealed retinal nerve fiber bundle defects and reduced vessel density in the corresponding areas, both projecting to the pit. The visual field showed localized scotomas spatially corresponding to the nerve fiber bundle/OCTA defects in both patients. The visual field defect was a progressing (extending and deepening) paracentral scotoma in the Japanese patient, and a localized superior paracentral and superior arcuate scotoma in the Caucasian patient. Our cases show that peripapillary pits occurring in both Japanese and white European eyes can cause localized retinal nerve fiber bundle and OCTA damage and visual field defects of which some can worsen during the follow-up. To separate scotomas due to peripapillary pits and glaucoma is therefore of clinical importance and requires special attention from ophthalmologists.
Substaging of pT1 Urothelial Bladder Carcinoma Predicts Tumor Progression and Overall Survival
Authors: Grobet-Jeandin Elisabeth , Wirth Gregory Johannes , Benamran Daniel , Dupont Amandine , Tille Jean-Christophe , Iselin Christophe Emmanuel
Published: May 2021

Introduction: Limitations in tumor staging and the heterogeneous natural evolution of pT1 urothelial bladder carcinoma (UBC) make the choice of treatment challenging. We evaluated if histopathological substaging (pT1a, pT1b, and pT1c) helps predict disease recurrence, progression, and overall survival following transurethral resection of the bladder (TURB). Methods: We included 239 consecutive patients diagnosed with pT1 UBC at TURB in a single institution since 2001. Each sample was interpreted by our specialized uropathologists trained to subclassify pT1 stage. Three groups were distinguished according to the degree of invasion: T1a (up to the muscularis mucosae [MM]), T1b (into the MM), and T1c (beyond the MM). Results: T1 substaging was possible in 217/239 (90%) patients. pT1a, b, and c occurred in 124 (57), 59 (27), and 34 (16%), respectively. The median follow-up was 3.1 years, with a cumulative recurrence rate of 52%, progression rate of 20%, and survival rate of 54%. Recurrence was not significantly associated with tumor substage (p = 0.61). However, the Kaplan-Meier survival analysis showed a significantly higher progression rate among T1b (31) and T1c (26%) tumors than T1a (13%) (log-rank test: p = 0.001) stages. In a multivariable model including gender, age, ASA score, smoking, tumor grade, and presence of carcinoma in situ, T1 substage was the single variable significantly associated with progression-free survival (HR 1.7, p = 0.005). Nineteen patients (9%) needed radical cystectomy; among them, 12/19 (63%) had an invasive tumor. Overall survival was significantly associated with tumor substaging (p = 0.001). Conclusion: Histopathological substaging of pT1 UBC is significantly associated with tumor progression and overall survival and therefore appears to be a useful prognostic tool to counsel patients about treatment options.
Explaining the Differences in Opioid Overdose Deaths between Scotland and England/Wales: Implications for European Opioid Policies
Authors: van Amsterdam Jan , van den Brink Wim , Pierce Mimi
Published: May 2021

Backgrounds: Between 2009 and 2018, the number of opioid-related deaths (ORDs) in Scotland showed a dramatic increase, whereas in England and Wales, a much lower increase in ORD was seen. This regional difference is remarkable, and the situation in Scotland is worrisome. Therefore, it is important to identify the drivers of ORD in Scotland. Methods: A systematic literature review according to PRISMA guidelines was conducted to identify peer-reviewed studies about key drivers for the observed differences in ORDs between Scotland and England/Wales. In addition, non-peer-reviewed reports on nationwide statistical data were retrieved via Google and Google Scholar and analysed to quantify differences in ORD drivers between Scotland and England/Wales. Results: The systematic review identified some important drivers of ORD, but none of these studies provided direct or indirect comparisons of ORD drivers in Scotland and England/Wales. However, the reports with nationwide statistical data showed important differences in ORD drivers between Scotland and England/Wales, including a higher prevalence of people using opioids in a problematic way (PUOP), more polydrug use in people using drugs in a problematic way (PUDP), a higher age of PUDP, and lower treatment coverage and efficacy of PUDP in Scotland compared to England/Wales, but no regional differences in injecting drug use, incarceration/prison release without treatment, and social deprivation in PUDP. Conclusion: It is concluded that the opioid crisis in Scotland is best explained by a combination of drivers, consisting of a higher population involvement in (problematic) opioid use (notably methadone), relatively more polydrug use (notably benzodiazepines and gabapentinoids), a steeper ageing of the PUOP population in the past 2 decades, and lower treatment coverage and efficacy in Scotland compared to England/Wales. The findings have important consequences for strategies to handle the opioid crisis in Scotland.
Frühes Mammakarzinom: Hinzunahme von Gemcitabin zur adjuvanten Chemotherapie ohne Vorteil
Authors: Banys-Paluchowski Maggie , Krawczyk Natalia
Published: May 2021

Background: When chemotherapy is indicated in patients with early breast cancer, regimens that contain anthracyclines and taxanes are established standard treatments. Gemcitabine has shown promising effects on the response and prognosis in patients with metastatic breast cancer. The SUCCESS-A trial (NCT02181101) examined the addition of gemcitabine to a standard chemotherapy regimen in high-risk early breast cancer patients. Methods: A total of 3754 patients with at least one of the following characteristics were randomly assigned to one of the two treatment arms: nodal positivity, tumor grade 3, age ≤ 35 years, tumor larger than 2 cm, or negative hormone receptor status. The treatment arms received either three cycles of 5-fluorouracil, epirubicin, and cyclophosphamide, followed by three cycles of docetaxel (FEC → Doc); or three cycles of FEC followed by three cycles of docetaxel and gemcitabine (FEC → Doc/Gem). The primary study aim was disease-free survival (DFS), and the main secondary objectives were overall survival (OS) and safety. Results: No differences were observed in the 5-year DFS or OS between FEC → Doc and FEC → Doc/Gem. The hazard ratio was 0.93 (95% CI, 0.78 to 1.12; P = 0.47) for DFS and 0.94 (95% CI, 0.74 to 1.19; P = 0.60) for OS. For patients treated with FEC → Doc and FEC → Doc/Gem, the 5-year probabilities of DFS were 86.6% and 87.2%, and the 5-year probabilities of OS were 92.8% and 92.5%, respectively. Conclusion: Adding gemcitabine to a standard chemotherapy does not improve the outcomes in patients with high-risk early breast cancer and should therefore not be included in the adjuvant treatment setting. Trial registration: Clinicaltrials.gov NCT02181101 and EU Clinical Trials Register EudraCT 2005–000490–21. Registered September 2005.
Летальний випадок генералізованоної вітряної віспи у ВІЛ- інфікованої дитини (клініко-патологоанатомічний аналіз)
Authors: Lytvyn H. O. , Tomashova S. A. , Vovk V. V. , Dybas I. V. , Hladchenko O. I.
Published: May 2021

Резюме.

Вітряна віспа є одним з висококонтагіозних гострих інфекційних захворювань, які можуть мати важкий перебіг хвороби, ускладнений залученням вісцеральних органів та центральної нервової системи, з розвитком загрозливих для життя станів у ВІЛ-інфікованих дітей. У поданому клінічному випадку описано важкий перебіг генералізованої форми вітряної віспи з розвитком пневмонії ускладненої гострим дистрес синдромом. Важість перебігу хвороби обумовлена ВІЛ-статусом дитини та відсутністю антиретровірусної терапії, що і призвело до летального завершення.

Висновки. Постмортальним дослідженням підтверджено VZV-інфекцію з вираженими альтеративними змінами внутрішніх органів та змінами в лімфатичних вузлах, характерними для ВІЛ-інфекції.
КОРОНАВІРУСНА ХВОРОБА У ВАГІТНИХ: СУЧАСНИЙ СТАН ПИТАННЯ
Authors: Riabokon O. V. , Cherkaskiy V. V. , Riabokon Yu. Yu.
Published: May 2021

На підставі огляду наукової літератури висвітлено дані про перебіг COVID-19 у вагітних, перинатальну передачу вірусу та особливості лікування. На сьогодні встановлені певні особливості клінічних і лабораторних проявів COVID-19 у вагітних, які слід враховувати при ранній діагностиці захворювання та оцінці ступеня тяжкості хвороби. На особливу увагу заслуговують хворі вагітні у II-III триместрах, оскільки є повідомлення про значне погіршення перебігу інфекції з швидким прогресуванням гострої дихальної недостатності та поліорганної недостатності в перинатальному або післяпологовому періоді. У лікуванні вагітних з тяжким і критичним перебігом коронавірусної хвороби на сьогодні слід користуватися діючими у відповідній країні уніфікованими рекомендаціями.
ВПЛИВ ЗОВНІШНЬОСЕКРЕТОРНОЇ НЕДОСТАТНОСТІ ПІДШЛУНКОВОЇ ЗАЛОЗИ НА ПЕРЕБІГ ПЕРВИННОГО ОСТЕОАРТРОЗУ ЗА УМОВ КОМОРБІДНОСТІ
Authors: Бабінець Л. С. , Галабіцька І. М
Published: May 2021

Ураження органів шлунково-кишкового тракту (ШКТ), що супроводжується зниженням екскреторної функції підшлункової залози (ПЗ), є частими патологічними процесами, що супроводжують первинний ОА як коморбідні стани.
Мета – провести дослідження параметрів суглобового болю та їх взаємозв’язків із показниками екскреторної функції підшлункової залози у пацієнтів із первинним ОА з коморбідними станами.
Матеріал і методи. Було обстежено 174 амбулаторних пацієнти з первинним ОА у поєднанні із захворюваннями, що супроводжуються зниженням екскреторної функції ПЗ, у стані повної та неповної клінічної ремісії.
Результати. Аналіз отриманих показників вмісту фекальної α-еластази пацієнтів показав наявність зниження ексреторної функції ПЗ у групі дослідження ((64,24±5,85) мкг/г), порівняно з групою контролю ((212,71±4,65) мкг/г) (р<0,05). Показник ВАШ у спокої був (25,54±3,42) мм, показник ВАШ при рухах – (38,81±4,41) мм. Було встановлено, що між парами кореляційного зв’язку наявні статистично значимі середньої сили кореляційні зв’язки.
Висновки. Виявлені кореляції довели взаємозалежність та обтяжливість між зниженням екскреторної функції підшлункової залози та силою больового суглобового синдрому у пацієнтів з первинним ОА.
ПОСТКОВІДНИЙ СИНДРОМ: КЛІНІЧНІ ПРОЯВИ ТА ЇХ ОСОБЛИВОСТІ
Authors: Курах А. В. , Чубірко К. І. , Чопей І. В. , Бичко М. В. , Дебрецені К. О. , Гечко М. М.
Published: May 2021

Мета роботи полягала в дослідженні найчастіших клінічних проявів постковідного синдрому (ПС) та впливу наявності поширених коморбідних станів на частоту виникнення даного синдрому.

Матеріал і методи. Пошук проводили у базах PubMed та Medline. Було використано наступні ключові слова: «post-covid syndrome», «COVID-19», «persisting symptoms», «risk factors», «long COVID». До уваги бралися статті, опубліковані в рецензованих виданнях.

Результати. Зважаючи на невеликий час, який пройшов від початку пандемії, кількість проведених досліджень ПС є незначною. Більшість із них було проведено за методикою анкетування пацієнтів через певні проміжки часу після завершення госпіталізації (найменший становив 2 тижні, а найбільший – 24 тижні). Проаналізувавши результати деяких досліджень ми встановили, що такі симптоми як загальна слабість, задишка та тривога зустрічалися практично в кожного хворого. Рідше у хворих персистували симптоми кашлю, болю в грудній клітці та інших частинах тіла, порушення сну та уваги. Звертає на себе увагу той факт, що у пацієнтів, які мали принаймні один коморбідний стан, зростав ризик збереження симптомів гострого COVID-19 протягом 8–18 тижнів. Так, пацієнти з ожирінням, цукровим діабетом та респіраторним дистрес-синдромом частіше мали тяжчий перебіг гострого COVID-19 та довшу тривалість персистенції симптомів. Пацієнти старших вікових груп (старше 50 років) частіше мали персистенті симптоми, порівняно з особами у віці 18–34 та 35–49 років.

Висновок. Найчастішими симптомами, які зустрічаються при ПС, були загальна слабість, задишка та тривожність. Ці симптоми зустрічалися у всіх вікових групах, але частота їх виникнення та тривалість, імовірно, зростає з віком. Також наявність принаймні одного коморбідного стану збільшувала ризик виникнення ПС.
СУЧАСНІ ПОГЛЯДИ НА ОСНОВНI МЕТАБОЛIЧНI ТА РЕГУЛЯТОРНI ЕФЕКТИ ТИРЕОЇДНИХ ГОРМОНIВ
Authors: Ліщук О. З. , Суслик Г. І. , Сафонова О. В. , Ліщук Б. Ф.
Published: May 2021

В огляді представлені сучасні дані літератури про основні метаболічні та регуляторні ефекти тиреоїдних гормонів.

Мета – провести аналіз публікацій, що відображають уже відомі основнi метаболiчнi та регуляторнi ефекти тиреоїдних гормонiв, продемонструвати результати останніх досліджень, а також показати тенденції та перспективи розвитку у дослідженні клініко-патогенетичного значення гормонів щитоподібної залози.

Висновки. Висока поширеність захворювань щитоподібної залози серед населення та їх етіологічна гетерогенність зумовлюють необхідність подальших досліджень впливу тиреоїдних гормонів на різні аспекти метаболізму, що дозволить покращити розуміння механізмів формування патологічних станів, асоційованих із порушеннями їх обміну, та оптимізувати підходи до їх фармакотерапії.
ГЕНДЕРНІ ТА ВІКОВІ ОСОБЛИВОСТІ ЯКОСТІ ЖИТТЯ ХВОРИХ НА ДЕПРЕСИВНІ РОЗЛАДИ
Authors: Белов О. О.
Published: May 2021

Мета – дослідити особливості якості життя хворих на депресивні розлади з урахуванням гендерних та вікових особливостей.

Матеріал і методи. Клінічно обстежено 107 чоловіків і 138 жінок, хворих на депресивні розлади ендогенного характеру, з використанням методики оцінки якості життя Mezzich et al. в адаптації Н. О. Марути.

Результати. Хворим на депресивні розлади притаманні низька самооцінка якості життя (ЯЖ), особливо за сферами психологічного благополуччя, загального сприйняття життя, працездатності, особистісної реалізації та фізичного благополуччя. У жінок виявлено нижчі показники ЯЖ за сферами фізичного благополуччя, психологічного благополуччя, самообслуговування і незалежності дій, працездатності, міжособистісної взаємодії та соціоемоційної підтримки, а також за інтегральними сферами суб᾽єктивного благополуччя/задоволеності та виконання соціальних ролей, і інтегральним показником ЯЖ. Оцінка ЯЖ фахівцем виявила вищі показники ЯЖ у чоловіків, при цьому значущими відмінності були лише за сферами духовної реалізації та загального сприйняття життя. Оцінка ЯЖ фахівцем була у середньому в 1,5 рази вищою, ніж самооцінка хворими. З віком показники ЯЖ за всіма сферами погіршуються.

Висновки. Депресія супроводжується вираженим зниженням ЯЖ за всіма сферами, яке суб᾽єктивно тяжче сприймається жінками, але об᾽єктивно більше виражене у чоловіків; це погіршання стає більш вираженим з віком.
ХАРАКТЕРИСТИКА КЛІНІЧНОГО ПЕРЕБІГУ ГАСТРОЕЗОФАГЕАЛЬНОЇ РЕФЛЮКСНОЇ ХВОРОБИ ТА ОЦІНКА ПСИХОСОМАТИЧНОГО СТАНУ ДАНИХ ПАЦІЄНТІВ
Authors: Дебрецені К. О. , Чопей І. В. , Чубірко К. І.
Published: May 2021

Мета – оцінка впливу психосоматичного стану на клінічний перебіг і якість життя хворих на ГЕРХ.

Матеріал і методи. У групу обстеження було включено 80 пацієнтів із ГЕРХ. Клінічне обстеження хворих включало традиційну оцінку скарг, анамнезу захворювання і життя, даних об᾽єктивного обстеження. Психологічна частина обстеження складалася з індивідуальної бесіди з пацієнтом і психодіагностичних тестів.

Результати. Проведено аналіз основних показників, що відображають дані про захворювання на ГЕРХ, тривалість його перебігу і частоту виникнення. Проведено оцінку та аналіз основних клінічних та психосоматичних проявів захворювання.

Висновки. Неерозивна ГЕРХ знижує якість життя хворих за всіма шкалами фізичного і психологічного здоров᾽я.
НОВІ ЧАСИ – НОВІ ВИКЛИКИ (ОСОБЛИВОСТІ МЕДИЧНОЇ ОСВІТИ В НОВИХ РЕАЛІЯХ)
Authors: Кашуба М. О. , Кучер С. В.
Published: May 2021

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Cognitive analysis of the social representations of suicide among hospital emergency professionals
Authors: Meira Saulo Sacramento , Vilela Alba Benemérita Alves , Lopes Claudia Ribeiro Santos , Alves Jeorgia Pereira , Pereira Hernane Borges de Barros
Published: May 2021

Objective: to analyze the constitutive contents of the social representations of suicide by health professionals in the emergency department through an analysis of the cognitive network. Method: study based on the Theory of Social Representations carried out with 104 emergency room professionals from a hospital in Bahia, Brazil. A free word association task was conducted using the term suicide enabling the creation of a semantic network that was analyzed using the Cognitive Network Analysis model. Results: this network was composed of 42 vertices (i.e., words evoked by the professionals) and 273 edges (i.e., connections between words), with a mean degree of 13. The representational structure was formed by four dimensions (biological, affective-psychological, social, and religious) that explained the interface between the primary (i.e., central core) terms “despair,” “depression,” “disease,” “sadness,” “death,” “absence of God,” and “family fragility” and the secondary (i.e., periphery) terms “loneliness,” “lack of love,” “weakness,” “emotional distress,” “frustration,” “conflict,” “solution,” “mistake,” “fear,” “non-acceptance,” “anxiety,” “lack of control,” and “kill.” Conclusion: despite the presence of reductionist aspects, the representational structure created by the healthcare professionals of the investigated hospital conveyed the meaning and image of suicide across its multidimensional aspects, favoringchanges in individual and collective practices ...
Fatores de risco para ideação suicida entre universitários atendidos por um serviço de assistência de saúde estudantil
Authors: Machado Rayni Pereira , Zago Karine Santana de Azevedo , Mendes-Rodrigues Clesnan , Calderari Elaine Saraiva , Ramos Daniela Aparecida de Sousa Moreira , Gomes Fabiola Alves
Published: May 2021

Objetivo: identificar os fatores de risco para ideação suicida entre universitários atendidos no serviço de assistência de saúde estudantil de uma Universidade Federal no estado deMinas Gerais. Método: pesquisa transversal, retrospectiva, de abordagem quantitativa, a partir de banco de dados administrativos gerados pela Divisão de Saúde de uma Universidade Federal no estado de Minas Gerais. Para todas as análises, utilizou-se o software SPSS versão 20.0. Adotouse significância de 5%. Resultados: foram analisados 545formulários de atendimentos. A maioria dos atendidos era do sexo feminino, a média de idade foi de 22 anos e há maior prevalência em estudantes de graduação. O uso abusivode substâncias psicoativas foi associado à ideação suicida (p=0,010), bem como o uso abusivo de álcool (p=0,020). Os preditores para ideação suicida são: uso de psicotrópico (p=0,022); tentativa de suicídio prévia (p=0,002); comportamento autolesivo não suicida (p=0,038); abuso de álcool (p= 0,010) e estudar no Campus de Uberlândia (p=0,001). Em contrapartida, as variáveis relacionadas aos conflitos na universidade (p=0,004) e relacionamento interpessoal (p=0,007) foram consideradas protetivas. Conclusão: consideram-se necessárias intervenções com base nos fatores de risco identificados na pesquisa, a fim de se obter êxito nas estratégias de prevenção do comportamento suicida.