bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral ovarian fibromas as the sole manifestation of Gorlin syndrome in a 22-year-old woman: a case report and literature review
Authors: Zhu Menghan , Li Jun , Duan Jie , Yang Jing , Gu Weiyong , Jiang Wei
Published: October 2023

Background

Nevoid basal cell carcinoma syndrome (NBCCS, Gorlin syndrome) is a rare autosomal dominantly inherited disorder that is characterized by multisystem disorder such as basal cell carcinomas, keratocystic odontogenic tumors and skeletal abnormalities. Bilateral and/or unilateral ovarian fibromas have been reported in individuals diagnosed with NBCCS.

Case presentation

A 22-year-old female, presented with low back pain, and was found to have bilateral giant adnexal masses on pelvic ultrasonography, which had been suspected to be malignant ovarian tumors. Positron emission tomography/computed tomography showed multiple intracranial calcification and skeletal abnormalities. The left adnexa and right ovarian tumor were resected with laparotomy, and pathology revealed bilateral ovarian fibromas with marked calcification. We recommended the patient to receive genetic testing and dermatological examination. No skin lesion was detected. Germline testing identified pathogenic heterozygous mutation in PTCH1 (Patched1).

Conclusions

The possibility of NBCCS needs to be considered in patients with ovarian fibromas diagnosed in an early age. Skin lesions are not necessary for the diagnosis of NBCCS. Ovarian fibromas are managed with surgical excision with an attempt at preserving ovarian function. Follow-up regime and counseling on options for future fertility should be offered to patients.
Results of the transition from posterolateral to anterior minimally invasive approach for total hip arthroplasty
Authors: Obando Daniel Vernaza , Gallego Kelly Johana , Gonzalez Sofía , Álvarez Alejandro Gallego , Bautista María , Sánchez-Vergel Alfredo
Published: October 2023

Background

The anterior minimally invasive (AMI) approach reduces soft tissue damage, risk of dislocation and enhances recovery, but it is associated with certain complications. The aim of this study is to compare the outcomes of patients who underwent total hip arthroplasty (THA) through posterolateral (PL) and AMI approaches performed by the same surgeon, in order to determine the learning curve associated with this new approach.

Methods

This retrospective cohort study included patients who underwent THA via PL and AMI approach between 2017 and 2022, with a minimum follow-up of 1 year. Hip fracture and oncologic patients were excluded. Demographic variables, functional scores and perioperative complications were assessed. A bivariate analysis was performed to identify differences between groups.

Results

Data of 124 AMI and 120 PL patients were analyzed. Demographic characteristics among groups were homogeneous. Functional outcomes at 3 months were superior for AMI (Oxford: 43 vs. 38; p < 0.05), no dislocations were identified (0% vs. 4.2%; p < 0.05) and no differences in the transfusion rate were found (6.5% AMI vs. 6.7% PL; p = 0.996). Infection rate was 4% for AMI and 3.4% for PL (p = 0.572). Surgical time was shorter for the PL approach, but the median surgical time of the last 25 AMI cases was shorter.

Conclusions

The AMI approach is an excellent alternative for patients requiring THA. Although surgical time and perioperative bleeding were greater during the learning curve, this approach offers improved functional outcomes and a lower dislocation rate, without significant differences in transfusion and infection outcomes, demonstrating that responsible innovation and safe implementation of new techniques is possible.
Continuous data capture of gait and mobility metrics using wearable devices for postoperative monitoring in common elective orthopaedic procedures of the hip, knee, and spine: a scoping review
Authors: Natarajan Pragadesh , Fonseka R. Dineth , Maharaj Monish Movin , Koinis Lianne , Mobbs Ralph Jasper
Published: October 2023

Background

Surgical procedures involving the hip, knee, or spine represent a majority of orthopaedic procedures performed electively in the health care system. Postoperative care is a key aspect of surgery and mobilisation without injury is the primary objective. Recent advances in wearable technologies allow objective evaluation of walking metrics to inform and guide postoperative care following orthopaedic surgery.

Purpose

The aim of this scoping review is to explore current applications of wearable devices, objective data capture and gait analysis in monitoring postoperative recovery following commonly performed elective orthopaedic procedures of the hip, knee and spine.

Methods

A search against pre-defined criteria was performed on the following scientific databases from date of inception to February 28th, 2021: Medline (via OvidSP), Embase (via OvidSP) and Cochrane Library (via CENTRAL). Data were collected according to a predetermined checklist including study participants, surgery, wearable device (model), sensor location, and monitoring parameters such as mobility metrics, monitoring timepoints and monitoring duration for each study included in our review. Quality was assessed independently using the Newcastle Ottawa Scale (NOS).

Conclusions

To our knowledge, this is the first review of wearable monitoring (of postoperative recovery) following hip, knee and spine surgery. Patients undergoing elective orthopaedic procedures may benefit from wearable monitoring of their walking health and mobility metrics.
Robustness of ad hoc microphone clustering using speaker embeddings: evaluation under realistic and challenging scenarios
Authors: Kindt Stijn , Thienpondt Jenthe , Becker Luca , Madhu Nilesh
Published: October 2023

Speaker embeddings, from the ECAPA-TDNN speaker verification network, were recently introduced as features for the task of clustering microphones in ad hoc arrays. Our previous work demonstrated that, in comparison to signal-based Mod-MFCC features, using speaker embeddings yielded a more robust and logical clustering of the microphones around the sources of interest. This work aims to further establish speaker embeddings as a robust feature for ad hoc microphone clustering by addressing open and additional questions of practical interest, arising from our prior work. Specifically, whereas our initial work made use of simulated data based on shoe-box acoustics models, we now present a more thorough analysis in more realistic settings. Furthermore, we investigate additional important considerations such as the choice of the distance metric used in the fuzzy C-means clustering; the minimal time range across which data need to be aggregated to obtain robust clusters; and the performance of the features in increasingly more challenging situations, and with multiple speakers. We also contrast the results on the basis of several metrics for quantifying the quality of such ad hoc clusters. Results indicate that the speaker embeddings are robust to short inference times, and deliver logical and useful clusters, even when the sources are very close to each other.
Structural characterization, physicochemical property, and antioxidant activity of polysaccharide components from Eucommia ulmoides leaves
Authors: Liu Mengpei , Wang Yan , Wang Rong , Du Qingxin , Wang Lu
Published: October 2023

Background

Eucommia ulmoides (E. ulmoides) leaves are identified as a new resource of medicine and food homology. In this study, the structural characterization, physicochemical properties, and antioxidant activity of E. ulmoides polysaccharides (EUP) were studied.

Results

Three components with different molecular weights of 1.51 × 105 Da (EUP1), 3.05 × 104 Da (EUP2) and 1.17 × 105 Da (EUP3) were purified from E. ulmoides leaves. They were composed of l-rhamnose (Rha), d-arabinose (Ara), d-mannose (Man), d-glucose (Glu) and d-galactose (Gal), while EUP2 also contained small amounts of d-xylose (Xyl). Three components all had typical polysaccharides absorption peaks, which may be polysaccharides with β configuration of pyranose structure, and amorphous structure of acid polysaccharides with good thermal stability below 270 ℃. However, the molecular weight, monosaccharide composition and apparent morphology of the three components were different, resulting in a stronger scavenging ability of EUP2 and EUP3 against DPPH and OH free radicals.

Conclusion

The results will provide a theoretical reference for developing EUP-related foods and drugs.

Graphical Abstract
Attribute Selection Hybrid Network Model for risk factors analysis of postpartum depression using Social media
Authors: Gopalakrishnan Abinaya , Gururajan Raj , Venkataraman Revathi , Zhou Xujuan , Ching Ka Chan , Saravanan Arul , Sen Maitrayee
Published: October 2023

Background and objective

Postpartum Depression (PPD) is a frequently ignored birth-related consequence. Social network analysis can be used to address this issue because social media network serves as a platform for their users to communicate with their friends and share their opinions, photos, and videos, which reflect their moods, feelings, and sentiments. In this work, the depression of delivered mothers is identified using the PPD score and segregated into control and depressed groups. Recently, to detect depression, deep learning methods have played a vital role. However, these methods still do not clarify why some people have been identified as depressed.

Methods

We have developed Attribute Selection Hybrid Network (ASHN) to detect the postpartum depression diagnoses framework. Later analysis of the post of mothers who have been confirmed with the score calculated by the experts of the field using physiological questionnaire score. The model works on the analysis of the attributes of the negative Facebook posts for Depressed user Diagnosis, which is a large general forum. This framework explains the process of analyzing posts containing Sentiment, depressive symptoms, and reflective thinking and suggests psycho-linguistic and stylistic attributes of depression in posts.

Results

The experimental results show that ASHN works well and is easy to understand. Here, four attribute networks based on psychological studies were used to analyze the different parts of posts by depressed users. The results of the experiments show the extraction of psycho-linguistic markers-based attributes, the recording of assessment metrics including Precision, Recall and F1 score and visualization of those attributes were used title-wise as well as words wise and compared with daily life, depression and postpartum depressed people using Word cloud. Furthermore, a comparison to a reference with Baseline and ASHN model was carried out.

Conclusions

Attribute Selection Hybrid Network (ASHN) mimics the importance of attributes in social media posts to predict depressed mothers. Those mothers were anticipated to be depressed by answering a questionnaire designed by domain experts with prior knowledge of depression. This work will help researchers look at social media posts to find useful evidence for other depressive symptoms.
Parenting by mothers in immigrant families from Poland, Russia and Turkey in Germany: Migration-related similarities or origin-related differences?
Authors: Öztürk Yasmin , Reisenauer Eveline , Castiglioni Laura , Walper Sabine
Published: October 2023

Even if families in migration contexts have been the subject of an increasing amount of attention in migration research in the recent years, there is a noticeable knowledge deficit with regard to current parenting practices and socialization goals of immigrant families living in Germany. This is particularly striking since child-rearing is of central importance for children’s development and their educational pathways. This paper seeks to fill this gap, drawing on the survey “Growing up in Germany: Everyday Life” (AID:A) provided by the German Youth Institute (DJI). Similarities and differences in attitudes towards parenting among immigrant mothers compared to mothers without migration backgrounds were analyzed with regard to parenting practices (emotional warmth, punishment and child’s active participation) and socialization goals (performance/self-control and positive social behavior). In a sample of 5870 mothers reporting on a child under the age of nine, mothers in families where both they and the father had Turkey, Russia or Poland as their country of origin were included and compared to autochthonic families. The results revealed significant differences in parenting practices and socialization goals between mothers with and without migration backgrounds. Concerning parenting practices, Turkish and Russian mothers differed significantly from German mothers with regard to emotional warmth and punishment. In terms of socialization goals, all immigrant mothers placed more emphasis on both performance/self-control, as well as positive social behavior for their children than mothers without migration backgrounds in Germany.
Translation to German and linguistic validation of the Rapid Assessment of Physical Activity (RAPA) questionnaire
Authors: Kulnik Stefan Tino , Gutenberg Johanna , Mühlhauser Kathrin , Topolski Tari , Crutzen Rik
Published: October 2023

Purpose

To produce a culturally adapted translation of the Rapid Assessment of Physical Activity (RAPA) questionnaire for German speaking Austrians and to conduct a linguistic validation of the new language version.

Methods

The original English RAPA questionnaire was translated into German for Austria and underwent an independent forward and back translation, followed by cognitive debriefing interviews with older adults aged 55 to 78 years with and without health conditions (n = 13), for linguistic validation.

Results

Several distinct choices were made in the translation of the RAPA questionnaire to German, including the use of colloquial terms for ‘physical activity’ and ‘intensity’; and the decision to keep to the original examples and images of different physical activities for illustrating the intensity levels (light, moderate, vigorous) of physical activity. In cognitive debriefing, interviewees commented that some example activities for the respective intensity levels could – depending on the individual – also represent a higher or lower intensity level; and that the wording of RAPA items 4 and 5, which describe the category ‘under-active regular’ aerobic activity, was difficult to understand. Both issues were addressed and resolved through minor iterative modifications made during the cognitive debriefing process.

Conclusions

A new version of the RAPA questionnaire in German for Austria has been produced by forward and back translation and linguistic validation. The questionnaire may now undergo psychometric evaluation.
Efficacy and safety of baricitinib in treatment of systemic lupus erythematosus: a systematic review and meta-analysis
Authors: Allam Abdallah R. , Alhateem Mohamed Salah , Mahmoud Abdelrahman Mohamed
Published: October 2023

Background

SLE is an autoimmune disease marked by broad immunological dysregulation and multi-system inflammation. Baricitinib is one of the novel treatments for SLE. We conducted this meta-analysis to evaluate its safety and effectiveness in treating SLE.

Method

We looked for all published randomized controlled trials in PubMed, Scopus, Web of Science, and Cochrane and included all RCTs comparing baricitinib and placebo in the treatment of SLE. Review Manager 5.4 program was used for data analysis.

Results

Three trials with a total of 1849 individuals were included. Participants in the baricitinib group were significantly more likely to attain SRI-4 response than those in the placebo group [RR = 1.11, 95% CI (1.02, 1.21), P = 0.01]. Additionally, baricitinib performed better than the placebo in terms of reduction of ≥ 4 points from baseline in SLEDAI-2 K score [RR = 1.13, 95% CI (1.04, 1.22), P = 0.004]. In terms of SLEDAI-2 K remission of arthritis or rash, baricitinib was also superior to placebo [RR = 1.08, 95% CI (1.00, 1.17), P = 0.04]. Treatment-emergent adverse events did not differ significantly [RR = 1.01, 95% CI (0.97, 1.05), P = 0.61].

Conclusion

Baricitinib is potentially safe and effective in the treatment of SLE. It has successfully met the study’s primary endpoint and some secondary endpoints highlighting its potential to improve the outcomes of SLE. Despite achieving an SRI-4 response, glucocorticoids sparing and some other secondary outcomes weren’t reached by baricitinib.
Effectiveness of integrated education and relaxation program on migraine-related disability: a randomized controlled trial
Authors: Hisham Sara , Manzour Ayat , Fouad Mohammed M. , Amin Randa M. , Hatata Hisham A. , Marzouk Diaa
Published: October 2023

Background

Migraine is one of the most disabling disorders worldwide. Globally, in 2019, headache disorders were the cause of 46.6 million years of disability, with migraine accounting for 88.2% of these. The value of integrative strategies in migraine management has been raised due to the recurrent and provoked nature of migraine. So, the current study aimed to evaluate the effectiveness of implementing a therapeutic patient education and relaxation training program versus usual pharmacological treatment alone on the frequency, severity, and duration of migraine attacks as the primary outcome and migraine-related disability and quality of life as the secondary outcome. A randomized controlled trial was conducted at the specialized headache clinic of a tertiary referral center. Sixty patients were randomly assigned to intervention or control groups. Participants in the intervention arm received the education and relaxation training program and were instructed to perform daily relaxation exercises in addition to their routine pharmacological treatment, whereas the control group only received their routine treatments. Follow-up was done after 1 and 3 months using a headache diary and a migraine-specific quality of life questionnaire (MSQ).

Result

After implementation of the program, there was a significant reduction in migraine attack severity in the intervention group compared to the control group, and they also had significantly fewer migraine headache days/month and duration of migraine attacks compared to patients in the control group. Statistically significant improvement in the role-function restrictive, role-function preventive, and emotional function domains of MSQ.

Conclusion

An integrated migraine management program has a significant effect on reducing the burden of migraine attacks and improving the daily activities of migraine sufferers.
Correlation between toe brachial index and walking ability in peripheral arterial disease with type 2 diabetes mellitus
Authors: Arora Esha , Yadav Hrishikesh , Maiya G. Arun , Devasia Tom , Bhat Ram , Kamath Ganesh
Published: October 2023

Background

The primary symptom of peripheral arterial disease (PAD) is intermittent claudication and the most common non-invasive diagnostic method is ankle brachial index. Peripheral arterial disease is usually accompanied by various other co-morbidities like type 2 diabetes mellitus, hypertension, and hypercholesterolemia. Literature suggests that when peripheral arterial disease is accompanied by type 2 diabetes mellitus, the ankle-brachial index can be falsely elevated due to medial calcification of the arteries. Therefore, an assessment of microcirculation using the toe brachial index is needed to diagnose PAD in these individuals. It has been well established that walking ability and ankle-brachial index are correlated in peripheral arterial disease. However, there is a dearth of literature on whether there is a correlation between toe brachial index (TBI) and walking ability. Therefore, the objective of the study is to find the correlation between toe brachial index and walking ability in type 2 diabetes mellitus with peripheral arterial disease. A total of 1485 participants were screened for the study, among which 133 met the inclusion criteria. Informed consent was obtained and the included participants were assessed for their demographic details. Toe brachial index was performed with the help of Doppler and 6-min walk test was performed to measure the claudication in the participants.

Results

In the present study of 133 participants, we found a strong positive correlation between toe brachial index and 6-min walk distance (r = 0.911 p value < 0.05). The walking ability is directly proportional to the TBI, i.e., the lesser the values of TBI, the lesser the walking distance covered in peripheral arterial disease with type 2 diabetes mellitus.

Conclusion

The present study concludes that there is a strong positive correlation between toe brachial index and 6-min walk distance.
“So, We Found a Way:” How Changing Modalities Affected a Year-Long Mentored Research Experience for Associate’s Degree Students
Authors: Nerio Ron , Shetty Veer , MacLachlan Effie
Published: October 2023

The CUNY Research Scholars Program (CRSP) offers mentored research experiences for associate degree students at an urban minority-serving public university system. This study reports our assessment of the program’s impact during the COVID-19 pandemic. ​
Standardized Titration Protocol Reduces the Incidence of Paclitaxel Infusion-Related Hypersensitivity Reactions
Authors: Sefah Kofi , Kilowski Karolina A. , Gifford Sarah A. , Grove Angela , Shaffer Jon , Bryan Baylee , Ahmad Sarfraz , Holloway Robert W.
Published: October 2023

PURPOSE

Infusion-related hypersensitivity reactions with paclitaxel are common despite the use of dexamethasone and diphenhydramine premedications. Paclitaxel titration protocols that may reduce reactions are empirically derived from clinical observations, and there are no phase III trials that confirm superiority of any management recommendations. The purpose of this study was to compare the frequency and severity of hypersensitivity reactions associated with a recently initiated standardized paclitaxel titration protocol verses standard-of-care (SOC) infusion protocols.

MATERIALS AND METHODS

This was a retrospective review of hypersensitivity reactions in patients receiving paclitaxel infusions at five ambulatory infusion centers using a standardized titration protocol (February 2021 to April 2021) versus SOC paclitaxel (November 2018 to December 2019). Patients were age 18 years or older and presented for their first or second infusions. The primary study measure was the rate of hypersensitivity reactions. Secondary evaluations included the timing of the reaction after the start of the infusion, use of premedications, and severity of reactions.

RESULTS

A total of 451 patients were included in this study. Eighty-four (18.6%) patients were identified in the titration protocol group and 367 (81.4%) patients in the SOC group. Hypersensitivity reactions occurred in 4.8% of the titration group and 18.3% of the SOC group (odds ratio [OR], 0.224; 95% CI, 0.09 to 0.74; P = .002). Grade 3 or greater infusion reactions were 0% in the titration group versus 18% in the SOC group (OR, 0.28; P < .008). Reactions occurred later with the titration protocol, compared with the SOC paclitaxel infusion. Finally, no differences were observed in the use of appropriate premedications.

CONCLUSION

A standardized paclitaxel titration protocol was associated with a significant reduction in the rate of infusion-related hypersensitivity reactions in patients receiving their first and second infusions. A prospective randomized trial is needed to validate these observations.
Electoral Cycles in Macroprudential Regulation
Authors: Müller Karsten
Published: October 2023

Do politics matter for macroprudential policies? I show that changes in macroprudential regulation exhibit a predictable electoral cycle in the run-up to 221 elections across 58 countries from 2000 through 2014. Policies restricting mortgages and consumer credit are systematically looser before elections, particularly during economic expansions. Consistent with theories of opportunistic political cycles, this pattern is stronger when election outcomes are uncertain, regulators are closely tied to politicians, and institutions are poor. These results suggest that political pressures may limit the ability of regulators to “lean against the wind.” (JEL D72, E32, G01, G21, G28)
Solving a Continent-Scale Inventory Routing Problem at Renault
Authors: Bouvier Louis , Dalle Guillaume , Parmentier Axel , Vidal Thibaut
Published: October 2023

This paper is the fruit of a partnership with Renault. Their reverse logistic requires solving a continent-scale multiattribute inventory routing problem (IRP). With an average of 30 commodities, 16 depots, and 600 customers spread across a continent, our instances are orders of magnitude larger than those in the literature. Existing algorithms do not scale, so we propose a large neighborhood search (LNS). To make it work, (1) we generalize existing split delivery vehicle routing problems and IRP neighborhoods to this context, (2) we turn a state-of-the-art matheuristic for medium-scale IRP into a large neighborhood, and (3) we introduce two novel perturbations: the reinsertion of a customer and that of a commodity into the IRP solution. We also derive a new lower bound based on a flow relaxation. In order to stimulate the research on large-scale IRP, we introduce a library of industrial instances. We benchmark our algorithms on these instances and make our code open source. Extensive numerical experiments highlight the relevance of each component of our LNS.

Funding: This work was supported by Renault Group.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2022.0342 .
Hristiyan Çevreye Ait Eski Türkçe Metinlerde Dinî İfadeler
Authors: KESKİN Berker
Published: October 2023

Türk dili tarihi içerisinde Türkçenin bir yazı dili olarak ilk örnekleri Eski Türkçe devrine aittir. VIII. yüzyılda Orhun Türkçesiyle başlayan bu devir, Eski Uygur Türkçesiyle gelişerek devam etmiştir. Devrin ikinci safhasında ilkine göre hem çok daha fazla sayıda eser ortaya konmuş hem de konular çeşitlenmiştir. Bu bakımdan Eski Uygurcadan miras kalan metinlerin büyük çoğunluğunun dinî bir karakter taşıdığı ifade edilebilir. Budizm çerçevesindeki eserler önde gelmekle birlikte az sayıda da olsa Manihaizm ve Hristiyanlıkla ilgili eser veya metin parçaları bulunmaktadır. Bu çalışmanın esas konusu, Eski Uygurca metinlerdeki Hristiyanlıkla ilgili dinî ifadelerin tespitidir. Öncelikle Hristiyan Türk topluluklarının kabul ettiği Nestûrîlik mezhebi ve bunun Uygurlar arasında yayılımı ana hatlarıyla incelenecek, Hristiyan çevreye ait metinlerin içeriği hakkında bilgi verilecektir. Metinlerde yer alan dinî ifadelerin örnekleriyle birlikte açıklanmasına ek olarak bunların Budist, Manihaist ve diğer Eski Türkçe metinlerdeki varlığı sorgulanacaktır. Ayrıca bu ifadelerin İslamiyet’in kabulü sonrası yazılan eserlerdeki dinî ifadelerle mukayese edilmesi amaçlanmaktadır.
1720-1730’lu Yıllarda Osmanlı Devleti’nin Kafkasya Siyasetinde Azerbaycan’ın Kuzeybatı Topraklarının Yeri ve Rolü
Authors: LATİFOVA Elvira
Published: October 2023

Araştırmakta olduğumuz dönem Osmanlı Devleti’nin Kafkasya siyasetinde özel bir aşamayı oluşturmaktadır. Bu dönemde Osmanlı Devleti Kafkasya’da güçlenme konusunda Doğu’da geleneksel rakibi Safevi evleti dışında Rusya İmparatorluğu ile de mücadele etmek zorunda kaldı. Osmanlı Devleti, önceki dönemlerde olduğu gibi, 1720-1730’lu yıllarda da rakipleri ile mücadelede yerli Müslüman yönetimleri güçlendirerek onlara güvenme siyasetini sürdürdü. Söz konusu yerel yönetimler arasında Azerbaycan’ın kuzeybatısında bulunan Sahur (İlisu) Sultanlığı, Şeki Hâkimliği ve Car-Tala Cemaatlikleri bölgesel ağırlığa sahipti. Bu durumu dikkate alan Osmanlı Devleti, söz konusu bölgesel güçlerle ilişkilere özel önem vermişti. Mevcut durumda yerel yöneticiler daha çok kendi çıkarlarını koruma yönünde hareket etseler de, Osmanlı-Safevi-Rusya rekabetinde Osmanlı yönetimini kabul etmeyi tercih ediyorlardı. Bu seçimde dinî faktör önemli bir rol oynamıştır. Çalışmamızda XVIII. yüzyılın 20-30’lu yıllarında Azerbaycan’ın kuzeybatı topraklarının Osmanlı Devleti’nin Kafkasya siyasetindeki yeri ve rolü dönemin kaynaklarına istinaden ele alınmıştır.
DESAFIOS AO CUMPRIMENTO DAS METAS DE UNIVERSALIZAÇÃO DO SANEAMENTO BÁSICO RATIFICADAS PELO NOVO MARCO LEGAL DO SETOR
Authors: Saiani Carlos Cesar Santejo , Toneto Júnior Rudinei , Rodrigues Regiane Lopes
Published: October 2023

O objetivo desse estudo foi apresentar alguns desafios ao cumprimento das metas de universalização ratificadas pelo Novo Marco Legal do Saneamento Básico brasileiro. Enfatizando o abastecimento de água e o esgotamento sanitário, mas sem ignorar problemas em outros serviços, foi discutida a configuração atual da provisão, com grande participação de companhias estaduais. Em parte dos municípios por elas atendidos, a relação contratual foi considerada como irregular pelo novo marco, o que dificulta a expansão dos atendimentos devido à instabilidade jurídica e às sanções legais (restrições de acesso a recursos federais para o setor). Um desafio ainda maior aqui evidenciado é a existência de severos déficits de acesso em municípios menos populosos e urbanizados e com menores níveis de renda, bem como em domicílios pobres. Ou seja, em locais com maiores custos e menores capacidades de investir com recursos próprios e em potenciais usuários que não podem pagar pelo acesso.
Role of four-dimensional computer tomography (4D-CT) in non-localising and discordant first-line imaging in primary hyperparathyroidism
Authors: Sayed S , Das A , Turner B , Wadhwa VS , Pathak KA
Published: October 2023

Background

Accurate preoperative localisation of parathyroid adenoma is imperative for the success of minimally invasive parathyroidectomy (MIP).

Objective

Our study aimed to evaluate the role of four-dimensional computer tomography (4D-CT) scan as an imaging modality in patients with failed and discordant localisation reported in the first-line imaging modalities (ultrasonography and 99mTc-MIBI-SPECT/CT).

Methods

This is a prospective cohort study performed at a university teaching centre from March 2013 to July 2021. All patients with primary hyperparathyroidism who had failed localisation by ultrasonography and 99mTc-MIBI-SPECT/CT (SpCT), or discordance between them, had 4D-CT performed in this study.

Results

One hundred and two sporadic cases of pHPT with failed/discordant first-line imaging had 4D-CT imaging prior to parathyroidectomy. In 102 patients, 105 parathyroid adenomas were reported on histopathology. 4D-CT was able to localise 78% of them to the correct side and 64% to the correct quadrant in 102 patients, as compared with US (correct side 21%, correct quadrant 16%) and 99mTc-MIBI-SPECT/CT (correct side 36%, correct quadrant 31%). 4D-CT had a sensitivity, precision, accuracy and F1 score for correct quadrant localisation as 79%, 81%, 66% and 80%; and for correct side localisation as 82%, 98%, 80% and 89%, respectively. 4D-CT was able to identify three ectopic adenomas (two in superior mediastinum and one in the oesophageal wall) which were not detected on US or SpCT.

Conclusion

4D-CT was found to be sensitive and accurate in preoperative localising of the diseased parathyroid glands after failed/discordant US and SpCT. This led to more patients being offered MIP as the primary surgery and improved operative outcomes.
The carbon footprint of surgical operations: a systematic review update
Authors: Robinson PN , Surendran KSB , Lim SJ , Robinson M
Published: October 2023

Introduction

Sustainability in healthcare is a rapidly developing area of research with recent formal recognition from institutions around the world. We completed an update of a systematic review published in 2020. The aims of this review were to determine the reported carbon footprints of surgical operations in hospitals worldwide, identify variations in reported carbon footprints and highlight carbon hotspots associated with surgery.

Methods

A systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. The MEDLINE®, Embase® and Cochrane Library databases were searched, and eligibility criteria applied. The study characteristics, scope of product inventory and results were extracted and synthesised. A quality assessment of each study was completed to inform the reliability of the research.

Results

1,308 articles were identified and 7 met the inclusion criteria for the review. The carbon footprint ranged from 28.49kg to 505.1kg carbon dioxide equivalents (CO2e). Medical devices and consumables were the greatest contributor to emissions, with material production and manufacture representing the majority of this carbon hotspot. There were significant methodological limitations and a lack of consistency in carbon footprint calculations between studies.

Conclusions

This systematic review identifies medical devices and consumables as the largest carbon hotspot where healthcare providers should target their sustainability initiatives. Nevertheless, the number of studies was limited and the quality of the evidence was weak. We recommend that researchers in healthcare sustainability develop international standards for conducting and reporting such studies. This would allow for comparison of individual studies and facilitate meta-analysis of cumulative evidence. A reliable evidence base is a prerequisite for identifying optimal interventions to ensure societal benefits.
CORESS is an independent charity, supported by AXA Health, the MDU and the Kirby Laing Foundation
Authors: Corbett H
Published: October 2023

We are grateful to those who have provided the material for these reports. The online reporting form is available on the website ( coress.org.uk ), which also includes previous Feedback reports, and via the CORESS app. Published cases will be acknowledged by a Certificate of Contribution, which may be included in the contributor's record of continuing professional development, or which may form part of appraisal or annual review of competence progression portfolio documentation. Trainee contributions are particularly welcome.
Broadband design of silica-PLC mode-dependent-loss equalizer for 2LP-mode transmission systems
Authors: Sato Takanori , Wada Masaki , Mori Takayoshi , Sakamoto Taiji , Imada Ryota , Matsui Takashi , Nakajima Kazuhide , Saitoh Kunimasa
Published: October 2023

A new configuration of mode-dependent-loss (MDL) equalizer for two linearly-polarized mode transmission systems using the silica planar lightwave circuit platform is proposed. This device acts as an LP01-mode attenuator (precisely, LP01/LP21 mode converter) to adjust the MDL keeping a high transmission of the LP11 modes. Almost all components constructing the device are based on the adiabatic mode conversion, which brings broadband operation. Especially, a newly proposed E12/E22 mode converter plays a key role in broadband MDL equalization. It is numerically revealed that the flattened spectra with designated transmission can be obtained for the wavelength from 1200 nm to 1650 nm.
Terahertz imaging through emissivity control
Authors: Mrnka Michal , Penketh Harry , Hooper Ian R. , Saxena Sonal , Grant Nicholas E. , Murphy John D. , Phillips David B. , Hendry Euan
Published: October 2023

Electromagnetic radiation in the terahertz (THz) frequency band has
unique potential for future communication and imaging applications.
However, the adoption of THz technologies is hindered by the lack of
cost-effective THz sources. Here we demonstrate a way to generate and
control THz radiation, via spatio-temporal emissivity modulation. By
patterning the optical photoexcitation of a surface-passivated silicon
wafer, we locally control the free-electron density, and thereby
pattern the wafer’s emissivity in the THz part of the electromagnetic
spectrum. We show how this unconventional source of controllable THz
radiation enables a form of incoherent computational THz imaging. We
use it to image various concealed objects, demonstrating that this
scheme has the penetrating capability of other THz imaging approaches,
without the requirement of femtosecond pulsed laser sources.
Furthermore, the incoherent nature of thermal radiation also ensures
the obtained images are free of interference artifacts. Our
spatio-temporal emissivity control could enable a family of
long-wavelength structured illumination, imaging, and spectroscopy
systems.
Downscaled seasonal forecasts for the California Current System: Skill assessment and prospects for living marine resource applications
Authors: Jacox Michael G. , Buil Mercedes Pozo , Brodie Stephanie , Alexander Michael A. , Amaya Dillon J. , Bograd Steven J. , Edwards Christopher A. , Fiechter Jerome , Hazen Elliott L. , Hervieux Gaelle , Tommasi Desiree
Published: October 2023

Ocean forecasting is now widely recognized as an important approach to improve the resilience of marine ecosystems, coastal communities, and economies to climate variability and change. In particular, regionally tailored forecasts may serve as the foundation for a wide range of applications to facilitate proactive decision making. Here, we describe and assess ~30 years of retrospective seasonal (1–12 month) forecasts for the California Current System, produced by forcing a regional ocean model with output from a global forecast system. Considerable forecast skill is evident for surface and bottom temperatures, sea surface height, and upper ocean stratification. In contrast, mixed layer depth, surface wind stress, and surface currents exhibit little predictability. Ocean conditions tend to be more predictable in the first half of the year, owing to greater persistence for forecasts initialized in winter and dynamical forecast skill consistent with winter/spring influence of the El Niño–Southern Oscillation (ENSO) for forecasts initialized in summer. Forecast skill above persistence appears to come through the ocean more than through the atmosphere. We also test the sensitivity of forecast performance to downscaling method; bias correcting global model output before running the regional model greatly reduces bias in the downscaled forecasts, but only marginally improves prediction of interannual variability. We then tailor the physical forecast evaluation to a suite of potential ecological applications, including species distribution and recruitment, bycatch and ship-strike risk, and indicators of ecosystem change. This evaluation serves as a template for identifying promising ecological forecasts based on the physical parameters that underlie them. Finally, we discuss suggestions for developing operational forecast products, including methodological considerations for downscaling as well as the respective roles of regional and global forecasts.
Risk factors and management of biliary leakage after Endocystectomy for hepatic cystic echinococcosis
Authors: Abbasi Dezfouli Sepehr , El Rafidi Ahmad , Aminizadeh Ehsan , Ramouz Ali , Al-Saeedi Mohammed , Khajeh Elias , Mieth Markus , Weber Tim Frederik , Chang De-Hua , Hoffmann Kathrin , Büchler Markus W. , Mehrabi Arianeb
Published: October 2023

Background

Endocystectomy is a conservative surgical approach to managing cystic echinococcosis. Bile leakage is the main complication of this technique. The aim of this study was to evaluate the factors associated with bile leakage and to assess the outcomes and cost efficiency of strategies used to treat bile leakage.

Methodology/Principal findings

Patients who underwent endocystectomy between 2005 and 2020 were included. The preoperative characteristics, intra- and postoperative outcomes, hospital costs, and cost efficiency (the Diagnosis-Related Group reimbursement minus the overall cost) were evaluated prospectively. A total of eighty patients with 142 cysts were included. Postoperative complications occurred in 17 patients (21%), including 11 patients with bile leakage (type A: 1, type B: 6 and type C: 4 patients, total 13%). Bile leakage was more frequent in patients with preoperative MRI signs of cysto-biliary fistulas or intraoperative visible cysto-biliary fistulas (p = 0.03 and p = 0.04, respectively) and in patients with cysts larger than 8 cm (p = 0.03). Patients with bile leakage who underwent reoperation (type C) had significantly shorter hospital stays (9 vs. 16 days, p<0.01) and better cost efficiency than those who received radiologic or endocscopic interventions (€2,072 vs. -€2,097 p = 0.01). No mortality was observed, and recurrence was seen in two patients.

Conclusions/Significance

Endocystectomy is a safe and efficient technique. Preoperative and intraoperative cysto-biliary fistulas and a cyst diameter larger than 8 cm are correlated to postoperative bile leakage. Early operative management of bile leakage reduces hospital stay and improves cost efficiency compared with radiologic or endoscopic treatments.
Candidate gene-environment interactions in substance abuse: A systematic review
Authors: Jiang Zheng , Chen Zidong , Chen Xi
Published: October 2023

Background

The abuse of psychogenic drugs can lead to multiple health-related problems. Genetic and environmental vulnerabilities are factors in the emergence of substance use disorders. Empirical evidence regarding the gene–environment interaction in substance use is mixed. Summaries of the latest findings from a candidate gene approach will be useful for revealing the significance of particular gene contributions. Thus, we aim to identify different gene–environment interactions in patterns of substance use and investigate whether any effects trend notably across different genders and races.

Methods

We reviewed published studies, until March 1, 2022, on substance use for candidate gene–environment interaction. Basic demographics of the included studies, target genes, environmental factors, main findings, patterns of gene–environment interaction, and other relevant information were collected and summarized.

Results

Among a total of 44 studies, 38 demonstrated at least one significant interaction effect. About 61.5% of studies on the 5-HTTLPR gene, 100% on the MAOA gene, 42.9% on the DRD2 gene, 50% on the DRD4 gene, 50% on the DAT gene, 80% on the CRHR1 gene, 100% on the OPRM1 gene, 100% on the GABRA1 gene, and 50% on the CHRNA gene had a significant gene–environment interaction effect. The diathesis–stress model represents a dominant interaction pattern (89.5%) in the studies with a significant interaction effect; the remaining significant effect on substance use is found in the differential susceptibility model. The social push and swing model were not reported in the included studies.

Conclusion

The gene–environment interaction research on substance use behavior is methodologically multidimensional, which causes difficulty in conducting pooled analysis, or stated differently–making it hard to identify single sources of significant influence over maladaptive patterns of drug taking. In decreasing the heterogeneity and facilitating future pooled analysis, researchers must (1) replicate the existing studies with consistent study designs and measures, (2) conduct power calculations to report gene–environment correlations, (3) control for covariates, and (4) generate theory-based hypotheses with factorial based experiments when designing future studies.
The usage of spatial econometric approach to explore the determinants of ecological footprint in BRI countries
Authors: Chen Qian , Madni Ghulam Rasool , Shahzad Adnan Ali
Published: October 2023

Protecting our environment is not a choice, but a responsibility we owe to future generations. Numerous studies examined the factors affecting the environmental deterioration but this research takes a step further by employing a spatial dependence model to evaluate spatial impact of ecological footprint and its contributing factors, particularly productive capacities which is hardly investigated in economic literature of BRI economies. For the purpose, the annual data of 54 BRI countries is analyzed for the time period from 2000 to 2018 by employing various econometric techniques. The outcomes of the Durbin model express that neighboring economies significantly affect the ecological footprint of an economy, highlighting the need for a regional policy framework to address environmental issues. It is also found that improving the productive capacities, green investment and democratic quality decrease the ecological footprint while per capita GDP, globalization, and development of financial sector increase the environmental deterioration. The significant interdependence of the countries within the region, a regional policy and vision must be implemented to safeguard the environment. The research findings can facilitate policy formulation aimed at promoting environmental sustainability, with particular focus on enhancing productive capacities and green investments.
Association between the use of epidural analgesia during labour and incidence of postpartum depression
Authors: Ahmad Hanin Mohammed Yaqoob , Althagafi Lama Adnan , Albluwe Ghazal Zuhair , Kadi Shahd Mohammed , Alhassani Relam Ibrahim , Bahkali Nedaa Mohammed
Published: October 2023

Introduction

Postpartum depression is a significant episode of depression beginning after giving birth. The prevalence of postpartum depression is approximately 20% in Jeddah, Saudi Arabia. Epidural analgesia is the gold standard for labour pain management. Conflicting results exist regarding the association between postpartum depression and epidural analgesia use during labour. Accordingly, this study assessed the association between epidural analgesia use and postpartum depression incidence.

Methods

A prospective observational study of 170 mothers was conducted, with surveys administered after labour and at six weeks postpartum. Surveys included the following: mothers’ demographics, obstetric history, postpartum depression (Edinburgh Postnatal Depression Scale), and pain severity (Visual Analogue Scale).

Results

In the final analysis, 91 patients were enrolled. Epidural analgesia was administered to 48.4% of mothers during labour. Nearly two-thirds of mothers learned about EA via sources including family members and social media. However, more than half reported worries regarding epidural analgesia. Edinburgh Postnatal Depression Scale scores showed that 38 mothers (41.8%) likely had depressive symptoms within two days following delivery. Further, 35 (38.5%) met criteria for postpartum depression at six weeks postpartum. For both groups regardless use of analgesia, the mean Visual Analogue Scale score at two days postpartum was 4.16 ± 2.13. Data revealed no correlation between epidural analgesia use and Edinburgh Postnatal Depression Scale within two days and at six weeks postpartum. Multiple regression analysis showed Edinburgh Postnatal Depression Scale scores correlated with Visual Analogue Scale scores but not epidural analgesia use at 1–2 days postpartum.

Conclusion

This study showed that depressive symptoms resolved in three percent of participants. This suggests that institutions should increase postpartum depression awareness during the antenatal period and implement effective post-delivery screening systems for postpartum depression.