bluuebunny/crossref_metadata_2025 huggingface dataset:
Recognition of Neonatal Hospitalization Cost in an Intensive Care Unit in Greece and the Deviation from Its Current Reimbursement System
Authors: Christoforidou Antonia , Platis Charalambos , Zoulias Emmanouil , Karafyllis Giannis
Published: May 2021

In this paper efforts have been made to record the actual, real cost of health care services in a Neonatal Intensive Care Unit (N.I.C.U.) of a public hospital. It is well known that, in recent years, the hospitals have been reimbursed with the system of Diagnosis-Related Groups (D.R.G.’s). The purpose of this study is to determine whether the costs according with D.R.G.’s correspond to the actual-real cost, as this is recorded in the N.I.C.U. This cost is called direct cost. Here is a case study of a premature neonate in the intensive care unit (N.I.C.U.). From the outset, the age of pregnancy, the birth weight, the duration of hospitalization in N.I.C.U. and the needs of the newborn in oxygen, medication, as well as nutrition are defined which are very important in shaping the cost. Then, the cost is calculated according to the D.R.G.’s system. By setting three basic diagnoses (I.C.D.-10), we find the D.R.G. which better describes the case, as well as the associated costs. Then, we calculate the direct cost and list all the consumables, exams, staff costs, overheads. Comparing the two results we find that the cost of D.R.G. does not meet the direct cost of hospitalization. There is a significant deviation from the actual real cost, which proves the under-costing of the health services. The D.R.G.’s system leads hospitals to increase their financial deficits and provide degraded quality health services. It is necessary to readjust the D.R.G.’s according to the reality and the redefinition of the hospital’s reimbursement system to meet the direct – real cost of the health services offered.
Automatic Diagnosis of Ocular Toxoplasmosis from Fundus Images with Residual Neural Networks
Authors: Parra Rodrigo , Ojeda Verena , Vázquez Noguera José Luis , García Torres Miguel , Mello Román Julio César , Villalba Cynthia , Facon Jacques , Divina Federico , Cardozo Olivia , Castillo Verónica Elisa , Castro Matto Ingrid
Published: May 2021

Ocular toxoplasmosis (OT) is commonly diagnosed through the analysis of fundus images of the eye by a specialist. Despite Deep Learning being widely used to process and recognize pathologies in medical images, the diagnosis of ocular toxoplasmosis(OT) has not yet received much attention. A predictive computational model is a valuable time-saving option if used as a support tool for the diagnosis of OT. It could also help diagnose atypical cases, being particularly useful for ophthalmologists who have less experience. In this work, we propose the use of a deep learning model to perform automatic diagnosis of ocular toxoplasmosis from images of the eye fundus. A pretrained residual neural network is fine-tuned on a dataset of samples collected at the medical center of Hospital de Clínicas in Asunción, Paraguay. With sensitivity and specificity rates equal to 94% and 93%,respectively, the results show that the proposed model is highly promising. In order to replicate the results and advance further in this area of research, an open data set of images of the eye fundus labeled by ophthalmologists is made available.
Phenotyping COVID-19 Patients by Ventilation Therapy: Data Quality Challenges and Cohort Characterization
Authors: Essay Patrick , Mosier Jarrod , Subbian Vignesh
Published: May 2021

The COVID-19 pandemic introduced unique challenges for treating acute respiratory failure patients and highlighted the need for reliable phenotyping of patients using retrospective electronic health record data. In this study, we applied a rule-based phenotyping algorithm to classify COVID-19 patients requiring ventilatory support. We analyzed patient outcomes of the different phenotypes based on type and sequence of ventilation therapy. Invasive mechanical ventilation, noninvasive positive pressure ventilation, and high flow nasal insufflation were three therapies used to phenotype patients leading to a total of seven subgroups; patients treated with a single therapy (3), patients treated with either form of noninvasive ventilation and subsequently requiring intubation (2), and patients initially intubated and then weaned onto a noninvasive therapy (2). In addition to summary statistics for each phenotype, we highlight data quality challenges and importance of mapping to standard terminologies. This work illustrates potential impact of accurate phenotyping on patient-level and system-level outcomes including appropriate resource allocation under resource constrained circumstances.
ClinFlow – An Interactive Application for Clinical Data Mining
Authors: Stoicescu Oana , Ferreira Eija , Tamminen Satu , Siirtola Pekka , Chandra Gunjan , Veijola Riitta , Röning Juha
Published: May 2021

Analyzing clinical data comes with many challenges. Medical expertise combined with statistical and programming knowledge must go hand-in-hand when applying data mining methods on clinical datasets. This work aims at bridging the gap between clinical expertise and computer science knowledge by providing an application for clinical data analysis with no requirement for statistical programming knowledge. Our tool allows clinical researchers to conduct data processing and visualization in an interactive environment, thus providing an assisting tool for clinical studies. The application was experimentally evaluated with an analysis of Type 1 Diabetes clinical data. The results obtained with the tool are in line with the domain literature, demonstrating the value of our application in data exploration and hypothesis testing.
A Comprehensive Portal for Clinical and Translational Data Warehouses
Authors: Johns Marco , Müller Armin , Wirth Felix Nikolaus , Prasser Fabian
Published: May 2021

Data-driven methods in biomedical research can help to obtain new insights into the development, progression and therapy of diseases. Clinical and translational data warehouses such as Informatics for Integrating Biology and the Bedside (i2b2) and tranSMART are important solutions for this. From the well-known FAIR data principles, which are used to address the aspects of findability, accessibility, interoperability and reusability. In this paper, we focus on findability. For this purpose, we describe a portal solution that acts as a catalogue for a wide range of data warehouse instances, featuring a central access point and links to training material, such as user manuals and video tutorials. Moreover, the portal provides an overview of the status of multiple warehouses for developers and a set of statistics about the data currently loaded. Due to its modular design and the use of modern web technologies, the portal is easy to extend and customize to reflect different corporate designs and institutional requirements.
On the Concepts of Identity and Similarity in the Context of Biomedical Record Linkage
Authors: Sariyar Murat , Holm Jürgen
Published: May 2021

Record linkage refers to a range of methods for merging and consolidating data in a manner such that duplicates are detected and false links are avoided. It is crucial for such a task to discern between similarity and identity of entities. This paper explores the implications of the ontological concepts of identity for record linkage (RL) on biomedical data sets. In order to draw substantial conclusions, we use the differentiation between numerical identity, qualitative identity and relational identity. We will discuss the problems of using similarity measures for record pairs and quality identity for ascertaining the real status of these pairs. We conclude that relational identity should be operationalized for RL.
Emotion Recognition Using Spectral Feature from Facial Electromygraphy Signals for Human-Machine Interface
Authors: Shiva Jayendhra , Makaram Navaneethakrishna , Karthick P.A. , Swaminathan Ramakrishnan
Published: May 2021

Recognition of the emotions demonstrated by human beings plays a crucial role in healthcare and human-machine interface. This paper reports an attempt to classify emotions using a spectral feature from facial electromyography (facial EMG) signals in the valence affective dimension. For this purpose, the facial EMG signals are obtained from the DEAP dataset. The signals are subjected to Short-Time Fourier Transform, and the peak frequency values are extracted from the signal in intervals of one second. Support vector machine (SVM) classifier is used for the classification of the features extracted. The extracted feature can classify the signals in the valence dimension with an accuracy of 61.37%. The proposed feature could be used as an added feature for emotion recognition, and this method of analysis could be extended to myoelectric control applications.
Designing an eHealth Coaching Solution to Improve Transitional Care of Seniors’ with Heart Failure: End-User Needs
Authors: Rochat Jessica , Villaverde Alexandra , Klitzing Helge , Langemyr Larsen Tore , Vogel Martin , Rime Jacques , Anghel Ionut , Cioara Tudor , Lovis Christian
Published: May 2021

Based on scientific studies, heart failure is the principal cause of hospitalization among seniors. More than 50% of elderly with heart failure are readmitted to hospital within six months. Readmission is linked with poor compliance with medical treatment and recommendations, emphasizing the need for a tool to help seniors better comply with post-discharge measures. The goal of this study was to identify end-user needs for the development of a coaching solution aiming to support elderly patients but also formal and informal caregivers. End-user needs were identified through interviews with the three end-user profiles: seniors with heart failure and formal and informal caregivers. The results present six categories of needs: daily treatment follow-up; healthcare network communication; transfer of information; synchronization with current digital tools; information access; and psychosocial support. The identified needs will help to develop an eHealth solution to improve care management and coaching after discharge.
Health and Social Care During Coronavirus Outbreak: The Exploitation of Long Lasting Memories – LLM Care
Authors: Romanopoulou Evangelia , Zilidou Vasiliki , Gylou Sotiria , Dratsiou Ioanna , Katsouli Aikaterini , Karagianni Maria , Petronikolou Vasileia , Varella Annita , Bamidis Panagiotis
Published: May 2021

The Covid-19 pandemic has globally introduced a new crisis with severe consequences and led to a series of pandemic-related containment measures, including social distancing and self-isolation may cause significant impact on mental health. This study describes a social care initiative that was actualized during the Covid-19 outbreak with regard to the potential benefits in older adults’ quality of life through the use of the Integrated Healthcare System Long Lasting Memories Care (LLM Care), and specifically the web-based cognitive training software. Online questionnaires, assessing various psychosocial and mental health domains, were distributed to 28 older adults before and after the interaction with the software aiming at evaluating the potential positive effect and usability of cognitive training software. Overall, the study demonstrates that the interaction with the web-based cognitive training software during the pandemic plays a significant role in maintaining mental health among older people, through improvements in well-being.
Building a Knowledge Graph Representing Causal Associations Between Risk Factors and Incidence of Breast Cancer
Authors: Daowd Ali , Barrett Michael , Abidi Samina , Abidi Syed Sibte Raza
Published: May 2021

This paper explores the use of semantic- and evidence-based biomedical knowledge to build the RiskExplorer knowledge graph that outlines causal associations between risk factors and chronic disease or cancers. The intent of this work is to offer an interactive knowledge synthesis platform to empower health-information-seeking individuals to learn about and mitigate modifiable risk factors. Our approach analyzes biomedical text (from PubMed abstracts), Semantic Medline database, evidence-based semantic associations, literature-based discovery, and graph database to discover associations between risk factors and breast cancer. Our methodological framework involves (a) identifying relevant literature on specified chronic diseases or cancers, (b) extracting semantic associations via knowledge mining tool, (c) building rich semantic graph by transforming semantic associations to nodes and edges, (d) applying frequency-based methods and using semantic edge properties to traverse the graph and identify meaningful multi-node NCD risk paths. Generated multi-node risk paths consist of a source node (representing the source risk factor), one or more intermediate nodes (representing biomedical phenotypes), a target node (representing a chronic disease or cancer), and edges between nodes representing meaningful semantic associations. The results demonstrate that our methodology is capable of generating biomedically valid knowledge related to causal risk and protective factors related to breast cancer.
The Information from Medical Data Based: Prevalence and Expected Median Survival Time of Drug-Induced Hepatotoxicity Among Thai Patients with TB
Authors: Khiewkhern Santisith , Pratumchai Nuchnapa , Sattayarak Parichart , Phuwilert Patcharin , Noo-In Supattra , Areeruk Naree
Published: May 2021

Background: Hepatotoxicity is very frequent and is a dangerously adverse effect of anti-TB medications. This effect can reduce the effectiveness of the treatment by compromising treatment regimens. Among these first-line quadruple therapy drugs (INH, RMP, PZA, and EMB), INH, RMP, and PZA are metabolized mostly by the liver, and due to this, are likely hepatotoxic. However, the survival times of hepatotoxicity among patients with TB in Thailand are currently not available. The aims of the present study were to assess the prevalence and survival time of drug-induced hepatotoxicity in patients with TB. Methods: A cross-sectional retrospective study was performed to explore the survival time of the development of drug-induced hepatotoxicity among 327 patients with TB who received standard drug treatment at the TB clinic in Phichit Hospital. Data was collected from the HOSxP program and medical records from 2016 to 2018. Kaplan-Meier and Cox’s regressions were used for data analysis. Results: The results showed that prevalence of drug-induced hepatotoxicity was 6.42% and confirmed that patients with TB who were <50 years of age will be a median survival time on drug-induced hepatotoxicity is 17 days and 30 days for those who age group ≥50 years. Conclusion: The median survival time of drug-induced hepatotoxicity among patients with TB who were <50 years of age is 17 days. So, patients with TB whose ages are less than 50 years should receive liver function tests such as AST and ALT and investigate risk behavior before receiving the anti- TB treatment.
Digital Skills and Skills to Deal with COVID-19 Information: Sociodemographic Differences in a Cross-Sectional Study
Authors: Götz Nina-Alexandra , Hannemann Niels , Schmidt Lisa , Babitsch Birgit
Published: May 2021

In the current COVID-19 pandemic, the importance of digital media as a source of information for health-related behavior is impressively demonstrated. Until now there has been a lack of national research on the influence of socioeconomic differences in digital literacy and in the use of COVID-19 information. This study aims to analyze the influence of educational status and subjective social status on digital literacy and on the ability in using COVID-19 information. Data from a cross-sectional online survey were used. The results indicate social differences in digital literacy and in the ability to critically evaluate COVID-19 information.
Maintaining the Link Between Patients and Their Families During the COVID Pandemic Using Visio: Iterative Development and Evaluation
Authors: Ehrler Frederic , Bornet Dit Vorgeat Helena , Zimmermann Ivol Catherine
Published: May 2021

Access to hospitals has been dramatically restricted during the COVID 19 pandemic. As a result, the patients were unable to communicate with their families other than through virtual communication channels. A still significant number of patients, which do not have access to modern videoconference tools, were completely isolated. As a result, the University Hospitals of Geneva decided to implement a Visio conference system inside their patient app ecosystem to allow every patient to remain connected. This article presents the iterative development of the solution in order to respond to the specific timely constraint of the situations as well as its evaluation by the patients and caregivers. Two iterations of the tool have been developed. The first relied on an existing commercial platform whereas the second is a fully integrated solution in our patient app ecosystem. The very positive evaluation at the first stage by more than 300 patients, relatives and caregivers convinced us to invest additional effort to provide a fully integrated solution. The second version, evaluated by 16 patients, confirmed that the Visio reaches its objective of reducing isolation during hospitalization. This initiative is completely in line with the objective of the hospital of providing human centered care.
eHealth Patient Portal – Becoming an Indispensable Public Health Tool in the Time of Covid-19
Authors: Stanimirovic Dalibor
Published: May 2021

Patient Portal represents a connecting service for the Slovenian eHealth solutions and enables patients with effective and secure access to their medical documentation. Ever since its national roll-out in 2017 the number of visits of the Patient Portal has been constantly growing, however, during the time of Covid-19, the number of visits has increased dramatically to reach almost 1.9 million visits in 2020. This article initially presents the functionalities of the Patient Portal and the dynamics of the visits to the Patient Portal in the time of Covid-19. In the second part, the article outlines the most significant benefits to healthcare stakeholders provided by the Patient Portal in the period of Covid-19. The study applies a focus group methodology. Structured focus group discussions were carried out with prominent experts, who are in charge of the Patient Portal and other national eHealth solutions in Slovenia. Research results indicate that the Patient Portal has attracted enormous interest and has become one of the essential public health tools empowering patients and supporting the enactment of public health policies and measures during the Covid-19 crisis.
Interdisciplinary Teaching of Digital Competencies for Undergraduate Medical Students – Experiences of a Teaching Project by Medical Informatics and Medicine
Authors: Behrends Marianne , Paulmann Volker , Koop Christian , Foadi Nilufar , Mikuteit Marie , Steffens Sandra
Published: May 2021

The increasing digitalization of medicine stressed the importance of teaching digital competencies in undergraduate medical education. However, in many medical curricula in Germany, medical informatics is underrepresented. Due the upcoming reorganization of medical undergraduate education in Germany, topics previously assigned to medical informatics represent curricular challenges for all medical disciplines. Against this background, experiences from the project DigiWissMed show how medical informatics can support the teaching of digital competencies in all disciplines of medical education. Therefore, interdisciplinary teaching teams of medical informatics professionals and physicians were formed. In different academic years, this teaching teams jointly designed and implemented new seminars to convey digital competencies. The seminars covers topics such as technology acceptance, telemedicine and assistive health care related to the medical specialty. So, in the project DigiWissMed, the practicability and usefulness of interdisciplinary teaching teams to convey digital competencies could be demonstrate. In the digitalization process of medicine, medical informatics plays a key role. For future-proof medical education, experts of this field should be involved in teaching digital competencies, too.
Adjustable Data Cleaning Towards Extracting Statistical Information
Authors: Mavrogiorgou Argyro , Kiourtis Athanasios , Manias George , Kyriazis Dimosthenis
Published: May 2021

Each device, organization, or human, is affected by the effects of Big Data. Analysing these vast amounts of data can be considered of vital importance, surrounded by many challenges. To address a portion of these challenges, a Data Cleaning approach is being proposed, designed to filter the non-important data. The functionality of the Data Cleaning is evaluated on top of Global Terrorism Data, to furtherly create policies on how terrorism is affecting national healthcare.
The Potential of an Artificial Intelligence for Disability Advocacy: The WikiDisability Project
Authors: Gorman Rachel , Maret Pierre , Creighton Alexandra , Kundi Bushra , Muhlenbach Fabrice , Buettgen Alexis , Dua Enakshi , Reaume Geoffrey , Mgwigwi Thumeka , Dinca-Panaitescu Serban , El Morr Christo
Published: May 2021

Human rights monitoring for people with disabilities is in urgent need for disability data that is shared and available for local and international disability stakeholders (e.g., advocacy groups). Our aim is to use a Wikibase for editing, integrating, storing structured disability related data and to develop a Natural Language Processing (NLP) enabled multilingual search engine to tap into the wikibase data. In this paper, we explain the project first phase.
Diversity in Health Informatics: Mentoring and Leadership
Authors: Moen Anne , Chronaki Catherine , Petelos Elena , Voulgaraki Despina , Turk Eva , Névéol Aurélie
Published: May 2021

Diversity, inclusion and interdisciplinary collaboration are drivers for healthcare innovation and adoption of new, technology-mediated services. The importance of diversity has been highlighted by the United Nations’ in SDG5 “Achieve gender equality and empower all women and girls”, to drive adoption of social and digital innovation. Women play an instrumental role in health care and are in position to bring about significant changes to support ongoing digitalization and transformation. At the same time, women are underrepresented in Science, Technology, Engineering and Mathematics (STEM). To some extent, the same holds for health care informatics. This paper sums up input to strategies for peer mentoring to ensure diversity in health informatics, to target systemic inequalities and build sustainable, intergenerational communities, improve digital health literacy and build capacity in digital health without losing the human touch.
Importance of Digital Literacy in the Process of Confronting the Stress During COVID-19 Pandemic
Authors: Bosanac Daša , Luic Ljerka
Published: May 2021

COVID-19 pandemic is a global problem that raised the perception of stress to a completely new level, unseen so far in peace conditions. To reduce the level of stress and deal with its accumulated consequences, people enforce different strategies and coping mechanisms. In the vast amount of information available, imposed by the media, and often filled with falsehoods and catastrophizing related topics, it can be very challenging to distinguish the truth from falsehoods. The existence of an adequate level of digital literacy and e-Health literacy can help society to deal with that problem. Digital and e-Health literacy enables society to search for information efficiently, while remaining critical and open-minded, and use the newly adopted knowledge to improve our mental health. The aim of the paper was to present the frequency of news searches and trusting the COVID-19 related information in the group of medical professionals in Croatia. The survey was conducted using an online questionnaire, containing psychological questionnaires and relevant questions about everyday functioning. Based on the results that show a significant correlation between the frequency of information search and the lack of trust in the search results, we discuss the importance of digital and e-Health literacy, primarily within medical professionals.
Correlation of Serum IL-6 Levels with Muscle Mass, Muscle Strength, and Physical Performance in Elderly Gymnastics Community in Mohammad Hoesin General Hospital Palembang
Authors: Erfin Muhammad , Nur Riviati  , Nova Kurniati  , Erial Bahar  , Erwin Sukandi  , Sudarto
Published: May 2021

Introduction. Old age is related to geriatric syndrome where there are several health problems that often occur related to a decrease in body function and an increase in the inflammatory process. Decrease in muscle mass, muscle strength and physical performance will cause a condition of sarcopenia and frailty syndrome in the elderly. The importance of prevention so that sarcopenia does not occur in the elderly by evaluating the factors that can cause it, one of which is controlling interleukin 6 (IL-6) as proinflammatory. The purpose of this study was to determine the correlation between serum IL-6 levels with muscle mass, muscle strength and physical performance in the elderly gymnastics-community in Mohammad Hoesin General Hospital, Palembang.

Methods. This research is an observational analytic study with a cross-sectional approach which was conducted at the Integrated Geriatric Clinic Internal Medicine RSMH Palembang from November 2019 to November 2020. A sample of 31 people aged > 60 years was examined for muscle mass, muscle strength, physical performance and IL-levels. 6 serum. All data processing and analysis in this study used the SPSS version 25 for Windows program.

Results. of the 31 subjects, 27 were female (87.1%) and 4 male (12.9%). The mean value of muscle mass is37.9 kg/m2, muscle strength 23 kg, and physical performance 6.1 m/sec.There were 28 (90.3%) samples with elevated serum IL-6 levels, while 3 (9.7%) samples had normal levels. There was a significant negative correlation (p = 0.000) with a strong correlation strength (r = -0.722) between serum IL-6 levels and muscle mass and a significant negative correlation (p = 0.050) with a weak correlation strength (r = -0.354) between IL levels -6 serums with physical performance.

Conclusions. There was a significant negative correlation between serum IL-6 levels and muscle mass and physical performance. So, it is very important to prevent an increase in serum IL-6 levels so that the elderly do not fall into a state of sarcopenia.
Immobilization of Phenylalanine Ammonia-lyase via EDTA Based Metal Chelate Complexes – Optimization and Prospects
Authors: Sánta-Bell Evelin , Kovács Norbert Krisztián , Alács Bálint , Molnár Zsófia , Hornyánszky Gábor
Published: May 2021

Immobilized metal ion affinity chromatography principles were applied for selective immobilization of recombinant polyhistidine tag fused phenylalanine ammonia-lyase from parsley (PcPAL) on porous polymeric support with aminoalkyl moieties modified with an EDTA dianhydride (EDTADa)-derived chelator and charged with transition metal ions. Out of the five investigated metal ions - Fe3+, Co2+, Ni2+, Cu2+, Zn2+ - the best biocatalytic activity of PcPAL was achieved when the enzyme was immobilized on the Co2+ ion-charged support (31.8 ± 1.2 U/g). To explore the features this PcPAL obtained by selective immobilization, the thermostability and reusability of this PAL biocatalyst were investigated. To maximize the activity of the immobilized PcPAL the surface functionalization of the aminoalkylated polymeric carrier was fine-tuned with using glycidol as a thinning group beside EDTADa. The maximal activity yield (YA=103 %) was earned when the EDTADa and glycidol were used in 1 to 24 ratio. The reversibility of the immobilization method allowed the development of a support regeneration protocol which enables easy reuse of the functionalized support in case of enzyme inactivation.
Ivan Ilʹin and the Kremlin’s Strategic Communication of Threats: Evil, Worthy and Hidden Enemies
Authors: Pynnöniemi Katri
Published: May 2021

Enemy images can be thought of as scripts that articulate a logic of enmity and identify a source of threat towards the Self. In this chapter, Russian émigré philosopher Ivan Ilʹin’s identification of Russia’s enemies are used as a reference point in the analysis of the Kremlin’s strategic communication of threats. The analysis of Ilʹin’s enemy images and their juxtaposition with the Kremlin’s strategic communication of threats opens up three different but complementary scripts that explain threats and risks for Russia’s state security.
Repatriation operation in South Australia during the COVID-19 pandemic: initial planning and preparedness
Authors: Meena Sonali , Chan Joel , Phan Tuong-Vi , Butenko Samantha , Hurley Jenny , McGowen Paul , Kirkpatrick Emily , Upton Lisa , Abdul Rahim Razlyn , McConnell Matthew , Hall Robert
Published: May 2021

With COVID-19 affecting millions of people around the globe, quarantine of international arrivals is a critical public health measure to prevent further disease transmission in local populations. This measure has also been applied in the repatriation of citizens, undertaken by several countries as an ethical obligation and legal responsibility. This article describes the process of planning and preparing for the repatriation operation in South Australia during the COVID-19 pandemic. Interagency collaboration, development of a COVID-19 testing and quarantining protocol, implementing infection prevention and control, and building a specialised health care delivery model were essential aspects of the repatriation operational planning, with a focus on maintaining dignity and wellbeing of the passengers as well as on effective prevention of COVID-19 transmission. From April 2020 to mid-February 2021, more than 14,000 international arrivals travellers have been repatriated under the South Australian repatriation operations. This paper has implications to inform ongoing repatriation efforts in Australia and overseas in a pandemic situation.
Длина начального участка осесимметричной турбулентной струи, образующейся в пенном розеточном оросителе для автоматических установок пожаротушения
Authors: Likhomanov Aleksey O. , Kamlyuk Andrey N.
Published: May 2021

Цель. Выполнить анализ теоретических подходов к описанию структуры осесимметричных турбулентных струй, а также к расчету их начального участка в режиме распыливания. Теоретически рассчитать длину дужек пенного розеточного оросителя (т.е. расстояние от выходного отверстия оросителя до его розетки), при которой происходит наиболее интенсивное пенообразование, и сопоставить полученный результат с экспериментальными данными.

Методы. В ходе работы использовался ряд теоретических методов исследования (анализ, синтез, сравнение) для изучения подходов к описанию и расчету осесимметричных турбулентных струй, а также для сопоставления теоретически рассчитанных данных по длине дужек пенного розеточного оросителя с результатами эксперимента.

Результаты. Сформулирована гипотеза об оптимальной длине дужек L пенного розеточного оросителя с целью обеспечения наиболее интенсивного пенообразования в нем: оптимальная длина дужек должна равняться длине начального участка струи, образующейся на выходе из штуцера оросителя Lн, т.е. L = Lн. Рассчитаны нижний и верхний пределы диапазона значений длины начального участка струи воды, образующейся на выходе из штуцера розеточного оросителя определенной геометрии: 117 ≤ Lн ≤ 201 мм. При экспериментальном определении кратности пены (характеризует интенсивность пенообразования), генерируемой розеточным оросителем, для которого выполнялся теоретический расчет, оптимальное по данной характеристике пены значение длины дужек оказалось равным L = 114 ± 4 мм, что согласуется с теорией с поправкой на более низкий коэффициент поверхностного натяжения пенообразующего раствора по сравнению с обычной водой. Кроме того, предложено выражение для расчета длины начального участка струи для рассматриваемого штуцера пенного розеточного оросителя, которое в первом приближении может быть применено для оценки значения Lн при использовании разных марок и типов пенообразователей, а также при распыливании в газе с иной плотностью.

Область применения исследований. Полученные результаты могут быть использованы для дальнейшего изучения процесса пенообразования в розеточных оросителях для автоматических установок пожаротушения с целью повышения их огнетушащей эффективности. Предложенное выражение для расчета длины начального участка образующейся на выходе из пенного розеточного оросителя струи может быть применено для оценки значения данного параметра при использовании разных марок и типов пенообразователей, а также при распыливании в газе с иной плотностью.
Additional treatment with Carnoy solution in surgical therapy of ameloblastomas: Case report
Authors: Cavalcanti Thames Bruno Barbosa , Souza Rosa Lins de , Catunda Ivson Souza , Pinto Priscilla Sarmento , Viana Ruan de Sousa , Silva Igor Chaves Gama da , Melo Sthephany Ellen Mendes de , Brito Felipe Ricardo Cisneiros , Santos Greiciane Miguel de Azevedo , Gôndola Abdiel Ortega
Published: May 2021

Introduction: Ameloblastoma is a benign neoplasm characterized by the proliferation of odontogenic epithelium that mainly affects the gnathic bones and, due to its invasive and expansive growth, presents high rates of recurrence to surgical treatment. Among the most conservative treatments are enucleation and marsupialization; among radicals, resections are more widespread. Objective: The objective is to present, through a case report, conservative surgical treatment with enucleation followed by the use of the Carnoy solution. Case report: A 24-year-old male patient arrives at the outpatient clinic of Hospital da Restauração with painful complaints of mild and constant intensity in the region of the left mandibular angle, with an evolution of three weeks. After a panoramic X-ray, the presence of the included 38 tooth was associated with an extensive unilocular radiolucent lesion, surrounding the angle and mandibular ramus. Preoperative examinations were performed for incisional biopsy. Histopathological diagnosis was unicystic ameloblastoma. In view of the histopathology obtained, we opted for enucleation of the lesion with concomitant use of direct Carnoy solution in the region of the lesion. Discussion: The choice of therapeutic behavior depends on the size, type of lesion, location and histopathology. After the surgical decision, a radiographic clinical follow-up is necessary to assess possible recurrences. Carnoy's solution is a cauterizing agent with moderate tissue penetration, rapid local fixation and hemostatic action, whose surgical use in cystic lesions has occurred since the beginning of the 20th century. Conclusion: Conservative treatment with the enucleation technique followed by complementary therapy using Carnoy's solution proved to be quite effective.
Vantagens da utilização de antibióticos encapsulados em lipossomas para o combate de infecções causadas por enterobactérias
Authors: Silva Júlio Eduardo Barbosa da , Souza Jaqueline Barbosa de , Macêdo Daniel Charles dos Santos , Campos Luís André de Almeida , Cavalcanti Isabella Macário Ferro
Published: May 2021

Introdução: O tratamento de doenças causadas por enterobactérias é um desafio cada vez maior. Esse problema resulta na ineficiência dos antibióticos combaterem os patógenos ou estimularem a fagocitose de células do sistema reticuloendotelial, principalmente contra bactérias que se instalam e se multiplicam no interior de células fagocíticas. Alguns antibióticos são ineficazes em adentrar as células ou tem sua capacidade reduzida pela membrana plasmática. Assim, a comunidade científica reúne esforços buscando novas alternativas terapêuticas que ultrapassem essas limitações. Os lipossomas são nanocarreadores lipídicos capazes de encapsular antibióticos, visando o aumento na especificidade da entrega, a concentração de compostos entregues ao local, manter a concentração plasmática dos fármacos e proteger os princípios ativos. Assim, o objetivo dessa revisão foi descrever as principais propriedades lipossomais, enfatizando as vantagens de utilizar essas vesículas lipídicas para administração de antibióticos frente a infecções causadas por enterobactérias. Metodologia: Trata-se de uma revisão bibliográfica através de buscas nas bases eletrônicas nacionais e internacionais selecionando artigos de 2007 a 2020 utilizando os descritores:  Bactérias gram-negativas, Resistência bacteriana, Antimicrobianos e Nanotecnologia. Resultados: Lipossomas catiônicos e furtivos constituídos principalmente por colesterol, PEG, fosfatidilcolina e carboximetilquitosana encapsulando fármacos como amoxicilina, ciprofloxacina, cloxacilina, vancomicina, azitromicina, amoxicilina, cefepime, gentamicina e cefotaxime demonstraram atividade antibacteriana. Lipossomas encapsulando fármacos como cloranfenicol, azitromicina, gentamicina e polimixina B apresentaram maior eficiência antibiofilme frente a enterobactérias quando comparados aos fármacos não encapsulado. Conclusão: Os resultados mostraram que os lipossomas apresentam potencial terapêutico significativo para o tratamento de infecções causadas por enterobactérias.
Baixa prevalência de infecções por Clostridioides difficile em Hospitais de Referência em Oncologia
Authors: Tenório Catarina , Araújo Paulo Sérgio Ramos de , Lins Ana Kelly , Sobrinho Carlos Roberto Weber , Magalhães Vera
Published: May 2021

As infecções por Clostridioides difficile (CDI) aumentaram em gravidade e incidência durante a última década. O câncer predispõe os pacientes à CDI, devido à maior exposição aos fatores de risco. O presente estudo teve como objetivo determinar a prevalência, resposta clínica, desfecho, descrever os fatores de risco estabelecidos na literatura em pacientes oncológicos com CDI. O estudo foi realizado em dois serviços de referência em oncologia de Recife/PE e envolveu pessoas com idade ≥18 anos, que apresentaram o quadro de diarreia após 48horas da admissão hospitalar, no período de novembro/2017 a agosto/2019.  Para o diagnóstico de CDI  foi utilizado o exame Reação em Cadeia da Polimerase em Tempo Real (qRT-PCR). Um total de 156 pacientes foram incluídos, a CDI foi identificada em 7,05% (11/156) dos pacientes estudados, todos isolados foram rastreados e amplificados por qRT-PCR quanto à presença dos genes que codificam as toxinas A e B (tcdA e tcdB), toxina binária (cdtA) e triose fosfato isomerase (tpi). O câncer de mama 27,3% (3/11) e a leucemia linfóide aguda 18,2% (2/11) foram os cânceres mais frequentes; 90,9% (10/11) fizeram uso de antibióticos e 63,6% (7/11) dos casos evoluíram para óbito. Apesar de utilizar a técnica qRT-PCR, que é a mais sensível e específica, a prevalência de CDI foi baixa 7,05% (11/156), não houve registros de casos de CDI graves, sendo a maioria dos casos leves, o que sugere uma circulação de cepas com baixa virulência que determinam menor morbidade e mortalidade.
Fracture Analysis of Vacancy Defected Nitrogen Doped Graphene Sheets Via MD Simulations
Authors: Shirzadi Jahromi Hassan , Mehdipour Fatemeh , Firoozi Ghasem
Published: May 2021

The novel hexagonal monolayer sheet of carbon atoms, graphene, has attracted great attention due to their exceptional electrical and mechanical properties. Their phenomenally high strength and elastic strain, nevertheless, can be altered by structural defects due to stress concentration. In this paper, the fracture behaviour of graphene sheets and nitrogen doped graphene sheets with vacancies were investigated using molecular dynamics (MD) simulations at the different temperatures of 300K, 500K, and 900K. The results reveal a significant strength loss caused by both the defects and vacancies and doped nitrogen in graphene. The deformation process of graphene at various strain rate levels, with regard to the failure behaviour, is discussed. The validity of the proposed MD simulations is verified by comparing the simulation results with the available predictions from the quantized fracture mechanics.
Assessment of Liver Function for Evaluation of Short- and Long-Term Outcomes in Type B Aortic Dissection Patients Undergoing Thoracic Endovascular Aortic Repair
Authors: Liu Jitao , Wu Min , Xie Enmin , Chen Lyufan , Su Sheng , Zeng Hongke , Geng Qingshan , Yang Fan , Luo Jianfang
Published: May 2021

Background and Aims: Patients with decreased liver function suffer from poor outcomes when undergoing procedures. We aimed to explore the impact of liver fibrosis identified by aspartate transaminase-to-platelet ratio index (APRI) and poor liver functional reserve assessed by a model of end-stage liver disease (MELD) and albumin–bilirubin(ALBI) score on the prognosis of patients with type B aortic dissection (TBAD) undergoing thoracic endovascular aortic repair (TEVAR).

Methods: A retrospective analysis of a prospectively maintained database from 2010 to 2017 was performed. APRI > 0.5 was used to identify those with significant liver fibrosis. Logistic and Cox regression analyses were performed to investigate the association between liver fibrosis, MELD, and ALBI with adverse events.

Results: TEVAR was performed on 812 TBAD patients including 35 with liver fibrosis and 777 without. Twenty-four (3.0%) patients deceased during hospitalization and 69 (8.8%) patients died after a median 48.2 months follow-up. Multivariable analysis revealed that liver fibrosis, MELD, and ALBI were independently associated with in-hospital [fibrosis: odds ratio (OR) 23.73, 95% confidence interval (CI) 8.89–63.33, P < 0.001; MELD: OR 1.08, 95% CI 1.03–1.14, P = 0.003; ALBI: OR 4.45; 95% CI 1.56–12.67, P = 0.005] and follow-up mortality [fibrosis: hazard ratio (HR) 4.69, 95% CI 1.93–11.42, P = 0.001; MELD: HR 1.07, 95% CI 1.04–1.10, P < 0.001; ALBI: HR 2.88, 95% CI 1.53–5.43, P = 0.001]. The association was further corroborated by a subgroup analysis.

Conclusion: Liver fibrosis and poor liver functional reserve could significantly increase the morbidity and mortality after TEVAR. APRI, MELD, and ALBI should be calculated and routinely used for preoperative risk stratification. Strict preoperative preparation and elaborate postoperative care are necessary to improve these patients' prognosis.
Case Report: Combined Intra-Lesional IL-2 and Topical Imiquimod Safely and Effectively Clears Multi-Focal, High Grade Cutaneous Squamous Cell Cancer in a Combined Liver and Kidney Transplant Patient
Authors: Vidovic Dejan , Simms Gordon A. , Pasternak Sylvia , Walsh Mark , Peltekian Kevork , Stein John , Helyer Lucy K. , Giacomantonio Carman A.
Published: May 2021

Cutaneous squamous cell carcinoma (cSCC) is the second most common non-melanoma skin cancer worldwide, with ever increasing incidence and mortality. While most patients can be treated successfully with surgical excision, cryotherapy, or radiation therapy, there exist a subset of patients with aggressive cSCC who lack adequate therapies. Among these patients are solid organ transplant recipients who due to their immunosuppression, develop cSCC at a dramatically increased rate compared to the normal population. The enhanced ability of the tumor to effectively undergo immune escape in these patients leads to more aggressive tumors with a propensity to recur and metastasize. Herein, we present a case of aggressive, multi-focal cSCC in a double organ transplant recipient to frame our discussion and current understanding of the immunobiology of cSCC. We consider factors that contribute to the significantly increased incidence of cSCC in the context of immunosuppression in this patient population. Finally, we briefly review current literature describing experience with localized therapies for cSCC and present a strong argument and rationale for consideration of an IL-2 based intra-lesional treatment strategy for cSCC, particularly in this immunosuppressed patient population.
Dermatologic Toxicities of Targeted Therapy and Immunotherapy in Head and Neck Cancers
Authors: Espinosa Maria L. , Abad Chelsea , Kurtzman Yaira , Abdulla Farah R.
Published: May 2021

Treatment of head and neck cancers requires multidisciplinary collaboration to reduce morbidity and mortality associated with the tumor burden, as well as to preserve function of organs and structures. With the use of various new targeted therapies come new adverse events including dermatologic toxicities, which may consist of xerosis, nail and hair changes, morbilliform or papulopustular rashes, to more severe eruptions such as Stevens–Johnson syndrome. We describe the dermatologic toxicities and corresponding grades of severity and associated pathophysiology resulting from seven therapeutics used to treat head and neck cancers: cetuximab, trastuzumab, pembrolizumab, nivolumab, lentatinib, larotrectinib, and entrectinib. Being familiar with these dermatologic toxicities allows clinicians to provide comprehensive counseling for patients, encourage preventative measures, and to know when it is appropriate to hold therapy or permanently stop treatment.
The Locating-Chromatic Number of Origami Graphs
Authors: Irawan Agus , Asmiati Asmiati , Zakaria La , Muludi Kurnia
Published: May 2021

The locating-chromatic number of a graph combines two graph concepts, namely coloring vertices and partition dimension of a graph. The locating-chromatic number is the smallest k such that G has a locating k-coloring, denoted by χL(G). This article proposes a procedure for obtaining a locating-chromatic number for an origami graph and its subdivision (one vertex on an outer edge) through two theorems with proofs.
Environmental Spread of Antibiotic Resistance
Authors: Skandalis Nicholas , Maeusli Marlène , Papafotis Dimitris , Miller Sarah , Lee Bosul , Theologidis Ioannis , Luna Brian
Published: May 2021

Antibiotic resistance represents a global health concern. Soil, water, livestock and plant foods are directly or indirectly exposed to antibiotics due to their agricultural use or contamination. This selective pressure has acted synergistically to bacterial competition in nature to breed antibiotic-resistant (AR) bacteria. Research over the past few decades has focused on the emergence of AR pathogens in food products that can cause disease outbreaks and the spread of antibiotic resistance genes (ARGs), but One Health approaches have lately expanded the focus to include commensal bacteria as ARG donors. Despite the attempts of national and international authorities of developed and developing countries to reduce the over-prescription of antibiotics to humans and the use of antibiotics as livestock growth promoters, the selective flow of antibiotic resistance transmission from the environment to the clinic (and vice-versa) is increasing. This review focuses on the mechanisms of ARG transmission and the hotspots of antibiotic contamination resulting in the subsequent emergence of ARGs. It follows the transmission of ARGs from farm to plant and animal food products and provides examples of the impact of ARG flow to clinical settings. Understudied and emerging antibiotic resistance selection determinants, such as heavy metal and biocide contamination, are also discussed here.
Antioxidant Defenses in Plants: A Dated Topic of Current Interest
Authors: Guidi Lucia , Tattini Massimiliano
Published: May 2021

Plants have been challenged against oxidative stress since their appearance on land [...]