bluuebunny/crossref_metadata_2025 huggingface dataset:
Intravenous alteplase has different effects on the efficacy of aspiration and stent retriever thrombectomy: analysis of the COMPASS trial
Authors: Mokin Maxim , Waqas Muhammad , Fifi Johanna T , De Leacy Reade , Fiorella David , Levy Elad I , Snyder Kenneth , Hanel Ricardo A , Woodward Keith , Chaudry Imran , Rai Ansaar T , Frei Donald , Delgado Almandoz Josser E , Kelly Michael , Arthur Adam S , Baxter Blaise W , English Joey , Linfante Italo , Fargen Kyle M , Turk Aquilla , Mocco J , Siddiqui Adnan H
Published: October 2021

Background

There is conflicting evidence on the utility of intravenous (IV) alteplase in patients with emergent large vessel occlusion (ELVO) treated with mechanical thrombectomy (MT).

Methods

This was a post hoc analysis of the COMPASS: a trial of aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion. We compared clinical, procedural and angiographic outcomes of patients with and without prior IV alteplase administration.

Results

In the COMPASS trial, 235 patients had presented to the hospital within the first 4 hours of stroke symptom onset and were eligible for analysis. On univariate analysis, administration of IV alteplase prior to MT was found to be significantly associated with favorable outcomes (modified Rankin scale (mRS) 0–2 at 3 months; 55.6% vs 40.0% in the MT-only group, P=0.037). However, on multivariate analysis, only baseline (pre-stroke) mRS, admission National Institutes of Health Stroke Scale (NIHSS) score and age were identified as independent predictors of favorable outcomes at 3 months. We found higher final thrombolysis in cerebral infarction (TICI) 2b/3 rates in patients without the use of alteplase prior to the aspiration first approach (100.0% vs 87.9% in IV altepase +aspiration first MT, P=0.03). In the stent retriever first group, final TICI 2b/3 rates were identical in patients with and without IV alteplase administration (87.5% and 87.5%, P=1.0).

Conclusions

Prior administration of IV alteplase may adversely affect the efficacy of aspiration, but does not seem to influence the stent retriever first approach to MT in patients with anterior circulation ELVO.
Transvenous embolization of a cerebrospinal fluid–venous fistula for the treatment of spontaneous intracranial hypotension
Authors: Borg Nicholas , Oushy Soliman , Savastano Luis , Brinjikji Waleed
Published: October 2021

Cerebrospinal fluid–venous fistula is an increasingly recognized cause of spontaneous intracranial hypotension.1 The site of the leak is between the dural sleeve around a spinal nerve root and the surrounding foraminal veins. In appropriately investigated patients, transvenous embolization of the draining foraminal and paraspinal veins has been shown to be an effective way of treating the disease, with low periprocedural morbidity, improvement in symptoms and radiological appearances.2 Video 1 shows the technique employed in a typical case using Onyx (Medtronic, Minnesota, USA) to embolize a CSF–venous fistula at the right T10 neural foramen.

Video 1

Video showing the technique for trans-venous embolization of a right T10 CSF-venous fistula for the treatment of spontaneous intracranial hypotension. The first section covers patient selection and work up, before then focusing on the technical aspects of navigating through the azygos system to the target foramen and completely occluding the pathway for CSF outflow.
Assessment of a wastewater stabilization pond system for removal of arsenic, iron, and ammonia from reverse osmosis water treatment plant residual wastewater
Authors: Bull Harrison , Ekhlasi Nia Ali , Asadi Mohsen , McPhedran Kerry
Published: October 2021

Drinking water treatment plants (DWTPs) produce wastewaters with elevated concentrations of heavy metals, metalloids, ammonia, and other contaminants. These wastewaters require treatment via processes including wastewater stabilization ponds (WSPs). This study assessed the arsenic (As), iron (Fe), and ammonia (NH3) concentrations in a Saskatchewan DWTP WSP system of five sequential ponds. Drone imaging combined with flow and depth data was used to estimate retention times which increased from 7–9 to 8–10 days after the DWTP upgrade. Concentration trends showed Fe decreased from Pond 1 to 3 and increased in Ponds 3 and 5, while As decreased from Pond 1 to 5. Average effluent As concentrations of 10.6 µg/L were above the 5.0 µg/L guideline, while concentration guidelines for both Fe and NH3 were easily met post-upgrade in 2020. Several actions are recommended to ensure adequate WSP operation including dredging, aeration, and installing macrophytes capable of As uptake.
Covering dimension of Cuntz semigroups II
Authors: Thiel Hannes , Vilalta Eduard
Published: October 2021

We show that the dimension of the Cuntz semigroup of a [Formula: see text]-algebra is determined by the dimensions of the Cuntz semigroups of its separable sub-[Formula: see text]-algebras. This allows us to remove separability assumptions from previous results on the dimension of Cuntz semigroups.

To obtain these results, we introduce a notion of approximation for abstract Cuntz semigroups that is compatible with the approximation of a [Formula: see text]-algebra by sub-[Formula: see text]-algebras. We show that many properties for Cuntz semigroups are preserved by approximation and satisfy a Löwenheim–Skolem condition.
Effect of rolling deformation on microstructure and properties of Cu–Ni–Mo alloy prepared by aluminothermic reaction
Authors: Zheng Yuehong , Zhao He , Zhu Sijia , La Peiqing , Zhan Faqi , Zhu Min , Sheng Jie , Liu Haibin
Published: October 2021

The metallic element Mo has almost no solid solubility in copper and can be used as a nucleation particle to refine the grain size and increase the recrystallization temperature of the alloy during solidification. It is expected to obtain copper alloys with good comprehensive properties by reasonably controlling the addition amount of Mo. However, it is difficult to prepare Cu–Mo alloys with uniform structure and there are few related literatures. In this paper, the aluminothermic reaction method, which has the advantages of simple process, low cost, and large size of the prepared alloy, was adopted, and a cluster model with the atomic ratio of Mo and Ni of 1:12 was introduced to design the alloy composition. Here, five alloys with different copper contents were prepared and followed by room temperature rolling with 40%, 60%, and 80% deformation. The results show that the as-cast Cu–Ni–Mo alloys exhibit good formability, have no macroscopic defects and present a small amount of precipitates. With the increase of alloy elements Ni and Mo, the hardness and strength of the alloys increase obviously, while the electrical conductivity decreases gradually. For the rolled alloys, a large number of lamellar deformed structures are formed, the grains are obviously refined, the precipitated phases are broken and the distribution is more uniform, thus the strength and hardness of the alloy increase significantly, the plasticity decrease significantly, while the conductivity changed little. In this study, high-strength samples were obtained, which may be a valuable exploration for the preparation of Cu–Ni–Mo alloy sheets with excellent microstructure and mechanical properties.
Quantum fluctuations of the metric, three-geometries and conformal embeddings in four-manifolds
Authors: Davis Simon
Published: October 2021

In this paper, connections between the path integrals for four-dimensional quantum gravity and string theory are emphasized. It is shown that there is a natural relation between these two path integrals based on the theorems on embeddings of two-dimensional surfaces in four dimensions and four-dimensional manifolds in ten dimensions. The isometry groups of the three-geometries that are spatial hypersurfaces confomally embedded in the four-manifolds are required to be subgroups of [Formula: see text], which is the invariance group of the Pfaffian differential system satisfied by one form in the cotangent bundles on the four-manifolds. Based on this and other physical conditions, the three-geometries are restricted to be [Formula: see text], [Formula: see text] and [Formula: see text] with a boundary, which may be included in the quantum gravitational path integral over four-manifolds which are closed at initial times followed by an exponential expansion compatible with supersymmetry.
A review of the composition and chemistry of peridotite mantle xenoliths in volcanic rocks from Antarctica and their relevance to petrological and geophysical models for the lithospheric mantle
Authors: Martin Adam P.
Published: October 2021

This chapter reviews the geochemistry and petrology of mantle peridotite xenoliths from across Antarctica, including parameters that are of most relevance to geophysical studies. This Memoir is the first time such a complete overview of the chemistry of Antarctic mantle xenoliths has been available and Antarctica should no longer be the ignored continent in studies of mantle xenoliths in volcanic rocks. Xenoliths indicate that the chemistry, heat flow and water content of the Antarctic lithospheric mantle varies regionally at scales of one to thousands of kilometres. The prevalence of variability in xenoliths suggests that the Antarctic mantle is ubiquitously heterogeneous. This has important, yet unquantified, implications for interpreting geophysical data and for reference Earth models used in Antarctic geophysical studies. Information about and interpretations of Antarctic mantle xenoliths can be linked to studies from once adjacent continental blocks in Africa, India, Australia, New Zealand and South America. Together, this can improve understanding of the mantle contribution to glacial isostatic adjustment and geodynamic models to show how the Antarctic mantle fits with adjacent continents in the puzzle of lithospheric blocks. Numerous, fundamental and important research questions remain unanswered making further study of the Antarctic mantle an exciting prospect for future research.
Modeling the Impacts of Income on the Subjective Happiness: An Empirical Study
Authors: Ma Guiping , Ma Changsong
Published: October 2021

The influence of income on the subjective happiness of teachers in Chinese private universities is researched in this paper. First of all, considering the features of the Chinese private university, the measuring model of the subjective happiness of teachers in higher institutions was established. Then, the private university teachers in China were taken as investigation objects to collect data samples. Finally, based on the questionnaire data, the author will verify the measuring model by using the structural equation model. The empirical research results show that the welfare system of the investor has a positive impact on the teacher income, and the income has a notable positive impact on the subjective happiness of teachers through consumption level and housing conditions. Therefore, it has a significant positive influence on the subjective happiness of the teachers in Chinese private colleges. With the higher income, the subjective happiness of the teachers becomes stronger. In addition, the welfare system of the investor will also have a positive influence on the subjective happiness of the teachers through expenditure system, management culture, and enterprise welfare.
Increased ROS‐Dependent Fission of Mitochondria Causes Abnormal Morphology of the Cell Powerhouses in a Murine Model of Amyotrophic Lateral Sclerosis
Authors: Stein Jan , Walkenfort Bernd , Cihankaya Hilal , Hasenberg Mike , Bader Verian , Winklhofer Konstanze F. , Röderer Pascal , Matschke Johann , Theiss Carsten , Matschke Veronika
Published: October 2021

Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease in humans and remains to have a fatal prognosis. Recent studies in animal models and human ALS patients indicate that increased reactive oxygen species (ROS) play an important role in the pathogenesis. Considering previous studies revealing the influence of ROS on mitochondrial physiology, our attention was focused on mitochondria in the murine ALS model, wobbler mouse. The aim of this study was to investigate morphological differences between wild‐type and wobbler mitochondria with aid of superresolution structured illumination fluorescence microscopy, TEM, and TEM tomography. To get an insight into mitochondrial dynamics, expression studies of corresponding proteins were performed. Here, we found significantly smaller and degenerated mitochondria in wobbler motor neurons at a stable stage of the disease. Our data suggest a ROS‐regulated, Ox‐CaMKII‐dependent Drp1 activation leading to disrupted fission‐fusion balance, resulting in fragmented mitochondria. These changes are associated with numerous impairments, resulting in an overall self‐reinforcing decline of motor neurons. In summary, our study provides common pathomechanisms with other ALS models and human ALS cases confirming mitochondria and related dysfunctions as a therapeutic target for the treatment of ALS.
The Valuable Role of Imaging Modalities in the Diagnosis of the Uncommon Presentations of COVID-19: An Educative Case Series
Authors: Khaleghi Mohammadreza , Aziz-Ahari Alireza , Rezaeian Nahid , Asadian Sanaz , Mounesi Sohi Amirsajjad , Motamedi Omid , Azhdeh Shilan
Published: October 2021

The outbreak of coronavirus disease 2019 (COVID-19) in late 2019 rapidly turned into a global pandemic. Although the symptoms of COVID-19 are mainly respiratory ones, the infection is associated with a wide range of clinical signs and symptoms. The main imaging modality in COVID-19 is lung computed tomography (CT) scanning, but the diagnosis of the vast spectrum of complications needs the application of various imaging modalities. Owing to the novelty of the disease and its presentations, its complications—particularly uncommon ones—can be easily missed. In this study, we describe some uncommon presentations of COVID-19 diagnosed by various imaging modalities. The first case presented herein was a man with respiratory distress, who transpired to suffer from pneumothorax and pneumomediastinum in addition to the usual pneumonia of COVID-19. The second patient was a hospitalized COVID-19 case, whose clinical condition suddenly deteriorated with the development of abdominal symptoms diagnosed as mesenteric ischemia by abdominal CT angiography. The third patient was a case of cardiac involvement in the COVID-19 course, detected as myocarditis by cardiac magnetic resonance imaging (MRI). The fourth and fifth cases were COVID-19-associated encephalitis whose diagnoses were established by brain MRI. COVID-19 is a multisystem disorder with a wide range of complications such as pneumothorax, pneumomediastinum, mesenteric ischemia, myocarditis, and encephalitis. Prompt diagnosis with appropriate imaging modalities can lead to adequate treatment and better survival.
Government-Expert Joint Intervention with Treatment Algorithm and Improved Hypertension Management and Reduced Stroke Mortality in a Primary-Care Setting
Authors: Heizhati Mulalibieke , Li Nanfang , Zhang Delian , Abulikemu Suofeiya , Chang Guijuan , Hong Jing , Maimaiti Nuerguli , Hu Junli , Wang Lei , Duiyimuhan Gulinuer
Published: October 2021

Hypertension management is suboptimal in the primary-care setting of developing countries, where the burden of both hypertension and cardiovascular disease is huge. Therefore, we conducted a government-expert joint intervention in a resource-constrained primary setting of Emin, China, between 2014 and 2016, to improve hypertension management and reduce hypertension-related hospitalization and mortality. Primary-care providers were trained on treatment algorithm and physicians for specialized management. Public education was delivered by various ways including door-to-door screening. Program effectiveness was evaluated using screening data by comparing hypertension awareness, treatment, and control rates and by comparing hypertension-related hospitalization and total cardiovascular disease (CVD) and stroke mortality at each phase. As results, 313 primary-health providers were trained to use the algorithm and 3 physicians attended specialist training. 1/3 of locals (49490 of 133376) were screened. Compared to the early phase, hypertension awareness improved by 9.3% (58% vs. 64%), treatment by 11.4% (39% vs. 44%), and control rates by 33% (10% vs. 15%). The proportion of case/all-cause hospitalization was reduced by 35% (4.02% vs. 2.60%) for CVD and by 17% (3.72% vs. 3.10%) for stroke. The proportion of stroke/all-cause death was reduced by 46% (21.9% in 2011–2013 vs. 15.0% in 2014–2016). At the control area, the proportion of case/all-cause mortality showed no reduction. In conclusion, government-expert joint intervention with introducing treatment algorithm may improve hypertension control and decrease related hospitalization and stroke mortality in underresourced settings.
Energy Characteristics of Seismic Waves on Cardox Blasting Tube
Authors: Cui Xuejiao , Ke Bo , Yu Songtao , Li Ping , Zhao Mingsheng
Published: October 2021

In order to study the energy characteristics of seismic waves on the liquid CO2 blasting system, the blasting seismic wave signal of liquid CO2 blasting was obtained by on-site microseismic monitoring tests. The adaptive optimal kernel time-frequency analysis method was used to study the basic time-frequency properties of the seismic wave signal. Combining wavelet packet transform decomposition and reconstruction and adaptive optimal kernel time-frequency analysis method, the liquid CO2 energy distribution of the seismic wave signal was further analyzed. And the energy regression model of seismic wave source of liquid CO2 blasting system was discussed. The results show that the vibration velocity is at a low level, and the main frequency range is between 30 and 70 Hz, and the duration is about 20-30 ms. The energy is mainly distributed in 0-125 Hz, which is composed of two main regions. The power function model can be used to describe the attenuation law of the seismic wave energy. The energy conversion coefficient and characteristic coefficient of the source of liquid CO2 blasting system were defined and analyzed. Combined with the empirical formula of the Sadovsky vibration velocity, the energy regression model of the seismic wave source of liquid CO2 blasting system was obtained.
Coexistence of Prefibrotic Myelofibrosis with Monoclonal Gammopathy of Undetermined Significance: A Case Report
Authors: Ismail Omar M. , Amer Aliaa , Ibrahim Feryal A. , Abu-Tineh Mohammad , Yassin Mohamed A.
Published: October 2021

The coexistence of dual hematological neoplasms is an unusual and challenging presentation due to the different combination of etiopathology. The presentation of synchronous dual hematological malignancies can be one of the 3 types: myeloid + lymphoid or dual lymphoid or dual myeloid. Here, we are reporting a case of a 53-year-old male with simultaneous presence of JAK2 V617F-positive myeloproliferative neoplasm with features favoring prefibrotic phase of primary myelofibrosis (pre-PMF) in combination with monoclonal gammopathy of undetermined significance (MGUS). In such cases of simultaneous existence of dual hematological neoplasm management, it is recommended to treat the more aggressive one. Currently, our management plan is focusing on treating the pre-PMF and observation of MGUS with regular monitoring for transformation to MM.
Effect of Conventional Medical Therapy or Laparoscopic Sleeve Gastrectomy on Urinary Albumin in Japanese Subjects with Severe Obesity: An Observational Study
Authors: Watanabe Yasuhiro , Yamaguchi Takashi , Yamaoka Shuhei , Abe Kazuki , Onda Hiroki , Nakamura Shoko , Tanaka Sho , Oshiro Takashi , Ohira Masahiro , Nagayama Daiji , Shimizu Naomi , Tatsuno Ichiro , Saiki Atsuhito
Published: October 2021

Introduction: In patients with severe obesity, albuminuria can be improved by both conventional medical therapy and bariatric surgery. The purpose of this study was to compare the impact of weight loss achieved through conventional medical therapy or laparoscopic sleeve gastrectomy (LSG) on albuminuria in Japanese subjects with severe obesity and identify the factors involved. Methods: We retrospectively evaluated the clinical characteristics including the urinary albumin/creatinine ratio (UACR) of 340 consecutive subjects with a body mass index ≥35 who received LSG (n = 242) or medical therapy (n = 98) between 2010 and 2018 and were followed for at least 12 months. Results: The baseline of the UACR was not different between the 2 groups. At the 12-month follow-up, total weight loss (TWL) and decreases in glycosylated hemoglobin (HbA1c) and loge UACR were greater in the LSG group than in the medical therapy group (body weight; −35.7 kg vs. −8.0 kg, p < 0.001, HbA1c; −1.4% vs. −0.7%, p < 0.001, loge UACR; −0.3 vs. 0.9, p < 0.001). The rate of complete remission of diabetes was significantly higher in the LSG group than in the medical therapy group. At 12 and 36 months (n = 111 in the medical therapy group, n = 56 in the LSG group at 36 months), loge UACR increased in the medical therapy group, while it remained unchanged or decreased in the LSG group. In subjects with microalbuminuria and macroalbuminuria, changes in the loge UACR correlated with percent total body weight loss (%TWL) in both groups at 12 months. Percent TWL contributed independently to the change in the loge UACR, irrespective of whether LSG was performed. In receiver-operating characteristic analysis, a weight loss of 7.8% predicted a decrease in the UACR (∆UACR <0 at 12 months). Conclusion: Our analysis suggests that albuminuria may increase over time if only medical therapy is continued. To improve albuminuria, weight loss may be more important than whether LSG is performed.
The Effect of Receiving a Diagnosis of Alzheimer’s Disease and Related Dementias on Social Relationships of Older Adults
Authors: Amano Takashi , Reynolds Addam , Scher Clara , Jia Yuane
Published: October 2021

Introduction: Although early diagnosis has been recognized as a key strategy to improve outcomes of Alzheimer’s disease and related dementias (ADRD), the effect of receiving a diagnosis on patients’ well-being is not well understood. This study addresses this gap by examining if receiving a dementia diagnosis influences social relationships. Methods: Data from the 3 waves (2012, 2014, and 2016) of the Health and Retirement Study were utilized as part of this study. This study examined whether receiving a new diagnosis of ADRD changed subsequent social relationships (social networks, social engagement, and social support). Regression analyses with inverse probability weighting were performed to estimate the impact of receiving a dementia diagnosis on changes in social relationships. Results: Receiving a new diagnosis of ADRD reduced both informal and formal social engagement. We found no statistically significant impacts of receiving a diagnosis of ADRD on social networks and social support. Conclusions: Results suggest that receiving a new diagnosis of ADRD may have unintended impacts on social relationships. Practitioners and policymakers should be aware of these consequences and should identify strategies to alleviate the negative impact of receiving a diagnosis of ADRD and methods to mobilize support networks after receiving a diagnosis.
Locus Coeruleus Noradrenergic Modulation of Diurnal Corticosterone, Stress Reactivity, and Cardiovascular Homeostasis in Male Rats
Authors: Thrivikraman K.V. , Kinkead Becky , Owens Michael J. , Rapaport Mark H. , Plotsky Paul M.
Published: October 2021

Introduction: Activation of the locus coeruleus-noradrenergic (LC-NA) system during awakening is associated with an increase in plasma corticosterone and cardiovascular tone. These studies evaluate the role of the LC in this corticosterone and cardiovascular response. Methods: Male rats, on day 0, were treated intraperitoneally with either DSP4 (50 mg/kg body weight) (DSP), an LC-NA specific neurotoxin, or normal saline (SAL). On day 10, animals were surgically prepared with jugular vein (hypothalamic-pituitary-adrenal [HPA] axis) or carotid artery (hemodynamics) catheters and experiments performed on day 14. HPA axis activity, diurnally (circadian) and after stress (transient hemorrhage [14 mL/kg body weight] or air puff-startle), and basal and post-hemorrhage hemodynamics were evaluated. On day 16, brain regions from a subset of rats were dissected for norepinephrine and corticotropin-releasing factor (CRF) assay. Results: In DSP rats compared to SAL rats, (1) regional brain norepinephrine was decreased, but there was no change in median eminence or olfactory bulb CRF content; (2) during HPA axis acrophase, the plasma corticosterone response was blunted; (3) after hemorrhage and air puff-startle, the plasma adrenocorticotropic hormone response was attenuated, whereas the corticosterone response was dependent on stressor category; (4) under basal conditions, hemodynamic measures exhibited altered blood flow dynamics and systemic vasodilation; and (5) after hemorrhage, hemodynamics exhibited asynchronous responses. Conclusion: LC-NA modulation of diurnal and stress-induced HPA axis reactivity occurs via distinct neurocircuits. The integrity of the LC-NA system is important to maintain blood flow dynamics. The importance of increases in plasma corticosterone at acrophase to maintain short- and long-term cardiovascular homeostasis is discussed.
Perfil epidemiológico dos óbitos por acidente vascular encefálico no Brasil entre 2007 e 2016: um estudo de base de dados nacional
Authors: Costa Gabrielle Victória Souza , Romeo André Luis Barbosa
Published: October 2021

Objetivo: Descrever o perfil epidemiológico dos pacientes com óbito por Acidente Vascular Encefálico (AVE) no Brasil e analisar a tendência temporal da mortalidade por AVE segundo a região geográfica. Métodos: Estudo observacional descritivo de série temporal com dados secundários obtidos a partir do Departamento de Informática do Sistema Único de Saúde (DATASUS), referentes ao período entre 2007 e 2016. As categorias da Classificação Internacional das Doenças, 10ª edição, (CID-10) utilizadas foram I60-I69. Não foi necessária a submissão do projeto a um Comitê de Ética em Pesquisa. Resultados: No período analisado, ocorreram 998.529 óbitos por AVE no Brasil, dos quais 50,3% eram do sexo masculino, 51,2% brancos, 35,9% com idade igual ou superior a 80 anos, 37,2% casados e 46,8% com escolaridade igual ou inferior a 3 anos de estudo. Houve tendência de redução da mortalidade no país, (β=-0,262), estando fortemente associado ao tempo (r=0,861) e estatisticamente significante (p=0,001). As regiões sudeste e sul apresentaram as maiores tendências de redução da mortalidade (β=-0,519 e -0,461, respectivamente). Conclusões: Os óbitos por AVE ocorreram predominantemente em indivíduos do sexo masculino, brancos, idosos, casados e com baixa escolaridade. A redução da mortalidade por AVE aconteceu de forma desigual no país, de modo que as regiões com melhores condições socioeconômicas, sudeste e sul, tiveram as maiores tendências de queda.
Coagulação intravascular disseminada: uma abordagem diagnóstica
Authors: Andrade Alice Maia Marinho de , Vieira Mariana Soares , Horta Ramona Dias , Chaves Mayra Aline
Published: October 2021

A coagulação intravascular disseminada é caracterizada pela desregulação na homeostase da coagulação e é desencadeada por várias afecções. Essa síndrome possui alta taxa de mortalidade -45 a 78%- sendo preponderante a sua identificação. Entretanto, o seu reconhecimento é desafiador por existir várias etiologias subjacentes, diagnósticos diferenciais, dificuldade na interpretação de exames e rápida evolução na forma aguda. Assim, foi realizada uma revisão narrativa utilizando PUBMED e SciELO, a fim de estruturar informações para melhor compreensão e acurácia no diagnóstico da coagulação intravascular disseminada.
Pancreatite aguda por áscaris lumbricoides: relato do caso e revisão de literatura
Authors: Correa Nathália Beck , Carlotto Fernanda Marcante , Mainardi Luiza Seganfredo , Morassutti Alessandra
Published: October 2021

A infecção parasitária pelo Ascaris lumbricoides representa um acometimento comum no Brasil e em outras regionalidades subdesenvolvidas. A localização do verme em vesícula biliar é rara e quando há presença de quadro clínico importante, essa hipótese deve ser levantada como diagnóstico diferencial frente a outras doenças da árvore biliar. Relatamos o caso de paciente de 65 anos admitido em emergência devido à pancreatite por etiologia de áscaris em vesícula biliar, o qual, posteriormente, evoluiu para quadro alarmante de disfunção de múltiplos órgãos.
Terapia por pressão subatmosférica de baixo custo como alternativa para fechamento abdominal temporário em hospital público: relato de caso
Authors: Gonçalves Matheus Dantas Gomes , Lima Diego Laurentino , Cordeiro Raquel Nogueira , Ferreira Fabio Eduardo Revorêdo Rabelo , Moraes Carlos Esdras Almeida , Carvallho Márcio Rogério Carneiro
Published: October 2021

A utilização da pressão subatmosférica através de curativo à vácuo em pacientes com abdome aberto é usada cada vez mais para o fechamento abdominal temporário. O curativo à vácuo pode ser utilizado como uma “ponte” entre o surgimento da lesão inicial e a cirurgia de fechamento definitivo da ferida, naqueles casos em que o fechamento fascial primário não é possível. O objetivo deste trabalho é apresentar uma proposta prática para o fechamento abdominal temporário utilizando curativo à vácuo (técnica de Barker modificada), como alternativas as demais técnicas. O mecanismo de ação envolve o controle do exsudato, redução do edema intersticial perilesional, aumento do fluxo sanguíneo, estímulo à formação de tecido de granulação e contração da ferida. O curativo apresentou baixos custos, fácil aplicação e utilizando materiais disponíveis com frequência na maioria dos hospitais públicos. De acordo com a literatura, a técnica de Barker modificada apresenta bons resultados e índices de complicações semelhantes aos kits de TPN comerciais.
Between the Islamic and Chinese Universal Empires: The Ottoman Empire, Ming Dynasty, and Global Age of Explorations
Authors: Chen Yuan Julian
Published: October 2021

This article studies two sixteenth-century Asian texts: Khitay namah, a Persian travelogue about the Ming dynasty written by the Muslim merchant Ali Akbar and presented to the Ottoman sultan, and Xiyu, an illustrated Chinese geographical treatise with detailed travel itinerary from China to Istanbul by the Ming scholar-official Ma Li. In addition to demonstrating the breadth of Ottoman and Chinese knowledge about each other in the global Age of Exploration, these two books, written respectively for the monarchs of the self-proclaimed Islamic and Chinese universal empires, reflect the Ottoman and Chinese imperial ideologies in an era when major world powers aggressively vied for larger territories and broader international influence. Both the Ottoman and Chinese authors recast the foreign Other as the familiar Self – Ali Akbar constructed an Islamized China while Ma Li depicted a Sinicized Ottoman world – to justify their countries’ claims to universal sovereignty and plans for imperial expansion. Like many contemporary European colonial writers, Ali Akbar’s and Ma Li’s exploration of foreign societies, their literary glorification of their own culture’s supremacy, and their imposition of their own cultural thinking on foreign lands all served their countries’ colonial enterprise in the global Age of Exploration.
Garra hormuzensis, a new species from the upper Kol River drainage in the Persian Gulf basin (Teleostei: Cyprinidae)
Authors: ZAMANI-FARADONBE MAZAHER , ZHANG E. , KEIVANY YAZDAN
Published: October 2021

Garra hormuzensis, new species, is described from the Kol River drainage. It is distinguished from its congeners in the Iranian part of the Persian Gulf basin by having 7½ branched dorsal-fin rays, usually 9+8 branched caudal-fin rays, the breast, belly and back in front of the dorsal-fin origin covered by scales, and a free lateral and posterior margins of the gular disc. It is further characterised by having a minimum K2P distance of 1.16% to G. mondica in the mtDNA COI barcode region.
A Self-Powered Sensor for Body Motion Mechanical Energy Collection and Monitor
Authors: Wang Ling , Zhu Yongsheng , Liu Junduo , Jia Changjun , Zhao Ruiting
Published: October 2021

A self-powered sensor for the collection and monitor of body motion mechanical energy is manufactured. This sensor is made up of PVDF which is dealt with polarization. According to practical needs, single or multiple sensors could be selected to serve the function. Through piezoelectric
voltage signal that produced by tester body motion mechanical energy to achieve body motion monitor and energy collection to charge microelectronic equipment. This kind of study can help collect body motion energy, facilitate sports training, guide exercise rehabilitation, and promote evaluation
of human movement ability to prevent potential risks such as falls. It provides new ideas to material science and sports science practical application.
Performance Degradation of Polymer Solar Cells Measured in High Humidity Environment
Authors: Fallata Arwa Abdulrazzaq , Bahabry Rabab Riyad , Mahmoud Alaa Y.
Published: October 2021

Performance degradation is one of the crucial difficulties for the market of organic solar cell (OSC) devices. These deteriorative characteristics can be attributed to many factors, mainly to the chemical reactivity of the device multiple layers with the environment. Here, we investigate
the performance of a standard OSC device made of the polymer poly(3-hexylthiophene-2,5-diyl) and the fullerene [6,6]-phenyl-C61-butyric-acid-methyl-ester (P3HT:PCBM) as a photoactive layer in a high humidity environment (53%) within 100 days divided into three periods. The results confirm
that the OSC devices’ encapsulations should be completed immediately after the fabrication due to fast chemical degradation of the photoactive layer, which reduces the Jsc by 15% after 40 mins of fabrication. We also found that the FF has been reduced by 17.36% from its initial value
after 1152 hours due to a deficiency of the interfacial charge transfer between the multiple layers of the device. Finally, the performance of the device’s decays to zero after 2400 hours.
Classification and Inspection of Debonding Defects in Solid Rocket Motor Shells Using Machine Learning Algorithms
Authors: Guo Xufei , Yang Yanwei , Han Xingcheng
Published: October 2021

Debonding problems along the propellant/liner/insulation interface are a critical factor affecting the integrity of solid rocket motors and one of the major causes of their structural failure. Due to the complexity of interface debonding detection and its low accuracy, a method of wavelet packet transform (WPT) combined with machine learning is proposed. In this research, multi-layer structure specimens were prepared to simulate the structure of a solid rocket motor. First, ultrasonic non-destructive testing technology was used to obtain defect data. Then, WPT algorithm was employed to extract characteristic signals of the defect data. Moreover, k-nearest neighbor model, Random Forest model and support vector machine model were applied to the classification. The results showed that the accuracies of the three models were 84.67%, 90.66% and 95.33%, respectively. Positive results indicate that WPT with machine learning model exhibited excellent classification performance. Therefore, WPT combined with machine learning can achieve a precise classification of debonding defects and has the potential to assist or even automate the debonding inspection process of solid rocket motors.
Multi-Channel Data Stream Transmission Method of Internet of Things in Power Systems (IOTIPS) Based on Big Data Analysis
Authors: Zhang Taoyun , Zhang Guangdong , Zhang Yugang , Wang Jin , Xue Ling
Published: October 2021

To solve the problems of frequent network link jitter and high bit error rate is the development direction of power grid communication technology. Therefore, a multi-channel data stream transmission method of Internet of things in power systems based on big data analysis is proposed.
The data stream matching method based on big data stability mechanism is constructed by using data stream matching method to match the data stream to be transmitted and improve the anti-noise performance of the transmission process; the multichannel model of data stream transmission is constructed,
and the matched data stream is transmitted by the multi-channel model; the big data analysis technology is used to process the data stream transmission process and improve the transmission performance of the model; the adaptive multi-channel equalization control method of sampling decision
is used to realize the equalization design of data stream transmission channel, optimize the model transmission process, and reduce the bit error rate of transmission. Experimental results show that this method has better channel equalization performance; the link jitter frequency of this
method is low, and it has better transmission stability; the lowest bit error rate can reach 0%, and the reliability of data stream transmission is high.
Gamma function method for the nonlinear cubic-quintic Duffing oscillators
Authors: Wang Kang-Jia , Wang Guo-Dong
Published: October 2021

In this article, the gamma function method, for the first time ever, is used to solve the nonlinear cubic-quintic Duffing oscillators. The nonlinear cubic-quintic Duffing oscillators with and without the damped and quadratic terms are considered respectively. By the gamma function method, it only needs one-step to get the approximate solution. The comparisons with the existing solutions reveal that the proposed method is simple but effective in solving the small amplitude oscillation.
Focused ultrasound stimulation on meibomian glands for the treatment of evaporative dry eye
Authors: Lu Gengxi , Gollapudi Sumanth , Li Runze , Pfeiffer Margaret L , Mehta Preeya , Jiang Laiming , Hamm-Alvarez Sarah , Humayun Mark , Zhou Qifa , Zhang-Nunes Sandy X
Published: October 2021

Current treatments for meibomian gland dysfunction have several limitations, creating a necessity for other advanced treatment options. The purpose of this study is to determine the effectiveness of focused ultrasound stimulation for the treatment of dry eye disease caused by meibomian gland dysfunction. An in vivo study of nine Dutch Belted rabbits was conducted with focused ultrasound stimulation of the meibomian glands. A customized line-focused ultrasonic transducer was designed for treatment. Fluorescein imaging, Schirmer’s test, and Lipiview II ocular interferometer were used to quantify outcomes from three aspects: safety, tear production, and lipid layer thickness. Both tear secretion and lipid layer thickness improved following ultrasound treatment. Five to 10 min after the ultrasound treatment, the mean values of lipid layer thickness increased from 55.33 ± 11.15 nm to 95.67 ± 22.77 nm ( p < 0.05), while the mean values measured with the Schirmer’s test increased from 2.0 ± 2.3 to 7.2 ± 4.3 ( p < 0.05). Positive effects lasted more than three weeks. Adverse events such as redness, swelling, and mild burn, occurred in two rabbits in preliminary experiments when the eyelids sustained a temperature higher than 42°C. No serious adverse events were found. The results suggest that ultrasound stimulation of meibomian glands can improve both tear production and lipid secretion. Ultimately, ultrasound stimulation has the potential to be an option for the treatment of evaporative dry eye disease caused by meibomian gland dysfunction.
Performance of primary health care workers in detection of mental disorders comorbid with epilepsy in rural Ethiopia
Authors: Tsigebrhan Ruth , Fekadu Abebaw , Medhin Girmay , Newton Charles R. , Prince Martin J. , Hanlon Charlotte
Published: October 2021

Background

Timely detection and management of comorbid mental disorders in people with epilepsy is essential to improve outcomes. The objective of this study was to measure the performance of primary health care (PHC) workers in identifying comorbid mental disorders in people with epilepsy against a standardised reference diagnosis and a screening instrument in rural Ethiopia.

Methods

People with active convulsive epilepsy were identified from the community, with confirmatory diagnosis by trained PHC workers. Documented diagnosis of comorbid mental disorders by PHC workers was extracted from clinical records. The standardized reference measure for diagnosing mental disorders was the Operational Criteria for Research (OPCRIT plus) administered by psychiatric nurses. The mental disorder screening scale (Self-Reporting Questionnaire; SRQ-20), was administered by lay data collectors. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PHC worker diagnosis against the reference standard diagnosis was calculated. Logistic regression was used to examine the factors associated with misdiagnosis of comorbid mental disorder by PHC workers.

Results

A total of 237 people with epilepsy were evaluated. The prevalence of mental disorders with standardised reference diagnosis was 13.9% (95% confidence interval (CI) 9.6, 18.2%) and by PHC workers was 6.3% (95%CI 3.2, 9.4%). The prevalence of common mental disorder using SRQ-20 at optimum cut-off point (9 or above) was 41.5% (95% CI 35.2, 47.8%). The sensitivity and specificity of PHC workers diagnosis was 21.1 and 96.1%, respectively, compared to the standardised reference diagnosis. In those diagnosed with comorbid mental disorders by PHC workers, only 6 (40%) had SRQ-20 score of 9 or above. When a combination of both diagnostic methods (SRQ-20 score ≥ 9 and PHC diagnosis of depression) was compared with the standardised reference diagnosis of depression, sensitivity increased to 78.9% (95% (CI) 73.4, 84.4%) with specificity of 59.7% (95% CI 53.2, 66.2%). Only older age was significantly associated with misdiagnosis of comorbid mental disorders by PHC (adjusted odds ratio, 95% CI = 1.06, 1.02 to 1.11).

Conclusion

Routine detection of co-morbid mental disorder in people with epilepsy was very low. Combining clinical judgement with use of a screening scale holds promise but needs further evaluation.
“That same stigma...that same hatred and negativity:” a qualitative study to understand stigma and medical mistrust experienced by people living with HIV diagnosed with COVID-19
Authors: Hall Andre , Joseph Olivier , Devlin Samantha , Kerman Jared , Schmitt Jessica , Ridgway Jessica P. , McNulty Moira C.
Published: October 2021

Background

The COVID-19 and HIV epidemics have exacerbated existing inequities among vulnerable groups and severely impacted communities of color. People living with HIV (PLWH), who may already face stigma or discrimination, are at risk of experiencing further stigma as a result of COVID-19, which can result in medical mistrust.

Methods

We performed qualitative interviews between June and August 2020 among 32 PLWH, including 10 individuals diagnosed with COVID-19. A majority of participants perceived themselves as having an increased risk of contracting COVID-19 due to their HIV status.

Results

Of those who tested positive for COVID-19, the majority regarded their HIV diagnosis as having a more profound impact on their lives but found similarities between COVID-19 stigma and HIV-related stigma. Many participants also expressed mistrust.

Conclusions

These results can be used to better understand the perspectives of PLWH during the COVID-19 pandemic and have important implications for potential COVID-19 vaccine hesitancy and future health crises.
Gender minority stress and access to health care services among transgender women and transfeminine people: results from a cross-sectional study in China
Authors: Sha Yongjie , Dong Willa , Tang Weiming , Zheng Lingling , Huang Xi , Muessig Kathryn E. , Tucker Joseph D.
Published: October 2021

Background

Transgender and gender diverse individuals often face structural barriers to health care because of their gender minority status. The aim of this study was to examine the association between gender minority stress and access to specific health care services among transgender women and transfeminine people in China.

Methods

This multicenter cross-sectional study recruited participants between January 1st and June 30th 2020. Eligible participants were 18 years or older, assigned male at birth, not currently identifying as male, and living in China. Gender minority stress was measured using 45 items adapted from validated subscales. We examined access to health care services and interventions relevant to transgender and gender diverse people, including gender affirming interventions (hormones, surgeries), human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Multivariable regression was used to measure correlations between gender minority stress and access to health care service.

Results

Three hundred and twenty-four people completed a survey and data from 277 (85.5%) people were analyzed. The mean age was 29 years old (standard deviation [SD] = 8). Participants used hormones (118/277, 42.6%), gender affirming surgery (26/277, 9.4%), HIV testing (220/277, 79.4%), STI testing (132/277, 47.7%), PrEP (24/276, 8.7%), and PEP (29/267, 10.9%). Using gender affirming hormones was associated with higher levels of discrimination (adjusted odds ratio [aOR] 1.41, 95% confidence interval [CI] 1.17–1.70) and internalized transphobia (aOR 1.06, 95%CI 1.00–1.12). STI testing was associated with lower levels of internalized transphobia (aOR 0.91, 95%CI 0.84–0.98).

Conclusions

Our data suggest that gender minority stress is closely related to using health services. Stigma reduction interventions and gender-affirming medical support are needed to improve transgender health.