bluuebunny/crossref_metadata_2025 huggingface dataset:
La construcción de las noticias en «el caso de Julen»: un estudio comparativo de la cobertura mediática
Authors: Gil-Quintana Javier , Osuna-Acedo Sara , Marta Lazo Carmen
Published: December 2021

El presente artículo, que contiene un estudio de prensa mixto y comparativo, tiene como objetivo analizar la cobertura mediática de una noticia eventualmente conocida como «el caso de Julen». El impacto de la historia se ha analizado con un método específico: en primer lugar, se analizaron 72 fuentes de medios nacionales e internacionales utilizando Mynewsonline. A continuación, se compararon con las distintas perspectivas que ofrecen los diarios españoles El País, El Mundo y ABC, con especial atención a la teoría del encuadre (framing). La historia de Julen fue seleccionada como estudio de caso debido a su extraordinario impacto en los medios locales e internacionales. Los resultados confirman que la cobertura analizada en la muestra no solo relató el hecho de manera fáctica. Los medios se centraron en ángulos y criterios sensacionalistas, como los conflictos emocionales relacionados con la pena, el dolor y la fascinación mórbida. Para incrementar sus ingresos, los medios de comunicación se dejaron enredar en un circo mediático.
Laparoscopic treatment of rare median arcuate ligament syndrome – medium-term follow-up
Authors: Dowgiałło-Gornowicz Natalia , Grochowska Weronika , Lech Paweł , Saluk Sławomir , Michalik Maciej
Published: December 2021

Introduction: Median arcuate ligament syndrome (MALS) is a rare cause of chronic epigastric pain. The presentation might be unclear and non-specific. Diagnosing the syndrome requires interdisciplinary methods and specialists. Treatments consist of celiac axis release performed laparoscopically or robotically, and intraluminal stenting.

 Aim: The aim of the study was to report the medium-term postoperative follow-up results for four patients with MALS.

 Materials and methods: We performed 5 laparoscopic celiac axis releases in patients with MALS in our department in 2018. The study included 4 patients who were admitted 16–23 months after surgery for computed tomography angiography.

  Results: Patients constituted 4 women aged 28–63 with a mean body mass index of 22.4 kg/m2. The diagnosis of MALS was confirmed by computed tomography angiography, which showed severe (>70%) narrowing of the celiac axis. Patients underwent laparoscopic celiac axis release, and were all discharged on the first postoperative day with no postoperative complications. The patients’ quality of life improved and their symptoms subsided completely. Follow-up computed tomography angiography confirmed full decompression of the celiac axis in all 4 patients, with no stenosis caused by scarification of the celiac axis.

  Conclusion: Laparoscopy is a valuable and safe method to treat patients with MALS.
Functional tests of the ETCS and rail traffic control systems
Authors: Drózd Paweł , Rosiński Adam
Published: December 2021

The paper presents the issues of railway traffic control devices testing and focuses on European Train Control System (ETCS) devices widely implemented in railways. The functions of the ETCS system, principles of operation are described. The basic telegrams transmitted in the track-to-train relation are listed. The process of designing and verifying the implemented data and what parameters are checked at the stage of field tests using the locomotive is briefly described. The functional model of the SRK devices, including ETCS elements, was presented, and the close relationship between the base layer of the railway traffic control devices and the ETCS was shown. Equipment testing reduces the availability of the rail network, engages staff, and generates costs. A test generation method is presented to minimize the impact. Two indicators are proposed for reducing the set of checks, the cost of checking and the information effectiveness. The cost of checking due to the problematic estimate is generalized, divided into three groups taking into account the difficulty and resource consumption of bringing the devices to the initial state and their operation according to the test. Therefore, the obtained set of checks is suboptimal and ensures complete coverage of the functions with tests, which is essential when testing devices. The tests are carried out using available setting commands and the implementation of tasks - entry and exit routes at the station. The proposed method is universal and can be applied to any railway traffic control device, regardless of the manufacturing technology. It is a non-invasive method in the structure of the tested devices and does not require additional hardware resources.
AWARENESS OF DIGITAL THREATS AMONG CHILDREN AND YOUTH, IN THE OPINION OF THEIR PARENTS – STUDY RESULTS
Authors: Szeligiewicz-Urban Danuta
Published: December 2021

The paper deals with the issue of awareness of digital threats among children and teenagers. The empirical study analyzes the opinions of parents of preschool and school children using an online questionnaire. The results show that in the opinion of parents, the awareness of various risks in children remains average, and it fluctuates between 30-40% in relation to most of the analyzed issues. A number of favorable and unfavorable changes in the behavior of the respondents’ children as a result of using the Internet and video games are also shown. The analysis of the correlation coefficients shows that the parents’ gender is only significant in the case of two issues (parental support and ridiculing content), and that there is no dependence on education in the studied group. The greatest number of correlations in various studied issues was observed for the age of the child. In addition, the results shed new light on the subject matter, showing the evolution of parents’ attitudes towards more conscious parental control over the use of the Internet and video games.
Improving the Oxygen Barrier of Polyamide Food Packaging by Using Nanoclay
Authors: PAARA Tonis , LANGE Sven , SAAL Kristjan , LÕHMUS Rünno , KRUMME Andres , MÄNDAR Hugo
Published: December 2021

The effect of nanoclay additive on polyamide film oxygen permeability is investigated from the perspective of possible use as a laminate component for low-cost food packaging material. Montmorillonite nanoclay was melt-mixed in an industrial grade polyamide by twin-screw extrusion and the mixture was hot-pressed to a ~50 µm thick film. The film with 10 wt.% of nanoclay loading showed a 17 % decrease in the oxygen transmission rate (OTR), as compared to the pristine polyamide film (72 and 87 cm3/m2∙24 h, respectively). Despite the relatively high loading of the filler the obtained OTR exceeds that of the food packaging preferred upper limit of 10 cm3/m2∙24 h. XRD measurements confirmed the near-complete exfoliation of the nanoclay platelets. The platelets were found to be at an average angle of 9.5 degrees relative to the film’s surface plane. To comply with the requirements for food packaging, this angle needs to be decreased down to 0.4 degrees. To achieve this, different film-making methods enabling better control over the filler particles’ orientation need to be explored. Nanoclay addition increased the films’ yield strength (23 % for 10 wt.% film) and stiffness, while not affecting the films’ optical appearance.
Alternative Techniques for Treatment of Thoracic Aneurysms without Ideal Anatomy
Authors: Armando Martinez Jorge , Ortiz Herrasti Enrique , Alberto Bacelis Raúl , Manuel Córdova Pedro , Estrella Diaz Ingrid
Published: December 2021

The combination of open surgery and thoracic endovascular repair [TEVAR] are considered hybrid procedures, they are used today to solve the different pathologies of the thoracic aorta, these procedures are presented as a therapeutic alternative for those patients who are not candidates for a procedure conventional surgical procedure, either because they are considered “high risk” patients, due to their pathological history, or in those patients who present a complex anatomy that makes it difficult to complete the repair with endovascular therapies in its entirety. To familiarize ourselves with these therapies, we consider it important to classify them by anatomical segments according to the Ishimaru classification to facilitate their understanding.
Middleware Patterns for Cloud Platforms
Authors: S.D. Farrow Gary
Published: December 2021

This chapter explores how traditional system architectures are being affected by the emergence of ‘Uber’ style platform models that provide business services with huge global reach. The specific demands and characteristics of such platforms are discussed which in turn dictate their technical requirements. The chapter will explain how middleware technologies have evolved to support today’s requirements for such massively scalable platform solutions. The latest preferred architectural paradigms dictate the use of micro-services and APIs are central to the design of such platforms. Similarly, event based architectures are another key paradigm that must be supported. The role of modern middleware and cloud technologies to support these newly dominant paradigms will be explained. Key architectural patterns pertinent to global platform solutions are illustrated. The role of modern middleware in fulfilling these patterns is highlighted using real-world examples from the field of open finance.
Mirogabalin as a Novel Gabapentinoid for the Treatment of Chronic Pain Conditions: An Analysis of Current Evidence
Authors: Chen Eric Y. , Beutler Sascha S. , Kaye Alan D. , Edinoff Amber N. , Khademi Seyed-Hossein , Stoltz Andrea E. , Rueb Nicole R. , Cornett Elyse M. , Suh Winston J.
Published: December 2021

: Neuropathic pain is a challenge for physicians to treat and often requires a multimodal approach with both pharmacologic and lifestyle interventions. Mirogabalin, a potent, selective ligand of the α2δ-1 and α2δ-2 subunits of voltage-gated calcium channels (VGCCs), provides analgesia by inhibiting neurotransmitter release at the presynaptic end of the neuron. Mirogabalin offers more sustained analgesia than its gabapentinoid counterparts in addition to a wider safety margin for adverse events. Recent clinical trials of mirogabalin have demonstrated both efficacy and tolerability of the drug for the treatment of diabetic peripheral neuropathic pain and postherpetic neuralgia, leading to its approval in Japan. While still not yet FDA approved, mirogabalin is still in its infancy and offers potential into the treatment of neuropathic pain and its associated comorbidities.
Development of Multi-epitope Subunit Vaccine Against Pseudomonas aeruginosa Using OprF/OprI and PopB Proteins
Authors: Sabzehali Fattaneh , Goudarzi Hossein , Salimi Chirani Alireza , Yoosefi Izad Mohammad Hossein , Goudarzi Mehdi
Published: December 2021

Background: The emerging problem of antibiotic resistance in Pseudomonas aeruginosa is a global health concern; hence, revealing innovative therapeutic approaches (such as designing an immunogenic vaccine candidate) is needed. There is no evidence of the availability of an effective vaccine that can combat the infection caused by this microorganism. Objectives: This research was conducted to develop a potential chimeric vaccine against P. aeruginosa using reverse vaccinology approaches. Methods: The present vaccine candidate comprised outer membrane protein F and I (OprF/OprI) and PopB with appropriate linkers. After applying meticulous immune-informatics investigation, the multi-epitope vaccine was created, including helper T lymphocyte (HTL), cytotoxic T lymphocyte (CTL), interferon gamma (IFN-γ), and interleukin 4 (IL-4) epitopes. Then, the physicochemical characteristics, allergenicity, toxicity, and antigenicity were analyzed. After investigating the secondary structure, the tertiary structure (3D) model was generated, refined, and validated via computational methods. Besides, the strong protein-ligand interaction and stability between the vaccine candidate and toll-like receptor 4 (TLR4) were determined via molecular docking and dynamics analyses. Moreover, in silico cloning accompanied by pET-22b (+) was used to achieve high translation efficiency. Results: Our results presumed that the chimeric-designed vaccine was thermostable and contained optimal physicochemical properties. This vaccine candidate was nontoxic and highly soluble and had stable protein and TLR4 interaction, adequately overexpressed in Escherichia coli. Overall, it could induce immune responses and repress this microorganism. Conclusions: Therefore, to inhibit Pseudomonas infections experimentally, the efficacy and safety of the vaccine design need to be validated.
Assessment of the Awareness of Radiology Residents About Ionizing Radiations and Their Risks of Educational Hospitals, Kermanshah, Iran
Authors: Abbasi Azizi Sogand , Tohidnia Mohammad-Rasoul , Zhaleh Mohsen
Published: December 2021

Background: Although many radiological examinations are requested daily to aid clinical diagnosis by the referring physician, it should be kept in mind that ionizing radiation has adverse biological effects on the life of living organisms, which may vary in individuals depending on the dose and duration of exposure. Therefore, radiologists and their assistants should have comprehensive information about ionizing radiation. Methods: In this descriptive cross-sectional study, all the radiology residents (41) were included in the study. The questionnaire consisted of two parts, the first part including of demographic information and part 2 includes 21 questions about the effective dose created by a chest X-ray, the approximate effective dose from various imaging examines, as well as the awareness of the risks of brain, abdominal CT scans. Results: The results showed that out of 41 residents, 56.1% were male. Based on these results, 19.5% were aware of the approximate effective dose received by a patient on PA chest X-ray. Also, knowledge of some X-ray absorptiometry parameters based on chest X-ray in PA position are: 12.2% abdominal CT scan, 17.1% and 2.4% brain and chest CT scan respectively. In this study the radiology resident’s awareness about dangers of ionizing radiation and the likelihood of cancer were evaluated in 31% and 48.8% of brain and abdominal CT scan, respectively. Conclusions: According to the findings, awareness of radiology residents in Kermanshah university of medical sciences is at an inappropriate level. Therefore, training is needed to raise the awareness of radiology residents by conducting several workshops.
Classification of High-Resolution Computed Tomography Manifestations for COVID-19 Patients: A Systematic Review
Authors: Alibabaei Sanaz , Rohollahpour Elham , Tahmasbi Marziyeh
Published: December 2021

Context: The early detection of COVID-19 is of paramount importance for the disease treatment and control. As real-time reverse-transcription polymerase chain reaction indicates a low sensitivity, the computed tomography of patients' chest can play an effective role in the diagnosis of COVID-19, particularly for patients with false-negative RT-PCR tests. It is also effective in monitoring the clinical trends and assessing the severity of the disease. Objectives: Accordingly, this study aimed to review the different manifestations of the COVID-19 infections in High-Resolution Computed Tomography images of patients' chests and analyze the distribution of the disease in the lungs. The results can contribute to providing a comprehensive and concise reference on the appearance of various types of involvement and lung lesions and the extent of these lesions in the COVID-19 patients. Data Sources: We systematically searched four major indexing databases (namely PubMed, Science Direct, Google Scholar, and Cochrane Central) for articles published by May 2021 using the following keywords: High-Resolution Computed Tomography (HRCT), COVID-19, and Manifestations. Results: Overall, 29 studies addressing the role of HRCT in detecting and evaluating the manifestations of the COVID-19 infection in patients' lungs as ground glass opacification (GGO), consolidation, irregular solid nodules, fibrous stripes, crazy paving pattern, air bronchogram sign, etc. were reviewed. Conclusions: GGO was the most common finding, as reported in 96.6% of the reviewed articles, followed by consolidations (65.5%) and irregular solid nodules (55.2%). Most patients revealed the disease process as a bilateral distribution in the peripheral areas of the lung.
The Impact of Rope Jump Exercise Training on Hemolytic Anemia Parameters in Obese Adolescent Boys
Authors: TaheriChadorneshin Hossein , Nazari Somayeh
Published: December 2021

Background: One of the theories about hemolytic anemia concerns foot-strike on the ground. Rope jump exercise training (RJET) is performed with high foot-strike repetitions on the ground. Objectives: This paper aimed to study the possible effect of RJET on hematological parameters involved in hemolysis. Methods: Twenty obese adolescent boys with a mean age of 13.40 ± 1.09 years were allocated into two equal groups of control and RJET (n = 10 each). The RJET group performed simple rope jumping for eight weeks (three days a week). Blood samples were collected before and after the protocol. Independent t-test and Mann-Whitney U test were used for data analysis. Results: Our findings showed no significant inter-group differences for erythrocyte, platelet, and leukocyte parameters. However, given the effect of time, a significant reduction was observed in monocyte count in the RJET group. In contrast, eosinophil count significantly increased after RJET. Conclusions: According to the results, foot striking induced by RJET had no adverse effect on hemolytic anemia in obese adolescent boys.
Reflections on Revising Part 1 of the ERDs
Authors: Brehany John F. ,   The National Catholic Bioethics Center
Published: December 2021

This article is the second part in an examination of the Ethical and Religious Directives for Catholic Health Facilities. This installment explores the first section of the most recent edition of the ERDs, discussing what changes were made and why. It also discusses how the ERDs might change in the next edition and what issues will need to be addressed, as well as the best structure in which to present them.
The Myth of Semiotic Arguments in Democratic Theory and How This Exposes Problems with Peer Review
Authors: Taylor James Stacey ,   Philosophy Documentation Center
Published: December 2021

In a recent series or books and articles Jason Brennan and Peter M. Jaworski (writing both together and separately) have developed criticisms of what they term “semiotic” arguments. They hold that these arguments are widely used both to criticize markets in certain goods, to defend democracy, and criticize epistocracy. Their work on semiotics is now widely (and approvingly) cited. In this paper I argue that there is no reason to believe that any defenders of democracy or critics of epistocracy have offered semiotic arguments for their positions. I then explain how the operation of academic incentives has led to this being overlooked by both Brennan and Jaworski and their critics. I conclude with suggestions for how to revise peer review so that such errors are less likely to be made in the future.
Programmed Death Ligand-1 Expression Is Associated With Poorer Survival in Anal Squamous Cell Carcinoma
Authors: Monsrud Ashley L. , Avadhani Vaidehi , Mosunjac Marina B. , Flowers Lisa , Krishnamurti Uma
Published: December 2021

Context.—

Upregulation of programmed death ligand-1 (PD-L1), an immunoregulatory protein, is associated with an adverse outcome in several malignancies. Very few studies have evaluated PD-L1 expression in invasive anal squamous cell carcinoma (ASCC).

Objective.—

To assess PD-L1 expression in patients with ASCC and correlate it with clinicopathologic factors and clinical outcomes.

Design.—

Fifty-one cases of ASCC were immunostained for PD-L1. PD-L1 expression by combined positive score and tumor proportion score was correlated with age, sex, HIV status, HIV viral load, CD4 count, stage, and outcomes. Kaplan-Meier curves for overall survival were plotted and compared using the log-rank test. Cox regression analysis was performed to identify significant prognostic factors (2-tailed P < .05 was considered statistically significant).

Results.—

PD-L1 was positive in 24 of 51 cases (47%) by combined positive score and in 18 of 51 (35%) by tumor proportion score. The median cancer-specific survival and 5-year overall survival were significantly lower in PD-L1+ patients. Age, sex, HIV status, HIV viral load, stage, and cancer progression were not significantly different between the 2 groups. CD4 count of more than 200/μL was significantly higher in PD-L1+ patients. PD-L1+ status remained statistically significant for worse overall survival on multivariate analysis.

Conclusions.—

PD-L1+ status is an independent adverse prognostic factor for overall survival in ASCC. This study highlights the potential of PD-L1 targeted therapy in better management of ASCC.
Cyclic Vomiting Syndrome in Pediatric Patients: A Review of Therapeutics
Authors: Tillman Emma M. , Harvath Emily M.
Published: December 2021

Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder that can present quite a challenge to clinicians caring for children with this complex disease. Different therapeutic interventions are recommended for prophylaxis and acute abortive therapy for a CVS attack. The aim of this review is to summarize therapeutic treatment recommendations from the 2008 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHN) Consensus Statement on the Diagnosis and Management of Cyclic Vomiting Syndrome and discuss studies contemporary to this expert recommendation. After an extensive search of medical databases, 8 studies that evaluated therapeutic treatments for CVS were identified. Amitriptyline and cyproheptadine remain the standard of care for prophylaxis. Nutritional supplements such as carnitine and coenzyme Q10 have shown efficacy in decreasing episodes and severity in small studies with high tolerability among patients. The combination of ondansetron and sumatriptan are recommended for abortion of an acute vomiting episode, but other agents such as aprepitant and sedative agents can be considered when vomiting is refractory to initial treatments.
Strategies for Implementing Pediatric Dose Standardization: Considerations From the Vizient University Health System Consortium Pharmacy Network Pediatric Pharmacy Committee
Authors: Campbell Christopher T. , Wheatley Kristin H. , Svoboda Leanne , Campbell Courtney E. , Norris Kelley R.
Published: December 2021

Pediatric patients are at a heightened risk for medication errors due to variability in medication ordering and administration. Dose rounding and standardization have been 2 practices historically used to reduce variability and improve medication safety. This article will describe strategies for implementing pediatric dose standardization.

Local practice often dictates the operational decisions made at an institutional level, leading to a lack of a standard methodology. Vizient survey results demonstrate there is wide variation in dose standardization and ready-to-use (RTU) practices although most responding institutions have attempted to limit bedside manipulation to reduce medication error. There are many barriers to consider before pursuing dose standardization at an institution. These include selecting medications to standardize, calculating appropriate standardized doses, preparing RTU products, and supplying the products to the patient. Strategies to overcome implementation issues are described as well as identification of knowledge gaps related to the preparation and use of RTU products in the pediatric population.

There is opportunity to enhance an institution's ability to provide RTU medications. Although there are several barriers, those that have had successful implementation have leveraged their information technology systems, garnered multidisciplinary support, and customized their practice to meet their operational demands.
Trends and Costs Associated With the Diagnosis and Treatment of Infantile Spasms: A 10-Year Multicenter Retrospective Review
Authors: Weingarten Mindl M. , Cokley Jon A. , Moffett Brady , DiCarlo Shannon , Misra Sunita N.
Published: December 2021

OBJECTIVE

Early treatment of infantile spasms (IS) may be imperative for improvement of neurodevelopmental outcomes. Existing studies have led to inconclusive recommendations with variation in treatment. Our objective was to determine the national average cost, initial diagnostic workup, treatments, and hospital length of stay for patients with IS.

METHODS

This retrospective cohort study was designed to review data of patients < 2 years from 43 non-profit institutions. Data obtained included patient demographics, length of stay, admission cost, and treatments used from 2004 to 2014. Cost data were collected and adjusted to 2014 dollars, the year data were analyzed.

RESULTS

A total of 6183 patients met study criteria (n = 3382, 55% male). Three-quarters of patients (n = 4684, 76%) had an electroencephalogram, 56.4% had brain imaging (n = 3487), and 17% (n = 1050) underwent a lumbar puncture. Medication for IS was initiated during inpatient hospital stay in two-thirds of all patients (n = 4139, 67%). Most patients were initiated on corticotropin (n = 2066, 33%) or topiramate (n = 1804, 29%). Average length of stay was 5.8 days with an average adjusted cost of $18,348. Over time there was an 86.6% increase in cost from an average $12,534.54 (2004) to $23,391.20 (2014), a significant change (p < 0.01). This correlated with an increase in average length of stay.

CONCLUSIONS

Variability exists in diagnostic workup and pharmacotherapy initiated for IS, which may lead to differences in the cost of hospital stay. Further studies may help determine contributing factors to increased cost and improve health care utilization for IS patients.
Inhaled Budesonide in Neonatal Respiratory Distress Syndrome of Near-Term Neonates: A Randomized, Placebo-Controlled Trial
Authors: Elfarargy Mohamed S. , Al-Ashmawy Ghada M. , Abu-Risha Sally M. , Khattab Haidy A.
Published: December 2021

OBJECTIVE

This study evaluates the value of inhaled budesonide (BUD) administration in neonatal respiratory distress syndrome (RDS) cases especially for near-term neonates.

METHODS

A randomized controlled trial involving 120 neonates with respiratory distress, which was diagnosed as RDS, was conducted from July 2016 to March 2018. The neonates studied were divided into 2 groups: group 1 (the inhaled BUD group), consisting of 60 neonates who received BUD (2 mL, 0.25-mg/mL suspension) inhalation, twice daily for 5 days; and group 2 (the placebo group), consisting of 60 neonates with RDS who received humidified distilled sterile water inhalation (2 mL). Downes score, RDS grades, and interleukin 8 (IL-8) levels were monitored and measured on the first and fifth days of incubation.

RESULTS

Statistically significant differences (SSDs) in RDS grades, Downes score, and IL-8 levels on the fifth day of admission were observed between groups 1 and 2 (p = 0.001) and between the first and fifth days of incubation in group 1 (p = 0.001). The SSDs in the duration of hospitalization (p = 0.001) and the number of neonates receiving mechanical ventilation (p = 0.032) were found between both groups.

CONCLUSIONS

Budesonide inhalation is associated with improvements in clinical and laboratory parameters in neonates with RDS
A Retrospective Review of Opioid Prescribing Practices for At-Risk Pediatric Populations Undergoing Ambulatory Surgery
Authors: Lee Sterling , Reid Ashley , Tong Suhong , Silveira Lori , Thomas James J. , Masaracchia Melissa M.
Published: December 2021

OBJECTIVE

Pediatric patients with sleep-disordered breathing (SDB) and obesity are at risk for opioid-induced respiratory depression. Although monitoring in the inpatient setting allows for early recognition of opioid-related adverse events, there is far less vigilance after ambulatory surgery as patients are discharged home. Guidelines for proper opioid dosing in these pediatric subsets have not been established. We sought to determine if at-risk children were more likely to receive doses of opioids outside the recommended range.

METHODS

Baseline opioid prescribing data for all outpatient surgery patients receiving an opioid prescription between January 2019 and June 2020 were retrospectively reviewed. Patients with SDB or obesity were identified. To obtain more information about prescribing practices, we analyzed patient demographics, size descriptors used for calculations, and prescription characteristics (dose, duration, and prescribing surgical service).

RESULTS

A total of 4674 patients received an opioid prescription after outpatient surgery. Of those, 173 patients had SDB and 128 were obese. Surgical subspecialties rendering most of the opioid prescriptions included otolaryngology and orthopedics. Obese patients were more likely (64%) to be prescribed opioids using ideal weight at higher mg/kg doses (>0.05 mg/kg; 83.3%; p < 0.0001). When providers used actual body weight, lower mg/kg doses were more likely to be used (53.7%; p < 0.0001). No prescriptions used lean body mass.

CONCLUSIONS

Overweight/obese children were more likely to receive opioid doses outside the recommended range. Variability in prescribing patterns demonstrates the need for more detailed guidelines to minimize the risk of opioid-induced respiratory complications in vulnerable pediatric populations.
Comparison of Timing to Develop Anti-Drug Antibodies to Infliximab and Adalimumab Between Adult and Pediatric Age Groups, Males and Females
Authors: Trotta Maria Consiglia , Alfano Roberto , Cuomo Giovanna , Romano Ciro , Gravina Antonietta Gerarda , Romano Marco , Galdiero Marilena , Montemurro Maria Vittoria , Giordano Antonio , D'Amico Michele
Published: December 2021

OBJECTIVE

To compare the timing of serum anti-drug antibodies in adult and pediatric age groups, males and females, treated for inflammatory bowel disease or arthritis with adalimumab or infliximab by retrospectively combining data collected during a 2-year therapeutic drug monitoring period.

METHODS

Four hundred thirty sera were divided in groups collected at 0, 3, 6, 12, and 24 months (T0, T3, T6, T12, and T24) after initiation of therapy and assayed for drug and relative anti-drug antibodies levels. At each time point, the percentage of sera presenting anti-drug antibodies, as well as the drug concentrations, were calculated and correlated with patient age and sex.

RESULTS

Anti-drug antibodies were present in 31.5% of sera and were significantly higher in the pediatric age group than in the adult age group, through all time points. The percentages of sera showing anti-drug antibodies were significantly different as early as 3 months and were sera from pediatric female group. The percentages of sera showing anti-drug antibodies reached the highest value at 6 months in the pediatric age group and at 12 months in the adult age group.

CONCLUSIONS

Sera from pediatric had an earlier presence of anti-drug antibodies than adults. In particular, pediatric females sera showed the fastest anti-drug antibodies development.
Antimicrobial Prophylaxis and Anticoagulation Therapy in Pediatric ECMO: A Survey Study
Authors: Frazier Cierra A. , Scott Brittany M. , Johnson Peter N. , LaRochelle Joseph M.
Published: December 2021

OBJECTIVE

The purpose was to characterize antimicrobial and anticoagulation therapies used in health systems with children receiving extracorporeal membrane oxygenation (ECMO).

METHODS

An anonymous electronic survey assessing health system demographics and antimicrobial and anticoagulation therapies during ECMO was distributed to the American College of Clinical Pharmacy Pediatric Practice and Research Network and the Pediatric Pharmacy Association Critical Care Special Interest Group. The primary objective was to identify the number of respondents using antimicrobial prophylaxis for ECMO cannulation and ECMO runs. Secondary objectives included the first- and second-line anticoagulants and anticoagulation laboratory parameters. Additionally, the antimicrobial regimens and the dosing and administration of antithrombin III (AT III) with systemic anticoagulation were collected. Descriptive statistics were employed.

RESULTS

The questionnaire was completed by 38 respondents from 33 health systems; respondents practiced in the pediatric ICU (n = 20; 52.6%), cardiovascular ICU (n = 14; 36.8%), and neonatal ICU (n = 4; 10.5%). Twenty-eight (73.6%) respondents use antimicrobial prophylaxis during ECMO cannulation or ECMO runs, with most units using cefazolin monotherapy. Thirty-five (92.1%) respondents use heparin as the first-line anticoagulant and used a variety of laboratory tests including anti-factor Xa, activated clotting time, and activated partial thromboplastin time. The most common second-line anticoagulant was bivalirudin (n = 24; 63.2%). Thirty-six (94.7%) respondents use AT III with heparin, with most patients receiving AT III dosing calculated based on a formula for the desired AT III concentration.

CONCLUSIONS

The majority of respondents use antimicrobial prophylaxis, but variations in the regimens were noted. Heparin was the most common anticoagulant, but variations in laboratory monitoring and concomitant use of AT III were found.
Extended Interval Aminoglycoside Treatment for Klebsiella Pneumoniae Endocarditis in an Extremely Low Birth Weight Neonate
Authors: Simpkins Justin , Miller Sarah , Shirley Debbie-Ann
Published: December 2021

Infective endocarditis (IE) in neonates is associated with high mortality and incidence has been increasing over the past two decades. The majority of very low birth weight infants will be treated with at least one nephrotoxic medication during their hospital course. Over one-quarter of very low birth weight neonates exposed to gentamicin may develop acute kidney injury (AKI); this is particularly worrisome as AKI is an independent factor associated with increased neonatal mortality and increased length of stay. AKI during periods of neonatal nephrogenesis, which continues until 34–36 weeks postmenstrual age, may also have serious effects on the long-term nephron development which subsequently puts infants at risk of chronic kidney disease. Extended interval (EI) aminoglycoside (AMG) dosing has been used for decades in adult populations and has proven to reduce AKI while being at least as effective as traditional dosing, although there is limited published research for using an EI AMG in endocarditis in adults or pediatric patients. We describe an extremely low birth weight neonate, born preterm at 24 weeks gestation treated for Klebsiella pneumoniae IE that required AMG therapy who also had concurrent AKI. We utilized EI AMG combination therapy for treatment of Klebsiella pneumoniae endocarditis with good outcome and encourage others to report their experiences to improve our knowledge of EI AMG in this population.
Caracterização morfofisiológica de isolados de rizóbios provenientes de solos ácidos da Amazônia Central
Authors: Souza Luiz Carlos Costa de , Hara Francisco Adilson dos Santos , Vendruscolo Jhony , Inácio Ariele Cristine Ferreira , Silva Milena Sousa
Published: December 2021

Os rizóbios, além de fixarem o nitrogênio atmosférico, possuem capacidade de solubilizar fosfatos insolúveis e produzir o ácido indolacético (AIA). Esses microrganismos representam alternativas viáveis para a produção agrícola sustentável na Amazônia. Este trabalho teve como objetivo realizar a caracterização morfofisiológica de isolados de rizóbios proveniente de solos ácidos da região de Manaus. Foram obtidos 22 isolados provenientes de raízes de leguminosas tropicais, sendo que 100% dos isolados mostraram-se tolerantes à acidez, e a maioria (86%) cresceu satisfatoriamente em meio alcalino. Isso indica que os isolados  são bastante versáteis com relação ao pH do solo. Todos os isolados foram sensíveis ao alumínio trocável (2 cmolc dm-3). Apenas nove isolados (41%) foram capazes de solubilizar o fosfato de cálcio e nenhum solubilizou o fosfato de alumínio. Em relação à produção de AIA, 52% foram capazes de sintetizar esse metabólito em meio com triptofano e tiveram a produção classificada entre baixa (38%) e média (52%). A partir da análise de cluster foi possível identificar 5 grupos distintos de rizóbios com 80% de grau de similaridade, evidenciando elevada diversidade morfofisiológica. Alguns isolados da mesma planta apresentam diferenças marcantes quanto às suas características.
Incidência de Leucoptera coffeella (Lepidoptera: Lyonetiidae) em diferentes variedades e sistemas de manejo do cafeeiro
Authors: Fernandes Camila Aparecida Silva , Dias Yasmin Ferroni de Souza , Alcantra Eliana , Freitas Aurivan Soares de , Rezende Ramiro Machado , Marques Rosângela Francisca de Paula Vitor , Oliveira Alisson Souza de
Published: December 2021

O cafeeiro é uma cultura de importância na economia brasileira e o país ocupa o primeiro lugar na produção mundial. O cafeeiro pode sofrer perdas na produtividade, pelo fato da ocorrência de fatores climáticos, problemas fitossanitários e ataque de insetos-praga. Leucoptera coffeella é a principal praga que ataca o cafeeiro, devido às lesões que a lagarta provoca na folha. Objetivou-se com esta pesquisa avaliar a incidência do bicho-mineiro em diferentes variedades e sistemas de manejo do cafeeiro. A avaliação de incidência do bicho-mineiro foi realizada em Três Corações e Jesuânia, nos meses de setembro e outubro, em cafeeiros de diferentes variedades cultivados nos sistemas convencional, irrigado e orgânico. As áreas foram divididas em talhões uniformes e para cada variedade foram avaliadas 20 plantas, amostrando-se ao acaso 10 ramos do terço médio, analisando duas folhas do terceiro e/ou quarto par de folhas por ramo num delineamento casualizado. No sistema orgânico a variedade Catuaí apresentou índice de predação de 1,28% e área foliar danificada de 1,67%, valores maiores em relação a variedade Arara, e para o índice de infestação, os valores não se diferenciaram estatisticamente. No sistema irrigado, a variedade Mundo Novo apresentou índice de infestação de 1,73%, número maior em relação às outras variedades analisadas. No sistema convencional, a variedade Mundo Novo apresentou maior índice de infestação, com 2,23% e maior índice de AFD com 1,84%. A variedade Arara foi a que apresentou maior índice de predação, com 1,50%. Assim conclui-se que variedades de cafeeiro apresentam diferenças em relação à infestação de bicho-mineiro, área foliar danificada e predação em diferentes sistemas de manejo.
Efeitos do clima e sazonalidade nos atropelamentos de Rhinella Jimi, em duas rodovias do Agreste de Pernambuco
Authors: Tenório José Cleiton Souza , Lopes Arthur Macário , Vilar Dayara Claudia Souto Maior de Moraes , Araújo Bianca Gonzaga de , Souza Werônica Meira de , Neves Rachel Maria de Lyra , Telino Júnior Wallace Rodrigues
Published: December 2021

As mudanças climáticas podem gerar algumas transformações na biosfera como o aumento dos eventos extremos (secas e enchentes) e aumento das temperaturas. As estradas são ambientes de desenvolvimento econômico e estão vinculadas aos processos de projeção da interiorização de determinada região, com tais benefícios as estradas também causam alguns efeitos à biodiversidade, como a formação de subpopulações, processos de fragmentação dos ambientes, como também animais atropelados, que em alguns períodos do ano, algumas espécies são mais frequentemente observadas atropeladas que outras. Neste sentido, o intuito deste trabalho foi verificar a relação existente entre o clima e a frequência de atropelamentos da espécie Rhinella jimi em dois fragmentos de rodovias no Semiárido pernambucano. As coletas do material informacional biológico foram feitas a partir de observação de duas rodovias pernambucanas, a BR 232 e 423. Os dados de distribuição e sazonalidade foram comparados com o número de atropelamentos da espécie. Foram verificados alguns fatores relacionados ao crescimento de indivíduos atropelados  depois do período chuvoso, além de uma relação de crescimento dos atropelamentos  durante as chuvas, indicando que os atropelamentos estão vinculados às atividades metabólicas do animal e seu consequente desenvolvimento populacional depois dos períodos de chuva, uma vez que a característica de  adaptabilidade dos anfíbios no semiárido é vinculada a sua maior atividade e rápida reprodução nos períodos chuvosos e redução metabólica nos períodos mais secos e escassos de alimento. Assim, as flutuações pluviométricas ao longo do ano, além de permitirem adaptabilidade aos organismos, possibilitam pontualmente o seu desenvolvimento populacional no ambiente.
Resgate, apreensão e destinação da herpetofauna pelos órgãos de fauna na região metropolitana do Recife, Pernambuco: contribuição para conservação
Authors: Negromonte Mayara Gabrielly , Mascarenhas Junior Paulo Braga , Santos Ednilza Maranhão dos , Correia Jozelia Maria de Sousa
Published: December 2021

O tráfico de animais, a introdução de espécies exóticas e a destruição de hábitats são fatores que levam à distrurbios na biodiversidade, principalmente em grupos sinantrópicos, como  vários répteis e anfíbios. Diante disto, este trabalho teve como objetivo realizar um diagnóstico da herpetofauna resgatada, apreendida, recebida e destinada pelos órgãos de fauna responsáveis em Pernambuco entre os anos de 2010 e 2014. Foram analisados 1369 boletins de ocorrência (B.O.), com um total de 1793 indivíduos, divididos em 24 taxóns (21,3% testudines, 16,2% crocodilianos, 11,6% lagartos, 50,6% serpentes e 0,1% anfisbenas). As principais espécies registradas foram a Boa constrictor (n=429), Caiman latirostris (n=295), Chelonoidis sp. (n=184), Iguana iguana (n=154) e Amphisbaena sp. (n=2). Entre as espécies consideradas com maior grau de ameaça, foram recebidos Eretmochelys imbricata e Podocdemis unifilis (espécie exótica para fauna da região). A maioria dos registros veio do município de Recife (24,1%). Foi observado um maior número de resgates na época chuvosa, principalmente para os crocodilianos e as serpentes. Testudines foi o grupo com maior número de apreensões e entregas voluntárias (n= 33 e 90, respectivamente), possivelmente por ser o mais associado a pets. De maneira geral, o tráfico de animais é um problema para os órgãos ambientais no estado de Pernambuco e as políticas publicas precisam ser mais eficientes. Há também necessidade de melhor aparato estrutural e de pessoal para tornar mais eficiente a identificação e o manejo (captura e sotura) dos animais resgatados, bem como o incentivo a ações educativas com a população.
Comparação da eficiência dos tratamentos físico-químicos de efluente têxtil utilizando sulfato de alumínio, carvão ativado e o processo oxidativo avançado fenton (H2O2)
Authors: Sousa Shara Sonally Oliveira de , Lacerda Gleyton Lopez Barboza , Albuquerque Milla Gomes , Santos Patrícia Nazaré Ferreira dos , Tavares Rosângela Gomes , Santos Suelen Nascimento dos , Dias Viviane Borges
Published: December 2021

As etapas de lavagem e tingimento dos tecidos resultam em um efluente altamente poluidor, necessitando de tratamento prévio para posterior despejo em corpo hídrico. Há diversos tipos de tratamentos de efluentes, e, com base nisso, a escolha de um tratamento adequado irá depender das características químicas do efluente em questão e o seu grau de toxicidade. Este presente trabalho tem como objetivo avaliar e comparar a eficiência dos processos de tratamento físico-químicos coagulação-floculação seguido de adsorção e POA usando como resposta os parâmetros cor, turbidez, pH e DQO (demanda química de oxigênio). As amostras utilizadas nos testes foram advindas de uma lavanderia industrial de jeans, sendo o efluente têxtil final. Para os tratamentos, as amostras foram coletadas e não foram realizados nenhum tipo de tratamento prévio. O carvão ativado foi utilizado como adsorvente e sulfato de alumínio como coagulante. Para o tratamento estatístico foram realizados os testes de normalidade de Shapiro-Wilk (α= 0,05) para depois serem realizados a regressão linear bivariada, correlação de Pearson e a correlação bivariada de Kendall para posterior análise descritiva. O POA obteve uma melhor resposta frente aos outros tratamentos e os melhores resultados para a diminuição do parâmetro analisado: DQO (96%) na quantidade de Fe+2/ H2O2 de 0,55 g.
Tratamento de efluente sanitário pela associação de tanque séptico e wetland construído aerado e não aerado
Authors: Martins Lucas de Albuquerque , Marques Rosângela Francisca de Paula Vitor
Published: December 2021

O objetivo deste trabalho foi avaliar o desempenho e o comportamento de um sistema de tratamento de esgoto sanitário de uma mineradora, localizada no município de Nova Lima – MG, composto por tanque séptico (TS) seguido de um wetland aerado horizontal de escoamento subsuperficial (WAHESS) e um wetland horizontal de escoamento subsuperficial (WHESS), em escala plena e o potencial de replicabilidade em outros sistemas e empresas. O sistema de tratamento de efluentes foi dimensionado para uma vazão média diária de 40 m³ dia⁻¹, cargas de DBO (Demanda bioquímica de oxigênio) de 13,5 kg dia⁻¹, de DQO (Demanda química de oxigênio) de 27,5 kg dia⁻¹, e carga de SST (Sólidos suspensos totais) de 15 kg dia⁻¹, sendo composto por dois TS de 18 m³ cada e TDH (Tempo de detenção hidráulica) de 0,5 dia, seguido de dois Wetlands construídos (WC), sendo o primeiro com TDH de 1,49 dia⁻¹ cultivado com Cyperus prolifer e o segundo com TDH de 0,64 dia⁻¹ cultivado com Thalia Dealbata, tendo a brita nº 1 como meio suporte nos wetlands. Foram avaliadas as variáveis DBO, DQO, SST, turbidez, pH e temperatura com periodicidade quinzenal, totalizando 10 amostras no período de 03/10/2019 a 18/02/2020, além dos dados de vazão. Observou-se que o sistema de WC foi essencial para o tratamento de efluentes, sendo o WAHESS o que apresentou maiores taxas de remoção dos poluentes (94% e 88% para DBO e DQO respectivamente, SST com 83% e turbidez com 94%), seguido do WHESS. O estudo permitiu concluir que o emprego de WC para o tratamento de esgoto doméstico após tratamento por TS, foi eficiente, atingindo os valores exigidos pela legislação estadual vigente para lançamento de efluentes.