bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome of combined trabeculectomy with cataract surgery in patients on prostaglandin analogs and aqueous suppressants
Authors: Aswin PR , Mohan Neethu , Sundar Balagiri , Ponnat Arvin Kurian , Radhakrishnan Shanthi , Krishnadas Subbaiah R , Schehlein Emily
Published: January 2024

Purpose:

To compare the effect of prostaglandin analogs (PGA) against other glaucoma medications (non-PGA) on the intraocular pressure (IOP) outcomes of combined trabeculectomy with phacoemulsification, and the conjunctival cell profile in persons with primary open-angle (POAG) and pseudoexfoliation glaucoma (PXFG).

Methods:

A prospective cohort study was conducted among 116 patients with POAG or PXFG on glaucoma medications for a minimum of 3 months undergoing glaucoma triple procedure. Patients were divided into two groups (PGA and non-PGA) based on preoperative exposure to PGA. IOP outcomes were assessed for up to 2 years. Conjunctival biopsy specimens were obtained at the time of surgery, and histopathological analysis was performed.

Results:

Forty-two patients were in the PGA group, 67 were in the non-PGA group, and seven were lost to follow-up. The non-PGA group had lesser mean postoperative IOP and needed fewer postoperative medications compared to the PGA group in all visits up to 2 years. The non-PGA group had better complete success rate (50.7% vs. 14.3%, P < 0.001). Kaplan–Meier survival estimates showed a significant difference in cumulative complete success rate between non-PGA (67%) and PGA (26%) by 24 months (P < 0.001). The Cox proportional model showed the type of drug to be significantly associated with surgical failure. Histopathological analysis revealed that the PGA group had higher numbers for each type of inflammatory cell (except mast cells) compared to the non-PGA group.

Conclusion:

Patients on PGA are likely to have a higher postoperative IOP and may need more medications for IOP control after a glaucoma triple procedure.
Comparative analysis of outcomes of two (popular) techniques of haptic exteriorization in scleral fixation intra-ocular lens surgery – A retrospective study
Authors: Baskaran Prabu , Srinivasan Karthik , Govindaraj Indu , Rajendran Anand , Rajamani Archana , Mahalingam Maanasi , Ramakrishnan Seema
Published: January 2024

Purpose:

To compare the visual outcomes and complication rates between the extra-ocular needle-guided haptic insertion technique (XNIT) and the conventional handshake (HS) technique of scleral fixation intra-ocular lens (SFIOL).

Methods:

In this retrospective study, we retrieved data of those patients who had undergone SFIOL surgery from January 2018 to May 2022 at our institute for aphakia following either a complicated cataract surgery or an ocular trauma and had a minimum follow-up of 3 months.

Results:

Of the 156 eyes, the HS technique was done in 80 eyes and the remaining 76 eyes with XNIT. At 3 months follow-up visit, there was no significant difference in the median best corrected visual acuity (BCVA) (P= 0.988) and uncorrected visual acuity (UCVA) (P= 0.765) between the two techniques. There was no statistically significant difference between pre-operative median BCVA and post-operative UCVA in XNIT (P= 0.961) and the HS technique (P= 0.831) at 3 months follow-up visit. The complication rates between the two techniques were minimal and comparable. The most common post-operative complication was corneal edema. The incidence of cystoid macular edema was slightly more in the XNIT group but not statistically significant (P= 0.05). Two patients in the HS group developed retinal detachment, which settled after repeat surgery.

Conclusion:

The newer XNIT technique was found to be as safe and effective as compared to the conventional HS technique.
Acrogeria: A Rare Congenital Aging Syndrome
Authors: Thirumalaiswamy Aparna , Kharkar Vidya D , Bhargava Anmol
Published: January 2024

Acrogeria is a rare, nonhereditary genetic syndrome that presents with nonprogressive atrophy of the skin of the distal extremities, giving it an aged appearance. The patients have characteristic facies with pinched faces, an “owl-eyed” appearance, and a beaked nose. We report a 14-year-old female patient of acrogeria who presented with typical clinical findings and dermoscopic features. Acrogeria, with onset usually at birth or thereafter, is often sporadic with potential genetic underpinnings. Uncommon features encompass skeletal and soft-tissue anomalies. The prognosis is generally favorable for these patients due to the lack of systemic involvement. To the best of our knowledge, dermoscopic features of acrogeria have not been described previously. We report this case owing to its rarity and to describe the dermoscopic features seen in this rare syndrome.
The Enigma of a Keratitis-Ichthyosis-Deafness with Silence, Scaling, and Related Syndrome
Authors: Kharodawala Mariya , Pradhan Shekhar N. , Gosavi Anil , Tolat Sunil
Published: January 2024

Ichthyosis is a group of genetic disorders characterized by generalized dry skin and scaling, and it can be frequently associated with erythroderma. Here, we report a case of ichthyosis associated with a rare syndrome. A 6-year-old congenitally deaf female presented with severe scaling and generalized erythema for 6 months which began with a scaly plaque over the face at the age of 18 months and gradually covered the whole body. Three similar episodes happened after that with a gap of 6 months. There were multiple scaly erythematous plaques present over the trunk and limbs and thick hyperkeratotic plaques were present in axillary and inguinal folds. The scalp hairs were sparse. Histopathology showed psoriasiform changes. Salivary sample sent for genetic analysis revealed an heterozygous mutation c.42C>G (p.Asn14Lys) in GJB2 gene that is known to harbor pathogenic mutations associated with keratitis-ichthyosis-deafness (KID) syndrome. KID syndrome presents with the triad of keratitis, progressive erythrokeratoderma, and hearing loss.
Mask-related Facial Dermatoses in an Asian Pediatric Population in the Era of COVID-19 Pandemic: A Cross-sectional Study
Authors: Lee Hwee Chyen , Ho Valerie P. Y. , Yew Yik Weng , Ang Seng Bin
Published: January 2024

Introduction:

Mask-related dermatoses have been widely reported in adults since the global COVID-19 pandemic. Compulsory mask wearing has been mandated in many countries. As pediatric dermatologists, we aim to characterize different types of mask-related dermatoses in the pediatric population, evaluate the prevalence, and potential exacerbating and mitigating factors to improve compliance in children in this era of regular mask wearing.

Methods:

We conducted a cross-sectional study from November 1, 2020, to January 31, 2021, at a tertiary hospital in the form of an anonymous online questionnaire. This included all children aged (2–20 years old) in our pediatric dermatology clinics, tertiary education students (16–20 years old), and children of hospital/health-care cluster staff (2–20 years old).

Results:

Of the 577 participants who reported regular mask wearing, 140 (24.3%) reported symptoms. The most common symptoms were itching (74.5%), dryness (49.6%), dyspnea (32.1%), and oily skin (29.9%). The most common rashes were acne (48.9%), eczema (27%), dryness/peeling (23.4%), urticaria (18.2%), and cheilitis (16.8%). The most statistically significant risk factors for developing mask-related symptoms and/or rashes were (a) prolonged duration of mask wearing/day and (b) preexisting dermatoses and/or atopic history (especially atopic dermatitis).

Conclusions:

As the pediatric population remains vulnerable to emerging COVID-19 variants and other respiratory viruses, masks remain an important form of protection in daily life. Like in adults, regular mask wearing can lead to various facial symptoms/dermatoses in pediatric wearers, adding to dermatological burden during a pandemic. Those with preexisting risk factors should be made aware of this. We recommend all pediatric mask wearers should not exceed continuous mask wearing for 4 h and to take scheduled “mask breaks” in safe, well-ventilated areas.
Pediatric Epidemiology of Skin Disorders in a Mediterranean Population with a Nonreferral-based Health-care System: A Retrospective Large Series Analysis
Authors: Soutou Boutros , El Jalkh Jason , Ibrahim Élio , Jneid Ramy Abou , Helou Josiane , Tomb Roland
Published: January 2024

Introduction:

Data from the Levant regarding pediatric dermatoses are limited. The objective was to estimate the prevalence of pediatric dermatoses in a health-care system that allows every patient to directly reach a specialist.

Patients and Methods:

It is a single-center, chart review, epidemiological study of patients who consulted, between 2010 and 2022, at the general dermatology department of a tertiary care university hospital. A random draw of 10% of the files was screened. Patients aged between 0 and 18 years at the time of consultation were included and their files were analyzed.

Results:

The study population consisted of 151,050 files, of which 10% were manually screened. Finally, 2313 “pediatric” files were analyzed, corresponding to 15.3% of the sample, with a female-to-male ratio of 1281/1032 (1.24). Of these analyzed files, 2912 diagnoses were distributed in the age categories as follows: 464 (16%) at preschool age, 1134 (39%) at school age, and 1314 (45%) at adolescence. The most prevalent diagnoses in males were acne (19.6%), atopic dermatitis (9.7%), and molluscum contagiosum (8.1%); in females, acne (27.4%), atopic dermatitis (9.4%), and warts (5.8%). Acne was the most frequent diagnosis overall (24%) and in the adolescents’ subgroup, with a female-to-male ratio of 1.77. The prevalence of atopic dermatitis decreased from 21.1% at preschool age to 10.9% at school age to 4.3% in adolescence. The most prevalent diagnoses at school age were molluscum contagiosum and warts.

Conclusion:

These updated percentages help configure suitable public health strategies for children in countries of approximate genetic background and similar life habits.
Microphthalmia, Dermal Aplasia, and Sclerocornea Syndrome: A Case Report and Review of Literature
Authors: Mendiratta Vibhu , Yadav Anukriti
Published: January 2024

Microphthalmia, dermal aplasia, and sclerocornea (MIDAS) syndrome is a rare syndrome manifesting at birth with a wide variety of abnormalities which include microphthalmia and/or anophthalmia, sclerocornea, linear skin defects with dermal aplasia limited to the face and neck, ocular abnormalities, central nervous system involvement, cardiac anomalies, hearing impairment, and genitourinary malformations. This report describes MIDAS syndrome in a 6-day-old female neonate who presented with multiple erosions with crusted plaques over the face and neck since birth and bilateral microphthalmia with microcornea with corneal opacity.
Frequency and characteristics of chronic fatigue syndrome in multiple sclerosis patients at a university hospital in Eastern Saudi Arabia
Authors: AlAmri Abdullah S. , AlShamrani Foziah J. , AlMohish Noor M. , Zafar Azra S. , Alnaaim Saud A. , Alazman Hatem A. , Al-Ghanimi Ibrahim A. , AlNahdi Abdullah A. , AlDawsari Fahad A. , AlMatrafi Shahad B. , Alzahrani Ghaida R. , Alnamlah Muna S. , Alkhalifa Rawan A.
Published: January 2024

BACKGROUND:

Multiple sclerosis (MS) is a chronic, inflammatory demyelinating disease that affects various parts of the central nervous system. Fatigue, a common symptom, transient, prolonged, or chronic experienced by individuals with MS, can significantly impact daily functioning. It can be associated with underlying pathological processes or can have an idiopathic cause, such as chronic fatigue syndrome (CFS). The study aimed to assess the presence and etiology of fatigue in MS patients and its relationship with CFS.

MATERIALS AND METHODS:

This cross-sectional study was conducted in the Eastern Province of Saudi Arabia. Data were collected using a questionnaire from a sample of 225 MS patients receiving care at our university hospital. The questionnaire included the Centers for Disease Control and Prevention (CDC) criteria for diagnosing CFS and the Expanded Disability Status Scale to evaluate fatigue in MS patients.

RESULTS:

Of the total of 225 MS patients who participated in this study, 87.1% were diagnosed with relapsing-remitting MS, 6.7% with primary progressive MS, 3.6% with clinically isolated syndrome, and 2.7% with secondary progressive MS. About 53% had experienced fatigue that persisted for over 6 months. Analysis of CFS diagnosis revealed that 7.3% of patients met both CDC criteria and self-reported answers while 17.5% reported having CFS despite not meeting the CDC criteria. These findings highlight a significant lack of agreement between patient-reported diagnoses and established criteria, indicating poor agreement (P = 0.028).

CONCLUSION:

The study found an association between CFS and MS, and a significant impact on daily functioning. The study revealed lack of agreement between patient-reported diagnoses and established criteria for CFS. This emphasizes the need for a standardized approach to diagnosis and evaluation of fatigue in MS patients.
Impact of COVID-19 pandemic on healthcare delivery for lysosomal storage disorders at a tertiary care public hospital in Mumbai
Authors: Muranjan M , Karande S , Rajoria S
Published: January 2024

Introduction:

Management of lysosomal storage disorders (LSDs) requires periodic visits for medical surveillance and hospitalizations. Management of LSDs may have been adversely impacted during the COVID-19 pandemic.

Objective:

To identify the factors impacting health care for patients with LSDs during the COVID-19 pandemic.

Methods:

An observational study was conducted in Mumbai comparing infusion practices and reasons for missed infusions for 15 months before March 2020 versus two phases during the pandemic (April 2020–March 2021 and April 2021–March 2022) in patients receiving intravenous enzyme replacement therapy (ERT) and on oral substrate reduction therapy (SRT).

Results:

Fifteen patients with LSDs were enrolled. Before the pandemic, 6/13 (46%) were receiving ERT at the study site, 4/13 (31%) at a local hospital, and 3/13 (23%) at home; two were on SRT. The median distance traveled for receiving ERT was 37 km, and 4.4 infusions/patient were missed. From April 2020 to March 2021, two more patients opted for home ERT infusions. The median distance traveled for receiving ERT was 37 km, and 11.6 infusions/patient were missed. From April 2021 to March 2022, one more patient opted for home ERT infusions. The median distance traveled for receiving ERT was 7 km, and 5.6 infusions/patient were missed. The pandemic also affected SRT compliance adversely. For all patients, the cause of disrupted treatment was travel curbs (69%) and fear of getting COVID-19 infection (38%).

Conclusions:

Treatment of LSDs was disrupted during the pandemic, with an increase in missed ERT infusions and SRT doses.
Aflibercept treatment for delayed retinotomy-associated choroidal neovascularization: A case report and literature review
Authors: Yeh Cyuan-Yi , Liang Yi-Ting , Cheng Cheng-Kuo
Published: January 2024

A 67-year-old male presented to our clinic with sudden onset of blurred vision and metamorphopsia of his left eye for 2 weeks. He had a history of combined rhegmatogenous retinal detachment and vitreous hemorrhage and underwent an uneventful pars plana vitrectomy, 360° scleral buckling, and drainage retinotomy for his left eye 3 years ago. The anatomic and visual outcomes after surgery were good, without complications. On examination during this visit, an orange–red subretinal mass connected to the previous drainage retinotomy scar was noted. Spectral-domain optical coherence tomography revealed severe subretinal fluid with type-2 choroidal neovascularization (CNV) mass at the superior nasal macular area in connection with the margin of the previous retinotomy scar. Fundus fluorescein angiography showed an active CNV. The patient underwent monthly intravitreal aflibercept in the left eye. After four doses of aflibercept, his CNV regressed with no recurrence on follow-up at 20 months. In conclusion, iatrogenic CNV is a rare complication following uneventful vitreoretinal surgery and can develop years after the operation. It is crucial to early diagnose and treat it with intravitreal antivascular endothelial growth factor treatment for a favorable outcome and long-term remission.
Extraocular muscle bridle traction suture assisted Paul glaucoma implant surgery for severe conjunctival scarring
Authors: Shao Yi-Ching , Wang Lu-Chun , Lee Yi-An
Published: January 2024

Glaucoma drainage device implantation can be complex and challenging, particularly in patients with conjunctival scarring. However, in this case, involving a young man with refractory glaucoma who had undergone multiple ocular surgeries, the implantation of a Paul glaucoma drainage device was successfully performed after the application of extraocular muscle bridle sutures. The patient exhibited a stable intraocular pressure ranging from 12 to 18 mmHg without antiglaucoma medication during the 3-month follow-up period. Thus, this surgical technique improves the accuracy and ease of inferior-temporal quadrant glaucoma drainage implantation, resulting in good treatment outcomes.
Bilateral optic neuritis and encephalopathy as the atypical presentations of multiple sclerosis following severe acute respiratory syndrome coronavirus 2 infection
Authors: Liu Sheng-Yu , Hsieh Wan-Jen , Hsueh Hsueh-Wen , Lin Chao-Wen
Published: January 2024

Numerous evidence suggests coronavirus disease 2019 (COVID-19) potentially triggers demyelinating diseases, inclusive of multiple sclerosis (MS), and acute disseminated encephalomyelitis (ADEM), and various mechanisms have been proposed. We report a 42-year-old male presented with bilateral optic neuritis and encephalopathy, 2 weeks following COVID-19 infection. He denied any history or family history of neurological and ocular diseases. Severe bilateral visual impairment (only light perception) and pain with eye movement were reported. Fundoscopy revealed bilateral optic disc swelling. Magnetic resonance imaging showed tortuous bilateral optic nerves with optic nerve and nerve sheath enhancement. Multiple hyperintense nodules in bilateral cerebral white matter were noted on fluid-attenuated inversion recovery T2-weighted imaging without diffusion restriction or gadolinium contrast enhancement. Hypointense nodules in cerebral white matter were also noted on T1-weighted imaging, which implied some old lesions. Dissemination in space and time and cerebrospinal fluid-specific oligoclonal bands confirmed the diagnosis of MS. Both serum aquaporin-4 and myelin oligodendrocyte glycoprotein antibodies were negative. He received pulse steroid therapy for 5 days, followed by slowly tapering oral prednisolone. His vision, ocular motion pain, and encephalopathy improved gradually. However, the visual outcome was still poor (bilateral 20/400), and optic atrophy was noticed during 1-year follow-up. To our knowledge, this is the first case of MS following severe acute respiratory syndrome coronavirus 2 infection presented with bilateral optic neuritis and encephalopathy. Since these manifestations are exceedingly rare in MS, we suspect acute immune reactions induced by COVID-19 could bring about the atypical ADEM-like presentations of MS.
Computer vision recognition in the teaching classroom: A Review
Authors: Jiang Hui , Fu Wentao
Published: January 2024

Artificial intelligence introduces computer vision recognition into the teaching classroom, and computer vision recognition technology lays a solid foundation for the intelligent teaching classroom. Through the classroom camera video stream to the classroom student information data collection, voice, posture, facial, physiological signal data recognition analysis processing to extract and define the characteristics of student behaviour, automatic classification behaviour and then record and display student behaviour, thus effectively help teachers to grasp the students learning state and emotions, to promote the quality of teaching has far-reaching significance.
State-of-the-art review on energy management systems, challenges and top trends of renewable energy based microgrids
Authors: Wu Yefan , Cui JinZhu , Liu Caiyan
Published: January 2024

Due to the increasing demand for electrical energy worldwide and environmental concerns, modern power systems are looking for a fundamental change. These changes include reducing dependence on the primary electricity grid and using renewable energy sources on a large scale. The emergence of microgrids in electrical energy systems will improve the level of these systems due to technical, economic, and environmental benefits. In this research work, the authors have conducted extensive studies on control methods, types of power sources, and the size of microgrids and analyzed them in tabular form. In addition, the review of communication technologies and standards in microgrids, as well as the review of microgrid energy management systems to optimize the efficiency of microgrids, is one of the main goals of the authors in this article. Also, in this article, the top 10 trends of microgrids in 2023 have been examined to increase the flexibility of network infrastructure, which helps readers to improve their strategic decisions by providing an overview of emerging technologies in the energy industry.
A rare goblet cell adenocarcinoma arising from Barrett’s esophagus: the first reported case in the esophagus
Authors: Oh Chi Eun , Kim Sung Eun , Oh Sun-Ju
Published: January 2024

Goblet cell adenocarcinoma (GCA) is a rare and distinctive amphicrine tumor comprised of goblet-like mucinous cells and neuroendocrine cells. It is believed to originate from pluripotent stem cells located at the base of crypts. GCA predominantly arises from the appendix, with a few reported cases in extra-appendiceal locations such as the colorectum, small intestine, and stomach. In this case report, we present a unique instance of a 64-year-old male who initially received a diagnosis of neuroendocrine carcinoma in the distal esophagus based on biopsy but, following resection, was subsequently re-diagnosed with GCA arising from Barrett’s esophagus.
Decategorified Heegaard Floer theory and actions of both $E$ and $F$
Authors: Manion Andrew
Published: January 2024

We define larger variants of the vector spaces one obtains by decategorifying bordered (sutured) Heegaard Floer invariants of surfaces. We also define bimodule structures on these larger spaces that are similar to, but more elaborate than, the bimodule structures that arise from decategorifying the higher actions in bordered Heegaard Floer theory introduced by Rouquier and the author. In particular, these new bimodule structures involve actions of both odd generators

E

and

F

of

\mathfrak{gl}(1|1)

, whereas the previous ones only involved actions of

E

. Over

\mathbb{F}_2

, we show that the new bimodules satisfy the necessary gluing properties to give a 1+1 open-closed TQFT valued in graded algebras and bimodules up to isomorphism; in particular, unlike in previous related work, we have a gluing theorem when gluing surfaces along circles as well as intervals. Over the integers, we show that a similar construction gives two partially defined open-closed TQFTs with two different domains of definition depending on how parities are chosen for the bimodules. We formulate conjectures relating these open-closed TQFTs with the

\mathfrak{psl}(1|1)

Chern–Simons TQFT recently studied by Mikhaylov and Geer–Young.
Determinants of unhealthy living by gender, age group, and chronic health conditions across districts in Korea using the 2010-2017 Community Health Surveys
Authors: Bui Thi Tra , Nguyen Thi Huyen Trang , Lee Jinhee , Kim Sun Young , Oh Jin-Kyoung
Published: January 2024

OBJECTIVES: We investigated the prevalence and determinants of unhealthy living by gender, age, and comorbidities across Korean districts.METHODS: For 806,246 men and 923,260 women from 245 districts who participated in the 2010-2017 Korean Community Health Surveys, risk scores were calculated based on obesity, physical inactivity, smoking, and high-risk alcohol consumption, each scored from 0 (lowest risk) to 2 (highest risk). A risk score ≥4 was defined as indicating unhealthy living, and weighted proportions were calculated for each district. Using multivariate regression, an ecological model including community socioeconomic, interpersonal, and neighborhood factors was examined by gender, age, and comorbidities.RESULTS: The mean age-standardized rate of unhealthy living was 24.05% for men and 4.91% for women (coefficients of variation, 13.94% and 29.51%, respectively). Individuals with chronic diseases more frequently exhibited unhealthy lifestyles. Unhealthy lifestyles were associated with educational attainment (β-coefficients: men, -0.21; women, -0.15), high household income (β=0.08 and 0.03, respectively), pub density (β=0.52 and 0.22, respectively), and fast-food outlet density (β=2.81 and 1.63, respectively). Negative associations were observed with manual labor, social activity participation, and hospital bed density. Unhealthy living was positively associated with living alone among women and with being unemployed among middle-aged men. Access to parks was negatively associated with unhealthy living among young men and women. The ecological model explained 32% of regional variation in men and 41% in women.CONCLUSIONS: Improving the neighborhood built and socioeconomic environment may reduce regional disparities in lifestyle behaviors; however, the impacts may vary according to socio-demographic traits and comorbidities.
An epidemic of cataract surgery in Korea: the effects of private health insurance on the National Health Insurance Service
Authors: Lee Hyejin , Hwang Soo-Hee , Park Choon-Seon , Chung Seol-Hee , Chen Catherine L. , Lee Jin Yong , Lee Jin Soo
Published: January 2024

OBJECTIVES: In Korea, the National Health Insurance Service (NHIS) covers essential healthcare expenses, including cataract surgery. To address concerns that private health insurance (PHI) might have inflated the need for such procedures, we investigated the extent of the PHI-attributable increase in cataract surgery and its impact on NHIS-reimbursed expenses.METHODS: This retrospective, observational study uses nationwide claims data for cataract surgery from 2016 to 2020. We examined trends in utilization and cost, and we estimated the excess numbers of (1) cataract operations attributable to PHI and (2) types of intraocular lenses used for cataract surgery in 2020.RESULTS: Between 2016 and 2020, a 36.8% increase occurred in the number of cataract operations, with increases of 63.5% and 731.8% in the total healthcare costs reimbursed by NHIS and PHI, respectively. Over a 5-year period, the surgical rate per 100,000 people doubled for patients aged <65 years (from 328 in 2016 to 664 in 2020). Among the 619,771 cases in 2020 of cataract surgery reimbursed by the Korean diagnosis-related group system, more non-NHIS-covered intraocular lenses were used for patients aged <65 years than ≥65 years (68.1 vs. 14.2%). In 2020 alone, an estimated 129,311 excess operations occurred, accounting for an excess cost of US$115 million.CONCLUSIONS: A dramatic increase in the number and cost of cataract operations has occurred over the last 5 years. The PHI-related increase in operations resulted in increased costs to NHIS. Measures to curtail the non-indicated use of cataract surgery should be implemented regarding PHI.
Socioeconomic inequality in health-related quality of life among Korean adults with chronic disease: an analysis of the Korean Community Health Survey
Authors: Nguyen Thi Huyen Trang , Bui Thi Tra , Lee Jinhee , Choi Kui Son , Cho Hyunsoon , Oh Jin-Kyoung
Published: January 2024

OBJECTIVES: Health-related quality of life is crucial for people dealing with chronic illness. This study investigated the quality of life in individuals with 5 common chronic conditions in Korea. We also analyzed socioeconomic factors such as education, income, occupation, and urbanization to identify determinants of inequality.METHODS: Using 2016 Korea Community Health Survey data, we examined individuals aged 30 or older with chronic diseases (diabetes, hypertension, cardiovascular disease, hyperlipidemia, arthritis) using the EuroQol 5-Dimension 3 Level tool. We analyzed the associations between socioeconomic factors (education, income, occupation, urbanization) and quality of life using descriptive statistics and regression analysis. Inequality indices (relative inequality index, absolute inequality index) were used to measure inequality in quality of life.RESULTS: Individuals with higher income levels showed a 1.95-fold higher likelihood of a better quality of life than those with the lowest income. The lowest income group had higher odds of mobility (adjusted odds ratio [aOR], 2.2), self-care (aOR, 2.1), activity limitations (aOR, 2.4), pain/discomfort (aOR, 1.8), and anxiety/depression (aOR, 2.3). Educational disparities included a 3-fold increase in mobility and daily activity problems for those with elementary or lower education. Well-educated participants had a 1.94 times higher quality of life, with smaller differences in anxiety/depression and self-management. The income gap accounted for 14.1% of variance in quality-of-life disparities.CONCLUSIONS: Addressing socioeconomic disparities in the quality of life for individuals with chronic diseases necessitates tailored interventions and targeted health policies. This research informs policymakers in developing focused initiatives to alleviate health inequities. It emphasizes the importance of mental health support and ensuring affordable, accessible healthcare services.
New Approaches to Predict the Sperm Quality by the Spermatozoal miRNA Content in Fish: A Review
Authors: Kocabaş Filiz Kutluyer , Kocabaş Mehmet
Published: January 2024

The survival of the progeny and fertilization success depend on high-quality mature spermatozoa containing DNA and coding and non-coding RNAs besides the female gamete quality. Sperm cells and gonads in fish contain different RNA classes. It is possible that the development of fish could be affected by miRNA and/or other non-coding RNAs being abundant in Teleost fish and having important functions. Studies about the presence of miRNA in some fish species (e.g. Danio rerio, Salmo salar, Carassius auratus, Cyprinus carpio) showed that sperm motility is regulated by miRNA. Nevertheless, limited knowledge and several hypotheses have been presented about classes and content of RNAs in fish spermatozoa. More research about the effects of miRNA on fish reproduction and sperm quality are needed for population, aquatic ecosystems, and broodstock management, and the evaluation of molecular sperm quality parameters with miRNA could be used together with traditional techniques.
Experiences in Improving the Quality of Community-Based Fever Management from Three Malaria-Endemic African Countries
Authors: Ahmed Jehan , Nothem Adam , Mostel Jadmin , Ciceron Annie , Nuñez Luigi , Raobela Oméga , Raoiliarison Andry Patrick , Lankhulani Sosten , Munthali John , Cissoko Mady , Kamaté Beh , Yattara Oumar , Coumaré Samba , Wolf Katherine
Published: January 2024

The WHO affirms that trained, supervised, and supported community health workers (CHWs) can deliver high-quality health services effectively and has called for documentation of enabling factors, needs, and implementation strategies of successful CHW programs. In response, the U.S. President’s Malaria Initiative Impact Malaria Project conducted a study to document implementation approaches, best practices, and lessons learned for quality improvement (QI) of community-based fever management in Madagascar, Malawi, and Mali. The team conducted 10 key informant interviews (KIIs) with individuals at national, regional, and district levels using an open-ended interview guide tailored to each level, and a desk review of documents and materials related to community-based QI. Each country’s community health landscape and QI approaches were summarized into four categories identified during the KIIs (training, supervision, coaching/mentoring, and review meetings) and compared. Results found that Madagascar, Malawi, and Mali all had well-defined community health strategies that include QI, but countries could not extend their full package of community-based QI approaches to all CHWs as a result of limited human and financial resources. Vertical funding for health programs limits the scope and coverage of QI approaches, especially at the community level. Recommendations from key informants for strengthening community-based QI included integrating QI approaches to improve cost efficiency, to define roles and responsibilities more clearly, to engage communities and all health system levels in implementation, and to digitize QI tools. Increased financial and skilled human resources are needed for community-based QI activities to achieve their intended effect.
Examination of Diagnostic Performance of New IgG4 Rapid Test Compared with IgG- and IgG4-ELISAs to Investigate Epidemiology of Strongyloidiasis in Northeast Thailand
Authors: Wongphutorn Phattharaphon , Noordin Rahmah , Anuar Nor Suhada , Worasith Chanika , Kopolrat Kulthida Y. , Homwong Chutima , Tippayawat Patcharaporn , Techasen Anchalee , Pitaksakurat Opal , Sithithaworn Jiraporn , Eamudomkarn Chatanun , Sithithaworn Paiboon
Published: January 2024

Strongyloidiasis, caused by Strongyloides stercoralis, is a neglected tropical disease with a global distribution. The infection can be fatal in immunocompromised individuals, and accurate diagnosis leading to timely treatment can save lives. Serodiagnosis is a sensitive method for diagnosis and is recommended for screening high-risk individuals. A point-of-care rapid test will facilitate the screening activities, especially in low-resource settings. This study aims to apply a new IgG4 immunochromatographic test using S. stercoralis recombinant antigen (SsRapid® cassette test) and to compare it with in-house IgG and IgG4 enzyme-linked immunosorbent assays (IgG- and IgG4-ELISAs) using native Strongyloides ratti antigen to investigate the epidemiology of strongyloidiasis in northeast Thailand. A total of 300 people participated, with 136 males and 164 females of a similar mean age. The reference tests were fecal examinations using the formalin-ethyl acetate concentration technique and an agar plate culture technique. The prevalence of S. stercoralis determined by SsRapid (81.7%) was significantly higher than that by fecal examinations (43.3%) or by antibody detection by IgG-ELISA (53.0%) or IgG4-ELISA (44.0%). The diagnostic sensitivities of SsRapid, IgG-ELISA, and IgG4-ELISA were found to be 93.9%, 77.7%, and 63.1%, respectively. The rate of positive tests by the SsRapid was significantly correlated to the levels of Strongyloides-specific IgG4 and IgG antibodies. By all diagnostic methods, male participants had a significantly higher prevalence of strongyloidiasis than females. Age was significantly associated with the concentration of specific serum IgG but not with the SsRapid grading score. In conclusion, SsRapid was shown to be a sensitive and valuable diagnostic test for the epidemiology study of strongyloidiasis.
Application of an ARFIMA Model to Estimate Hepatitis C Epidemics in Henan, China
Authors: Wang Yongbin , Liang Ziyue , Qing Siyu , Liu Xingyan , Xu Chunjie
Published: January 2024

Hepatitis C (HC) presents a substantial burden, and a goal has been established for ending HC epidemics by 2030. This study aimed to monitor HC epidemics by designing a paradigmatic autoregressive fractionally integrated moving average (ARFIMA) for projections until 2030, and evaluating its efficacy compared with the autoregressive integrated moving average (ARIMA). Monthly HC incidence data in Henan from January 2004 to June 2023 were obtained. Two periods (January 2004 to June 2022 and January 2004 to December 2015) were treated as training sets to build both models, whereas the remaining periods served as test sets to perform performance evaluation. There were 465,196 HC cases, with an escalation in incidence (average annual percentage change = 8.64, 95% CI: 3.71–13.80) and a peak in March and a trough in February. For both the 12 and 90 holdout data forecasts, ARFIMA generated lower errors than ARIMA across various metrics: mean absolute deviation (252.93 versus 262.28 and 235.37 versus 1,689.65), mean absolute percentage error (0.17 versus 0.18 and 0.14 versus 0.87), root mean square error (350.31 versus 362.31 and 311.96 versus 1,905.71), mean error rate (0.14 versus 0.15 and 0.11 versus 0.82), and root mean square percentage error (0.26 versus 0.26 and 0.24 versus 1.01). Autoregressive fractionally integrated moving average predicted 181,650 (95% CI: 46,518–316,783) HC cases, averaging 22,706 (95% CI: 5,815–39,598) cases annually during 2023–2030. Henan faces challenges in eliminating HC epidemics, emphasizing the need for strengthened strategies. Autoregressive fractionally integrated moving average can offer evidence-based insights for public health measures.
Potential Application of Rubber-Graphene Compounds in the Automotive Parts
Authors: Veloso Verônica , Pinto Eduardo , Santiago Marcelo , Bortoli Bruna , Ribeiro Willian , Polkowski Rodrigo
Published: January 2024

Rubber is one of the most used materials currently selected to produce automotive parts, but, for specific applications, some improvement is required in its properties through the addition of some components to the rubber compound formulation. Because of that, mechanical, thermal, and chemical properties are enhanced in order to meet strict requirements of the vast range of application of the rubber compounds. In addition to improving material properties, the combination of different substances, also aims to improve processability and reduce the costs of the final product. Recently, the use of nanofillers has been very explored because of their distinctive properties and characteristics. Among the nanofillers under study, graphene is known for its high-barrier property, thermal and electrical conductivities, and good mechanical properties. A large number of researches on rubber/graphene compounds preparation methods and applications can be found in literature and results are promising, including for rubbers largely used in automotive industry, such as acrylonitrile butadiene rubber (NBR), natural rubber (NR) styrene butadiene (SBR), butyl rubber (IIR), and ethylene-propylene-diene (EPDM). The observed improvements obtained with the addition of graphene in rubbers can have a good impact on durability and performance of a lot of different rubber automotive parts, such seals, hoses, tires, and anti-vibration parts. This work is an overview about rubber-graphene compounds, bringing aspects of preparation methods and some final characteristics that can be valuable for automotive industry, such as mechanical and chemical resistance, and barrier property.
Investigation of the Impact of Fiberglass on the Performance of Injected Thermoplastic Automotive Parts
Authors: de Oliveira Neto Raimundo Arrais , da Rocha Loi Monique , Junior Luis Roberto Martins Rego , Junior Georges Louis Nogueira Guimarã
Published: January 2024

Manufacturing processes impact many factors on a product. Depending on the selected method, development time, part performance and cost are affected. In the automotive sector, there is a growing demand for weight reduction due to the advent of electrification and the greenhouse gas emission regulations. In addition, geometric complexity is a challenging factor for the feasibility of mass production of parts. In this scenario, plastic materials are a very interesting option for application in various vehicle parts, since these materials can be molded by injection, vacuum forming, among others, while maintaining good mechanical properties. Almost a third of a vehicle’s parts are polymeric, making the development of these materials strategic for car manufacturers. This article investigates the impact of the presence of fiberglass in a thermoplastic automotive body part. Three rounds of injection simulations were performed using Autodesk Moldflow Adviser considering polypropylene with 20 %, 30 %, and 40 % of fiberglass in its composition. A parametric analysis is performed and the performance curves for volumetric shrinkage at ejection and deflection are plotted. The higher the fiberglass percentage, the higher the impact strength, dimensional stability, and stiffness.
DRBFM Methodology Applied to Design Changing in Fuel Supply Modules
Authors: de Azevedo Fernandes Luiz Eduardo , de Oliveira Melo Lazaro Benedito , André Marco Pellizzon
Published: January 2024

Robustness and reliability are key elements for product success in the automotive market. On this purpose, the Design Review Based on Failure Modes (DRBFM) is a product development methodology to guide on potential risks assessment related to new design proposals. This paper shows the DRBFM structure and mindset for new products, using function and behavior evaluation. Moreover, the methodology will be demonstrated for a real automotive case, considering a new component design for Fuel Supply Module (FSM). The FSM is responsible to deliver fuel to the engine and maintain the pressure in the fuel rail during the spark engine operation. To fit these main functions, the electrical fuel pump inside the module must be always working submerged even if the fuel tank is almost empty. This the reason for this product has the jet pump component that is responsible to actively drag fuel during this worst fuel tank volume condition. During a new FSM customer application, the function presented previously had failure in the test bench, so a new design for the Jet Pump Connector (JPC) was proposed to solve the issue. Using an analytical model and experimental results to prove the correlation between design and function, it was possible to validate the influence of the new design proposed to meet the specification. Additionally, due the methodology applied, it was possible to confirm that this change will guarantee all functional and behavior necessary for this product application in the customer’s vehicle.
A Systematic Review of Automotive Wiring Harness Innovations
Authors: Reis B. , Cella H. Della , Ferreira M. , Vaz S. , Cossolino G. , Montes R. , Ferreira F.F.V.M.
Published: January 2024

This paper discusses automotive electrical harnesses, emphasizing their applicability and considering crucial aspects such as reliability, safety, innovation, simulation, and manufacturing. This text proposes to explore an introduction and addresses the importance of ensuring the reliability of harnesses. Highlighting the Electrified vehicle development importance and the harness applicability in both high-voltage and low-voltage systems, as well as the need for safe practices during design. Featuring innovation in the area, mentioning the evolution of materials and technologies used in modern wiring harnesses. Simulation is presented as an essential tool in the development process, allowing performance analysis prior to physical production. Finally, manufacturing is discussed, highlighting the importance of efficient processes and quality control.
Microstructure of cast iron resistant to hydrogen embrittlement
Authors: Turola Jéssica , Obara Rafael Brisolla , Ferrarese André , Albaneze Aline Fernanda , de Souza Cabezas Carlos
Published: January 2024

One of the most promising applications for the use of hydrogen in vehicles is in the combustion engine. According to the legislation proposal being considered by European Union, hydrogen internal combustion engines (H2ICE) are zero emissions solution. Among the existing solutions, H2ICE is becoming the preferred one on long haul trucks and offroad applications. This is due to the high durability of the powertrain, the lower initial investment when compared to other alternatives, and the possibility of using low purity hydrogen. However, despite the high potential use of hydrogen, because of it is the smallest known chemical element, its use can result in the penetration of hydrogen into metallic materials, with the undesirable effect of embrittlement. This effect occurs mainly when the material surface is exposed to high temperatures and pressures, or under corrosion. By diffusing into the crystal lattice, hydrogen is accumulated in the interstices and crystalline defects, reducing the ductility of the metallic material. Unlike high strength steels, cast irons present graphite that can accommodate diffused hydrogen, delaying the embrittlement effect. The morphology and amount of graphite, as well as the alloying elements and phases present, play a key role in this issue. As shown in a previous work, using a pressurized vessel, cast iron specimens where exposed to an atmosphere of 20% H2 and 80% N2 at 150 bar and 300 °C for 7 days, and hydrogen embrittlement was not verified. In the present work, the effects of hydrogen embrittlement on different cast iron microstructure were evaluated by a qualitative fracture analysis technique. To this purpose, a current density of 16 mA/cm2 was applied for 24 h in electrolytic solution. Hydrogen embrittlement was not verified since the fractures presented in all samples showed river marks, characteristic of brittle fracture, and dimples, characteristic of ductile fracture. This indicates that the hydrogen saturation to generate embrittlement was not reached.
Anisotropic structural modeling of fiber-reinforced polymers used in engine peripheral components
Authors: Bueno Estela Mari Ricetti , Higa Armando , Bazaneli José Augusto
Published: January 2024

The evolution of materials technology has provided in recent decades the replacement of the raw material of many parts made of metal by polymers, carbon fibers, ceramics, and composite materials. This process has been driven by the permanent need to reduce weight and costs, which, even after replacing raw materials, still demand permanent improvement and optimization in the sizing process and in the manufacturing process. In the automotive industry, many components have been replaced by fiber-reinforced polymers, from finishing parts to structural components that are highly mechanically stressed and often also subjected to high temperatures. Although they are lighter and have a lower final cost than conventional metallic parts, components made of fiber-reinforced polymers bring great technological challenges to the development project. Within this context, computational modeling is an indispensable ally for obtaining a product capable of meeting the severe conditions required for its service. Peripheral engine components such as air, oil and fuel filters, canisters, valve covers and intake manifolds are examples of components that are commonly made of fiber reinforced polymers, but that present relevant thermo-mechanical and vibrational requests. The simulation of the polymer injection process and its coupling to structural modeling is a crucial differential in the development of these products. The consideration of the anisotropy caused by the reinforcing fibers in the polymer has a very relevant impact in terms of stresses and strains, as well as the stiffness of these components. The fiber alignment that defines the anisotropy in the part is obtained from the simulation of the injection process and introduced in the finite element model that will be used for structural evaluation of the component. Aiming to illustrate the relevance of this anisotropic structural modeling approach, which couples the manufacturing process with structural simulation, two case studies are presented: a fuel filter subjected to rupture test comparing numerical and experimental results and the second case is the natural frequency analysis and vibration modes of a valve cover.