bluuebunny/crossref_metadata_2025 huggingface dataset:
Inquérito de toxoplasmose e de tripanossomíases realizado no Território do Amapá pela III Bandeira Científica do Centro Acadêmico "Oswaldo Cruz" da Faculdade de Medicina da Universidade de São Paulo
Authors: Deane Leonidas Mello , Deyama Alberto Yoshiharu , Cesar Airton Pessoa , Barone Antonio Alci , Losasso Neto Antonio , Lucon Antonio Marmo , Farfel Aron Saul , Lombardi Clovis , Boni Deise de , Rivitti Evandro Ararigboia , Suzuki Hisashi , Carlquist Ivan , Tsushida Koiti , Massucci Lourdes , Stolf Noedir Antonio Groppo , Butugan Ossamu , Machado Regis Pinheiro , Tellian Sarkis , Andreozzi Sergio Marino , Tamaki Tutomo , Kashiwagi Yogi , Campos Zuleika Machado de , Deane Maria José Von Paumgartten , Jamra Lígia , Guimarães Eni Maria Câmara , Siqueira Gilberto Rolando Vidal de , Reis Lídia dos
Published: May 2024

Descreve-se uma excursão realizada em janeiro de 1962 por estudantes da Faculdade de Medicina da Universidade de São Paulo ao Território do Amapá, onde realizaram inquéritos de toxoplasmose e tripanossomíase na cidade de Macapá e nas vilas de Paredão e Ferreira Gomes.A reação de Sabin-Feldman foi positiva em 68,1 % das 354 pessoas examinadas e a intradermorreação com toxoplasmina em 46,4% de 366. A distribuição das provas positivas é apresentada por localidade, sexo, idade e côr.A reação de fixação do complemento para doença de Chagas (prova de Guerreiro e Machado, técnica quantitativa), feita em 353 pessoas, não apresentou nenhum resultado seguramente positivo, sendo ainda negativos os 116 xenodiagnósticos efetuados com ninfas de triatomíneos (Rhodnius prolixus).Fazem-se ainda considerações sobre o intenso surto de malária que ocorria então na região.
Inquérito sorológico sôbre leptospiroses realizado no Vale do Cariri, Estado do Ceará, pela III Bandeira Científica do Centro Acadêmico Oswaldo Cruz da Faculdade de Medicina da Universidade de São Paulo
Authors: Castro Raymundo Martins , Corrêa Marcello Oswaldo Álvares , Soeiro Alfredo Correia , Machado Filho Álvaro de Faria , Campos Antonio Carlos de , Massa Boanerges Souza , Araújo Carlos Gomes de , Almeida Clemente Isnard Ribeiro de , Lotufo Heloisa A. , Klajner Henrique , Gonçalez João , Carneiro Neto José , Martins José E. Costa , Duarte José Enio Servilha , Oliveira Laerte de , Palella Maria , Nóbrega Mário Smith , Setian Nuvarte , Attab Filho Pedro Miguel , Corrêa Reinaldo Souza , Almeida Thomaz Ribeiro de , Natale Vail
Published: May 2024

Com o propósito de estudar o problema das leptospiroses no Vale do Cariri, Ceará, foram examinados 376 soros colhidos entre moradores da região. Foram feitas provas de sôro-aglutinação usando-se os seguintes sôro-tipos de Leptospira: L. icterohemorrhagiae, L. canícola, L. grippo-typhosa, L. pomona, L. bataviae, L. australis B, L. sejroe, L. pyrogenes e L. suis. Seis soros reagiram positivamente frente à L. icterohemorrhagiae, o que dá percentual de 1,59%. Dois dos indivíduos haviam nascido e vivido no Vale, donde foi possível concluir que a leptospirose existe, autóctone, na região.
Considerações sobre os resultados da aplicação de um teste para avaliação do aproveitamento no curso de neurologia
Authors: Tolosa Adherbal Pinheiro Machado , Canelas Horácio Martins
Published: May 2024

São apresentados os resultados da aplicação de um teste para avaliação do aproveitamento em neurologia, dos quinto-anistas da Faculdade de Medicinade São Paulo, Universidade de S. Paulo. São analisadas as proporções de acerto segundo a natureza das questões, sendo comentada a correlação positiva observada entre as notas práticas e as do teste.
Traumatisos uretrais
Authors: Editores Os
Published: May 2024

Os A.A., nesse trabalho, fazem uma revisão sobre as afecções urológicas traumáticas da uretra. Utilizando dados da literatura e de sua experiência pessoal.Os traumatismos da uretra são considerados em relação ao local em que ocorrem (uretrapeniana, bulbar e membranosa), enfatizando-se a etiopatogenia, quadro clínico e o tratamento de cada um desses tipos de lesões. Finalmente são estudados os mecanimos e o tratamento da impotência sexual decorrente de lesões uretrais, e m particular dos politraumatizados com fratura de bacia e rotura da uretra posterior.
Propedêutica urológica completa nas fístulas uro-ginecológicas
Authors: Freire Geraldo de Campos , Montelatto Nelson Ileo Dias , Kawasaki Jorge , Góes Gilberto Menezes de
Published: May 2024

Os autores apresentam o resultado da experiência adquirida com a realização de 71 exames uro-ginecológicos em pacientes portadoras de fístulas entre os dois sistemas. Comenta-se o valor das antigas provas do "azul de metileno" diante das vantagens da inspeção vesical e vaginal com o auxílio da luz de fibra óptica. Os autores propõem uma metodologia orientada especificamente no sentido de facilitar a indicação da cirurgia corretiva destas dístulas.
Alterações orgânicas no diabetes
Authors: Doi Sonia de Quateli , Lottenberg Simão Augusto , Halpern Alfredo
Published: May 2024

Os autores fazem uma revisão e análise crítica dos diversos tipos de lesões orgânicas que aparecem durante a evolução do diabetes, discutindo alguns aspectos fisiopatológicos e clínicos.
Ressecções pulmonares
Authors: Groppo Antônio Amauri , Fernandes Paulo Manuel Pêgo , Costa Roberto , Stolf Noedir Antonio Groppo
Published: May 2024

O autor faz uma avaliação dos modernos métodos de ressecção pulmonar, seus tipos e suas indicações. Analisa também os cuidados básicos, indispensáveis no Pré e Pós-operatório.
Interações bilaterais no sistema óptico acessório de pombos: um estudo neuroanatômico eletrofisiológico
Authors: Cukiert Arthur , Azevedo T. A. , Brito Luiz Roberto Giorgetti
Published: May 2024

O sistema óptico acessório (SOA) tem sido objeto de intensa investigação nos últimos anos, sobretudo após a demonstração de suas ligações com mecanismos de integração visuo-motora. Um aspecto interessante emergente desses estudos, realizados principalmente em aves, diz respeito à possível existência de conexões recíprocas entre os núcleos principais desse sistema, bilateralmente. O presente estudo visou estudar esse aspecto da organização funcional do SOA em pombos, por métodos neuroanatômicos e eletrofisiológicos. Microinjeções eletroforéticas de peroxidase do rábano silvestre (HRP) ou HRP conjugada à aglutinina do germe de trigo (WGA-HRP) foram efetuadas no núcleo da raiz óptica basal (nROB), principal componente do SOA em aves. Em experimentos separados, foram feitos registros unitários e de campo no nROB, e aplicados pulsos elétricos no nROB contralateral o no trato óptico. Os principais resultados obtidos podem ser resumidos como segue: 1) Neurônios marcados retrogradamente por HRP ou WGA-HRP foram encontrados no nROB contralateral, em suas regiões central, dorsal e lateral. 2) A estimulaçao elétrica do nROB pode gerar potenciais de campono nROB contralateral, anti e ortodrômicos, 3) A atividade unitária no nROB pode ser suprimida, reduzida ou mesmo levemente facilitada pelos pulsos aplicados no nROB contralateral. Inibição pareceu o efeito predominante e pode ser observada também sobre atividade provocada a partir do trato óptico. Estes dados confirmam a existência de conexões inter-hemisféricas no SOA de pombos, indicando ainda que o nROB está sujeito a uma importante ação modulatória a partir de seu equivalente contralateral. Isto poderia representar um importante mecanismo de controle oculomotor nesses animais e talvez outros vertebrados.
Tratamento cirúrgico da insuficiência coronariana aguda
Authors: Cesar Luiz Antonio Machado
Published: May 2024

É feita uma análise geral a respeito das várias formas clínicas de apresentação da Insuficiência Coronariana, conceituação sobre seus aspectos agudos e a abordagem terapêutica medicamentosa nos quadros agudos, exceto o Infarto Agudo do Miocárdio.
Disritmias cardíacas: aspectos clínicos e terapêuticos
Authors: Solimene Maria Cecília
Published: May 2024

São estudadas as formas mais comuns de disritmias cardíacas, sob o ponto de vista eletrocardiográfico e clínico, dando-se ênfase aos aspectos mais importantes da terapêutica. São considerados também os medicamentos antiarrítmicos mais utilizados na prática habitual.
Experiência preliminar com o uso do cateter em veia central de silicone para quimioterapia antineoplásica
Authors: Waitzberg Dan Linetzky , Vasconcelos Helio Raia , Bresciani Claudio Caldas , Gama-Rodrigues Joaquim
Published: May 2024

O uso preliminar de cateteres de silicone, implantados em veia jugular interna e exteriorizados por túnel subcutâneo, para finalidade de favorecer o acesso a quimioterapia antineoplásica foi analisado em seis pacientes.Salientam-se a técnica de inserção, os cuidados de assepsia e heparinização necessárias que permitiram a manutenção dos cateteres por três meses em média, variando sua duração de 6 a 66 semanas. Ocorreram duas complicações em média: infecção e obstrução do cateter. Ambas foram tratadas sem implicar na remoção do mesmo.O uso de cateteres implantáveis de longa permanência, para acesso venoso central para quimioterapia, constitui alternativa válida, desde que sejam seguidos cuidadosamente os cuidados na profilaxia de eventuais complicações.
Diderot em preto-e-branco: as paixões de Mlle d'Aisnon e de Mme de La Pommeraye, segundo Robert Bresson
Authors: Coelho Maria Cecília de Miranda N.
Published: May 2024

Meu objetivo neste artigo é examinar alguns aspectos da adaptaçãopara o cinema, feita por Robert Bresson, de um episódio do romance de Denis Diderot, Jacques le fataliste. Pretendo analisar, comparativamente, a caracterização das duas personagens femininas principais, a partir da categoria de paixão, comentaras mudanças muito significativas no enredo e composição de personagens no filme, como a alteração do nome de Mlle d'Aisnon e de Mme de La Pommeraye para Agnès e Hélène, respectivamente. Na minha interpretação, apesar de elementos melodramáticos, o filme Les Dames du Bois de Boulogn e pode ser visto como obra de tonalidade trágica.
Litigating Collective Obligations before the International Court of Justice: Progress, Challenges and Prospects
Authors: Papa Maria Irene
Published: May 2024

The International Court of Justice (ICJ) has generally dealt with questions raised by cases concerning the common interests of States in an episodic, fragmentary, and at times contradictory manner. However, a number of significant rulings have thus far been given, and recent developments have brought the issue of public interest litigation back into the spotlight. This article aims to bring together into a coherent and systematic framework the relevant data that can be drawn from the ICJ’s contentious case law. To this end, the examination is divided into three parts, distinguishing respectively between questions that can be considered to have been already resolved (i.e. questions concerning the jurisdiction in public interest cases), those that are currently being clarified (i.e. the issue of standing to institute proceedings for the protection of common interests) and those that are still entirely open (i.e. the qualification of the legal position of the omnes, the relationship between the standing of the specially affected State and that of the other omnes, and the remedies that the omnes are entitled to claim from the wrongdoer). The article highlights the ICJ’s unwillingness to address the question as to whether Article 48 ARSIWA may currently be deemed to reflect customary international law and some inconsistencies between the approaches of the ILC and the ICJ as regards collective obligations. This proves that, despite considerable progress in recent case law, the legal regime of collective obligations remains far from being clear, and many aspects still deserve close scrutiny.
The International Criminal Court (ICC)’s Procedural Practice and Domestic Legal Sources
Authors: Pérez-León-Acevedo Juan-Pablo
Published: May 2024

Through the analysis of the ICC’s procedural jurisprudence related to Article 21(1)(c) of the ICC Statute, this article examines how the ICC has used domestic laws. To fill a legal gap in its instruments, the ICC “shall apply […] general principles of law derived by the Court from national laws of legal systems of the world including, as appropriate, the national laws of States that would normally exercise jurisdiction over the crime” (Article 21(1)(c)). The ICC has not directly applied specific domestic laws. Instead, it has used domestic procedural legal sources to derive general principles of law as a subsidiary applicable legal source and mainly when the ICC’s Judges are trying to fill legal gaps in the ICC’s legal instruments based on comparative law approaches. Thus, the present article shows how outdated the idea of domestic law as a fact has become, and the variety of functions domestic law plays currently in international courts and for international adjudicators.
Balancing the Interest in Prosecuting International Crimes against the Fair Trial Guarantees
Authors: Acconciamessa Lorenzo
Published: May 2024

The Italian Constitutional Court recently issued its ruling in the context of the criminal proceedings concerning the torture of Giulio Regeni, an Italian PhD student whose dead body was found in Egypt. The case raised the issue of whether the impossibility of prosecuting the alleged perpetrators of acts of torture was compatible with Italy’s international obligations. The Constitutional Court concluded that the duty to prosecute torture imposed to hold the trial even in absentia, subject to the right of the accused to obtain a retrial. This contribution will show how the Constitutional Court filled a lacuna in the domestic legal framework by balancing the international obligations at stake. It will assess the questionable aspect of the judgment, notably the identification of the source of the alleged duty of the State of passive nationality of the victim to prosecute of torture. Lastly, it will assess the case in the light of the international legal framework concerning trials in absentia.
Nkemvou, Nelo, and Tabula
Authors: Márquez García Ricardo
Published: May 2024

The Cameroon Grassfields faced extreme violence during German colonization in the early twentieth century. The German colonial army used various strategies, such as armed attacks, executions, looting, hostage-taking, and other repressive measures. After military subjugation by the German colonial army, however, the use of various forms of violence continued. Germans made use of multiple strategies in this mountain region to procure laborers for the colonial apparatus on the coast. At the same time, they claimed to be fighting “slave trade” and “slavery.” However, the coercive measures and violence used for this purpose were and are often characterized by those affected and their descendants as forms of “slave trade” and “slavery.” This article adopts an actor-centered approach that combines written sources with corresponding oral accounts and sheds light on local narratives about “labor recruitment.” This will reveal how and why colonized actors conceptualized the systems of coercion they resisted against differently from the German colonizers. The article argues that taking the perspective of colonized actors into account calls into question the distinction between “slave trading” and “labor recruitment.”
Feudalism on the Loango Coast?
Authors: Wimmler Jutta
Published: May 2024

Louis de Grandpré’s book Voyage à la Côte Occidentale d’Afrique, published in 1801, is well-known to historians of Africa working on the eighteenth-century Loango Coast, located in the Cabinda province of Angola and the Democratic Republic of the Congo. In describing the laws and customs of the African societies in this region, de Grandpré invites the reader to imagine these societies as “feudal” in character and draws on the semantics of “slavery” in doing so. This article proposes that we need to place this text in the context in which it was written, namely the French Revolution and the rise of Napoleon Bonaparte. We also need to consider why the author published this book in the first place, in order to understand how the terms “slave” and “slavery” function in this text. The article argues that Louis de Grandpré used the feudal/slavery nexus consciously in order to provide a legitimizing framework for a possible French conquest, hoping to prove his own loyalty and usefulness to Napoleon.
“A State Is Powerful if Its People Are Being Put to [Good] Use”
Authors: Schwermann Christian
Published: May 2024

People of ancient Chinese states appear to have been asymmetrically dependent on their lords since the fourth century BCEfor three reasons: because they were ranked according to merit; because they could be sentenced to forced or convict labor; and because they were seen as and managed like a resource by their landlords. Instead of describing such states as all-encompassing slave societies based on state slavery, this article argues that it is more useful to examine structures of dependency and to identify the organizing principles on which they were based. In ancient China, such principles were formulated in the fourth and third centuriesBCEas part of an emerging reflection on principles of “laws and procedures” (fashu法術). Early Chinese “specialists in laws and procedures” (fashu zhi shi法術之士), as they called themselves, were not only familiar with concepts such as division of labor, economic cycles, supply and demand, incentives, or contrarian investment, but they also thought about resources and their management. The article explores this subject primarily through the economic thought ofShang jun shu商君書 (The Documents Pertaining to the Lord of Shang), a collection of treatises dating from about 360 to 210 BCEon radical administrative reforms designed to increase the productivity and efficiency of subjects in the fields of agriculture and warfare.
Influence of the Type of Mathematical Problems on Students’ and Pre-service Teachers’ Interest and Performance. A Replication and Elaboration Study
Authors: García-Cerdá Clara , Segura Carlos , Ferrando Irene
Published: May 2024

Several studies confirm the importance of the role of students’ interest in learning mathematics. This article describes the process of conceptual replication of Rellensmann and Schukajlow’s (2017) research on how the connection to the reality of a mathematical problem affects the interest in solving it. Our study distinguishes between intramathematical problems, word problems and modelling problems. It was implemented with 80 Spanish ninth-grade students and 80 pre-service teachers. The results show that Spanish students are more interested in intramathematical problems and less interested in modelling problems, while pre-service teachers are more interested in problems connected to reality, especially word problems. We also provide data regarding the performance of students and prospective teachers, which is higher in word problems. In addition, we find that there are significant relationships between performance and task-specific interest. These results complement the original study, as they allow us to contrast whether there are differences with German students and to explain the German pre-service teachers’ judgements of students’ interest in problems with and without a connection to reality.

The impact sheet to this article can be accessed at 10.6084/m9.figshare.25507636.
A new marine tardigrade species (Heterotardigrada: Batillipedidae) from the southeast coast of India
Authors: VISHNUDATTAN N. K. , RUBAL MARCOS , NANDAN S. BIJOY
Published: May 2024

A new marine tardigrade species, Batillipes chandrayaani sp. nov. is described from the sandy mid littoral region of the southeast coast of India. This novel species can be distinguished from all its congeners by the presence of a dorsal indentation in the anterior cephalic region, shape of primary clavae, presence of secondary clavae, segmented dorsal body due to the presence of transverse cuticle folds, shape of leg IV sensory organ with the presence of two van der Land’s organs, long hook shaped lateral body projections on the caudal segment and the presence of a semi-circular cuticular projection on the coxal region of leg II and leg III.
Notes on type specimens of Rhinogobius flumineus (Mizuno 1960) (Perciformes: Gobiidae) and Cobitis takatsuensis Mizuno 1970 (Cypriniformes: Cobitidae) in Tokushima Prefectural Museum, Tokushima, Japan
Authors: ITO TAIKI , SUZAWA YUZURU , SATO YOICHI
Published: May 2024

Rhinogobius flumineus and Cobitis takatsuensis were described as new species by Prof. Nobuhiko Mizuno in 1960 and 1970, respectively. Within the manuscripts, he mentioned that he had preserved the type specimens of these species in his private collection. Professor Mizuno concluded his tenure at Ehime University, Japan, in 1996, and subsequently, Tokushima Prefectural Museum (TKPM) received his collection, which included the type specimens of R. flumineus and C. takatsuensis. However, the whereabouts of his collection is not widely known. Here we provide detailed notes of the holotypes and paratypes of R. flumineus and C. takatsuensis housed in TKPM. The information presented herein will contribute to future taxonomic investigations of East Asian freshwater fishes.
Cross-border Product Payments in Sub-Saharan Africa! How MSMEs React to PAPSS as E-payment Innovation: Moderating Role of Experience
Authors: Oloveze Ambrose Ogbonna , Ollawa Charles C. , Chukwuoyims Kelvin , Onya Victoria Ogwu
Published: May 2024

The purpose of the study is to evaluate micro, small and medium enterprises’ (MSMEs) reaction to the pan-African payment and settlement system (PAPSS). The new cross-border e-payment technology is designed to facilitate cross- border instant payments, motivate cross-border businesses and promote sub-Saharan African trades which have been a real problem following the involvement of third currency, untimely payment and regulations that impact payments across borders. The study is important because of the non-existence of empirical results on what motivates MSMEs’ intention to use it and how the experience might impact the intention to use PAPSS. Thus, the study considered the impact of MSMEs’ previous experience on e-payment as a moderating influence on intention to use PAPSS. An adapted questionnaire that was structured on 7-point Likert scale was used in the survey to collect data from MSMEs in Nigeria. Structural equation modelling and the Hayes process for moderation were used in the analysis. The authors learned that ease of use is the strongest indirect determinant of intention to use PAPSS while perceived compatibility is the strongest direct determinant of intention to use PAPSS. Further, the authors discovered the important role of the simplicity of the innovation and its compatibility with users’ characteristics in promoting intention to use. The level of experience is confirmed to be significant in moderating intention to use PAPSS. Therefore, deeper involvement of the apex banks and commercial banks in communicating simplicity is paramount to achieve significant progress, while the services of tech experts and professionals can be utilised to provide periodic information to business owners through organised TV and radio programmes. Notably, this is a novel study that focuses on new cross-border payments in sub-Saharan Africa.
Outcome Analysis of a Series of Mixed-Grade, Non-muscle Invasive, Papillary Carcinomas of the Bladder
Authors: Chambers Meagan , Andre Alexa T. , Wright Jonathan L. , Vakar-Lopez Funda , Tretiakova Maria , Reder Nicholas P. , Haffner Michael C. , True Lawrence D.
Published: May 2024

Introduction: Papillary urothelial carcinomas are currently graded as either low- or high-grade tumors based on World Health Organization (WHO) 2022 guidelines for genitourinary tumors. However, a minority of tumors are mixed-grade tumors, composed predominantly of low-grade cancer with a minor high-grade component. In the 2022 WHO these cancers are recognized as having outcomes comparable to low-grade cancers, although data to date has been limited. Methods: The pathology records of a large academic institution were searched for mixed-grade, non-muscle invasive papillary carcinomas of the bladder and ureter in order to characterize prognosis of these cancers. Results: Of 136 cancers, the majority (n = 104, 76.5%) were solitary, mixed-grade tumors, while 21 (15.4%) had a concurrent low-grade cancer and 11 (8.1%) had multiple mixed-grade tumors at the time of diagnosis. At follow-up (median 48.3 months, range = 1.3 months-18.1 years), 71 cancers recurred (52.2%): 52 (38.2%) as low- or mixed-grade cancers and 18 (13.2%) as high-grade cancers. There were no instances of stage-progression to >pT2. Conclusions: The clinical outcome of mixed-grade carcinomas was similar to what has been reported for low-grade carcinomas. Based on our results, and prior congruent studies of mixed-grade lesions, these lesions may be regarded as a distinct sub-category with a better prognosis than high-grade tumors.
Transport properties of mechanochemically synthesized copper (I) selenide for potential applications in energy conversion and storage
Authors: Achimovičová Marcela , Gáborová Katarína , Navrátil Jiří , Levinský Petr , Skurikhina Olha , Kurimský Juraj , Briančin Jaroslav , Plecháček Tomáš , Drenčaková Dáša
Published: May 2024

This work studied the thermal stability, electrical, and thermoelectrical properties of copper(I) selenide, Cu2Se synthesized by high-energy milling in a planetary ball mill. The phase composition was investigated by X-ray powder diffraction analysis and scanning electron microscopy. The conversion of the precursors during mechanochemical synthesis and the stability of the product was monitored by thermal analysis. The dependence of electrical properties on the product porosity was observed. For the densification of Cu2Se, the method of spark plasma sintering was applied to prepare suitable samples for thermoelectric characterization. High-temperature thermoelectric properties of synthetic Cu2Se were compared to its natural analogue-mineral berzelianite in terms of its potential application in energy conversion. Based on the results a relatively high figure-of-merit, ZT parameter (~ 1.15, T = 770 K) was obtained for undoped Cu2Se, prepared by rapid mechanochemical reaction (5 min). Cyclic voltammetry measurements of Na/NaClO4/Cu2Se cell implied that mechanochemically synthesized Cu2Se could be used as a promising intercalation electrode for sodium-ion batteries.
Development of Malaysian-MIND diet scores for prediction of mild cognitive impairment among older adults in Malaysia
Authors: M Zapawi Muhamad Mustaqim , You Yee Xing , Shahar Suzana , Shahril Mohd Razif , Malek Rivan Nurul Fatin , Nik Mohd Fakhruddin Nik Nur Izzati , Yap Anastasia Xin Wei
Published: May 2024

Background

Mild Cognitive impairment (MCI) is a pre-demented state in the elderly populace. The Mediterranean & Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet has shown promise in reducing the risk of MCI and Alzheimer’s disease in older people. Notably, the existing MIND diet is not adapted to the specific needs of older adults in Malaysia, considering distinct food cultures and availability. Consequently, this study aimed to develop the Malaysian version of the MIND diet (MY-MINDD) scores and investigate their association with MCI in the older adult populace of Malaysia.

Methods

A comprehensive pooled data analysis was conducted on combined data from 810 participants sourced from the longitudinal Long-Term Research Grant Scheme-Towards Useful Aging (LRGS-TUA) and Fundamental Research Grant Scheme (FRGS) studies. The MY-MINDD scores were developed by incorporating existing MIND diet food groups, their corresponding scoring mechanisms, and consideration of common Malaysian foods which are proven to be beneficial and detrimental to cognitive function. To substantiate the MY-MINDD scoring system, its association with MCI was evaluated using a series of validated neuropsychological test batteries.

Results

MY-MINDD consists of seven food groups promote brain health and four food groups exert negative cognitive outcomes. The study participants had an average age of 67.9 ± 4.7 years. The collective MY-MINDD score for all participants was 6.4 ± 0.1 (out of a maximum 11 points), revealing a lower score in individuals with MCI at 6.0 ± 1.7 compared to those without MCI at 6.6 ± 1.6 (p < 0.001). According to hierarchical multivariate binary logistic regression analysis, being in the highest tertile of MY-MINDD score was linked to reduced odds of MCI (odds ratio (OR) = 0.43, 95% confidence interval (CI): 0.26–0.72, p < 0.001) in the fully adjusted model in comparison to the lowest tertile.

Conclusion

The development of the MY-MINDD scores for Malaysian older population revealed that a stronger adherence to this diet is linked to a reduced risk of MCI. Further substantiation of the MY-MINDD scores using more objective measures, such as neuroimaging approaches and other neuropsychological batteries, is necessary.
Incidence and risk factors of post COVID-19 syndrome: a Tunisian cohort study
Authors: Zemni Imen , Gara Amel , Bennasrallah Cyrine , Ezzar Salma , Kacem Meriem , Chokri Roua , Maatouk Amani , Abroug Hela , Dhouib Wafa , Fredj Manel Ben , Bouanene Ines , Belguith Asma Sriha
Published: May 2024

Background

It has become increasingly clear that SARS-CoV-2 infection can lead to persistent physical and mental health problems lasting weeks or months, requiring prolonged periods of clinical care and increasing the burden on the healthcare system. This phenomenon, known as post COVID-19 syndrome (PCS), is a relatively new condition, its incidence is still unclear and differs between studies.

Objectives

In this cohort study, we aimed to estimate the incidence of PCS and to identify its risk factors in the Tunisian population.

Methods

This is a prospective cohort study that enrolled patients diagnosed with COVID-19 from the triage unit of the University Hospital of Monastir, Tunisia. between April 2021 and June 2022. Patients were contacted by phone for a follow-up evaluation of PCS 12- weeks after the diagnosis date.

Results

A total of 1451 individuals diagnosed with COVID-19 during the study period, responded to the follow-up evaluation after 3 months. The incidence of PCS was found to be 44.03% (95% CI [41.47; 46.58]), with fatigue being the most common symptom (21.5%), followed by cognitive impairment (10.3%), including memory loss and difficulty concentrating. Multivariate analysis revealed that the main associated factors to PCS were female gender (RR = 1.54; CI95% [1.30 - 1.82]), pre-existing comorbidities (RR = 1.30; CI95% [1.10 - 1.52]), duration of acute COVID-19 illness (days) (RR = 1.02; CI95% [1.01 - 1.03]), hospitalization (RR = 1.27; CI95% [1.05 - 1.53]), number of COVID-19 episodes (RR = 1.46; CI 95% [1.28 - 1.67]) and patients having receive two or more doses of vaccine prior to COVID-19 infection (RR = 0.82; CI95% [0.70 - 0.96]).

Conclusion

Our study allowed to estimate the incidence and identify risk factors of PCS. Recognizing these factors could help to better understand the underlying mechanisms and guide interventions for prevention and management of this condition.
Comparison of outcomes between early-stage cervical cancer patients without high-risk factors undergoing adjuvant concurrent chemoradiotherapy and radiotherapy alone after radical surgery
Authors: Zhou Yuncan , Wang Weiping , Tang Jia , Hu Ke , Zhang Fuquan
Published: May 2024

Purpose

For patients with early-stage cervical cancer without high-risk factors, there is no consensus regarding the optimal postoperative treatment regimen and whether postoperative concurrent radiochemotherapy (CCRT) is superior to radiotherapy (RT) alone.

Patients and methods

The medical records of patients with stage I-IIA cervical cancer, who underwent radical surgery and postoperative RT or CCRT between June 2012 and December 2017, were retrospectively reviewed. Patients with any high-risk factors, including positive pelvic lymph node(s), positive resection margin(s), and parametrial invasion, were excluded. Patients with large tumors (≥ 4 cm), deep stromal invasion (≥ 1/2), and lymphovascular space involvement were categorized as the intermediate-risk group. Patients without intermediate-risk factors were categorized as the low-risk group.

Results

A total of 403 patients were enrolled and divided into 2 groups according to postoperative treatment: RT alone (n = 105); and CCRT (n = 298). For risk stratification, patients were also divided into 2 groups: intermediate-risk (n = 350); and low-risk (n = 53). The median follow-up was 51.7 months. Patients in the intermediate-risk group and those with multiple intermediate-risk factors were more likely to undergo CCRT. For patients who underwent RT alone or CCRT in the intermediate-risk group, 5-year overall survival (OS) rates were 93.4% and 93.8% (p = 0.741), and 5-year disease-free survival (DFS) rates were 90.6% and 91.4%, respectively (p = 0.733). Similarly, for patients who underwent RT alone or CCRT in the low-risk group, the 5-year OS rates were 100.0% and 93.5% (p = 0.241), and 5-year DFS rates were 94.4% and 93.5%, respectively (p = 0.736). Adjuvant CCRT or RT were not independent risk factors for either OS or DFS. Patients who underwent CCRT appeared to develop a higher proportion of grade ≥ 3 acute hematological toxicities than those in the RT group (44.0% versus 11.4%, respectively; p < 0.001). There was no significant difference in grade ≥ 3 chronic toxicities of the urogenital and gastrointestinal systems between the CCRT and RT groups.

Conclusion

There was no significant difference in 5-year OS and DFS rates between patients with early-stage cervical cancer without high-risk factors undergoing postoperative CCRT versus RT alone. Patients who underwent CCRT appeared to develop a higher proportion of grade ≥ 3 acute hematological toxicities than those who underwent RT alone.
Adverse childhood events and self-harming behaviours among individuals in Ontario forensic system: the mediating role of psychopathy
Authors: Kaggwa Mark Mohan , Chaimowitz Gary A. , Erb Bailea , Moulden Heather , Prat Sebastien , Davids Arianna , Olagunju Andrew T.
Published: May 2024

Background

Adverse childhood events (ACEs), psychopathy, and self-harming behaviours are prevalent among individuals in the forensic psychiatry system. While existing literature suggests that ACEs, self-harm, and psychopathy are interrelated, little is known about the interplay of psychopathic traits in this relationship. The present study aimed to determine the mediating role of psychopathy in the relationship between ACEs and self-harming behaviours in forensic patients.

Methods

This was a retrospective study of patients under the Ontario Review Board (ORB) between 2014 and 2015. In the analysis, we included patients with complete data on ACEs, self-harming behaviours, and a Psychopathy Checklist-Revised (PCL-R) score - a measure of psychopathic traits and their severity conducted during the reporting period. Mediation analysis was based on the Baron and Kenny approach, and sensitivity analysis was performed based on the types of ACEs.

Results

​​​The sample population (n = 593) was made up of adults, with a mean age of 41.21 (± 12.35) years and were predominantly males (92.37%). While there was a partial mediating effect of psychopathy on the relationship between ACEs and incidents of self-harming behaviours in the past year, the mediation was complete in the relationship between ACEs and a lifetime history of self-harming behaviours. Following sensitivity analysis based on the types of ACE, the mediating effects were more attributed to specific ACEs, especially having experienced child abuse or having an incarcerated household member before 18 years.

Conclusion

Among forensic patients in Ontario, psychopathy mediates​ ​the relationship between experiencing ACEs and engaging in self-harming behaviours. Effective intervention to mitigate self-harming behaviours in this population should consider the potential role of psychopathy, especially among individuals who have experienced ACEs involving a history of child abuse and a family who was incarcerated.
“R” you getting this? Factors contributing to the public’s understanding, evaluation, and use of basic reproduction numbers for infectious diseases
Authors: Vromans Ruben D. , Bol Nadine , van Wezel Marloes M. C. , Krahmer Emiel J.
Published: May 2024

Background

We (1) examined the effects of evaluative labels and visual aids on people’s understanding, evaluation, and use of the COVID-19 reproduction number (or “r-number”), (2) examined whether people’s perceived susceptibility and (intended) adherence to preventive measures changed after being exposed to the r-number, and (3) explored whether these effects and changes depended on people’s numeracy skills.

Methods

In an online experiment, participants from a large Dutch representative sample (N = 1,168) received information about the COVID-19 r-number displayed on the corona dashboard of the Dutch Ministry of Health, Welfare and Sport. The r-number was either presented with or without a categorical line display (i.e., evaluative label) and with or without an icon-based tree diagram (i.e., visual aid) explaining how the number works. Regarding people’s use of the statistic, we measured perceived susceptibility to COVID-19 and adherence (intention) to five preventive measures before and after exposure to the r-number. After exposure, we also measured participants’ understanding, perceived usefulness, affective and cognitive evaluation, and objective numeracy.

Results

About 56% of participants correctly interpreted the r-number, with highly numerate people having better understanding than less numerate people. Information about the r-number was perceived as more useful when presented with a visual aid. There were no differences across experimental conditions in people’s understanding, affective, and cognitive evaluations. Finally, independent of experimental conditions, intention to adhere to preventive measures was higher after seeing the r-number, but only among highly numerate people.

Conclusions

Although evaluative labels and visual aids did not facilitate people’s understanding and evaluation of the r-number, our results show that the statistic is perceived as useful and may be used to stimulate adherence to preventive measures. Policy makers and public health communicators are advised to clearly explain why they are giving these numbers to – especially – the less numerate people, but also how people could use them for behavior change to combat the spread of virus during a pandemic.
Fourteen-year trends in overweight, general obesity, and abdominal obesity in Amazonian indigenous peoples
Authors: Fidelis Baniwa Eliniete de Jesus , Putira Sacuena Eliene Rodrigues , Della Noce Rosilene Reis , Quaresma Vanessa Barroso , Alencar Teodora Honorato , Lemes Renan Barbosa , Araújo Antônia Cherlly , Cayres-Vallinoto Izaura Maria Vieira , Guerreiro João Farias
Published: May 2024

Background

Available data show that the epidemiological profile of most indigenous Brazilian populations is characterized by the coexistence of long-standing health problems (high prevalence of infectious and parasitic diseases, malnutrition, and deficiency diseases, such as anemia in children and women of reproductive age), associated with new health problems, especially those related to obesity (hypertension, type 2 diabetes mellitus and dyslipidemia). Based on this scenario, this study analyzed the nutritional profile of the adult population of seven indigenous peoples from the Brazilian Amazon in the years 2007 and 2021.

Methods

A total of 598 adults individuals were analyzed in 2007 (319 women and 279 men) and 924 in 2021 (483 women and 441 men), from seven indigenous peoples located in the state of Pará, who were assisted during health actions carried out in 2007 and in 2021. Body mass index classification used the World Health Organization criteria for adults: low weight, < 18.5 kg/m2; normal weight, ≥ 18.5 and < 25 kg/m2); overweight, ≥ 25 and < 30 kg/m2, and obesity, ≥ 30 kg/m2. A waist circumference (WC) < 90 cm in men and < 80 cm in women was considered normal.

Results

The data revealed heterogeneous anthropometric profiles, with a low prevalence of nutritional changes in the Araweté, Arara and Parakanã peoples, and high proportions of excess weight and abdominal obesity in the Kararaô, Xikrin do Bacajá, Asurini do Xingu and Gavião peoples, similar to or even higher than the national averages.

Conclusion

Different stages of nutritional transition were identified in the indigenous peoples analyzed, despite apparently having been subjected to the same environmental pressures that shaped their nutritional profile in recent decades, which may indicate different genetic susceptibilities to nutritional changes. The evidence shown in this study strongly suggests the need to investigate in greater depth the genetic and environmental factors associated with the nutritional profile of Brazilian indigenous peoples, with assessment of diet, physical activity and sociodemographic and socioeconomic variables that enable the development of appropriate prevention and monitoring measures.
The effects of real-time waveform analysis software on patient ventilator synchronization during pressure support ventilation: a randomized crossover physiological study
Authors: Nakornnoi Barnpot , Tscheikuna Jamsak , Rittayamai Nuttapol
Published: May 2024

Background

Patient-ventilator asynchrony commonly occurs during pressure support ventilation (PSV). IntelliSync + software (Hamilton Medical AG, Bonaduz, Switzerland) is a new ventilation technology that continuously analyzes ventilator waveforms to detect the beginning and end of patient inspiration in real time. This study aimed to evaluate the physiological effect of IntelliSync + software on inspiratory trigger delay time, delta airway (Paw) and esophageal (Pes) pressure drop during the trigger phase, airway occlusion pressure at 0.1 s (P0.1), and hemodynamic variables.

Methods

A randomized crossover physiologic study was conducted in 14 mechanically ventilated patients under PSV. Patients were randomly assigned to receive conventional flow trigger and cycling, inspiratory trigger synchronization (I-sync), cycle synchronization (C-sync), and inspiratory trigger and cycle synchronization (I/C-sync) for 15 min at each step. Other ventilator settings were kept constant. Paw, Pes, airflow, P0.1, respiratory rate, SpO2, and hemodynamic variables were recorded. The primary outcome was inspiratory trigger and cycle delay time between each intervention. Secondary outcomes were delta Paw and Pes drop during the trigger phase, P0.1, SpO2, and hemodynamic variables.

Results

The time to initiate the trigger was significantly shorter with I-sync compared to baseline (208.9±91.7 vs. 301.4±131.7 msec; P = 0.002) and I/C-sync compared to baseline (222.8±94.0 vs. 301.4±131.7 msec; P = 0.005). The I/C-sync group had significantly lower delta Paw and Pes drop during the trigger phase compared to C-sync group (-0.7±0.4 vs. -1.2±0.8 cmH2O; P = 0.028 and − 1.8±2.2 vs. -2.8±3.2 cmH2O; P = 0.011, respectively). No statistically significant differences were found in cycle delay time, P0.1 and other physiological variables between the groups.

Conclusions

IntelliSync + software reduced inspiratory trigger delay time compared to the conventional flow trigger system during PSV mode. However, no significant improvements in cycle delay time and other physiological variables were observed with IntelliSync + software.

Trial registration

This study was registered in the Thai Clinical Trial Registry (TCTR20200528003; date of registration 28/05/2020).
Development of palliative care clinical practice guidelines and referral care pathways for primary care practitioners in Pakistan
Authors: Hashmi Syeda Amrah , Martins Russell Seth , Ishtiaq Annum , Rizvi Nashia Ali , Mustafa Mohsin Ali , Pervez Alina , Siddiqui Ayra , Shariq Syeda Fatima , Nadeem Sarah , Haider Adil H. , Waqar Muhammad Atif
Published: May 2024

Background

Despite a large burden of life-limitingillness, there exists a dearth of services of palliative care in Pakistan. International guidelines have questionable applicability in Pakistan due to the socioeconomic differences. We generated a protocol describing the process of developing comprehensive palliative care guidelines and palliative care referral pathways for primary care practitioners to adopt in Pakistan.

Methods

A GRADE-ADOLOPMENT approach with modification has been employed to create guidelines for a Pakistani context. The “National Comprehensive Cancer Network Guidelines Insights: Palliative Care, Version 2.2021” was used as the source guideline. Recommendations from the source guideline were reviewed by two local palliative care specialists to either “Adopt,” “Adapt” or “Exclude”. The finalized recommendations were incorporated into the local palliative care guideline. Clinical diagnosis and referral pathways were made from the finalized guideline. Any gaps in management found in the pathways were filled by taking existing recommendations from other credible guidelines.

Results

Twenty-seven recommendations were adopted without modification. No recommendations were deemed to be adapted and 15 were excluded. The referral care pathways created were reflective of the local guideline and included elements of initial assessment, preliminary management, reassessment, and referral. 6 additional recommendations were made.

Conclusion

The described clinical practice guidelines and primary care clinical referral pathways will aid to standardize palliative care provision in Pakistan. These can be used by other resource constrained settings to develop guidelines within their own local context.
Students’ and junior doctors’ perspectives on radiology education in medical school: a qualitative study in the Netherlands
Authors: Harthoorn Frederike S. , Scharenborg Sascha W. J. , Brink Monique , Peters-Bax Liesbeth , Henssen Dylan J. H. A.
Published: May 2024

Background

Modern medicine becomes more dependent on radiologic imaging techniques. Over the past decade, radiology has also gained more attention in the medical curricula. However, little is known with regard to students’ perspectives on this subject. Therefore, this study aims to gain insight into the thoughts and ideas of medical students and junior doctors on radiology education in medical curricula.

Methods

A qualitative, descriptive study was carried out at one medical university in the Netherlands. Participants were recruited on social media and were interviewed following a predefined topic list. The constant comparative method was applied in order to include new questions when unexpected topics arose during the interviews. All interviews were transcribed verbatim and coded. Codes were organized into categories and themes by discussion between researchers.

Results

Fifteen participants (nine junior doctors and six students) agreed to join. From the coded interviews, four themes derived from fifteen categories arose: (1) The added value of radiology education in medical curricula, (2) Indispensable knowledge on radiology, (3) Organization of radiology education and (4) Promising educational innovations for the radiology curriculum.

Conclusion

This study suggests that medical students and junior doctors value radiology education. It provides insights in educational topics and forms for educational improvement for radiology educators.