bluuebunny/crossref_metadata_2025 huggingface dataset:
New Developments in Revealed Preference Theory: Decisions Under Risk, Uncertainty, and Intertemporal Choice
Authors: Echenique Federico
Published: May 2020

This article reviews recent developments in revealed preference theory. It discusses the testable implications of theories of choice that are germane to specific economic environments. The focus is on expected utility in risky environments, subjected expected utility and maxmin expected utility in the presence of uncertainty, and exponentially discounted utility for intertemporal choice. The testable implications of these theories for data on choice from classical linear budget sets are described and shown to follow a common thread. The theories all imply an inverse relation between prices and quantities, with different qualifications depending on the functional forms in the theory under consideration.
Modeling Overcharge at Lithiated-Graphite Porous Electrodes: Plating and Dissolution of Lithium
Authors: Baker Daniel , Verbrugge Mark
Published: May 2020

In recent work, we developed a set of equations that can be used to treat Li plating and subsequent electro-dissolution, and we analyzed how the equation system behaved for a particle of graphite, a fundamental unit of the negative electrode in lithium ion cells. In this work, we apply the same governing equations to the more realistic setting of a porous electrode consisting of many graphite particles. We propose a Li activity model wherein the activity of plated lithium differs from the activity of bulk Li in a thin layer (on the order of monolayers) at the interface with the graphite substrate and transitions smoothly to the activity of bulk Li at greater distances from the graphite interface. Since it is unclear at this point exactly how large this interfacial layer should be, we also show how to treat the limiting case, in which the interfacial layer thickness goes to zero and the activity of any deposited Li is that of bulk Li, which significantly complicates the porous-electrode analysis. We find the two approaches (i.e., finite thickness on the order of monlayers and zero thickness for the interfacial layer) yield very similar results.
Physical Origin of the Differential Voltage Minimum Associated with Lithium Plating in Li-Ion Batteries
Authors: O’Kane Simon E. J. , Campbell Ian D. , Marzook Mohamed W. J. , Offer Gregory J. , Marinescu Monica
Published: May 2020

The main barrier to fast charging of Li-ion batteries at low temperatures is the risk of short-circuiting due to lithium plating. In-situ detection of Li plating is highly sought after in order to develop fast charging strategies that avoid plating. It is widely believed that Li plating after a single fast charge can be detected and quantified by using a minimum in the differential voltage (DV) signal during the subsequent discharge, which indicates how much lithium has been stripped. In this work, a pseudo-2D physics-based model is used to investigate the effect on Li plating and stripping of concentration-dependent diffusion coefficients in the active electrode materials. A new modelling protocol is also proposed, in order to distinguish the effects of fast charging, slow charging and Li plating/stripping. The model predicts that the DV minimum associated with Li stripping is in fact a shifted and more abrupt version of a minimum caused by the stage II-stage III transition in the graphite negative electrode. Therefore, the minimum cannot be used to quantify stripping. Using concentration-dependent diffusion coefficients yields qualitatively different results to previous work. This knowledge casts doubt on the utility of DV analysis for detecting Li plating.
HOR Activity of Pt-TiO2-Y at Unconventionally High Potentials Explained: The Influence of SMSI on the Electrochemical Behavior of Pt
Authors: Geppert Timon N. , Bosund Markus , Putkonen Matti , Stühmeier Björn M. , Pasanen Antti T. , Heikkilä Pirjo , Gasteiger Hubert A. , El-Sayed Hany A.
Published: May 2020

The formation of strong metal support interactions (SMSI) is known for many metal/metal oxide systems and its consequences are well established in the field of heterogeneous catalysis, but this knowledge has only been recently transferred to the field of electrocatalysis. In this study, Pt was deposited via atomic layer deposition (ALD) onto TiO2−Y, which allowed a good control of the particle size through the number of ALD cycles. During the ALD process, a thin-film of reduced titania is formed on the Pt surface, which leads to SMSI effects. With increasing Pt particle size, the fraction of the titania-covered Pt surface decreases. As a result, the extent of platinum oxide formation in cyclic voltammetry (CV) measurements scales with the size of the Pt particles. The influence of these thin titanium oxide films, which cover the Pt surface, on the catalytic behavior with respect to oxygen reduction reaction (ORR), hydrogen oxidation reaction (HOR), CO oxidation and oxygen evolution reaction (OER) is investigated by using an RDE setup. The covering TiOX thin-films reduce the ability to catalyze ORR, OER and CO oxidation, while it does not influence the HOR and Pt H-UPD formation. These findings indicate that proton and hydrogen transport are possible through the thin TiOX film, while oxygenated species suffer from transport limitations through the thin-film. Due to this selective permeability, these materials are able to oxidize hydrogen well beyond 1.2 VRHE.
The Role of Tungsten on the Phase Transformation Kinetics and its Correlation with the Localized Corrosion Resistance of 25Cr Super Duplex Stainless Steels
Authors: Torres Cristian , Hazarabedian María Sofía , Quadir Zakaria , Johnsen Roy , Iannuzzi Mariano
Published: May 2020

Super Duplex Stainless Steels (SDSS) have excellent corrosion resistance due to their high concentration of alloying elements like Cr, Mo, and N. There is still, however, disagreement on the role of tungsten in the corrosion resistance of stainless steels. In this regard, the influence of tungsten on tertiary phase precipitation kinetics remains a chief source of controversy. In this study, three different SDSS with different tungsten contents have been investigated, namely, UNS S32750 (W-free), S32760 (0.6 wt% W), and S39274 (2.1 wt% W). Different isothermal aging conditions were studied, followed by microstructure characterization using scanning electron microscopy, energy dispersive X-ray spectroscopy, electron backscatter diffraction, and transmission electron microscopy to quantify the type and volume fraction of tertiary phases and intermetallic compounds. Time-Temperature-Transformation-Corrosion maps were constructed by quantifying the changes in pitting corrosion resistance caused by the precipitation of incremental amounts of deleterious phases. Results showed that 2.1 wt% W additions retarded the precipitation kinetics of all tertiary phases—includingσ-phase—favoring the formation ofχ-phase. Bothχ- andσ-phase affected corrosion resistance, reducing the critical pitting temperature by 10 °C–20 °C at concentrations well below 1 vol%.
LRRK2 mutation alters behavioral, synaptic, and nonsynaptic adaptations to acute social stress
Authors: Guevara Christopher A. , Matikainen-Ankney Bridget A. , Kezunovic Nebojsa , LeClair Katherine , Conway Alexander P. , Menard Caroline , Flanigan Meghan E. , Pfau Madeline , Russo Scott J. , Benson Deanna L. , Huntley George W.
Published: May 2020

Depression is associated with Parkinson’s disease (PD), and environmental stress is a risk factor for both. We investigated how LRRK2-G2019S PD mutation affects depression-like behaviors, synaptic function, and intrinsic neuronal excitability following stress. In response to stress, the mutation drives abnormal synaptic changes, prevents adaptive changes in intrinsic excitability, and leads to aberrant behaviors, thus defining new ways in which PD mutations derail adaptive plasticity in response to stress that may contribute to disease onset.
The Impact of Hyperoxia on Outcome of Patients Treated with Noninvasive Respiratory Support
Authors: Pala Cifci Seyhan , Urcan Tapan Yasemin , Turemis Erkul Bengu , Savran Yusuf , Comert Bilgin
Published: May 2020

Objective. Oxygen therapy is one of the most common treatment modalities for hypoxemic patients, but target goals for normoxemia are not clearly defined. Therefore, iatrogenic hyperoxia is a very common situation. The results from the recent clinical researches about hyperoxia indicate that hyperoxia can be related to worse outcomes than expected in some critically ill patients. According to our literature knowledge, there are not any reports researching the effect of hyperoxia on clinical course of patients who are not treated with invasive mechanical ventilation. In this study, we aimed to determine the effect of hyperoxia on mortality, and length of stay and also possible side effects of hyperoxia on the patients who are treated with oxygen by noninvasive devices. Materials and Methods. One hundred and eighty-seven patients who met inclusion criteria, treated in Dokuz Eylul University Medical Intensive Care Unit between January 1, 2016, and October 31, 2018, were examined retrospectively. These patients’ demographic data, oxygen saturation (SpO2) values for the first 24 hours, APACHE II (Acute Physiology and Chronic Health Evaluation II) scores, whether they needed intubation, if they did how many days they got ventilated, length of stay in intensive care unit and hospital, maximum PaO2 values of the first day, oxygen treatment method of the first 24 hours, and the rates of mortality were recorded. Results. Hyperoxemia was determined in 62 of 187 patients who were not treated with invasive mechanic ventilation in the first 24 hours of admission. Upon further investigation of the relation between comorbid situations and hyperoxia, hyperoxia frequency in patients with COPD was detected to be statistically low (16% vs. 35%, p<0.008). Hospital mortality was significantly high (51.6% vs. 35.2%, p<0.04) in patients with hyperoxia. When the types of oxygen support therapies were investigated, hyperoxia frequency was found higher in patients treated with supplemental oxygen (nasal cannula, oronasal mask, high flow oxygen therapy) than patients treated with NIMV (44.2% vs. 25.5%, p<0.008). After exclusion of 56 patients who were intubated and treated with invasive mechanical ventilation after the first 24 hours, hyperoxemia was determined in 46 of 131 patients. Mortality in patients with hyperoxemia who were not treated with invasive mechanical ventilation during hospital stay was statistically higher when compared to normoxemic patients (41.3% vs 15.3%, p<0.001). Conclusion. We report that hyperoxemia increases the hospital mortality in patients treated with noninvasive respiratory support. At the same time, we determined that hyperoxemia frequency was lower in COPD patients and the ones treated with NIMV. Conservative oxygen therapy strategy can be suggested to decrease the hyperoxia prevalence and mortality rates.
Cocaine-Induced Giant Bullous Emphysema
Authors: Douedi Steven , Upadhyaya Vandan D. , Patel Ishan , Mazahir Usman , Costanzo Eric , Hossain Mohammad A.
Published: May 2020

Background. Emphysematous bullae, defined as airspaces of greater than or equal to one centimeter in diameter, have a variety of etiologies such as tobacco use and alpha-1 antitrypsin being the most common. Emphysematous bullae have also been reported in patients using cocaine usually involving the lung periphery and sparing the central lung parenchyma. We present a case of a male with a history of cocaine abuse found to have a singular giant emphysematous bulla occupying >95% of the right hemithorax requiring video-assisted thoracic surgery (VATS) with a favorable outcome. Case Presentation. A 50-year-old male with a history of chronic cocaine abuse was found unresponsive in the field and given multiple doses of naloxone without any improvement in mental status. On presentation to the emergency department, chest X-ray as well as CT scan of the chest were performed which were suggestive of an extensive pneumothorax of the right lung requiring placement of a chest tube. The patient was subsequently intubated and underwent bronchoscopy with right chest VATS which found a giant bulla encasing the entire right pleural cavity. During the procedure, he underwent resection of the bullae and a partial right pleurodesis. After the procedure, patient’s respiratory status significantly improved, and he was discharged in a stable condition. Conclusion. Cocaine use is a rare but identifiable factor that can cause giant bullous emphysema (GBE) resulting in severe complications and even death. The purpose of this case presentation is to support early identification and treatment of GBE using bullectomy with VATS, improving outcomes and decreasing morbidity and mortality.
Patient Delay in Hospital Visiting and the Weekend Effect of Surveillance Report on Hand-Foot-and-Mouth Disease and Epidemic Parotitis in Hanzhong City, China
Authors: Wei Jianjun , Zhu Zhonghai , Qi Qi , Zeng Lingxia
Published: May 2020

Background. We aimed at investigating the prevalence and associated factors of patient delay in hospital visiting and weekend effect of disease surveillance on hand-foot-and-mouth disease and epidemic parotitis/mumps. Methods. Daily report data on hand-foot-and-mouth disease and epidemic parotitis cases between January 1, 2014, and December 31, 2017, in Hanzhong, Shaanxi, China, were collected. The patient delay in hospital visiting was defined by the date difference between disease onset and patient’s visit to hospital. Differences of delayed durations and percentages were compared by using nonparametric or χ2 tests across gender, age, occupation, disease classification, epidemic and nonepidemic seasons, and years of disease onset. Additionally, to determine whether there existed a weekend effect of disease surveillance, the mean cases reported on weekdays and weekends were also compared. Results. A total of 14,814 patients with hand-foot-and-mouth disease and 4013 with epidemic parotitis were recorded, respectively. We found that 43.1% of the hand-foot-and-mouth disease and 36.5% of the epidemic parotitis patients had delayed visiting to hospital. All patients were reported through the online surveillance system on the day of visiting hospital. The percentage of delayed visiting to hospital differed significantly by years and epidemic and nonepidemic seasons and between children in and not in childcare center (all p values <0.05). In addition, the reported numbers of both diseases fluctuated on weekdays but obviously decreased on weekends regardless of the epidemic or nonepidemic seasons. Conclusions. The reported cases of HFMD and epidemic parotitis had an obvious weekend effect, with an increasing tendency of cases delaying in hospital visiting over the recent years in Hanzhong, China. Parents and caregivers rather than health systems should be primarily targeted for the prevention and control of infectious diseases and their local outbreaks such as community-based education on the second-dose vaccination of mumps and/or hand hygiene.
The NASA Twins Study: The Effect of One Year in Space on Long-Chain Fatty Acid Desaturases and Elongases
Authors: Schmidt Michael A. , Meydan Cem , Schmidt Caleb M. , Afshinnekoo Ebrahim , Mason Christopher E.
Published: May 2020

Background: At present, there is no clear understanding of the effect of long-duration spaceflight on the major enzymes that govern the metabolism of omega-6 and omega-3 fatty acids. To address this gap in knowledge, we used data from the NASA Twins Study, which includes a multiscale omics investigation of the changes that occurred during a year-long (340 days) human spaceflight. Embedded within the NASA Twins data are specific analytes associated with fatty acid metabolism. Objectives: To examine the long-chain fatty acid desaturases and elongases in a single human during 1 year in space. Method: One male twin was on board the International Space Station (ISS) for 1 year, while his monozygotic twin served as a genetically matched ground control. Longitudinal assessments included the genome, epige­nome, transcriptome, proteome, metabolome, microbiome, and immunome during the mission, as well as 6 months before and after. The gene-specific fatty acid desaturase and elongase transcriptome data (FADS1, FADS2, ELOVL2, and ELOVL5) were extracted from untargeted RNA-seq measurements derived from white blood cell fractions. Results: Most data from the elongases and desaturases exhibited relatively similar expression profiles (R2 >0.6) over time for the CD8, CD19, and lymphocyte-depleted (LD) cell fractions, indicating overall conservation of function within and between the subjects. Both cell-type and temporal specificity was observed in some cases, and some differences were also apparent between the polyadenylated (polyA) fraction of processed RNAs versus the ribodepleted (ribo–) fraction. The flight subject showed a stronger enrichment of the fatty acid metabolic process pathway across almost all cell types (columns, CD4, CD8, CPT, and LD), most especially in the ribodepleted fraction of RNA, but also with the polyA+ fraction of RNA. Gene set enrichment analysis (GSEA) measures across three related fatty acid metabolism pathways showed a differential between the ground and the flight subject. Conclusions: There appears to be no persistent alteration of desaturase and elongase gene expression associated with 1 year in space. However, these data provide evidence that cellular lipid metabolism can be responsive and dynamic to spaceflight, even though it appears cell-type and context specific, most notably in terms of the fraction of RNA measured and the collection protocols. These results also provide new evidence of mid-flight spikes in expression of selected genes, which may indicate transient responses to specific insults during spaceflight.
Abnormal Bodily Phenomena in First Episode Psychosis: A Preliminary Exploratory Cohort Study
Authors: Röhricht Frank , Eranti Savitha , Ballerini Massimo , Mancini Milena , Neale Josephine , Tsoumpris Athanasios , Stanghellini Giovanni
Published: May 2020

Schizophrenia patients frequently display an array of abnormal bodily phenomena (ABPs). There is literature to suggest that the presence of ABPs may be representative of a fundamental disruption of the embodied and prereflexive state of selfhood and hence be relevant for the development of schizophrenia spectrum disorders. ABPs have been considered as trait features of vulnerability to psychosis and may have value as potential markers for early detection, target symptoms for prevention and predictors of clinical outcomes. This longitudinal cohort study aimed to explore: (1) the prevalence of ABPs in first episode psychosis, (2) their longitudinal stability, (3) how ABPs compare with data from patients with enduring psychosis, and (4) how aspects of disorders of self-experience (DSEs) and ABPs and the corresponding instruments relate to each other. Sixteen patients were recruited from an early intervention in psychosis service. They were assessed with a series of structured and semi-structured interviews at point of entry, after 6 months and 12 months of follow-up. A variety of ABPs and DSEs were displayed in all study subjects, associated with high levels of core psychotic symptoms and reduced with treatment over time. Compared with findings of both acute and chronic schizophrenia patients, the prevalence of ABPs seems to be representative of severity and acuteness of the illness. Two factors were identified with stable trait characteristics and might be of predictive value for the course of the illness. Further studies with bigger samples are needed to further test the value of ABPs as early markers of detection and predictors of clinical course. The association between DSEs and ABPs warrants further investigation.
Rates and Determinants for the Use of Anticoagulation Treatment before Stroke in Patients with Known Atrial Fibrillation
Authors: Giustozzi Michela  , Agnelli Giancarlo , Quattrocchi Silvia , Acciarresi Monica , Alberti Andrea , Caso Valeria , Vedovati Maria Cristina , Venti Michele , Paciaroni Maurizio
Published: May 2020

Introduction and Objective: Even though the introduction of less cumbersome anticoagulant agents has improved, the rates ofoverall anticoagulant treatment in eligible patients with atrial fibrillation (AF) remain to be defined. We aimed to assess the rates of and determinants for the use of anticoagulation treatment before stroke in patients with known AF since the introduction of direct oral anticoagulants (DOAC) in clinical practice. Methods: Consecutive patients admitted to an individual stroke unit, from September 2013 through July 2019, for acute ischemic stroke or transient ischemic attack (TIA) with known AF before the event were included in the study. Logistic regression analysis was used to identify independent predictors of the use of anticoagulant treatment. Results: Overall, 155 patients with ischemic stroke/TIA and known AF were included in this study. Among 152 patients with a CHA2DS2-VASc score >1, 43 patients were not receiving any treatment, 47 patients were receiving antiplatelet agents, and the remaining 62 patients were on oral anticoagulants. Among 34 patients on DOAC, 13 were receiving a nonlabeled reduced dose and 18 out of 34 patients on vitamin K antagonists had an INR value <2 at the time of admission. Before stroke, only 34 out of 155 patients (21.9%) were adequately treated according to current guidelines. Previous stroke/TIA was the only independent predictor of the use of anticoagulant therapy. Conclusions: Only 21.9% of the patients hospitalized for a stroke or TIA with known AF before the event were adequately treated according to recent treatment guidelines. It is important to improve medical information about the risk of AF and the efficacy of anticoagulants in stroke prevention.
Transoral Endoscopic Coblation Tongue Base Surgery in Obstructive Sleep Apnea: Resection versus Ablation
Authors: Bahgat Ahmed , Bahgat Yassin , Alzahrani Rajab , Montevecchi Filippo , Cammaroto Giovanni , Vicini Claudio
Published: May 2020

Background: A new transoral tongue base surgical procedure for the treatment of snoring and obstructive sleep apnea (OSA) is described. It is named “Robo-Cob” technique because it is similar to transoral robotic surgery (TORS) but it is performed by means of coblation technology in order to resect the tongue base in countries where TORS is not an available option for such benign conditions. Methods: In this prospective, randomized, controlled trial, the new Robo-Cob technique was carried out in 25 adult OSA patients with confirmed tongue base hypertrophy at preoperative drug-induced sedation endoscopy. The results of this procedure were compared with the coblation endoscopic lingual lightening (CELL) technique used to ablate (or minimally resect) the central part of the tongue base, in another 25 adult OSA patients with similar characteristics (age, sex, preoperative body mass index and Apnea-Hypopnea Index, AHI). The base of tongue surgery was part of multilevel surgery including also septoturbinoplasty and barbed reposition pharyngoplasty (with/without tonsillectomy). Results: In this study, the Robo-Cob technique is proved to be feasible and effective in all cases either alone or when combined with other procedures in multilevel surgical settings. No/minimal intraoperative or postoperative complications were observed. Postoperative pain as measured by visual analog scale ranged from 3 to 7. No tracheostomy was done in any patient. Objective clinical improvement was confirmed by a level 3 polygraphy performed 6 months after surgery. There was significant difference in operative time at the level of the tongue base between Robo-Cob and CELL techniques, with shorter times observed within the Robo-Cob group. Moreover, the Robo-Cob technique provided tongue base tissue specimens that allowed measurement of the volume that ranged from 5 to 17 cm3 (mean 11.64 ± 3.49 cm3). It was found that resection of at least 10 cm3 of tongue base tissue was associated with better outcomes in terms of postoperative AHI reduction. Conclusion: In this study, the added values of using coblation for resection and not ablation appear to be the short surgical time, the low postoperative tissue edema, and the possibility of providing tissue specimens to measure resected volumes.
Negative Consequences of Substance Use in European University Students: Results from Project SNIPE
Authors: McAlaney John , Dempsey Robert C. , Helmer Stefanie M. , Van Hal Guido , Bewick Bridgette M. , Akvardar Yildiz , Guillén-Grima Francisco , Orosová Ol’ga , Kalina Ondrej , Stock Christiane , Zeeb Hajo
Published: May 2020

Background: University students are a risk group for heavy substance use and the experience of various potentially severe negative substance use consequences which may impact on their health, social, and academic functioning. Whilst the experience of negative consequences of substance use is well understood in North American student samples, there is little data on these experiences in European students. In order to develop effective harm prevention and reduction interventions for students’ substance use, there needs to be an understanding of the types of consequences experienced in European student samples. Objectives: The aim of the study was to investigate the prevalence and predictors of the experience of negative substance use-related consequences amongst university students in 7 European countries. Methods: University students (n = 4,482) in Belgium, Denmark, Germany, the Slovak Republic, Spain, Turkey, and the UK completed an online survey of their substance use behaviours and the experience of associated negative consequences. Results: European students reported that experiencing a hangover or illness, missing class, being short of money, and experiencing memory loss were the most commonly experienced negative consequences of substance use. Not living with other students and using alcohol, cannabis, sedatives, and cocaine were also associated with higher odds of experiencing these negative consequences. Conclusions: In contrast to North American data, European university students tended to experience consequences that are associated with lower level health risks rather than more severe consequences (e.g., drink-driving and physical injury). Harm prevention and reduction interventions for students should be targeted towards those consequences that are most salient to the target group to ensure feedback is relevant and potentially more effective in changing students’ substance use behaviours.
Re-Enclavation of a Dislocated Retropupillary Fixated Iris Claw Lens: A Case Report
Authors: Leisser Christoph , Findl Oliver
Published: May 2020

A male patient, 63 years of age, presented with dislocation of a retropupillary fixated iris claw lens due to nasal haptic disenclavation. During re-enclavation the intraocular lens dislocated again. To avoid further dislocation, both superior fingers of the haptics were pushed through the iris tissue to achieve more stable support of the haptic ends. This method of fixation appeared to be well tolerated.
Modos de orientação na floresta e as formas do entender no extrativismo comercial da castanha entre quilombolas do Alto Trombetas, Oriximiná/PA
Authors: Scaramuzzi Igor Alexandre Badolato
Published: May 2020

Os quilombolas do Alto Trombetas, município de Oriximiná/PA, desde o tempo que se estabeleceram nesta região no início do séc. XIX até os dias de hoje, têm o extrativismo comercial da castanha como a principal modalidade de intercâmbio comercial desenvolvida com os diversos segmentos regionais que habitavam e habitam a região. Atualmente, os castanhais localizados no território dos quilombolas são de usufruto coletivo e para evitar a concorrência muitos extrativistas, através da restrição da transmissão de certos saberes relacionados ao ramo castanheiro, buscam a exclusividade de uso de fragmentos específicos destas florestas. Alguns saberes que muitas vezes concretizam por longo tempo este desejo da exclusividade e que integram os modos locais de conhecer e de se relacionar com os castanhais, são assinalados pelo conceito local denominado entender. Entender uma mata de castanhal se faz pela prática contínua e de longa duração da coleta das amêndoas das castanheiras e das atividades paralelas do extrativismo da castanha como a caça, a pesca e a coleta de outros gêneros vegetais nos mesmos fragmentos florestais. Este artigo busca, através da descrição e análise etnográfica de algumas habilidades constituintes do ramo castanheiro, especialmente dos modos de orientação na floresta, demonstrar como os saberes expressos pelo conceito de entender, se produzem e se atualizam nesta atividade.
Tuberculose em trabalhadores de serviços de saúde
Authors: Pustiglione Marcelo , Galesi Vera Maria Neder , Santos Laedi Alves Rodrigues dos , Bombarda Sidney , Tognini Silvana , Freitas Ailton Catreus de , Feijó Camila De Aquino
Published: May 2020

Desde o início dos anos setenta do século passado vários autores apontam a tuberculose (TB) como risco à saúde dos trabalhadores de serviços de saúde. Estudos evidenciam que estes profissionais têm quatro vezes mais chance de adoecer por TB que a população em geral e que profissionais de saúde em atividade em hospitais têm taxa de teste tuberculínico positivo de 63,1% e conversão em 8,7% (10,7 por 1.000 pessoas/mês). São apontados como fatores de risco associados à conversão ao teste tuberculínico: (1) exposição nosocomial a paciente com TB pulmonar; (2) categoria profissional de enfermeiro; e (3) ausência de medidas de biossegurança implantadas no hospital. Vários autores apontam: (1) taxa de infecção muito elevada entre profissionais da saúde, o que se torna em objeto de preocupação tanto para a equipe de controle de infecção do ambiente de saúde quanto para os profissionais de segurança do trabalho; (2) uma taxa de positividade ao teste tuberculínico de 26,7% nos profissionais de saúde, tendo a maioria desses trabalhadores contato direto com paciente com tuberculose bacilífera; e (3) que os profissionais com menos de quatro anos de exposição ao bacilo apresentam taxas maiores de positividade ao teste. De acordo com os dados da Divisão de Tuberculose do Centro de Vigilância Epidemiológica da Secretaria da Saúde do Estado de São Paulo, considerando os anos de 2006 a 2016, são notificados em média 210 casos novos da doença em trabalhadores de serviços de saúde. Diante deste cenário e da urgência de implantação de ações preventivas específicas para o conjunto dos trabalhadores potencialmente expostos ao Mycobacterium tuberculosis (Bacilo de Koch ou BK) constituiu-se um Grupo de Trabalho (GT) para construção de um Protocolo de Prevenção de Tuberculose Ocupacional (PPTO). O objetivo deste artigo é fundamentar a elaboração deste instrumento de prevenção de uma doença ocupacional grave e de promoção da saúde dos trabalhadores potencialmente expostos.
Alternativas terapêuticas e aplicação de bacteriófagos como estratégia no uso de antibióticos no tratamento de doenças bacterianas
Authors: Dellalibera-Joviliano Renata , De Melo Samara Ariane , Ceni Henrique De Mello Remelli
Published: May 2020

Resistance to treatment of different microorganisms has been considered a major concern in the public health and medical fields. Pharmacological, microbiological, immunological approaches and the search for therapeutic alternatives have gained prominence in this area in order to understand the theme. In this context, the objective was to compile information correlating with alternative therapies with the problem of bacterial diseases in view of the multidrug resistance developed by antibiotic superbugs, since they represent the main treatment used in patients with these comorbidities. The electronic bases used as facilitators of the theme included SciELO, PubMed, MEDLINE and LILACS, period 2010-2019. From the active approaches, it is observed that the expansion of the therapeutic collection and prolongation of treatment to all periods of the natural process of bacterial diseases, avoiding the imminent seclusion regarding the offer of treatments to the most distinct cases of resistance, is considered a differential aspect. Still, aiming at solving this impasse, seeking effective therapeutic alternatives in the treatment of the most varied cases of bacterial diseases, and the possibility of its execution, either exclusively or mainly complementary to the use of antibiotics. Multiple intervention possibilities have been considered to include haemofiltration devices, quorum detection inhibitors, advanced immunotherapies, bacteriophage use, alternative efforts to limit virulence, integrative medicine measures such as homeopathy and herbal medicine. After the analysis, it was concluded that due to its efficacy and selective mechanism of action among the therapeutic alternatives found, the most promising was the application of bacteriophages.
Perfil dos pacientes com gangrena de Fournier utilizando a oxigenoterapia hiperbárica como tratamento adjuvante
Authors: Tikami Kátia Fumika , Simão José Cláudio , Passerotti Larissa Camargo , Barbosa Adriana Sierra Assencio Almeida
Published: May 2020

Objetivo: Avaliar os resultados obtidos da oxigenoterapia hiperbárica (OHB) como tratamento adjuvante na Gangrena de Fournier (GF). Casuística e Método: Estudo transversal, retrospectivo e descritivo baseado na análise de prontuários físicos de pacientes portadores de GF submetidos a oxigenoterapia hiperbárica, através da câmara hiperbárica no período de fevereiro de 2008 a maio de 2018, atendidos em uma clínica de oxigenoterapia hiperbárica na cidade de Bauru, SP. Os dados coletados foram: idade, sexo, etiologia, comorbidades, localização e extensão da lesão, número total de sessão e mortalidade. Resultado: Trinta e oito pacientes foram analisados, sendo 76% do sexo masculino, com média de idade de 55,6 anos. Entre os pacientes, 17 (44,7%) obtiveram alta médica, 18 (47,4%) interromperam o tratamento antes do término e ocorreram três (8,21%) óbitos. A principal etiologia foi o abcesso e os principais comorbidades predisponentes foram a diabetes mellitus e a hipertensão arterial. A localização e extensão com áreas mais afetadas foram na região escrotal, seguida pela região perineal. Conclusão: Os resultados deste estudo demostraram que o efeito da OHB como tratamento adjuvante oferece vantagem no tratamento da GF, resultando em considerável alta médica dos pacientes e baixa mortalidade.
Relação entre o estresse e a autoestima de gestantes durante o pré-natal
Authors: Gomes Franco Celso da Silva , Aragão Francisca Bruna Arruda , Serra Liana Linhares Lima , Chein Maria Bethânia Costa , Santos Joelmara Pereira Furtado dos , Santos Liane Maria Rodrigues dos , Reis Andréa Dias , Lopes Fernanda Ferreira
Published: May 2020

Objetivo: analisar os componentes do perfil psicossocial de gestantes durante o pré-natal. Métodos: estudo quantitativo, analítico, realizado com 160 gestantes, entre 14 e 47 anos de idade, atendidas num Hospital de referência do Maranhão, em 2017. Resultados: a maioria das gestantes tinha entre 19 a 35 anos de idade (48,75%); realizaram de 0 a 5 consultas de pré-natal (40,65%) e eram nulíparas (43,13%). A análise de regressão linear evidenciou a influência do estresse devido a problemas financeiros e relacionados à família, os itens que mais explicaram o constructo autoestima foram sentir que não é um fracasso e sentir-se satisfeita consigo mesma; A correlação de Pearson do estresse e autoestima foi negativa e com influência significativamente forte. Conclusão: o estresse dentre os fatores psicossociais é o que mais influencia para alterações no pré-natal provavelmente na autoestima, pois quando relacionado com estresse evidenciou relação negativa.
Tratamento tardio de fratura do complexo zigomático-orbitário com uso de fixação interna rígida
Authors: Reis Danyella Carolyna Soares dos , Duarte Danilo Maldonado e , Rodrigues Cristóvão Marcondes de Castro , Silva Cláudia Jordão , Rocha Flaviana Soares
Published: May 2020

As fraturas do complexo zigomático-orbitário são bastante frequentes devido a sua localização e projeção na face, podendo gerar grandes transtornos funcionais e estéticos ao paciente. O osso zigomático é essencial na configuração da face, sendo a principal estrutura formadora do terço médio dela. Os traumas que mais frequentemente provocam fraturas do complexo zigomático-orbitário são agressões físicas, acidentes de trânsito e esportivos. O tipo de fratura, tempo decorrido, a severidade e o envolvimento de outras estruturas faciais influenciam a modalidade de tratamento a ser empregado. O presente trabalho apresenta um caso clínico de fratura do complexo zigomático-orbitário esquerdo, diagnosticada tardiamente, e tratada por meio de osteotomia, redução e fixação em três pontos com placas e parafusos do sistema 1.5, e reconstrução do assoalho orbitário com tela de titânio.
Agenesia da artéria pulmonar direita
Authors: Queiroz Rodolfo Mendes , Tannus Carolina Souza , Boyadjian Armeny Arantes , Beneduzzi Maria Luisa , Mello Denise Fabri Rezende Engracia , Febronio Eduardo Miguel , Valentin Marcus Vinicius Nascimento
Published: May 2020

Agenesia isolada da artéria pulmonar direita ou esquerda é uma rara anomalia congênita dada pela falta do desenvolvimento embriológico de um dos arcos aórticos. A apresentação clínica é variável, sendo a mais comum na infância, na forma de hipertensão pulmonar contralateral. No adulto, a hemoptise pode ser uma das manifestações clínicas, e nos indivíduos assintomáticos esta anomalia pode ser reconhecida em exames de diagnóstico por imagem. Relatamos o caso de paciente do sexo feminino, 63 anos, encaminhada para investigação de imagem nodular no hilo pulmonar esquerdo observada em radiografia torácica. Tomografia computadorizada evidenciou agenesia da artéria pulmonar direita com suprimento arterial pulmonar homolateral ocorrendo por vasos colaterais, pulmão esquerdo com proeminência das artérias e veias hilares e peri-hilares, provavelmente simulando uma nodulação na radiografia realizada previamente, volume discretamente reduzido do pulmão direito com espessamento dos septos interlobulares secundário, provavelmente devido ao aumento da microcirculação colateral intraparenquimatosa.
Type 1 autoimmune pancreatitis
Authors: Oliveira Gustavo Mesquita de , Alves Lia de Freitas Araújo , Cabral Paloma Lucena , Pequeno Ana Luiza Viana , Coelho Clóvis Rêgo , Lima Rodrigo Vieira Costa
Published: May 2020

Type 1 autoimmune pancreatitis is a cause of chronic pancreatitis related to the systemic disease known as IgG4-related Sclerosing Disease. Case report: We report the case of a 64-year-old male patient who presented recurrent epigastric pain radiating to the back, associated with jaundice, xerostomia, nausea, and vomiting, since 2014, diagnosed two years later with an unresectable pancreatic adenocarcinoma. The diagnosis was questioned after a few follow-up months without clinical deterioration when it was suggested the possibility of type 1 autoimmune pancreatitis in its pseudotumoral form. The patient was then treated with glucocorticoids, obtaining significant clinical improvement. After two years of follow-up, he returned asymptomatic with images suggestive of sclerosing cholangitis and a large liver abscess. Importance of the issue: The present case denotes the difficulty found in this diagnosis due to clinical and radiological resemblances with pancreatic adenocarcinoma. Besides that, it presents a seldom described disease complication, the liver abscess.
Communicability distance reveals hidden patterns of Alzheimer’s disease
Authors: Lella Eufemia , Estrada Ernesto
Published: May 2020

The communicability distance between pairs of regions in human brain is used as a quantitative proxy for studying Alzheimer’s disease. Using this distance, we obtain the shortest communicability path lengths between different regions of brain networks from patients with Alzheimer’s disease (AD) and healthy cohorts (HC). We show that the shortest communicability path length is significantly better than the shortest topological path length in distinguishing AD patients from HC. Based on this approach, we identify 399 pairs of brain regions for which there are very significant changes in the shortest communicability path length after AD appears. We find that 42% of these regions interconnect both brain hemispheres, 28% connect regions inside the left hemisphere only, and 20% affect vermis connection with brain hemispheres. These findings clearly agree with the disconnection syndrome hypothesis of AD. Finally, we show that in 76.9% of damaged brain regions the shortest communicability path length drops in AD in relation to HC. This counterintuitive finding indicates that AD transforms the brain network into a more efficient system from the perspective of the transmission of the disease, because it drops the circulability of the disease factor around the brain regions in relation to its transmissibility to other regions.
The Long-Term Effect of Military Conscription on Personality and Beliefs
Authors: Ertola Navajas Gabriela , López Villalba Paula A. , Rossi Martín A. , Vazquez Antonia
Published: May 2020

We estimate the causal impact of military conscription on long-term beliefs and personality traits. To address potential endogeneity concerns, we exploit the conscription lottery in Argentina. We combine administrative data from the conscription lottery with data from a survey we designed on beliefs and personality traits. We find that men who were conscripted are more likely to adopt a military mind-set and that the effect is long lasting. Given the many people who go through military conscription, our results are useful for understanding how personality traits and beliefs are formed for a very salient part of the world's population.
Blameless Aegisthus Revisited
Authors: Xian Ruobing
Published: May 2020

In this article I offer a new interpretation of the puzzling phrase ἀµύµονος Αἰγίσθοιο at Od. 1.29 by focusing on the context of Od. 1.29-31. A closer analysis of the passage within the narrative logic of the proem strongly suggests that Zeus, after the departure of Poseidon, should think of Odysseus. While Zeus’ opening speech is to be understood as a covert signal to Athena, Homer’s audience is invited to recognize the speech’s direct relevance to Odysseus: the narrator deliberately utilizes the apparent incongruity of the phrase ‘blameless Aegisthus’ to alert the audience to its significance. Not only is the epithet ἀµύµων most frequently attributed to Odysseus in the Odyssean tradition, but also the formulaic combination between Zeus (ἴστω νῦν Ζεύς) and ‘blameless Odysseus’ (Ὀδυσῆος ἀµύµονος) helps the audience to reflect upon the epic hero’s fate and deeds.
Development of the “POP” scoring system for predicting obstetric and gynecological diseases in the emergency department: a retrospective cohort study
Authors: Okada Asami , Okada Yohei , Fujita Hiroyuki , Iiduka Ryoji
Published: May 2020

Background

Obstetric and gynecological (OBGY) diseases are among the most important differential diagnoses for young women with acute abdominal pain. However, there are few established clinical prediction rules for screening OBGY diseases in emergency departments (EDs). This study aimed to develop a prediction model for diagnosing OBGY diseases in the ED.

Methods

This single-center retrospective cohort study included female patients with acute abdominal pain who presented to our ED. We developed a logistic regression model for predicting OBGY diseases and assessed its diagnostic ability. This study included young female patients aged between 16 and 49 years who had abdominal pain and were examined at the ED between April 2017 and March 2018. Trauma patients and patients who were referred from other hospitals or from the OBGY department of our hospital were excluded.

Results

Out of 27,991 patients, 740 were included. Sixty-five patients were diagnosed with OBGY diseases (8.8%). The “POP” scoring system (past history of OBGY diseases + 1, no other symptoms + 1, and peritoneal irritation signs + 1) was developed. Cut-off values set between 0 and 1 points, sensitivity at 0.97, specificity at 0.39, and negative likelihood ratio (LR-) of 0.1 (95% CI: 0.02–0.31) were considered to rule-out, while cut-off values set between 2 and 3 points, sensitivity at 0.23 (95% CI 0.13–0.33), specificity at 0.99 (95% CI 0.98–1.00), and positive likelihood ratio (LR+) of 17.30 (95% CI: 7.88–37.99) were considered to rule-in.

Conclusions

Our “POP” scoring system may be useful for screening OBGY diseases in the ED. Further research is necessary to assess the predictive performance and external validity of different data sets.
Association between NAFLD and risk of prevalent chronic kidney disease: why there is a difference between east and west?
Authors: Zhang Min , Lin Su , Wang Ming-fang , Huang Jiao-feng , Liu Shi-ying , Wu Su-mei , Zhang Hao-yang , Wu Zi-mu , Liu Wen-Yue , Zhang Dong-Chu , Hao Chuan-ming , Zhu Yue-yong , Zheng Ming-Hua , Wang Xiao-zhong
Published: May 2020

Backgrounds

There is a discrepancy between west and east on the relationship between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD). This study aimed to find out the possible reason for this and to clarify the association between NAFLD and CKD by analyzing two population-based datasets from the US and China.

Methods

Two health examination datasets from China and the US were used. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 or and/or abnormal albuminuria and/or overt proteinuria. Binary logistic regression was used to examine the association between NAFLD and CKD.

Results

A total of 60,965 participants were analyzed, including 11,844 from the US and 51,229 from China. The prevalence of NAFLD was 27.12% in the Chinese population and 36.08% in the US population (p < 0.001). The proportions of CKD and late stage CKD (stages 3–5) were higher in the US population than the Chinese one. NAFLD was independently associated with an increased risk of CKD in Chinese population, whereas in the US population, the NAFLD was not an independent risk factor of CKD. In subgroup analyses which excluded late stages CKD (stages 3–5), the risks of mild renal function decline became consistent: NAFLD was associated with early stages of CKD but not the late stages of CKD in both populations.

Conclusion

NAFLD increased the risk of early stages of CKD in both Chinese and the US population. The conflicting results reported by previous studies might result from the different proportion of late stages of CKD.