bluuebunny/crossref_metadata_2025 huggingface dataset:
Dual Strategy of Reconfiguration with Capacitor Placement for Improvement Reliability and Power Quality in Distribution System
Authors: Nasser Hussain Ali , Rafa Abed Wathiq , Muneer Yaqoob Mohanad
Published: March 2023

The demand for electrical power has been increasing rapidly due to higher industrial output and deregulation. The concerns have been raised about the ability of distribution networks to provide adequate power for the customers with an appropriate level of quality and reliability. To ameliorate the performance of the radial distribution system (RDS), the optimal capacitor placement (OCP), and the distribution system reconfiguration (DSR) strategies have been implemented in the current work to achieve the highest power quality and system reliability in a balanced manner at the same time. Three different scenarios were implemented, the first scenario of dual sequential (OCP after DSR), the second scenario of dual sequential (DSR after OCP), and the third scenario of dual simultaneous (DSR with OCP). These scenarios were tested on typical 33 and 69 bus IEEE RDS using the binary salp swarm algorithm (BSSA) based on the multiobjective functions (MOFs), in order to identify the most effective scenario performance that achieved the highest power quality and system reliability. The MOF was formulated to improve the power quality by increasing the voltage buses and reducing the power losses. While the constraints include limits of system reliability indices to provide optimal constraints on negative interactions of power quality. The simulation results demonstrate that the second scenario of dual sequential (DSR after OCP) provide superior in comparison with the first scenario of dual sequential (OCP after DSR) for enhancing the RDS reliability indices, voltage buses, and reducing power losses. Finally, the best result can be realized with dual simultaneous (DSR and OCP) in the third scenario compared to the dual sequential scenarios.
Topological Indices of Total Graph and Zero Divisor Graph of Commutative Ring: A Polynomial Approach
Authors: Mondal Sourav , Imran Muhammad , De Nilanjan , Pal Anita
Published: March 2023

The algebraic polynomial plays a significant role in mathematical chemistry to compute the exact expressions of distance-based, degree-distance-based, and degree-based topological indices. The topological index is utilized as a significant tool in the study of the quantitative structure activity relationship (QSAR) and quantitative structures property relationship (QSPR) which correlate a molecular structure to its different properties and activities. Graphs containing finite commutative rings have wide applications in robotics, information and communication theory, elliptic curve cryptography, physics, and statistics. In this article, the topological indices of the total graph

T

ℤ

n

n
∈

ℤ

+

, the zero divisor graph

Γ

ℤ

r

n

(

r

is prime,

n
∈

ℤ

+

), and the zero divisor graph

Γ

ℤ

r

×

ℤ

s

×

ℤ

t

(

r
,
s
,
t

are primes) are computed using some algebraic polynomials.
A Comparative Evaluation of Antibacterial Efficacy of Moringa oleifera Leaf Extract, Octenidine Dihydrochloride, and Sodium Hypochlorite as Intracanal Irrigants against Enterococcus faecalis: An In Vitro Study
Authors: Alharbi Afrah M. , Alharbi Tahani M. , Alqahtani Mashael S. , Elfasakhany Fathy M. , Afifi Ibtesam K. , Rajeh Mona T. , Fattouh Mohamed , Kenawi Laila Mohamed Mohamed
Published: March 2023

Objectives. The aim of this study is to investigate and compare the microbial efficacy of Moringa oleifera leaf extract, octenidine dihydrochloride (OCT), NaOCl, and their combinations as intracanal irrigants against Enterococcus faecalis. Materials and Methods. Sixty single-rooted mandibular premolars were decoronated followed by root canal preparation. Each root specimen was autoclaved, inoculated with E. faecalis, and incubated at 37°C for 48 hr. Then, the specimens were divided into six groups based on the irrigation solution used: 2.5% NaOCl (Group 1), 0.1% OCT (Group 2), M. oleifera leaves extract (Group 3), a combination of M. oleifera extract and 1.25% NaOCl (Group 4), a combination of M. oleifera extract and OCT (Group 5) and normal saline (Group 6). Microbial samples were taken from each root canal before (S1) and after (S2) irrigation and the bacterial viability was assessed using colony-forming units (CFU) on bile esculin agar plates. Results. Comparing the number of CFU/ml before and after irrigation showed a significant reduction (

P
<
0.001

) in all studied groups. Comparison between the CFU/ml after irrigation by NaOCl and each of the combination groups showed a significant difference. Conclusion. M. oleifera leaves extract and 0.1% OCT solutions have antibacterial effect against E. faecalis comparable to 2.5% NaOCl and might be used as root canal irrigants. The combination groups showed better antimicrobial activities than individual irrigants. However, further studies are required to investigate the biocompatibility and possible toxic effects of the tested irrigants.
Generation 4.0 of the programmer selection decision support system: MCDM-AHP and ELECTRE-elimination recommendations
Authors: Akmaludin Akmaludin , Sihombing Erene Gernaria , Rinawati Rinawati , Handayanna Frisma , Sari Dewi Linda , Arisawati Ester
Published: March 2023

The industrial world in the era of generation 4.0 needs personnel related to human resources who can handle crucial problems, especially in terms of data digitalization. The purpose of this paper is to analyze the supporting criteria that can be used as a measure of programmer selection for the needs of the industrial world which can provide optimal decisions and pay attention to the use of multi-criteria that have different quantitative assessments such as criteria related to contradictory times in its application. The problem, in the industrial world, does not only require speed alone but requires professional staff who can transform into digital technology, digitalization technology is needed in terms of the data conversion and transferring process, so a programmer has an important role in changing favorable conditions because it requires a selection process to get the best professional from several programmers. The method that can be used in multi-criteria decision-making-analytic hierarchy process (MCDM-AHP) and elimination et choix traduisant la realite (ELECTRE) methods in the concept of elimination. This method is part of the MCDM, which uses eight criteria in the selection and evaluation process. The results obtained from several selected programmers produce several professionally selected people, and can be used as an optimal benchmark for the programmer selection and evaluation process with a long preference index stage through the elimination process, this provides evidence that the selection and evaluation process can determine decision making which is optimal for a select number of programmers that only a few have through the aggregate dominant matrices.
Preventive remediation methods minimize soil pollution
Authors: Mangkoedihardjo Sarwoko , Samudro Harida
Published: March 2023

Soil quality is rich in various substances, as well as a rich variety of uses for life, which leads to the potential for pollution. Once soils are polluted, remediation is mitigative and must be carried out, which has been the focus of many studies so far. However, preventive remediation is the focus of the novelty of this study, which aims to prepare predictive methods. This is a literature review of various studies over the last ten years, which are related to soil quality indicators through the respiration process. Based on the soil microbial respiration process platform, which contains various substances, the results of this study found three preventive remediation methods, namely indicators of substance reactants, gas products, and toxicity to microbes. The three methods simply require measuring the parameters of biochemical oxygen demand, and chemical oxygen demand, in addition to specific measurements of carbon dioxide and microbial enumeration. The advantage of the preventive remediation method is the application of soil response indicators to various types and amounts of contaminants. The implementation of preventive remediation is prior to building infrastructure, which is able to predict changes in soil quality through monitoring, thereby minimizing the potential for mitigative remediation.
Plasma Progerin in Patients With Hutchinson-Gilford Progeria Syndrome: Immunoassay Development and Clinical Evaluation
Authors: Gordon Leslie B. , Norris Wendy , Hamren Sarah , Goodson Robert , LeClair Jessica , Massaro Joseph , Lyass Asya , D’Agostino Ralph B. , Tuminelli Kelsey , Kieran Mark W. , Kleinman Monica E.
Published: March 2023

Background:

Hutchinson-Gilford progeria syndrome (HGPS) is an ultrarare, fatal, premature aging disease caused by a toxic protein called progerin. Circulating progerin has not been previously detected, precluding research using readily available biological samples. This study aimed to develop a plasma progerin assay to evaluate progerin’s quantity, response to progerin-targeted therapy, and relationship to patient survival.

Methods:

Biological samples were collected by The Progeria Research Foundation Cell and Tissue Bank from a non-HGPS cohort cross-sectionally and a HGPS cohort longitudinally. HGPS donations occurred at baseline and intermittently while treated with farnesylation inhibitors lonafarnib±pravastatin and zoledronate, within 3 sequential open-label clinical trials at Boston Children’s Hospital totaling >10 years of treatment. An ultrasensitive single-molecule counting progerin immunoassay was developed with prespecified performance parameters. Intra- and interpatient group statistics were descriptive. The relationship between progerin and survival was assessed by using joint modeling with time-dependent slopes parameterization.

Results:

The assay’s dynamic detection range was 59 to 30 000 pg/mL (
R
2
=0.9987). There was no lamin A cross-reactivity. Mean plasma progerin in non-HGPS participants (n=69; 39 male, 30 female; age, 0.2–71.3 years) was 351±251 pg/mL, and in drug-naive participants with HGPS (n=74; 37 female, 37 male; age, 2.1–17.5 years) was 33 261±12 346 pg/mL, reflecting a 95-fold increase in affected children (
P
<0.0001). Progerin levels did not differ by sex (
P
=0.99). Lonafarnib treatment resulted in an average per-visit progerin decrease from baseline of between 35% to 62% (all
P
<0.005); effects were not augmented by adding pravastatin and zoledronate. Progerin levels fell within 4 months of therapy and remained lower for up to 10 years. The magnitude of progerin decrease positively associated with patient survival (
P
<0.0001; ie, 15 000 pg/mL decrease yields a 63.9% decreased risk of death). For any given decrease in progerin, life expectancy incrementally increased with longer treatment duration.

Conclusions:

A sensitive, quantitative immunoassay for progerin was developed and used to demonstrate high progerin levels in HGPS plasma that decreased with lonafarnib therapy. The extent of improved survival was associated with both the magnitude of progerin decrease and duration at lower levels. Thus, plasma progerin is a biomarker for HGPS whose reduction enables short- and long-term assessment of progerin-targeted treatment efficacy.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifiers: NCT00879034 and NCT00916747.
Arterial Hypertension in Women: State of the Art and Knowledge Gaps
Authors: Chapman Niamh , Ching Siew M. , Konradi Aleksandra O. , Nuyt Anne Monique , Khan Taskeen , Twumasi-Ankrah Betty , Cho Eun J. , Schutte Aletta E. , Touyz Rhian M. , Steckelings U. Muscha , Brewster Lizzy M.
Published: March 2023

Hypertension is the leading risk factor for cardiovascular disease and premature death among women globally. However, there is a fundamental lack of knowledge regarding the sex-specific pathophysiology of the condition. In addition, risk factors for hypertension and cardiovascular disease unique to women or female sex are insufficiently acknowledged in clinical guidelines. This review summarizes the existing evidence on women and female-specific risk factors and clinical management of hypertension, to identify critical knowledge gaps relevant to research, clinical practice, and women’s heart health awareness. Female-specific risk factors relate not only to reproduction, such as the association of gynecological conditions, adverse pregnancy outcomes or menopause with hypertension, but also to the specific roles of women in society and science, such as gender differences in received medical care and the underrepresentation of women in both the science workforce and as participants in research, which contribute to the limited evidence-based, gender- or sex-specific recommendations. A key point is that the development of hypertension starts in young, premenopausal women, often in association with disorders of reproductive organs, and therefore needs to be managed early in life to prevent future cardiovascular disease. Considering the lower blood pressure levels at which cardiovascular disease occurs, thresholds for diagnosis and treatment of hypertension may need to be lower for women.
A Bodily Haunting
Authors: Simpson Hannah
Published: March 2023

The woman’s wordless scream in Not I and Happy Days acts as a spectral-yet-embodied rendering of unspoken and apparently unspeakable sexual trauma. If trauma symptomology is itself a form of bodily haunting—the past intruding into the present—the wordless scream performs this phenomenon on Beckett’s stage, as a disruptive return of the repressed through the body itself. This essay explores how the performed scream returns embodied trauma to embodied expression in Not I and Happy Days, emphasising the voice as a simultaneously spectral yet profoundly corporeal force. It then examines the potential therapeutic effect of the scream in performance, drawing on a range of actor testimonies.
Love and Gender Relations from the Perspective of Familism: Based on Fieldwork in Contemporary Rural North Zhejiang
Authors: Chen (陈云龙) Yunlong
Published: March 2023

In response to the academic debate about the “individualization” of the patterns of love and marriage in contemporary China, this article takes the spousal selection and marriage and love practices of peasants in northern Zhejiang since China’s reform and opening up as the basis of field study, and explores the roles and functions of love and gender relations and their relationship to ethical factors in the overall process of “spousal selection→marriage→family→giving birth.” We also find that although the “love” factor has become more and more important in the marriage practice of recent generations (especially among rural women) and has even become an indispensable key to starting marital family life, it has not fully established its own independent space and value. It has in fact been boosted, guided, and controlled by, and incorporated into, the traditional marriage and family pattern. This traditional pattern, with its own unique resilience, has integrated love into the family life cycle, gradually pulling it into the orbit of traditional marriage and family, and successfully carrying on the “sacred undertaking” of the ancestors. This overall characteristic is more pronounced in developed eastern coastal villages (among young women) than in less developed central and western rural areas (among young women). In terms of theory and methodology, the “individualization” of love and marriage among contemporary Chinese peasants needs to be put back into the framework of “familism” for in-depth reflection, rather than simply being understood from the standpoint of “individualization” and from the binary opposition between “individualism” and “familism.”
Erigeron morelensis (Asteraceae): a rediscovery after more than 120 years of a microendemic and threatened species in central Mexico
Authors: CERROS-TLATILPA ROSA , MIGUEL-VÁZQUEZ MÓNICA I. , CASPETA-MANDUJANO JUAN M. , MÉNDEZ-CANO RAFAEL , GUERRERO JOSE A.
Published: March 2023

The rediscovery of Erigeron morelensis, not collected since 1898, is reported. Between 2021 and 2022, E. morelensis was recorded at two sites in the northwestern canyons of Cuernavaca, Morelos, Mexico, which are subjected to degradation pressure. The morphological description is updated and complemented, and a key for E. sect. Erigeridium is included. Data about the known distribution, ecology and habitat of the species are provided. Based on the IUCN criteria, it is recommended that the species be listed as Critically Endangered (CR).
Three interesting fungi from American bullfrog larvae (Rana catesbeiana) in Yunnan, China
Authors: YANG ERFU , LU WENHUA , TIBPROMMA SAOWALUCK , DAI DONGQIN , GAO YING , PROMPUTTHA ITTHAYAKORN , KARUNARATHNA SAMANTHA C.
Published: March 2023

American bullfrog (Rana catesbeiana) is an alien invasive species in southwest China native to the central and eastern United States and southeastern Canada. After the 19th century, they extensively appear in aquaculture and natural environments worldwide as a delicious food but also creating a serious threat to the survival and development of native species. In the early rainy season, dead American bullfrog larvae floating on the water of unnamed ponds in Qujing Normal University, Yunnan Province, China were collected and brought to the mycology laboratory, and three interesting fungal strains were isolated from their intestinal contents. Phylogenetic analyses were carried out on the resultant isolates based on multiple gene sequences (ITS, LSU, rpb2, tub2, tef1-α), and results confirmed that the three strains belong to three species, namely; Boothiella tetraspora, Sordaria macrospora and Trichoderma virens. The morphological characteristics were also used to describe the fungal taxa. Photographic plates, descriptions, and phylogenetic trees that show the placements of the fungal species are reported herein.
Type designation of the Maritime pine Pinus pinaster (Pinaceae)
Authors: FERRER-GALLEGO P. PABLO
Published: March 2023

The typification of the name Pinus pinaster (Pinaceae) is discussed. The designation of the type is based on the consultation of the original elements and the literature cited in the protologue. An illustration published by Duhamel du Monceau in 1755 is designated as the lectotype.
On the molecular taxonomy of the Dendrobaena alpina species complex, with description of a new species (Crassiclitellata, Lumbricidae)
Authors: CSUZDI CSABA , VALCHOVSKI HRISTO , KRÍZSIK VIRÁG , PAVLÍČEK TOMÁŠ , SZEDERJESI TÍMEA
Published: March 2023

The molecular phylogenetic analysis of the D. alpina species group and related taxa revealed that this group in the present form is polyphyletic. The dark-red pigmented D. alpina alpina (Rosa, 1884) specimens from the Alps form a distinct clade together with D. alpina alteclitellata (Pop, 1938) and D. clujensis Pop, 1938 (Central European clade). The unpigmented Bulgarian specimens are now part of a clade consisting of Anatolian and Levantine species, namely D. orientalis Černosvitov, 1940, D. pentheri (Rosa, 1905), D. orientaloides Zicsi, 1985 and D. semitica Rosa, 1893a. Consequently, the unpigmented worms from Bulgaria represent a new species described herein as Dendrobaena misirlioglui sp. nov.
Contribution to the knowledge of the genus Boucheona (Oligochaeta, Hormogastridae) in France with a newly described species and a redescribed species
Authors: MARCHÁN DANIEL F. , NOVO MARTA , DOMÍNGUEZ JORGE , SÁNCHEZ NURIA , DECAËNS THIBAUD
Published: March 2023

Hormogastrid earthworms are found in the diversity hotspot of the Franco-Iberian domain, together with the better-known family Lumbricidae. Integrative systematics (the combination of morphological, molecular and ecological data) have increased our knowledge of the diversity and evolutionary history of these earthworms, highlighting unresolved taxonomic conflicts. One example of a species group in need of integrative taxonomic revision is the genus Boucheona in France. In this work, we analyzed their diversity using previously published data together with additional data obtained from recently sampled localities. Molecular data including DNA barcodes and additional markers enabled us to reconstruct Bayesian and time-calibrated phylogenies to discuss the evolutionary relationships among the different taxa, and to propose hypotheses regarding their biogeographical history. Based on our results, four species of Boucheona are present in Southern France, including two new taxa. Morphological distinctness and molecular phylogenetics results supported the status of four populations as the newly described Boucheona corbierensis sp. nov., as well as the status of “Hormogaster pretiosa var. nigra” as an independent species, redescribed as Boucheona tenebrae sp. nov. These results provide a new perspective of the importance of the genus Boucheona in southern France, as the possible evolutionary origin of a clade of giant anecic earthworms with unknown (but probably remarkable) impact on ecosystem functioning across their range.
Two new species of crane fly (Diptera: Limoniidae) from Tasmania, Australia
Authors: BILLINGHAM ZACARIAH D. , THEISCHINGER GUNTHER , LEVESQUE-BEAUDIN VALERIE
Published: March 2023

Two new species of Australian crane fly are described, illustrated and with COI sequences included: Gynoplistia (Gynoplistia) lutruwita Billingham & Theischinger sp. nov., and Molophilus (Molophilus) serricauda Billingham & Theischinger sp. nov., both from the Huon Valley region of southern Tasmania. Their affinities with other known Australian species are discussed.
The safety and efficacy of sequential intramuscular/oral ziprasidone treatment of acute episode in patients with schizophrenia: a multicenter, open-labeled study
Authors: Wu Yaxue , Li Yanli , Liang Weiye , Bai Luyuan , Yu Jianjin , Li Keqing , Zhang Yunshu , Guo Yanmei , Liu Zenglong , Wang Jian , Zhang Congpei , Wang Xijin , Xu Jia , Liu Liping , Li Juan , Yang Fude
Published: March 2023

Background

Ziprasidone mesylate injection is an atypical antipsychotic drug which is recently approved in China. In combination with its oral formulation, sequential therapy with ziprasidone brings new interventions to patients with agitation in the acute phase of schizophrenia. The purpose of this 7-day multicenter study conducted in China was to evaluate the efficacy and safety of ziprasidone sequential treatment through intramuscular/oral routes in agitated patients with schizophrenia.

Methods

A total of 95 patients were enrolled from three centers in this study. The study duration was 7 days. In the first 3 days, subjects were administered an intramuscular injection of ziprasidone 10–40 mg daily and started sequentially with oral ziprasidone 40–80 mg at dinner (or lunch) from the day of the last intramuscular injection. In the following 4 days, according to the severity of the symptoms and the drug response, 120–160 mg of ziprasidone was orally administered daily. In total, six visits were scheduled to assess the Positive and Negative Syndrome Scale (PANSS), the Behavioral Activity Rating Scale (BARS), the Clinical Global Impression of Severity (CGI-S), and Improvement (CGI-I) scores throughout the procedure. Lastly, adverse events were recorded during treatment.

Results

Out of the 95 patients that were enrolled, 83 cases were effectively completed. Visits 3, 4, 6, PANSS, and PANSS-excited component (PANSS-EC) subscale points, and Visit 2–Visit 6 viewpoints, BARS scale points, and baseline scores denote a progressive downward trend (P < 0.001). In this study, 62 adverse events were reported. The most common adverse events were extrapyramidal symptoms (EPS) (23 cases) and excessive sedation(10 cases), and 13 cases of prolonged QTc interval were reported.

Conclusions

Ziprasidone IM demonstrated significant and rapid reduction in agitation, and sequential oral formulation keep stability and continuation of the treatment can further ensure efficacy. Ziprasidone sequential therapy may provide a new approach to acute agitation in schizophrenic patients.

Trial registration

The Chinese Clinical Trials Registry; URL: https://www.chictr.org.cn: ChiCTR-OIC-16007970.
Characteristics of submucosal leiomyomas that could cause severe hemorrhage with relugolix: an observational study
Authors: Wada Yoshimitsu , Takei Yuji , Minezumi Takumi , Hirashima Hiroto , Fujiwara Hiroyuki
Published: March 2023

Background

Relugolix, an oral gonadotrophin-releasing hormone receptor antagonist, was launched in Japan in 2019. Although there have been several studies on relugolix for leiomyomas, few have focused on submucosal leiomyomas. Submucosal leiomyomas cause bleeding more frequently than leiomyomas in other locations. There is only one case report described a patient treated for a submucosal leiomyoma with relugolix who developed severe hemorrhage. However, it remains unclear which characteristics of submucosal leiomyomas can lead to severe hemorrhage. Thus, the aim of this study was to investigate the characteristics of submucosal leiomyomas that would cause severe hemorrhage when treated with relugolix.

Methods

We retrospectively reviewed records of patients who underwent treatment for submucosal leiomyoma with relugolix (40 mg once daily for up to 6 months) in our institute between December 2019 and September 2021. We evaluated the clinical course and characteristics of submucosal leiomyoma in patients who developed severe hemorrhage.

Results

A total of 17 patients were treated for submucosal leiomyoma with relugolix. Two patients developed severe hemorrhage and required emergent surgery and blood transfusions. Only those two of the 17 patients had a submucosal leiomyoma of the International Federation of Gynecology and Obstetrics (FIGO) type 0, which has a stalk. In the remaining 15 patients who had FIGO type 1 or 2 leiomyoma, hemorrhage did not occur.

Conclusions

Our study suggests that the use of relugolix for FIGO type 0 leiomyomas may be associated with a risk of hemorrhage. However, relugolix may be a safe and effective treatment option for patients with FIGO type 1 or 2 leiomyomas.
Psychometric properties of the persian version of the physician teaching self-efficacy questionnaire
Authors: Hayat Ali Asghar , Shateri Karim , Kamalian Fard Sepideh , Sabzi Shahr Babak Elnaz , Faraji Dehsorkhi Hatam
Published: March 2023

Introduction

Theories and numerous empirical studies indicate teaching performance and students’ learning progress are affected by teaching self-efficacy. Therefore, the present study examines the psychometric properties of the Persian version of the physician teaching self-efficacy questionnaire.

Methods

The 16-item physician teaching self-efficacy questionnaire was translated from English to Persian and back-translated to English and then administered to 242 medical teachers from six medical universities. To assess construct validity, researchers made use of confirmatory factor analysis. To check the reliability and validity of the physician teaching self-efficacy questionnaire, we used internal consistency, discriminant, convergent, and criterion validity.

Results

PLS-SEM results substantiated the original three factor structure of the questionnaire which is dyadic, triadic, and self-regulation. For all sub-scales, internal consistency- measured by Cronbach’s alpha and composite reliability, convergent validity- measured by factor loading and AVE, and discriminant validity- measured by cross-loading, Fornell-Larcker, and HTMT metrics- confirmed the construct reliability and validity of the questionnaire. A positive correlation was, also, fund between teaching motivation and experience with the physician teaching self-efficacy questionnaire scales, proving the criterion validity of the questionnaire.

Conclusion

The Persian version of physician teaching self-efficacy questionnaire is a valid, highly reliable, and multidimensional tool to measure physicians’ clinical teaching self-efficacy working in medical universities.
A cost-effectiveness analysis of surgical care delivery in Eastern Uganda-a societal perspective
Authors: Nwanna–Nzewunwa Obieze , Agwang Esther , Carvalho Melissa , Ajiko Mary-Margaret , Oke Rasheedat , Yoon Christopher , Diab Mohamed M , Kirya Fred , Marseille Elliot , Juillard Catherine , Dicker Rochelle A.
Published: March 2023

Background

The mismatch between the global burden of surgical disease and global health funding for surgical illness exacerbates disparities in surgical care access worldwide. Amidst competing priorities, governments need to rationally allocate scarce resources to address local needs. To build an investment case for surgery, economic data on surgical care delivery is needed. This study focuses on femur fractures.

Methods

This prospective cohort study at Soroti Regional Referral Hospital (SRRH), captured demographic, clinical, and cost data from all surgical inpatients and their caregivers at SRRH from February 2018 through July 2019. We performed descriptive and inferential analyses. We estimated the cost effectiveness of intramedullary nailing relative to traction for femur fractures by using primary data and making extrapolations using regional data.

Results

Among the 546 patients, 111 (20.3%) had femur fractures and their median [IQR] length of hospitalization was 27 days [14, 36 days]. The total societal cost and Quality Adjusted Life Year (QALY) gained was USD 61,748.10 and 78.81 for femur traction and USD 23,809 and 85.47 for intramedullary nailing. Intramedullary nailing was dominant over traction of femur fractures with an Incremental Cost Effectiveness Ratio of USD 5,681.75 per QALY gained.

Conclusion

Femur fractures are the most prevalent and most expensive surgical condition at SRRH. Relative to intramedullary nailing, the use of femur traction at SRRH is not cost effective. There is a need to explore and adopt more cost-effective approaches like internal fixation.
Differences in characteristics and infection severity between odontogenic and other bacterial oro-naso-pharyngeal infections
Authors: Vilén Suvi-Tuuli , Ahde Hanna , Puolakka Tuukka , Mäkitie Antti , Uittamo Johanna , Snäll Johanna
Published: March 2023

Background

Different bacterial infections of the oro-naso-pharyngeal (ONP) region may progress and require hospital care. The present study clarified differences in infection characteristics between hospitalized patients with odontogenic infections (OIs) and other bacterial ONP infections. The specific aim was to evaluate clinical infection variables and infection severity according to infection aetiology, particularly regarding features of OIs compared with other ONPs.

Methods

Records of patients aged ≥16 years requiring hospital care for an acute bacterial ONP infection in the emergency units of Otorhinolaryngology or Oral and Maxillofacial Surgery at the Helsinki University Hospital (Helsinki, Finland) during 2019 were evaluated retrospectively. The main outcome variables were need for intensive care unit (ICU) treatment and length of hospital stay. The primary predictor variable was infection category, defined as OI or other ONP. The secondary predictor variable was specific ONP infection group. Additional predictor variables were primary clinical infection signs, infection parameters at hospital admission, and delay from beginning of symptoms to hospitalization. Explanatory variables were sex, age, current smoking, heavy alcohol use or substance abuse, and immunosuppressive disease, immunosuppressive medication, or both. Comparison of study groups was performed using Fisher’s exact test, student’s t-test, and Mann-Whitney U.

Results

A total of 415 patients with bacterial ONPs fulfilled the inclusion criteria. The most common infections were oropharyngeal (including peritonsillar, tonsillar, and parapharyngeal infections; 51%) followed by infections from the odontogenic origin (24%). Clinical features of OIs differed from other ONPs. Restricted mouth opening, skin redness, or facial or neck swelling (or both) were found significantly more often in OIs (p < 0.001). OIs required ICU care significantly more often than other ONPs (p < 0.001) and their hospital stay was longer (p = 0.017).

Conclusions

Infections originating from the tonsillary and dental origin had the greatest need for hospitalization. Clinical features of OIs differed; the need for ICU treatment was more common and hospital stay was longer compared with other ONPs. Preventive care should be emphasized regarding OIs, and typical infection characteristics of ONP infection subgroups should be highlighted to achieve early and prompt diagnosis and treatment and to reduce hospitalization time.
The interplay between malaria vectors and human activity accounts for high residual malaria transmission in a Burkina Faso village with universal ITN coverage
Authors: Perugini Eleonora , Guelbeogo Wamdaogo M. , Guglielmo Federica , Poggi Cristiana , Gabrieli Eugenio , Ranson Hilary , della Torre Alessandra , Pombi Marco
Published: March 2023

Background

Mosquito and human behaviour interaction is a key determinant of the maximum level of protection against malaria that can be provided by insecticide-treated nets (ITNs). Nevertheless, scant literature focuses on this interaction, overlooking a fundamental factor for efficient malaria control. This study aims to estimate malaria transmission risk in a Burkina Faso village by integrating vector biting rhythms with some key information about human habits.

Methods

Indoor/outdoor human landing catches were conducted for 16 h (16:00–08:00) during 8 nights (September 2020) in Goden village. A survey about net usage and sleeping patterns was submitted to half the households (October–December 2020). A subsample of collected specimens of Anopheles gambiae sensu lato was molecularly processed for species identification, Plasmodium detection from heads-thoraxes and L1014F pyrethroid-resistance allele genotyping. Hourly mosquito abundance was statistically assessed by GLM/GAM, and the entomological inoculation rate (EIR) was corrected for the actual ITN usage retrieved from the questionnaire.

Results

Malaria transmission was mainly driven by Anopheles coluzzii (68.7%) followed by A. arabiensis (26.2%). The overall sporozoite rate was 2% with L1014F estimated frequency of 0.68 (N = 1070 out of 15,201 A. gambiae s.l. collected). No major shift in mosquito biting rhythms in response to ITN or differences between indoor and outdoor catches were detected. Impressive high biting pressure (mean 30.3 mosquitoes/person/hour) was exerted from 20:00 to 06:00 with a peak at 4:00. Human survey revealed that nearly all inhabitants were awake before 20:00 and after 7:00 and at least 8.7% had no access to bednets. Adjusting for anthropological data, the EIR dropped from 6.7 to 1.2 infective bites/person/16 h. In a scenario of full net coverage and accounting only for the human sleeping patterns, the daily malaria transmission risk not targetable by ITNs was 0.69 infective bites.

Conclusions

The high mosquito densities and interplay between human/vector activities means that an estimated 10% of residual malaria transmission cannot be prevented by ITNs in the village. Locally tailored studies, like the current one, are essential to explore the heterogeneity of human exposure to infective bites and, consequently, to instruct the adoption of new vector control tools strengthening individual and community protection.

Graphical Abstract
Epidemiological Features and Outcomes of HTLV-1 Carriers Diagnosed With Cancer: A Retrospective Cohort Study in an Endemic Country
Authors: Valcarcel Bryan , Enriquez-Vera Daniel , De-la-Cruz-Ku Gabriel , Chambergo-Michilot Diego , Calderón-Huaycochea Hafid , Malpica Luis
Published: March 2023

PURPOSE

Human T-lymphotropic virus type 1 (HTLV-1) is an endemic virus in Latin America that is directly linked to adult T-cell leukemia/lymphoma (ATL). Previous studies have suggested an oncogenic role of HTLV-1 in non-ATL neoplasms and have found higher mortality in HTLV-1 carriers without ATL.

METHODS

In this retrospective cohort study, HTLV-1 carriers were identified through screening at a tertiary cancer center between 2006 and 2019. We compared the overall survival (OS) outcomes of patients with ATL with those with other solid or hematologic malignancies by sex stratification.

RESULTS

We identified 1,934 HTLV-1 carriers diagnosed with cancer. The median age at diagnosis was 62 (range 20-114) years, 76% were female, 60% had no or elementary school education, and 50% were born in the Andean highlands. The most common non-ATL neoplasm was cervical cancer (50%) among females and non-ATL non-Hodgkin lymphoma (26%) among males. With a median follow-up of 66 months, the 5-year OS of HTLV-1 carriers with non-ATL neoplasms (26%-47% for females and 22%-34% for males) was inferior to those reported in the general population. As expected, patients with ATL had a worse prognosis (5-year OS: 10% for females and 8% for males).

CONCLUSION

HTLV-1 carriers with cancer were middle age and from underprivileged settings, suggesting an undetected transmission among vulnerable populations, especially females. Survival estimates of HTLV-1 carriers with non-ATL neoplasms were lower than the regional outcomes. Future research should ascertain how the biology of HTLV-1 and health care disparities affect the outcomes of HTLV-1 carriers, as well as determine the burden of HTLV-1 infection in the cancer population to recommend screening in the outpatient setting of endemic regions.
Structures All the Way Down: Literary Methods and the Detail
Authors: Levine Caroline
Published: March 2023

This essay makes the case that most methods in literary studies explicitly privilege the detail but covertly depend on structures. The article turns to structuralism, specifically to the debate between Vladimir Propp and Claude Lévi-Strauss about the role of the detail, for a method that keeps structures in view, even while focusing on details. Suggesting that structuralist methods could usefully reshape the teaching of literature now, the essay reads two novels that both depend on and depart from traditional fairy-tale patterns: Jane Yolen’s Briar Rose (1992) and Helen Oyeyemi’s Boy, Snow, Bird (2014).
The Detail of Place and the Place of Detail
Authors: Wong Shirley Lau
Published: March 2023

Literary settings are often celebrated for richly representing the many details of a particular place. The close association between detail and setting stems from the realist presumption that detail constitutes what Roland Barthes calls an “index of . . . atmosphere”: the accumulation of details provides an authentic sense of place. But the detail’s usual role in constructing immersive worlds seems antithetical to the project of the so-called global novel, which has often been characterized by placelessness and by cosmopolitan, jet-setting characters. This essay examines the relationship between place, detail, and narrative in Teju Cole’s Open City (2011), which has often been praised for its intimate portrayal of New York. With Open City Cole offers a metanarrative commentary on the detail’s function in previous literary periods and modes, from the nineteenth-century novel’s harnessing of detail to create plush, seemingly real worlds to modernist and postmodern fiction’s interrogation of the detail’s supposed referentiality. Engaging with the detail’s many legacies, Cole underscores the latent violence of detail in the global novel, namely, its capacity to draw something into the foreground or make it recede into the background.
Η σημασία της ηλεκτροφυσιολογικής διερεύνησης στην αξιολόγηση ασθενών με συγκοπή ή προσυγκοπή αγνώστου αιτιολογίας
Authors: Δουνδουλάκης Ιωάννης
Published: March 2023

Εισαγωγή: Προηγούμενες μελέτες έχουν αναδείξει το σημαντικό κόστος για τηδιαγνωστική προσέγγιση των ασθενών με συγκοπή και έχουν προτείνει την υιοθέτησημιας πιο συστηματικής οδού φροντίδας των ασθενών αυτών. Σκοπός: Ο σκοπός αυτής της μελέτης κοόρτης ανάπτυξης και κοόρτης επικύρωσηςήταν να αναπτύξει μια δομημένη προσέγγιση, για ασθενείς με ανεξήγητη συγκοπή, ηοποία θα χρησιμοποιηθεί ως αρχικό ημερήσιο εργαλείο για τον εντοπισμό μιαςυποομάδας ασθενών που θα ωφεληθούν από τη μόνιμη εμφύτευση βηματοδότη ή/καιαπινιδωτή. Μέθοδοι: Χρησιμοποιήσαμε δύο ανεξάρτητες κοόρτες: μία (ανάπτυξης) με 665ασθενείς για να αναπτύξουμε τη διαγνωστική μας προσέγγιση και μια άλλη(επικύρωσης) βασισμένη σε 160 ασθενείς με ανεξήγητη συγκοπή. Εφαρμόστηκε έναςαλγόριθμος δύο βημάτων. Όταν επιτεύχθηκε η διάγνωση από τον ηλεκτροφυσιολογικόέλεγχο, προσφέρθηκε στον ασθενή η εμφύτευση μόνιμου βηματοδότη ή/και απινιδωτή.Το πρωτογενές καταληκτικό σημείο της μελέτης ήταν ο χρόνος μέχρι την υποτροπήςτης συγκοπής. Αποτελέσματα: Υπολογίστηκε ο αριθμός που απαιτείται για θεραπεία (NNT) για τουςασθενείς με θετική διαγνωστική προσέγγιση. Ο αριθμός των ασθενών με ανεξήγητησυγκοπή και οριακή φλεβοκομβική βραδυκαρδία που χρειαζόταν για θεραπεία ήταν 5(ΝΝΤ=5) και ο αριθμός των ασθενών με ανεξήγητη συγκοπή και αποκλεισμό σκέλουςπου χρειαζόταν για θεραπεία ήταν 3 (ΝΝΤ=3) σε μια μέση παρακολούθηση περίπου 4ετών. Μετά τη δομημένη προσέγγιση, εμφανίστηκε το πρωτογενές καταληκτικό σημείο(συγκοπή) (μέση παρακολούθηση περίπου 2,5 ετών) σε 14 από τους 82 (17,1%) μεβηματοδότη ή/και απινιδωτή και σε 19 από τους 57 (33%) με αρνητική διαγνωστικήπροσέγγιση. Συμπέρασμα: Το χαμηλό NNT στην κοόρτη ανάπτυξης και το χαμηλό ποσοστόυποτροπής της συγκοπής στην κοόρτη επικύρωσης υποδεικνύουν τον προτεινόμενοαλγόριθμο ως ένα χαμηλού κόστους, μιας ημέρας, δομημένο εργαλείοδιαστρωμάτωσης για αυτούς τους ασθενείς.
Μουσειολογική θεωρία και ιδεολογική της χρήση σε αφηγήματα μουσείων
Authors: Νίτσιου Παρασκευή
Published: March 2023

Η διατριβή εμπίπτει στον τομέα της πολιτιστικής διαχείρισης. Κινείται μεταξύ μιας ελλείπουσας μουσειολογικής θεωρίας σε θέματα διαχείρισης πολιτισμού και μιας πλεονάζουσας μουσειακής πρακτικής. Ερευνητικό αντικείμενο της διατριβής αποτελεί η δόμηση ενός μουσειολογικού θεωρητικού προβληματισμού και την εφαρμογή του ολιστικά στον θεσμό του μουσείου, από τον σχεδιασμό του μουσειολογικού αφηγήματος μέχρι την οργάνωση και τη διοίκηση του οργανισμού. Η θεωρία αυτή αφορά τόσο τον κοινωνικό ρόλο των μουσείων και τη θεσμική πολιτική τους υπόσταση, όσο και τον μουσειολογικό λόγο που διατυπώνεται, μέσω των δράσεων, και κυρίως των εκθεσιακών, και του μουσειολογικού-νοηματικού σχεδιασμού, καθώς και τη συμμετοχή τους σε και την αφόρμησή τους από κοσμοαντιληπτικά περιβάλλοντα, ιδεολογικές στάσεις και θεωρητικές προσεγγίσεις. Επιπλέον, στο πλαίσιο της διατριβής αναπτύσσεται ένα μοντέλο μεθόδου για τη διαδικασία μουσειολογικού-νοηματικού προγραμματισμού και σχεδιασμού. Με δεδομένο ότι το μουσειολογικό αφήγημα συγκροτείται από τις ομάδες των αντικειμένων και τις μεταξύ τους σχέσεις, το συνοδευτικό ερμηνευτικό υλικό, τα κείμενα και βέβαια τον αρχιτεκτονικό μουσειολογικό λόγο, δηλαδή το μουσειολογικό-νοηματικό πλαίσιο και το μουσειολογικό-αρχιτεκτονικό περιβάλλον, το μοντέλο διερευνά τρία παραδείγματα εκθέσεων σε μουσεία, όπου μπορούν να εντοπιστούν οι θεωρητικές ερμηνευτικές προσεγγίσεις που χρησιμοποιήθηκαν και να ανιχνευθούν, κατά το δυνατόν, τα ιδεολογικά προστάγματα των συντελεστών της έκθεσης, (επιμελητές, μουσειολόγοι, αρχιτέκτονες-μουσειολόγοι, κύριος του έργου, μουσειοπαιδαγωγοί, κ.ά.) στην ερμηνεία του υλικού πολιτισμού. Για το μοντέλο αυτό χρησιμοποιήθηκαν ως πεδίο εφαρμογής τρία παραδείγματα μουσειακών εκθέσεων με απολύτως διαφορετικό περιεχόμενο: Το Λαογραφικό Μουσείο Βελβεντού, το Μουσείο της Ιεράς Μητροπόλεως Θεσσαλονίκης και το Μουσείο Οίνου Γεροβασιλείου. Η εκτεταμένη και αναλυτική ανάπτυξη αυτού του μοντέλου, στοχεύει στην κάλυψη ενός σοβαρού κενού που υπάρχει στο πεδίο της εφαρμοσμένης μουσειολογίας, όχι μόνο στην Ελλάδα αλλά και διεθνώς.
Impact of dietary components and reactive oxygen species (ROS) in the colon and its microbiota in a low-grade inflammation mouse model
Authors: Παπουτσής Δημήτριος
Published: March 2023

Διάφοροι παράγοντες, συμπεριλαμβανομένων των διαιτητικών συστατικών, της μικροχλωρίδας του εντέρου και τις ανταποκρίσεις του ξενιστή, διαδραματίζουν επιτακτικό ρόλο για την υγεία του εντέρου. Οι αλληλεπιδράσεις μεταξύ της διατροφής, της μικροχλωρίδας του παχέος εντέρου και του ξενιστής προτείνεται να είναι σημαντικοί για την αποφυγή ανισορροπίας μικροβιακών οικοσυστημάτων του εντέρου και πρόκλησης φλεγμονής χαμηλού βαθμού. Τα συστατικά των φυτικών ινών, ειδικότερα, έχουν τονιστεί για τα θετικά αποτελέσματά τους στη μικροχλωρίδα και την προστασία του εντέρου από φλεγμονή. Επιπλέον, αν και δίαιτες υψηλής περιεκτικότητας σε λιπαρά, βασισμένες κυρίως σε ζωικό λίπος, έχουν συσχετιστεί με φλεγμονή του εντέρου δεν είναι σαφές σε ποιο βαθμό επηρεάζουν οι διαφορετικές πηγές λίπους και οι τρόποι πρόσληψης λίπους στην διαδικασία πρόκλησης φλεγμονής στο έντερο.Ο γενικός στόχος της παρούσας διατριβής ήταν να διερευνήσει τη διαφορετική επίδραση κλασμάτων από φυτικές ίνες καιπρωτεΐνες από φασόλια καθώς και διαφορετικούς τύπους λίπους στη σύνθεση της μικροχλωρίδας καιστην υγεία του παχέος εντέρου σε ποντίκια με ή χωρίς χαμηλής βαθμού φλεγμονής στο έντερο. Ένας άλλος στόχος ήταν νανα αξιολογήσει το ρόλο των ελευθέρων ριζών στην χαμηλού βαθμού φλεγμονή και την διαμόρφωση της μικροβιακής κοινότητας στο παχύ έντερο.
Paleochristian and byzantine monuments of Thessaloniki, Arab Norman Palermo, and the Cathedral Churches of Cefalù and Monreale
Authors: Πλατσά Αργυρή
Published: March 2023

Η συμμετοχή των τοπικών κοινωνιών έχει γίνει μια σημαντική προσέγγιση στον τομέα της πολιτιστικής διαχείρισης. Οι ευρωπαϊκές αρχές υποστηρίζουν την ιδέα της ατομικής συμμετοχής στον τομέα της πολιτιστικής κληρονομιάς μέσω της προώθησης συμβάσεων, χάραξης πολιτικών και σχετικών δράσεων που προωθεί η Ευρωπαϊκή Επιτροπή. Σε επίπεδο διεθνών οργανισμών, η ΟΥΝΕΣΚΟ έχει ενσωματώσει και προωθεί αρχές συμμετοχικής προσέγγισης επίσης. Οι επιχειρησιακές κατευθυντήριες γραμμές για την εφαρμογή της Σύμβασης για την προστασία της Παγκόσμιας Πολιτιστικής και Φυσικής Κληρονομιάς προτείνουν την ανάδειξη και τη διαχείριση των χώρων με συμμετοχικά μέσα στα άρθρα 108 και 123 (ΟΥΝΕΣΚΟ, 2019). Ωστόσο, οι χώρες έχουν διαφορετική κατανόηση αυτών των αρχών και, κατά συνέπεια, διαφορετικό επίπεδο εφαρμογής τους στις πολιτικές διαχείρισης της πολιτιστικής κληρονομιάς . Η διατριβή αυτή διερευνά τη φύση της κοινοτικής συμμετοχής στη σύνταξη σχεδίων διαχείρισης για μνημεία παγκόσμιας κληρονομιάς στη Νότια Ευρώπη (Ιταλία και Ελλάδα) μέσω των περιπτωσιολογικών μελετών του Αραβο-Νορμανδικού Παλέρμο και των καθεδρικών ναών της Τσεφαλού και του Μονρεάλε και των Παλαιοχριστιανικών και Βυζαντινών Μνημείων της Θεσσαλονίκης. Πιο συγκεκριμένα, το επίπεδο συμμετοχής της τοπικής κοινότητας στο διαχειριστικό σχέδιο του Αραβο-Νορμανδικού Παλέρμο και των Καθεδρικών Ναών της Τσεφαλού και Μονρεάλε , το οποίο έχει χαρακτηριστεί «συμμετοχικό», αποκαλύπτεται μέσω ανάλυσης επίσημων εγγράφων και συνεντεύξεων με τους πρωταγωνιστές της σύνθεσης του διαχειριστικού σχεδίου . Οι ίδιες μέθοδοι ακολουθούνται και για την ελληνική περίπτωση όπου η διαδικασία εισαγωγής σχεδίων διαχείρισης για όλα τα ελληνικά μνημεία παγκόσμιας πολιτιστικής κληρονομιάς βρίσκεται σε εξέλιξη. Η θέση που καταλαμβάνει η συμμετοχή τοπικών κοινωνιών στο νομοθετικό πλαίσιο των δύο χωρών αποκαλύπτεται και καταγράφονται οι διαφορές και διαφοροποιήσεις μεταξύ των δύο χωρών. Τι συμβαίνει στην πράξη αναλύεται μέσω των δύο περιπτωσιολογικών μελετών. Οι προτεραιότητες και ο τρόπος λειτουργίας για κάθε περίπτωση έρχεται στην επιφάνεια και συγκρίνεται μέσω των επίσημων εγγράφων, των διαχειριστικών σχεδίων και συνεντεύξεων. Η συμμετοχή των τοπικών κοινωνιών και η πτυχή της «ζωντανής κληρονομιάς» των μνημείων δεν αποτελούν κορυφαία προτεραιότητα στην ατζέντα των διαχειριστικών σχεδίων. Μια ανισορροπία δύναμης μεταξύ θεσμικών οργάνων και τοπικών κοινοτήτων επιβεβαιώνει τις περιορισμένες ευκαιρίες συμμετοχής.