bluuebunny/crossref_metadata_2025 huggingface dataset:
ANÁLISE DAS CARACTERÍSTICAS E DESAFIOS DO DOCENTE-GESTOR EM UMA IFES: UM ESTUDO NA UFERSA
Authors: Pascoal de Morais Jeferson , Aragonês Amaro da Silva D'hougo , Galvê Araújo Silva Napiê
Published: October 2022

Objetivo: O objetivo deste artigo é analisar as competências gerenciais associadas ao papel do docente gestor nas IFES, em especial na Universidade Federal Rural do Semiárido (UFERSA).
Método / abordagem: Foi utilizada uma abordagem qualitativa e exploratória. Foram realizadas entrevistas com docentes-gestores, utilizando um roteiro semiestruturado. A análise de dados se deu pelo uso da técnica de análise de conteúdo e o software Atlas TI.
Principais resultados: Os resultados demonstram que os docentes da UFERSA assumem os cargos de gestão sem receber treinamento prévio. A busca por treinamento é suscitada mais por necessidade pessoal do que incentivo formal ou institucional. Identificou-se que, por vezes, o docente tem de preterir tarefas cotidianas e focar nas atribuições de gestor. Constatou-se que docentes-gestores desempenham o papel de forma empírica, por meio de interação com outros grupos e adaptação de experiências prévias.
Contribuições metodológicas / sociais / gerenciais: Foi constatado que os docentes-gestores desconhecem normativas que delineiem sua atuação dentro das Instituições de Ensino Superior. Nesse contexto, destacaram a importância em desenvolver competências interpessoais como forma de compensar tal carência. Desse modo, a interação com grupos sociais foi considerada como essencial para a gestão de qualidade.
 Originalidade / relevância: O artigo contribui com a discussão sobre o papel do docente-gestor ao caracterizar o papel do docente-gestor na UFERSA e quais as principais dificuldades encontradas pelos docentes que exercem o papel de gestor.
Analysis of Facility Condition Assessment Practice: Facility Managers Hiring Preferences of AEC Service Providers
Authors: Hillestad Derek , Sullivan Kenneth , Hurtado Kristen
Published: October 2022

Facility Condition Assessments (FCA's) in the facility management (FM) profession is a growing area of research. However, the study of who is providing FCA services in the facility management profession has largely not been explored. Thus, this research aims to identify a current state of academic research and industry standards on FCA service providers and AEC stakeholders, which AEC service providers conduct FCA's and how FCA service providers are selected. A study consisting of 303 decision makers in the facility management profession identified which Architects, Engineers and Construction (AEC) service providers are conducting FCA's, hiring preferences of FCA service providers, how FCA projects are procured and awarded and limiting factors to conduct an FCA with in-house personnel. The results of the study identify an industry trend to outsource FCA services to a multi-disciplinary team of AEC professionals, with experience conducting FCA's as a primary hiring preference. Globally, this is the first study of its kind to identify who FM's are hiring to provide condition assessments in facilities or buildings. This research contributes to the body of knowledge by taking the first step towards providing owners and or operators considerations regarding varying service providers when deciding to pursue an FCA project. Further, the apparent lack of asset organization methods, standards and guidelines used in the practice of FCA's in the FM profession presents an opportunity for future research efforts.
Systemic Sclerosis Sine Scleroderma as a Rare Etiology of Chronic Intestinal Pseudo-Obstruction
Authors: Edwards Mitchell , Ray Jennifer , Al-Taee Ahmad , Marsicano Elizabeth
Published: October 2022

Chronic intestinal pseudo-obstruction (CIPO) is a disruption of the enteric nervous system characterized by chronic intestinal dysmotility and dilation. It has many underlying causes. We present a 52-year-old woman with 53 kg unintentional weight loss, abdominal pain, and vomiting. She had dilated small bowel loops with air fluid levels and no transition point on CT. Esophagogastroduodenoscopy (EGD) revealed aperistalsis and undigested duodenal food. The secondary cause was found to be Undifferentiated Connective Tissue Disorder (UCTD), a rheumatologic disorder that does not meet criteria for any single disease. This is the first reported case of UCTD being presented by CIPO.
Pasteurella multocida Intramuscular Chest Abscess in a Healthy Man
Authors: Beliavsky Alina , Krajden Sigmund , Chae Anita , Newton Barbara , Sue-A-Quan Greg
Published: October 2022

Pasteurella multocida (P. multocida) is the most commonly isolated pathogen in human cat bite wounds. We describe the case of a healthy 56-year-old man who presented with constitutional symptoms and a swollen right arm. He was found to have multi-focal abscesses secondary to P. multocida, with the portal of entry likely being a small wound on his right hand.P. multocida is thought to cause disease in humans either through direct inoculation or colonization of the human nasopharynx and subsequent reactivation during an immunocompromised state. Our case describes a rare presentation of invasive P. multocida infection in an immunocompetent host, occurring through either hematogenous or lymphatic spread.
RésuméPasteurella multocida (P. multocida) est l’agent pathogène isolé le plus souvent dans les blessures par morsure de chat. Nous décrivons le cas d’un homme de 56 ans en bonne santé présentant des signes généraux et un œdème du bras droit. Il s’est avéré qu’il présentait des abcès multifocaux secondaires à P. multocida, le point de pénétration de la bactérie étant probablement une petite blessure sur sa main droite.P. multocida provoquerait la maladie chez l’humain soit par inoculation directe ou par colonisation du nasopharynx et une réactivation ultérieure au cours d’une immunosuppression. Notre cas décrit une présentation rare d’infection invasive à P. multocida chez un hôte immunocompétent, survenant par l’intermédiaire d’une dissémination par voie hématogène ou lymphatique.
First Case of COVID-19 N501Y Variant of Concern Infection in a Patient with Chronic HIV Infection
Authors: Ye Wen Qing , Britto Joanne , Neary John , Crowther Mark
Published: October 2022

COVID-19 pneumonia continues to have high global prevalence, mortality, and morbidity with the emergence of new variants of concerns due to vaccination inequality. There continues to be limited data on the outcomes of HIV-infected patients with COVID-19. In this report, we present the case of a 62-year old male with chronic HIV who presented with unexplained fever and initial negative COVID-19 PCR, and no radiographic evidence of COVID-19 on chest x-ray or CT Chest. Due to the increased prevalence of COVID-19 and the emergence of variants of concern, diagnostic testing for COVID-19 should be repeated in patients who are persistently febrile despite previous negative swabs and lack of exposure. Patients with immunocompromised states, such as HIV infection, may have atypical clinical presentations, time to PCR positivity, or imaging findings of COVID-19. A thorough investigation for other causes of unexplained fever should also be conducted despite the community prevalence of COVID-19.
ResumeLa pneumonie COVID-19 continue d’avoir une prévalence, une mortalité et une morbidité élevées dans le monde, avec l’émergence de nouvelles variantes préoccupantes en raison de l’inégalité de la vaccination. Il existe toujours peu de données sur les résultats des patients infectés par le VIH atteints de COVID-19. Dans ce rapport, nous présentons le cas d’un homme de 62 ans atteint du VIH chronique qui s’est présenté avec une fièvre inexpliquée et une PCR initiale négative pour le COVID-19, et aucune preuve radiographique du COVID-19 sur la radiographie du thorax ou le CT Chest. En raison de l’augmentation de la prévalence du COVID-19 et de l’émergence de variantes préoccupantes, le test de diagnostic du COVID-19 doit être répété chez les patients qui sont constamment fébriles malgré des écouvillons négatifs antérieurs et l’absence d’exposition. Les patients immunodéprimés, tels que les personnes infectées par le VIH, peuvent avoir des présentations cliniques atypiques, un délai de positivité de la PCR ou des résultats d’imagerie du COVID-19. Une recherche approfondie d’autres causes de fièvre inexpliquée doit également être menée malgré la prévalence communautaire du COVID-19.
Membranous Obstruction of the Inferior Vena Cava Associated with Antiphospholipid Syndrome Presenting with Bilateral Lower Limb Edema
Authors: Allard-Chamard Hugues , Lefebvre Marco , Benko Andrew , Chamberland Martine
Published: October 2022

AbstractMembranous obstruction of the inferior vena cava (MOIVC) is an infrequent disorder characterized by an acquired intrinsic obstruction of the hepatic portion of the vena cava. Clinical presentation may vary from an asymptomatic state, to a slowly evolving course of lower extremity swelling, ascites, and progressive cirrhosis. MOIVC may rarely be caused by prothrombotic disorders. Herein, we describe a patient with lupus-erythematosus-associated antiphospholipid syndrome (APS) who presented with subacute venous claudication and bilateral lower limb edema while on oral anticoagulation. Cavography confirmed a diagnosis of MOIVC. The patient successfully underwent percutaneous balloon angioplasty for definitive management and remained symptom-free at 4-year follow-up on long-term anticoagulation therapy. To our knowledge, this is the fourth case description of MOIVC associated with APS successfully treated with balloon angioplasty, but the first with a subacute clinical presentation.RésuméL’obstruction membraneuse de la veine cave inférieure est une pathologie peu fréquente caractérisée par une obstruction intrinsèque de la portion hépatique de la veine cave. La présentation clinique varie et inclut une absence de symptômes, des signes congestifs progressifs tels que de l’œdème des membres inférieurs, de l’ascite et une cirrhose progressive. L’obstruction membraneuse peut rarement être causée par des états pro-thrombotiques. Nous rapportons le cas d’une patiente porteuse d’un syndrome des antiphospholipides associé au lupus érythémateux et qui s’est présentée avec de l’œdème subaigu et bilatéral des membres inférieurs sous anticoagulothérapie orale. La cavographie a confirmé le diagnostic d’obstruction membraneuse de la veine cave. La patiente a bénéficié avec succès d’un traitement d’angioplastie par ballon et elle demeure asymptomatique sous anticoagulants après 4 ans de suivi. A notre connaissance, ce cas représente la 4ième description d’obstruction membraneuse de la veine cave associée au syndrome des antiphospholipides et traitée par angioplastie, mais la première avec une présentation clinique subaiguë.
The Cost-Effectiveness of Mammography-Based Breast Cancer Screening in Canada
Authors: Tahir Talha , Wong Melanie , Tahir Rabia , Wong Michael
Published: October 2022

Background: The current literature on female breast cancer screening is largely focused on the health out-comes that result from screening. There is comparatively little data on the cost-effectiveness of the screening.
Methods: This systematic review sought to identify all studies published within the last 10 years that analyzed the cost-effectiveness of mammography-based female breast cancer screening policies in Canada.
Results: Seven studies were included, and four were applicable to the average-risk Canadian women. Triennial screening for average-risk women aged 50–69 years was the most cost-effective in terms of cost per QALY. The use of MRI with mammography for women with the BRCA1/2 mutation was cost-effective, while annual mammography-based screening for women with dense breasts was cost-ineffective.
Conclusion: Analyses of the cost-effectiveness of mammography-based screening within Canadian populations are few in numbers and have heterogeneous methodologies. The existing data suggest that Canada’s current screening policy to screen average-risk women aged 50–74 years, biennially or triennially is cost-effective.
RésuméContexte : La documentation actuelle sur le dépistage du cancer du sein chez la femme est principalement axée sur les résultats cliniques qui découlent du dépistage. Il existe relativement peu de données sur le rapport coût/efficacité du dépistage.
Méthodologie  : Cette revue systématique a tenté de repérer toutes les études publiées au cours des dix dernières années qui ont analysé la rentabilité des politiques de dépistage du cancer du sein par mammogra-phie chez la femme au Canada.
Résultats : Sept études ont été retenues, et quatre d’entre elles s’appliquent aux femmes canadiennes à risque moyen. Le dépistage triennal chez les femmes à risque moyen âgées de 50 à 69 ans est le plus rentable en ce qui concerne le coût par AVAQ. L’utilisation de l’IRM couplée à la mammographie chez les femmes présentant la mutation BRCA1/2 est rentable, tandis que le dépistage annuel par mammographie chez les femmes aux seins denses ne l’est pas.
Conclusion : Les analyses du rapport coût/efficacité du dépistage par mammographie au sein des populations canadiennes sont peu nombreuses et leurs méthodologies sont hétérogènes. D’après les données existantes, la politique actuelle du Canada en matière de dépistage, qui consiste à faire subir une mammographie de dépi-stage aux femmes à risque moyen âgées de 50 à 74 ans tous les deux ou trois ans, est rentable.
Maternal Metastatic Synovial Sarcoma in Pregnancy
Authors: Okonkwo Maureen , Wallace Alison , Colwell Bruce , McCoy Kyle , Shetty Nabha , Miller Ashley , Nash Christopher
Published: October 2022

Pregnancy with known metastatic cancer is rare. A case of a woman with known metastatic synovial sarcoma in pregnancy is presented in the study. Her disease progressed with an enlarging and new pulmonary metastasis requiring bilateral pulmonary metastasectomies, both during pregnancy and after delivery. Her pregnancy was uncomplicated otherwise, and she had a successful at term vaginal delivery of a healthy female baby. During her second pregnancy, her disease aggressively recurred at eight weeks gestation without therapeutic options. Thus, palliative care was initiated and she died shortly thereafter. The implications of sarcoma growth and the potential thromboembolic risk with active malignancy in pregnancy is discussed in the study.
RésuméLa grossesse accompagnée d’un cancer métastatique connu est rare. Cette étude présente le cas d’une femme enceinte atteinte d’un sarcome synovial métastatique connu. Sa maladie a progressé sous forme d’une nouvelle métastase pulmonaire en croissance nécessitant une métastasectomie pulmonaire bilatérale pratiquée pendant la grossesse et après l’accouchement. Sa grossesse s’est déroulée sans autre complication et elle a accouché à terme par voie vaginale d’une fille en bonne santé. Au cours de sa deuxième grossesse, son cancer a récidivé de manière agressive à huit semaines de grossesse sans qu’aucune option thérapeutique ne soit possible. Par conséquent, des soins palliatifs ont été mis en place et elle est décédée peu de temps après. Cette étude exam-ine les conséquences de la croissance du sarcome et le risque thromboembolique potentiel lié aux tumeurs malignes actives durant la grossesse.
Implementation of a Structured Morbidity and Mortality Rounds on an Internal Medicine Clinical Teaching Unit
Authors: Schwartzentruber Ben , Tam Penny , Chiu Allison
Published: October 2022

Morbidity and mortality rounds (MMRs) are widely used in a variety of medical settings; however, their implementation and quality are highly variable. In this quality improvement project, we implemented the Ottawa Morbidity and Mortality Model (OM3) at a quaternary teaching hospital inpatient internal medicine clinical teaching unit (CTU). We assessed adherence to the model using a locally developed scale and surveyed participants regarding acceptability of the change. We used several measures to improve adherence, including regular involvement of allied health professionals, screening of cases for appropriateness, providing a template to the residents who prepare cases for presentation, and limiting the number of presentations at each session. Adherence to OM3 improved over time and was consistently high by the end of our data-collecting period. The intervention was also widely accepted by participants, and rounds were found to be valuable to participants. Implementing a validated, structured format, such as OM3, can improve the quality of MMRs while being accepted by participants in an internal medicine teaching hospital.
RésuméLes revues de morbidité et mortalité (RMM) sont largement utilisées dans divers contextes médicaux, mais leur mise en œuvre et leur qualité varient considérablement. Dans ce projet d’amélioration de la qualité, nous avons implanté l’Ottawa Morbidity and Mortality Model (OM3) dans une unité d’enseignement clinique (UEC) de médecine interne en milieu hospitalier universitaire de soins quaternaires. Nous avons évalué l’adhésion au modèle à l’aide d’une échelle conçue localement et interrogé les participants sur l’acceptabilité de ce changement. Nous avons utilisé plusieurs mesures pour améliorer l’adhésion, notamment la participation régulière de professionnels paramédicaux, la vérification de la pertinence des cas, la fourniture d’un modèle aux résidents qui préparent les cas à présenter et la limitation du nombre de présentations de cas à chaque séance. L’adhésion à l’OM3 augmente au fil du temps et est toujours élevée à la fin de notre période de collecte des données. Cette intervention est aussi largement acceptée par les participants, et les revues se sont révélées précieuses pour les participants. La mise en œuvre d’un format structuré et validé comme l’OM3 peut améliorer la qualité des RMM tout en étant acceptable pour les participants en médecine interne dans un hôpital universitaire.
Xanthogranulomatous Pyelonephritis Presenting as Bilateral Enlarged Kidneys
Authors: Chan Barry , Nijjar Preety
Published: October 2022

A 63-year-old male presented with acute gross hematuria, dysuria, and mild left-sided flank pain. Examination revealed asymmetrically distended flanks with two palpable masses. Investigations were notable for acute kidney injury and Proteus mirabilis bacteria in the urine.RésuméUn homme de 63 ans présente une hématurie macroscopique aiguë, une dysurie et une légère douleur au flanc gauche. L’examen physique révèle des flancs asymétriquement distendus avec deux masses palpables. Les examens ont révélé une lésion rénale aiguë et la présence de la bactérie Proteus mirabilis dans les urines.
Perioperative management of Patients with Obstructive Sleep Apnea
Authors: Mbadjeu Hondjeu Arnaud Romeo , Chung Frances , Wong Jean
Published: October 2022

Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing with up to 60% of surgical patients with moderate-to-severe OSA unrecognized at the time of preoperative assessment. OSA is a known modifier of perioperative outcomes, with an increase in difficult airway management and postoper-ative morbidity with early and late serious complications that may occasionally result in death. It is critical to identify at-risk patients during the preoperative period as it allows for risk stratification and mitigation, and postoperative monitoring. In this review, we will discuss the preoperative assessment, and intraoperative and postoperative management of patients with diagnosed or suspected OSA.
RésuméLe syndrome d'apnées obstructives du sommeil (SAOS) est la forme la plus frequente de troubles respira-toires du sommeil avec jusqu'à 60 % des patients chirurgicaux atteints de formes modérée à sévère de SAOS sans diagnostic formel ni traitement spécifique au moment de l'évaluation préopératoire. Le SAOS altère les résultats périopératoires, avec une augmentation de la gestion difficile des voies respiratoires et de la morbidité postopératoire associée à des complications critiques précoces et tardives pouvant parfois entraîner la mort. il est donc essentiel d'identifier les patients à risque pendant la période préopératoire enfin d'appliquer des procédures de modération de risque, ainsi que des précautions et une surveillance adéquates. Dans cette revue, après un aperçu de la physiopathologie du SAOS, nous discuterons de l'évaluation préopératoire, de la prise en charge intraopératoire et postopératoire des patients atteints de SAOS confirmée ou suspectée.
Correlation of Carotid Doppler Flowmetry with Fluid Responsiveness in Mechanically Ventilated Patients Undergoing Coronary Artery Bypass Grafting -- A Popular Grey Zone
Authors: Budak Ali Baran
Published: October 2022

The authors conducted a prospective, observational study to evaluate the
correlation of fluid responsiveness with commonly used carotid
doppler-derived indices like carotid artery blood flow (CBF), carotid
corrected flow time (FTc), respirophasic variation in carotid artery
blood flow peak velocity (ΔVpeak) in patients undergoing CABG. They
claimed that altough only ΔVpeak demonstrated some predictive power with
areas under receiver operating characteristic (AUROC) of 0.671, carotid
doppler ultrasound indices were found to be not dependable as a
substitute for invasive methods to assess fluid responsiveness. The
presence of studies advocating quite different sentiments in the
literature regarding feasibility and reliability show that there is a
long way gone and a long way to go.
Redo mitral surgery after coronary artery bypass grafts under hyperkalemic hypothermia using thoracotomy and axillary artery cannulation in a patient with functional bilateral internal thoracic arteries and atheromatous aorta
Authors: Suzuki Ryo , Akita Masafumi , Itohara Takaki , Komatsu Takuya
Published: October 2022

We report a case of redo mitral and tricuspid valve repair via right
thoracotomy under hypothermia and systemic potassium administration with
axillary artery cannulation in a patient after coronary artery bypass
grafting (CABG) with patent bilateral internal thoracic artery (ITA)
grafts crossing over the sternum. Redo mitral valve surgery is
challenging through re-sternotomy as previous CABG with patent ITA poses
a risk of injury due to dense adhesion. Herein, dangerous dissection
around the aorta and functional ITA grafts was avoided by performing the
procedure under systemic hypothermia via thoracotomy. Furthermore,
considering the presence of atheroma in the aorta, the axillary artery
was used as a perfusion route to prevent stroke events. Performing
axillary artery cannulation and right thoracotomy under hypothermic
cardiac arrest with systemic hyperkalemia without clamping the patent
bilateral ITAs and aorta allowed us to execute redo mitral valve surgery
after CABG without major postoperative cardiac or cerebral
complications.
NEUTROPHIL TO LYMPHOCYTE RATIO PREDICTS PERMANENT PACEMAKER IMPLANTATION IN TAVR PATIENTS
Authors: Totaro Antonio , Testa Gianluca , Calafiore Antonio , Ienco Vincenzo , Sacra Vincenzo , Busti Andrea , Pierro Antonio , Sperlongano Simona , Golino Paolo , Sacra Cosimo
Published: October 2022

Introduction. In this prospective multicenter analysis, we
aimed to investigate the predictive role of neutrophil/lymphocyte ratio
(NLR) in permanent pacemaker implantation (PPI) in patients undergoing
transcatheter aortic valve replacement (TAVR). Material and
methods. 179 consecutive patients without previous PPI underwent TAVR
from February 2017 to September 2021. Patients were further divided
based on presence (n=48) and absence of conduction abnormalities (CAs)
at hospital admission (n=131). Results. In patients
with previous CAs, NLR values did not differ significantly between
patients requiring PPI (n=16, 33%) and those not requiring it. In
contrast, in patients with no CAs at hospital admission, NLR values
measured at admission and on TAVR day were significantly higher in
patients requiring PPI (n=17, 13%) (4.07±3.22 vs 3.01±1.47, p=0.025,
and 10.81±7.81 vs 5.84±3.78, p=0.000, respectively). Multivariable
analysis showed that NLR at TAVR day was an independent predictor of PPI
in patients without CAs (OR 1.294; 95% CI 1.028-1.630; p=0.028), but
not in those with previous CAs. ROC curve analysis showed that the cut
point was a NLR value of >7.25. Time to PPI was delayed
till 21 days in patients without CAs. Conclusions. In this
prospective study, higher NLR values on the day of TAVR day were
associated with an increased PPI rate in patients undergoing TAVR with
no previous CAs. It is advisable, being inflammation part of the
process, to prolong the time of observation for all patients without CAs
till at least 21 days not to miss any new CA necessitating PPI.
Compact multiband bandpass filters based on parallel coupled split structure multimode resonators
Authors: luo jie , Shi Kaibo , Gao Shanshan
Published: October 2022

In this letter, a novel sext-band bandpass filter (BPF) using two
split-type multiple-mode resonators is proposed. The filter is composed
of two sets of resonators which are respectively designed to realize
Filter 1 with two passbands and Filter 2 with quad passbands. Then the
two BPFs are combined by parallel coupling feed lines for sext-band
responses, and each of the six centre frequencies in the proposed
sext-band BPF is able to be controlled due to the design freedom. To
validate the design and analysis, a prototype filter has been fabricated
with six passbands centered at 1.88/2.59/3.48/5.26/5.82/6.75 GHz. The
measured result of the fabricated filter agrees well with the
simulation, which shows that the proposed structure is a good candidate
for sext-band BPF designs and validates the proposed design flow well.
A case of chronic ossified hematoma presented as a skull lesion: A literature review on two rare conditions, cephalhematoma, and intradiploic hematoma
Authors: Iranmehr Arad , Sarpoolaki Mohammad Kazem , Zeinalizadeh Mehdi
Published: October 2022

Ossified cephalhematoma (OCH) is a rare condition, especially when it
presents as a skull lesion in the older pediatric population, which can
managed with craniectomy and en-bloc excision of the organized hematoma.
COVID-19 Vaccine During Pregnancy and Perinatal Outcomes
Authors: Almutairi Amani , Asiri Mufareh , Alsuwaidan Salem , Sufyani Reem , AlSalem Shumukh , Alghamdi Joud
Published: October 2022

Initially, there was little data on the safety of immunization against
COVID-19 infection in pregnant women. However, previous studies revealed
no safety concerns for pregnant women or newborns who received an mRNA
COVID-19 vaccine during pregnancy. Therefore, this study aimed to
investigate the effects of COVID-19 vaccination on perinatal outcomes.
Methods: This cross-sectional study. It started from January 2022 to
June 2022. The questionnaire was developed and validated by experts.
This study included all women admitted to the postpartum ward who were
more than 18 years old and had received the COVID-19 vaccine. The study
excluded women without proof of their vaccination status or who could
not complete the questionnaire. The primary outcome was the effect of
COVID-19 vaccination on gestational age and birth weight. Results: A
total of 365 participants. The mean gestational age of the unvaccinated
women was 38.83 ± 1.62 weeks (p < 0.001), higher than that of
vaccinated women (37.69 ± 2.9 weeks). However, the average birth weight
for the unvaccinated women was 2.96 ± 0.4 kg (p = 0.89) and for
vaccinated women (2.97 ± 0.66 kg). Conclusion: COVID-19 vaccination,
regardless of the type of vaccine received before, during, or after
pregnancy, is not associated with any unfavorable perinatal outcomes.
Medication-Induced Mood Disorders Following Epidural Steroid Injections: A Case Series
Authors: Vangeison Christian , Roys Joseph , Catalanotto Marissa , Kupperman Wyatt , Kovacs Alexander , Husu Emanuel
Published: October 2022

Medication-induced mood disorders have been rarely reported following
epidural steroid injections (ESI). This case series presents three
patients who met DSM-V criteria for substance/medication-induced mood
disorder after an ESI. In considering a candidacy for ESI, the rare but
significant, side effects of psychiatric side effects should be
disclosed to patients.
Characteristics of the Phenotype of Mixed Cardiomyopathy in Patients with Implantable Cardioverter-Defibrillators
Authors: Pathak Rajeev Kumar , Raja Deep , Samarawickrema Indira , Menon Sarat Krishna , Singh Rikvin , Mehta Abhinav , Tuan Lukah , PANDURANGI ULHAS , Callans David J. , Marchlinski Francis E. , Abhayaratna Walter P. , Sanders Prashanthan
Published: October 2022

Introduction: The prognosis of mixed cardiomyopathy (CMP) in
patients with implanted cardioverter-defibrillators (ICDs) has not been
investigated. We aim to study the demographic, clinical, device
therapies and survival characteristics of mixed CMP in a cohort of
patients implanted with a defibrillator. Methods: The term
mixed CMP was used to categorise patients with impaired left ventricular
ejection fraction attributed to documented non-ischemic triggers with
concomitant moderate coronary artery disease. This is a single center
observational cohort of 526 patients with a mean follow-up 8.7±3.5
years. Results: There were 42.5% patients with ischemic
cardiomyopathy (ICM), 26.9% with non-ischemic cardiomyopathy (NICM) and
30.6% with mixed CMP. Mixed CMP, compared to NICM, was associated with
higher mean age (69.1±9.6 years), atrial fibrillation (55.3%) and
greater incidence of comorbidities. The proportion of patients with
mixed CMP receiving device shocks was 23.6% compared to 18.4% in NICM
and 27% in ICM. The VT cycle length recorded in mixed CMP (281.6 ±
43.1ms) was comparable with ICM (282.5 ± 44ms; p=0.9) and lesser than
NICM (297.7 ± 48.7ms; p=0.1). All-cause mortality in mixed CMP (21.1%)
was similar to ICM (20.1%; p=0.8) and higher than NICM (15.6%; p=0.2).
Kaplan-Meier curves revealed hazards of 1.57 (95% CI: 0.91, 2.68) for
mixed CMP compared to NICM. Conclusion: In a cohort of patients
with ICD, the group with mixed CMP represent a phenotype predominantly
comprised of elderly with higher incidence of comorbidities. Mixed CMP
resembles ICM in terms of number of device shocks and VT cycle length.
Long-term prognosis of patients with mixed CMP is worse than NICM and
similar to ICM.
Machine Learning for Prediction of Maternal Hemorrhage and Transfusion
Authors: Ahmadzia Homa , Dzienny Alexa , Bopf Mike , Federspiel Jerome , Amdur Richard , Rice Madeline , Rodriguez Laritza
Published: October 2022

Objectives: To improve PPH prediction and to compare machine learning
and traditional statistical methods. Design: Cross-sectional Setting:
Deliveries across US hospitals Population: Deliveries across 12 US
hospitals from the 2002-2008 Consortium for Safe Labor dataset Method:
We developed models using the Consortium for Safe Labor dataset. Fifty
antepartum and intrapartum characteristics and hospital characteristics
were included. Logistic regression, support vector machines, multi-layer
perceptron, random forest, and gradient boosting were used to generate
prediction models. Receiver operating characteristic area under the
curve (ROC-AUC) and precision/recall area under the curve (PR-AUC) were
used to compare performance. Main Outcome Measure: The primary outcome
was transfusion of blood products or PPH (estimated blood loss
≥1,000mL). The secondary outcome was transfusion of any blood products.
Results: Among 228,438 births, 5,760 women (3.1%) had a postpartum
hemorrhage, 5,170 women (2.8%) had a transfusion, and 10,344 women
(5.6%) met criteria for the transfusion-PPH composite. Models
predicting transfusion-PPH composite using antepartum and intrapartum
features had the best positive predictive values with the gradient
boosting machine learning model performing best overall (ROC-AUC=0.833,
95% CI [0.828-0.838]; PR-AUC=0.210 95% CI [0.201-0.220]). The
most predictive features in the gradient boosting model predicting
transfusion-PPH composite were mode of delivery, oxytocin incremental
dose for labor(mU/min), intrapartum tocolytic use, presence of
anesthesia nurse, and hospital type. Conclusion: Machine learning offers
higher discrimination than logistic regression in predicting PPH. The
CSL dataset may not be optimal for analyzing risk due to strong subgroup
effects, which decreases accuracy and limits generalizability.
Inclusion Body Myositis Triggerred with Long-term Imatinib Use
Authors: Deniz Rabia , Güzelbey Tevfik , Narinoğlu Sanem , Şirin-Kalem Gizem , Ekmen Şevket Ali , Gündoğdu-Ünverengil Gökçen , Karaali Zeynep
Published: October 2022

Inclusion body myositis (IBM) is an acquired myopathy of both
inflammatory and degenerative nature. Here we report a case of IBM
associated with prolonged use of imatinib not reported in the literature
so far. An 81 years old male with a history of gastrointestinal stromal
tumor (GIST) operated 8 years ago was evaluated for the progressive loss
of weight and muscle strength leading to total immobilization in 6
months. He was under imatinib for 8 years despite the remission of GIST.
Physical examination disclosed diffuse loss of muscle strength, most
prominently involvement of distal upper and proximal lower extremity in
an asymmetrical pattern with normal serum creatinine kinase level (CK).
Further investigations including bilateral thigh MRI, electromyography
(EMG), and PET/CT suggested myositis and degenerative myopathy and ruled
out any malignancy. Quadriceps femoris biopsy proved the diagnosis of
IBM and no trigger except for imatinib was displayed. Clinical
improvement in terms of wieght loss and muscle weakness was achieved
after discontinuation of imatinib. Since imatinib is widely used in
different conditions, it is important to be aware of even its rare
adverse effects. Poor response of IBM to conventional immunosuppressive
agents enhances the value of etiology identification to relieve symptoms
in addition to supportive care.
Discovering Interactions in Augmentation Strategies: Impact of Duloxetine on the Metabolism of Aripiprazole
Authors: Margraff Teresa , Gaebler Arnim Johannes , Neuner Irene , Haen Ekkehard , Schoretsanitis Georgios , Paulzen Michael
Published: October 2022

Objective: Although clinically widespread, scientific evidence for
augmentation strategies in the treatment of severe mental illnesses is
still limited. Combining different drugs increases the potential for
drug-drug interactions enhancing the risk of adverse drug reactions. We
aimed to unravel potential pharmacokinetic interactions between
ari-piprazole and duloxetine. Methods: Plasma concentrations of
aripiprazole from a large therapeutic drug monitoring da-tabase were
analyzed. Two groups of 78 patients each, receiving aripiprazole as a
monotherapy, or combined with duloxetine, were compared addressing a
potential impact of duloxetine on the metabolism of aripiprazole being
reflected in higher plasma concentrations of aripiprazole and higher
dose-adjusted plasma concentra-tions (C/D). Results: Patients
co-medicated with duloxetine showed significantly higher plasma
concen-trations of aripiprazole (p=0.02) than in the control group by
54.2% while the dose-adjusted plasma concentrations were 45.6% higher
in the co-medication group (p=0.001). Conclusions: Combining duloxetine
and aripiprazole leads to significantly higher drug concentra-tions of
aripiprazole, most likely via an inhibition of cytochrome P450 CYP2D6
and to a lesser extent of CYP3A4 by duloxetine. Clinicians have to
consider potentially occurring adverse drug reactions caused by
increased plasma levels of aripiprazole when adding duloxetine to a
treatment regimen with aripiprazole.
Historical development of the Regime Geometry Equations, Part-I
Authors: Rauf Ateeq ur , Khan Afed Ullah , Khan Wisal
Published: October 2022

The present study intended to review the historical development of the regime geometry equations proposed by many researchers since 1895. Kennedy started the search for the attributes of stable channels on the Upper Bari Doab Canal of Punjab in 1980-1984. The regime concept was presented by Lindley (1919) that later on Lacey (1930) modified to a set of most widely used regime relations. Later on, Blench (1941-1957), and Simons and Albertson (1960) presented their equations. This period is called ‘canal regime period’ because most of the research focused on canal design. The concept of regime was extended to river systems by Leopold and Maddock in 1953. In 1963, Henderson proposed some regime equations that can be applied for predicting canal and river geometry. This period was the transition from canal regime period to river regime period and from an empirical approach to analytical approach and is called as ‘Transitional Period’. Many other researchers written the information based on analytical approach, or a combination between analytical and empirical approaches, and more focused to river regime especially gravel bed river regime. This period is, called ‘River regime period’. Flow discharge, sediment size, and bed-load sediment are the three main factors that influence the geometry of alluvial channels. The hydraulic geometry relationships indicate that sediment size and bed-load sediment strongly influence the channel slope, moderately influence the flow velocity, and slightly influence the channel depth and the channel width. This study also shows that in terms of Shields parameter, the exponents of discharge, sediment size, and sediment transport are dependent on the relative submergence (D/d50).
An analysis into the alternative strategies of substantial energy saving for the facilities of University of Jeddah, Khulais branch
Authors: Janajrah Mamoun A
Published: October 2022

The main objective of this study is to develop strategies which aim to improve the energy saving and the sustainability at the University of Jeddah (UJ) - Khulais branch. The energy saving can be improved by reducing -indirectly- the cooling load, while the sustainability can be improved by recycling the sewage water, generating energy from the solar irradiance and improving land-use efficiency. Initially, the main reasons for increasing energy consumption in the buildings were identified. The most important reasons were large heat gain through the flat rooftops and sidewalls, infiltration and exfiltration, partial damage to the insulation materials of walls and ceilings, and thermal mass. To reduce the heat gained through buildings' rooftops, it is proposed to shade the rooftops by tilted and ventilated airgap Building Integrated Photovoltaic (BIPV). BIPV also help to improve the shading efficiency, land use efficiency, natural cooling of the rooftops and PV modules, Energy Efficiency Rating (EER) of the air-cooled ac system, and efficiency of night ventilation system. To reduce heat gained through the sidewalls, it is proposed to shade the walls by planting long-stemmed trees (Eucalyptus) around the buildings. Irrigating the trees by gray water will improve the sustainability and improve Leed Credit Point. Previous studies and current measurements of solar radiation under shaded surfaces have shown that shading the building is an appropriate strategy to reduce solar heat gain. Startup load of air conditioning system is another source of increasing energy use and it forms around 10-20% of the total cooling load due to high indoor temperature at the morning. As the buildings are not occupied after 3:00 PM, and during weekends, it is proposed to use mechanical night ventilation to reduce the indoor temperature and to improve the air quality. Connecting the ventilation system with a separate control system and the BMS at the buildings help to reach to the possible minimum indoor temperature.
Characteristics of Type 2 Diabetes in Female and Male Youth
Authors: Rodriguez Beatriz Castillo , Astudillo Marcela , Tosur Mustafa , Rafaey Ahmad , McKay Siripoom , Bacha Fida , Balasubramanyam Ashok , Redondo Maria J.
Published: October 2022

The incidence of type 2 diabetes in children is rising and carries a worse prognosis than in adults. The influence of sex on pediatric type 2 diabetes outcomes has not been well investigated. We studied 715 youth with type 2 diabetes diagnosed at a median age of 13.7 years and compared sex differences in demographic, clinical, and laboratory characteristics within the first year of diagnosis. Females diagnosed with type 2 diabetes were younger and at a higher stage of pubertal development than males, yet presented with lower A1Cs, a lower prevalence of diabetic ketoacidosis, and higher HDL cholesterol levels.
Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)
Authors: de Boer Ian H. , Khunti Kamlesh , Sadusky Tami , Tuttle Katherine R. , Neumiller Joshua J. , Rhee Connie M. , Rosas Sylvia E. , Rossing Peter , Bakris George
Published: October 2022

People with diabetes and chronic kidney disease (CKD) are at high risk for kidney failure, atherosclerotic cardiovascular disease, heart failure, and premature mortality. Recent clinical trials support new approaches to treat diabetes and CKD. The 2022 American Diabetes Association (ADA) Standards of Medical Care in Diabetes and the Kidney Disease: Improving Global Outcomes (KDIGO) 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease each provide evidence-based recommendations for management. A joint group of ADA and KDIGO representatives reviewed and developed a series of consensus statements to guide clinical care from the ADA and KDIGO guidelines. The published guidelines are aligned in the areas of CKD screening and diagnosis, glycemia monitoring, lifestyle therapies, treatment goals, and pharmacologic management. Recommendations include comprehensive care in which pharmacotherapy that is proven to improve kidney and cardiovascular outcomes is layered on a foundation of healthy lifestyle. Consensus statements provide specific guidance on use of renin-angiotensin system inhibitors, metformin, sodium–glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and a nonsteroidal mineralocorticoid receptor antagonist. These areas of consensus provide clear direction for implementation of care to improve clinical outcomes of people with diabetes and CKD.
Determination of 3D structure and molecular interaction for mir-135b and its silencer as Triple Negative Breast Cancer (TNBC) biomarkers
Authors: Valeska Margareta Deidre , Parikesit Arli Aditya
Published: October 2022

Triple Negative Breast Cancer (TNBC) is considered as the most dangerous breast cancer type in women and the most difficult to be medicated due to its unresponsive nature towards drug treatments. However, as transcriptomics studies are becoming more advanced, the research on non-coding (nc)RNAs like miRNA and siRNA is being considered as a more feasible approach to deal with TNBC. The mir-135b, a newly found miRNA that has a role in the molecular mechanism of TNBC, is studied mainly for its function as a possible biomarker and a drug candidate. The molecular interaction and structures are still unknown and determining them is the objective of this research. This research utilizes the RNAComposer webservice for 3D RNA structure prediction and the AutoDockTool for molecular docking to determine their interaction. The result shows satisfactory illustration of mir-135b and its siRNA structures with feasible bindings between them. It is shown that the bindings are strong enough to maintain silencing of the gene. However, the molecular docking result shows reversible interaction based on the binding energy meaning its biomarker potential requires combination with other special drug delivery systems. It could be inferred that the siRNAs have potential to be developed in the wet laboratory settings.
Educação personalizada e avaliação formativa em ecossistemas de aprendizagem digitais no ensino superior
Authors: Lima Regina Maria Ferreira da Silva , Viana Maria Aparecida Pereira
Published: October 2022

Este artigo visa refletir sobre a premente mudança de paradigma educacional, a fim de incorporar o currículo digital e as tecnologias à educação, contrapondo-se à centralidade do professor no processo de ensino-aprendizagem, respeitando-se as diferenças culturais. O estudo realizado tomou por base a lição de Luckesi e Hoffmann (avaliação formativa); de Candau, Almeida e Silva, Moreira, Schlemmer (currículo e cultura digital); Zaduski, Lima e Schlunzen Junior (ecossistemas digitais). O método empregado foi o bibliográfico, em uma abordagem qualitativa de pesquisa, bem como explicativa. Os resultados apontam para a possibilidade de se institucionalizar nas universidades o modelo de ecossistemas digitais de aprendizagem, por meio do ensino híbrido, viabilizando a educação personalizada, o respeito às diferenças culturais e a consolidação do currículo digital.
Construindo uma proposta curricular inovadora na educação básica a partir da cultura maker
Authors: Gonzaga Kátia Valéria Pereira
Published: October 2022

Este artigo pretende relatar e refletir criticamente, à luz de referenciais teóricos, sobre o processo investigativo da construção e desenvolvimento coletivo de uma Proposta Curricular para Educação Básica, no período entre 2016 e 2019, em uma escola privada da zona oeste do município do Rio de Janeiro, em resposta às necessidades apontadas no diagnóstico inicial realizado, quando a autora assumiu a direção pedagógica da escola, a partir da socialização dos desafios colocados por uma nova realidade local e global contemporânea, resultando em práticas baseadas em um currículo interdisciplinar, metodologia maker, pedagogia de projetos, sustentabilidade, metodologias ativas, web currículo, inovação, tecnologia, servindo de referência para outras experiências na educação básica e superior, tendo por referenciais teóricos: Almeida (2005-2006; 2009); Almeida e Silva (2014); Almeida e Valente (2012); Almeida e Silva (2011); Blikstein (2017); Blikstein, Valente e Moura (2020); Valente e Blikstein (2019); Moreira, Morgado e Ramos (2019); Freire (1996); Papert (1980); Rossi; Gonçalves e Moon (2019), e Fazenda (1991).
Possibilidades avaliativas e consciência histórica na produção de narrativas digitais em podcast
Authors: Silva Raphael de França e , Alves Thema Panerai
Published: October 2022

No contexto contemporâneo, necessitamos desenvolver métodos para o uso de tecnologias digitais na disciplina de História, visto que existem poucos estudos nessa temática. Este artigo analisou as possibilidades avaliativas e os indícios de consciência histórica nas produções de narrativas digitais em podcast, realizadas durante uma dinâmica de avaliação formadora, na disciplina de História da Educação no Brasil, ministrada a uma turma de Pedagogia. Tratou-se de um estudo qualitativo, baseado no método do estudo de caso, cujos dados foram interpretados por meio de análise de conteúdo. No final do estudo, pudemos confirmar o potencial da dinâmica de avaliação formadora baseada na produção de narrativas digitais em podcast. Isso propiciou a avaliação do desenvolvimento de conceitos substantivos, vislumbrando indícios de consciência histórica nas produções e favorecendo a criação, pelos estudantes, de uma representação narrativa acerca dos contextos históricos estudados.
Verde-hódos, verde-metá
Authors: Carmo Robert Santos do , Vasconcelos Michele de Freitas Faria de
Published: October 2022

“Você ainda está verde.” A afirmação proferida no espaço acadêmico-escolarizado de mestrado fez-se pergunta: o que pode uma pesquisa verde? A oposição verde/maduro circunstancia políticas formativas e subjetivas em cena (e disputa) no cenário cotidiano e acadêmico. Nesse sentido, ocupamo-nos em afirmar o verde e fazê-lo trabalhar, aliás, brincar. Quando o que está posto é: ‘não pensem, copiem as ideias pré-fabricadas’, o verde apresenta uma questão à academia, faz a máquina escolar (curricular) desfuncionar, forçando-a a pensar. No entanto, como pôr o verde a trabalhar? Apostamos na literatura infantojuvenil como intercessor, mais precisamente O menino do dedo verde (DRUON, 1976). Tistu, protagonista da narrativa, é quem empresta o polegar verde – munido de uma transgressão metodológica, que desvia do caminho acadêmico mercadológico desenvolvimentista e moral. Com Tistu, semeamos uma vida, revolvendo as terras de um currículo e/ou de uma metodologia de pesquisa que toma o verde como hódos (caminho) e também como metá (meta, objetivo).