bluuebunny/crossref_metadata_2025 huggingface dataset:
Socioeconomic determinants of myalgic encephalomyelitis/chronic fatigue syndrome in Norway: a registry study
Authors: Hilland Geir Haakon , Anthun Kjartan Sarheim
Published: May 2024

Background

Previous research has shown that socioeconomic status (SES) is a strong predictor of chronic disease. However, to the best of our knowledge, there has been no studies of how SES affects the risk of Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) that has not been based upon self-reporting or retrospectively screening of symptoms. As far as we know, this is therefore the first study that isolate and describe socioeconomic determinants of ME/CFS and calculate how these factors relate to the risk of ME/CFS diagnosis by utilizing individual level registry data. This allows for objective operationalization of the ME/CFS population, and makes it possible to model SES affect the risk of ME/CFS diagnosis, relative to control groups.

Data and methods

We conduct a pooled cross-sectional analysis of registry data from all adult patients diagnosed with ME/CFS from 2016 to 2018 in Norway, coupled with socioeconomic data from statistics Norway from 2011 to 2018. We operationalize SES as household income and educational attainment fixed at the beginning of the study period. We compare the effects of SES on the risk of ME/CFS diagnosis to a population of chronically ill patients with hospital diagnoses that share clinical characteristics of ME/CFS and a healthy random sample of the Norwegian population. Our models are estimated by logistic regression analyses.

Results

When comparing the risk of ME/CFS diagnosis with a population consisting of people with four specific chronic diseases, we find that high educational attainment is associated with a 19% increase (OR: 1.19) in the risk of ME/CFS and that high household income is associated with a 17% decrease (OR:0.83) in risk of ME/CFS. In our second model we compare with a healthy population sample, and found that low educational attainment is associated with 69% decrease (OR:0.31) in the risk of ME/CFS and that low household income is associated with a 53% increase (OR: 1.53).

Conclusion

We find statistically significant associations between SES and the risk of ME/CFS. However, our more detailed analyses shows that our findings vary according to which population we compare the ME/CFS patients with, and that the effect of SES is larger when comparing with a healthy population sample, as opposed to controls with selected hospital diagnoses.
Trematode infection in ruminants and diversity of snail hosts across three agro-ecological zones in Ethiopia
Authors: Megersa Bekele , Hussein Bilisuma , Shemsu Jemila , Kassahun Redeat , Merera Olana , Moje Nebyou , Edao Bedaso Mammo , Waktole Hika , Ashenafi Hagos , Ayana Dinka
Published: May 2024

The occurrence of trematodes among ruminants and their snail vectors is a major concern across various agro-ecological regions of Ethiopia. Trematodes pose significant threats to animals, causing considerable economic losses and impacting public health. In this study, we have investigated 784 ruminant fecal samples, and 520 abattoir samples, alongside the collection and identification of snail vectors from various agro-ecological regions. Fecal examinations revealed Fasciola, Paramphistomum and Schistosoma species infected 20.5% (95% CI: 17.6, 23.8), 11.7% (95% CI: 9.6, 14.2), and 6.3% (95% CI: 4.1, 9.1) of the animals, respectively. The overall prevalence of trematodes among ruminants was 28.8% (95% CI: 25.7, 32.1%), with 6.0% (95% CI: 4.3, 7.7) showing mixed infections. Fasciola was more prevalent in Asela (26%) compared to Batu (19%) and Hawassa (11.5%), while a higher proportion of animals in Batu were infected with Paramphistomum. Schistosoma eggs were detected only in Batu (12.5%), but not in other areas. Sheep and cattle exhibited higher infection rates with Fasciola, Paramphistoma, and Schistosoma compared to goats. Significant associations were observed between trematode infections and risk factors including agro-ecology, animal species, body condition score, and deworming practices. About 20.8% and 22.7% of the slaughtered animals harbored Fasciola and Paramphistomum flukes, respectively, with a higher prevalence in Asela and Hawassa abattoirs compared to Batu abattoir. Additionally, a total of 278 snails were collected from the study areas and identified as lymnae natalensis, lymnae trancatula, Biomphalaria pffiferi, Biomphlaria sudanica, and Bulinus globosus. In conclusion, the study highlights the widespread occurrence of trematode infections, emphasizing the need for feasible control measures to mitigate their economic and public health impacts.
Quantitative MRI imaging of parenchyma and venation networks in Brassica napus leaves: effects of development and dehydration
Authors: Boulc’h Pierre-Nicolas , Collewet Guylaine , Guillon Baptiste , Quellec Stéphane , Leport Laurent , Musse Maja
Published: May 2024

Background

Characterisation of the structure and water status of leaf tissues is essential to the understanding of leaf hydraulic functioning under optimal and stressed conditions. Magnetic Resonance Imaging is unique in its capacity to access this information in a spatially resolved, non-invasive and non-destructive way. The purpose of this study was to develop an original approach based on transverse relaxation mapping by Magnetic Resonance Imaging for the detection of changes in water status and distribution at cell and tissue levels inBrassica napusleaves during blade development and dehydration.

Results

By combining transverse relaxation maps with a classification scheme, we were able to distinguish specific zones of areoles and veins. The tissue heterogeneity observed in young leaves still occurred in mature and senescent leaves, but with different distributions of T2values in accordance with the basipetal progression of leaf blade development, revealing changes in tissue structure. When subjected to severe water stress, all blade zones showed similar behaviours.

Conclusion

This study demonstrates the great potential of Magnetic Resonance Imaging in assessing information on the structure and water status of leaves. The feasibility ofin plantaleaf measurements was demonstrated, opening up many opportunities for the investigation of leaf structure and hydraulic functioning during development and/or in response to abiotic stresses.
Preoperative fasting glucose value can predict acute kidney injury in non-cardiac surgical patients without diabetes but not in patients with diabetes
Authors: Pang Qianyun , Feng Yumei , Yang Yajun , Liu Hongliang
Published: May 2024

Background

Postoperative acute kidney injury (AKI) is a common and costly complication after non-cardiac surgery. Patients with or without diabetes could develop hyperglycemia before surgery, and preoperative hyperglycemia was closely associated with postoperative poor outcomes, but the association between preoperative fasting blood glucose level and postoperative AKI is still unclear.

Methods

Data from patients undergoing non-cardiac surgery in Chongqing University Cancer Hospital from January 1, 2017, to May 31, 2023, were collected, preoperative glucose value and perioperative variables were extracted, the primary exposure of interest was preoperative glucose value, and the outcome was postoperative AKI.

Results

Data from 39,986 patients were included in the final analysis, 741(1.9%) patients developed AKI, 134(5.6%) in the cohort with DM, and 607(1.6%) in the cohort without DM(OR 1.312, 95% CI 1.028–1.675, P = 0.029). A significant non-linear association between preoperative glucose and AKI exists in the cohort without DM after covariable adjustment (P = 0.000), and every 1 mmol/L increment of preoperative glucose level increased OR by 15% (adjusted OR 1.150, 95% CI 1.078–1.227, P = 0.000), the optimal cut-point of preoperative fasting glucose level to predict AKI was 5.39 mmol/L (adjusted OR 1.802, 95%CI 1.513–2.146, P = 0.000). However, in the cohort with DM, the relation between preoperative glucose and postoperative AKI was not significant after adjusting by covariables (P = 0.437). No significance exists between both cohorts in the risk of AKI over the range of preoperative glucose values.

Conclusion

A preoperative fasting glucose value of 5.39 mmol/L can predict postoperative acute kidney injury after non-cardiac surgery in patients without diagnosed diabetes, but it is not related to AKI in patients with the diagnosis.
Effect of Nano-TiO2 and Polypropylene Fiber on Mechanical Properties and Durability of Recycled Aggregate Concrete
Authors: Wei Xiong , Xiaoqing Wang , Chunmei Li
Published: May 2024

In order to promote the engineering application of recycled concrete, the effects of PPF and nano-TiO2 dioxide on the mechanical properties and durability of recycled concrete were studied.

Polypropylene fiber recycled concrete(PRAC) and nano-TiO2 recycled concrete(TRAC) were prepared by adding different volume contents of PPF and nano-TiO2. The experimental findings demonstrated that the PPF and nano-TiO2 improved the splitting tensile strength of RAC better than the compressive strength. When the volume content of nano-TiO2. and PPF is 0.8% and 1.0%, respectively, the corresponding splitting tensile strength of concrete reaches the maximum value(3.4 and 3.7 MPa). The contribution rates of nano-TiO2 and PPF with different volume contents to the mechanical properties of RAC have optimal values, which are 0.4 and 1.0%, respectively. The incorporation of nano-TiO2 and PPF can effectively inhibit the loss of RAC mass and the generation of pores under freeze–thaw conditions, and slow down the decrease of dynamic elastic modulus. When the volume content of PPF is 1.0% and the volume content of nano-TiO2 is 0.4%, the protection effect on the internal structure of RAC is better, and its carbon resistance is better. The results of RSM model analysis and prediction show that both PPF and nano-TiO2 can be used as admixture materials to improve the mechanical properties and durability of RAC, and the comprehensive improvement effect of PPF on RAC performance is better than that of nano-TiO2.
Enhancing Pragmatic Language skills for Young children with Social communication difficulties (E-PLAYS-2) trial: study protocol for a cluster-randomised controlled trial evaluating a computerised intervention to promote communicative development and collaborative skills in young children
Authors: Murphy Suzanne , Bell Kerry , Cook Erica Jane , Crafter Sarah , Davidson Rosemary , Fairhurst Caroline , Hicks Kate , Joffe Victoria , Messer David , Robinson-Smith Lyn , Strachan Luke , Torgerson David , Welch Charlie
Published: May 2024

Background

A number of children experience difficulties with social communication and this has long-term deleterious effects on their mental health, social development and education. The E-PLAYS-2 study will test an intervention (‘E-PLAYS’) aimed at supporting such children. E-PLAYS uses a dyadic computer game to develop collaborative and communication skills. Preliminary studies by the authors show that E-PLAYS can produce improvements in children with social communication difficulties on communication test scores and observed collaborative behaviours. The study described here is a definitive trial to test the effectiveness and cost-effectiveness of E-PLAYS delivered by teaching assistants in schools.

Methods

The aim of the E-PLAYS-2 trial is to establish the effectiveness and cost-effectiveness of care as usual plus the E-PLAYS programme, delivered in primary schools, compared to care as usual. Cluster-randomisation will take place at school level to avoid contamination. The E-PLAYS intervention will be delivered by schools’ teaching assistants. Teachers will select suitable children (ages 5–7 years old) from their schools using guidelines provided by the research team. Assessments will include blinded language measures and observations (conducted by the research team), non-blinded teacher-reported measures of peer relations and classroom behaviour and parent-reported use of resources and quality of life. A process evaluation will also include interviews with parents, children and teaching assistants, observations of intervention delivery and a survey of care as usual.

The primary analysis will compare pragmatic language scores for children who received the E-PLAYS intervention versus those who did not at 40 weeks post-randomisation. Secondary analyses will assess cost-effectiveness and a mixed methods process evaluation will provide richer data on the delivery of E-PLAYS.

Discussion

The aim of this study is to undertake a final, definitive test of the effectiveness of E-PLAYS when delivered by teaching assistants within schools. The use of technology in game form is a novel approach in an area where there are currently few available interventions. Should E-PLAYS prove to be effective at the end of this trial, we believe it is likely to be welcomed by schools, parents and children.

Trial registration

ISRCTN 17561417, registration date 19th December 2022.

Protocol version: v1.1 19th June 2023.
Determinants of implanon discontinuation among women in Gedeo Zone, South Ethiopia: a case–control study
Authors: Bezabih Tihtina , Agidew Selamawit Dires , Kebede Selamawit Semagn , Belay Moges Mareg , Siyoum Ever , Ashenafi Eden , Birhane Mahlet
Published: May 2024

Background

The main public health problem that has a significant impact on the high fertility rate, unintended pregnancies, and induced abortion is Implanon cessation. In addition to Implanon being underutilized in Ethiopia, the rate of cessation is higher among women who started using it. Nevertheless, little is known about the factors that lead to Implanon cessation.

Objectives

The study was aimed to determine the factors that led women to discontinue Implanon in Gedeo Zone, Southern Nation Nationalities and Peoples Region, southern Ethiopia, 2019.

Method

A community-based unmatched case–control study design was carried out. Cases and controls were selected by a multi-stage sampling with a 1:2 case-to-control ratio. Data was entered into EPi-data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 20 for analysis. A bivariate and multivariable logistic regression was used to identify the factors affecting Implanon discontinuation. The adjusted odd ratio (AOR) with 95% Confidence Interval (CI) was used to determine the precision of estimates, and statistical significance was declared at a p-value of 0.05.

Result

From 516 women included in to the study, 495 (cases = 166 and controls = 329) women have responded to the questionnaires making a response rate of 96%. Monthly income 500—1000 birr [AOR: 0.3; 95% CI (0.2–0.5)], above 1000 birr [AOR: 0.2; 95% CI (0.1–0.4)], history of abortion [AOR: 2.0; 95% CI (1.0–4.1)], birth spacing [AOR: 0.6; 95% CI (0.3–0.9)], partner objection [AOR: 2.4; 95% CI (1.4–4.2)] were significantly associated factors.

Conclusion

This study identified that monthly income, having abortion history, birth spacing, partner objection were the factors that affect Implanon discontinuation. To reduce implanon discontinuation, reducing abortion, involving partner and increasing the birth spacing, appropriate counseling before the insertion and appropriate follow-up by a health care practitioner are highly recommended.
Simultaneous determination of five plant hormones in cotton leaves using QuEChERS combined with HPLC‒MS/MS
Authors: Wang Wenhao , Song Xianpeng , Wang Dan , Ma Yajie , Shan Yongpan , Ren Xiangliang , Hu Hongyan , Wu Changcai , Yang Jun , Ma Yan
Published: May 2024

Background

Plant hormones profoundly influence cotton growth, development, and responses to various stresses. Therefore, there is a pressing need for an efficient assay to quantify these hormones in cotton. In this groundbreaking study, we have established QuEChERS-HPLC‒MS/MS method, for the simultaneous detection of multiple plant hormones in cotton leaves, allowing the analysis and quantification of five key plant hormones.

Results

Sample extraction and purification employed 0.1% acetic acid in methanol and C18 for optimal recovery of plant hormones. The method applied to cotton demonstrated excellent linearity across a concentration range of 0.05–1 mg·L−1, with linear regression coefficients exceeding 0.99. The limits of quantification (LOQs) were 20 μg·kg−1 for GA3 and 5 μg·kg−1 for the other four plant hormones. Recovery rates for the five plant hormones matrix spiked at levels of 5, 10, 100, and 1000 μg·kg−1 were in the range of 79.07% to 98.97%, with intraday relative standard deviations (RSDs) ranging from 2.11% to 8.47%. The method was successfully employed to analyze and quantify the five analytes in cotton leaves treated with plant growth regulators.

Conclusion

The study demonstrates that the method is well-suited for the determination of five plant hormones in cotton. It exhibits excellent selectivity and sensitivity in detecting field samples, thus serving as a robust tool for in-depth research into cotton physiology.
Fire regime attributes shape pre-fire vegetation characteristics controlling extreme fire behavior under different bioregions in Spain
Authors: Beltrán-Marcos David , Suárez-Seoane Susana , Fernández-Guisuraga José Manuel , Azevedo João C. , Calvo Leonor
Published: May 2024

Background

Designing effective land management actions addressed to increase ecosystem resilience requires us to understand how shifting fire regimes are shaping landscapes. In this study, we aim to assess the link between fire regime and pre-fire vegetation biophysical characteristics (type, amount, and structure) in controlling extreme fire behavior across Atlantic-Transition-Mediterranean bioregions in Spain marked by different summer drought conditions and dominant plant regenerative traits. We used remote sensing metrics to estimate fire severity and pre-fire vegetation characteristics in eight study areas recently affected by large and highly severe wildfires under different environmental contexts. Furthermore, to account for fire regime attributes, we retrieved, for each target wildfire, the perimeter of the past wildfires that occurred between 1985 and 2022 and calculated fire recurrence, the time the since last fire (TSLF), and fire severity of previous wildfires (FSPW). The effect of fire regime attributes on pre-fire vegetation was examined using generalized linear mixed models (GLMMs).

Results

During the study period, fire recurrence decreased significantly in all bioregions analyzed. Fire severity increased under Atlantic conditions and decreased under Mediterranean environmental context, where the time since the last fire was the highest. Pre-fire fuel type and amount were identified as primary drivers of fire severity, being both strongly modulated by fire regime but following distinct mechanisms depending on the environmental context of each bioregion. In Atlantic sites, more frequent past wildfires of low to moderate fire severity were associated with a greater dominance of fire-prone shrublands with moderate fuel amounts, which increases the risk of severe wildfires. Similar trends occurred in Transition and Mediterranean sites but under the previous occurrence of highly severe wildfires. Specifically, long times after highly severe wildfires (> 30 years) increased fuel amount in conifer-dominated ecosystems in all bioregions analyzed, heightening susceptibility to extreme fire behavior.

Conclusions

Our findings highlight that fire-prone ecosystems need adaptative management strategies to mitigate the effects of fire regime changes, but these actions should be specific to the climatic and ecological context.
Underrepresentation of Indigenous mental health professionals in Bangladesh
Authors: Faruk Md. Omar , Ramos Miguel R. , Ching Umay
Published: May 2024

Indigenous people worldwide are at increased risk of mental health problems compared with non-Indigenous people. Longstanding impacts of colonisation, systematic exclusion from rights and subsequent discrimination, and lack of access to quality education and healthcare, including mental healthcare, have been identified as contributory factors to these disproportionate mental health problems. With limited access, Indigenous people are less likely to seek healthcare, owing to the insufficient number of healthcare professionals representing Indigenous communities. In the face of growing numbers of mental health problems in Indigenous people in Bangladesh, this paper sheds light on the inadequate number of mental health professionals, particularly from Indigenous communities, and the potential impacts of this on the well-being of Indigenous people, and considers ways to increase representation of Indigenous mental health professionals. The aim is to ensure that the mental health system in Bangladesh is inclusive and embraces the country's diversity.
Εθνικός Σύνδεσμος Ελλήνων Σπουδαστών Ιταλίας
Authors: Αθανασίου Αρτεμησία
Published: May 2024

Η διδακτορική διατριβή έχει ως αντικείμενο έρευνας τον Εθνικό Σύνδεσμο Ελλήνων Σπουδαστών Ιταλίας, ΕΣΕΣΙ, [Lega nazionale degli studenti greci in Italia] μιας φοιτητικής οργάνωσης που δημιουργήθηκε και έδρασε στην Ιταλία την περίοδο 1967-1974. Ο ΕΣΕΣΙ ιδρύθηκε αμέσως μετά το πραξικόπημα της 21ης Απριλίου από Έλληνες σπουδαστές που φοιτούσαν στα ιταλικά πανεπιστήμια και η κινηματική του δράση ταυτίστηκε με τις πρακτικές του ακροδεξιού εξτρεμισμού. Η μελέτη αποτελεί ένα εγχείρημα διεπιστημονικής προσέγγισης. Ερείδεται στην αρχειακή έρευνα για να αναδείξει την ιστορία του Συνδέσμου και πλαισιώνεται από την υφιστάμενη επιστημονική θεωρία για την Ακροδεξιά, προκειμένου να ορίσει την τυπολογία του. Κεντρικός άξονας της εργασίας είναι η υπόθεση ότι ο ΕΣΕΣΙ αποτελεί μια ισχυρή ιστορική κληρονομιά για τον χώρο των ακροδεξιών νεολαιίστικών οργανώσεων της Ελλάδας και της Ιταλίας, αλλά και καταγωγική μήτρα των ακροδεξιών κομμάτων και μορφωμάτων της Τρίτης Ελληνικής Δημοκρατίας. Εξετάζονται οι σχέσεις με το στρατιωτικό καθεστώς της Αθήνας, με την ελληνική Πρεσβεία της Ρώμης, με τις προξενικές αρχές αλλά και με τις αντιδικτατορικές οργανώσεις της Ιταλίας. Πέραν της αρχειακής έρευνας που έλαβε χώρα στην Ελλάδα και στην Ιταλία, αξιοποιούνται περισσότερα από 40 έντυπα και πραγματοποιούνται συνεντεύξεις με ανθρώπους που έζησαν από κοντά τα γεγονότα. Με βάση τα παραπάνω συγκροτείται η ιστορία του ΕΣΕΣΙ, ως μιας αντιφοιτητικής οργάνωσης που λειτούργησε ως μοχλός παρακολούθησης των φοιτητριών και φοιτητών που ανέπτυξαν αντιδικτατορική δράση και ως μηχανισμός προπαγάνδας της χούντας.
Μελέτη σπάνιων μορφών της νόσου των Charcot-Marie-Tooth στον ελληνικό πληθυσμό
Authors: Κοντογεωργίου Ζωή
Published: May 2024

Η παρούσα διδακτορική διατριβή είχε ως στόχο να συμπληρώσει και ολοκληρώσει την συνολικότερη μελέτη σπανίων κληρονομικών νευροπαθειών στον Ελληνικό πληθυσμό και πραγματοποιήθηκε αρθρωτά με σκοπό να καλύψει όσο το δυνατόν μεγαλύτερο φάσμα των διαταραχών αυτών. Συνολικά η εργασία εξελίχθηκε σε 5 επίπεδα τα οποία συνοψίζονται ως εξής. Μελετήθηκε η φυλοσύνδετη μορφή CMTX ως αποτέλεσμα παραλλαγών σε ρυθμιστικές περιοχέςτου υπεύθυνου γονιδίου όπου από επιλέχθηκαν και ελέγχθηκαν 54 ασθενείς δείκτες εκ των οποίων κανείς δεν παρουσίασε παραλλαγή στην εξεταζόμενη περιοχή. Ακολούθως μελετήθηκε η αναφερόμενα συχνότερη υπολειπόμενη μορφή της νόσου η CMT4C όπου επιλέχθηκαν και ελέγχθηκαν 50 ασθενείς δείκτες για παραλλαγές του γονιδίου SH3TC2 εκ των οποίων 13 παρουσίασαν παραλλαγές στην εξεταζόμενη περιοχή. Μελετήθηκε η υπολειπόμενη μπορφή της νόσου με νευρομυοτονία ARAN-NM επιλέχθηκαν και ελέγχθηκαν 42 ασθενείς δείκτες για παραλλαγές του γονιδίου HINT1 εκ των οποίων 4 παρουσίασαν παραλλαγές στην εξεταζόμενη περιοχή. Παράλληλα μελετήθηκε το σύνδρομο CANVAS όπου επιλέχθηκαν και ελέγχθηκαν 77 ασθενείς δείκτες για την παθογονική επέκταση στο γονίδιο RFC1 εκ των οποίων 5 παρουσίασαν παραλλαγές στην εξεταζόμενη περιοχή. Τέλος μελετήθηκαν οι αξονικές μορφές της νόσου CMT2 όπου επιλέχθηκαν και ελέγχθηκαν 60 ασθενείς δείκτες για παραλλαγές σε 25 σχετιζόμενα με τη νόσο γονίδια εκ των οποίων 20 παρουσίασαν παραλλαγές που εντοπίζονται σε 8 από τα γονίδια που εξετάστηκαν. Εν κατακλείδι, η ολοκλήρωση της παρούσας μελέτης φαίνεται ότι κατάφερε να συμπληρώσει σε μεγάλο βαθμο την γενετική εικόνα των Ελλήνων ασθενών με CMT, εγκαθιστώντας συγχρόνως τεχνολογίες αιχμής στο Εργαστήριο της Μονάδας Νευρογενετικής της Α΄Νευρολογικής Κλινικής του ΕΚΠΑ και αυξάνοντας τη δυνατότητα για μελέτες υψηλότερου επιπέδου καθώς και για έγκυρη και έγκαιρη διάγνωση και γενετική συμβουλή.
Cluster as a Network Mechanism of Regional Post-Industrial Economic Systems
Authors: Kadtsyna E.
Published: May 2024

The study is aimed at the addition of theoretical and methodological provisions related to the features of the development of the post-industrial economic mechanism. The need for supplementing the provisions with an interpretation of the cluster approach in the development of the economic mechanism of post-industrial systems, clarifying its economic significance and proposing on its basis practical mechanisms for implementing the information economy is justified.
As a mechanism, it is proposed to create an intersectoral cluster structure that contributes to the development of the process of informatization of industrial sectors. With the help of the proposed mechanism, it is possible to provide methodological and practical tools for the implementation of information policy and the development of informatization based on the cluster approach.
Desinformação em foco: o papel da fotografia na disseminação de notícias falsas sobre política
Authors: Francisco Cassini Adriel Henrique , Ito Liliane de Lucena
Published: May 2024

A desinformação é um problema crescente na contemporaneidade, e a fotografia tem sido usada como uma ferramenta para credibilizar peças desinformativas. Este artigo discute a importância de compreender os mecanismos complexos por trás da desinformação imagética e como a fotografia pode ser usada para influenciar e formar opiniões. Para analisar a fotografia como estratégia de desinformação, é necessário compreender suas características e estrutura verossímil. Neste sentido, foram selecionadas duas peças desinformativas: “Julgamento de Dilma no período da ditadura militar” e “Povos yanomami no Brasil”, que foram analisadas de acordo com o método de Barthes (1990). Os resultados mostram como a fotografia pode ser usada para manipular a opinião pública sobre governos, crises e atores políticos, e como é importante que jornalistas, educadores e cidadãos estejam atentos a esses mecanismos para navegar com discernimento em um mundo onde a desinformação visual desempenha um papel cada vez mais influente.
Generalized Riskiness Index in Vehicle Routing Under Uncertain Travel Times: Formulations, Properties, and Exact Solution Framework
Authors: Zhang Zhenzhen , Zhang Yu , Baldacci Roberto
Published: May 2024

We consider a vehicle routing problem with time windows under uncertain travel times where the goal is to determine routes for a fleet of homogeneous vehicles to arrive at the locations of customers within their stipulated time windows to the maximum extent while ensuring that the total travel cost does not exceed a prescribed budget. Specifically, a novel performance measure that accounts for the riskiness associated with late arrivals at the customers, called the generalized riskiness index (GRI), is optimized. The GRI covers several existing riskiness indices as special cases and generates new ones. We demonstrate its salient managerial and computational properties to motivate it better. We propose alternative set partitioning-based models of the problem. To obtain the optimal solution, we develop an exact solution framework combining route enumeration and branch-price-and-cut algorithms, in which the GRI is dealt with in route enumeration and column generation subproblems. We mainly reduce the solution space by exploiting the GRI and budget constraints’ properties without losing optimality. The proposed method is tested on a collection of instances derived from the literature. The results show that a new instance of the GRI outperforms several existing riskiness indices in mitigating lateness. The exact method can solve instances with up to 100 nodes to optimality. It can consistently solve instances involving up to 50 nodes, outperforming state-of-the-art methods by more than doubling the manageable instance size.

Funding: This work was supported by the National Natural Science Foundation of China [Grants 72101187, 72371204, 72021002, and 71901180], the Qatar National Research Fund [Grant ARG01-0430-230029], Natural Science Foundation of Sichuan Province [24NSFSC6232], and Guanghua Talent Project of the Southwestern University of Finance and Economics.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2023.0345 .
Delayed closure of ventricular septal defect with prolonged mechanical support
Authors: Shehzad Dawood , Shehzad Mustafa , Ahmad Muhammad , Wassey Abdul , Zara Noor , Younis Humna , Khan Haider Ali Babar
Published: May 2024

Introduction: Ventricular septal defect (VSD) is a severe complication following acute myocardial infarction (MI) resulting from mechanical disruption of the interventricular septum due to extensive myocardial necrosis. Despite advances in management, the mortality rate approaches 50%. We report a case of a 58-year-old male with VSD following MI who was successfully treated with a delayed surgical approach after haemodynamic support using Impella. Case description: A 58-year-old man with type 2 diabetes mellitus and hypertension presented with three days of chest pain. Testing revealed late presenting acute anterior ischaemic infarction and left-to-right shunt in the apical ventricular septum. Urgent cardiac catheterisation showed near-total occlusion of the left anterior descending artery. An Impella CP® was placed before angioplasty with a drug-eluting stent to optimise haemodynamics. After a multidisciplinary discussion, the Impella CP® was upgraded to Impella 5.5®, and surgery was delayed allowing for scar formation. The patient remained in the intensive care unit, where he underwent physical therapy, showing improvements in exercise tolerance by the time of surgery. He underwent a left ventriculotomy with a successful repair via an endocardial patch 28 days after initial presentation. Post-operative recovery was uneventful, with the patient discharged five days later, reporting no physical limitations one month post-discharge. Conclusion: The successful management of VSD post-MI relies on interdisciplinary collaboration, careful timing of surgical intervention and the strategic use of mechanical support devices such as the Impella. This case highlights the potential for favourable outcomes when tailored treatment approaches are employed.
Cost of Training Crisis: Anaesthetics
Authors: Smith Rose , Davey Molly
Published: May 2024

The anaesthetic training programme in the United Kingdom (UK) spans over seven years and is overseen by the Royal College of Anaesthetists (RCOA). Junior doctors in England are currently striking amid ongoing pay negotiations with the government, and almost all junior doctors are worried about the cost of living. This article provides an overview of the average financial cost of training for doctors in the anaesthetic training programme. The cost incurred by anaesthetic trainees illustrates the level of financial burden faced by trainees across multiple specialities. The cost includes: student loan repayment (with interest rates), compulsory membership fees (including the Royal College of Anaesthetists and General Medical Council), postgraduate examinations (Fellowship of the Royal College of Anaesthetist exams are compulsory to complete training) and medical indemnity. The average trainee spends between 5.6% and 7.4% of their annual salary on non-reimbursable costs. This article delineates for aforementioned expenses and compares them with the training programs in Australia and New Zealand, given their status as frequent emigration destinations for UK doctors.
Pandemic effect on ischaemic burden and prehospital time in acute coronary syndrome
Authors: Steege Noah , Crandell Jamie , DeVon Holli A , Rosamond Wayne D , Wong Eugenia , Chronowski Kevin , Grover Joseph , Zègre-Hemsey Jessica K
Published: May 2024

Background:

Acute coronary syndrome (ACS) requires rapid identification and intervention. Early recognition of symptoms, detection of ischaemic markers in electrocardiograms (ECGs) and timely reperfusion therapy all reduce the total ischaemic time. In 2020, SARS-CoV-2 emerged as a new threat to people with cardiac disease: calls to emergency departments, emergency department visits and hospital admissions for acute cardiac conditions decreased, possibly because patients delayed seeking care because of fear of SARS-CoV-2 exposure. The hypothesis of this study was that patients presenting with ACS during the pandemic would have more ischaemic features and longer prehospital time intervals than those presenting before the pandemic. However, there were no significant differences between pre-pandemic and pandemic groups regarding incidence of ECG ischaemic markers, elevated troponin, adverse outcomes or prehospital time intervals. Non-ST-elevation myocardial infarction was significantly higher in the pandemic sample, which suggests that patients with less severe symptoms sought treatment during the pandemic.
Australian paramedic ECG interpretation in acute coronary syndrome
Authors: Wyld Luke , Clegg Lisa , Griffin Kristina
Published: May 2024

Background:

The paramedic use of electrocardiogram (ECG) is the gold standard for prehospital identification of acute myocardial infarction. Following an extension to their scope of practice, all paramedics have the capability to identify an ST-elevation myocardial infarction (STEMI). However, there have been no investigations into paramedic ECG interpretation.

Aims:

This study aimed to investigate paramedic accuracy regarding ECG interpretation and compare findings with international literature.

Methods:

Anonymous participants were voluntarily recruited to interpret 12 ECGs. A literature review was undertaken to compare results with previous studies.

Findings:

Paramedics correctly identified the ECGs with a mean score of 63%. Accuracy in ECG interpretation increased with a higher educational background and specialist training. Postgraduate mean accuracy was 83.33%, with specialist accuracy at 83.53%.

Conclusions:

Further education and research into interpreting difficult ECGs is necessary. Australian services may consider the implementation of modified cardiac protocols to include suspected non-STEMI.
Pediatric Hearing Loss and the Multidisciplinary Approach. The Hearing Disability Team (HDT) Experience
Authors: Palma Silvia , Nascimbeni Laura , Pecovela Maria Chiara , Ciorba Andrea , Pirani Graziella , Monzani Daniele , Genovese Elisabetta
Published: May 2024

Hearing loss is among the utmost common disorders in children and a late diagnosis can impact language and cognitive development. With the aim of implementing an early hearing detection program (EHDP), the Emilia Romagna region has officially approved, since 2012, a NHS program distinguishing well babies and NICU children. Aim of this study is to evaluate the results of the application of these regional guidelines through data flow from the Child and Adolescent Mental Health Services (CAMHS).
Data of children born between 2012 and 2018 and admitted to the service in the same period were collected, 84 children (56 males,28 females) were enrolled; 65% of the children were taken in charge by CAMHS within the first year of life. Concerning the NHS results, 77 (91%) children resulted fail at the screening test (6 unilateral fails), while the result was not available in one case; 6 children resulted pass. Most cases, 79 (94%), presented bilateral hearing loss. In particular, 14 (17.8%) children had a profound hearing loss, 10 (12.6%) a severe hearing loss, 10 (12.6%) a mild hearing loss (6 were conductive), 22 (27.8%) a moderate hearing loss, and 23 (29.2%) a moderate/severe hearing loss. Finally, 5 resulted affected by unilateral hearing loss (2 profound hearing loss, 3 severe).
This study confirmed that regional recommendations about early diagnosis of hearing loss have been applied and most children accessed the CAMHS timely. To this aim synergism between hospital and territorial services, determining the implementation of the organization system was the keystone.
Larnite Porous Granule Production using Eggshell
Authors: Kalemtas Ayse , Aydin Gulsum , Sert Ozge
Published: May 2024

In the current study, a biowaste, chicken eggshell, was used with commercial silica powder as a raw material resource for synthesizing porous bioceramic, larnite, granules with a solid-state reaction method. This study was carried out in two primary stages. In the first step, spherical structures were obtained using a facile spherical salt bead production technique developed by Jinnapat and Kennedy. Powdered chicken eggshells and commercial silica powder were used as the inorganic starting materials to produce the spherical structures. After the shaping procedure, it was determined that spherical granules with a broad range of granule sizes, ranging from less than 2 mm to the micrometer level, were achieved. Then, in the second step, a high-temperature heat treatment was carried out to produce porous larnite granules. Performed XRD analysis revealed that the phase purity of the larnite phase was achieved at the high-temperature heat treatment done at 1250°C for 2 hours. However, it was observed that after sintering, the size of the ceramic granules slightly increased, losing their general spherical shape by sticking to each other during the sintering process. Microstructure investigations of the larnite granules revealed a fine, homogenous microstructure with a bimodal porosity distribution. The coarse porosity between the fine larnite particle clusters was determined to reach up to 15-20 mm.
Examination Through Experimentation of The Utilization of Paper, Pulp and Waste Cloth In Concrete
Authors: anvar E Tarikh , Seethapathi M. , Nandhini S. , Das Mohan
Published: May 2024

The objective is to establish relationships between these strength parameters and the incorporation of Bio-waste materials, including different proportions of paper mass and discarded textiles, in the concrete mix. Additionally, tile samples are cast to assess the impact resistance behavior. Two types of bio-concrete have been developed, and their distinctive properties, including compressive strength of cubes, Split tensile strength of cylinders, flexural strength of beam, water absorption absorptive, and surface treatment, are studied. To evaluate the potential practical applications of these materials, all the conducted tests are compared with those performed on control concrete. The bio-concrete gives equal strength compared with control conventional concrete. The BC gives 90% of results from control concrete and the weight of the concrete is very low compared with normal concrete.
TECNOLOGIA RECREATIVA EM UNIDADE PEDIÁTRICA E CIRÚRGICA: REVISÃO INTEGRATIVA
Authors: Valentim da Silva Moreira Italo , Da Silva Sabino Aderlaine , Andrade da cunha Marques Anne Grace , Véras Fontes Esteves Arinete
Published: May 2024

Introdução: toda e qualquer criança, onde ela estiver, tem o direito de brincar.  No entanto, quando a criança está doente, ela pode ser submetida a tratamento com internações e ações hospitalares que afetam sua rotina, afastando-a dos seus pares e podendo privá-la de brincar. Tal situação implica em pouco contato social com outras crianças, dificuldades emocionais e baixo nível de atividade física, o que pode acarretar prejuízos à criança. Objetivo: analisar nas evidências científicas a importância e benefício das tecnologias recreativas utilizadas em unidade cirúrgica pediátrica. Materiais e Método: estudo de revisão integrativa, com questão de pesquisa elaborada pela estratégia PICO, selecionando-se os descritores "Tecnologia Biomédica", "Recreação", "Centro Cirúrgico", "Sala de Cirurgia", "Bloco Cirúrgico", "Cirurgia", "Sala de Operações", “Enfermagem Pediátrica”, “Equipe de Enfermagem”, “Profissionais de Enfermagem”, “Enfermeiras”, “Saúde da Criança”, em português e inglês, e utilizou-se o operador booleano AND ou OR. Realizou-se a busca em quatro fontes de literatura científica, no período de setembro de 2020 a fevereiro de 2021. Aplicaram-se os critérios de inclusão e exclusão, bem como os dados extraídos por formulário próprio. Resultados: a amostra final quantificou doze estudos e seus resultados foram agrupados em duas categorias: Atividades lúdicas e seus benefícios para a criança hospitalizada; Percepção dos profissionais e de familiares na recreação do paciente. Conclusão: o estudo contribuirá para que profissionais da área da saúde tenham um olhar diferenciado no cuidado do paciente hospitalizado, levando em consideração que o brincar oferta subsídios primordiais na amenização da aflição.
RISCO DE SUICÍDIO ENTRE UNIVERSITÁRIOS DA ÁREA DA SAÚDE E OS FATORES ASSOCIADOS
Authors: Tinti de Andrade Maria Betânia , Vieira Coelho Ferreira Luana , Da Cruz Sequeira Carlos Alberto , Olímpia Barbosa Felipe Adriana , Guidorizzi Zanetti Ana Carolina , Alves Nogueira Denismar , Marilda Rodrigues Resck Zélia , Graziani Giacchero Vedana Kelly
Published: May 2024

INTRODUÇÃO: O suicídio é apontado como a quarta causa de morte entre jovens na faixa etária de 15 a 29 anos. Nesta faixa etária encontram-se os universitários, que podem vivenciar em sua vida acadêmica um período marcado por angustias, incertezas, desafios e sofrimentos que somados a outros fatores podem favorecer o risco de suicídio. OBJETIVO: Identificar os fatores de risco para o suicídio em estudantes universitários da área da saúde. MATERIAIS E MÉTODO: Estudo de abordagem quantitativa, desenvolvido com estudantes universitários matriculados a partir do 5° período nos cursos de graduação em Biomedicina, Enfermagem, Farmácia, Fisioterapia, Medicina, Nutrição e Odontologia de uma instituição de ensino superior localizada no Sul de Minas Gerais. Foram autoaplicados cinco instrumentos: Questionário sociodemográfico, educacional e clínico; Avaliação do Risco de Suicídio; Escala de Esperança de Herth; Inventário de Depressão Maior e Escala de Autoestima de Rosenberg.  RESULTADOS: Participaram do estudo 747 universitários, 27,6% apresentavam risco de suicídio. Os preditores de risco de suicídio foram ter sintomas depressivos, baixa autoestima, diagnóstico de transtorno mental, uso de psicofármacos e insatisfação com o apoio social. CONCLUSÃO: O estudo poderá subsidiar referencial para intervenções, investigações e políticas públicas para o apoio aos estudantes universitários e para a prevenção do suicídio nessa população.
AVALIAÇÃO DO PROGRAMA MAIS MÉDICOS DA PERSPECTIVA DOS USUÁRIOS
Authors: Souza Gleriano Josué , Conceição Martins Lourdes , Krein Carlise , Dias Pedreschi Chaves Lucieli
Published: May 2024

Introdução: o Programa Mais Médicos (PMM) contribuiu para ampliar a cobertura da Atenção Primária à Saúde (APS). Objetivo: avaliar segundo a experiência de usuários o PMM. Método: pesquisa avaliativa de método misto concomitante realizada em Tangará da Serra – Mato Grosso, com usuários cadastrados na área de abrangência de unidades de saúde da família que tinham na sua equipe médicos do PMM, durante o período de 2016 a 2018. Para os dados quantitativos, a análise descritiva foi gerada por meio do software IBM SPSS®, versão 21. Para a análise temática dos dados qualitativos, utilizou-se o software Qualitative Solutions Research NVivo® 10 que oportunizou apresentação em duas categorias: “PMM: da desconfiança ao reconhecimento por meio da prática médica” e “Prática acolhedora ao usuário e o vínculo: via de mão dupla”. A mixagem dos dados explorou a completude das informações levantadas. Resultados: participaram 1036 usuários, em maior frequência a favor do Programa, que relataram superação quanto à comunicação do idioma e reconhecimento na melhoria do acesso à consulta médica com a diminuição do tempo de espera. Existe satisfação com a prática do profissional, desperta contribuições mútuas entre os usuários e o profissional, ampliando possibilidades de corresponsabilidade com a saúde no território. Conclusão: Revelam-se subsídios do PMM no município, que projetou a ampliação da cobertura com reconhecimento de seus usuários, maior possibilidade de efetivar atributos da APS e fomentar a organização de uma rede de atenção, ao mesmo tempo o desafio da sustentabilidade dessa proposta pela dependência de cooperação do Programa.
OS DESAFIOS DA ATENÇÃO FARMACÊUTICA ÀS PESSOAS COM DEFICIÊNCIA AUDITIVA
Authors: Lima Medeiro Dlanio , Gadelha de Oliveira Edilene
Published: May 2024

Introdução: A Atenção Farmacêutica consiste em um conjunto de ações de cuidado, direcionadas à promoção, proteção e recuperação da saúde, visando o uso racional de medicamentos. No entanto, este cuidado requer atenção especial quando o atendimento é direcionado às pessoas com deficiência. Objetivos: O objetivo desta pesquisa foi refletir sobre os desafios enfrentados pela Atenção Farmacêutica no atendimento às pessoas com deficiência auditiva, no intuito de garantir o direito ao acesso à uma boa orientação farmacêutica. Métodos: Trata-se de uma revisão integrativa em fontes de busca no Google Acadêmico e em bases de dados: SciELO, LILACS, PUBMED, e nos repositórios das universidades brasileiras, entre 2012 e 2022. Resultados: De acordo com a revisão de literatura, os resultados apontaram a importância de o atendimento farmacêutico ser inclusivo. Para isso, é imprescindível o conhecimento de Libras para se ter uma comunicação eficaz com pacientes surdos, ao passo que as ações de leitura labial, escrita ou mímica são paliativas. Conclusões: Conclui-se que os principais desafios enfrentados na Atenção Farmacêutica para pessoas surdas ou com deficiência auditiva são a falta de conhecimento de Libras e interesse em conhecer e compreender a cultura das pessoas surdas.
COMPORTAMENTO DE SAÚDE E SENTIMENTOS MATERNOS NA AMAMENTAÇÃO DURANTE A PANDEMIA COVID-19
Authors: Morau Martins da Rocha Lázara , Moraes de Paula Marcella , Araújo da Fonseca Maria de Fatima , Brandão Piovesan Amália , Barros de Pontes Mônica
Published: May 2024

INTRODUÇÃO: A pandemia da COVID-19 configurou um cenário de dificuldades, inclusive em relação à amamentação. A prática de comportamentos de saúde, como o isolamento social e o uso de máscaras, configuraram mudanças drásticas para as puérperas. OBJETIVO: O presente estudo buscou descrever as consequências dessas mudanças de comportamento de saúde e suas implicações no cotidiano das nutrizes. MATERIAIS E MÉTODOS: Realizou-se uma abordagem qualitativa e descritiva, por meio de entrevistas via ligação ou Google Forms com as mulheres cadastradas no Banco de Leite Humano do Hospital Cassiano Antônio de Morais. A análise das informações foi realizada por categorias. RESULTADOS: Na sessão de comportamento de saúde, predominou a realização do isolamento social e práticas de higiene. Na de medidas de prevenção, todas negam uso de medicamentos preventivos e a maioria demonstrou-se a favor da vacina. Já em relação aos sentimentos, prevaleceu o medo, entretanto, o isolamento social foi dado como favorável, devido ao fortalecimento do laço materno. CONCLUSÃO: Em suma, apesar do medo da contaminação, as nutrizes relataram que se adaptaram bem as mudanças de hábitos e o maior tempo em casa foi bem-visto pelas entrevistadas.