bluuebunny/crossref_metadata_2025 huggingface dataset:
Antimicrobial use among paediatric inpatients at hospital sites within the Canadian Nosocomial Infection Surveillance Program, 2017/2018
Authors: Rudnick Wallis , Conly John , Thirion Daniel J. G. , Choi Kelly , Pelude Linda , Cayen Joelle , Bautista John , Beique Lizanne , Comeau Jeannette L. , Dalton Bruce , Delport Johan , Dhami Rita , Embree Joanne , Émond Yannick , Evans Gerald , Frenette Charles , Fryters Susan , Happe Jennifer , Katz Kevin , Kibsey Pamela , Langley Joanne M. , Lee Bonita E. , Lefebvre Marie-Astrid , Leis Jerome A. , McGeer Allison , McKenna Susan , Neville Heather L. , Slayter Kathryn , Suh Kathryn N. , Tse-Chang Alena , Weiss Karl , Science Michelle ,   the Canadian Nosocomial Infection Surveillance Program
Published: April 2023

Background

Antimicrobial resistance threatens the ability to successfully prevent and treat infections. While hospital benchmarks regarding antimicrobial use (AMU) have been well documented among adult populations, there is less information from among paediatric inpatients. This study presents benchmark rates of antimicrobial use (AMU) for paediatric inpatients in nine Canadian acute-care hospitals.

Methods

Acute-care hospitals participating in the Canadian Nosocomial Infection Surveillance Program submitted annual AMU data from paediatric inpatients from 2017 and 2018. All systemic antimicrobials were included. Data were available for neonatal intensive care units (NICUs), pediatric ICUs (PICUs), and non-ICU wards. Data were analyzed using days of therapy (DOT) per 1000 patient days (DOT/1000pd).

Results

Nine hospitals provided paediatric AMU data. Data from seven NICU and PICU wards were included. Overall AMU was 481 (95% CI 409–554) DOT/1000pd. There was high variability in AMU between hospitals. AMU was higher on PICU wards (784 DOT/1000pd) than on non-ICU (494 DOT/1000pd) or NICU wards (333 DOT/1000pd). On non-ICU wards, the antimicrobials with the highest use were cefazolin (66 DOT/1000pd), ceftriaxone (59 DOT/1000pd) and piperacillin-tazobactam (48 DOT/1000pd). On PICU wards, the antimicrobials with the highest use were ceftriaxone (115 DOT/1000pd), piperacillin-tazobactam (115 DOT/1000pd), and cefazolin (111 DOT/1000pd). On NICU wards, the antimicrobials with the highest use were ampicillin (102 DOT/1000pd), gentamicin/tobramycin (78 DOT/1000pd), and cefotaxime (38 DOT/1000pd).

Conclusions

This study represents the largest collection of antimicrobial use data among hospitalized paediatric inpatients in Canada to date. In 2017/2018, overall AMU was 481 DOT/1000pd. National surveillance of AMU among paediatric inpatients is necessary for establishing benchmarks and informing antimicrobial stewardship efforts.
Explaining the process of formation of ageism among the iranian older adults
Authors: Yaghoobzadeh Ameneh , Asgari Parvaneh , Nasrabadi Alireza Nikbakht , Mirlashari Jila , Navab Elham
Published: April 2023

Background

Ageism is considered as one of the consequences of the industrialization of societies, which appears in various forms in different cultures. This study aimed to explain the process of formation of ageism among the older adults people.

Methods

The research was conducted using grounded theory method. Data were collected from 28 participants using in-depth semi-structured interviews and field notes. Data were analyzed using open, axial, and selective coding.

Results

Fear of loneliness and rejection striving to tackle ageism “was identified as the core category of the study. Concepts such as “family context” and “cultural context” were relevant. After identifying the strategies used by the older adults in response to the context (“maintaining integrity”, “socio-cultural care” and “proper health care”, “striving to tackle ageism”) was the most important process in ageism by the Iranian older adults.

Conclusion

Findings of this study indicated that individual, family and social factors play an important role in the process of ageism among the older adults. These factors sometimes exacerbate or moderate the process of ageism. By recognizing these factors, various social institutions and organizations (including the health care system and the national media (radio and television)) can help the older adults achieve successful aging by emphasizing the issues related to the social aspect.
Analysing domain-specific problem-solving processes within authentic computer-based learning and training environments by using eye-tracking: a scoping review
Authors: Mayer Christian W. , Rausch Andreas , Seifried Jürgen
Published: April 2023

Recently, many studies have been published on the use of eye-tracking to analyse complex problem-solving processes within authentic computer-based learning and training environments. This scoping review aims to provide a systematic report of the current state-of-the-art for related papers. Specifically, this work offers a scoping review of studies that analyse problem-solving processes by using eye-tracking (alongside additional process data such as log files, think aloud, facial expression recognition algorithms, or psychophysiological measures) within authentic technology-based learning and training environments for professional and vocational education and training (VET). A total of 12 studies were identified. The most commonly calculated measures in eye-tracking research are position measures, and these are almost exclusively position duration measures such as the proportion of fixation times or total dwell times. Count measures are also mostly related to the number or proportion of fixations and dwells. Movement measures are rarely computed and usually refer to saccade directions or a scan path. Also, latency and distance measures are almost never calculated. Eye-tracking data is most often analysed for group comparisons between experts vs. novices or high vs. low-performing groups by using common statistical methods such as t-test, (M)ANOVA, or non-parametric Mann–Whitney-U. Visual attention patterns in problem-solving are examined with heat map analyses, lag sequential analyses, and clustering. Recently, linear mixed-effects models have been applied to account for between and within-subjects differences. Also, post-hoc performance predictions are being developed for future integration into multimodal learning analytics. In most cases, self-reporting is used as an additional measurement for data triangulation. In addition to eye-tracking, log files and facial expression recognition algorithms are also used. Few studies use shimmer devices to detect electrodermal activity or practice concurrent thinking aloud. Overall, Haider and Frensch’s (1996, 1999) “information reduction hypothesis” is supported by many studies in the sample. High performers showed a higher visual accuracy, and visual attention was more focused on relevant areas, as seen by fewer fixation counts and higher fixation duration. Low performers showed significantly fewer fixation durations or substantially longer fixation durations and less selective visual attention. Performance is related to prior knowledge and differences in cognitive load. Eye-tracking, (in combination with other data sources) may be a valid method for further research on problem-solving processes in computer-based simulations, may help identify different patterns of problem-solving processes between performance groups, and may hold additional potential for individual learning support.
Modeling the impacts of projected climate change on wheat crop suitability in semi-arid regions using the AHP-based weighted climatic suitability index and CMIP6
Authors: Alsafadi Karam , Bi Shuoben , Abdo Hazem Ghassan , Almohamad Hussein , Alatrach Basma , Srivastava Amit Kumar , Al-Mutiry Motrih , Bal Santanu Kumar , Chandran M. A. Sarath , Mohammed Safwan
Published: April 2023

Due to rapid population growth and the limitation of land resources, the sustainability of agricultural ecosystems has attracted more attention all over the world. Human activities will alter the components of the atmosphere and lead to climate change, which consequently affects crop production badly. In this context, wheat is considered an important crop and ranks as one of the top strategic crops globally. The main objective of this research is to develop a new approach (a weighted climatic suitability index) for evaluating the climate suitability for wheat production. The specific objectives are to project the impact of future climate change on wheat suitability using three models based on WCSI and CMIP6-based projections and to identify the most vulnerable area to climate change and productivity reduction. The climatic criteria for wheat production were selected and classified into eight indicators based on the Sys' scheme and the FAO framework, and then the weighted overlay approach was used in conjunction with the analytic hierarchy process. To confirm the reliability of the integrated WCSI, we determined the nonlinear curve fitting of integrated WCSI-induced wheat yields by the exponential growth equation. Finally, the CMIP6-GCMs projected from three shared socioeconomic pathways were used for WCSI mapping and predicting wheat yields in the short and long term (Southern Syria was selected as a case study). The results show that the nonlinear correlation between wheat yields and the integrated WCSI was 0.78 (R2 = 0.61) confirming the integrated WCSI's reliability in reflecting yield variation caused by climate suitability. The results indicated that WCSI for wheat will be lower over the study area during 2080–2100 compared to the current climate. During 2080–2100, the wheat yield is projected to decrease by 0.2–0.8 t. ha−1 in the western parts of the study area. The findings of this study could be used to plan and develop adaptation strategies for sustainable wheat production in the face of projected climate change. The results of the study will also help in the strategic planning of wheat production in Syria under the projected climate. The results of this research are limited to small areas as a case study, although they are not relevant to similar regions worldwide. However, the study employs novel analytical methods that can be used broadly.
Co-learning commentary: a patient partner perspective in mental health care research
Authors: Riches Linda , Ridgway Lisa , Edwards Louisa
Published: April 2023

Background

Although including patients as full, active members of research teams is becoming more common, there are few accounts about how to do so successfully, and almost none of these are written by patient partners themselves. Three patient partners contributed their lived experience to a three-year, multi-component mental health research project in British Columbia, Canada. As patient partners, we contributed to innovative co-learning in this project, resulting in mutual respect and wide-ranging benefits. To guide future patient partners and researchers seeking patient engagement, we outline the processes that helped our research team ‘get it right’.

Main body

From the outset, we were integrated into components of the project that we chose: thematically coding a rapid review, developing questions and engagement processes for focus groups, and shaping an economic model. Our level of engagement in each component was determined by us. Additionally, we catalyzed the use of surveys to evaluate our engagement and the perceptions of patient engagement from the wider team. At our request, we had a standing place on each monthly meeting agenda. Importantly, we broke new ground when we moved the team from using previously accepted psychiatric terminology that no longer fit the reality of patients’ experiences. We worked diligently with the team to represent the reality that was appropriate for all parties. The approach taken in this project led to meaningful and successfully integrated patient experiences, fostered a shared understanding, which positively impacted team development and cohesion. The resulting ‘lessons learned’ included engaging early, often, and with respect; carving out and creating a safe place, free from stigma; building trust within the research team; drawing on lived experience; co-creating acceptable terminology; and cultivating inclusivity throughout the entire study.

Conclusion

We believe that lived experience can and should go hand-in-hand with research, to ensure study outcomes reflect the knowledge of patients themselves. We were willing to share the truth of our lived experience. We were treated as co-researchers. Successful engagement came from the ‘lessons learned’ that can be used by other teams who wish to engage patient partners in health research.
Pre-operative intravitreal bevacizumab for tractional retinal detachment secondary to proliferative diabetic retinopathy: the Alvaro Rodriguez lecture 2023
Authors: Arevalo J. Fernando , Beatson Bradley
Published: April 2023

The treatment of proliferative diabetic retinopathy (PDR) has evolved significantly since the initial use of panretinal photocoagulation as a treatment in the 1950s. Vascular endothelial growth factor inhibitors have provided an effective alternative without the risk of peripheral vision loss. Despite this, the risk of complications requiring surgical intervention in PDR remains high. Intravitreal bevacizumab has shown promise as a preoperative adjuvant to vitrectomy for PDR complications, albeit with a purported risk for tractional retinal detachment (TRD) progression in eyes with significant fibrous proliferation. Here we will discuss anti-VEGF agent use in PDR and its role in surgical intervention for PDR complications including TRD.
Global prevalence of Clostridioides difficile in 17,148 food samples from 2009 to 2019: a systematic review and meta-analysis
Authors: Borji Soroush , Kadivarian Sepide , Dashtbin Shirin , Kooti Sara , Abiri Ramin , Motamedi Hamid , Moradi Jale , Rostamian Mosayeb , Alvandi Amirhooshang
Published: April 2023

Background

Clostridioides (Clostridium) difficile is an important infectious pathogen, which causes mild-to-severe gastrointestinal infections by creating resistant spores and producing toxins. Spores contaminated foods might be one of the most significant transmission ways of C. difficile-associated infections. This systematic review and meta-analysis study were conducted to investigate the prevalence of C. difficile in food.

Methods

Articles that published the prevalence of C. difficile in food in PubMed, Web of Science, and Scopus databases were retrieved using selected keywords between January 2009 and December 2019. Finally, 17,148 food samples from 60 studies from 20 countries were evaluated.

Results

The overall prevalence of C. difficile in various foods was 6.3%. The highest and lowest levels of C. difficile contamination were detected to seafood (10.3%) and side dishes (0.8%), respectively. The prevalence of C. difficile was 4% in cooked food, 6.2% in cooked chicken and 10% in cooked seafood.

Conclusions

There is still little known concerning the food-borne impact of C. difficile, but the reported contamination might pose a public health risk. Therefore, to improve the food safety and prevent contamination with C. difficile spores, it is necessary to observe hygienic issues during foods preparation, cooking and transfer.
Study protocol for an economic evaluation and budget impact of implementation strategies to support routine provision of antenatal care for gestational weight gain: a stepped-wedge cluster trial
Authors: Wynne Olivia , Szewczyk Zoe , Hollis Jenna , Farragher Eva , Doherty Emma , Tully Belinda , Paolucci Francesco , Gillham Karen , Reeves Penny , Wiggers John , Kingsland Melanie
Published: April 2023

Background

Antenatal clinical practice guidelines recommend routine assessment of weight and provision of advice on recommended weight gain during pregnancy and referral to additional services when appropriate. However, there are barriers to clinicians adopting such best-practice guidelines. Effective, cost-effective, and affordable implementation strategies are needed to ensure the intended benefits of guidelines are realised. This paper describes the protocol for evaluating the efficiency and affordability of implementation strategies compared to the usual practice in public antenatal services.

Method

The prospective trial-based economic evaluation will identify, measure, and value key resource and outcome impacts arising from the implementation strategies compared with usual practice. The evaluation will comprise of (i) costing, (ii) cost-consequence analyses, where a scorecard approach will be used to show the costs and benefits given the multiple primary outcomes included in the trial, and (iii) cost-effectiveness analysis, where the primary outcome will be incremental cost per percent increase in participants reporting receipt of antenatal care for gestational weight gain consistent with the guideline recommendations. Affordability will be evaluated using (iv) budget impact assessment and will estimate the financial implications of adoption and diffusion of this implementation strategy from the perspective of relevant fund-holders.

Discussion

Together with the findings from the effectiveness trial, the outcomes of this economic evaluation will inform future healthcare policy, investment allocation, and research regarding the implementation of antenatal care to support healthy gestational weight gain.

Trial registration

Trial Registration: Australian and New Zealand Clinical Trials Registry, ACTRN12621000054819 (22/01/2021)http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380680&isReview=true.
Simulating creep induced moment redistribution in prestressed concrete bridges constructed by the balanced cantilever method: ad hoc traditional formulae versus real time-dependent analysis
Authors: Rashed Magdy , Mehanny Sameh S. F.
Published: April 2023

Assessing available numerical techniques adopted to determine the design time-dependent moment for prestressed concrete segmental bridges constructed by the balanced cantilever method is of utmost importance to the bridge design community. In essence, despite some apparent diversity, there are basically two key conventional approaches to compute the design time-dependent moment accounting for creep effects for this type of bridges. The first is a family of varied simplified methods typically known to practicing designers and with pre-consensus on their reliability and effectiveness. Time-dependent moments retrieved from these classical methods always reside in an intermediate state falling between the results from “two” time-independent analysis cases, namely, (a) sequentially adding all partial permanent loads and prestressing pertaining to various construction steps using the part-bridge structural system corresponding to each step, and (b) assuming all loads and prestressing forces to be applied at-once to the final completed bridge. The second approach is through performing real sophisticated step-by-step time-dependent analysis using a specialized software. The research primary objective is to assess the validity/reliability of commonly used ad-hoc approaches that evolved over the years relying on simplified analyses/formulae to cater for time-dependent creep effects for this type of bridges. Aiming at realistic conclusions, three case-study real-world segmental balanced cantilever bridges over the Nile River in Egypt are elected. Midas Civil commercial package is used to perform time-dependent finite element analyses for the three bridges. Main parameters considered are, inter alia, time-dependent effects of creep and shrinkage of concrete, relaxation of prestressed steel, losses due to friction and anchor setting of prestressing tendons, sequence of construction, and construction-driven temporary change of support conditions (where applicable). The study concludes that creep-induced moment redistribution from simplified traditional formulae typically adopted in the literature may lead to a considerable error in estimating the design time-dependent moment in balanced cantilever bridges.
Avelumab First-Line Maintenance for Advanced Urothelial Carcinoma: Results From the JAVELIN Bladder 100 Trial After ≥2 Years of Follow-Up
Authors: Powles Thomas , Park Se Hoon , Caserta Claudia , Valderrama Begoña P. , Gurney Howard , Ullén Anders , Loriot Yohann , Sridhar Srikala S. , Sternberg Cora N. , Bellmunt Joaquim , Aragon-Ching Jeanny B. , Wang Jing , Huang Bo , Laliberte Robert J. , di Pietro Alessandra , Grivas Petros
Published: April 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned coprimary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.

Initial results from the phase III JAVELIN Bladder 100 trial (ClinicalTrials.gov identifier: NCT02603432 ) showed that avelumab first-line (1L) maintenance plus best supportive care (BSC) significantly prolonged overall survival (OS) and progression-free survival (PFS) versus BSC alone in patients with advanced urothelial carcinoma (aUC) who were progression-free after 1L platinum-containing chemotherapy. Avelumab 1L maintenance treatment is now a standard of care for aUC. Here, we report updated data with ≥ 2 years of follow-up in all patients, including OS (primary end point), PFS, safety, and additional novel analyses. Patients were randomly assigned 1:1 to receive avelumab plus BSC (n = 350) or BSC alone (n = 350). At data cutoff (June 4, 2021), median follow-up was 38.0 months and 39.6 months, respectively; 67 patients (19.5%) had received ≥2 years of avelumab treatment. OS remained longer with avelumab plus BSC versus BSC alone in all patients (hazard ratio, 0.76 [95% CI, 0.63 to 0.91]; 2-sided P = .0036). Investigator-assessed PFS analyses also favored avelumab. Longer-term safety was consistent with previous analyses; no new safety signals were identified with longer treatment duration. In conclusion, longer-term follow-up continues to show clinically meaningful efficacy benefits with avelumab 1L maintenance plus BSC versus BSC alone in patients with aUC. An interactive visualization of data reported in this article is available.
Randomized Phase III Trial Evaluating Subcutaneous Rituximab for the First-Line Treatment of Low–Tumor Burden Follicular Lymphoma: Results of a LYSA Study
Authors: Cartron Guillaume , Bachy Emmanuel , Tilly Hervé , Daguindau Nicolas , Pica Gian-Matteo , Bijou Fontanet , Mounier Christiane , Clavert Aline , Damaj Gandhi Laurent , Slama Borhane , Casasnovas Olivier , Houot Roch , Bouabdallah Krimo , Sibon David , Fitoussi Olivier , Morineau Nadine , Herbaux Charles , Gastinne Thomas , Fornecker Luc-Matthieu , Haioun Corinne , Launay Vincent , Araujo Carla , Benbrahim Omar , Sanhes Laurence , Gressin Remy , Gonzalez Hugo , Morschhauser Franck , Ternant David , Xerri Luc , Tarte Karin , Pranger Delphine
Published: April 2023

PURPOSE

Rituximab improves progression-free survival (PFS) and time to next treatment (TTNT) when compared with the watch and wait strategy for patients with low–tumor burden follicular lymphoma (FL). Prolonged rituximab maintenance did not prolong TTNT, whereas it raises concerns about resources use and patient adhesion. Our aim was then to investigate the use of short rituximab maintenance using the subcutaneous (SC) route in patients with low–tumor burden FL.

METHODS

Patients with histologically confirmed CD20+ low–tumor burden FL were randomly assigned to receive either rituximab, 375 mg/m2 once daily on D1, D8, D15, and D22, intravenous route (IV, control arm), or rituximab, 375 mg/m2, on day 1 (D1), IV followed by rituximab 1,400 mg total dose, SC once daily on D8, D15, and D22, with maintenance at months 3 (M3), M5, M7, and M9 (experimental arm). The primary end point was PFS. Secondary end points included safety, overall response rates, TTNT, and overall survival (OS).

RESULTS

Two hundred two patients with low–tumor burden FL were randomly assigned to the experimental (n = 100) or control arm (n = 102). The primary end point was met: the 4-year PFS was 58.1% (95% CI, 47.5 to 67.4) and 41.2% (95% CI, 30.6 to 51.6) in experimental and control arms, respectively (hazard ratio, 0.585 [0.393 to 0.871]; P = .0076). Complete response (CR) rates were 59.0% (95% CI, 48.7 to 68.7) in the experimental arm and 36.3% (95% CI, 27.0 to 46.4) in the control arm ( P = .001). TTNT and OS were not significantly different. CR was associated with longer PFS and TTNT. High rituximab exposure during the first three months was independently associated with higher CR, PFS, and TTNT.

CONCLUSION

SC rituximab improves PFS for patients with low–tumor burden FL when used in induction followed by short maintenance. High rituximab exposure during the first 3 months after treatment initiation is, however, the only parameter influencing patient outcomes.
Adverse skin reactions to antiepileptic drugs - a review
Authors: Gruszczyńska Michalina , Jarzemski Adam , Kolossa Agnieszka , Porzych Rafał
Published: April 2023

Introduction and objective: Treatment with antiepileptic drugs (AEDs) is frequently used all around the world. Just like in the course of all the drugs administration, side effects may appear, including characteristic side effects presenting on the skin. The aim of the study was to analyse adverse skin reactions to antiepileptic drugs, focusing on their epidemiology, symptoms and treatment.

Methods: Databases including PubMed and Google Scholar were browsed using keywords.

Description of the state of knowledge: The majority of adverse skin reactions (ASRs) constitute mild rashes and urticaria, however in about 10% cases severe reactions may occur, which can be life-threatening. They include Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), Stevens-Johnson syndrome (SJS), Toxic Epidermal Necrolysis (TEN), Serum Sickness and Serum Sickness - like Reactions and Drug Induced Vasculitis. In the course of TEN mortality rates are highest, however all reactions can be dangerous and treatment should be applied immediately. In mild and moderate cases drug withdrawal is usually sufficient, however more severe cases need to be treated with immunosuppressive agents.

Summary: The awareness about possible adverse effects and their treatment is crucial as some can be life-threatening and immediate therapy increases the chance of recovery.
Há Mundial no TikTok? Há Mundial no TikTok? Uma análise da cobertura dos media portugueses ao Mundial de Futebol 2022.
Authors: Giacomelli Fábio , Morais Ricardo
Published: April 2023

O Mundial de Futebol 2022, realizado no Catar, foi o primeiro grande evento desportivo global aberto ao público no período pós-pandemia. O evento, que teve grande cobertura mediática, foi também um dos primeiros, no universo desportivo, a realizar-se numa época marcada pela expansão da cobertura nas redes sociais digitais. Neste contexto destaca-se em particular um aumento da produção de conteúdos audiovisuais na vertical, resultado da influência de plataformas que se têm destacado nos últimos anos, como o Instagram ou o TikTok. Considerando este crescimento, mas também os dados que apontam para uma fraca aposta por parte dos media em algumas destas novas plataformas, neste estudo consideramos importante explorar a forma como os media de Portugal utilizaram o TikTok para reportar os acontecimentos da maior competição global de Futebol. Para alcançar este objetivo escolheu-se doze perfis de órgãos de comunicação social portugueses e fez-se uma análise pormenorizada das publicações, com o intuito de compreender se existe uma produção nativa de conteúdo na plataforma ou apenas uma adaptação de conteúdos, que não permitem utilizar todos os recursos das plataformas e, dessa forma, se afastam dos utilizadores. Os resultados apontam para o uso da plataforma na cobertura do mundial, ainda que através de uma produção adaptada e sobretudo orientada para a divulgação de conteúdos opinativos, o que acaba por refletir uma fraca aposta numa das plataformas que mais tem crescido e onde muitos dos utilizadores fazem parte do público que se tem afastado dos media.
Análise comparativa do recorte das imagens veiculadas no Facebook dos candidatos presidenciais no Brasil e na Espanha: um estudo semiótico.
Authors: Farias Coelho Patricia Margarida , Simancas González Esther
Published: April 2023

ste artigo propõe um estudo comparativo no recorte das imagens da rede social Facebook dos candidatos presidenciais do Brasil e da Espanha. No Brasil, no ano de 2022, especificamente dos candidatos Luiz Inácio Lula da Silva (Partido dos Trabalhadores - PT) e Jair Bolsonaro (Partido Liberal - PL), e da Espanha, no ano de 2018, Pedro Sánchez (PSOE) e Pablo Casado (Partido Popular - PP). Buscaremos verificar de que maneira cada país cria as imagens de seus candidatos para suas páginas pessoais. O corpus deste estudo constitui-se dos recortes das páginas principais do Facebook dos candidatos presidenciais criadas no Brasil e na Espanha. Temos, neste artigo, dois objetivos, bem claros e específicos: (i) fazer uma análise semiótica do plano do conteúdo (níveis narrativo, discursivo e fundamental) do recorte das imagens; e (ii) analisar o plano da expressão a partir das categorias cromáticas e topológicas, a fim de verificar como cada candidato cria sua imagem na rede social para as campanhas eleitorais. Como arcabouço teórico nos apoiamos na semiótica discursiva, principalmente nas pesquisas de Greimas e Courtés (2008), Floch (1985, 1995a, 1995b), Oliveira (2004), Oliveira & Teixeira (2009), Barros (2002), Fiorin (1999, 2000, 2002) e Fontanille & Zilberberg (2001). A metodologia utilizada será a descritiva, como prevê a semiótica francesa, e o método empregado é o hipotético-dedutivo. Os resultados esperados pretendem demonstrar que os elementos verbais e visuais tornam as páginas da rede social dos candidatos presidenciais mais significativas para o seu eleitor/receptor (enunciatário/destinatário), que é influenciado a escolher e votar em um determinado candidato.
Long-standing osteomyelitis: a case report and discussion
Authors: McDonnell Fiona , Eyeson Josiah
Published: April 2023

Osteomyelitis is a chronic inflammatory bone disease, which can present management difficulties owing to its complex pathogenic process and increasingly virulent micro-organisms. The incidence of the condition has decreased in recent years, primarily due to the availability of antimicrobial therapy; however, this alone does not always resolve symptoms. Once established osteomyelitis can be challenging to manage. This case demonstrates that in certain instances a more aggressive form of multidisciplinary treatment is required to improve the condition and alleviate the patient's symptoms, allowing for a better quality of life.

CPD/Clinical Relevance: Knowledge of osteomyelitis is relevant to both general dental practitioners and specialists involved in the management of patients with complex medical needs.
Musicological analysis of the recitation of Surah Al-Fatiha in the musically-performed congregational worship
Authors: Indrawan Andre , Salsabil Salsabil , Islami Muhammad Fikrul
Published: April 2023

The Qur’anic recitation with melodious vocals and melodies has a significant role in implementing congregational prayers in a mosque. Musical recitation by a competent Imam can increase the worshipers’ comfort during the prayers. However, little is known to the general public about what is behind the beautiful recited voice. Some Muslims believe that the recitation of the Qur’an in prayer could not be included as music, even though some musicological aspects support its aesthetics. Although the artistic significance of the Qur’an’s recitation is not uncommon among Muslims and even contested openly, the musicological aspects of its recitation in congregational prayer rarely be discussed. The problem discussed in this study is what underlies the recitation of a trained Imam so that the worshippers sincerely feel comfort in following the congregational. This study aims to identify the scale modes within recited Qur’anic verses by the Imam during the congregational prayer at the Jogokariyan Mosque in Yogyakarta. This research uses qualitative methods with a participating observation as its approach. The analysis unit of this study is the Al-Fatiha Chapter recitation by one of the best Imams of the mosque while leading the congregational prayers during the month of Ramadhan this year. Data disclosure uses musicological analysis involving field data recording transcription and theoretical methods. The research stage includes the field research process, transcription from the Qur’anic reading by the subject, theoretical analysis, and formulating findings. This study has resulted in an array of knowledge concerning the Imams and Muadzin management system and the characteristics of the Qur’anic recitation performed by the research subject. From a Western musicological perspective, the music transcription showed varieties of Qur’anic recitation tunes produced by the Imam within the framework of major and minor scale modes. The Imam clarified that the recitation implemented Islamic music theory known as maqam types. In conclusion, the Bayati maqam applied by the Imam resembles the Phrygian Mode of Medieval mode. Meanwhile, the Hijaz maqam resembles the Phrygian Dominant scale. Implication: While for some circles of Islamic society, music is controversial in reality, many valued aspects of Islamic religious activities can contribute to the development of musicological studies.
DESIGUALDADE SALARIAL DE GÊNERO EM FEIRA DE SANTANA
Authors: Tatiane de Araújo Jesus  , Cleiton Silva de Jesus
Published: April 2023

Procurou-se nesta pesquisa construir uma base de dados, a partir das informações encontradas na Relação Anual de Informações Sociais (RAIS) do Ministério da Economia, para investigar a evolução da desigualdade salarial de gênero em Feira de Santana.
Surgical techniques to reduce oronasal fistula risk in wide cleft palate repair: a systematic review
Authors: Kreshanti Prasetyanugraheni , Sadikin Patricia Marcellina , Anggraeni Margareth Ingrid , Wibowo Jasmine Athiyya , Bangun Kristaninta
Published: April 2023

BACKGROUND Wide cleft palate is a common congenital anomaly, particularly in developing countries with limited access to plastic surgeons and specialized cleft centers. It can be severe and may contribute to the development of oronasal fistula, which can occur in up to 78% of cases. Despite numerous surgical techniques for wide cleft repair, the best method remains unclear. This study aimed to identify surgical techniques for wide cleft palate repair to minimize the occurrence of oronasal fistula.

METHODS Literature searching was conducted using multiple online databases including PubMed, Scopus, and Cochrane Library. The keywords used were “cleft palate”, ” surgery”, “technique”, “palatoplasty”, and “wide”. Inclusion and exclusion criteria were applied to select relevant studies, and the quality was assessed.

RESULTS A total of 12 studies discussed surgical techniques to repair the primary wide cleft palate and their outcome on oronasal fistula formation. The surgical techniques included modified Furlow palatoplasty, two-flap palatoplasty, and modified Bardach’s two-flap palatoplasty. The incidence of oronasal fistula was 9.6% (n = 28/291) in one-stage Furlow palatoplasty and 12.0% (n = 24/200) in the modified one-stage two-flap palatoplasty.

CONCLUSIONS Two-flap palatoplasty and Furlow palatoplasty (and their modifications) were the safe surgical techniques for wide cleft repair with a low occurrence of oronasal fistula.
Design of a panoramic annular lens system with an ultra-wide angle via an annular Gaussian radial basis function freeform surface
Authors: Yang Yingzhe , Wang Jia , Li Yuejia , Bai Jian
Published: April 2023

The panoramic annular lens (PAL) system can capture plentiful scene information in real time. The locally described freeform surface can provide more degrees of freedom for the optical system design than the globally described one. In this paper, we propose a locally described annular Gaussian radial basis function freeform surface that enables a high-performance yet compact PAL system. The designed PAL system achieves an ultra-wide field of view (FOV) of (30∘∼125∘)×360∘. The F-theta distortion of the system is less than 3%, and the modulation transfer function across the whole FOV is greater than 0.5 at 100 lp/mm. The proposed system can be implemented for various applications such as video conferencing or robotic navigation.
Knowledge and attitudes of deaf persons towards safe abortion services in Ghana
Authors: Mprah Wisdom Kwadwo , Duorinaah Juventus , Opoku Maxwell Peprah , Nketsia William , Amponteng Michael
Published: April 2023

Background

Deafness refers to partial or total loss of hearing, which, if not appropriately accommodated, may interfere with day-to-day living experiences. Deaf people encountered challenges in their efforts to access essential services, such as health care. While some attention has been given to general access to reproductive health services, less research has focused on the experiences of deaf women and girls when accessing safe abortion services. With unsafe abortion being a major cause of maternal deaths among women in developing countries, this study attempted to explore the perception of deaf women and girls in Ghana towards safe abortion services.

Objective

The main aim of this study was to understand the perception and awareness safe abortion services among deaf women and girls in Ghana. In doing this, the contributors towards unsafe abortion practices among deaf women and girls were gathered.

Method

Penchansky and Thomas’ accessibility to health care theory availability, accessibility, accommodation/adequacy, affordability, and acceptability guides this study. A semi-structured interview guide based on components of the theory was used for data collection from 60 deaf persons.

Results

The components of the theory were used as a priori themes that guided the data analysis. The results showed challenges associated with the indicators of health access. For instance, in terms of availability, it was revealed that deaf women had little knowledge about existing laws on safe abortion in Ghana. In relation to acceptability, deaf women were highly opposed to abortion for cultural and religious reasons. However, there was consensus that safe abortion could be conducted under certain conditions.

Conclusion

The results of the study have implications for policymaking aimed at attaining equitable access to reproductive health care for deaf women. The need for policymakers to expedite public education and incorporate the needs of deaf women in reproductive health policies, as well as other study implications, are discussed.
Investigating the use of pollen DNA metabarcoding to quantify bee foraging and effects of threshold selection
Authors: Arstingstall Katherine A. , DeBano Sandra J. , Li Xiaoping , Wooster David E. , Rowland Mary M. , Burrows Skyler , Frost Kenneth
Published: April 2023

DNA metabarcoding of pollen is a useful tool for studying bee foraging ecology. However, several questions about this method remain unresolved, including the extent to which sequence read data is quantitative, which type of sequence count removal threshold to use and how that choice affects our ability to detect rare flower visits, and how sequence artefacts may confound conclusions about bee foraging behavior. To address these questions, we isolated pollen from five plant species and created treatments comprised of pollen from each species alone and combinations of pollen from multiple species that varied in richness and evenness. We used ITS2 and rbcL metabarcoding to identify plant species in the samples, compared the proportion of pollen by mass to the proportion of sequencing reads for each plant species in each treatment, and analyzed the sequencing data using both liberal and conservative thresholds. We collected pollen from foraging bees, analyzed metabarcoding data from those samples using each threshold, and compared the differences in the pollinator networks constructed from the data. Regardless of the threshold used, the relationship between the proportion of pollen by mass and sequencing reads was inconsistent, suggesting that the number of sequence reads is a poor proxy for pollen abundance in mixed-species samples. Using a liberal threshold resulted in greater detection of original plant species in mixtures but also detected additional species in mixtures and single-species samples. The conservative threshold reduced the number of additional plant species detected, but several species in mixtures were not detected above the threshold, resulting in false negatives. Pollinator networks produced using the two thresholds differed and illustrated tradeoffs between detection of rare species and estimation of network complexity. Threshold selection can have a major effect on conclusions drawn from studies using metabarcoding of bee pollen to study plant-pollinator interactions.
A retrospective study on epidemiological analysis of pre-hospital emergency care in Hangzhou, China
Authors: Wang Jiangang , He Yanbin , Chen Xiaoling , Chen Miaomiao , Tang Chunfu , Lu Fenghua , Qi Ming , Zhang Jungen
Published: April 2023

Out-of-hospital cardiac arrest (OHCA) is a leading cause of global mortality, with numerous factors influencing the patient survival rate and prognosis. This study aimed to evaluate the OHCA epidemiology in China and elaborate on the current Hangzhou emergency system status. This retrospective analysis was based on the medical history system of the Hangzhou Emergency Center registered from 2015–2021. We provided a detailed description of OHCA characteristics and investigated the factors affecting the success rate of emergency treatment in terms of epidemiology, causes of onset, bystander rescue, and outcome factors. We included 9585 out-of-hospital cardiac arrest cases, of which 5442 (56.8%) had evidence of resuscitation. Patients with underlying diseases constituted the vast majority (80.1%); trauma and physicochemical factors accounted for 16.5% and 3.4%, respectively. Only 30.4% of patients (about 80.0% of bystanders witnessed) received bystander first aid. The outcome rate of emergency doctors dispatched by emergency centres was significantly higher than doctors dispatched by hospitals. Additionally, physician’s first-aid experience, emergency response time, emergency telephone availability, initial heart rhythm, out-of-hospital defibrillation, out-of-hospital intubation, and using of epinephrine significantly can significantly improve the out-of-hospital return of spontaneous circulation in patients. All steps in pre-hospital care are important for patients, especially for bystander first aid and physician’s first-aid experience. The popularity of first-aid training and the public emergency medical system are not potent enough. We should take those key factors into consideration when developing a pre-hospital care system for OHCA.
The potential cost-effectiveness of novel cord blood therapies in children with autism spectrum disorder
Authors: Borre Ethan D. , Myers Evan , Hamilton Lopez Marianne , Kurtzberg Joanne , Shaz Beth , Troy Jesse , Sanders Schmidler Gillian D.
Published: April 2023

Objective

To model the long-term clinical and economic outcomes of potential cord blood therapy in autism spectrum disorder (ASD).

Study design

Markov microsimulation of ASD over the lifespan was used to compare two strategies: 1) standard of care (SOC), including behavioral and educational interventions, and 2) novel cord blood (CB) intervention in addition to SOC. Input data reflecting behavioral outcomes included baseline Vineland Adaptive Behavior Scale (VABS-3), monthly VABS-3 changes, and CB intervention efficacy on adaptive behavior based on a randomized, placebo-controlled trial (DukeACT). Quality-adjusted life-years (QALYs) were correlated to VABS-3. Costs for children with ASD ($15,791, ages 2–17 years) and adults with ASD ($56,559, ages 18+ years), and the CB intervention (range $15,000–45,000) were incorporated. Alternative CB efficacy and costs were explored.

Results

We compared model-projected results to published data on life-expectancy, mean VABS-3 changes, and lifetime costs. Undiscounted lifetime QALYs in the SOC and CB strategies were 40.75 and 40.91. Discounted lifetime costs in the SOC strategy were $1,014,000, and for CB ranged from $1,021,000-$1,058,000 with CB intervention cost ($8,000-$45,000). At $15,000 cost, CB was borderline cost-effective (ICER = $105,000/QALY). In one-way sensitivity analysis, CB cost and efficacy were the most influential parameters on CB ICER. CB intervention was cost-effective at costs<$15,000 and efficacies ≥2.0. Five-year healthcare payer projected budgetary outlays at a $15,000 CB cost were $3.847B.

Conclusions

A modestly effective intervention designed to improve adaptive behavior in autism can be cost-effective under certain circumstances. Intervention cost and efficacy most affected the cost-effectiveness results and should be targeted to increase economic efficiency.
Seasonal variations in gut microbiota and disease course in patients with inflammatory bowel disease
Authors: Tani Mizuki , Shinzaki Shinichiro , Asakura Akiko , Tashiro Taku , Amano Takahiro , Otake-Kasamoto Yuriko , Yoshihara Takeo , Yoshii Shunsuke , Tsujii Yoshiki , Hayashi Yoshito , Inoue Takahiro , Motooka Daisuke , Nakamura Shota , Iijima Hideki , Takehara Tetsuo
Published: April 2023

Background and aim

Environmental factors are associated with onset and course of inflammatory bowel disease (IBD). Our previous study by about 1,100 IBD patients revealed half of the patients experienced seasonal exacerbation of disease. We investigated the seasonality of fecal microbiota composition of IBD patients.

Methods

Fecal samples were consecutively collected in each season from IBD outpatients and healthy controls between November 2015 and April 2019. Participants who were treated with full elemental diet or antibiotics within 6 months or had ostomates were excluded. Bacterial profiles were analyzed by 16S rRNA sequencing, and the changes between the diseases and seasons were compared.

Results

A total of 188 fecal samples were analyzed from 47 participants comprising 19 Crohn’s disease (CD) patients, 20 ulcerative colitis (UC) patients, and 8 healthy controls (HC). In CD patients, the phylum Actinobacteria and TM7 were both significantly more abundant in autumn than in spring and winter, but not in UC patients and HC. Moreover, the genera Actinomyces, a member of Actinobacteria, and c_TM7-3;o_;f_;g_ (TM7-3), that of TM7, were significantly more abundant in autumn than in spring, and the abundance of Actinomyces was significantly correlated with that of TM7-3 throughout the year in CD patients, but not in UC patients and HC. CD patients with high abundance of TM7-3 in the autumn required significantly fewer therapeutic intervention than those without seasonal fluctuation.

Conclusions

Oral commensals Actinomyces and its symbiont TM7-3 were correlatively fluctuated in the feces of CD patients by season, which could affect the disease course.