bluuebunny/crossref_metadata_2025 huggingface dataset:
Judiciário: a institucionalização como poder
Authors: Sadek Maria Tereza Aina
Published: September 2022

O artigo tem por objetivo apresentar o processo de construção da identidade do Judiciário, tendo por base o modelo constitucional presidencialista de tripartição de poderes. Ao longo do tempo, o Judiciário e seus integrantes fizeram-se presentes na arena pública e na vida social, constituindo-se como protagonistas de primeira grandeza. A discussão parte do suposto de que o desenho constitucional forja características que respondem pela identidade da instituição. Esses atributos, contudo, configuram virtualidades que podem ser impulsionadas ou debilitadas por traços de seus ocupantes, bem como pelas relações com atores externos.
Intravenous Thrombolysis With Alteplase at 0.6 mg/kg in Patients With Ischemic Stroke Taking Direct Oral Anticoagulants
Authors: Okada Takashi , Yoshimoto Takeshi , Wada Shinichi , Yoshimura Sohei , Chiba Tetsuya , Egashira Shuhei , Kimura Shunsuke , Shiozawa Masayuki , Inoue Manabu , Ihara Masafumi , Toyoda Kazunori , Takashima Hiroshi , Koga Masatoshi
Published: September 2022

Background

We elucidated the safety of treatment with alteplase at 0.6 mg/kg within 24 hours for patients on direct oral anticoagulants (DOACs) before ischemic stroke onset.

Methods and Results

Consecutive patients with acute ischemic stroke who underwent intravenous thrombolysis using alteplase at 0.6 mg/kg from 2011 to 2021 were enrolled from our single‐center prospective stroke registry. We compared outcomes between patients taking DOACs and those not taking oral anticoagulants within 48 hours of stroke onset. The primary safety outcome was the rate of symptomatic intracranial hemorrhage with a ≥4‐point increase on the National Institutes of Health Stroke Scale score from baseline. The efficacy outcome was defined as 3‐month modified Rankin Scale score of 0 to 2 after stroke onset. Of 915 patients with acute ischemic stroke who received intravenous thrombolysis (358 women; median age, 76 years; median National Institutes of Health Stroke Scale score, 10), 40 patients took DOACs (6 took dabigatran, 8 took rivaroxaban, 16 took apixaban, and 10 took edoxaban) within 24 hours of onset and 753 patients did not take any oral anticoagulants. The rate of symptomatic intracranial hemorrhage was comparable between patients on DOACs and those not on oral anticoagulants (2.5% versus 2.4%,
P
=0.95). The rate of favorable outcomes was comparable between the 2 groups (59.4% versus 58.2%,
P
=0.46), although the admission National Institutes of Health Stroke Scale score was higher in patients on DOACs. No significant differences showed in any intracranial hemorrhage within 36 hours or mortality at 3 months.

Conclusions

Intravenous thrombolysis would be safely performed for patients on DOACs following the recommendations of the Japanese guidelines.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02251665.
Comparison of Bolus Dosing of Methohexital and Propofol in Elective Direct Current Cardioversion
Authors: Beaty Elijah H. , Fernando Rohesh J. , Jacobs Marie L. , Winter Gillian G. , Bulla Catalina , Singleton Matthew J. , Patel Neel J. , Bradford Natalie S. , Bhave Prashant D. , Royster Roger L.
Published: September 2022

Background

Methohexital and propofol can both be used as sedation for direct current cardioversion (DCCV). However, there are limited data comparing these medications in this setting. We hypothesized that patients receiving methohexital for elective DCCV would be sedated more quickly, recover from sedation faster, and experience less adverse effects.

Methods and Results

This was a prospective, blinded randomized controlled trial conducted at a single academic medical center. Eligible participants were randomly assigned to receive either methohexital (0.5 mg/kg) or propofol (0.8 mg/kg) as a bolus for elective DCCV. The times from bolus of the medication to achieving a Ramsay Sedation Scale score of 5 to 6, first shock, eyes opening on command, and when the patient could state their age and name were obtained. The need for additional medication dosing, airway intervention, vital signs, and medication side effects were also recorded. Seventy patients who were randomized to receive methohexital (n=37) or propofol (n=33) were included for analysis. The average doses of methohexital and propofol were 0.51 mg/kg and 0.84 mg/kg, respectively. There were no significant differences between methohexital and propofol in the time from end of injection to loss of conscious (1.4±1.8 versus 1.1±0.5 minutes;
P
=0.33) or the time to first shock (1.7±1.9 versus 1.4±0.5 minutes;
P
=0.31). Time intervals were significantly lower for methohexital compared with propofol in the time to eyes opening on command (5.1±2.5 versus 7.8±3.7 minutes;
P
=0.0005) as well as at the time to the ability to answer simple questions of age and name (6.0±2.6 versus 8.6±4.0 minutes;
P
=0.001). The methohexital group experienced less hypotension (8.1% versus 42.4%;
P
<0.001) and less hypoxemia (0.0% versus 15.2%;
P
=0.005), had lower need for jaw thrust/chin lift (16.2% versus 42.4%;
P
=0.015), and had less pain on injection compared with propofol using the visual analog scale (7.2±9.7 versus 22.4±28.1;
P
=0.003).

Conclusions

In this model of fixed bolus dosing, methohexital was associated with faster recovery, more stable hemodynamics, and less hypoxemia after elective DCCV compared with propofol. It can be considered as a preferred agent for sedation for DCCV.

Registration

URL:
https://www.clinicaltrials.gov/ct
; Unique identifier: NCT04187196.
Deferral of Coronary Revascularization in Patients With Reduced Ejection Fraction Based on Physiological Assessment: Impact on Long‐Term Survival
Authors: Gallinoro Emanuele , Paolisso Pasquale , Di Gioia Giuseppe , Bermpeis Kostantinos , Fernandez‐Peregrina Estefania , Candreva Alessandro , Esposito Giuseppe , Fabbricatore Davide , Bertolone Dario Tino , Bartunek Jozef , Vanderheyden Marc , Wyffels Eric , Sonck Jeroen , Collet Carlos , De Bruyne Bernard , Barbato Emanuele
Published: September 2022

Background

Deferring revascularization in patients with nonsignificant stenoses based on fractional flow reserve (FFR) is associated with favorable clinical outcomes up to 15 years. Whether this holds true in patients with reduced left ventricular ejection fraction is unclear. We aimed to investigate whether FFR provides adjunctive clinical benefit compared with coronary angiography in deferring revascularization of patients with intermediate coronary stenoses and reduced left ventricular ejection fraction.

Methods and Results

Consecutive patients with reduced left ventricular ejection fraction (≤50%) undergoing coronary angiography between 2002 and 2010 were screened. We included patients with at least 1 intermediate coronary stenosis (diameter stenosis ≥40%) in whom revascularization was deferred based either on angiography plus FFR (FFR guided) or angiography alone (angiography guided). The primary end point was the cumulative incidence of all‐cause death at 10 years. The secondary end point (incidence of major adverse cardiovascular and cerebrovascular events) was a composite of all‐cause death, myocardial infarction, any revascularization, and stroke. A total of 840 patients were included (206 in the FFR‐guided group and 634 in the angiography‐guided group). Median follow‐up was 7 years (interquartile range, 3.22–11.08 years). After 1:1 propensity‐score matching, baseline characteristics between the 2 groups were similar. All‐cause death was significantly lower in the FFR‐guided group compared with the angiography‐guided group (94 [45.6%] versus 119 [57.8%]; hazard ratio [HR], 0.65 [95% CI, 0.49–0.85];
P
<0.01). The rate of major adverse cardiovascular and cerebrovascular events was lower in the FFR‐guided group (123 [59.7%] versus 139 [67.5%]; HR, 0.75 [95% CI, 0.59–0.95];
P
=0.02).

Conclusions

In patients with reduced left ventricular ejection fraction, deferring revascularization of intermediate coronary stenoses based on FFR is associated with a lower incidence of death and major adverse cardiovascular and cerebrovascular events at 10 years.
Glenzocimab: A GPVI (Glycoprotein VI)-Targeted Potential Antiplatelet Agent for the Treatment of Acute Ischemic Stroke
Authors: Wichaiyo Surasak , Parichatikanond Warisara , Rattanavipanon Wipharak
Published: September 2022

It has previously been shown in several animal experiments that platelet GPVI (glycoprotein VI) contributes to thrombosis, particularly in ischemic stroke. Moreover, GPVI levels are upregulated in stroke patients. This review describes the therapeutic roles of anti-GPVI antibody in preclinical models of ischemic stroke and provides the current evidence for potential benefits of glenzocimab, a Fab fragment of humanized anti-GPVI monoclonal antibody, in stroke patients. Anti-GPVI antibody, JAQ1, significantly decreased infarct volume and improved neurological function in mice with transient middle cerebral artery occlusion, a model of ischemic stroke, with no or minor bleeding tendency. Intravenous injection of glenzocimab in nonhuman primates produced rapid inhibition of ex vivo platelet aggregation induced by collagen (a GPVI ligand). Complete platelet inhibition is observed at 30 minutes following administration without increasing the risk of bleeding. In humans, glenzocimab is well tolerated and produces dose-dependent antiplatelet activity. More importantly, glenzocimab (125–1000 mg) was safe when administered as soon as possible (<3 hours) following reperfusion with the r-tPA (recombinant tissue-type plasminogen activator) in patients with acute ischemic stroke. Although glenzocimab 1000 mg (a selected dose) did not demonstrate a significant improvement in overall clinical outcomes, it appeared to provide benefits in severe cases and in patients who required thrombectomy. This promising efficacy together with a good safety profile of glenzocimab warrant further investigation in phase III (ACTISAVE [Adaptive Efficacy and Safety Study of Glenzocimab Used as an Add-On Therapy on Top of Standard of Care in the 4.5 Hours Following an Acute Ischemic Stroke]) clinical study.
Cistercian Adventures in Glass
Authors: Koestlé-Cate Jonathan
Published: September 2022

Stained glass windows created by Jean-Pierre Raynaud and Pierre Soulages for the Abbeys of Noirlac and Conques employ a minimalistic style sensitive to their Romanesque contexts but also express qualities one might call Cistercian, even though only one of the commissions was created for an actual Cistercian abbey. As a form of monasticism, “Cistercian” signifies values of simplicity, poverty, and austerity presented by the founders of the Cistercian Order as essential to the monastic life and embodied in the rigor of their architecture. Natural light is a key element in Cistercian fenestration, differing significantly from the display of color associated with Gothic stained glass. I argue that a form of neo-Cistercianism is evident in and exemplified by the works of Raynaud and Soulages for their respective abbey commissions, in which an aesthetic of restraint and economy aims, above all, to treat the configuration of light as the primary consideration.
A new species of Pseudodiaptomus (Copepoda, Calanoida, Pseudodiaptomidae) from off Tanjung Merah, Bitung, North Sulawesi, Indonesia
Authors: Mulyadi
Published: September 2022

A new species of the demersal copepod genus Pseudodiaptomus is described from Sulawesi, Indonesia. This species is definitely assigned to the Nudus species group. Pseudodiaptomus kleini n. sp. is distinguishable in the female by the posterior corners of its Pdg5 with 3 spine-like processes, the symmetrical CR, the Ur1 without any processes, and the form of the P5; in the male by the Ur1 naked, and the form of the P5.
Complementary description and record of Peltidium perturbatum Geddes, 1968 (Copepoda, Harpacticoida, Peltidiidae) from the Northwestern Tropical Atlantic
Authors: Suárez-Morales Eduardo
Published: September 2022

During a survey of the zooplankton community of a protected coastal system on the Caribbean coast of Mexico, several adult females and immature individuals of the usually benthic or epiphytic harpacticoid copepod genus Peltidium, were recovered; they were identified as the Bahamian species P. perturbatum Geddes, 1968. This species has not been recorded from other areas of the Northwestern Tropical Atlantic (NWTA) region after its original description. Based on the examination of the Mexican Caribbean material, a complementary description of this species is presented including new details of antennules, caudal rami, leg 1, and cuticular ornamentation by using SEM analysis. Its finding in the Mexican Caribbean represents the southernmost record of the genus in the Americas and the first record for the Mexican copepod fauna. A key to the known species of the genus in the NWTA is also provided.
Performance of New Near-Real-Time PERSIANN Product (PDIR-Now) for Atmospheric River Events over the Russian River Basin, California
Authors: Afzali Gorooh Vesta , Shearer Eric J. , Nguyen Phu , Hsu Kuolin , Sorooshian Soroosh , Cannon Forest , Ralph Marty
Published: September 2022

Most heavy precipitation events and extreme flooding over the U.S. Pacific coast can be linked to prevalent atmospheric river (AR) conditions. Thus, reliable quantitative precipitation estimation with a rich spatiotemporal resolution is vital for water management and early warning systems of flooding and landslides over these regions. At the same time, high-quality near-real-time measurements of AR precipitation remain challenging due to the complex topographic features of land surface and meteorological conditions of the region: specifically, orographic features occlude radar measurements while infrared-based algorithms face challenges, differentiating between both cold brightband (BB) precipitation and the warmer nonbrightband (NBB) precipitation. It should be noted that the latter precipitation is characterized by greater orographic enhancement. In this study, we evaluate the performance of a recently developed near-real-time satellite precipitation algorithm: Precipitation Estimation from Remotely Sensed Information Using Artificial Neural Networks (PERSIANN) Dynamic Infrared–Rain Rate-Now (PDIR-Now). This model is primarily dependent on infrared information from geostationary satellites as input; consequently, PDIR-Now has the advantage of short data latency, 15–60-min delay between observation to precipitation product delivery. The performance of PDIR-Now is analyzed with a focus on AR-related events for cases dominated by NBB and BB precipitation over the Russian River basin. In our investigations, we utilize S-band (3-GHz) precipitation profilers with Joss/Parsivel disdrometer measurements at the Middletown and Santa Rosa stations to classify BB and NBB precipitation events. In general, our analysis shows that PDIR-Now is more skillful in retrieving precipitation rates over both BB and NBB events across the topologically complex study area as compared to PERSIANN-Cloud Classification System (CCS). Also, we discuss the performance of well-known operational near-real-time precipitation products from 2017 to 2019. Conventional categorical and volumetric categorical indices, as well as continuous statistical metrics, are used to show the differences between various high-resolution precipitation products such as Multi-Radar Multi-Sensor (MRMS).
Preparing in Advance to Respond in-the-Moment: Investigating Parallel Changes in Planning and Enactment in Teacher Professional Development
Authors: Kavanagh Sarah Schneider , Danielson Katie A. , Schiavone Gotwalt Elizabeth
Published: September 2022

Despite warrants for classroom discussion, research consistently finds that discussions in K-12 classrooms remain rare. Our research investigates whether and in what ways practice-based teacher learning opportunities focused on discussion facilitation influence opportunities for student talk. Grounded in data from a job-embedded professional development program for fourth- to eighth-grade literacy teachers, we analyzed videos of teachers co-planning and co-facilitating discussions with students. Findings indicate that, across 1 year, during co-facilitated classroom discussions, teacher talk decreased, while student talk increased. In a parallel finding, our analysis of co-planning sessions revealed that the ways teachers planned for discussions also changed. Teachers went from engaging only in what we call proactive pedagogical reasoning to balancing that with what we have come to call responsive pedagogical reasoning.
Psychiatric Treatment and Repeat Suicide Attempts Among Adults With Substance Use, by HIV Status, United States, 2014-2020
Authors: Iqbal Shareen A. , Truman Benedict I. , Crosby Alex E.
Published: September 2022

Objectives:

The association among psychiatric treatment history, HIV, and suicide reattempts among people starting treatment for substance use is not well understood. The objective of this study was to describe, by HIV status, the risk and protective factors associated with suicide reattempts among adults seeking treatment for substance use.

Methods:

The study included 340 390 US adult residents aged ≥18 years in the Addiction Severity Index–Multimedia Version network from January 1, 2014, through December 31, 2020. We used adjusted logistic regression models to estimate strength of association between prior psychiatric treatment, HIV status, and sociodemographic factors and suicide reattempts within 30 days of treatment evaluation.

Results:

Adults who had been prescribed psychiatric medication were less likely to have a recent suicide reattempt (adjusted odds ratio [aOR] = 0.8; 95% CI, 0.7-0.8) than adults with no prescription history. Adjusted models found similar protective effects between psychiatric treatment and suicide reattempts among adults reporting abuse, mental illness, injection drug use, and limited activity because of a medical condition. Conversely, the following were associated with recent suicide reattempts: being male (aOR = 1.4; 95% CI, 1.3-1.5), having a high school education/GED (General Educational Development) or less (aOR = 1.2; 95% CI, 1.1-1.2), being single (aOR = 1.2; 95% CI, 1.1-1.3), experiencing a pain problem (aOR = 1.2; 95% CI, 1.2-1.3), and not being referred to substance use treatment by court (aOR = 3.4; 95% CI, 3.2-3.7).

Conclusions:

A history of prescribed psychiatric medication is significantly associated with a reduced risk for suicide reattempts among adults seeking substance use treatment. Clinicians should consider incorporating mental health and suicide assessments into substance use treatment plans.
Place, Violence, and Resistance: Impacts of Mining in the Chilean Andes
Authors: Carrasco Anita
Published: September 2022

The indigenous community of Estación San Pedro has turned a sense of place into an act of resistance to the impacts of mining on its homeland in the Chilean Andes. In 2007 San Pedrinos wrote to the headquarters of Chile’s National Copper Corporation claiming compensation for historical dispossession of water, forced migration from their homeland, and the disintegration of their traditional way of life. San Pedrinos continue to return to their homeland despite the mining corporation’s historical attempts to obliterate them.

La comunidad indígena de Estación San Pedro ha convertido su sentido de lugar en un acto de resistencia ante los impactos de la minería en su tierra natal, localizada en los Andes chilenos. En 2007, los san pedrinos escribieron a la sede de la Corporación Nacional del Cobre de Chile exigiendo una compensación por el despojo histórico de agua, la migración forzada de su lugar natal y la desintegración de su forma de vida tradicional. Los san pedrinos continúan regresando a su tierra natal a pesar de los intentos históricos de la corporación minera por destruirlos.
Can clinical judgement overcome flawed materials when assessing black children: The need for more intervention-based pedagogy and less assessment negligence
Authors: Graves Scott L.
Published: September 2022

Albert Beckham, who was the first Black school psychologist in the U.S., frequently used intelligence tests with Black children. This usage required clinical decision making to explain the results obtained from psychoeducational assessments. In their discussion of this aspect of Beckham’s work, introduce the concept of Culturally Relevant Clinical Judgement. This paper discusses issues related to the continued use of cognitive assessment instruments as it relates to clinical judgment in special education eligibility decision-making in comparison to alternatives such as Response-to-Intervention (RtI).
The best structure of the Tampa Scale for Kinesiophobia for patients with chronic low back pain has two domains and nine items
Authors: Pontes-Silva André , Dibai-Filho Almir Vieira , Costa de Jesus Sulamizia Filomena , Santos de Oliveira Leonardo Antônio , Bassi-Dibai Daniela , Fidelis de Paula Gomes Cid André , Avila Mariana Arias
Published: September 2022

Purpose

To identify the best internal structure of the Tampa Scale for Kinesiophobia in chronic low back pain patients.

Design

Questionnaire validation study was designed for this study.

Setting

This study was conducted in physical therapy facility.

Subjects

Respondents reporting chronic low back pain (≥3 points on the 11-point Numerical Pain Rating Scale).

Main measures

We included participants of both sexes, with a self-report of low back pain ≥3 months and with pain intensity ≥3 on the 11-point Numerical Pain Rating Scale; participants also answered the Roland–Morris Disability Questionnaire and the Pain-Related Catastrophizing Thoughts Scale for low back pain disability and catastrophizing, respectively. The dimensionality and number of items of the Tampa Scale for Kinesiophobia were evaluated using the confirmatory factor analysis. Criterion validity was assessed using Spearman’s correlation coefficient using the original version of the 17-item Tampa Scale for Kinesiophobia as the gold standard.

Results

A total of 122 participants were included, with mean values of low back pain duration ≥48 months, pain intensity >5 and disability >8. Tampa Scale for Kinesiophobia structure with two domains and nine items was the most suitable, with adequate values in all fit indices (Chi-square/degree of freedom <3, Comparative Fit Index and Tucker–Lewis Index >0.90, and root mean square error of approximation <0.08) and lower Akaike information criterion and Bayesian information criterion values. We observed a high correlation between the 17-item Tampa Scale for Kinesiophobia and the activity avoidance domain (rho = 0.850, P < 0.001) and somatic focus domain (rho = 0.792, P < 0.001) of the nine-item Tampa Scale for Kinesiophobia.

Conclusion

Tampa Scale for Kinesiophobia structure with two domains (activity avoidance and somatic focus) and nine items is the most suitable for patients with chronic low back pain.
Training to Build Nutrition Capacity in the Nigerian Agricultural Sector: Initial Assessment and Future Directions
Authors: Adeyemi Olutayo , Phorbee Olapeju , Samuel Folake , Sanusi Rasaki , Afolabi Wasiu , Covic Namukolo , Onabolu Adeyinka , Ajieroh Victor
Published: September 2022

Background:

In response to calls to increase nutrition-sensitive agriculture (NSA), the Federal Ministry of Agriculture and Rural Development developed the Nigeria Agricultural Sector Food Security and Nutrition Strategy 2016-2025 (AFSNS). Capacity development activities to facilitate the AFSNS implementation subsequently commenced.

Objective:

This study analyzed the processes and outputs of initial capacity development efforts, examined findings from the analysis using existing literature, and identified critical next steps for nutrition capacity development in the Nigerian agriculture sector.

Methods:

The study reviewed documents including a proposal for nutrition training of agriculture sector actors, reports of meetings held among 6 resource persons who designed and/or delivered training, training reports, participants’ pre- and posttraining assessments, and participants’ training evaluation. Interviews were conducted with 2 resource persons involved in training design and delivery. Documents and interviews were coded and analyzed to identify emergent themes. Participants’ pre- and posttests results were compared using paired t test in Stata 12.0.

Results:

Knowledge and practice gaps were more extensive than had been anticipated. Training had some but limited effects on knowledge scores at the federal level. Modules addressing implementation practices had to be scaled down for participants to keep up with the learning pace. Existing literature indicates that such training would have been better planned as part of a broader sectoral nutrition workforce strategy, to facilitate greater tailoring of training to participants’ job roles.

Conclusion:

Effective AFSNS implementation requires developing and operationalizing a comprehensive short-, medium- and long-term Agriculture Sector Nutrition Capacity Development Strategy for Nigeria.
Nitrogen flow in livestock waste system towards an efficient circular economy in agriculture
Authors: Doyeni Modupe Olufemi , Barcauskaite Karolina , Buneviciene Kristina , Venslauskas Kestutis , Navickas Kestutis , Rubezius Mantas , Baksinskaite Ausra , Suproniene Skaidre , Tilvikiene Vita
Published: September 2022

The race is on to achieve an important level of efficiency in the attainment of a circular economy in agriculture especially with the aim of sustainable nitrogen management. This cycle in the agricultural sector cuts across livestock farming, agriculture-induced waste generation, recycling and utilization, energy generation, crop production, ecosystem protection and environmental management through the mitigation of climate changes. In this work, we assess the process and functionalities of livestock waste generated from the piggery farm and their combinations with other by-products such as biochar and ash in comparison with mineral fertilization as sources of nitrogen applied in agricultural soil. The experiment was performed in a controlled environment with wheat ( Triticum aestivum L.) grown in a neutral and an acidic soil. Pig manure was used as the primary feedstock, fed and processed to biogas and nutrient-rich digestate by the anaerobic digestion process. The results revealed that the co-amendments of pig manure digestate with biochar and ash had complimentary positive effect on measured indices such as mobile potassium, phosphorus, biomass yield and nitrogen use efficiency. The mineral nitrogen fertilizer significantly induced carbon dioxide emissions from day 35 when compared to emissions from the organic amendments. In contrast, the organic amendments influenced nitrous oxide emissions from the onset till day 30 before flattening out. The individual combination of pig manure digestate with biochar and ash had a negative influence on enzymatic activity (dehydrogenase). Soil microbial biomass carbon was induced across all treatments in both soil types. Pig manure digestate + ash and pig manure digestate had 32.1 and 48.8% soil microbial biomass increase in neutral soil and acidic soil, respectively. Overall, the processing and application of single-use amendment or in combination with biochar and ash holds huge potential in the optimization of nitrogen and carbon efficiency towards sustainable soil management via improving soil quality, carbon sequestration and climate change.
Pediatric Status Epilepticus Severity Score (STEPSS): Predictive Performance of Functional Outcomes: A Prospective Single-Center Study
Authors: Soydan Ekin , Gonullu Ahmet , Aksoy Yigit , Guzin Yigithan , Ceylan Gokhan , Topal Sevgi , Colak Mustafa , Hepduman Pınar , Sandal Ozlem Sarac , Atakul Gulhan , Karaarslan Utku , Unalp Aycan , Apa Hurşit , Agın Hasan
Published: September 2022

Objective: To prospectively investigate the predictive value of the modified Status Epilepticus Severity Score (STESS) for pediatric use (STEPSS) regarding unfavorable outcomes in the short term. Methods: Patients diagnosed as status epilepticus in the emergency department between January 2019 and June 2021 at a tertiary center of the University of Health Sciences, Dr. Behcet Uz Children's Hospital, were included in the study. The patients were followed up in the emergency department, neurology clinic, and pediatric intensive care unit until discharge. Demographic and clinical characteristics, STEPSS, and Pediatric Overall Performance Category Scale (POPC) scores were calculated. We defined a Pediatric Overall Performance Category Scale score ≥3 as an unfavorable outcome. We compared the effect of STEPSS on unfavorable outcomes and mortality. Results: 124 children were included. The median age was 33 months (interquartile range 16.2-84.7). Seventy-two (58.1%) patients had acute symptomatic etiology. We found that the STEPSS score with the receiver operating characteristic curve (area under the curve  = 0.917, P < .001) could predict unfavorable outcomes (Pediatric Overall Performance Category Scale score ≥3) in children with status epilepticus. The Youden index (0.76) showed that a STEPSS score >2 was the optimal cutoff point for an unfavorable outcome. We found STEPSS useful in predicting mortality (area under the curve  = 0.853, P < .001). The Youden index (0.58) indicated that a STEPSS >2 was the optimal cutoff for mortality: sensitivity 0.90 (95% confidence interval [CI] 0.58-0.99), specificity 0.67 (95% CI 0.57-0.77), positive predictive value 0.21, negative predictive value 0.98, positive likelihood ratio 2.7, negative likelihood ratio 0.14. Conclusion: We determined that STEPSS can be predicted unfavorable outcomes and mortality. We think that STEPSS can be used as a useful clinical score with further studies and external validations.
Minimal voting paradoxes
Authors: Brandt Felix , Matthäus Marie , Saile Christian
Published: September 2022

Voting paradoxes date back to the origin of social choice theory in the 18th century, when the Chevalier de Borda pointed out that plurality—then and now the most common voting rule—may elect a candidate who loses pairwise majority comparisons against every other candidate. Since then, a large number of similar, seemingly paradoxical, phenomena have been observed in the literature. As it turns out, many paradoxes only materialize under some rather contrived circumstances and require a certain number of voters and candidates. In this paper, we leverage computational optimization techniques to identify the minimal numbers of voters and candidates that are required for the most common voting paradoxes to materialize. The resulting compilation of voting paradoxes may serve as a useful reference to social choice theorists as well as an argument for the deployment of certain rules when the numbers of voters or candidates are severely restricted.
Highly conducting corn starch doped ionic liquid solid polymer electrolyte for energy storage devices
Authors: Konwar Subhrajit , Singh Abhimanyu , Singh Pramod K , Singh Ram Chandra , Rawat Suneyana , Dhapola Pawan Singh , Agarwal Daksh , Yahya MZA
Published: September 2022

In this study, a new biopolymer electrolyte (BPE) is successfully developed using corn starch complexed with ammonium iodide (NH4I) as host, and low viscosity ionic liquid 1-Ethyl, 3-Methyl Imidazolium Thiocyanate (EMImSCN), as a plasticizer. This ionic liquid doped BPE shows high ionic conductivity of the order 10−4 S/cm and electrochemical stability window more than 3 V, which is suitable for electrochemical application. The ionic transference number (tion) of 0.98 confirms the system to be predominantly ionic in nature. Fourier transform infrared spectroscopy (FTIR) shows complex nature, while polarized optical microscopy (POM) gives us an idea about the semi-crystalline nature of BPE. Maximum conducting ionic liquid doped BPE sandwiched electric double layer capacitor (EDLC) and dye sensitize solar cell (DSSC) shows efficient performance.
Trends in all-cause hospitalizations for systemic lupus erythematosus in Mexico, 2000–2019
Authors: Mendoza-Pinto Claudia , Etchegaray-Morales Ivet , Munguía-Realpozo Pamela , Solis-Poblano Juan Carlos , Méndez-Martínez Socorro , Osorio-Peña Ángel David , Ayón-Aguilar Jorge , Abud-Mendoza Carlos , García-Carrasco Mario
Published: September 2022

Background

Hospitalizations due to systemic lupus erythematosus (SLE) incur substantial resource use. Hospitalization trends provide a key benchmark of the disease burden. However, there is little long-term data in Mexico. Therefore, we evaluated Mexican hospitalization trends for SLE during 2000–2019.

Methods

Hospitalization trends of SLE were studied using data from 2000 to 2019 releases of the National Dynamic Cubes of the General Direction of Health Information, which provides data on hospitalization discharges in Mexico. Patients aged ≥15 years hospitalized during the study period with a principal discharge diagnosis of SLE (ICD-10 code M32) were included.

Results

From 2000 to 2019, there were 17,081 hospitalizations for SLE, of which 87.6% were in females and 87% in subjects aged 15–44 years. From 2000 to 2019, the age-standardized hospitalization rate for patients with SLE increased from 0.38 per 100,000 persons to 0.65 per 100,000 persons with an average annual percentage change (APC) of 2.9% (95% CI 6.2–63.2). Although there was a significant uptrend from 2000 through 2011, there was a significant decline from 2011 to 2019 (APC: −4.8%, 95% CI −7.0% to −2.5%). Similar trends were identified in subjects aged 15–44 years and in both sexes. The length of stay and inpatient mortality decreased between 2000–2009 and 2010–2019.

Conclusions

Although there was a substantial increase in SLE hospitalizations in 2000–2019, in 2011–2019, a decreased trend was reported in younger patients and in females and males. The length of stay was also reduced.
Challenges of Licensed Counselors and Other Licensed Mental Health Providers Working With Neurodiverse Adults: An Instrumental Case Study
Authors: Mitran Carrie Leigh
Published: September 2022

For enhanced access to treatment and outcomes, it is imperative that counselors and therapists be aware of and confident in adapting their techniques to the needs of neurodiverse individuals. The shortage of trained professionals and limited training in professional counseling and other mental health support services specific to neurodiverse adults has deprived them of therapy. The purpose of this qualitative case study was to explore the challenges of licensed counselors and other licensed mental health providers who work with neurodiverse adults. Ensuring that neurodiverse adults receive appropriate socio-psychological assistance and competent services from licensed counselors requires a proper understanding of the current challenges that these professionals face. Findings from an instrumental case study comprising individual open-ended interviews to investigate the challenges faced by five licensed counselors and other licensed mental health providers who work with neurodivergent clients were analyzed in a thematic fashion and are presented herein. This instrumental case study identified concerns that were built on existing knowledge that allowed adaptation to and evolution within new cultural norms that characterize neurodiversity, which should be treated as a cultural difference and not “a less than” or “more than” condition. The evidence provided in this thematic analysis is connected to social emotional learning, universal design for learning, universal design, and social learning theories that have significant implications for practitioners.
Prognostic Performance of Hestia Criteria in Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis
Authors: Wang Yubin , Feng Yinhe , Du Rao , Yang Xiaoya , Huang Jifeng , Mao Hui
Published: September 2022

Previous studies have suggested that Hestia criteria could effectively identifying patients with acute pulmonary embolism (PE) who were at low risk of mortality for outpatient treatment or early discharge. But the performance of Hestia criteria in stratifying patients at different risk class is still unknown. We sought to comprehensively evaluate the prognostic impact of Hestia criteria for PE. The literatures search was conducted in PubMed, Web of Science and EMBASE from 1 August 2011 to 31 October 2021. Finally, Eight studies with 4110 patients were included in our meta-analysis. Overall, the pool percentage of patients classified as low-risk group and high-risk group were 41.4%% and 58.6% respectively, and the all-course mortality rates of each group were 2.3% and 10.6%, respectively. The pooled rate of PE-related composite adverse outcomes in high-risk group was increasingly higher than in low-risk group (15.7% vs 4.4%). High risk group was also markedly associated with overall mortality (OR: 7.21, 95%CI: 4.96-10.46, p < 0.00001), and PE-related adverse outcomes (OR:5.38, 95% CI:3.95-7.32, p < 0.00001). The pooled sensitivity, specificity, PLR, NLR of Hestia criteria for overall mortality were 0.90 (95% CI:0.83-0.94), 0.43 (95% CI:0.31-0.55), 1.6 (95% CI:1.3-1.9), 0.23 (95% CI: 0.15-0.35), respectively. The area under SROC curve (AUC) was 0.81 (95% CI: 0.77-0.84). The result of our meta-analysis indicate that Hestia criteria can effectively identify PE patients at low risk of poor prognosis with high sensitivity and NPV, but its prognostic role in patients with higher risk class still need to be verified.
Novel approach of desensitization in allergic reaction to Olaparib
Authors: Beurer Björn M , Sprenger Luise M , Graneß Kristina , Feldmann Freia , Warnke Ulrich , Biersack Maria G , Fischer Dorothea
Published: September 2022

Introduction

PARP (Poly ADP Ribose Polymerase) inhibitors are an effective maintenance therapy for various entities, such as BRCA (breast cancer gene) mutated or HRD (homologous recombination deficiency) positive primary platin-sensitive advanced ovarian cancer after platin induction therapy and in relapse after responding to carboplatin reinduction. Other entities are metastatic BRCA mutated pancreas, prostate and Her2-negative breast cancer. Therefore, patients with allergic reactions to PARP inhibitors should undergo a desensitization procedure to be able to receive this efficient therapy.

Case report

We conducted a two-day desensitization on a 45-year-s old patient with advanced ovarian cancer who displayed symptoms of an allergic reaction to Olaparib.

Management and outcome

Using an Olaparib tablet suspension, we orally administered increasing Olaparib doses, starting with 12.5 mg and reaching a cumulative dose of 387.5 mg on the first day and starting with 100 mg and reaching a cumulative dose of 600 mg on the second day, without concomitant antiallergic medication. Except for mild erythema on day one receding within the hour, no further allergic reactions appeared during desensitization. The patient has since received 300 mg of Olaparib twice a day without further complications or interruptions.

Conclusion

Desensitization in a two-day suspension protocol is a safe method that ensures effective maintenance therapy for patients with allergic reactions to PARP inhibitors.
Titanium modular stems in total hip arthroplasty due to developmental dysplasia: a registry comparison with single-taper implants
Authors: Castagnini Francesco , Cosentino Monica , Bordini Barbara , Montalti Maurizio , Biondi Federico , Faldini Cesare , Traina Francesco
Published: September 2022

Introduction:

The routine use of proximal femoral modularity was discouraged in total hip arthroplasties (THAs). However, titanium dual-taper (DT) implants may provide some advantages over single-taper (ST) stems in cases of complex deformity. A registry study comparing ST and DT stems in dysplasia was designed, aiming to assess: (1) survival rates at long-term; (2) reasons for revision; (3) the profile of failed implants.

Methods:

The arthroplasty registry RIPO was investigated for cementless THAs performed for dysplasia since 2000. ST implants were compared to titanium-on-titanium DT stems. Demographics and implant features were collected. Survival rates and reasons for revision were compared. The profile of DT stem failures in dysplasia was defined.

Results:

6429 implants were included in the study, 3642 ST and 2787 DT. The demographic and implant features of the 2 cohorts were not comparable. The DT cohort achieved higher survival rates at long-term (93.9% vs. 91.6%, p = 0.018). DT implants showed a higher rate of implant breakage (0.6%, p = 0.011) and a lower rate of aseptic loosening ( p = 0.005). There were no differences in terms of revisions for dislocation. No metallosis occurred. There were more revisions in DT implants in males <65 years, with a 28-mm head size or smaller.

Conclusions:

Modularity did not result in lower survival rates in dysplastic patients and may even reduce the rate of aseptic loosening in comparison to ST stems. The rate of implant breakage is not negligible. Younger males are not good candidates for titanium DT stems.
Social media regulation, third-person effect, and public views: A comparative study of the United States, the United Kingdom, South Korea, and Mexico
Authors: Chung Myojung , Wihbey John
Published: September 2022

Given the prevalence of misinformation on social media and accompanying negative externalities, platform regulation has become a highly contested public issue globally. This study investigated (a) what global publics think about platform regulation and (b) the psychological mechanisms underlying such opinions through the lens of the third-person effect. Four national surveys, conducted in the United States, the United Kingdom, South Korea, and Mexico in April–September 2021, revealed that both presumed media influence on self and others play important but different roles in predicting support for two distinctive forms of platform regulation (i.e. government regulation of social media platforms versus content moderation by social media platforms). Self-efficacy (self-perceived ability to spot misinformation) and other-efficacy (perception of others’ ability to spot misinformation) were identified as two crucial antecedents of third-person perception. There were also nuanced but noteworthy differences in public attitudes toward platform regulations across the four countries studied.
Envy, self-esteem, and distributive justice
Authors: Stensen Vegard
Published: September 2022

Most agree that envy, or at least the malicious kind(s), should not have any role in the moral justification of distributive arrangements. This paper defends a contrary position. It argues that at the very least John Rawls, Axel Honneth and others that care about the social bases of self-esteem have good reasons to care about the levels of envy that different distributive principles reliably generate. The basic argument is that (1) envy involves a particular kind of harm to self-esteem such that excluding envy-avoidance from the more general commitment to protect self-esteem requires a justification. (2) There are no strong reasons for this exclusion. I discuss three objections to the second premise: that envy is irrational, that it is unfair to prevent and compensate for it, and that envy-avoidance is unreasonable due to the vicious or antisocial nature of envy. The response is that envy can be rational with respect to opportunities for attaining social esteem; that it is not unfair to prevent or compensate for envy that is reasonably unavoidable and relatively burdensome; and the kind of envy-avoidance I defend does not appear unreasonable if distinguished from a form of preference-satisfaction.
Clinical role of intrarenal venous flow patterns in decompensated heart failure with worsening renal function
Authors: Poh Kok Wei , Ngan Cheng Huong , Tan Siok Nee , Burhan Amirul Azmi , Wong Ji Yin , Er Chee Kent , Sivandan Shobhana
Published: September 2022

Introduction:

The clinical implication of intrarenal venous flow patterns in decompensated heart failure with worsening renal function is unknown. We aimed to study the relationship between intrarenal venous flow patterns, inferior vena cava volume status, caval index, clinical degree of congestion and the renal outcome in patients with decompensated heart failure and worsening renal function. Secondary objectives were to study the combined endpoint of readmission and mortality rate within 30 days (after the last scan) among intrarenal venous flow patterns and the effect of congestion status on the renal outcome.

Methods:

Twenty-three patients admitted for decompensated heart failure (ejection fraction ⩽40%) with worsening renal function (absolute increase in serum creatinine of 26.5 µmol/L or ⩾1.5-fold increment from baseline) were enrolled in this study. A total of 64 scans were performed. Patients were visited on day 0, 2, 4 and 7 (or earlier if discharged). Patients were called 30 days after discharge to evaluate readmission or mortality. Intrarenal venous flow patterns were ranked from continuous, interrupted, biphasic, to monophasic. Clinical congestion was scored from 0 to 7.

Results:

Intrarenal venous flow patterns had statistically significant positive correlations with inferior vena cava volume status (Spearman’s ρ, 0.51; p < 0.01) and congestion score ( ρ, 0.65; p < 0.01) and a significant negative correlation with caval index ( ρ, −0.53; p < 0.01). Intrarenal venous flow patterns were not significant in predicting estimated glomerular filtration rate improvement or the combined endpoint. Reduced congestion significantly predicted an estimated glomerular filtration rate improvement on the following scan day ( p = 0.04, odds ratio = 4.3, 95% confidence interval = 1.1–17.2).

Conclusion:

Although intrarenal venous flow patterns correlate with other congestive parameters, clinical congestion status rather than intrarenal venous flow patterns predicted the renal outcome.
Artificial intelligence, illegalised mobility and lucrative alchemy of border utopia
Authors: Milivojevic Sanja
Published: September 2022

Artificial intelligence (AI) has captured the interest of academia and a range of industries. Much of this appeal is driven by the obsession with military and political supremacy, and a desire to control people and their movements. This article looks at the expansion and impact of AI systems deployed along physical borders on the mobility of illegalised non-citizens and border security in the Global North. Using the case study of Silicon Valley’s Anduril, the article focuses on the US–Mexico border and assesses AI’s role in hindering illegalised mobility and reconfiguring border control. Two key contributions are made in the paper. First, AI advances must become the focus of border criminologies, examined within the milieu from which the technology emerged. Second, virtual walls are commercial, political and anti-humanitarian. They are opaque, resembling alchemy, flawed but with profound consequences. The article adds to the debate on whether AI experiments should be permitted in border control.