bluuebunny/crossref_metadata_2025 huggingface dataset:
Neural Adversarial Attacks with Random Noises
Authors: Hajri Hatem , Césaire Manon , Schott Lucas , Lamprier Sylvain , Gallinari Patrick
Published: December 2022

In this paper, we present an approach which relies on the use of random noises to generate adversarial examples of deep neural network classifiers. We argue that existing deterministic attacks, which perform by sequentially applying maximal perturbations on selected components of the input, fail at reaching accurate adversarial examples on real-world large scale datasets. By exploiting a simple Taylor expansion of the expected output probability under the noise perturbation, we introduce noise-based sparse (or L0) targeted and untargeted attacks. Our proposed method, called Voting Folded Gaussian Attack (VFGA), achieves significantly better L0 scores than state-of-the-art L0 attacks (such as SparseFool and Sparse-RS) while being faster on both CIFAR-10 and ImageNet. Moreover, we show that VFGA is also applicable as an L∞ attack and outperforms the state-of-the-art projected gradient attack (PGD) method.
A Successful Pregnancy in a Hemihysterectomized Patient–A Case Report
Authors: Domingues Sofia Jovina , Pinto Luísa
Published: December 2022

Introduction. Didelphys uterus, two separate uterine horns or a double uterus with two separate cervices, is one of several congenital uterine anomalies (CUA), accounting for 5% of CUA. CUA could be associated with dysmenorrhea, pelvic pain, and decreased fertility. During pregnancy, it has been associated with higher risk of miscarriage, preterm birth, malpresentation, and fetal growth restriction. There still is insufficient evidence on the efficacy and safety of surgical interventions in CUA, including hemihysterectomy, in what improvement of reproductive performance is concerned. Objective. The aim of the present case report is to review the literature and complement information on pregnancy outcomes after hemihysterectomy, contributing to a better counseling of women planning a pregnancy under these circumstances. Case Presentation. This paper case reports a successful pregnancy in a woman previously submitted to a hemihysterectomy and removal of a vaginal septum by hysteroscopy, due to a symptomatic didelphys uterus. An ipsilateral renal agenesis was also present. A cesarean was performed at 38 weeks’ gestation and a healthy baby was born. Discussion. This paper reports an exceptional clinical situation, with only 9 cases described in the last 6 decades. As in previously reported cases, a cesarean was performed at term, resulting in a live childbirth. In these cases, a higher live birth rate and a lower incidence of preterm deliveries was found, comparing with uterine didelphys pregnancies. Conclusion. Understanding both the exact nature of a uterine anomaly before a surgical treatment and the prognosis for a future pregnancy after the intervention are of paramount importance for precise counseling of future parents.
Influences of Heider Balance on Knowledge, Attitude, Practice, and Quality of Life in Bladder Cancer Patients after Urinary Diversion
Authors: Zou Hao-yu , Zhang Liu-yi , Qin Yue-lan , Li Ping , Zhang Li , Yang Ke
Published: December 2022

Objective. To explore the influences of Heider balance on knowledge, attitude, practice (KAP), and quality of life in bladder cancer patients after urinary diversion. Methods. A set of bladder cancer patients after urinary diversion in our hospital from January 2016 to December 2020 were included in this study. Patients who received out-hospital intervention based on Heider balance were included in the observation group (85 cases). Meanwhile, patients who received routine out-hospital intervention were included in the control group (85 cases), and these patients matched with the observation group by gender, age, and education level. The scores of KAP, WHO quality of life-100 (WHOQOL-100) before discharge and at 6 months after discharge, and the rate of complications were compared in the two groups. Results. At 6 months after discharge, the score of these items of KAP including basic knowledge of disease, procedure of pouch replacement, dealing with pouch leakage, skin care of stoma, purchase and storage of pouch, dealing with stoma complications, optimistic mentality for disease, optimistic mentality for stoma, trust in medical staff, willingness to correct bad habits, confidence in maintaining health behavior, maintaining in health dietary habit, maintaining in health behavior, learning from relevant books, learning from relevant videos, experienced in pouch replacement, and experienced in care of stoma of the observation group were significantly higher than those of the control group (t = 6.144, 9.366, 3.129, 3.809, 4.173, 5.923, 2.788, 8.871, 3.291, 10.797, 7.067, 7.805, 3.828, 9.454, 2.827, 4.059, and 8.662, respectively, all

P
<
0.05

). The scores of 16 items of WHOQOL-100 such as energy and fatigue, sleep and rest, positive feelings, thinking, learning, memory and concentration, self-esteem, body image and appearance, negative feelings, mobility, activities of daily living, dependence on medical support, personal relationships, social support, health and social care: availability and quality, opportunities to get new information/skills, opportunities for recreation and leisure, and quality of life from viewpoint in the observation group were significantly higher than those in the control group (t = 2.666, 2.571, 2.961, 3.453, 4.279, 2.781, 3.775, 4.807, 5.850, 4.194, 3.324, 3.873, 5.118, 3.244, 2.956, and 4.218, respectively, all

P
<
0.05

). The rate of complications of the observation group was significantly lower than that of the control group (x2 = 5.829,

P
<
0.05

). Conclusion. The Heider balance can help to reduce the rate of complications, improve knowledge, attitude, practice, and quality of life in urinary diversion patients. These merits make it an attractive approach in guidance of out-hospital intervention.
Auricular Acupressure Effect on Autonomic Responses Evoked by a Cold Pressor Test in Healthy Volunteers: A Pilot Study
Authors: Trinh Dieu-Thuong Thi , Nguyen Van-Huy , Bui Minh-Man Pham , Nguyen Van-Dan , Nguyen Thu-Thao Thi , Thai Hoai-Nam , Thai Khac-Minh
Published: December 2022

Objective. This pilot study was conducted to investigate changes in the pulse rate and blood pressure in healthy volunteers after applying auricular acupressure at the “heart acupoint.” Methods. A total of 120 healthy volunteers with hemodynamic indexes within normal limits were randomly allocated into 4 groups to receive auricular acupressure treatment either at the heart acupoint of the left or the right, or in both ears, and one control group without applying auricular acupressure. Results. Before the application of auricular acupressure, there were no statistical differences in pulse rate and blood pressure increments among the four groups during the first cold pressor test. In groups in which auricular pressure was applied, the pulse rate was significantly reduced after the application of auricular acupressure in three groups; however, no statistically significant difference was detected among the groups. Changes in blood pressure were not statistically significant in or among the different groups after applying auricular acupressure. The average recorded pulse rate values during the second cold pressor test (after auricular acupressure) were significantly lower compared to the corresponding values taken during the first cold pressor test (before auricular acupressure) (

p

 < 0.05); however, pulse rate increments during the two cold pressor tests (with and without auricular acupressure) were similar (

p

 > 0.05). Conclusions. These findings suggest that auricular acupressure could be used as an adjunctive nonpharmacological method for reducing the pulse rate.
Characterization of Boride Coatings on AISI 8620 Steels without and with Hydrogen Permeation
Authors: Doñu Ruiz Marco Antonio , García Bustos Ernesto David , de la Mora Ramirez Tomas , Sánchez Huitron David , Cortes Suarez Víctor Jorge , López Perrusquia Noé
Published: December 2022

The present work studied the characterization of boriding coatings without and with exposed hydrogen permeation on AISI 8620 through microstructure and mechanical behavior. A dehydrated paste pack process was carried out for the formation of boride coatings on AISI 8620 at 1173, 1223, and 1273 K for 6 h of exposure time for each temperature. After boronizing, hydrogen was introduced into the borided steels by in situ cathodic charging using an H2SO4 acid electrolyte. Specimens borided without and with hydrogen were characterized by scanning electron microscopy with energy dispersive spectroscopy and X-ray diffraction. The experimental techniques of the Vickers microhardness and three-point bending were used. As a result, the hydrogen diffusion on steel AISI 8620 borided shows a significant increase in microhardness. Furthermore, three-point bend tests showed an increased strength on 8620 steel borided. However, the ductility and strength value on 8620 steel borided surfaces presented a drastic reduction due to hydrogen permeation. The results revealed that the borided coatings provided strength and reduced the hydrogen embrittlement index on AISI 8620 borided.
Investigating the Sustainability of Return to Scale Classification in a Two‐Stage Network Based on DEA Models
Authors: Sarparast Maryam , Hosseinzadeh Lotfi Farhad , Amirteimoori Alireza
Published: December 2022

Purpose. The purpose of this study is to sensitivity analysis analyze the returns to scale in two‐stage network based on DEA models. The main focus of the firms has always been to obtain the maximum output with the least available resources, which points to the improvement of the firm’s performance and the importance of returns to scale and technical improvement. Design/Methodology/Approach. This study examines the sensitivity of returns to scale classifications in a two‐stage DEA network. A new input‐oriented model was progressed to identify the efficient decision‐making units in the two‐stage network, after which a new method of determining the returns to scale classifications in the efficient DMUs in two‐stage network (constant, increasing, or decreasing returns to scale) was established. Findings. The stability of the returns to scale classifications in the two‐stage network was analyzed. A stability region for changes in primary inputs and final outputs is only determined especially for DMUs that are efficient so that it maintains the classification of the returns to scale units. The results are shown by numerical examples. Practical Implications. The sensitivity analysis of returns to scale classifications is one of the most significant issues in data envelopment analysis (DEA), which plays an essential role in management decisions. Originality/Value. Using this model can help improve the performance of companies by using new tools and also improve the quality of work and increase acceptance competition.
A New Cytology Staining Method: A Fast Approach for Rapid On-Site Evaluation on Thyroid Fine-Needle Aspiration Cytology
Authors: Alves Paula de Melo , Ferreira Fernando , Oliveira Telma , Alves Daniela , Canberk Sule , Schmitt Fernando C.
Published: December 2022

Introduction: Thyroid fine-needle aspiration (FNA) is a well-established technique in the cytology literature. Through the introduction of rapid stains in cytology practice, the ever-increasing utility of rapid on-site evaluation (ROSE) has strengthened the place of FNA as a primary diagnostic method in patient management. There are few stain variants available in the market for ROSE, namely Diff-Quik (DQ), Toluidine blue, and ultrafast Papanicolaou stains. Recently, our group developed a new staining variant labeled as original “BlueStain®” technique that was not previously tested in this context. Methods: 40 FNA thyroid cases were studied. At least two slides were prepared from each patient: one stained by DQ and the other by BlueStain®. Simultaneously, a ROSE diagnosis was performed as the two staining methods were compared, evaluating the parameters of background, cellularity, details of colloid presence, cell morphology, nuclear details, cytoplasmic details, and overall staining, scored on a scale from 1 to 3, representing poor, average, and good, respectively. Results: The quality index was slightly better for BlueStain® (53% vs. 47%) but not significantly different between the two stains. BlueStain® provides better details in both the presence and type of colloid as well as nuclear details, which are regarded as very important for diagnosis in thyroid cytology. There were eight cases with discordant diagnosis when compared between two stains from the same patient. In five cases of indeterminate cases, BlueStain® allows to bring them to the benign category, probably because this staining method allows a clear observation of the colloid in the background of the smears. However, since we are observing two different slides, we cannot rule out that these differences are a question of sample collecting and/or smearing. Conclusions: Our data demonstrates that BlueStain® is suitable to provide good-quality slides for primary assessments of thyroid aspirates studied by ROSE. In fact, in some aspects, this new staining method shows better preservation of colloid and cell details, revealing itself as an alternative to the DQ stain variant, upholding performance level while being 10 times cheaper and simpler because it requires just one step of staining.
Potencialidades e desafios do trabalho multiprofissional nos Centros de Atenção Psicossocial
Authors: Jafelice Giovana Telles , Silva Daniel Augusto da , Marcolan João Fernando
Published: December 2022

Objetivos: verificar potencialidades e desafios do trabalho multiprofissional em Saúde Mental na prática dos serviços junto aos trabalhadores dos Centros de Atenção Psicossocial de São Paulo, SP, Brasil. Método: estudo qualitativo, exploratório, descritivo. Entrevistados 27 trabalhadores de nove Centros de Atenção Psicossocial Adulto vinculados a Prefeitura Municipal de São Paulo. Responderam quatro questões norteadoras elaboradas pelos autores, avaliadas por análise de conteúdo temático. Resultados: na categoria Potencialidades do trabalho em equipe multiprofissional nos Centros de Atenção Psicossocial, destacaram- se cuidado ampliado ofertado pela proposta dos Centros de Atenção Psicossocial, formação na área e parcerias possíveis nas equipes, presença de estagiários/residentes; na categoria Desafios do trabalho em equipe multiprofissional, a precarização do trabalho e sofrimento do trabalhador, presençada “lógica ambulatorial”, falta de recursos humanos e de formação adequada, valorização da lógica medicamentosa, prevalência do saber e poder médico, falta de horizontalidade na relação com usuários, fragilidade da interação com outros equipamentos da rede de cuidados e intersetorial. Conclusão: há distanciamento entre Políticas Públicas de Saúde Mental e prática efetiva dos profissionais, coexistência dos paradigmas biomédico e da Atenção Psicossocial nos serviços, comprometendo efetivação dos pressupostos da Reforma Psiquiátrica e o lugar de sujeito de direito aos usuários dos serviços.
acompanhamento terapêutico como estratégia de continência do sofrimento psíquico
Authors: Pitiá Ana Celeste de Araújo , Santos Manoel Antônio dos
Published: December 2022

Este estudo consiste em uma pesquisa bibliográfica que abrange a produção científica na área do Acompanhamento Terapêutico (AT). O objetivo foi avaliar sistematicamente a produção científica indexada nas bases de dados MedLine, PsycINFO e LILACS no período de 1977 a 2001, incluindo também livros e teses produzidos nesse período. Para tanto foram utilizadas as palavras-chave: therapeutic companion e acompanhante terapêutico. Foi feita uma seleção dos resumos que preencheram os critérios de inclusão, cujas publicações foram recuperadas na íntegra. Os resultados indicam que a maioria dos estudos abordou aspectos técnicos do trabalho na clínica do AT, apontando para o perfil desejável do profissional acompanhante terapêutico (at).
Processo de ressocialização de usuários de substâncias lícitas e ilícitas
Authors: Possa Terezinha , Durman Solânia
Published: December 2022

Esta pesquisa objetivou conhecer o modo de vida de oito indivíduos, moradores de rua, usuários de substâncias lícitas e ilícitas, na faixa etária de 21 a 50 anos, em processo de ressocialização, numa organização não-governamental: Associação Nova Aliança - ANA, no município de Cascavel, PR, em 2003. O estudo baseou-se nos pressupostos teóricos da reabilitação psicossocial emanados do Movimento da Reforma Psiquiátrica. Trata-se de pesquisa de natureza qualitativa, descritiva, com a participação de 8 usuários. Os dados foram coletados por meio de 3 questões norteadoras, analisados qualitativamente à luz do referencial teórico. Este estudo apontou que o aspecto para trabalhar a ressocialização seria priorizar os aspectos sociais e econômicos, implicando no aumento de sua contratualidade afetiva, social e econômica, viabilizando sua autonomia.
Ensaio de uma metodologia: problema, experiência e projeções
Authors: Jessen Constanza Blanco , Cortés Ana Harcha
Published: December 2022

Ensaio de uma metodologia: problema, experiência e projeções
‘Mercatores isti regulandi’: Monopolies and moral regulation of the market in Pedro de Oñate’s De contractibus
Authors: Decock Wim
Published: December 2022

Compared to the writings of other teólogos-juristas belonging to the so-called School of Salamanca, Pedro de Oñate’s (1567-1646) De contractibus has met with little if almost no interest in the literature. It nevertheless marks an epochal achievement in the history of juridical and economic thought. Published between 1646 and 1654, Oñate’s De contractibus epitomizes five centuries of scholastic thinking about the moral regulation of the market. It is a spectacular work, addressing hundreds of problems related to contractual agreements and commercial life in general. This paper offers an overview of Oñate’s lengthy assessment of monopolistic practices, including price-fixing cartels, import barriers, the creation of artificial scarcity, and legal monopolies, including the conceptualization of intellectual property. Two major conclusions can be reached from the close-reading of Oñate’s treatment of monopolistic practices. First, Oñate’s opinions are marked by an even starker emphasis on individual rights, property and freedom than those of his colleagues working in major cities on the other side of the Atlantic. Second, his analysis is not only the reflection of his extraordinary knowledge of centuries of scholastic thinking about the morality of the market, but also of his practical experience in the New World.
A new species of Gonolobus (Apocynaceae, Asclepiadoideae, Gonolobineae) from Loja, Ecuador
Authors: ALVARADO-CÁRDENAS L.O. , CERCHIAI ALICIA
Published: December 2022

We here describe a new species of Gonolobus from southeastern Loja, Ecuador: Gonolobus rumihuilcanus. The species is morphologically similar to G. albomarginatus, G. leianthus, and G. saraguranus but differs in corolla and corona morphology, and distribution. A conservation status assessment, description, photographs, and a key to congeners in Ecuador are provided. The discovery increases to five the number of Gonolobus species reported for Ecuador, with three of them endemic.
Revision of Fortipalpa Kasparyan & Ruíz-Cancino, (Ichneumonidae, Cryptinae)
Authors: SUPELETO FERNANDA A. , SANTOS BERNARDO F. , AGUIAR ALEXANDRE P.
Published: December 2022

Fortipalpa Kasparyan & Ruíz-Cancino, 2007 originally accommodates only its type species, F. yucatanica Kasparyan & Ruíz-Cancino, 2007. The genus can be distinguished from all other Neotropical Cryptini by having mandible with ventral tooth subequal to slightly longer than dorsal tooth; propodeum anteriorly smooth, posteriorly with transverse striation; T1 long and slender, without anterolateral tooth; and ovipositor moderately long and straight, with ventral valve without a lobe covering dorsal valve. The genus is revised, and the following new species are proposed, described, and illustrated: F. exelysae sp. nov., F. frida sp. nov., F. heredia sp. nov., F. panamensis sp. nov., F. pichincha sp. nov., F. sacha sp. nov., and F. shakira sp. nov. The male of F. exelysae sp. nov., the first for the genus, is also described and illustrated; other males remain unknown. The type species is redescribed and illustrated, including pictures of the paratype and a new record to Trinidad. Figures, distribution maps and a taxonomic key are provided for all valid species.
Perilestes jueni (Zygoptera: Perilestidae), new species from Amazonas State, Northern Brazil
Authors: MENDOZA-PENAGOS CRISTIAN CAMILO , GONÇALVES MYCKEY KENZY E SILVA , VILELA DIOGO SILVA
Published: December 2022

Perilestes jueni sp. nov. (Brazil, Amazonas State, São Gabriel da Cachoeira, Ponto 8 (0.165, -67.007, 92 m asl), 2.xii.2021, C.C. Mendoza-Penagos M. Silva-Gonçalves & S. Da Silva Ribeiro leg.) is described based on one male collected in a remote area of the Brazilian Amazon Forest. The new species is separated from congeners based on cercus morphology.
Leading-Mode Connections of the Interannual Variability in Upper-Ocean Salinity in the Tropical Indian Ocean
Authors: Huang Ke , Feng Ming , Wu Ying , Wang Dongxiao , Zhou Wen , Zu Tingting , Wang Weiqiang , Xie Qiang , Yang Lei , Yao Jinglong , Zhou Wei
Published: December 2022

Leading modes of interannual variability in upper-ocean salinity in the tropical Indian Ocean (TIO) and their connections were studied based on 17 years (2002–18) of oceanic historical and reanalysis data. Empirical orthogonal function (EOF) analysis depicted the dominant roles of the first two leading modes in salinity variability in the TIO over a wide range of interannual time scales. Among the rich oscillations of the leading EOF modes, a coherent near-biennial band was identified with basinwide loading of sea surface salinity anomalies (SSSa) (EOF1) leading/lagging the northeast–southwest dipolar mode of SSSa (EOF2) by around 4 months across the TIO, with southwestward migration of SSSa center. The spatial loadings of the SSSa leading modes in the TIO were strongly shaped by sea surface temperature–related freshwater fluxes and wind-driven regional ocean circulation on a near-biennial time scale. Composite analysis of the mixed layer salinity budget reflected characteristic features of basin-scale ocean–atmosphere coupling, both temporally and regionally during the life cycle of the near-biennial fluctuation in anomalous salinity in the TIO. Consistent with the intrinsic oscillation paradigm in the observed Indian Ocean dipole (IOD) variation, the dynamic and thermodynamic feedbacks associated with switches from the positive to negative IOD modes provided the phase-connection mechanisms for the SSSa leading-mode displacement over the TIO.

Significance Statement

This study investigates the leading modes of interannual variability in upper-ocean salinity in the tropical Indian Ocean (TIO). The intrinsic oscillation and associated dynamic and thermodynamic feedbacks over the TIO drive the basinwide connections of upper-ocean salinity variability. Our results show that a coherent near-biennial band is identifiable within the leading modes of sea surface salinity anomalies (SSSa), in which the wind-induced horizontal advections and evaporation-minus-precipitation anomalies associated with the switches from positive to negative Indian Ocean dipole modes mainly provide the phase-transition mechanism of SSSa. This research illustrates substantial evidence for the displacement of basin-scale sea surface temperature anomalies modulating the structures of SSSa and inducing the dynamical connections of leading modes of SSSa on the near-biennial time scale.
Time constant to determine PEEP levels in mechanically ventilated COVID-19 ARDS: a feasibility study
Authors: Depta Filip , Euliano Neil R. , Zdravkovic Marko , Török Pavol , Gentile Michael A.
Published: December 2022

Background

We hypothesized that the measured expiratory time constant (TauE) could be a bedside parameter for the evaluation of positive end-expiratory pressure (PEEP) settings in mechanically ventilated COVID-19 patients during pressure-controlled ventilation (PCV).

Methods

A prospective study was conducted including consecutively admitted adults (n = 16) with COVID-19-related ARDS requiring mechanical ventilation. A PEEP titration using PCV with a fixed driving pressure of 14 cmH2O was performed and TauE recorded at each PEEP level (0 to 18 cmH2O) in prone (n = 29) or supine (n = 24) positions. The PEEP setting with the highest TauE (TauEMAX) was considered to represent the best tradeoff between recruitment and overdistention.

Results

Two groups of patterns were observed in the TauE plots: recruitable (R) (75%) and nonrecruitable (NR) (25%). In the R group, the optimal PEEP and PEEP ranges were 8 ± 3 cmH2O and 6–10 cmH2O for the prone position and 9 ± 3 cmH2O and 7–12 cmH2O for the supine position. In the NR group, the optimal PEEP and PEEP ranges were 4 ± 4 cmH2O and 1–8 cmH2O for the prone position and 5 ± 3 cmH2O and 1–7 cmH2O for the supine position, respectively. The R group showed significantly higher optimal PEEP (p < 0.004) and PEEP ranges (p < 0.001) than the NR group. Forty-five percent of measurements resulted in the most optimal PEEP being significantly different between the positions (p < 0.01). Moderate positive correlation has been found between TauE vs CRS at all PEEP levels (r2 = 0.43, p < 0.001).

Conclusions

TauE may be a novel method to assess PEEP levels. There was wide variation in patient responses to PEEP, which indicates the need for personalized evaluation.
A systematic review and narrative synthesis of the experiences with caring for older people living with dementia in Sub-Saharan Africa
Authors: Mwendwa Purity , Lawlor Brian , Kroll Thilo , De Brún Aoife
Published: December 2022

Background

In low- and middle-income countries, including sub-Saharan Africa little is known about the experiences with caring for people living with dementia. The purpose of this systematic review and narrative synthesis was to examine the experiences with caring for older people living with dementia at home.

Results

In total, 366 abstracts were identified and following screening, 19 studies were included in the synthesis. Six themes were identified: conceptualising dementia, caregiving arrangements, the impact of caregiving, caregiver identity and role, managing caregiving, unmet caregiver needs.

Conclusion

There is a dearth of research in relation to caregiving for older people living with dementia in sub-Saharan Africa. There is need for better information campaigns and support programs directed at family and professional caregivers in this context.
Predictors of time to recovery from uncomplicated severe acute malnutrition among 6–59 months children treated in out patient treatment in health posts of Nagele Arsi district: a retrospective cohort study
Authors: Tsegaye Ashenafi , Lencha Bikila , Kumsa Kebede
Published: December 2022

Background

Access to outpatient therapeutic feeding programs (OTP) for all children who have uncomplicated severe acute malnutrition (SAM) remains a global public health priority. Identifying predictors that determine time-to-recovery from severe acute malnutrition optimize therapeutic success. However, reliable evidence on the determinants of time to recovery at health posts was not available in Nagele Arsi district of South Ethiopia.

Objective

This study was aimed to identify determinants of time-to-recovery from uncomplicated SAM among children aged (6–59) months treated at an OTP in health posts of Nagele Arsi district, Southern Ethiopia.

Methods

Institutional based retrospective cohort study was conducted among 357 children treated in Negele Arsi district from July1, 2018 to June 30, 2020. The children were selected using simple random sampling from 20 health posts. SAM treatment outcomes were compared against international SPHERE standards. The average time-to-recovery was estimated using Kaplan-Meier survival curve and the independent predictors of time to recovery were determined using multivariable Cox-proportional hazard model. The strength of the association was done using adjusted hazard ratio (AHR) with 95% confidence intervals. Statistical significance was declared at p value < 0.05. The results were presented by text, tables and figures.

Result

A total of 284 (79.6%) children recovered during follow up. The mean weight gain for recovered children was 4.7 + 2.4 g/kg/day. The median time-to-recovery was 44 days 95% CI (42.7–45.3). Children who received Amoxicillin, AHR =2.574, 95% CI (1.879–3.525); de-wormed, AHR = 1.519, 95% CI (1.137–2.031); received Vitamin A, AHR = 2.518, 95% CI, (1.921–3.301) and new admissions, AHR = 1.823, 95%CI, (1.224–2.715) were more likely to recover. However, those who admitted with non-edema, AHR = 0.256, 95% CI, (0.189–0.346); had cough at admission, AHR = 0.513, 95 CI, (0.366–0.719) and had diarrhea at admission AHR = 0.5, 95% CI, 0.5 (0.350–0.712) were less likely to recover.

Conclusion and recommendation

The recovery rate was within the acceptable ranges of International Sphere Standards. Those children who had cough and diarrhea should be given due attention from health extension workers and program planners. Appropriate provision of routine medication and timely intervention of co-morbidity are needed to increase chance of early recovery.
A comparative analysis of the work environments for registered nurses, nurse aides, and caregivers using the 5th Korean Working Conditions Survey
Authors: Kim Sung Shin , Kim Yun Jin , Park Jun Sik , Ho Seoung Hee , Kweon Hyosun , Bae Young-Hyeon
Published: December 2022

Background

Since the quality of work life of healthcare workers is affected by various factors, an improvement in their work environment can reduce the burden on them, increasing their performance. This study aimed to identify the current problems in working environments for registered nurses (RNs), nurse aides (NAs), and caregivers using the 5th Korean Working Conditions Survey (KWCS), presenting measures to improve working conditions by analyzing their predictors: 1) degree of exposure to work-related risk factors (musculoskeletal and mental), 2) working patterns, 3) work-family balance, 4) work situations, and 5) self-rated health.

Methods

The sampling frame was a list of apartment and general survey zones, excluding islands, dormitories, special social facilities, tourist hotels, and foreigner zones, among the total survey zones of the 2010 Population and Housing Census. The KWCS was given to 50,205 participants of various occupations, and responses from 494 RNs, 201 NAs, and 505 caregivers were extracted to compare their 1) degree of exposure to work-related risk factors (musculoskeletal and mental), 2) working pattern, 3) work-family balance, 4) work situations, and 5) self-rated health.

Results

The response rate was 0.449. There were significant differences in all the variables (exposure to musculoskeletal and mental work-related risk factors, working pattern, work-family balance, work situations, self-rated health, and satisfaction with working conditions) among RNs, NAs, and caregivers (p < 0.001). The degree of work-related musculoskeletal and mental risk exposure was higher among caregivers and RNs than among NAs; irregular working patterns, challenges with work-family balance, and work environment satisfaction were higher among caregivers than among NAs. In addition, work situations were poorer among caregivers and NAs than among RNs. Self-rated health was the highest among caregivers, followed by RNs and NAs. The most potent predictor of self-rated health was occupation, followed by work environment satisfaction and work-family balance; the most potent predictor of work environment satisfaction was self-rated health, followed by degree of exposure to work-related musculoskeletal and mental risk factors, occupation, work-family balance, work situation, and working patterns.

Conclusion

This study confirmed that a variety of factors influence work environment satisfaction. Thus, practical and realistic measures to improve work environments tailored to each healthcare occupation should be developed at the national and community levels. Further qualitative studies are needed to analyze the work environments of nurses and other care workers in depth.
Higher fasting blood glucose worsens knee symptoms in patients with radiographic knee osteoarthritis and comorbid central sensitization: an Iwaki cohort study
Authors: Chiba Daisuke , Ohyama Tetsushi , Sasaki Eiji , Daimon Makoto , Nakaji Shigeyuki , Ishibashi Yasuyuki
Published: December 2022

Background

Although cross-sectional and cohort data suggest that higher serum blood glucose levels in patients with knee osteoarthritis (KOA) are associated with more severe knee symptoms, little is known about the longitudinal relationship between serum blood glucose and knee symptoms, particularly considering central sensitization (CS) comorbidity, which also worsens knee symptoms.

Methods

We evaluated the longitudinal relationship between serum blood glucose and knee symptoms by dividing the cohort of patients with KOA into those with and without CS. We hypothesized that higher serum blood glucose levels would worsen knee symptoms. A total of 297 participants (mean age: 59.6 years; females: 211; average BMI: 23.7 kg/m2) were enrolled in this study. At baseline, plain radiographs of the bilateral knee joints were evaluated according to the Kellgren–Lawrence grade (KLG). All participants exhibited at least a KLG ≥ 2 in each knee. At baseline, fasting blood glucose (FBG) and Central Sensitization Inventory-9 (CSI-9) were evaluated; ≥ 10 points on the CSI-9 was defined as CS+. Knee injury and Osteoarthritis Outcome Score (KOOS) was evaluated at baseline and at 1-year follow-up; the change in KOOS (ΔKOOS) was calculated by subtracting the KOOS at baseline from that at the 1-year follow-up. Multiple linear regression analysis was conducted with ΔKOOS as the dependent variable and FBG at baseline as the independent variable, adjusted for age, sex, BMI, and CSI-9 at baseline.

Results

Of the 297 subjects, 48 (16.2 %) were defined as CS+. In the CS − group, there was no association between FBG levels at baseline and ΔKOOS. In contrast, FBG at baseline was negatively associated with ΔKOOS pain (B = − 0.448; p = 0.003), ADL (B = − 0.438; p = 0.003), and sports (B = − 0.706; p = 0.007).

Conclusions

In patients with radiographic KOA and CS, higher blood glucose levels were associated with deteriorated knee symptoms during the 1-year follow-up. Healthcare providers should pay attention to controlling blood glucose, particularly in patients with KOA and concurrent CS, to mitigate their knee symptoms.

Study design

Retrospective cohort study (evidence level: III).
Nivolumab Plus Cabozantinib With or Without Ipilimumab for Advanced Hepatocellular Carcinoma: Results From Cohort 6 of the CheckMate 040 Trial
Authors: Yau Thomas , Zagonel Vittorina , Santoro Armando , Acosta-Rivera Mirelis , Choo Su Pin , Matilla Ana , He Aiwu Ruth , Cubillo Gracian Antonio , El-Khoueiry Anthony B. , Sangro Bruno , Eldawy Tarek E. , Bruix Jordi , Frassineti Giovanni Luca , Vaccaro Gina M. , Tschaika Marina , Scheffold Christian , Koopmans Petra , Neely Jaclyn , Piscaglia Fabio
Published: December 2022

PURPOSE

To investigate the safety and efficacy of nivolumab plus cabozantinib with or without ipilimumab in patients with advanced hepatocellular carcinoma.

METHODS

In cohort 6 of the multicohort, open-label, phase I/II CheckMate 040 study, patients who were treatment-naive, sorafenib-intolerant, or had progressed on sorafenib were randomly assigned 1:1 to nivolumab 240 mg once every 2 weeks plus cabozantinib 40 mg once daily (doublet arm); or nivolumab 3 mg/kg every 2 weeks plus cabozantinib 40 mg once daily with ipilimumab 1 mg/kg once every 6 weeks (triplet arm). Primary objectives were safety and tolerability, objective response rate, and duration of response by investigator assessment per RECIST v1.1. Secondary objectives included progression-free survival (by blinded independent central review) and overall survival.

RESULTS

Seventy-one patients were randomly assigned: 36 to the doublet arm and 35 to the triplet arm. After 32.0-month median follow-up, objective response rate (95% CI) was 17% (6 to 33) and 29% (15 to 46) in the doublet and triplet arms, respectively. Median (95% CI) duration of response was 8.3 (6.9 to not estimable) months in the doublet arm and not reached (0.0 to not estimable) in the triplet arm. Median progression-free survival was 5.1 and 4.3 months, and median overall survival was 20.2 and 22.1 months for the doublet and triplet arms, respectively. Grade 3-4 treatment-related adverse events occurred in 50% and 74% of patients and treatment-related adverse events leading to discontinuation were reported for 11% and 23% in the doublet and triplet arms, respectively. There were no treatment-related deaths in either arm.

CONCLUSION

Nivolumab plus cabozantinib with or without ipilimumab showed encouraging preliminary antitumor activity and had consistent safety profiles with those established for the individual drugs in patients with advanced hepatocellular carcinoma.
Evolution of Transradial Access for Mechanical Thrombectomy—A Single Center Experience
Authors: Munich Stephan A. , Saganty Ruth S. , Joshi Krishna C. , Radaideh Yazan
Published: December 2022

BACKGROUND:

Transradial access (TRA) recently has gained popularity among neurointerventionalists. However, hesitation to its use for mechanical thrombectomy (MT) remains.

OBJECTIVE:

To evaluate and describe the evolution of TRA for MT.

METHODS:

We performed a retrospective analysis of patients undergoing TRA for MT. We performed a chronological ternary analysis to assess the impact of experience. We assessed the impact of a guide catheter designed specifically for TRA.

RESULTS:

We identified 53 patients who underwent TRA for MT. There was a statistically significant decrease in contrast use (148.9 vs 109.3 vs 115.2 cc), procedure time (62.4 vs 44.7 vs 41.3 minutes), fluoroscopy time (39.2 vs 44.7 vs 41.3 minutes), and puncture-to-recanalization time (40.6 vs 27.3 vs 29.4) over time. There was trend toward improved thrombolysis in cerebral infarction ≥ 2b recanalization rate (72.2% vs 77.8% vs 100%) over time. The introduction of a radial-specific catheter had a statistically significant positive impact on contrast use (133.8 vs 93 cc, P = .043), procedure time (54.2 vs 36.4 minutes, P = .003), fluoroscopy time (33.7 vs 19.8 minutes, P = .004), puncture-to-recanalization time (35.8 vs 25.1 minutes, P = .016), and thrombolysis in cerebral infarction ≥ 2b recanalization rate (71.4% vs 100%, P = .016).

CONCLUSION:

TRA is a safe and effective route of endovascular access for MT. Experience with this technique improves its efficacy and efficiency. The introduction of a TRA-specific catheter expands the armamentarium of the neurointerventionalist and may facilitate lesion access during MT procedures. Continued development of radial-specific devices may further improve MT outcomes.
Institucionalização e participação social no plano diretor urbanístico de uma Capital Amazônica
Authors: Brito Paula Almeida , Medeiros Haroldo de Sá , Souza Mariluce Paes de , Matos Gleimiria Batista da Costa
Published: December 2022

O plano diretor urbanístico das cidades foi regulamentado para garantir e aumentar mecanismos de participação, alcançando legitimidade e corresponsabilização, mas embora a legislação indique obrigatoriedade do plano diretor para as cidades com mais de 20 mil habitantes, a sua aplicação não é a realidade em algumas regiões. O principal objetivo deste artigo foi analisar a institucionalização da revisão do plano diretor do município de Porto Velho, realizando uma pesquisa qualitativa que utiliza procedimentos descritivos por meio de um estudo de caso. Nos dados secundários, foi adotada a análise de conteúdo de Bardin (2011), por meio do processo de Cidade (2004), composto por três etapas, que correspondem ao fluxo de institucionalização. Os resultados encontrados sustentam que a obrigatoriedade da participação popular em tornar o processo de institucionalização do plano diretor transparente para romper com o modelo tradicional e intervencionista, também pode ser utilizado como um instrumento eminentemente político, justificando o esforço em sua efetiva implementação e também encontrando grandes resistências, descréditos e ausência de participação, que são justificados por sua efetiva implementação. Assim busca contribuir com um entendimento mais amplo sobre o plano diretor e na geração de informações para auxiliar gestores públicos na administração urbanística das cidades amazônicas.
A extensão dos contratos de programa de saneamento para reequilíbrio à luz da Lei nº. 14.026/2020 e do Decreto nº. 10.710/2021
Authors: Aragão Alexandre Santos de
Published: December 2022

O presente artigo busca avaliar a juridicidade da extensão de prazo como forma regular de recomposição do equilíbrio econômico-financeiro dos contratos de programa à luz do novo . Nesse objetivo, examina-se o tratamento conferido pela Lei nº 14.026/2020 àqueles instrumentos de delegação, destacando a manutenção de sua higidez e a preservação das suas inerentes garantias, inclusive econômico-financeiras. Em seguida, o trabalho analisa os diferentes mecanismos de preservação do equilíbrio contratual, dando especial atenção à prorrogação para fins de reequilíbrio, mecanismo de recomposição que não se confunde com a prorrogação ordinária por juízo de conveniência e oportunidade da administração pública. À luz dessas premissas, demonstra-se de que maneira a extensão de prazo dos contratos de programa para fins de reequilíbrio encontra abrigo não apenas na legislação geral, como também não contraria a legislação específica do setor de saneamento básico, especialmente a Lei nº 14.026/2020 e o Decreto nº 10.710/2021.
Η επίδραση του φλεγμονώδους και οξειδωτικού στρες στη δομή και λειτουργικότητα του αρτηριακού δικτύου υγιών μετεμμηνοπαυσιακών γυναικών
Authors: Χονδρού Ασημίνα
Published: December 2022

Τα αποτελέσματα της μελέτης καταδεικνύουν την επίδραση των επιπέδων της RBP4 στην αρτηριακή σκληρία, σε υγιείς μετεμμηνοπαυσιακές γυναίκες. Η ηλικία και η αρτηριακή πίεση σχετίζονται με τις τιμές της RBP4. Η καρωτιδική αρτηριακή σκληρία σχετίζεται με τα επίπεδα της RBP4 ανεξάρτητα από την παρουσία παραδοσιακών επιβαρυντικών παραγόντων της καρδιαγγειακής νόσου.Παρατηρήσαμε μια θετική συσχέτιση μεταξύ των επιπέδων της RBP4 και των επιπέδων της ομοκυστεΐνης, ενός διαδεδομένου παράγοντα καρδιαγγειακής νόσου στις μετεμμηνοπαυσιακές γυναίκες (Mijatovic et al., 2001, Villa et. al., 2007). Υψηλά επίπεδα ομοκυστεΐνης σχετίζονται με υψηλά επίπεδα RBP στη μελέτη μας. Ενδιαφέρουσα παρουσιάζεται και η σχέση των επιπέδων της ομοκυστεΐνης με την PWV, καθώς γυναίκες με υψηλότερα επίπεδα ομοκυστεΐνης εμφάνισαν υψηλές τιμές PWV και S.I συγκριτικά με γυναίκες με χαμηλά επίπεδα ομοκυστεΐνης. Ωστόσο, η ομοκυστεΐνη δεν φαίνεται να σχετίζεται με την συστολική και διαστολική πίεση, δείχνοντας την άμεση σχέση ομοκυστεΐνης και αρτηριακής σκληρίας. Στη μελέτη μας φαίνεται πως τα επίπεδα της RBP4 σχετίζονται με την αρτηριακή σκληρία (PWV και S.I) ανεξάρτητα της παλμικής πίεσης, της ομοκυστεΐνης και του δείκτη HOMA-IR.Τα επίπεδα της RBP4 εμφανίζουν άμεση συσχέτιση με τους παραδοσιακούς παράγοντες καρδιαγγειακής νόσου. Παρατηρήσαμε άμεση σχέση μεταξύ των επιπέδων της RBP4 και της ολικής χοληστερόλης, όπως και επίσης της RBP4 με τα τριγλυκερίδια. Το ορμονικό προφίλ κατά τη μετάβαση στην εμμηνόπαυση μπορεί να σχετίζεται με τα επίπεδα της RBP4. Πιθανοί μηχανισμοί που εξηγούν τα ευρήματά μας αφορούν α) την επαγώμενη οιστρογονοεξαρτώμενη ρύθμιση του λιπώδη ιστού μετά την εμμηνόπαυση (Van et. al., 2006) β) την οιστρογονική ένδεια που μεσολαβεί του μεταβολισμού του ρετινοϊκού οξέος μεσω της ρύθμισης της έκφρασης της RBP4 στον λιπώδη ιστό (Matsuda et. al., 2004) μια διαδικασία που εμπλέκει τους οιστρογονικούς υποδοχείς τύπου α και τύπου β. Στα αποτελέσματά μας, δεν επιβεβαιώθηκε συσχέτιση μεταξύ των επιπέδων της RBP4 στον ορό και των επιπέδων ινσουλίνης ή ινσουλινοαντοχής. Η απουσία συσχέτισης μεταξύ δεικτών του μεταβολισμού της γλυκόζης και της RBP4 στη μελέτη μας, μπορεί ενδεχομένως να σχετίζεται με το γεγονός πως οι γυναίκες στη μελέτη μας δεν ήταν υπέρβαρες και δεν είχαν ινσουλινοαντοχή.Ο εκφυλισμός του μέσου-έσω χιτώνα σχετίζεται με την ηλικία και οδηγεί σε μια πλάτυνση του παλμικού σφυγμού και κατά συνέπεια αρτηριακή σκληρότητα (Yang et al., 2005, Avolio et. al., 1983). Επιπλέον, η μείωση των επιπέδων των οιστρογόνων, κατά την μετάβαση στην εμμηνόπαυση και η ακόλουθη σχετική αυξηση ανδρογόνων, επιταχύνει την αρτηριακή σκληρία (36).
Μετανάστευση, υποκειμενικότητα και παραγωγή του αστικού χώρου
Authors: Κυριακούλη Αργυρώ
Published: December 2022

Στην παρούσα διατριβή διερευνώνται οι ιστορικοποιημένες διασυνδέσεις της παραγωγής και της κυβερνητικότητας της διαεθνικής μετανάστευσης στον ευρωμεσογειακό χώρο και την Ελλάδα με την παραγωγή και τη διαπραγμάτευση της μεταναστευτικής υποκειμενοποίησης των μεταναστών και μεταναστριών μαύρου χρώματος στην καθημερινότητα της πόλης της Αθήνας. Με την ιστορικοποίηση τόσο της «από τα πάνω» θεσμικής πολιτικής διαχείρισης της διαεθνικής μετανάστευσης όσο και της «από τα κάτω» παραγωγής της μαύρης μεταναστευτικής υποκειμενικότητας στο πεδίο του πολιτικού της καθημερινής ζωής, η διερεύνηση επιχειρεί να αναδείξει τις πρακτικές φυλετικοποίησης του μαύρου μεταναστευτικού υποκειμένου αλλά και τις διαδικασίες διάσχισης των εθνοφυλετικών «συνόρων» και παραγωγής υποκειμενικοτήτων στα πολυτοπικά κοινωνικοχωρικά και πολιτικοπολιτισμικά πεδία της καθημερινότητας των μεταναστών και μεταναστριών μαύρου χρώματος.Ξεκινώντας από την κριτική ανάλυση των λόγων και των λογοθετικών πεδίων που συναρθρώνουν την επίσημη και τη μη επίσημη κυβερνητικότητα της παγκόσμιας μετανάστευσης, στην Ε.Ε και την Ελλάδα, και περνώντας στην ανάδειξη της πολλαπλότητας και της πολυτοπικότητας των διαδικασιών υποκειμενοποίησης των μεταναστών και μεταναστριών μαύρου χρώματος σε συνθήκες διαεθνικότητας, η έρευνα ολοκληρώνεται με την ανάλυση των βιογραφικών συνεντεύξεων των μεταναστών και μεταναστριών από την Σιέρα Λεόνε. Στο μεταναστευτικό τους ταξίδι, στα χρόνια ζωής στην Ελλάδα, στο βίωμα τους στην πόλη της Αθήνας της κρίσης και στα μελλοντικά τους σχέδια, οι μετανάστες και οι μετανάστριες από την Σιέρα Λεόνε επανατοποθετούν την υποκειμενικότητά τους μεταξύ μνήμης, εμπειρίας και φαντασίας, αναδεικνύοντας τις διαδικασίες φυλετικοποίησης της μαύρης μεταναστευτικής υποκειμενικότητας αλλά και της ενεργοποίησης «άλλων» υποκειμενικοτήτων που διαταράσσουν τις συνοριοποιήσεις και τις «κλειστές» εθνοφυλετικές κατηγοριοποιήσεις και φέρνουν στο προσκήνιο τις δυνητικότητες για μια «ανοιχτή», δυναμική και χειραφετητική (δι)υποκειμενικότητα.
Ιus gentium και κυριαρχία
Authors: Κατσούλης Ευθύμιος
Published: December 2022

Τα ζητήματα αυτής της έρευνας σχετίζονται πρωτίστως με την έννοια του φυσικού δικαίου σε σχέση με θέματα κυριαρχίας κατά την περίοδο της Ισπανικής ανακάλυψης του Νέου Κόσμου. Το όλο ερευνητικό εγχείρημα προσεγγίζει το αποικιοκρατικό περιβάλλον της Ισπανικής κατάκτησης του Νέου Κόσμου μέσα από μία γενικότερη αναπροσαρμογή της φιλοσοφικής, θεολογικής και πολιτικής σκέψης πάνω στο πεδίο της φιλοσοφίας του δικαίου κατά την περίοδο της πρώιμης Νεότερης Ευρώπης.Κύριος στόχος της συγκεκριμένης έρευνας είναι η παρουσίαση της φιλοσοφικής σκέψης του Francisco de Vitoria, ενός εκ των σημαντικότερων εισηγητών και θεμελιωτών του διεθνούς δικαίου στην Ισπανία κατά τον 16ο αιώνα. Δευτερεύων στόχος είναι η πλήρωση ενός μεγάλου και διακριτού κενού στην ελληνόγλωσση επιστημονική βιβλιογραφία στον Ισπανικό φιλοσοφικό χώρο σκέψης.Με την έρευνα αυτή αναδεικνύεται ένα φάσμα συγκρούσεων δογμάτων και στερεοτύπων του εξεταζόμενου στοχαστή σε πεδία όπως η φύση, το δίκαιο, η πολιτική, τα ανθρώπινα δικαιώματα, η έννοια της κυριαρχίας, ο ρόλος της εκκλησίας, ο ρόλος του κυρίαρχου κράτους.Κύριο συμπέρασμα αποτελεί η ύπαρξη ενός νομικού status και ενός φιλοσοφικού πλαισίου τα οποία ρυθμίζουν τη λειτουργία του δικαίου σε κάθε πεδίο της ανθρώπινης ύπαρξης. Αυτό είναι σημαντικότατο, κυρίως στην εποχή μας που αντιμετωπίζει πολύπλοκα προβλήματα όπως η ανθρωπιστική κρίση, το μεταναστευτικό και ο γεωπολιτικός αναθεωρητισμός μεταξύ άλλων.