bluuebunny/crossref_metadata_2025 huggingface dataset:
Particle swarm optimization based sliding mode control for maximum power point tracking in solar PV systems
Authors: Odo Matthew Chinedu , Ejiogu Emenike Chinedozi
Published: April 2024

One of the most significant renewable energies is photovoltaic (PV) energy, however it has a low efficiency due to its variable maximum power point that depends on weather conditions. In order to guarantee the system's best performance, intelligent algorithms can effectively track this point in real-time utilizing the maximum power point tracking (MPPT) method. Consequently, it is crucial to maximize the use of the solar energy that has been captured as well as the PV system's generated electricity. Variations in solar irradiance affects the amount of electric energy obtained from solar arrays. For efficient extraction of electricity from solar PV systems, MPPT algorithms are required. Sliding mode control (SMC) can be used in the control of nonlinear systems. However, the effectiveness of SMC can be improved by the choice of the sliding coefficients. In this paper, optimal search using particle swarm optimization (PSO) is used in the design of the sliding manifold. Results obtained via simulations showed that MPPT tracking efficiencies obtained for the PSO based SMC and the conventional SMC are 99.65% and 96.79% respectively. That means, PSO based SMC is 2.86% better than conventional SMC.
SHE PWM based 21 level inverters with hardware analysis
Authors: Arulappan Annai Theresa Alphonse , Selvaraj Malathi , Aladian Ambikapathy
Published: April 2024

Recently, the advancement of multilevel inverters (MLI) has been a crucial factor in high power and medium voltage applications. This MLI has multiple topologies and has been used in a variety of applications. Cascaded MLI is preferred over other forms of multilevel inverter topologies. Nonetheless, significant obstacles are encountered when implementing these topologies. They necessitate an increased number of switches, DC sources, capacitors, and diodes. Increased losses and total harmonic distortion (THD) will be present in the system. In addition, the MLI is more expensive. The better construction of a multilevel inverter results in more output levels with fewer switches, sources, and driver circuits, as well as low THD. A new single-phase cascaded asymmetrical DC voltage sources based multilevel inverter design and the selective harmonic elimination (SHE) approach are used to attain these goals. After confirming in MATLAB/Simulink, the hardware implementation of the multilevel inverter in 21 levels was completed in this article.
Contribuciones a la paz en colombia desde las prácticas y sentidos de paz desarrollados por la ecoaldea Varsana
Authors: Pulido Muñoz Lyda Constanza
Published: April 2024

En el presente artículo se sintetiza el resultado de la investigación cualitativa “Los sentidos y prácticas de paz realizados por los devotos de la Ecoaldea Varsana, en asociación con la Red del Pacto Mundial Consciente en Colombia, rpmc”, para lograrlo, el enfoque metodológico, pensado desde la sistematización de experiencias, comprendió el análisis y la interpretación de la información. Como problemática se contemplaron los antecedentes, las prácticas y sentidos de paz, los puntos de inflexión y el estado actual de la experiencia; y se emplearon como técnicas la observación participante, la revisión documental, entrevistas semiestructuradas y talleres de línea de tiempo. Asimismo, se destacaron los actores participantes: Devotos (de Krishna) y Activistas de la rpmc. El problema de investigación consistió en visibilizar las acciones de paz y reconocerlas como prácticas de autorrealización de los devotos residentes de Varsana, tales como: Banco de semillas / Semillas nativas por la vida. Boicot pacífico. Kiva (el encuentro de los pueblos ancestrales), Canto al agua, Chaski Fest (Festival de arte consciente), entre otras.
“Arquitetura eu não sei o que é.”
Authors: Ruggiero Amanda Saba , Andrade Carlos Roberto Monteiro de
Published: April 2024

Sem resumo.
Móveis com material não convencional Soluções do arquiteto Jorge Caron*
Authors: Caron Jorge Osvaldo
Published: April 2024

Texto de Jorge Caron sobre móveis de fibrocimento.
Notas para uma proposta de atelier
Authors: Caron Jorge Osvaldo
Published: April 2024

Não se aplica.
Caro Caron
Authors: Camargo Azael Rangel
Published: April 2024

Sem resumo.
Depoimento
Authors: Peres Renata Bovo
Published: April 2024

Sem resumo.
Simetrias transumantes: arquitetura e teatro no pensamento de Jorge O. Caron
Authors: Masseran Paulo Roberto
Published: April 2024

Sem resumo.
Concurso é bom sim: para toda e qualquer obra pública
Authors: Caron Jorge Osvaldo
Published: April 2024

Sem resumo.
Erros envolvendo troca de medicamentos na dispensação de um hospital: quais classes de medicamentos estão envolvidas?
Authors: Morais Jéssica Octávia de , Martins Jordânia Ferreira , Melo Lays Cássia Santos Duarte , Soares Lorena Aguiar , Sanches Cristina , Baldoni André Oliveira , Pereira Mariana Linhares
Published: April 2024

Erros podem ocorrer nos processos de prescrição, dispensação e administração do medicamento. Um destes erros se dá pela troca de medicamentos no momento da dispensação e dessa maneira, pode haver falha no tratamento e/ou risco para o paciente.  O objetivo deste estudo é identificar as principais classes de medicamentos envolvidas neste tipo de erro. Para o mesmo, foram utilizados registros manuais de erros de dispensação, que consiste nas notificações do período de 01/12/2009 a 14/07/2019 de um hospital de médio porte de Minas Gerais, e, classificou-se cada medicamento desses erros de acordo com a classe anatômico-terapêutico-química - em inglês Anatomical Therapeutic Chemical (ATC). Dentre o total de erros (n=3937) notificados pelas três farmácias do hospital, observou-se a ocorrência de 755 (19,18%) erros relacionados com a troca de medicamentos, sendo que os medicamentos do tipo “Look-Alike” e “Sound-Alike” (LASA) (N=303; 40,13%), os agentes anti-infecciosos (N=238; 31,52%) e medicamentos potencialmente perigosos (N=189; 25,03%) estão envolvidos na maioria dos erros deste estudo. Dessa maneira, a automatização do serviço e a educação continuada dos profissionais da saúde são umas das alternativas para evitar esses erros, promover segurança do paciente, contribuindo com desfechos clínicos favoráveis aos pacientes.
Miocardite aguda associada a edema cerebral difuso em paciente com Covid-19: relato de caso
Authors: Rossa Isabella Cristina Mendes , Marques Gustavo Lenci , Twardowschy Carlos Alexandre
Published: April 2024

A infecção pelo vírus da síndrome respiratória aguda grave 2 (SARS-CoV-2), além de provocar danos graves ao sistema respiratório, pode desencadear lesões cardíacas e cerebrais. Estudos sugerem que tanto o parênquima cerebral quanto o miocárdio podem ser infectados diretamente pelo vírus. Ademais, o estado hiperinflamatório secundariamente desencadeado promove inflamação endotelial, vascular e miocárdica, instabilidade de placas, estado de hipercoagulabilidade e desbalanço eletrolítico. O presente trabalho tem como objetivo descrever o caso de uma paciente com COVID-19 com apresentação de miocardite aguda associada a edema cerebral. Tratava-se de uma paciente do sexo feminino, 44 anos, admitida com sintomas da COVID-19. Ao longo da internação, ela apresentou elevação de troponina cardíaca I, assim como hipocinesia difusa na ecocardiografia transtorácica, o que sugeriu o diagnóstico de miocardite. Em seguida, uma tomografia de crânio evidenciou edema cerebral difuso e herniação tonsilar, sendo que a paciente evoluiu com morte encefálica. O caso relatado mostra um provável impacto da miocardite sobre o sistema nervoso central, sendo possível inferir que o baixo débito pode reduzir a perfusão cerebral, provocando a piora do prognóstico, devido ao processo de resposta endógena do edema. Além disso, apresenta a possibilidade de dano direto do vírus ao miocárdio e ao parênquima cerebral, visto que esse fato poderia desencadear um desfecho de igual gravidade.  Nesse sentido, existe a necessidade de outros estudos para investigação dos efeitos do SARS-CoV-2 nesses tecidos, pois não foi possível descartar a ação direta do vírus no tecido cardíaco e cerebral.
Arritmias e as suas correlações fisiopatológicas com a infecção do SARS-COV2
Authors: Nogueira Sandy de Carvalho , Nepomuceno Josiane das Graças , Frazão Frederico Lopes , Laboissière Renato Santos
Published: April 2024

Introduction: The pandemic caused by SARS-CoV 2 is considered one of the most critical public health events in the last decades. That said, knowledge of the manifestations of the disease is relevant. Of the changes already described in the literature, cardiac arrhythmias have been receiving increasing prominence. Objective: To discuss the pathogenesis of arrhythmias in the context of the Coronavirus infection and, thus, elucidate the mechanisms of aggression of this virus against cardiac tissue. Methods: This is a cross-sectional and integrative review. Research was carried out in databases such as SciELO, PubMed and Google Scholar. Articles in English, Portuguese and Italian published between 2020 and 2023 were selected. Result: Cardiac arrhythmia because of infection is related to the hyperinflammatory state developed in response to the virus or by direct invasion of structures that have the ACE-2 receptor. Ischemic lesions occur in the sinoatrial node and in the myocardium because of the formation of vascular thrombi caused by inflammation, which impair the rhythm and contraction of this organ, taking it from its sinus rhythm. Regarding direct invasion, the sarcolemma of the cardiomyocytes is ruptured, thus impairing the adequate propagation of the electrical impulse throughout the cardiac tissue and compromises its normal functioning. Conclusion: There is a close relationship between COVID-19 infection and the occurrence of arrhythmias, as well as an increase in morbidity and mortality in infected patients.
Redução do Número de Diagnóstico de Câncer do Trato Digestivo Alto durante a Pandemia Covid-19: Revisão Integrativa de Literatura
Authors: Goi Ana Paula Copetti , Dalbosco Ana Katharina , Vedana Bruna , Pilatti Dayane , Garcia Marina Capoani , Alt Luciano Luiz
Published: April 2024

Introduction: In 2019, the World Health Organization was alerted about cases of infection with COVID-19. Due to the measures taken to prevent contamination, many pre-scheduled consultations, treatments and exams were suspended or cancelled. Objectives: This study aims to identify literature data on upper digestive tract cancer diagnosis numbers in patients that had performed endoscopy during the COVID-19 pandemic, along with a pre-pandemic control group. Methods: A literature review was performed through searches on the SciELO, Science Direct, PubMed, and BVS Regional Portal platforms. After applying the inclusion and exclusion criteria, 8 articles were selected for the study. Results: All articles reported a decrease in diagnoses of upper digestive tract cancer (reduction ranged from 76.3% to 19.28%) and in endoscopies performed (reduction ranged from 87.5% to 43.1%) during the pandemic. Conclusion: The COVID-19 pandemic reduced the accessibility of resources and; consequently, increased the number of underdiagnoses of pathologies with no direct relationship with the coronavirus. Thus, a significant reduction in the number of diagnoses of upper digestive tract cancer was observed due to the decline in the number of endoscopies performed.
A influência do estilo de vida e hábitos alimentares no perfil nutricional de estudantes de medicina e outros acadêmicos da área de saúde
Authors: Kanuf Vinicius Salermo , Oliveira Emily Carolina Assis , Borges Gustavo Henrique de Oliveira Carmo , Gomes Anna Carollina Barbosa , Silva João Marcos Luiz da , Bastos Carla Santos , Arruda Jalsi Tacon
Published: April 2024

A series of risk factors and changes in lifestyle habits tend to worsen in health students, due to the stressful routine. In addition to the requirement for dedication and performance, medical students are exposed to other harmful lifestyle habits, including poor diet, sedentary lifestyle, sleep disorders, stress, and mental disorders, as well as alcoholism and smoking. This work analyzed the lifestyle and habits related to the nutritional profile of academics in the health area, especially medical students, observing the main dysfunctional practices, their prevalence, associated conditions, and harmful consequences. An integrative literature review was carried out on the CAPES, SciELO and LILACS Journal Portal databases. It was found that medical students have high levels of overweight, ranging between 26% and 32.2%; and obesity ranging between 4% and 7.8%. Unhealthy lifestyle habits such as inadequate eating practices, sedentary lifestyle, alcoholism, and smoking are common, especially linked to long and stressful routines, in addition to easier access to medicines. The vulnerable position experienced by medical and healthcare students is evident, with a prevalence of lifestyle habits considered to be at risk for the development of obesity and risk factors for other chronic non-communicable diseases.
Importância do médico Fisiatra no tratamento das dores neuromusculares: uma overview
Authors: Ferreira Hayani Yuri , Barbosa Samantha Gonçalves , Melo Jamili Namara Freitas de , Lemes Neto Edílio Póvoa , Lucas Paula Machado da Costa
Published: April 2024

As doenças neuromusculares incluem um grupo de patologias de etiologia hereditária ou adquirida, podendo ou não terem caráter progressivo e, podem afetar os componentes do sistema nervoso periférico, responsável por conduzir os estímulos nervosos de movimento e sensibilidade através da medula espinal, nervos e músculos.
Two new species of Pseudocrangonyx (Amphipoda: Pseudocrangonyctidae) from the hyporheic zones in South Korea
Authors: LEE CHI-WOO , MIN GI-SIK
Published: April 2024

Pseudocrangonyx Akatsuka & Komai, 1922, is the most diverse group of subterranean amphipods in the groundwater communities of Far East Asia and is related to the biogeographic origin and evolution of subterranean amphipod fauna in the region. In this study, we describe two new subterranean species of pseudocrangonyctid amphipods, P. seomjinensis sp. nov. and P. danyangensis sp. nov., from the hyporheic zones in South Korea. These new species can be distinguished from their congeners by the length of the uropod 2 outer ramus, the number of accessory flagella of antenna 1, and telson shape. Additionally, we determined sequences of the nuclear 28S rRNA and the mitochondrial cytochrome c oxidase subunit I gene of the new species for molecular analyses.
A new species of Micrapate (Insecta: Coleoptera: Bostrichidae) from Brazil, with a key to Brazilian species
Authors: LIU LAN-YU , BEAVER ROGER A. , FLECHTMANN CARLOS A. H.
Published: April 2024

Micrapate spinula Liu, sp. nov., is described from the cerrado savanna biome of Brazil (Mato Grosso do Sul and Minas Gerais), together with information on its biology and natural enemies. A key to the Micrapate species known from Brazil is provided.
Factors Affecting Consumers Compliance Intention: Consumption Tax Evasion as an Ethical Dilemma
Authors: Krishna Swathy , V Shacheendran
Published: April 2024

Consumption tax evasion (CTE) is an ethical dilemma that can enlarge the presence of the shadow economy. The empirical literature mainly focused on the ethical dimension of the business community, thus there is insufficient literature related to the ethical decision-making process on the consumer’s side. So, the present study attempts to explore the ethical decision-making process of consumers regarding CTE. The study used three major components of Jones’s Issue Contingent Model to study the consumer’s ethical decision-making regarding CTE. The study proposes a conceptual model by linking idealism, relativism, religiosity and attitude with the three components of the issue contingent model. The result of the study was based on primary data collected from consumers in the Kerala State. The data obtained was examined using the PLS-SEM technique which confirms the influence of idealism, relativism and attitude on the moral recognition of consumers regarding CTE. The result also concludes that moral recognition leads to moral judgement, which in turn, plays a vital role in inculcating moral compliance intention in the minds of consumers.
Multitarget Mechanism of Artemisia Plants to Fight Respiratory Tract Infections Based on Network Pharmacology and Molecular Docking
Authors: Xu Zhao-zhen , Sun Zhi-xin , Sharopov Farukh-S , Setzer William-N , Sun Yan-fang
Published: April 2024

Objective: To study the mechanism of Artemisia in the treatment of respiratory tract infection (RTI) by network pharmacology and molecular docking. Methods: The active constituents and targets of Artemisia were screened by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). Gene Cards database to obtain disease targets associated with RTI. The key targets of intersection were used to construct the protein–protein interaction (PPI) network, and the hub gene was obtained through topological analysis to construct the pharmacology regulation network of traditional Chinese medicine. The key targets were analyzed by R language enrichment, and the regulatory network diagram of the key target function/pathway was constructed. Molecular docking verifies the binding of the drug to the target predicted by network pharmacology. Results: 144 active components of Artemisia regulated 133 target proteins related to RTI, the core components were β-sitosterol, quercetin, isorhamnetin, artemisinin, etc. Gene ontology enrichment analysis showed that Artemisia regulates receptor ligand activity, cytokine activity, and other molecular functions by acting on membrane region, membrane raft and other cellular structures in the treatment of RTI, thus affecting biological processes such as the response to drugs and bacteria-derived molecules. Kyoto Encyclopedia of Genes and Genomes enrichment analysis indicated that phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt), tumor necrosis factor, interleukin-17 (IL-17) signaling pathway was the main pathway for RTI treatment. The molecular docking method confirmed the high affinity between the active ingredient and the RTI target. Conclusions: Artemisia species, a multitarget medication, has been shown to be a viable therapy option for RTI by network pharmacology techniques based on data mining and molecular docking approaches.
Medical Insurance Representatives Perceptions on National Health Insurance Primary Healthcare Re-Engineering in South Africa: A Qualitative Study
Authors: Naidoo Vivian , Suleman Fatima , Bangalee Varsha
Published: April 2024

The South African government is moving toward universal health coverage (UHC) with the passing of the National Health Insurance (NHI) Bill. Access to quality primary healthcare (PHC) is the cornerstone of UHC principles. The South African governmental health department have begun focusing efforts on improving the efficiency and functionality of this system; that includes the involvement of private healthcare professionals and medical insurance companies. This study sought to explore perceptions of medical insurance company personnel on PHC re-engineering as part of NHI restructuring. A qualitative research design was adopted in this study. Semi-structured interviewed were conducted on 10 participants. Their responses were audio recorded and transcribed utilizing Microsoft Word® documents. Nvivo® was used to facilitate the analysis of data. A thematical approach was used to categories codes into themes. Although participants were in agreement with the current healthcare reform in South Africa. The findings of this study have highlighted several gaps in the NHI Bill at the current point in time. In order to achieve standardized quality of care at a primary level; it is imperative that reimbursement frameworks with clearly detailed service provision and accountability guidelines are developed.
Shooting and Fishing Prohibitions in the Water Bodies of Ajmer–Pushkar During Colonial Period: The Case of Marginalised Communities
Authors: Dass Persis Latika
Published: April 2024

Popular perception views the colonial regime as totally unconcerned about the notions of propriety and sentiments associated with the native population. Such a view does not bar us from studying colonial governance and the public works that it undertook under normal governance. The case study of fishing prohibitions imposed on the lakes of Ajmer–Pushkar highlights not only the regard that the colonial government had towards the religious sentiments of the masses but also the influence of modern Western ideas of environment conservation. Parallel to this runs the narrative of communal tension that erupts due to the prioritisation of religious sentiments of the majority community by the British State. The poor, whose sustenance is dependent on fishing, find ways to breach the colonial prohibitions, thereby challenging the regime’s authority. Similarly, the representatives of the vegetarian merchant class use their influence to compel the British administrators to take the steps they favoured. No consensus or conclusion is reached due to the complex nature of the whole affair, but the reading of the correspondence that emergence to and from the Chief Commissioner’s Office of Ajmer–Merwara on the subject may give us an insight into the various factors that influenced the functioning of the colonial administration and the diverse kinds of reaction that these elicited from the native population.
Benralizumab in severe eosinophilic asthma by previous biologic use and key clinical subgroups: real-world XALOC-1 programme
Authors: Jackson David J. , Pelaia Girolamo , Emmanuel Benjamin , Tran Trung N. , Cohen David , Shih Vivian H. , Shavit Anat , Arbetter Douglas , Katial Rohit , Rabe Adrian Paul J. , Garcia Gil Esther , Pardal Marisa , Nuevo Javier , Watt Michael , Boarino Silvia , Kayaniyil Sheena , Chaves Loureiro Cláudia , Padilla-Galo Alicia , Nair Parameswaran
Published: April 2024

Background

Pivotal phase 3 trials and real-world studies have demonstrated benralizumab's overall efficacy and safety in severe eosinophilic asthma (SEA). Additional large-cohort data are needed to confirm its real-world effectiveness in SEA according to previous biologic use and key baseline characteristics important for treatment selection.

Methods

XALOC-1 is a large, multinational, retrospective, observational, real-world study programme of benralizumab in adults with SEA. This 48-week integrated analysis assessed annualised exacerbation rate (AER), maintenance oral corticosteroid (mOCS) use, asthma symptom control and lung function during a 12-month baseline period and up to 48 weeks after benralizumab initiation. Subgroup analyses were based on previous biologic use and key baseline clinical characteristics (mOCS use, blood eosinophil count, exacerbation history, age at asthma diagnosis, fractional exhaled nitric oxide level and presence of atopy and chronic rhinosinusitis with nasal polyps).

Results

Out of 1002 patients analysed, 380 were biologic-experienced. At week 48, 71.3% were exacerbation-free (versus17.2% at baseline); relative reduction in AER was 82.7% overall and 72.9% in biologic-experienced patients; rates were maintained across all key clinical characteristic subgroups. Of patients using mOCS at baseline (n=274), 47.4% (130 out of 274) eliminated their use by week 48; the mean reduction from baseline in daily dose was 51.2% and, notably, 34.9% in biologic-experienced patients (n=115). Clinically significant improvements in asthma symptom control and lung function were observed.

Conclusion

In this large, real-world programme, SEA patients treated with benralizumab had substantial improvements in clinical outcomes irrespective of previous biologic use and key clinical characteristics important to therapeutic decision-making in clinical practice.
A review of emerging health threats from zoonotic New World mammarenaviruses
Authors: Lendino Arianna , Castellanos Adrian A. , Pigott David M. , Han Barbara A.
Published: April 2024

Despite repeated spillover transmission and their potential to cause significant morbidity and mortality in human hosts, the New World mammarenaviruses remain largely understudied. These viruses are endemic to South America, with animal reservoir hosts covering large geographic areas and whose transmission ecology and spillover potential are driven in part by land use change and agriculture that put humans in regular contact with zoonotic hosts.

We compiled published studies about Guanarito virus, Junin virus, Machupo virus, Chapare virus, Sabia virus, and Lymphocytic Choriomeningitis virus to review the state of knowledge about the viral hemorrhagic fevers caused by New World mammarenaviruses. We summarize what is known about rodent reservoirs, the conditions of spillover transmission for each of these pathogens, and the characteristics of human populations at greatest risk for hemorrhagic fever diseases. We also review the implications of repeated outbreaks and biosecurity concerns where these diseases are endemic, and steps that countries can take to strengthen surveillance and increase capacity of local healthcare systems. While there are unique risks posed by each of these six viruses, their ecological and epidemiological similarities suggest common steps to mitigate spillover transmission and better contain future outbreaks.
45 years of tetracycline post exposure prophylaxis for STIs and the risk of tetracycline resistance: a systematic review and meta-analysis
Authors: Vanbaelen Thibaut , Manoharan-Basil Sheeba Santhini , Kenyon Chris
Published: April 2024

There is considerable interest in the use of doxycycline post exposure prophylaxis (PEP) to reduce the incidence of bacterial sexually transmitted infections (STIs). An important concern is that this could select for tetracycline resistance in these STIs and other species. We searched PubMed and Google Scholar, (1948–2023) for randomized controlled trials comparing tetracycline PEP with non-tetracycline controls. The primary outcome was antimicrobial resistance (AMR) to tetracyclines in all bacterial species with available data. Our search yielded 140 studies, of which three met the inclusion criteria. Tetracycline PEP was associated with an increasedprevalence of tetracycline resistance in Neisseria gonorrhoeae, but this effect was not statistically significant (Pooled OR 2.3, 95% CI 0.9-3.4). PEP had a marked effect on the N. gonorrhoeae tetracycline MIC distribution in the one study where this was assessed. Prophylactic efficacy was 100% at low MICs and 0% at high MICs. In the one study where this was assessed, PEP resulted in a significant increase in tetracycline resistance in commensal Neisseria species compared to the control group (OR 2.9, 95% CI 1.5-5.5) but no significant effect on the prevalence of tetracycline resistance in Staphylococcus aureus. The available evidence suggests that PEP with tetracyclines could be associated with selecting tetracycline resistance in N. gonorrhoeae and commensal Neisseria species.
Factors affecting anophthalmic socket reconstruction outcomes using autologous oral mucosal graft
Authors: Aryasit Orapan , Panyavisitkul Yanin , Damthongsuk Parichat , Singha Penny , Rattanalert Narisa
Published: April 2024

Background

Limited studies have reported surgical outcomes that are defined by strict criteria following grade 2 or 3 socket reconstruction using an oral mucosal graft (OMG). We aimed to determine factors influencing surgical outcomes of anophthalmic socket reconstruction using OMG in patients with grade 2 or 3 socket contractures.

Methods

Thirty-seven patients who underwent socket reconstruction with autologous OMG between January 2007 and December 2017 were retrospectively analyzed. The successful outcome was defined as an eye prosthesis wearing without experiencing displacement and the absence of any re-operations or additional surgeries following socket reconstruction. Factors affecting surgical outcomes were identified using multivariate analysis.

Results

A total of 15 male and 22 female patients (mean age: 40.2 ± 17.2 years) were included. The median duration of socket contracture was 21.5 years. Grade 2 and 3 socket contractures, based on Tawfik’s classification, were reported in 20 and 17 patients, respectively. Twenty-eight and eight patients underwent socket reconstruction using OMG alone and OMG combined with a hard palate graft, respectively. The success rates of grades 2 and 3 socket contracture reconstruction were 80.0% and 52.9%, respectively. Multivariate analysis demonstrated that only grade 3 contractures were predictive of worse outcomes. At the final visit (mean follow-up: 6.3 years), 34 patients (91.9%) could wear their eye prostheses.

Conclusions

Socket reconstruction using autologous OMG can provide acceptable results in grade 2 and 3 contractures; however, satisfactory results were more significantly reported in grade 2 than in grade 3 contractures.
Pelvic floor muscle contraction automatic evaluation algorithm for pelvic floor muscle training biofeedback using self-performed ultrasound
Authors: Muta Miyako , Takahashi Toshiaki , Tamai Nao , Suzuki Motofumi , Kawamoto Atsuo , Sanada Hiromi , Nakagami Gojiro
Published: April 2024

Introduction

Non-invasive biofeedback of pelvic floor muscle training (PFMT) is required for continuous training in home care. Therefore, we considered self-performed ultrasound (US) in adult women with a handheld US device applied to the bladder. However, US images are difficult to read and require assistance when using US at home. In this study, we aimed to develop an algorithm for the automatic evaluation of pelvic floor muscle (PFM) contraction using self-performed bladder US videos to verify whether it is possible to automatically determine PFM contraction from US videos.

Methods

Women aged ≥ 20 years were recruited from the outpatient Urology and Gynecology departments of a general hospital or through snowball sampling. The researcher supported the participants in their self-performed bladder US and videos were obtained several times during PFMT. The US videos obtained were used to develop an automatic evaluation algorithm. Supervised machine learning was then performed using expert PFM contraction classifications as ground truth data. Time-series features were generated from the x- and y-coordinate values of the bladder area including the bladder base. The final model was evaluated for accuracy, area under the curve (AUC), recall, precision, and F1. The contribution of each feature variable to the classification ability of the model was estimated.

Results

The 1144 videos obtained from 56 participants were analyzed. We split the data into training and test sets with 7894 time series features. A light gradient boosting machine model (Light GBM) was selected, and the final model resulted in an accuracy of 0.73, AUC = 0.91, recall = 0.66, precision = 0.73, and F1 = 0.73. Movement of the y-coordinate of the bladder base was shown as the most important.

Conclusion

This study showed that automated classification of PFM contraction from self-performed US videos is possible with high accuracy.
A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers
Authors: Christopher Michael , Bowen Sarah , Witkiewitz Katie , Grupe Daniel , Goerling Richard , Hunsinger Matthew , Oken Barry , Korecki Tyrus , Rosenbaum Nils
Published: April 2024

Background

Law enforcement officers (LEOs) are exposed to significant stressors that can impact their mental health, increasing risk of posttraumatic stress disorder, burnout, at-risk alcohol use, depression, and suicidality. Compromised LEO health can subsequently lead to aggression and excessive use of force. Mindfulness training is a promising approach for high-stress populations and has been shown to be effective in increasing resilience and improving mental health issues common among LEOs.

Methods

This multi-site, randomized, single-blind clinical feasibility trial was intended to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of mindfulness-based resilience training (MBRT) versus an attention control (stress management education [SME]) and a no-intervention control, on physiological, attentional, and psychological indices of stress and mental health. The current study was designed to enhance efficiency of recruitment, engagement and retention; optimize assessment, intervention training and outcome measures; and ensure fidelity to intervention protocols. Responsiveness to change over time was examined to identify the most responsive potential proximate and longer-term assessments of targeted outcomes.

Results

We observed high feasibility of recruitment and retention, acceptability of MBRT, fidelity to assessment and intervention protocols, and responsiveness to change for a variety of putative physiological and self-report mechanism and outcome measures.

Conclusions

Results of this multi-site feasibility trial set the stage for a full-scale, multi-site trial testing the efficacy of MBRT on increasing LEO health and resilience, and on decreasing more distal outcomes of aggression and excessive use of force that would have significant downstream benefits for communities they serve.

Trial registration

ClinicalTrials.gov, NCT03784846. Registered on December 24th, 2018.
Understanding health system resilience in responding to COVID-19 pandemic: experiences and lessons from an evolving context of federalization in Nepal
Authors: Regmi Shophika , Bertone Maria Paola , Shrestha Prabita , Sapkota Suprich , Arjyal Abriti , Martineau Tim , Raven Joanna , Witter Sophie , Baral Sushil
Published: April 2024

Introduction

The COVID-19 pandemic has tested the resilience capacities of health systems worldwide and highlighted the need to understand the concept, pathways, and elements of resilience in different country contexts. In this study, we assessed the health system response to COVID-19 in Nepal and examined the processes of policy formulation, communication, and implementation at the three tiers of government, including the dynamic interactions between tiers. Nepal was experiencing the early stages of federalization reform when COVID-19 pandemic hit the country, and clarity in roles and capacity to implement functions were the prevailing challenges, especially among the subnational governments.

Methods

We adopted a cross-sectional exploratory design, using mixed methods. We conducted a desk-based review of all policy documents introduced in response to COVID-19 from January to December 2020, and collected qualitative data through 22 key informant interviews at three tiers of government, during January-March 2021. Two municipalities were purposively selected for data collection in Lumbini province. Our analysis is based on a resilience framework that has been developed by our research project, ReBUILD for Resilience, which helps to understand pathways to health system resilience through absorption, adaptation and transformation.

Results

In the newly established federal structure, the existing emergency response structure and plans were utilized, which were yet to be tested in the decentralized system. The federal government effectively led the policy formulation process, but with minimal engagement of sub-national governments. Local governments could not demonstrate resilience capacities due to the novelty of the federal system and their consequent lack of experience, confusion on roles, insufficient management capacity and governance structures at local level, which was further aggravated by the limited availability of human, technical and financial resources.

Conclusions

The study findings emphasize the importance of strong and flexible governance structures and strengthened capacity of subnational governments to effectively manage pandemics. The study elaborates on the key areas and pathways that contribute to the resilience capacities of health systems from the experience of Nepal. We draw out lessons that can be applied to other fragile and shock-prone settings.
Under the dual effect of inflammation and pulmonary fibrosis, CTD-ILD patients possess a greater susceptibility to VTE
Authors: Jiang Wenli , Jia Wenhui , Dong Chunling
Published: April 2024

As an autoimmune disease, the persistent systemic inflammatory response associated with connective tissue disease (CTD) is involved in the development of venous thromboembolism (VTE). However, clinical data showed that the risk of VTE in patients differed between subtypes of CTD, suggesting that different subtypes may have independent mechanisms to promote the development of VTE, but the specific mechanism lacks sufficient research at present. The development of pulmonary fibrosis also contributes to the development of VTE, and therefore, patients with CTD-associated interstitial lung disease (CTD-ILD) may be at higher risk of VTE than patients with CTD alone or patients with ILD alone. In addition, the activation of the coagulation cascade response will drive further progression of the patient’s pre-existing pulmonary fibrosis, which will continue to increase the patient’s risk of VTE and adversely affect prognosis. Currently, the treatment for CTD-ILD is mainly immunosuppressive and antirheumatic therapy, such as the use of glucocorticoids and janus kinase-inhibitors (JAKis), but, paradoxically, these drugs are also involved in the formation of patients’ coagulation tendency, making the clinical treatment of CTD-ILD patients with a higher risk of developing VTE challenging. In this article, we review the potential risk factors and related mechanisms for the development of VTE in CTD-ILD patients to provide a reference for clinical treatment and prevention.
Optimization of inoculum production of Stemphylium botryosum for large-scale resistance screening of lentils
Authors: González Mario , Barilli Eleonora , Rispail Nicolas , Rubiales Diego
Published: April 2024

Background

Stemphylium blight incited by Stemphylium botryosum poses a significant threat to lentil crops worldwide, inducing severe defoliation and causing substantial yield losses in susceptible varieties under favorable conditions. While some moderate levels of resistance have been identified within lentil germplasm, a low number of resistant cultivars are available to farmers. Adding to the common constraints of resistance breeding, a notable challenge is generating a sufficient number of spores for large-scale screenings, which are essential for pinpointing additional sources of resistance for integration into breeding programs. Therefore, there is a pressing need to improve existing screening methods and tailor them for large-scale material selection. In pursuit of this objective, a protocol for the efficient production of fungal material has been adapted.

Results

Optimization of fungal material production was successfully achieved by comparing the use of fungal mycelia and spores. Spore production was found to be optimal when produced on solid V8-PDA(hi) medium, while liquid Richard’s medium was identified as superior for mycelium yield. Furthermore, a refined screening method was developed by evaluating the resistance of six lentil accessions to stemphylium blight. This assessment included the use of either fungal mycelia (at densities ranging from 1 to 5 g L− 1) or spores (with densities ranging from 5 × 104 to 2 × 105 conidia mL− 1) under three different relative humidity levels (from 50 to 100%). Both humidity levels and inoculum dose significantly influenced the final disease rating (DR) and the relative Area Under the Disease Progress Curve (rAUDPC). Differences among genotypes in final symptom severity (DR) became more pronounced after inoculation with inoculum densities of 5 g L− 1 of mycelium or of 105 and 2 × 105 conidia mL− 1 of spore under 100% relative humidity. Given the challenges associated with the large-scale production of S. botryosum spores, inoculations with 5 g L− 1 of mycelium is highly recommended as a practical alternative for conducting mass-scale screenings.

Conclusions

The findings from this study underscore the critical importance of maintaining high level of humidity during inoculation and disease progression development for accurately assessing resistance to stemphylium blight. The optimization of mycelial production for suspension inoculation emerges as a more reliable and efficient approach for conducting large-scale screening to assess germplasm resistance against stemphylium blight in lentil crops.
Ulnar carpal translation following palmar locking plate fixation for distal radius fractures: a retrospective analysis
Authors: Huang Shan-Yang , Huang Hui-Kuang , Wu Chin-Hsien , Chang Chih-Hsun , Huang Yi-Chao , Wang Jung-Pan
Published: April 2024

Background

Concomitant injuries to the radiocarpal ligaments may occur during episodes of distal radius fractures, which may not cause acute subluxation or dislocation but can lead to radiocarpal instability and progress over time. This study aimed to analyze the occurrence of ulnar carpal translation (UCT) after open reduction and internal fixation of distal radius fractures and evaluate the associated factors of UCT.

Methods

The retrospective study has been done now and includes patients treated between 2010 and 2020 who had undergone reduction and locking plate fixation of distal radius fractures. We assessed radiographs taken immediately after the operation and at 3 months post-operation, enrolling patients with UCT for evaluation. In addition to demographic data, we evaluated radiographic parameters, including fracture pattern, fragment involvement, and ulnar variance. We also assessed the palmar tilt-lunate (PTL) angle to determine associated rotatory palmar subluxation of the lunate (RPSL).

Results

Among the 1,086 wrists, 53 (4.9%) had UCT within 3 months post-operation. The majority of wrists with UCT exhibited normal to minus ulnar variance (49 wrists; mean: −1.1 mm), and 24 patients (45.3%) had concomitant RPSL. Fracture classification was as follows: 19 type A3 (35.8%), 5 type C1 (9.4%), 11 type C2 (20.8%), and 18 type C3 (34.0%). Radial styloid was involved in 20 wrists (37.7%), palmar rim in 18 wrists (34.0%), dorsal rim in 25 wrists (47.2%), and die-punch fractures in 3 wrists (5.7%). Concomitant ulnar styloid fractures were present in 29 wrists (54.7%).

Conclusion

This study highlights the potential for UCT to occur following reduction and fixation of distal radius fractures, particularly in cases with a more severe fracture pattern and combined with ulnar minus variance. The high incidence of concomitant RPSL provides further evidence for the possibility of associated radiocarpal ligament insufficiency after distal radius fracture.
Thoracoscopic treatment of mediastinal ectopic parathyroid adenomas: a Latinamerica experience case series and literature review
Authors: Karla Veronica Chavez , Mariana Chavez-Tostado , Adriana Graciela Peña-Rivera , Gabino Cervantes-Perez , Francina Valezka Bolaños-Morales
Published: April 2024

Background

Hyperparathyroidism (HPT) is a disease caused by hypersecretion of one or more parathyroid glands, it can be associated with ectopic mediastinal parathyroid glands (MEPA) in 2% of cases. The use of video-assisted thoracoscopic surgery (VATS) for the surgical resection of these glands is a safe, cost-effective, and low morbidity option for patients with MEPA. We report a case series of patients with this disease managed with VATS, the first in Mexico and Latinamerica.

Methods

From 2008 to 2022, a retrospective study involving patients with MEPA and treated by VATS approach was performed in a tertiary hospital in Mexico city. Relevant biochemical and clinical variables such as imaging studies, pre and postoperative laboratory results, surgical strategy, outcomes and pathological analysis were analyzed.

Results

Four cases of mediastinal parathyroid adenomas causing HPT were included. All patients were female with a median age of 52.5 years-old (range 46–59 years), half of the patients had primary HPT and the others tertiary HPT after kidney transplant. 75% of cases had a MEPA in the medium mediastinum, all had a preoperative positive SPECT-CT 99mTc Sestamibi scan. Mean preoperative PTH was 621.3pg/mL (182-1382pg/mL). All patients successfully underwent parathyroidectomy with a VATS approach, no deaths were reported.

Conclusions

VATS is a minimally invasive surgery that provides adequate access to mediastinal located glands, optimal visualization of mediastinal structures and has a high resection success rate with less complications and morbidity than open approaches.
Efficacy of moxidectin, using various dose regimens, against JYD-34, a macrocyclic lactone resistant isolate of Dirofilaria immitis
Authors: Martin Elizabeth M. , Mitchell Elizabeth B. , Yoon Stephen , McCall John W. , Fankhauser Becky , Mansour Abdelmoneim , McCall Scott , Pollmeier Matthias
Published: April 2024

Background

Macrocyclic lactones (MLs) are the only class of drugs currently commercially available that are effective for preventing heartworm disease. The data presented in this article provide information on the efficacy of oral moxidectin against JYD-34, a known ML-resistant Dirofilaria immitis isolate, when dogs are treated under various dosing regimens.

Methods

Fifty-two purpose-bred Beagle dogs were used in five laboratory studies. All dogs were inoculated with 50 D. immitis third-stage larvae (L3) (JYD-34 isolate) 30 days prior to the first treatment. Dogs were randomized to treatment (four to five animals in each group) with one, three, or five monthly doses of oral moxidectin ranging from 6 to 100 µg/kg body weight. In each study, control dogs were not treated. Five to 6 months after L3 inoculation, dogs were euthanized, and adult worms were counted to evaluate efficacy of the dosing regimens.

Results

Adult heartworms were recovered from all control dogs, with an overall geometric mean of 29.7 worms (range 15.2 to 38.0, individual counts ranged from 8 to 51). Five monthly doses of 6 µg/kg provided 83.3% and 90.2%, efficacy, and the same number of monthly doses of 9 µg/kg demonstrated 98.8% and 94.1% efficacy. Three monthly doses of 30 and 50 µg/kg demonstrated 97.9% and 99.0% efficacy, respectively, while a single dose of 100 µg/kg demonstrated 91.1% efficacy.

Conclusions

Five monthly doses of 9 µg/kg provided similar or only marginally lower efficacy against JYD-34, a known ML-resistant isolate, compared to substantially higher doses administered for 3 months. This underscores the importance of duration of exposure to moxidectin when facing ML-resistant isolates. Repeated administration of lower doses of moxidectin are an alternative to higher doses in the prevention of heartworm disease associated with less susceptible or resistant isolates.

Graphical Abstract