bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution changes of cutaneous leishmaniasis: A postulated risk of disease transmission in Hambantota, Sri Lanka
Authors: Sudarshani K A Mangala
Published: January 2024

Background & objectives:

Leishmaniasis is caused by various species of Leishmania. Approximately 20 of them are pathogenic to mammals. In Sri Lanka, cutaneous leishmaniasis (CL) is an established vector-borne disease. CL originates and spreads mainly through sand fly bite in many endemic countries. Objective of the present study was to compare the geographical distribution and demographic features of CL cases in 2014 and 2016 in Hambantota district, Sri Lanka.

Methods:

The patients who were presented to the Tangalle Base Hospital from June to December in 2014 and 2016 were examined and a descriptive study was carried out using a structured-questionnaire. Slit -skin smears were collected from each patient, Giemsa-stained and examined under the light microscope to identify Leishmania amastigotes.

Results:

Out of 256 and 314 suspected CL patients, 156 and 155 were identified positive for the year 2014 and 2016 respectively. Out of 12 District Secretary Divisions in the Hambantota district, highest number of CL cases, 85 and 86 was reported from Tangalle DSD in 2014 and 2016 respectively. Number of identified CL patients in Beliatta DSD had increased from 50 to 67 during the study period. In both years, majority of the CL patients were ≥ 50 years old with males more infected than females. Although CL association with occupations were insignificant, housewives were the highly (23%) infected occupants in this area.

Interpretation & conclusion:

Based on present findings, geographical distribution within DSDs in Hambantota district had changed. It emphasizes the importance of CL as a health problem in Hambantota district.
The potential habitat and environmental fitness change of Aedes albopictus in Western Eurasia for 2081–2100
Authors: Trájer Attila J
Published: January 2024

Background & objectives:

The range of Aedes albopictus, the most important vector mosquito in Western Eurasia is growing due to climate change. However, it is not known how it will influence the habitats occupied by the species and its environmental fitness within its future range.

Methods:

To study this question, the habitat characteristic of the mosquito was investigated for 2081–2100.

Results:

The models suggest a notable future spread of the mosquito in the direction of Northern Europe and the parallel northward and westward shift of the southern and eastern potential occurrences of the mosquito. The models suggest a notable increase in generation numbers in the warmest quarter, which can reach 4–5 generations in the peri-Mediterranean region. However, both the joint survival rate of larvae and pupae and the number of survival days of adults in the warmest quarter exhibit decreasing values, as does the potential disappearance of the mosquito in the southern regions of Europe and Asia Minor, along with the growing atmospheric CO2 concentration-based scenarios.

Interpretation & conclusion:

While in 1970–2000 Aedes albopictus mainly occupied the hot and warm summer temperate regions of Europe, the species will inhabit dominantly the cool summer temperate (oceanic) and the humid continental climate territories of North and North-Eastern Europe in 2081–2100.
Development of data-driven machine learning models and their potential role in predicting dengue outbreak
Authors: Mazhar Bushra , Ali Nazish Mazhar , Manzoor Farkhanda , Khan Muhammad Kamran , Nasir Muhammad , Ramzan Muhammad
Published: January 2024

Dengue fever is one of the most widespread vector-borne viral infections in the world, resulting in increased socio-economic burden. WHO has reported that 2.5 billion people are infected with dengue fever across the world, resulting in high mortalities in tropical and subtropical regions. The current article endeavors to present an overview of predicting dengue outbreaks through data-based machine-learning models. This artificial intelligence model uses real world data such as dengue surveillance, climatic variables, and epidemiological data and combines big data with machine learning algorithms to forecast dengue. Monitoring and predicting dengue incidences has been significantly enhanced through innovative approaches. This involves gathering data on various climatic factors, including temperature, rainfall, relative humidity, and wind speed, along with monthly records of dengue cases. The study functions as an efficient warning system, enabling the anticipation of dengue outbreaks. This early warning system not only alerts communities but also aids relevant authorities in implementing crucial preventive measures.
Structure-based virtual screening study for identification of potent insecticides against the Anopheles gambiae to combat the malaria
Authors: Helmi Nawal
Published: January 2024

Background & objectives:

Vector-borne infectious diseases contribute significantly to global mortality, with over 700,000 annual deaths, and malaria alone accounts for more than 400,000 of these fatalities. Anopheles gambiae, a prominent mosquito species, serves as a primary vector for transmitting malaria to humans. To address this issue, researchers have identified the D1-like dopamine receptor (DAR), specifically DOP2, as a promising target for developing new insecticides.

Methods:

The three-dimensional structure of DOP2 from A. gambiae was unavailable in the PDB database, an in-silico approach was used to model and validate the DOP2 protein's structure. The Discovery Studio 2021 program was then used to identify potential binding sites on the DOP2 protein. A virtual screening of 235 anti-parasitic compounds was performed against DOP2 using PyRx 0.8.

Results:

The screening demonstrated strong binding and interactions with active site residues of the DOP2 protein for five compounds: Diclazuril, Kaempferol, Deracoxib, Clindamycin, and Diaveridine. These compounds exhibited higher binding affinity values compared to the control (Asenapine). In addition, the predicted physiochemical properties for these compounds were within acceptable ranges, and there were no violations in druglikeness properties.

Interpretation & conclusion:

These compounds show promise as potential new insecticides targeting the A. gambiae mosquito by inhibiting the DOP2 protein. However, additional experimental validation is required to optimize their efficacy as DOP2 protein inhibitors.
Impact on CD4+ CD25High-CD127low regulatory T (Treg) cells of neoadjuvant therapy for rectal cancer patients
Authors: Maoxi Liu , Haiyi Liu
Published: January 2024

Background:

The efficacy of neoadjuvant therapy for rectal cancer has not been assessed.

Objective:

To evaluate proportional changes in peripheral blood immune cells in rectal cancer patients after neoadjuvant therapy and assess the relationship between tumor regression and regulatory T (Treg) cells.

Materials and Methods:

Rectal cancer patients who had received neoadjuvant therapy prior to surgery at Shanxi Cancer Hospital between January and September 2018 were enrolled in the study. Treg, CD4+ T, CD8+ T, NK, B cells, and CD4+/CD8+ ratio in peripheral blood before and after neoadjuvant therapy were measured by flow cytometry. Patients were divided into down-staging and control groups, depending on their responses to neoadjuvant therapy.

Results:

A total of 108 patients were enrolled. The proportion of Treg cells was significantly lower after neoadjuvant therapy (P < 0.05) but no changes were seen in CD4+ T, CD8+ T, NK, B cells, or CD4+/CD8+ ratio (all P > 0.05). There were 76 patients in the down-staging and 32 in the control groups. There were no significant differences in clinical parameters between down-staging and control groups (all P > 0.05). There were no significant differences in immune cell proportions between the two groups prior to neoadjuvant therapy (all P > 0.05). Treg, CD4+ T, and B cells were all significantly lower in the down-staging group after neoadjuvant therapy than before (P < 0.05). CD4+/CD8+ ratios were lower (P < 0.05) while proportions of Treg and natural killer (NK) cells did not change after neoadjuvant therapy in the control group. Following neoadjuvant therapy, Treg and B cells were lower while CD4+ and CD4+/CD8+ ratios were higher in the down-staging group compared to the control group (P < 0.01).

Conclusion:

Treg cells may constitute a reference for judging the effect of neoadjuvant therapy in rectal cancer patients.
A correlation study between mean platelet volume and platelet aggregation study in acute coronary syndrome patients
Authors: Navya PT , Natarajan M
Published: January 2024

Introduction:

Platelets play an important role in cardiovascular disease mainly in the development of acute thrombotic events. Elevated platelet indices have been proposed as a risk factor for acute coronary syndrome (ACS). It remains uncertain whether increased platelet indices are the result or the cause of ACS.

Aim and Objective:

This study aimed to correlate mean platelet volume (MPV) and platelet aggregation response to know the functional status of platelets based on their size.

Materials and Methods:

A total of 50 patients with ST-segment elevation ACS (STE-ACS) or non-ST-segment elevation ACS (NSTE-ACS) were included and their MPV was measured and platelet aggregometry was performed. Patients were divided into two groups, patients with MPV ≤9.1 fl as group 1 and those with MPV >9.1 fl as group 2. The mean maximum platelet aggregation response (MMPAR) with ADP, Collagen, and Epinephrine, of both the groups, were compared. MMPAR to ADP, Collagen, and Epinephrine in group 1 was 74.47%, 66.13%, and 72.9%, respectively, and in group 2, 72.94%, 59.97%, and 72.43%, respectively. There was no statistically significant difference in the MMPAR to ADP, Collagen, and Epinephrine among the two groups.

Conclusion:

Increased MPV does not indicate the platelets are hyperreactive. An increase in MPV may be because of the increased release of immature platelets from bone marrow as there is increased consumption of platelets at the site of thrombus formation in ACS.
The spectrum of pathologic lesions in spleen in patients with acquired immunodeficiency syndrome: Autopsy report of 257 patients
Authors: Lanjewar Dhaneshwar N. , Kavatkar Anita N.
Published: January 2024

Background:

Human immunodeficiency virus (HIV) infection continues to persist in India over the past three decades. The involvement of the spleen in these patients has a wide array of differentials with opportunistic infections and malignancies. The spectrum of splenic lesions in patients with HIV/AIDS has not been described in the Indian literature.

Materials and Methods:

A retrospective study was designed to understand the spectrum of splenic pathology in patients with HIV/AIDS. The specimens of the spleen obtained at autopsy in 257 patients over a period of 29 years were systematically analyzed.

Results:

Among 257 patients, 197 (77%) were males and 60 (23%) were females with a heterosexual route of transmission in 246 (96%) patients. There were 236 (92%) patients from the pre-highly active anti-retroviral therapy era, while 21 (8%) patients had received highly active anti-retroviral therapy for a short duration. The most frequent splenic pathology identified was tuberculosis, noted in 135 (52%) patients, manifesting as military lesions (119 patients, 46%), tuberculous abscesses (13 patients, 5%), and tuberculosis associated with splenic infarcts (03, 1%) patients. The other pathologies noted were cryptococcosis in 17 (7%) patients, malarial infection in 13 (5%) patients, and cytomegalovirus infection in 01 (0.5%) patient. The other findings identified were chronic passive venous congestion, perivascular fibrosis, hemosiderosis, and amyloidosis. In addition, absence or depletion of lymphocyte was noted in 98 (38%) patients and in 4 (1.5%) patients diffuse large B-cell lymphoma was found.

Conclusions:

Patients with HIV/AIDS presenting with splenic lesions have a wide array of differentials, such as tuberculosis, opportunistic infection, and the lymphoma. This study provides a better insight into the splenic lesions in patients with AIDS in India.
Cognitive functioning in older adults with type-2 diabetes, study from Southern India
Authors: Sadanand Shilpa , Bharath Srikala , Kumar Janakiprasad Keshav , Bantwal Ganapathi , Philip Mariamma
Published: January 2024

Background:

Evidence suggests that type-2 diabetes mellitus (T2DM) is associated with cognitive impairment. There is a dearth of research on T2DM and cognition in older adults from India. We aimed to study the cognitive functioning of older persons with T2DM compared to healthy controls (HC) and understand the influence of illness characteristics and other associated comorbidity on cognitive functioning.

Methods:

One hundred eight older persons with T2DM and 107 HC matched for age, gender, and education were invited to participate in the study. Both groups were assessed using NIMHANS Neuropsychological Battery for the Elderly.

Results:

The mean age of the study group (T2DM and HC) was 66 (±5) years; 60% were male with an average of 12 years of formal education. More than 95% of the subjects were from an urban background and belonged to either middle or upper socioeconomic status. Compared to HC, persons with T2DM performed poorly on all memory tasks (both verbal and visual memory), constructional ability, verbal fluency, working memory, and attention tasks. Lower educational levels and the presence of T2DM were the strongest predictors of poorer cognitive performance in the study group.

Conclusions:

T2DM seems to affect cognitive domains differently. In this study, memory was the most affected cognitive domain, followed by executive functions and attention. Recent memory deficits could be a forerunner of early dementia. There is a need for longitudinal studies focusing on T2DM and cognition in the elderly from India, providing more insights into the early detection and prevention of dementia in this risk group.
Buccal mucosal graft ureteroplasty: The new normal in ureteric reconstructive surgery – Our initial experience with the laparoscopic and robotic approaches
Authors: Sahay Shailesh Chandra , Kesarwani Pawan , Sharma Girish , Tiwari Arvind
Published: January 2024

Introduction:

Upper ureteric stricture is always a challenging case to treat for any urologist. Due to chronic inflammation and multiple interventions, it becomes a complex entity to treat. Buccal Mucosal Graft (BMG) Ureteroplasty is a reconstructive surgery used to treat upper ureteric stricture but the results and experience with this modality is less explored so far. We present here our study of 16 cases of BMG ureteroplasty and its outcomes done by the laparoscopic and robotic approaches.

Patients and Methods:

We analysed 16 cases of BMG ureteroplasty, which were performed both laparoscopically and robotically. All these cases were long ureteric strictures, not amenable to excision or endoscopic intervention. We performed using an onlay BMG without complete mobilisation of the ureter. The omentum or nearby fat was used as a bed for onlay BMG.

Results:

All 16 patients underwent onlay ureteroplasty. The reconstructed ureter was wrapped with omentum in nine of the cases, while in seven patients, nearby fat was used. The median stricture length was 5.28 cm, and the median operative time was 143.5 min. The mean operative time was 143.5 min. 15 of 16 (93.75%) cases were successfully clinically and radiologically on follow-up.

Conclusion:

Long-segment upper ureteric strictures are a difficult entity to operate on. BMG ureteroplasty is a safe and effective way of managing such strictures. Robot-assisted ureteroplasty provides the benefits of improved ergonomics, easy manoeuvrability and precision surgery to the patients. Our experience with both laparoscopic and robotic ureteroplasty would encourage urologists all over to use BMG ureteroplasty as an effective long-term procedure for ureteral reconstruction.
Uniportal video-assisted thoracic surgery Ivor-Lewis oesophagectomy with circular stapling anastomosis
Authors: Nachira Dania , Biondi Alberto , D’Ugo Domenico , Margaritora Stefano
Published: January 2024

Amongst all minimally invasive oesophagectomies, uniportal video-assisted thoracic surgery (VATS) Ivor-Lewis remains the most challenging procedure due to the skills required for performing the intrathoracic anastomosis. We present an easy and safe circular stapling latero-terminal anastomosis for performing uniportal VATS Ivor-Lewis. The patient had an uneventful post-operative recovery and was disease-free 9 months after surgery.
Anticipated Stigma among Patients with Multiple Sclerosis in Saudi Arabia
Authors: Albarraq Rahaf Hamood , Alhujaili Naseem Abdulmohi , Alshehri Ziyad Ibrahim , Alqarni Abdullah Mohammed , Bawareth Rime Mohammed
Published: January 2024

Background:

Social stigma is a major problem among patients with multiple sclerosis (MS), which can affect their quality of life. There is limited research from Saudi Arabia on the anticipated stigma among patients with MS.

Objectives:

To determine the levels of anticipated stigma and its predictors in patients with MS in Saudi Arabia.

Methods:

This cross-sectional study included adult patients with MS across Saudi Arabia. Sociodemographic and medical information, including age, gender, marital status, educational level, duration of disease, number of MS episodes in the past 12 months, previous diagnosis of mental illness, and performing activities of daily living without assistance, were collected. Anticipated stigma was measured using an Arabic version of the Chronic Illness Anticipated Stigma Scale.

Results:

A total of 222 patients with MS were included. Moderate to severe anticipated stigma was found among 70.4% of the patients. The highest anticipated stigma mean score was from work colleagues (2.96/5). Predictors of stigma were age (P = 0.049), gender (P = 0.016), marital status (P = 0.015), education level (P = 0.003), number of MS episodes in the previous year (P < 0.001), and previous diagnosis of a mental disorder (P = 0.001).

Conclusions:

The findings of this study indicate the need for developing programs that reduce the anticipated stigma among patients with MS in Saudi Arabia.
Spatial Epidemiology of Signet-ring Cell Colorectal Cancer in India
Authors: Kazi Mufaddal , Patel Harshit , Choudhary Nazia , Jain Agrim , Dudhat Shruti , Naik Sakshi , Desouza Ashwin , Saklani Avanish
Published: January 2024

Background:

Signet-ring cell colorectal carcinoma (SRCC) is an extremely aggressive yet uncommon histologic subtype of colorectal cancer (CRC) with an unknown etiology. There is a stark difference in the prevalence of signet cancers between Western countries and the Indian subcontinent; however, India itself is a vast and diverse country with variable cancer incidence.

Objective:

To study the spatial epidemiology of SRCC in India for identifying regions with high prevalence.

Methods:

This retrospective study included all patients diagnosed with colorectal adenocarcinoma at Tata Memorial Hospital, the largest colorectal cancer referral unit in India, between January 2020 and December 2022. Geocoding based on the location of the residence was done to map the incidences. Comparisons were performed between the proportion of signet cell and non-signet colorectal cancers.

Results:

A total of 4100 patients with colon or rectal adenocarcinomas were included, of which signet cell histology was found in 624 (15%) patients. SRCC accounted for the highest proportions of CRCs in the Central (19%) and Northern (19%) regions, and the lowest in the North-Eastern (10%) and Western (12%) regions of India (P < 0.001), with non-overlapping confidence intervals. Compared with patients with non-signet CRCs, those with SRCC more commonly had colon cancers (22% vs. 17%; P = 0.003) and belonged to a lower socioeconomic background (67% vs. 59%; P < 0.001).

Conclusions:

This study found that SRCCs accounted for a significant proportion of CRC cases in India, but there was no substantial disparity in distribution across regions.
Simplified segmental scleral buckling without localization and cryopexy: A retrospective comparison with conventional segmental scleral buckling
Authors: Lin Pei-Hsuan , Lee Yi-An , Wang Lu-Chun
Published: January 2024

PURPOSE:

The aim of this study was to propose a simplified segmental scleral buckling (SSSB) technique that does not require break localization for less-experienced vitreoretinal surgeons.

MATERIALS AND METHODS:

This retrospective study compared the clinical results of 46 conventional and 23 SSSB (conventional segmental SB [CSSB] and SSSB, respectively) procedures in a tertiary referral retinal center in Taiwan between 2008 and 2019. In the CSSB group, breaks were localized during surgery. In the SSSB group, a wider sponge band and a longer scleral buckle were used to maximize the chances of sealing the retinal breaks based on the preoperative fundus examination findings and to minimize the positioning error caused by cyclotorsion, without performing indirect ophthalmoscopy. The primary outcome was assessed after 6 months. Patient characteristics, surgical parameters, and outcomes were compared between groups. The main outcomes were the duration of surgery, changes in visual acuity, primary success rate, rhegmatogenous retinal detachment recurrence rate, and the frequency of further laser photocoagulation.

RESULTS:

SSSB had a shorter duration than CSSB and was associated with more frequent use of longer and wider explants and need for further laser retinopexy. Both groups showed high primary success rates (95.65%).

CONCLUSION:

The primary success rates for the SSSB and CSSB groups were comparable and equally high. SSSB required laser retinopexy more frequently and was a shorter procedure.
Implementation of a Multicomponent Program to Improve Effective Use and Maintenance of Medical Equipment in Sri Lankan Hospitals
Authors: Chaminda J. L. P. , Dharmagunawardene Dilantha , Rohde Alexia , Kularatna Sanjeewa , Hinchcliff Reece
Published: January 2024

Background:

Medical equipment (ME) maintenance retains an asset’s original anticipated useful life and preserves its reliability and cost-effectiveness. This study developed and implemented a multicomponent program to improve ME use and maintenance in nine Sri Lankan hospitals from May 2020 to May 2021.

Methods:

This pre–post implementation study involved an initial baseline assessment of existing ME maintenance systems, the development and implementation of a multicomponent improvement program, and a 3-month postevaluation. Five targets ME were selected for the study: oxygen regulator, electrocardiogram (ECG) machine, suction apparatus, blood pressure apparatus, and mini autoclave. A pretested questionnaire was administered to randomly selected nursing officers (n = 101) and health-care assistants (n = 120) to obtain baseline ME maintenance data. Six focus group discussions and 24 key informant interviews were conducted with key stakeholders to codesign the multicomponent interventions, which included: developing a standard operating procedure targeting preventive maintenance activities; establishing focal points to provide technical and logistic support; staff training; and the introduction of institutional ME maintenance documents. Program effectiveness was assessed at 3 months postimplementation using the seven predefined outcome variables.

Results:

Baseline assessment identified no ME maintenance programs implemented in any of the hospitals. The highest availability was observed for oxygen regulator (62% to 82.3%) and ECG machine (66.1% to 84.7%). The highest functionality improvement was observed for ECG machine (40.4% to 79.7%). The positive perception of maintenance process of ME achieved the highest (33% to 80%) improvement. Following program implementation, improvements were noted in: the availability (P = 0.00) and functionality (P = 0.00 to P = 0.02) of all selected ME; equipment maintenance processes (P = 0.000); as well as staff knowledge, skills, perceptions, and satisfaction.

Conclusions:

The program improved the use and maintenance of ME and was widely supported by the key stakeholders. The approach is relevant to other resource-poor hospital settings, as inadequate ME maintenance causes health system inefficiencies.
Prevalence and Correlates of Vitamin D Deficiency among Adult Population in Urban and Rural Areas of the National Capital Region of Delhi, India
Authors: Praveen Pradeep A. , Singh Archna , Lakshmy Ramakrishnan , Amarchand Ritvik , Berry Parul , Krishnan Anand , Prabhakaran Dorairaj , Tandon Nikhil , Roy Ambuj
Published: January 2024

High prevalence of Vitamin D deficiency has been reported among selective population, but its population prevalence from representative adult population is lacking in India. The aim of this study was to estimate the prevalence and identify the correlates of Vitamin D deficiency among urban and rural areas of the National Capital Region (NCR) of Delhi, India. Serum Vitamin D levels of 1403 adults (aged 30 years above), 702 from urban and 701 from rural NCR of Delhi, who participated in a representative cross-sectional survey were measured using the quantitative chemiluminescent immunoassay method. The prevalence of Vitamin D deficiency was classified as severe deficient, and insufficient at three serum levels of 25-hydroxyvitamin D–<10, 10–<20, and 20–<30 ng/mL, respectively. The median (interquartile range) 25-hydroxyvitamin D levels in urban and rural areas were 7.7 (5.2, 10.8) ng/mL and 16.2 (10.9, 22.3) ng/mL, respectively. The prevalence of Vitamin D severe deficiency, deficiency, and insufficiency in urban areas were 71%, 27%, and 2%, respectively. The corresponding prevalence in rural areas was 20%, 47%, and 25%. Urban location (odds ratio [OR] [95% confidence interval [CI]: 11.7 [8.6, 15.9]), female gender (OR [95% CI]: 1.5 [1.1, 2.2]), and abdominal obesity (OR [95% CI]:1.5 [1.1, 2.0]) were independently associated with severe deficiency. This study revealed a high prevalence of severe vitamin deficiency among the adult living in NCR, more so among urban areas, women, and obese.
Availability of Hypertension and Diabetes Mellitus Care Services at Subdistrict Level in Bangladesh
Authors: Jubayer Shamim , Hasan Md. Mahmudul , Luna Mahfuja , Al Mamun Mohammad Abdullah , Bhuiyan Mahfuzur Rahman , Sayem Noor Nabi , Amin Mohammad Robed , Farrell Margaret , Moran Andrew E. , Gupta Reena , Choudhury Sohel Reza
Published: January 2024

Background:

In Bangladesh, the rapid rise of noncommunicable diseases (NCDs) has become a significant public health concern. This study assesses the readiness of hypertension (HTN)- and diabetes mellitus-related services at primary health-care facilities in Northeast Bangladesh.

Methodology:

A cross-sectional survey using a semi-structured interview was conducted between April 2021 and May 2021 among 51 public primary health-care facility staff (upazila health complexes [UHCs]). The NCD-specific service readiness was assessed using an adapted questionnaire from the WHO manual of Service Availability and Readiness Assessment and included four domains: guidelines and staff, basic equipment, diagnostic facility, and essential medicine. For each domain, the mean readiness index score was calculated. Facilities with a readiness score of above 70% were considered to be ready.

Results:

The diagnostic capacity of the UHCs ranged from 0% to 88.9%, the availability of essential medicine and basic equipment varied between 15.4%–69.2% and 36.4%–100%, respectively, whereas the score in availability of basic amenities was between 57.1% and 100%. The score for the protocol drugs used to manage HTN was 52.9%, whereas for diabetes, it was 88.2%. The average general service readiness score for the facilities was 59.1%. Overall 17.6% of the facilities were assessed to be ready.

Conclusion:

Currently, primary health-care facilities are not ready to implement the national guidelines for diagnosing and treating diabetes and HTN due to shortages of medications, staff, and diagnostic materials.
Weighted central limit theorems for central values of $L$-functions
Authors: Bui Hung M. , Evans Natalie , Lester Stephen , Pratt Kyle
Published: January 2024

We establish a central limit theorem for the central values of Dirichlet

L

-functions with respect to a weighted measure on the set of primitive characters modulo

q

as

q \rightarrow \infty

. Under the Generalized Riemann Hypothesis (GRH), we also prove a weighted central limit theorem for the joint distribution of the central

L

-values corresponding to twists of two distinct primitive Hecke eigenforms. As applications, we obtain (under GRH) positive proportions of twists for which the central

L

-values simultaneously grow or shrink with

q

as well as a positive proportion of twists for which linear combinations of the central

L

-values are non-zero.
Aluminum Alloy, Sheet and Plate, Alclad 6.3Cu - 0.30Mn - 0.18Zr - 0.10V - 0.06Ti Alclad 2219-T81 Sheet Solution Heat Treated, Cold Worked, and Precipitation Heat Treated Alclad 2219-T851 Plate Solution Heat Treated, Stress Relieved, and Precipitation Heat Treated
Authors:   AMS D Nonferrous Alloys Committee
Published: January 2024

This specification covers an aluminum alloy in the form of sheet and plate 0.020 to 0.499 inch (0.51 to 12.67 mm), inclusive, in nominal thickness, clad on two sides (see 8.5).
Ukarabati wa Mfuatano wa Irabu kama Sababu ya Muunganiko wa Maneno katika Gᴉrᴉmi
Authors: Stephano Rehema
Published: January 2024

Mfuatano wa irabu katika lugha nyingi za Kibantu haupendelewi katika mazungumzo. Huepukwa kwa kutumia ukarabati wa namna mbalimbali. Kwa hiyo, makala hii inahusu ukarabati unaofanyika ili kuepukana na kutumia irabu zinazofuatana katika mpaka wa kisintaksia, yaani baina ya maneno yanayofuatana katika Gᴉrᴉmi (F32). Nadharia ya Fonolojia Zalishi Asilia imetumika kuchambua na kujadili data za makala hii. Mbinu za kukusanya data zilizotumika katika utafiti huu ni mbili: mbinu ya uhakiki wa kisarufi na ya usaili. Matokeo ya utafiti yanaonesha kwamba, katika Gᴉrᴉmi, ukarabati wa mfuatano wa irabu baina ya neno na neno hufanywa kwa kutumia michakato mitatu ya kifonolojia ambayo ni mvutano wa irabu, udondoshaji wa irabu na uyeyushaji wa irabu. Ukarabati huo hufanyika kurahisisha matamshi na mazungumzo. Kufuatia matokeo haya, makala inapendekeza tafiti zaidi kufanyika ili kubaini jinsi mifanyiko ya kifonolojia inavyokarabati matamshi ya maneno yanayohusisha mfuatano wa irabu katika lugha zingine, hasa za Kibantu.
Utata wa Maudhui ya Kisarufi katika Vitabu vya Kiada vya Kiswahili Kidato cha Kwanza na cha Tatu Nchini Tanzania
Authors: Mushumbwa Lcheraus R.
Published: January 2024

Vitabu vya kiada ni nyenzo muhimu katika ufundishaji wa somo la Kiswahili nchini Tanzania. Hutumika kama mwongozo wa ufundishaji wa mada zilizoteuliwa kwa kiwango husika cha elimu. Kutokana na umuhimu huo, vitabu hivyo huandikwa vizuri na kwa mpangilio mzuri wenye mantiki na unaoeleweka. Inapotokea kitabu cha kiada kimekuwa na changamoto za maudhui, kuna uwezekano wa maarifa yaliyokusudiwa kutowafikia walengwa kama inavyotakiwa. Hivyo basi, malengo ya makala hii ni kuchambua utata wa kimaudhui unaojitokeza kwenye vipengele vya mada za sarufi katika vitabu vya kiada vya Kiswahili (kidato I na III) na kupendekeza utatuzi wake kwa ajili ya maboresho zaidi. Data za makala hii zimepatikana kwa mbinu ya usomaji makini wa vitabu teule vilivyoandikwa na Taasisi ya Elimu Tanzania (TET). Matokeo ya utafiti yanadhihirisha kuwapo kwa utata kwenye baadhi ya vipengele vya sarufi katika vitabu hivyo. Baadhi ya utata uliobainika unahusu fasili za dhana, mifano iliyotolewa na ufafanuzi wa kushadidia hoja zilizomo vitabuni. Makala inapendekeza kuwa vitabu husika vinapaswa kupitiwa tena ili kurekebisha maudhui yanayoibua utata uliobainishwa.
Do changes in intracoronary pressure aid coronary spasm diagnosis using the spasm provocation test?
Authors: Teragawa Hiroki , Oshita Chikage , Uchimura Yuko
Published: January 2024

BACKGROUND

Although the spasm provocation test (SPT) can diagnose coronary spasms, it would be helpful if it could also predict their occurrence.

AIM

To investigate whether coronary spasms can be predicted using changes in intracoronary artery pressure measured using a pressure wire during the SPT.

METHODS

Seventy patients underwent SPTs with pressure-wire measurement of intracoronary artery pressure. During each SPT, the pressure wire was advanced into the distal portion of the right coronary artery (RCA) and left anterior descending coronary artery, and the ratio of intracoronary pressure to aortic pressure (Pd/Pa) was monitored. Coronary spasm was defined as an arterial narrowing of > 90% in response to the administration of acetylcholine (ACh), with chest symptoms and/or ischemic electrocardiographic changes. ACh was administered to the RCA at low, moderate, or high doses of 20, 50, or 80 µg, respectively, and to the left coronary artery (LCA) at low, moderate, or high doses of 50, 100, or 200 µg, respectively. Coronary arteries with coronary spasms at low doses of ACh were defined as group L, and those with coronary spasms at moderate or high doses were defined as group MH. Those who did not occur coronary spasms at any ACh dose were designated as group N.

RESULTS

Among the 132 coronary arteries assessed using a pressure wire, there were 49 in group N, 25 in group L, and 58 in group MH. Baseline Pd/Pa was the lowest in group L (P = 0.001). The decrease in the Pd/Pa between baseline to low doses of ACh was lower in group MH than in group N (P < 0.001). A receiver-operating characteristics analysis showed that the cutoff baseline Pd/Pa value for predicting group L was 0.95, with a sensitivity of 0.600 (15/25) and a specificity of 0.713 (76/107) and that the cutoff value of Pd/Pa from baseline to low doses of ACh for predicting group MH was −0.04, with a sensitivity of 0.741 (43/58) and a specificity of 0.694 (34/49).

CONCLUSION

These findings suggest that indices of intracoronary pressure during SPT may be useful means for predicting the occurrence of coronary spasms.
“There are no secrets here”: Sex and Scandal in the Streets of Curaçao
Authors: Roitman Jessica
Published: January 2024

This article challenges the assumptions about what spaces were actually private in the late early modern colonial world. Centered on a case of adultery amongst the Sephardic Jewish community of Curaçao in the late eighteenth century, this piece looks at the entangled lives of enslaved people, Dutch colonial officials, free people of color, Protestants, Catholics, and Jews. Gossip, private information transition, and the architecture and town planning of Willemstad, Curaçao, are integral to this story of community norms, legal systems, and colonial spaces.
Privacy, Literacy, and Gender in Early Modern Jewish Letters from Prague (1619)
Authors: Diemling Maria
Published: January 2024

How private were Jewish letters in the early modern period? This article discusses Jewish epistolary culture and notions of privacy by examining an extraordinary cache of Jewish letters that were mostly written on a single day— 22 November 1619—in a single city, Prague, and sent to a single destination, Vienna. The letters never arrived and ended up in the archives where they were preserved for posterity. These letters allow us a glimpse into the lives of ordinary Jews in politically tumultuous times in which privacy and confidentiality could never be taken for granted. This article pays particular attention to gendered communication and privacy. It has been argued that in epistolary culture women are afforded a voice and speak for themselves. The evidence suggests that collaborative forms of writing that involved more than one writer were still common in early seventeenth-century Jewish correspondence, indicating zones of “privileged confidentiality” within larger family networks.
Foundations of probability-raising causality in Markov decision processes
Authors: Baier Christel , Piribauer Jakob , Ziemek Robin
Published: January 2024

This work introduces a novel cause-effect relation in Markov decision
processes using the probability-raising principle. Initially, sets of states as
causes and effects are considered, which is subsequently extended to regular
path properties as effects and then as causes. The paper lays the mathematical
foundations and analyzes the algorithmic properties of these cause-effect
relations. This includes algorithms for checking cause conditions given an
effect and deciding the existence of probability-raising causes. As the
definition allows for sub-optimal coverage properties, quality measures for
causes inspired by concepts of statistical analysis are studied. These include
recall, coverage ratio and f-score. The computational complexity for finding
optimal causes with respect to these measures is analyzed.
PRONTUÁRIO ELETRÔNICO DO PACIENTE E AS REDES DE ATENÇÃO À SAÚDE
Authors: Santos Jackelyne de Souza dos , Pereira Adilma dos Santos Brito , Araújo Camila Sabino de , Castro Roberta Araújo de , Costa Vitória Gonçalves de Lima
Published: January 2024

A Tecnologia da Informação (TI) agrega e afeta de maneira significante nas organizações, como nas instituições em saúde. Os dados e informações obtidas por meio da informática em saúde, onde a TI traz inovações, permite análise de dados e decisões assertivas relacionadas aos processos desenvolvidos nas instituições. As organizações de Saúde, com os avanços na medicina e competitividade no mercado, vêm aderindo as evoluções no se trata de Prontuário Eletrônico do Paciente. Objetivo: Refletir acerca do prontuário eletrônico do paciente na rede de atenção básica. Metodologia: Trata-se de uma revisão de literatura realizada nas bases de dados: BVS e materiais disponibilizados pela MUST. Selecionados ao final 09 artigos. Conclusão: Diante do estudo realizado, evidenciou a importância da evolução na tecnologia da informação, para avanços necessários no que se refere ao PEP aplicado na RAS, para fim de gerenciamento no nível populacional de doenças crônicas, para detecção em tempo hábil de planejamento e intervenção.
O PAPEL DA ÉTICA NO COMBATE ÀS EMERGÊNCIAS DE SAÚDE PÚBLICA DE IMPORTÂNCIA INTERNACIONAL
Authors: Galvão Larissa Cruz de Macêdo Coelho , Araújo Dirty Paula de , Melo Márcia Cristina Reis Campos , Castro Roberta Araújo de , Almeida Tamires Mendes
Published: January 2024

A  COVID-19,  causada  pelo  coronavírus  SARS-CoV-2,  é  uma  nova  infecção  aguda  emergente  que  alcançou  rapidamente  graves  proporções  pandêmicas,  as  quais  requereram reflexões e respostas bioéticas em um curto espaço de tempo e em escala global. As muitas questões éticas que surgiram exigiram e ainda exigem que as diferenças políticas, culturais, ideológicas sejam postas de lado e que se reflita de modo coletivo sobre soluções eticamente aceitáveis. Muito trabalho foi feito na última década sobre questões éticas específicas que surgem no contexto de certas facetas da preparação para emergências pandêmicas, como a ética da alocação de recursos escassos, como vacinas ou equipamentos de emergência, e as questões éticas que surgem em relação a doenças infecciosas. Com base nesse contexto, o objetivo deste artigo é destacar as questões éticas envolvidas na preparação e resposta a emergências de saúde pública.
Modos de producción, agentes económicos y mercado
Authors: Morán Cabezas Augusto Leonidas , Rea Vozmediano Rebeca Edith
Published: January 2024

Dentro de este capítulo los estudiantes trataran temas muy elementales los cuales permitan contribuir al desarrollo de sus competencias formativas basadas en conceptualizaciones de modos de producción, comunidad primitiva, feudalismo, socialismo, capitalismo, economía mixta. agentes económicos, el individuo la familia, el estado, el sector financiero, interrelación entre los agentes económicos, el mercado, generalidades, mercado de bienes, mercado de capitales, mercado de trabajo modelos de mercado, competencia perfecta competencia imperfecta, aquí el estudiante conoce el problema de la escasez hace uso eficiente de los recursos, produce bienes o servicios, a través de los agentes económicos los introduce en al mercado y genera economía
Introducción a la contabilidad de costos
Authors: Jácome Caluguillin Paola Samanta , Anaguano Pérez Juan Carlos , Carvajal Lita Mariana De Jesús , Rea Vozmediano Rebeca Edith
Published: January 2024

La contabilidad de costos es una herramienta poderosa y universal en la gestión financiera y la toma de decisiones estratégicas. Este libro es una guía completa y accesible para estudiantes, profesionales y académicos, que aborda su importancia en el mundo empresarial y académico y cómo permite a las organizaciones comprender, controlar y optimizar sus recursos, y desempeña un papel fundamental en la toma de decisiones críticas y la sostenibilidad, competitividad y crecimiento de las organizaciones. Incluye explicaciones claras, ejemplos prácticos y casos reales para comprender los conceptos y aplicaciones de la contabilidad de costos.
How the government fought against parasites in the 1950–1960s (case study of Karelia)
Authors: Вавулинская Л.И.
Published: January 2024

В статье на основе впервые вводимых в научный оборот доку- ментов Национального архива Республики Карелия и архива МВД России по Республике Карелия рассмотрены вопросы работы правоохранительных органов и органов социального обеспечения республики по выявлению и привлечению к труду так называемых тунеядцев в 1950–1960-х гг. Освещены меры по ликвидации и предупреждению нищенства, трудности в трудоустройстве и оказании социальной помощи лицам, задержанным органами милиции, показано привлечение прессы, Русской православной церкви и общественности к проблемам тунеядства и бродяжничества, выявлена региональная специфика борьбы с антиобщественными элементами. Выяснены причины неэффективности мер по сокращению численности бродяг и нищих в 1950–1960-х гг.

Based on the documents of the National Archive of the Republic of Karelia and the archive of the Ministry of Internal Affairs of Russia for the Republic of Karelia, firstly introduced into scientific circulation, the article examines issues of the work of law enforcement and social security bodies of the republic to identify and recruit the so- called parasites in the 1950s and 1960s. The author highlights measures to eliminate and prevent begging, boost employment and provide social assistance to persons detained by police authorities, shows involvement of the press, the Russian Orthodox Church and the public in the problems of parasitism and vagrancy, and reveals the regional specifics of the fight against antisocial elements. The reasons for the ineffectiveness of measures to reduce the number of vagrants and beggars in the 1950s and 1960s are clarified.
Selo Gledić, Gledićke planine i Srpsko-Dubrovačka vlastela Gledić
Authors:   CENTAR ZA MITOLOŠKE STUDIJE SRBIJE, Andrejić Živojin R.
Published: January 2024

Although the Gledic folk from Dubrovnik are not mentioned in Serbia among the people from Dubrovnik who held its mines, customs, trade, goldsmiths, and the like, it can be seen that they also had strong ties with Serbian rulers and nobility in the 16th century. Therefore, there is a possibility that one of the Gledics from Dubrovnik became a Serbian noble who held the town of Cestin and the surrounding areas up to Borac during the time of Nikola Altomanovic-Vojinovic and his son, the Grand Župan Altoman, as well as a mine in the Gledic mountain region, which was named after them. Based on all the aforementioned, this assumption is very appealing but not actually confirmed at this time.
The Impact of Innovations and Technological Development on Modern Society and Global Dynamics
Authors: Dub Andrii
Published: January 2024

In the modern world, technical development and innovations are crucial in determining social, economic, and cultural realities. The topic of the impact of these factors on global dynamics is becoming increasingly relevant, considering their continuous advancement and globalization trends. The purpose of the present academic paper is to analyze the impact of innovations and technological development on modern society, with a special focus on global transformations. The dialectical approach was used as the research methodology, supplemented by systemic, structural-functional and sociological methods. As a result of the research, the historical context of innovations, their impact on social-cultural processes and the role of technological development as a driver of global change were identified. The primary focus was on analyzing the interaction of technologies with social structures, as well as their influence on the formation of new cultural codes and identities. It has been revealed that technologies not only serve as a catalyst for social and cultural transformations but also cause a number of social challenges, including resource imbalance, risks of dehumanization and new forms of inequality. The academic paper also emphasizes the importance of adaptive strategies of society in response to technological challenges. This research makes a significant contribution to understanding the dynamics of modern society by emphasizing the key role of technology in global processes and showing ways to integrate it effectively to achieve sustainable development.
Successful Control of Some Challenging Cases in Late Adult and Elderly Onset Atopic Dermatitis with Dupilumab Injection in Kuwaiti Patients: A Prospective Pilot Study
Authors: Almasry Iman
Published: January 2024

Atopic Dermatitis is severely itchy skin disease with chronic prolonged course and relapsing flares, which was considered mainly infantile or childhood in onset for a long time. Atopic Dermatitis is not any more a pediatric dermatosis, an emerging new entity in adult and elderly patients became more and more identified. An elderly onset of Atopic Dermatitis is mainly due to aging process. There are various causes that reduce skin function, especially senile xerosis of skin in these age group. Dryness itself makes skin as weak as a protective barrier in elderly, in addition to pathophysiological changes in aging human skin. All previous factors might trigger Atopic Dermatitis pictures over elderly patient. Atopic Dermatitis in elderly might does not look so bad as morphological reflection on skin, but intolerable pruritus’ accompanied this skin condition is more concerned. Dupilumab as well-known safe and effective controlling therapy for atopic dermatitis, given a light at end of tunnel specially for severe pruritus’ which affect badly life quality in these poor patients. This article represents a close review of etiopathogenesis of late adult and elderly onset atopic dermatitis. Also, we represent 10 cases of confirmed late adult and elderly Atopic Dermatitis who have a proper control on Dupilumab injection safely without any drawbacks on patients.
Incremento do teto de média e alta complexidade - desafio à gestão municipal
Authors: Gomes Márcia Lúcia de Oliveira , Xavier Patrícia de Araújo , Da Silva Júnior José Pascoal , De Freitas Francisca Samya Silva , Rodrigues Dinete Leilane Teixeira , Barbosa Kelsen Tavares , De Oliveira Marizângela Lissandra , Do Nascimento Mere Benedita
Published: January 2024

Na gestão do Sistema Único de Saúde, os incentivos de custeio surgiram para estimular os municípios a incorporarem programas que lhes acrescentassem receitas financeiras para obtenção de melhores resultados. Foi realizada uma investigação descritiva, exploratória e transversal, utilizando dados do Sistema de Informação Ambulatorial, Sistema de Informação Hospitalar e Sistema de Controle do Limite Financeiro da Média e Alta Complexidade, do Ministério da Saúde, do ano de 2022, todos de acesso público, dos 184 municípios cearenses. Observou-se que 58% dos municípios do Ceará - Brasil produziram mais que o valor do teto de média e alta complexidade (MAC), quando não se considerou os incentivos e 35% considerando os incentivos. Diante do cenário atual, com mais da metade dos municípios produzindo aquém do teto MAC, sugere-se que as equipes municipais sejam capacitadas no que se refere à alimentação dos sistemas de informação.