Search

The ventriculoperitoneal shunt (VP shunt) is one of the most common neurosurgical procedures performed in daily practice. Various complications following a VP shunt are as follows: post-procedure shunt-related infections, shunt block, shunt displacement or exteriorisation and haemorrhage associated with it. Delayed intraventricular haemorrhage is a relatively uncommon complication following the aforementioned procedure. Here we present an atypical case of a 72-year-old male who presented with subarachnoid haemorrhage with hydrocephalus and underwent a VP shunt, following which the patient had early intraventricular haemorrhage (eIVH) with an unfortunate outcome. Here, we propose pathophysiology and risk factors for eIVH.

Earth pressure balance machine (EPBM) operation is sensitive to the properties of the excavated soil due to the requirements of proper soil conditioning and maintenance of necessary chamber pressure. However, soil properties are invariably only available at a limited number of borehole explorations and soil samplings conducted during the subsoil investigation. Thus, it is crucial to identify properties of the tunnel excavation face, such as clay-sand mixed conditions, grain size distributions, and clogging potential along the whole alignment beside the few borehole locations to attain optimally efficient EPBM operation. Therefore, this paper presents the development of machine learning prediction models (i.e., classifiers and regressors) to estimate the properties of the tunnel excavation face using EPBM operational data collected during the tunneling operation as input features. Geotechnical data collected from boreholes and soil samples can be used to validate prediction models and calibrate them. To develop such models, the Northgate Link Extension (N125) tunneling project, constructed in Seattle, Washington, the USA, is used to capture and identify the true ground conditions. The results indicate successful prediction performances by the models, providing indication that EPBM parameters are crucial pointers of the tunnel excavation face properties to help attain optimally efficient EPBM operation.

A 49-year-old female patient presented at the hospital with a history of herpetic blisters, frequent episodes of vomiting and loose stools, bilateral upper and lower limb weakness, and diminishing sensorium. She was diagnosed with hyponatraemia and respiratory failure and later became unconscious with absent brainstem reflexes. The patient was initially treated for herpetic encephalitis, a chronic obstructive pulmonary disease with acute exacerbation, hyponatraemia and neuroparalytic snake bite. Further evaluation, however, identified the uncommon Guillain Barre syndrome presentation with overlap of Bickerstaff brainstem encephalitis. This is an uncommon disorder characterised by the involvement of higher mental functions, fixed dilated pupils, absent brainstem reflexes and quadriplegia that resembles a neuroparalytic snake bite and brain death. After receiving intravenous immunoglobulins for treatment, the patient completely recovered.

Amblyopia, the most common visual impairment of childhood, is a public health concern. An extended period of optical treatment before patching is recommended by the clinical guidelines of several countries. The aim of this study was to compare an intensive patching regimen, with and without extended optical treatment (EOT), in a randomised controlled trial.

To evaluate the effectiveness of maternal pertussis vaccination for preventing pertussis infections in Aboriginal and Torres Strait Islander infants under seven months of age. Retrospective cohort study; analysis of linked administrative health data. Mother–infant cohort (Links2HealthierBubs) including all pregnant women who gave birth to live infants (gestational age ≥ 20 weeks, birthweight ≥ 400 g) in the Northern Territory, Queensland, and Western Australia during 1 January 2012 – 31 December 2017. Proportions of women vaccinated against pertussis during pregnancy, rates of pertussis infections among infants under seven months of age, and estimated effectiveness of maternal vaccination for protecting infants against pertussis infection, each by Indigenous status. Of the 19 892 Aboriginal and Torres Strait Islander women who gave birth to live infants during 2012–2017, 7398 (37.2%) received pertussis vaccine doses during their pregnancy, as had 137 034 of 259 526 non‐Indigenous women (52.8%; Indigenous vnon‐Indigenous: adjusted odds ratio, 0.66; 95% confidence interval [CI], 0.62–0.70). The annual incidence of notified pertussis infections in non‐Indigenous infants declined from 16.8 (95% CI, 9.9–29) in 2012 to 1.4 (95% CI, 0.3–8.0) cases per 10 000 births in 2017; among Aboriginal and Torres Strait Islander infants, it declined from 47.6 (95% CI, 16.2–139) to 38.6 (95% CI, 10.6–140) cases per 10 000 births. The effectiveness of maternal vaccination for protecting non‐Indigenous infants under seven months of age against pertussis infection during 2014–17 was 68.2% (95% CI, 51.8–79.0%); protection of Aboriginal and Torres Strait Islander infants was not statistically significant (36.1%; 95% CI, –41.3% to 71.1%). During 2015–17, maternal pertussis vaccination did not protect Aboriginal and Torres Strait Islander infants in the NT, Queensland, and WA against infection. Increasing the pertussis vaccination rate among pregnant Aboriginal and Torres Strait Islander women requires culturally appropriate, innovative strategies co‐designed in partnership with Indigenous organisations and communities.

•What is the primary question addressed by this study?Are there sex differences in clinical presentation, general functioning and mood symptoms among older adults with bipolar disorder?•What is the main finding of this study?Female sex was associated with psychiatric hospitalization and male sex with higher rates of lifetime substance abuse disorders.•What is the meaning of the finding?Older aged women with bipolar disorder experience a more severe course of illness, emphasizing the importance of addressing sex-specific disparities in healthcare.

Purpose: The existing powertrain mounting system (PMS) design principles only assume uncoupled PMS as 6 degrees of freedom (DOF). This assumption ignores the dynamic interactions between PMS and other systems. To address this shortcoming, a coupled PMS and multi-driveline mounting system (MDMS) problem is formulated and investigated. Furthermore, design logic and simulation methods to optimize the PMS based on the vibration reduction contributed from the PMS in real vehicle operating conditions are proposed in this paper. Methods: Firstly, the key events that occur in real vehicle operating conditions are formulated and described along with eigenvalues and mode energy criteria. Secondly, a multi-body dynamics simulation model of a vehicle with 16 DOF and 22 DOF problems is taken into consideration to design the PMS. This simulation model is validated with experimentally measured vibrations on the powertrain mount. Thirdly, the influence of MDMS on PMS vibration performance is analytically evaluated in terms of eigensolutions and frequency responses. Finally, a novel systematic and procedural analysis approach is proposed. This new approach treats the PMS and MDMS as coupled 12 DOF systems, which are modeled by considering the powertrain mass and its bushing stiffness proprieties; along with the multi-driveline masses, joints kinematics, and its bushing stiffness proprieties. This coupled system with the vehicle model forms a 22 DOF system and is used for rigid body modes (RBM) optimization analysis. Result and Conclusions: The results demonstrate that the conventional approach achieves all design objectives during the early design stage as evident from the results of the 16 DOF case. However, the PMS isolation performance degrades when this model is applied to real vehicle operating events, as demonstrated by the 22 DOF case. The findings of the proposed optimized system demonstrate that under key real vehicle operating events, PMS vibration performance is enhanced by the better decoupling of the rigid body modes (RBM) parameters. This study’s main contribution is the observation that by treating PMS and MDMS as a coupled system during PMS design, vehicle vibration behavior can be further improved. The approach of considering and formulating real vehicle events helps to reduce the gap between the theoretically predicted and practical measured vibration performance of PMS.

Introduction: Diabetes distress (DD) and diabetes burnout (DB) are recognized psychological phenomena in patients with T1DM (type 1 diabetes mellitus). Still, there is an urgent need to create professional psychological intervention procedures to provide patients with adequate care. Aim: The aim of the study was to assess the level of DD and DB in T1DM patients at baseline and after 5 of sessions psychological intervention in the group of participants who applied for help. Methods: 34 T1DM patients who requested psychological support (22 females, 12 males) and 30 patients in a control group (14 females, 16 males) participated in the study. At baseline clinical test results between groups were compared. Next, in the studied group measurements were repeated after a set of five psychological face-to-face individual interventions which lasted 30–60 min each. They were support sessions with elements of cognitive-behavioral interventions done by clinical psychologists. Session 1: introduction, interview and collection of test results; session 2–4: work on the indicated by the patient and test results most problematic aspect of diabetes, session 5: a summary and plan for further treatment if needed. The control group results were obtained only at baseline. Research tools: DDS; PAID, Diabetes Burnout test by Polonsky. Results: At the baseline, significant differences were observed between the studied group and control group: in DB/DD levels: DB (3.9 ± 1.7 vs 2.4 ± 1.6; p< 0.001); DDS (3.2 ± 1.0 vs 2.7 ± 1.0; p= 0.064); PAID (62.3 ± 14.1vs 34.4 ± 21.0; p< 0.001). There were also group differences in HbA1c levels (8.7 ± 2.4 vs 7.3 ± 1.5; p= 0.028). After psychological interventions, there was a significant improvement in DB (3.9 ± 1.7vs 2.9 ± 1.2; p< 0.001; DDS (3.2 ± 1 vs 3.0 ± 0.7; p= 0.03); PAID (62.3 ± 14.1 vs 51.8 ± 12.5; p< 0.001). Conclusions: DD and DB constitute a significant problem in the group of T1DM patients, but providing appropriate specialist care may help them accept diabetes and improve life satisfaction, as well as regain control over their diabetes management.

Abstract: The metabolic syndrome presents a serious challenge to health professionals. The aim of the present study is to analyze the impact of a brief counselling on cardiovascular risk factors among 40-year-old men. Forty-six males living in north-eastern Helsinki voluntarily completed the follow-up study between 2001 and 2004, and were assessed for clinical risk factors. The mean differences were determined by a paired t-test, and the interaction between groups and time by the F-test with repeated measures ANOVA. After baseline assessment and in 2002, males received a 45 minute nurse-delivered counselling session with self-administered protocol. Cardiovascular risk factors improved significantly (p<0.05) from baseline within months. However, the final measurements obtained after three years showed that almost all risk factors, except the low and high density lipoprotein, tended to revert back to baseline. The profiles were similar in all predictor groups. Brief counselling had an impact on risk factors measured in 2002, but only a partial effect on them in 2004. Conclusive results lead to the idea thatmore collaboration is needed between private health care agencies and official primary health care for ensuring the continuity of improved health habits among middle-aged males.

Contrails (condensation trails) are line-shaped ice clouds caused by aircraft and are a substantial contributor to aviation-induced climate change. Contrail avoidance is potentially an inexpensive way to significantly reduce the climate impact of aviation. An automated contrail detection system is an essential tool to develop and evaluate contrail avoidance systems. In this article, we present a human-labeled dataset named OpenContrails to train and evaluate contrail detection models based on GOES-16 Advanced Baseline Imager (ABI) data. We propose and evaluate a contrail detection model that incorporates temporal context for improved detection accuracy. The human labeled dataset and the contrail detection outputs are publicly available on Google Cloud Storage at gs://goes_contrails_dataset.

Abstract: Background: The primary hypothesis for this study was that epidural analgesia reduces the use of opioids and thus advances bowel function and oral intake and shortens hospital stay after laparoscopic sigmoidectomy performed according to principles of enhanced recovery after surgery. Methods: For this study, 60 patients with complicated diverticular disease were randomized to the epidural anesthesia group or the control group before surgery. Postoperative oxycodone consumption, pain, and recovery parameters were followed for 14 days. Results: The epidural group needed less oxycodone than the control group until 12 h postoperatively. They experienced significantly less pain related to coughing and motion until postoperative day 2. In the epidural group, fewer patients experienced significant pain, and the duration of postoperative pain was shorter. Postoperative oral intake, bowel function, hospital stay, and overall complication rate were similar in the two groups. However, the control group had more postoperative hematomas. Conclusions: Epidural analgesia significantly alleviates pain, reducing the need for opioids during the first 48 h after laparoscopic sigmoidectomy. However, epidural analgesia does not alter postoperative oral intake, mobilization, or length of hospital stay.

Fahr’s syndrome affects fewer than 1 in 100,000 people. It is an inherited neurological disorder, which is distinguished by atypical calcium deposition in the movement-controlling areas of brain, that is thalamus, dentate nucleus, basal ganglia, cerebellum, cerebral cortex, hippocampus and subcortical white matter. The majority of patients often experience extrapyramidal symptoms, cerebellar signs, speech difficulty, dementia and neuropsychiatric manifestations. This disease’s molecular genetics have not been thoroughly investigated. Typically, young to middle-aged adults are affected though basal ganglia calcification in hypoparathyroidism is quite uncommon. Laboratory results and radiographic brain imaging helps in reaching the diagnosis. The treatment is mainly symptomatic. We present a case of Fahr’s syndrome associated with hypoparathyroidism.

Cerebellar ataxia in adults is always a diagnostic challenge. One of the important causes of late-onset cerebellar ataxia is hypomagnesemia. Hypomagnesemia can have varied manifestations and is attributable to numerous causes. Identification of hypomagnesemia-induced cerebellar syndrome (HiCS) is important as it is reversible but often missed. HiCS has distinct clinical findings and characteristic magnetic resonance imaging (MRI) findings. HiCS presents with distinct clinical, biochemical, and neuroimaging findings, but it cannot be ruled out even in the absence of neuroimaging findings. This condition has to be treated promptly and meticulously to avoid precipitating any serious complications, and a strong suspicion is required for the diagnosis. The underlying cause should be evaluated and managed, as HiCS is a serious but potentially reversible disease with a good prognosis. We present a case of HiCS presenting with a characteristic history of recurrent ataxia, tremor, and vertigo that improved with treatment. Our patient was atypical, as there were no significant MRI findings attributable to hypomagnesemia. Only seven case reports are available throughout the world that show such disparity.

Staphylococcus aureusis a key pathogen in atopic dermatitis (AD) pathogenicity. Over half of AD patients are carriers of S. aureus. Clinical isolates derived from AD patients produce various staphylococcal enterotoxins, such as staphylococcal enterotoxin C or toxic shock syndrome toxin. The production of these virulence factors is correlated with more severe AD. In this study, we propose cationic heme-mimetic gallium porphyrin (Ga3+CHP), a novel gallium metalloporphyrin, as an anti-staphylococcal agent that functions through dual mechanisms: a light-dependent mechanism (antimicrobial photodynamic inactivation, aPDI) and a light-independent mechanism (suppressing iron metabolism). Ga3+CHP has two additive quaternary ammonium groups that increase its water solubility. Furthermore, Ga3+CHP is an efficient generator of singlet oxygen and can be recognized by heme-target systems such as Isd, which improves the intracellular accumulation of this compound. Ga3+CHP activated with green light effectively reduced the survival of clinical S. aureusisolates derived from AD patients (>5 log10CFU/mL) and affected their enterotoxin gene expression. Additionally, there was a decrease in the biological functionality of studied toxins regarding their superantigenicity. In aPDI conditions, there was no pronounced toxicity in HaCaT keratinocytes with both normal and suppressed filaggrin gene expression, which occurs in ∼50% of AD patients. Additionally, no mutagenic activity was observed. Green light-activated gallium metalloporphyrins may be a promising chemotherapeutic to reduce S. aureuscolonization on the skin of AD patients.

The article focuses on the Environmental Law and Policy Annual Review (ELPAR), which aims to discuss and present feasible environmental law and policy proposals from legal academic literature. It covers the selection process of articles, the methodology used to categorize environmental law scholarship, and the goals of tracking trends in the field.

AbstractIntroduction:Disaster Medicine (DM) requires skills, knowledge, and prior experience that are rarely put to test by health care providers. Pediatric DM presents unique challenges in terms of both knowledge and practice.Methods:An anonymous survey consisting of demographic and five-point Likert scale questions was administered to physicians, nurses, and other medical personnel from Israel’s major medical emergency teams who were deployed to respond to the refugee crisis in Ukraine. This included teams from the Hadassah and Tel Aviv Sourasky Medical Centers and the Israel Ministry of Health.Results:Of the 171 members of the medical teams deployed on the Ukraine border, a total of 105 responses were obtained (61.4%) from 61 physicians, 50 nurses, and 12 other health care providers. The teams were composed of pediatricians (31.6%), internal medicine physicians (21.6%), Emergency Medicine and intensive care physicians (18.0%), and 31.0% other specialties.For 60% of the participants, this was their first deployment, and 78% had received no training in DM. Members rated the need for DM training at 4/5 (IQR 3-5). Forty-nine (49) members (46.6%) were not briefed on situational awareness and 97 members (89.5%) were not trained in the recognition of acute stress reactions. The responders also rated their concerns about providing medical aid to children at 2/5 (IQR 1-3). A medical clown was part of the teams 42.8% of the time; the presence of clowns was rated at a median of 4/5 (IQR 4-5). The team members underscored the need for more targeted training in DM at 5/5 (IQR 3-5).Conclusion:The findings highlight the need for the formulation of a disaster education model that includes pediatric DM.

Introduction:Kidney transplant graft function depends on optimised haemodynamics. However, high fluid volumes risk hypervolaemic complications. The Edwards Lifesciences ClearSight™ device permits fluid titration through markers of preload and beat-to-beat blood pressure monitoring. We evaluated the implementation of a novel goal-directed haemodynamic therapy protocol to determine whether patient outcomes had improved. Design:A retrospective evaluation of standard care versus goal-directed haemodynamic therapy in adults undergoing kidney transplantation was performed in a single centre between April 2016 and October 2019. Twenty-eight standard-of-care patients received intraoperative fixed-rate infusion and 28 patients received goal-directed haemodynamic therapy. The primary outcome was volume of fluid administered intraoperatively. Secondary outcomes included blood product and vasoactive drug exposure, graft and recipient outcomes. Results:Intraoperative fluid administered was significantly reduced in the goal-directed haemodynamic therapy cohort (4325 vs 2751 ml, P< .001). Exposure to vasopressor (67.9% vs 42.9%, P= .060) and blood products (17.9% vs 3.6%, P= .101) was unchanged. Immediate graft function (82.1% vs 75.0%, P= .515), dialysis requirement (14.3% vs 21.4%, P= .729) and creatinine changes post-operatively were unchanged. In the goal-directed haemodynamic therapy cohort, 1 patient had pulmonary oedema (3.6%) versus 21.4% in the standard cohort. Patients in the goal-directed haemodynamic therapy group were more likely to mobilise within 48 hours of surgery (number needed to treat = 3.5, P= .012). Conclusions:Protocolised goal-directed haemodynamic therapy in kidney transplantation was safe and may improve patient, graft, and surgical outcomes. Clinical trials assessing goal-directed approaches are needed.

•This paper is the first of its kind among the African Kenyan population that highlights the various anatomical patterns of presentation of the digastric muscle. These were classified according to the system described by De-Ary-Pires et al in the year 2003. However, we describe additional variations that we encountered regarding all the three components of the digastric muscle (anterior belly, posterior belly, and intermediated tendon) which have not been described previously.•In light of this, we suggest a modification of the classification system that better reflects the additional patterns that we describe in this paper. Additionally, this paper goes a step further to describe the baseline morphometry of the digastric muscle which has never been done prior to this study. Even though this may have been overlooked in the past, this data has significant clinical and surgical implications that impact both pre-operative planning and intra-operative procedures. The relationship of the muscle to neighboring structures such as the hypoglossal nerve and stylohyoid muscle have also been described.

Supplemental Digital Content is Available in the Text.

The genus Ralstoniacomprises of aerobic, gram-negative, oxidase positive, nonfermentative, largely environmental organisms. They are an emerging pathogen in the hospital setting and are increasingly associated with opportunistic infections and outbreaks. We hereby present a case series of six patients diagnosed with bacteraemia caused by Ralstoniaspp. and a brief review of literature. These cases highlight that isolation of a nonfermenting gram-negative bacillus from blood culture of a patient admitted in critical care setting should not be ignored as mere contaminant. Clinicians and microbiologists need to work as a team to combat this novel bug.

AbstractBackground:Terrorism remains a major threat and concern in many countries around the world. Pediatric populations represent approximately 30% of the world population, and in the event of a terrorist attack, can either be primary targets, to include the possibility of abduction, or unintended victims. They are unique in their vulnerabilities and, therefore, require special consideration.Methods:This study is a semi-quantitative, epidemiological analysis of all terrorism-related pediatric fatalities and injuries sustained from 1970-2019. Data collection was performed using a retrospective database search through the Global Terrorism Database (GTD). Summaries of events including search terms associated with pediatric population were individually reviewed and those describing the deaths, injuries, or abductions were tallied.Results:Of the over 200,000 terror events, 2,302 events met inclusion criteria. This represented 1.14% of total events which involved death, injury, or abduction. Of 2,032 events, a total of 2,275 pediatric fatal injuries (FI) were recorded, as well as 2,280 pediatric non-fatal injuries (NFI). The most common weapons used in all attacks involving the pediatric population were explosives (1,539 [66.8%]), firearms (543 [23.5%]), other (169 [7.3%]), and melee (83 [3.6%]). A total of 275 of the 2,032 events were related to abductions, with 71 cases involving the abduction of 10 individuals or more.Conclusion:Pediatric casualties in terrorist events represent a small proportion of overall victims. However, it should be understood that the pediatric population has unique vulnerabilities, and when directly impacted by terrorism, can have long-term physical and psychosocial sequelae, as well as a devastating emotional impact on the community.

Background:Craniofacial anthropometry provides essential data for diagnosis and treatment planning, with the norms for many races having been investigated. The results reveal that facial morphometry varies greatly because of geographical, ethnic, and racial variations. This study aims to gather the normative anthropometric data and compare the differences in facial morphometry between the Kenyan population and that of the Chinese. Methods:Four vertical measurements (trichion–nasion, nasion–subnasale, subnasale–gnathion, and superaurale–subaurale) and 6 horizontal measurements (zygion–zygion, exocanthion–endocanthion, endocanthion–endocanthion, pupil-pupil, alare–alare, and chelion–chelion) were obtained manually from subjects with no craniofacial abnormality. Results:A total of 180 participants (90 Kenyans and 90 Chinese) were included. Among the Kenyans, males generally had greater dimensions in comparison to the Kenyan females with the exception of the upper third, lower third, and intercanthal, and interpupillary distances. Among the Chinese, there was a significant difference between the 2 genders with the exception of intercanthal distance. All measurements were greater in Chinese males in comparison to the females. Comparison between races shows that Kenyans had greater vertical measurements with exception of the ear length for both genders. The Chinese males had increased facial width and intercanthal distance, while the Chinese females showed increased intercanthal distance compared to Kenyans. Kenyans exhibited hyperleptoprosopic-type face, while Chinese exhibited mesoprosopic-type face, with none of the 2 groups conforming to the neoclassical canons. Conclusion:Kenyans generally have greater craniofacial measurements versus Chinese, except for the facial width and intercanthal distance for males and interorbital distance for females.

Purpose: This paper conceptualizes the broaden-build and self-determination theories that act as the major theoretical framework to investigate the role of psychological detachment and job crafting behaviours in predicting intrinsic motivation through emotional stability. It was hypothesized that emotionally stable employees are better able to detach themselves from work and craft their job according to their preference and abilities, which would inculcate experience and make them intrinsically motivated. Design/methodology/approach: The sample comprised 396 employees, who are employed in different organizations across India. To test the hypotheses, the authors conducted structural equation modelling on SPSS AMOS 22. Findings: The results highlight the partial mediating role of emotional stability in the association of psychological detachment with intrinsic motivation as well as the fully mediating role between job crating and intrinsic motivation. Research limitations/implications: The study is conducted in a non-western collectivist culture and it makes significant contribution to the available literature on intrinsic motivation by proving that psychological detachment and job crafting act as predictor and highlighting the psychological state through emotional stability. The study further adds toward theory building around the construct of emotional stability, as it is still in its infancy. Practical implications: This study has depicted that emotionally stable employees who are psychologically detached and have proactive job crafting behaviour can achieve higher intrinsic motivation. Originality/value: On the basis of the recovery process (i.e. the effort-recovery model), the broaden and build theory and self-determination theory (SDT), this paper demonstrates that emotional stability plays the role of mediator that drives psychological detachment and encourages job crafting, which has the ability to intrinsically motivate the employees.

ObjectiveTo assess the association between in uteroexposure to seasonal inactivated influenza vaccine (IIV) and the risk of a diagnosis of a neurodevelopmental disorder in early childhood.DesignRetrospective cohort study.SettingPopulation-based birth registry linked with health administrative databases in Western Australia (WA).ParticipantsSingleton, liveborn children born between 1 April 2012 and 1 July 2016 in WA.ExposureReceipt of seasonal IIV during pregnancy obtained from a state-wide antenatal vaccination database.Main outcome measuresClinical diagnosis of a neurodevelopmental disorder was recorded from hospital inpatient and emergency department records. We used Cox proportional hazard regression, weighted by the inverse-probability of treatment (vaccination), to estimate the hazard ratio (HR) of neurodevelopmental disorders associated with in uteroexposure to seasonal IIV.ResultsThe study included 140 514 children of whom, 15 663 (11.2%) were exposed to seasonal IIV in utero. The prevalence of neurodevelopmental disorders was 5.4%, including mental or behavioural (0.4%), neurological (5.1%), seizure (2.2%) and sleep disorders (2.7%). Maternal IIV was not associated with increased risk of neurodevelopmental disorders (HR 1.00; 95% CI 0.91 to 1.08). Children exposed in the first trimester had a lower risk of seizure disorders (adjusted HR [aHR] 0.73; 95% CI 0.54 to 0.998), and preterm children exposed any time during pregnancy had a lower risk of sleep disorders (aHR 0.63; 95% CI 0.41 to 0.98).ConclusionsWe did not observe increased risk of neurodevelopmental disorders following in uteroexposure to seasonal IIV. Although we observed some evidence for lower risk of seizure and sleep disorders, additional studies are required to confirm.

Abstract – Novel methods are needed to make industrial plants more resilient to disruptions. Those disruptions are usually originating from both internal and external environment. Therefore, in the industrial environment, it is getting increasingly important to obtain an accurate overview of the functions of a production system (PS). Likewise, monitoring of production processes are also getting increasingly important due to the increasing interconnectedness of PSs. While causes of malfunctions in most PS being unintentionally and not easily caught a priori, early detection of malfunctions is important from an economic and a safety point of view. Current evaluation methods are primarily oriented towards the analysis of plant components. They do not consider, a change in product quality when it comes to the analysis of the reduction or the analysis of sabotage.

Women's role in the Indian society can bolster, if women performance (WP) and the work life balance (WLB) complement each other. Studies have recognised several items, which influence WP and WLB levels. Consideration needs to be given to the consequences of these items on the psychological distress and well-being of working women. The sample consisted comprises 90 women employees aged between 20 to 55, in higher education sector, comprising of both public and private sectors. Key variables included WP, WLB and demographic traits as control variables. The initial investigation was done through descriptive statistics. Multiple regression analysis was also used to assess the association between WP and WLB. ANOVA was used to check the mediation effect of demographics on WP. Results, suggests that workplace stress significantly affects women's performance. Whereas, two other phenomena i.e., women's health and excessive workload also adversely affect women's efficiency.

Approximately 6.8 million people die annually because of problems related to the central nervous system (CNS), and out of them, approximately 1 million people are affected by neurodegenerative diseases that include Alzheimer’s disease, multiple sclerosis, epilepsy, and Parkinson’s disease. CNS problems are a primary concern because of the complexity of the brain. There are various drugs available to treat CNS disorders and overcome problems with toxicity, specificity, and delivery. Barriers like the blood–brain barrier (BBB) are a challenge, as they do not allow therapeutic drugs to cross and reach their target. Researchers have been searching for ways to allow drugs to pass through the BBB and reach the target sites. These problems highlight the need of nanotechnology to alter or manipulate various processes at the cellular level to achieve the desired attributes. Due to their nanosize, nanoparticles are able to pass through the BBB and are an effective alternative to drug administration and other approaches. Nanotechnology has the potential to improve treatment and diagnostic techniques for CNS disorders and facilitate effective drug transfer. With the aid of nanoengineering, drugs could be modified to perform functions like transference across the BBB, altering signaling pathways, targeting specific cells, effective gene transfer, and promoting regeneration and preservation of nerve cells. The involvement of a nanocarrier framework inside the delivery of several neurotherapeutic agents used in the treatment of neurological diseases is reviewed in this study.

Der industrielle Griff-in-die-Kiste (engl. Industrial Bin Picking) steht weiter im Fokus der Bemühungen um wirtschaftliche Fertigungsautomatisierungssysteme. Trotz erfolgreicher Forschungsarbeiten in diesem Bereich verfehlen viele Systeme industrielle Anforderungen an die technische Verfügbarkeit. Diese Arbeit untersucht die Taktzeit und Größe des Entkopplungsspeichers als Einflussgrößen auf die technische Verfügbarkeit des industriellen Griff-in-die-Kiste. Ausgehend von einer für diesen Anlagentyp charakteristischen Variabilität wird ein Taktzeitprofil simuliert. Daraus lässt sich bereits in der Planungsphase der IGK-Anlagenentwicklung eine mittlere Taktzeit bestimmen und eine geeignete Kapazität des Entkopplungsspeichers ableiten um folglich eine ausreichende technische Verfügbarkeit zu erreichen.

To assess changes in retinopathy of prematurity (ROP) diagnosis in single and serial retinal images.