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OBJECTIVE To establish an echocardiographic technique and 2-dimensional reference parameters for southern stingrays (Hypanus americanus). A second objective was to compare echocardiographic measurements obtained from animals of different sex, size, environment, handling technique, and position. ANIMALS 84 presumed healthy, wild, semiwild, and aquarium-housed southern stingrays. PROCEDURES Animals, anesthetized and manually restrained, were positioned in dorsal recumbency, and echocardiography was performed. A subset of this population was also imaged in ventral recumbency for comparison. RESULTS Echocardiography was feasible, and reference parameters were established for this species. While some standard measurements could not be assessed due to body habitus, all valves, chambers, and the conus were clearly visualized in the majority of animals. Statistical significance was reached for some variables when comparing animals from different environments and handling methods, but these differences were not considered clinically relevant. The data were therefore separated into 2 subsets of echocardiographic reference parameters based on disc width since some of the measurements were dependent on body size. This approach mostly separated the sexes due to strong sexual dimorphism. CLINICAL RELEVANCE Limited information is available regarding cardiac disease in elasmobranchs; most of the available information on cardiac physiology focuses on a few shark species. Two-dimensional echocardiography is a noninvasive tool utilized to evaluate cardiac structure and functionality. Southern stingrays are one of the most commonly displayed elasmobranchs in public aquaria. This article expands on the growing body of information regarding veterinary care in elasmobranchs and provides clinicians and researchers with another diagnostic modality to utilize in screening for health/disease.

This review was carried out with the objective to study patterns of neurological, psychological and other physical consequences of COVID-19 in the long term. The guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) had been followed; 22 articles, published during January 2020 to September 2021, were selected. Original research, review articles, editorial and viewpoints were included. Google Scholar, Medline, and PubMed were searched through 2020 till 2021.Data collection in selected studies was performed mainly through the online survey, telephone survey, use of medical records, and patient interviews. This systematic review contains the studies conducted in the American, Asian and European countries. The major outcomes identified were the neurological, psychological, and other long-term chronic manifestations of COVID‐19. This review demonstrates that long-COVID has started to bring a huge wave of patients, the count of them being millions now, who can enter a phase of disability due to neurological damages if not treated during the early course of illness. Though more disabling than lethal, long-COVID patients with a neurological deficit is expected to overburden the healthcare system globally which is already been struggling to handle acute COVID-19 patients in this once-in-a-lifetime pandemic. Keywords: COVID-19, Neurological and Psychological symptoms, Physical Symptoms, Long-COVID.

Hydrogel sensors are well suited to measuring the concentration of substances in liquids, and, because the hydrogel is biocompatible, they are ideal for medical use. Hydrogels change their volume in response to stimuli. The larger the hydrogel, the more pronounced the measurement signal. However, a larger volume also leads to slower swelling due to the longer diffusion paths. One method of determining the degree of swelling is to measure the swelling pressure using a piezoresistive pressure sensor. With current approaches, measurement times of several minutes can be achieved. By exploiting the bimorph effect, we were able to reduce the thickness of the hydrogel and, thus, reduce the response time of the entire sensor to less than 1 min. The aim of this paper is now to show how a sensor with short response times can be designed and manufactured and, in particular, how to find a suitable hydrogel composition, how to appropriately structure the hydrogel layer and how a robust adhesion of the hydrogel to the sensor chip can be achieved. As a result, we were able to show that such hydrogel sensors with response times of just a few seconds are possible.

O presente resumo estendido apresenta a aplicabilidade da inteligência artificial e internet das coisas (Internet of Things) no sistema pedagógico através da engenharia. Tal abordagem busca entender, investigar e atenuar as dificuldades que o estudante encontra para permanecer matriculado no seu curso de graduação e não abandonar os seus estudos na instituição de ensino. O propósito deste artigo é mostrar como a inteligência artificial e a internet das coisas podem auxiliar didaticamente os universitários, mitigar e fomentar novos métodos pedagógicos, motivar o interesse dos alunos durante o curso de formação, e construir profissionais mais qualificados para o mercado de trabalho. Esta tarefa será alcançada a partir de uma pesquisa para apresentar a utilização de um aplicativo de celular e uma rede social educacional, mostrando as ações desde o seu cliente (aluno) até a sua conexão com o usuário final (monitor). Com a finalidade de prestar apoio didático aos alunos que buscam ajuda na sala do Núcleo de Apoio Psicopedagógico (NAPP), o clímax do trabalho está na criação de um espelho inteligente, feito de recursos provindos da robótica, internet das coisas e linguagem de programação, capaz de interagir com os estudantes para a resolução de dúvidas e praticar exercícios de uma forma dinâmica e inovadora.

Nonylphenols (NPs) are a degradation product of nonylphenol ethoxylate surfactants, which occur in many samples from the environment, food, and human organism. NPs are persistent and toxic and exhibit estrogenic activity. One of the challenges in understanding the estrogenic effects of NPs is the large number of isomers that may exist in different samples. After analyzing selected foods from different countries by high-performance liquid chromatography coupled with tandem mass spectrometry, NPs were detected in 8 of the 12 food samples. The concentration of NPs, based on fresh weight, ranged from 0.5 to 18.9 μg kg−1. The highest NP contents were found in coffee samples, and therefore an isomer-specific analysis was carried out by comprehensive two-dimensional gas chromatography coupled with time-of-flight mass spectrometry (GCxGC-TOF-MS). Fourteen pure isomers of NP were used as standards for cross-referencing the NP isomers. We identified the two main NP isomers in the coffee samples as 4-[3-ethyl-1,1-dimethylpentyl]-phenol and 4-[1-ethyl-1,3-dimethylpentyl]-phenol or NP128 and NP111 (Juelich nomenclature), respectively. The GCxGC-TOF-MS system with a liquid nitrogen cryogenic modulator used in this study is suitable for the isomer-specific analysis of NP and can be applied and further optimized for future routine analysis in food control.

The vibration and acoustic behavior of electric machines is an important aspect of the design process. A crucial part of the modeling is the correct prediction of the stator’s vibration behavior, characterized by the stator’s eigenfrequencies and eigenmodes. For this purpose, a calculation approach called the analytical beam element model (ABM) was presented in a previous paper [18], where Euler–Bernoulli beams were used to describe the vibration behavior of the stator. The ABM introduced offers an alternative to the finite element (FE) method and to classical analytical models. In this paper, the model is examined and extended further. Different approaches conceived to better describe the influence of the stator yoke’s thickness by using Timoshenko beams and a multi-layer discretization are presented and discussed. Furthermore, a new feature that considers the lever arm effect of the stator teeth with respect to the yoke is introduced. The results are compared to FE calculations and measurements. Lastly, the improved ABM is used to calculate the vibration behavior of four stators with outer diameters ranging from $$160\,\text{mm}$$ 160 mm to $$7\,\text{m}$$ 7 m . The results are compared to FE results to prove the accuracy of the ABM.

Phase correlation (PC) is a well-known method for estimating cloud motion vectors (CMVs) from infrared and visible spectrum images. Commonly, phase shift is computed in the small blocks of the images using the fast Fourier transform. In this study, we investigate the performance and the stability of the blockwise PC method by changing the block size, the frame interval, and combinations of red, green, and blue (RGB) channels from the total sky imager (TSI) at the United States Atmospheric Radiation Measurement user facility's Southern Great Plains site. We find that shorter frame intervals, followed by larger block sizes, are responsible for stable estimates of the CMV, as suggested by the higher autocorrelations. The choice of RGB channels has a limited effect on the quality of CMVs, and the red and the grayscale images are marginally more reliable than the other combinations during rapidly evolving low-level clouds. The stability of CMVs was tested at different image resolutions with an implementation of the optimized algorithm on the Sage cyberinfrastructure test bed. We find that doubling the frame rate outperforms quadrupling the image resolution in achieving CMV stability. The correlations of CMVs with the wind data are significant in the range of 0.38–0.59 with a 95 % confidence interval, despite the uncertainties and limitations of both datasets. A comparison of the PC method with constructed data and the optical flow method suggests that the post-processing of the vector field has a significant effect on the quality of the CMV. The raindrop-contaminated images can be identified by the rotation of the TSI mirror in the motion field. The results of this study are critical to optimizing algorithms for edge-computing sensor systems.

Background: In the absence of evidence from randomised controlled trials, observational data can be used to emulate clinical trials and guide clinical decisions. Observational studies are, however, susceptible to confounding and bias. Among the used techniques to reduce indication bias are propensity score matching and marginal structural models. Objective: To use the comparative effectiveness of fingolimod vs natalizumab to compare the results obtained with propensity score matching and marginal structural models. Methods: Patients with clinically isolated syndrome or relapsing remitting MS who were treated with either fingolimod or natalizumab were identified in the MSBase registry. Patients were propensity score matched, and inverse probability of treatment weighted at six monthly intervals, using the following variables: age, sex, disability, MS duration, MS course, prior relapses, and prior therapies. Studied outcomes were cumulative hazard of relapse, disability accumulation, and disability improvement. Results: 4608 patients (1659 natalizumab, 2949 fingolimod) fulfilled inclusion criteria, and were propensity score matched or repeatedly reweighed with marginal structural models. Natalizumab treatment was associated with a lower probability of relapse (PS matching: HR 0.67 [95% CI 0.62-0.80]; marginal structural model: 0.71 [0.62-0.80]), and higher probability of disability improvement (PS matching: 1.21 [1.02 -1.43]; marginal structural model 1.43 1.19 -1.72]). There was no evidence of a difference in the magnitude of effect between the two methods. Conclusions: The relative effectiveness of two therapies can be efficiently compared by either marginal structural models or propensity score matching when applied in clearly defined clinical contexts and in sufficiently powered cohorts.

The non-marine mollusc fauna of the northern part of t1he Narinda karst of north-western Madagascar, mostly from the Anjajavy Peninsula and Analalava District is enumerated based on collections made in the past 20 years. 102 species are recorded (73 terrestrial, 12 freshwater and 17 littoral). Twenty four are described as new species: Omphalotropis lavanensis n. sp., Boucardicus crassus n. sp., Boucardicus malama n. sp., Boucardicus minoratus n. sp., Cyclotopsis pectinata n. sp., Tropidophora narindana n. sp., Tropidophora tenona n. sp., Tropidophora jugia n. sp., Tropidophora neoliratoides n. sp., Tropidophora rovidrovitra n. sp., Gulella foucaultia n. sp., Gulella martiniana n. sp., Gulella anjajavyensis n. sp., Gulella volontany n. sp., Gulella antonibe n. sp., Parvedentulina lavana n. sp., Microcystis zorony n. sp., Microcystis embertoni n. sp., Sitala dickensi n. sp., Ctenophila tangolika n. sp., Kalidos unistriata n. sp., Kalidos quadrangulata n. sp., Kalidos narindana n. sp., and Kalidos mahafatifaty n. sp. A further six are new records for Madagascar. We propose two changes of genera and one new synonym. Madagascar’s dry forest continues to decline in area and much of the forest in the region is fragmentary. Three species were only recorded from old shells and may be locally extinct.

This study examines current developments of conspicuous consumption in the fitness community on social media. During the Covid-19-pandemic digital communities had to change as in-person events were canceled. This paper investigates the differences in conspicuous consumption for fitness content creators, depending on their workout location (gym vs. home workout). Through a netnography based on Instagram, posts and videos were qualitatively analyzed. While conspicuous consumption was present in both workout styles, it differed in its manifestation. Posts about gym workouts focused more unilaterally on the status of the content creator by using measurable goals, lighting, posing, and hashtags about their body parts. In contrast, home workouts focused on the status achieved through community building by showing training instructions for the followers and engaging in the comments. Social media users seem to be able to engage in conspicuous consumption with the fitness community through following content creators.

Machine learning (ML) has received enormous attention in science and beyond. Discussed here are the status, opportunities, challenges and limitations of ML as applied to X-ray and neutron scattering techniques, with an emphasis on surface scattering. Typical strategies are outlined, as well as possible pitfalls. Applications to reflectometry and grazing-incidence scattering are critically discussed. Comment is also given on the availability of training and test data for ML applications, such as neural networks, and a large reflectivity data set is provided as reference data for the community.

Due to an increasing number of children under the age of three attending early childhood education and care (ECEC), there is an increasing need for high-quality care settings. In addition to primary caregivers, ECEC teachers are important socializers of children’s emotional development and may become children’s attachment figures. Early preventive interventions bear the potential to reduce the risk for later maladaptive development in the social-emotional domain. The first objective of the present article is to introduce the Papilio-U3 program, a universal preventive intervention program to foster positive and sensitive teacher-child interactions, to foster children’s early social-emotional competence and secure child-teacher attachment relationships in ECEC, and to prevent children’s emotional and behavioral problems. Furthermore, we report the design and first results of the formative evaluation derived from the pilot evaluation study. The program was developed according to the Intervention Mapping Approach, and the present article describes the planning process comprising a needs assessment and description of the intervention context, the derivation of the logic model of change, a detailed account of the program design, production, implementation, and an overview of the program evaluation study (multi-centric, randomized-controlled trial). The total sample of the evaluation study comprised 125 teachers (age M= 34.0, SD = 10.1, 98.4 % female) from 55 ECEC centers. For the formative evaluation, teachers of the intervention group (n = 61) reported on training content, methods, material, organizational conditions, and potential challenges in the course of program implementation. Finally,we provide directions to revise the program and to guide future implementation of preventive intervention programs in the ECEC context.

In this paper, the first steps towards integrating a mass sensing system into an existing miniaturized ceramic DSC (differential scanning calorimetry) chip are presented. A vibration setup is developed based on the mass-dependent change in frequency of the DSC chip as an oscillating cantilever. A simulation model reveals that the resolution of the measurement can be improved by reducing the chip thickness. In this study, different measurement methods (acoustic, optical, and piezoresistive) are investigated. Three complete measurement systems are set up and evaluated with regard to their integration in the DSC chip. All presented measurement methods show promising results and already allow mass measurements with a resolution of 100 µg.

Purpose: The purpose of this study was to explore experiences with concealing stuttering in children and young people who stutter based on recollections from adults. In addition, we explored how school-based speech therapists can be helpful or unhelpful to children who are concealing stuttering from the perspective of adults who stutter. Method: Thirty adults who stutter, who previously or currently conceal stuttering, participated in semistructured interviews exploring their early experiences with hiding stuttering. Purposeful and random sampling was used to diversify experiences and opinions. Reflexive thematic analysis was used to develop themes and subthemes to describe participants' experiences. Results: All participants in the study reported beginning to conceal stuttering at 18 years of age or younger, with more than two thirds sharing that they began in elementary school. Participants reported that exposure to implicit and explicit ableist messaging about stuttering and traumatic social experiences at school contributed to their inclination to hide disfluencies. Many participants described concealment as a strategy for protecting themselves from stigma. Several participants condemned fluency shaping, calling it harmful and likening it to teaching concealment. Participants believed that speech therapists could be helpful by promoting safe and supportive school environments and by being responsive to the social and emotional challenges that can accompany speaking differently and navigating stigma at school. Conclusions: Some children who stutter may attempt to protect themselves from stigma by concealing their disfluencies, but doing so can feel isolating and confusing. Speech therapists can play an important role in making the school environment safer and more supportive for children who stutter.

This clinical guideline is intended for use by orthopedic surgeons and physicians who care for patients with possible or documented septic arthritis of a native joint (SANJO). It includes evidence and opinion- based recommendations for the diagnosis and management of patients with SANJO. Executive summary Purpose: the European Bone and Joint Infection Society (EBJIS) has initiated this interdisciplinary collaborative project to create a concise evidence-based clinical guideline for the management of SANJO (septic arthritis of a native joint). Method: a steering committee identified 25 clinical dilemmas related to SANJO and grouped these into nine categories as reported below. For each category, a work group of international experts was recruited amongst members of the European Bone and Joint Infection Society (EBJIS), and for the chapter on SANJO after ACL reconstruction, the recommendations were made in cooperation with appointed members of the European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA). The work groups followed a predefined process of systematic literature search, weighting in the strength of recommendations and quality of evidence (Fig. 1). A detailed description of the methods, background, and evidence reporting for each recommendation with references can be found in the associated work group report (see the Appendix).

Trimethylborane (TMB) and its chemistry upon pyrolysis have been investigated by threshold photoelectron spectroscopy. TMB shows an unstructured spectrum and its adiabatic ionization energy (IE

The management of degenerative spine pathology continues to be a significant source of costs to the US healthcare system. Besides surgery, utilization of healthcare resources after spine surgery drives costs. The responsibility of managing costs is gradually shifting to patients and providers. Patient-centered predictors of healthcare utilization after elective spine surgery may identify targets for cost reduction and value creation. Therefore, our study aims to quantify patterns of healthcare utilization and identify risk factors that predict high healthcare utilization after elective spine surgery.A total of 623 patients who underwent elective spine surgery at a tertiary academic medical center by one of three fellowship-trained orthopedic spine surgeons between 2013 and 2018 were identified in this retrospective cohort study. Healthcare utilization was quantified including advanced spine imaging, emergency and urgent care visits, hospital readmission, reoperation, PT/OT referrals, opioid prescriptions, epidural steroid injections, and pain management referrals. Patient variables, namely, the Charlson comorbidity index (CCI) and the American Society of Anesthesiologists (ASA) classification system, were assessed as potential predictors for healthcare utilization.Among all patients, a wide range of health utilization was identified. Age, body mass index, Charlson Comorbidity Index, and American Society of Anesthesiology class were identified as positive predictors of postoperative healthcare utilization including emergency department visits, spine imaging studies, opioid and nerve blocker prescriptions, inpatient rehabilitation, any referrals, and pain management referrals.Markers of patient health-such as CCI and ASA class-may be used to predict healthcare utilization following elective spine surgery. Identifying at-risk patients and addressing these challenges prior to surgery is an important step to deliver efficient postoperative care.3.

Background Although the world is experiencing a deficit in the neurosurgical workforce, the number of neurosurgeons in Germany has increased within the last two decades. The aim of the present study was to assess the neurosurgical workforce in Germany, compare it to European countries, and assess structures in neurosurgical departments in Germany. Methods Data regarding the number of neurosurgeons in Germany as well as the number of departments, beds, cases, and neurosurgical procedures were gathered. A survey among German neurosurgical departments was performed to assess the structure of neurosurgical care. Furthermore, another survey among European countries was performed to acquire information regarding the number of surgeons and the regulation of training. Results From 2000 to 2019, the number of board-certified neurosurgeons in Germany increased by 151% from 973 to 2,446. During the same period, the German population increased by only 1% from 82.26 million to 83.17 million. Thus, the number of neurosurgeons per 100,000 inhabitants increased from 1.18 to 2.94. The increase of neurosurgeons is not paralleled by an increase in departments or an increase in neurosurgical procedures within the active neurosurgical departments. In comparison to the participating European countries, where the number of neurosurgeons per 100,000 inhabitants ranged from 0.45 to 2.94, with Germany shows the highest number. Conclusions German institutions of medical administration urgently need to consider regulation of neurosurgical specialist training to prevent a further uncontrolled increase in neurosurgeons in a manner that is not adapted to the needs of neurosurgical care for the German population. Actions might include a regulation of entry to the training and of the number of training sites. Furthermore, an integration of non-physician assistant health care professionals and delegation of non-surgical workload from neurosurgeons is necessary. A further increase in neurosurgeons would be associated with a decrease in the surgical caseload per surgeons during training and after board certification, which might compromise the quality of neurosurgical care.

Introduction Children and adolescents with multiple disabilities and mental disorders (CAMD) are frequently treated with antipsychotic drugs. However, CAMD are particularly susceptible to serious adverse drug reactions (sADRs). This retrospective study examined the frequency of sADRs to antipsychotics in CAMD. Further, the potential preventability of these sADRs through therapeutic drug monitoring (TDM) and the potential socio-economic benefits of TDM were explored. Methods Routine clinical data of all patients treated at a specialized psychiatric clinic for CAMD between January 2017 and December 2018 were retrospectively examined. Data on the occurrence of sADRs (definition according to the European Medicines Agency), their causality with antipsychotics, as well as their preventability (Schumock criteria) were extracted from patient files. The prolongation of the hospital stay due to sADRs was calculated, and the cost savings were estimated if TDM had been applied. The data were based on a subsample of the KiDSafe project, supported by the Innovation Fund of the Joint Federal Committee, grant number 01NVF16021. Results One hundred two CAMD who were administered at least one antipsychotic drug during inpatient treatment were identified. Of these patients, 22 (21.6%) sADRs with a possible causal relationship with the antipsychotic treatment were documented. Eleven sADRs (50%) could potentially have been prevented through TDM. Mitigating sADRs through TDM likely would have prevented prolonged hospital stays and thus conferred considerable savings for health insurance companies. Discussion The routine implementation of TDM is urgently recommended for antipsychotic treatment in CAMD to increase drug therapy safety.

Ultrasound shear wave elasticity imaging is a valuable tool for quantifying the elastic properties of tissue. Typically, the shear wave velocity is derived and mapped to an elasticity value, which neglects information such as the shape of the propagating shear wave or push sequence characteristics. We present 3D spatio-temporal CNNs for fast local elasticity estimation from ultrasound data. This approach is based on retrieving elastic properties from shear wave propagation within small local regions. A large training data set is acquired with a robot from homogeneous gelatin phantoms ranging from 17.42 kPa to 126.05 kPa with various push locations. The results show that our approach can estimate elastic properties on a pixelwise basis with a mean absolute error of 5.01+-4.37 kPa. Furthermore, we estimate local elasticity independent of the push location and can even perform accurate estimates inside the push region. For phantoms with embedded inclusions, we report a 53.93% lower MAE (7.50 kPa) and on the background of 85.24% (1.64 kPa) compared to a conventional shear wave method. Overall, our method offers fast local estimations of elastic properties with small spatio-temporal window sizes.

The structure of the title compound, C30H42N4O2, has orthorhombic (Pbca) symmetry. This compound comprises a 4-amino-1,8-naphthalimide core with a 2,2,6,6-tetramethyl-4-piperidinyl substituent bonded to each nitrogen atom. The structure displays N—H...O hydrogen bonding. The structure exhibits disorder of the main molecule.

PDF file - 112K, expression of cox-2 and VEGF

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