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Abstract The intracellular position of genes may impact their expression, but it has not been possible to accurately measure the 3D position of chromosomal loci. In 2D, loci can be tracked using arrays of DNA-binding sites for transcription factors (TFs) fused with fluorescent proteins. However, the same 2D data can result from different 3D trajectories. Here, we have developed a deep learning method for super-resolved astigmatism-based 3D localization of chromosomal loci in live E. coli cells which enables a precision better than 61 nm at a signal-to-background ratio of ~4 on a heterogeneous cell background. Determining the spatial localization of chromosomal loci, we find that some loci are at the periphery of the nucleoid for large parts of the cell cycle. Analyses of individual trajectories reveal that these loci are subdiffusive both longitudinally (x) and radially (r), but that individual loci explore the full radial width on a minute time scale.

PURPOSEManagement of locally advanced rectal cancer (LARC) includes neoadjuvant chemoradiotherapy (NACRT) followed by total mesorectal excision. Recently, total neoadjuvant treatment (TNT) has gained attention. In developing countries, patients with rectal cancer often present at advanced stages. This study assesses treatment patterns and outcomes in LARC at a largest referral center in Ethiopia.MATERIALS AND METHODSA cross-sectional study was conducted on 100 patients with LARC treated at Tikur Anbessa Specialized Hospital from January 2020 to September 2022.RESULTSThe median age at diagnosis was 45.5 years (range, 20-86), with 51% male. Of the patients, 81% had no previous oncologic treatment and 75.3% was discussed in a multidisciplinary tumor board. Up-front surgery was planned for 44.4% of patients, whereas 22.2% and 8.6% were assigned to TNT and NACRT, respectively. Among 81 treatment-naïve patients, 79 were triaged for surgery, but only 47 (59.5%) underwent surgery, achieving an 89.9% R0 resection rate. Of 36 up-front planned surgeries, 35 proceeded as planned, whereas only 12 of 43 (28%) planned after neoadjuvant treatment underwent surgery. Neoadjuvant chemotherapy (NACT) was given to 37% of patients, with 16.7% (5 of 30) undergoing subsequent surgery. Radiotherapy was given to 24.2% of participants, with 56.25% undergoing surgery. Short-course radiotherapy (SCRT) was given to two patients. Only 14.8% completed all planned treatments, with radiation waiting time (median, 10 months) being the main impediment.CONCLUSIONTimely administration of neoadjuvant treatment is not possible in most resource-limited settings. Because of better treatment completion, up-front surgery looks a more viable option than NACT in these situations. Extended waiting time for radiotherapy can be mitigated by opting for alternatives like SCRT in selected patients.

Abstract Introduction Acromioclavicular joint dislocations (ACD) are one of the most common shoulder injuries. There is no consensus in how to treat higher graded ACD ≥ Rockwood grade III. This study compares operative versus conservative treatment regarding costs and clinical outcome parameters. Materials and Methods This retrospective, consecutive case-control-study includes 14 patients. Seven operatively treated patients were matched, by Rockwood grade, with seven conservatively treated patients. The cost was extracted out of the clinical- and insurance-based cost sheets and furthermore these include the loss of earnings. Clinical examination, demographic data as well as different outcome-questionnaires were recorded. Results There were no significant differences between operative and conservative treated patients for outcome Questionnaires. Of note, there was a significantly higher incidence of tenderness over the AC-joint (p = 0.0038) postoperatively. As expected, economical evaluation showed various findings in favor of the conservative treatment. The costs for medical services (11012.39vs.1163.81USD; p = 0.0061), days of hospitalization (3.3vs.0days; p III) compared to conservative is economically inefficient. Under consideration of clinical comparable results, indications for operative treatment should be set very carefully.

PURPOSEPediatric radiotherapy is a necessary and challenging component of oncologic care for children in low- and middle-income countries (LMICs). Collaboration between institutions in LMICs and high-income countries (HICs) has been shown to be effective in improving oncologic treatment outcomes; however, literature regarding pediatric radiotherapy twinning partnerships is limited.METHODSEmory University has a long-standing twinning collaboration with Tikur Anbessa Specialized Hospital (TASH) for certain medical specialties. After securing institutional funding, a faculty member and a resident from the Emory University Department of Radiation Oncology set out to establish a twinning program with TASH for pediatric radiotherapy.RESULTSEmory and TASH faculty and residents established initial communications virtually via email and video correspondence. TASH residents and faculty completed surveys regarding pediatric radiotherapy institutional and educational needs to outline goals of collaboration. Five lectures and case-based practicums were identified focused on Wilms tumor, medulloblastoma, rhabdomyosarcoma, Hodgkin lymphoma, and palliative radiotherapy. The Emory team then conducted a visit to TASH during which lectures and practicums were delivered. The Emory team directly observed and guided simulation and treatment planning procedures. TASH residents practiced decision making, simulation, contouring, and field placement for Wilms tumor cases on the basis of didactics and feedback provided by the Emory team. Additionally, a needs assessment regarding pediatric oncologic resources was completed. Clinical care pathways and standard operating procedures were drafted by collaborators. Virtual peer-review sessions were established to continue collaborations abroad and plan for next in-person visit.CONCLUSIONCollaborative efforts by global experts have helped to establish and improve treatment protocols for childhood cancer. The presented twinning experience may serve as a model for other LMIC and HIC centers for establishing similar partnerships.

Objectives A woman's health and wellbeing are impacted by illegal abortion since improper procedures can lead to consequences like extreme bleeding, infection, and damage to the reproductive organs and low awareness and attitude toward abortion law is one of the public health problems in Ethiopia. This study aimed to assess the knowledge, and attitude, and identify the effect of short birth interval and wealth index on the abortion law among reproductive-age women in Bule Hora town, Southern Oromia, Ethiopia. Methods A community-based cross-sectional study design was conducted from June 20 to July 20, 2022. A systematic random sampling technique was carried out to select 402 reproductive-age women. Data was collected by using a structured questionnaire with face-to-face interviews after the tools were pretested. The data was cleaned, coded, and entered into Epidata 3.1 and exported to STATA 14 for analysis. The model goodness of fit was checked using the Hosmer-Lemeshow test. Statistical significance is declared at P

Single-molecule 3D tracking is critical to understand macromolecular dynamics but achieving this at a sub-millisecond resolution remains challenging. Here the authors present a 3D tracking method based on cross-entropy minimization and the true excitation point spread function.

Objective: This study was aimed to determine the level of knowledge of reproductive rights and related factors among youths of Bule Hora town, 2021. Methods: A Community-based cross-sectional study was carried out among youths of Bule Hora Town from February 1 to 30, 2021. A systematic random sampling method was used to select 407 youths. A pretested face-to-face interview of a structured questionnaire was used to collect the data. The data entry was performed by using EPI-DATA Version 3.1 and transferred to SPSS version 23 for analysis. Bivariable and multivariable logistic regression analysis was done to find the factors related to knowledge of reproductive rights. Adjusted odds ratios (AOR) with 95% CI at a p-value

Abstract Cationic non-viral vectors show great potential to introduce genetic material into cells, due to their ability to transport large amounts of genetic material and their high synthetic versatility. However, designing materials that are effective without showing toxic effects or undergoing non-specific interactions when applied systemically remains a challenge. The introduction of shielding polymers such as polyethylene glycol (PEG) can enhance biocompatibility and circulation time, however, often impairs transfection efficiency. Herein, a multicomponent polymer system is introduced, based on cationic and hydrophobic particles (P(nBMA46-co-MMA47-co-DMAEMA90), (PBMD)) with high delivery performance and a pH-responsive block copolymer (poly((N-acryloylmorpholine)-b-(2-(carboxy)ethyl acrylamide)) (P(NAM72-b-CEAm74), PNC)) as shielding system, with PNAM as alternative to PEG. The pH-sensitive polymer design promotes biocompatibility and excellent stability at extracellular conditions (pH 7.4) and also allows endosomal escape and thus high transfection efficiency under acidic conditions. PNC shielded particles are below 200 nm in diameter and showed stable pDNA complexation. Further, interaction with human erythrocytes at extracellular conditions (pH 7.4) was prevented, while acidic conditions (pH 6) enabled membrane leakage. The particles demonstrate transfection in adherent (HEK293T) as well as difficult-to-transfect suspension cells (K-562), with comparable or superior efficiency compared to commercial linear poly(ethylenimine) (LPEI). Besides, the toxicity of PNC-shielded particles was significantly minimized, in particular in K-562 cells and erythrocytes. In addition, a pilot in vivo experiment on bone marrow blood cells of mice that were injected with PNC-shielded particles, revealed slightly enhanced cell transfection in comparison to naked pDNA. This study demonstrates the applicability of cationic hydrophobic polymers for transfection of adherent and suspension cells in culture as well as in vivo by co-formulation with pH-responsive shielding polymers, without substantially compromising transfection performance. Graphical Abstract

Background: Despite the negative consequence of the unmet need for family planning no study has been conducted on women working in the industrial parks. Therefore this study aimed to determine the prevalence of unmet need for family planning and its associated factors among women in reproductive age working in Hawassa industrial park. Methods: An institution-based cross-sectional study was conducted from July 1 to 30/2021 among randomly selected 405 women working in Hawassa industrial park. Data was collected using face-to-face interviews using a pre-tested structured questionnaire. The data was entered into Epi-data 3.1 and exported to SPSS Version 24 for statistical analysis. Bivariable and multivariable logistic regression analyses were used to identify factors associated with the unmet needs for family planning. Independent factors associated with the unmet need for family planning were assessed using AOR with their corresponding 95% CIs at P-value < 0.05 cut of point. Result: In this study, the prevalence of unmet need for family planning was 27.7% (95% CI 23.2 to 32.3). Educational status [AOR = 4.53; CI (1.62, −12.61)], marital status (AOR = 7.2; 95% CI: (3.77, 13.73)], residence [AOR = 0.56; 95% CI: (0.31, 0.99)], and knowledge of family planning [AOR = 0.36; 95% CI: (0.20, 0.63)] were independent predictors of unmet need for family planning. Conclusion: This study found that the prevalence of unmet needs for family planning was high. Educational status, marital status, residence, and knowledge of family planning were significantly associated with unmet needs of family planning.

El estudio explora el pensamiento del profesorado sobre lo que cree y lo que hace en sus diversas prácticas de enseñanza, todo ello mediante un cuestionario de escala Likert, una entrevista episódica y una observación de clase. Se analizaron las respuestas al cuestionario de 81 profesores de biología en servicio, 15 entrevistas episódicas y 9 clases de biología. Los resultados muestran que las creencias del profesorado sobre la enseñanza están en una perspectiva constructivista cuando piensan en lo que se debe y cree hacer, y en una perspectiva tradicional cuando se refiere a la explicación que sigue un libro de texto. El profesorado, además, concibe las prácticas de enseñanza como pautas de pensamiento y acción en tres dimensiones: disciplinar, didáctica y afectiva, siendo esta última la menos evidenciada en las clases observadas, las acciones de cuestionamiento las más representativas de la dimensión didáctica y la enseñabilidad del contenido científico como acción propia de la dimensión disciplinar.

Abstract Background Globally, at least 1 billion people have a vision impairment that could have been easily prevented or easily treated. Cataract is the leading preventable and most treatable causes of blindness and bilateral low vision among adults. Despite being the leading cause of preventable and most treatable blindness, the lack of knowledge about the disease and its option of treatment is still a major barrier in reducing the blindness owing to cataract in the developing countries particularly in Ethiopia. Hence, the aim of this study is to determine the level of knowledge about cataract and associated factors among adults in Yirgalem Town, Sidama National Regional State, Southern Ethiopia, 2020. Methods A community-based cross-sectional study design was conducted among randomly selected 599 adult’s age 18 years and above from May 10–30, 2020. A multi-stage sampling technique was used to select the study participants. Data were collected using pre-tested and structured face-to-face interview questionnaires. The collected data were entered to Epi data version 3.1 and then exported to SPSS version 21 for analysis. Bi-variable and multivariable logistic regression was used to identify associated factors of knowledge about cataract. Adjusted Odds Ratio (AOR) together with 95% Confidence Interval (CI) was used to declare the statistical association between dependent and independent variables. Results Of the total study participants, 379 (64.7%), [(95% CI: 60.7–68.6%)] of them had good knowledge about cataract. Age (≥40 years) [AOR = 2.29(95% CI 1.18–4.44)], Elementary school completed [AOR = 2.31(95% CI 1.30–4.10)], High school & above [AOR = 5.55(95% CI 2.81–10.89)], governmental and non-governmental employed [AOR = 5.62 (95% CI 2.78–11.38)], Merchant [AOR = 1.72(95% CI 1.03–2.88)], Positive Attitude [AOR = 3.85(95% CI 2.94–6.47)] were positively significantly associated with knowledge about cataract. Whereas, rural residence [AOR = 0.19 (95% CI: 0.12–0.31)] was negatively associated with knowledge about cataract. Conclusions More than one third of the participants still had poor knowledge about cataract. This implies that health facilities should be engaged and raises the awareness of the community and empowers people about eye care needs.

Abstract Background Neonatal near miss is a neonate who nearly died but survived from a severe complication occurred during pregnancy, birth or within 0–28 days of extra-uterine life. However, there is no available data that quantifies the magnitude of neonatal near miss (NNM) in Ethiopia where there is high prevalence of neonatal mortality. Therefore, this study is designed to provide information about the magnitude and associated factors of neonatal near miss among women who give a live birth at Hawassa City Governmental hospitals, 2019. Methods A facility based cross-sectional study design was conducted on 604 mothers who gave live neonates at Adare General Hospital and Hawassa University Comprehensive and Specialized Hospital from May 9, 2019 to June 7, 2019. Face to face interviewer administered structured questionnaire with a supplementation of maternal and neonatal medical records with checklists were used to collect the data. Data were coded and entered in to Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. Descriptive statistics was run and the data were presented using frequency tables and figure. The bi-variable and multivariable logistic regression was used to identify the possible factors of neonatal near miss. Finally, Adjusted Odds Ratio and 95% Confidence Intervals were used to declare statsticall significance. Result Among all 604 selected live births an overall proportion of NNM cases, 202 (33.4%) (95% CI: 29.7–37.1%) was obtained at Hawassa City Government Hospitals. Respiratory distress 158 (94%) and infection or sepsis 138 (84%) were found to be the leading causes of NNM cases in our study. Governmental and non-governmental employed mother (AOR = 3.05, 95% CI: 1.46–6.44) and Cesarean Section delivery (AOR = 1.89, (95% CI: 1.25–2.83)) were positively significantly associated with neonatal near miss. Whereas, pregnancy induced Hypertension (AOR = 0.43, 95%CI: 0.27–0.69) was negatively associated with neonatal near miss. Conclusion This study revealed relatively high prevalence of NNM in the study areas. Employed women, pregnancy induced hypertension and cesarean section mode of delivery were found to be independent factors affecting the prevalence of NNM cases. Therefore, HUCSH and Adare general Hospitals should focus on proving quality antenatal care and prevention of occupational related problems among pregnant women.

Background Even though colostrum discarding hurts child health, little is known about the extent of the problem and its contributing factors in Southern Ethiopia. This study aimed to determine the prevalence of colostrum avoidance practices and associated factors among mothers of children aged less than 12 months in Jinka town, South Ethiopia. Methods A community-based cross-sectional study was conducted at Jinka Town from March 1 to 30, 2020. A total of 420 mothers having children less than 12 months of age were selected by systematic sampling technique. The data were collected by using pretested interviewer-administered and semi-structured questionnaires. The data was entered using EPI DATA 3.1 and exported to SPSS version 23 for analysis. Descriptive statistics, binary and multivariable logistic regression analysis were done. Adjusted odds ratio with 95% CI at a p-value < 0.05 was estimated to identify statistically significant variables with colostrum avoidance practices. Results The prevalence of colostrum avoidance practice was 9.8% [95% CI: (6.9–12.5)]. Delayed initiation of breastfeeding [AOR = 9.08(95% CI 4.16–19.83)], lack of breastfeeding counseling [AOR = 2.33(95% CI 1.11–4.87)], home delivery of index child [AOR = 2.48 (95% CI 1.16–5.27)] and poor knowledge on breastfeeding [AOR = 4.55(95% CI 1.95–10.63)] were factors associated with colostrum avoidance practices. Conclusion Colostrum avoidance practice among mothers of children aged less than 12 months in Jinka town was high. Delayed initiation of breastfeeding, lack of breastfeeding counseling, home delivery, and knowledge of breastfeeding practice were factors associated with colostrum avoidance practice.

Background: Pelvic organ prolapse is a common disorder, with up to 40% of women worldwide having some form of anatomical prolapse, and it is a significant public health problem in developing countries including Ethiopia. The prevalence of pelvic organ prolapse in Ethiopia is 13% in Benchi Maji. This study is designed to provide information about the determinants of pelvic organ prolapse among gynecologic patients attending public referral hospitals in the Amhara region, 2020. Method: Institution-based unmatched case-control study design was conducted from March to June 2020 among randomly selected 348 mothers (116 cases and 232 controls). A convenient sampling technique was used to select cases, and controls were selected by systematic random sampling technique. A pre-tested and structured interviewer-administered questionnaire was used to collect the data. Data were coded and entered into Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. Finally, adjusted odds ratio and 95% confidence intervals were used to declare statistical significance. Result: The result showed that being unable to read and write (illiterate) (adjusted odds ratio = 3.91; 95% confidence interval = 1.06–14.39), age of women >= 40 (adjusted odds ratio = 2.91; 95% confidence interval = 1.255–6.736), giving first birth before age of 20 (adjusted odds ratio = 5.72; 95% confidence interval = 1.73–18.94), carrying heavy objects (adjusted odds ratio = 2.296; 95% confidence interval = 1.102–4.785), parity ⩾ 4 (adjusted odds ratio = 7.02; 95% confidence interval = 1.16–42.45), and family history of pelvic organ prolapse (adjusted odds ratio = 3.09; 95% confidence interval = 1.24–7.71) were significantly associated with pelvic organ prolapse. Conclusion: This study concluded that being unable to read and write, age ⩾ 40, multiparity, family history of pelvic organ prolapse, early childbirth, and carrying heavy objects were the risk factors of pelvic organ prolapse. Providing health education on planning the number of children, and the impact of carrying heavy loads on pelvic organs, preventing early childbirth, and encouraging women to pursue their education at least up to primary school level is recommended.

Background: Youth faces various sexual and reproductive health problems in developing countries like Ethiopia. Major health problems like unintended pregnancy, unsafe abortion, and sexually transmitted infections are common among youth in Ethiopia. This study aimed to determine the level of utilization of youth-friendly reproductive health services and associated factors among youth in Aleta Wondo town, southern Ethiopia, from 20 to 30 June 2020. Methods: A community-based cross-sectional study was conducted among youths of Aleta Wondo town from 20 to 30 June 2020. A total of 421 study participants were selected from households of selected kebeles in the town by using a systematic random sampling method. Data were collected using structured pretested face-to-face interviewer-administered questionnaires. The data were entered using Epi-data version 4.4.2 and exported to SPSS version 25 for analysis. Bivariate and multivariate logistic regression models were used to determine factors significantly associated with the utilization of youth-friendly reproductive health services. Adjusted odds ratio and 95% confidence interval with p value of

Background Regardless of its benefit in promoting maternal health, contributing to a healthy pregnancy, little is known concerning the prevalence of utilization of preconception care and its determinant in southern Ethiopia. Hence, this study designed to determine the prevalence of utilization of preconception care and contributing factors among pregnant women in West Guji Zone, Southern Ethiopia, 2021. Methods A community-based cross-sectional study was conducted among systematically selected 660 pregnant women in West Guji from June 15 to July 30, 2021. A pretested interviewer-administered structured questionnaire was used to collect the data. Data entry was done in Epidata version3.1 and exported to SPSS version 25 for analysis. Descriptive statistics were used to summarize the data. To identify the factors associated with the utilization of preconception care binary and multivariable logistic regression analysis was performed. Adjusted odds ratios (AOR) with 95% CI were estimated to assess the strength of associations and statistical significance was declared at a p-value < 0.05. Results One hundred-forty seven, 22.3% [95% CI (19.2, 25.4)] of mothers utilized preconception care. Being college and above [(AOR = 5.51 95%CI 91.43-21.19)] and secondary [(AOR = 4.46 95%CI (1.38-14.39)] in educational status, rich [(AOR = 4.23 95%CI (1.32-13.55)], having good knowledge about preconception care [AOR = 2.34 95%CI (1.05-5.28)], having a positive attitude towards preconception care [(AOR = 9.99 95%CI (4.25-23.48)] and deciding with her husband regarding maternal health services [(AOR = 4.71 95%CI (1.91-11.56)] were factors positively affecting utilization of preconception care. Conclusions The utilization of preconception care in the study area is low. Being college and above and secondary in educational status, rich, good knowledge, positive attitude towards preconception care, and deciding with her husband regarding maternal health services were independent factors promoting the utilization of preconception care. Information, education, and communication activities should be strengthened to increase awareness of mothers about preconception care.

Monitoring and controlling thermoelectric power plants (TPPs) operational parameters have become essential to ensure system reliability, especially in emergencies. Due to system complexity, operating parameters control is often performed based on technical know-how and simplified analytical models that can result in limited observations. An alternative to this task is using time series forecasting methods that seek to generalize system characteristics based on past information. However, the analysis of these techniques on large diesel/HFO engines used in Brazilian power plants under the dispatch regime has not yet been well-explored. Therefore, given the complex characteristics of engine fuel consumption during power generation, this work aimed to investigate patterns generalization abilities when linear and nonlinear univariate forecasting models are used on a representative database related to an engine-driven generator used in a TPP located in Pernambuco, Brazil. Fuel consumption predictions based on artificial neural networks were directly compared to XGBoost regressor adaptation to perform this task as an alternative with lower computational cost. AR and ARIMA linear models were applied as a benchmark, and the PSO optimizer was used as an alternative during model adjustment. In summary, it was possible to observe that AR and ARIMA-PSO had similar performances in operations and lower error distributions during full-load power output with normal error frequency distribution of −0.03 ± 3.55 and 0.03 ± 3.78 kg/h, respectively. Despite their similarities, ARIMA-PSO achieved better adherence in capturing load adjustment periods. On the other hand, the nonlinear approaches NAR and XGBoost showed significantly better performance, achieving mean absolute error reductions of 42.37% and 30.30%, respectively, when compared with the best linear model. XGBoost modeling was 8.7 times computationally faster than NAR during training. The nonlinear models were better at capturing disturbances related to fuel consumption ramp, shut-down, and sudden fluctuations steps, despite being inferior in forecasting at full-load, especially XGBoost due to its high sensitivity with slight fuel consumption variations.

A newborn has a limited capacity to maintain temperature when exposed to cold environment. Neonatal hypothermia, a common neonatal problem, carries high case fatality rate particularly if concurrently occurs with other neonatal problems. This study assessed neonatal thermal care practices and beliefs among rural women in west Guji Zone, south Ethiopia. A community based cross sectional quantitative study combined with qualitative study was undertaken in rural areas of west Guji Zone, Ethiopia. Randomly selected 388 rural mothers of infants less than 6 months old were participated in the quantitative study. Three focus group discussions were conducted among mothers of infants less than 6 months old. Quantitative data were collected by using structured and pretested Afaan Oromo version questionnaire adapted from relevant literatures. Qualitative data were collected by focus group discussion guide. The quantitative data were cleaned, coded and analyzed by SPSS version 20. Qualitative data were transcribed, translated, coded, and analyzed by thematic analysis approach. In general rural women believe that thermal protection of newborn is important. The findings show that approximately 75% and 85% of newborns were dried and wrapped respectively after delivery. However drying and wrapping of newborn are usually done after the first newborn’s bath. Just over 84% of newborns were bathed within the first 6 hours of delivery and majority of them were bathed with warm water. About 69.1% and 57.7% of women put head cover to their newborns immediately after birth, and initiated breast feeding within one hour of delivery respectively. Skin to skin care of newborn is non-existent in the study area and perceived as an odd, frightening and potentially dangerous practice. Studied women practice some of the recommended neonatal thermal cares and believe in their importance in keeping newborn warm. However, practice and beliefs about delayed first bath is against standard recommendation, whereas skin to skin care is non-existent and perceived as an odd practice. Interventions to familiarize skin to skin care and reduce misconceptions surrounding it should be introduced into the study area to improve thermal cares of high risk newborns.

There is little available evidence that quantifies the determinats of NNM in Ethiopia despite an increasing magnitude of neonatal mortality. Therefore, this study was designed to provide concrte evidence about the determinats of NNMS among neonates admitted to Guji and Borena Zones Public Hospitals, Southern Ethiopia, 2021. A facility based unmatched case control study design was conducted on 402 (134 cases and 268 controls) selected neonates admitted to Bule Hora, Adola and Yabelo General Hospitals from February 1-March 31, 2021. Cases were consecutively selected. Whereas for each case, two controls were selected by systematic random sampling technique. The data collection included a pretested and structured face-to-face interviewer administered questionnaire with a supplementation of maternal and neonatal medical records with checklists. Then the data were coded and entered in to Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. The descriptive statistics run and the results of the data were presented using frequencies, and tables. Bivariable and multi variable logistic regression was used for the analsysis of the data. Finally, Adjusted Odds Ratio together with 95% Confidence Intervals and p value

Hydrogen is seen as a future energy carrier since its chemical compounds make up a large part of the Earth’s surface. This study sought to analyze the impact related to the inclusion of hydrogen and oxygen gases produced on demand by an alkaline electrolyzer to the engine added directly through the fuel intake line. For this purpose, performance parameters were monitored, such as liquid fuel consumption and greenhouse gas emissions, and correlated to any effect observed on the engine’s power output and combustion behavior. A 58 kVA nominal power motor-generator was used, coupled with a resistive load bank (20 kW), where two fuel configurations were tested (diesel injection only and a mixture of diesel, hydrogen and oxygen) and compared. A total of 42 tests were performed considering both the admission gases into the fuel intake line and also diesel supply only for baseline. A substantial decrease in fuel consumption was observed (7.59%) when the blend configuration was used despite a decrease in the engine’s work (1.07%). It was also possible to see a common pattern between NO and NO2 emissions for both fuel configurations, while the behavior of the CO2 and CO emissions indicated a higher complete diesel burning fraction when using the gases on demand. Therefore, we can verify that the use of hydrogen and oxygen gases produced on demand in the fuel intake line is a promising alternative to provide a decrease in liquid fuel consumption and an overall improvement in engine combustion.

Objectives: Globally, novel coronavirus disease 2019 (COVID-19) has spread rapidly since it was first identified and challenging the provision of essential services for low-resource countries. Healthcare workers involved in providing care are at high risk of developing mental health problems. The aim of this was to determine the prevalence of depressive symptoms due to COVID-19 and associated factors among healthcare workers in the West Guji zone in public health facilities, southern Ethiopia. Methods: A facility-based cross-sectional study was conducted in public health facilities found in the West Guji zone. A simple random sampling technique was employed to select 283 study subjects. This study was used to assess the prevalence of depression symptoms using Depression, Anxiety and Stress Scale-21, a depression subscale. Descriptive statistics, binary and multiple logistic regressions were used. Adjusted odds ratios (AORs) with 95% confidence interval will be estimated to assess the strength of associations and statistical significance will be declared at a p -value < 0.05. Results: Out of 283 eligible healthcare workers, 275 respondents had participated in this study with a 97.2% response rate. The prevalence of depressive symptoms was 21.5%. The independent predictors associated with depressive symptoms due to COVID-19 were age (adjusted odds ratio = 2.35, 95% confidence interval = 1.126–3.95), family size (adjusted odds ratio = 3.56, 95% confidence interval = 1.09–11.62), alcohol use (adjusted odds ratio = 4.31, 95% confidence interval = 1.76–10.55), medical illness (adjusted odds ratio = 9.56, 95% confidence interval = 3.71–24.59), having training on COVID-19 (adjusted odds ratio = 0.37, 95% confidence interval = 0.17–0.81), and lack of knowledge on COVID-19 (adjusted odds ratio = 15.34, 95% confidence interval = 6.32–37.21). Conclusion: The prevalence of depressive symptoms among healthcare workers due to COVID-19 was high. Factors associated with depressive symptoms were age, family size, alcohol use, medical illness, having training on COVID–19, and lack of knowledge on COVID-19.

BackgroundCurtailing physical contact between individuals reduces transmission and spread of the disease. Social distancing is an accepted and effective strategy to delay the disease spread and reduce the magnitude of outbreaks of pandemic COVID-19. However, no study quantified social distancing practice and associated factors in the current study area. Therefore, the study aimed to assess social distancing practice and associated factors in response to COVID-19 pandemic in West Guji Zone, Southern Ethiopia, 2020.Methods and materialsA Community based cross-sectional study design was conducted among randomly selected 410 household members of Bule Hora Town, West Guji Zone. Data were collected by pre-tested interviewer administered structured questionnaire adapted from previous peer reviewed articles. The data were coded and entered in to Epi data version 3.5 and analyzed by SPSS version 23. The bivariate and multivariate logistic regressions analysis was done to identify factors associated with social distancing practice. Adjusted odds ratio with 95% confidence interval and p value ResultOut of 447 planned samples, 410 participants were successfully interviewed and included into final analysis; making the response rate of 91.7%. The median (±IQR) age of study participants was 28(±9) years. In this study, 38.3% [95% CI: 33.5%, 43.1%)] of the study participants have good social distancing practices for the prevention of COVID-19. Age group 26-30 years [AOR = 2.56(95% CI: 1.18-5.54)] and 31-35 years [AOR = 3.57(95%CI: 1.56-8.18)], employed [AOR = 6.10(95%CI: 3.46-10.74)],poor knowledge [AOR = 0.59 (95% CI:0.36-0.95)], negative attitude [AOR = 0.55 (95% CI:0.31-0.95)] and low perceived susceptibility [AOR = 0.33(95%CI: 0.20-0.54)] were significantly associated with good social distancing practice.ConclusionSocial distancing practice is relatively poor in the study area. The knowledge and attitude level of participants were identified to be the major factors for the observed poor social distancing practice. Sustained efforts to improve awareness and attitudes towards COVID-19 prevention might improve adherence to social distancing practices.

Background:. Primary traumatic anterior shoulder dislocations can be associated with displaced anterior glenoid rim fractures. Nonoperative treatment of such fractures has been shown to have excellent results in a small cohort of patients; as such, we have been treating these fractures nonoperatively, regardless of fragment size and degree of displacement, provided that post-reduction computed tomography scans revealed an anteroposteriorly centered humeral head. The aim of this study was to analyze the medium- to long-term results of nonoperative treatment of displaced anterior glenoid rim fractures, assessing in particular the residual instability and development of osteoarthritis. Methods:. In a 2-center study, 30 patients with a mean age of 48 years (range, 29 to 67 years) were evaluated clinically with use of the Subjective Shoulder Value, Constant score, American Shoulder and Elbow Surgeons score, and Western Ontario Shoulder Instability index, as well as radiographically with use of radiographs and computed tomography scans at a mean follow-up of 9 years (range, 5 to 14 years). Results:. Fracture-healing was documented in all patients. Seven patients (23%) had post-fracture onset of osteoarthritis (5 with Samilson grade I and 2 with Samilson grade IV). Of these, 1 patient had recurrent instability that was successfully treated with hemiarthroplasty 9 years after the index injury (relative Constant score, 101%), and was excluded from further analysis. No other patient had a recurrent redislocation, subluxation, or positive apprehension. The other 6 patients with new-onset radiographic osteoarthritis were pain-free (mean Constant score pain scale, 15 points) with good shoulder function (relative Constant score, 84% to 108%). A total of 26 patients (90%) rated their functional outcome as good or very good, and 3 patients (10%) rated it as fair. The mean relative Constant score was 97% (range, 61% to 108%), the mean American Shoulder and Elbow Surgeons score was 92 points (range, 56 to 100 points), and the mean Western Ontario Shoulder Instability index score was 126 points (range, 0 to 660 points). All patients returned to full-time work. Conclusions:. Nonoperative treatment of anterior glenoid rim fractures following primary traumatic anterior shoulder dislocation results in excellent clinical outcomes with a very low rate of residual instability and, thus, treatment failure. Asymptomatic radiographic osteoarthritis occurred in roughly 1 of 4 patients. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Background & Aim: Today, with the advent of technology, due to the growing data in the field of health care, it is difficult to manage and analyze this type of data known as the Big Data. This analysis has many capabilities to improve the quality of care, reduce errors and reduce costs in care services. Methods: This study is based on search of databases (PubMed, Google Scholar, Science Direct, and Scopus). This investigation has done with the websites and the specialized books with standard key words. After a careful study, 50 sources were in the final article. Results: Since the Big Data Analysis in the field of health has been growing and also considered in recent years, this survey identified the necessity of these analyses, the definition of the Big Data, the benefits, resources, architecture, applications, analysis, platforms, Examples and challenges in the field of health care. Conclusions: Familiarity with the big data concepts in the field of healthcare can help researchers in conducting applied research and thus improve the quality of health care services and reduce costs.

Super-resolution localization microscopy produces biophysical information in the form of estimated positions of single molecules. Here, Lindénet al. estimate the uncertainty of single localizations, and show that this additional information can improve data analysis and localization precision.

BackgroundPre-lacteal feeding is one of the major harmful practices being faced while feeding the newborns. Although it affects child health, little is known about the extent of the problem and its contributing factors in the study area. Therefore, this study aimed to figure the prevalence of pre-lacteal feeding practices and associated factors among mothers of children aged less than 12 months in Jinka Town.MethodsA community-based cross-sectional study was conducted at Jinka Town from March 1 to 30, 2019. A total of 430 mothers, having children less than 12 months of age, were selected by systematic sampling technique. The data were collected by using pretested and interviewer- administered structured questionnaires. The data were entered using epidata 4.2.1 and exported to SPSS version 23 for analysis. Adjusted odds ratios, 95% confidence intervals and p-values were reported.ResultsThe prevalence of pre-lacteal feeding practice was 12.6% [95% CI (9.5-15.7)]. Having no maternal education [AOR = 4.82(95%CI 1.60-14.24)], colostrum avoidance [AOR = 4.09(95% CI 1.62-7.67)], lack of breast feeding counseling [AOR: = 2.51(95% CI 1.20-5.25)], home delivery [AOR = 3.34 (95% CI 1.52-7.33)], lack of knowledge about risks of pre-lacteal feeding [AOR = 2.86 (95% CI 1.30-6.29] and poor knowledge on breast feeding practices [AOR = 3.63(95% CI 1.62-8.11)] were factors associated with pre-lacteal feeding practices.ConclusionPre-lacteal feeding practice among mothers of children aged less than 12 months in Jinka town was found to be higher than the national prevalence. Illiterate, colostrum avoidance, lack of breastfeeding counseling, home delivery, lack of knowledge on the risk of pre-lacteal feeding, and poor knowledge on breastfeeding practice were factors associated with pre-lacteal feeding practices.

ABSTRACT Background: The health benefits associated with moderate wine consumption, as with ethanol and phenolic compounds, include different mechanisms still little understandable. Aim: Evaluate glycemic and weight variations, and the deposit of triglycerides, cholesterol and liver glycogen with red wine consumption. Methods: 60 ApoE knockout mice were divided into three groups of 20: Wine Group (WG), Ethanol Group (EG) and Water Group (WAG). They received daily: WG 50 ml of wine and 50 ml water; EG 6 ml ethanol and WAG 94 ml of water. All groups were followed for four months. The food intake was monitored daily, in the period from eight to ten hours and held every five days. The measurement of water intake was also made every five days. The weighing of the animals took place every ten days. Results: The WG had higher weight increase as compared to the other groups. The concentration of hepatic triglyceride was higher in WG (57%) and the EG group was lower (31.6%, p

PURPOSE: To evaluate macro and microscopically, changes following the use of the aqueous extract of babassu (Orbignya phalerata) in the lung parenchyma and pleura of rats. METHODS: Sixty adult male rats with average weight of 350 g, were randomized into two groups of 30 animals (experimental and control) further divided into sub-groups of 10 to be sacrificed at 48 h, 72 h and 21 days. The substance was injected into the right pleura of the animals. RESULTS: There was intense pleuropulmonary macroscopic reaction with statistically significant differences between groups respectively (p0.05). CONCLUSION: The aqueous extract of babassu (Orbignya phalerata) was found to be highly irritating to the pleura and lung of rats, evidenced macroscopically by numerous adhesions and inflammation while no major changes were evident microscopically.

OBJETIVO: Avaliar a espirometria no pré e pós-operatório de doentes com sequela de tuberculose, submetidos à lobectomia. MÉTODOS: Foram selecionados 20 doentes, com idade entre 15 e 56 anos, de ambos os sexos, com história pregressa de tratamento de tuberculose, apresentando infecção de repetição ou hemoptises. Foram submetidos à lobectomia pulmonar. O tempo de tratamento da tuberculose foi seis meses e o aparecimento dos sintomas entre um e 32 anos. Foram avaliadas a capacidade vital (CV), a capacidade vital forçada (CVF), o volume expiratório forçado (VEF1), o VEF1/CVF, o fluxo expiratório forçado (FEF) e o pico de fluxo expiratório (PFE) após o primeiro, terceiro e sexto meses em relação ao pré-operatório. O nível de significância (á) aplicado em todos os testes foi 5%, ou seja, considerou-se significativo quando pOBJECTIVE: To evaluate pre and post-operative spirometry in patients with tuberculosis sequelae undergoing lobectomy. METHODS: We selected 20 patients, aged between 15 and 56 years, of both genders, with a history of tuberculosis treatment, with repeated infections or hemoptysis and indication of pulmonary lobectomy. The tuberculosis treatment time was six months, and onset of symptoms, between one and 32. We evaluated and compared vital capacity (VC), forced vital capacity (FVC), forced expiratory volume (FEV1), the FEV1/FVC, forced expiratory flow (FEF) and peak expiratory flow (PEF) preoperatively and after the first, third and sixth postoperative months (POM). The significance level (á) used in all tests was 5%, ie, it was considered significant when p

Desde la perspectiva del Proyecto Curricular de Licenciatura en Biología (PCLB), la Investigación se convierte en un elemento de vital importancia en la formación inicial de profesores de Biología, desde una mirada crítica y transformadora que repercute en el diseño y ejecución de los “Proyectos de práctica pedagógica” y posteriormente en los Trabajos de Grado.

INTRODUÇÃO: O mesocarpo de Orbignya phalerata tem sido usado em estudos experimentais procurando verificar sua ação pró-inflamatória. OBJETIVO: Analisar comparativamente as alterações histológicas proporcionadas pelo extrato aquoso do babaçu nas feridas cutâneas. MÉTODOS: Sessenta ratos da linhagem Wistar, adultos, machos, foram utilizados. O procedimento experimental constituiu-se em uma incisão circular de 2cm de diâmetro na pele com punch metálico. Após este procedimento comum a todos, os animais foram distribuídos aleatoriamente em dois grupos contendo 30 animais cada. No grupo controle não foi utilizada a substância pesquisada e sim, solução fisiológica (Cloreto de sódio a 0,9%). No grupo experimento utilizou-se solução aquosa de Orbignya phalerata em uso tópico. Os animais foram acompanhados e mortos em sete, 14 e 21 dias. Foi feita análise histológica comparativa entre os grupos. RESULTADOS: Observou-se diferença significativa a favor da cicatrização do grupo experimento em relação ao grupo controle nos 7º e 14º dias, no que diz respeito à reepitelização. CONCLUSÃO: O uso tópico do mesocarpo de Orbignya phalerata (Babassu) contribuiu positivamente para a cicatrização das feridas cutâneas em ratos com a dosagem de 25mg/ml.INTRODUCTION: The mesocarp of Babassu (Orbignya phalerata) has been used in experimental studies trying to check its pro-inflammatory effect. PURPOSE: To analyse comparatively the histological changes made by the water extract of Babassu in skin surgical wounds. METHODS: Sixty Wistar adults male rats were used. The experimental procedure was a circle skin incision of 2 cm in diameter made with a metal punch. After this procedure done in all animals, they were randomized in two groups of 30. In the control group, the phytotherapic agent wasn't used but saline solutin. In the experimental group, the water extract of Orbignya phalerata was used in the cut sites. All animals were followed and killed after seven, 14 and 21 days. Comparative histological analysis was made among the groups. RESULTS: In the microscopic view, a significant reepitelization effect on the healing process of the experimental group in relation to the control group in the 7th and 14th days, was recognized. CONCLUSION: The use of the mesocarp of Orbignya phalerata in skin surgical wounds contributed positively in the healing process in rats.

Presentamos resultados parciales de la primera fase de la investigación Estado del arte de las características del campo de conocimiento sobre la enseñanza de la Biología (EB), financiada por el Centro de Investigaciones de la Universidad Pedagógica Nacional. En este trabajo se sistematizó el contenido de 161 artículos sobre EB publicados durante los años 2007 y 2008 en 17 revistas especializadas, preguntándonos si existe un campo de conocimiento y una comunidad académica que se ocupe de este asunto. La metodología que orientó esta investigación corresponde a un enfoque cualitativo-interpretativohermenéutico, la estrategia de análisis documental y la modalidad de estado del arte. Para abordar el problema de investigación, nos basamos en los criterios que se han acogido para la caracterización de la didáctica de las ciencias. Aunque a partir de los hallazgos no podemos afirmar que la EB corresponde a un campo de conocimiento, identificamos tendencias a favor de dicha tesis, siendo necesario ampliar el periodo de tiempo de análisis de las publicaciones.

Ésta es la primera de dos ponencias que el Grupo Conocimiento Profesional del Profesor de Ciencias presenta en torno a los resultados parciales del proyecto de investigación, Construcción del Conocimiento Profesional del Profesor de Biología (CPPB), en el contexto del Proyecto Curricular de Licenciatura en Biología (PCLB) de la Universidad Pedagógica Nacional 1 .

Presentamos resultados parciales de la investigación Las Prácticas de Campo planificadas en el Proyecto Curricular de Licenciatura en Biología de la Universidad Pedagógica Nacional, caracterización desde la perspectiva del Conocimiento Profesional del Profesor de Biología. Dicha investigación pretende caracterizar las Prácticas de Campo planificadas por parte de los formadores de formadores y su aporte a la construcción del Conocimiento Profesional de los futuros profesores de Biología. Para este caso, concretamente nos referimos a la planificación de las Prácticas de Campo de primer semestre con base en las guías, el documento de presentación del semestre y los programas de los espacios académicos del semestre involucrados en la salida de campo. La caracterización se llevó a cabo desde un enfoque cualitativo, a partir del método de análisis de contenido, teniendo en cuenta un sistema de categorías empleado para el análisis de Trabajos Prácticos en la enseñanza de la Biología. Encontramos resultados con respecto a la tipología del trabajo, la integración de espacios académicos, los referentes epistemológicos y la reflexión docente en la formación inicial.

Presentamos resultados parciales de la investigación Construcción del Conocimiento Profesional del Profesor de Biología (CPPB), en el Proyecto Curricular de Licenciatura en Biología (PCLB) de la Universidad Pedagógica Nacional, particularmente sobre los aspectos formativos de dos actividades curriculares (diseño de Unidades Didácticas UDy formulación de anteproyectos pedagógicos APP).

El presente escrito muestra el trabajo de práctica pedagógica I y II desarrollado al interior del Grupo de Investigación Conocimiento Profesional del Profesor de Ciencias, en la Universidad Pedagógica Nacional (UPN) durante el 2007-2008 con estudiantes de sexto semestre de Licenciatura en Biología, con el fin de contribuir a la construcción del Conocimiento Profesional del Profesor de Biología, a través de las prácticas de campo como estrategia en la enseñanza de la biología. En un primer acercamiento, se indagó las concepciones de los estudiantes acerca de la relación entre las prácticas de campo y el Conocimiento Profesional del Profesor de Biología, evidenciando que consideraban la importancia de éstas, únicamente, a partir de su rol como aprendices y su incidencia en la construcción del Conocimiento Biológico, sin tener en cuenta la importancia de éstas en su quehacer como docentes. En este sentido, como contenido formativo favorecer en los estudiantes de sexto semestre, la práctica de campo como una estrategia en la enseñanza de la biología, para esto se plantearon talleres, reflexiones y un espacio en el cual los futuros profesores diseñaron una práctica de campo para alumnos de segundo grado de educación básica de una Institución Educativa Distrital. Dichos espacios y reflexiones permitieron a los futuros maestros, considerar la práctica de campo como una estrategia en la enseñanza de la biología la cual aporta a la construcción de un Conocimiento propio del profesor de biología

The conflict between classical and quantum physics can be identified through a series of yes-no tests on quantum systems, without it being necessary that these systems be in special quantum states. Kochen-Specker (KS) sets of yes-no tests have this property and provide a quantum-versus-classical advantage that is free of the initialization problem that affects some quantum computers. Here, we report the first experimental implementation of a complete KS set that consists of 18 yes-no tests on four-dimensional quantum systems and show how to use the KS set to obtain a state-independent quantum advantage. We first demonstrate the unique power of this KS set for solving a task while avoiding the problem of state initialization. Such a demonstration is done by showing that, for 28 different quantum states encoded in the orbital-angular-momentum and polarization degrees of freedom of single photons, the KS set provides an impossible-to-beat solution. In a second experiment, we generate maximally contextual quantum correlations by performing compatible sequential measurements of the polarization and path of single photons. In this case, state independence is demonstrated for 15 different initial states. Maximum contextuality and state independence follow from the fact that the sequences of measurements project any initial quantum state onto one of the KS set’s eigenstates. Our results show that KS sets can be used for quantum-information processing and quantum computation and pave the way for future developments.

OBJETIVO: Avaliar a espirometria no pré e pós-operatório de doentes com sequela de tuberculose, submetidos à lobectomia. MÉTODOS: Foram selecionados 20 doentes, com idade entre 15 e 56 anos, de ambos os sexos, com história pregressa de tratamento de tuberculose, apresentando infecção de repetição ou hemoptises. Foram submetidos à lobectomia pulmonar. O tempo de tratamento da tuberculose foi seis meses e o aparecimento dos sintomas entre um e 32 anos. Foram avaliadas a capacidade vital (CV), a capacidade vital forçada (CVF), o volume expiratório forçado (VEF1), o VEF1/CVF, o fluxo expiratório forçado (FEF) e o pico de fluxo expiratório (PFE) após o primeiro, terceiro e sexto meses em relação ao pré-operatório. O nível de significância (á) aplicado em todos os testes foi 5%, ou seja, considerou-se significativo quando p

The Morgagni hernia is the rarest kind of diaphragmatic hernia , occurring in 3% of all cases. It consists of the protrusion of the abdominal content into the thoracic cavity including omentum and transverse colon, among others. It is more common in the right side and appears more frequently after 40 years of age or after a raise in the intra-abdominal pressure. Patients with Morgagni hernia are usually asymptomatic. In the X-ray it appears like an opaque image in the cardiophrenic angle.Surgical correction is the treatment of choice for this conditions. We present one case of Morgagni hernia successfully treated.

Thymomas are rare neoplasms of mediastinum. We present two cases of large asymptomatic thymomas exceeding the mediastinal space and surgically managed in an university hospital. The larger tumor weighted 950g and the other 500g.

Although the production of carboxymethylcellulose from different raw materials is commercial, its preparation from agro-industrial residues has still been poorly explored in terms of performance, cost-effectiveness, and sustainability. Here, sugarcane bagasse was used as raw material for the carboxymethylcellulose (CMCb) synthesis within the biorefinery context. Sequential treatments were used for the removal of hemicellulose and lignin and the isolation of cellulose, whose conversion into CMCb was carried out through treatments with NaOH and monochloroacetic acid (MCA). The chemical modifications led to a CMCb with a substitution degree of 0.44, purity of 71.3 %, and 32 % crystallinity. Our residue-based CMCb was adequate for microorganism encapsulation, a high-value application, promoting viable conidia after 5 months of storage in equivalent conditions of high-purity, commercial CMC. Our findings show a route for the preparation of valuable polysaccharides from waste in future biorefineries, which, depending on their characteristics, can be applied in different processes. Here we use them for the encapsulation of a bioagent, although they can easily be used in other applications such as packaging and coating., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Currently, standardized magnetic resonance imaging (MRI) scoring systems and protocols for assessment of idiopathic inflammatory myopathies (IIMs) in children and adults are lacking. Therefore, we will perform a scoping review of the literature to collate and evaluate the existing semi-quantitative and quantitative MRI scoring systems and protocols for the assessment and monitoring of skeletal muscle involvement in patients with IIMs. The aim is to compile evidence-based information that will facilitate the future development of a universal standardized MRI scoring system for both research and clinical applications in IIM. A systematic search of electronic databases (PubMed, EMBASE, and Cochrane) will be undertaken to identify relevant articles published between January 2000 and October 2023. Data will be synthesized narratively. This scoping review seeks to comprehensively summarize and evaluate the evidence on the scanning protocols and scoring systems used in the assessment of diagnosis, disease activity, and damage using skeletal muscle MRI in IIMs. The results will allow the development of consensus recommendations for clinical practice and enable the standardization of research methods for the MRI assessment of skeletal muscle changes in patients with IIMs., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: To define disease activity measures, muscle strength and functional assessments in new-onset juvenile dermatomyositis (JDM) patients, at disease onset and follow up., Methods: A registry was set up in 18 hospitals, enrolling patients over 3-years (2015-2018). Clinical assessments were performed at baseline, and at 6, 12, 18 and 24 months after diagnosis. Disease Activity Score (DAS20), skin and musculoskeletal DAS sub-scales; Manual Muscle Test (MMT8); Childhood Myositis Assessment Scale (CMAS); Childhood Health Assessment Questionnaire disability index (CHAQ&#95;DI 0-3) and 10 cm Visual Analog Scale (VAS) for overall wellbeing scores were compared by Poisson Model and Wald post-test for repeated measures., Results: Ninety-six cases, being 61 (64%) females, median age 10 years had JDM diagnosis and 12 (13%) onset calcinosis. Mean ±SD scores at diagnosis and 6 months intervals for DAS20 (0-20) were 7.8±5, 6.3 ±4.8, 5±4, 4.9 ±5 and 0.5 ±2.3; with significant difference from baseline (p<0.01). Skin DAS subscales were 2.8±3.3, 1.8±2.9, 1,1±2.2, 0.6±1.8, 0.4±1.5. MMT (0-80) 62.6±20.4, 70.2±13.5, 73.3±11, 75.7±7.9 and 74.8±7.8, with significant difference from baseline up to 6 months (p=0.016); CMAS (0-53) 29.5±11.4, 33.1±8.3, 34.2±5.8, 34±6 and 33.3±5.4. CHAQ-DI (0-3) 1±0.9, 0.6±0.7, 0.8±0.8, 1±0.8 and 1±0.3; parents VAS 4.1±2.5, 2±2.1; 1.3±2.8, 4.1±3.1, 1.7±2.2. There was no significant difference for CMAS, CHAQ-DI and parents VAS from baseline up to 24-month assessment., Conclusions: DAS20 scores improved gradually during follow up, MMT8 improved significantly during the first 6 months and CMAS, CHAQ-DI and parents VAS scores had no significant improvement with persistent functional impairment over 2-years.

Objective: To evaluate the influence of environmental factors and prematurity relating to juvenile dermatomyositis (JDM), its course and refractoriness to treatment., Methods: A case-control study with 35 patients followed up at a tertiary hospital and 124 healthy controls, all residents of São Paulo. Patients were classified according to monocyclic, polycyclic or chronic disease courses and refractoriness to treatment. The daily concentrations of pollutants (inhalable particulate matter-PM 10 , sulfur dioxide-SO 2 , nitrogen dioxide-NO 2 , ozone-O 3 and carbon monoxide-CO) were provided by the Environmental Company of São Paulo. Data from the population were obtained through a questionnaire., Results: Fifteen patients had monocyclic courses, and 19 polycyclic/chronic courses. Eighteen patients were refractory to treatment. Maternal occupational exposure to inhalable agents (OR = 17.88; IC 95% 2.15-148.16, p = 0.01) and exposure to O 3 in the fifth year of life (third tertile > 86.28µg/m 3 ; OR = 6.53, IC95% 1.60-26.77, p = 0.01) were risk factors for JDM in the multivariate logistic regression model. The presence of a factory/quarry at a distance farther than 200 meters from daycare/school (OR = 0.22; IC 95% 0.06-0.77; p = 0.02) was a protective factor in the same analysis. Prematurity, exposure to air pollutants/cigarette smoke/sources of inhalable pollutants in the mother's places of residence and work during the gestational period were not associated with JDM. Prematurity, maternal exposure to occupational pollutants during pregnancy as well as patient's exposure to ground-level pollutants up to the fifth year of life were not associated with disease course and treatment refractoriness., Conclusion: Risk factors for JDM were maternal occupational exposure and exposure to O 3 in the fifth year of life., (© 2024. The Author(s).)

Despite being composed of recyclable materials, the main technological challenge of multilayer carton packs involves the efficient decompatibilization of the cellulosic, polymeric, and metallic phases. Here, a simple two-step mechanochemical process is described that uses only aqueous media and mechanical force to promote phase separation in order to fully recycle multi-layer carton packaging. The first step produces value-added micro- and nanocellulose, while in the second step, aluminum is extracted, forming precipitated aluminum and aluminum oxyhydroxides. Solid polyethylene (PE) remains with a degree of purity defined by the process efficiency. The results show that cellulose is efficiently extracted and converted into micro- and nanocellulose after 15 min of milling. In the second stage, approximately 90% of the aluminum is extracted from the PE after 15 min of milling. Due to the separation and drying medium conditions, the finely divided particles of extracted aluminum also have oxyhydroxides in their composition. It is believed that a passivation layer forms on the metallic aluminum particle. The techno-economic analysis revealed a positive net present value (NPV) of $17.5 million, with a minimum selling price of 1.62 USD/kg of cellulose. The environmental analysis concluded that most of the environmental impact of the process is associated with the entry of carton packages into the system, incorporating a small environmental load related to the industrial process. The results indicate a promising option toward a circular economy and carbon neutrality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: The skin ischemia and necrosis (SKIN) score was introduced to standardize the assessment of mastectomy skin flap necrosis (MSFN) severity and the need for reoperation. The authors evaluated the association between the SKIN score and the long-term postoperative outcomes of MSFN after mastectomy and immediate breast reconstruction., Methods: The authors conducted a retrospective cohort study of consecutive patients who developed MSFN after mastectomy and immediate breast reconstruction from January of 2001 to January of 2021. The primary outcome was breast-related complications after MSFN. Secondary outcomes were 30-day readmission, operating room (OR) débridement, and reoperation. Study outcomes were correlated with the SKIN composite score., Results: The authors identified 299 reconstructions in 273 consecutive patients with mean follow-up time of 111.8 ± 3.9 months. Most patients had a composite SKIN score of B2 (25.0%, n = 13), followed by D2 (17.3%) and C2 (15.4%). We found no significant difference in rates of OR débridement ( P = 0.347), 30-day readmission ( P = 0.167), any complication ( P = 0.492), or reoperation for a complication ( P = 0.189) based on the SKIN composite score. The composite skin score was a poor predictor of reoperation, with an area under the curve of 0.56. A subgroup analysis in patients who underwent implant-based reconstruction revealed no difference in rates of OR débridement ( P = 0.986), 30-day readmission ( P = 0.530), any complication ( P = 0.492), or reoperation for a complication ( P = 0.655) based on the SKIN composite score., Conclusions: The SKIN score was a poor predictor for postoperative MSFN outcomes and reoperation. An individualized risk-assessment tool that incorporates the anatomic appearance of the breast, imaging data, and patient-level risk factors is needed., Clinical Question/level of Evidence: Risk, IV., (Copyright © 2023 by the American Society of Plastic Surgeons.)

Background: Mastectomy skin flap necrosis (MSFN) is a common complication following mastectomy that causes significant distress to patients and physicians and also compromises oncologic, surgical, and quality-of-life outcomes., Objectives: We sought to investigate the long-term outcomes of MSFN following implant-based reconstruction (IBR) and determine the rates and predictors of post-MSFN complications., Methods: This was a 20-year analysis of consecutive adult (>18 years) patients who developed MSFN following mastectomy and IBR from January 2001 to January 2021. Multivariable analyses were performed to identify factors associated with post-MSFN complications., Results: We identified 148 reconstructions, with a mean follow-up time of 86.6 ± 52.9 months. The mean time from reconstruction to MSFN was 13.3 ± 10.4 days, and most cases (n = 84, 56.8%) were full-thickness injuries. Most cases (63.5%) were severe, 14.9% were moderate, and 21.6% were mild. Forty-six percent (n = 68) developed a breast-related complication, with infection being the most common (24%). An independent predictor of overall complications was longer time from reconstruction to MSFN (odds ratio [OR], 1.66; P = .040). Aging was an independent predictor of overall complications (OR, 1.86; P = .038); infection (OR, 1.72; P = .005); and dehiscence (OR, 6.18; P = .037). Independent predictors of dehiscence were longer interval from reconstruction to MSFN (OR, 3.23; P = .018) and larger expander/implant size (OR, 1.49; P = .024). Independent predictors of explantation were larger expander/implant size (OR, 1.20; P = .006) and nipple-sparing mastectomy (OR, 5.61; P = .005)., Conclusions: MSFN is associated with high risk of complications following IBR. Awareness of the timing and severity of MSFN and the predictors of post-MSFN complications is crucial for guiding evidence-based decision-making and improving outcomes., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: We evaluated cardiac function in juvenile idiopathic arthritis (JIA) patients by 2D speckle-tracking echocardiography (2DSTE) and to assess possible associations with clinical, laboratorial, and treatment data., Methods: A group of 42 JIA patients and 42 healthy controls were evaluated using both conventional echocardiography and 2DSTE. JIA patients underwent clinical and laboratory assessment., Results: Conventional echocardiography data demonstrated normal left ventricular (LV) ejection fraction in both groups (71 vs. 71%; p = .69). 2DSTE analysis demonstrated that JIA patients presented significantly lower LV global systolic longitudinal strain (LVGLS) (-18.76 vs. -22%; p < .0001), LV systolic strain rate (LVSSR) (1.06 vs. 1.32 s-1; p < .0001), LV diastolic strain rate (LVDSR) (1.58 vs. 1.8 s-1; p < .0137), right ventricular global systolic strain (RVGLS) (-24.1% vs. -27.7%; p = .0002), and right ventricular systolic strain rate (RVSSR) (1.4 vs. 1.8 s-1; p = .0035). JIA patients under biological agents presented higher LVGLS (p = .02) and RVLS (p = .01). We also detected an association between LVGLS and C-reactive protein [CRP; -20% in normal CRP (10/42) vs. -18% in elevated CRP patients (32/42), p = .03]., Conclusions: JIA patients present different echocardiographic status from healthy patients. Moreover, our data suggest that JIA patients under biological agents present association with better cardiac function as shown by strain analysis., (© Japan College of Rheumatology 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: To assess mental health and life conditions in adolescents with autoimmune rheumatic diseases (ARDs) and healthy controls quarantined during COVID-19 pandemic., Method: A cross-sectional study included 155 ARD adolescents and 105 healthy controls. Online survey included self-reported strengths and difficulties questionnaire (SDQ), and a semi-structured questionnaire with demographic data, daily home and school routine, physical activities, and COVID-19 information during the pandemic., Results: Among patients, 56% had juvenile idiopathic arthritis (JIA), 29% juvenile systemic lupus erythematosus (JSLE), and 15% juvenile dermatomyositis (JDM). No differences were found regarding sex, ethnicity, and current age between ARD patients and controls (p > 0.05). Abnormal emotional SDQ (38% vs. 35%, p = 0.653) were similar in both groups. Logistic regression analyses in ARD patients demonstrated that female (OR = 2.4; 95%CI 1.0-6.0; p = 0.044) was associated with severe emotional SDQ dysfunction, whereas sleep problems were considered as a risk factor for both worse total SDQ (OR = 2.6; 95%CI 1.2-5.5; p = 0.009) and emotional SDQ scores (OR = 4.6; 95%CI 2.2-9.7; p < 0.001). Comparisons between ARD patients with and without current prednisone use showed higher median scores of peer problems in the first group [3 (0-10) vs. 2 (0-7), p = 0.049], whereas similar median and frequencies between JIA, JSLE, and JDM (p > 0.05)., Conclusions: Approximately one third of JIA, JSLE, and JDM patients presented abnormal total and emotional scores of SDQ during COVID-19 quarantine. Sleep problems were the main factor associated with emotional difficulties in these ARD adolescents. The knowledge of mental health issues rates in adolescents with ARD supports the development of prevention strategies, like sleep hygiene counseling, as well as the references of the affected patients to specialized mental health services, as necessary. Key Points • One third of ARD patients presented mental health issues during COVID-19 quarantine • Sleep problems were associated with emotional difficulties. • It is necessary to warn pediatric rheumatologists about the importance of sleep hygiene counseling., (© 2022. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)