Frequent Conditions Research Articles

Clinical indications associated with new opioid use for pain management in the United Kingdom: using national primary care data.

Prescription opioids for noncancer pain in the United Kingdom have increased over the past 2 decades, alongside associated harms. Policies addressing opioid prescribing must be tailored to individual patient needs with specific disease systems. The aim of this study was to evaluate clinical conditions associated with new opioid initiation in noncancer pain using nationally representative UK data. Primary care electronic health records from January 1, 2006, to September 31, 2021, were used from the Clinical Research Practice Datalink to identify incident opioid prescriptions. Patient histories were reviewed using code lists for opioid-related conditions with a 5-year look-back for chronic conditions and a 1-year look-back for surgical indications before opioid initiation. In total, 3,030,077 new opioid use episodes in 2,027,402 patients were identified, with 61% being women, 77% aged 45 years and older, and 48% from the highest deprivation quintile. Ten systems associated with opioid initiation were identified, which were not mutually exclusive, as patients could have opioids prescribed for multiple indications. The most common were musculoskeletal (80.8%), respiratory (57.6%), infections (30.4%), trauma/injury (20.4%), neurology (19.9%), and postsurgical indications (5.5%). Osteoarthritis (60.7%) and low back pain (41.0%) were the most frequent musculoskeletal conditions. Orthopedic surgeries accounted for 41.2% of all postsurgical indications. This is the first study in the United Kingdom evaluating large-scale national data to assess indications associated with opioid initiation. Nearly 3 quarters of new opioid prescriptions for noncancer pain were in patients with musculoskeletal conditions, often for conditions with limited evidence for opioid efficacy. These findings could inform targeted interventions and future policies to support nonpharmacological interventions in the most common conditions where opioid harms outweigh benefits.

Ensemble LVQ Model for Photovoltaic Line-to-Line Fault Diagnosis Using K-Means Clustering and AdaGrad

Line-to-line (LL) faults are one of the most frequent short-circuit conditions in photovoltaic (PV) arrays which are conventionally detected and cleared by overcurrent protection devices (OCPDs). However, OCPDs are shown to face challenges when detecting LL faults under critical detection conditions, i.e., low mismatch levels and/or high fault impedance values. This occurs due to insufficient fault current, thus leaving the LL faults undetected and leading to power losses and even catastrophic fire hazards. To compensate for OCPD deficiencies, recent studies have proposed modern artificial intelligence (AI)-based methods. However, various limitations can still be witnessed even in AI-based methods, such as (i) most of the models requiring a massive training dataset, (ii) critical fault detection conditions not being taken into consideration, (iii) models not being accurate enough when dealing with critical conditions, etc. To this end, the present paper proposes a learning vector quantization (LVQ)-based ensemble learning model in which three LVQs are individually trained to detect and classify LL faults in PV arrays. The initial LVQ vectors are determined using the k-means clustering method, and the learning rate is optimized by the adaptive gradient (AdaGrad) optimizer. The training and testing datasets are collected according to the PV array’s current–voltage (I–V) characteristic curve, and several features are extracted based on the Canberra and chi-squared distance techniques. The model utilizes a small training dataset, considers various critical detection conditions for LL faults—such as different mismatch levels and fault impedance values—and the final experimental results show that the model achieves an impressive average accuracy of 99.26%.

Experimental study on seismically isolated systems using a novel roller-type bearing with energy dissipation capacity

The roller-type isolation bearing is highly effective in limiting the transmission of lateral seismic forces to the superstructure. This paper introduces a novel roller-type bearing with energy dissipation capacity (RB-EDC), which includes flat bearing seats, rollers, limit plates with energy dissipation capability, and limit rings. The RB-EDC is characterized by its excellent energy dissipation capacity, simple manufacturing process, low cost, vertical tensile bearing capacity and stable performance in extremely cold regions due to its specific configuration and materials. The design procedure for the RB-EDC is detailed herein. Subsequently, pseudo-dynamic comparison tests were conducted on both a seismic isolation system specimen and a RC column specimen under frequent and rare earthquake conditions to validate the damping performance of the RB-EDC. The seismic isolation system consists of the RB-EDC and an RC column identical to the RC column specimen. The results indicate that, compared to the RC column specimen, the column in the seismic isolation system specimen significantly reduces crack distribution ranges, rebar strain, concrete strain, and displacement at the column top under seismic actions. The RB-EDC exhibits significant energy dissipation capacity even during frequent earthquakes, demonstrating effective damping performance. However, the residual displacement of the RB-EDC increases with seismic intensity, which may impact the damping performance of the bearing in future potential earthquakes, indicating the need for further redesign to incorporate self-centering capacity.

Prevalence of schizophrenia spectrum disorders in the Lazio region, Italy: use of an algorithm based on health administrative databases

BackgroundMental healthcare provision is undergoing substantial reconfiguration in many regions of the world. Such changes require a broad, evidence-based approach incorporating epidemiological data and information on local needs. The objective of this study was to estimate the prevalence of schizophrenia spectrum disorders (SSD) in the Lazio region and its geographical distribution using regional administrative healthcare databases.MethodsCases of SSD (15–64 years old) were identified using an algorithm based on data from the hospital discharge registry (ICD IX CM: 295, 297, 298 [excl. 298.0], 299) and the ticket exemption database [code 044], between 2006 and 2019. We calculated crude, age- and gender-specific prevalence estimates on December 31, 2019. We also calculated age- and gender-adjusted prevalence to compare prevalence in different regional areas.ResultsWe identified 18,371 cases. The overall prevalence was 5.03 per 1000 population (95% CI 4.96–5.10). Age-adjusted prevalence estimates were 4.18 (95% CI 4.09–4.27) per 1000 for women and 5.92 (95% CI 5.81–6.04) per 1000 for men. The prevalence was higher among older age groups, in both genders. There were differences in prevalence within the region, ranging from 4.25/1000 in the province of Viterbo to 5.42/1000 in Rome and 6.02/1000 in the province of Frosinone. When we analysed the subcategories of SSD, the three most frequent conditions were schizophrenia, schizoaffective disorder, and psychosis NOS. In general, the prevalence was higher in men for all the conditions but delusional disorders and brief psychosis.ConclusionsOur results show that the overall prevalence of SSD among adults in the Lazio region is similar to those published in previous reviews, but an uneven regional distribution was observed. While possible underestimation must be considered, administrative databases represent a valuable source of information for epidemiological surveillance and healthcare planning.

Acute Approach to Central Nervous System Infections in Kazakhstan

Background Neuroinfections in children are a socially significant problem of our time, as they can lead to disability and death of the patient, which actualizes the need for their early clinical diagnosis. The purpose of the study: to identify patterns of clinical manifestations of central nervous system lesions in children with neuroinfections. Materials and methods The cases of neuroinfections in 101 children treated at the “City Clinical Infectious Diseases Hospital” (Shymkent) in the period from 2018 to 2022 were analyzed, of which 37 patients with viral neuroinfections, 64 with bacterial ones. Results The predominance of bacterial neuroinfections over viral ones was revealed, with a predominance among young boys. Headache or its equivalents (in children under one year old) were observed in 72.5%; most often in children with viral infections of the nervous system (81.2%), less often in patients with bacterial infections (65.4%), p 0.01. In most cases, the disease manifested with the phenomena of fever and vomiting. When assessing the neurological status, the duration of preservation of two frequently occurring meningeal signs (rigidity of the occipital muscles, Kernig’s symptom) was taken into account, which was 6 ± 1.3 days and 5 ± 1.1 days in the group with bacterial neuroinfections, and 4 ± 1.8 and 5 ± 1.7 days, respectively, in the group with viral neuroinfections (p 0.05). With pneumococcal etiology, the most severe and protracted cases of the course of neuroinfections are recorded. Frequent emergency conditions in infectious lesions of the central nervous system in the form of cerebral edema, septic shock, which occur more often in bacterial neuroinfections, have been identified. Conclusion Neuroinfections are characterized by a symptom complex of clinical manifestations, which should be interpreted by doctors in a timely and correct manner in order to diagnose early and minimize adverse outcomes of the disease. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1206-1212

Soil moisture and water redistribution patterns in white oak (Quercus alba) saplings and trees in fragmented urban woodlands

In the midwestern United States, models predict extended summer heatwaves and increasingly frequent and prolonged drought conditions. In the Chicago region, the potential for large-scale mortality of white oak trees (Quercus alba) coupled with the ongoing decline of white oak sapling recruitment are major concerns for researchers and practitioners. In this study, we determined the sources of water used by mature white oak trees and saplings in three qualitatively different sites within a remnant oak forest in Chicago during the 2021 drought. We investigated soil moisture dynamics (volumetric water content, VWC) and water isotope composition of leaf tissues (δD, δ18O), rainwater, and groundwater. These data were linked to sapling height (proxy for biomass) and ectomycorrhizal (ECM) functional types. We predicted that: (i) mature oak trees use deeper water sources and conducted hydraulic redistribution (HR), and (ii) mature trees shared water with saplings during dry periods via long-distance ECM functional types. Soil moisture decreased progressively from June to October (spring to fall), with August and September having the lowest moisture (<20 % VWC). Following rainfall recharge, temporal patterns of soil moisture showed gravity drainage and then ongoing stair-stepwise drawdown consistent with plant evapotranspiration. Leaf δD and δ18O values in mature trees and saplings were consistent with water uptake from rainfall and subsequent enrichment via evapotranspiration. In two sites, mature trees and saplings demonstrated distinct δD: δ18O slopes, with mature trees more enriched than saplings. In the third site, mature trees and saplings δD: δ18O slopes overlapped but here, the ECM community was dominated by contact-type ECM and sapling height increased with distance from the mature oak. Our findings indicate that HR was not a component of site ecohydrology, and future climate conditions may present increasing challenges for white oak recruitment as both mature trees and saplings compete for limited rainfall-derived soil moisture.

IPNA clinical practice recommendations for the diagnosis and management of children with IgA nephropathy and IgA vasculitis nephritis.

IgA nephropathy and IgA vasculitis with nephritis, albeit rare, represent two relatively frequent glomerular conditions in childhood. Compared to adults, pediatric IgA nephropathy has a more acute presentation, most frequently with synpharyngitic macrohematuria and histologically with more intense inflammation and less intense chronic damage. Management of these conditions is controversial and supported by little high-quality evidence. The paucity of evidence is due to the disease heterogeneity, its inter-ethnic variability, and the difficulty of extrapolating data from adult studies due to the peculiarities of the condition in children. IgA vasculitis with nephritis is a kidney manifestation of a systemic disorder, typical of the pediatric age, in which both the diagnosis of kidney involvement and its management are poorly defined, and an interdisciplinary approach is crucial. Both conditions can have a profound and long-lasting impact on kidney function and the global health of affected children. The International Pediatric Nephrology Association has therefore convened a diverse international group of experts from different disciplines to provide guidance on the recommended management of these conditions in children and to establish common definitions and define priorities for future high-quality, evidence-based collaborative studies for the benefit of children.

Degenerative mitral stenosis by echocardiography: presentation and outcome

Abstract Aims Degenerative mitral stenosis (DMS) is due to degenerative mitral annular calcification (MAC) and valvular calcification. However, DMS impacts on the outcome, and therefore, potential treatment needs are poorly known. We aimed at evaluating survival after DMS diagnosis by Doppler echocardiography in routine practice. Methods and results A cohort of 2937 (75 ± 12 years, 67% women) consecutive patients were diagnosed between 2003 and 2014 with DMS (diastolic mean gradient ≥ 5 mmHg), with analysis of short- and long-term survival. All patients had overt mitral annular/valvular degenerative calcification without rheumatic involvement. Mean gradient was 6.5 ± 2.4 mmHg, and DMS was considered mild in 50%, moderate in 44%, and severe in 6%. DMS was associated with left atrial enlargement (52 ± 23 mL/m2) and elevated pulmonary pressure (49 ± 16 mmHg) despite generally normal ejection fraction (61 ± 13%). DMS was associated with frequent comorbid conditions (74% hypertension, 58% coronary disease, and 52% heart failure) and humoural alterations (haemoglobin 11.3 ± 1.8 g/dL and creatinine 1.5 ± 1.4 mg/dL). One-year mortality was 22%, most strongly related to older age, higher comorbidity, and abnormal haemoglobin/creatinine but only weakly to DMS severity (with anaemia 42% irrespective of DMS severity, P = 0.99; without anaemia 18, 23, and 28% with mild, moderate, and severe DMS, respectively, P &amp;lt; 0.0004). Long-term mortality was high (56% at 5 years) also mostly linked to aging and weakly to DMS severity [with anaemia P = 0.90; without anaemia: adjusted-hazard ratio: 1.30 (1.19–1.42), P &amp;lt; 0.0001, for moderate vs. mild DMS and 1.63 (1.34–1.98), P &amp;lt; 0.0001, for severe vs. mild DMS]. Conclusion DMS is a condition of the elderly potentially resulting in severe mitral obstruction and haemodynamic alterations. However, DMS is frequently associated with severe comorbidities imparting considerable mortality following diagnosis, whereas DMS severity is a weak (albeit independent) determinant of mortality. Hence, patients with DMS should be carefully evaluated and interventional/surgical treatment prudently considered in those with limited comorbidity burden, particularly without anaemia. Keywords: Degenerative Mitral Stenosis; Outcome; Natural history; Ecocardiography; Mitral Stenosis.

Development of a patient-centered app in Germany as a special health and organizational support by surveying patients with cardiovascular diseases.

A variety of health-related mobile applications (apps) and wearables often encompass a narrow application area. Our study therefore aims to provide the basis for the development of an app that comprehensively assists patients to deal with their disease in the best possible way and that improves the course of the disease in the long term. We conducted a multicenter analysis of patients using a questionnaire study at two German clinics and surveyed 100patients with cardiovascular disease. For the analysis of the interviews, particularly Likert scales were used. 24.0% were female, median age was 62.5years. Leading causes for hospitalization were coronary artery disease (40.0%) and heart failure (22.0%). The most frequent pre-existing conditions were arterial hypertension (55.0%), atrial fibrillation or atrial flutter (31.0%), and again coronary artery disease (31.0%). Typical disease associated feelings were fear for life (43.0%) and uncertainty (43.0%). When considering future management of the disease, 75.0% felt motivated, 70.0% felt confident, and 68.0% felt hopeful. Of the patients surveyed, 60.0% indicated a willingness to use the app and another 24.0% were potentially willing to do so. Furthermore, significantly more patients < 63years stated a willingness or potential willingness to use the app (p = 0.029). For those considering an app usage in general, the most favoured features were a document management (81.8%) and a medication management (65.9%). While only 36.4% indicated that the app could at least partially alleviate their worries, 94.3% expected a reduction in organizational effort. With respect to age groups, there was no significant difference (organizational effort: p = 0.239; worries: p = 0.275). Particularly younger patients < 63years with cardiovascular disease show a substantial willingness to use an app as a special health support, particularly in terms of document and medication management. They especially hope for a reduction in organizational effort.

A Survey of Image Enhancement and Dehazing Algorithms to Improving Autonomous Navigation in Fog and Dust.

Video captured during sand-dust weather conditions indicates significant degradation, diminished contrast, and pronounced color distortion. The reason behind this phenomenon is the impact of sand-dust particles, which result in the dispersion and assimilating of light. Consequently, resultant image seems blurred and lacks contrast. Additionally, the alteration in color is attributed to the swift reduction of blue light. Adverse weather circumstances, such as fog, sand, and dust storms, cause problems with vision for deploying self-driving automobiles. To guarantee secure and seamless operations during frequent adverse weather conditions, video enhancement plays a vital role in facilitating vehicular mobility and navigational in both road and air transportation. To improve the safety and efficiency of operation, it is imperative to employ video dehazing techniques, particularly in adverse weather conditions. The purpose of our overview is to offer interested researchers a thorough and methodical examination of image enhancement approaches, serving as an important point of reference for their work. The text explored different image enhancement methods, along with the challenges, constraints, advantages, and drawbacks associated with using these techniques throughout the past five years. Specifically, it focused on three aspects: supervised algorithms, unsupervised algorithms, and quality evaluation.

A - 139 A Neuropsychological Case Study of an Individual Diagnosed with Langerhans Cell Histiocytosis

Abstract Objective Langerhans cell histiocytosis (LCH) is a rare, idiopathic, cancer-like condition resulting from an overproduction of Langerhans cells. Disseminated LCH can spread across various anatomical systems, and prognosis is mainly dependent on organ involvement. Due to the rarity of this condition, potential neuropsychological effects are not fully understood. However, current research suggests that individuals with LCH are prone to develop various comorbid neuropsychiatric problems such as depression, anxiety, and impaired intellectual functioning. Method The current case is an 18-year-old, right-handed, Hispanic female who was diagnosed with LCH (brain and bone) in 2020. Cognitive symptoms began in 2016 at age 11. She was initially diagnosed with a low-grade glioma after a biopsy of a supracellular mass in 2017 but has developed various comorbid conditions since then. These include panhypopituitarism, NMDA encephalitis with behavioral disturbance, encephalomalacia, and epilepsy. She has undergone two 9-month rounds of chemotherapy and has been followed for neuroimaging with MRI and CT since 2017. Results Neuropsychological test findings from January 2024 indicated global deficits in intellectual functioning. Severe disruptions in sleep–wake cycle were also evident during testing. Although language abilities were relatively well preserved, abstract reasoning and executive functioning were greatly impaired. Psychological screeners also suggested anxiety and depression. Conclusions This case provides evidence of neurocognitive and psychiatric symptoms that can occur as a result of LCH and frequent comorbid health conditions. Neuropsychological testing can help monitor these effects on individuals with LCH across the lifespan.

Impaired Emotional Processing in Major Depressive Disorder. Accuracy versus Processing Speed

Depression is one of the most frequent conditions within the general population, ranking among the most burdensome in terms of public health expenses, productivity loss and social costs. The condition has been linked with cognitive deficits that may even continue in remission phases, social cognition being one potentially affected cognitive function. In our study, the Penn’s Emotional Acuity Test included in the CogtestTM battery was used to assess emotion recognition accuracy and processing speed. The Structured Clinical Interview for the Montgomery-Asberg Depression Rating Scale was used to assess the intensity of the symptomatology. A total of 48 depressed individual individuals (65% females), with a mean age of 49.8 ± 10.4 years, and 40 healthy controls (75% females), with a mean age of 35.2 ± 6.9 years were included. As compared to controls, depressive participants recorded significantly less correct answers (9.3 ± 3.8 vs. 11.2 ± 3.6, p = 0.019 – Student’s t test) and slower processing speeds (6795 ± 3366 vs. 4042 ± 1623, p 0.001 – Mann-Whitney U test) in emotion processing. Furthermore, symptom severity significantly influences only processing speed and not accuracy in emotion recognition tasks. Thus, we conclude that depressive individuals have a significant deficit in processing speed and accuracy when identifying the intensity of other peoples’ emotions.

A High-Resolution Distribution Dataset of Paddy Rice in India Based on Satellite Data

India, as the world’s second-largest rice producer, accounting for 21.7% of global rice production, plays a crucial role in ensuring global food supply stability. However, creating high-resolution rice maps for India, such as those at 10 to 30 m, poses significant challenges due to frequent cloudy weather conditions and the complexities of its agricultural systems. This study used a sample-independent mapping method for rice in India using the synthetic aperture radar (SAR)-based Rice Index (SPRI). We produced 10 m spatial resolution rice distribution maps for three years (i.e., 2018, 2020, and 2022) for 23 states in India, covering 98% of Indian rice production. The method effectively utilized the unique characteristics of rice in the vertical–horizontal (VH) backscatter coefficient time series of Sentinel-1, from ttransplantation to the maturity stage, combined with cloud-free Sentinel-2 imagery. By calculating the SPRI values for each agricultural field object using adaptive parameters, the planting locations of rice were accurately identified. On average, the user, producer, and overall accuracy over all investigated states and union territories was 84.72%, 82.31%, and 84.40%, respectively. Additionally, the regional-scale validation based on the statistical area at the district level showed that the coefficient of determination (R2) ranged from 0.53 to 0.95 for each state, indicating that the spatial distribution of the statistical planted area at the district level was reproduced well.

Exploring the reality of seafarers' deaths and injuries and preventive measures from the cases of overwork-related disorders

Till date, only few studies have detailed the reality of overwork-related disorders among seafarers. Therefore, in this study, we aimed to evaluate the prevalence of overwork-related disorders among seafarers and assess factors such as patient attributes, diseases diagnosed at the time of determination, workload factors, and other aspects, thereby suggesting relevant preventative measures. Among all the patients identified with overwork-related disorders from April 2010 to March 2017, 2,280 cases of cerebrovascular and cardiovascular diseases and 3,517 cases of mental disorders were selected. To identify seafarer-related cases, keywords related to seafarers were extracted. Subsequently, 33 cases of cardiovascular disease and 19 cases of mental disorders were obtained. The average age of the patients with cerebrovascular and cardiovascular diseases was 56.7 years; for those with mental disorders, it was 45.2 years. The patients were most commonly engaged in fishing, transportation, and postal services. Most patients were employed in the deck department or were captains. The most common types of vessels were fishing and cargo ships. Among the diseases diagnosed at the time of determination, cerebrovascular diseases accounted for 20 cases (60.6%) and cardiovascular diseases accounted for 13 cases (39.4%), with cerebral and myocardial infarctions being the most frequent conditions. Among mental disorders, "mood disorders" accounted for 7 cases (36.8%), and "neurotic disorders, stress-related disorders, and somatoform disorders" accounted for 12 cases (63.2%), with major depressive episodes, post-traumatic stress disorder, and adjustment disorders being the most common. The most common workload factor for patients with cerebrovascular and cardiovascular diseases was "long-term excessive work," and among non-workload factors, "long working hours" and "irregular working hours" were prevalent. For mental disorders, 8 cases were attributed to "extreme psychological stress." Specific events leading to these diseases included "interpersonal relationships," "experiencing accidents or disasters," and "work quantity and quality." Both cerebrovascular and cardiovascular diseases, as well as mental disorders, showed a notable aging trend among seafarers. Thus, measures that consider the characteristics of elderly workers, such as their physical function, are important. Additionally, as seafarers are distributed across various industries and occupations, measures should be specifically tailored to their industry and job type. Our study confirmed that long working hours and irregular working hours were prevalent in both cases. Therefore, there is an urgent need for further efforts to prevent and mitigate overwork-related deaths among seafarers, including organizational support from onshore workplaces and enhancement of medical and operational support using information and communication technology.

Assessment of multi-professional primary healthcare center quality by patients with multimorbidity

BackgroundThe main aim of this study was to build an item bank for assessing the care quality of multi-professional healthcare centers (MPHCC) from the perspective of patients with multimorbidity. This study was part of the QUALSOPRIM (QUALité des SOins PRIMaires; primary healthcare quality) research project to create a psychometrically robust self-administered questionnaire to assess healthcare quality.MethodsFirst, twelve experts built an item bank using data from a previous qualitative work and a systematic literature review. Second, the validity of each item was assessed in a sample of patients. Adult patients with multimorbidity were recruited from six French MPHCC. Items were assessed based on ceiling effects, the level of missing or neutral responses and patient feedback. Patient feedback was recorded after the item bank completion. Based on results, items were validated, improved, or removed during expert meetings. In case of disagreement the Delphi method was used to reach consensus.ResultsThe study sample included 209 outpatients. The most frequent medical conditions were cardiovascular risk factors, cardiovascular diseases and rheumatological conditions. In total, a bank of 109 items classified in nine domains was built. The validity assessment led to the removal of 34 items. Retained items explored a variety of topics related to care quality: availability, accessibility, premises’ layout and building, technical care, expertise, organization, relationships with caregivers and communication, involvement and personal relationships.ConclusionsThis study allowed cross-validation of a bank of 75 items, leading to a complete picture of the patient perception of care quality items. Overall, patients were generally satisfied with their care at the MPHCC. Nonetheless, there were still numerous items on subjects for which patients’ satisfaction could be improved.

Model-based optimisation of solar-assisted ORC-based power unit for domestic micro-cogeneration

Integrating flat solar thermal collectors and organic Rankine cycle (ORC)-based power units in micro-cogeneration systems ensures a reduction in CO2 emissions in domestic applications. The key component of these systems is the expander, which must withstand frequent off-design operating conditions owing to the intermittent nature of the solar source. Despite being in the first stage of technological development, scroll expanders are widely adopted in small-scale applications owing to their operating flexibility and robustness. In this study, a domestic micro-cogeneration unit equipped with a scroll expander is characterised experimentally. The experimental data are used to calibrate the expander and ORC unit models. The models are used to evaluate the operating limits of the units as functions of the main operating parameters. The maximum power and efficiency are obtained as 300 W and 3 %, respectively, for hot water temperatures between 90 °C and 100 °C, close to the rated performances. Finally, the effect of adopting a dual-intake port on the expander and unit performance is assessed. The technology facilitates the widening of the operating range (20–140 g/s mass flow rate of WF) and a peak power production of 1.2 kW.

Evaluation by app in smartphones of awake bruxism at the return of presential classes in two university centers

Background. The return to normality post-pandemic brought some inconveniences to the population, especially students. To evaluate the frequency of awake bruxism behaviors through the use of an app on smartphones in dental students returning to presential classes. Awake bruxism was evaluated with the creation of an app that according to the authors evaluates: relaxed jaw muscles, dental contact, jaw effort, clenching teeth and teeth grinding, 5 frequent oral conditions in the population. The frequency of awake/daytime bruxism (AB) in healthy individuals when comparing other populations with possible risk factors for additive bruxism (psychological factors, depression, suicide delusions, etc.), evaluating consequent clinical signs (fatigue, muscle pain, attritions and dental openings). Methods: The sample of three hundred (n=300) young adults legally enrolled in two Ecuadorian universities, the sample was selected among fifth, sixth, seventh, eighth and ninth semester students legally enrolled and who are attending Faculty of Dentistry classes in 2 different cities (Quito and Guayaquil). The app was configured to provide 20 alerts during the day x seven days a week, in real time. Results. The study obtained 95% reliability and 5% error in research, was used. The relaxation condition was present in all users, but 40% of the alerts were associated with jaw and tooth discomfort, 39% corresponded to the discomfort of mandibular clenching, and 24% corresponded to tooth contact. A direct significant association was found between the state of relaxation and nonrelaxation, with a high probability of reports related to nonrelaxation (p ≤ 0.05). Conclusions: Awake bruxism with the app was evaluated, identifying 5 behaviors such as: relaxed mandibular muscles, dental contact, mandibular effort, clenching and grinding teeth, frequent conditions in the population; reporting a state of mandibular relaxation, there is a high probability that a condition of nonrelaxation would be reported (p≤0.05).

Concurrent genotyping and expression of NLRP3 inflammasome in pityriasis versicolor patient's skin lesions.

The goal of this study is to investigate the impact of the rs35829419 SNP on the serum level of NLRP3, and to assess the relationship between NLRP3 and its SNP and vulnerability to Pityriasis versicolor. Pityriasis versicolor (PV) is one of the most frequent skin conditions linked to skin pigmentation changes. Malassezia plays a key role in the pathogenesis of PV. A case-control study, 50 patients with pityriasis versicolor and 44 healthy controls. Real-time PCR was used to genotype NLRP3 (rs35829419) and ELISA assay of NLRP3 levels in tissue samples. There was a significantly higher median NLPR3 levels in PV patients than controls. A significant predominance of A allele of Q 705K was in patients than controls. The risk of having the disease in the presence of A allele is nearly 10 times than having C allele. In PV patients, there was a significant relationship between NLPR3 levels and Q 705K genotypes with higher NLPR3 levels in AA genotype. A potential correlation between PV and the Q705K polymorphism, pointing to evidence of NLRP3 alteration in PV patients. The NLRP3 inflammasome may be an appropriate therapeutic target for Malassezia-associated skin disorders.

Parental ADHD knowledge and medical visit status of school-aged children in Shanghai

IntroductionThe diagnosis and care of children and adolescents with neurodevelopmental disorders presents a public health crisis in China. Attention deficit hyperactivity disorder (ADHD) is one of the most frequent conditions. Many Chinese children and adolescents with ADHD are underdiagnosed and undertreated. This study aimed to evaluate the awareness and attitude parents have about ADHD, and investigated potential factors influencing ADHD medical visit status among school-aged children in Shanghai.MethodsA random cluster sampling method was used, and four primary schools in Shanghai were selected. One class was randomly selected from each grade, including students and their parents. Parents completed the Swanson, Nolan, and Pelham Version IV Questionnaire (SNAP-IV) parent form and questionnaire concerning ADHD awareness, knowledge, attitude and status of ADHD medical visit. Descriptive analysis was conducted on the overall results and logistic regression analysis was performed to explore the influencing factors of ADHD medical visit.ResultsWe received 617 valid questionnaires. There were 313 boys (50.7%) and 304 girls (49.2%), with a median age of 8 years old (p25 = 7, p75 = 9). 42.4% parents believed they had some knowledge about ADHD, and 73.5% of them thought ADHD was a neurologically based disorder or neurological condition by nature. Parental ADHD information came from the following sources: Internet/TV (n = 458, 74.2%), families/friends (n = 267, 43.2%), print publication (n = 208, 33.7%), psychiatrists/pediatricians (n = 192, 31.1%), schools/teachers (n = 186, 30.1%) and other ADHD patients (n = 48, 7.7%). When children had ADHD-like behaviors, most parents (61.5%) educated children to behave themselves, 59.1% parents tried to get help from psychiatrists/pediatricians, 55.5% of them would ask psychologist for help. In terms of the ADHD prevalence, the SNAP-IV positive screen rate was 4.3% (n = 27). Only 33.3% (9/27) of parents went to the hospital for consultation and treatment. Multivariate logistic regression model showed that parental knowledge about ADHD (OR = 13.67, 95%CI: 1.72, 144.39, P = 0.01) was significantly correlated with the medical visit. Parents with sufficient knowledge of ADHD tend to visit hospital for help when they thought their children had ADHD related symptoms.ConclusionsThe majority of parents accepted ADHD as a neurodevelopmental disorder by nature, but some parents still had certain misunderstandings about ADHD. The main source of information for parents to obtain information about ADHD was through the TV/Internet. Parents’ perceptions and knowledge were key to whether children received appropriate treatment for their ADHD. However, medical visits to address ADHD among school-aged children were still lower than expected. Government and healthcare institutes should work to improve ADHD public awareness and to help patients and their families gain access to mental health resources.

How building arrangements can improve outdoor thermal comfort and indoor sunlight?

In the context of frequent extreme hot weather conditions, high-dense urban areas posed more life-threatening challenges. Such as university dormitories, as important residential spaces, have received very little attention. Moreover, how building arrangements can simultaneously impact internal and external environments remain poorly understood. To bridge this gap, student residential areas of Jiangsu University in Zhenjiang, China were considered as a case study, with the aim of optimal building arrangements that can simultaneously improve the outdoor thermal comfort (OTC) and indoor sunlight (ISL). A combination of on-site measurement and numerical models were employed to simulate various scenarios with different building orientations, building heights and layouts. The result revealed that: first, the building orientation emerged as a dominant factor influencing both OTC and ISL, with the optimal value identified as SE-30°. Second, in the context of extremely hot weather conditions, increasing building height or floor-area ratio contributed to improved OTC. Finally, the building arrangement with inconsistent heights of north-to-south descending order, exhibited a notable reduction in hot outdoor spaces by 18.6%, and attributed to enhanced airflow. The findings provide clear guidelines for improved strategies at the detailed urban design scale, and can further contribute to the development of sustainable cities.