Lower Severity Levels Research Articles

The incidence of incomplete abortion and the prevalence of abortion-related morbidity in South African public hospitals, 2018

Background. The occurrence of abortion-related morbidity indicates limited access to safe abortion. Globally, unsafe abortions remain a persistent, yet preventable, cause of maternal mortality. South Africa (SA) is internationally recognised for its progressive reproductive rights framework, supported by its Constitution and laws. However, evidence suggests that women encounter barriers to accessing safe abortions, including stigma, resistance from healthcare providers, a shortage of trained professionals and a lack of awareness of their rights. We hypothesised that, 20 years after the promulgation of the Choice on Termination of Pregnancy Act, the incidence of incomplete abortion (ICA) and the prevalence of abortion-related morbidity would change, influenced by access to safe abortion and the introduction of medication abortion. We wanted to compare our data with 2000 and 1994 survey results to assess change. Objectives. To estimate the incidence of incomplete abortion and describe the prevalence of abortion-related morbidity in SA public hospitals in 2018. Methods. This was a cross-sectional, retrospective study. We selected a stratified random sample of public hospitals. We extracted data from medical records of women who presented with ICA during a predetermined 21-day period in 2018. Data were captured directly into a REDCap database. To estimate the national incidence of ICA, we used population estimates for 2018, comprising 17 199 227 women aged 12 - 49 years, and 1 200 436 live births. The prevalence of ICA morbidity is reported. We compared the rates in this study with those reported from similar studies in 2000 and 1994. Results. We found 913 medical records of women presenting with ICA in the 56 public hospitals. ICA incidence was 367 (274 - 459) per 100 000 women aged 12 - 49 years. The average age of the women was 27 years, and the majority had a previous pregnancy before the ICA. A large proportion (73.9%) of women were in the first trimester. There was no sign of infection in 92.5% of records, no organ failure in 99.1% of records and there were no deaths. There was no change in the ICA incidence when compared with the 1994 and 2000 results. Women’s mean age and having a previous pregnancy were similar in the three studies (1994, 2000 and 2018). The proportion of women presenting in the first trimester increased over time: 60.5% in 1994, 67.1% in 2000 and 73.9% in 2018. There has been a decline in the prevalence of abortion-related morbidity, demonstrated by lower levels of severity, no signs of infections and no organ failure. Conclusion. ICA incidence has not changed, but related morbidity is declining. Various factors could explain our findings, but the lack of change in ICA incidence indicates that access to formal abortion care has not improved over the past 20 years.

Quality of Life in Adults with Atopic Dermatitis in Relation to Disease Severity: Nationwide Data in Japan.

The impact of atopic dermatitis (AD) on daily life and different levels of quality of life (QOL) according to AD severity has not been fully elucidated. This study aimed to assess QOL in relation to the AD severity in Japan. This observational study used anonymized data of health insurance association members and their families registered to a mobile health app. The QOL measures included the Dermatology Life Quality Index (DLQI), EuroQol five-dimensional five-level descriptive system (EQ-5D-5L), Work Productivity and Activity Impairment (WPAI), and sleep disturbance Numerical Rating Scale (NRS). The data were assessed according to AD severity: the Patient-Oriented Eczema Measure (POEM: 0-2, "clear/almost clear"; 3-7, "mild"; 8-16, "moderate"; 17-24, "severe"; 25-28, "very severe"); and itch NRS (0-10). Of 1507 adults with AD symptoms or undergoing treatments, 882 were identified with AD diagnosis records. Of those, 229 (26.0%), 242 (27.4%), 273 (31.0%), and 138 (15.6%) were included in the clear/almost clear, mild, moderate, and severe/very severe POEM groups, with mean ± standard deviation DLQI scores of 2.0 ± 2.7, 3.6 ± 3.3, 6.1 ± 4.4, and 10.4 ± 5.7, respectively. Higher DLQI scores were observed with increasing POEM severity and itch NRS (Spearman's rank correlation coefficient 0.629 and 0.615, respectively). EQ-5D-5L scores slightly lowered with increasing POEM severity, whereas WPAI percentage slightly increased. Sleep disturbance NRS increased with increasing AD severity in terms of POEM and itch NRS. Adults identified with AD diagnosis records (n = 882) yielded higher WPAI percentages than those without (n = 1204) in all four domains (Wilcoxon rank sum test, p < 0.001 for all). This study, using real-world data in Japan, presented valuable data on the relationship between AD severity and various aspects of QOL. The data suggested greater QOL impairment with increasing AD severity; even at lower severity levels, QOL was impacted to some extent. The results highlight the need for careful consideration during clinical practice.

Analyzing Crash Severity: Human Injury Severity Prediction Method Based on Transformer Model

Traffic accident-related injuries and fatalities are a serious global public health and social development challenge. The accurate prediction of crash severity improves road safety and reduces casualties, as well as serving road managers and policy makers. Prediction models need to learn and analyze the various characteristic factors of traffic accidents and capture from them the inherent complex relationship between accident characteristics and the severity of traffic accidents. However, most accident prediction studies lack analytical predictions of injury severity, and predictive models rely on the content and quality of accident datasets. To increase the robustness and accuracy of prediction models, this paper leverages a Transformer-based architecture for the severity prediction of traffic collisions from human injury severity. This framework learns both text and sequence data from accident datasets. After comparative analysis, the framework can achieve the prediction of human injury severity under different data categories and show good prediction performance at low injury severity levels using only textual data or sequence data.

Ladder fuels rather than canopy volumes consistently predict wildfire severity even in extreme topographic-weather conditions

Drivers of forest wildfire severity include fuels, topography and weather. However, because only fuels can be actively managed, quantifying their effects on severity has become an urgent research priority. Here we employed GEDI spaceborne lidar to consistently assess how pre-fire forest fuel structure affected wildfire severity across 42 California wildfires between 2019–2021. Using a spatial-hierarchical modeling framework, we found a positive concave-down relationship between GEDI-derived fuel structure and wildfire severity, marked by increasing severity with greater fuel loads until a decline in severity in the tallest and most voluminous forest canopies. Critically, indicators of canopy fuel volumes (like biomass and height) became decoupled from severity patterns in extreme topographic and weather conditions (slopes >20°; winds > 9.3 m/s). On the other hand, vertical continuity metrics like layering and ladder fuels more consistently predicted severity in extreme conditions – especially ladder fuels, where sparse understories were uniformly associated with lower severity levels. These results confirm that GEDI-derived fuel estimates can overcome limitations of optical imagery and airborne lidar for quantifying the interactive drivers of wildfire severity. Furthermore, these findings have direct implications for designing treatment interventions that target ladder fuels versus entire canopies and for delineating wildfire risk across topographic and weather conditions.

The moderating effect of insomnia severity in the association between noise annoyance and psychotic experiences in adolescents

ABSTRACT Adolescence has been identified as a particularly vulnerable age group with a high prevalence of insomnia and a heightened susceptibility to experiencing psychotic experiences, which in turn increases the risk of developing psychotic disorders. In particular, insomnia symptoms were found to be predominant among noise-sensitive adolescents exhibiting a higher level of noise annoyance. This study aimed to assess the moderating effect of insomnia severity between noise annoyance and psychotic disorders among Lebanese adolescents. A cross-sectional study was conducted among 527 Lebanese adolescents. Participants filled a self-administered online questionnaire. Insomnia moderated the association between noise annoyance and psychotic disorders. Noise annoyance was significantly associated with a higher risk of emergence of psychotic disorders. At low and moderate levels of insomnia severity, higher noise annoyance was significantly associated with higher psychotic experiences. Understanding how these variables interact provide valuable insights into the underlying mechanisms leading to psychotic disorders among adolescents.

New Aspects of Mortellaro’s Disease: A Literature Review

Introduction. All over the word, hoof diseases, and Mortellaro’s disease in particular, are being among the most widespread and difficult to treat diseases in dairy cattle husbandry. They cause irreparable economic damage to the dairy industry by reducing the cattle reproductive ability indicators, feed conversion ratio, which compels to spend considerable amounts on treatment, prevention and culling of animals. Mortellaro’s disease is especially widespread in Europe and Western countries, but the current rate of national economy growth leads to the necessity to purchase the cattle abroad, which results in the increase of the Mortellaro’s disease incidence in Russia: at the farms where cattle has been imported, the percentage of the disease is 14.17±5.15% of the total number of hoof diseases in the herd. The aim of this review is to summarise the results of scientific research on the Mortellaro’s disease pathogenesis over the past 20 years.Materials and Methods. To achieve the stated objective, the criteria of inclusion into the search were defined. It was decided to include in the review the studies/reports presenting the results on: 1) the disease etiology and factors affecting the course of Mortellaro’s disease; 2) symptoms of Mortellaro’s disease manifestation in different species of farm animals; 3) the methods of Mortellaro’s disease treatment. The materials published in Elsevier, ASM Journal, Irish Veterinary Journal, Thieme, American Dairy Science Association, Epidemics, Schweiz Arch Tierheilkd, Journal of Clinical Microbiology, eLIBRARY.RU, Google Scholar have been investigated in the frame of the literature search. The search by the following keywords was done: interdigital dermatitis, Mortellaro’s disease, hoof diseases of cattle, contagious interdigital dermatitis. The time range of sources – those published within the period from 2003 to 2023.Results. In total, 44 articles have been analysed, 33 of which have been included in the present review. According to the studied materials, one of the prerequisites underlying the spread of Mortellaro’s disease in the Russian Federation is the import of the infected cattle, since the measures undertaken during the temporary housing and quarantine periods do not give the desired result. The animals get infected with the bacteria of the genus Treponema, which are localized deep in the hoof tissues, therefore, after the disease is endured, it turns into its chronic form. The specific symptoms of Mortellaro’s disease course in various cattle breeds have been established: in beef cows and buffaloes the interdigital dermatitis is characterised by a low level of pain symptom severity; in sheep – by the ulcerative lesions of the сoronary band, which progress and lead to the destruction of the abaxial hoof wall and loss of the hoof horn. The areas with the erosion are very painful, but the intercellular adhesive junctions are not lost, which allows for positive prognosis of the disease. The main indicators of productivity and fertility are reduced due to the disease, as is the immunity in general, and there is an estrous cycle delay. In the samples of patients sick with the digital dermatitis, an increase of the number of intact and degranulated mast cells is observed, compared to the healthy ones, which indicates that mast cells can play an important role in the pathogenesis of digital dermatitis. Nowadays, the Mortellaro’s disease treatment abroad and in Russia is based on the elimination of symptoms, and not the pathogen itself. The local treatment is mainly represented by the antiseptic baths, surgical treatment, local application of antibiotics to the wound. The experiments on antibiotic susceptibility of Treponema, which are the important step in the search for the specific treatment of Mortellaro’s disease, have been performed. The antibiotic susceptibility tests gave positive results (all isolates of Treponema were sensitive to tiamulin, valnemulin, tylosin, aivlosin, lincomycin, doxyclin), however, the difficulty lies in the method of drug administration into the source of Treponema localization, since the conventional ways of administration of antibiotics entail restrictions on the sale of milk and meat.Conclusion. The presented review of the scientific publications on Mortellaro’s disease made it possible to summarise the currently known results and identify the areas for further research. For example, it should be still investigated why the interdigital dermatitis requires the presence of many Treponema species rather than one? What role do representatives of the Mycoplasma, Porphyromonas and other bacteria play in the pathogenesis of the studied disease? And of course, there is a serious scientific gap in finding treatment of Mortellaro’s disease capable of eliminating the pathogen itself, rather than its symptoms. It should be mentioned that not all Treponema species can be cultivated, which also slows down the scientific process and makes the problem of Mortellaro’s disease treatment relevant worldwide.

ETDRS grading with CLARUS ultra-widefield images shows agreement with 7-fields colour fundus photography

BackgroundTo analyse and compare the grading of diabetic retinopathy (DR) severity level using standard 35° ETDRS 7-fields photography and CLARUS™ 500 ultra-widefield imaging system.MethodsA cross-sectional analysis of retinal images of patients with type 2 diabetes (n = 160 eyes) was performed for this study. All patients underwent 7-fields colour fundus photography (CFP) at 35° on a standard Topcon TRC-50DX® camera, and ultra-widefield (UWF) imaging at 200° on a CLARUS™ 500 (ZEISS, Dublin, CA, USA) by an automatic montage of two 133° images (nasal and temporal). 35° 7-fields photographs were graded by two graders, according to the Early Treatment Diabetic Retinopathy Study (ETDRS). For CLARUS UWF images, a prototype 7-fields grid was applied using the CLARUS review software, and the same ETDRS grading procedures were performed inside that area only. Grading of DR severity level was compared between these two methods to evaluate the agreement between both imaging techniques.ResultsImages of 160 eyes from 83 diabetic patients were considered for analysis. According to the 35° ETDRS 7-fields images, 22 eyes were evaluated as DR severity level 10–20, 64 eyes were evaluated as DR level 35, 41 eyes level 43, 21 eyes level 47, 7 eyes level 53, and 5 eyes level 61. The same DR severity level was achieved with CLARUS 500 UWF images in 92 eyes (57%), showing a perfect agreement (k > 0.80) with the 7-fields 35° technique. Fifty-seven eyes (36%) showed a higher DR level with CLARUS UWF images, mostly due to a better visualization of haemorrhages and a higher detection rate of intraretinal microvascular abnormalities (IRMA). Only 11 eyes (7%) showed a lower severity level with the CLARUS UWF system, due to the presence of artifacts or media opacities that precluded the correct evaluation of DR lesions.ConclusionsUWF CLARUS 500 device showed nearly perfect agreement with standard 35° 7-fields images in all ETDRS severity levels. Moreover, CLARUS images showed an increased ability to detect haemorrhages and IRMA helping with finer evaluation of lesions, thus demonstrating that a UWF photograph can be used to grade ETDRS severity level with a better visualization than the standard 7-fields images.Trial registrationApproved by the AIBILI - Association for Innovation and Biomedical Research on Light and Image Ethics Committee for Health with number CEC/009/17- EYEMARKER.

Activity, triage levels and impact of the pandemic on hospital emergency departments: A multicentre cross-sectional study.

Describe the activity of hospital emergency departments (EDs) and the sociodemographic profile of patients in the eight public hospitals in Spain, according to the different triage levels, and to analyse the impact of the SARS-CoV-2 pandemic on patient flow. An observational, descriptive, cross-sectional and retrospective study was carried out. Three high-tech public hospitals and five low-tech hospitals consecutively included 2,332,654 adult patients seen in hospital EDs from January 2018 to December 2021. Hospitals belonging to the Catalan Institute of Health. The main variable was triage level, classified according to a standard for the Spanish structured triage system known as Sistema Español de Triaje. For each of the five triage levels, a negative binomial regression model adjusted for year and hospital was performed. The analysis was performed with the R 4.2.2 software. The mean age was 55.4 years. 51.4% were women. The distribution of patients according to the five triage levels was: level 1, 0.41% (n = 9565); level 2, 6.10% (n = 142,187); level 3, 40.2% (n = 938,203); level 4, 42.6% (n = 994,281); level 5, 10.6% (n = 248,418). The sociodemographic profile was similar in terms of gender and age: as the level of severity decreased, the number of women, mostly young, increased. In the period 2020-2021, the emergency rate increased for levels 1, 2 and 3, but levels 4 and 5 remained stable. More than half of the patients attended in high-technology hospital EDs were of low severity. The profile of these patients was that of a young, middle-aged population, mostly female. The SARS-CoV2 pandemic did not change this pattern, but an increase in the level of severity was observed. What problem did the study address? There is overcrowding in hospital EDs. What were the main findings? This study found that more than half of the patients attended in high-technology hospital EDs in Spain have low or very low levels of severity. Young, middle-aged women were more likely to visit EDs with low levels of severity. The SARS-CoV2 pandemic did not change this pattern, but an increase in severity was observed. Where and on whom will the research have an impact? The research will have an impact on the functioning of hospital EDs and their staff. Not applicable.

Determinants of anxiety and depression disorders among patients with pulmonary arterial hypertension

Abstract Introduction Pulmonary arterial hypertension (PAH) is a rare chronic disease that, as it progresses, contributes to decreased ability to perform daily activities, deterioration of physical and mental well-being and social functioning. Patients with PAH experience anxiety and depression-like disorders that directly affect their quality of life. In view of the above, it is necessary to determine the determinants that affect the deterioration of mental functioning in this group of patients. Purpose The aim of the study was to determine the prevalence of anxiety and depression and their determinants. Material and methods The study included 89 patients , pulmonary arterial hypertension (PAH), who participated in the Therapeutic Treatment of Pulmonary Arterial Hypertension program by the National Health Service. Patients were asked to complete a standardized questionnaire (HADS) to assess Anxiety and Depression and a self-report questionnaire assessing sociodemographic factors and severity of symptoms. Medical data were taken from the hospital registry. Results In the study group, the mean anxiety score (HADS-A) was M=5.33 (SD=3.31), and the mean depression score (HADS-D) was M=4.4 (SD=3.78), indicating their low level of severity. Significant levels of the studied mood disorders are observed in one in five patients covered by the NHF drug program. Factors significantly (p&amp;lt;0.05) correlating with the severity of anxiety symptoms were chest pain (r=0.343), weakness (r=0.256), fatigue (r=0.327), MWT score 6 (r= -0.266), and arrhythmias (r=0.42). In addition to the above-mentioned factors, significant correlations (p&amp;lt;0.05) were obtained with the severity of depressive symptoms, for such factors as WHO FC Class (r=0.427), eldery age (r=0.263), NT-pro BNP (r=0.239). Conclusions Drug and depressive disorders in the study group of PAH patients are not common and may affect one in five patients (study participants on PAH treatment). The occurrence of anxiety disorders correlates with many PAH symptoms, sociodemographic and clinical factors. Learning about the factors associated with the occurrence of mental disorders can help to better identify them and prevent their occurrence.

Prospective Acceptability of Digital Therapy for Major Depressive Disorder in France: Multicentric Real-Life Study.

Major depressive disorder is one of the leading causes of disability worldwide. Although most international guidelines recommend psychological and psychosocial interventions as first-line treatment for mild to moderate depression, access remains limited in France due to the limited availability of trained clinicians, high costs for patients in the context of nonreimbursement, and the fear of stigmatization. Therefore, online blended psychological treatment such as Deprexis could improve access to care for people with depression. It has several advantages, such as easy accessibility and scalability, and it is supported by evidence. This study aims to evaluate the real-life acceptability of Deprexis for people with depression in France outside of a reimbursement pathway. Deprexis Acceptability Study Measure in Real Life (DARE) was designed as a multicenter cross-sectional study in which Deprexis was offered to any patient meeting the inclusion criteria during the fixed inclusion period (June 2022-March 2023). Inclusion criteria were (1) depression, (2) age between 18 and 65 years, (3) sufficient French language skills, and (4) access to the internet with a device to connect to the Deprexis platform. Exclusion criteria were previous or current diagnoses of bipolar disorder, psychotic symptoms, and suicidal thoughts during the current episode. The primary objective was to measure the prospective acceptability of Deprexis, a new digital therapy. Secondary objectives were to examine differences in acceptability according to patient and clinician characteristics and to identify reasons for refusal. All investigators received video-based training on Deprexis before enrollment to ensure that they all had the same level of information and understanding of the program. A total of 245 patients were eligible (n=159, 64.9% were women and n=138, 56.3% were single). The mean age was 40.7 (SD 14.1) years. A total of 78% (n=191) of the patients had moderate to severe depression (according to the Patient Health Questionnaire-9 [PHQ-9]). More than half of the population had another psychiatric comorbidity (excluding bipolar disorder, psychotic disorders, and suicidal ideation). A total of 33.9% (n=83) of patients accepted the idea of using Deprexis; the main reason for refusal was financial at 83.3% (n=135). Multivariate logistic regression identified factors that might favor the acceptability of Deprexis. Among these, being a couple, being treated with an antidepressant, or having a low severity level favored the acceptance of Deprexis. DARE is the first French study aiming at evaluating the prospective acceptability of digital therapy in the treatment of depression. The main reason for the refusal of Deprexis was financial. DARE will allow better identification of factors influencing acceptability in a natural setting. This study highlights the importance of investigating factors that may be associated with the acceptability of digital interventions, such as marital status, medication use, and severity of depression.

525 - Real-world effectiveness of upadacitinib in moderate-to-severe atopic dermatitis (AD): Results from cross-sectional analyses of the CorEvitas AD Registry

Abstract Introduction/Background Upadacitinib is an oral Janus kinase inhibitor approved to treat moderate-to-severe atopic dermatitis (AD). While clinical trials have demonstrated its efficacy in treating the signs and symptoms of AD, less is known about its effectiveness in a real-world setting. Objectives This cross-sectional study describes the real-world clinical and patient-reported outcomes of adults with AD enrolled in the CorEvitas AD Registry and treated with upadacitinib for at least four or more weeks. Methods The CorEvitas AD Registry is a prospective, non-interventional registry of adults diagnosed with AD by a dermatologist or qualified dermatology practitioner. The current analysis included participants enrolled between July 21, 2020 through August 7, 2023 who were treated with upadacitinib for at least 4 weeks at the time of evaluation by their provider. Outcome measures included assessments of: skin clearance (Validated Investigators Global Assessment Scale for Atopic Dermatitis [vIGA-AD™], Eczema Area and Severity Index [EASI]); worst itch in the past 24 hours (Peak Pruritus Numeric Rating Scale [PP-NRS]); symptom frequency (Patient-Oriented Eczema Measure [POEM]); quality of life (Dermatologic Life Quality Index [DLQI]); and disease control (Atopic Dermatitis Control Tool [ADCT]). Outcomes were cross-sectionally summarized using data collected at the latest registry visit (Overall cohort), as well as 1 to less than 5 months (1-5 months) and 5-9 months following upadacitinib initiation (Month 1-5 cohort and Month 5-9 cohort, respectively). Subgroup analyses were also conducted based on prior use of biologics indicated for AD (bio-naïve, bio-experienced). Data were analyzed as observed with no imputation. Safety events were not assessed in this ­analysis. Results A total of 335 patients (mean age 45.6 years; 51.6% female; 64.2% White) were treated with upadacitinib (15 mg: n=221 [70.8%]; 30 mg: n=91 [29.2%]; median treatment duration: 6.9 months). Some patients reported concomitant use of topical corticosteroids (28.1%) and prior use of biologics indicated for AD (dupilumab: 45.4%; tralokinumab: 6.0%). For the Overall cohort, 57.3% had clear or almost clear skin (vIGA-AD 0/1). An EASI ≤3 was observed in 74.8% of patients and 45.3% reported no/minimal itch (PP-NRS 0/1); 40.9% had both EASI ≤3 and PP-NRS 0/1. Most patients (69.3%) reported that their AD was controlled (ADCT &amp;lt;7), 36.4% reported clear or almost clear disease (POEM 0–2), and 39.8% reported no impact of AD on their quality of life (DLQI 0/1). Similar results were observed for the Month 1-5 (n=144) and Month 5-9 (n=194) cohorts; results in bio-naïve and bio-experienced patients were comparable. Conclusions More than half of patients with ≥4 weeks of upadacitinib treatment had clear or almost clear skin and greater than two-thirds reported controlled disease, with similar results observed in both bio-naïve and bio-experienced patients. Over a third reported no/minimal symptom and disease burden. These findings suggest that low levels of disease severity are observed with real-world use of upadacitinib. Future analyses will aim to report changes in disease severity and burden due to persistent upadacitinib treatment.

A deep learning-based transformer model for photovoltaic fault forecasting and classification

According to the US-based National Renewable Energy Lab (NREL), solar energy losses due to faults were 3.5 % in 2004, which increased to 17.5 % in 2018. Therefore, the fault prediction mechanism will enable PV practitioners to reduce losses effectively, enhancing the solar system's efficiency and power output. This paper proposes a deep learning-based Transformer model for robust fault prediction in photovoltaic. Transformer uses attention mechanism that considers data points as a language units “word” and learn dependencies among them to predict upcoming data points. Unlike other forecasting algorithms, our proposed approach does not rely on previous trends. In case of PV faults, trends do not exist. The proposed algorithm utilizes rate of change of solar cell parameters for establishing a trend to forecast faults, enabling proactive fault mitigation. It also classifies faults with different severity levels to identify the level of predictive maintenance required. The proposed approach is extensively evaluated using MATLAB on datasets of several faults with low, medium, and high severity levels. The proposed Transformer model achieves a forecasting mean average error (MAE) of 0.09377. Performance of the proposed forecasting and classification algorithm is compared with existing machine learning-based regression and classification techniques such as KNN, SVM, and NN, where proposed approach outperforms state-of-the-art approaches.

Soil Burn Severities Evaluation Using Micromorphology and Morphometry Traits After a Prescribed Burn in a Managed Forest

Prescribed burn is a tool that must imply low soil burn severity (SBS) levels; however, a wide range of soil impacts have been demonstrated because of the influence of very variable factors. The effects on biological, physical, and chemical soil properties are well reported in numerous studies; nonetheless, there are still questions about the effect of prescribed burns on soils at the micro-scale. As a result, an analysis of the link between micromorphological features and SBS does not currently exist. Thus, the main aim of the present study is to perform a micro-scale evaluation for complementing the SBS visual examination after prescribed burning in a managed pine forest in western Mexico. Morphometry and micromorphology analyses of mineral soil revealed that at low SBS levels, only the soil structure in the first centimeter is affected by prescribed burns. While at high SBS, the prescribed burn affected the first 2 cm, showing soil structure disturbance, ash filling porous, and soil aggregates getting reddish. Therefore, immediate actions have to be made by land managers after applying prescribed burns before the first rain to prevent post-fire surface soil erosion, particularly in bare soil patches where the burned aggregates are more susceptible to rain splash and runoff.

The behavior of reinforced lightweight concrete beams with initial cracks

This research examines the performance of reinforced lightweight concrete beams subjected to several degrees of damage (50%, 60%, 70%, and 100%). It can use a sheet made of Carbon Fiber Reinforced Polymer (CFRP) to reinforce. The Full U-wrapping rehabilitation method was tested in the presented experimental program. In this method, CFRP sheets are attached to the bottom only and the side and bottom of the beam section. Experiments proved that the service load (Ps) increases by 7.06 % from a damage level of 50 % to 70 %, rises by 1.21 % from a damage level of 60 % to 70 %, and falls by 3.07 % from a damage level of 100 %. The result also rose for the fortified sample by 11.99%. Increases of 42.67 %, 33.07 %, and 23.73 % in the stiffness ratio (k) were observed at damage intensities of 50, 60, and 70 %, respectively. Damage at lower severity levels is increasing at a faster rate. The ductility of the restored LWC beams is more excellent than the control, as with the stiffness. Damage levels of 50%, 60%, and 70% saw increased ductility of 35.60, 34.92, and 34.69 %, respectively.

Disordered eating behaviours and body shape dissatisfaction among adolescents with type 1 diabetes: a cross sectional study

BackgroundDisordered eating behaviours (DEBs) are variations in regular eating patterns and behaviours and might include symptoms and behaviours of eating disorder with lower level of severity. Such behaviours are common during adolescence at which time several physical and psychological changes occur favouring unhealthy dietary behaviours. Although the magnitude of DEBs is high among high—income countries, similar data are limited among adolescents with diabetes in low-income countries including Ethiopia. This study aimed to assess the magnitude of DEBs and its relationship with body shape dissatisfaction among adolescents with diabetes on follow-up at selected public hospitals in Addis Ababa, Ethiopia.MethodsHospital based cross sectional study was conducted among randomly selected 395 adolescents with diabetes attending public hospitals in Addis Ababa from January to December, 2021. Data were collected using structured pretested standard diabetes eating problem survey revised (DEPS-R) questionnaire, body part satisfaction scale of 8 items, and anthropometric measurements. Descriptive statistics such as median alongside interquartile range was used to describe the continuous variables. Binary bivariable and multivariable logistic regression was used for data analysis. Mann–Whitney U-test and Kruskal–Wallis test were used to evaluate the difference between median scores of independent variables. Adjusted odds ratios (AOR) alongside 95% confidence intervals (CIs) were estimated to measure the strength of association between variables of interest.ResultsThe magnitude of disordered eating behaviours within the last 30 days was 43.3%, [95% CI: (38%, 48%)]. In multivariable analysis, body shape dissatisfaction [AOR = 2.21, 95% CI (1.28, 3.82, p = 0.0001)], family history of diabetes mellitus [AOR = 1.59, 95% CI (1.03, 2.47, p = 0.038)], late adolescence period [AOR = 2.10, 95% CI (1.33, 3.34, p = 0.002)], having diabetic complication[AOR = 2.32, 95% CI (1.43, 3.75, p = 0.001)],and being overweight [AOR = 2.25, 95% CI (1.32, 3.82, p = 0.003)] were significantly associated with DEBs.ConclusionsThe magnitude of DEBs was high among the study participants. Body shape dissatisfaction, family history of diabetes mellitus, being in late adolescence period, diabetic complication, and nutritional status of adolescents were significantly associated with DEBs. Therefore, preventive interventions need to be designed by all relevant actors working on health promotion of young population to address factors influencing DEBs among adolescent population with diabetes.

Long-term field evaluation of Pera sweet orange selections under the Brazilian humid subtropical climate

Currently, a low number of citrus varieties are commercially planted to supply the Brazilian citrus industry demand. The diversification of citrus scion and rootstock varieties is an important strategy to prevent disease outbreaks and to obtain higher off-season profits, as well as to extend fruit supply for the citrus processing industry. The aim of this study was to evaluate 16 Pera sweet orange selections (Citrus ×sinensis Osbeck) under a humid subtropical climate in the northwest region of the state of Paraná, Brazil regarding tree development, production, and disease incidence. The experimental orchard was planted in December 2012 in a randomized block design with three replications and five trees per plot. All scions were grafted on Rangpur lime rootstock (C. ×limonia Osbeck). The evaluations were performed from 2016 through 2022, and included vegetative growth, yield, fruit quality, estimated tree density and productivity for new plantings, and incidence of diseases as citrus canker, huanglongbing (HLB), and citrus tristeza virus (CTV). All data was submitted to ANOVA and means grouped by the Scott Knott’s test (p ≤ 0.05). Pera Perão was the most vigorous variety, with the heaviest and largest fruit, and was among the selections with the highest content of soluble solids (SS), titratable acidity (TA) and juice. However, this variety showed a light-yellow juice color, and one of the lowest SS·TA−1 ratio. This selection had the lowest percentage of fruits with citrus canker but was among the selections with the highest HLB incidence. The selections Ovale, Clone 9, and Clone 42 also showed higher vegetative growth and fruit length, but lower SS content, juice yield and technological indices. All other Pera selections had lower tree height and canopy volume than Ovale, Clone 9, and Clone 42, and adequate overall fruit quality. Conversely, Pera Comprida, Dibbern, Morretes, and Seleç ão 12 scored lower cumulative fruit yield. Pera Pirangi and Comprida had the highest citrus canker incidence on fruits, while Morretes, Ovo, Pirangi, Seleç ão 12, and Seleç ão 27 had the highest HLB incidence alongside Perão. Low severity level of stem pitting was observed within the evaluated selections. The scores ranged from one (absence of stem pitting) to two (sparse surface stem pitting). IAC, Olímpia, Mel, Bianchi, and IPR 159 revealed to be the most suitable for new plantings under humid subtropical edaphoclimatic conditions, as trees had small vegetative growth, high yield performance and fruit quality, in addition to showing lower incidences of citrus canker, HLB and CTV.

LEGAL PROTECTION OF THE STATE HOSPITAL AS THE IMPACT OF INDONESIAN

The purpose of this study is to analyze the legal consequences of implementing Indonesian Case Based Groups in Hospitals and to analyze government hospital laws on the implementation and services in hospitals as a result of the tariffs of Indonesian Case Based Groups. Several studies have found that a number of cases in hospitals have higher rates than BPJS Kesehatan payments, while other cases, for example with a lower severity level, hospital rates are still lower than INA-CBGs rates.The application of the INA-CBGS tariff in health services creates several legal consequences that intersect with administrative law in relation to abuse of authority, criminal law in relation to criminal acts of corruption and civil law in relation to the dispute resolution process, namely the existence of a mediation process beforehand. The form of legal protection for government hospitals in carrying out health services as a result of the INA CBGS Tariff is regulated in several regulations, namely as stated in Article 50 letter a. The Medical Practice Law and Article 75 of the Health Personnel Law, Article 45 of the Hospital Law paragraph (2), Article 58 of Law No. 36 of 2009 Concerning Health, and internally hospitals can also be regulated in Hospital by Laws and can also be in the form of a Director's Regulation Hospital.

Stator inter-turn short-circuit fault diagnosis in induction motors applying VI loci-based technique

Due to the susceptibility of low-power three-phase induction motors (IMs) to stator inter-turn short-circuits (ITSC), researchers have been required to develop practical and cost-effective online systems for detecting faults in the stator winding. It is highly recommended to detect faults at a low fault severity level, as the fault current circulating through the shorted turns exponentially increases due to a reduction in insulation resistance and associated insulation degradation. The proposed Voltage–Current (VI) loci-based technique is a non-invasive, less expensive, and fault-sensitive approach that has been scarcely implemented in industries for stator ITSC faults analysis and accurate faulty phase identification, even under low fault severity. The proposed algorithm can compensate for various factors such as unbalanced supply voltages, asymmetries in winding construction, and errors in sensing element calibration. Experimental results presented for a three-phase 1 hp, 415 V SCIM investigate and validate the competency of the proposed work.

Religious Attendance, Religious Coping, and Systemic Inflammation among Older African American Adults

Older African Americans bear a disproportionate burden of cardiovascular disease risk. One factor underlying these effects may be lifetime stressors exposure. Prior research has shown that religious attendance and positive religious coping, exhibiting a trusting relationship with God, are positively related to health outcomes. Mixed results emerged for negative religious coping. We examined whether these factors interacted with stress in predicting systemic inflammation, a key mechanism in stress-related chronic disease risk. Data was collected from the Health among Older Adults Living in Detroit study (N= 211, M= 67.6 yrs., 73.3% female). Measures included the number and severity of life stressors (measured via the Adult Stress and Adversity Inventory), religious attendance, positive/negative religious coping, and C-Reactive Protein (CRP). Number of participants (N= 114-119) varied in different analyses because of listwise deletion. Religious attendance and negative religious coping did not interact with any lifetime stressor indicators in predicting CRP. However, a significant interaction was found between stress severity and positive religious coping. A significant negative association emerged between positive religious coping and CRP for participants at -1.5 SD (but not +1.5 SD) from average stress severity. At very high levels of stress severity (~+2 SD), a positive link was found between positive religious coping and CRP. Positive religious coping may help to buffer against inflammation for older African American adults reporting low levels of lifetime stress severity. For participants reporting very high levels of stress, religious coping might have deleterious effects on inflammation.

Образ жизни студентов, в том числе с нарушениями в физическом развитии, в условиях пандемии COVID‑19

The article deals with issues that characterize the lifestyle of students in the context of the COVID‑19 pandemic. A number of researchers found that during this period, cases of physical and mental health disorders, non-compliance with the norms of good nutrition, a significant decrease in physical activity, changes in the physical parameters of the body, weight gain, etc. became more frequent among students. Materials and methods. An international methodology was applied to assess the structure of the students’ lifestyle – the Health-Promoting Lifestyle Profile Questionnaire (HLPP-II). The methodology takes into account the characteristic features of 6 integral components (responsibility for health, physical activity, nutrition, spiritual growth, interpersonal relationships and stress management). For the purpose of comparative analysis, 505 students surveyed were divided into 3 groups depending on the body mass index: those with underweight, with normal body weight, and those with excess body weight. Findings. The results obtained made it possible to establish that among those with a deficiency or excess of body weight compared with those with normal body weight, there were significantly more students with a low level of severity of all 6 considered components of the overall level of health.