RESUMO
To explore the effects of climate change on malaria and 20 neglected tropical diseases (NTDs), and potential effect amelioration through mitigation and adaptation, we searched for papers published from January 2010 to October 2023. We descriptively synthesised extracted data. We analysed numbers of papers meeting our inclusion criteria by country and national disease burden, healthcare access and quality index (HAQI), as well as by climate vulnerability score. From 42 693 retrieved records, 1543 full-text papers were assessed. Of 511 papers meeting the inclusion criteria, 185 studied malaria, 181 dengue and chikungunya and 53 leishmaniasis; other NTDs were relatively understudied. Mitigation was considered in 174 papers (34%) and adaption strategies in 24 (5%). Amplitude and direction of effects of climate change on malaria and NTDs are likely to vary by disease and location, be non-linear and evolve over time. Available analyses do not allow confident prediction of the overall global impact of climate change on these diseases. For dengue and chikungunya and the group of non-vector-borne NTDs, the literature privileged consideration of current low-burden countries with a high HAQI. No leishmaniasis papers considered outcomes in East Africa. Comprehensive, collaborative and standardised modelling efforts are needed to better understand how climate change will directly and indirectly affect malaria and NTDs.
RESUMO
A woman in her 40s was involved in a motor vehicle collision and sustained a closed Hawkins type IV talar neck fracture dislocation. The injury was treated with reduction, percutaneous pinning and spanning external fixation, followed by definitive treatment with total talus arthroplasty (TTA) 2 months following injury. This is a unique example of definitive management for a severe talar neck fracture dislocation with arthroplasty in the subacute setting. TTA is perhaps a primary option for these injuries at high risk for avascular necrosis, non-union, malunion and post-traumatic arthritis.
Assuntos
Fratura-Luxação , Fraturas Ósseas , Fraturas Fechadas , Luxações Articulares , Tálus , Feminino , Humanos , Fratura-Luxação/diagnóstico por imagem , Fratura-Luxação/cirurgia , Fixação Interna de Fraturas , Fraturas Ósseas/cirurgia , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/cirurgia , Tálus/diagnóstico por imagem , Tálus/cirurgia , Tálus/lesões , Adulto , Pessoa de Meia-IdadeRESUMO
AIM: This study aimed to assess the effect of iron deficiency on parent-reported changes in quality of life (QOL) among children receiving an adenotonsillectomy for paediatric obstructive sleep apnoea (OSA). METHODS: This was a retrospective review study that recruited children under 16 years of age undergoing an adenotonsillectomy, adenoidectomy, or tonsillectomy for clinically diagnosed paediatric OSA between June 2020 and January 2021 inclusive, in Western Australia. The main outcome measures for this study were changes in QOL by age group and iron status, defined by an absolute change of more than 3 points on OSA-18 survey domains. RESULTS: About 249 participants had iron studies performed on perioperative blood samples drawn at operation and completed both pre-operative and post-operative OSA-18 QOL questionnaires at initial consultation and 8-12 weeks post-surgery, respectively. 41.8% were iron deficient, 53.8% were borderline iron deficient and 4.4% had normal iron levels. Following surgery, a decrease was observed for all OSA-18 score domains in post-operation scores compared to pre-operation scores in both iron-deficient and borderline iron-deficient cohorts. 'Daytime Problems' in the <2 years group, within the iron-deficient cohort, was the only domain that found to be non-superior (i.e. 'not better') following surgery. CONCLUSIONS: Following adenotonsillectomy, patients with paediatric OSA reported significant improvements in QOL regardless of their iron status. Those undergoing an adenotonsillectomy for paediatric OSA had a high prevalence of iron deficiency at operation, especially those under 6 years of age.
Assuntos
Deficiências de Ferro , Apneia Obstrutiva do Sono , Tonsilectomia , Adenoidectomia , Criança , Humanos , Ferro , Polissonografia , Qualidade de Vida , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/cirurgiaRESUMO
Nerve gas mimic binding with Rhodamine B ethylenediamine (1) was studied in organic media. Binding of the nerve gas mimic, diethyl chlorophosphate (DCP), with the probe generated a non-fluorescent intermediate and a fluorescent product. Fluorescent and non-fluorescent products generated were identified using mass spectrometry and X-ray crystallography. Time-dependent density functional theory calculations were also used to investigate the electronic structure of the fluorescent probe in the ground and lowest lying π â π* singlet excited state. Though good agreement between theory and experiment can be obtained for the intense peak in the experimental spectrum using non-hybrid functionals, care must be taken when modelling these complexes due to the appearance of an n â π* transition that is too low in energy and appears to fall in the shoulders of the π â π* transitions.
Assuntos
Agentes Neurotóxicos , Etilenodiaminas , Corantes Fluorescentes/química , Agentes Neurotóxicos/química , Rodaminas/químicaRESUMO
Piriformis syndrome is described as a neuromuscular condition which occurs when the sciatic nerve is compressed and/or irritated by the piriformis muscle. It is characterized by acute tenderness in the buttock with sciatica-like pain radiating into the posterior aspect of the thigh, leg, and foot. The neurogenic leg and foot pain experienced with this condition is consistent with involvement of the sciatic nerve. However, the posterior thigh pain associated with piriformis syndrome is due to involvement of the posterior femoral cutaneous nerve (i.e., posterior cutaneous nerve of the thigh), which is a branch of the sacral plexus independent of the sciatic nerve. This nerve is rarely mentioned relative to piriformis syndrome even though posterior thigh pain is more prevalent in patients than leg and foot pain. In the few instances when the posterior femoral cutaneous nerve is referenced relative to piriformis syndrome the neuralgic signs associated with it are attributed to compression by piriformis. Yet, given the dramatic size difference between the sciatic and posterior femoral cutaneous nerves one would expect direct piriformis compression to impact the sciatic nerve first and produce leg/foot pain at a far greater frequency than posterior thigh pain. However, the opposite is seen in the literature, which raises the question, what underlying mechanism is responsible for this phenomenon? It is hypothesized that the prevalence of posterior femoral cutaneous nerve involvement in piriformis syndrome is due to compression of the inferior gluteal vein by a hypertrophied piriformis muscle.
Assuntos
Síndrome do Músculo Piriforme , Nádegas , Humanos , Perna (Membro) , Plexo Lombossacral , Síndrome do Músculo Piriforme/complicações , Nervo IsquiáticoRESUMO
Gordonia bacteriophage Yvonnetastic was isolated from soil in Pittsburgh, PA, using Gordonia terrae 3612 as a host. Yvonnetastic has siphoviral morphology and a genome of 98,136 bp, with 198 predicted protein-coding genes and five tRNA genes. Yvonnetastic does not share substantial sequence similarity with other sequenced bacteriophage genomes.
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PURPOSE: To determine whether image enhancement improves visual search performance and whether enhanced images were also preferred by subjects with vision impairment. METHODS: Subjects (n = 24) with vision impairment (vision: 20/52 to 20/240) completed visual search and preference tasks for 150 static images that were enhanced to increase object contours' visual saliency. Subjects were divided into two groups and were shown three enhancement levels. Original and medium enhancements were shown to both groups. High enhancement was shown to group 1, and low enhancement was shown to group 2. For search, subjects pointed to an object that matched a search target displayed at the top left of the screen. An "integrated search performance" measure (area under the curve of cumulative correct response rate over search time) quantified performance. For preference, subjects indicated the preferred side when viewing the same image with different enhancement levels on side-by-side high-definition televisions. RESULTS: Contour enhancement did not improve performance in the visual search task. Group 1 subjects significantly (p < 0.001) rejected the High enhancement, and showed no preference for medium enhancement over the original images. Group 2 subjects significantly preferred (p < 0.001) both the medium and the low enhancement levels over original. Contrast sensitivity was correlated with both preference and performance; subjects with worse contrast sensitivity performed worse in the search task (ρ = 0.77, p < 0.001) and preferred more enhancement (ρ = -0.47, p = 0.02). No correlation between visual search performance and enhancement preference was found. However, a small group of subjects (n = 6) in a narrow range of mid-contrast sensitivity performed better with the enhancement, and most (n = 5) also preferred the enhancement. CONCLUSIONS: Preferences for image enhancement can be dissociated from search performance in people with vision impairment. Further investigations are needed to study the relationships between preference and performance for a narrow range of mid-contrast sensitivity where a beneficial effect of enhancement may exist.