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Christian Gessner,1 Frederik Trinkmann,2,3 Sanaz Bahari Javan,4 Raimund Hövelmann,4 Valentina Bogoevska,4 George Georges,5 Elena Nudo,6 Carl-Peter Criée7 1Pneumologische Praxis Leipzig, Universitätsklinikum Leipzig, Institut für Klinische Immunologie, Leipzig, Germany; 2Pneumology and Critical Care Medicine, Thoraxklinik at University Hospital Heidelberg, Translational Lung Research Center Heidelberg (TLRC), Member of German Center for Lung Research (DZL), Heidelberg, Germany; 3Department of Biomedical Informatics (DBMI) at the Center for Preventive Medicine and Digital Health Baden-Württemberg (CPD-BW), University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany; 4Department of Medical Affairs, Chiesi GmbH, Hamburg, Germany; 5Corporate R&D, Chiesi USA Inc., Cary, NC, USA; 6Global Medical Affairs, Chiesi Farmaceutici S.p.A., Parma, Italy; 7Department of Sleep and Respiratory Medicine, Evangelical Hospital Goettingen-Weende, Bovenden, GermanyCorrespondence: Christian Gessner, Pneumologische Praxis Leipzig, Universitätsklinikum Leipzig, Institut für Klinische Immunologie, Tauchaer Straße 12, Leipzig, 04357, Germany, Tel +49 341 60 20 960, Email ch.gessner@pneumologe-leipzig.dePurpose: Real-word evidence on the effectiveness of switching from dual therapies or triple therapies (multiple inhalers) to extrafine single-inhaler triple therapy (efSITT), which consists of the inhaled corticosteroid (ICS) beclomethasone, the long-acting β2-agonist (LABA) formoterol and the long-acting muscarinic antagonist (LAMA) glycopyrronium, in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) is limited. The impact of switching to efSITT on health-related quality of life (HRQoL), COPD specific symptoms, lung function and treatment adherence were assessed in routine clinical care.Patients and Methods: Patients were recruited at 148 sites in Germany between 2017 and 2020 in this multicenter, non-interventional observational study. Demographics, clinical data and treatment history were collected at baseline. HRQoL (measured by COPD Assessment Test [CAT]), lung function and adherence (measured by Test of Adherence to Inhalers [TAI]) were assessed at baseline and after six months. Descriptive analyses were conducted by prior treatment and GOLD groups as well as for the overall population.Results: 55.1% of the 2623 included patients were male. Mean age was 65.8 years. 57.5% of the patients were previously treated with ICS+LABA+LAMA (multiple inhalers), 23.9% with ICS/LABA (single or two inhalers) and 18.6% with LAMA/LABA (single or two inhalers). After six months, largest mean improvements in the total CAT score were observed in the ICS/LABA (− 3.9) and LAMA/LABA (− 3.9) prior treatment groups as well as in patients in GOLD group B (− 2.9). In the overall population, the CAT items for cough, phlegm, and dyspnea decreased on average by − 0.4 points each. After six months, FEV1 increased by 2.0 percentage points in relation to predicted values. The percentages of measured sRtot and RV of predicted values decreased by 24.5 and 4.4 percentage points, respectively. The percentage of patients with good adherence increased from 67.8% to 76.5%.Conclusion: Treatment switch to efSITT resulted in an improvement of HRQoL, COPD specific symptoms, lung function parameters and adherence under real-world conditions.Keywords: COPD, extrafine single inhaler triple therapy, treatment adherence, CAT score

This summary deals with the invisibility of psychological violence against women in the field of gender violence and consequent silencing. Attempting for the forms of abuseof patriarchal power, as well as for the machismo that permeates society, not only masculine but also not imaginary of feminine collective life. From a quali-quanti nature, we will start from a bibliographic study, a documentary and content analysis, as well as methodological approaches and other techniques for data collection. Many studies with countless faces of the defense of violence against Mulher FERNANDES (2012); SILVA (2009); ZIZEK (2008). In this sense, it is worth mentioning that this work raisedimportant questions. Taking into account, mainly, or fate of these (psychological) violences will occur in a sad way, so that many women are not perceived as inserted in a context of violence. Concerning the techniques and instruments of data collection, we even verified that the investigation contributed to the analysis and understanding of the interfaces of violence against a woman in the municipality of Maceió-AL, once the reports of the Secretary of State for Public Security ( SSP-AL) will show every 141 (cento e quarenta e um) cases of violence against women in the 2020 carnival period, in Alagoas.

This article exposes domestic violence against women in times of Pandemic COVID-19 to carry out the analysis of the conjunctural interfaces of gender today, seeking to identify what are the implications in taking the option for Law 11.340 / 06 (Law Maria da Penha ), when used in the criminal justice system as a trigger in the correction of violent conflicts against women. Of a quali-quanti nature, we will start from the bibliographic study, from the documentary and content analysis as methodological approaches and other techniques for data collection. Many studies contain the many faces of the defense of violence against women FERNANDES (2012); SILVA (2009); ZIZEK (2008) in the domestic reality, stating that the constitutional norms must be structured and ordered in such a way as to enable the prompt identification of the legal position in which the jurisdicted BARROSO (2009) invest; PORTO (2008); SILVA (2009), among others, and such positions must be safeguarded by appropriate tutelage instruments, suitable for their practical realization. Concerning the techniques and instruments of data collection, we also verified that the research contributed to the analysis and understanding of the interfaces of violence against women in the city of Maceió-AL, since the data from the report of the State Secretariat of Public Security ( SSP-AL) showed 141 (one hundred and forty-one) cases of violence against women during Carnival 2020, in Alagoas. In Maceió, however, without further reflection on the reasons for the high rates of domestic violence against women in times of COVID-19, due to the continuous research process, data from Patrulha Maria da Penha (2020) reveal that in the city the increase was from 146% (one hundred and forty-six percent) from January to May 26, 2020. Therefore, highlighting the data in comparison with the same period of the previous year.

In this paper, the amount of heat wasted from different parts of a 12-liter compression ignition engine and the recoverable heat from these parts were investigated. Then, two-stage configuration of organic Rankine cycle was introduced for simultaneous heat recovery from exhaust gases and coolant. Finally, parameters such as hybrid generated power, engine thermal efficiency, and brake specific fuel consumption were studied at different engine speeds under full engine load. By adopting this method, 35 kW hybrid power can be generated consequently, causing 9.5% reduction in brake specific fuel consumption. [ABSTRACT FROM AUTHOR]

O trabalho ora apresentado parte de estudos bibliográficos e documentais, visitas, observações e entrevista com os segmentos escolares: equipe gestora, professores e alunos, tendo como objetivo apresentar as análises da pesquisa na iniciação científica, concernente à gestão democrática relacionada à Educação de Jovens e Adultos (EJA) de uma escola da rede pública municipal de Maceió, Alagoas. Partindo da temática "Gestão e EJA", o desenvolvimento da pesquisa visou esclarecer como a EJA vem sendo tratada pela equipe gestora da instituição de ensino. Essa por sua vez, desdobrou-se em especificidades como: a análise documental do Projeto Político Pedagógico (PPP) e a participação dos jovens e adultos nas Instâncias Colegiadas. Os estudos de Paro (1996), Lück (2002), Cury (2000), Pazetto; Whittman (1999), entre outros, foram usados como referencial teórico para subsidiar a análise, uma vez que, esses autores, ao contrário da visão restrita e burocratizada de administração escolar, afirmam que a gestão escolar deve passar a ser compreendida como mecanismo coletivo de tomada de decisões pelos diversos atores sociais que compõem o cenário escolar.

This study was carried out in three farmed rainbow trout (Oncorhynchus mykiss) of Guilan Province. Heavy metals (Iron and Lead) were measured using Atomic absorption spectrometry in food, water and fish muscles of farms. The amounts of Iron and Lead (Mean ±SD) in all water samples from studied farms were 55.29±2.71 and 2.066±0.714 µg/L, respectively. The amounts of Iron and Lead (Mean± SD) in consumed feed of studied farms were 494.51± 89.18 and 3.494± 1.462 mg/kg, respectively. Also, the amounts of Iron and lead in fish muscle of studied farms were measured as 7.715± 1.050 and 0.39970± 0.073 mg/kg, respectively. The obtained results revealed the existence of higher amounts of iron in fish muscle above Codex standard, 2001 and lower amounts of lead levels from the mentioned standard in studied farms. The obtained data showed no significant differences in water, food and muscle of fish in studied areas (p>0.05).

The present study was designed to determine the levels of heavy metals (Cu, Pb, Ni, Cr, Zn, Mn, Cd, and Co), Mn, and As in Iranian-grown rice and imported rice consumed in Neyshabur City. For this research, 90 samples from 30 different brands widely consumed in this city were collected. The content of heavy metals and the health risks associated with their use were then studied. The study found that Zn (14.21 mg kg -1 ) had the highest content in Iranian and imported rice varieties, whereas Cd (0.02 mg kg -1 ) had the lowest value. The health risk assessment was also done in three scenarios and separately for two types of rice. The results showed that the total hazard quotient (i.e., THQ) was measured for all metals and all three scenarios, and for both types of rice, it is THQ > 1, which indicates the risk of non-carcinogenic in rice. The cancer risk for three scenarios and two types of imported and Iranian rice is in the unsafe range for As (8.80 × 10 -4 to 7.00 × 10 -3 ), Ni (4.60 × 10 -4 to 3.60 × 10 -3 ) and Cr (2.20 × 10 -4 to 1.90 × 10 -3 ) and negligible for Pb (1.09 × 10 -6 to 1.49 × 10 -5 ) and Cd (7.83 × 10 -6 to 8.20 × 10 -5 )., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

The identification of volatile organic components in snuff was accomplished using GC-MS analysis in this study. The findings of the GC-MS analysis revealed the presence of nicotine, its derivatives, and several other toxic chemicals that are hazardous to human health. Furthermore, the content of 34 elements in four brands of snuff consumed in Neyshabur City was determined by ICP-OES analysis (with five repetitions). The health hazards of measured heavy elements were examined from two perspectives: carcinogenic (7 heavy elements were checked) and non-carcinogenic (4 heavy elements were checked). The investigation of non-carcinogenic hazards from inhalation was based on the computation of the hazard quotient (HQ) factor, and the results indicated that inhaling five heavy metals, Cu, Pb, Ni, Zn, and Cd, does not represent a substantial health risk ((HQ < 1). In contrast, the computed HQ factors for Cr and As were relatively high (1 < HQ < 10), indicating a substantial health risk from breathing these two elements. The carcinogenic factor (CR value) results revealed that the degree of carcinogenic risk for Cd was very low (CR value less than 1 × 10 -6 ) and did not pose a concern to the consumer population. However, the risk of As, Cr, and Ni exposure is considerable in the carcinogenic risk range (CR values between 1 × 10 -6 and 1 × 10 -4 )., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Introduction: Ventilator-associated events (VAEs) are one of the main sources of concern in critically ill patients due to the high frequency and mortality. We conducted this analysis to compare the effects of open endotracheal suctioning system with closed one on the incidences of VAEs in adult patients receiving mechanical ventilation (MV)., Materials and Methods: A comprehensive literature search was performed in PubMed, Scopus, Cochrane Library, and hand searching bibliographies of retrieved articles. The search was confined to randomized controlled trials with human adults comparing closed tracheal suction systems (CTSS) vs open tracheal suction systems (OTSS) in prevention of ventilator-associated pneumonia (VAP). Full-text articles were used in order to extract the data. Data extraction was only started after completing the quality assessment., Results: The search resulted in 59 publications. Among them, 10 were identified as eligible for meta-analysis. There was a significant increase in incidence of VAP when using OTSS compared to CTSS, so that OCSS increased the incidence of VAP by 57% (OR 1.57, 95% CI 1.063-2.32, p = 0.02)., Discussion: Our results showed that using CTSS can significantly decrease VAP development compared to OTSS. This conclusion does not yet mean the routine use of CTSS as a standard VAP prevention measure for all patients since individual patient's disease and cost are other factors that should be in mind when determining the choice of the suctioning system. High-quality trials with a larger sample size are highly recommended., How to Cite This Article: Sanaie S, Rahnemayan S, Javan S, Shadvar K, Saghaleini SH, Mahmoodpoor A. Comparison of Closed vs Open Suction in Prevention of Ventilator-associated Pneumonia: A Systematic Review and Meta-analysis. Indian J Crit Care Med 2022;26(7):839-845., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd.)

Background: Seeking novel anticancer agents with minimal side effects against gastric cancer is vitally important. Copper, as an important trace element, takes roles in different physiologic pathways. Also, there is a higher demand for copper in cancer cells than normal ones. Copper complexes containing a therapeutic ligand could be promising candidates for gastric cancer chemotherapy., Methods and Results: In this work, copper oxide nanoparticles were synthesized, functionalized with glutamic acid (CuO@Glu) and conjugated with thiosemicarbazone (CuO@Glu/TSC NPs). The NPs were characterized and their antiproliferative potential against AGS cancer cells was investigated using MTT, flow cytometry, Hoechst staining, and caspase 3 activation assays. The FT-IR results showed the proper binding of TSC to CuO@Glu NPs and crystallinity of the prepared NPs was confirmed by the XRD pattern. The EDX analysis confirmed the presence of Cu, N, C, O, and S elements and lack of impurities. The Hydrodynamic size and zeta potential of the CuO@Glu/TSC NPs were 168 nm and 27.5 mV, respectively. The NPs had spherical shape and were in a size range of 10 to 60 nm in diameter. This work revealed that CuO@Glu/TSC NPs efficiently inhibited the proliferation of AGS cells with significantly lower IC 50 value (203 µg/mL) than normal HEK293 cells (IC 50  = 435 µg/mL). Flow cytometry and Hoechst staining obviously revealed apoptosis induction among CuO@Glu/TSC treated cells, and caspase-3 activity significantly increased by 1.4 folds., Conclusions: This study introduced CuO@Glu/TSC as an efficient anticancer against gastric cancer cells with lower toxicity toward normal cells which could be employed for cancer treatment after further studies., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

This study aimed to determine and analyze heavy metal pollution in the street dust of Neyshabur city of Iran. In this regard, the concentration of ten heavy metals, including Al, Fe, Mn, Zn, Cu, Cr, Ni, Pb, Co, and Cd, was measured at 60 street dust samples. The samples from Neyshabur city in three zones were collected, including high traffic, low traffic, and rural. Twenty samples in each area, 10-sample in summer and 10-sample in winter, were studied. The average concentration of the target heavy metals (mg kg -1 ) in the street dust samples was as follows: 50514.09 for Al, 42473.33 for Fe, 647.4 for Mn, 230.07 for Zn, 146.44 for Cu, 96.18 for Cr, 73.25 for Ni, 40.56 for Pb, 14.86 for Co, and 1.32 for Cd. Based on the findings, it can be concluded that non-carcinogenic risk assessment for all quantified heavy metals was less than the allowed values. In addition, the carcinogenic risk assessment of these metals indicated high carcinogenic-risk indexes through exposure to Cr for adults and exposure to Cr, Co, and Ni for children. As a consequence of this investigation, efforts to avoid the transmission of heavy metals in the environmental soil of Neyshabur city should be encouraged., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Purpose: This study was designed to measure the concentrations of heavy (Pb, Cu, Fe, Ni, and Zn) metals in water, soil, and frequently edible leafy vegetables in the Iranian population and assessed the carcinogenic and non-carcinogenic health risk in consumers., Methods: The samples of soil, water, and vegetables were collected from forms near the Tehran-Mashhad highway in Neyshabur, Iran. The content of heavy metals in the samples was analyzed using Atomic Absorption Spectrophotometry., Results: The average concentrations of Pb, Cu, Fe, Ni, and Zn were 5.56, 3.35, 4.74, 2.95, and 5.27 mg/kg, respectively. Lead concentration in all of the vegetable samples was higher than the permissible value endorsed by the World Health Organization (WHO) / Food and Agriculture Organization (FAO). In contrast, the concentrations of all the other heavy metals in the samples were less than the maximum permissible levels recommended by WHO/FAO. Similarly, the water and soil samples were highly contaminated by Lead. The hazard quotient (HQ) of all the heavy metals was distinctively less than one, and it did not exceed 0.3 in any of the age groups. Furthermore, the carcinogenic risk for nickel was only higher than the recommended value, especially in women., Conclusion: While it seems that consuming vegetables has no acute health risk related to heavy metals, long-term and regular ingestion of the vegetables are likely to make cancer risk. Besides, due to the high concentration of Pb in soil and vegetables, regular and integrated assessment of heavy metals in soil, water, and food is necessary., Competing Interests: Conflict of interestWe wish to draw the attention of Editor the the following fact that there is no conflict of interest in this work., (© Springer Nature Switzerland AG 2021.)

Many central nervous system (CNS) diseases, such as Alzheimer's disease (AD), affect the deep brain region, which hinders their effective treatment. The hippocampus, a deep brain area critical for learning and memory, is especially vulnerable to damage during early stages of AD. Magnetic drug targeting has shown high potential in delivering drugs to a targeted disease site effectively by applying a strong electromagnetic force. This study illustrates a nanotechnology-based scheme for delivering magnetic nanoparticles (MNP) to the deep brain region. First, we developed a mathematical model and a molecular dynamic simulation to analyze membrane crossing, and to study the effects of particle size, aggregation, and crossing velocities. Then, using in vitro experiments, we studied effective parameters in aggregation. We have also studied the process and environmental parameters. We have demonstrated that aggregation size can be controlled when particles are subjected to external electromagnetic fields. Our simulations and experimental studies can be used for capturing MNPs in brain, the transport of particles across the intact BBB and deep region targeting. These results are in line with previous in vivo studies and establish an effective strategy for deep brain region targeting with drug loaded MNPs through the application of an external electromagnetic field.

Data-driven healthcare uses predictive analytics to enhance decision-making and personalized healthcare. Developing prognostic models is one of the applications of predictive analytics in medical environments. Various studies have used machine learning techniques for this purpose. However, there is no specific standard for choosing prediction models for different medical purposes. In this paper, the ISAF framework was proposed for choosing appropriate prediction models with regard to the properties of the classification methods. As one of the case study applications, a prognostic model for predicting cardiac arrests in sepsis patients was developed step by step through the ISAF framework. Finally, a new modified stacking model produced the best results. We predict 85 % of heart arrest cases one hour before the incidence (sensitivity> = 0.85) and 73 % of arrest cases 25 h before the occurrence (sensitivity> = 0.73). The results indicated that the proposed prognostic model has significantly improved the prediction results compared to the two standard systems of APACHE II and MEWS. Furthermore, compared to previous research, the proposed model has extended the prediction interval and improved the performance criteria., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Heavy metal pollution of soils in industrial zones continues to attract attention because of its potential human health risks. The present research is an attempt to assess the pollution status of heavy metals including As, Cd, Cr, Ni, and Pb using various indices like contamination factor (CF), pollution index (I POLL ), and geo-accumulation index (I geo ). In total, 60 surface soil samples were collected from four area (north, south, east, and west) in Khayyam industrial zone from depths of 10-20 cm. The results indicated that average metal concentration ranges (in mg/kg) observed in study soils were 8.84, 1.9, 37.66, 15.77, and 57.33 for As, Cd, Cr, Ni, and Pb, respectively. The concentrations of heavy metals As, Cr, Ni, and Pb with the exception of Cd in soils of southern areas of the industrial zone were higher. Cd concentration vary negligibly in sampling sites of north, south, east, and west. Based on the CF, I POLL , and I geo indices, the pollution of soil in regard to concentration of heavy metals was in the following order: Cd > As > Pb > Ni > Zn. Industrial activities have therefore resulted in elevated concentrations of so in the soil environments in the Khayyam industrial zone. Based on the results of human health risk assessments, the soil metals pose negligible carcinogenic and non-carcinogenic risks to the adults and children living in this area. The need for the monitoring of the soil around the industrial zone, especially for Cd and As, is needed to reduce potential environmental issues.

Background: Sepsis-associated cardiac arrest is a common issue with the low survival rate. Early prediction of cardiac arrest can provide the time required for intervening and preventing its onset in order to reduce mortality. Several studies have been conducted to predict cardiac arrest using machine learning. However, no previous research has used machine learning for predicting cardiac arrest in adult sepsis patients. Moreover, the potential of some techniques, including ensemble algorithms, has not yet been addressed in improving the prediction outcomes. It is required to find methods for generating high-performance predictions with sufficient time lapse before the arrest. In this regard, various variables and parameters should also been examined., Objective: The aim was to use machine learning in order to propose a cardiac arrest prediction model for adult patients with sepsis. It is required to predict the arrest several hours before the incidence with high efficiency. The other goal was to investigate the effect of the time series dynamics of vital signs on the prediction of cardiac arrest., Method: 30 h clinical data of every sepsis patients were extracted from Mimic III database (79 cases, 4532 controls). Three datasets (multivariate, time series and combined) were created. Various machine learning models for six time groups were trained on these datasets. The models included classical techniques (SVM, decision tree, logistic regression, KNN, GaussianNB) and ensemble methods (gradient Boosting, XGBoost, random forest, balanced bagging classifier and stacking). Proper solutions were proposed to address the challenges of missing values, imbalanced classes of data and irregularity of time series., Results: The best results were obtained using a stacking algorithm and multivariate dataset (accuracy = 0.76, precision = 0.19, sensitivity = 0.77, f1-score = 0.31, AUC= 0.82). The proposed model predicts the arrest incidence of up to six hours earlier with the accuracy and sensitivity over 70%., Conclusion: We illustrated that machine learning techniques, especially ensemble algorithms have high potentials to be used in prognostic systems for sepsis patients. The proposed model, in comparison with the exiting warning systems including APACHE II and MEWS, significantly improved the evaluation criteria. According to the results, the time series dynamics of vital signs are of great importance in the prediction of cardiac arrest incidence in sepsis patients., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The aim of this study was to evaluate corrosion and scaling potential of drinking water resources Iranshahr in order to considering necessary solutions to solve possible problems including internal corrosion of pipes, deterioration of water quality and reduce of water transfer capacity of distribution network system. The data showed that Langelier index ranged between -1.53 to -0.96, Ryznar index between 9.63-10.54, Aggressive index between 12.04 and 12.91, and Puckorius index between 9.05-10.68 for drinking water resources Iranshahr. Studied indices indicated that the drinking water in Iranshahr can be considered as corrosive.