Punctate Inner Choroidopathy: A Systematic Review

This article reviews clinically relevant data regarding punctate inner choroidopathy, mainly the various treatment options. Punctate inner choroidopathy is an uncommon, inflammatory, multifocal chorioretinopathy affecting mostly young myopic women. It is characterized by the presence of multiple, small, well-defined, yellow-white fundus lesions, in the absence of intraocular inflammation. We describe etiology, clinical findings and ancillary tests that help in the diagnosis and detection of complications. Treatment options that have been used to manage patients with PIC and CNV include immunosuppressants, corticoids, laser photocoagulation, photodynamic therapy, intravitreal anti-VEGF agents and submacular surgery

Cerebral Sinovenous Thrombosis in Children: Clinical Presentation and Extension, Localization and Recanalization of Thrombosis

Many important questions regarding pathophysiology and treatment of cerebral sinovenous thrombosis need clarification and may depend on further knowledge on the etiology, site, extension and recanalization of the thrombosis. We studied these variables in a cohort of children and adolescents from seven Portuguese Centers. We conclude from our results that the deep venous system and the superior longitudinal sinus are less frequently affected with thrombosis but have a greater potential for serious neurologic disease and for major sequelae. Non-recanalization, at least in the long term, is not an adverse prognostic factor. Extensive propagation of the thrombus from the initial site of origin seems to be common. The early identification of risk factors and their treatment coupled with an aggressive attitude towards diagnosis and treatment for thrombosis involving the deep venous system would be warranted

Punctate Inner Choroidopathy: A Systematic Review

This article reviews clinically relevant data regarding punctate inner choroidopathy, mainly the various treatment options. Punctate inner choroidopathy is an uncommon, inflammatory, multifocal chorioretinopathy affecting mostly young myopic women. It is characterized by the presence of multiple, small, well-defined, yellow-white fundus lesions, in the absence of intraocular inflammation. We describe etiology, clinical findings and ancillary tests that help in the diagnosis and detection of complications. Treatment options that have been used to manage patients with PIC and CNV include immunosuppressants, corticoids, laser photocoagulation, photodynamic therapy, intravitreal anti-VEGF agents and submacular surgery

Event-based decision support algorithm for real-time flood forecasting in urban drainage systems using machine learning modelling

Urban flooding is a major problem for cities around the world, with significant socio-economic consequences. Conventional real-time flood forecasting models rely on continuous time-series data and often have limited accuracy, especially for longer lead times than 2 hrs. This study proposes a novel event-based decision support algorithm for real-time flood forecasting using event-based data identification, event-based dataset generation, and a real-time decision tree flowchart using machine learning models. The results of applying the framework to a real-world case study demonstrate higher accuracy in forecasting water level rise, especially for longer lead times (e.g., 2–3 hrs), compared to traditional models. The proposed framework reduces root mean square error by 50%, increases accuracy of flood forecasting by 50%, and improves normalised Nash–Sutcliffe error by 20%. The proposed event-based dataset framework can significantly enhance the accuracy of flood forecasting, reducing the occurrences of both false alarms and flood missing and improving emergency response systems

Methadone Intoxication in a Child: Toxic Encephalopathy?

Methadone is used in the treatment of opioid addiction. Acute intoxication can lead to severe consequences and can even be lethal. In several case reports and small series, a presumably toxic leukoencephalopathy is described resulting from inhalation of heroin. We present the case of a 3-year-old boy who ingested methadone accidentally. In a coma with acute obstructive hydrocephalus owing to massive cerebellar edema and supratentorial lesions, he was successfully treated with methylprednisolone and cerebrospinal fluid external drainage. To our knowledge, this is the first report of an encephalopathy associated with synthetic opioid intoxication

Participation, knowledge production, and evaluative research: participation by different actors in a mental health study

This article reflects on the interrelations between participation, knowledge production, and public policy evaluation in light of issues from our own experience with evaluative research on a municipal network of Psychosocial Care Centers (CAPS) in Brazil. The article discusses the coordination of the complex process and the potentials and limits of partnerships for conducting qualitative evaluative studies in mental health with participation by different social actors. The authors conclude that qualitative evaluative research aligned with the perspective of including different points of view representing various segments is the best approach for understanding the numerous spin-offs from the implementation of services linked to the Brazilian psychiatric reform movement, given the inherent specificities of the mental health field.No presente texto apresentamos considerações sobre pesquisa avaliativa qualitativa e participativa com base em investigação desta natureza realizada junto a uma rede municipal de Centros de Atenção Psicossocial (CAPS) ligados ao Sistema Único de Saúde (SUS). A coordenação do complexo processo, bem como as potencialidades e limites do estabelecimento de parcerias para a realização de trabalhos de investigação avaliativa qualitativa em saúde mental, com a inclusão de diferentes atores sociais, são aqui discutidas. Concluímos que a pesquisa avaliativa qualitativa aliada à perspectiva de inclusão de distintos pontos de vista dos vários segmentos envolvidos é a que melhor se adequa à compreensão dos muitos desdobramentos oriundos da implementação de serviços ligados ao movimento de reforma psiquiátrica brasileira, dado as especificidades inerentes ao campo da saúde mental.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo (UNIFESP)Universidade Estadual de Campinas FCMUNIFESPSciEL

Parental cultural models and resources for understanding mathematical achievement in culturally diverse school settings

This paper proposes that the theoretical concept of cultural models can offer useful insights into parental involvement in their child’s mathematical achievement and the resources they use to go about gaining information in culturally diverse learning settings. This examination takes place within a cultural-developmental framework and draws on the notion of cultural models to explicate parental understandings of their child’s mathematics achievement and what resources are used to make sense of this. Three parental resources are scrutinized: (a) the teacher, (b) examination test results, and (c) constructions of child development. The interviews with 22 parents revealed some ambiguity around the interpretation of these resources by the parent, which was often the result of incongruent cultural models held between the home and the school. The resources mentioned are often perceived as being unambiguous but show themselves instead to be highly interpretive because of the diversity of cultural models in existence in culturally diverse settings. Parents who are in minority or marginalized positions tend to have difficulties in interpreting cultural models held by school, thereby disempowering them to be parentally involved in the way the school would like

A novel substitution in NS5A enhances the resistance of hepatitis C virus genotype 3 to daclatasvir

Hepatitis C virus (HCV) genotype 3 presents a high level of both baseline and acquired resistance to direct-acting antivirals (DAAs), particularly those targeting the NS5A protein. To understand this resistance we studied a cohort of Brazilian patients treated with the NS5A DAA, daclatasvir and the nucleoside analogue, sofosbuvir. We observed a novel substitution at NS5A amino acid residue 98 [serine to glycine (S98G)] in patients who relapsed post-treatment. The effect of this substitution on both replication fitness and resistance to DAAs was evaluated using two genotype 3 subgenomic replicons. S98G had a modest effect on replication, but in combination with the previously characterized resistance-associated substitution (RAS), Y93H, resulted in a significant increase in daclatasvir resistance. This result suggests that combinations of substitutions may drive a high level of DAA resistance and provide some clues to the mechanism of action of the NS5A-targeting DAAs

Socially negotiating privacy boundaries and academic identities

Research examining privacy in a higher education setting tends to focus on the student perspective whilst largely overlooking the academic perspective. Moreover, it fails to fully conceptualise the social, relational, and contextual complexities of privacy and the vital role it has on academics’ ability to form their identity. To address these knowledge gaps, this paper draws on the social theory of privacy to examine how academics socially negotiate privacy boundaries and the influence these negotiations have on their identity. Data were gathered through a qualitative case study analysis of a higher education institution in the United Kingdom (UK). The findings reveal how academic preferences and context-dependent social meanings influence the construction of dialectical privacy boundaries that allow academics to create and maintain various personal boundaries. These negotiated boundaries are influenced by the nature of the relationship between individuals, the levels of trust between colleagues, and the social norms governing workplace relationships. The findings also reveal how these negotiated privacy boundaries provide an intimate territory within which academics co-construct their identity through a complex series of social interactions occurring over time

Addressing drinking water salinity due to sea water intrusion in Praia de Leste, Parana, by a brackish water desalination pilot plant

Seawater intrusion into the Pombas River, source of freshwater to Praia de Leste on the coast of Parana in Brazil presents a problem to the water utility as most water treatment plants in Brazil are conventional. To find a solution to this problem, a pilot plant (1 m3 /h) consisting of ultrafiltration (UF) followed by reverse osmosis (RO) was developed and evaluated. For testing, brackish water was produced with a concentration of 1,500 ± 100 mg/L of total dissolved solids (TDS), mixing seawater and fresh water. To evaluate the water quality, TDS, electrical conductivity, pH, temperature, apparent color, turbidity, alkalinity, total hardness, calcium, chloride and sulfate were monitored. For operational performance, flowrates, osmotic pressure, filtration rate, recovery rate and mass balance were analyzed. On average, the UF system removed 96.4% of turbidity and 98.6% of apparent color; whereas the RO system removed 99.4% of TDS. The overall average recovery (UF and RO) was 45.81% with average osmotic pressure of 8.21 bar, filtration rate of 30.7 L/h/m2 in the UF system and 21.7 L/h/m2 in the RO system. From a water quality point of view, the system was effective in processing brackish into fresh water of high quality