Statelessness of Children born to Venezuelan Parents in Colombia: Lawmaking without Convincing Policies

This article examines the Colombian legislation against statelessness issued due to the humanitarian emergency in Venezuela in recent years. There have been three waves of Venezuelan migration: the first, in 2005; the second, in 2017; and the last wave, from 2017 to the present day. For this analysis, it was used a qualitative socio-legal method adopting a descriptive approach. The paper affirms that, despite the efforts of Colombian entities to regulate the statelessness of minors born to Venezuelan parents, these regulations contain legal vacua due to a lack of communication between the different State bodies. Such void causes legal contradictions and legal uncertainty in the national system, and, subsequently, violates in a direct manner the fundamental rights of children born to Venezuelan migrants in Colombia.

En el presente artículo se analiza la legislación colombiana contra la apatridia expedida a raíz de la migración ocasionada por la emergencia humanitaria en Venezuela durante los últimos años. La migración venezolana se puede dividir en tres oleadas, la primera en el año de 2005, la segunda en el año de 2010 y la última desde el año de 2017 hasta la actualidad. Para la realización del presente artículo, se utilizó el método cualitativo de carácter sociojurídico con un enfoque descriptivo. Finalmente, se concluye que, a pesar del esfuerzo de las entidades colombianas por regular la apatridia de los menores hijos de padres venezolanos, dicha legislación presenta vacíos normativos por la falta de comunicación de los diferentes órganos del Estado. Dichos vacíos crean contradicciones, generan inseguridad jurídica en el ordenamiento nacional y, ulteriormente, violentan de manera directa los derechos fundamentales de los menores hijos de migrantes venezolanos nacidos en Colombia.

Este artigo analisa a legislação colombiana contra a apatridia emitida como resultado da migração causada pela emergência humanitária na Venezuela nos últimos anos. A migração venezuelana pode ser dividida em três ondas, a primeira em 2005, a segunda em 2010 e a última de 2017 até o presente. Para este artigo, usamos um método sociojurídico qualitativo com uma abordagem descritiva. Por fim, conclui-se que, apesar dos esforços das entidades colombianas para regulamentar a apatridia de menores nascidos de pais venezuelanos, essa legislação apresenta lacunas regulatórias devido à falta de comunicação entre os diferentes órgãos do Estado. Essas lacunas criam contradições, geram insegurança jurídica no sistema jurídico nacional e, consequentemente, violam diretamente os direitos fundamentais das crianças nascidas na Colômbia de migrantes venezuelanos.

Evaluation of the agreement and reliability of Transpalpebral Tonometers compared with Goldmann Applanation Tonometer – A systematic Review and Meta-Analysis Protocol

In 2020, the global prevalence of glaucoma was estimated to be 76 million and it was projected to increase to 111.8 million by 2040. Accurate intraocular pressure (IOP) measurement is imperative in glaucoma management since it is the only modifiable risk factor. Numerous studies have compared the reliability of IOP measured using transpalpebral tonometers and Goldmann applanation tonometry (GAT). This systematic review and meta-analysis aims to update the existing literature with a reliability and agreement comparison of transpalpebral tonometers against the gold standard GAT for IOP measurement among individuals presenting for ophthalmic examinations. The data collection will be performed using a predefined search strategy through electronic databases. Prospective methods-comparison studies published between January 2000 and September 2022 will be included. Studies will be deemed eligible if they report empirical findings on the agreement between transpalpebral tonometry and Goldmann applanation tonometry. The standard deviation and limits of agreement between each study and their pooled estimate along with weights and percentage of error will be reported using a forest plot. Cochrane’s Q test and the I2 statistic will be used to assess heterogeneity, and the publication bias will be investigated using a funnel plot, Begg’s and Egger’s tests. The review results will provide additional evidence on the reliability of transpalpebral tonometers that, in turn, could possibly assist practitioners to make informed decision about using it as a screening or diagnostic device for clinical practice, outreach camps, or home-based screening. Institutional Ethics Committee registration number: RET202200390. PROSPERO Registration Number: CRD42022321693.

A comparison of the quality of images of chest X-ray between handheld portable digital X-ray & routinely used digital X-ray machine

Background & objectives: Chest X-ray (CXR) is an important screening tool for pulmonary tuberculosis (TB). Accessibility to CXR facilities in difficult-to-reach and underserved populations is a challenge. This can potentially be overcome by deploying digital X-ray machines that are portable. However, these portable X-ray machines need to be validated before their deployment in the field. Here, we compare the image quality of CXR taken by a newly developed handheld X-ray machine with routinely used reference digital X-ray machine through the conduct of a feasibility study. Methods: A total of 100 participants with suspected pulmonary TB were recruited from the outpatient departments of a medical college and a community health centre in Agra. Each participant underwent CXR twice, once with each machine. Both sets of de-identified images were independently read by two radiologists, who were blinded to the type of X-ray machine used. The primary outcome was agreement between image qualities produced by these two machines. Results: The intra-observer (radiologist) agreements regarding the status of the 15 CXR parameters ranged between 74 per cent and 100 per cent, with an unweighted mean of 87.2 per cent (95% confidence interval: 71.5-100). The median Cohen’s kappa values for intra-observer agreement were 0.62 and 0.67 for radiologists 1 and 2, respectively. In addition, on comparison of the overall median score of quality of the image, the handheld machine images had a higher score for image quality. Interpretation & conclusions: The current study shows that a handheld X-ray machine, which is easy to use and can potentially be carried to any area, produces X-ray images with quality that is comparable to digital X-ray machines routinely used in health facilities.

Agreement study of anterior segment parameters measured by two kinds of ocular biometry based on imaging principle of Scheimpflug / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the differences and agreement of anterior segment biometric parameters of myopic patients measured by domestic Scansys and the imported Sirius based on the principle of Scheimpflug imaging technique.METHODS: In this case series study, 103 cases(103 eyes)that underwent pre-refractive surgery(including small incision lenticule extraction, femtosecond laser-assisted in situ keratomileusis, transepithelial photorefractive keratectomy and implantable contact lens implantation)at Aier Excellent Eye Hospital from May 2022 to October 2022 were recruited. Preoperative keratometry(Km), central corneal thickness(CCT), anterior chamber depth(ACDEndo.), anterior chamber angle(ACA), anterior chamber volume(ACV), white to white(WTW)of patients were recorded.RESULTS: The results of Km, CCT, ACA, and WTW measured by Scansys and Sirius were 42.88(41.54, 44.60)and 42.98(41.56, 44.52)D,(541.52±29.08)and(549.55±29.62)μm, 42.70°±2.67° and 46.63°±5.13°, 12.10±0.60 and 11.98±0.47 mm, respectively, showing the difference was statistically significant(all P<0.01). The ACV measured by Scansys and Sirius was 194.26±31.06 and 191.47±25.65 mm3, and ACDEndo. was 3.40(3.17, 3.57)and 3.43(3.19, 3.56)mm, with no statistically significant difference(all P>0.05). The range of Km, CCT, ACA, ACDEndo., ACV and WTW values measured by the two instruments was small, with an average difference close to zero, and the points percentage of 95% limits of agreement(LoA)was <5%, which is of good consistency.CONCLUSIONS: Scansys and Sirius have small differences and good agreement in the parameters, which can be replaced by each other in clinical practice. Scansys could theoretically be used to extrapolate the implantable contact lens model or could be a new option for anterior segment parameter measurements.

The Agreement between State-Trait-Anxiety-Inventory (STAI) and Beck Anxiety Inventory (BAI) on Measuring Anxiety Level Among Adult Patients Before Venepuncture Procedure

@#Introduction: Venepuncture procedure is painful and anxiety associated with venepuncture is common. There are many tools for assessing anxiety levels in an outpatient setting. Hence, this study is to compare the degree of agreement between State-Trait-Anxiety-Inventory (STAI) and Beck Anxiety Inventory (BAI) for measuring anxiety levels among adult patients before venepuncture procedure. Methods: A cross-sectional pilot study was conducted among patients while waiting for a venepuncture procedure in the Phlebotomy Unit, UiTMMC in April 2020. The Malay-validated version of the State-Trait-Anxiety-Inventory (STAI) and Beck Anxiety Inventory (BAI) were used to assess the anxiety level. Differences between sets of data were plotted as described by Bland-Altman to determine the agreement between these two assessment tools. Results: A total of 330 patients participated in the study with a mean age of 46.34 ± 14.34 years old and gender was equally distributed. The scores of state-anxiety (STAI-S), trait-anxiety (STAI-T) and BAI score were 30.04 ± 20.74; 29.51 ± 19.11; and 40.98 ± 20.45, respectively. The score of anxiety using BAI was higher compared to STAI-S (p<0.001) and STAI-T (p<0.001). The mean difference between the STAI-S and BAI was -10.94 (95%CI: -53.01, 26.87) and between the STAI-T and BAI was -11.47 (95%CI: -42.26, 19.32). However, very few patients’ scores outside the 95% LOA for both differences. Conclusion: The STAI and BAI are concordances in measuring anxiety levels among these patients. However, the anxiety score using BAI was higher than STAI. Thus, both assessment tools can be used in clinical practice in measuring anxiety in the out-patients setting.

Analysis of clinical characteristics of 36 patients with pyoderma gangrenosum and comparison between the PARACELSUS score and Delphi criteria for their diagnosis / 中华皮肤科杂志

Objective:To analyze clinical characteristics, treatment, and outcomes of 36 patients with pyoderma gangrenosum, and to compare and evaluate the applicability and consistency between the PARACELSUS score and Delphi criteria.Methods:From January 2000 to January 2022, clinical data were collected from 36 patients who were diagnosed with pyoderma gangrenosum in the Hospital of Dermatology, Chinese Academy of Medical Sciences. The PARACELSUS score and Delphi criteria were applied to their diagnosis, and the kappa test was used to evaluate the consistency between the two diagnostic criteria.Results:Among the 36 patients, 6 (16.67%) had definite precipitating factors before the onset, and 31 (86.11%) exhibited lesions with different degrees of pain. Ulcerative lesions predominatd in 31 (86.11%) patients, which mostly involved the lower extremities, while 16 (44.44%) presented with multiple lesions all over the body. Four (11.11%) patients were complicated by inflammatory bowel disease, and 3 (8.33%) with inflammatory arthritis. Glucocorticoids, Tripterygium wilfordii, and cyclosporin were the main systemic treatment options, and tumor necrosis factor-α antagonist was used in 8 (22.22%) patients. Twenty-two (64.71%) and 17 (50.00%) patients were diagnosed with pyoderma gangrenosum using the PARACELSUS score and Delphi criteria, respectively. The kappa test showed moderate agreement between the two diagnostic criteria (kappa value = 0.47, 95% CI: 0.19 - 0.76, P = 0.004) . Conclusions:Classic ulcerative subtype was the major subtype in the patients with pyoderma gangrenosum, who were usually complicated by inflammatory bowel disease and inflammatory arthritis. Glucocorticoids and immunosuppressants were the main therapeutic drugs. The PARACELSUS score and Delphi criteria focus on different aspects of pyoderma gangrenosum, and the PARACELSUS score is recommended in the context of absence of typical histopathological manifestations.

A clinical cross-sectional study of resting energy expenditure in children with cerebral palsy / 中华实用儿科临床杂志

Objective:To investigate the characteristics of resting energy expenditure (REE) in children with cerebral palsy (CP) graded with different levels of Gross Motor Function Classification System (GMFCS), and to evaluate the accuracy and association of commonly used REE prediction formulas in children with CP.Methods:It was a retrospective study involving 36 children with CP aged 24-144 months who visited the Third Affiliated Hospital of Zhengzhou University between September 2021 and August 2022.REE was measured by the indirect calorimetry.Based on the GMFCS, children with CP were divided into grade Ⅰ-Ⅱ group (20 cases), grade Ⅲ group (6 cases) and grade Ⅳ-Ⅴ group(10 cases). During the same period, 11 age-matched healthy children were included in control group.The measured REE (MREE) between children with CP and healthy controls was compared.Predicted REE (PREE) calculated by the Harris-Benedict, WHO, Schofield-W, Schofield-WH and Oxford prediction formulas were compared with MREE in children for their consistency and correlation.Independent samples were analyzed using t-test or Mann- Whitney U test, and categorical data were analyzed using Chi- square test.Using paired t-test and Pearson linear correlation analysis to analyze the correlation between MREE and PREE.The accuracy of PREE values calculated by different formulas was assessed using the root mean square error. Results:The MREE in control group and children with CP were (952.18±270.56) kcal/d and (801.81±201.89) kcal/d, respectively.There was no significant difference in the MREE between grade Ⅰ-Ⅱ group versus control group[(868.30±194.81) kcal/d vs.(952.18±270.56) kcal/d, P>0.05], and grade Ⅲ group versus control group [(813.17±192.48) kcal/d vs.(952.18±270.56) kcal/d, P>0.05]. The MREE was significantly lower in grade Ⅳ-Ⅴ group than that of control group [666.00(513.50, 775.50) kcal/d vs.(952.18±270.56) kcal/d, P=0.011]. There were no significant difference between MREE and PREEs calculated by Harris-Benedict, WHO, Schofield-W, Schofield-WH, and Oxford (all P>0.05). The correct classification fraction calculated by the 5 formulas were 33.3%, 47.2%, 41.7%, 47.2%, and 41.7%, respectively.The r values of the consistency of PREE calculated by the 5 formulas were 0.585, 0.700, 0.703, 0.712, and 0.701, respectively.The Blande-Altman Limits of Agreement were (-297.77, 359.22), (-245.60, 326.94), (-250.62, 316.05), (-242.22, 177.36) and (-241.28, 325.81), respectively.The clinically acceptable range was -80.18 to 80.18 kcal/d.The root mean square error were 168.09 kcal/d, 149.64 kcal/d, 146.24 kcal/d, 144.23 kcal/d and 148.77 kcal/d, respectively. Conclusions:The MREE values decreased significantly in children with CP classified as CMFCS grade Ⅳ and Ⅴ.When REE cannot be regularly monitored by indirect calorimetry to develop nutritional support programs, children with CP may be prioritized to estimate REE using the prediction formula of Schofield-WH.

Agreement of corneal high-order aberrations measured by three wavefront aberrometers in myopic adults / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the agreement of corneal high-order aberrations from Topcon KR-1W, i.Profiler and OPD-Scan Ⅲ wavefront aberrometers in myopic adults.METHODS:A prospective clinical study. A total of 92 adult patients(92 eyes)with myopia in the department of optometry, the People's Hospital of Guangxi Zhuang Autonomous Region from June to August 2022 were enrolled. The third-order and fourth-order corneal aberrations at the pupil diameter of 4 and 6mm were measured by Topcon KR-1W, i.Profiler, and OPD-Scan Ⅲ, respectively. The difference and agreement of the three aberrometers were evaluated.RESULTS: The measurements at 6mm pupil diameter were all greater than those at 4mm pupil diameter. Although there were no statistical differences in the measurements of Z-44、Z-24 by the three aberrometers at 4 pupil diameter(P&#x003E;0.05), there were statistical differences in other measurements(P&#x003C;0.05). The aberration results measured by the three aberrometers were statistically different at the 6mm pupil diameter(P&#x003C;0.05). The 95% limit of agreement(95%LoA)of the measurements of higher-order aberration, including the third-order aberrations at 4mm pupil diameter and the third-order and fourth-order aberrations at 6mm pupil diameter(except for the Z-24)were greater than 0.1μm. The concordance correlation coefficient(Pc)was lower than 0.90, indicating a poor consistency. The correlation coefficients of corneal higher-order aberrations were significantly different among the three aberrometers at 4 and 6mm pupil diameter(r4mm=0.215～0.805, P4mm&#x003C;0.05; r6mm=0.561～0.916, P6mm&#x003C;0.001).CONCLUSION:There were significant differences in the measurements of the third- and fourth-order corneal aberrations at 4 and 6mm pupil diameter among Topcon KR-1W, i.Profiler, and OPD-Scan Ⅲ, and the agreements were poor, so they are not interchangeably in clinical applications.

Biometry and intraocular power calculation using a swept-source optical coherence tomography: A repeatability and agreement study

Purpose: To evaluate the repeatability of biometry and intraocular lens (IOL) power using Galilei G6 and to determine the agreement of its measurements with those of IOL Master 700 and IOL Master 500. Methods: Hundred mature cataract eyes were examined twice with Galilei G6 and the results were compared with those of other two devices. Axial length (AL), minimum (K1), maximum (K2), and mean keratometry, anterior chamber depth (ACD), white-to-white (WTW) diameter, lens thickness (LT), and the calculated IOL power were the studied parameters. The correlation coefficient, within-subject standard deviation (Sw), Bland–Altman method, and 95% limits of agreement (LoA) were used for statistical analysis. Results: The intraclass correlation coefficient (ICC) was above 0.9 for all indices, and the LoA ranged from a minimum of 0.08 mm for AL to a maximum of 0.50 D for K1. Sw also ranged between a minimum of 0.02 for AL, ACD, and WTW and a maximum of 0.13 for K1. In the Galilei G6–IOL Master 700 pair, the narrowest and widest LoA were calculated for AL (0.07 mm) and K2 (0.49 D), respectively. In the Galilei G6–IOL Master 500 pair, the narrowest and widest widths of LoA were calculated for AL (0.17 mm) and K2 (0.92 D), respectively. In the first pair, the LoA of IOL power (0.57 D) were the best for Haigis formula and in the second pair, the best agreement (LoA: 0.35 D) was observed for Holladay-1. Conclusion: Galilei G6 provided repeatable biometric measurements. The agreement between biometry and IOL power calculation was better in the Galilei G6–IOL Master 700 pair compared to the Galilei G6–IOL Master 500

Use of Scheimpflug Tomography and OCT Tomography to Examine Corneal Dimensional and Anterior Chamber Depth before and after LASIK Surgery

Aims: The aim of this study is to compare corneal parameters in: central corneal thickness (CCT), thinnest corneal thickness (TCT), mean radius of curvature (Rm) and anterior chamber depth (ACD) obtained from Pentacam Schiempflug and OCT Tomography imaging which are checked preoperatively and six months postoperatively after LASIK surgery.Methodology: Our sample consisted of 40 eyes. Changes in corneal dimensions were monitored before and after LASIK surgery using scheimpflug tomography (Pentacam HR) and optical coherence tomography (OCT). The parameters measured were CCT, TCT, Rm and the ACD. The results between the two techniques were compared with the Bland-Altman method.Results: During the analysis of the results, a statistically significant difference was observed between the two techniques in terms of the preoperative CCT as well as the TCT both preoperatively and postoperatively.Scheimpflug tomography gives higher values of the CCT than OCT, up to thickness 530nm, while above this it seems that OCT overestimates the thickness of the cornea. Scheimpflug tomography at the TCT seems to give higher values than OCT tomography, up to thickness 520 nm, while above that it seems that OCT tomography overestimates TCT. We have similar results postoperatively for TCT.The two techniques agree on the ACD and the Rm rating.Conclusion: How converging or different the two imaging devices are because it is important for both clinical practice and research may be a point of reference for starting a new research.

Concordância entre instrumentos de triagem nutricional em idosos hospitalizados / Agreement between nutritional screening instruments in hospitalized older patients

ABSTRACT Background The prevalence of hospitalized elderly patients has grown substantially and has impacted the hospital health services. Thus, it is believed that an investigation of the nutritional status associated with different clinical situations in elderly patients could contribute to multidisciplinary hospital intervention and nutritional care actions suitable for this population. Objective To investigate the relationship between two nutritional screening instruments in hospitalized older patients and to compare clinical variables between these two instruments. Methods Retrospective study with hospitalized older patients (n=277), investigating the agreement between two nutritional screening instruments. The data were analyzed using the McNemar, chi-square, Fisher, Mann-Whitney tests and the kappa coefficient for the agreement assessment. Results There was a significant difference (P=0.0002) between the nutritional risk classifications of the two nutritional screening instruments and moderate agreement (k=0.5430) between them. The association between nutritional risk screening and age (P=0.0255), length of hospital stay (P<0.0001), gender (P=0.0365) and illness (P=0.0001) were assessed. There was an association between Mini Nutritional Assessment and length of stay (P<0.0001), illness (P=0.0001) and body weight evolution (P=0.0479). Conclusion The nutritional risk screening and Mini Nutritional Assessment showed moderate agreement in the assessment of elderly patients.

RESUMO Contexto A prevalência de pacientes idosos hospitalizados tem crescido substancialmente e impactado os serviços de saúde hospitalar. Desta forma, acredita-se que uma investigação do estado nutricional, associado a situações clínicas variadas em pacientes idosos, poderia contribuir para ações de intervenção hospitalar multidisciplinares e de cuidado nutricional adequadas para esta população. Objetivo Investigar a relação entre dois instrumentos de triagem nutricional em pacientes idosos hospitalizados e comparar variáveis clínicas entre estes dois instrumentos. Métodos Estudo retrospectivo com pacientes idosos hospitalizados (n=277), sendo investigado a concordância entre dois instrumentos de triagem nutricional. Os dados foram analisados pelos testes McNemar, qui-quadrado, Fisher, Mann-Whitney e o coeficiente kappa para a avaliação de concordância. Resultados Houve diferença significativa (P=0,0002) entre as classificações de risco nutricional pelos dois instrumentos de triagem nutricional e concordância moderada (k=0,5430) entre eles. Verificou-se associação entre triagem de risco nutricional e idade (P=0,0255), tempo de internação (P<,0001), sexo (P=0,0365) e doenças (P=0,0001). Houve associação entre a Mini Avaliação Nutricional e tempo de internação (P<0,0001), doenças (P=0,0001) e evolução do peso corporal (P=0,0479). Conclusão Triagem de risco nutricional e a Mini Avaliação Nutricional apresentam concordância moderada para a avaliação de pacientes idosos.

International experience about the applications of drug Managed Entry Agreements and its enlightenment to China / 中国药房

OBJECTIVE To boost access to medical insurance for drugs and improve the accessibility and affordability of drugs. METHODS The current status of the application of international and domestic drug Managed Entry Agreement （MEA）were investigated through literature research method and other methods ，and analyzed comparatively from the aspects of the scope of agreement drugs ，the types of agreements and the content of the agreement ，etc. The problems existing in the application of drug MEA in China were summarized to put forward the suggestions. RESULTS & CONCLUSIONS The UK ，Australia and Italy had rich experience in the application of drug MEA ，and the operation management mechanism were complete. The scope of drugs included in MEA in these countries were relatively broad and the types of agreements were relatively diversified. In China ，drugs included in MEA were mainly oncology drugs and rare disease drugs. The types of agreements mainly included “finance-based agreements”and effect guarantee/effect-based payment in individual-level of“performance-based agreements ”. China ’s evidence collection platform was imperfect and lacked standardized process of MEA. It is suggested that stakeholders should consider increasing the types of drugs ，diversified types of agreements ，improving the accuracy and continuity of evidence collection ， establishing a standardized process for MEA.

The Legal Correspondence of Sexual Self-Defense Capability Assessment / 法医学杂志

OBJECTIVES@#To understand the legal application and case deposition of assessment opinions of sexual self-defense capability, and to explore the necessity of legal correspondence in the sexual defense capability assessment.@*METHODS@#According to the self-made questionnaire, the cases of sexual self-defense capability assessment completed by the Academy of Forensic Science from January 1, 2012 to December 31, 2018 were statistically analyzed through telephone interviews and referrals.@*RESULTS@#Among the 69 cases, 3 cases (4.3%) had complete sexual self-defense capability, 30 cases (43.5%) had weakened sexual self-defense capability, 32 cases (46.2%) had no sexual self-defense capability, and 4 cases (5.8%) were not suitable for assessment. Among the 30 cases with weakened sexual self-defense ability, 15 cases were filed and investigated by public security authorities for rape and 15 cases were not. The inconsistent rate of disposition was 1∶1. Among the 15 rape cases filed and investigated by the public security authorities, 10 cases were arrested and prosecuted by the procuratorate and sentenced to fixed-term imprisonment by the court, while the other 5 cases were not arrested and prosecuted by the procuratorate, with an inconsistent rate of disposition being 2∶1.@*CONCLUSIONS@#The legal application of the assessment opinion on the weakening of sexual self-defense capability is inconsistent, and the judicial disposition is confusing. It is imperative to unify and correspond the classification of sexual self-defense capability with the legal requirements.

Agreement of manual, semi-automatic, and automatic measurements in measuring diameters and volumes of solid pulmonary nodules / 中华放射学杂志

Objective:To assess the agreement of manual measurement, semi-automatic measurement based on computer-aided diagnosis (CAD), and automatic measurement based on artificial intelligence (AI) in measuring diameters and volumes of solid pulmonary nodules.Methods:The clinical and low dose CT (LDCT) data of 165 participants in lung cancer screening of Sichuan Cancer Hospital from July 2018 to April 2020 were retrospectively analyzed. The largest nodule of each participant was selected to analyze, and its diameter and volume were measured by one junior and one senior radiologist using manual measurement, semi-automatic measurement based on CAD, and automatic measurement based on AI. Referring to Lung CT imaging reporting and data system (Lung-RADS, version 1.1), all nodules were classified into Lung-RADS 2, 3, 4A, 4B, 4X categories and low and high risk groups according to the diameter and volume measured by different measurement methods. Repeated-measures analysis of variance and paired t-test were used to compare the differences in the diameter and volume of lung nodules measured by different methods. The consistency of the three methods in measuring nodule diameter and volume was assessed by the correlation coefficient (ICC). Linear weighted Kappa coefficient was applied to assess the consistency of different measurement methods in Lung-RADS classification results; simple Kappa coefficient was applied to assess the consistency of different methods in high and low risk grouping results. Results:Difference in the diameters of pulmonary nodules measured by manual measurement, semi-automatic measurement based on CAD, and automatic measurement based on AI was statistically significant [(14.9±6.3) mm, (17.0±6.7) mm, (15.0±5.7) mm, F=88.39, P<0.001], and the pairwise comparisons showed that there was significant difference between semi-automatic measurement based on CAD and manual measurement method ( t=10.97, P<0.001), semi-automatic measurement based on CAD and automatic measurement based on AI ( t=10.07, P<0.001), but no significant difference between manual measurement method and automatic measurement based on AI method ( t=1.04, P=0.301). There was no significant difference in the measurement of pulmonary nodule volumes between the semi-automatic measurement and the automatic measurement method based on AI ( Z=0.70, P=0.482). The consistency of pulmonary nodules diameter measured by different measurement methods was high (ICC>0.75), and the consistency of semi-automatic and automatic measurement of lung nodule volume was high (ICC=0.927). The consistency of three methods for lung-RADS classification and high-and low-risk grouping according to nodule diameter was good (Kappa>0.80). The agreements between the semi-automatic measurement and the automatic measurement method for Lung-RADS classification and high-and low-risk grouping according to nodule volume were good (Kappa>0.80). Conclusion:In terms of diameter measurement of solid pulmonary nodules, automatic measurement based on AI is more consistent with manual measurement than semi-automatic measurement based on CAD. The agreement between automatic measurement and semi-automatic measurement is high in terms of volume measurement.

Agreement evaluation between adaptive optics visual simulator and conventional refraction methods / 中华实验眼科杂志

Objective:To evaluate the difference and agreement of cycloplegic refraction between adaptive optics visual simulator (VAO) and conventional refraction methods.Methods:A diagnostic test study was conducted.Thirty-one eyes of 31 healthy subjects including 15 males and 16 females were enrolled in November, 2019 in Affiliated Hospital of North Sichuan Medical College.Mean age of the subjects was (20.1±1.0) years, and the right eye was taken for data analysis.Cycloplegic refraction was measured by VAO and conventional refraction methods, respectively.Spherical power, cylindrical power, Jackson cross-cylinder power at axis 90° and 180° (J 0) and Jackson cross-cylinder power at axis 45° and 135° (J 45) vector powers were recorded.Paired t-test was used to compare the refractive parameters between different refraction methods, and the intraclass correlation coefficient (ICC) and Bland-Altman plots were used to evaluate the agreement between VAO and conventional refraction methods.This study adhered to the Declaration of Helsinki, and the research protocal was approved by an Ethics Committee of Affiliated Hospital of North Sichuan Medical College (No.2020ER[A]018). Written informed consent was obtained from each subject prior to any medical examination. Results:For subjective refraction, the ICC for spherical power, cylindrical power, J 0 and J 45 between VAO and phoropter were 0.97, 0.75, 0.84 and 0.09, respectively.For objective refraction, the ICC for spherical power, cylindrical power, J 0 and J 45 between VAO and autorefractor were 0.98, 0.70, 0.74 and 0.61, respectively.The mean differences in spherical power, cylindrical power, J 0 and J 45 between VAO and phoropter were (0.05±0.32), (-0.23±0.28), (-0.10±0.14) and (-0.04±0.16)D, respectively, and the differences in cylindrical power and J 0 were statistically significant (both at P<0.01), whereas no significant differences in spherical power and J 45 were found ( P=0.41, 0.18). The mean differences in spherical power, cylindrical power, J 0 and J 45 measured by VAO and autorefractor were (-0.70±0.26), (-0.07±0.46), (-0.03±0.27) and (0.01±0.12)D, respectively, and the spherical power measurement by VAO was significantly more negative than the autorefractor ( t=15.09, P<0.01), while no significant differences in cylindrical power, J 0 and J 45 were found ( P=0.39, 0.59, 0.63). No significant difference values in spherical power, cylindrical power, J 0 and J 45 were found between the two objective refraction methods and phoropter subjective refraction (all at P>0.05). Conclusions:With cycloplegia, spherical power obtained by VAO objective refraction is more negative compared with autorefractor.There is a good agreement of spherical power and astigmatism vector values measured by VAO and phoropter subjective refraction, and the measurement differences are clinically acceptable.

Modeling of Brazilian Carbon Dioxide Emissions: a Review

Abstract: Brazil is a signatory to the Paris Agreement and aims to reduce 43% of CO2 emissions by 2030, compared to 2005. However, changes in energy policies are needed to achieve this goal, evaluating the produced effects on emissions. One way to predict these effects is through mathematical modeling. In this paper, we carried out a literature review to identify the most used model types and independent variables to forecasting Brazilian CO2 emissions. The review showed that gray models and artificial neural networks are the most used ones. Furthermore, we also identified that economic growth and energy consumption are the main independent variables.

Economía política de la política agraria en Colombia: de la Ley 200 de 1936 al Acuerdo de Paz de 2016 / Political economy of agricultural policy in Colombia: from Law 200 of 1936 to the 2016 Peace Agreement / Economia política da política agrícola na Colômbia: da Lei 200 de 1936 ao Acordo de Paz de 2016

RESUMEN En esta investigación se estudia la política agraria en Colombia y su relación con el conflicto entre campesinos y terratenientes, entorno a los activos productivos rurales. Se aborda la discusión sobre el acceso a la tierra y se examina cada uno de los planes nacionales de desarrollo, para elaborar una trazabilidad histórica de la política agraria en Colombia durante el periodo 1936-2016. El problema de investigación se deriva de la persistencia de la pobreza y marginación social de la población rural, identificada en la Misión Rural y reconocida en el Acuerdo de Paz de 2016. Se concluye que la configuración histórica del Estado fue incorporando los intereses de las estructuras de poder económico y político de cada momento. Cuando el Estado quiso resolver el conflicto por la tierra, la capacidad ejecutiva de las instituciones era limitada y tergiversada por los grupos de interés dominantes que tenían la ventaja de redactar las leyes y aplicarlas de acuerdo con sus preferencias. Por esta razón las condiciones socioeconómicas de los campesinos siguen siendo parecidas a las que tenían hace un siglo. CLASIFICACIÓN JEL P16, P26, O12, O13, O43

ABSTRACT This research studies agrarian policy in Colombia and its relationship with the conflict between peasants and landowners, around rural productive assets. The discussion on access to land is approached and each one of the national development plans is examined, to elaborate a historical traceability of the agrarian policy in Colombia during the period 1936-2016. The research problem stems from the persistence of poverty and social marginalization of the rural population, identified in the rural mission and recognized in the 2016 peace agreement. It is concluded that the historical configuration of the State was incorporating the interests of the economic and political power structures of each moment. When the State wanted to resolve the conflict over land, the executive capacity of the institutions was limited and distorted by the dominant interest groups who had the advantage of writing the laws and applying them according to their preferences. For this reason, the socioeconomic conditions of the peasants continue to be similar to those they had a century ago. JEL CLASSIFICATION P16, P26, O12, O13, O43

RESUMO Esta pesquisa estuda a política agrária na Colômbia e sua relação com o conflito entre camponeses e proprietários de terras em torno dos ativos produtivos rurais. Aborda-se a discussão sobre o acesso à terra e examina-se cada um dos planos nacionais de desenvolvimento, para elaborar uma rastreabilidade histórica da política agrária na Colômbia durante o período 1936-2016. O problema de pesquisa decorre da persistência da pobreza e marginalização social da população rural, identificada na Missão Rural e reconhecida no Acordo de Paz 2016. Conclui-se que a configuração histórica do Estado foi incorporando os interesses das estruturas do poder econômico e político de cada momento. Quando o Estado queria resolver o conflito de terras, a capacidade executiva das instituições era limitada e distorcida pelos grupos de interesse dominantes que tinham a vantagem de redigir as leis e aplicá-las de acordo com suas preferências. Por isso, as condições socioeconômicas dos camponeses continuam semelhantes às de um século atrás. CLASSIFICAÇÃO JEL P16, P26, O12, O13, O43

Cohortes de premedicación en endoscopia alta con simeticona, N-acetilcisteína, Hedera helix y validación de la escala visual / Cohorts of premedication for endoscopy of the upper gastrointestinal tract with simethicone, N-acetylcysteine, Hedera helix and visual scale validation

Resumen Los parámetros de calidad para endoscopia digestiva alta han introducido indicadores intraprocedimiento, dentro de los cuales la adecuada visibilidad de la mucosa, libre de saliva, moco o burbujas, puede aumentar la posibilidad de detección de lesiones en fase temprana. Sin embargo, el uso de mucolíticos y antiburbujas ha mostrado gran variabilidad de eficiencia según las soluciones, concentraciones, tiempos de exposición y escala de visibilidad aplicados. Objetivos: determinar la efectividad de diferentes soluciones de premedicación para la limpieza de la mucosa digestiva; validar, mediante una prueba de concordancia interobservador, una nueva escala de adecuada visualización de la mucosa (TVMS) para el esófago, estómago y duodeno; y reportar eventos adversos o complicaciones relacionadas con las soluciones utilizadas y los procedimientos realizados. Material y métodos: estudio de cohortes prospectivas comparativas. Se incluyeron 412 pacientes adultos, ASA I y ASA II, para endoscopia diagnóstica bajo sedación consciente, distribuidos en 6 cohortes similares, divididas en dos grupos: no premedicación, 2 cohortes C1 (ayuno de 6 a 8 horas)y C2 (agua 100 mL); premedicación, 4 cohortes C3 a C6 (C3: agua 100 m L + simeticona 1000 mg; C4: agua 100 mL + simeticona 200 mg + N-acetilcisteína 600 mg; C5: agua 100 mL + simeticona 200 mg + N-acetilcisteína 1000 mg; C6: agua 100 mL + simeticona 200 mg + Hedera helix 70 mg). Se ingirió la solución 15 a 30 minutos antes del paso por cricofaríngeo. Se realizó la prueba de Kappa para medir la concordancia interobservador de la escala TVMS. Resultados: De 412 pacientes, 58% fueron de sexo femenino; 23% (136) fue de cohortes C1 y C2 y 67% (276) fue de cohortes C3 a C6. El tiempo medio de exposición a cada solución fue de 24,4 minutos. El volumen de lavado para lograr una adecuada visualización fue significativamente diferente entre ambos grupos: en los pacientes con premedicación se utilizaron 75,6 mL, mientras que en los pacientes sin premedicación se utilizaron 124 mL (p = 0,000), con una calidad de TVMS excelente de 88,7% frente al 41,4%, respectivamente. La cohorte C4 (agua 100 mL + simeticona 200 mg + N-acetilcisteína 600 mg) mostró ser la más efectiva con una diferencia significativa (p = 0,001) frente a C1 (ayuno) y C2 (placebo con agua 100 mL), y también tuvo una eficiencia superior frente a C3, C5 y C6 en su orden. No se presentaron eventos adversos o complicaciones en relación con la endoscopia, la sedación y los productos usados en la premedicación. Conclusiones: la solución más efectiva como premedicación para lograr una excelente visibilidad de la mucosa digestiva correspondió a la cohorte C4 (SIM 200 + NAC 600 + H2O 100 mL). La escala TVMS propuesta es una herramienta muy completa y fácil de aplicar por más de un observador. La premedicación ingerida, con antiburbuja, mucolítico y agua hasta 100 mL, entre 15 y 30 minutos previos a endoscopia, es segura en las condiciones descritas en este estudio.

Abstract Quality parameters for upper gastrointestinal endoscopy have introduced intraprocedural indicators, including adequate mucosal visualization free of saliva, mucus, or bubbles, which may increase the possibility of early-stage injury detection. The use of mucolytics and anti-foaming agents has shown great efficiency variability depending on the type of solution, concentrations, exposure times and visibility scale applied. Objectives: To determine the effectiveness of different premedication solutions for cleaning the digestive mucosa; to validate, by means of an interobserver concordance test, a new scale for the adequate visualization of the mucosa (TVMS) for the esophagus, stomach, and duodenum; and to report adverse events or complications associated with the solutions used and the procedures performed. Material and methods: Prospective, comparative cohort study. 412 adult patients, ASA I and ASA II, were included for diagnostic endoscopy under conscious sedation. They were distributed in 6 similar cohorts and divided into two groups: non-premedication, 2 in C1 (fasting 6 to 8 hours) and C2 (water 100 mL) cohorts; premedication, 4 C3 to C6 cohorts (C3: water 100 mL + simethicone 1000 mg; C4: water 100 ml + simethicone 200 mg + N-acetylcysteine 600 mg; C5: water 100 ml + simethicone 200 mg + N-acetylcysteine 1000 mg; C6: water 100 ml + simethicone 200 mg + Hedera helix 70 mg). The solution was swallowed 15 to 30 minutes passing through the cricopharyngeus muscle. The Kappa test was performed to measure interobserver concordance of the TVMS scale. Results: Of 412 patients, 58% were female; 23% (136) were included in the C1 and C2 cohorts; and 67% (276) were in the C3 to C6 cohorts. The average exposure time to each solution was 24.4 minutes. The wash volume for proper visualization was significantly different between the two groups. In premedicated patients, 75.6 mL of solution were used, while in patients without premedication, 124 mL were used (p = 0.000), with an excellent quality of TVMS of 88.7% versus 41.4%, respectively. The C4 cohort (water 100 mL + simethicone 200 mg + N-acetylcysteine 600 mg) was the most effective with a significant difference (p= 0.001) compared with the C1 (fasting) and C2 (placebo with water 100 mL) cohorts. It also had better efficiency compared to the C3, C5 and C6 cohorts in that order. There were no adverse events or complications associated with endoscopy, sedation, or premedication products. Conclusions: The most effective solution as a premedication to achieve excellent visibility of the digestive mucosa was that used in the C4 cohort (SIM 200 + NAC 600 + H2OR 100 mL). The proposed TVMS scale is a very complete and easy tool to apply by more than one observer. Premedication ingested, with anti-foam, mucolytic and water up to 100 mL, between 15 and 30 minutes before endoscopy, is safe under the conditions described in this study.

Retrospective study of the concordance between clinical and histopathological diagnosis in oral pathology / Estudio retrospectivo de la concordancia entre diagnóstico clínico e histopatológico en patología oral

Objectives: Evaluate the agreement between the clinical and histopathological diagnosis of oral lesions in patients submitted to biopsies. Identify the most frequent oral lesions and their correlation with age, gender, and anatomical location. Methods: A retrospective study of 368 pathological examinations collected between 2008 and 2018, corresponding to biopsies performed at the Clínica Universitária Egas Moniz. A detailed analysis of the histopathological reports attached to the patients' files was made and the variables gender, age, anatomical site, clinical diagnosis, and histopathological diagnosis was evaluated. Results: The most affected gender was female (55%); the most common age group was 61-70 years old; The most biopsied anatomical location was the gum (23.9%); the five most common pathological entities were fibroma(26.4%),root cyst(8.7%),oral lichen planus(7.6%), hemangioma (6.3%) and oral leukoplakia (6.0%). On agreement, 74.5% of the cases were concordant and 25.5% discordant. The most concordant lesions were Radicular Cyst (90.6%), Traumatic Injury (87.5%), Hemangioma (82.6%), Fibroma (82.5%) and Mucocele (82.5%). Conclusion: this study proves a significant level of agreement between clinical and histopathological diagnosis in this particular area, consistently obtained in a ten years period of time.

Objetivos: Evaluar el nivel de acuerdo entre el diagnóstico clínico e histopatológico de lesiones orales en pacientes sometidos a biopsias. Identificar las lesiones orales más frecuentes y su correlación con la edad, el sexo y la ubicación anatómica. Métodos: Estudio retrospectivo de 368 exámenes patológicos recogidos entre 2008 y 2018, correspondientes a biopsias realizadas en la Clínica Universitária Egas Moniz. Se realizó un análisis detallado de los informes histopatológicos adjuntos a los archivos de los pacientes y se evaluaron las variables de género, edad, sitio anatómico, diagnóstico clínico y diagnóstico histopatológico. Resultados: El género más afectado fue femenino (55%); el grupo de edad más común fue de 61-70 años; La ubicación anatómica más biopsiada fue la encía (23,9%); las cinco entidades patológicas más comunes fueron fibroma (26,4%), quiste radicular (8,7%), liquen plano oral (7,6%), hemangioma (6,3%) y leucoplasia oral (6,0%). Según el grado de acuerdo, el 74,5% de los casos fueron concordantes y el 25,5% discordantes. Las lesiones más concordantes fueron Quiste Radicular (90,6%), Lesión Traumática (87,5%), Hemangioma (82,6%), Fibroma (82,5%) y Mucocele (82,5%). Conclusión: este estudio demuestra un nivel significativo de acuerdo entre el diagnóstico clínico e histopatológico en esta área en particular, obtenido consistentemente en un período de diez años de tiempo

Agreement of Spatiotemporal Gait Characteristics between Gaitboter Gait Analysis System and Noraxon Gait Analysis System / 中国康复理论与实践

Objective:To assess the agreement between measurements of spatiotemporal gait characteristics made with Gaitboter and Noraxon gait analysis systems. Methods:From February to April, 2019, 35 healthy adults were recruited to participate in gait analysis using Gaitboter and Noraxon gait analysis apparatuses, respectively. Stance phase, swing phase, stride length, cadence, velocity and toe out were recorded and computed. Intraclass correlation coefficients (ICC) and Bland-Altman plots were used to evaluate the agreement between the two gait analysis systems. Results:There was a good reliability in spatiotemporal gait characteristics between two gait analysis systems (ICC 0.691 to 0.835). Bland-Altman plots also showed good agreement. Conclusion:The measurements of temporal and spatial parameters with Gaitboter and Noraxon gait analysis systems yield acceptable agreement, and further study needs to be conducted on the validity of the Gaitboter gait analysis system.