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Association of congenital Heart Defects (cHD) with Factors Related to Maternal Health and Pregnancy in Newborns in Puerto Rico

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congenital Heart Disease 2024年第1期19卷 19-31页

作者： Yamixa Delgado caliani Gaytan Naydi Perez Eric miranda Bryan colón Morales Mónica Santos Biochemistry&Pharmacology Department San Juan Bautista School of MedicineCaguas00726Puerto Rico Hispanic Alliance for clinical and Translational Research University of Puerto Rico Medical Sciences CampusSan Juan00936Puerto Rico Department of Internal Medicine University of Puerto Rico Medical Sciences CampusSan Juan00936Puerto Rico

Background:Given the pervasive issues of obesity and diabetes both in Puerto Rico and the broader United States,there is a compelling need to investigate the intricate interplay among body mass index(BMI),pregesta-tional,and gestational maternal diabetes,and their potential impact on the occurrence of congenital heart defects(cHD)during neonatal development.Methods:Using the comprehensive System of Vigilance and Surveillance of congenital Defects in Puerto Rico,we conducted a focused analysis on neonates diagnosed with cHD between 2016 and 2020.Our assessment encompassed a range of variables,including maternal age,gestational age,BMI,pregestational diabetes,gestational diabetes,hypertension,history of abortion,and presence of preeclampsia.Results:A cohort of 673 patients was included in our study.The average maternal age was 26 years,within a range of 22 to 32 years.The mean gestational age measured 39 weeks,with a median span of 38 to 39 weeks.Of the 673 patients,274(41%)mothers gave birth to neonates diagnosed with cHD.Within this group,22 cases were linked to pre-gestational diabetes,while 202 were not;20 instances were associated with gestational diabetes,compared to 200 without;and 148 cases exhibited an overweight or obese BMI,whereas 126 displayed a normal BMI.conclusion:We identiﬁed a statistically signiﬁcant correlation between pre-gestational diabetes mellitus and the occurrence of cHD.However,our analysis did not show a statistically signiﬁcant association between maternal BMI and the likelihood of cHD.These results may aid in developing effective strategies to prevent and manage cHD in neonates.

关键词： congenital heart defects(cHD) obesisty maternal health diabetes body mass index(BMI)

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颅底斜坡区的内镜解剖及手术入路考虑

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临床耳鼻咽喉头颈外科杂志 2014年第20期28卷 1550-1554页

作者：刘剑锋杨大章 juan c.fernandez-miranda Paul A.Gardner carl H.Snyderman 中日友好医院耳鼻咽喉科北京100029 匹兹堡大学医学中心神经外科匹兹堡大学医学中心耳鼻咽喉科

目的:确定内镜经鼻颅底外科中线颅底区后颅窝的主要靶区-斜坡的关键解剖标志。方法:8例(16侧)新鲜尸头,颈总动脉、椎动脉以及颈总静脉硅胶灌注后,行导航cT扫描。采用Storz内镜系统和内镜手术器械,应用Stryker影像导航和内镜手术磨钻,行... 详细信息

目的:确定内镜经鼻颅底外科中线颅底区后颅窝的主要靶区-斜坡的关键解剖标志。方法:8例(16侧)新鲜尸头,颈总动脉、椎动脉以及颈总静脉硅胶灌注后,行导航cT扫描。采用Storz内镜系统和内镜手术器械,应用Stryker影像导航和内镜手术磨钻,行内镜经鼻入路斜坡区的入路解剖。应用Storz Image 1系统采集高清图像。结果:颅底斜坡区分为上斜坡、中斜坡和下斜坡3个亚区。确认斜坡硬膜外软组织标志以及斜坡区骨性解剖标志。硬膜内解剖标志,上斜坡有脚间池、大脑后动脉、大脑后动脉后交通支、小脑上动脉、脑神经Ⅲ、大脑脚;中斜坡有脑桥前池、基底动脉、脑神经Ⅵ、脑桥;下斜坡有延髓前池、椎动脉、脑神经Ⅻ、延髓。斜坡手术入路分为上斜坡、中斜坡、下斜坡以及全斜坡入路。结论:对颅底斜坡区关键解剖结构的深入把握,是内镜经鼻颅底外科处理该区域病变安全性和有效性的重要保障。

关键词：颅底斜坡解剖

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海绵窦的内镜解剖以及手术入路

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中华耳鼻咽喉头颈外科杂志 2013年第11期48卷 901-907页

作者：刘剑锋曲秋懿杨大章韩军张秋航 carl H.Snyderman juan c.fernandez-miranda Paul A.Gardner 中日友好医院耳鼻咽喉科北京100029 首都医科大学宣武医院颅底外科中心美国匹兹堡大学医学中心颅底外科中心

目的探讨内镜下海绵窦的解剖特点以及手术入路.方法 6例（12侧）新鲜尸头,有色硅胶灌注血管.行内镜经鼻-蝶入路和经筛-翼-蝶入路,完成蝶窦开放,蝶窦后壁切除,翼突部分切除和蝶窦外侧壁切除.充分暴露海绵窦及其周围结构.应用Stroz Imag... 详细信息

目的探讨内镜下海绵窦的解剖特点以及手术入路.方法 6例（12侧）新鲜尸头,有色硅胶灌注血管.行内镜经鼻-蝶入路和经筛-翼-蝶入路,完成蝶窦开放,蝶窦后壁切除,翼突部分切除和蝶窦外侧壁切除.充分暴露海绵窦及其周围结构.应用Stroz Image l高清系统采集图像.结果颈内动脉海绵窦段穿行海绵窦将海绵窦分为5个部分,即内侧海绵窦、外侧海绵窦、海绵窦后上腔隙、海绵窦后下腔隙和海绵窦前下腔隙.海绵窦段颈内动脉的分支包括：脑膜垂体干、Mcconnell包膜动脉和下外侧干.颅神经Ⅲ、Ⅳ走行于海绵窦外侧壁的上部；颅神经Ⅴ1自Meckel腔向眶上裂斜行；颅神经Ⅵ自海绵窦后下腔隙底部从颈内动脉后膝部的内侧绕行到外侧,穿过海绵窦窦腔,向外上前至眶上裂.内镜经鼻海绵窦手术入路分为经蝶-鞍-内侧海绵窦入路（颈内动脉内侧入路）和经筛-翼-蝶-外侧海绵窦入路（颈内动脉外侧入路）.前者可以暴露海绵窦段颈内动脉的内侧部,部分海绵窦后上、后下腔隙.后者可以暴露海绵窦前下腔隙、外侧海绵窦以及外侧壁的颅神经.结论海绵窦的解剖非常复杂,颈内动脉以及颅神经Ⅲ、Ⅳ、Ⅴ1、Ⅵ穿行其内,与周同重要静脉窦相交通.熟悉掌握内镜下海绵窦解剖以及手术入路对于内镜下处理海绵窦以及海绵窦相关的病变有重要意义.

关键词：海绵窦内窥镜检查耳鼻喉外科手术颅底蝶鞍解剖学,局部

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Male genitourinary schistosomiasis-related symptoms among long-term Western African migrants in Spain: a prospective population-based screening study

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贫困所致传染病(英文) 2024年第2期13卷 1-10页

作者： Roure Sílvia Vallès Xavier Pérez-Quílez Olga López-Mu?oz Israel chamorro Anna Abad Elena Valerio Lluís Soldevila Laura Espa?a Sergio Hegazy Alaa H. A. Fernández-Rivas Gema Gorriz Ester Herena Dolores Oliveira Mário Miralles Maria carme conde carmen Montero-Alia juan José Fernández-Pedregal Elia miranda-Sánchez Jose Llibre Josep M. Isnard Mar Bonet Josep Maria Estrada Oriol Prat Núria clotet Bonaventura The Schisto-Stop study group Primary Health care Unit Mataró-(Rocafonda-Palau) Barcelona North Metropolitan Health Directorate Catalan Institute for Health Camí Ral el Ravalet Mataró Barcelona Spain Barcelona North Metropolitan Primary care Directorate Catalan Institute for Health Ctra. de Barcelona Sabadell Barcelona Spain Directorate for Innovation and Interdisciplinary cooperation Barcelona North Metropolitan Health Directorate Catalan Institute for Health C/Can Ruti S/N Badalona Spain Irsicaixa-AIDS Research Institute Hospital Universitari Germans Trias i Pujol University Hospital c/Can Ruti s/n Badalona Spain Infectious Diseases Directorate Barcelona North Metropolitan Health Directorate Catalan Institute for Health C/Can Ruti S/N Badalona Spain International Health Program (PROSIcS) Barcelona North Metropolitan Territorial Directorate for Infectious Diseases Catalan Institute for Health CAP La Salut Passatge dels Encants S/N Badalona Spain Fundació Lluita contra les Infeccions c/Can Ruti s/n Badalona Spain Infectious Diseases Department Hospital Universitari Germans Trias i Pujol c/Can Ruti s/n Badalona Spain Germans Trias i Pujol Research Institute c/Can Ruti s/n Badalona Spain Microbiology Department Germans Trias i Pujol University Hospital c/Can Ruti s/n Badalona Spain Department of Genetics and Microbiology Universitat Autònoma de Barcelona c/Can Ruti s/n Badalona Spain Faculty of Medicine University of Asyut El Fateh Assiut Governorate Egypt Department of Urology Germans Trias i Pujol University Hospital c/Can Ruti s/n Badalona Spain canovelles Primary Health care Unit Barcelona North Metropolitan Health Directorate Catalan Institute for Health C/Indústria Canovelles Spain

Background Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe. Male urogenital manifestations are often neglected. We aimed to ascertain the prevalence of genitourinary clinical signs and symptoms among long-term African migrants in a non-endemic European country using a serology test.Methods We carried out a prospective, community-based cross-sectional study of adult male migrants from sub-Saharan Africa living in Spain.Schistosoma serology tests and microscopic urine examinations were carried out, and clinical data were obtained from an electronic medical record search and a structured questionnaire.Results We included 388 adult males, mean age 43.5 years [Standard Deviation (SD) = 12.0, range: 18–76]. The median time since migration to the European Union was 17 [Interquartile range (IQR): 11–21] years. The most frequent country of origin was Senegal (N = 179, 46.1%). Of the 338, 147 (37.6%) tested positive forSchistosoma. Parasite eggs were present in the urine of only 1.3%. Nine genitourinary clinical items were significantly associated with positiveSchistosoma serology results: pelvic pain (45.2%;OR = 1.57, 95%cI: 1.0–2.4), pain on ejaculation (14.5%;OR = 1.85, 95%cI: 1.0–3.5), dyspareunia (12.4%;OR = 2.45, 95%cI: 1.2–5.2), erectile dysfunction (9.5%;OR = 3.10, 95%cI: 1.3–7.6), self-reported episodes of infertility (32.1%;OR = 1.69, 95%cI: 1.0–2.8), haematuria (55.2%;OR = 2.37, 95%cI: 1.5–3.6), dysuria (52.1%;OR = 2.01, 95%cI: 1.3–3.1), undiagnosed syndromic STIs (5.4%), and orchitis (20.7%;OR = 1.81, 95%cI: 1.0–3.1). clinical signs tended to cluster.conclusions Urogenital clinical signs and symptoms are prevalent among male African long-term migrants with a positiveSchistosoma serology results. Genital involvement can be frequent even among those with long periods of non-residence in their sub-Saharan African countries of origin. Further research is needed to develop diagnostic tools and validate therapeutic approaches to chronic schistosomiasis.

关键词： Schistosomiasis chronic schistosomiasis Urogenital schistosomiasis Male genital schistosomiasis Longterm migrant

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内镜经翼突入路的解剖及其在处理颅底病变中的应用

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中华耳鼻咽喉头颈外科杂志 2015年第11期50卷 909-914页

作者：刘剑锋韩军杨大章刘丹丹李锐于炎冰张秋航 juan c. fernandez-miranda Paul A. Gardner carl H. Snyderman 中日友好医院耳鼻咽喉科北京100029 中日友好医院神经外科北京100029 首都医科大学宣武医院耳鼻咽喉头颈外科 center for cranial Base Surgery University of Pittsburgh MedicalCenter Pittsburgh Pennsylvania USA

目的通过内镜经鼻经翼突入路解剖研究获得相关解剖标志，总结应用该径路处理蝶骨翼突周围颅底病变的经验。方法2例（4侧）成人尸头经血管硅胶灌注后，行导航cT扫描后进行手术入路解剖，拍摄获得高清图像。回顾性分析内镜经鼻经翼突入路... 详细信息

目的通过内镜经鼻经翼突入路解剖研究获得相关解剖标志，总结应用该径路处理蝶骨翼突周围颅底病变的经验。方法2例（4侧）成人尸头经血管硅胶灌注后，行导航cT扫描后进行手术入路解剖，拍摄获得高清图像。回顾性分析内镜经鼻经翼突入路治疗的12例颅底病变患者的临床资料。其中蝶窦侧隐窝自发性脑脊液鼻漏3例；翼腭窝、颞下窝神经鞘瘤2例，神经纤维瘤2例；中颅窝颞下窝沟通皮样囊肿1例、颅底侵袭性真菌病1例、上咽旁间隙基底细胞腺瘤1例；腺样囊性癌1例、颅底软骨肉瘤1例。结果在人路解剖方面，获得该入路的一些重要解剖标志，如蝶腭孔及其内容物、翼管及其内容物、三叉神经上颌支及圆孔、三叉神经下颌支和卵圆孔、咽鼓管翼突部等。3例自发性脑脊液鼻漏患者一次性修补成功；4例翼腭窝、颞下窝神经来源的良性肿瘤患者术中全切，术后随访10～120个月无复发。颅底皮样囊肿、颅底侵袭性真菌病、上咽旁间隙基底细胞腺瘤患者，病变全切，随访13～84个月无复发。颅底软骨肉瘤患者术中肿瘤大部分切除，术后放化疗，肿瘤控制；腺样囊性癌患者，术中肿瘤全切，术后随访5年复发，再次手术。除2例术后短期出现腭部麻木感觉异常外，无其他并发症。结论掌握翼突入路的解剖标志对于处理翼突周围的颅底病变有重要意义。内镜经鼻经翼突入路是处理部分翼突周围颅底病变的安全有效的技术。

关键词：颅底解剖标志内窥镜检查鼻外科手术脑脊液鼻漏神经鞘瘤

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Heuristic Solution to the conundrum of the Zitterbewegung

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Journal of Modern Physics 2022年第3期13卷 301-314页

作者： juan A. miranda-colόn Independent Researcher Puerto Rico USA

Assuming the Dirac wavefunction describes the state of a single particle. We propose that the relation derived by Schrödinger, which contains the Zitterbewegung term, is a position equation for an amplitude modulated wave. Namely, the elementary constituents are amplitude modulated waves. Indeed, we surmise that a second wave is associated with the particle, which corresponds to a signal. At the same time, we interpret that Broglie’s wave corresponds to a carrier. Furthermore, the quantum object is a recording medium and, like in a hologram, information encoded on its surface. We suggest a description and the cause of the Zitterbewegung heretofore never considered regarding the previous assertions. Hereunder, we shall also apply the quantum amplitude modulation interpretation to the single-photon wave function by Bialynicki-Birula. The predictions are testable, thence providing evidence for the proposed hypothesis.

关键词： Zitterbewegung Electron Photon Photon Wave Function Maxwell’s Equations Measurement Problem

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How to Achieve a Warp Drive

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Journal of Modern Physics 2023年第S1期14卷 1771-1782页

作者： juan A. miranda-colόn Independent Researcher Puerto Rico USA

In this paper, we delve into the intrinsic nature of mass and gravity, as per the amplitude modulation interpretation of the quantum theory. We explore the idea that the elementary constituent is an electromagnetic configuration that interacts with the quantum field, leading to the emergence of inertia and gravity as a reaction to the exchange with the quantum field. While these two phenomena have a common origin, they are distinct. Our proposal suggests manipulating the connection between the quantum field and the particle using high-frequency electromagnetic fields, thereby making a warp drive possible.

关键词： Photon Inertia Gravity Maxwell’s Equations Magnetic Monopoles Fine Structure constant Warp Drive Zitterbewegung

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The Impact of Hurricane Strikes on Short-Term Local Economic Activity: Evidence from Nightlight Images in the Dominican Republic

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International Journal of Disaster Risk Science 2019年第3期10卷 362-370页

作者： Oscar A.Ishizawa juan Josémiranda Eric Strobl World Bank Group SocialUrbanRural and Resilience(SURR)Global PracticeWashingtonDC20433USA Economic Research World Bank GroupWashingtonDC20433USA University of Bern 3012BernSwitzerland

The Dominican Republic is highly exposed to adverse natural events that put the country at risk of losing hard-won economic, social, and environmental gains due to the impacts of disasters. This study used monthly nightlight composites in conjunction with a wind field model to econometrically estimate the impact of tropical cyclones on local economic activity in the Dominican Republic since 1992. It was found that the negative impact of storms lasts up to 15 months after a strike, with the largest effect observed after 9 months. Translating the reduction in nightlight intensity into monetary losses by relating it to quarterly gross domestic product(GDP) suggests that on average the storms reduced GDP by about USD 1.1 billion(4.5% of GDP 2000 and 1.5% of GDP 2016).

关键词： Dominican Republic Econometric analysis Hurricanes Nightlights

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Quantitative Electrophilicity Measures

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物理化学学报 2018年第6期34卷 662-674页

作者： GONZáLEZ Marco Martínez cáRDENAS carlos RODRíGUEZ juan I. LIU Shubin HEIDAR-ZADEH Farnaz miranda-QUINTANA Ramón Alain AYERS Paul W. Laboratory of computational and Theoretical chemistry Faculty of Chemistry University of Havana Havana 10400 Cuba. Departamento de Quimica and Centro de Quimica Universidade de Coimbra 3004-535 Coimbra Portugal. Departamento de Fisica Fac

Quantitative correlation of several theoretical electrophilicity measures over different families of organic compounds are examined relative to the experimental values of Mayr et al.Notably,the ability to predict these values accurately will help to elucidate the reactivity and selectivity trends observed in charge-transfer reactions.A crucial advantage of this theoretical approach is that itprovides this information without the need of experiments,which are often demanding and time-consuming.Here,two different types of electrophilicity measures were analyzed.First,models derived from conceptual density functional theory(c-DFT),including Parr's original proposal and further generalizations of this index,are investigated.For instance,the approaches of Gázquez et al.and chamorro et al.are considered,whereby it is possible to distinguish between processes in which a molecule gains or loses electrons.Further,we also explored two novel electrophilicity definitions.On one hand,the potential of environmental perturbations to affect electron incorporation into a system is analyzed in terms of recent developments in c-DFT.These studies highlight the importance of considering the molecular surroundings when a consistent description of chemical reactivity is needed.On the other hand,we test a new definition of electrophilicity that is free from inconsistencies(so-called thermodynamic electrophilicity).This approach is based on Parr's pioneering insights,though it corrects issues present in the standard working expression for the calculation of electrophilicity.Additionally,we use machine-learning tools(i.e.,symbolic regression) to identify the models that best fit the experimental values.In this way,the best possible description of the electrophilicity values in terms of different electronic structure quantities is obtained.Overall,this straightforward approach enables one to obtain good correlations between the theoretical and experimental quantities by using the simple,yet powerful,interpretative advantage of c-DFT method

关键词： Electrophilicity conceptual density functional theory Symbolic regression Genetic programming Grammatical evolution

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Preliminary study of gravimetric anomalies in the Magallanes-Fagnano fault system,South America

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Geodesy and Geodynamics 2018年第1期9卷 42-49页

作者： juan Manuel Alcacer María Romina Onorato Laura P.Perucca Silvia miranda cONIcET-Av.lgnacio de La Roza(oeste)590 J5402DCSSan JuanArgentina Departmento Geofisica Universidad Nacional de San JuanAv.Ignacio de ga Roza(oeste)590J5402DC5San JuanArgentina cIGEOBIO-cONIcET Gabinete de Neotect6nica y Geomorfologfa(INGEO)Facultad de Ciencias ExactasFfsicas y NaturalesUniversidad Nacional de San JuanAv.lgnacio de La Roza(oeste)590J5402DCSSan JuanArgentina

The main objective of this research is to recognize several geological structures associated with the shear zones of the MFFS（Magallanes-Fagnano fault system） by the analysis and interpretation of gravimetric anomalies. Besides, to compare the gravimetrical response of the cortical blocks that integrate the region under study, which is related to the different morphotectonic domains recognized in the region. This research was developed employing data obtained from World Gravity 1.0, which includes earth and satellite gravity data derived from the EGM2008 model. The study and interpretation of the MFFS from the analysis and processing of the gravimetric data, allowed appreciation of a noticeable correlation with the most superficial cortical structure.

关键词： Gravimetry Isostatic anomaly Magallanes-Fagnano fault system Argentina

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