RESUMEN

Background: High Consequence Infectious Diseases (HCIDs), have the potential to cause pandemics and require particular focus for preparedness due to their high mortality rates. The application of Personal Protective Equipment (PPE) for HCIDs is complex and carries significant risk of Health Care Worker (HCW) contamination if done incorrectly. Previous reviews have reported a lack of information on the nature of training provided and the ideal timing of repeat training to best retain skills. Simulation Based Mastery Learning (SBML) is a methodology for skill acquisition which encompasses deliberate practice and repeated assessment until the learner achieves a pre-set Mastery standard. SBML has been demonstrated to improve competence, skill retention and patient outcomes in other clinical procedures. SBML has not been previously studied or utilised in HCID PPE training. Aim: We aimed to increase the likelihood of safe clinical practice by evidencing that Lothian modified SBML for PPE effectively prepares our priority learners. Methods: A quasi-experimental within group post-test design was used. Learners undertook a modified SBML programme which included two-hour asynchronous and two-hour synchronous components. Findings: 11 learners (10 infectious diseases registrars and 1 infectious diseases consultant) were enrolled in the programme with 8 completing all stages, all of whom achieved the Mastery passing standard. The resources were highly rated by learners with the exemplar videos of skills highlighted as particularly useful. Self-assessed preparedness for each skill increased following pre-learning and synchronous sessions. Conclusion: Modified SBML can be used as an effective methodology for the training and assessment of HCWs in the donning and doffing of HCID PPE.

RESUMEN

Telemetry technology is ubiquitous for studying the behavior and demography of wildlife, including the use of traditional very high frequency (VHF) radio telemetry and more recent methods that record animal locations using global positioning systems (GPS). Satellite-based GPS telemetry allows researchers to collect high spatial-temporal resolution data remotely but may also come with additional costs. For example, recent studies from the southern Great Basin suggested GPS transmitters attached via backpacks may reduce the survival of greater sage-grouse (Centrocercus urophasianus) relative to VHF transmitters attached via collars that have been in use for decades. While some evidence suggests GPS backpacks reduce survival, no studies have examined the effects of GPS backpacks on breeding behavior and success. Therefore, we compared survival, breeding behavior, and nest success of sage-grouse hens marked with both VHF collars and GPS backpack transmitter over a 7-year period in central Idaho, USA. GPS backpacks reduced spring-summer survival of sage-grouse hens relative to hens with VHF collars, where daily mortality probability was 68%-82% higher from March 1 to August 1. Yet satellite GPS backpacks did not consistently affect nest success or the likelihood or timing of nest initiation relative to VHF collars. Daily nest survival varied annually and with timing of nest initiation and nest age, but marginal effects of transmitter type were statistically insignificant and interactions between transmitter type and study year produced no meaningful patterns. Our results corroborate recent studies for the effect of satellite GPS backpacks on sage-grouse survival, but also suggest that these transmitters do not appear to affect components of fecundity. Our results therefore add important context to recent debate surrounding the effects of GPS backpacks on sage-grouse, and the relative strengths and weaknesses of different transmitter types for understanding behavior and population dynamics.

RESUMEN

This article discusses several aspects related to the modeling of the radio channel in the wind farm propagation environment. The first part of the article is filled with the analysis of the ITU-R BT.1893-1 model, which-as will be shown-is also applicable to systems operating in the VHF and UHF bands. The conducted measurement campaign makes it possible to model a radio channel for VHF operating systems in the wind farm propagation environment. Thanks to the obtained results, the authors propose the VHF radio channel model for that environment. Using the software implementation of this model, the authors carry out a detailed simulation analysis of the impact of wind turbines on radio systems operating in the VHF band. The main motivation for this work is the growing importance of the offshore wind energy in general, numerous investments in that area in Poland, and the lack of existing mathematical models regarding the wind farms' impact on the VHF systems. The VHF band is of special interest here, as this part of the spectrum is utilized by numerous marine administration and border protection radio systems, which can be adversely affected by the wind turbines (due to interference and/or radio shadowing).

RESUMEN

This research aims to analyze the impact of the Earth-Space link on the Automatic Identification System (AIS) signals of ships. To achieve this, we established a simulation system that measures the receiving power of AIS signals via satellite platforms. We validated the system by utilizing observation data from Tiantuo-5. Through this simulation, we quantitatively analyzed the effects of ionospheric TEC (Total Electron Content) and space loss on the received power. During the processing of observation data, we construct a geometric propagation model utilizing the measured positions of both the satellite and the ship. We then calculate the antenna gain and remove any system errors. Additionally, we eliminate the deviation of elevation and azimuth angles caused by satellite motion. This allows us to determine the actual power of different ships reaching the receiving platform. Upon comparing the measured power data with the simulated power, it was noted that both exhibited an increasing trend as the elevation angle increased. This led to an RMSE (Root Mean Square Error) result of approximately one, indicating the accuracy of the simulation system. These findings hold significant implications for analyzing interference factors in satellite-ground links.

RESUMEN

Very high frequency (VHF) radio tracking technology deployed on terrestrial vertebrates has been well utilized in ecology without much evolution since the 1960s. With the advent of multi-species rewilding projects, and the new field of reintroduction biology, there has been an increase in requirements for telemetry systems to monitor survival and mortality for many animals simultaneously. Common, pulsed VHF can only monitor one individual on each radio frequency, and the number of individuals monitored is constrained by the amount of time spent on each frequency to facilitate a detection and the number of receivers. Coded VHF largely removes these constraints by using a digital code that can simultaneously monitor up to 512 individuals on a single frequency. Incorporated into an autonomous monitoring system, the coded VHF system also greatly reduces time in the field to confirm the status of individuals. Here we demonstrate the utility of coded VHF technologies applied to monitoring a reintroduced population of brush-tailed bettong (Bettongia penicillata) on the Southern Yorke Peninsula in southern Australia. A system of autonomous monitoring towers was able to monitor 28 different individuals simultaneously without having to change frequency on any of the towers. During a single 24-h period, one individual was recorded 24,078 times. Key benefits of the high detection rate and autonomous recording are, a timely response to mortalities or a predation event, the detection of nocturnal, cryptic, or burrowing species whenever they are active, and the reduced need for personnel to be in the field.

RESUMEN

In the ultrasonic non-destructive evaluation of thin films, it is essential to have ultrasonic transducers that are able to generate surface acoustic waves (SAW) of suitably high frequencies in a wide frequency range of between ten and several hundred megahertz. If the characterization is carried out with the transducer in contact with the sample, it is also necessary that the transducers provide a high level of mechanical displacement (>100 s pm). This level allows the wave to cross the transducer−sample interface and propagate over the distance of a few millimeters on the sample and be properly detected. In this paper, an emitter transducer formed of interdigitated chirp electrodes deposited on 128° Y-cut LiNbO3 is proposed. It is shown that this solution efficiently enables the generation of SAW (displacement level up to 1 nm) in a frequency range of between 100 and 240 MHz. The electrical characterization and a displacement field analysis of SAW by laser Doppler vibrometry are presented. The transducer's significant unidirectionality is demonstrated. Finally, the characterization of two titanium thin films deposited on silicon is presented as an example. A meaningful SAW velocity dispersion (~10 m/s) is obtained, which allows for the precise estimation (5% of relative error) of the submicrometer thickness of the layers (20 and 50 nm).

RESUMEN

Viral hemorrhagic fever (VHF) is a term referring to a group of life-threatening infections caused by several virus families (Arenaviridae, Bunyaviridae, Filoviridae and Flaviviridae). Depending on the virus, the infection can be mild and can be also characterized by an acute course with fever accompanied by hypervolemia and coagulopathy, resulting in bleeding and shock. It has been suggested that the course of the disease is strongly influenced by the activation of signaling pathways leading to RIG-I-like receptor-dependent interferon production. RIG-I-like receptors (RLRs) are one of two major receptor families that detect viral nucleic acid. RLR receptor activation is influenced by a number of factors that may have a key role in the differences that occur during the antiviral immune response in VHF. In the present study, we collected data on RLR receptors in viral hemorrhagic fevers and described factors that may influence the activation of the antiviral response. RLR receptors seem to be a good target for VHF research, which may contribute to better therapeutic and diagnostic strategies. However, due to the difficulty of conducting such studies in humans, we suggest using Lagovirus europaeus as an animal model for VHF.

Asunto(s)

RESUMEN

UAVs, used for professional purposes, often intervene in unfamiliar terrain and challenging conditions. Unlike recreational UAVs, such professional and specialised UAVs are very expensive to develop and operate, and their value is not negligible. Due to the nature of operations in an unknown or dangerous environment, there are also situations with forced interruption and termination of the flight mission or a collision with the environment. Locating a lost vehicle presents a new challenge for UAV operators. The possibilities of today's localised commercial aircraft in distress (COSPASS/SARSAT systems) are undesirable for selective special-purpose drones. The optimisation of the location in the event of an emergency or catastrophic landing may be justified by a social or other condition, where the user wants to search for the device by a system other than the one experienced for rescuing people, ideally on their reserved frequencies. The article proposes a new approach to solving the problem based on the design of a terrestrial localisation system based on the methods of processing and correlation of the obtained data by the physical principle of the Doppler effect and its own system adaptation. This creates an innovative concept of a targeting system based on the broadcasting of distress (VHF) signal by crashed UAV. This signal is captured and evaluated by the IDVOR system, making it possible to determine the direction in which the searched UAV is placed. In order to determine the difference between standard targeting systems of the UAV, which use information about position (exact coordinates (x,y,z)), the IDVOR system is able to determine direction, independent of other systems in every "enemy" or "inhospitable" territory.

Asunto(s)

RESUMEN

Autophagy is a process focused on maintaining the homeostasis of organisms; nevertheless, the role of this process has also been widely documented in viral infections. Thus, xenophagy is a selective form of autophagy targeting viruses. However, the relation between autophagy and viruses is ambiguous-this process may be used as a strategy to fight with a virus, but is also in favor of the virus's replication. In this paper, we have gathered data on autophagy in viral hepatitis and viral hemorrhagic fevers and the relations impacting its viral pathogenesis. Thus, autophagy is a potential therapeutic target, but research is needed to fully understand the mechanisms by which the virus interacts with the autophagic machinery. These studies must be performed in specific research models other than the natural host for many reasons. In this paper, we also indicate Lagovirus europaeus virus as a potentially good research model for acute liver failure and viral hemorrhagic disease.

Asunto(s)

RESUMEN

Homeothermy requires increased metabolic rates as temperatures decline below the thermoneutral zone, so homeotherms typically select microhabitats within or near their thermoneutral zones during periods of inactivity. However, many mammals and birds are heterotherms that relax internal controls on body temperature and go into torpor when maintaining a high, stable body temperature, which is energetically costly. Such heterotherms should be less tied to microhabitats near their thermoneutral zones and, because heterotherms spend more time in torpor and expend less energy at colder temperatures, heterotherms may even select microhabitats in which temperatures are well below their thermoneutral zones. We studied how temperature and daily torpor influence the selection of microhabitats (i.e., diurnal roosts) by a heterothermic bat (Myotis thysanodes). We (1) quantified the relationship between ambient temperature and daily duration of torpor, (2) simulated daily energy expenditure over a range of microhabitat temperatures, and (3) quantified the influence of microhabitat temperature on microhabitat selection. In addition, warm microhabitats substantially reduced the energy expenditure of simulated homeothermic bats, and heterothermic bats modulated their use of daily torpor to maintain a constant level of energy expenditure across microhabitats of different temperatures. Daily torpor expanded the range of energetically economical microhabitats, such that microhabitat selection was independent of microhabitat temperature. Our work adds to a growing literature documenting the functions of torpor beyond its historical conceptualization as a last-resort measure to save energy during periods of extended or acute energetic stress.

Asunto(s)

RESUMEN

When wild-caught Eurasian lynx (Lynx lynx) from the Slovak Carpathian Mountains were reintroduced to Central Switzerland in the early 1970s and spread through the north-western Swiss Alps (NWA), they faced a largely unfamiliar landscape with strongly fragmented forests, high elevations, and intense human land use. For more than 30 years, radio-collared lynx have been monitored during three different project periods (in the 1980s, 1990s, and 2010s). Our study explored, how lynx over generations have learned to adjust to the alpine environment. We predicted that (1) lynx nowadays select more strongly for open habitats, higher elevations, and steep slopes compared to the early stages of recolonization and that (2) consequently, there were significant changes in the Eurasian lynx' prey spectrum. To test our predictions, we analyzed telemetry data (VHF, GPS) of 13 adult resident lynx in the NWA over 35 years, using Resource Selection Functions. Furthermore, we compared kills recorded from different individuals inhabiting the same region during three project periods. In general, lynx preferred forested areas, but over the years, they avoided open habitat less. Compared to the early stage of the recolonization, lynx in the most recent project period selected for higher elevations and the proportion of chamois in their prey spectrum surmounted that of roe deer. Potential driving factors for the observed changes could be increasing tolerance to human presence, intraspecific competition, or fitness benefits through exploitation of new resources. Long-term studies like ours provide important insight into how animals can respond to sudden environmental changes, e.g., in the course of translocations into new areas or anthropogenic alterations of their habitats.

RESUMEN

Low-hydrogen-containing amorphous silicon (a-Si) was deposited at a low temperature of 80 °C using a very high frequency (VHF at 162 MHz) plasma system with multi-split electrodes. Using the 162 MHz VHF plasma system, a high deposition rate of a-Si with a relatively high deposition uniformity of 6.7% could be obtained due to the formation of high-ion-density (>1011 cm-3) plasma with SiH4 and a lack of standing waves by using small multi-split electrodes. The increase in the radio frequency (RF) power decreased the hydrogen content in the deposited silicon film and, at a high RF power of 2000 W, a-Si with a low hydrogen content of 3.78% could be deposited without the need for a dehydrogenation process. The crystallization of the a-Si by ultraviolet (UV) irradiation showed that the a-Si can be crystallized with a crystallinity of 0.8 and a UV energy of 80 J without dehydrogenation. High-resolution transmission electron microscopy showed that the a-Si deposited by the VHF plasma was a very small nanocrystalline-like a-Si and the crystalline size significantly grew with the UV irradiation. We believe that the VHF (162 MHz) multi-split plasma system can be used for a low-cost low-temperature polysilicon (LTPS) process.

RESUMEN

PURPOSE: Report the outcomes of the implantable collamer lens (ICL) in myopic astigmatism using very high-frequency (VHF) digital ultrasound sizing. METHODS: Analysis of 42 consecutive ICL procedures using EVO and EVO+ (Visian V4c) lenses (STAAR Surgical) was done. ICL size was chosen using the ultrasound-based Kojima Formula with Insight 100 VHF digital ultrasound (VHFDU). Standard visual outcomes analysis was performed using 3-month data, also including contrast sensitivity, refractive and corneal vector analysis, and ECC. Postoperative lens position was evaluated using VHF digital ultrasound. RESULTS: Attempted SEQ was -10.83±3.39D (-4.40 to -16.98D). Cylinder was -1.46±1.15D (0.00 to -4.25D). One-year follow-up was available in 86% of the eyes and 3 months in 96%. Postoperative UDVA was 20/20 or better in 89% of the eyes, relative to 71% preoperatively. Postoperative SEQ refraction was ±0.50 D in 74% and ±1.00 D in 98% of the eyes. There was a gain of one line of CDVA in 43% of the eyes, 2 or more lines in 10% of the eyes, while there was a one line loss in 7% and no eyes lost 2 or more lines. The vector mean for the corneal SIA was 0.24 D Ax 100. Contrast sensitivity showed a statistically significant increase with a mean of 0.14 log units at 6, 12, and 18 cycles per degree (P<0.01). The mean change in ECC was -153±353 cells/mm2. Lens vault was 506±233 µm (114-924 µm). Footplate insertion was in zonular position in 48.3%, ciliary body in 49.2%, and sulcus in 2.5% of locations. CONCLUSION: ICL implantation resulted in high safety and efficacy but with an implantation vault range that ideally would be improved upon. VHF digital ultrasound of the lens footplate and posterior anatomical relations may provide essential information for evaluating postoperative vault outliers.

RESUMEN

A new measurement technique of electrical parameters of superconducting thin films at the Very High Frequency (VHF) range is described, based on resonators with microstrip (MS) structures. The design of an optimal resonator was achieved, based on a thorough theoretical analysis, which is required for derivation of the exact configuration of the MS. A theoretical model is presented, from which an expression for the attenuation of a MS line can be derived. Accordingly, simulations were performed, and an optimal resonator for the VHF range was designed and implemented. Production constraints of YBa2Cu3O7 (YBCO) limited the diameter of the sapphire substrate to 3″. Therefore, a meander configuration was formed to fit the long λ/4 MS line on the wafer. By measuring the complex input reflection coefficients of a λ/4 resonator, we extracted the quality factor, which is mainly affected by the dielectric and conductor attenuations. The experimental results are well fitted by the theoretical model. The dielectric attenuation was calculated using the quasi-static analysis of the MS line. An identical copper resonator was produced and measured to compare the properties of the YBCO resonator in reference to the copper one. A quality factor of ~6·105 was calculated for the YBCO resonator, three orders of magnitude larger than that of the copper resonator. The attenuation per unit length of the YBCO layer was smaller by more than five orders of magnitude than that of the copper.

RESUMEN

BACKGROUND: Hantavirus pulmonary syndrome (HPS) is well-known in South and North America; however, not enough data exist for the Caribbean. The first report of clinical orthohantavirus infection was obtained in Barbados, but no other evidence of clinical orthohantavirus infections among adults in the Caribbean has been documented. METHODS: Using enzyme linked immunosorbent assay (ELISA) tests followed by confirmatory testing with immunofluorescent assays (IFA), immunochromatographic (ICG) tests, and pseudotype focus reduction neutralization tests (pFRNT), we retrospectively and prospectively detected orthohantavirus-specific antibodies among patients with febrile illness in Barbados. RESULTS: The orthohantavirus prevalence rate varied from 5.8 to 102.6 cases per 100,000 persons among febrile patients who sought medical attention annually between 2008 and 2016. Two major orthohantavirus epidemics occurred in Barbados during 2010 and 2016. Peak orthohantavis infections were observed observed during the rainy season (August) and prevalence rates were significantly higher in females than males and in patients from urban parishes than rural parishes. CONCLUSIONS: Orthohantavirus infections are still occurring in Barbados and in some patients along with multiple pathogen infections (CHIKV, ZIKV, DENV and Leptospira). Orthohantavirus infections are more prevalent during periods of high rainfall (rainy season) with peak transmission in August; females are more likely to be infected than males and infections are more likely among patients from urban rather than rural parishes in Barbados.

RESUMEN

Monitoring arterial blood pressure (BP), represents a more accurate evaluation of hemodynamics than heart rate alone and is essential for preventing and treating intra- and post-operative complications in wildlife chemical immobilization. The objectives of the study were to test the correlation between standard oscillometry and Korotkoff's technique in anesthetized free-ranging brown bears in Croatia and Scandinavia and to assess the blood pressure in both locations. Five bears were snared and darted with xylazine and ketamine in Croatia, and 20 bears were darted from a helicopter with medetomidine and tiletamine-zolazepam in Scandinavia. Blood pressure was simultaneously measured with both techniques every 5 minutes. Correlation between techniques, trends of BP variation, and the factors of the capture which likely influenced BP were assessed. Successful measurements of BP were achieved in 93% of all attempts with the Korotkoff's technique but in only 29% of all attempts with oscillometry. The latter method mostly provided lower values of BP compared to Korotkoff's technique in yearlings. Most bears showed a decreasing trend in systolic and mean BP over time, consistent between the two techniques. All bears were hypertensive: the auscultatory technique detected moderate to severe systolic hypertension in 25% and 84% of bears in Croatia and in Scandinavia, respectively, with significantly higher BP in subadults and adults compared to yearlings. Only Korotkoff's method resulted in a reliable and effective tool for BP assessment in brown bears. The anesthetic protocols used in the present study in association with the capture methods produced hypertension in all animals.

RESUMEN

This work presents the design for an antenna element that can be used in radio arrays for the monitoring and detecting of radio emissions from cosmic particles' interactions in the atmosphere. For these applications, the pattern stability over frequency is the primary design goal. The proposed antenna has a high gain over a relative bandwidth of 88%, a beamwidth of 2.13 steradians, a small group delay variation and a very stable radiation pattern across the frequency bandwidth of 110 to 190 MHz. It is dual polarized and has a simple mechanical structure which is easy and inexpensive to manufacture. The measurements show that the ground has insignificant impact on the overall radiation pattern.

RESUMEN

Lassa virus (LASV), an arenavirus causing Lassa fever, is endemic to West Africa with up to 300,000 cases and between 5000 and 10,000 deaths per year. Rarely seen in the United States, Lassa virus is a CDC category A biological agent inasmuch deliberate aerosol exposure can have high mortality rates compared to naturally acquired infection. With the need for an animal model, specific countermeasures remain elusive as there is no FDA-approved vaccine. This natural history of aerosolized Lassa virus exposure in Macaca fascicularis was studied under continuous telemetric surveillance. The macaque response to challenge was largely analogous to severe human disease with fever, tachycardia, hypotension, and tachypnea. During initial observations, an increase trend of activated monocytes positive for viral glycoprotein was accompanied by lymphocytopenia. Disease uniformly progressed to high viremia followed by low anion gap, alkalosis, anemia, and thrombocytopenia. Hypoproteinemia occurred late in infection followed by increased levels of white blood cells, cytokines, chemokines, and biochemical markers of liver injury. Viral nucleic acids were detected in tissues of three non­survivors at endpoint, but not in the lone survivor. This study provides useful details to benchmark a pivotal model of Lassa fever in support of medical countermeasure development for both endemic disease and traditional biodefense purposes.

Asunto(s)

RESUMEN

Free-ranging brown bears (Ursus arctos) were snared and subsequently darted with a combination of xylazine-ketamine in Croatia (n = 5) or darted from a helicopter with a combination of medetomidine-tiletamine-zolazepam in Scandinavia (n = 20). Three adults and one yearling (1 year old) bear were captured in Croatia, with one adult being captured twice. The Scandinavian bears were divided into Group A (yearlings, n = 7) and Group B (subadults, n = 2 and adults, n = 11). The exertion time (time from activation of the trap or from the start of the helicopter chase to recumbency) and the induction time (time from darting to recumbency) were recorded. The rectal temperature (Tr) was measured as soon as possible after induction and then monitored at frequent intervals (varied between individuals) in immobilized bears. Blood pressure (BP) was measured with a non-invasive method (Korotkoff's technique) every 5 minutes. The heart rate (HR), respiratory rate (RR), and arterial haemoglobin oxygen saturation (SpO2) were recorded every 5 minutes. Reliability of the BP monitoring technique, trends of variation of the physiological variables, and the factors related to the capture were assessed. Both exertion and induction times were longer in Croatian bears than in Scandinavian bears. In Croatian bears, the Tr was either constant or slightly decreasing, with hyperthermia recorded in two individuals (Tr > 39.0° C). In Scandinavian bears, 17 of 20 individuals developed an initial hyperthermia. Four of five bears in Croatia and 17 of 20 bears in Scandinavia showed a decreasing trend in systolic and mean BP over time. According to the Korotkoff method, all bears were hypertensive (mean BP > 130 mmHg) with varying severity, and the systolic pressure was significantly lower in yearlings when compared to subadults and adults. Yearlings had significantly (p < 0.05) higher HR than subadults and adults, however there was no significant differences in RR, SpO2, and Tr between the age groups. All Croatian bears and 13 of 20 Scandinavian bears were moderately to severely hypoxemic (SpO2 < 90%). Further studies with simultaneous invasive and non-invasive (Korotkoff) BP monitoring techniques are required to confirm the accuracy of methods used in this study. The data presented here provides evidence of the physiological impact of different capture methods and chemical immobilization of brown bears in Croatia and Scandinavia.

RESUMEN

In 1967, several workers involved in poliomyelitis vaccine development and production fell ill at three different locations in Europe with a severe and often lethal novel disease associated with grivets (Chlorocebus aethiops) imported from Uganda. This disease was named Marburg virus disease (MVD) after the West German town of Marburg an der Lahn, where most human infections and deaths had been recorded. Consequently, the Marburg episode received the most scientific and media attention. Cases that occurred in Frankfurt am Main, West Germany, were also described in commonly accessible scientific literature, although they were less frequently cited than those pertaining to the Marburg infections. However, two infections occurring in a third location, in Belgrade, Yugoslavia, have seemingly been all but forgotten. Due in part to their absence in commonly used databases and in part to the fact that they were written in languages other than English, the important articles describing this part of the outbreak are very rarely cited. Here, we summarize this literature and correct published inaccuracies to remind a younger generation of scientists focusing on Marburg virus and its closest filoviral relatives of this important historical context. Importantly, and unfortunately, the three episodes of infection of 1967 still represent the best in-depth clinical look at MVD in general and in the context of "modern" medicine (fully resourced versus less-resourced capacity) in particular. Hence, each individual case of these episodes holds crucial information for health care providers who may be confronted with MVD today.

Asunto(s)