bluuebunny/crossref_metadata_2025 huggingface dataset:
Proximal muscle weakness as the sole manifestation of Cushing’s disease, misdiagnosed as dermatomyositis: a case report
Authors: Jeddi Marjan , Shams Mesbah
Published: December 2022

Background

Cushing’s syndrome consists of signs and symptoms related to prolonged exposure to high levels of glucocorticoid, and should be considered in individuals with the discriminatory signs and symptoms. Proximal myopathy is an important discriminatory sign.

Case presentation

We report the case of a 36-year-old Iranian man who presented with proximal muscle weakness. He visited a rheumatologist in an outpatient clinic, and according to proximal muscle weakness and heliotrope rash (based on the rheumatologist’s notes) with the impression of dermatomyositis, prednisolone and azathioprine were prescribed for him that did not improve his clinical status and he was gradually wheelchair dependent. He was admitted to the hospital for evaluation of paraneoplastic syndromes. Standard laboratory tests and imaging were unremarkable, other than a brain magnetic resonance imaging that demonstrated a 30 × 12 mm homogeneously enhancing mass in the sellar region with extension to the suprasellar area. He had serum cortisol of 295 ng/mL, and adrenocorticotropic hormone of 222 pg/mL (on 5 mg prednisolone twice daily), with a diagnosis of Cushing’s disease. He underwent two sessions of trans-sphenoidal surgery 4 months apart. After the first surgery, the proximal muscle weakness improved dramatically and he was walking with the aid of a walker, and after the second surgery he is walking without any aids.

Conclusion

This case report emphasizes the high diagnostic importance of proximal muscle weakness as the sole presenting manifestation of Cushing’s syndrome/disease.
Co-treatment with grape seed extract and mesenchymal stem cells in vivo regenerated beta cells of islets of Langerhans in pancreas of type I-induced diabetic rats
Authors: Farid Alyaa , Haridyy Hebatallah , Ashraf Salma , Ahmed Selim , Safwat Gehan
Published: December 2022

Background

Nowadays, diabetes mellitus is known as a silent killer because individual is not aware that he has the disease till the development of its complications. Many researchers have studied the use of stem cells in treatment of both types of diabetes. Mesenchymal stem cells (MSCs) hold a lot of potential for regenerative therapy. MSCs migrate and home at the damaged site, where they can aid in the repair of damaged tissues and restoring their function. Oxidative stress and inflammation represent a huge obstacle during MSCs transplantation. Therefore, the present study aimed to evaluate the role of grape seed extract (GSE) administration during MSCs transplantation in streptozotocin (STZ)-induced type I diabetes. Furthermore, testing some of GSE components [procyanidins(P)-B1 and P-C1] in conjunction with MSCs, in vivo, was performed to determine if one of them was more effective in relieving the measured attributes of diabetes more than the whole GSE.

Methods

Firstly, GSE was prepared from the seeds of Muscat of Alexandria grapes and characterized to identify its phytochemical components. Experimental design was composed of control group I, untreated diabetic group II, GSE (300 mg/kg)-treated diabetic group III, MSCs (2 × 106 cells/rat)-treated diabetic group IV and GSE (300 mg/kg)/MSCs (2 × 106 cells/rat)-treated diabetic group V. Type I diabetes was induced in rats by intravenous injection with 65 mg/kg of STZ. Treatment started when fasting blood glucose (FBG) level was more than 200 mg/dl; GSE oral administration started in the same day after MSCs intravenous injection and continued daily for 30 consecutive days.

Results

The results showed that GSE/MSCs therapy in type I-induced diabetic rats has dramatically managed homeostasis of glucose and insulin secretion; together with, improvement in levels of inflammatory markers and oxidative stress.

Conclusion

Co-treatment with GSE and MSCs in vivo regenerates beta cells in type I-induced diabetic rats.
Caprine milk as a source of income for women instead of a taboo: a comparative analysis of the implication of women in the caprine and bovine value chains in Fatick, Senegal
Authors: Habanabakize Ernest , Diasse Mame Astou , Cellier Marjorie , Toure Katim , Wade Idrissa , Ba Koki , Camara Astou Diao , Cortbaoui Patrick , Corniaux Christian , Vasseur Elsa
Published: December 2022

Domestic animals, especially small ruminants, are an important source of income for millions of smallholder farmers, particularly women, in Senegal. The aim of this study was to understand the place of the bovine and caprine milk value chains and to identify the role and challenges for women in the Fatick livestock production sector. A survey was conducted among a sample of 50 female producers, including 30 and 20 from the bovine and caprine milk value chains, respectively. Descriptive statistics were performed to compare the caprine and bovine milk value chains in terms of activities, products, and implications for household incomes while showing the place of women at different links of these value chains. The result of the study showed that the bovine milk value chain provided higher income compared to the caprine’s, but the latter was found to be more diverse in terms of milk-derived products with increased income opportunities’ potential. Remoteness, lack of equipment, and cultural biases were reported to be the main constraints in the caprine value chain, while milk price fluctuations were reported to be the biggest challenge for producers in the bovine milk value chain. Access to land and government subsidy programs and domestic time management were the main and specific challenges affecting women in the bovine and caprine value chains. Therefore, there is a need for the establishment of policies and interventions that consider the needs, opportunities, and complementarity offered by both the caprine and bovine milk value chains across smallholder women settings, while putting gender mainstreaming at the center of the discussions and reforms.
Profile and determinants of delayed care-seeking and diagnosis among patients with imported malaria: a retrospective study in China, 2014–2021
Authors: Zhang Tao , Wang Duoquan , Qian Yingjun , Ruan Wei , Liu Ying , Xia Jing , Yan Hui , Sui Yuan , Lu Shenning , Xu Xian , Jiang Jingjing , Lyu Xiaofeng , Wang Shuqi , Li Shizhu , Li Weidong
Published: December 2022

Background

In areas where malaria has been eliminated, delayed care-seeking and diagnosis of imported malaria are constant threats. This study aimed to describe the profile and determinants of delayed care-seeking and diagnosis among patients with imported malaria in China.

Methods

This retrospective study assessed surveillance data obtained from 2014 to 2021 in the Chinese provincial-level administrative divisions (PLADs) of Anhui, Henan, Hubei, and Zhejiang, and Guangxi. Epidemiological characteristics were analyzed using descriptive statistics. Furthermore, factors associated with delayed care-seeking and diagnosis among imported malaria cases were identified using multivariate logistic regression.

Results

Overall, 11.81% and 30.08% of imported malaria cases had delays in seeking care and diagnosis, respectively. During the study period, there was a decreasing trend in the proportion of imported malaria cases with delayed care-seeking (χ2 = 36.099, P < 0.001) and diagnosis (χ2 = 11.395, P = 0.001). In multivariate analysis, independent risk factors associated with delayed care-seeking include PLADs (Guangxi as reference), consultations in high-level facilities for the first medical visit, infections with non-Plasmodium falciparum species, and older age. However, PLADs (Guangxi as reference), the purpose of traveling (labour as reference), and infections with non-P. falciparum species increased the risk of delayed diagnosis. Delayed care-seeking (adjusted odds ratio: 1.79, P = 0.001) and diagnosis (adjusted odds ratio: 1.62, P = 0.004) were risk factors for severe disease development.

Conclusions

Based on this study’s findings, we strongly advocate for improved access to quality healthcare to reduce the rate of misdiagnosis at the first visit. Infections caused by non-P. falciparum species should be highlighted, and more sensitive and specific point-of-care detection methods for non-P. falciparum species should be developed and implemented. In addition, education programs should be enhanced to reach target populations at risk of malaria infection. All these factors may reduce delayed care-seeking and diagnosis of imported malaria.

Graphical Abstract
Bayesian calibration of coupled computational mechanics models under uncertainty based on interface deformation
Authors: Willmann Harald , Nitzler Jonas , Brandstäter Sebastian , Wall Wolfgang A.
Published: December 2022

Calibration or parameter identification is used with computational mechanics models related to observed data of the modeled process to find model parameters such that good similarity between model prediction and observation is achieved. We present a Bayesian calibration approach for surface coupled problems in computational mechanics based on measured deformation of an interface when no displacement data of material points is available. The interpretation of such a calibration problem as a statistical inference problem, in contrast to deterministic model calibration, is computationally more robust and allows the analyst to find a posterior distribution over possible solutions rather than a single point estimate. The proposed framework also enables the consideration of unavoidable uncertainties that are present in every experiment and are expected to play an important role in the model calibration process. To mitigate the computational costs of expensive forward model evaluations, we propose to learn the log-likelihood function from a controllable amount of parallel simulation runs using Gaussian process regression. We introduce and specifically study the effect of three different discrepancy measures for deformed interfaces between reference data and simulation. We show that a statistically based discrepancy measure results in the most expressive posterior distribution. We further apply the approach to numerical examples in higher model parameter dimensions and interpret the resulting posterior under uncertainty. In the examples, we investigate coupled multi-physics models of fluid–structure interaction effects in biofilms and find that the model parameters affect the results in a coupled manner.
Association between anticholinergic activity and xerostomia and/ or xerophthalmia in the elderly: systematic review
Authors: Prado-Mel E. , Ciudad-Gutiérrez P. , Rodríguez-Ramallo H. , Sánchez-Fidalgo S. , Santos-Ramos B. , Villalba-Moreno A. M.
Published: December 2022

Purpose

The aim of this work was to investigate the association between anticholinergic burden or anticholinergic drug use and xerostomia and/or xerophtalmia in elderly through a systematic review of the published literature.

Methods

A search was carried out in 3 databases (CINAHL, Embase and Pubmed). Studies conducted in people ≥65 years of age, who took anticholinergic medications, and measured the association between the anticholinergic burden or the use of these medications with the prevalence of xerostomia and / or xerophthalmia, published up to August 2022, were selected. Studies published in languages other than Spanish and/or English were excluded.

Results

One thousand two hundred eleven articles were identified, 10 were selected for this review: six cross-sectional studies, two cohorts, one case-control and one randomized controlled clinical trial. A total of 3535 patients included in the different studies were studied. The most used scales were the Anticholinergic Drug Scale (ADS) and the Anticholinergic Risk Scale (ARS). Four articles studied the relationship between the use of anticholinergic medication and the prevalence of xerostomia and / or xerophthalmia, finding a positive relationship with xerostomia in all of them. Another 6 measured the relationship between anticholinergic burden and xerostomia and / or xerophthalmia. Four found a positive relationship between anticholinergic burden and xerostomia and/or xerophthalmia.

Conclusions

Our findings suggest a clear relationship between the use of anticholinergic drugs or anticholinergic burden and the presence of xerostomia. This relationship was less conclusive in the case of xerophthalmia.
Incorporating personalized learning in a role-playing game environment via SID model: a pilot study of impact on learning performance and cognitive load
Authors: Zhong Lin
Published: December 2022

While role-playing games and personalized learning have been regarded as effective tools to improve students’ learning, incorporating personalized learning into role-playing games is challenging and approaches are limited to cognitive and motivational variables. Aiming at expanding approaches to incorporate personalization into role-playing games, this study included affective and cognitive variables to develop a personalized role-playing game, guiding by the situational design model. A pilot study was conducted to examine the effectiveness of the game on students’ learning performance and cognitive load. Results showed that personalized role-playing game environment was effective in improving students’ performance, reducing extraneous load, and promoting germane load. This study also found that although decreased extraneous load, could leave students more GL capacity for efficient learning, this would not necessarily lead to performance improvement. Students need to be motivated to invest sufficient germane load to actively process the learning materials and thus, improve performance. The findings have several implications for future research designing personalized educational games aimed to promote efficient learning.
Recreational off-highway vehicle exposure, safety behaviors and crash experiences among adolescents
Authors: Jennissen Charles A. , Schaeffer Sienna E. , Hoogerwerf Pamela J. , Wetjen Kristel M. , Mulford Lauren J. , Champoux Katharine L. , Okoro Uche E. , Denning Gerene M.
Published: December 2022

Background

Recreational off-highway vehicles (ROVs), often called utility task vehicles (UTVs), are designed to be driven by those ≥ 16 years and manufacturers recommend passengers be at least 12 years old. This study’s objective was to determine Iowa adolescents’ exposure to ROVs, riders’ use of restraint devices, and crash prevalence.

Methods

Adolescents participating in the Safety Tips for ATV Riders (STARs) program at their schools were anonymously surveyed by the Iowa Off-Road Vehicle Safety Task Force from Fall 2014-Fall 2019. Frequency, bivariate (chi square and Fisher’s exact test) and logistic regression analyses were performed using SAS software, V.9.4.

Results

A total of 4,023 students (9–18 years) from 18 school districts participated. Overall, 68% reported having ridden in an ROV. The proportions having ridden an ROV by where participants lived were farm (85%) > country/not farm (73%) > town (60%), p < 0.0001. Of those asked additional ROV questions (n = 2152), 39% of ROV riders reported riding at least weekly in the previous 12 months. Of those riding ROVs in the past year, 29% reported having at least one crash. Males and respondents living on farms had higher percentages reporting crashes, as compared to females (31% vs. 24%, p = 0.005) and those living elsewhere (35% vs. 24%, p = 0.0003). Thirty-seven percent of ROV riders never or almost never wore their seatbelt. Seatbelt use was inversely proportional to age, p < 0.001. A higher proportion of females reported always or almost always wearing a seat belt (42% vs. 36%, p = 0.0016). Percentages never or almost never wearing seatbelts by residence were farm (47%) > country/not farm (38%) > town (32%), p = 0.0005. Almost daily riders and those reporting having been in a crash were both 1.7 times more likely to never or almost never wear a seatbelt as compared to infrequent riders and those without a crash, respectively.

Conclusions

Iowa adolescents frequently ride ROVs and often without a seatbelt, putting them at greater risk for serious injury or death in a crash. Almost 30% of riders reported an ROV-related crash in the past year. Our study identified a high-risk population that could be targeted for ROV safety education and other injury prevention efforts.
Investigation on air conditioning load patterns and electricity consumption of typical residential buildings in tropical wet and dry climate in India
Authors: Ramapragada Pavan , Tejaswini Dharani , Garg Vishal , Mathur Jyotirmay , Gupta Rajat
Published: December 2022

The residential sector accounts for around 24% of the total electricity consumption in India. Recent studies show that air conditioners (ACs) have become a significant contributor to residential electricity consumption. Further, it is predicted that by 2037, the demand for ACs will increase by four times due to their affordability and availability. Not many studies have been found on residential AC usage patterns and the factors (AC load, setpoint, hours of usage) that influence household electricity consumption. This paper investigates the residential AC usage patterns and AC’s contribution to total residential electricity consumption. Twenty-five urban homes from a wet and dry climatic region of India were monitored for nine months (in 2019) to determine overall household electricity consumption patterns, AC usage, and indoor environment during summer, monsoon, and winter. Analysis of seasonal consumption patterns shows a significant difference in electricity usage between homes with ACs and homes without ACs during the summer season. The average electricity consumption for AC homes was 15.1 kWh/day during summer, 6.6 kWh/day during monsoon, and 6.1 kWh/day during the winter season. Results showed that AC alone contributed to 39% of the total household consumption in summers. The peak AC usage in all homes is observed during sleep hours which was generally between 10:00 pm and 6:00 am and the average AC runtime was 6.2 h. The average indoor temperature was recorded as 26.9 °C during the AC ON period. The AC peak load, i.e., the maximum electricity demand during the AC ON period, is 1.7 kW on average during the study period. The average annual consumption of homes with ACs was 2881 kWh, and for non-AC homes, the consumption was 2230 kWh. Findings from our analysis provide a detailed understanding of AC consumption profiles and the difference in electricity consumption characteristics between AC and non-AC homes across different seasons.
Gossypiboma as a rare complication of septoplasty procedure: case report and review of literatures
Authors: Ebeid Kamal
Published: December 2022

Background

Foreign body granuloma due to retained surgical sponge is also called gossypiboma. Only one case of nasal septum gossypiboma has been reported.

In this report, we present a case of retained surgical sponge at the septoplasty site.

Case presentation

A 16-year-old male patient came to our emergency department complaining of nasal obstruction associated with low-grade fever. With past history of septoplasty 3 months ago. Endoscopic examination of the nasal cavity revealed bilateral smooth swelling of the nasal septum, no fluid was detected with aspiration. A CT scan of the nose and paranasal sinuses revealed significant posterior septal swelling. A consent had been taken from the parents, and the patient was prepared for endoscopic exploration under general anesthesia. Elevation of bilateral mucoperichondrial and mucoperiosteal flaps was done. There was a firm swelling with intense reaction all around, after meticulous dissection of this lesion and was delivered with Blakesley forceps. On closer examination it was a missed cotton ball. The patient follow-up for 12 months was excellent with complete disappearance of his complaints.

Conclusions

Retained surgical items should be considered in the differential diagnosis of post-operative nasal septum swellings. Sponges used for nasal surgery should be of appropriate size and attached to a thread and should be counted.
Prevalence and prognostic significance of chronic respiratory diseases among hospitalized patients with COVID-19 infection: a single-center study
Authors: Abdelghany E. , Abdelfattah Rasha A. , Shehata S. Rabea , Abdelaziz A.
Published: December 2022

Background

WHO recognized the COVID-19 outbreak in China as a pandemic crisis on March 11, 2020. Patients with chronic respiratory diseases (CRDs) have limited physiological reserve; this lead to the assumption that COVID-19 infection in such patients could carry worse prognosis.

Aim of study

To detect the prevalence and prognostic significance of CRDs among hospitalized patients with COVID-19 infection.

Methods

The study was carried out at Minia Cardiothoracic University Hospital; all hospitalized COVID-19 patients during the period from January 2021 to August 2021 were included.

Patients were subjected to full medical history taking, full blood count, inflammatory markers (CRP, serum ferritin, serum lactate dehydrogenase (LDH), serum D-dimer, PCR for COVID-19 infection), and HRCT chest.

Need for and duration of mechanical ventilation whether invasive or non-invasive, duration of hospital stay, and condition at hospital discharge were recorded.

Diagnosis for chronic respiratory disease was considered when patients have documented previous history and investigations compatible with the diagnosis, e.g., previous pulmonary function tests, chest CT, or sleep study.

Results

Comorbid chronic respiratory diseases were present in 57 patients (17.6%). Regarding presenting symptoms, no significant difference exists between patients with and without CRDs except for sputum production which was more frequent among patients with underlying CRDs.

Elevated inflammatory markers (ferritin, D-dimer, and LDH) were more frequently observed in patients without CRDs (p < 0.0001, 0.033, and 0.008, respectively).

COVID-19 with comorbid CRDs patients were more hypoxemic at presentation than other patients (p = 0.032).

There was significant number of COVID-19 patients with CRDs were discharged on home oxygen therapy (p = 0.003).

Regarding mortality in our cohort of patients, no significant difference exist between patients with and without CRDs (p 0.374)

Among patients with comorbid CRDs, the highest mortality was observed on patients with OSA followed by ILDS and then COPD.

Conclusion

The presence of CRD was not found to be a poor prognostic value of COVID-19. Inflammatory markers (ferritin, D-dimer, and LDH) were significantly higher in COVID-19 patients without CRD than COVID-19 with CRD.
Robust and efficient waveform-based velocity-model building by optimal transport in the pseudotime domain: Methodology
Authors: Provenzano Giuseppe , Brossier Romain , Métivier Ludovic
Published: December 2022

Full-waveform inversion (FWI) aims at a broadband reconstruction of the subsurface physical properties by fitting the entire recorded wavefield. In realistic exploration seismic surveys, however, conventional FWI often fails to retrieve the deep velocity model due to the limited penetration depth of diving waves. Joint FWI (JFWI) unifies reflection-waveform inversion and early arrival waveform inversion to reconstruct simultaneously the shallow and deep subsurface kinematics. However, several factors limit the appeal of JFWI velocity-model building: (1) conflict between fixed reflectivity and evolving kinematics, creating phase ambiguity at short offsets; (2) susceptibility to cycle skipping at mid-to-long offsets, thus reliance on the quality of the starting model; and (3) cost of building and updating the reflective model. We have developed a fully operational JFWI-based methodology that systematically addresses the aforementioned issues. JFWI is reformulated in the pseudotime domain, to enforce consistency between velocity and reflectivity in a cost-effective fashion, without repeated least-squares migrations. A JFWI graph-space optimal transport (GSOT) objective function is designed to avert cycle skipping, whereas nonuniqueness is mitigated at no extra cost by smoothing the velocity gradient along the structures extracted from the reflective model. A dedicated asymptotic-based preconditioner is developed for impedance waveform inversion, making it possible to obtain sharp and balanced reflective images in a fraction of the time. We determine that pseudotime GSOT-JFWI retrieves complex velocity macromodels from limited-offset data sets with minimal preprocessing, starting from noninformative initial solutions. Compared with depth-domain JFWI, the computing cost is reduced significantly, along with a simpler and less subjective design of data weighting and inversion strategy. Pseudotime GSOT-JFWI provides FWI with the necessary low wavenumbers to converge to the broadband model, reducing the need for accurate starting models, on the road to a fully waveform-based imaging workflow.
Outcomes of Infants and Young Children With Relapsed Medulloblastoma After Initial Craniospinal Irradiation–Sparing Approaches: An International Cohort Study
Authors: Erker Craig , Mynarek Martin , Bailey Simon , Mazewski Claire M. , Baroni Lorena , Massimino Maura , Hukin Juliette , Aguilera Dolly , Cappellano Andrea M. , Ramaswamy Vijay , Lassaletta Alvaro , Perreault Sébastien , Kline Cassie N. , Rajagopal Revathi , Michaiel George , Zapotocky Michal , Santa-Maria Lopez Vicente , La Madrid Andres Morales , Cacciotti Chantel , Sandler Eric S. , Hoffman Lindsey M. , Klawinski Darren , Khan Sara , Salloum Ralph , Hoppmann Anna L. , Larouche Valérie , Dorris Kathleen , Toledano Helen , Gilheeney Stephen W. , Abdelbaki Mohamed S. , Wilson Beverly , Tsang Derek S. , Knipstein Jeffrey , Oren Michal Yalon , Shah Shafqat , Murray Jeffrey C. , Ginn Kevin F. , Wang Zhihong J. , Fleischhack Gudrun , Obrecht Denise , Tonn Svenja , Harrod Virginia L. , Matheson Kara , Crooks Bruce , Strother Douglas R. , Cohen Kenneth J. , Hansford Jordan R. , Mueller Sabine , Margol Ashley , Gajjar Amar , Dhall Girish , Finlay Jonathan L. , Northcott Paul A. , Rutkowski Stefan , Clifford Steven C. , Robinson Giles , Bouffet Eric , Lafay-Cousin Lucie
Published: December 2022

PURPOSE

Infant and young childhood medulloblastoma (iMB) is usually treated without craniospinal irradiation (CSI) to avoid neurocognitive late effects. Unfortunately, many children relapse. The purpose of this study was to assess salvage strategies and prognostic features of patients with iMB who relapse after CSI-sparing therapy.

METHODS

We assembled a large international cohort of 380 patients with relapsed iMB, age younger than 6 years, and initially treated without CSI. Univariable and multivariable Cox models of postrelapse survival (PRS) were conducted for those treated with curative intent using propensity score analyses to account for confounding factors.

RESULTS

The 3-year PRS, for 294 patients treated with curative intent, was 52.4% (95% CI, 46.4 to 58.3) with a median time to relapse from diagnosis of 11 months. Molecular subgrouping was available for 150 patients treated with curative intent, and 3-year PRS for sonic hedgehog (SHH), group 4, and group 3 were 60%, 84%, and 18% ( P = .0187), respectively. In multivariable analysis, localized relapse ( P = .0073), SHH molecular subgroup ( P = .0103), CSI use after relapse ( P = .0161), and age ≥ 36 months at initial diagnosis ( P = .0494) were associated with improved survival. Most patients (73%) received salvage CSI, and although salvage chemotherapy was not significant in multivariable analysis, its use might be beneficial for a subset of children receiving salvage CSI < 35 Gy ( P = .007).

CONCLUSION

A substantial proportion of patients with relapsed iMB are salvaged after initial CSI-sparing approaches. Patients with SHH subgroup, localized relapse, older age at initial diagnosis, and those receiving salvage CSI show improved PRS. Future prospective studies should investigate optimal CSI doses and the role of salvage chemotherapy in this population.
Education–Occupation Mismatch and Nativity Inequality Among Highly Educated U.S. Workers
Authors: Li Xiaoguang , Lu Yao
Published: December 2022

Extensive research has documented persistent nativity inequality in the U.S. labor market, even among high-skilled immigrants. Yet, this phenomenon has not been sufficiently explained. This study investigates whether different types of education–occupation mismatch are a source of this inequality. Using longitudinal data from the Survey of Income and Program Participation, we examine nativity differences in the incidence and wage penalty of education–occupation mismatch among highly educated workers. The results demonstrate that high-skilled immigrants, especially those with foreign degrees, are more vulnerable to vertical and horizontal mismatch and suffer higher wage penalties from mismatched employment than similarly educated native-born workers. Auxiliary analyses show that the disadvantage foreign-educated skilled immigrants experience is largely concentrated among immigrants from countries with lower quality tertiary education, immigrants with lower English proficiency, and those with degrees in non-STEM fields and fields with demanding licensing requirements. These results point to skilled immigrants' limited human capital transferability, which stems from the quality and applicability of educational credentials, language proficiency, and institutional barriers.
Pictorial Realism in Peter Weiss’sThe Aesthetics of Resistance
Authors: Potts Alex
Published: December 2022

This article explores an often overlooked, broadly realist aspect of Weiss’s engagement with visual art in The Aesthetics of Resistance. Analysis of the role played in the novel by painted depiction usually focuses on dramatic stagings of figures engaged in violent struggle. The focus here is on a different kind of art depicting generic situations rather than singular events, one that closely echoes aesthetic and ideological priorities evident in the conception of Weiss’s novel. The pictorial realism that particularly drew his attention consisted both of modern social realism, where a politics of class resonated with his powerfully committed and richly articulated Marxism, and the “epic” realism of the early modern artist Pieter Brueghel the Elder. The way in which in the latter, concrete, rationally graspable realities would merge into phantasmagoria and monstrous deformations spoke perhaps more forcefully to his politically activist aesthetics of resistance.
Collaboration and knowledge integration for successful brain therapeutics – lessons learned from the pandemic
Authors: Loza Maria Isabel , Hmeljak Julija , Bountra Chas , Audia James E. , Chowdhury Sohini , Weiman Shannon , Merchant Kalpana , Blanco Maria-Jesus
Published: December 2022

Brain diseases are a major cause of death and disability worldwide and contribute significantly to years of potential life lost. Although there have been considerable advances in biological mechanisms associated with brain disorders as well as drug discovery paradigms in recent years, these have not been sufficiently translated into effective treatments. This Special Article expands on Keystone Symposia's pre- and post-pandemic panel discussions on translational neuroscience research. In the article, we discuss how lessons learned from the COVID-19 pandemic can catalyze critical progress in translational research, with efficient collaboration bridging the gap between basic discovery and clinical application. To achieve this, we must place patients at the center of the research paradigm. Furthermore, we need commitment from all collaborators to jointly mitigate the risk associated with the research process. This will require support from investors, the public sector and pharmaceutical companies to translate disease mechanisms into world-class drugs. We also discuss the role of scientific publishing in supporting these models of open innovation. Open science journals can now function as hubs to accelerate progress from discovery to treatments, in neuroscience in particular, making this process less tortuous by bringing scientists together and enabling them to exchange data, tools and knowledge effectively. As stakeholders from a broad range of scientific professions, we feel an urgency to advance brain disease therapies and encourage readers to work together in tackling this challenge.
Η παιδική παραβατικότητα
Authors: Καλεντάκης Εμμανουήλ
Published: December 2022

Σκοπός της παρούσας διατριβής είναι η ανάδειξη του φαινομένου της παιδικής παραβατικότητας ως ενός κρίσιμου κοινωνικού προβλήματος, του οποίου οι συνέπειες είναι επικίνδυνες όχι μόνο για το ίδιο το παιδί και την οικογένειά του, αλλά και για το μέλλον της ελληνικής κοινωνίας. Η έρευνα επικεντρώνεται στην παραβατικότητα παιδιών ηλικίας 8-15 ετών, πριν δηλαδή ολοκληρωθεί το στάδιο της εφηβείας, γεγονός το οποίο συνδέεται, ως προς τις επιπτώσεις, σε μεγάλο βαθμό με την αναπτυξιακή πορεία του ατόμου, την συμπεριφορά του στην εφηβεία, και κυρίως τον κίνδυνο εκδήλωσης παραβατικής συμπεριφοράς στην ενήλικη ζωή. Η συγκεκριμένη μελέτη επιχειρεί τη διασύνδεση των απόψεων των διαφόρων φορέων, οι οποίοι εμπλέκονται στην πρόληψη και αντιμετώπιση αυτού του φαινομένου. Προς τούτο, μέσα από την μελέτη, συγκριτική ανάλυση και ερμηνεία των απόψεων των ειδικών από διαφορετικά επιστημονικά πεδία, και συγκεκριμένα εκπροσώπων της δικαιοσύνης, παιδαγωγών/εκπαιδευτικών, εγκληματολόγων και ειδικών ψυχικής υγείας και λαμβάνοντας συγχρόνως υπόψη την διεθνή και εγχώρια βιβλιογραφία, κυρίως τα ερευνητικά δεδομένα άλλων μελετών, επιχειρείται να απαντηθούν τα ερωτήματα που θέτει η συγκεκριμένη έρευνα. Τα ερευνητικά ερωτήματα αναφέρονται τόσο στην κρισιμότητα του προβλήματος και τις συνέπειές του, όσο και στην σπουδαιότητα της έγκαιρης παρέμβασης και την συμβολή των προγραμμάτων για την πρόληψη και αντιμετώπισή του.
Η αποτελεσματικότητα της θεραπείας με υπερβαρικό οξυγόνο στην τελική έκβαση ασθενών με αιφνίδια απώλεια ακοής
Authors: Δόβα Σταματία
Published: December 2022

Σκοπός: Η εκτίμηση της θεραπευτικής επίδρασης του συνδυασμού των συστηματικών κορτικοστεροειδών και της θεραπείας με υπερβαρικό οξυγόνο σε ασθενείς με ιδιοπαθή αιφνίδια απώλεια ακοής. Υλικά και μέθοδος: Πενήντα ασθενείς με ιδιοπαθή αιφνίδια απώλεια ακοής τυχαιοποιήθηκαν σε 2 ομάδες: η ομάδα ελέγχου έλαβε Δεξαμεθαζόνη ενδοφλέβια και η θεραπευτική ομάδα έλαβε Δεξαμεθαζόνη ενδοφλέβια σε συνδυασμό με 15 συνεδρίες θεραπείας υπερβαρικού οξυγόνου ως αρχική θεραπεία. Εκτίμηση της ακοής πραγματοποιήθηκε κατά την είσοδο στο νοσοκομείο , τις ημέρες 9, 14 ,25 και 3 μήνες μετά την έναρξη της θεραπείας. Τα κριτήρια του Siegel χρησιμοποιήθηκαν για την εκτίμηση των ακοολογικών αποτελεσμάτων. Ως επιτυχής θεραπεία ορίστηκε η ακουστική βελτίωση μεγαλύτερη από 10 dBHL. Aναγνώριση τυχόν προγνωστικών παραγόντων έγινε με την ανάλυση γραμμικής παλινδρόμησης. Αποτελέσματα: Tα ποσοστά ακουστικής βελτίωσης ( βασιζόμενα στα κριτήρια του Siegel) ήταν 64% στη θεραπευτική ομάδα και 56% στην ομάδα ελέγχου, διαφορά η οποία δεν ήταν στατιστικά σημαντική (p=0.369). Το τελικό ακουστικό κέρδος βρέθηκε 22,5 dBHL για την ομάδα ελέγχου και 17,5 dBHL για τη θεραπευτική ομάδα, διαφορά η οποία δεν είναι στατιστικά σημαντική. Διαφορές, όσον αφορά το ακουστικό κέρδος ανάμεσα στις δύο ομάδες, του μέσου όρου της ακοής για καθεμία από τις παρακάτω 6 συχνότητες (0,25, 0,5, 1, 2, 4, 8 kHz) δε βρέθηκαν στατιστικά σημαντικές. Επιπλέον, όταν οι ασθενείς από κάθε ομάδα κατηγοριοποιήθηκαν σε 5 υποομάδες σύμφωνα με τη βαρύτητα της βαρηκοΐας (ήπια, μέτρια, μετρίως σοβαρή, σοβαρή, πρακτική κώφωση) , οι διαφορές στο θεραπευτικό αποτέλεσμα ανάμεσα στις υποομάδες της ίδιας βαρύτητας δεν ήταν σημαντικές. Η κατιούσα ακοομετρική καμπύλη αποδείχθηκε αρνητικός προγνωστικός παράγοντας και στις δύο ομάδες, καθώς οδήγησε σε σημαντικά χαμηλότερο ακουστικό κέρδος (30dB) σε σύγκριση με άλλα σχήματα καμπυλών (b=-29.10, 95% CI=-56.39,-1.82). Συμπεράσματα: H προσθήκη της θεραπείας με υπερβαρικό οξυγόνο στα συστηματικά κορτικοστεροειδή δεν προκάλεσε σημαντική ακουστική βελτίωση, παρά την ήπια τάση για μεγαλύτερο ποσοστό βελτίωσης της ομάδας συνδυαστικής θεραπείας. Η παρουσία κατιούσας ακοομετρικής καμπύλης έχει αρνητική προγνωστική αξία. Η ηλικία, το χρονικό διάστημα που μεσολάβησε μέχρι την έναρξη της θεραπείας, η παρουσία ιλίγγου ή εμβοών και η σοβαρότητα της απώλειας ακοής δεν έχουν επίδραση στη διαδικασία ανάρρωσης. Ο εργαστηριακός έλεγχος δεν προσφέρει κάποιο πρόσθετο όφελος σε ασθενείς με ιδιοπαθή αιφνίδια απώλεια ακοής.
A cross-sectional study on assessment of spiritual health and its associated factors among undergraduate students in a medical college in Mangalore, Karnataka
Authors: Raghuveer Pracheth , Bhatia Ravjot , Motappa Rohith , Sachith Malavika
Published: December 2022

Background: Spirituality and spiritual health are an integral component of an individual’s health and wellbeing. Among medical undergraduates and professionals, spiritual health has positive effects on the individual by decreasing burnout, psychological distress, and rates of substance abuse. Spiritual health is also correlated with increased satisfaction and meaning in life. Spiritual health also influences future patient care, builds patient- provider communication channels, and improves patient outcomes.

Methods: A cross-sectional study was conducted to assess the spiritual health levels of medical undergraduates in a medical college, in Karnataka, India, and to identify the factors associated with it. Using a pre-designed, validated semi-structed questionnaire, 600 medical undergraduates were approached and provided the forms. Spiritual health was assessed across the three domains of self-development, self-actualization, and self-realization using the Spiritual Health Assessment Scale (SHAS).

Results: A total of 436 medical undergraduates participated. Majority (67.7%) of participants were girls. Most (62%) were found to have fair spiritual health with a large portion of the rest (36%) having good spiritual health and 2% had poor spiritual health. A significant association was found  between spiritual health and the father’s (p=0.005) and mother’s (p=0.012) education levels. Spiritual health was also found to be associated with living in a nuclear family (p=0.04).

Conclusions: Majority of the medical undergraduates had fair spiritual health. Parents' education levels and nuclear family were significantly associated with spiritual health.
Case Report: Endotracheal tube as life-saving tool to control an aortic rupture in intensive care unit
Authors: Campanella Ciro , Abbass Mohannad , Marzi Umberto , Masini Franco , Lentini Salvatore
Published: December 2022

Background: Aortic rupture and suture dehiscence can complicate a cardiac operation, especially in case of infections of the surgical site. Such a complication can be life-threatening and require immediate surgical treatment.

Case: We report the case of a 13-year-old girl who suffered a sudden dehiscence of the aortic suture line in the context of deep sternal wound infection, while in the surgical intensive care unit after a double valve replacement. Control of bleeding was obtained by the insertion of an endotracheal tube into the ascending aorta and inflation of the tube cuff to plug the aortic bleeding point. The extracorporeal circulation was then established and under deep hypothermic arrest the defect was successfully repaired. The patient was discharged 14 days after surgery and reviewed at the outpatient clinic in good health.

Conclusions: An endotracheal tube can be used in cases of uncontrollable aortic bleeding as a life-saving tool to bridge the patient to adequate surgical treatment.
Investigating the circulating sphingolipidome response to a single high-intensity interval training session within healthy females and males in their twenties (SphingoHIIT): Protocol for a randomised controlled trial
Authors: Carrard Justin , Angst Thomas , Weber Nadia , Bienvenue Joëlle , Infanger Denis , Streese Lukas , Hinrichs Timo , Croci Ilaria , Schmied Christian , Gallart-Ayala Hector , Höchsmann Christoph , Koehler Karsten , Hanssen Henner , Ivanisevic Julijana , Schmidt-Trucksäss Arno
Published: December 2022

Introduction: Growing scientific evidence indicates that sphingolipids predict cardiometabolic risk, independently of and beyond traditional biomarkers such as low-density lipoprotein cholesterol. To date, it remains largely unknown if and how exercise, a simple, low-cost, and patient-empowering modality to optimise cardiometabolic health, influences sphingolipid levels. The SphingoHIIT study aims to assess the response of circulating sphingolipid species to a single session of high-intensity interval training (HIIT).

Methods: This single-centre randomised controlled trial (RCT) will last 11 days per participant and aim to include 32 young and healthy individuals aged 20-29 (50% females). Participants will be randomly allocated to the HIIT (n= 16) or control groups (physical rest, n= 16). Participants will self-sample fasted dried blood spots for three consecutive days before the intervention (HIIT versus rest) to determine baseline sphingolipid levels. Dried blood spots will also be collected at five time points (2, 15, 30, 60min, and 24h) following the intervention (HIIT versus rest). To minimise the dietary influence, participants will receive a standardised diet for four days, starting 24 hours before the first dried blood sampling. For females, interventions will be timed to fall within the early follicular phase to minimise the menstrual cycle's influence on sphingolipid levels. Finally, physical activity will be monitored for the whole study duration using a wrist accelerometer.

Ethics and dissemination: The Ethics Committee of Northwest and Central Switzerland approved this protocol (ID 2022–00513). Findings will be disseminated in scientific journals and meetings.

Trial Registration The trial was registered on www.clinicaltrials.gov (NCT05390866, https://clinicaltrials.gov/ct2/show/NCT05390866) on May 25, 2022.
Perception of nurses, medical laboratory scientists, and midwives toward coronavirus vaccination in Khartoum State, 2021—a cross sectional study
Authors: Abdelrahman Abrar Tariq , A'lam Elhuda Daffalla , Tariq Abdelnabi Hala , Ahmed Abdelfatah Abdellateef , Abd Alla Ahmed Bakheet
Published: December 2022

Background: Nurses, medical laboratory scientists and midwives comprise a large portion of healthcare personnel. Healthcare personnel have an important role in guiding and encouraging patients and communities, and showing role modeling behavior.

Objective: This study aimed to evaluate and explore the perception of nurses, medical laboratory scientists, and midwives toward coronavirus vaccination.

Methods: A descriptive cross-sectional facility-based study was conducted. Data were collected using an online Google form questionnaire. Demographic variables were analyzed using frequencies and percentages. The association between independent variables and the decision of receiving the COVID-19 vaccine were evaluated by binary logistic regression and Chi-square test.

Results: In this study, 375 responses were collected, of which 324 (86.4%) were female. The majority of the participants (73.9%) were aged between 20 and 30 years. There were 160 (42.7%) medical laboratory scientists, 145 (38.7%) nurses, and 70 (18.7%) midwives. More than half of the participants (53.6%) accepted receiving vaccination against COVID-19. Results showed a positive correlation of vaccine acceptance with nurses, medical laboratory scientists, and midwives, suggesting that they are more likely to be vaccinated.

Conclusion: There was a good perception towards COVID-19 vaccination, as 53.4% of the participants accepted receiving the COVID-19 vaccine, which is a good rate for acceptance. This finding has a positive impact on the whole vaccination process, as the recommendations of medical laboratory scientists, nurses, and midwives affect the behavior of the general population toward vaccination.
Development of the lexicon, trained panel validation and sensory profiling of new ready-to-eat plant-based "meatballs" in tomato sauce
Authors: Talens Clara , Lago Maider , Illanes Eder , Baranda Ana , Ibargüen Mónica , Santa Cruz Elena
Published: December 2022

Background: Providing educational content for children and parents can promote healthy nutritional habits. During the TITAN project, a pilot digital contest where participants have to developed ready-to-eat meatballs in sauce, using only plant-based ingredients, will be tested. The objective of this study was to develop the lexicon needed to objectively assess the sensory profile of this product.

Methods: Eight judges were recruited and trained. Thirteen 1-hour sessions took place over three months. The steps followed were the selection of commercial reference, generation of descriptors, training of the panel, validation of the trained panel and product characterisation. The judges chose one commercial reference (using simple hedonic evaluation) to serve as a reference. The accepted intensity scale for the generated descriptors was from 0 (low intensity) to 9 (very intense). To test the first versions of the game, food product developers involved in the project, acted as participants, and used a mix of lentils, quinoa, and oats to enhance the commercial version. R-project software was used to analyse the performance of the panel and the sensory profiles.

Results: A glossary with 14 descriptors was generated. The discriminatory capacity of the panel was confirmed by examining the significance of the product effect (p < 0.05). The product–judge interaction was not significant (p > 0.05) for most of the evaluated attributes, indicating a good degree of panel agreement. Overall, the panel was considered reproducible after 9 sessions. Although the appearance, firmness, fragility and chewiness were considered similar to the reference, juiciness and taste (understood as meaty flavour) of the new product were deemed improved.

Conclusions: According to the panel, two of the most appreciated attributes associated with meat analogues, juiciness and taste, were improved compared to the commercial reference. Therefore, the first approach for further development of the contest/game was validated.
Algorithms for Difference-of-Convex Programs Based on Difference-of-Moreau-Envelopes Smoothing
Authors: Sun Kaizhao , Sun Xu Andy
Published: December 2022

In this paper, we consider minimization of a difference-of-convex (DC) function with and without linear equality constraints. We first study a smooth approximation of a generic DC function, termed difference-of-Moreau-envelopes (DME) smoothing, where both components of the DC function are replaced by their respective Moreau envelopes. The resulting smooth approximation is shown to be Lipschitz differentiable, capture stationary points, local, and global minima of the original DC function, and enjoy some growth conditions, such as level-boundedness and coercivity, for broad classes of DC functions. For a smoothed DC program without linear constraints, it is shown that the classic gradient descent method and an inexact variant converge to a stationary solution of the original DC function in the limit with a rate of [Formula: see text], where K is the number of proximal evaluations of both components. Furthermore, when the DC program is explicitly constrained in an affine subspace, we combine the smoothing technique with the augmented Lagrangian function and derive two variants of the augmented Lagrangian method (ALM), named linearly constrained DC (LCDC)-ALM and composite LCDC-ALM, targeting on different structures of the DC objective function. We show that both algorithms find an ϵ-approximate stationary solution of the original DC program in [Formula: see text] iterations. Comparing to existing methods designed for linearly constrained weakly convex minimization, the proposed ALM-based algorithms can be applied to a broader class of problems, where the objective contains a nonsmooth concave component. Finally, numerical experiments are presented to demonstrate the performance of the proposed algorithms.

Funding: This work was partially supported by the NSF [Grant ECCS1751747].

Supplemental Material: The e-companion is available at https://doi.org/10.1287/ijoo.2022.0087 .