bluuebunny/crossref_metadata_2025 huggingface dataset:
FRI642 The Effect Of Early Basal Insulin Administration On Diabetic Ketoacidosis (DKA) Management
Authors: Al-Marsumi Hadeel , Pollack Simcha Z , Simon Nicole
Published: October 2023

Disclosure: H. Al-Marsumi: None. S.Z. Pollack: None. N. Simon: None.

Background: DKA and HHS are considered serious acute complications of diabetes and constitute endocrine emergencies. Management of DKA and HHS consists of fluid, potassium replacement and weight-based adjusted rate intravenous insulin infusion, with close monitoring of capillary glucose, serum electrolytes, venous PH, and Beta-hydroxybutyrate. Current Standard DKA management protocols introduce and overlap subcutaneous insulin with intravenous insulin infusion after anion gap closure. In United states, few studies looked at different outcomes after early administration of basal insulin (i.e. before anion gap closure) during DKA management. Objective: The purpose of this research is to study the effect of early administration of basal long-acting insulin in addition to intravenous insulin on the time to anion gap closure, incidence of rebound hyperglycemia, hypoglycemia, transitional failure, length of ICU stays and length of Hospital stays, compared to intravenous insulin infusion only. Methods: This was a single-center, retrospective chart review study of adults 21 years or older admitted to the hospital with DKA diagnosis between September 2020 and May 2022. The patients were divided into two groups (Study group which includes those with early administration of basal long-acting insulin in addition to intravenous insulin infusion and Standard group which includes patients who received intravenous insulin infusion only). The primary outcome was the time to anion gap closure. The other outcomes included incidence of rebound hyperglycemia, hypoglycemia, transitional failure, length of ICU stay, as well as the length of hospital stay. Results: A total of 231 admissions were included for analysis; 29 patients were included in the (Study group) and 202 in the (Standard group). The mean time ± standard deviation for hours till anion gap closure in the study group and standard group were (21.3938 ± 25.2603 and 12.7679 ± 9.3512) respectively showing no statistical difference between the two groups with a P value of 0.0789. The incidence of hypoglycemia was 21% in the study group and 24% in the standard group with P value of 0.8173. There was no statistical difference in length of ICU stays, length of hospital stays, incidence of rebound hyperglycemia, transitional failure between the study and control groups with a p value of (0.3867, 0.7207, 0.7758 and 0.1387) respectively. Conclusion: There was no statistical difference in time to anion gap closure, length of ICU stays, length of hospital stays, incidence of rebound hyperglycemia, hypoglycemia, transitional failure between the study and Standard groups. Further Studies are needed to evaluate the effect of early basal insulin administration on DKA management.

Presentation: Friday, June 16, 2023
FRI649 ADMIRE: Assessing Dapagliflozin And Metformin As An Initial Regimen In Diabetes Mellitus For Enhanced Glucose Control
Authors: Phadke Dr Uday , Gopal Dr Jayashree , Biswas Dr Kaushik , Birla Dr Ashish , Prasad Ashish , Joshi Priyanka
Published: October 2023

Disclosure: D. Phadke: None. D. Gopal: None. D. Biswas: None. D. Birla: None. A. Prasad: None. P. Joshi: None.

Introduction: Early aggressive glucose lowering in type 2 diabetes mellitus (T2DM) has shown improved outcomes, and combination oral antidiabetic agents (OAAs) on top of lifestyle therapy are necessary. In India, most T2DM patients receive combination therapy with two or more OAAs to achieve glycemic targets more rapidly. The fixed dose combination (FDC) of dapagliflozin and metformin is widely used in India, as it improves glycemia, reduces weight and blood pressure (BP), and has good tolerability. This study aimed to evaluate physician practices, efficacy, and tolerability of dapagliflozin and metformin FDC as initial therapy for T2DM patients in a real-world setting. Methods: This multicenter, retrospective, observational study enrolled 481 T2DM patients across 49 clinical units for a period of 6 months. The study aimed to evaluate physician practices, efficacy, and tolerability of dapagliflozin and metformin FDC as the initial choice FDC in T2DM. The study was conducted in compliance with the principles of the Declaration of Helsinki, good clinical practice, and regulatory guidelines. Ethical approval for the study was obtained on August 6, 2022, and the study was conducted from August 15, 2022, to January 20, 2023. Results: The study demonstrated that dapagliflozin and metformin FDC significantly reduced weight by 4.2 kg (p < 0.0001), fasting plasma glucose by 21.4 mg/dL (p < 0.0001), and improved estimated glomerular filtration rate (eGFR) by 1.9 m²/1.73 ml/min (p < 0.0001). Additionally, systolic BP was reduced by 10.7 mmHg (p < 0.0001), and diastolic BP was reduced by 6.6 mmHg (p < 0.0001), which is in combination with the concomitant medications. Incidence of genito-urinary tract infection was 8.9%. Conclusion: In a real-world setting, dapagliflozin and metformin FDC can be used as initial therapy for T2DM with good efficacy, tolerability, and safety. Physicians preferred this combination due to its ability to promote weight loss, reduce cardiovascular events, and decline in renal function. The excellent safety and efficacy reported by physicians for this FDC of dapagliflozin and metformin has contributed to improved compliance with the treatment. Thus, in the Indian population, dapagliflozin and metformin FDC is effective, safe, and has good tolerability as an initial therapy for T2DM.

Presentation: Friday, June 16, 2023
SAT098 Method For Predicting Time-below-range From Ambulatory Glucose Profile
Authors: Takeishi Soichi , Inoue Tatsuo
Published: October 2023

Disclosure: S. Takeishi: None. T. Inoue: None.

Time-below-range (TBR) for target duration is described in ambulatory glucose profile (AGP) reports of continuous glucose monitoring (CGM). However, for a method to reduce hypoglycemia, it is necessary to determine the frequency of hypoglycemia and the time zone when hypoglycemia occurs. Thus, in this study, we evaluated a method for predicting TBR from AGP. This is a cross-sectional study. We analyzed glucose levels (GL) measured using CGM (FreeStyle Libre Pro) over 24 hours for 13 days (from 00:00 on Day 2 to 00:00 on Day 15 [CGM attachment: Day 1]) for 100 outpatients with type 2 diabetes, whose diabetic treatment did not change through the CGM-wearing duration. We proposed the metric, “eTBR<70AGP” as follows: ① when 95 percentile values were <70 mg/dL, GL<70 mg/dL were defined to exist at 100% (percentages were defined as “hypoglycemia existing rate [HER]”). When 95 percentile values were not <70 mg/dL, and 75 percentile values were <70 mg/dL, GL<70 mg/dL were defined to exist at 95%. When 75 percentile values were not <70 mg/dL and 50 percentile values were <70 mg/dL, GL<70 mg/dL were defined to exist at 75%. When 50 percentile values were not <70 mg/dL and 25 percentile values were <70 mg/dL, GL<70 mg/dL were defined to exist at 50%. When 25 percentile values were not <70 mg/dL and 5 percentile values were <70 mg/dL, GL<70 mg/dL were defined to exist at 25%. However, when 5 percentile values were not <70 mg/dL, GL<70 mg/dL were defined as nonexistent for convenience. ② We applied the definition mentioned in ① to the percentile values in the 13 days for each 96 timepoint of measurement every 15 minutes over 24-hours and determined the HER. ③ We calculated the eTBR<70AGP as the average of HER of the 96 timepoint. We also calculated “TBR (<70 mg/dL)” [TBR<70] for the 13 days. In patients overall (n=100), eTBR<70AGP correlated to TBR<70 (r=0.997, p<0.001). The optimal cutoff value of TBR<70 for “eTBR<70AGP - TBR<70 > 0” was 1.0% with sensitivity of 97% and specificity of 91% in receiver operating characteristic analysis [Area under the curve (AUC): 0.98, p<0.001]. In patients with TBR<70>1% (n=34), eTBR<70AGP was clinically equivalent to TBR<70 as values (11.3% vs 9.0%). However, eTBR<70AGP was statistically significantly higher than TBR<70 (p<0.001). In patients with TBR<70<1% (n=66), eTBR<70AGP was clinically equivalent to TBR<70 as values (0.04% vs 0.08%). However, eTBR<70AGP was statistically significantly lower than TBR<70 (p=0.02). eTBR<70AGP may be substituted for TBR<70 without underestimating the risk of hypoglycemia. Thinking in the calculation process of eTBR<70AGP may be utilized for assessment of the risk of hypoglycemia at each time zone.

Presentation: Saturday, June 17, 2023
SAT130 Examining Rates Of Post-hospital Discharge Follow-up In An Endocrinology Clinic
Authors: Khan Talha , Kumar Ajay M , Champion Amber , Izuora Kenneth E
Published: October 2023

Disclosure: T. Khan: None. A.M. Kumar: None. A. Champion: None. K.E. Izuora: None.

Introduction: Outpatient follow up following hospital discharge is a critical factor in improving overall health outcomes especially among patients with chronic medical conditions. Previous research has demonstrated improved patient outcomes and lower readmission rates in patients with outpatient follow up after hospital discharge. In this single center QI project, we sought to understand the follow-up rate and the reasons for not following up among our patient population. Methods: This study is a root cause analysis following the Plan-Do-Study-Act cycle. All the patients seen by the UNLV inpatient endocrinology consult service in June and July 2022 were recorded. Patients discharged to hospice or discharged after July 31, 2022 were excluded from the study. After December 1, 2022 the number of patients that followed up at UNLV endocrinology clinic from the list was recorded. All patients that met inclusion criteria for the study and did not follow up at UNLV endocrinology clinic were contacted by phone and reason for not following up was recorded. Results: Over the 2 months of recruitment, 74 patients were consulted on by the endocrinology service and 67 met study inclusion criteria. From this group, only 13 patients had established follow-up care at the UNLV endocrinology clinic. From the remaining 54 patients, 5 had died. The 49 remaining patients who met criteria for the study but did not follow up were contacted via telephone (3 attempts). Of this, 8 patients either did not answer phone calls three separate times or did not have an active listed phone number.

Of the 41 patients contacted, the most frequent reason for not following up was inability to contact the clinic (6 patients, 14.6%), unawareness of need for follow-up (5 patients, 12.2%), prior established endocrinology care outside of UNLV (5 patients, 12.2%), no indication for follow-up (5 patients, 12.2%), and PCP managing the condition (5 patients, 12.2%). Of the remaining, 4 patients were not instructed to follow up, 3 patients had insurance not accepted at the UNLV endocrinology clinic, 2 patients were unable to get a convenient appointment and 2 patients established care at other endocrine clinics. The following reasons for not following up were given by one patient per category: leaving the city, discharge to prison, appointment canceled by the clinic, and refusing to answer any questions. Conclusion: From these responses, we can formulate methods to improve clinic follow-up after clinic discharge. The primary method to improve clinic follow-up after hospital discharge is to improve ease of contact with the clinic such as ensuring phone lines are adequately attended. An additional measure would be to stress need for follow-up at time of hospital discharge in addition to having printed instructions for clinic follow-up in the discharge paperwork.

Presentation: Saturday, June 17, 2023
Exploring the Association Between Thyroid Function and Oral Microbiome Diversity: An NHANES Analysis
Authors: Zheng Liang , Yang Rui , Li Ruixia , Chen Wanna , Zhang Jing , Lv Weiming , Lin Bo , Luo Jiajun
Published: October 2023

Objective

To investigate the association between thyroid functions and the oral microbiome diversity.

Method

Data from the US National Health and Nutrition Examination Survey (NHANES; 2009-2012) were analyzed. Thyroid functions were defined using thyroid hormones and related biomarkers. Oral microbiome was measured using the observed number of amplicon sequence variants (ASVs) and the Bray-Curtis dissimilarity. Linear regression was used to estimate the average change (β) and 95% CI for the number of ASVs against thyroid functions, adjusted for sociodemographic variables, health conditions, urinary iodine status, and periodontitis. Non-metric multidimensional scaling (NMDS) was used to analyze the Bray-Curtis dissimilarity.

Results

A total of 2943 participants were analyzed. The observed number of ASVs has a weighted mean of 128.9. Self-reported thyroid disease was associated with reduced number of ASVs (β = −9.2, 95% CI: −17.2, −1.2), if only adjusted for sociodemographic variables and health conditions. In the fully adjusted model, compared to normal thyroid function, both subclinical and clinical hyperthyroidism were associated with reduced number of ASVs (β = −59.6, 95% CI: −73.2, −46.0; β = −28.2, 95% CI: −50.0, −6.5, respectively). Thyroid peroxidase antibody level higher than the reference range was associated with higher observed ASV (β= 9.0, 95% CI: 1.2, 16.9). NMDS analysis suggested significant difference in oral microbiome composition between free triiodothyronine groups (P = .002), between free thyroxine groups (P = .015), and between thyroglobulin groups (P = .035).

Conclusion

Hyperthyroidism was associated with reduced oral microbiome diversity. Free triiodothyronine, free thyroxine, and thyroglobulin levels may alter the oral microbiome composition.
Effect of Cobalt-60 Treatment Dose Rate on Arteriovenous Malformation Obliteration After Stereotactic Radiosurgery With Gamma Knife
Authors: Anthes Victoria B. , Schwartz Michael , Cusimano Michael , Radovanovic Ivan , Kulkarni Abhaya V. , Laperriere Normand , Payne David , Heaton Robert , van Prooijen Monique , Das Sunit , Tsang Derek S.
Published: October 2023

BACKGROUND AND OBJECTIVES:

Stereotactic radiosurgery (SRS) marginal dose is associated with successful obliteration of cerebral arteriovenous malformations (AVM). SRS dose rate—how old the cobalt-60 sources are—is known to influence outcomes for some neurological conditions and benign tumors. The objective of this study was to determine the association between cobalt-60 treatment dose rate and cerebral AVM obliteration in patients treated with SRS.

METHODS:

We performed a retrospective cohort study of 361 patients undergoing 411 AVM-directed SRS treatments between 2005 and 2019 at a single institution. Lesion characteristics, SRS details, obliteration dates, and post-treatment toxicities were recorded. Univariate and multivariate regression analyses of AVM outcomes regarding SRS dose rate (range 1.3-3.7 Gy, mean = 2.4 Gy, median = 2.5 Gy) were performed.

RESULTS:

At 10 years post-SRS, 68% of AVMs were obliterated on follow-up imaging. Dose rates >2.9 Gy/min were found to be significantly associated with AVM obliteration compared with those <2.1 Gy/min (P = .034). AVM size, biologically effective dose, and SRS marginal dose were also associated with obliteration, with obliteration more likely for smaller lesions, higher biologically effective dose, and higher marginal dose. Higher dose rates were not associated with the development of post-SRS radiological or symptomatic edema, although larger AVM volume was associated with both types of edema.

CONCLUSION:

Patients with cerebral AVMs treated with higher SRS dose rates (from newer cobalt-60 sources) experience higher incidences of obliteration without a significant change in the risk of post-treatment edema.
Chinese Neurosurgical Randomized Controlled Trials: Dynamics in Trial Implementation and Completion
Authors: Liu Tao , Liu Mingqi , Sha Zhuang , Wu Chenrui , Zhao Zhihao , Yuan Jiangyuan , Feng Dongyi , Nie Meng , Jiang Rongcai
Published: October 2023

BACKGROUND AND OBJECTIVES:

The focus on evidence-based neurosurgery has led to a considerable amount of neurosurgical evidence based on randomized controlled trials (RCTs) being published. Nevertheless, there has been no systematic appraisal of China's contribution to RCTs. Information about the changes in characteristics of Chinese neurosurgical RCTs before and during the COVID-19 pandemic is limited. This study aims to perform a detailed examination and comprehensive analysis of the characteristics of Chinese neurosurgical RCTs and to examine the differences before and during the COVID-19 pandemic.

METHODS:

We conducted a comprehensive database search including PubMed, Web of Science, Embase, and Cochrane Library up to March 2023, with a criterion of inclusion based on an impact factor above 0. We subsequently examined the design and quality parameters of the included RCTs and assessed the differences before and during the COVID-19 pandemic (based on follow-up ending before or after January 2020). Moreover, we investigated potential factors that may affect the quality and developmental trends of neurosurgical RCTs in China.

RESULTS:

The main focus of the 91 neurosurgical RCTs was vascular disease (47.3%) and trauma (18.7%). Over half of the trials used Consolidated Standards of Reporting Trial diagrams (69.2%), and the majority compared nonsurgical treatments (63.7%). Larger trials tended to have better quality scores, but those with significant efficacy were less likely to have power calculations. Over time, there was an increase in the use of Consolidated Standards of Reporting Trial diagrams and well-specified outcomes. The COVID-19 pandemic may have hindered the completion of neurosurgical RCTs in China, but it has had little impact on the design and quality so far.

CONCLUSION:

Chinese neurosurgeons have made significant progress in advancing neurosurgical RCTs despite challenges. However, shortcomings in sample size and power calculation need attention. Improving the rigor, rationality, and completeness of neurosurgical RCT design is crucial.
Neurological Surgery Residency Programs in the United States: A National Cross-Sectional Survey
Authors: Ng Patrick R. , Yearley Alexander G. , Eatz Tiffany A. , Ajmera Sonia , West Timothy , Razak Shahaan S. , Lazaro Tyler , Urakov Timur , Jones Pamela S. , Coumans Jean-Valery , Stapleton Christopher J. , Shankar Ganesh , Chen H. Isaac , Komotar Ricardo J. , Patel Akash J. , Nahed Brian V.
Published: October 2023

BACKGROUND AND OBJECTIVES:

The Accreditation Council for Graduate Medical Education has approved 117 neurological surgery residency programs which develop and educate neurosurgical trainees. We present the current landscape of neurosurgical training in the United States by examining multiple aspects of neurological surgery residencies in the 2022–2023 academic year and investigate the impact of program structure on resident academic productivity.

METHODS:

Demographic data were collected from publicly available websites and reports from the National Resident Match Program. A 34-question survey was circulated by e-mail to program directors to assess multiple features of neurological surgery residency programs, including curricular structure, fellowship availability, recent program changes, graduation requirements, and resources supporting career development. Mean resident productivity by program was collected from the literature.

RESULTS:

Across all 117 programs, there was a median of 2.0 (range 1.0-4.0) resident positions per year and 1.0 (range 0.0-2.0) research/elective years. Programs offered a median of 1.0 (range 0.0-7.0) Committee on Advanced Subspecialty Training–accredited fellowships, with endovascular fellowships being most frequently offered (53.8%). The survey response rate was 75/117 (64.1%). Of survey respondents, the median number of clinical sites was 3.0 (range 1.0-6.0). Almost half of programs surveyed (46.7%) reported funding mechanisms for residents, including R25, T32, and other in-house grants. Residents received a median academic stipend of $1000 (range $0-$10 000) per year. Nearly all programs (93.3%) supported wellness activities for residents, which most frequently occurred quarterly (46.7%). Annual academic stipend size was the only significant predictor of resident academic productivity (R2 = 0.17, P = .002).

CONCLUSION:

Neurological surgery residency programs successfully train the next generation of neurosurgeons focusing on education, clinical training, case numbers, and milestones. These programs offer trainees the chance to tailor their career trajectories within residency, creating a rewarding and personalized experience that aligns with their career aspirations.
Mapping oto-pharyngeal development in a human inner ear organoid model
Authors: Steinhart Matthew R. , van der Valk Wouter H. , Osorio Daniel , Serdy Sara A. , Zhang Jingyuan , Nist-Lund Carl , Kim Jin , Moncada-Reid Cynthia , Sun Liang , Lee Jiyoon , Koehler Karl R.
Published: October 2023

Inner ear development requires the coordination of cell types from distinct epithelial, mesenchymal and neuronal lineages. Although we have learned much from animal models, many details about human inner ear development remain elusive. We recently developed an in vitro model of human inner ear organogenesis using pluripotent stem cells in a 3D culture, fostering the growth of a sensorineural circuit, including hair cells and neurons. Despite previously characterizing some cell types, many remain undefined. This study aimed to chart the in vitro development timeline of the inner ear organoid to understand the mechanisms at play. Using single-cell RNA sequencing at ten stages during the first 36 days of differentiation, we tracked the evolution from pluripotency to various ear cell types after exposure to specific signaling modulators. Our findings showcase gene expression that influences differentiation, identifying a plethora of ectodermal and mesenchymal cell types. We also discern aspects of the organoid model consistent with in vivo development, while highlighting potential discrepancies. Our study establishes the Inner Ear Organoid Developmental Atlas (IODA), offering deeper insights into human biology and improving inner ear tissue differentiation.
Effects of Different Weekly Set Progressions on Muscular Adaptations in Trained Males: Is there a Dose-Response Effect?
Authors: Enes Alysson , De Souza Eduardo O. , Souza-Junior Tácito P.
Published: October 2023

Purpose

This study investigated the effect of progressively adding sets for the lower- limb every two weeks versus performing a constant set volume in resistance-trained males.

Methods

Thirty-one resistance-trained males (age 24.4 ± 2.9 years; height 175.5 ± 6.5 cm; body mass 80.1 ± 9.4 kg; body fat 14.4 ± 3.1%; resistance training [RT] experience 5.1 ± 2.2 years; one repetition maximum (1-RM) barbell back squat:body mass ratio 1.7 ± 0.1 a.u.) were randomly allocated into a Constant Group (CG, n = 10), a four sets progression group (4SG, n = 10) or a six sets progression group (6SG, n = 11). After a 2-week washout period and another 2-week familiarization period, participants performed a lower-limb training program twice a week for 12 weeks. Maximum dynamic strength (1-RM) in the barbell back squat, vastus lateralis cross-sectional area (CSA), and the sum of lateral thigh muscle thickness (∑MT) at 30, 50 and 70% of the femur length were assessed at baseline and after the 12-week training program.

Results

Regarding 1-RM, multiple comparisons revealed that 6SG elicited higher muscle strength gains than 4SG (p = 0.002) and CG (p < 0.0001), and 4SG had greater improvements than CG (p = 0.023). CSA and ∑MT showed no between-group differences (p = 0.067 and p = 0.076, respectively). However, an inspection of 95% confidence intervals suggests a potential dose-response relationship, with results appearing to plateau in the higher volume conditions.

Conclusions

Our results suggest that progressively adding four or six sets per week every two weeks elicited greater lower-limb strength in resistance-trained individuals over a 12-week training period. While our findings indicate a possible small benefit for higher volume conditions regarding hypertrophic adaptations in this population, the limited certainty of our findings warrants caution.
Distortion estimation methodologies and architectures for high linearity and efficiency power amplifiers in CMOS technologies
Authors: Μπαξεβανάκης Δημήτριος
Published: October 2023

Η εν λόγω διατριβή καταπιάνεται με δύο διαφορετικά θέματα, τα οποία σχετίζονται αμφότερα με την ευρύτερη πτυχή της γραμμικής συμπεριφοράς κυκλωματικών διατάξεων. Το πρώτο μέρος της διατριβής αφορά στην ανάπτυξη και υλοποίηση μεθόδων εκτίμησης αρμονικής παραμόρφωσης και παραμόρφωσης ενδοδιαμόρφωσης σε γραμμικά κυκλώματα CMOS, ενώ το δεύτερο κομμάτι αφορά στην ανάπτυξη και υλοποίηση μίας αρχιτεκτονικής σταδίου ισχύος υψηλής γραμμικότητας και απόδοσης. Η αρμονική παραμόρφωση (harmonic distortion) και η παραμόρφωση ενδοδιαμόρφωσης (intermodulation distortion) αποτελούν δύο από τα σημαντικότερα μεγέθη που χαρακτηρίζουν την συμπεριφορά ηλεκτρονικών διατάξεων, με την εκτίμησή τους πολλές φορές να αποδεικνύεται πολύπλοκο εγχείρημα. Προς αυτή την κατεύθυνση, στον πρώτο θεματικό άξονα της διατριβής παρουσιάζονται δύο συστηματικές μέθοδοι εκτίμησης των προαναφερθέντων ειδών παραμόρφωσης. Οι προτεινόμενες μέθοδοι μπορούν να υλοποιηθούν εύκολα σε αριθμητικά υπολογιστικά περιβάλλοντα και γλώσσες προγραμματισμού, εφαρμόζονται σε πληθώρα CMOS κυκλωματικών τοπολογιών που παρουσιάζουν ασθενή μη–γραμμική συμπεριφορά και προσφέρουν μεγάλη ακρίβεια εκτίμησης παράλληλα με υψηλή ταχύτητα εκτέλεσης. Οι μέθοδοι βασίζονται στην μοντελοποίηση του κυκλώματος ενδιαφέροντος ως μίας δομής διασυνδεδεμένων σταδίων διαγωγιμότητας (Gm–stages), τα οποία αποδίδουν με ακρίβεια την συμπεριφορά των αντίστοιχων τμημάτων που μοντελοποιούν μέσω μίας συνάρτησης ρεύματος εξαρτώμενης από τις τάσεις εισόδου, εξόδου και γινομένων τους. Η διαδικασία εκτίμησης της παραμόρφωσης γίνεται στο πεδίο του χρόνου μέσω δύο προσεγγιστικών βημάτων, όπου μειώνεται η υπολογιστική πολυπλοκότητα και απαιτείται απλά η επίλυση δύο συστημάτων γραμμικών εξισώσεων. Οι προτεινόμενες μέθοδοι εφαρμόζονται σε διάφορες διατάξεις ολοκληρωμένων κυκλωμάτων CMOS σε περιβάλλον προσομοίωσης, όπου επιβεβαιώνεται η ακρίβεια και ταχύτητά τους. Στον δεύτερο θεματικό άξονα της διατριβής παρουσιάζεται μία αρχιτεκτονική σταδίου ισχύος η οποία χαρακτηρίζεται από υψηλή γραμμικότητα και ταυτόχρονα υψηλή απόδοση. Η προτεινόμενη αρχιτεκτονική συνδυάζει την άριστη γραμμικότητα των σταδίων ισχύος τάξης–Α (Class–A power stages) με ένα σύστημα συνεχούς δυναμικής τροφοδοσίας για μείωση των απωλειών ισχύος στα τρανζίστορ εξόδου και επιπρόσθετη βελτίωση της συνολικής γραμμικότητας. Το σύστημα δυναμικής τροφοδοσίας αποτελείται από δύο DC–DC μετατροπείς (DC–DC converters) ικανών να παράξουν τάσεις τροφοδοσίας συχνοτήτων έως μερικές δεκάδες kHz, με στόχο την χρήση της τοπολογίας σε εφαρμογές αναπαραγωγής ήχου (audio) ή μετρήσεων χαμηλόσυχνων σημάτων. Η θεωρητική ανάλυση της προτεινόμενης αρχιτεκτονικής σταδίου ισχύος ακολουθείται από μία proof–of–concept υλοποίησή της σε τεχνολογία ολοκληρωμένων κυκλωμάτων CMOS σε περιβάλλον προσομοίωσης, όπου αναδεικνύονται τα χαρακτηριστικά και πλεονεκτήματα της αρχιτεκτονικής.
Byzantine baths in the Prefecture of Illyricum
Authors: Αρβανιτίδου Ιωάννα
Published: October 2023

Στην διατριβή καταλογογραφήθηκαν (Παράρτημα) όλα τα λουτρικά συγκροτήματα που εντοπίστηκαν στην Περιφέρεια του Ιλλιρικού και κατασκευάστηκαν από τα μέσα του 3ου αιώνα έως και τα μέσα του 15ου αιώνα. Επίσης, συμπεριλήφθηκαν λουτρικά οικοδομήματα που κατασκευάστηκαν κατά την ρωμαϊκή περίοδο, αλλά συνέχισαν να λειτουργούν και στην βυζαντινή εποχή. Στην παρούσα έρευνα μελετήθηκαν οι λουτρικές εγκαταστάσεις στις δεκατρείς επαρχίες της περιοχής του Ιλλυρικού και παρατηρήθηκε μια σταδιακή μείωση της κατασκευής λουτρικών συγκροτημάτων με την πάροδο των αιώνων. Κατά τη μετάβαση από τους ρωμαϊκούς χρόνους στη βυζαντινή περίοδο παρατηρήθηκε σημαντική μείωση της κατασκευής, η οποία συνεχίστηκε στη μέση και υστεροβυζαντινή περίοδο, ενώ κατά τον 7ο και 8ο αιώνα παρατηρήθηκε παντελής έλλειψη νέων κατασκευών. Ταυτόχρονα, υπήρξε μια αλλαγή στον τρόπο λούσης, με στροφή προς την ιδιωτικοποίηση λόγω της επικράτησης του χριστιανισμού και των νέων ηθικών αξιών που έφερε η νέα θρησκεία. Η τάση αυτή αντικατοπτρίζεται στη σταδιακή κατάργηση της ταυτόχρονης λούσης ανδρών και γυναικών και στην κατασκευή ενός νέου τύπου θερμαινόμενου θαλάμου, πιθανότατα εξοπλισμένου με φορητούς λουτήρες. Όλες οι παραπάνω αλλαγές οδήγησαν στη δημιουργία ενός νέου τύπου λουτρού, του Βυζαντινού Λουτρού, το οποίο ήταν ένα μικρό κτίριο με τους απολύτως απαραίτητους χώρους. Αυτός ο νέος αρχιτεκτονικός τύπος λουτρού, ο οποίος άρχισε να εφαρμόζεται από τον 11ο αιώνα μ.Χ., έχει σχήμα σταυρού και αποτελείται από τρεις χώρους. Ο πρώτος θάλαμος, ο οποίος μπορεί να ήταν θερμαινόμενος ή όχι, δεν είχε υδραυλικό σύστημα και εξυπηρετούσε τις ανάγκες των λουομένων πριν εισέλθουν βασικό λουτρικό δωμάτιο. Ο δεύτερος θάλαμος είναι το κύριο δωμάτιο λούσης και διέθετε δύο πλευρικές εσοχές με ατομικούς λουτήρες. Ο ένας από τους λουτήρες είχε ζεστό νερό, ενώ η θερμοκρασία του νερού στον δεύτερο λουτήρα δεν ήταν σαφώς προσδιορισμένη, καθώς υπάρχουν παραδείγματα με κρύο και χλιαρό νερό. Ο τρίτος θάλαμος είναι η κινστέρνα του κτίσματος, η οποία τροφοδοτούσε με νερό τους λουτήρες του δεύτερου θαλάμου.
What is Stress in Epilepsy? A Content Analysis and an open letter to the World Health Organization (WHO): Highly Time to Define Stress
Authors: Pilafas Georgios , Louka Penelope , Lyrakos Georgios
Published: October 2023

Aim: Stress is one of the most researched issues in Behavioral Medicine and Health Psychology. The background review illustrated that much peer-reviewed quantitative studies do not define accurately the concept of stress in epilepsy and/or use a different rationale in their definition. This contributes further in major medical and psychological debates and research questions in the last decade of whether stress is ‘epileptogenic’ and ‘seizure triggering’ for epileptic patients.
Material and Method: The present qualitative study applied a content analysis on Chapter 5 of World Health Organization’s (WHO) first and latest global report on epilepsy -from a Health Psychology point of view-, seeking for (i) a universal definition of stress in epilepsy, (ii) what stressors are more related to ‘epileptogenesis’ and ‘seizure triggering’ –if any- and (iii) any proposed stress relief and management strategies to be delivered by psychologists.
Results and Conclusions: Primary and secondary content analysis presented that WHO does not define stress as a single entity, but rather shows an unspecified link with ‘social stigma’ or ‘social stressors’. Moreover, WHO does not show taking leadership in defining stress for research purposes. Lastly, there are some thoughts that although WHO applies the biopsychosocial model in this report, it considers that the ‘psycho’ part of the model concerns entirely the field of ‘psychopathology’.
The efficacy of a specifically designed printed material on satisfaction from information provision and Quality of Life of hematopoietic stem cell transplantation patients: A randomized controlled trial
Authors: Kiropoulou Asimina , Katsareli Maria , Zyga Sofia , Nanas Serafeim , Vasileiadis Ioannis
Published: October 2023

Background: Patients with hematological malignancies who undergo hematopoietic stem cell transplantation (HSCT) face complex challenges and need appropriate information to help them cope with the physical and psychological demands of their treatment and experience greater health related quality of life (HRQoL). This study investigated the impact of a specially designed booklet about HSCT, on patients’ satisfaction from information, overall emotional distress and HRQoL.
Method and Material: A total of 127 HSCT patients were randomly assigned to receive standard verbal information (control group, n=63) or the additional printed information (intervention group, n=64). Patients’ satisfaction was assessed at two time-points; at admission to the transplant unit and at discharge. Emotional distress and HRQoL were also evaluated at 3 and 6 months post-HSCT. Intention-to-treat analysis was performed.
Results: Patients’ characteristics were similar in the two arms. The experimental group reported highest levels of satisfaction when compared with patients attending standard verbal approach (p<0.004). No significant differences between groups were noted, regarding patients’ desired attitude about the amount of perceived information. Overall, 65% of patients wanted all the available information. Most participants considered that the booklet was easy to read and helpful in recalling medical instructions. High levels of satisfaction were strongly correlated with reduction in anxiety levels and improvement in overall HRQoL, at discharge from the transplant unit.
Conclusion: Our results demonstrate printed materials can be a beneficial and practical method for patients to gain comprehensible information for HSCT. However, further well-designed, longitudinal multicenter randomized trials are needed to confirm our findings.
The influence of canned laughter in the sense of humor of healthy Greek adults. A pilot study with debatable results.
Authors: Vichou Maria Danai , Neila Alexandra , Gavala Olga , Kotidou Filomila Dimitra , Pilafas Georgios , Louka Penelope
Published: October 2023

Background: Humor is the individual’s perception of something interpreted as funny. It is usually accompanied by emotional and vocal reactions, such as laughter. Scientists have long studied the factors that can influence this response and have argued whether it is contagious. Canned laughter is widespread in American situation comedies, but does it influence the sense of humor of the audience? To test this question, much research has been conducted, but the findings remain controversial.
Method and Material: This laid the foundations to create a study on healthy Greek adult population to examine the influence of canned laughter on their sense of humor, using independent sample test comparison in SPSS software. Thirty individuals were recruited through the convinent sampling method and participated in the study. Half of them watched a video with canned laughter in the background (M=6.53, SD=2.1), whereas the rest watched a video without canned laughter (M=5.46, SD=1.77). Then they were asked to evaluate the comicality of the video on a Likert scale.
Results: The data was collected with the use of questionaries and the statistical analysis was conducted in SPSS. The results showed that there were no significant differences in the means of the two groups, concluding that there was not a direct influence of canned laughter on the humor of the participants, t(28)= -1.505, p= .868
Conclusion: Great limitations to this study were the sampling method, the language of the videos that were not in the native language of the participants, and the tendency of the participants to respond with socially liked answers.
Impact of brand equity and service quality on the reputation of universities and students’ intention to choose them: The case of IIUM and UIN
Authors: Rizard Sylvia Rozza , Waluyo Bambang , Jaswir Irwandi
Published: October 2023

Background:Numerous studies have been carried out on the impacts of brand equity and service quality of higher education institutions (HEIs) on their reputation and students’ satisfaction. This research aimed to compare the impact of brand equity and service quality on universities’ reputations, namely Universitas Islam Negeri (UIN) in Indonesia and International Islamic University Malaysia (IIUM) in Malaysia, and Indonesian students’ intention to choose the universities, which is moderated by study expense (price). UIN and IIUM are HEIs with a similar university concept, and Indonesian students have recently shown a high interest in them. The two universities have faculties not only in the field of Islamic studies but in general fields of studies as well, which are usually held by non-Islamic Universities. Therefore, their competitiveness against non-Islamic universities, especially the University of Indonesia (UI) has increased.

Methods:The statistical measurement tool used was structural equation modeling (SEM). The number of items stated in the questionnaire was 45. Therefore, minimum data to be collected were 5 × 45 or 225 which rounded up to 228 from Indonesian students at UIN and IIUM (114 UIN students, and 114 Indonesian student respondents from IIUM).

Results:The study results show that the universities’ reputations are strongly affected by their brand equity and service quality, which then affect students’ intention to choose the universities. Students had a higher intention to choose IIUM than UIN. The limitation of this research is that the effect of study expense on the intention of Indonesian students to study at UIN or IIUM has not yet been conducted. It will be conducted in the next study.

Conclusions:These results are expected to be useful to UIN, IIUM, and especially Politeknik Negeri Jakarta (PNJ) in determining a strategy to enhance their reputations and the intention of Indonesian students to study there.
Treatment of acute sub-massive pulmonary embolism with balloon angioplasty and thrombolysis simultaneously
Authors: Arokiaraj Mark Christopher
Published: October 2023

Background: Acute sub-massive pulmonary embolism is a common clinical condition, and it is associated with high mortality and morbidity. This condition is commonly associated with various co-morbidities and clinical circumstances.

Methods: This is a case report series of 4 patients, wherein the thrombolysis and balloon angioplasty was performed simultaneously using a Cordis 6F diagnostic catheter and later exchanged with a 6F guide catheter in the respective pulmonary artery when a larger balloon was required.

Results: All these four patients achieved successful revascularization of the respective pulmonary artery. One patient expired 30 hours after the procedure with a significant reduction in the symptoms suddenly, which was likely a second episode of pulmonary embolism. No bleeding manifestations were observed in any of the patients. The other three patients are on follow-up.

Conclusion: Simultaneous coronary balloon dilatation and thrombolysis is a useful method in the treatment of sub-massive acute pulmonary embolism. If needed, higher caliber balloons can be used for the same technique using guide catheters.
Determining current approaches to the evaluation of the quality of healthcare simulation-based education provision: a scoping review.
Authors: Pogson Rachel , Henderson Helen , Holland Matt , Sumera Agnieszka , Sumera Kacper , Webster Carl A.
Published: October 2023

Background: With an increase in simulation being used in healthcare education, there is a need to ensure the quality of simulation-based education is high. This scoping review was conducted to answer the question: What are the current approaches to the evaluation of the quality of health-care simulation-based education provision?

Methods: Databases PubMed, Cochrane, ERIC, CINAHL and Medline were searched in March 2023 to retrieve peer-reviewed healthcare research and review articles written in the English language within the last 20 years. All data were extracted from six studies, themed and presented in the main text and in tabular form.

Results: Two scoping reviews, one systematic review and three research articles were included. Three main themes were found: adherence to existing design frameworks, lack of validation of these frameworks and lack of evaluation frameworks, and a proposed evaluation framework. Many of the excluded articles focussed on gaining participant feedback to evaluate simulation activities, rather than evaluating the quality of the design and implementation of the simulation.

Conclusions: Benchmarking of current United Kingdom (UK) healthcare simulation against UK and international simulation standards is required to increase its quality, therefore, an agreed UK template framework to evaluate simulation packages is recommended.
Tácito y el ejército romano: el caso de los centuriones/Tacitus and the Roman Army: The Case of the Centurions
Authors: Palao Vicente Juan José
Published: October 2023

Este trabajo analiza la figura del centurión en la obra de Tácito a partir del examen de las noticias recogidas en sus escritos sobre este cargo y su comparación con la caracterización llevada a cabo por otros autores que le precedieron, como Polibio, César, Salustio o Livio. El objetivo de dicho análisis es determinar si Tácito fue un mero continuador de los topoi de la tradición literaria con respecto a este grado del ejército romano o si, por el contrario, desarrolló, amplió y adaptó esos lugares comunes para ponerlos al servicio de los intereses de su obra.
Germánico en Egipto (Tac. ann. 2.60-61)/ Tácito, Heródoto y la escenografía de la certeza en la historiografía antigua
Authors: Ballesteros-Sánchez Juan Ramón
Published: October 2023

El texto propone una nueva interpretación para la descripción que realiza Tácito (Ann. 2.60-61) del viaje por Egipto de Germánico (19 d. C.). El autor establece paralelos de este texto con las Historias de Heródoto para definir una intención teórica en el mismo. Tácito utiliza este episodio egipcio para reflexionar sobre los métodos y las posibilidades de alcanzar certezas por medio del discurso histórico.
Routing Replenishment Workers: The Prize Collecting Traveling Salesman Problem in Scattered Storage Warehouses
Authors: Bock Stefan , Boysen Nils
Published: October 2023

Many online retailers apply scattered (or mixed-shelves) storage in the picking areas of their warehouses. Instead of keeping unit loads together, individual pieces of stock keeping units (SKUs) are stored on various shelves throughout the warehouse. This storage strategy increases the probability that—whatever it is that customers order jointly—somewhere in the warehouse these products will be located in close proximity. Hence, a picker can retrieve them without excessive unproductive walking. The price for this advantage on the picking side, however, is additional effort for the replenishment workers (also denoted as stowers) when restocking the shelves. Instead of moving only a single homogeneous unit load toward an SKU’s designated storage position, each stower has to travel along multiple open shelf spaces until all products on the cart are stored on shelves. The resulting stower routing problem is equivalent to the well-known prize collecting traveling salesman problem (PCTSP). While the PCTSP for general graphs is known to be strongly [Formula: see text]-hard, we show that in a warehousing environment, where all open storage positions are located along parallel aisles, it is only binary [Formula: see text]-hard. The special parallel-aisle structure allows us to derive an exact solution algorithm with pseudo-polynomial runtime, which solves even instances with hundreds of open storage positions to proven optimality in just a few seconds. Our computational tests show that the performance gains of an optimized stowing process over the status quo, where stowers operate without decision support, are significant. Especially, when the fill level of a warehouse is high, directing stowers on optimized routes promises huge improvements.

History: Accepted by Andrea Lodi, Area Editor for Design & Analysis of Algorithms – Discrete.

Funding: This work was supported by the German Science Foundation/Deutsche Forschungsgemeinschaft (DFG) by the grant “Routing of human and automated order pickers in modern warehouses” (BO 3148/14-1 and BO 1972/2-1).

Supplemental Material: The e-companion is available at https://doi.org/10.1287/ijoc.2022.0173 .
Group Equality in Adaptive Submodular Maximization
Authors: Tang Shaojie , Yuan Jing
Published: October 2023

In this paper, we study the classic submodular maximization problem subject to a group equality constraint under both nonadaptive and adaptive settings. It is shown that the utility function of many machine learning applications, including data summarization, influence maximization in social networks, and personalized recommendation, satisfies the property of submodularity. Hence, maximizing a submodular function subject to various constraints can be found at the heart of many of those applications. On a high level, submodular maximization aims to select a group of most representative items (e.g., data points). However, the design of most existing algorithms does not incorporate the fairness constraint, leading to underrepresentation or overrepresentation of some particular groups. This motivates us to study the submodular maximization problem with group equality, in which we aim to select a group of items to maximize a (possibly nonmonotone) submodular utility function subject to a group equality constraint. To this end, we develop the first constant-factor approximation algorithm for this problem. The design of our algorithm is robust enough to be extended to solving the submodular maximization problem under a more complicated adaptive setting. Moreover, we further extend our study to incorporating a global cardinality constraint and other fairness notations.

History: Accepted by Andrea Lodi, Area Editor for Design & Analysis of Algorithms–Discrete.

Supplemental Material: The online supplement is available at https://doi.org/10.1287/ijoc.2022.0384 .
An Onto-Epistemological Analysis of Information Privacy Research
Authors: Xu Heng , Zhang Nan
Published: October 2023

Privacy is one of the most pressing concerns in the continuously evolving landscape of information technology. Despite decades of vigorous and multifaceted exploration in the interdisciplinary field of information privacy, a consensual or unifying theory remains elusive. Moreover, the complexities of issues surrounding privacy are frequently labeled as “too big to understand” in the public press. At this critical juncture, it is beneficial to delve deeper into the foundational assumptions that privacy scholars have about privacy phenomena. In this commentary, we offer a fresh perspective by drawing on Dreyfus’ influential exegesis of the Heideggerian onto-epistemological framework to reflect on these assumptions. The perspective we offer yields three integrative recommendations for future privacy research to open to new research directions. We illustrate how these new directions could not only grow future privacy research but also facilitate the design of more effective privacy-protection measures in practice.