bluuebunny/crossref_metadata_2025 huggingface dataset:
Arrhenius type empirical ignition delay equations based on the phenomenology of in-cylinder conditions for wide operating ranges in modern diesel engines
Authors: Sakane Yuhei , Kanno Ryota , Yurui Yang , Kobashi Yoshimitsu , Shibata Gen , Ogawa Hideyuki
Published: April 2023

Ignition delays were systematically measured in a DI diesel engine under wide ranging and various engine operating conditions, including engine speeds, fuel injection pressures, intake gas temperatures, intake gas pressures, and intake oxygen concentrations changed with EGR. Empirical equations to predict the ignition delay based on the Arrhenius equation with and without the Livengood-Wu integral and multiple regression analysis of the experimental results. The simple equation assuming constant conditions during the ignition delay without the Livengood-Wu integral can accurately predict the ignition delay. However, the lack of generality has remained as the fuel injection pressure is directly included in the Arrhenius equation which should contain only the chemical parameters. To improve the generality of the equation, the ignition delay was separated into the initial physical process of the fuel spray breakup and the following chemical process. The start of the Livengood-Wu integral was set at the breakup time of liquid fuel jet assuming that the chemical reactions do not occur before the fuel spray breakup, and that the physical factors are directly involved in the physical processes and indirectly in the chemical processes. The fuel spray tip dynamics based on Wakuri’s momentum theory was introduced to express the changes in the conditions in the fuel spray during the ignition delay. The ignition delay can be accurately predicted by the equation with the Livengood-Wu integral and six parameters, including the breakup time, the mass flow rates of air and fuel at the cross section of the spray tip, the oxygen partial pressure, the engine speed, and the averaged in-cylinder gas temperature. The empirical equation predicted longer ignition delays at high ignition pressure conditions, and the accuracy was improved by performing a multiple regression analysis separately at each fuel injection pressure, suggesting unknown factors varying with the fuel injection pressures.
Silencing of FAM111B inhibits tumor growth and promotes apoptosis by decreasing AKT activity in ovarian cancer
Authors: Wang Wei , Gu Yun , Ni Hao , Quan Qiuying , Guo Lingchuan
Published: April 2023

Ovarian cancer is the most lethal gynecological tumor in women worldwide. FAM111B (family with sequence similarity 111 member B) is an oncoprotein associated with multiple cancers, but its biological functions in ovarian cancer remain elusive. In this study, FAM111B was overexpressed in ovarian cancer tissues and cell lines. Functional studies in vitro revealed that silencing of FAM111B inhibited ovarian cancer cell proliferation, invasion, and migration, as well as increased cell apoptosis. Furthermore, FAM111B silencing arrested the ovarian cancer cell cycle at the G1/S phase. Furthermore, western blot assays demonstrated that silencing of FAM111B resulted in downregulation of phospho-AKT (p-AKT) protein expression, as well as upregulation of p53 and caspase-1 protein expression. The xenograft animal model of ovarian cancer demonstrated that FAM111B silencing inhibited tumor growth, enhanced cell apoptosis, and inhibited Ki-67 and proliferating cell nuclear antigen (PCNA) protein expression in vivo. Conversely, the overexpression of FAM111B exhibited opposite effects on the ovarian cancer xenograft. It was previously established that inactivating AKT inhibited ovarian cancer progression. This study found that silencing of FAM111B inhibits tumor growth and promotes apoptosis by decreasing AKT activity in ovarian cancer. Caspase-1 and p53 signaling also influenced the function of FAM111B in SKOV3 cells. Collectively, our results demonstrate that silencing of FAM111B is a potential therapeutic strategy against ovarian cancer.
Removal of Migrated Vascular Closure Device Plug Material From the Popliteal Artery Using the Bi-Directional Approach “Push Balloon Into Vessel and Close Embolus From Retrograde Site (PINCER)” Technique: A Case Report
Authors: Yoshioka Naoki , Morita Yasuhiro , Tokuda Takahiro , Yamada Takehiro , Morishima Itsuro
Published: April 2023

Vascular closure devices (VCDs) are widely used to achieve rapid hemostasis after percutaneous intervention via the common femoral artery (CFA), with well-established efficacy and safety. Although VCD-related artery occlusion is rare, it can be critical. A 72-year-old female underwent endovascular therapy (EVT) for stent occlusion in the left superficial femoral artery through a 7-Fr guiding sheath from the right CFA. After the procedure, an acute right popliteal artery (POP-A) occlusion, associated with the EXOSEAL VCD plug, occurred. The plug material was successfully removed using a bidirectional approach. The migration plug was blocked to prevent distal vessel migration and pushed gently to close the antegrade system, using an over-the-wire balloon from the retrograde site. We named this the “Push balloon INto vessel and Close Embolus from Retrograde site” (PINCER) technique. Finally, the plug was successfully removed using biopsy forceps. Acute limb ischemia (ALI) caused by EXOSEAL is a rare condition. Removal of the emboli by EVT is clinically significant because it is minimally invasive. However, it is sometimes difficult to remove the embolus using only antegrade approach; thus, the bidirectional approach using the PINCER technique can be effective in these situations.
Finding the (biomarker-defined) subgroup of patients who benefit from a novel therapy: No time for a game of hide and seek
Authors: McShane Lisa Meier , Rothmann Mark D , Fleming Thomas R
Published: April 2023

An important element of precision medicine is the ability to identify, for a specific therapy, those patients for whom benefits of that therapy meaningfully exceed the risks. To achieve this goal, treatment effect usually is examined across subgroups defined by a variety of factors, including demographic, clinical, or pathologic characteristics or by molecular attributes of patients or their disease. Frequently such subgroups are defined by the measurement of biomarkers. Even though such examination is necessary when pursuing this goal, the evaluation of treatment effect across a variety of subgroups is statistically fraught due to both the danger of inflated false-positive error rate from multiple testing and the inherent insensitivity to how treatment effects differ across subgroups.

Pre-specification of subgroup analyses with appropriate control of false-positive (i.e. type I) error is recommended when possible. However, when subgroups are specified by biomarkers, which could be measured by different assays and might lack established interpretation criteria, such as cut-offs, it might not be possible to fully specify those subgroups at the time a new therapy is ready for definitive evaluation in a Phase 3 trial. In these situations, further refinement and evaluation of treatment effect in biomarker-defined subgroups might have to take place within the trial. A common scenario is that evidence suggests that treatment effect is a monotone function of a biomarker value, but optimal cut-offs for therapy decisions are not known. In this setting, hierarchical testing strategies are widely used, where testing is first conducted in a particular biomarker-positive subgroup and then is conducted in the expanded pool of biomarker-positive and biomarker-negative patients, with control for multiple testing. A serious limitation of this approach is the logical inconsistency of excluding the biomarker-negatives when evaluating effects in the biomarker-positives, yet allowing the biomarker-positives to drive the assessment of whether a conclusion of benefit could be extrapolated to the biomarker-negative subgroup.

Examples from oncology and cardiology are described to illustrate the challenges and pitfalls. Recommendations are provided for statistically valid and logically consistent subgroup testing in these scenarios as alternatives to reliance on hierarchical testing alone, and approaches for exploratory assessment of continuous biomarkers as treatment effect modifiers are discussed.
To Eat the Cake and Have It, too: How Marketers Control Influencer Conduct within a Paradigm of Letting Go
Authors: Borchers Nils S.
Published: April 2023

The influencer industry follows a paradigm of letting go of control, which assumes that collaborations with influencers will only be effective if marketers grant influencers substantial autonomy in their conduct. However, yielding control constitutes a risk to marketers, because influencers might act differently than desired. This article assumes that, rather than letting go of control, marketers are developing a set of control techniques that are compatible with the paradigm. Grounded in multiple data sources (a secondary analysis of data from two interview studies, ethnographic field data, and member check interviews), it draws on organizational control theory to identify 11 control techniques that marketers employ when collaborating with influencers. In doing so, this article contributes to emerging research on the power structures in the influencer industry. In particular, it adds to the body of knowledge by systematically accounting for marketers’ set of control techniques and identifying hitherto undescribed techniques. On a broader level, this article reconstructs the paradigm of letting go of control in the influencer industry, while simultaneously providing a critical scrutiny of this paradigm.
Characterization of the Rhizosphere Bacterial Microbiome and Coffee Bean Fermentation in the Castillo-Tambo and Bourbon Varieties in the Popayán-Colombia Plateau
Authors: Pino Andrés Felipe Solis , Espinosa Zuly Yuliana Delgado , Cabrera Efren Venancio Ramos
Published: April 2023

Background

The microbial biodiversity and the role of microorganisms in the fermentation of washed coffee in Colombia were investigated using the Bourbon and Castillo coffee varieties. DNA sequencing was used to evaluate the soil microbial biota and their contribution to fermentation. The potential benefits of these microorganisms were analyzed, including increased productivity and the need to understand the rhizospheric bacterial species to optimize these benefits.

Methods

This study used coffee beans for DNA extraction and 16 S rRNA sequencing. The beans were pulped, samples were stored at 4ºC, and the fermentation process was at 19.5ºC and 24ºC. The fermented mucilage and root-soil samples were collected in duplicate at 0, 12, and 24 h. DNA was extracted from the samples at a concentration of 20 ng/µl per sample, and the data obtained were analyzed using the Mothur platform.

Results

The study demonstrates that the coffee rhizosphere is a diverse ecosystem composed primarily of microorganisms that cannot be cultured in the laboratory. This suggests that the microbial community may vary depending on the coffee variety and play an essential role in fermentation and overall coffee quality.

Conclusions

The study highlights the importance of understanding and optimizing the microbial diversity in coffee production, which could have implications for the sustainability and success of coffee production. DNA sequencing techniques can help characterize the structure of the soil microbial biota and evaluate its contribution to coffee fermentation. Finally, further research is needed to fully understand the biodiversity of coffee rhizospheric bacteria and their role.
Stakeholders’ perspectives on the development of an Africa-focused postgraduate diploma to address public mental health training needs in Africa: a qualitative study
Authors: van der Westhuizen Claire , Richter Marlise , Kagee Ashraf , Roomaney Rizwana , Schneider Marguerite , Sorsdahl Katherine
Published: April 2023

Background

Despite the significant contribution of mental health conditions to the burden of disease, there is insufficient evidence from Africa to inform policy, planning and service delivery. Thus, there is a need for mental health research capacity building, led by African public mental health researchers and practitioners, to drive local research priorities. The aim of African mental health Researchers Inspired and Equipped (ARISE) was to develop a one-year postgraduate diploma (PGDip) in public mental health to address the current gaps in public mental health training.

Methods

Thirty-six individual interviews were conducted online with three groups of participants: course convenors of related PGDips in South Africa, course convenors of international public mental health degree programmes and stakeholders active in public mental health in Africa. The interviewers elicited information regarding: programme delivery, training needs in African public mental health, and experiences of facilitators, barriers and solutions to successful implementation. The transcribed interviews were analysed by two coders using thematic analysis.

Results

Participants found the Africa-focused PGDip programme acceptable with the potential to address public mental health research and operational capacity gaps in Africa. Participants provided several recommendations for the PGDip, including that: (i) the programme be guided by the principles of human rights, social justice, diversity and inclusivity; (ii) the content reflect African public mental health needs; (iii) PGDip faculty be skilled in teaching and developing material for online courses and (iv) the PGDip be designed as a fully online or blended learning programme in collaboration with learning designers.

Conclusions

The study findings provided valuable insight into how to communicate key principles and skills suited to the rapidly developing public mental health field while keeping pace with changes in higher education. The information elicited has informed curriculum design, implementation and quality improvement strategies for the new postgraduate public mental health programme.
Gender-based differences in interaction effects between childhood maltreatment and problematic mobile phone use on college students’ depression and anxiety symptoms
Authors: Zhang Yulin , Li Shuqin , Xu Huiqiong , Jin Zhengge , Li Ruoyu , Zhang Yi , Wan Yuhui
Published: April 2023

Background

Childhood maltreatment and problematic mobile phone use are risk factors for depression and anxiety symptoms among college students. However, how the interaction between the two factors affects depression and anxiety has yet to be validated. This study aimed to investigate the independent and interaction effects of childhood maltreatment and problematic mobile phone use on depression and anxiety among college students and explored gender-based differences in these associations.

Method

A cross-sectional study was conducted from October to December 2019. We collected data from 7623 students at two colleges in Hefei and Anqing cities in Anhui Province, China. Multinomial logistic regression models were performed to explore the associations of childhood maltreatment and problematic mobile phone use with depression and anxiety symptoms and their interaction effects on depression and anxiety symptoms.

Results

Childhood maltreatment and problematic mobile phone use were significantly associated with increased risk of depression and anxiety symptoms (P < 0.001). Moreover, following adjustments for covariates, there was a multiplicative interaction between childhood maltreatment and problematic mobile phone use on depression and anxiety symptoms (P < 0.001). Gender-based differences were also observed in the associations. For instance, depression was more common in males and male students with childhood maltreatment were at higher risk of depression-only symptoms.

Conclusion

Focusing on childhood maltreatment and problematic mobile phone use could facilitate a reduction in the occurrence of depression and anxiety symptoms in college students. Furthermore, it is necessary to develop gender-targeted intervention strategies.
Head posture mediates the association of cognition with hand grip and pinch strength in older adults: an examination using structural equation modeling
Authors: Celik Halil Ibrahim , Unver Banu , Akbas Eda , Erdem Emin Ulas
Published: April 2023

Background

The association of cognition with hand grip and pinch strength has been well-recognized in older adults. The authors sought to explore: (1) associations among forward head posture (FHP), cognition, and hand grip and pinch strength in older adults; and (2) the mediator role of FHP in these pathways using structural equation modeling (SEM).

Methods

This cross-sectional study included 88 older adults (70.5% male; mean age = 68.75±3.87 years). Cognition was assessed by the Mini-Mental State Examination (MMSE), head posture by the Craniovertebral Angle (CVA) obtained from photographic analysis, hand grip strength by a handheld dynamometer, and pinch strength by a pinch meter. Using the two SEMs, a potential mediator role of the CVA was investigated. While the MMSE was addressed as an independent variable in both models, hand grip and pinch strength were addressed as dependent variables in model 1 and model 2, respectively.

Results

The correlations between the CVA and MMSE (r = 0.310), hand grip strength (r = 0.370), and pinch strength (r = 0.274 to 0.292) were statistically significant (p < 0.001). In addition, significant associations were found between the MMSE and hand grip and pinch strength, ranging from 0.307 to 0.380 (p < 0.001). The mediation analysis showed that the standardized total (β = 0.41, p < 0.001) and indirect (mediated) effects (β = 0.12, p = 0.008) of the MMSE on hand grip strength were significant in model (1) The results were similar for model (2) The standardized total (β = 0.39, p = 0.001) and indirect effects (β = 0.10, p = 0.026) of the MMSE on pinch strength were significant. As a partial mediator in both models, the CVA explained 29% and 26% of the total effect in models 1 and 2, respectively.

Conclusions

The CVA was associated with the MMSE, hand grip strength, and pinch strength, and CVA partially mediates the association of the MMSE with grip and pinch strength in older adults, indicating that cognition had an effect on grip and pinch strength through an indirect path via head posture. This finding reveals that evaluating head posture and providing corrective therapeutic interventions as needed may be beneficial in reducing the negative impact of decreased cognition on motor functions in older adults.
Learning styles of medical students and related factors
Authors: Gayef Albena , Çaylan Ayşe , Temiz Selahattin Alp
Published: April 2023

Background

The concept of learning style is quite important for teachers to teach, organize students’ learning experiences, and accomplish educational goals. Motivation is one of the most important psychological concepts in education. Motivation is multidimensional and ranges from amotivation to extrinsic motivation and intrinsic motivation. When students are motivated extrinsically, they enjoy striving toward rewards and goals which may differ from individual goals. Intrinsically motivated students enjoy exploring, learning, and curiosity-oriented academic efforts. Understanding learning styles can make it easier to create, modify, and develop more efficient curriculum and educational programs. It can also encourage students’ participation in these programs and motivate them to gain professional knowledge This study aims to determine the learning styles of medical school students and to evaluate whether there is a relationship between their learning styles and academic motivation and the sociodemographic variables.

Methods

In this study a questionnaire containing socio-demographic factors, Grasha-Reichmann Learning Styles Scale, Academic Motivation Scale was filled out by 1st, 2nd, 3rd, 4th, and 5th -year medical students of the 2019–2020 academic year. Frequency, percentage, mean, ANOVA, Pearson correlation analysis, and independent group t-test (for analyzing data with normal distribution) were applied. Mann Whitney U test, Kruskal Wallis test, and Spearman correlation analysis were used for analyzing data without normal distribution.

Results

We found that the mean of independent learning was the highest among the learning style dimensions, and the mean of the intrinsic motivation to know (IMKN) was the highest among the academic motivation dimensions. We found that there were significant relationships between independent learning and intrinsic motivation (IM), between avoidant learning and extrinsic motivation (EM) and between collaborative learning and IMKN, IM to accomplish things (IMAT) and IM to experience stimulation (IMES).

Conclusion

We think that different teaching methods can be applied to strengthen collaborative learning, participant learning, and intrinsic motivation. We hope that this research will contribute to medical education on the subject of establishing appropriate teaching methods. Teachers have to plan and implement activities based on students’ learning styles and academic motivation to encourage students to effectively participate in the classroom.
Economic burden of acute otitis media, pneumonia, and invasive pneumococcal disease in children in the United States after the introduction of 13-valent pneumococcal conjugate vaccines during 2014–2018
Authors: Hu Tianyan , Song Yan , Done Nicolae , Mohanty Salini , Liu Qing , Sarpong Eric M. , Lemus-Wirtz Esteban , Signorovitch James , Weiss Thomas
Published: April 2023

Background

Streptococcus pneumoniae remains a leading cause of morbidity, mortality, and healthcare resource utilization (HRU) among children. This study quantified HRU and cost of acute otitis media (AOM), pneumonia, and invasive pneumococcal disease (IPD).

Methods

The IBM MarketScan® Commercial Claims and Encounters and Multi-State Medicaid databases from 2014 to 2018 were analyzed. Children with AOM, all-cause pneumonia, or IPD episodes were identified using diagnosis codes in inpatient and outpatient claims. HRU and costs were described for each condition in the commercial and Medicaid-insured populations. National estimates of the number of episodes and total cost ($US 2019 for each condition were extrapolated using data from the US Census Bureau.

Results

Approximately 6.2 and 5.6 million AOM episodes were identified in commercial and Medicaid-insured children, respectively, during the study period. Mean cost per AOM episode was $329 (SD $1505) for commercial and $184 (SD $1524) for Medicaid-insured children. A total of 619,876 and 531,095 all-cause pneumonia cases were identified among commercial and Medicaid-insured children, respectively. Mean cost per all-cause pneumonia episode was $2304 (SD $32,309) in the commercial and $1682 (SD $19,282) in the Medicaid-insured population. A total of 858 and 1130 IPD episodes were identified among commercial and Medicaid-insured children, respectively. Mean cost per IPD episode was $53,213 (SD $159,904) for commercial and $23,482 (SD $86,209) for the Medicaid-insured population. Nationally, there were over 15.8 million cases of AOM annually, with total estimated cost of $4.3 billion, over 1.5 million cases of pneumonia annually, with total cost of $3.6 billion, and about 2200 IPD episodes annually, for a cost of $98 million.

Conclusions

The economic burden of AOM, pneumonia, and IPD among US children remains substantial. IPD and its manifestations were associated with higher HRU and costs per episode, compared to AOM and all-cause pneumonia. However, owing to their higher frequencies, AOM and all-cause pneumonia were the main contributors to the economic burden of pneumococcal disease nationally. Additional interventions, such as the development of pneumococcal conjugate vaccinees with sustained protection of existing vaccine type serotypes as well as broader inclusion of additional serotypes, are necessary to further reduce the burden of disease caused by these manifestations.
Eosinophilic solid and cystic renal cell carcinoma with TSC2 mutation: a case report and literature review
Authors: He Xin , Chen Ying , Tang Hao , Xu Yujuan , Zhu Xingyan , Wang Caihong , Chen Qiang , Guo Deyu
Published: April 2023

Background

Eosinophilic solid and cystic renal cell carcinoma (ESC-RCC) is an under-recognized, emerging new entity of sporadic renal neoplasms, which is listed as a rare type of renal cell carcinoma in the 2022 WHO renal tumor classification. It is easily misdiagnosed because its characteristics are insufficiently understood.

Case presentation

We report one case of ESC-RCC, a 53-year-old female patient with a right kidney mass found during clinical examination. The patient experienced no discomforting symptoms. Computer-tomography imaging at our urinary department showed a round soft tissue density shadow around the right kidney. Microscopic examination revealed a tumor displaying a solid-cystic composition of eosinophilic cells with unique features, revealed by characteristic immunohistochemical markers (CK20-positive/CK7-negative), and a nonsense mutation in TSC2. Ten months after the renal tumor resection, the patient presented in good condition with no recurrence or metastasis.

Conclusions

The distinct morphological, immunophenotypic, and molecular characteristics of ESC-RCC we describe here, based on our case and the relevant literature, highlight the key points of the pathological and differential diagnosis of this novel renal neoplasm. Our findings will therefore deepen our understanding of this novel renal neoplasm and help reduce misdiagnosis.
Transition for adolescents with a rare disease: results of a nationwide German project
Authors: Grasemann Corinna , Höppner Jakob , Burgard Peter , Schündeln Michael M. , Matar Nora , Müller Gabriele , Krude Heiko , Berner Reinhard , Lee-Kirsch Min Ae , Hauck Fabian , Wainwright Kerstin , Baumgarten Sylvana , Atinga Janet , Bauer Jens J. , Manka Eva , Körholz Julia , Kiewert Cordula , Heinen André , Kretschmer Tanita , Kurth Tobias , Mittnacht Janna , Schramm Christoph , Klein Christoph , Graessner Holm , Hiort Olaf , Muntau Ania C. , Grüters Annette , Hoffmann Georg F. , Choukair Daniela
Published: April 2023

Purpose

The transition process from paediatric/adolescent to adult medical care settings is of utmost importance for the future health of adolescents with chronic diseases and poses even more difficulties in the context of rare diseases (RDs). Paediatric care teams are challenged to deliver adolescent-appropriate information and structures. Here we present a structured transition pathway which is patient-focused and adoptable for different RDs.

Methods

The transition pathway for adolescents 16 years and older was developed and implemented as part of a multi-centre study in 10 university hospitals in Germany. Key elements of the pathway included: assessment of patients’ disease-related knowledge and needs, training/educational and counselling sessions, a structured epicrisis and a transfer appointment jointly with the paediatric and adult specialist. Specific care coordinators from the participating university hospitals were in charge of organization and coordination of the transition process.

Results

Of a total of 292 patients, 286 completed the pathway. Deficits in disease-specific knowledge were present in more than 90% of participants. A need for genetic or socio-legal counselling was indicated by > 60%. A mean of 2.1 training sessions per patient were provided over a period of almost 1 year, followed by the transfer to adult care in 267 cases. Twelve patients remained in paediatric care as no adult health care specialist could be identified. Targeted training and counselling resulted in improved disease-specific knowledge and contributed to empowering of patients.

Conclusion

The described transition pathway succeeds to improve health literacy in adolescents with RDs and can be implemented by paediatric care teams in any RD specialty. Patient empowerment was mainly achieved by individualized training and counselling.
Portal hypertension in patients with hepatocellular carcinoma and immunotherapy: prognostic relevance of CT-morphologic estimates
Authors: Müller Lukas , Gairing Simon J. , Foerster Friedrich , Weinmann Arndt , Mittler Jens , Stoehr Fabian , Graafen Dirk , Düber Christoph , Galle Peter R. , Kloeckner Roman , Hahn Felix
Published: April 2023

Background

Clinically significant portal hypertension (CSPH) has been identified as an important prognostic factor in patients with hepatocellular carcinoma (HCC) undergoing curative treatment. This study aimed to assess PH estimates as prognostic factors in patients with HCC treated with immunotherapy.

Methods

All patients with HCC treated with an immunotherapeutic agent in first or subsequent lines at our tertiary care center between 2016 and 2021 were included (n = 50). CSPH was diagnosed using the established PH score for non-invasive PH estimation in pre-treatment CT data (cut-off ≥ 4). Influence of PH on overall survival (OS) and progression-free survival (PFS) was assessed in uni- and multivariable analyses.

Results

Based on the PH score, 26 patients (52.0%) were considered to have CSPH. After treatment initiation, patients with CSPH had a significantly impaired median OS (4.1 vs 33.3 months, p < 0.001) and a significantly impaired median PFS (2.7 vs 5.3 months, p = 0.02). In multivariable Cox regression, CSPH remained significantly associated with survival (HR 2.9, p = 0.015) when adjusted for established risk factors.

Conclusions

Non-invasive assessment of CSPH using routine CT data yielded an independent prognostic factor in patients with HCC and immunotherapy. Therefore, it might function as an additional imaging biomarker to detect high-risk patients with poor survival and possibly for treatment decision making.
Simplified screening and referral protocol for sinonasal mucormycosis in post COVID-19 patients
Authors: Singh Jitendra , Arora Rubeena , Rawat Vijay , Singh Vikas , Goyal Snigdha , Joshi Liza
Published: April 2023

Background

To study incidence of sinonasal mucormycosis in active and post COVID-19 patients in a district-level hospital in India and develop a simplified screening and referral protocol for use at peripheral centres to aid rapid diagnosis/treatment.

Methods

Study design: A prospective, interventional cohort study conducted from April 2021 to January 2022. Setting: Secondary level hospital in North India. Inclusion criteria: COVID-19 positive patients with diabetes mellitus as co-morbidity and with at least one of the following: received steroid therapy and/or on high flow oxygen therapy and/or had prolonged hospital stay (> 7 days). Exclusion criteria: Patients already immunocompromised/having malignancy/organ transplant recipients. Clinical workup: History, examination, imaging (CECT/MRI nose and paranasal sinuses if indicated), diagnostic nasal endoscopy + Nasal scrapings for KOH mount to detect fungal elements. STROBE guidelines were followed in the study.

Results

Fourteen out of 250 patients tested positive for mucormycosis (incidence 5.6%). Thirteen were symptomatic, one patient was asymptomatic and detected on screening. No significant difference was found in mucormycosis versus non-mucormycosis group with respect to HbA1c status, vaccination status or steroid + oxygen treatment (p > 0.05 in all scenarios). Patients were treated with intravenous liposomal amphotericin B and surgical debridement when indicated. Two succumbed to disease (survival 85.7%). A clinical screening protocol was thus developed which can be used as an effective tool even at far-flung and remote healthcare facilities for diagnosis and timely referral of patients.

Conclusions

Mucormycosis is a potentially lethal disease which needs rapid diagnosis and timely action to decrease morbidity and mortality.
A modified NARX approach for evaluating the time history effect of climate change on load combination in designing façade structures
Authors: Rezvanifar Mostafa , Vosoughifar Hamidreza
Published: April 2023

In recent years, researchers, designers, and project owners have deemed the dry facade system to be a suitable option. Consequently, much research has been conducted on the structural behavior of the dry facade system when subjected to seismic loads, climate change, thermal loads, etc. Of particular concern is the destructive phenomenon of corrosion due to climate change in coastal areas which can damage the infrastructure of the dry façade. To address this issue, a modified NARX method was employed in this study to predict climate change variables for use in dry facade analysis. The author of this paper developed a flowchart and subroutines in MATLAB as a new toolbox for this purpose. Temperature was identified as the most influential parameter in consequent configurations and was thus considered in load combination for the design of a dry facade structure. The statistical results obtained from NARX showed good agreement with measured data; specifically, there was a low mean absolute error (MAE) of 0.345 °C, a low root-mean-square error (RMSE) of 0.442 °C, and a high coefficient of determination (R2) of 0.998 (P-value = 0.918 > 0.05). Finally, this study proposed a modified formula for load combination to ensure durability and constructability of dry facades in coastal cities.
Semisupervised seismic impedance inversion with data augmentation and uncertainty analysis
Authors: Luo Ren , Chen Huaizhen , Wang Benfeng
Published: April 2023

Seismic inversion for impedance is an important task for reservoir characterization. Supervised-learning-based methods improve inversion accuracy for impedance. However, they require a large number of training labels. To reduce the reliance on training labels and further improve the accuracy of impedance inversion, we propose a new data augmentation strategy to simulate layer thickness variation during semisupervised learning which uses unlabeled seismic data properly. Using the Marmousi-II model, we first compare the impedance estimated using the open-loop (OL) method and that obtained using the physics-constrained closed-loop (PC-CL) method at different data augmentation rates to demonstrate the effectiveness of the proposed inversion method. In the case of applying the proposed method to a field data set, comparisons between the estimated impedance results using the OL and PC-CL methods and those obtained using the model-based inversion method are shown for verification. Detailed comparisons between the inversion results of the impedance and well-log data are displayed to emphasize the superiority of the proposed PC-CL method. The residuals between the observed field data and simulated seismic data generated using the estimated impedance are shown to further verify the accuracy of the estimated impedance of the proposed PC-CL method. Aside from the impedance inversion results, epistemic uncertainties are calculated for further performance evaluations of the impedance inversion.
Exploratory Study of the Association of Genetic Factors With Recovery of Adrenal Function in Cushing Disease
Authors: Nguyen Matthew H , Zhang Wei , Pankratz Nathan , Lane John , Chitiboina Prashant , Faucz Fabio R , Mills James L , Stratakis Constantine A , Tatsi Christina
Published: April 2023

Successful treatment of endogenous Cushing disease (CD) is often followed by a period of adrenal insufficiency (AI). We performed an exploratory study on genetic factors potentially involved in the hypothalamic-pituitary-adrenal (HPA) axis recovery in patients with CD after remission. We identified 90 patients who achieved remission after surgery and had a minimum of 3 months follow-up. Variants in a selected panel of genes that were rare in the general population and predicted as damaging in silico were retrieved from whole exome sequencing analysis. We did not identify any variant with significant correlation with recovery time after adjusting for multiple comparisons. On gene-specific analysis the BAG1 gene showed a correlation with shorter duration of postsurgical AI, but both patients with BAG1 variants later experienced a recurrence. After excluding patients with recurrence, no statistical association was recorded. To conclude, we did not identify a strong genetic modifier of HPA recovery in this exploratory study.
Racial Disparities in Compensation Among US Anesthesiologists: Results of a National Survey of Anesthesiologists
Authors: Vandenberg Megan T. , Kraus Molly , Misra Lopa , Hertzberg Linda , Buckner-Petty Skye , Padmanabhan Asha , Tollinche Luis E. , Milam Adam J.
Published: April 2023

BACKGROUND:

A racial compensation disparity among physicians across numerous specialties is well documented and persists after adjustment for age, sex, experience, work hours, productivity, academic rank, and practice structure. This study examined national survey data to determine whether there are racial differences in compensation among anesthesiologists in the United States.

METHODS:

In 2018, 28,812 active members of the American Society of Anesthesiologists were surveyed to examine compensation among members. Compensation was defined as the amount reported as direct compensation on a W-2, 1099, or K-1, plus all voluntary salary reductions (eg, 401[k], health insurance). Covariates potentially associated with compensation were identified (eg, sex and academic rank) and included in regression models. Racial differences in outcome and model variables were assessed via Wilcoxon rank sum tests and Pearson’s χ2 tests. Covariate adjusted ordinal logistic regression estimated an odds ratio (OR) for the relationship between race and ethnicity and compensation while adjusting for provider and practice characteristics.

RESULTS:

The final analytical sample consisted of 1952 anesthesiologists (78% non-Hispanic White). The analytic sample represented a higher percentage of White, female, and younger physicians compared to the demographic makeup of anesthesiologists in the United States. When comparing non-Hispanic White anesthesiologists with anesthesiologists from other racial and ethnic minority groups, (ie, American Indian/Alaska Native, Asian, Black, Hispanic, and Native Hawaiian/Pacific Islander), the dependent variable (compensation range) and 6 of the covariates (sex, age, spousal work status, region, practice type, and completed fellowship) had significant differences. In the adjusted model, anesthesiologists from racial and ethnic minority populations had 26% lower odds of being in a higher compensation range compared to White anesthesiologists (OR, 0.74; 95% confidence interval [CI], 0.61–0.91).

CONCLUSIONS:

Compensation for anesthesiologists showed a significant pay disparity associated with race and ethnicity even after adjusting for provider and practice characteristics. Our study raises concerns that processes, policies, or biases (either implicit or explicit) persist and may impact compensation for anesthesiologists from racial and ethnic minority populations. This disparity in compensation requires actionable solutions and calls for future studies that investigate contributing factors and to validate our findings given the low response rate.
William Falconer: Sailor, Poet, Lexicographer
Authors: Jones William
Published: April 2023

William Falconer (1732–1770) suffered a catastrophic shipwreck as a young man, which became the subject of his celebrated poem The Shipwreck (1762), with revised and extended editions in 1764 and 1769. He is also the compiler of the Dictionary of the Marine which remained the standard work of nautical reference until the end of the sailing ship. Largely forgotten through the 20th century, Falconer's work is now being recognised as a significant and unique contribution to our understanding of the literature, and indeed the world view, of the eighteenth century. This essay traces his life and intellectual development from an impoverished childhood to a career in both the merchant and Royal Navy, and to distinguished achievements as poet, sea-scientist and lexicographer.
Διαφοροποιημένη διδασκαλία στο μάθημα των Αρχαίων Ελληνικών
Authors: Ανυφαντή Μαρία
Published: April 2023

Το παρόν πόνημα στόχο έχει να ασχοληθεί με τη Διαφοροποίηση της Διδασκαλίας σε τάξεις Λυκείου μικτής ικανότητας στο μάθημα των Αρχαίων Ελληνικών, όχι απλώς σε θεωρητικό επίπεδο μα και μέσω έρευνας στη σχολική πράξη. Αρχικά, θα επιχειρηθεί μια ανασκόπηση και αποδελτίωση της βιβλιογραφίας σχετικά με τον προγραμματισμό, τα είδη και τις τεχνικές αλλά και το ζήτημα της αξιολόγησης στη Δ.Δ. και, εν συνεχεία, θα γίνει έρευνα μελέτης περίπτωσης με τεχνικές έρευνας δράσης εκπαιδευτικών που την εφαρμόζουν στη σχολική πράξη. Στην έρευνα που θα παρουσιασθεί υπάρχουν μια τάξη που αποτελεί το πειραματικό δείγμα και άλλη μια που λειτουργεί ως ομάδα ελέγχου. Στην τάξη με το πειραματικό δείγμα θα συντελεσθούν 3 παρεμβάσεις των δυο διδακτικών ωρών η καθεμία τους από την ερευνήτρια και 3 παρεμβάσεις με σχέδια της ερευνήτριας και εφαρμογή από την εκπαιδευτικό της τάξης. Με την ολοκλήρωση κάθε παρέμβασης θα τελείται τριγωνοποίηση στα μέσα συλλογής δεδομένων, ώστε να βγούνε συμπεράσματα για την αποτελεσματικότητα της διαφοροποιημένης διδασκαλίας. Παράλληλα, η ερευνήτρια θα παρακολουθεί με κλείδα παρατήρησης την παραδοσιακή μετωπική διδασκαλία που αφορά κοινές ενότητες και συντελείται στην ομάδα ελέγχου, ώστε να προκύψουν τα τελικά συγκριτικά συμπεράσματα για τις μεθόδους διδασκαλίας.Στόχος είναι, μέσω τόσο του θεωρητικού όσο και του πρακτικού μέρους του πονήματος, να παρουσιαστούν περιγραφές παρεμβάσεων διαφοροποίησης και μια ερμηνεία τους, που θα ωθήσουν σε μια ολική θεώρηση του ζητήματος και σε μια ευκαιρία να διαπιστωθούν από τον αναγνώστη οι λόγοι, οι τρόποι εφαρμογής της Δ.Δ. και οι πιθανές αναδιαμορφώσεις που χρειάζονται τέτοιες προσπάθειες.Λέξεις-Κλειδιά: διαφοροποίηση, τεχνικές, προγραμματισμός, αξιολόγηση, Αρχαία Ελληνικά, έρευνα .
The redefinition of the tragic cycle of hybris-ate-nemesis-tisis in Aeschylus, Sophocles, and Euripides
Authors: Σπηλιωτόπουλος Γεώργιος
Published: April 2023

Στα πλαίσια της παρούσας διατριβής εξερευνώ τους τρόπους με τους οποίους οι τρεις μεγάλοι τραγικοί ποιητές Αισχύλος, Σοφοκλής και Ευριπίδης αναμορφώνουν τον τραγικό κύκλο της ύβρεως-άτης-νεμέσεως-τίσεως, όπως είναι γνωστός από τον Όμηρο και εμφανίζεται ως στοιχείο πλοκής στην αρχαία ελληνική λογοτεχνία. Εξετάζω περιπτώσεις στις οποίες η διαδικασία της άτης-νεμέσεως-τίσεως στην τραγωδία δεν προκύπτει εξαιτίας της ύβρεως του τραγικού ήρωα. Επιπλέον, διατείνομαι ότι οπουδήποτε παρατηρείται μια ιδιομορφία ή επαναπροσδιορισμός του λεγόμενου τραγικού κύκλου, αυτό δεν αποτελεί τυχαίο γεγονός αλλά συνιστά μια σημαντική ποιητική δήλωση που χρήζει περαιτέρω προσοχής. Στις περιπτώσεις που η ακολουθία αυτή επαναπροσδιορίζεται από τους τρεις μεγάλους αττικούς τραγικούς, μια αναπόφευκτη εξωτερική δύναμη, όπως η μοίρα, η ανάγκη ή τα ανθρώπινα πάθη των θεών υποκαθιστά ένα στοιχείο της αλληλουχίας των γεγονότων και οδηγεί τον τραγικό ήρωα στην καταστροφή. Διερευνώ την παραπάνω πρόταση εξετάζοντας όλες τις σωζόμενες τραγωδίες και τα αποσπάσματα του Αισχύλου, του Σοφοκλή και του Ευριπίδη, χρησιμοποιώντας τον τραγικό κύκλο ως θεωρητικό εργαλείο για την ανάλυσή μου. Σε αυτή την έρευνα δίνεται ιδιαίτερη έμφαση στις επιμέρους έννοιες "ύβρις-άτη-νέμεσις-τίσις" και προτείνεται κατά περίπτωση μια διαφορετική ή εναλλακτική αγγλική μετάφραση για ορισμένα χωρία, όπου οι όροι λειτουργούν ως μέρη της ακολουθίας του τραγικού κύκλου. Παρέχονται γραφήματα που αναπαριστούν σχηματικά πώς λειτουργεί ο τραγικός κύκλος σε κάθε εξεταζόμενη περίπτωση κατά τη μετάβαση του ήρωα από την ευτυχία στη δυστυχία. Καταλήγοντας, εξετάζονται πιο διφορούμενες περιπτώσεις όπου, παρά το γεγονός ότι ο τραγικός κύκλος φαίνεται να ακολουθεί την αναμενόμενη πορεία του, εξακολουθούν να υπάρχουν ισχυρές ενδείξεις για μια σκόπιμη απόκλιση από την αναμενόμενη ακολουθία που υπό κανονικές συνθήκες προορίζεται να οδηγήσει στην αποκατάσταση της θρησκευτικής τάξης ή της θείας δικαιοσύνης.
Σχεδιασμός και υλοποίηση κοινωνικής πολιτικής στις λιγότερο αναπτυγμένες περιφέρειες της Ελλάδας
Authors: Χατζηκωνσταντινίδου Σημέλα
Published: April 2023

Η ανάδειξη της περιφέρειας ως βαθμό αποκεντρωμένης διοίκησης αποτελεί σημαντική θεσμική μεταρρύθμιση. Στην τοπική αυτοδιοίκηση η συνύπαρξη ισότιμων θεσμών δημιουργεί μια ανταγωνιστική μεταξύ τους θέση και πρέπει να υπάρχει επακριβής καθορισμός αρμοδιοτήτων. Βέβαια, εξακολουθούν να υφίστανται περιορισμοί καθώς οι πόροι είναι συγκεκριμένοι και υπάρχει μεγάλος βαθμός εξάρτησης από την κεντρική διοίκηση. Οι Ο.Τ.Α. δεν έχουν φορολογική αυτοτέλεια,το σύστημα χρηματοδότησης τους είναι δαιδαλώδες και έχουν μικρή ευελιξία στηνχρήση πόρων. Από τα έσοδα, ένα μέρος χρησιμοποιούν οι Ο.Τ.Α. για χρηματοδότηση συνολικών αναγκών, ενώ το υπόλοιπο κατανέμεται σε δράσεις υποχρεωτικές από την νομοθεσία ή προσδιορίζονται από υπουργικές αποφάσεις. Στα πλαίσια της διατριβής, η κοινωνική πολιτική εκλαμβάνεται και αντιμετωπίζεται ερευνητικά, ως παράδειγμα άσκησης εθνικής κοινωνικής πολιτικής. Σε αυτό λοιπόν το πλαίσιο, ως άσκηση κοινωνικής πολιτικής νοούνται όλα τα θεσμοθετημένα μέτρα και εφαρμοζόμενες πολιτικές ή και άτυπες πρακτικές που στοχεύουν στην πρόληψη και αντιμετώπιση των αναγκών όχι μόνο των ευπαθών πληθυσμιακών ομάδων αλλά και του γενικού πληθυσμού της επικράτειας, τόσο στο στάδιο της υποδοχής με τις υπηρεσίες του κράτους όσο και στο στάδιο της ένταξης ή της «αποκατάστασης» των ατόμων.