bluuebunny/crossref_metadata_2025 huggingface dataset:
“I wanted to hide but also to be found”: the high school experiences of young adults who grew up in the same home as a sibling with depression
Authors: Levkovich Inbar , Labes Michal
Published: June 2023

Background

Depression is a mental health condition that can have far-reaching consequences for the entire family, not just for the affected individual. Siblings are particularly vulnerable in that the unremitting stress and guilt at home can affect multiple aspects of their lives, including relationships, added responsibilities, and health. This pressure may affect siblings’ own emotional well-being and academic success. Most studies in this field have examined the impact of depression on the affected adolescents or their parents, whereas few have examined the impact on siblings. Sibling studies have been limited by lack of sample homogeneity, especially in the context of coping in high school. This study sought to examine the retrospective experiences of young adults who lived in the same house as a sibling with depression while they were in high school.

Methods

This qualitative study examined 21 young adults (aged 18–29) who grew up with a sibling with depression. In-depth, semi-structured interviews were conducted from May to September 2022. The interviews were recorded and transcribed and underwent thematic analysis.

Results

Three main themes emerged from the interviews: (1) “School as a place of refuge”: The perspective of participants who grew up with a sibling with depression regarding their high school experience. (2) “I wanted the adults at school to see me”: Relations between research participants and the school educational staff. (3) “I was afraid people would relate to me as the sibling of a crazy person”: Participants’ relationships with their peers.

Conclusions

This study sheds light on the experiences of adolescents who grew up with a sibling with depression. The findings point to feelings of being invisible, self-nullification, avoiding sharing with others, and transparency. The participants were afraid that if their peers found out about their sibling they would also be stigmatized and alienated. The study shows that adolescents living with a sibling with depression need support at school.
A new insomnia treatment service: the benefits and challenges of establishing a trainee-led service
Authors: Waterman Lauren Z. , Creed Michael
Published: June 2023

Chronic insomnia is undertreated in the UK despite being a common mental disorder that severely affects quality of life. The lead author, a psychiatry trainee, implemented a new group cognitive–behavioural therapy for insomnia (CBT-I) service for secondary care patients in London with chronic insomnia and comorbid mental illness. Expertise was propagated by trainees teaching other trainees. Nine patients completed all sessions, all with moderate-to-severe insomnia on the Insomnia Severity Index (ISI) at baseline assessment (mean score 21.6). All patients seen at follow-up had improved, scoring in the ‘subthreshold’ or ‘no clinically significant insomnia’ ranges on the ISI (mean 6.6), and all with improvements in comorbid psychiatric symptoms and functioning. This evaluation demonstrates that group CBT-I can be easily learned and delivered by those without formal CBT or sleep medicine training. This could increase the availability and accessibility of treatment. However, bureaucratic challenges were faced, and trainee-led innovations should be better facilitated.
Homelessness and associated factors over a 13-year period among psychiatric in-patients in Berlin, Germany: routine data analysis
Authors: Jalilzadeh Masah Dario , Schouler-Ocak Meryam , Gutwinski Stefan , Gehrenbeck Kirsten , Deutscher Karl , Schindel Daniel , Lech Sonia , Schreiter Stefanie
Published: June 2023

Background

Homeless patients in psychiatric hospitals are a scarcely studied and there is lack of knowledge about factors associated with homelessness and in-patient treatment.

Aims

To determine the change over time in the number of homeless psychiatric in-patients and to examine factors associated with homelessness.

Method

Retrospective data analysis of 1205 selected electronic patient files on psychiatric in-patient treatment in a university psychiatric hospital in Berlin, Germany. The rate of patients experiencing homelessness over a 13-year period (2008–2021) and the sociodemographic and clinical factors associated with homelessness are analysed over time.

Results

Our study revealed a 15.1% increase in the rate of homeless psychiatric in-patients over the 13-year period. Of the whole sample, 69.3% people lived in secure private housing, 15.5% were homeless and 15.1% were housed in sociotherapeutic facilities. Homelessness was significantly associated with being male (OR = 1.76 (95% CI 1.12–2.76), born outside of Germany (OR = 2.22, 95% CI 1.47–3.34), lack of out-patient treatment (OR = 5.19, 95% CI 3.35–7.63), psychotic disorders (OR = 2.46, 95% CI 1.16–5.18), reaction to severe stress (OR = 4.19, 95% CI 1.71–10.24), personality disorders (OR = 4.98, 95% CI 1.92–12.91), drug dependency (OR = 3.47, 95% CI 1.5–8.0) and alcohol dependency (OR = 3.57, 95% CI 1.67–7.62).

Conclusions

The psychiatric care system is facing an increasing number of patients in precarious social situations. This should be considered in resource allocation planning in healthcare. Individual solutions for aftercare, along with supported housing, could counteract this trend.
Analysis of the Pediatric Radiotherapy Landscape in Mexico and a Subsequent Educational e-Contouring Intervention
Authors: Mailhot Vega Raymond B. , Garcia Robles Beatriz E. , Morris Christopher G. , Buss Kara , Mejia Ulises , Poitevin Adela , Chilaca Rosas Maria Fatima , Perez Villanueva Heynar , Felix Leyva Jesus Armando , Indelicato Daniel J. , De la Mata Dolores
Published: June 2023

PURPOSE

Mexico and Central America have the highest childhood cancer incidence in the West. Pediatric-specific oncology knowledge contributes to the disparity. We sought to (1) determine the self-identified treatment patterns and needs of Mexican pediatric radiation oncologists and (2) pilot a workshop to improve contouring accuracy.

MATERIALS AND METHODS

Partnering with local experts and the Sociedad Mexicana de Radioterapeutas (SOMERA), a 35-question survey was designed to ascertain pediatric radiotherapy capacity and distributed through the SOMERA listserv. The most challenging malignancies were selected for workshop. Participants received precontouring and postcontouring homework to assess improvement per the Dice metric. The Wilcoxon sign-rank test was used for comparative statistics.

RESULTS

Ninety-four radiation oncologists attempted and 79 completed the survey. Forty-four (76%) felt comfortable treating a pediatric patient, and 36 (62%) were familiar with national protocols for pediatric treatment. Most had access to nutrition, rehabilitation, endocrinology, and anesthesia; 14% had access to fertility services and 27% to neurocognitive support; 11% noted no support, and only one respondent had child-life support. The postsurvey contouring workshop was conducted for high-grade glioma, medulloblastoma, and Hodgkin lymphoma. Significant improvements were seen in all target volumes.

CONCLUSION

We present the first national survey of Mexico's pediatric radiotherapy capacity and Latin American e-contouring educational intervention with preworkshop and postworkshop Dice metrics, noting statistically significant improvement in all target volumes. Participation improved compared with prior experience through SOMERA partnership and Continuing Medical Education incentivization.
Evidence and Lessons on the Health Impacts of Public Health Funding from the Fight against HIV/AIDS
Authors: Dillender Marcus
Published: June 2023

HIV/AIDS has been one of the largest public health crises in recent history, and the US federal government has spent hundreds of billions of dollars fighting the disease. This study examines the impact of the large amounts of federal funding allocated to US cities to combat HIV/AIDS through the Ryan White CARE Act’s first title. The findings indicate that the cost to avoid an HIV/AIDS death through the program is roughly $334,000, that the program has saved approximately 57,000 lives through 2018, and that funding disparities are responsible for the uneven progress in combating HIV/AIDS across the United States. (JEL H51, H75, I12, I18)
Οι μεταξύ των συμβαλλομενων και έναντι τρίτων σχέσεις από τη λειτουργία ανοικτού - αλληλόχρεου λογαριασμού στο πλαίσιο συμβάσεων ανοίγματος πίστωσης
Authors: Βρεττού Μαρία-Ελένη
Published: June 2023

Η παρούσα διατριβή εξετάζει τη λειτουργία του ανοικτού - αλληλόχρεου λογαριασμού στο πλαίσιο συμβάσεων ανοίγματος πίστωσης εστιάζοντας στις μεταξύ των συμβαλλομένων και έναντι τρίτων σχέσεις που δημιουργούνται από τη λειτουργία αυτή. Ειδικότερα, εξετάζονται τα σημαντικότερα ζητήματα που έχουν διαχρονικά απασχολήσει τη νομολογία και τη θεωρία και επιχειρείται η κατηγοριοποίησή τους αναλόγως προς τη θεμελίωση της επίλυσής τους. Η πρώτη κατηγορία περιλαμβάνει α) το ζήτημα της ευθύνης για το κατάλοιπο αλληλόχρεου λογαριασμού ομόρρυθμου εταίρου που αποχωρεί από την εταιρεία κατά τη διάρκεια λειτουργίας του λογαριασμού, β) το ζήτημα του επιτρεπτού της κατάσχεσης στον τραπεζικό αλληλόχρεο λογαριασμό και γ) το ζήτημα της καταδολιευτικής απαλλοτρίωσης κατά τη διάρκεια λειτουργίας του λογαριασμού. Η δεύτερη κατηγορία αφιερώνεται στο ζήτημα της τύχης των παρασχεθεισών κάθε είδους ασφαλειών υπέρ μεμονωμένων απαιτήσεων που εισέρχονται στον αλληλόχρεο λογαριασμό και υπέρ του οριστικού καταλοίπου. Τέλος, ο τρίτος κύκλος ζητημάτων αναφέρεται στην καταγγελία της πιστωτικής σχέσης εκ μέρους του πιστωτικού ιδρύματος και το συνακόλουθο οριστικό κλείσιμο του αλληλόχρεου λογαριασμού. Για καθένα από τα ανωτέρω ζητήματα παρουσιάζονται εξαντλητικά οι θέσεις που έχουν υποστηριχθεί στη θεωρία και τη νομολογία, ενώ παρατίθενται και κριτικές παρατηρήσεις επ’ αυτών βασιζόμενες στην προσεκτική ανάλυση της ελάσσονος προτάσεως των δικαστικών αποφάσεων, στον εντοπισμό των αντιτιθέμενων κάθε φορά συμφερόντων, στην αποκάλυψη του κριτηρίου στάθμισης αυτών από τη νομολογία και στον έλεγχο της συμβατότητας αυτού με τις θεμελιώδεις αρχές που γίνεται δεκτό ότι διέπουν τον ανοικτό - αλληλόχρεο λογαριασμό. Ακολουθεί στο τελευταίο κεφάλαιο η πρόταση της γράφουσας για μια νέα αξιολογική θεώρηση της λειτουργίας του αλληλόχρεου λογαριασμού βασιζόμενη στην κατάστρωση μιας όσο το δυνατόν πιο ολοκληρωμένης πρακτικής αντιπρότασης νέων κριτηρίων εξισορρόπησης των εκάστοτε αντιμαχόμενων συμφερόντων.
Γενική Επιτροπεία της Επικρατείας στο Ελεγκτικό Συνέδριο και η καταπολέμηση της διαφθοράς
Authors: Κάρκαλης Ιωάννης
Published: June 2023

Η διατριβή εξετάζει τη συμβολή του θεσμού της Γενικής Επιτροπείας της Επικρατείας στο Ελεγκτικό Συνέδριο στην καταπολέμηση της διαφθοράς. Παρουσιάζει αναλυτικά: α) το φαινόμενο της διαφθοράς, β) το θεσμό της Γενικής Επιτροπείας της Επικρατείας από τη γένεσή του ως σήμερα. Από την παρουσίαση και ανάλυση, αφενός των παραμέτρων που συνθέτουν το φαινόμενο της διαφθοράς, καθώς και των προσπαθειών καταπολέμησής της από τη διεθνή κοινότητα, αφετέρου της διάρθρωσης, της οργάνωσης και των αρμοδιοτήτων της Γενικής Επιτροπείας της Επικρατείας, όπως αυτές εξελίχθηκαν στο ιστορικό διηνεκές και υφίστανται σήμερα, προκύπτει ο θεσμικός ρόλος της Γενικής Επιτροπείας της Επικρατείας στην καταπολέμηση της διαφθοράς με αιχμή του δόρατος την αρμοδιότητά της για Μη Ποινική Δήμευση. Η τελευταία εντάσσεται στο πλαίσιο της αυξανόμενης στη διεθνή κοινότητα δυναμικής να καταπολεμηθεί η διαφθορά προεχόντως σε μη ποινικό επίπεδο διαμέσου της κατάσχεσης του αδικαιολόγητου περιουσιακού οφέλους της διεφθαρμένης συναλλαγής (Μη Ποινική Δήμευση). Η αρμοδιότητα Μη Ποινικής Δήμευσης της Γενικής Επιτροπείας της Επικρατείας παρουσιάζεται και αναλύεται σε βάθος σε όλη της την έκταση, αναδεικνύονται οι αδυναμίες του υφιστάμενου συστήματος και εντέλει προτείνονται εκείνες οι θεσμικές βελτιώσεις που είναι αναγκαίες για την ενδυνάμωση του θεσμού στην κατεύθυνση επιτυχίας της αποστολής του.
Precipitation-related increase events of the electromagnetic component of secondary cosmic rays: Spectral analysis
Authors: Balabin Yuriy , Germanenko Aleksey , Gvozdevsky Boris , Maurchev Evgeniy , Mikhalko Evgeniya
Published: June 2023

We report the measurement results of differential spectra of electromagnetic radiation in the range 0.1–4 MeV, which occurs in the atmosphere as a component of secondary cosmic rays. Spectral monitoring was performed using a spectrometer based on the Nai (TL) crystal in 2022–2023. The main purpose of the measurements was to determine spectral characteristics of the electromagnetic radiation during increase events, when the electromagnetic radiation flux from the atmosphere rises by tens of percent with respect to the background level. From a thorough analysis of the spectra of many dozens of events, we have drawn a conclusion that although the lines of natural radionuclides are present on the spectra and contribute their share, their total contribution to the increase events is ~0.1 of the total energy supplied during an increase. We unambiguously conclude that the effect of increasing electromagnetic radiation during precipitation is not due to the presence of radionuclides in precipitation.
CAII lines in a quiet region on the Sun I. Dynamic processes in the solar atmosphere
Authors: Turova Irina , Grigoryeva Sofiya , Ozhogina Olga
Published: June 2023

We have studied oscillation processes in the quiet Sun outside a coronal hole at different levels of the solar chromosphere. The study was based on spectroscopic observations of ionized calcium lines (K, H, and 849.8 nm) obtained by the Sayan Solar Observatory’s Automated Solar Telescope (AST). Spectral analysis of time series for some parameters of the lines has been carried out. We have compared the results of this work with the results of our study of oscillation processes in quiet regions located at the base of a coronal hole. The oscillation power was found to be higher in the region of the quiet Sun outside a coronal hole. At the same time, for the regions under study there is a common tendency for the oscillation power to decrease with height for all frequency ranges, except for the low-frequency one, in most chromospheric structures. In structures with a weak magnetic field, the power increases with height to the lower chromosphere and decreases somewhat to the upper chromosphere.
Spectral features of ionospheric plasma waves excited by powerful HF radio waves radiated at frequencies near electron gyroharmonics and F2-layer critical frequency
Authors: Borisova Tatiana , Blagoveshchenskaya Nataly , Kalishin Alexey
Published: June 2023

We present the result of the studies into characteristics of high-latitude ionospheric F-region longitudinal plasma waves (Langmuir and ion-acoustic), caused by the impact of powerful HF radio waves of ordinary (O-mode) or extraordinary (X-mode) polarization of the EISCAT/Heating facility, Tromsø, Norway. The powerful HF radio waves on October 20, 2012 and February 26, 2013 were emitted in the direction of the magnetic zenith with a step change in the effective radiation power (ERP). The radiation frequency fH of the EISCAT/Heating facility on February 26, 2013 was close to the F2-layer critical frequency foF2 (fH/foF2~1) and exceeded the electron gyroresonance frequency fH>5fce. On October 20, 2012, the conditions fH/foF2~0.85–0.95 and fH<6fce were fulfilled. Analysis of EISCAT measurements of an incoherent scatter radar (ISR) at a frequency of 930 MHz, spatially aligned with the heating facility for radiation conditions ERP<200 MW, has shown that parametric decay instabilities are excited at the ionospheric heights where the pump frequency is close to the plasma Langmuir frequency, fH≈fPL. We have studied peculiarities of excitation of the decay parametric instabilities as a function of height in the ionosphere and pump wave polarization, the ratios between fH and foF2, and also fH and nfce.
El marco jurídico de la Unión Europea sobre protección de datos y garantías ciudadanas ante la Administración pública electrónica.
Authors: Puerta Domínguez Enrique Manuel
Published: June 2023

El presente estudio aborda, en clave analítica tanto de la legalidad europea como de la jurisprudencia del Tribunal de Justicia, las virtualidades aplicativas que tiene la normativa de la UE en materia de protección de datos en lo que afecta a las relaciones entre las Administraciones públicas y los ciudadanos. Tal normativa es exigente a la hora de deparar las obligaciones que competen a los que realizan el tratamiento o depósito de datos personales, y es de recibo que sean los entes públicos los que deban, antes que nada, dar ejemplo de una buena gestión. Materia rica y compleja, aun no ampliamente abordada, conoce una sugerente casuística jurisprudencial.
Rupture of pancreatic pseudocyst and therapeutic conduct: a case report
Authors: Graciano Victor P. , Rodante Andressa C. , Netto Idari F. O. , Pin Alessandro S. , Lacerda Ludymilla O. P. , Pontes Gabriela M. , Marciano Ricardo D.
Published: June 2023

Introduction: To report on a clinical case of a pancreatic pseudocyst that evolved to rupture and to understand the main therapeutic approaches adopted for pancreatic pseudocysts, thus fostering a better approach to such cases. Case report: Female patient, 30 years old, with pseudocystoadenoma and acute abdomen due to cystic rupture. Discussion: The therapeutic forms for pancreatic pseudocysts are expectant management, drainage (endoscopic and percutaneous) and surgical treatment. Results: The best approach addresses the treatment of the patient's clinical condition and pancreatic pseudocyst. For this to happen, a clinical evaluation,by means of complementary examinations, is required.
Impact of zinc supplementation on male infertility: a systematic review
Authors: De Lima Jean F. , Daniel Natália V. S. , Pietro Luciana
Published: June 2023

Introduction: According to the World Health Organization (WHO), infertility is defined as a failure in fertilization without any use of a contraceptive method for at least 12 consecutive months, with the individual being of reproductive age and having an active sexual life, where male infertility has been assuming a prominent position.This condition is considered to beof high importance in the contemporary world. Objectives:To systematically review the literature on the impactof oral zinc supplementation on male infertility and to assess whether its intake exerts a therapeutic effect, based on the evaluation of seminal parameters, according to manuals publishedby the WHO. Methodology: A systematic review was carried out by means ofa search, in the English and Portuguese languages, for original articles in the Pubmed, Science Direct, Lilacs and Scieloscientific databases. Results: The intervention groups ranged from 18 to 77 individuals and the control groups ranged from 8 to 113 individuals. Regarding age, the average age of the participants in the studies was31 years. The daily dose of zinc administered in thetrials variedfrom 66mg to 500mg and its use time ranged from three to six months. In the end, 87.5% of the studies showed positive results on the sperm parameters evaluated after the intervention. Conclusion:The results weremainly attributed to the protective effect that the trace element provided, reducing the lipid peroxidation index of plasma membranes and improving DNA integrity, thus increasing the fertilization capacity.
DIREITOS HUMANOS DOS REFUGIADOS: A VIOLÊNCIA CONTRA O HOMO SACER À LUZ DA CORTE INTERAMERICANA DE DIREITOS HUMANOS / HUMAN RIGHTS OF REFUGEES: VIOLENCE AGAINST HOMO SACER IN THE LIGHT OF THE INTER-AMERICAN COURT OF HUMAN RIGHTS
Authors: Santana Agatha Gonçalves , Amin Aleph Hassan Costa , Dos Santos Caroline Coelho
Published: June 2023

Resumo: O presente trabalho aborda a temática da desumanização dos direitos humanos dos refugiados que se encontram em situação de extrema vulnerabilidade diante do cenário de violações em que estão inseridos. Tem como problemática entender de que forma os atos de violência perpetrados contra os refugiados contribuem à desumanização dos direitos das pessoas em situação de deslocamento. Como metodologia, analisa-se os direitos dos refugiados através dos dispositivos internacionais de proteção de direitos humanos, bem como de julgados da Corte Interamericana de Direitos Humanos (Corte IDH) referentes à violação dos direitos desses indivíduos. O método utilizado foi o hipotético-dedutivo, através de pesquisa bibliográfica e documental, com ênfase na técnica de pesquisa de análise na legislação internacional dos direitos humanos dos refugiados. Conclui-se que este fenômeno é instaurado mediante análise da definição do termo homo sacer e da violação ao princípio do non refoulement decorrente da intolerância dos Estados receptores de emigrados.Palavras-chave: Direitos humanos; Refugiados; Violência; Homo sacer; Corte Interamericana de Direitos Humanos. Abstract: The present work addresses the issue of dehumanization of the human rights of refugees who are in a situation of extreme vulnerability in the face of the scenario of violations in which they are inserted. It is problematic to understand how the acts of violence perpetrated against refugees contribute to the dehumanization of the rights of people in situations of displacement. As a methodology, the rights of refugees are analyzed through international provisions for the protection of human rights, as well as judgments of the Inter-American Court of Human Rights (IHR Court) regarding the violation of the rights of these individuals. The method used was the hypothetical-deductive, through bibliographic and documentary research, with emphasis on the research technique of analysis in the international legislation of the human rights of refugees. It is concluded that this phenomenon is established by analyzing the definition of the term homo sacer and the violation of the principle of non-refoulement resulting from the intolerance of the receiving States of emigrants.Keywords: Human rights; Refugees; Violence; Homo sacer; Inter-American Court of Human Rights.
COLABORAÇÃO PREMIADA: INSPIRAÇÃO E COMPATIBILIZAÇÃO COM O ORDENAMENTO JURÍDICO BRASILEIRO / AWARD-WINNING COLLABORATION: INSPIRATION AND COMPATIBILITY WITH THE BRAZILIAN LEGAL SYSTEM
Authors: Afonso Paulo Adaias Carvalho , Pereira Ricardo Souza , Lofrano José Renato Hojas
Published: June 2023

Resumo: Desde a superação da vingança privada, com o Estado monopolizando a jurisdição criminal, tornou-se essencial compreender o processo penal como uma garantia individual contra abusos. Neste ponto, a Constituição de 1988 representou considerável avanço. Por outro lado, com avanço da criminalidade organizada, o legislador começou a buscar meio de estimular delinquentes a contribuir com a persecução penal, demonstrando a necessidade premente de utilização de elementos da justiça criminal negocial criminal no cotidiano forense brasileiro, em especial a colaboração premiada. De forte inspiração no common law, a colaboração premiada é uma espécie da justiça criminal negocial (gênero) inserida no ordenamento jurídico brasileiro e, como tal, deve receber adequação para compatibilização com o sistema jurídico brasileiro. O trabalho se propõe a identificar formas de compatibilização de instituto tão amplo aos direitos e garantias constitucionais do Brasil. Para elaboração do presente trabalho, adotou-se como metodologia a pesquisa bibliográfica, em especial sobre artigos científicos, livros, jurisprudência e legislação interna, com abordagem empírica do ingresso da Lei n.º 12.850/13 e a evolução jurisprudencial.Palavras-chave: Direitos fundamentais; Colaboração premiada; Lei de organização criminosa; Dinamogenesis; Justiça criminal negocial. Abstract: Since the overcoming of private revenge, with the State monopolizing criminal jurisdiction, it has become essential to understand the criminal process as an individual guarantee against abuse. At this point, the 1988 Constitution represented a considerable advance. On the other hand, with the advancement of organized crime, the legislator began to look for ways to encourage offenders to contribute to criminal prosecution, demonstrating the pressing need to use elements of criminal business criminal justice in the Brazilian forensic routine, in particular the award-winning collaboration. Strongly inspired by the common law, the award-winning collaboration is a kind of business criminal justice (gender) inserted in the Brazilian legal system and, as such, should be adapted to make it compatible with the Brazilian legal system. The work aims to identify ways of making such a broad institute compatible with Brazil's constitutional rights and guarantees. For the preparation of this work, bibliographic research was adopted as a methodology, especially on scientific articles, books, jurisprudence and internal legislation, with an empirical approach to the enactment of Law No. 12,850/13 and the jurisprudential evolutionKeywords: Fundamental rights; Award-winning collaboration; Criminal organization law; Dynamogenesis; Business criminal justice.
Some observations on altering hedging phenomenon in courtroom discourse
Authors:   Yaroslav Mudryi National Law University, Zaitseva Margarуta
Published: June 2023

The paper updates on the notion «hedging». While analyzing, we have not encountered any research on its peculiarities in the courtroom discourse. So, it is possible to affirm that this study is relevant. With that in mind, the aim of this study is to explore the characteristics of hedging in courtroom discourse. The results of our survey confirmed that in courtroom discourse hedges perform the role of strengthening arguments, the persuasive function; the function of building rapport with the jury; the function of strengthening the credibility/unreliability of the utterance. Hedges are implemented for different purposes: to insulate the speaker from possible criticism and protect themselves from misinterpretation – attribution shield hedges. If the speaker is not completely confident the statement – plausibility shield hedges and approximators. Impersonalizers objectify what is being said. Personal involvement indicators reinforce the emotional aspect of a statement. They are also determined by extra-linguistic factors such as the historical context and the characteristics of the court case in question, etc. This study seems promising as it is thought to be interesting to compare hedges in the speeches of prosecutors and lawyers, for instance, or in the speeches of judges.
Max's legacy: an evaluation of the impacts of baby loss on staff and families
Authors: Whitehouse Claire , Crane Racheal , Rostron Heather , Cater Kirsty
Published: June 2023

Background/Aims

There is a paucity of literature on the impact of baby loss experiences on family and staff. This study aimed to explore existing support available to families and staff in a UK hospital for first trimester miscarriage, as well as experiences of baby loss, and make recommendations for future care.

Methods

A mixed-methods service evaluation was conducted. Data were gathered from healthcare professionals (surveys, phase 1; interviews, phase 2) and service users who had experienced baby loss (focus group discussions, phase 3). Qualitative data were analysed thematically, alongside descriptive quantitative results.

Results

Communication, support, recognition of loss and environment were key contributors to positive and negative experiences for staff and families. Peer support enhanced communication, reduced isolation and increased ability to function on a daily basis following loss.

Conclusions

Formal, resourced maternity bereavement aftercare services are essential to the support the experiences, outcomes and safety of staff and families experiencing baby loss and miscarriage.
Women's experiences accessing continuity of care in Ireland: a qualitative study
Authors: Hunter Andrew , Lennon Roisin A , Biesty Linda
Published: June 2023

Background/Aims

In January 2017, a continuity of care advanced midwife practitioner service was introduced in an Irish maternity unit. Continuity is central to high-quality maternity care, but little is known about it at an advanced practice level or about women's experiences of this model of caregiving. This study's aim was to provide insight into the experiences of women accessing a continuity of care service in Ireland.

Methods

A qualitative descriptive design and thematic analysis was used. A total of 11 women, who attended the advanced midwifery practitioner service and had experienced a different model of care in a previous pregnancy, were interviewed.

Results

Two themes were identified. Positive comparison to previous care, which had three subthemes, and access to the advanced midwifery practitioner, with four subthemes.

Conclusions

Continuity from an approachable and competent practitioner with time for discussion and unscheduled access to the service was rated highly. Participants wanted to ‘future proof’ the service and recommended that continuity of care needs to be available to all pregnant women and at the forefront of service development.
The need for a cultural revolution
Authors: Qureshi Amber
Published: June 2023

Amber Qureshi outlines the crucial value a dental nurse brings, and why they deserve to be respected.
The daily demands
Authors: Atkinson Shadae
Published: June 2023

Shadae Atkinson outlines the demands and challenges in the life of a dental nurse.
The Happy Dental Nurse!
Authors: O'Neill Hayley
Published: June 2023

Hayley O'Neill discusses some key resources to support dental nurses and the wider team.
Reaping the benefits
Authors: Marsh Zoe
Published: June 2023

Zoe Marsh details the many advantages of choosing a career as a locum dental nurse.
The search for effective treatment
Authors: Garlo-Melkas Nina
Published: June 2023

Nina Garlo-Melkas explains the use of Lumoral therapy as an adjunct therapy to non-surgical periodontal treatment in smokers.
The Mechanics of All-Electric Flight
Authors: Knight Helen
Published: June 2023

New project will focus on six key areas of mechanical engineering
Wireless Technology Could Block Cancerous Tumours
Authors: Knight Helen
Published: June 2023

Device simulates electrical signals produced by body
The Heat is on to Improve Solar Power Generation
Authors: Knight Helen
Published: June 2023

System being developed to provide electricity and high-temperature heat for high-rise buildings
Making Moves on Hip Replacement
Authors: Knight Helen
Published: June 2023

Simulator looks at shape and motion to improve patient outcomes
Bionic Strides
Authors: Nathan Stuart
Published: June 2023

The sci-fi vision of prosthetics that can be controlled by the brain is moving a step closer to reality.
Sensors Cut Arctic Ice
Authors: Wade Andrew
Published: June 2023

SmartICE provides people in the Arctic with better information about this capricious landscape.
Making a Power of Difference
Authors: Excell Jon
Published: June 2023

The boss of one of the world's largest automation companies on collaboration, innovation, and why we shouldn't fear the robots.
A Cut Above
Authors: Excell Mike
Published: June 2023

Latest-generation machining centres tackle the need for adaptable and versatile manufacturing; while cutting tool developers attend to the detail at the sharp end.
Taking Measures
Authors: Stirling Will
Published: June 2023

Additive manufacturing can throw conventional metrology off-course, so new techniques need to be devised to improve sampling and measuring.
Pools of Engagement
Authors: Fowler David
Published: June 2023

SMEs, often hardest hit by the skills gap, can learn valuable lessons on recruiting talent from larger engineering firms.
Gender Pay Gap is Getting Wider
Authors: Excell Jon
Published: June 2023

Women trailing by £13,000 a year
Consortium Gets Autonomous Vehicle Trials on the Road
Authors: Knight Helen
Published: June 2023

Testing environment will be largest in UK
Siri Hits the Road
Authors: Nathan Stuart
Published: June 2023

Voice-activated digital assistants are spreading from our homes to our cars. Stuart Nathan looks at what it could mean for the future of driving
Machine Tools on the Right Track
Authors: Excell Mike
Published: June 2023

Global developments continue to meet a wide range of challenges from end users in both high-end technology and traditional markets.
Closing the Circle
Authors: Excell Mike
Published: June 2023

AMRC's Advanced Structural Testing Centre supports local innovators with global potential.
Planning Target Volume Margin Determination for Volumetric Modulated Arc Therapy Planning in Cervix Cancers Using an Empty Bladder Protocol
Authors:   Graduate School, Medical Physics Program, Bunnachak Anand , Tharavichitkul Ekkasit ,   Graduate School, Medical Physics Program,   Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University,   Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, Wanwilairat Somsak ,   Graduate School, Medical Physics Program,   Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Nobnop Wannapha ,   Graduate School, Medical Physics Program,   Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University,   Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Published: June 2023

OBJECTIVE To evaluate the planning target volume (PTV) margin and bladder volume variation of volumetric modulated arc therapy (VMAT) in cervical cancer using an empty bladder protocol. METHODS Ten patients with cervical cancer who had indications to receive whole pelvic radiotherapy and who had been identified to receive whole pelvic irradiation with a dose of 46-55.2 Gy in 23 fractions planned by VMAT were included. International Commission on Radiation Units and Measurements (ICRU) Report 83 was used to report plan parameters. The empty bladder protocol is designed for use with all patients before simulation and irradiation. From June 2020 to February 2021, 215 fractions from the 10 patients were evaluated. The ‘all fraction’ set-up errors were recorded using cone-beam computed tomography (CBCT) and were interpreted as error margins using the Van Herk Formula. RESULTS The calculated PTV margins were 0.75, 0.84, and 0.98 cm on the X, Y, and Z-axes, respectively. The median volume of the bladder before irradiation was 40.6 cc, with an interquartile range of 31.9 to 59.2 cc. The average change in bladder volume from the planning volume was 23.56%. CONCLUSIONS Using the empty bladder protocol, the clinical target volume (CTV) to PTV margin was 1 cm following the Van Herk formula. No patients experienced side effects of grade 3 or greater. The empty bladder protocol is a method which can reduce target placement error and reduce patient discomfort without causing serious side effects. KEYWORDS PTV margin, VMAT, IGRT, Cervix cancer, Empty bladder
Review of the national usage of antibiotics in arthroplasty surgery: a need for evidence-based prescribing
Authors: Hassanzadeh H , Ferro A , Woods K , Baring T
Published: June 2023

Introduction

Surgical site infections (SSI) remain one of the most serious complications of arthroplasty surgery. The role of antibiotic prophylaxis in preventing SSI post-arthroplasty is well established. However, there is considerable heterogeneity in prophylactic prescribing across the United Kingdom (UK), which is contradicted by the contemporaneous evidence. This descriptive study aimed to compare the current first-line antibiotic recommendations across hospitals in the UK and The Republic of Ireland for elective arthroplasty procedures.

Methods

The MicroGuide mobile phone application was used to access hospital antibiotic guidelines. First-line antibiotic recommendation and dosing regimen for primary elective arthroplasties were recorded.

Findings

A total of nine distinct antibiotic regimens were identified through our search. The most frequently used first-line antibiotic was cefuroxime. This was recommended by 30 of the 83 (36.1%) hospitals in the study. This was followed by a combination of flucloxacillin and gentamicin, which was used by 38 of 124 (31%) hospitals. There was also significant heterogeneity in dosing regimens. A single prophylactic dose was most commonly recommended (52%); 4% of hospitals recommended two prophylactic doses, 19% three doses and 23% four doses.

Conclusions

Single-dose prophylaxis is recognised as at least noninferior to multiple-dose prophylaxis in primary arthroplasty. There is considerable variation in the local antibiotic recommendations for surgical site prophylaxis post-primary arthroplasty surgery, with respect to both recommended first-line antibiotic and dosing regimens. With increasing emphasis on the importance of antibiotic stewardship and the emergence of antibiotic resistance, this study highlights the need for an evidence-based approach to prophylactic dosing across the UK.
Advanced control of an acousto-optic filter performance through arbitrary RF signals
Authors: Perennou Andre , Quintard Veronique , Arellanes Adan Omar
Published: June 2023

The proposed study consists of using the capabilities of an arbitrary waveform generator to create a specific radio frequency (RF) signal to be applied to an acousto-optic tunable filter based on quasicollinear interaction. By controlling the duration and shape of the acoustic pulse, the filter transmission function can be changed in terms of selectivity and side-lobe levels. The measurement results show good agreement with the simulation model based on the fast Fourier transform. In particular, the Hamming window has been found to be a good option for suppressing side lobes in the transmission function, even when using high acoustic powers.
The Brain/MINDS Marmoset Connectivity Resource: An open-access platform for cellular-level tracing and tractography in the primate brain
Authors: Skibbe Henrik , Rachmadi Muhammad Febrian , Nakae Ken , Gutierrez Carlos Enrique , Hata Junichi , Tsukada Hiromichi , Poon Charissa , Schlachter Matthias , Doya Kenji , Majka Piotr , Rosa Marcello G. P. , Okano Hideyuki , Yamamori Tetsuo , Ishii Shin , Reisert Marco , Watakabe Akiya
Published: June 2023

The primate brain has unique anatomical characteristics, which translate into advanced cognitive, sensory, and motor abilities. Thus, it is important that we gain insight on its structure to provide a solid basis for models that will clarify function. Here, we report on the implementation and features of the Brain/MINDS Marmoset Connectivity Resource (BMCR), a new open-access platform that provides access to high-resolution anterograde neuronal tracer data in the marmoset brain, integrated to retrograde tracer and tractography data. Unlike other existing image explorers, the BMCR allows visualization of data from different individuals and modalities in a common reference space. This feature, allied to an unprecedented high resolution, enables analyses of features such as reciprocity, directionality, and spatial segregation of connections. The present release of the BMCR focuses on the prefrontal cortex (PFC), a uniquely developed region of the primate brain that is linked to advanced cognition, including the results of 52 anterograde and 164 retrograde tracer injections in the cortex of the marmoset. Moreover, the inclusion of tractography data from diffusion MRI allows systematic analyses of this noninvasive modality against gold-standard cellular connectivity data, enabling detection of false positives and negatives, which provide a basis for future development of tractography. This paper introduces the BMCR image preprocessing pipeline and resources, which include new tools for exploring and reviewing the data.
Validation of an electrochemical sensor based on gold nanoparticles as a point-of-care test for quantitative determination of glycated hemoglobin
Authors: Boonprasert Kanyarat , Tharavanij Thipaporn , Pechyen Chiravoot , Ponsanti Khanittha , Tangnorawich Benchamaporn , Viyanant Vithoon , Na-Bangchang Kesara
Published: June 2023

Monitoring the level of glycated hemoglobin (HbA1c) has become the gold standard measure for diabetes mellitus (DM) diagnosis and control, used in conjunction with fasting blood glucose (FBG) and oral glucose tolerance test. This study aimed to investigate the applicability of a newly developed nanoparticle-based electrochemical sensor—multiwalled nanotubes incorporated with gold nanoparticles (POCT-HbA1cMWCNTs/AuNPs)—used as a routine point-of-care test (POCT) for detection of HbA1c for the diagnosis of DM. Finger-prick and venous blood samples were collected from 108 DM and 98 non-DM subjects to determine HbA1c and total hemoglobin by POCT-HbA1cMWCNTs/AuNPs compared with the standard HPLC method. The performance of the POCT-HbA1cMWCNTs/AuNPs was evaluated using the standard cut-off HbA1c level of >6.5%. The test’s sensitivity, specificity, positive predictive value, and negative predictive value were 100.00%, 90.32%, 87.23%, and 100.00%, respectively. The probability of DM diagnosis in a subject with HbA1c >6.5% (positive predictive value) was 87.23% (82/94). The accuracy of the POCT-HbA1cMWCNTs/AuNPs was 94.18%, with a %DMV (deviation from the mean value) of 0.25%. The results indicate satisfactory assay performance and applicability of the POCT-HbA1cMWCNTs/AuNPs for diagnosis of DM using the cut-off criteria of HbA1c >6.5.
Accelerated absorption of regular insulin administered via a vascularizing permeable microchamber implanted subcutaneously in diabetic Rattus norvegicus
Authors: Steyn Leah V. , Drew Delaney , Vlachos Demetri , Huey Barry , Cocchi Katie , Price Nicholas D. , Johnson Robert , Putnam Charles W. , Papas Klearchos K.
Published: June 2023

In Type 1 diabetes patients, even ultra-rapid acting insulins injected subcutaneously reach peak concentrations in 45 minutes or longer. The lag time between dosing and peak concentration, as well as intra- and inter-subject variability, render prandial glucose control and dose consistency difficult. We postulated that insulin absorption from subcutaneously implantable vascularizing microchambers would be significantly faster than conventional subcutaneous injection. Male athymic nude R. norvegicus rendered diabetic with streptozotocin were implanted with vascularizing microchambers (single chamber; 1.5 cm2 surface area per side; nominal volume, 22.5 μl). Plasma insulin was assayed after a single dose (1.5 U/kg) of diluted insulin human (Humulin®R U-100), injected subcutaneously or via microchamber. Microchambers were also implanted in additional animals and retrieved at intervals for histologic assessment of vascularity. Following conventional subcutaneous injection, the mean peak insulin concentration was 22.7 (SD 14.2) minutes. By contrast, when identical doses of insulin were injected via subcutaneous microchamber 28 days after implantation, the mean peak insulin time was shortened to 7.50 (SD 4.52) minutes. Peak insulin concentrations were similar by either route; however, inter-subject variability was reduced when insulin was administered via microchamber. Histologic examination of tissue surrounding microchambers showed mature vascularization on days 21 and 40 post-implantation. Implantable vascularizing microchambers of similar design may prove clinically useful for insulin dosing, either intermittently by needle, or continuously by pump including in “closed loop” systems, such as the artificial pancreas.
Similar connectivity of gut microbiota and brain activity networks is mediated by animal protein and lipid intake in children from a Mexican indigenous population
Authors: Ramírez-Carrillo Elvia , G-Santoyo Isaac , López-Corona Oliver , Rojas-Ramos Olga A. , Falcón Luisa I. , Gaona Osiris , de la Fuente Rodríguez Rosa María , Hernández Castillo Ariatna , Cerqueda-García Daniel , Sánchez-Quinto Andrés , Hernández-Muciño Diego , Nieto Javier
Published: June 2023

The gut microbiota-brain axis is a complex communication network essential for host health. Any long-term disruption can affect higher cognitive functions, or it may even result in several chronic neurological diseases. The type and diversity of nutrients an individual consumes are essential for developing the gut microbiota (GM) and the brain. Hence, dietary patterns might influence networks communication of this axis, especially at the age that both systems go through maturation processes. By implementing Mutual Information and Minimum Spanning Tree (MST); we proposed a novel combination of Machine Learning and Network Theory techniques to study the effect of animal protein and lipid intake on the connectivity of GM and brain cortex activity (BCA) networks in children from 5-to 10 years old from an indigenous community in the southwest of México. Socio-ecological conditions in this nonwestern lifestyle community are very homogeneous among its inhabitants but it shows high individual heterogeneity in the consumption of animal products. Results suggest that MST, the critical backbone of information flow, diminishes under low protein and lipid intake. So, under these nonwestern regimens, deficient animal protein and lipid consumption diets may significantly affect the GM-BCA connectivity in crucial development stages. Finally, MST offers us a metric that unifies biological systems of different nature to evaluate the change in their complexity in the face of environmental pressures or disturbances. Effect of Diet on gut microbiota and brain networks connectivity.
Expression of microRNAs and their target genes in melanomas originating from gynecologic sites
Authors: DiVincenzo Mallory J. , Angell Colin D. , Suarez-Kelly Lorena P. , Ren Casey , Barricklow Zoe , Moufawad Maribelle , Fadda Paolo , Yu Lianbo , Backes Floor J. , Ring Kari , Mills Anne , Slingluff Craig , Chung Catherine , Gru Alejandro A. , Carson William E.
Published: June 2023

Melanomas from gynecologic sites (MOGS) are rare and have poor survival. MicroRNAs (miRs) regulate gene expression and are dysregulated in cancer. We hypothesized that MOGS would display unique miR and mRNA expression profiles. The miR and mRNA expression profile in RNA from formalin fixed, paraffin embedded vaginal melanomas (relative to vaginal mucosa) and vulvar melanomas (relative to cutaneous melanoma) were measured with the Nanostring Human miRNA assay and Tumor Signaling mRNA assay. Differential patterns of expression were identified for 21 miRs in vaginal and 47 miRs in vulvar melanoma (fold change >2, p<0.01). In vaginal melanoma, miR-145-5p (tumor suppressor targetingTLR4,NRAS) was downregulated and miR-106a-5p, miR-17-5p, miR-20b-5p (members of miR-17-92 cluster) were upregulated. In vulvar melanoma, known tumor suppressors miR-200b-3p and miR-200a-3p were downregulated, and miR-20a-5p and miR-19b-3p, from the miR-17-92 cluster, were upregulated. Pathway analysis showed an enrichment of “proteoglycans in cancer”. Among differentially expressed mRNAs, topoisomerase IIα (TOP2A) was upregulated in both MOGS. Gene targets of dysregulated miRs were identified using publicly available databases and Pearson correlations. In vaginal melanoma, suppressor of cytokine signaling 3 (SOCS3) was downregulated, was a validated target of miR-19b-3p and miR-20a-5p and trended toward a significant inverse Pearson correlation with miR-19b-3p (p = 0.093). In vulvar melanoma, cyclin dependent kinase inhibitor 1A (CDKN1A) was downregulated, was the validated target of 22 upregulated miRs, and had a significant inverse Pearson correlation with miR-503-5p, miR-130a-3p, and miR-20a-5p (0.005 < p < 0.026). These findings support microRNAs as mediators of gene expression in MOGS.