bluuebunny/crossref_metadata_2025 huggingface dataset:
Super Drought under Global Warming: Concept, Monitoring Index, and Validation
Authors: Wang Lin , Huang Gang , Chen Wen , Wang Ting
Published: April 2023

Recent decades have witnessed growing frequency and severity of catastrophic droughts in many regions of the world. Despite lots of studies having been dedicated to extreme drought investigation, the fundamental question that has long been ignored is, What is extreme drought? The answer is much more complex than it first appears, because a critical issue in the study of drought is the multiscalar nature. To address the challenge, this study establishes the theoretical basis of the super drought concept, which refers to the simultaneous occurrence of extreme droughts at multiple time scales. The physical significance of super drought represents compound dry extremes in all parts of water resources or equivalently a grand loss in total water storage, which is identified as the essential determinant distinguishing high-impact droughts from those causing mild damage. To have a quantitative representation, a novel monitoring index called comprehensive multiscalar index (CMI) is developed based on the vine copula framework. It turns out that CMI is a plausible measure to determine the overall rarity of multiscalar drought and recognize super drought. Furthermore, the worldwide skill of CMI and super drought identification are testified against Gravity Recovery and Climate Experiment (GRACE) total water storage. Compared to traditional indices that lack comprehensive treatment of drought, CMI performs better in capturing the variation of overall water availability and enables the accurate detection of real water scarcity, with gross improvements in correlation and root-mean-square error scores exceeding the 10−3 significance level. To facilitate end users and policy-makers, near-real-time monitoring and a historical data repository are available through the public website superdrought.com.
Financial Toxicity for Caregivers of Pediatric Patients With Long-Term Tracheostomies
Authors: Rosi-Schumacher Mattie , Nagy Ryan , Favre Nicole , DiNardo Lauren , Carr Michele M.
Published: April 2023

Objective:

To assess financial toxicity experienced by caregivers of children with long-term tracheostomies.

Methods:

Cross-sectional survey study with comparison group conducted at a tertiary pediatric hospital and outpatient clinic. Pediatric (<18 years) patients with tracheostomies for ≥12 months were recruited for the study. Patients who underwent tympanostomy tube placement or adenotonsillectomy were recruited as controls. Eligible patients’ caregivers were contacted to fill out a questionnaire including the validated Comprehensive Score for Financial Toxicity survey.

Results:

Surveys were completed for 72 patients, including 31 in the study group (mean age, 6.58 years, 95% confidence interval [CI], 4.85-8.30 years) and 41 controls (mean age, 6.42 years, 95% CI, 5.15-10.52 years) ( P = .864). The mean duration of tracheostomy was 3.98 years (95% CI, 2.91-5.05 years). The mean household income and education level were lower in the study group than in the control group. Caregivers of the study group were more likely to have public health insurance or be uninsured. Caregivers of study patients reported greater financial toxicity, with a lower mean Comprehensive Score for Financial Toxicity (18.23 [95% CI, 15.20-21.25]) than caregivers of controls (34.27 [95% CI, 32.05-36.49]; P < .001). Linear regression analysis showed that survey scores were lower for caregivers who employed home nursing care ( P < .001).

Conclusion:

Caregivers of pediatric patients requiring long-term tracheostomies experience greater financial toxicity than caregivers of pediatric patients who have typical otolaryngologic surgery.
Coloniality, reframing and diversity in New Testament Apocrypha: More Noncanonical Scriptures, volume 2
Authors: Charles Ronald
Published: April 2023

The author’s aim in this review article is to highlight a few points that he finds intriguing, especially with regard to the classification of the texts and the question of genre, in the second volume of New Testament Apocrypha: More Noncanonical Scriptures, edited by Tony Burke and published by Eerdmans in 2020. He also reflects on what the process of rereading and reframing the narratives present in these texts entails. Choosing which texts to translate and which ones to read and analyse is a process that needs to be evaluated for various reasons. In conclusion, the author mentions a few areas of research that the volume pushes scholars to examine further.
Police violence, corrupt cops, and the repudiation of stigma among underclass residents in Mexico City
Authors: Guy Roger S , Chomczyński Piotr A
Published: April 2023

The relationship between police corruption and violence is well established in Latin America. Those with less power in poor communities often adapt their actions to serve their group interests in response to constraints placed on them by law enforcement. Using ethnographic and qualitative methods, we probe the effect of corrupt police behavior on the stigma of arrest and imprisonment by members of impoverished neighborhoods in Mexico City. Using an interpretive approach, we find that widespread corruption and police violence has indirectly mitigated the negative effects of the stigma or arrest and incarceration by what we term the repudiation of stigma. For the subjects in our study, the adjustment to pervasive corruption has led amelioration of the social stigma associated with arrest and incarceration among those with whom they share similar biographies of experience. More generally, repudiation of stigma highlights the ability of the marginalized to deflect the social consequences of being arrested and having a criminal record.
Multiple trajectories of depressive symptoms among Chinese in middle and late life: Characterization and risk factors
Authors: Li Chao , Liu Jin , Ju Yumeng , Liu Bangshan , Zhang Yan
Published: April 2023

Background:

Depressive symptoms, which are continuously changing, are an essential manifestation of depression and can increase the risk of mental disorders and other diseases. Because the causes and cures for depression have not yet been identified, finding the characteristics, and risk factors of depressive symptom trajectories can help us identify at-risk populations early and reduce the related public disease burden.

Aims:

Herein we aimed to figure out the specific manifestations of depressive symptom trajectories among Chinese adults, explore the risk profiles of trajectory groups with higher depression burdens, and test the longitudinal associations between blood biomarkers with depressive symptoms.

Methods:

Trajectories of participants’ depressive symptoms measured by the Center for Epidemiologic Studies Depression scores were modeled with growth mixture models from 2011 to 2018. Multinomial logistic models tested associations of baseline covariates with trajectories. Generalized estimating equations were used to explore the longitudinal associations between blood data and depressive symptoms in two waves from 2011 to 2015.

Results:

Among the sample of 5,641 individuals aged 40 or over, four heterogeneous depressive symptom trajectories were defined: stable-low, high-decrease, stable-high, and low-increase. At baseline, demographic factors and health statuses such as gender, education, income, and self-reported health status were associated with trajectories. A significant association was found between high-density lipoprotein and depressive symptoms.

Conclusions:

These findings provide clues for predicting and identifying adults with elevated depression burdens in middle and late life and may facilitate the development of targeted preventive strategies for this population.
Knowledge, attitudes and practices towards suicide among immigrants from the horn of Africa in Victoria, Australia
Authors: Mihtsintu Yonas , Yohannes Keflemariam , Gebrat Arhet
Published: April 2023

This study explored suicide risks and protective factors in the first generation-immigrants to Victoria, Australia, from five countries of the Horn of Africa. The aim was to contribute towards an effective and culturally sensitive interventions to prevent suicide. The research used a survey study of knowledge, attitudes and practices towards suicide, in representative samples recruited from each community using snowball sampling. The results identified three major risk factors including, (1) lack of interface between community resources and support services, (2) prevalent negative attitudes towards suicide, and (3) gaps in suicide awareness. The roles of religious and community leaders and spiritual healers were identified as protective factors providing the communities with support to deal with suicide and other mental health issues. In conclusion, the overall impact of these risk factors was that they lead to delayed lifesaving interventions, thus contributing to an increased likelihood of suicide incidents or other adverse outcomes. These protective factors have a key role to serve as a link between the communities and health services, to address issues of delay in accessing services as well as to address negative attitudes towards suicide and the gaps in suicide literacy.
Evaluation of Respondent-Driven Sampling Prevalence Estimators Using Real-World Reported Network Degree
Authors: Avery Lisa , Rotondi Michael
Published: April 2023

Respondent-driven sampling (RDS) is used to measure trait or disease prevalence in populations that are difficult to reach and often marginalized. The authors evaluated the performance of RDS estimators under varying conditions of trait prevalence, homophily, and relative activity. They used large simulated networks ( N = 20,000) derived from real-world RDS degree reports and an empirical Facebook network ( N = 22,470) to evaluate estimators of binary and categorical trait prevalence. Variability in prevalence estimates is higher when network degree is drawn from real-world samples than from the commonly assumed Poisson distribution, resulting in lower coverage rates. Newer estimators perform well when the sample is a substantive proportion of the population, but bias is present when the population size is unknown. The choice of preferred RDS estimator needs to be study specific, considering both statistical properties and knowledge of the population under study.
Toxicologic Pathology Forum: Tissue Evaluation in Nonclinical Toxicity Studies for Prophylactic Vaccines
Authors: Sellers Rani S.
Published: April 2023

Nonclinical toxicity testing (GLP) of prophylactic vaccines to support human clinical trials is outlined in the World Health Organization nonclinical vaccine-development guidelines, which are followed by most regulatory agencies globally. Vaccine GLP toxicity studies include at least two groups: a buffer control (often phosphate-buffered saline) group and a highest anticipated clinical dose formulation group. However, studies may include additional groups, including lower-dose formulation groups and adjuvant-containing formulation control groups. World Health Organization guidelines touch upon expectations for dose group and tissue selection for microscopic evaluation, but there is variation in the interpretation of this aspect of these guidelines between vaccine developers. This opinion piece proposes a scientifically based approach for defining appropriate groups to evaluate in the dosing and recovery phases in nonclinical vaccine toxicity studies, as well as suggestions on selecting tissues for microscopic evaluation at the recovery phase of studies to promote alignment between vaccine manufacturers.
Outcome of massive pulmonary embolism treated only with extracorporeal membrane oxygenation and anticoagulation without thrombolytic therapy or surgical embolectomy
Authors: Sim Hyung Tae , Jo Min Seop , Chang Yong Jin , Cho Deog Gon , Kim Jong Woo
Published: April 2023

Introduction

Although thrombolytic therapy is the standard treatment for massive pulmonary thromboembolism (PTE), it is often ineffective in patients with circulatory collapse. Surgical embolectomy is another treatment option, but whether it is absolutely necessary is controversial. We sought to evaluate the outcomes of patients with massive PTE treated with intensive critical care including extracorporeal membrane oxygenation (ECMO) without thrombolytic therapy or surgical embolectomy.

Methods

We analyzed 39 patients who were treated for massive PTE from January 2011 to June 2019. Massive PTE was treated with anticoagulation and hemodynamic support at an intensive care unit. ECMO was applied in patients with circulatory collapse. The computed tomography (CT) obstruction index and the ratio of the right ventricle to left ventricle short-axis diameters (RV/LV) were measured using serial CT angiography to confirm changes in pulmonary emboli and RV strain.

Results

Twenty-one patients were in cardiogenic shock, and 15 of them needed cardiopulmonary resuscitation (CPR). Fifteen patients were treated with ECMO and nine of them were weaned successfully. The overall in-hospital mortality was 23% (9/39). On the follow-up CT scan after 6 months, residual PTE was observed in 10 patients and their median CT obstruction index was 6.25 % (range 2.5–35). The initial mean RV/LV ratio was 1.8 ± 0.47 and the value measured at follow-up CT decreased to less than 1 (0.9 ± 0.1).

Conclusions

Intensive critical care with heparin alone and timely ECMO support without thrombolytic therapy could be an effective treatment option in patients with acute massive PTE.
Efficacy of electrophysical agents in fibromyalgia: A systematic review and network meta-analysis
Authors: Gikaro John Marwa , Bigambo Francis Manyori , Minde Victor Mark , Swai Elia Asanterabi
Published: April 2023

Objective

To examine the effectiveness of electrophysical agents in fibromyalgia.

Data sources

CINAHL, Cochrane Library, Embase, Medline, PEDro, and Web of Science were searched from their inceptions to March 27, 2023.

Methods

This study was registered in PROSPERO (CRD42022354326). Methodological quality of included trials was assessed using PEDro scale, and the quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system. The primary outcomes were pain, functional status, and mood.

Results

Fifty-four studies involving 3045 patients with fibromyalgia were eligible for qualitative synthesis and 47 (pain), 31 (functional status), and 26 (mood) for network meta-analysis. The network consistency model revealed that, when compared with true control, transcutaneous electrical nerve stimulation and microcurrent improved pain symptoms ( P = 0.006 and P = 0.037, respectively); repetitive transcranial magnetic stimulation improved patient functional status ( P = 0.018); and microcurrent ( P = 0.001), repetitive transcranial magnetic stimulation ( P = 0.022), and no treatment ( P = 0.038) significantly improved mood after intervention. Surface under the cumulative ranking indicated that microcurrent was most likely to be the best for managing pain and mood (surface under the cumulative ranking: 70% and 100%, respectively); low-level laser therapy for pain and mood (80% and 70%, respectively); and repetitive transcranial magnetic stimulation for improving functional status and mood (80% and 70%, respectively).

Conclusion

This review found low to moderate quality evidence that microcurrent, laser therapy, and repetitive transcranial magnetic stimulation are the most effective electrophysical agents for improving at least one outcome in fibromyalgia.
Appreciating the experience of multiple sclerosis fatigue
Authors: Van Denend Toni , Gecht-Silver Maureen , Kish Jacqueline , Plow Matthew , Preissner Katharine
Published: April 2023

Introduction:

Fatigue is one of the most common symptoms experienced by people with multiple sclerosis (MS) and can have a significant negative impact on participation in valued roles and activities. Understanding and supporting the management of MS fatigue is a priority to promote participation in life roles. This study explored how participants with MS who were enrolled in a fatigue management randomized clinical trial describe and explain their fatigue experience using a secondary qualitative analysis of interventionists’ treatment notes.

Method:

Clinical documentation including the subjective and objective portions of 85 treatment notes were collected and analyzed using a qualitative research design with multiphase coding.

Results:

Four major themes were identified including Fatigue Nature, Struggle, and Responding to the Reality of Fatigue with an overarching identified theme of Impact on Participation. Under the major themes, subthemes (11 total) were also identified and provided nuanced detail into each theme.

Conclusion:

People with MS fatigue describe their experience in a variety of ways. Findings will support occupational therapy practitioners to enhance empathy, understanding, and collaboration when working with clients with MS fatigue.
Routing Optimization of Regional Flexible Transit Under the Mixed Demand Mode
Authors: Wang Siqing , Wang Jian , Hu Xiaowei , Dong Tingting , Niu Zhipeng
Published: April 2023

To meet trip demands and avoid transit capacity waste or shortages, this study investigates the routing optimization of flexible transit with time windows. We introduce the time penalty costs to accommodate the impacts of early and late vehicle arrivals on passengers’ satisfaction. A routing optimization model is developed to minimize the system operation costs and the costs incurred by passengers' time penalties. The problem is solved by a designed adaptive genetic algorithm that adopts an adaptive mutation strategy to dynamically adjust the mutation probability and mutation operator. The numerical experiments compare the results of the mixed demand model, in which vehicles can pick up and drop off passengers simultaneously, to those of the separate pick-up and delivery modes. Finally, a sensitive analysis is conducted to explore the impact of operational factors (vehicle speed, maximum one-way travel time, and weighting ratios between operating and penalty costs) on the system's performance (total costs, per capita mileage, and average seat occupancy rate). Our results confirm the advantages of the developed adaptive genetic algorithm over traditional ones with respect to the convergence speed and optimality gap. Moreover, the numerical results indicate that the mixed demand operation mode of transit reduces total costs by an average of 2.35% compared to separate pick-up and delivery modes. The results also reveal that an increase in the weights of the operating cost can reduce the total cost. The findings of this work can provide guidance to the operation of regional flexible transit.
A Profile of Positive and Negative Caregiving Experiences Among Canadian Older Adults: The Relevance of Demographic and Care Contexts
Authors: Lee Yeonjung , Bierman Alex
Published: April 2023

This study examines the predictors of burdens and benefits of informal caregiving to caregivers by examining how demographic characteristics and care contexts simultaneously predict separate scales of positive and negative caregiving experiences. The Caregiving, Aging, and Financial Experiences study is a national survey which examines a representative sample of 4010 Canadians between the ages of 65 and 85, including 1641 informal caregivers that are the focus of the current analysis. Seemingly unrelated regression analyses show that there are similarities as well as differences in predictors between the two caregiving experiences. More frequent involvement in caregiving is associated with greater negative caregiving experiences but those are not significant predictors for less positive caregiving experiences. This study demonstrates that there are some overlaps of determinants of the two caregiving experiences, and a few of them are distinct. Further studies should warrant to identify additional, unobserved factors explaining variance in positive caregiving experience.
Levels of Clara cell secretory protein and surfactant protein A in municipal solid waste management workers in Ibadan, Southwest Nigeria
Authors: Odewabi Adesina O , Ajibola Romoke S , Oritogun Kolawole S , Ekor Martins
Published: April 2023

Toxic pneumonitis and related respiratory symptoms are common among waste management workers (WMWs). Products of different cellular responses following exposure to toxic components of wastes can lead to the production of a variety of biomolecules. There is a growing recognition of the importance of biomarkers in risk assessment and a strong advocacy for their determination and use as indicators of health and safety. This study assessed the prevalence of respiratory symptoms and the relevance of pulmonary surfactant protein A (SP-A) and Clara cell 16 protein (CC16) as indicators of occupational inhalation exposure to toxic substances and irritants in WMW. A total of 172 subjects consisting of 112 WMWs and 60 Non-WMWs were recruited by purposive sampling. Data on socio-economic and work-related symptoms were collected using structured questionnaire. CC16 and SP-A were determined by ELISA in serum samples. Clinical history reveals a slightly higher prevalence of respiratory symptoms in WMWs relative to control subjects. Increased permeability of the lung–blood barrier, characterized by significant elevation of serum SP-A and serum CC16, was associated with respiratory symptoms in WMWs. Steady increases in SP-A and CC16, respectively, in relation to occupational duration were observed in WMWs relative to control. Receiver operating characteristic curve and multivariate analyses revealed SP-A and CC16 as important lung biomarkers for assessing sub-clinical effects of occupational exposure. Our data suggest SP-A and CC16 may be relevant indicators for assessing occupational inhalation exposure to toxic substances and irritants among WMWs.
The Gut Microbiome and Mental Health
Authors: Wilson Debra Rose , Binford Leslie , Hickson Shondell
Published: April 2023

The gut microbiome has been well researched in the past few years and may be a target for treating mental illness. Trillions of bacteria in the digestive system work with the brain, immune function, and endocrine pathways. This gut microbiome ecosystem mediates the interaction between the human being and the environment making its inclusion in holistic nursing essential. Changes in normal balance of the gut microbiome occur with diet, antibiotics and other medications, stress, cancer treatment, geography and environment, and current illnesses. When the microbiome is challenged a “dysbiotic” state leads to inadequate production of needed neurotransmitters such as serotonin and dopamine. Research has shown links between the dysbiosis, and the inflammatory response system that are known to contribute to depression, anxiety, and schizophrenia. Understanding the role of the gut microbiome can be beneficial to holistic nurses, providing a new tool to prevent, treat, or reduce symptoms of mental illness and improve general immune function. This innocuous holistic approach to mental wellness is becoming an important evidenced-based approach.
Surface topography of cylindrical precision grinding based on multi-source information fusion
Authors: Hu Lai , Zhang Hua , Zha Jun , Chen Yaolong
Published: April 2023

In this study, spindle precision bearings and rotary vector (RV) reducer thin-walled bearings were taken as research objects. Based on the analysis of the metamorphic layer of bearings, the multidimensional research on the surface topography of parts by multisource information fusion (grinding force, grinding temperature, grinding strain, grinding vibration, and grinding acoustic emission (AE)) was put forward. The research shows that there are “dark layers” in the outer ring and inner ring of spindle precision bearings, and “white layers” and “dark layers” in the outer ring and inner ring of RV reducer thin-walled bearings. Feed speed has the greatest influence on grinding force, wheel speed, and grinding depth have the greatest influence on grinding temperature, wheel speed has the greatest influence on grinding strain, feed speed, and wheel speed have the greatest influence on grinding vibration, and workpiece speed has the greatest influence on grinding AE. When the grinding force is minimum ( x-axis: 1.3 N, y-axis: 0.9 N); the grinding temperature is highest (110.8°C), the grinding strain is maximum (46.6%), the grinding vibration is maximum (vibration range: 400 m/s2–400 m/s2) and the grinding AE is maximum (variation range: 2 V–1 V), the surface topography is most prominent (Ra: 0.97 μm). Grinding wheel speed and grinding depth have the greatest influence on surface topography, followed by feed speed, while workpiece speed has less influence.
Serious Games in Entrepreneurship Education: A Learner Satisfaction and Theory of Planned Behaviour Approaches
Authors: Martins Izaias , Perez Juan Pablo P. , Osorio Diana , Mesa Jorge
Published: April 2023

This study aimed to understand whether serious games in entrepreneurship education can improve the antecedents and entrepreneurial intention. Serious games are defined as tools designed to educate or train through entertainment, and providing environments that facilitate deeper learning. A pre-test, post-test quasi-experimental design was used by considering 963 undergraduate students. This study adopted analysis techniques such as one-way repeated measures analysis of variance, two-sample t-test and structural equation modelling to test the hypotheses. The findings show that students in the treatment group increased their attitudes, perceived control, and overall entrepreneurial intention compared to the control group. Equally important is highlighting the positive relationship between learner satisfaction using serious games and the antecedents of entrepreneurial intention in the treatment group. These findings provide insights into the discussions that remain open about the effects of entrepreneurship education on the intention by revealing the impact of specific benefits for students derived from serious games in the course. The study also has broader implications for the theory and practice of teaching entrepreneurship.
Self and Reality: An Upaniṣadic View
Authors: Raj Puja
Published: April 2023

Among 108 Upaniṣads, the central theme of the true knowledge of Self is consistent. The wholesome philosophy of Upaniṣad is focused towards the enlightenment or proliferation of mind through the knowledge of Self as the source which is both Constitutive as well as Regulative source. According to Upaniṣadic view, only when we understand and realize the true nature of self, we can understand the concept of reality. In this article, I would concentrate on the idea of Self and Reality from the perspective of Bṛhadāraṇyaka Upaniṣad, which portrays that the manifestation of the universe is done out of self, which is identical with the ultimate reality Brahman, through consciousness. Moreover, with the reference to Bṛhadāraṇyaka Upaniṣad, I would make an attempt to highlight the nature of Self, methodologies to understand the Self, the ground of this empirical reality with diversity, and the ungendered Self.
Electro-structural modeling of smart laminated composite plate under hygrothermal environment for optimum vibration energy harvesting
Authors: Panda Subhransu Kumar , Srinivas Jonnalagadda
Published: April 2023

Smart laminated composite structures with piezoelectric patches are widely used in vibration control applications in several engineering fields. Precise mathematical models are required for the coupling of base structural and piezoelectric field variables. This paper presents the electro-structural analysis and optimization studies of piezoelectric energy harvester with laminated composite substrate plate subjected to base excitations. The coupled electro-mechanical equations are derived from recently proposed first-order shear deformation theory via the Hamilton’s principle by considering hygrothermal effects. The coupled-field solution is obtained from Ritz-approximation and validated with three-dimensional finite element analysis. Effects of multiple piezoelectric patch topologies over the plate surface on the open-circuit voltage and displacement response are illustrated. Furthermore, the influences of piezoelectric-patch sizes, ply-orientation, size, and location of the tip mass are initially studied on the magnitude of output power and efficiency. An optimization study is conducted to identify the geometric and material variables for improvement of the harvester power output and efficiency.
Assessment of Depression in Adults and Youth
Authors: Klein Daniel N.
Published: April 2023

This article selectively reviews the key issues and measures for the assessment of depressive disorders and symptoms in youth and adults. The first portion of the article addresses the nature and conceptualization of depression and some key issues that must be considered in its assessment. Next, the diagnostic interview and clinician- and self-administered rating scales that are most widely used to diagnose, screen for, and assess the severity of depression in adults and youth are selectively reviewed. In addition, the assessment of three transdiagnostic clinical features (anhedonia, irritability, and suicidality) that are frequently associated with both depression and other forms of psychopathology is discussed. The article concludes with some broad recommendations for assessing depression in research and clinical practice and suggestions for future research.
Early Bird Gets the Worm: The Use of the Self-Directed IEP at the Middle School Level for Students with EBD
Authors: Balint-Langel Kinga , Troughton Leonard , Nation Ryan , Qureshi Afzal
Published: April 2023

Students with emotional and behavioral disorders (EBD) may benefit from specific instruction on ways to prepare for and participate in their own Individualized Education Program (IEP) meetings. In this article, we describe the application of a research-based self-directed IEP process that can be used by educators to effectively foster participation by students with EBD in their IEP meetings. Research support, a detailed overview, and guidelines on how educators can implement this research-based practice at the middle school level are included. Furthermore, we discuss the importance of implementing research- or evidence-based practices in the daily instructional programming of students with EBD in middle school.
Standard-Intensity Versus Low-Intensity Anticoagulation with Warfarin in Asian Patients with Atrial Fibrillation: A Multi-Center, Randomized Controlled Trial
Authors: Cho Jeong Gwan , Lee Ki Hong , Kim Yoo Ri , Kim Sunah , Gwak Jisoo , Cho Eunbit , Sin Yourim , Shin Seung Yong , Park Hyung Wook , Ko Jum Suk , Kim Nam Ho , Park Yae Min , Lee Jung Myung , Yoon Nam Sik , Kim Sung Soo , Kim Jun Hyung , Kim Dong Min
Published: April 2023

Anticoagulation with warfarin in Asian patients with atrial fibrillation (AF) often has been decreased as an international normalized ratio (INR) of prothrombin time 1.6-2.6 due to fear of bleeding, although universal criteria recommend an INR of 2.0-3.0. In this randomized, open-label trial, low-intensity anticoagulation (INR 1.6-2.6) was compared with standard-intensity anticoagulation (INR 2.0-3.0) with warfarin. A total 616 patients with AF and at least 1 risk factor for stroke were randomized to low-intensity anticoagulation (n = 308) and standard-intensity anticoagulation (n = 308) groups. The intention-to-treat analysis was performed to determine differences. The baseline characteristics of the two groups were comparable. New-onset stroke occurred in 2 patients (0.44% per year) in the low-intensity group and 5 patients (1.05% per year) in the standard-intensity group (HR 0.42, 95% CI 0.08-2.15). Major bleeding occurred in 4 patients (0.89% per year) in the low-intensity group and 5 patients (1.06% per year) in the standard-intensity group (HR 0.84, 95% CI 0.22-3.11). The rate of the net clinical outcome (composite of stroke, systemic embolism, major bleeding, and death) was 1.33% per year in the low-intensity group compared with 2.12% per year in the standard-intensity group (HR 0.63, 95% CI 0.23-1.72). In Asian patients with AF, clinical outcomes were not different between low-intensity and standard-intensity anticoagulation with warfarin.
Sensorless control of CuAlNi/KAPTON bimorph actuator
Authors: V Vetriselvi , K Dhanalakshmi , M Geetha , IA Palani
Published: April 2023

The recent development in smart material-based actuators are composite structures of thin film integrated SMA/PI bimorph in the view of actuator cum sensing in electromechanical systems for medical, robotics, and aerospace application. The purpose of the present work on integrated SMA/PI bimorph is to reveal their ability to perform as actuators and sensors and study on control characteristics for soft robotic, positioning, and valve applications. Vide this research paper, the SMA bimorph actuator [thin film SMA (CuAlNi)/polyimide (Kapton) bimorph] is used as actuator cum sensor for position control. Proposed a Proportional Derivative combined Variable Structure Controller (PD-VSC) to control the displacement by Joule heating actuation in two ways, which are sensor-based control and self-sensing control. From the control characteristics in from of tracking and disturbance rejection, it is concluded that the integrated CuAlNi/Kapton bimorph can be successfully implemented for soft robotic, positioning, and valve applications.
DNA methyltransferase expression (DNMT1, DNMT3a and DNMT3b) as a potential biomarker for anti-VEGF diabetic macular edema response
Authors: Camacho Pedro , Ribeiro Edna , Pereira Bruno , Varandas Teresa , Nascimento João , Henriques José , Dutra-Medeiros Marco , Delgadinho Mariana , Oliveira Ketlyn , Silva Carina , Brito Miguel
Published: April 2023

Purpose

DNA methylation is involved in Diabetic Retinopathy progression showing a metabolic memory mechanism. However, the association of DNA methyltransferase with diabetic macular edema is still unknown. We aimed to describe the differences in DNA methyltransferase gene expression in patients with different diabetic macular edema responses.

Methods

A total of 27 diabetic patients, aged 59–90 years, were prospectively enrolled in this cross-sectional study. The participants were classified into control group (CG, n = 11), diabetic macular edema responders (rDME, n = 9) and non-responder diabetic macular edema (nrDME, n = 7) after anti-vascular endothelial growth factor (anti-VEGF) treatment. Only cases with a complete ophthalmological examination, digital 133° color fundus, and SD-OCT assessments were used. After RNA extraction and first-strand cDNA synthesis, quantitative real-time PCR was performed with specific primers on the CFX Connect™ Real-Time PCR Detection System to assess differential transcriptional expression patterns.

Results

The DNMT1 gene showed a positive correlation (r = 0.617; p = 0.043) with Best Corrected Visual Acuity (BCVA) in CG, a positive correlation (r = 0.917; p = 0.010) with HbA1c in nrDME and a negative correlation (r = −0.659; p = 0.049) with GCL-IPL thickness in rDME. DNMT3A gene showed a positive correlation (r = −0.890; p = 0.001) with Sub-foveal Choroidal thickness in rDME whereas DNMT3b gene showed a negative correlation (r = −0.815; p = 0.007) with HbA1c and RNFL (r = −0.664; p = 0.026) in CG.

Conclusions

Patients with similar metabolic profile risk factors showed associated DNA methyltransferase transcriptional expression patterns differences fitting with the anti-VEGF diabetic macular edema response. Further studies are needed to clarify if these results (1) reflect disease evolution, (2) translate the therapeutic impact, (3) or can help to predict the therapeutic resistance profile.
E-Smoking out the Facts: The Philippines’ Vaping Dilemma
Authors: Sese Lance Vincent C. , Guillermo Ma. Celina L.
Published: April 2023

The Commercial Determinants of Health (CDH) have a major impact on the health of a country's population. The marketing and promotion of products and services by corporations, especially multinational businesses, can significantly impact individuals and communities, both positively and negatively. The vaping epidemic in the Philippines is an example of how commercial influences and government policies, in the context of disinformation, can exacerbate public health issues. The Philippines is facing a rising use of electronic nicotine delivery systems (ENDS) among youth. We conducted a literature review in PubMed and Google Scholar to examine the state of vaping in the Philippines and the lack of research on the health implications of the growing e-cigarette industry. We also discussed the vape bill which lapsed into law – Republic Act 11900, which regulates e-cigarettes and transfers the regulatory power from the Department of Health to the Department of Trade and Industry. We outlined a call to action on three fronts: tailoring national policies, funding research, and improving health education in the youth. Policymakers must prioritize public health gains over economic benefits and consider the impact of their decisions on future generations' health choices.
Correlation of NNMT and DKK1 Protein Expression With Clinicopathological Characteristics and Prognosis of Breast Cancer
Authors: Liang Tairong , Wu Xiuqian , Wang Lan , Song Tiantian , Wu Peishan , Niu Yongdong , Huang Haihua
Published: April 2023

Background:

Nicotinamide N-methyltransferase (NNMT) and Dickkopf-1 (DKK1) play an important role in the development of breast cancer, and the purpose of this study was designed to examine the clinical and prognostic significance of NNMT and DKK1 in breast cancer.

Methods:

The GEPIA2 database was used to evaluate the expression and survival of NNMT mRNA and DKK1 mRNA of breast cancer. Then an immunohistochemical study was carried out on 374 cases of breast tissue to identify the protein expression and significance of NNMT and DKK1. Next, the prognostic significance of DKK1 in breast cancer was explored by COX and Kaplan-Meier models.

Results:

Protein NNMT expression was correlated with lymph node metastasis and histological grade ( P < .05) while protein DKK1 expression was related to tumor size, pT stage, histological grade, and Ki-67 ( P < .05). Protein DKK1 was related to disease-specific survival (DSS), and low DKK1 expression indicated a poor prognosis of breast cancer patients ( P < .05). Combined expression of protein NNMT and protein DKK1 predicted different prognosis of DSS ( P < .05).

Conclusions:

Nicotinamide N-methyltransferase and DKK1 were linked to breast cancer malignancy and invasion. Breast cancer patients with low DKK1 expression had a worse prognosis. Oncotypes of NNMT and DKK1 expression predicted patient outcomes.
Young women’s sexual agency, relationality, and vulnerability: The Israeli case study of “attacking”
Authors: Levi Herz Rachel , Rozmarin Miri
Published: April 2023

The sexual agency of young women is constructed within various discourses that articulate multiple and conflicting social imperatives, such that they need to account for their sexual and social vulnerability while expressing their sexuality. This paper uses a common Israeli heteronormative youth practice called “attacking” to analyze young women’s sexual agency. Drawing on in-depth interviews with 39 young women aged 18–23, it explores how young women express their sexual agency while managing their vulnerability. Analyzed using a theory of vulnerability, our findings point to unique forms of relational agency that support young women’s subjective sexual expressions. The findings highlight the duality and ambiguities that young women face in spaces of “attacking,” showing how their agency is supported relationally by emerging alliances based on joint vulnerability. Based on these findings, this paper challenges the dichotomy between social forces and agency and establishes a conceptualization of relational agency with regard to young women’s sexuality.
The everyday advocacy work of the baby room leader
Authors: Sakr Mona
Published: April 2023

There is a growing body of literature on leadership and leadership development across the early years sector. Early years leadership research has so far tended to focus on positional leadership demonstrated by setting managers or preschool room leaders. There is a notable gap in the understanding of the role of the baby room leader, leading practice for children from birth to two, and how leadership can be developed in this specific context. Drawing on a design workshop with baby room leaders and nursery managers, as well as five follow-up semi-structured interviews with baby room leaders, this article offers an insight into the role of the baby room leader, with a particular focus on everyday advocacy. It presents four advocacy themes in baby room leadership: (1) highlighting and understanding the impact of baby room practice; (2) sharing a passion for working with babies; (3) advocating professional development specific to the baby room; and (4) challenging the discourses and stereotypes surrounding those who work in the baby room. These themes represent both current realities in baby room leadership and opportunities for future development and mobilisation.
Voronoi treemap in Manhattan distance and Chebyshev distance
Authors: Wang Yan Chao , Xing Yidan , Zhang Jie
Published: April 2023

The ordinary Voronoi treemap generated based on the Euclidean distance function has the flexibility to slightly adjust the layout when visualizing time-varying hierarchical data for better visual quality, preserving neighborhood relationships, and preserving a stable layout. However, its layout formed by segments with arbitrary orientations has poor shape stability between successive layouts at different time indexes, which is not conducive for the users to understand the plot and track the same node. In this paper, we propose novel Voronoi treemaps in Manhattan distance and Chebyshev distance respectively, such that the segments in the new layouts only have four orientations (horizontal, vertical, and ±45° to the [Formula: see text]-axis). The new layouts can not only heritage the abilities of ordinary Voronoi treemap, but preserve good shape stability. To achieve this, we first focus on the weighted bisector between two sites in Manhattan distance and design a bisector generation method for different weight values of two sites, as the bisector is the foundation to form a diagram. Then a divide-and-conquer method is utilized to form the bisectors into a Voronoi diagram, and a Voronoi treemap layout can be finally obtained by using Lloyd’s method to iteratively adjust the diagram. Moreover, we prove that the treemap algorithm in Manhattan distance can be adjusted to also generate the Voronoi treemap in Chebyshev distance via linear transformation, avoiding designing additional algorithm. The computational properties of the proposed methods are first evaluated to check whether the layouts can be generated fast and accurately. Then the perceptual properties are evaluated quantitatively and qualitatively based on quality metrics and user studies, respectively. The results demonstrate that the proposed Voronoi treemaps preserve similar layout stability, but better visual quality and shape stability than the ordinary Voronoi treemap. Our algorithms are simple and resolution-independent, but also provide alternatives to the Voronoi treemaps.
Digitization of the Greenland Vascular Plant Herbarium as a Unique Research Infrastructure to Study Arctic Climate Change and Inform Nature Management
Authors: Iwanycki Ahlstrand Natalie
Published: April 2023

The Greenland Vascular Plant Herbarium at the Natural History Museum of Denmark represents the largest collection of botanical specimens from Greenland and includes some of the oldest known specimens collected in the Arctic, as well as voucher specimens collected over time from important botanical expeditions. High-resolution digital images for all specimens in this collection have recently been obtained and accompanying specimen label data have been transcribed. Digitizing this invaluable botanical collection from Greenland allows us to make nearly 170,000 Arctic plant specimens available online to researchers, amateur botanists, nature managers and advisers, as well as the general public. Improved access to this museum collection will facilitate global change research and nature management in Greenland’s rapidly changing Arctic environment and will help promote the value of digitizing Arctic specimens maintained in natural history collections worldwide. Current and potential applications of Arctic herbarium material in climate change studies, and the biases and limitations of such herbarium material for these studies are discussed.
Energy-and-perception-aware planning and navigation framework for unmanned aerial vehicles
Authors: Takemura Reiya , Aoki Nobuaki , Ishigami Genya
Published: April 2023

This paper presents an energy and perception aware framework for path planning and navigation of unmanned aerial vehicles (UAVs) in GNSS-denied and spatiotemporal wind environments. The proposed framework mainly consists of the global and local path planning methods that respectively consider the energy consumption of an UAV and perception quality of a light detection and ranging (LiDAR) sensor mounted on the UAV. The energy consumption is estimated based on the aerodynamic model that calculates drag and lift forces on the UAV. The global planner then uses the total energy consumption in the spatiotemporal wind as the cost function to find an energy-efficient path as a set of waypoints. The local path planning navigates the UAV between the waypoints with maintaining the perception quality. The perception quality is quantified based on how well the LiDAR sensor scans feature points around the UAV that highly correlates with the navigation accuracy. Numerical simulation study for each of the global and local path planners validates their usefulness. Further, the overall framework is entirely verified in a long-range flight scenario of the photorealistic environments developed in the Gazebo simulation.
Year One of the Biden Administration: U.S. Foreign Policy Towards Russia
Authors: Sokolshchik Lev M.
Published: April 2023

The article provides an analysis of Russia’s role and place in President Biden’s U.S. foreign policy aims. Particularly, this paper explores clashing world order visions, issues pertaining to national sovereignty, post-Soviet space development, sanction policies, climate change issues, and global security. The following research reveals that the rivalry between the United States and Russia influences the system of international relations, because both parties promote substantially different concepts of the future world order. The Biden administration was unwilling to make the necessary concessions to accommodate Russia because 1) there is a huge gulf between the two country’s world views that even makes negotiations between the two almost impossible, and 2) because it does not take Russia seriously and views it as a declining power. As a result, the two sides were unable to come to some kind of negotiated agreement that would have addressed Russia’s concerns including the Ukraine issue. Instead, deterring Russia has become a priority for U.S. foreign policy in critical areas such as national sovereignty, the democratic development of post-Soviet countries, Russian-related human rights issues, and U.S. sanction policies against Russia. Comparing Trump’s presidency to the Biden administration’s first year in office, Biden has championed a more pragmatic narrative towards Russia. Most evidently, this is manifested in problems concerning universal global challenges such as strategic stability, cyber-security, and even aspects of climate change. Nevertheless, the possibility of concluding any serious negotiations between the parties on new world order parameters seems less realistic today than ever before.