bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining ecosystem (dis-)services on liver fluke infection in rural Northeast Thailand
Authors: Wang Yi-Chen , Law Andrea , Namsanor Jutamas , Sithithaworn Paiboon
Published: April 2023

Background

The direct reliance of humans on and their interactions with freshwater ecosystems in the Lower Mekong Basin have given rise to parasitic infections, which is particularly prevalent in Northeast Thailand where raw fish consumption is practiced. This study examined the interactions between environments, ecosystem (dis-)services, human raw fish consumption habits, and raw fish dish sharing on liver fluke infection risk.

Method

Water fecal contents and the first intermediate snail host were sampled between June and September of 2019. One hundred twenty questionnaires were surveyed in two villages of different environmental surroundings, one next to a river and the other located inland, in Northeast Thailand. Multivariate regression analyses using linear mixed effect models assessed the influence of social, behavioral and perceptual factors on raw fish consumption frequency, willingness to avoid consumption and liver fluke infection status. Social network analysis compared the degree of raw fish dish sharing between the villages and assessed the probable influence of connections to fish procurement locations and sharing activities on liver fluke infection risk.

Results

High abundance of the first intermediate snail host and presence of fecal contamination in water could endanger both villages to ecosystem disservices of parasitic transmission. The river-side village relied more on provisioning ecosystem services than the inland village (29.7% vs. 16.1% of villages) to consume raw fish as their main source of protein. Males in both villages (64.5 and 40.4 days/year for the respective villages) are also likely to consume koi pla and pla som, higher risk fish dishes, more frequently than females (4.1 and 4.3 days/year for the respective villages). The consumption habits of both villages were driven mostly by deriving cultural ecosystem services. Participation in raw fish dish sharing activities significantly reduced the odds of an individual being willing to avoid the consumption (Odds ratio = 0.19). Network analysis suggested that river-side villagers had a more direct raw fish dish sharing interaction and they procured fish from multiple locations; these characteristics might potentially account for more liver fluke infected households in the village.

Conclusion

Villagers’ raw fish consumption is driven by deriving cultural ecosystem services, and the geographic settings of the villages potentially affect villagers’ fish procurement locations and infection risk. The findings underscore the linkages between villagers and their surrounding ecosystem environments as pertinent determinants for foodborne parasitic disease risk.

Graphical Abstract
AI literacy in K-12: a systematic literature review
Authors: Casal-Otero Lorena , Catala Alejandro , Fernández-Morante Carmen , Taboada Maria , Cebreiro Beatriz , Barro Senén
Published: April 2023

The successful irruption of AI-based technology in our daily lives has led to a growing educational, social, and political interest in training citizens in AI. Education systems now need to train students at the K-12 level to live in a society where they must interact with AI. Thus, AI literacy is a pedagogical and cognitive challenge at the K-12 level. This study aimed to understand how AI is being integrated into K-12 education worldwide. We conducted a search process following the systematic literature review method using Scopus. 179 documents were reviewed, and two broad groups of AI literacy approaches were identified, namely learning experience and theoretical perspective. The first group covered experiences in learning technical, conceptual and applied skills in a particular domain of interest. The second group revealed that significant efforts are being made to design models that frame AI literacy proposals. There were hardly any experiences that assessed whether students understood AI concepts after the learning experience. Little attention has been paid to the undesirable consequences of an indiscriminate and insufficiently thought-out application of AI. A competency framework is required to guide the didactic proposals designed by educational institutions and define a curriculum reflecting the sequence and academic continuity, which should be modular, personalized and adjusted to the conditions of the schools. Finally, AI literacy can be leveraged to enhance the learning of disciplinary core subjects by integrating AI into the teaching process of those subjects, provided the curriculum is co-designed with teachers.
A multi-energy inertia-based power support strategy with gas network constraints
Authors: Miao Cairan , Wang Qi , Tang Yi
Published: April 2023

An integrated energy system with multiple types of energy can support power shortages caused by the uncertainty of renewable energy. With full consideration of gas network constraints, this paper proposes a multi-energy inertia-based power support strategy. The definition and modelling of gas inertia are given first to demonstrate its ability to mitigate power fluctuations. Since partial utilization of gas inertia can influence overall gas network parameters, the gas network is modelled with an analysis of network dynamic changes. A multi-energy inertia-based power support model and strategy are then proposed for fully using gas-thermal inertia resources in integrated energy systems. The influence of gas network constraints on strategy, economy and power outputs is analyzed. Special circumstances where the gas network can be simplified are introduced. This improves the response speed and application value. The feasibility and effectiveness of the proposed strategy are assessed using a real scenario.
Safety and feasibility of a novel bi-directional portal vein access kit during transjugular intrahepatic portosystemic shunt creation
Authors: Kang Richard D. , Nezami Nariman , Park Peter , DePalma Anthony A. , Loya Mohammed F. , Mhaskar Rahul , Engel Chad , Zwiebel Bruce , Hoots Glenn , Shaikh Jamil
Published: April 2023

Background

Transjugular intrahepatic portosystemic shunt (TIPS) creation remains as one of the more technically challenging endovascular procedures. Portal vein access from the hepatic vein often requires multiple needle passes, which increases procedure times, risk of complications, and radiation exposure. With its bi-directional maneuverability, the Scorpion X access kit may be a promising tool for easier portal vein access. However, the clinical safety and feasibility of this access kit has yet to be determined.

Materials and methods

In this retrospective study, 17 patients (12 male, average age 56.6 ± 9.01) underwent TIPS procedure using Scorpion X portal vein access kits. The primary endpoint was time taken to access the portal vein from the hepatic vein. The most common indications for TIPS were refractory ascites (47.1%) and esophageal varices (17.6%). Radiation exposure, total number of needle passes, and intraoperative complications were recorded. Average MELD Score was 12.6 ± 3.39 (range: 8–20).

Results

Portal vein cannulation was successfully achieved in 100% of patients during intracardiac echocardiography-assisted TIPS creation. Total fluoroscopy time was 39.31 ± 17.97 min; average radiation dose was 1036.76 ± 644.15 mGy, while average contrast dose was 120.59 ± 56.87 mL. The average number of passes from the hepatic vein to the portal vein was 2 (range: 1–6). Average time to access the portal vein once the TIPS cannula was positioned in the hepatic vein was 30.65 ± 18.64 min. There were no intraoperative complications.

Conclusions

Clinical utilization of the Scorpion X bi-directional portal vein access kit is both safe and feasible. Utilizing this bi-directional access kit resulted in successful portal vein access with minimal intraoperative complications.

Level of evidence

Retrospective cohort.
Benefit From Fractionated Dose-Dense Chemotherapy in Patients With Poor Prognostic Ovarian Cancer: ICON-8 Trial
Authors: Colomban Olivier , Clamp Andrew , Cook Adrian , McNeish Iain A. , You Benoit
Published: April 2023

PURPOSE

An international meta-analysis identified a group of patients with advanced epithelial ovarian cancer (EOC) with a very poor survival because of two unfavorable features: (1) a poor chemosensitivity defined by an unfavorable modeled CA-125 ELIMination rate constant K (KELIM) score <1.0 with the online calculator CA-125—Biomarker Kinetics, and (2) an incomplete debulking surgery. We assumed that patients belonging to this poor prognostic group would benefit from a fractionated densified chemotherapy regimen.

METHODS

The data set of ICON-8 phase III trial (ClinicalTrials.gov identifier: NCT01654146 ), where patients with EOC were treated with the standard three-weekly, or the weekly dose-dense, carboplatin-paclitaxel regimens and debulking primary surgery (immediate primary surgery [IPS] or delayed primary [or interval] surgery [DPS]), was investigated. The association between treatment arm efficacy, standardized KELIM (scored as favorable ≥1.0, or unfavorable <1.0), and surgery completeness was assessed by univariate/multivariate analyses in IPS and DPS cohorts.

RESULTS

Of 1,566 enrolled patients, KELIM was calculated with the online model in 1,334 with ≥3 CA-125 available values (85%). As previously reported, both KELIM and surgery completeness were complementary prognostic covariates, and could be combined into three prognostic groups with large OS differences: (1) good if favorable KELIM and complete surgery; (2) intermediate if either unfavorable KELIM or incomplete surgery; and (3) poor if unfavorable KELIM and incomplete surgery. Weekly dose-dense chemotherapy was associated with PFS/OS improvement in the poor prognostic group in both the IPS cohort (PFS: hazard ratio [HR], 0.50; 95% CI, 0.31 to 0.79; OS: HR, 0.58; 95% CI, 0.35 to 0.95) and the DPS cohort (PFS: HR, 0.53; 95% CI, 0.37 to 0.76; OS: HR, 0.57; 95% CI, 0.39 to 0.82).

CONCLUSION

Fractionated dose-dense chemotherapy might be beneficial for patients belonging to the poor prognostic group characterized by lower tumor chemosensitivity assessed with the online calculator CA-125—Biomarker Kinetics and incomplete debulking surgery. Further investigation in the future SALVOVAR trial is warranted.
Safety Monitoring Activity During EGFR or Anaplastic Lymphoma Kinase Inhibitor Therapy for Patients With Lung Cancer
Authors: Singh Avani M. , Rubiera-Pebe Rafael , Ahmad Yaser , Shafique Michael , Hicks J. Kevin , Tanvetyanon Tawee
Published: April 2023

Epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) are highly effective for treatment of EGFR- or ALK-mutated lung cancer. Nevertheless, they are associated with several unique toxicities. Although the available US Food and Drug Administration (FDA)–approved drug label can provide guidance for safety monitoring, its integration into clinical practice has not been previously described. We studied the conduct of safety monitoring activity (SMA) at a large academic institution. On the basis of FDA-approved drug labels, two drug-specific SMAs were identified for osimertinib, crizotinib, alectinib, or lorlatinib. Electronic medical records of patients initiated on these drugs from 2017 to 2021 were retrospectively reviewed. Each course of treatment was evaluated for the occurrence of SMAs and the corresponding adverse events. Analyses included 130 treatment courses from 111 unique patients. For each SMA evaluated, the prevalence of SMA conduct ranged from 10.0% to 84.6%. The most frequently conducted SMA was ECG for lorlatinib therapy and the least was creatine phosphokinase analysis for alectinib. We observed none of the assessed SMAs being conducted in 41 treatment courses (31.5%). EGFR inhibitor predicted a higher likelihood of both SMAs being conducted than ALK inhibitors ( P = .02). Serious, grade 3 or 4 adverse events were observed in 21 treatment courses (16.2%), including one grade 4 transaminitis related to alectinib. On the basis of our experience, the conduct of SMA was more challenging to implement for ALK inhibitor than for EGFR inhibitor. Clinicians should be vigilant and review the FDA-approved drug label before prescribing.
Transnasal Videoendoscopy for Preoperative Airway Risk Stratification: Development and Validation of a Multivariable Risk Prediction Model
Authors: Barclay-Steuart Alexander , Großhennig Hanna L. , Sasu Phillip , Wünsch Viktor A. , Stadlhofer Rupert , Berger Joanna , Stark Maria , Sehner Susanne , Zöllner Christian , Petzoldt Martin
Published: April 2023

BACKGROUND:

Transnasal flexible videoendoscopy (TVE) of the larynx is a standard of care for the detection and staging of pharyngolaryngeal lesions in otorhinolaryngology. Patients frequently present with existing TVE examinations before anesthesia. Although these patients are considered high risk, the diagnostic value of TVE for airway risk stratification is currently unknown. How can captured images or videos be used for anesthesia planning, and which lesions are most concerning? This study aimed to develop and validate a multivariable risk prediction model for difficult airway management based on TVE findings and to determine whether the discrimination of the Mallampati score can be improved by adding this new TVE model.

METHODS:

This retrospective single-center development and validation study assessed 4021 patients who underwent 4524 otorhinolaryngologic surgeries at the University Medical Centre Hamburg-Eppendorf between January 1, 2011, and April 30, 2018, with electronically stored TVE videos and included 1099 patients who underwent 1231 surgeries. TVE videos and anesthesia charts were systematically reviewed in a blinded fashion. The Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis was used for variable selection, model development, and cross validation.

RESULTS:

The prevalence of difficult airway management was 24.7% (304/1231). Lesions at the vocal cords, epiglottis, or hypopharynx were not selected by the LASSO regression, while lesions at the vestibular folds (ß-coefficient 0.123), supraglottic region (ß-coefficient 0.161), arytenoids (ß-coefficient 0.063), and viewing restrictions on the rima glottidis that cover ≥50% of the glottis area (ß-coefficient 0.485) and pharyngeal secretion retention (ß-coefficient 0.372) were relevant risk factors for difficult airway management. The model was adjusted for sex, age, and body mass index. The area under the receiver operating characteristic curve (95% confidence interval) of the Mallampati score was 0.61 (0.57–0.65) and 0.74 (0.71–0.78) of the TVE model combined with Mallampati (P < .001).

CONCLUSIONS:

Stored images and videos from TVE examinations can be reused for the purpose of predicting risk associated with airway management. Vestibular fold, supraglottic, and arytenoid lesions are most concerning, especially if they are accompanied by secretion retention or restrict the glottic view. Our data indicate that the TVE model improves discrimination of the Mallampati score and might, therefore, be a useful addition to traditional bedside airway risk examinations.
Chasing the cheetah: how field biomechanics has evolved to keep up with the fastest land animal
Authors: Shield Stacey , Muramatsu Naoya , Da Silva Zico , Patel Amir
Published: April 2023

Studying the motion of cheetahs – especially in the wild – is a technically challenging endeavour that pushes the limits of field biomechanics methodology. Consequently, it provides an interesting example of the scientific symbiosis that exists between experimental biology and the technological disciplines that support it. This article uses cheetah motion research as a basis to review the past, present and likely future of field biomechanics. Although the focus is on a specific animal, the methods and challenges discussed are broadly relevant to the study of terrestrial locomotion. We also highlight the external factors contributing to the evolution of this technology, including recent advancements in machine learning, and the influx of interest in cheetah biomechanics from the legged robotics community.
Challenging traditional understandings of leadership and followership through discourse
Authors: Σταυρίδου Αναστασία
Published: April 2023

Η μελέτη της ηγεσίας έχει απασψολήσει το επιστημονικό ενδιαφέρον για δεκαετίες και έχει μελετηθεί από ποικίλους κλάδους. Παρόλα αυτά, η ηγεσία παραμένει μία διφορούμενη έννοια. Απομακρυνόμενοι από προσεγγίσεις της έννοιας που βασίζονται στη θέση κάποιου, οι οποίες συνδέονται με άτομα σε ιεραρχικές θέσεις, η μελέτη αυτή διερευνά την άσκηση ηγεσίας και «ακολούθησης» (followership) σε μια ομάδα μπάσκετ πανεπιστημιακού επιπέδου του Ηνωμένου Βασιλείου χωρίς επίσημα διορισμένο προπονητή. Μέσω αυτής της μελέτης περίπτωσης, η ηγεσία και η «ακολούθηση» θεωρούνται ως «πρακτικές» (και όχι δεδομένα αξιώματα) που καθορίζονται μέσω του λόγου και της συνεργασίας των διαφόρων μελών της ομάδας, υπό την προϋπόθεση ότι οι πρακτικές αυτές συμβάλλουν στην επίτευξη των στόχων της ομάδας. Υιοθετώντας έναν εθνογραφικό σχεδιασμό και χρησιμοποιώντας ποιοτικές τεχνικές, η μελέτη αποκαλύπτει πώς οι έννοιες της ηγεσίας και ακολούθησης γίνονται «γλωσσικά» αντιληπτές κατά τη διάρκεια των time-out της ομάδας (δηλαδή, η διακοπή των 60 δευτερολέπτων στο παιχνίδι που επιτρέπει στους προπονητές να επικοινωνούν με την ομάδα). Τα δεδομένα, που περιλαμβάνουν περισσότερες από 110 ώρες βιντεοσκοπήσεων και 7 ημιδομημένες συνεντεύξεις, έχουν αναλυθεί χρησιμοποιώντας τις αρχές της Διαδραστικής Κοινωνιογλωσσολογίας (Interactional Sociolinguistics). Λαμβάνοντας ως σημείο αναφοράς προηγούμενες κριτικές προσεγγίσεις που αμφισβητούν παραδοσιακές προσεγγίσεις της έννοιας, αυτή η μελέτη αντικρούει τη διπολική σχέση ηγέτη-ακόλουθου που συνήθως συναντάται στην αθλητική βιβλιογραφία και καταλήγει στο συμπέρασμα ότι η ηγεσία και η «ακολούθηση» είναι διφορούμενες πρακτικές που πραγματοποιούνται μέσω του λόγου και σε πολλές περιπτώσεις ανεξάρτητα από τους ιεραρχικούς ρόλους. Ενώ οι παίκτες υιοθετούν ηγετικούς ρόλους, συχνά συμμετέχουν και σε δραστηριότητες «ακολούθησης», γεγονός που δείχνει ότι αυτές οι έννοιες είναι πολύπτυχες και συχνά αλληλοσυμπληρώνονται. Σε αντίθεση με τις ψυχολογικές μελέτες, η ακολούθηση νοείται ως μια λεκτική πρακτική παρά ως την αποδοχή της επιρροής ή της ηγεσίας των άλλων. Κατά συνέπεια, η μελέτη συμβάλλει σε συνεχείς θεωρητικές συζητήσεις σχετικά με την ηγεσία και την ακολούθηση, ενώ προσθέτει στο τρέχον, μάλλον περιορισμένο, κοινωνιογλωσσικό σώμα της βιβλιογραφίας σχετικά με την γλωσσική ηγεσία και ακολούθηση στον κόσμο του αθλητισμού.
Λογοτεχνική γεωγραφία
Authors: Μαργαρίτη Μαρία
Published: April 2023

Η Λογοτεχνική Γεωγραφία διαθέτει διάφορες μεθόδους προκειμένου να αναλύσει την αναπαράσταση του χώρου στη λογοτεχνία, όπως η Γεωκριτική μέθοδος, που στοχεύει στην ανάδειξη χωρικών σχέσεων και πτυχών του λογοτεχνικού έργου που δεν είναι τόσο εμφανείς κατά την ανάγνωση. Μια άλλη μέθοδος της Λογοτεχνικής Γεωγραφίας είναι η Λογοτεχνική Χαρτογραφία δηλαδή η κατασκευή χαρτών που απεικονίζουν τον αναπαριστάμενο χώρο εξετάζοντας τη σχέση μεταξύ πραγματικών και φανταστικών χώρων. Η παρούσα διδακτορική διατριβή αναφέρεται στο πεδίο της Λογοτεχνικής Γεωγραφίας, στο πλαίσιο της οποίας εφαρμόζεται η Γεωκριτική μέθοδος, όπως συστηματοποιήθηκε από τον Bertrand Westphal το 2007, και επιπλέον επιχειρείται μια χαρτογραφική απεικόνιση, σε δύο μυθιστορήματα του Στράτη Μυριβήλη, "Βασίλης ο Αρβανίτης" και "Παναγιά η Γοργόνα", οι πλοκές των οποίων τοποθετούνται στους οικισμούς, Μουριά και Σκάλα Μουριάς, στη Βόρεια Λέσβο.
Εκτίμηση δικτύου συνδεσιμότητας πολύπλοκων συστημάτων από χρονοσειρές υψηλής διάστασης
Authors: Φωτιάδης Ακύλας
Published: April 2023

Η παρούσα διδακτορική διατριβή πραγματεύεται την εκτίμηση του δικτύου συνδεσιμότητας από χρονοσειρές υψηλής διάστασης με εφαρμογές στον τομέα της χρηματοοικονομίας. Στο πρώτο και εισαγωγικό κεφάλαιο, γίνεται αναφορά στην ολοένα και αυξανόμενη παρουσία των χρονοσειρών στη σύγχρονη εποχή και σε μεθόδους ανάλυσης τους. Στο δεύτερο κεφάλαιο αναφέρονται βασικές έννοιες που αφορούν τα δυναμικά, αιτιοκρατικά και στοχαστικά συστήματα, ενώ στο τρίτο κεφάλαιο, παρουσιάζεται περιληπτικά ο τρόπος εφαρμογής της θεωρίας δικτύων στην ανάλυση πολυμεταβλητών χρονοσειρών. Στο τέταρτο κεφάλαιο, διερευνάται η εκτίμηση δικτύων αιτιότητας από χρονοσειρές υψηλής διάστασης με τη χρήση μη-γραμμικών μέτρων πληροφορίας, τα οποία στηρίζονται στην εκτίμηση της αιτιότητας κατά Granger, ενώ μελετάται και η επιρροή της πυκνότητας του δικτύου στη συμπεριφορά αυτών των μέτρων. Στο πέμπτο κεφάλαιο, παρουσιάζεται μια μεθοδολογία για την ανίχνευση ανάδυσης ή εξαφάνισης μη-γραμμικών αλληλεπιδράσεων σε πολύπλοκα συστήματα η οποία βασίζεται σε έναν κατάλληλο, στατιστικό έλεγχο υπόθεσης. Αναπτύσσεται επίσης ένας αλγόριθμος εντοπισμού δομικών αλλαγών σε πολύπλοκα συστήματα ο οποίος στηρίζεται στην εφαρμογή της προαναφερόμενης μεθοδολογίας σε χρονικά, κυλιόμενα παράθυρα. Στο έκτο κεφάλαιο και σε συνέχεια των προηγούμενων αποτελεσμάτων, προτείνονται βελτιώσεις για το μη-γραμμικό μέτρο εκτίμησης αιτιότητας κατά Granger της μερικής αμοιβαίας πληροφορίας από μικτή εμβύθιση οι οποίες στοχεύουν στη βελτίωση αδυναμιών του μέτρου που έχουν παρατηρηθεί σε παλιότερες μελέτες και αφορούν κυρίως περιπτώσεις ισχυρά στοχαστικών συστημάτων. Στο έβδομο κεφάλαιο αξιοποιείται η ανάλυση της κανονικής συσχέτισης, ο αλγόριθμος του Louvain από τη θεωρία δικτύων καθώς και ένας έλεγχος τυχαιοποίησης ώστε να εντοπιστούν κοινότητες σε πίνακες συσχέτισης από πολυμεταβλητές χρονοσειρές υψηλής διάστασης. Το όγδοο και τελευταίο κεφάλαιο ολοκληρώνει τη διατριβή συγκεντρώνοντας τα κυριότερα συμπεράσματά της.
Διερεύνηση της κρουστικής εκκένωσης κορώνα σε εναέριες γραμμές μεταφοράς
Authors: Μπούσιου Ευανθία
Published: April 2023

Σκοπό της παρούσας διατριβής αποτέλεσε η διερεύνηση της κρουστικής εκκένωσης κορώνα σε εναέριες γραμμές μεταφοράς. Αρχικά διερευνήθηκε η έναυση της εκκένωσης κορώνα κυλινδρικών αγωγών υπό συνθήκες συνεχούς ή βραδέως μεταβαλλόμενης ηλεκτρικής καταπόνησης. Εκτιμήθηκε το πεδίο έναυσης κορώνα τυπικών αγωγών εναέριων γραμμών μεταφοράς μέσω ενός θεωρητικού μοντέλου το οποίο ενσωματώνει κριτήρια έναυσης εκκένωσης κορώνα βασιζόμενα στην ανάπτυξη μιας κρίσιμης ηλεκτρονικής στιβάδας στην περιοχή ιονισμού γύρω από τον αγωγό. Αποσαφηνίστηκαν οι επιδράσεις της γεωμετρίας του αγωγού, της πολικότητα της τάσης καταπόνησης και των ατμοσφαιρικών συνθηκών στο πεδίο έναυσης της εκκένωσης και αναπτύχθηκε ένα εμπειρικό μοντέλο προσδιορισμού του, το οποίο αποτελεί εύχρηστο εργαλείο αξιολόγησης της δραστηριότητας κορώνα σε εναέριες γραμμές μεταφοράς καθώς και εκτίμησης του συντελεστή ανομοιομορφίας των αγωγών σε λειτουργία. Τα χαρακτηριστικά της εκκένωσης κορώνα υπό συνεχή ή βραδέως μεταβαλλόμενη ηλεκτρική καταπόνηση ωστόσο, δεν επεκτείνονται καθολικά στην περίπτωση της κρουστικής ηλεκτρικής καταπόνησης. Συνεπώς στη συνέχεια διερευνήθηκε συστηματικά η επίδραση της κατανομής του πεδίου, της κυματομορφής της υπέρτασης (πολικότητα, εύρος και κλίση του μετώπου) και των ατμοσφαιρικών συνθηκών στα βασικά χαρακτηριστικά έναυσης και ανάπτυξης της εκκένωσης κορώνα γύρω από κυλινδρικούς αγωγούς υπό συνθήκες κρουστικής καταπόνησης. Προσδιορίστηκαν οι διαφορετικές μορφές έναυσης της κρουστικής εκκένωσης κορώνα γύρω από κυλινδρικούς αγωγούς και αποσαφηνίστηκαν οι συνθήκες υπό τις οποίες η έναυση της κρουστικής κορώνα γίνεται με τη μορφή αίγλης, σποραδικών νηματίων ή ευσταθούς εκκένωσης νηματίου. Στο πλαίσιο της διατριβής διερευνήθηκαν μέσω συστηματικών πειραμάτων κλίμακας τα χαρακτηριστικά έναυσης και ανάπτυξης της κρουστικής εκκένωσης κορώνα. Στη βάση αυτών των πειραματικών αποτελεσμάτων καθώς και πειραματικών δεδομένων της διεθνούς βιβλιογραφίας αναπτύχθηκε μοντέλο εκτίμησης των βασικών χαρακτηριστικών έναυσης και ανάπτυξης της κρουστικής εκκένωσης κορώνα γύρω από κυλινδρικούς αγωγούς. Μέσω της εφαρμογής του προτεινόμενου μοντέλου, δείχθηκε η δυνατότητα εκτίμησης της εξασθένισης και παραμόρφωσης των οδευόντων κυμάτων υπέρτασης σε εναέριες γραμμές μεταφοράς ηλεκτρικής ενέργειας. Συνεπώς, η διατριβή συμβάλλει στην ακριβέστερη εκτίμηση των εισερχόμενων υπερτάσεων στους διασυνδεδεμένους υποσταθμούς και κατά συνέπεια στην ορθότερη διαστασιολόγηση των μονώσεων και των μέσων προστασίας έναντι υπερτάσεων, συνεισφέροντας σημαντικά στην πιο αξιόπιστη και οικονομική λειτουργία των συστημάτων ηλεκτρικής ενέργειας.
In vivo immunomodulatory effect and safety of MSC-derived secretome
Authors: Agung Nugrahaningsih Dwi Aris , Purwadi Purwadi , Sarifin Is , Bachtiar Indra , Sunarto Sunarto , Ubaidillah Ubaidillah , Larasati Ines , Satriyo Pamungkas Bagus , Setiasari Dicka Wahyu , Hasanah Maria Nur , At-thobari Jarir , Mubarika Sofia
Published: April 2023

Background: Secretomes have been gaining interest in treating several diseases due to their pharmaceutical effects, such as the immunomodulatory effect. This study aimed to determine the immunomodulatory effect of secretomes derived from human umbilical cord mesenchymal stem cells (MSCs) and their safety.

Methods: We conducted an in vivo immunomodulatory study using a carbon clearance assay. The safety of single-dose administration of secretome was done using fixed-dose methods of acute toxicity test.

Results: The phagocytic index was higher in mice treated with secretome than in untreated mice. The acute toxicity study also showed that the administration of secretome derived from human umbilical cord MSCs did not change the mice’s body weight, physical examination results, organ weight, and gross anatomy examination.

Conclusions: This study presents the potential of secretome derived from MSCs as a safe immunomodulatory agent.
WhatsApp as a medium to collect qualitative data among adolescents: lessons learned and considerations for future use
Authors: Singer Barbara , Walsh Caitlin M. , Gondwe Lucky , Reynolds Katie , Lawrence Emily , Kasiya Alinafe
Published: April 2023

To understand dynamics surrounding adolescents’ access to and use of contraception, perspectives of youth themselves must be considered. Methods of data collection leveraging technological solutions may provide avenues for increased anonymity for adolescents to share their experiences with contraception. With the use of WhatsApp and other smartphone-based messaging applications as platforms for qualitative methodologies, public health researchers may find increased access to adolescents through utilizing mediums that adolescents already engage with in their daily lives. This article describes the methodology of using WhatsApp for conducting focus group discussions with adolescents in Malawi, including lessons learned around data collection, data use, and data quality. In June 2018, VillageReach used WhatsApp to conduct focus group discussions (FGD) to collect qualitative data on contraceptive use from Malawian youth. WhatsApp FGD participants were male and female adolescents, aged 15-19 representing rural and urban populations across three geographic regions of Malawi (northern, central and southern). Youth researchers (YR), aged 22-25, were trained and facilitated fifteen WhatsApp FGDs, as in-person (12) and remote (3) sessions. WhatsApp FGDs consisted of a YR sharing fictitious but contextually realistic ASRH scenarios, and managing the virtual discussion with questions and probing. Youth indicated comfort using WhatsApp to express their opinions and experiences related to contraceptive use and preferences. Based on the data collected, the researchers felt that use of the technology may increase willingness to provide additional levels of information during anonymized WhatsApp FGDs vis à vis traditional, in-person FGDs. Using WhatsApp as a methodological tool to facilitate FGDs has practical implications for data collection, data quality, and data analysis. This paper reports lessons learned and advantages and disadvantages of using WhatsApp to conduct FGDs in a low-resource setting. It also calls for developing guidelines and an ethical code of conduct for future use of mobile applications in qualitative research.
MVMS: RNN based Pro-Active Resource Scaling in Cloud Environment
Authors: Thakkar Riddhi Sanjaykumar , Thakkar Dhyan , Bhavsar Madhuri
Published: April 2023

Cloud computing offers various services to its users, ranging from infrastructure, and system development environment, to software as a service over the internet. Having such promising services available over the internet consistently, it has become an ever-demanding facility. As a reliable services provider, a cloud service provider (CSP) needs to deliver its services seamlessly to users and is also required to optimally utilize the resources. Optimal resource utilization eliminates over and under-provisioning and improves the availability of cloud services. Therefore, it is a great need to have a model allowing CSP to systematize its resources to cater to customers' demands. Such a model should be computationally light and quick enough to produce effective results. In this work, a simple yet effective neural network-based resource prediction model named MVMS is proposed, which enables a CSP to predict the customer's resource demand in advance. The results show that compared to GRU, the proposed Multi-Variate Multi-Step (MVMS) model predicts the resources accurately. Thus, CSP can schedule the resources precisely and process real-time requests of users. Experiments on the bitbrains dataset indicate that the proposed MVMS resource prediction model is quick and accurate, with lower RMSE and MAE values.
Barriers to deprescribing proton pump inhibitors and how to overcome them
Authors: Field Rebecca , Field Hilary
Published: April 2023

Proton pump Inhibitors are one of the most commonly prescribed medications in the UK, and since the availability of over-the-counter proton pump Inhibitors, the true number of patients taking proton pump Inhibitors is unknown. With the boom in the number of proton pump Inhibitor prescriptions, increasing numbers are being prescribed outside of the recommended guidelines, most commonly beyond the advised course length. Like all medications, proton pump Inhibitors are not innocuous and have a range of side effects, therefore, clinicians need to consider deprescribing them. There are multiple barriers to deprescribing, so one of the roles of a gastrointestinal nurse is to consider these barriers and develop strategies as to how they can be overcome.
Study scope
Authors: Harrison Penny
Published: April 2023

A brief overview of recently published articles on endoscopy
Grow with the ESGENA
Authors: Donnelly Leigh
Published: April 2023

Leigh Donnelly discusses how ESGENA is expanding its membership and educational offerings to improve patient care and endoscopic practices in gastroenterology
The future of endoscopy training: a view from the North West of England
Authors: Haslam Neil , Collins Paul , Prendergast Jennifer , Murugesan Senthil , Makin Alistair
Published: April 2023

Health Education England has created seven endoscopy training academies across England. These will oversee the multidisciplinary training of all endoscopy staff on a regional basis to address the challenges of waiting times and recovery, which are often limited by human resources. This article outlines the North West vision for the future of endoscopy training and how it will impact on all staff, for the benefit of patients.
Single-shot multispectral quantitative phase imaging of biological samples using deep learning
Authors: Bhatt Sunil , Butola Ankit , Kumar Anand , Thapa Pramila , Joshi Akshay , Jadhav Suyog , Singh Neetu , Prasad Dilip K. , Agarwal Krishna , Mehta Dalip Singh
Published: April 2023

Multispectral quantitative phase imaging (MS-QPI) is a high-contrast label-free technique for morphological imaging of the specimens. The aim of the present study is to extract spectral dependent quantitative information in single-shot using a highly spatially sensitive digital holographic microscope assisted by a deep neural network. There are three different wavelengths used in our method: λ=532, 633, and 808 nm. The first step is to get the interferometric data for each wavelength. The acquired datasets are used to train a generative adversarial network to generate multispectral (MS) quantitative phase maps from a single input interferogram. The network was trained and validated on two different samples: the optical waveguide and MG63 osteosarcoma cells. Validation of the present approach is performed by comparing the predicted MS phase maps with numerically reconstructed (FT+TIE) phase maps and quantifying with different image quality assessment metrices.
High-quality color image restoration from a disturbed graded-index imaging system by deep neural networks
Authors: Hu Xuanyu , Duan Zaipeng , Yang Yang , Tan Yehong , Zhou Ruiqi , Xiao Jiong , Zeng Jinwei , Wang Jian
Published: April 2023

Imaging transmission plays an important role in endoscopic clinical diagnosis involved in modern medical treatment. However, image distortion due to various reasons has been a major obstacle to state-of-art endoscopic development. Here, as a preliminary study we demonstrate ultra-efficient recovery of exemplary 2D color images transmitted by a disturbed graded-index (GRIN) imaging system through the deep neural networks (DNNs). Indeed, the GRIN imaging system can preserve analog images through the GRIN waveguides with high quality, while the DNNs serve as an efficient tool for imaging distortion correction. Combining GRIN imaging systems and DNNs can greatly reduce the training process and achieve ideal imaging transmission. We consider imaging distortion under different realistic conditions and use both pix2pix and U-net type DNNs to restore the images, indicating the suitable network in each condition. This method can automatically cleanse the distorted images with superior robustness and accuracy, which can potentially be used in minimally invasive medical applications.
Chromatic aberration correction employing reinforcement learning
Authors: Schmidt Katharina , Guo Ning , Wang Wenjie , Czarske Juergen , Koukourakis Nektarios
Published: April 2023

In fluorescence microscopy a multitude of labels are used that bind to different structures of biological samples. These often require excitation at different wavelengths and lead to different emission wavelengths. The presence of different wavelengths can induce chromatic aberrations, both in the optical system and induced by the sample. These lead to a detuning of the optical system, as the focal positions shift in a wavelength dependent manner and finally to a decrease in the spatial resolution. We present the correction of chromatic aberrations by using an electrical tunable achromatic lens driven by reinforcement learning. The tunable achromatic lens consists of two lens chambers filled with different optical oils and sealed with deformable glass membranes. By deforming the membranes of both chambers in a targeted manner, the chromatic aberrations present in the system can be manipulated to tackle both systematic and sample induced aberrations. We demonstrate chromatic aberration correction of up to 2200 mm and shift of the focal spot positions of 4000 mm. For control of this non-linear system with four input voltages, several reinforcement learning agents are trained and compared. The experimental results show that the trained agent can correct system and sample induced aberration and thereby improve the imaging quality, this is demonstrated using biomedical samples. In this case human thyroid was used for demonstration.
Liquid crystal lens with a shiftable optical axis
Authors: Feng Wenbin , Liu Zhiqiang , Ye Mao
Published: April 2023

A liquid crystal (LC) lens with a laterally shiftable optical axis is proposed and demonstrated. The optical axis of the lens can be driven to shift within the lens aperture without compromising its optical properties. The lens is constructed by two glass substrates with identical interdigitated comb-type finger electrodes on the inner surfaces, and they are oriented at 90° with respect to each other. The distribution of voltage difference between two substrates is determined by eight driving voltages, and is controlled within the linear response region of LC materials, thereby generating a parabolic phase profile. In experiments, an LC lens with an LC layer of 50 µm and an aperture of 2 mm × 2 mm is prepared. The interference fringes and focused spots are recorded and analyzed. As a result, the optical axis can be driven to shift precisely in the lens aperture, and the lens maintains its focusing ability. The experimental results are consistent with the theoretical analysis, and good performance of the LC lens is demonstrated.
Optimized array nanostructure for plasmonically induced motion force generation
Authors: Balestrieri Sergio , Zito Gianluigi , Iodice Mario , Coppola Giuseppe
Published: April 2023

The growing demand to manipulate objects with long-range techniques has increasingly called for the development of techniques capable of intensifying and spatially concentrating electromagnetic fields with the aim of improving the electromagnetic forces acting on objects. In this context, one of the most interesting techniques is based on the use of plasmonic phenomena that have the ability to amplify and structure the electric field in very small areas. In this paper, we report the simulation analysis of a plasmonic nanostructure useful for optimizing the profile of the induced plasmonic field distribution and thus the motion dynamics of a nanoparticle, overcoming some limitations observed in the literature for similar structures. The elementary cell of the proposed nanostructure consists of two gold scalene trapezoids forming a planar V-groove. The spatial replication of this elementary cell to form linear or circular array sequences is used to improve the final nanoparticle velocity. The effect of the geometry variation on the plasmonic behaviour and consequently on the force generated, was analyzed in detail. The results suggest that this optimized plasmonic structure has the potential to efficiently propel macroscopic objects, with implications for various fields such as aerospace and biomedical research.
Charged-exciton complexes induced by interlayer carrier transfer in 2D Van der Waals heterostructure
Authors: We Ke , Sui Yizhen , Liu Qirui , Tang Yuxiang , Xu Zhongjie , Cheng Xiang'ai
Published: April 2023

High-order correlated excitonic states in semiconductors, such as trion, biexciton and polaron, etc. hold a great promising platform in contemporary quantum and nonlinear optics. The recently found 2D TMDs further gives such excitonic states additional valley properties, with bound states of excitons in opposite valleys in momentum spaces. Despite great efforts have been made on the emission properties of the excitonic states, their absorption feature, especially the ultrafast absorption dynamics, are rarely reported. Here, we reported the enhanced optical absorption of the charged-excitonic states in monolayer WS2, including singlet and triplet trions, charged biexcitons and semidark trions, by utilizing the interlayer charge transfer-induced photo-doping effect in graphene-WS2 heterostructure. Depending on the recombination rates of the doping electrons, the absorption intensity of the charged complexes exhibits ultrafast decay dynamics, with lifetime of several picoseconds. Due to many-body interaction, both increasing pump intensity and lattice temperature can broaden these fine excitonic absorption peaks and even reverse the shape of the transient absorption spectrum completely.
Lethal heatwaves are challenging India’s sustainable development
Authors: Debnath Ramit , Bardhan Ronita , Bell Michelle L.
Published: April 2023

Due to the unprecedented burdens on public health, agriculture, and other socio-economic and cultural systems, climate change-induced heatwaves in India can hinder or reverse the country’s progress in fulfilling the sustainable development goals (SDGs). Moreover, the Indian government’s reliance on its Climate Vulnerability Index (CVI), which may underestimate the impact of heatwaves on the country’s developmental efforts. An analytical evaluation of heat index (HI) with CVI shows that more than 90% of the country is at extremely cautious or dangerous levels of adversely impacting adaptive livelihood capacity, food grains yield, vector-borne disease spread and urban sustainability. The results also show by examining Delhi’s urban heat risk that heatwaves will critically hamper SDG progress at the urban scale. Linking HI with CVI identifies more of India’s vulnerability and provides an opportunity to rethink India’s climate adaptation policies through international cooperation in designing holistic vulnerability assessment methodologies. The conclusion emphasizes the urgent need to improve extreme weather impact assessment by combining multiple layers of information within the existing climate vulnerability measurement frameworks that can account for the co-occurrence and collision of climate change events and non-climate structural SDG interventions.
Informing adaptation strategy through mapping the dynamics linking climate change, health, and other human systems: Case studies from Georgia, Lebanon, Mozambique and Costa Rica
Authors: Loffreda Giulia , Chikovani Ivdity , Mocumbi Ana O. , Asmar Michele Kosremelli , Blanco Laura C. , Grant Liz , Ager Alastair
Published: April 2023

While scientific research supporting mitigation of further global temperature rise remains a major priority, CoP26 and CoP27 saw increased recognition of the importance of research that informs adaptation to irreversible changes in climate and the increasing threats of extreme weather events. Such work is inevitably and appropriately contextual, but efforts to generalise principles that inform local strategies for adaptation and resilience are likely crucial. Systems approaches are particularly promising in this regard. This study adopted a system dynamics framing to consider linkages between climate change and population health across four low- and middle-income country settings with a view to identifying priority inter-sectoral adaptation measures in each. On the basis of a focused literature review in each setting, we developed preliminary causal loop diagrams (CLD) addressing dynamics operating in Mozambique, Lebanon, Costa Rica, and Georgia. Participatory workshops in each setting convened technical experts from different disciplines to review and refine this causal loop analysis, and identify key drivers and leverage points for adaptation strategy. While analyses reflected the unique dynamics of each setting, common leverage points were identified across sites. These comprised: i) early warning/preparedness regarding extreme events (thus mitigating risk exposure); ii) adapted agricultural practices (to sustain food security and community livelihoods in changing environmental conditions); iii) urban planning (to strengthen the quality of housing and infrastructure and thus reduce population exposure to risks); iv) health systems resilience (to maintain access to quality healthcare for treatment of disease associated with increased risk exposure and other conditions for which access may be disrupted by extreme events); and v) social security (supporting the livelihoods of vulnerable communities and enabling their access to public services, including healthcare). System dynamics modelling methods can provide a valuable mechanism for convening actors across multiple sectors to consider the development of adaptation strategies.
The economic burden incurred by families caring for a young child with developmental disability in Uganda
Authors: Katumba Kenneth R. , Tann Cally J. , Webb Emily L. , Tenywa Patrick , Nampijja Margaret , Seeley Janet , Greco Giulia
Published: April 2023

Each year, nearly 30 million children globally are at risk of developmental difficulties and disability as a result of newborn health conditions, with the majority living in resource-constrained countries. This study estimates the annual cost to families related to caring for a young child with developmental disability in Uganda. Nested within a feasibility trial of early care and support for young children with developmental disabilities, this sub-study estimated the cost of illness, the cost of paternal abandonment of the caregiver and the affordability of care by household. Seventy-three caregivers took part in this sub-study. The average annual cost of illness to families was USD 949. The main cost drivers were the cost of seeking care and income lost due to loss of employment. Households caring for a child with a disability spent more than the national average household expenditure, and the annual cost of illness for all households was more than 100% of the national GDP per capita. In addition, 84% of caregivers faced economic consequences and resorted to wealth-reducing coping strategies. Families caring for a child with severe impairment incurred USD 358 more on average than those with mild or moderate impairment. Paternal abandonment was common (31%) with affected mothers losing an average of USD 430 in financial support. Caring for a young child with developmental disability was unaffordable to all the study households. Programmes of early care and support have the potential to reduce these financial impacts. National efforts to curb this catastrophic health expenditure are necessary.
Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania
Authors: Semrau Katherine E. A. , Mokhtar Rana R. , Manji Karim , Goudar Shivaprasad S. , Mvalo Tisungane , Sudfeld Christopher R. , Young Melissa F. , Caruso Bethany A. , Duggan Christopher P. , Somji Sarah S. , Lee Anne C. C. , Bakari Mohamed , Lugangira Kristina , Kisenge Rodrick , Adair Linda S. , Hoffman Irving F. , Saidi Friday , Phiri Melda , Msimuko Kingsly , Nyirenda Fadire , Michalak Mallory , Dhaded Sangappa M. , Bellad Roopa M. , Misra Sujata , Panda Sanghamitra , Vernekar Sunil S. , Herekar Veena , Sommannavar Manjunath , Nayak Rashmita B. , Yogeshkumar S. , Welling Saraswati , North Krysten , Israel-Ballard Kiersten , Mansen Kimberly L. , Martin Stephanie L. , Fleming Katelyn , Miller Katharine , Pote Arthur , Spigel Lauren , Tuller Danielle E. , Vesel Linda ,   for the LIFE Study Group
Published: April 2023

Globally, increasing rates of facility-based childbirth enable early intervention for small vulnerable newborns. We describe health system-level inputs, current feeding, and discharge practices for moderately low birthweight (MLBW) infants (1500-<2500g) in resource-constrained settings. The Low Birthweight Infant Feeding Exploration study is a mixed methods observational study in 12 secondary- and tertiary-level facilities in India, Malawi, and Tanzania. We analyzed data from baseline facility assessments and a prospective cohort of 148 MLBW infants from birth to discharge. Anthropometric measuring equipment (e.g., head circumference tapes, length boards), key medications (e.g., surfactant, parenteral nutrition), milk expression tools, and human milk alternatives (e.g., donor milk, formula) were not universally available. MLBW infants were preterm appropriate-for-gestational age (38.5%), preterm large-for-gestational age (3.4%), preterm small-for-gestational age (SGA) (11.5%), and term SGA (46.6%). The median length of stay was 3.1 days (IQR: 1.5, 5.7); 32.4% of infants were NICU-admitted and 67.6% were separated from mothers at least once. Exclusive breastfeeding was high (93.2%). Generalized group lactation support was provided; 81.8% of mother-infant dyads received at least one session and 56.1% had 2+ sessions. At the time of discharge, 5.1% of infants weighed >10% less than their birthweight; 18.8% of infants were discharged with weights below facility-specific policy [1800g in India, 1500g in Malawi, and 2000g in Tanzania]. Based on descriptive analysis, we found constraints in health system inputs which have the potential to hinder high quality care for MLBW infants. Targeted LBW-specific lactation support, discharge at appropriate weight, and access to feeding alternatives would position MLBW for successful feeding and growth post-discharge.