bluuebunny/crossref_metadata_2025 huggingface dataset:
Laparoscopic vs. open feeding jejunostomy insertion in oesophagogastric cancer
Authors: Mastoridis Sotiris , Bracalente Giada , Hanganu Christine-Bianca , Neccia Michela , Giuliani Antonio , Gillies Richard , Marshall Robert , Maynard Nicholas , Sgromo Bruno
Published: October 2021

Background

Jejunal feeding is an invaluable method by which to improve the nutritional status of patients undergoing neoadjuvant and surgical treatment of oesophageal malignancies. However, the insertion of a feeding jejunostomy can cause significant postoperative morbidity. The aim of this study is to compare the outcomes of patients undergoing placement of feeding jejunostomy by conventional laparotomy with an alternative laparoscopic approach.

Methods

A retrospective review of data prospectively collected at the Oxford Oesophagogastric Centre between August 2017 and July 2019 was performed including consecutive patients undergoing feeding jejunostomy insertion.

Results

In the study period, 157 patients underwent jejunostomy insertion in the context of oesophageal cancer therapy, 126 (80%) by open technique and 31 (20%) laparoscopic. Pre-operative demographic and nutritional characteristics were broadly similar between groups. In the early postoperative period jejunostomy-associated complications were noted in 54 cases (34.4%) and were significantly more common among those undergoing open as compared with laparoscopic insertion (38.1% vs. 19.3%, P = 0.049). Furthermore, major complications were more common among those undergoing open insertion, whether as a stand-alone or at the time of staging laparoscopy (n = 11/71), as compared with insertion at the time of oesophagectomy (n = 3/86, P = 0.011).

Conclusions

This report represents the largest to our knowledge single-centre comparison of open vs. laparoscopic jejunostomy insertion in patients undergoing oesophagectomy in the treatment of gastroesophageal malignancy. We conclude that the laparoscopic jejunostomy insertion technique described represents a safe and effective approach to enteral access which may offer superior outcomes to conventional open procedures.
The expression levels of MicroRNA-146a, RANKL and OPG after non-surgical periodontal treatment
Authors: Sattari Mandana , Taheri Ramezan Ali , ArefNezhad Reza , Motedayyen Hossein
Published: October 2021

Objective

MicroRNA-146a (miR-146a) is a regulator of inflammatory response. Periodontitis is a disease with immune pathophysiology of the periodontium in which the inflammation results in the destruction of the soft tissues and alveolar bone. Therefore, the aim of this study was to investigate the expressions of miR-146a, OPG, and RANKL in diseased and healthy periodontal tissues to understand whether miR-146a expression level may associate with OPG and RANKL mRNA levels and OPG/RANKL ratio after non-surgical periodontal treatment.

Methods

The levels of miR-146a, RANKL, and OPG in gingival tissues from patients with generalized periodontitis stages II and III and grades A and B (n = 15, group A), patients with generalized periodontitis stages III and IV and grade C (n = 15, group B), and healthy individuals (n = 10) were determined by real-time PCR. The associations of miR-146a expression with OPG and RANKL levels were evaluated.

Results

The levels of miR-146a in two subgroups within periodontitis patients were significantly higher than healthy subjects (P < 0.0001). MiR-146a showed the increased level in group A of patients compared with group B (P < 0.05). Clinical parameters such as probing depth (PD) and clinical attachment loss (CAL) were significantly higher in patients than control group (P < 0.05). The levels of OPG and RANKL were increased in patients compared with healthy subjects, although the elevated levels were not statistically significant. MiR-146a was not associated with OPG and RANKL levels and OPG/RANKL ratio.

Conclusions

The results of this study failed to show the associations of miR-146a level with OPG and RANKL levels and OPG/RANKL ratio in periodontitis after non-surgical periodontal treatment.
‘Fix the issues at the coalface and mental wellbeing will be improved’: a framework analysis of frontline NHS staff experiences and use of health and wellbeing resources in a Scottish health board area during the COVID-19 pandemic
Authors: Clarissa Catherine , Quinn Sam , Stenhouse Rosie
Published: October 2021

Background

Frontline healthcare staff working in pandemics have been reported to experience mental health issues during the early and post-peak stages. To alleviate these problems, healthcare organisations have been providing support for their staff, including organisational, cognitive behavioural and physical and mental relaxation interventions. This paper reports the findings of a study commissioned by a Scottish NHS health board area during the initial outbreak of COVID-19. The study aimed to understand the experience of NHS staff relating to the provision of wellbeing interventions between March and August 2020.

Methods

Data were gathered from free-text comments of eight surveys completed by a wide range of staff across sites within one NHS health board in Scotland. We conducted a framework analysis of the data.

Results

Our findings show that despite the provision of relaxational and cognitive behavioural interventions to support staff wellbeing during the early months of the COVID-19 pandemic, there were barriers to access, including heavy workload, understaffing, inconvenient locations and the stigma of being judged. Organisational factors were the most frequently reported support need amongst frontline staff across sites.

Conclusions

While relaxational and cognitive behavioural interventions were well received by staff, barriers to accessing them still existed. Staff support in the context of organisational factors, such as engagement with managers was deemed as the most important for staff wellbeing. Managers play a key role in everyday organisational processes and therefore are in the right position to meet increasing frontline staff demands due to the pandemic and removing barriers to accessing wellbeing support. Healthcare managers should be aware of organisational factors that might increase job demands and protect organisational resources that can promote wellbeing for frontline staff.
EFNA3 as a predictor of clinical prognosis and immune checkpoint therapy efficacy in patients with lung adenocarcinoma
Authors: Deng Mingming , Tong Run , Zhang Zhe , Wang Tao , Liang Chaonan , Zhou Xiaoming , Hou Gang
Published: October 2021

Background

Ephrin receptors (Eph) and their ligands, called ephrins, function in various disease processes. However, the expression level and prognostic value of Eph/ephrins in lung adenocarcinoma (LUAD) are still unclear.

Methods

The Oncomine and GEPIA databases were used to explore the differential expression of Eph/ephrins in LUAD. Kaplan–Meier plotter was selected to explore the prognostic value of Eph/ephrins. The cBioPortal database was used to analyze the genetic variation of the EFNA3 gene. Immunohistochemistry was used to analyze the expression level and clinical value of ephrin-A3 protein in clinical LUAD tissue. Weighted coexpression network analysis (WGCNA) and gene set enrichment analysis (GSEA) identified the potential regulatory mechanism of EFNA3. CCK-8 assays and colony-forming experiments were used to investigate whether EFNA3 can regulate cell proliferation ability in LUAD. Analysis of lactate, ATP, and glucose uptake levels was used to explore the effect of EFNA3 on glycolysis ability. In addition, we investigated the relationship between EFNA3 and tumor infiltrating immune cells (TIICs). Finally, the potential immunotherapy response prediction value of EFNA3 was also explored.

Results

In this study, we found that EFNA3 expression was significantly correlated with both overall survival (OS) and progression-free survival (PFS) in LUAD patients based on a comprehensive analysis of the Eph/Ephrin family. Next, the expression of the EFNA3 protein was increased in LUAD tissues and was designated an independent prognostic risk factor. Mechanistically, EFNA3 may be involved in nuclear division, synaptic function, and ion channel activity-related pathways. In vitro experiments confirmed the role of EFNA3 in promoting LUAD cells and showed that it could regulate glycolytic capacity. Moreover, EFNA3 was negatively associated with immunity, stromal infiltration, and several TIICs. Finally, EFNA3 was found to be positively related to multiple immunotherapy biomarkers.

Conclusions

In conclusion, increased EFNA3 in LUAD patients predicted worse clinical prognosis, promoted LUAD cell proliferation and glycolysis ability, and was related to immunotherapy response.
Antibiotic heteroresistance in Mycobacterium tuberculosis isolates: a systematic review and meta-analysis
Authors: Ye Mao , Yuan Wen , Molaeipour Leila , Azizian Khalil , Ahmadi Alireza , Kouhsari Ebrahim
Published: October 2021

Background

Mycobacterium tuberculosis (MTB) is responsible for tuberculosis; that continues to be a public health threat across the globe. Furthermore, increasing heteroresistance (HR)-the presence of resistant and susceptible isolates among MTB strains- has been reported from around the world. This phenomenon can lead to full resistance development and treatment failure.

Methods

We systematically searched the relevant studies in PubMed, Scopus, and Embase (Until October 21, 2020). The study outcomes revealed the weighted pooled prevalence of antibiotic HR in MTB isolates with subgroup analysis by year, quality of study, and heteroresistance detection method.

Results

A total of 38 studies which had investigated MTB isolates were included in the meta-analysis. Geographically, the highest number of studies were reported from Asia (n  =  24), followed by Africa (n  =  5). Nineteen studies reported HR to isoniazid, with a weighted pooled prevalence of 5% (95% CI 0–12) among 11,761 MTB isolates. Also, there is no important trend for the subgroup analysis by the study period (2001–2014 vs 2015–2017 vs 2018–2020). HR to rifampin was reported in 17 studies, with a weighted pooled prevalence of 7% (95% CI 2–14) among 3782 MTB isolates. HR to fluoroquinolone and ethambutol were reported in 12 and 4 studies, respectively, with weighted pooled prevalence of 10% and 1% among 2153 and 1509 MTB isolates, correspondingly.

Conclusion

Based on our analysis, HR in MTB isolates with different frequency rate is present worldwide. Thus, the selection of appropriate and reliable methods for HR detection is crucial for TB eradication.
The theoretical model of spatial production for innovation
Authors: Olah Daniel , Alpek B. Levente
Published: October 2021

The overall aim of the study is to create the theoretical model of spatial production for innovation, which provides a measurement basis for later research as well as providing a measurement framework for the territorial indexation of innovation. In addition, it raises the question of what factors can hinder and which can help the formation and development of the spatial production of innovation. In the context of the above, based on a chronological, multidimensional review and analysis of literature research, it summarizes and presents the possibilities of interpreting the concept of innovation, paying attention to its territorial aspects. The model presented in our study builds on the literature on the external–internal divisions of innovation barriers, but also differs in that the model simultaneously displays the socio-economic space (innovation ecosystem), the regional scales as well as time. Presenting the typological barriers to innovation and summarizing the related factors, as well as developing a model to measure the issue, can help by specifically promoting the development of regions with less innovation capacity and potential in this field, at the same time providing a basis for assessing the territorial aspects of the phenomenon, which may also support the creation of development programmes to support the resolution of territorial disparities.
Diagnostic accuracy of B-mode ultrasound, ultrasound elastography and diffusion weighted MRI in differentiation of thyroid nodules (prospective study)
Authors: Latif Mahmoud Abdel , El Rakhawy Magdy Mohamed , Saleh Mohamed Fathy
Published: October 2021

Background

The incidence of the thyroid nodules and its detection is increasing rapidly. The most precise method for diagnosis of the nodules of the thyroid is FNAC. But, about 10–20% of specimens of FNAC are indeterminate and non-diagnostic. Therefore, there is a demand for another diagnostic method for evaluating thyroid nodules. Thyroid ultrasound elastography may improve the ability to differentiate malignant from benign thyroid nodules. Few articles were published about the results of DW MRI in thyroid nodules, with its results confirmed that malignant nodules have lower mean ADC values than benign nodules. This study aims to investigate and compare the accuracy of B-mode ultrasound, ultrasound elastography and diffusion-weighted MRI in characterization of the nodules of the thyroid.

Results

The study included 56 patients with thyroid nodules (36 benign and 20 malignant). Thyroid ultrasound, ultrasound elastography and DWI were done for all patients. Ultrasound-guided FNA Cytological examination (as the gold standard) was done for 48 patients and surgical histopathology was done to 8 patients with non-diagnostic FNAC. The results showed: TIRADS score had sensitivity 90%, specificity 77.8% and accuracy of 82.14%. The elastography score had sensitivity 80%, specificity 88.9% and accuracy 85.7%. The use of the strain ratio had 80% sensitivity, 94.4% specificity and 89.3% accuracy. DWI and ADC value had 100% sensitivity and 94.4% specificity and the accuracy was 96.4% for differentiating malignant from benign thyroid nodules. Multi-parametric analysis by TIRADS and ADC had 100% accuracy.

Conclusion

Ultrasound elastography add valuable data over ultrasound TIRADS. But, diffusion weighted MRI and ADC value has more accuracy in differentiating malignant from benign thyroid nodules. The best performance was achieved by the combination of ACR-TIRADS and ADC value.
Development of a theory-based video-game intervention to increase advance care planning conversations by healthcare providers
Authors: Mohan Deepika , MacMartin Meredith A. , Chelen Julia S. C. , Maezes Carolyn B. , Barnato Amber E.
Published: October 2021

Background

Hospitalization offers an opportunity for healthcare providers to initiate advance care planning (ACP) conversations, yet such conversations occur infrequently. Barriers to these conversations include attitudes, skill, and time. Our objective was to develop a theory-based, provider-level intervention to increase the frequency of ACP conversations in hospitals.

Methods

We followed a systematic process to develop a theory-based, provider-level intervention to increase ACP conversations between providers and their hospitalized patients. Using principles established in Intervention Mapping and the Behavior Change Wheel, we identified a behavioral target, a theory of behavior change, behavior change techniques, and a mode of delivery. We addressed a limitation of these two processes of intervention development by also establishing a framework of design principles to structure the selection of intervention components. We partnered with a game development company to translate the output into a video game.

Results

We identified willingness to engage in ACP conversations as the primary contributor to ACP behavior, and attitudes as a modifiable source of this willingness. We selected self-determination theory, and its emphasis on increasing autonomous motivation, as a relevant theory of behavior change and means of changing attitudes. Second, we mapped the components of autonomous motivation (i.e., autonomy, competence, and relatedness) to relevant behavior change techniques (e.g., identity). Third, we decided to deliver the intervention using a video game and to use the narrative engagement framework, which describes the use of stories to educate, model behavior, and immerse the user, to structure our selection of intervention components. Finally, in collaboration with a game development company, we used this framework to develop an adventure video game (Hopewell Hospitalist).

Conclusions

The systematic development of a theory-based intervention facilitates the mechanistic testing of the efficacy of the intervention, including the specification of hypotheses regarding mediators and moderators of outcomes. The intervention will be tested in a randomized clinical trial.
Measuring neuropsychiatric symptoms in patients with early cognitive decline using speech analysis
Authors: König Alexandra , Mallick Elisa , Tröger Johannes , Linz Nicklas , Zeghari Radia , Manera Valeria , Robert Philippe
Published: October 2021

Background

Certain neuropsychiatric symptoms (NPS), namely apathy, depression, and anxiety demonstrated great value in predicting dementia progression, representing eventually an opportunity window for timely diagnosis and treatment. However, sensitive and objective markers of these symptoms are still missing. Therefore, the present study aims to investigate the association between automatically extracted speech features and NPS in patients with mild neurocognitive disorders.

Methods

Speech of 141 patients aged 65 or older with neurocognitive disorder was recorded while performing two short narrative speech tasks. NPS were assessed by the neuropsychiatric inventory. Paralinguistic markers relating to prosodic, formant, source, and temporal qualities of speech were automatically extracted, correlated with NPS. Machine learning experiments were carried out to validate the diagnostic power of extracted markers.

Results

Different speech variables are associated with specific NPS; apathy correlates with temporal aspects, and anxiety with voice quality—and this was mostly consistent between male and female after correction for cognitive impairment. Machine learning regressors are able to extract information from speech features and perform above baseline in predicting anxiety, apathy, and depression scores.

Conclusions

Different NPS seem to be characterized by distinct speech features, which are easily extractable automatically from short vocal tasks. These findings support the use of speech analysis for detecting subtypes of NPS in patients with cognitive impairment. This could have great implications for the design of future clinical trials as this cost-effective method could allow more continuous and even remote monitoring of symptoms.
Approach to the Patient: Safety of Growth Hormone Replacement in Children and Adolescents
Authors: Bamba Vaneeta , Kanakatti Shankar Roopa
Published: October 2021

The use of recombinant human growth hormone (rhGH) in children and adolescents has expanded since its initial approval to treat patients with severe GH deficiency (GHD) in 1985. rhGH is now approved to treat several conditions associated with poor growth and short stature. Recent studies have raised concerns that treatment during childhood may affect morbidity and mortality in adulthood, with specific controversies over cancer risk and cerebrovascular events. We will review 3 common referrals to a pediatric endocrinology clinic, followed by a summary of short- and long-term effects of rhGH beyond height outcomes. Methods to mitigate risk will be reviewed. Finally, this information will be applied to each clinical case, highlighting differences in counseling and clinical outcomes. rhGH therapy has been used for more than 3 decades. Data are largely reassuring, yet we still have much to learn about pharmaceutical approaches to growth in children and the lifelong effect of treatment.
The Ends of Media Studies
Authors: Starosielski Nicole
Published: October 2021

This article poses the question: what are the ends of media studies? It discusses a turn to “nature” and the elements that has pushed media studies beyond its traditional objects and subjects. While the conceptualization of environments and bodies as communicative substrates offers new avenues for media research, mediation has also been taken up in a wide range of disciplinary and intellectual contexts. Rather than establishing limits or an essential core of media studies, the article suggests that media scholars take an etic orientation and attend to the questions whose invisibility is constitutive of the field. Using the example of undersea cable systems, the article describes some of the many conceptual, institutional, and pedagogical ends of media analysis.
Sense Experiences
Authors: Gill Denise
Published: October 2021

This article provides an account of how sense experiences are drawn into processes of contest over the boundaries of citizenship and belonging. Based on ethnographic research in Istanbul and Ankara, it examines the ruptures of the 2016 failed coup attempt in Turkey. Particular forms of listening emerged in Western urban centers, newly attuned to sounds of warfare commingled with Islamic melodic devotionals ordered by state officials. Unique and pronounced engagements with bodily liquids accompanied the handling and placement of the dead. The multi-sensory experiences of Muslim women municipal employees who wash and shroud the deceased elucidated the foundational roles of scent and body weight in constituting martyrdom. This article demonstrates how the body politic operates—with various forms of acquiescence and repudiation—through sound, smell, and touch.
Integrated In Silico Studies on the Role of Nicotinamide Adenine Dinucleotide (NADH) Binding in Activating C-Terminal Binding Protein 2 (CtBP2)
Authors: Aoyagi Tsukasa , Yoshino Ryunosuke , Mitsuta Yuki , Morita Rikuri , Harada Ryuhei , Shigeta Yasuteru
Published: October 2021

The C-terminal binding protein 2 (CtBP2) plays a role in apoptosis and embryogenesis. Genetic knockout studies have been demonstrated to cause severe developmental defects and embryonic lethality. CtBP2 has three key domains and dimerizes for a significant role by binding with nicotinamide adenine dinucleotide (NADH). However, the molecular mechanism of CtBP2 dimerization and the effect of NADH binding are unknown. In this study, we performed molecular dynamics (MD) and docking simulation to reveal the mechanism of C-terminal binding protein 2 (CtBP2) dimerization and the effect of NADH binding on the dimer formation. Our MD simulation results detected seven salt bridges that are important for CtBP2 dimerization. And docking simulation demonstrated that the holo-monomer gave a higher probability of correct docking pose than the apo-monomer. Moreover, in docking simulation using a PXDLS model peptide, that holo form gave more docking poses than that apo form. These results suggested that the holo form has a structure that facilitates the formation of dimers and the binding of PXDLS peptides.
One-step Preparation of N-Unprotected Aziridines from 2H-Azirines by Addition of Ketene Silyl Acetals Catalyzed by Lewis Acids
Authors: Suzuki Itaru , Takenaka Yuya , Morishita Yoshitaka , Shibata Ikuya
Published: October 2021

The nucleophilic addition of ketene silyl acetals 2 into 2H-azirines 1 proceeded in the presence of Lewis acids such as InX3 or Sc(OTf)3 to give N-unprotected aziridines 3. The mild Lewis acidity of the catalyst is important for the achievement of this coupling. The generated aziridine 3 could then be transformed into either oxazolines or γ–amino carbonyls.
Synthesis of Carbazole-containing 1,2-Azaborine Derivatives Using Bora-Friedel–Crafts Reaction and Their Photophysical Properties
Authors: Yamamoto Koji , Yamada Itsuki , Kameyama Masaru , Yamamoto Koji , Nakamura Yosuke
Published: October 2021

Carbazole-containing 1,2-azaborine derivatives bearing various substituents were synthesized using bora-Friedel–Crafts reactions of 1,8-diphenylcarbazole derivatives, and the substituent effects on their photophysical properties were investigated. Furthermore, three carbazole-containing azaborine dimers with different annulation manners between the azaborine and benzene moieties were also successfully synthesized, and the effects of dimerization and differences in the annulation manners on their photophysical properties were disclosed.
Διγλωσσία και Δυσλεξία: Προκλήσεις και Υποστηρικτικές Πρακτικές
Authors: Βλάχου Κατερίνα
Published: October 2021

Οι δίγλωσσοι μαθητές με δυσλεξία πολύ συχνά λαμβάνουν μη έγκυρες και αναξιόπιστες διαγνωστικές εκτιμήσεις, αφού οι επιστήμονες αγωγής δυσκολεύονται να εντοπίσουν τις ειδικές μαθησιακές δυσκολίες και να τις διαφοροποιήσουν από τις μαθησιακές δυσκολίες. Δυστυχώς, η τακτική του «περίμενε μέχρι να αποτύχει», τα μη σταθμισμένα εργαλεία, η απουσία άτυπης αξιολόγησης, η προκατάληψη και η ανεπαρκής έρευνα των παιδαγωγών πάνω σε θέματα Ειδικής Αγωγής και Διαπολιτισμικής Εκπαίδευσης, οδηγούν συνήθως σε συνεχή σχολική αποτυχία. Ο εκπαιδευτικός, δυσκολεύεται να διαχειριστεί τα σύγχρονα σχολικά ζητήματα, ενώ ο δίγλωσσος μαθητής, χαρακτηρίζεται άλογα ως τεμπέλης και απομακρύνεται από τα σχολικά του καθήκοντα. Η παρούσα βιβλιογραφική ανασκόπηση ενημερώνει τους νέους εκπαιδευτικούς για τις προκλήσεις που συναντά ένας δίγλωσσος μαθητής με δυσλεξία στο γενικό σχολείο και προτείνει ορισμένες χρήσιμες εκπαιδευτικές πρακτικές. Με γνώμονα τον προβληματισμό, την κριτική και τη διάθεση για αλλαγή, κάθε εκπαιδευτικός οφείλει να υποστηρίζει τις δυνατότητες του μαθητή και να αντιμετωπίζει αποτελεσματικά τις αδυναμίες του.
Η δημιουργική γραφή στην εκπαίδευση: πεδία εφαρμογών, τρόποι δράσεων και σύγχρονες-καινοτόμες εκπαιδευτικές πρακτικές
Authors: Τσαρουχάς Νεκτάριος-Θεοχάρης
Published: October 2021

Η δημιουργική γραφή έχει οριστεί ως η ικανότητα του ατόμου να φαντάζεται και να δημιουργεί, να αισθάνεται και να εκφράζεται ελεύθερα, αυθεντικά και πρωτότυπα για τη δική του ικανοποίηση και ευχαρίστηση. Μεγάλο πλήθος ερευνητικών μελετών τεκμηριώνουν τις θετικές επιδράσεις της δημιουργικής γραφής, όπως για τη σεξουαλική κακομεταχείριση, την καταπράυνση ενδοψυχικών συγκρούσεων, την αυτοκτονικότητα, τα χρόνια συμπτώματα πόνου και τις καταχρήσεις. Η Δημιουργική Γραφή αποτελεί μια σύγχρονη εκπαιδευτική μέθοδο, η οποία φιλοδοξεί να αποδώσει και να μεταδώσει ορθά τον πρωτεύοντα ρόλο της έκφρασης, της γραφής και του λόγου στους μαθητές. Δηλαδή, πρόκειται για τη διαδικασία κατά την οποία με την κατάλληλη διέγερση της παιδικής δημιουργικότητας προκαλείται η παραγωγή λόγου με παιγνιώδη και απαλλαγμένο από αυστηρά μαθησιακά και αξιολογικά πλαίσια. Η μεθοδολογία προσεγγίζετε βιωματικά, μέσα από το παιχνίδι και τη μάθηση του λόγου και των δυνατοτήτων του και στηρίζεται στην αναδόμηση των στοιχείων της λέξης, της πρότασης και κατ’ επέκταση του κειμένου, με σκοπό την παραγωγή νέων κειμένων. Η Δημιουργική Γραφή μπορεί να λειτουργήσει με την απελευθέρωση της δημιουργικότητας και θεραπευτικά, προσφέροντας ψυχική εκτόνωση, εσωτερική απελευθέρωση του ατόμου, ενώ λειτουργεί αυτοεπιβεβαιωτικά και λυτρωτικά στην ενδόμυχη ψυχοσύνθεση του ατόμου και έχει αναγνωριστεί ως ένα σημαντικό εργαλείο για την ενδυνάμωση της αυτοπεποίθησης και της αυτοεπίγνωσης του ατόμου.
Stratos N. Dordanas and Nikos Papanastasiou, eds., Ο «μακρύς» ελληνογερμανικός εικοστός αιώνας: Οι μαύρες σκιές στην ιστορία των διμερών σχέσεων [The “long” Greek-German twentieth century: The dark shadows in the history of the bilateral relationships]
Authors: Vachtsevanou Chrysa
Published: October 2021

Review of Stratos N. Dordanas and Nikos Papanastasiou, eds. Ο «μακρύς» ελληνογερμανικός εικοστός αιώνας: Οι μαύρες σκιές στην ιστορία των διμερών σχέσεων [The “long” Greek-German twentieth century: The dark shadows in the history of the bilateral relationships]. Thessaloniki: Epikentro, 2018. 488 pp.
Crossover comparison of climate-change adaptation measures taken in the Gdansk (Baltic-sea) and Rotterdam (Nord-sea) deltas.
Authors: Sanders Fred , Sanders Hugo , Jonkers Karen
Published: October 2021

Gdansk in Poland and the Netherlands share a long-term relationship that started with the establishment of Dutch Mennonites in the Vistula delta in the 16th Century. Climate-change figures show that both the Polish Gdansk and DutchRotterdam deltas will suffer flooding due to sea level rise, with accumulating severe rainfall accompanied by high river levels; reasons that led to a comparison of the adaptation measures taken. On the basis of the crossover comparison studied, it can be concluded that Poland and the Netherlands have a virtually identical approach when it comes to climate-change impacts on their current situation. With regard to the long-term climate-change trend, the Netherlands in exploring for the future more ‘anticipatory’ measures with the development of new scenarios for the protection of land and cities. In the Netherlands the use of Hackathon approach is thereby used more often to explore such scenarios. The interaction between the experts and stakeholders of different expertise in this methodology show to lead to creative and new perspectives. This approach may also be recommended for the situation in Gdansk.
Demographic processes in Russia as a political problem
Authors: Erokhin Nikita
Published: October 2021

The purpose of this work is to identify and analyze the political consequences of demographic processes in Russia. The methodological basis of the study is indicative analysis, with the help of which it was possible to identify the main demographic factors that have the greatest impact on the political system of the Russian Federation. This influence was considered through the prism of the demographic security of the state. To assess it, 24 indicators were used, divided into three groups: indicators of the size and location of the population (1), indicators of population structure (2), indicators of population health (3). The author has formed a system of threshold values for each indicator, and based on the data of state and international statistics, which cover the period 1990–2020, the dynamics of indicators of demographic security in Russia is analyzed. The multifaceted nature of demographic security has become the reason for the use of an integral assessment (internment of particular indicators into a single index), which represents a numerical assessment of a certain part of the demographic situation in the country. As a result, integral assessments of Russia's demographic security over the past 30 years were calculated and their impact on the political sphere was analyzed. The practical significance of the work lies in the developed system of indicators of demographic security, which makes it possible to carry out a full analysis of the state of the demographic situation of the country and / or regions and to identify the most priority areas for demographic policy in Russia.
The Power of Subsampling in Submodular Maximization
Authors: Harshaw Christopher , Kazemi Ehsan , Feldman Moran , Karbasi Amin
Published: October 2021

We propose subsampling as a unified algorithmic technique for submodular maximization in centralized and online settings. The idea is simple: independently sample elements from the ground set and use simple combinatorial techniques (such as greedy or local search) on these sampled elements. We show that this approach leads to optimal/state-of-the-art results despite being much simpler than existing methods. In the usual off-line setting, we present SampleGreedy, which obtains a [Formula: see text]-approximation for maximizing a submodular function subject to a p-extendible system using [Formula: see text] evaluation and feasibility queries, where k is the size of the largest feasible set. The approximation ratio improves to p + 1 and p for monotone submodular and linear objectives, respectively. In the streaming setting, we present Sample-Streaming, which obtains a [Formula: see text]-approximation for maximizing a submodular function subject to a p-matchoid using O(k) memory and [Formula: see text] evaluation and feasibility queries per element, and m is the number of matroids defining the p-matchoid. The approximation ratio improves to 4p for monotone submodular objectives. We empirically demonstrate the effectiveness of our algorithms on video summarization, location summarization, and movie recommendation tasks.
A Learning-Based Optimization Approach for Autonomous Ridesharing Platforms with Service-Level Contracts and On-Demand Hiring of Idle Vehicles
Authors: Beirigo Breno A. , Schulte Frederik , Negenborn Rudy R.
Published: October 2021

Current mobility services cannot compete on equal terms with self-owned mobility products concerning service quality. Because of supply and demand imbalances, ridesharing users invariably experience delays, price surges, and rejections. Traditional approaches often fail to respond to demand fluctuations adequately because service levels are, to some extent, bounded by fleet size. With the emergence of autonomous vehicles, however, the characteristics of mobility services change and new opportunities to overcome the prevailing limitations arise. In this paper, we consider an autonomous ridesharing problem in which idle vehicles are hired on-demand in order to meet the service-level requirements of a heterogeneous user base. In the face of uncertain demand and idle vehicle supply, we propose a learning-based optimization approach that uses the dual variables of the underlying assignment problem to iteratively approximate the marginal value of vehicles at each time and location under different availability settings. These approximations are used in the objective function of the optimization problem to dispatch, rebalance, and occasionally hire idle third-party vehicles in a high-resolution transportation network of Manhattan, New York City. The results show that the proposed policy outperforms a reactive optimization approach in a variety of vehicle availability scenarios while hiring fewer vehicles. Moreover, we demonstrate that mobility services can offer strict service-level contracts to different user groups featuring both delay and rejection penalties.
Palliative care aspects of wound healing in complex patients: a case report
Authors: Allen Latricia L , Uphold Constance R , Koniaris-Rambaud Christine , House Kim , Gray Frances , Fitzgerald Linda , Vaughan Camille , Johnson Theodore M
Published: October 2021

Symptom or palliative management for wound care has commonly been reported in the literature as being focused on end-of-life care with less emphasis on being an effective supportive option for any patient with a wound in whom symptom management is indicated. This case report describes a frail older patient with a hard-to-heal pressure injury and multiple comorbidities to highlight palliative symptom management as a viable option to enhance patient comfort. Wound care providers may consider a palliative approach for hard-to-heal wound management that incorporates the whole patient, family and/or caregiver when faced with management of a frail older adult with a hard-to-heal wound to enhance the relief of suffering and improve quality of life. All procedures were performed in compliance with relevant laws and institutional guidelines and the appropriate institutional committee has approved them.

Declaration of interest:

The authors have no conflicts of interest to declare.
Modular assembly of dynamic models in systems biology
Authors: Pan Michael , Gawthrop Peter J. , Cursons Joseph , Crampin Edmund J.
Published: October 2021

It is widely acknowledged that the construction of large-scale dynamic models in systems biology requires complex modelling problems to be broken up into more manageable pieces. To this end, both modelling and software frameworks are required to enable modular modelling. While there has been consistent progress in the development of software tools to enhance model reusability, there has been a relative lack of consideration for how underlying biophysical principles can be applied to this space. Bond graphs combine the aspects of both modularity and physics-based modelling. In this paper, we argue that bond graphs are compatible with recent developments in modularity and abstraction in systems biology, and are thus a desirable framework for constructing large-scale models. We use two examples to illustrate the utility of bond graphs in this context: a model of a mitogen-activated protein kinase (MAPK) cascade to illustrate the reusability of modules and a model of glycolysis to illustrate the ability to modify the model granularity.
Realising the potential human development returns to investing in early and maternal nutrition: The importance of identifying and addressing constraints over the life course
Authors: Desmond Chris , Erzse Agnes , Watt Kathryn , Ward Kate , Newell Marie-Louise , Hofman Karen ,   on behalf of the INPreP group
Published: October 2021

The benefits of interventions which improve early nutrition are well recognised. These benefits, however, only accrue to the extent that later life circumstances allow. Consequently, in adverse contexts many of the benefits will never be realised, particularly for the most vulnerable, exacerbating inequality. Returns to investment in early nutrition could be improved if we identified contextual factors constraining their realisation and interventions to weaken these. We estimate cost and impact of scaling 10 nutrition interventions for a cohort of South African children born in 2021. We estimate associated declines in malnutrition and mortality, and improvements in years of schooling and future earnings. To examine the role of context over the life-course we estimate benefits with and without additional improvements in school quality and employment opportunities by socio-economic quintile. Scale up reduces national stunting (height for age < = -2SD) rates among children at 24 months by 3.18 percentage points, implying an increase in mean height for age z-score (HAZ) of 0.10, and 53,000 years of additional schooling. Quintile 1 (the poorest) displays the largest decline in stunting, and largest increase in mean HAZ. Estimated total cost of increasing coverage of the interventions for the cohort is US$90 million. The present value of the additional years of schooling is estimated at close to US$2 billion. Cost-benefit ratios suggest the highest return occurs in quintile 5 (1:23). Reducing inequality in school quality closes the gap between quintile 5 and the lower quintiles. If school quality and labour force participation were equal the highest returns are in quintile 1(1:31). An enabling environment is key to maximising human development returns from investing in early nutrition, and to avoid exacerbating existing inequality. Therefore, particularly for children in adverse conditions, it is essential to identify and implement complementary interventions over the life course.
Comparison and lessons learned from neglected tropical diseases and tuberculosis
Authors: Wang Alice , MacNeil Adam , Maloney Susan
Published: October 2021

Currently, tuberculosis (TB) is the leading cause of death from a single infectious agent and accounts for over one-third of all HIV-related deaths. However, research and programmatic funding have lagged far behind investments for many other diseases. For about a century, the current Bacillus Calmette-Guérin vaccine has been the only effective vaccine and is only effective in preventing severe disease in children; the first new therapeutic drug for TB in over 40 years was brought to market a few years ago; and until 10 years ago, diagnosis of TB depended on a century-old testing technique. This paper relates TB to neglected tropical diseases (NTDs) and highlights shared characteristics. The aim is to elevate awareness of TB within the framework of NTDs and gain insights from successes in addressing NTDs and how these lessons can be applied to help global health programs change the trajectory of the TB epidemic. A literature review was conducted to compare TB to NTDs and highlight lessons learned from NTD control that can be applied to the TB epidemic. Common features of NTDs include underlying burden of disease, influence and effect on poverty and development, and neglect through political will and funding. There are overarching principles for the design and implementation of NTD control programs that could be applied to ending TB.
Community-based prevalence of rheumatic heart disease in rural Ethiopia: Five-year follow-up
Authors: Gemechu Tadesse , Parry Eldryd H. O. , Yacoub Magdi H. , Phillips David I. W. , Kotit Susy
Published: October 2021

Background

As little is known about the prevalence and clinical progression of subclinical (latent) rheumatic heart disease (RHD) in sub-Saharan Africa, we report the results of a 5 year follow-up of a community based, echocardiographic study of the disease, originally carried out in a rural area around Jimma, Ethiopia.

Methods

Individuals with evidence of RHD detected during the baseline study as well as controls and their family members were screened with a short questionnaire together with transthoracic echocardiography.

Results

Of 56 individuals with RHD (37 definite and 19 borderline) in the original study, 36 (26 definite and 10 borderline) were successfully located 57.3 (range 44.9–70.7) months later. At follow-up two thirds of the definite cases still had definite disease; while a third had regressed. Approximately equal numbers of the borderline cases had progressed and regressed. Features of RHD had appeared in 5 of the 60 controls. There was an increased risk of RHD in the family relatives of borderline and definite cases (3.8 and 4.0 times respectively), notably among siblings. Compliance with penicillin prophylaxis was very poor.

Conclusions

We show the persistence of echocardiographically demonstrable RHD in a rural sub-Saharan population. Both progression and regression of the disease were found; however, the majority of the individuals who had definite features of RHD had evidence of continuing RHD lesions five years later. There was an increased risk of RHD in the family relatives of borderline and definite cases, notably among siblings. The findings highlight the problems faced in addressing the problem of RHD in the rural areas of sub-Saharan Africa. They add to the evidence that community-based interventions for RHD will be required, together with appropriate ways of identifying active disease, achieving adequate penicillin prophylaxis and developing vaccines for primary prevention.
Clinical diversity and treatment results in Tegumentary Leishmaniasis: A European clinical report in 459 patients
Authors: Guery Romain , Walker Stephen L. , Harms Gundel , Neumayr Andreas , Van Thiel Pieter , Gangneux Jean-Pierre , Clerinx Jan , Söbirk Sara Karlsson , Visser Leo , Lachaud Laurence , Bailey Mark , Bart Aldert , Ravel Christophe , Van der Auwera Gert , Blum Johannes , Lockwood Diana N. , Buffet Pierre ,   on behalf of the LeishMan Network and the French Cutaneous Leishmaniasis Study group
Published: October 2021

Background

Cutaneous leishmaniasis (CL) is frequent in travellers and can involve oro-nasal mucosae. Clinical presentation impacts therapeutic management.

Methodology

Demographic and clinical data from 459 travellers infected in 47 different countries were collected by members of the European LeishMan consortium. The infecting Leishmania species was identified in 198 patients.

Principal findings

Compared to Old World CL, New World CL was more frequently ulcerative (75% vs 47%), larger (3 vs 2cm), less frequently facial (17% vs 38%) and less frequently associated with mucosal involvement (2.7% vs 5.3%). Patients with mucosal lesions were older (58 vs 30 years) and more frequently immunocompromised (37% vs 3.5%) compared to patients with only skin lesions. Young adults infected in Latin America with L. braziliensis or L. guyanensis complex typically had an ulcer of the lower limbs with mucosal involvement in 5.8% of cases. Typically, infections with L. major and L. tropica acquired in Africa or the Middle East were not associated with mucosal lesions, while infections with L. infantum, acquired in Southern Europe resulted in slowly evolving facial lesions with mucosal involvement in 22% of cases. Local or systemic treatments were used in patients with different clinical presentations but resulted in similarly high cure rates (89% vs 86%).

Conclusion/Significance

CL acquired in L. infantum-endemic European and Mediterranean areas displays unexpected high rates of mucosal involvement comparable to those of CL acquired in Latin America, especially in immunocompromised patients. When used as per recommendations, local therapy is associated with high cure rates.
Schistosoma mansoni egg-derived extracellular vesicles: A promising vaccine candidate against murine schistosomiasis
Authors: Mossallam Shereen F. , Abou-El-Naga Iman F. , Abdel Bary Amany , Elmorsy Eman A. , Diab Radwa G.
Published: October 2021

Extracellular vesicles (EVs) are protein-loaded nano-scaled particles that are extracellularly released by eukaryotes and prokaryotes. Parasite’s EVs manipulate the immune system, making them probable next-generation vaccines. Schistosomal EVs carry different proteins of promising immunizing potentials. For evaluating the immune-protective role ofSchistosoma mansoni(S.mansoni) egg-derived EVs against murine schistosomiasis, EVs were isolated from culturedS.mansonieggs by progressive sequential cooling ultra-centrifugation technique. Isolated EVs were structurally identified using transmission electron microscope and their protein was quantified by Lowry’s technique. Experimental mice were subcutaneously immunized with three doses of 20 μg EVs (with or without alum adjuvant); every two weeks, then were challenged withS.mansonicercariae two weeks after the last immunizing dose. Six weeks post infection, mice were sacrificed for vaccine candidate assessment. EVs protective efficacy was evaluated through parasitological, histopathological, and immunological parameters. Results showed significant reduction of tegumentally deranged adult worms, hepatic and intestinal egg counts reduction by 46.58%, 93.14% and 93.17% respectively, accompanied by remarkable amelioration of sizes, numbers and histopathology of hepatic granulomata mediated by high interferon gamma (IFN γ) and antibody level. Using sera from vaccinated mice, the molecular weight of EVs’ protein components targeted by the antibody produced was recognized by western immunoblot. Results revealed two bands of ~ 14 KDa and ~ 21 KDa, proving that EVs are able to stimulate specific antibodies response. In conclusion, the present study highlighted the role ofS.mansoni-egg derived EVs as a potential vaccine candidate against murine schistosomiasis mansoni.
Assessing a chip based rapid RTPCR test for SARS CoV-2 detection (TrueNat assay): A diagnostic accuracy study
Authors: Ghoshal Ujjala , Garg Atul , Vasanth Shruthi , Arya Akshay K. , Pandey Ankita , Tejan Nidhi , Patel Vikas , Singh Vikram P.
Published: October 2021

COVID-19 testing is required before admission of a patient in the hospitals, invasive procedures, major and minor surgeries etc. Real Time Polymerase chain reaction is the gold standard test for the diagnosis, but requires well equipped biosafety laboratory along with trained manpower. In this study we have evaluated the diagnostic accuracy of novel TrueNat molecular assay for detecting SARS CoV-2. TrueNat is a chip-based real time PCR test and works on portable, light weight, battery powered equipment and can be used in remote areas with poor infrastructure. In this study 1807 patients samples were collected for both TrueNat and RTPCR COVID-19 testing during study period. Of these 174 (9.7%) and 174 (15%) were positive by RTPCR and TrueNat respectively and taking results of RTPCR as gold standard TrueNat test showed a sensitivity, specificity and diagnostic accuracy of 69.5, 90.9% and 89.2% respectively. It can be concluded that TrueNat is a simple, easy to use, good rapid molecular diagnostic test for diagnosis of COVID-19 especially in resource limited settings and will prove to be a game changer of molecular diagnostics in future.