bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses as the leading fighters during the COVID-19 pandemic: Self-transcendence
Authors: Aydın Mesiya , Aydın Avci İlknur , Kulakaç Özen
Published: March 2022

Background

The Covid 19 pandemic has led to and continues to pose challenges for healthcare systems globally, especially in intensive care units. This research was conducted to examine the self-transcendence of the leading fighters, intensive care nurses, during the Covid 19 pandemic.

Methods

The descriptive phenomenological research method was used in the study. The research was carried out between June and December 2020 with the nurses who care for Covid 19 patients in the Covid 19 intensive care service in different provinces of Turkey. The research was completed with 25 participants. A semi-structured interview form prepared based on the Theory of Self-Transcendence (vulnerability, self-transcendence, and well-being) and based on the literature was used to collect data.

Ethical considerations

Ethical requirements were respected in every phase of the research process. Results: The nurses in the study were found to experience vulnerability due to “administrative loneliness,” “inability to give care,” “fear of being a source of infection,” and “loneliness of patients.”

Conclusions

It has been found that “improvement in nursing roles and skills,” “being proud for oneself and the team,” “understanding the value of life,” and “feeling like a superhero due to the responsibilities shouldered during the pandemic” support nurses’ self-transcendence, which contributes to physical and mental well-being.
Persisting Type 2 Endoleaks Following EVAR for AAA Are Associated With AAA Expansion
Authors: Hatzl Johannes , Wang Vivian , Hakimi Maani , Uhl Christian , Rengier Fabian , Bruckner Thomas , Böckler Dittmar
Published: March 2022

Purpose:

To determine the evolution of abdominal aortic aneurysm (AAA) diameter in the presence of persisting type 2 endoleaks (pEL2) following endovascular abdominal aortic aneurysm repair (EVAR).

Materials and Methods:

This is a retrospective, single-center, case-control study. All patients with pEL2 (pEL2 group, persisting for > 12 months) between 2004 and 2018 were identified and compared with a 1:1 age- and gender-matched control with no endoleak (control group). Primary outcome measures were freedom from AAA expansion and freedom from AAA shrinkage over time. AAA diameter measurements were performed on computed tomography angiography (CTA). Secondary outcome measures were survival, AAA-related mortality, reinterventions for pEL2, incidence of secondary type 1 endoleaks (EL1), and infrarenal aortic branch vessel anatomy.

Results:

A total of 773 patients were treated with EVAR for AAA between 2004 and 2018. Of them, 286 patients demonstrated type 2 endoleaks (EL2) in postoperative CTA or intraoperative angiography (37%). Forty-five of 286 EL2 (15.7%) were pEL2 (pEL2 group). Freedom from AAA expansion in the pEL2 group was 100%, 96.7%, 85.2%, and 54.3% after 1, 2, 3, and 4 years, respectively, compared with 100% after 1, 2, 3, and 4 years in the control group (p<0.01). Freedom from AAA shrinkage in the pEL2 group after 1, 2, 3, and 4 years was 95.5%, 90.4%, 90.4%, and 79.1%, respectively, compared with 86.7%, 34.8%, 19.3%, and 19.3% in the control group (p<0.01). Overall survival at 1, 2, 3, and 4 years was 100%, 97.6%, 95.0% and 95.0% in the pEL2 group and 100% at 1, 2, 3, and 4 years in the control group (p=0.17). There were no AAA-related deaths in either group. Patients with pEL2 had a significantly increased number of infrarenal aortic branches (p<0.05, respectively). Eighteen patients (40.0%) in the pEL2 group underwent 34 reinterventions for pEL2, with a median follow-up (FU) of 925 days (0–4173). Clinical success was achieved in 9 patients (50.0%). Four patients (8.9%) with pEL2 developed secondary EL1 after a median FU of 1278 days (662–2121).

Conclusion:

pEL2 are associated with AAA expansion during midterm FU. Further studies are warranted to evaluate the association of AAA expansion due to pEL2 with clinical outcomes to allow recommendations with regard to treatment indications.
A metric for quantifying nonlinearity in k-dimensional complex-valued functions
Authors: Llewellyn Larry C , Grimaila Michael R , Hodson Douglas D , Graham Scott
Published: March 2022

Modeling and simulation is a proven cost-efficient means for studying the behavioral dynamics of modern systems of systems. Our research is focused on evaluating the ability of neural networks to approximate multivariate, nonlinear, complex-valued functions. In order to evaluate the accuracy and performance of neural network approximations as a function of nonlinearity (NL), it is required to quantify the amount of NL present in the complex-valued function. In this paper, we introduce a metric for quantifying NL in multi-dimensional complex-valued functions. The metric is an extension of a real-valued NL metric into the k-dimensional complex domain. The metric is flexible as it uses discrete input–output data pairs instead of requiring closed-form continuous representations for calculating the NL of a function. The metric is calculated by generating a best-fit, least-squares solution (LSS) linear k-dimensional hyperplane for the function; calculating the L2 norm of the difference between the hyperplane and the function being evaluated; and scaling the result to yield a value between zero and one. The metric is easy to understand, generalizable to multiple dimensions, and has the added benefit that it does not require a closed-form continuous representation of the function being evaluated.
Reading-based recognition and processing  of the oracle bone inscriptions:  An eye-tracking study
Authors: Chen Tingzhu , Wang Xiaoxue , Li Doudou , Jin Dawei
Published: March 2022

This paper aims at investigating the cognitive processing of the oracle bone inscriptions (OBIs) for L1 (first-language) speakers. Adopting both a behavioral and an eye-tracking experimental paradigm, the paper explores how language background and the prior learning of Chinese characters affect L1 speakers’ recognition and processing of the OBIs. Our results reveal the following. (1) L1 speakers process distinct oracle structural categories differently. In terms of accuracy, the recognition of the xiangxing and huiyi structures is better than that of the zhishi and xingsheng structures. In terms of eye-movement metrics, the differences in processing converged with the behavioral findings. (2) L1 speakers differ in the processing of oracle characters depending on their structural similarities with the corresponding modern Chinese characters. Furthermore, characters with structural symmetry are easier to recognize, as reflected in their higher accuracy (behavioral task) and shorter duration (eye-tracking task). (3) The recognition and the eye-movement experimental data reveal a significant effect of learning. The current study carries empirical and theoretical implications for understanding the underlying comprehension mechanisms of the OBIs and the application of computer-assisted oracle recognition techniques.
Medical marijuana knowledge and attitudes amongst internal medicine residents
Authors: Makki Iman , Zheng-Lin Binbin , Kohli Maanit
Published: March 2022

Background

Mounting evidence suggests the safety and efficacy of medical marijuana (MM) in treating chronic ailments, including chronic pain, epilepsy, and anorexia. Despite incremental use of medical and recreational cannabinoids, current limited evidence shows generalized unpreparedness of medical providers to discuss or recommend these substances to their patients. Herein, the present study aims to examine internal medicine residents’ knowledge of marijuana and their attitude towards its medical use.

Methods

This is a descriptive cross-sectional study. A survey with 12 standardized queries was created and distributed among the internal medicine residents from Mount Sinai Morningside-West (MSMW) program from July 2020 to December 2020. Participants included preliminary and categorical residents from post-graduate years one to three. The survey consisted of self-assessment of residents’ knowledge on the indication, contraindication, adverse effects of MM.

Results

Eighty-six (59%) out of 145 residents completed the questionnaire. Despite most trainees (70%) having considered certifying the use of MM for their patients, over 90% reported none to little knowledge on its use. Approximately 80% of the surveyed residents expressed willingness to receive an appropriate educational curriculum.

Conclusion

To the best of our knowledge, this is the first study that indicated a critical lack of medical marijuana-related knowledge in surveyed internal medicine residents. In a population with growing cannabis consumption, physician training on the indication, toxicity, and drug interaction of cannabinoids is warranted.
Incidence of thyroid nodules in early stage autosomal polycystic kidney disease
Authors: Zalewska Ewa , Kaniuka-Jakubowska Sonia , Wiśniewski Piotr , Jankowska Magdalena , Sworczak Krzysztof , Dębska-Ślizień Alicja
Published: March 2022

Background

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. Defect in cilia-mediated signaling activity is a crucial factor leading to cyst formation. Hence, ADPKD is regarded as a systemic disorder with multiple extrarenal complications, including cysts in other organs, for instance, the liver, pancreas, spleen, or ovaries. Interestingly, loss-of-function of primary cilia has been recently found to contribute to a malignant transformation from degenerated thyroid follicles. However, the increased incidence of thyroid nodules in ADPKD patients has not yet been fully confirmed.

Objectives

To determine the incidence of thyroid lesions in patients with ADPKD in comparison to previous population studies. Moreover, we aimed to investigate if the pace of the disease progression is associated with a higher prevalence of thyroid lesions.

Material and methods

In 49 early-stage ADPKD patients recruited from our center, we performed ultrasonography of the thyroid glands, and laboratory evaluation of thyroids function. We compared the results with population studies.

Results

Twenty-three individuals had solid, cystic-solid, or cystic lesions revealed in the ultrasonography and 2 patients had a positive past medical history for thyroidectomy due to nodular goiter. In 10 patients out of the 23, only minor cysts with no clinical significance were found and 13 out of the 23 patients had solid or cystic-solid lesions, which occurred to be benign based on three years of follow-up or the biopsy of the nodule.

Conclusions

We found no increased incidence of thyroid gland lesions in early ADPKD patients in comparison to previous population studies. Plausibly, mechanisms other than defective cilia signaling are involved in the risk for focal thyroid lesions formation. Moreover, the rate of progression of kidney function decline seems to be not accompanied by the higher incidence of thyroid pathology.
Do limbal relaxing incisions during cataract surgery still have a role?
Authors: Abu-Ain Mohammad Saleh , Al-latayfeh Motasem Mohammad , Khan Mohammad Irfan
Published: March 2022

Background

Though Limbal Relaxing Incisions (LRI) were used widely to correct pre-existing corneal astigmatism during cataract surgery, they have been replaced recently with the more expensive methods like the use of toric Intra Ocular Lenses (IOL) and femtosecond during cataract surgery. We conducted our study to re-evaluate the role of (LRI) in correcting pre-existing moderate corneal astigmatism during cataract surgery in settings where other options are neither available nor affordable.

Methods

Retrospective analysis of all consecutive cases of LRI performed by a single surgeon at the time of cataract surgery to correct moderate corneal astigmatism (1.5-3D) in a community hospital over a period of 6 months. Corneal astigmatism, uncorrected distance visual acuity (UDVA) and best corrected distance visual acuity (CDVA) were recorded pre-operatively, 4 weeks and 3 months post-operatively. Data on age, intraocular lens (IOL) power, predictive refraction and post-operative spherical equivalent was also collected and analyzed. The number and position of LRI was determined based on the pre-existing corneal astigmatism using online calculator.

Results

29 eyes of 25 patients with the mean age of 73.6 years (range: 46 to 90 years) and corneal astigmatism between 1.5 to 3D were included. Statistically significant reduction in the mean corneal astigmatism was recorded from 2.05 ± 0.45D preoperatively to 0.85 ± 0.56D postoperatively (P < 0.0001). All eyes showed reduction in astigmatism; 83% of eyes had < 1.0D post-operatively and 66% of eyes had < 0.75D. UDVA of 6/9 or better was recorded in 80% of eyes post-operatively (CDVA of 6/9 or better in 100%). The spherical equivalent was within 1.0D of the predictive refraction postoperatively in nearly all eyes (97%) and within 0.5D in 86% of the eyes. There were no peri-operative or post-operative complications were recorded in any case.

Conclusion

Combining LRI and cataract surgery to address moderate degrees of corneal astigmatism is a safe, reliable and predictable option especially in areas where more expensive methods such as toric IOL or excimer laser are not available or affordable. LRI has no significant effect on the spherical equivalent and is an excellent tool in reducing patient’s spectacle dependence.
The potential of food environment policies to reduce socioeconomic inequalities in diets and to improve healthy diets among lower socioeconomic groups: an umbrella review
Authors: Løvhaug Anne Lene , Granheim Sabrina Ionata , Djojosoeparto Sanne K. , Harrington Janas M. , Kamphuis Carlijn B. M. , Poelman Maartje P. , Roos Gun , Sawyer Alexia , Stronks Karien , Torheim Liv Elin , Twohig Cliona , Vandevijvere Stefanie , van Lenthe Frank J. , Terragni Laura
Published: March 2022

Socioeconomic inequalities in diets need to be tackled to improve population diets and prevent obesity and diet-related non-communicable diseases. The potential of food environment policies to reduce such inequalities has to date however not been appraised. The objective of this umbrella review was to assess the impact of food environment policies on socioeconomic inequalities in diets and to identify knowledge gaps in the existing literature, using the Healthy Food Environment Policy Index as a conceptual framework. The policies considered in the umbrella review are within six domains: 1) food composition 2) food labelling 3) food promotion 4) food provision 5) food retail 6) food pricing. A systematic search for systematic literature reviews on the effect of food environment policies on dietary-related outcomes across socioeconomic groups and published in English between 2004 and 2019 was conducted. Sixteen systematic literature reviews encompassing 159 primary studies were included, covering food composition (n = 2), food labelling (n = 3), food provision (n = 2), food prices (n = 13) and food in retail (n = 4). Quality assessment using the “Assessing the Methodological Quality of Systematic Reviews” quality rating scale showed that review quality was mainly low or critically low. Results suggest that food taxation may reduce socioeconomic inequalities in diets. For all other policy areas, the evidence base was poor. Current research largely fails to provide good quality evidence on impacts of food environment policies on socioeconomic inequalities in diets. Research to fill this knowledge gap is urgently needed.
Early life exposure to nicotine modifies lung gene response after elastase-induced emphysema
Authors: Blaskovic Sanja , Donati Yves , Ruchonnet-Metrailler Isabelle , Avila Yannick , Schittny Dominik , Schlepütz Christian Matthias , Schittny Johannes Constantin , Barazzone-Argiroffo Constance
Published: March 2022

Background

Chronic obstructive pulmonary disease (COPD) is among the top 5 causes of mortality in the world and can develop as a consequence of genetic and/or environmental factors. Current efforts are focused on identifying early life insults and how these contribute to COPD development. In line with this, our study focuses on the influence of early life nicotine exposure and its potential impact on (a) lung pulmonary functions, and (b) elastase-induced emphysema in adulthood.

Methods

To address this hypothesis, we developed a model of 2 hits, delivered at different time points: mouse pups were first exposed to nicotine/placebo in utero and during lactation, and then subsequently received elastase/placebo at the age of 11 weeks. The effect of nicotine pretreatment and elastase instillation was assessed by (a) measurement of pulmonary function at post-elastase day (ped) 21, and (b) transcriptomic profiling at ped3 and 21, and complementary protein determination. Statistical significance was determined by 3- and 2-way ANOVA for pulmonary functions, and RNAseq results were analyzed using the R project.

Results

We did not observe any impact of nicotine pre- and early post-natal exposure compared to control samples on lung pulmonary functions in adulthood, as measured by FLEXIVENT technology. After elastase instillation, substantial lung damage was detected by x-ray tomography and was accompanied by loss in body weight at ped3 as well as an increase in cell numbers, inflammatory markers in BAL and lung volume at ped21. Lung functions showed a decrease in elastance and an increase in deep inflation volume and pressure volume (pv) loop area in animals with emphysema at ped21. Nicotine had no effect on elastance and deep inflation volume, but did affect the pv loop area in animals with emphysema at ped21. Extensive transcriptomic changes were induced by elastase at ped3 both in the nicotine-pretreated and the control samples, with several pathways common to both groups, such as for cell cycle, DNA adhesion and DNA damage. Nicotine pretreatment affected the number of lymphocytes present in BAL after elastase instillation and some of the complement pathway related proteins, arguing for a slight modification of the immune response, as well as changes related to general body metabolism. The majority of elastase-induced transcriptomic changes detected at ped3 had disappeared at ped21. In addition, transcriptomic profiling singled out a common gene pool that was independently activated by nicotine and elastase.

Conclusions

Our study reports a broad spectrum of transient transcriptomic changes in mouse emphysema and identifies nicotine as influencing the emphysema-associated immune system response.
Paulo Freire: Review of “The Pedagogy of the Oppressed”
Authors: Gomes André
Published: March 2022

Book review of “The Pedagogy of the Oppressed” by Paulo Freire.
Intrauterine infusion of clinically graded human umbilical cord-derived mesenchymal stem cells for the treatment of poor healing after uterine injury: a phase I clinical trial
Authors: Huang Jingrui , Li Qi , Yuan Xiaohua , Liu Qiaoshu , Zhang Weishe , Li Ping
Published: March 2022

Background

Intrauterine adhesion and cesarean scar diverticulum are the main complications of poor healing after uterine injury. Human umbilical cord MSCs transplantation has been regarded as the most potential treatment in the clinic, the safety and efficacy of which in the clinic, however, remains unclear.

Methods

In this study, ten patients were enrolled: six with intrauterine adhesion and four with cesarean scar diverticulum. All the patients were injected with human umbilical cord MSCs twice into the uterus. Beside the chest X-ray, ECG and abdominal ultrasound, many laboratory tests including blood routine, liver and renal function, ovarian function, tumor biomarkers, and immune function were used to estimate the safe after stem cell transplanted. In addition, the efficacy of stem cell transplanted was shown by the endometrial thickness, the volume of the uterus, and cesarean scar diverticulum based on 3D ultrasound imaging.

Results

We found that all results of these laboratory tests were normal in these enrolled patients before and after cell injection. Meanwhile, the results of the chest X-ray and ECG were also normal in the treatment process. The abdominal ultrasound showed that the size of the left and right kidneys was inconsistent in one patient after cell therapy, while those of other patients were normal. In addition, endometrial thickness, the volume of the uterus, and cesarean scar diverticulum showed an improving tendency, but no significant difference was noted.

Conclusion

In summary, intrauterine injection of clinically graded human umbilical cord MSCs was safe for poor healing after uterus injury.

Trial registration NCT03386708. Registered 27 December 2017, https://clinicaltrials.gov/ct2/show/NCT03386708?cond=CSD&cntry=CN&draw=2&rank=2
EPC-EXs improve astrocyte survival and oxidative stress through different uptaking pathways in diabetic hypoxia condition
Authors: Halurkar Manasi Suchit , Wang Jinju , Chen Shuzhen , Bihl Ji Chen
Published: March 2022

Background

Hyperglycemia contributes to cardiovascular complications in patients with type 2 diabetes. We confirmed that high glucose (HG) induces endothelial dysfunction and cerebral ischemic injury is enlarged in diabetic mice. Stem cell-released exosomes have been shown to protect the brain from ischemic stroke. We have previously shown that endothelial progenitor cells (EPCs)-released exosomes (EPC-EXs) can protect endothelial cells from hypoxia/reoxygenation (H/R) and HG-induced injury. Here, we aim to investigate the effects of EPC-EXs on astrocytes under H/R and HG-induced injury and whether miR-126 enriched EPC-EXs (miR126-EPC-EXs) have enhanced efficacy.

Methods

EPC-EX uptake and co-localization were measured by fluorescent microscopy using PKH26 and DAPI staining. miR-126 enrichment was achieved by transfecting with miR-126 mimics and quantified with real-time PCR. After co-incubation, cell death or injury was measured by using LDH (Lactate Dehydrogenase) assay. Oxidative stress/ROS (reactive oxygen species) generation was measured by DHE (Dihydroethidium) staining and lipid peroxidation assay.

Results

The EPC-EXs were effectively taken up by the astrocytes in a concentration as well as time-dependent manners and were co-localized within the nucleus as well as the cytoplasm. Pathway uptake inhibitors revealed that the EPC-EXs are effectively taken up by the clathrin-mediated, caveolin-dependent, and micropinocytosis via PI3K/Akt pathway. H/R and HG-induced a cell injury which could be protected by EPC-EXs evidenced by decreased cell cytotoxicity, oxidative stress, and lipid peroxidation. Moreover, miR-126 overexpression could increase the level of miR-126 in astrocytes and enhance the protective effects of EPC-EXs.

Conclusions

These results collectively indicate that the EPC-EXs could protect astrocytes against the HG plus H/R-induced damage.
Enhanced production of alkane hydroxylase from Penicillium chrysogenum SNP5 (MTCC13144) through feed-forward neural network and genetic algorithm
Authors: Das Satyapriy , Negi Sangeeta
Published: March 2022

Alkane hydroxylase (AlkB), a membrane-bound enzyme has high industrial demand; however, its economical production remains challenging due to its intrinsic nature and co-factor dependency. In the current study, various critical process parameters for optimum production of AlkB have been optimized through feed forward neural network (FFNN) and genetic algorithm (GA) models using Penicillium chrysogenum SNP5 (MTCC13144). AlkB specific activity under preliminary un-optimized conditions i.e., 1% hexadecane, 7.4 pH, 11 days incubation time, 28 °C incubation temperature and 1 ml of inoculum size was 100 U/mg. ‘One variable at a time’ (OVAT) strategy was used to identify optimum physicochemical parameters and then its output data was fed to develop a model of FFNN with ‘6-12-1’ topology. Outputs of FFNN were further optimized through GA to minimize errors and intensify search level. This has provided superior predictive performances with 0.053 U/mg overall mean absolute percentage error (MAPE), 6.801 U/mg root mean square errors (RMSE), and 0.987 overall correlation coefficient (R). The AlkB specific activity improved by 3.5-fold, i.e., from 100 U/mg under preliminary un-optimized conditions to 351.32 U/mg under optimum physicochemical conditions obtained through FFNN-GA hybrid method, i.e., hexadecane (carbon source): 1.56% v/v, FeSO4: 0.63 mM, incubation temperature: 27.40 °C, pH: 7.38, incubation time: 12.35 days and inoculums size: 1.33 ml. The developed process would be a stepping stone to fulfill the high industrial demands of  Alkane hydroxylase.
Near infrared indocyanine green fluorescent cholangiography versus intraoperative cholangiography to improve safety in laparoscopic cholecystectomy for gallstone disease—a systematic review protocol
Authors: Pavel Mihai-Calin , Boira Mar Achalandabaso , Bashir Yasir , Memba Robert , Llácer Erik , Estalella Laia , Julià Elisabeth , Conlon Kevin C. , Jorba Rosa
Published: March 2022

Background

Laparoscopic cholecystectomy has become the standard surgical approach in the treatment of cholelithiasis. Diverse surgical techniques and different imaging modalities have been described to evaluate the biliary anatomy and prevent or early detect bile duct injuries. X-ray intraoperative cholangiography (IOC) and near infrared indocyanine green fluorescent cholangiography (NIR-ICG) are safe and feasible techniques to assess biliary anatomy. The aim of this systematic review will be to evaluate if NIR-ICG can visualize extrahepatic biliary anatomy more efficiently and safer than IOC in minimally invasive cholecystectomy for gallstone disease.

Methods

Literature search will be performed via MEDLINE (PubMed), Embase, Scopus, the Cochrane Central Register of Controlled Trials, and Web of Science Core Collection from 2009 to present. All randomized controlled clinical trials and prospective non-randomized controlled trials which report on comparison of NIR-ICG versus IOC will be included. All patients over 18 years old who require elective or urgent minimally invasive cholecystectomy (undergoing NIR-ICG during this procedure) due to gallstone disease both acute and chronic will be included. Since BDI has a low incidence, the primary outcome will be the ability to visualize extrahepatic biliary anatomy and the time to obtain relevant images of these structures.

Two researchers will individually screen the identified records, according to a list of inclusion and exclusion criteria. Bias of the studies will be evaluated with the Newcastle-Ottawa score for non-randomized studies and with The Cochrane Risk of Bias Tool for randomized controlled trials. Quality of evidence for all outcomes will be determined with the GRADE system. The data will be registered in a predesigned database. If selected studies are sufficiently homogeneous, we will perform a meta-analysis of reported results. In the event of a substantial heterogeneity, a narrative synthesis will be provided. Subgroup analysis will be used to investigate possible sources of heterogeneity.

Discussion

Understanding the benefits of this technique is critical to ensuring policymakers can make informed decisions as to where preventive efforts should be focused regarding specific imaging techniques. If ICG is proven to be faster and non-invasive, its routine use could be encouraged.

Systematic review registration

PROSPERO CRD42020177991.
Can monocultures be resilient? Assessment of buffer capacity in two agroindustrial cropping systems in Africa and South America
Authors: Mukhovi Stellah , Jacobi Johanna
Published: March 2022

Background

Buffer capacity—the capacity of a social–ecological system to cushion stress and shocks—is often seen as an important dimension of social–ecological system resilience. While numerous studies have focused on other dimensions of resilience in social–ecological systems, literature on buffer capacity is scanty.

Methods

Two agroindustrial cropping systems were surveyed based on wheat in Kenya, and soybean in Bolivia. The study was carried out in 2017–2018 using mixed methods; interviews, questionnaires, and observation. Two groups of indicators were used (livelihood capitals and functional and response diversity indicators). The five livelihood capitals, and functional and response diversity indicators (number of crops rotated, landscape heterogeneity, and percentage of arable land under natural vegetation) were used. Resilience indicators were assessed using a five-point Likert scale.

Results

Both systems had high scores on physical, financial and human capitals, while the functional and response diversity scores were low. Both systems are found to be vulnerable to economic and climate change related shocks hence need to develop more diversified patterns to increase ecological resilience.

Conclusion

The two cropping systems overall capacity to withstand shocks—particularly related mainly to climate change and variability and economic shocks was extremely low for soybean system and low for wheat. The two systems were found to have low scores of functional and response diversity especially with regard to landscape heterogeneity, crop and breed diversity and percentage of vegetation cover on arable land.
Continuous sulfide supply enhanced autotrophic production of alcohols with Clostridium ragsdalei
Authors: Oliveira Luis , Röhrenbach Simon , Holzmüller Verena , Weuster-Botz Dirk
Published: March 2022

Autotrophic syngas fermentation with clostridia enables the conversion of CO, CO2, and H2 into organic acids and alcohols. The batch process performance of Clostridium ragsdalei was studied in fully controlled and continuously gassed (600 mbar CO, 200 mbar H2, 200 mbar CO2) stirred-tank bioreactors. The final ethanol concentration varied as function of the reaction conditions. Decreasing the pH from pH 6.0–5.5 at a temperature of 37 °C increased the ethanol concentration from 2.33 g L−1 to 3.95 g L−1, whereas lowering the temperature from 37 to 32 °C at constant pH 6.0 resulted in a final ethanol concentration of 5.34 g L−1 after 5 days of batch operation. The sulphur availability was monitored by measuring the cysteine concentration in the medium and the H2S fraction in the exhaust gas. It was found that most of the initially added sulphur was stripped out within the first day of the batch process (first half of the exponential growth phase). A continuous sodium sulfide feed allowed ethanol concentrations to increase more than threefold to 7.67 g L−1 and the alcohol-to-acetate ratio to increase 43-fold to 17.71 g g−1.

Graphical Abstract
Evaluating different methods of MR-based motion correction in simultaneous PET/MR using a head phantom moved by a robotic system
Authors: Einspänner Eric , Jochimsen Thies H. , Harries Johanna , Melzer Andreas , Unger Michael , Brown Richard , Thielemans Kris , Sabri Osama , Sattler Bernhard
Published: March 2022

Background

Due to comparatively long measurement times in simultaneous positron emission tomography and magnetic resonance (PET/MR) imaging, patient movement during the measurement can be challenging. This leads to artifacts which have a negative impact on the visual assessment and quantitative validity of the image data and, in the worst case, can lead to misinterpretations. Simultaneous PET/MR systems allow the MR-based registration of movements and enable correction of the PET data. To assess the effectiveness of motion correction methods, it is necessary to carry out measurements on phantoms that are moved in a reproducible way. This study explores the possibility of using such a phantom-based setup to evaluate motion correction strategies in PET/MR of the human head.

Method

An MR-compatible robotic system was used to generate rigid movements of a head-like phantom. Different tools, either from the manufacturer or open-source software, were used to estimate and correct for motion based on the PET data itself (SIRF with SPM and NiftyReg) and MR data acquired simultaneously (e.g. MCLFIRT, BrainCompass). Different motion estimates were compared using data acquired during robot-induced motion. The effectiveness of motion correction of PET data was evaluated by determining the segmented volume of an activity-filled flask inside the phantom. In addition, the segmented volume was used to determine the centre-of-mass and the change in maximum activity concentration.

Results

The results showed a volume increase between 2.7 and 36.3% could be induced by the experimental setup depending on the motion pattern. Both, BrainCompass and MCFLIRT, produced corrected PET images, by reducing the volume increase to 0.7–4.7% (BrainCompass) and to -2.8–0.4% (MCFLIRT). The same was observed for example for the centre-of-mass, where the results show that MCFLIRT (0.2–0.6 mm after motion correction) had a smaller deviation from the reference position than BrainCompass (0.5–1.8 mm) for all displacements.

Conclusions

The experimental setup is suitable for the reproducible generation of movement patterns. Using open-source software for motion correction is a viable alternative to the vendor-provided motion-correction software.
Noise sensitivity of 89Zr-Immuno-PET radiomics based on count-reduced clinical images
Authors: Somasundaram Ananthi , García David Vállez , Pfaehler Elisabeth , Jauw Yvonne W. S. , Zijlstra Josée M. , van Dongen Guus A. M. S. , Menke-van der Houven van Oordt Willemien C. , Huisman Marc C. , de Vries Elisabeth G. E. , Boellaard Ronald
Published: March 2022

Purpose

Low photon count in 89Zr-Immuno-PET results in images with a low signal-to-noise ratio (SNR). Since PET radiomics are sensitive to noise, this study focuses on the impact of noise on radiomic features from 89Zr-Immuno-PET clinical images. We hypothesise that 89Zr-Immuno-PET derived radiomic features have: (1) noise-induced variability affecting their precision and (2) noise-induced bias affecting their accuracy. This study aims to identify those features that are not or only minimally affected by noise in terms of precision and accuracy.

Methods

Count-split 89Zr-Immuno-PET patient scans from previous studies with three different 89Zr-labelled monoclonal antibodies were used to extract radiomic features at 50% (S50p) and 25% (S25p) of their original counts. Tumour lesions were manually delineated on the original full-count 89Zr-Immuno-PET scans. Noise-induced variability and bias were assessed using intraclass correlation coefficient (ICC) and similarity distance metric (SDM), respectively. Based on the ICC and SDM values, the radiomic features were categorised as having poor [0, 0.5), moderate [0.5, 0.75), good [0.75, 0.9), or excellent [0.9, 1] precision and accuracy. The number of features classified into these categories was compared between the S50p and S25p images using Fisher’s exact test. All p values < 0.01 were considered statistically significant.

Results

For S50p, a total of 92% and 90% features were classified as having good or excellent ICC and SDM respectively, while for S25p, these decreased to 81% and 31%. In total, 148 features (31%) showed robustness to noise with good or moderate ICC and SDM in both S50p and S25p. The number of features classified into the four ICC and SDM categories between S50p and S25p was significantly different statistically.

Conclusion

Several radiomic features derived from low SNR 89Zr-Immuno-PET images exhibit noise-induced variability and/or bias. However, 196 features (43%) that show minimal noise-induced variability and bias in S50p images have been identified. These features are less affected by noise and are, therefore, suitable candidates to be further studied as prognostic and predictive quantitative biomarkers in 89Zr-Immuno-PET studies.
Protocol for a randomised controlled feasibility study examining the efficacy of brief cognitive therapy for the treatment of panic disorder in adolescents (PANDA)
Authors: Waite Polly
Published: March 2022

Background

Panic disorder occurs in between 1 and 3% of adolescents, is associated with high levels of co-morbidity, and without treatment, appears to have a chronic course. To improve access to effective psychological interventions, briefer versions of cognitive behaviour therapy (CBT) have been developed and evaluated for preadolescent children with anxiety disorders. However, there are currently no brief evidence-based CBT interventions for adolescents with anxiety disorders that can be delivered in less than eight sessions. Given that a brief version of cognitive therapy has been shown to be effective in adults with panic disorder, it is possible that an adapted version could be effective for adolescents with panic disorder.

Methods

The study will examine whether a definitive trial can be conducted, based on a single-centre feasibility randomised controlled trial using several well-defined criteria. Between 30 and 48 young people (age 11–18 years) who meet diagnostic criteria for panic disorder, attending a routine clinical service will be randomly allocated to receive either (i) brief cognitive therapy or (ii) a general form of CBT treatment that is more commonly used for adolescents with anxiety disorders. Both will be delivered 1:1 by a therapist and involve five treatment sessions and two booster sessions. Young people’s outcomes will be assessed at the end of treatment and at 3-month follow-up, and qualitative interviews will be conducted to examine acceptability. We will also explore outcomes 1 year after the completion of treatment.

Discussion

This study will test the feasibility of a randomised controlled trial to compare brief cognitive therapy to a general form of CBT for adolescents with panic disorder in the UK. The outputs from the study will provide a clear indication of the feasibility of a future definitive trial and, if indicated, the critical resources that will be required and key information to inform the design and maximise the successful completion of the trial. This has the potential to bring direct benefits to young people and their families, as well as services and society more broadly.

Trial registration

This trial is registered on the ISRCTN Registry, registration number ISRCTN14884288, registered retrospectively on 05/12/2019.
Lateral position for difficult intubation in a patient with history of hemiglossectomy and flap reconstruction: a case report
Authors: Yokogawa Fumiko , Oe Katsunori , Hosokawa Maiko , Masui Kenichi
Published: March 2022

Background

Reconstructive head and neck surgery can alter upper airway anatomy. We report a difficult intubation in a patient with a history of hemiglossectomy and reconstruction.

Case presentation

A 65-year-old female patient, who had undergone hemiglossectomy with the flap reconstruction, underwent video-assisted thoracoscopic esophagectomy for esophageal cancer. After the loss of consciousness during anesthesia induction, we failed to perform direct and oral fiberoptic intubation using a video laryngoscope and nasal fiberoptic intubation without or with video laryngoscope assistance in the supine position. Finally, shifting the patient to the left-lateral position allowed successful nasal fiberoptic intubation. Postoperatively, we were informed that she was unable to sleep in the supine position because of airway obstruction and therefore always slept on her side.

Conclusion

Preanesthetic evaluation of the influence of body position on the airway patency during sleep or sedation may aid in airway management.
Association Between Adherence to Clinical Practice Guidelines for Adjuvant Therapy for Breast Cancer and Survival in a Resource-Limited Setting
Authors: Song Chin Vern , Yip Cheng-Har , Mohd Taib Nur Aishah , See Mee Hoong , Teoh Li Ying , Monninkhof Evelyn M. , Saad Marniza , Uiterwaal Cuno S.P.M. , Bhoo-Pathy Nirmala
Published: March 2022

PURPOSE

Addressing unwarranted clinical variation in oncology practices is expected to lead to improved cancer outcomes. Particularly, the application and impact of treatment guidelines on breast cancer outcomes are poorly studied in resource-limited settings. We measured adherence to a set of locally developed adjuvant treatment guidelines in a middle-income setting. Importantly, the impact of guidelines adherence on survival following breast cancer was determined.

METHODS

Data of 3,100 Malaysian women with nonmetastatic breast cancer diagnosed between 2010 and 2017 were analyzed. Adherence to the Malaysian Clinical Practice Guidelines for Management of Breast Cancer second Edition was measured. Outcomes comprised overall survival and event-free survival.

RESULTS

Guideline adherence for chemotherapy, radiotherapy, hormonal therapy, and targeted therapy were 61.7%, 79.2%, 85.1%, and 26.2%, respectively. Older age was generally associated with lower adherence to guidelines. Compared with patients who were treated according to treatment guidelines, overall survival and event-free survival were substantially lower in patients who were not treated accordingly; hazard ratios for all-cause mortality were 1.69 (95% CI, 1.29 to 2.22), 2.59 (95% CI, 1.76 to 3.81), 3.08 (95% CI, 1.94 to 4.88), and 4.48 (95% CI, 1.98 to 10.13) for chemotherapy, radiotherapy, hormone therapy, and targeted therapy, respectively. Study inferences remain unchanged following sensitivity analyses.

CONCLUSION

Our study findings appear to suggest that adherence to treatment guidelines that have been adapted for resource-limited settings may still provide effective guidance in improving breast cancer outcomes.
Survey of US Medical Oncologists' Practices and Beliefs Regarding DPYD Testing Before Fluoropyrimidine Chemotherapy
Authors: Koo Kyoin , Pasternak Amy L. , Henry N. Lynn , Sahai Vaibhav , Hertz Daniel L.
Published: March 2022

PURPOSE:

Patients who carry reduced-activity DPYD polymorphisms have increased fluoropyrimidine (FP) toxicity risk. Although pretreatment DPYD testing is recommended throughout most of Europe, it is not recommended in the United States, and adoption has been limited. The objective of this survey was to describe the current practice in the United States regarding pretreatment DPYD testing and understand the factors deterring oncologists from ordering testing.

METHODS:

Survey invitations were e-mailed to 325 medical oncologists practicing in the United States who are members of the SWOG Cancer Research Network Gastrointestinal Cancer, Breast Cancer, or Early Therapeutics Committees. Descriptive statistics were used to evaluate survey responses.

RESULTS:

Responses were collected from 59 (18.2%) US medical oncologists, of whom 98% strongly or somewhat agree that patients with dihydropyrimidine dehydrogenase (DPD) deficiency have increased toxicity risk and 96% would modify FP dosing for a patient with known DPD deficiency. However, only 32% strongly or somewhat agree that pretreatment DPYD testing is useful to inform FP treatment, 20% have ever ordered pretreatment testing, and 3% order testing for at least 10% of their FP-treated patients. The most important factors that deter oncologists from ordering testing were low prevalence of DPD deficiency (54%) and lack of clinical practice guideline recommendations (48%).

CONCLUSION:

Clinical adoption of pretreatment DPYD testing is extremely limited in the United States. Utilization may be substantially increased by inclusion in the oncology clinical practice guideline recommendations, coverage through health insurance, and potentially education of medical oncologists regarding available treatment modification guidelines.
Before #MeToo: The History of the 9to5 Job Survival Hotline
Authors: Twarog Emily E. LB.
Published: March 2022

In the 1970s and 1980s, the tension between achievable goals and systemic change defined the work of the women's movement. This was very evident in the fight to end sexual harassment in the workplace. This article examines how 9to5, a national organization of women workers, created their own effective means of response, hence the early success of 9to5. In particular, it explores the use of the telephone hotline as a critical tool in information gathering and organizing.
Tossing Men Out of Bars: Consent in Today's Working Class
Authors: Balay Anne
Published: March 2022

Consent and sexuality are shaped by the class and labor contexts in which they emerge. This article imagines how these various overlapping categories operate by turning to particular stories of working-class resistance. How do truck drivers, adjunct professors, steelworkers, and others navigate their jobs and their genders as each produces and shapes the other? Dangerous and insecure labor contexts enable ways of inhabiting a body that are queer and perverse and transformative.
An Alternative Synthesis of Tribenzodecacyclenes and Experimental Barrier to Propeller Inversion
Authors: Fukamizo Shun , Ikeda Hiroshi , Tsurumaki Eiji , Toyota Shinji
Published: March 2022

The title polycyclic aromatic hydrocarbons were synthesized by Pd-catalyzed Heck-type cyclotrimerization of 2-bromoaceanthrylene derivatives. X-ray analysis of the 2,4,6-trimethylphenyl substituted derivative revealed that molecules took a propeller-shaped aromatic framework. The barrier to propeller inversion of this derivative was determined to be 81 kJ mol−1 by a dynamic NMR method.
Επίδραση των χαρακτηριστικών της προσωπικότητας, του στυλ μαθήσεως και της εξάρτησης από το πεδίο στις επιδόσεις των μαθητών γενικής εκπαίδευσης στο μάθημα της Χημείας Λυκείου
Authors: Ατλάσης Χρήστος
Published: March 2022

Η παρούσα διατριβή αποτελεί μια προσπάθεια διερεύνησης, της επίδρασης των χαρακτηριστικών της προσωπικότητας, του στυλ μάθησης, όπως και άλλων ψυχομετρικών παραγόντων, στις διαθέσεις αλλά και στις επιδόσεις των μαθητών γενικής εκπαίδευσης στο μάθημα της Χημείας. Στα πλαίσια αυτά, διερευνήσαμε: (α) τους τρόπους, με τους οποίους τα άτομα προσλαμβάνουν και επεξεργάζονται τις πληροφορίες, (β) τον τύπο της προσωπικότητάς τους και πως αυτά τα χαρακτηριστικά σχετίζονται με την επίδοση τους στο μάθημα της Χημείας.Ειδικότερα, η διατριβή αποτελείται από δύο μέρη, το θεωρητικό και το ερευνητικό. Όσον αφορά το θεωρητικό πλαίσιο της διατριβής αυτό στηρίζεται: α) στο μοντέλο των αισθητηρίων τρόπων μάθησης, β) στο πολυδιάστατο μοντέλο της προσωπικότητας της Myers- Briggs (Myers-Briggs Type Indicator, 1962), που αξιολογεί τους οκτώ λειτουργικούς τύπους του Jung (1954) και έχει μεταφραστεί και σταθμιστεί στον ελληνικό πληθυσμό από τους Stalikas & Fitopoulos (1998) και γ) στη Θεωρία της Πολλαπλής Νοημοσύνης του Howard Gardner (Gardner, 1983) που αναγνωρίζει εννέα είδη νοημοσύνης που έχουν την έδρα τους σε διαφορετικά σημεία του εγκεφάλου μας, καθώς το άτομο μαθαίνει, επικοινωνεί και επιλύει προβλήματα με νοητικές λειτουργίες που αποτελούν αποτέλεσμα του συνδυασμού των εννέα τύπων νοημοσύνης. Επίσης, όσον αφορά το ερευνητικό τμήμα της διατριβής διενεργούνται πέντε μελέτες. Δείγμα στις τέσσερεις πρώτες μελέτες της διατριβής αποτελούν 152 μαθητές από δύο Λύκεια της Θεσσαλονίκης (ένα δημόσιο και ένα ιδιωτικό). Στην τελευταία μελέτη το δείγμα αποτελείται από τους 56 μαθητές που πέτυχαν βαθμολογία πάνω από 80/100 στις Πανελλαδικές Εξετάσεις στο μάθημα της Χημείας και από 10 μαθητές που πέτυχαν βαθμολογία κάτω από 30/100.Τέλος, επιχειρείται η ερμηνεία των ευρημάτων με βάση τις θεωρίες για την προσωπικότητα και τις θεωρίες για τους τρόπους μάθησης, με βάση τους στόχους και τις υποθέσεις που είχαν τεθεί στο αρχικό στάδιο του σχεδιασμού της διδακτορικής διατριβής, ενώ γίνεται αναφορά στα βασικά συμπεράσματα της έρευνας και στην εφαρμογή τους στην εκπαιδευτική πράξη, αλλά υποβάλλονται και προτάσεις για μελλοντικές μελέτες και τη διασύνδεσή τους με την παιδαγωγική επιστήμη και την εκπαίδευση, γενικότερα.