bluuebunny/crossref_metadata_2025 huggingface dataset:
A new species of cascade frog (Anura: Ranidae: Amolops) from central Yunnan, China
Authors: Tang Shangjing , Sun Tao , Liu Shuo , Luo Sangdi , Yu Guohua , Du Lina
Published: July 2023

A new species of the genusAmolops,Amolops ailaosp. nov., is described from central Yunnan, China. The new species belongs to theA. mantzorumspecies group. Phylogenetic analyses based on the combination of mitochondrial 16S rRNA, COI, and cytb genes revealed that the new species is the sister taxon toAmolops ottorumwith strong support. Genetically, the new species differs fromA. ottorumby 5.0% in cytb sequences. Morphologically, the new species can be distinguished from known congeners by the combination of the following characters: true dorsolateral folds absent, but dorsolateral folds formed by series of glands present; circummarginal groove on tip of first finger absent; body size small (males SVL 33.0–35.1 mm and female SVL 41.3 mm); HW/SVL 0.32‒0.35; UEW/SVL 0.08‒0.10; THL/SVL 0.52‒0.56; vomerine teeth absent; interorbital distance narrower than internarial distance; tympanum distinct, less than half eye diameter; supratympanic fold present, indistinct; a pair of large tubercles on sides of cloaca; tibiotarsal articulation reaching beyond anterior corner of eye; and vocal sac absent. The cladogenesis events within theA. mantzorumgroup rapidly occurred from Pliocene 4.23 Mya to Pleistocene 1.2 Mya, coinciding with the recent intensive uplift of the Qinghai-Tibetan Plateau since the Pliocene. Combining findings in this study with the most recent taxonomic progress, we consider that there are 20 knownAmolopsspecies in Yunnan, China, accounting for the highest proportion of amphibian diversity of Yunnan, and five of them belong to theA. mantzorumgroup. Among different subfauna and water systems in Yunnan, the species diversity ofAmolopsin northwestern Yunnan and Nu River Basin is highest.
All professions can benefit — a mixed-methods study on simulation-based teamwork training for operating room teams
Authors: Escher Cecilia , Rystedt Hans , Creutzfeldt Johan , Meurling Lisbet , Hedman Leif , Felländer-Tsai Li , Kjellin Ann
Published: July 2023

Background

Operating rooms have become more technically complex due to new advanced procedures, which has increased demands on teamwork in the operating room. In response, team training has been proposed to improve team performance, workplace culture, and patient safety. We developed and delivered a simulation-based team training course for entire professional surgical teams. This type of intervention has been proposed by researchers but has not been widely published. The aims of this intervention study were to examine participants’ reactions to the course in terms of their motivation for the training and their self-efficacy in relation to their performance, as well as their views on transferring the lessons learned in the course to their workplace.

Methods

In a prospective mixed-methods intervention study, operating room professionals participated in a full-day simulation-based teamwork training course. Learning objectives were nontechnical skills, specifically communication and collaboration across the team.

Seventy-one staff members representing 5 operating room professions were included, and the average work experience of participants was 6 years.

Quantitative data on self-efficacy and situational motivation were collected by questionnaires before and after training. Qualitative data were collected through 5 focus group interviews that took place in direct relation to the courses and included a total of 31 participants. Transcripts were coded and analyzed using thematic analysis.

Results

All occupations showed a similar pattern in terms of increases in self-efficacy and intrinsic motivation after the training. Analysis of the qualitative data showed that training in one’s profession and in authentic multiprofessional teams was important factors for motivation. Participating staff described an awareness of undesirable communication barriers in surgical teams that can lead to risks for patients. Systematic training was definitely perceived as a means to reduce barriers and improve communication and collaboration.

Conclusion

Simulation-based training was equally well received by all professional groups. Our results confirm the feasibility of this type of training for professional teams and promising opportunities for improving teamwork skills. The qualitative data reveal both opportunities and limitations for transferring the learning experiences to the workplace.
Evaluating meaningful changes in physical functioning and cognitive declines in metachromatic leukodystrophy: a caregiver interview study
Authors: Martin Susan , Harris Nimanee , Romanus Dorothy
Published: July 2023

Background

Metachromatic leukodystrophy (MLD) is a rare lysosomal storage disease caused by deficient activity of arylsulfatase A (ASA). Treatment options for patients are limited; gene therapy based on haematopoietic stem cell transplantation is the only approved treatment for some subtypes of MLD. Any therapeutic benefit of treatments must be meaningful for patients and their families. We evaluated the clinical meaningfulness of slowing the decline in gross motor function as measured by the Gross Motor Function Classification in MLD (GMFC-MLD) from the caregiver perspective via semi-structured telephone interviews with caregivers of children with late-infantile MLD. We also evaluated the perceived significance of declines in communication abilities measured by the Expressive Language Function Classification in MLD (ELFC-MLD). This work could help to inform the endpoints of a phase 2 clinical trial (NCT03771898) assessing the efficacy of intrathecal recombinant human ASA in MLD.

Results

Twelve caregivers were recruited, reporting on 12 children with MLD. Children had a mean age of 6.1 years; mean age at symptom onset was 17.6 months. Most children (10/12) progressed from walking without support (categories 0–1) to a loss of locomotion (categories 5–6) in ≤ 2 years. Caregivers felt that GMFC-MLD and ELFC-MLD accurately described motor and language declines in their children, respectively. Most caregivers (10/12) reported that the idea of delaying disease progression would be meaningful. Further, a slowing of motor function decline in GMFC-MLD, from category 1 to category 3 or from category 2 to category 4 over 2 years, was seen as meaningful by all caregivers asked; however, only 3/12 caregivers reported that delayed decline would be meaningful if baseline category was ≥ 3. Caregivers also reported that delaying expressive language decline at any level that did not indicate a complete loss of expressive language (indicated by categories 1–3) would be meaningful.

Conclusions

Caregivers of children with MLD felt that a delayed decline in gross motor function, as assessed by the GMFC-MLD, would be meaningful, supporting the selection of primary and secondary endpoints for the phase 2 clinical trial. Communication abilities were another area of significance for consideration in future clinical trial design.
Adverse COVID-19 experiences and health-related quality of life in cancer survivors: indirect effects of COVID-19-related depression and financial burden
Authors: Perry Laura M. , Peipert John D. , Kircher Sheetal M. , Cantoral Jackelyn , Penedo Frank J. , Garcia Sofia F.
Published: July 2023

Background

Cancer survivors are at greater risk for poor health outcomes due to COVID-19. However, the pandemic's impact on patients’ health-related quality of life (HRQoL) is not well known. This study hypothesized that cancer survivors' adverse COVID-19 experiences would be associated with worse HRQoL. Further, this association would be moderated by psychosocial resiliency factors (perceived social support, benefits, and ability to manage stress) and mediated by psychosocial risk factors (anxiety, depression; health, financial and social concerns).

Methods

1,043 cancer survivors receiving care at Northwestern Medicine completed a cross-sectional survey on COVID-19 practical and psychosocial concerns from 6/2021 to 3/2022. Participants reported on 21 adverse COVID-19 experiences (e.g., COVID-19 hospitalization, death of family/friends, loss of income, medical delays). The survey assessed 9 psychosocial factors related to COVID-19: anxiety, depression; health care, financial, and social disruptions; health care satisfaction; social support, perceived benefits, and stress management skills. The FACT-G7 assessed HRQoL. Hypotheses were tested in a structural equation model. The number of reported adverse COVID-19 experiences was the primary (observed) independent variable. The dependent variable of HRQoL, and the proposed mediating and moderating factors, were entered as latent variables indicated by their respective survey items. Latent interaction terms between the independent variable and each resiliency factor tested moderation effects. Analyses were adjusted for demographic and COVID-specific variables.

Results

Participants were, on average, aged 58 years and diagnosed with cancer 4.9 years prior. They were majority female (73.3%), White (89.6%), non-Hispanic/Latino (94.5%), college-educated (81.7%), and vaccinated for COVID-19 (95.5%). An average of 3.8 adverse COVID-19 experiences were reported. Results of structural equation modeling demonstrated that the association between adverse COVID-19 experiences and HRQoL was explained by indirect effects through COVID-19-related depression (β = − 0.10, percentile bootstrap 95% CI − 0.15 to − 0.07) and financial concerns (β = − 0.04, percentile bootstrap 95% CI − 0.07 to − 0.01). Hypotheses testing moderation by resiliency factors were not significant.

Conclusions

Adverse COVID-19 experiences were associated with higher depression symptoms and financial concerns about COVID-19, and in turn, worse HRQoL. Oncology clinics should be cognizant of the experience of adverse COVID-19 events when allocating depression and financial support resources.
Sperm chromosomal abnormalities in infertile men with failed intracytoplasmic sperm injection (ICSI)
Authors: Elnahas Rania Fathy , Behery Amal Kotb , Kholeif Soha , Orief Yasser Ibrahim , Elhady Ghada Mohamed
Published: July 2023

Background

Male infertility is a major health problem with multi-factorial etiology. Intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of men with severely compromised semen parameters and improved their chances of achieving pregnancy. However, many concerns have been raised about ICSI safety; in part owing to utilizing aneuploid sperms from infertile men, which may be associated with an increased incidence of chromosomal aneuploidies in ICSI pregnancies. The aim of the study was to determine the incidence of sperm aneuploidies for chromosomes 13, 18, 21, X, and Y in semen of infertile males with failed ICSI. This will assist infertile couples and enable them to make informed decisions. For this purpose, sperm aneuploidy frequency for chromosomes 13, 18, 21, X, and Y was evaluated by multicolor fluorescence in-situ hybridization (FISH) in 35 patients with abnormal semen parameters, and 10 normozoospermic healthy men who served as controls.

Results

Sperm aneuploidies for chromosomes 13, 18, 21, X, and Y in semen from infertile men with failed ICSI were detected at higher frequencies than controls. Patients had significantly higher disomy, nullisomy, diploidy, and polyploidy frequencies compared to controls.

Conclusions

Infertile men with failed ICSI have a significantly increased frequency of sperm chromosome abnormalities compared to controls. Fluorescence in situ hybridization facilitated the study of numerical chromosomal abnormalities in human sperm nuclei (sperm FISH). Sperm FISH, prior to the application of assisted reproductive techniques, saves a considerable amount of time and resources.
Fluorodeoxyglucose positron emission tomography (18F-FDG PET)-computed tomography (CT) in the initial staging of bladder cancer: a single institution experience
Authors: Shahait Mohammed , Abu-Hijlih Ramiz , Farkouh Ala’a , Obeidat Shahed , Salah Samer , Abdlkadir Ahmed Saad , Al-Ibraheem Akram
Published: July 2023

Background

The purpose of this study was to assess the usefulness of fluorodeoxyglucose positron emission tomography (18F-FDG PET)-computed tomography (CT) scan for staging urinary bladder cancer. The study also sought to determine the effect of 18F-FDG PET/CT on management decisions and its implications for patient care.

Methods

A total of 133 patients with bladder cancer who had both conventional imaging and 18F-FDG PET/CT for initial staging were identified. All 18F-FDG-PET/CT findings were classified as true positive, true negative, false positive, or false negative based on their potential to impact the intent of treatment. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated using the standard definition. Furthermore, the rate of change in therapy intent was determined for the entire sample and for subgroups with non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) patients.

Results

The overall concordance rate between PET/CT and conventional imaging was around 54%. On conventional images, 18% of patients had localized disease, which was upstaged in 6.8% of cases using 18F-FDG PET/CT. Pelvic lymph node involvement was detected in 18.8% of cases using conventional imaging, which was downstaged to localized disease in 4.5% of cases using 18F-FDG PET/CT. While 63.2% of patients had systemic disease on a CT scan, 24.7% of cases were downstaged using PET/CT. Overall, the rate of change in therapy intent was 26.3% for the entire sample, 24.5% for NMIBC subgroup, and 27.3% for MIBC patients.

Conclusions

The study found that 18F-FDG PET/CT is an effective and accurate tool for staging bladder cancer in newly diagnosed patients. Approximately one quarter of patients had a change in management intent based on 18F-FDG PET/CT results. The study suggests that PET/CT should be used as a standard for newly diagnosed patients, but more research is needed to confirm this.
Bevacizumab in Combination With Oxaliplatin-Based Chemotherapy As First-Line Therapy in Metastatic Colorectal Cancer: A Randomized Phase III Study
Authors: Saltz Leonard B. , Clarke Stephen , Díaz-Rubio Eduardo , Scheithauer Werner , Figer Arie , Wong Ralph , Koski Sheryl , Lichinitser Mikhail , Yang Tsai-Shen , Rivera Fernando , Couture Felix , Sirzén Florin , Cassidy Jim
Published: July 2023

Purpose

To evaluate the efficacy and safety of bevacizumab when added to first-line oxaliplatin-based chemotherapy (either capecitabine plus oxaliplatin [XELOX] or fluorouracil/folinic acid plus oxaliplatin [FOLFOX-4]) in patients with metastatic colorectal cancer (MCRC).

Patients and Methods

Patients with MCRC were randomly assigned, in a 2 × 2 factorial design, to XELOX versus FOLFOX-4, and then to bevacizumab versus placebo. The primary end point was progression-free survival (PFS).

Results

A total of 1,401 patients were randomly assigned in this 2 × 2 analysis. Median progression-free survival (PFS) was 9.4 months in the bevacizumab group and 8.0 months in the placebo group (hazard ratio [HR], 0.83; 97.5% CI, 0.72 to 0.95; P = .0023). Median overall survival was 21.3 months in the bevacizumab group and 19.9 months in the placebo group (HR, 0.89; 97.5% CI, 0.76 to 1.03; P = .077). Response rates were similar in both arms. Analysis of treatment withdrawals showed that, despite protocol allowance of treatment continuation until disease progression, only 29% and 47% of bevacizumab and placebo recipients, respectively, were treated until progression. The toxicity profile of bevacizumab was consistent with that documented in previous trials.

Conclusion

The addition of bevacizumab to oxaliplatin-based chemotherapy significantly improved PFS in this first-line trial in patients with MCRC. Overall survival differences did not reach statistical significance, and response rate was not improved by the addition of bevacizumab. Treatment continuation until disease progression may be necessary in order to optimize the contribution of bevacizumab to therapy.
Modified gauge-unfixing formalism and gauge symmetries in the noncommutative chiral bosons theory
Authors: Costa Cleber N. , Ambrósio Gabriella V. , Alves Paulo R. F. , Ananias Neto Jorge , Thibes Ronaldo
Published: July 2023

We use the gauge-unfixing (GU) formalism framework in a two-dimensional noncommutative chiral bosons (NCCB) model to disclose new hidden symmetries. That amounts to converting a second-class system to a first-class one without adding any extra degrees of freedom in phase space. The NCCB model has two second-class constraints —one of them turns out as a gauge symmetry generator while the other one, considered as a gauge-fixing condition, is disregarded in the converted gauge-invariant system. We show that it is possible to apply a conversion technique based on the GU formalism direct to the second-class variables present in the NCCB model, constructing deformed gauge-invariant GU variables, a procedure which we name here as modified GU formalism. For the canonical analysis in noncommutative phase space, we compute the deformed Dirac brackets between all original phase space variables. We obtain two different gauge-invariant versions for the NCCB system and, in each case, a GU Hamiltonian is derived satisfying a corresponding first-class algebra. Finally, the phase space partition function is presented for each case allowing for a consistent functional quantization for the obtained gauge-invariant NCCB.
Targeted volume correlative light and electron microscopy of an environmental marine microorganism
Authors: Mocaer Karel , Mizzon Giulia , Gunkel Manuel , Halavatyi Aliaksandr , Steyer Anna , Oorschot Viola , Schorb Martin , Le Kieffre Charlotte , Yee Daniel P. , Chevalier Fabien , Gallet Benoit , Decelle Johan , Schwab Yannick , Ronchi Paolo
Published: July 2023

Photosynthetic microalgae are responsible for an important fraction of CO2 fixation and O2 production on Earth. Three-dimensional (3D) ultrastructural characterization of these organisms in their natural environment can contribute to a deeper understanding of their cell biology. However, the low throughput of volume electron microscopy (vEM) methods along with the complexity and heterogeneity of environmental samples pose great technical challenges. In the present study, we used a workflow based on a specific electron microscopy sample preparation method compatible with both light and vEM imaging in order to target one cell among a complex natural community. This method revealed the 3D subcellular landscape of a photosynthetic dinoflagellate, which we identified as Ensiculifera tyrrhenica, with quantitative characterization of multiple organelles. We show that this cell contains a single convoluted chloroplast and show the arrangement of the flagellar apparatus with its associated photosensitive elements. Moreover, we observed partial chromatin unfolding, potentially associated with transcription activity in these organisms, in which chromosomes are permanently condensed. Together with providing insights in dinoflagellate biology, this proof-of-principle study illustrates an efficient tool for the targeted ultrastructural analysis of environmental microorganisms in heterogeneous mixes.
PRINCIPAIS INDICADORES DE DESEMPENHO LOGÍSTICO DAS TRANSPORTADORAS NA QUALIDADE DA DISTRIBUIÇÃO DE MEDICAMENTOS NO BRASIL
Authors: Miquilim Marcello
Published: July 2023

O mercado de distribuição de medicamentos cresce a cada ano no Brasil, e a logística torna-se cada vez mais a estratégia da empresa não apenas em custos, mas em serviços e qualidade. O objetivo deste estudo é verificar quais são os principais indicadores de desempenho logístico das transportadoras na qualidade da distribuição de medicamentos no Brasil. Na cadeia de abastecimento de medicamentos, os distribuidores contratam transportadoras para que realizem as entregas para as farmácias, e mais da metade dos medicamentos que chegam às farmácias são nessas vias. Neste estudo, foi utilizado o método qualitativo, onde foram entrevistados 36 colaboradores de 9 empresas transportadoras e 9 farmácias recebedoras de medicamentos, vinculados aos maiores distribuidores de medicamentos no Brasil com representatividade de mais de 50% do mercado de distribuição de medicamentos no país. Na revisão de literatura, ficou confirmado que os indicadores de desempenho logístico com mais representatividade na qualidade da distribuição de medicamentos foram os prazos de entregas e a acuracidade dos pedidos, seguidos pelas regularizações da Anvisa para o transporte de medicamentos. Esses indicadores também foram os mais representativos no resultado das entrevistas, tanto da parte das transportadoras como por parte das farmácias.

 

Palavras-chave: Cadeia de Abastecimento. Transportes. Distribuição. Logística. Desempenho logístico. Qualidade na distribuição; Medicamentos.
Ομολογικές και ομοτοπικές ιδιότητες των επίπεδων προτύπων
Authors: Χατζησταυρίδης Κωνσταντίνος
Published: July 2023

Τα ακυκλικά συμπλέγματα προτύπων με πυρήνες που εμφανίζουν συγκεκριμένες ομολογικές ιδιότητες συνιστούν τη βάση της Gorenstein Ομολογικής Άλγεβρας. Σε αυτήν την εργασία μελετάμε τέτοια ακυκλικά συμπλέγματα κάτω από συνηθισμένες «πράξεις» προτύπων, όπως το τανυστικό γινόμενο και τις ομάδες ομομορφισμών, με σκοπό να ανακαλύψουμε κάποιες ενδιαφέρουσες ιδιότητές τους. Επιπλέον, θα ήταν χρήσιμο να διερευνηθεί η σχέση μεταξύ των πυρήνων του καινούριου συμπλέγματος, που προκύπτει από αυτές τις συγκεκριμένες πράξεις προτύπων. Η αναζήτηση αναλλοιώτων ωστόσο δεν περιορίζεται στην διατήρηση των ομολογικών ιδιοτήτων συμπλεγμάτων κάτω από πράξεις προτύπων, αλλά σχετίζεται με τις ενδιαφέρουσες έννοιες των silpR και spliR, τα οποία έχουν ορισθεί ως τα suprema των εμφυτευτικών μηκών των προβολικών προτύπων και των προβολικών μηκών των εμφυτευτικών προτύπων αντίστοιχα. Επειδή αυτές οι δυϊκές μεταξύ τους έννοιες μας δίνουν φράγματα για το πόσο απέχει ένας δακτύλιος από το να έχει όλα τα προβολικά πρότυπά του εμφυτευτικά και αντίστοιχα, όλα τα εμφυτευτικά πρότυπά του προβολικά, είναι χρήσιμο να καταλάβουμε σε μία πρώτη φάση το εάν και εάν ναι, υπό ποιές συνθήκες, η περατότητα του ενός αναλλοιώτου συνεπάγεται την περατότητα του άλλου. Προς αυτήν την κατεύθυνση, εκμεταλλευόμαστε την ιδιότητα κάποιων δακτυλίων να έχουν κάθε πεπερασμένα παραγόμενο ιδεώδες τους πεπερασμένα παριστώμενο, να είναι δηλαδή coherent.
Παραβατικότητα, φυλάκιση και σωφρονισμός στην Κέρκυρα κατά την περίοδο της Βρετανικής Προστασίας (1815-1864)
Authors: Δούντση Νικολαΐς-Αθηνά
Published: July 2023

Σκοπός της παρούσας διατριβής ήταν η μελέτη του συστήματος φυλάκισης στο Ιόνιο Κράτος -μέσα από την περίπτωση της Κέρκυρας- και πώς αυτό το σύστημα εξελίχθηκε στη διάρκεια των ετών, υπό την επίδραση της Βρετανικής Προστασίας και των νέων θεωριών περί σωφρονισμού που επικράτησαν τον 19ο αιώνα. Στόχος μας ήταν να παρουσιάσουμε την κοινωνία εντός των φυλακών της Κέρκυρας, τους ανθρώπους που την απαρτίζουν (τρόφιμοι και υπάλληλοι), τις ιδιαίτερες σχέσεις αλληλεπίδρασης που διαμορφώνονται, τις συνθήκες διαβίωσης και την καθημερινότητα. Βασικά θέματα με τα οποία ασχοληθήκαμε ήταν ο τύπος του συστήματος κράτησης (κοινοβιακό ή ατομικό), η στέγαση των φυλακών, η εποπτεία και η δ/νση των φυλακών, οι εσωτερικοί κανονισμοί, το ημερήσιο πρόγραμμα, η εργασία, η διατροφή, η ένδυση, η εκπαίδευση και η θρησκευτική κατήχηση. Εστιάσαμε ιδιαίτερα στην παραβατικότητα των κρατουμένων, διερευνώντας τι θεωρείται ως παραβατικότητα εντός των φυλακών, ποιοι ήταν οι παράγοντες που οδηγούσαν σε αυτήν και πώς την αντιμετώπιζε η πολιτεία, μέσα από τη νομοθεσία, τις πειθαρχικές ποινές αλλά και το σύστημα ανταμοιβών. Η εργασία των κρατουμένων και η εξέλιξή της από τιμωρητική (καταναγκαστικά έργα τύπου κάτεργου), σε σωφρονιστική (μισθωτή εργασία εξειδικευμένου τεχνίτη) και η οικονομική της διάσταση (πηγή εσόδων για το κράτος και για τον κρατούμενο), είναι ένα ακόμη βασικό θέμα της μελέτης μας. Τέλος, μελετούμε το είδος του σωφρονιστικού συστήματος που εφαρμόστηκε στο Ιόνιο Κράτος, σε ποιο πρότυπο βασίστηκε, ποιοι ήταν οι στόχοι του, ποια ήταν τα μέσα για την επίτευξή τους και αν αυτά αποδείχθηκαν αποτελεσματικά ή όχι. Όσον αφορά στη μεθοδολογία που ακολουθήσαμε, προσεγγίσαμε τα θέματα κυρίως μέσα από κείμενα (αλληλογραφία, αναφορές, αιτήσεις, καταγγελίες) που παρήγαγαν τα μέλη της κοινωνίας των φυλακών (Δ/ντές, υπάλληλοι, κρατούμενοι) και από νομοθετικά κείμενα της περιόδου. Για κάθε επιμέρους θέμα παρουσιάζεται η γενικότερη τάση της εποχής στις προηγμένες χώρες της δύσης όπως προκύπτει από τη μελέτη σχετικής βιβλιογραφίας, στη συνέχεια τα δεδομένα που προέκυψαν από τη μελέτη των αρχειακών πηγών και τέλος τα δικά μας ερωτήματα και συμπεράσματα.
Curative to palliative care transition challenges in the intensive care unit. A narrative review.
Authors: Koutsouki Sotiria , Kosmidis Dimitrios
Published: July 2023

Abstract

Introduction: The need for high quality palliative care services for critically ill patients and their families remains of high importance.

Purpose: This review aims to present the benefits and barriers to implementing palliative care in Intensive Care Units and suggest ways to facilitate the shift from therapeutic to palliative care.

Methods: PubMed, Scopus, and Google Scholar databases were searched online. Studies included were eligible for the provision of palliative care in the intensive care unit, published in English from 2012 through 2022.

Review: Evidence shows that integrating palliative care impacts the quality of life in intensive care unit and increases rates of use of palliative care facilities. On the other hand decrease length of stay and impacts the cost and the opportunity cost of the intensive care unit. The data suggest that a large subset of intensive care units patients would benefit from palliative care, but palliative care remains underutilized in the ICU setting. Lack of training in palliative care, organizational factors, decisions about end of life, lack of defined criteria for inclusion, and life-saving culture of the intensive care unit are barriers to providing palliative care. Efforts should focus on education, support for effective communication and decision-making, early integration of a palliative approach, redesign of clinical protocols, and reallocation of resources to provide an environment conducive to quality at the end of life.

Conclusion: Involving palliative care in critically ill patients has reduced intensive care unit resource use. Nurses need to define their essential management roles within the multidisciplinary critical care team and help develop systems by which these roles can be implemented.
Estimation of the prevalence of risk factors of type 2 diabetes in the population from age group 30-50 years in Wardha District
Authors: Kshirsagar Kalyani , Mude Gaurav
Published: July 2023

Background: One of the most prevalent long-lasting illnesses globally is type 2 diabetes mellitus (T2DM), and the population of diabetic people is increasing. A sizable population also has impaired glucose tolerance (IGT); of which many will eventually acquire type 2 diabetes. Population expansion, aging, urbanization, a rise in physical inactivity and obesity are all contributing factors to the rising incidence of diabetes worldwide. In April 2021, World Health Organization unveiled the Global Diabetes Compact, a worldwide initiative with an emphasis on supporting low-and middle-income countries. Its objective is to make notable advancements in  diagnosing and avoiding  diabetes. Through the compact, all parties are coming together to work toward the collective objective of lowering the risk of developing diabetes and ensuring that everyone who develops the disease has access to affordable, comprehensive, high-quality, and equitable care.

Methods: This study focuses on assessing the frequency of risk factors for type 2 diabetes in Wardha district. It is an observational study by using risk factor checklist we will assess the prevalence of risk factors related to diabetes.

Conclusions: The study’s strength lies in the use of a systematic risk factor checklist which will ensure consistency in data collection and minimize bias. The use of large sample size will also improve the precision of the study and increase the generalizability of the result.
Exploring system drivers of gender inequity in development assistance for health and opportunities for action
Authors: Bartel Doris , Coile Amanda , Zou Annette , Martinez Valle Adolfo , Nyasulu Hester Mkwinda , Brenzel Logan , Orobaton Nosa , Saxena Sweta , Addy Paulina , Strother Sita , Ogundimu Modupe , Banerjee Banny , Kasungami Dyness
Published: July 2023

Background: Deep-rooted and widespread gender-based bias and discrimination threaten achievement of the Sustainable Development Goals. Despite evidence that addressing gender inequities contributes to better health and development outcomes, the resources for, and effectiveness of, such efforts in development assistance for health (DAH) have been insufficient. This paper explores systemic challenges in DAH that perpetuate or contribute to gender inequities, with a particular focus on the role of external donors and funders.

Methods: We applied a co-creation system design process to map and analyze interactions between donors and recipient countries, and articulate drivers of gender inequities within the landscape of DAH. We conducted qualitative primary data collection and analysis in 2021 via virtual facilitated discussions and visual mapping exercises among a diverse set of 41 stakeholders, including representatives from donor institutions, country governments, academia, and civil society.

Results: Six systemic challenges emerged as perpetuating or contributing to gender inequities in DAH: 1) insufficient input and leadership from groups affected by gender bias and discrimination; 2) decision-maker blind spots inhibit capacity to address gender inequities; 3) imbalanced power dynamics contribute to insufficient resources and attention to gender priorities; 4) donor funding structures limit efforts to effectively address gender inequities; 5) fragmented programming impedes coordinated attention to the root causes of gender inequities; and 6) data bias contributes to insufficient understanding of and attention to gender inequities.

Conclusions: Many of the drivers impeding progress on gender equity in DAH are embedded in power dynamics that distance and disempower people affected by gender inequities. Overcoming these dynamics will require more than technical solutions. Groups affected by gender inequities must be centered in leadership and decision-making at micro and macro levels, with practices and structures that enable co-creation and mutual accountability in the design, implementation, and evaluation of health programs.
An observational analysis of risk factors associated with symptomatic third molar teeth
Authors: Bruce Douglas , Dudding Tom , Gormley Mark , Richmond Rebecca C , Haworth Simon
Published: July 2023

Background: Third molar teeth (wisdom teeth) are a common cause of pain and infection in young adults. The study aimed to describe the prevalence of symptomatic third molar teeth and identify factors which predispose to third molar symptoms in a birth cohort.

Methods: An observational study was undertaken nested in the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort based in south west England. The main outcomes were self-reported third molar pain, swelling and treatment for third molar problems, taken from questionnaires completed at age 23 years. The exposures including sex, dental history, socioeconomic status, diet, and genetic factors were obtained from earlier ALSPAC data.

Results: In total 4,222 ALSPAC participants responded to one or more questions about third molar teeth. The final sample included more female participants than male participants. The majority of participants (56.6%) reported at least one episode of pain associated with their third molars. Females had greater odds than males of reporting swelling (adjusted odds ratio (OR) 1.97; 95%confidence interval (CI) 1.56, 2.51), pain (adjusted OR=1.96; 95%CI 1.56, 2.51) and receiving both non-surgical and surgical treatment (adjusted OR=2.30; 95%CI 1.62, 3.35, adjusted OR=1.54; 95%CI 1.17, 2.06 respectively). Participants with previously filled teeth had greater odds of third molar extraction. There were no strong associations between index of multiple deprivation (IMD) score or sugar intake and the third molar outcomes. There was weak evidence for a genetic contribution to third molar pain.

Conclusions: Symptomatic third molars are common in this age group, with over half of the participants reporting pain or other symptoms. Female participants had greater odds for third molar pain, swelling and treatment.
Historia społeczna PRL filmem pisana. Kilka uwag na marginesie monografii Doroty Skotarczak, Stanisław Bareja. Jego czasy i filmy, Łódź 2022, Wydawnictwo Uniwersytetu Łódzkiego („PRL. Biografie”), ss. 257
Authors: Domke Radosław
Published: July 2023

Tekst omawia publikację naukową Doroty Skotarczak z 2022 r., pt. Stanisław Bareja. Jego czasy i filmy. Autor artykułu recenzyjnego wpisał swoje opracowanie w kontekst historii Polski Ludowej.
Existence theory for nabla fractional three-point boundary value problems via continuation methods for contractive maps
Authors: Jonnalagadda Jagan Mohan
Published: July 2023

In this article, we analyse an $\alpha$-th order, $1 < \alpha \leq 2$, nabla fractional
three-point boundary value problem (BVP). We construct the Green's function
associated to this problem and derive a few of its important properties.
We then establish sufficient conditions on existence and uniqueness of solutions
for the corresponding nonlinear BVP using the modern ideas of continuation methods
for contractive maps. Our results extend recent results on nabla fractional BVPs. Finally, we provide an example to illustrate the applicability of main results.
Niestandardowe formy książki jako narzędzia wspierania procesów edukacyjnych
Authors: Wójcik Magdalena
Published: July 2023

The subject matter of this article includes alternative, nonstandard forms of the book, such as the convergence book, haptic book, step-in-book and lapbook. The purpose of the conducted research was to determine the potential of using the new book forms for support of the cognitive processes of different groups among library users, especially in regard to children and persons with special educational needs. The method of analysis and criticism of literature according the accepted criteria and defined queries was used here. Consequently, the results of research connected with using the nonstandard forms of the book in the educational processes were discussed. The conducted research has shown that issues of the new forms of the book are not often analysed in the literature of the subject matter, particularly in scientific journals. The dissonance is evident between the activities realised by diverse entities conducting educational activities and the considerations on this subject. An analysis of selected, relatively rare studies presented in the literature of the subject matter has shown that usage of the alternative forms of the book can positively influence the educational processes of different groups of users, in diverse areas of cultivating competences.
Dać słowo, czyli jak uczyć biblioterapii – z doświadczeń nauczyciela akademickiego
Authors: Kawoń-Noga Dagmara
Published: July 2023

To Give the Word, That Is How to Teach Bibliotherapy – Experiences of an Academic Teacher The article presents a personal relation about the process of conducting classes in art therapy and bibliotherapy in the Higher Bank School of Opole within the studies of pedagogy, and with particular emphasis on this part of the course which concerns the issues of bibliotherapy. It includes the characteristics of learning effects in the categories of knowledge, skills and social competences resulting from a subject card. The article presents the course of the didactic process as well as some methodical problems and difficulties. It contains the assessment of effectiveness of selected methods with listeners and the description of the state of their knowledge and awareness on the subject of bibliotherapy – before and after the course.
Integracja poprzez książkę – budowanie dialogu społecznego na podstawie literatury
Authors: Bełtkiewicz Dorota
Published: July 2023

Integration constitutes a challenge for the education and culture sector in the age of dynamic, local and global transformations. Social inclusion, understood as the process of integrating individuals, groups or social categories (persons with experience of migration, disease, disorder, as well as disabled and elder people), requires planning and conducting activities which are optimal for all receivers. Integrating classes based on literature are the solution which brings positive and sustainable results. Appropriately selected works inspire a dialogue, and they encourage to search for integrating elements. Creative activities – based on the presented work – allow to know each other, favour synergy and multidimensional development.
Projective Hedging Algorithms for Multistage Stochastic Programming, Supporting Distributed and Asynchronous Implementation
Authors: Eckstein Jonathan , Watson Jean-Paul , Woodruff David L.
Published: July 2023

In “Projective Hedging Algorithms for Multistage Stochastic Programming, Supporting Distributed and Asynchronous Implementation,” Eckstein, Watson, and Woodruff derive a new class of decomposition methods for convex multistage stochastic programs defined on finite but potentially large scenario trees. These methods resemble Rockafellar and Wets’ now-classical progressive hedging (PH) method but are based on a flexible projective operator-splitting scheme instead of the standard alternating direction method of multipliers (ADMM). The new algorithms only need to reoptimize subproblems for a subset of the scenarios at each iteration, instead of all of them, and are also amenable to a form of asynchronous implementation, without the algorithm randomization or small step-size requirements usually imposed in such contexts. In the online appendix, the authors demonstrate significant computational gains over PH, applying hundreds or thousands of processor cores to problem instances with up to a million scenarios.
Generational Differences in Teachers’ Professional Competencies
Authors: Mikušková Eva Ballová
Published: July 2023

The study focused on generational differences in teachers’ professional competencies (interaction styles, teaching styles and didactic competencies) and motivation for the teaching profession. A total of 462 teachers (20 students with at least a bachelor’s degree; age: M = 43.36, SD = 11.05) participated in the study. The Questionnaire on Teacher Interaction (Slovak version), the Slovak Teaching Style Questionnaire, the Didactic Competencies Questionnaire and the Scale of Motivations for Choosing Teaching as a Career were administered. Teachers were divided into generations (Baby Boomers, born up through 1964; Generation X, born 1965 – 1980; Generation Y, born 1981 – 1996; Generation Z, born 1997 and later). The main finding of the study was that there were significant generational differences in professional competencies but no differences in motivation for the teaching profession. On the other hand, there were strong preferences for the leadership, helpful, student-teacher responsibility, understanding interaction styles and the supporting teaching style. Baby Boomers were also knowledge-oriented, Generations X and Y also goal-oriented, and Generation Z also preferred a managerial style. From didactic competencies, Baby Boomers were best in self-reflection and the realization of teaching; Generations X and Y were best in self-reflection and maintaining a positive classroom climate, and Generation Z was good in the realization of teaching.
The Implementation of Flipped Learning Model and STEM Approach in Elementary Education: A Systematic Literature Review
Authors: Rusnilawati Rusnilawati , Ali Siti Rahaimah Binti , Mohamad-Hanapi Mazarul Hasan , Sutama Sutama , Rahman Farizky
Published: July 2023

This study aimed to explore the implementation and impact of the Flipped Learning Model (FLM) and STEM Approach in elementary education. The advancement of technology and the Covid-19 pandemic has increased the importance of e-learning, including in elementary schools. The literature review analyzed 193 academic works published in the past six years using NVivo, Mendeley, and VOSviewer software. The validity of the data was verified through the analysis of five online databases. The results showed that STEM research has been well-developed with innovative approaches that improve learning outcomes, while FLM research in elementary schools is limited. The study suggested that combining FLM with STEM Approach (FLM-SA) can optimize learning in the technological era. By integrating FLM-SA, students can engage in active learning experiences in class and acquire fundamental knowledge outside of class, offering a solution to e-learning challenges. The study emphasized the strong connection between FLM and STEM Approach and how they can support each other to enhance student learning.
A curious case of a spontaneous infective native pseudoaneurysm of the internal carotid artery
Authors: Lim ETA , Yew HS , Laws PE
Published: July 2023

We present a case of a 77-year-old patient who presented with a stroke. She subsequently became unwell and was found to have a spontaneous infective native carotid artery pseudoaneurysm. The patient was managed conservatively as per her wishes. Despite the rarity of this clinical diagnosis, clinicians should be aware of the pathophysiology of this entity and the available literature on management.
Factors associated with the uncorrectable congenital heart disease in children with pulmonary arterial hypertension
Authors: Handoyo  , Gunawijaya Eka , Yantie Ni Putu Veny Kartika
Published: July 2023

BACKGROUND Pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is a common complication of uncorrected left-to-right shunt defects in acyanotic CHD and a frequent type of pulmonary hypertension in youth. The standards for operability in left-to-right shunts with increased pulmonary vascular resistance are not universally agreed upon. This study aimed to identify variables associated with uncorrectable lesion in children with PAH-CHD.

METHODS This retrospective study used a database of all children who underwent cardiac catheterization at Sanglah Hospital, Bali, from May 2009 to April 2021. Pulmonary hypertension was defined as pulmonary artery pressure of >25 mmHg, while correctability was a fall of >20% in the pulmonary arterial resistance index (PARI) with final value of <6 WU/m2 when doing an acute vasoreactivity test using 100% oxygen. The analyses were carried out using SPSS software version 22.0 (IBM Corp., USA).

RESULTS A total of 104 children were included. Cardiac catheterization showed that the uncorrectable group had a higher PARI (14.4 [8.88] WU/m2 versus 8.43 [3.85] WU/m2) and lower flow ratio (1.27 [0.83] versus 1.47 [0.77]) at baseline. In terms of correctability, pre-tricuspid lesions (OR = 0.05; 95% CI = 0.01–0.47; p = 0.01) and younger age group (OR = 0.32; 95% CI = 0.12–0.85; p = 0.01) were protective variables, whilst high baseline PARI (OR = 4.54; 95% CI = 1.64–12.57; p = 0.01) was unfavorable.

CONCLUSIONS High baseline PARI was the most significant variable in predicting uncorrectable left-to-right shunt defects in PAH-CHD.
Trauma por pandemia y postpandemia ante el virus COVID-19 y sus secuelas psicológicas. Una experiencia de intervención escolar para favorecer la regulación emocional de los niños y adolescentes
Authors: Gonzalo Marrodán José Luis
Published: July 2023

El presente artículo tiene como objetivo presentar una práctica educativa dirigida a fomentar la regulación emocional relacionada con el trauma y la seguridad psicológica del alumnado de Educación Primaria (5º y 6º) y Educación Secundaria de cuatro centros escolares privados-concertados de la provincia de Gipuzkoa (España). El marco epistemológico en el que se sustenta la intervención es la teoría polivagal de Porges y la teoría del apego. Mediante una serie de sesiones con los orientadores y tutores escolares, se les proporcionan conocimientos psicoeducativos y orientaciones concretas para favorecer la regulación emocional de los alumnos, usando técnicas como enraizar, tranquilizar, dar seguridad y narrar y aplazar la investigación. Los resultados obtenidos apuntan a una valoración general por parte de los profesores de la experiencia de intervención como positiva (80%), un 16% como muy positiva y un 4% como innecesaria). La modulación emocional de los alumnos en el aula se revela fundamental y los resultados apuntan a una experiencia subjetiva de mayor bienestar y mejora de la salud y de las relaciones. En la discusión se plantea que experiencias como la descrita, a pesar de sus limitaciones, son prometedoras en sus resultados para lograr mejorar la salud y calidad de vida de los alumnos y hacer de la vivencia escolar un lugar seguro, imprescindible para que los niños y adolescentes puedan estudiar y rendir académicamente. Propuestas de este tipo abren la puerta a modelos de conceptualización y gestión de las escuelas como espacios educativos sensibles al trauma, en las cuales toda la comunidad escolar se implica e involucra con los alumnos que hayan sufrido experiencias traumáticas en su vida.
Production and profitability in Swedish breweries, 1924-1950
Authors: Häggqvist Henric
Published: July 2023

Sweden’s alcohol policy during the 20th century was one of the strictest in Europe and it affected producers, such as alcoholic-beer brewers. This article analyses how production and profitability developed among brewery firms following the 1923 prohibition of strong beer. Breweries tried to find other high-return opportunities, for example by increasing the production of non-alcoholic beverages and reaching other segments of the consuming public. However, both production and profitability declined, hence diversification seems to have been rather negative for the brewery industry, although not for all its actors. The article concludes that while diversification gave breweries a way to reach other consumers, it was the largest actors that were best placed to reap the benefits of the closed-off market environment. Thus, the article shows how diversification of production may be a result of government intervention, which will affect firm performance negatively or positively, depending on market structure, competition, and cost structure.
Secondary lens with hybrid structure of freeform surface and microstructure for ultra-thin backlight unit
Authors: Feng Qibin , Sun Qiyu , Li Kejing , Wang Zi , Lv Guoqiang
Published: July 2023

Ultra-thin has become the development trend of the direct-lit backlight
unit (BLU). Double freeform surface lenses are commonly used in
direct-lit BLUs to reduce thickness. However, for an ultra-thin BLU
with quite small optical distance (OD) and a large LED pitch distance,
the curvature of the designed lens would be quite large, which would
make the final optical performance heavily affected by fabrication
errors. This paper proposes a lens with freeform surfaces and
microstructures. The rays from LEDs are first collimated by the
freeform surfaces and the collimated rays are then reflected by the
microstructures to the bottom of the BLU, which can effectively
enlarge the spot size and reduce the OD. The simulation results show
that the uniformity can be improved from 41.3% of the conventional
double freeform surface lens to 83% when OD is 3 mm. Such
hybrid lenses can avoid the fabrication of freeform surfaces with
large curvature and the advantages of easy design and easy
fabrication.