bluuebunny/crossref_metadata_2025 huggingface dataset:
How is primary care access changing? A retrospective, repeated cross-sectional study of patient-initiated demand at general practices in England using a modern access model, 2019–2022
Authors: Chappell Paul , Dias Alison , Bakhai Minal , Ledger Jean , Clarke Geraldine M
Published: August 2023

Objectives

To explore trends in patient-initiated requests for general practice services and the association between patient characteristics including demographics, preferences for care and clinical needs and modes of patient contact (online vs telephone), and care delivery (face-to-face vs remote) at practices using a modern access model.

Design

Retrospective repeated cross-sectional study spanning March 2019 to February 2022.

Setting

General practices in England using the askmyGP online consultation system to implement a modern general practice access model using digital and non-digital (multimodal) access pathways and digitally supported triage to manage patient-initiated requests.

Participants

10 435 465 patient-initiated requests from 1 488 865 patients at 154 practices.

Results

Most requests were initiated online (72.1% in 2021/2022) rather than by telephone. Online users were likely to be female, younger than 45 years, asking about existing medical problems, had used the system before and frequent attenders (familiar patients). During the pandemic, request rates for face-to-face consultations fell while those for telephone consultations and online messages increased, with telephone consultations being most popular (53.8% in 2021/2022). Video was seldom requested. More than 60% of requests were consistently delivered in the mode requested. Face-to-face consultations were more likely to be used for the youngest and oldest patients, new medical problems, non-frequent attenders (unfamiliar patients) and those who requested a face-to-face consultation. Over the course of the study, request rates for patients aged over 44 years increased, for example, by 15.4% (p<0.01) for patients aged over 74 years. Rates for younger patients decreased by 32.6% (p<0.001) in 2020/2021, compared with 2019/2020, before recovering to prepandemic levels in 2021/2022.

Conclusions

Demand patterns shed light on the characteristics of patients making requests for general practice services and the composition of the care backlog with implications for policy and practice. A modern general practice access model can be used effectively to manage patient-initiated demand.
Sodium bicarbonate for the treatment of severe metabolic acidosis with moderate or severe acute kidney injury in the critically ill: protocol for a randomised clinical trial (BICARICU-2)
Authors: Jung Boris , Huguet Helena , Molinari Nicolas , Jaber Samir
Published: August 2023

Introduction

When both severe metabolic acidemia (pH equal or less than 7.20; PaCO2 equal or less than 45 mm Hg and bicarbonate concentration equal or less than of 20 mmol/L) and moderate-to-severe acute kidney injury are observed, day 28 mortality is approximately 55%–60%. A multiple centre randomised clinical trial (BICARICU-1) has suggested that sodium bicarbonate infusion titrated to maintain the pH equal or more than 7.30 is associated with a higher survival rate (secondary endpoint) in a prespecified stratum of patients with both severe metabolic acidemia and acute kidney injury patients. Whether sodium bicarbonate infusion may improve survival at day 90 (primary outcome) in these severe acute kidney injury patients is currently unknown.

Methods and analysis

The sodium bicarbonate for the treatment of severe metabolic acidosis with moderate or severe acute kidney injury in the critically ill: a randomised clinical trial (BICARICU-2) trial is an investigator-initiated, multiple centre, stratified, parallel-group, unblinded trial with a computer-generated allocation sequence and an electronic system-based randomisation. After randomisation, the intervention group will receive 4.2% sodium bicarbonate infusion to target a plasma pH equal or more than 7.30 while the control group will not receive sodium bicarbonate. The primary outcome is the day 90 mortality. Main secondary outcomes are organ support dependences.

Ethics and dissemination

The trial has been approved by the appropriate ethics committee (CPP Nord Ouest, Rouen, France, 25 April 2019, number: 19.03.15.72446). Informed consent is required. If sodium bicarbonate improves day 90 mortality, it will become part of the routine care.

Trial registration number

NCT04010630.
Applying ensemble ecosystem model projections to future-proof marine conservation planning in the Northwest Atlantic Ocean
Authors: Bryndum-Buchholz Andrea , Blanchard Julia L. , Coll Marta , Pontavice Hubert Du , Everett Jason D. , Guiet Jerome , Heneghan Ryan F. , Maury Olivier , Novaglio Camilla , Palacios-Abrantes Juliano , Petrik Colleen M. , Tittensor Derek P. , Lotze Heike K.
Published: August 2023

Climate change is altering marine ecosystems across the globe and is projected to do so for centuries to come. Marine conservation agencies can use short- and long-term projections of species-specific or ecosystem-level climate responses to inform marine conservation planning. Yet, integration of climate change adaptation, mitigation, and resilience into marine conservation planning is limited. We analysed future trajectories of climate change impacts on total consumer biomass and six key physical and biogeochemical drivers across the Northwest Atlantic Ocean to evaluate the consequences for Marine Protected Areas (MPAs) and Other Effective area-based Conservation Measures (OECMs) in Atlantic Canada. We identified climate change hotspots and refugia, where the environmental drivers are projected to change most or remain close to their current state, respectively, by mid- and end-century. We used standardized outputs from the Fisheries and Marine Ecosystem Model Intercomparison Project and the 6th Coupled Model Intercomparison Project. Our analysis revealed that, currently, no existing marine conservation areas in Atlantic Canada overlap with identified climate refugia. Most (75%) established MPAs and more than one-third (39%) of the established OECMs lie within cumulative climate hotspots. Our results provide important long-term context for adaptation and future-proofing spatial marine conservation planning in Canada and the Northwest Atlantic region.
Figure S6 from Activator Protein-1 (AP-1) Signaling Inhibits the Growth of Ewing Sarcoma Cells in Response to DNA Replication Stress
Authors: Croushore Emma E. , Koppenhafer Stacia L. , Goss Kelli L. , Geary Elizabeth L. , Gordon David J.
Published: August 2023

Regulation of c-Myc.
Figure S2 from Activator Protein-1 (AP-1) Signaling Inhibits the Growth of Ewing Sarcoma Cells in Response to DNA Replication Stress
Authors: Croushore Emma E. , Koppenhafer Stacia L. , Goss Kelli L. , Geary Elizabeth L. , Gordon David J.
Published: August 2023

Treatment of EW8-RRM1-KO cells with prexasertib.
FIGURE 3 from Activator Protein-1 (AP-1) Signaling Inhibits the Growth of Ewing Sarcoma Cells in Response to DNA Replication Stress
Authors: Croushore Emma E. , Koppenhafer Stacia L. , Goss Kelli L. , Geary Elizabeth L. , Gordon David J.
Published: August 2023

Expression of c-Jun and c-Fos in Ewing sarcoma cells inhibits cell growth and downregulates c-Myc. A, EW8 and TC71 cell lines expressing doxycycline-inducible c-Jun and c-Fos were grown with or without doxycycline for 24 hours. Cell lysates were collected for immunoblotting. B, Colony formation assay for the TO-Jun/Fos cell lines grown with or without doxycycline for 10–12 days. C, Results of GSEA for gene sets downregulated in the EW8-RRM1-KO and TC71-RRM1-KO cell lines after removal of doxycycline for 48 hours. D, The TO-EW8-Fos/Jun and TO-TC71-Fos/Jun cell lines were grown with or without doxycycline for 72 hours. Cell lysates were then collected for immunoblotting. E, The EW8-RRM1-KO and TC71-RRM1-KO cell lines were grown with or without doxycycline for 48 hours. Cell lysates were then collected for immunoblotting. F and G, Ewing sarcoma cell lines were treated with gemcitabine (100 nmol/L) for 24 hours and then cell lysates were collected for immunoblotting. P values were calculated using a two-tailed Student t test. **, P < 0.01; ***, P < 0.001.
Lumiares
Authors: Nakamura Alline Alves
Published: August 2023

O ensaio[1] faz parte de uma pesquisa visual que tem como foco o deslocar por lugares familiares e íntimos, como um processo de redescoberta e de ressignificação do cotidiano através da fotografia. Com Lumiares pretendo revisitar o arquivo desta pesquisa, selecionando imagens que são atentas às fugazes aparições luminosas e ao sentimento de esperança aflorado por essas luminâncias.Palavras-Chave: ensaio, paisagem, fotografia, deslocamento, cotidiano.

 

[1] A maioria das fotos foi disponibilizada nas redes sociais da autora (Instagram e Facebook), sem estarem na forma de ensaio e com diferentes nuances nos tratamentos de luz, contraste, proporção, cortes e cor. A sexta imagem fez parte do ensaio visual Anteparos, publicado na Revista ARS, v. 18, n. 38, no ano de 2020. Disponível em: https://www.revistas.usp.br/ars/issue/view/11481. Acesso em 10 mar. 2023.
Demand and unmet need for modern contraception among mothers from a Pelotas Birth Cohort
Authors: Houvèssou Gbènankpon Mathias , Antúnez Simone Farías , Bertoldi Andréa D. , Silveira Mariângela Freitas da
Published: August 2023

OBJECTIVE: To determine the total demand and unmet need for contraception with modern methods and their determinants among mothers participating in the 2015 Pelotas Birth Cohort. METHODS: Data from the 48-month follow-up of mothers participating in the 2015 Pelotas Birth Cohort were analyzed. Only biological mothers (aged up to 49 years) of children belonging to the 2015 Birth Cohort and who answered the 48-month questionnaire were included in the study sample. Logistic regression and respective 95% confidence intervals were used to determine associated factors. RESULTS: The study sample consisted of 3,577 biological mothers. The prevalence of use of any contraceptive and of modern contraceptives was 86.0% (95%CI: 84.8–87.1) and 84.9% (95%CI: 83.7–86.1), respectively. The prevalence of unmet need for modern contraceptives was 10.7% (95%CI: 9.7–11.7), and the total demand for contraceptives was 95.6%. The factors associated with an unmet need for modern contraception were being over 34 years of age (OR = 0.6, 95%CI: 0.5–0.8), not having a husband or partner (OR = 1.9, 95%CI: 1.4–2.6), not being the head of the household (OR = 0.6, 95%CI: 0.4–0.9), having had three or more pregnancies (OR = 1.9, 95%CI: 1.3–2.6), and having had an abortion at least once after the birth of the child participating in the cohort (OR = 1.9, 95%CI: 1.0–3.6). CONCLUSIONS: Despite the high prevalence of modern contraceptive use, one in ten women had an unmet need for modern contraception and was at risk of unplanned pregnancy.
Genetically Predicted Blood Pressure and Cognition in Midlife: A UK Biobank Study
Authors: Lennon Matthew J. , Thalamuthu Anbupalam , Lam Ben Chun Pan , Crawford John D. , Sachdev Perminder S.
Published: August 2023

BACKGROUND:

This UK Biobank study uses a mendelian randomization approach to mitigate the variability and confounding that has affected previous analyses of the relationship between measured blood pressure (BP) and cognition and thus delineate the true association between the two.

METHODS:

Systolic BP (SBP) and diastolic BP polygenic risk scores (PRSs) were calculated using summary statistics from the International Consortium of Blood Pressure-Genome Wide Association Study (n=299 024). Adjusted nonlinear mixed-effects regression models were used, including a natural splines term for BP-PRS with outcomes of fluid intelligence, reaction time (RT), and composite attention score. Moderating effects of age, sex, and antihypertensive use were assessed in separate models.

RESULTS:

There were 448 575 participants (mean age, 56.3 years; age range, 37–72 years) included in the analysis after genetic and neurological disease exclusions. Genetic propensity for high SBP had an approximately linear association with worsened fluid intelligence (
P
=0.0018). This relationship was significantly moderated by age (
P
<0.0001). By contrast, genetic propensity for high and low SBP and diastolic BP predicted worse attention function (
P
=0.0099 and
P
=0.0019), with high PRSs predicting worse function than low PRSs. Genetic propensity for low SBP and diastolic BP was associated with considerably worse RTs, while for high SBP-PRSs, the RT plateaued (
P
<0.0001). The relationships between RT and the PRSs were significantly moderated by sex (
P
<0.0001) and antihypertensive use (
P
<0.0001).

CONCLUSIONS:

Genetic propensity for high and low BP impacts on midlife cognition in subtle ways and differentially affects cognitive domains. While a genetic propensity to low BP may preserve nontimed tests in midlife, it may come at a trade-off with worsened attention scores and RT.
Evaluating Carlquist’s Law from a physiological perspective
Authors: Johnson Kate M. , Everbach Sophie R. , Holbrook N. Michele , Olson Mark E.
Published: August 2023

“Carlquist’s Law” is a striking pattern of association between anatomical features in the wood of vessel-bearing plants. It derives from Sherwin Carlquist’s observation that xylem vessels tend to be solitary when embedded in a matrix of imperforate tracheary elements that appear to be conductive, whereas xylem vessels tend to be grouped when surrounded by seemingly non-conductive cells. Vessel-vessel contacts (vessel grouping) allow water to travel between conduits, but also provide pathways for air to propagate from embolized (air-filled) vessels into functional vessels. If the background matrix is conductive, it is conceivable that water could bypass embolized vessels, providing an alternative transport route in species with conductive backgrounds and solitary vessels. Much remains to be tested in this hypothesis, including the topology of the vessel networks in species with solitary versus grouped vessels and how conductive the different imperforate tracheary element types are. Exploring Carlquist’s Law promises to provide key insight into the causes of embolism in plant conduits, the modes of embolism passage between conduits, and how vessels and the cells in which they are imbedded may interact to govern the pathways of water flow through plants.
Gender and Austronesian Indigenous Identities: Narratives of Women in Seediq Bale and Utu
Authors: Fu Yu-wen
Published: August 2023

As early as 1989, Kimberlé Crenshaw had proposed investigating the interconnection between gender and ethnic identities, especially in her work about black identities. Subsequently, many scholars have extended investigation of the interconnection to the field of Indigenous studies. However, most studies focus on women’s suffering, rather than their active engagement in the process of anti-colonial resistance and Indigenous identity formation. Despite painful colonial histories—including displacement and assimilation—Indigenous peoples have resisted and survived and have been revived. Indigenous women played a crucial part in these processes, but their contributions were often neglected or forgotten. Through analyses of two renowned post-colonial films—Seediq Bale (dir. Wei Te-sheng, 2011) from Taiwan and Utu (dir. Geoff Murphy, 1983) from New Zealand—this essay explores how Seediq and Maori women showed great strength in Austronesian indigenous people’s resistance to colonialism and in their campaign to rewrite history.
Revision of Brazilian species of Aleochara Gravenhorst of the subgenus Xenochara Mulsant & Rey (Coleoptera: Staphylinidae: Aleocharinae)
Authors: BUSS BRUNA CAROLINE , CARON EDILSON
Published: August 2023

Aleochara species occur in fly-infested habitats. The larvae feed on the pupae of cyclorraphous Diptera. In Brazil, four subgenera and approximately 30 species have been found. This study provides a taxonomic revision of the Brazilian species of the subgenus Xenochara. Eight species are recognized: A. (X.) puberula Klug, 1833, A. (X.) verberans Erichson, 1839, A. (X.) simulatrix Sharp, 1883, A. (X.) taeniata Erichson, 1839, A. (X.) capitinigra sp. nov., A. (X.) repetita Sharp, 1887, A. (X.) lapidicola (Sahlberg, 1844) and A. (X.) leivasorum sp. nov. One species is revalidated: A. (X.) lapicola, a former junior synonym of A. (X.) taeniata. Two synonyms are proposed: A. opacula Bernhauer, 1901 as a junior synonym of A. (X.) repetita, and A. festiva Pace, 1990 as a junior synonym of A. (X.) lapidicola. Finally, a species key and a checklist with all synonyms are provided for the Brazilian species of Aleochara (Xenochara).
Association Between the Neutrophil-Lymphocyte Ratio and Prognosis of Patients Admitted to the Intensive Care Unit With Chronic Heart Failure: A Retrospective Cohort Study
Authors: Che Jinhang , Song Jiaqi , Long Yuxiang , Wang Chunping , Zheng Caiyin , Zhou Ruoyu , Liu Zengzhang
Published: August 2023

The present study aimed to explore the association between the neutrophil-to-lymphocyte ratio (NLR) and prognosis of critically ill chronic heart failure patients. The records of 5298 patients who met the inclusion criteria were extracted from the Medical Information Mart for Intensive Care IV database. The primary outcome was 30-days all-cause mortality and the secondary outcome was 90-days all-cause mortality. Multivariable logistic regression analysis was performed to examine the relationship between NLR and 30-days mortality. Subgroup analysis was carried out to identify whether the association between NLR and 30-days mortality differed across various subgroups. For 30-days mortality, after adjusting for multiple confounders, the odds ratio (OR) (95% confidence interval [CI]) for the second (NLR 4.0–8.4) and the third (NLR ≥8.4) tertiles were 1.52 (1.13–2.03) and 2.53 (1.92–3.34), respectively, compared with the first tertile (NLR <4.0). As for 90-days mortality, the OR for the second (NLR 4.0–8.4) was 1.34 (1.07–1.67) and 2.23 (1.81–2.76) for the third (NLR ≥8.4) tertiles compared with the reference (NLR<4.0). The interactions between the sepsis subgroup and 30-days mortality were significant. Our study concluded that the NLR was an independent predictor of 30- and 90-days mortality for critically ill patients with chronic heart failure.
Multivariate analysis of medical adhesive-related skin injury at the site of peripherally inserted central catheter insertion in cancer patients: A prospective cohort study
Authors: Yang Yanying , Liu Hongmei , He Mei , Yang Yuwei , Hu Meiling , He Run , Yang Jing
Published: August 2023

Objective:

At the site of peripherally inserted central catheter (PICC) catheterization in tumor patients, medical adhesive-related skin injury (MARSI) was reported related to patient age, infusion of certain chemotherapeutic agents, and tumor type, but did not review its relation to the use of clear patches and the puncture site of PICC. This study aims to analyze the risk factors for MARSI in more detail to provide supported data for reducing MARSI.

Method:

Total 382 cancer patients receiving catheterization via PICC were involved in this study from March 1, 2021, to September 28, 2021. According to MARSI occurrence or not, they were assigned into MARSI or non-MARSI group. Univariate and multivariate logistic regressions were used to analyze the risks of MARSI occurrence at PICC insertion site.

Results:

15% (60 of 382 cases) resulted in MARSI, out of which 8.1% (31/382) was categorized as contact dermatitis, and 7.1% (27/382) as mechanical injuries. The univariate analysis showed that there were significant differences in six aspects of the study, including BMI, MARSI history, dressing types, treatment by paclitaxel or 5-FU versus oxaliplatin, dressing frequency, and catheterization at biceps brachii medial ( p < 0.05). Via multivariate logistic regression analysis, it was discovered that except for previously reported risk factors, dressing change frequency (OR (95% CI) = 7.49 (2.36–23.80), p = 0.001), catheterization at biceps brachii medial (OR (95% CI) = 4.07 (1.82–9.10), p = 0.001), and breast cancer (OR (95% CI) = 3.27 (1.05–10.15), p = 0.041), there were significant risk factors for MARSI occurrence in tumor patients with PICC catheterization.

Conclusion:

Our study revealed a high incidence of MARSI at the PICC insertion site of cancer patients, presenting with contact dermatitis and mechanical injury. Independent risk factors were previous history of MARSI, a diagnosis of breast cancer, frequent dressing replacement, use of paclitaxel or 5-FU, and PICC catheterization at biceps brachii medial.
Assessment of adequacy and appropriateness of pain management practice among trauma patients at the Ethiopian Aabet Hospital: A prospective observational study
Authors: Ayano Wondwossen Alemu , Fentie Atalay Mulu , Tileku Melaku , Jiru Tilahun , Hussen Shemsu Umer
Published: August 2023

Introduction

Pain is unpleasant sensory and emotional experiences associated with actual and/or potential tissue damage. It is the most common and prevalent reason for emergency departments (ED) visits with prevalence over 70% in the world.

Aim of the Study

The study aimed to assess the adequacy and appropriateness of pain management at Aabet Hospital, Addis Ababa, Ethiopia.

Methods

A hospital-based prospective cross-sectional study was conducted at Aabet hospital from December 1, 2020 to March 30, 2021. Adult trauma patients having pain (at least score 1 on Numeric Rating Scale) with Glasgow Coma Scale score > 13 were eligible to participate in the study. The pain intensity was evaluated at the time of admission (o minute) and then at 60, 120, 180, and 240 minutes. The time of the first analgesics was registered. The adequacy and the appropriateness of the pain management were calculated through pain management index (PMI).

Results

Two hundred thirty-two (232) participants were included in this study of which 126 (54.3%) were admitted due to road traffic accident followed by fall 44(19%). Only 21 (9.1%) study participants received the first analgesic treatment within 30 minutes while 27(11.6%) participants had no treatment at all within 240 minutes. The mean pain intensity score at admission was 5.55 ± 2.32 and reduced to 4.09 ± 2.69. Nearly half 110 (47.4%) of the study participants were treated inadequately (PMI (-) score). There was a weak and negative correlation between PMI and time to analgesia (r = − .159, p = 0.0001). The type of analgesia used, the time to analgesia, and the degree of pain may predict 65% of the variance in PMI score (R2 = 0.65, P = .001).

Conclusion

From the results of this study, it can be concluded that acute pain in trauma patients was under and inappropriately treated.
Anaplastic lymphoma kinase overexpression enhances aggressive phenotypic characteristics of endometrial carcinoma
Authors: Yokoi Ako , Nakamura Yusaku , Hashimura Miki , Oguri Yasuko , Matsumoto Toshihide , Nakagawa Mayu , Ishibashi Yu , Ito Takashi , Ohhigata Kensuke , Harada Youhei , Fukagawa Naomi , Saegusa Makoto
Published: August 2023

Background

Although anaplastic lymphoma kinase (ALK) is overexpressed in several primary solid tumor types, its role in endometrial carcinoma (Em Ca) remains unclear.

Methods

We evaluated expression of ALK and its related molecules in clinical samples consisting of 168 Em Ca tissues. We also used Em Ca cell lines to evaluate the functional role of ALK.

Results

Cytoplasmic ALK immunoreactivity in the absence of chromosomal rearrangement was positively correlated with ALK mRNA expression, and was significantly higher in Grade (G) 3 Em Ca than in G1 or G2 tumors. ALK immunoreactivity was also significantly associated with expression of cancer stem cell (CSC)-related molecules (cytoplasmic CD133, ALDH1, Sox2) and neuroendocrine markers (CD56 and synaptophysin). Although the proliferative index was significantly higher in ALK-positive Em Ca when compared to ALK- negative malignancies, there was no association between ALK expression and other clinicopathological factors in this disease. In Em Ca cell lines, full-length ALK overexpression increased proliferation, decreased susceptibility to apoptosis, enhanced cancer stem cell features, and accelerated cell mobility, whereas these phenotypes were abrogated in ALK-knockdown cells. Finally, patients with tumors harboring either wild-type ALK or high ALK mRNA expression had a poorer prognosis than those with either mutant ALK or low ALK mRNA expression.

Conclusion

Full-length ALK overexpression occurs in a subset of Em Ca, particularly in G3 tumors, and contributes to the establishment and maintenance of aggressive phenotypic characteristics through modulation of several biological processes.
Receipt of mastectomy and adjuvant radiotherapy following breast conserving surgery (BCS) in New Zealand women with BCS-eligible breast cancer, 2010–2015: an observational study focusing on ethnic differences
Authors: Bartholomew Karen , Ghafel Mazin , Tin Tin Sandar , Aye Phyu S , Elwood J Mark , Hardie Claire , Scott Nina , Kidd Jacquie , Ramsaroop Reena , Campbell Ian
Published: August 2023

Background

Women with early breast cancer who meet guideline-based criteria should be offered breast conserving surgery (BCS) with adjuvant radiotherapy as an alternative to mastectomy. New Zealand (NZ) has documented ethnic disparities in screening access and in breast cancer treatment pathways. This study aimed to determine whether, among BCS-eligible women, rates of receipt of mastectomy or radiotherapy differed by ethnicity and other factors.

Methods

The study assessed management of women with early breast cancer (ductal carcinoma in situ [DCIS] and invasive stages I-IIIA) registered between 2010 and 2015, extracted from the recently consolidated New Zealand Breast Cancer Registry (now Te Rēhita Mate Ūtaetae NZBCF National Breast Cancer Register). Specific criteria were applied to determine women eligible for BCS. Uni- and multivariable analyses were undertaken to examine differences by demographic and clinicopathological factors with a primary focus on ethnicity (Māori, Pacific, Asian, and Other; the latter is defined as NZ European, Other European, and Middle Eastern Latin American and African).

Results

Overall 22.2% of 5520 BCS-eligible women were treated with mastectomy, and 91.1% of 3807 women who undertook BCS received adjuvant radiotherapy (93.5% for invasive cancer, and 78.3% for DCIS). Asian ethnicity was associated with a higher mastectomy rate in the invasive cancer group (OR 2.18; 95%CI 1.72–2.75), compared to Other ethnicity, along with older age, symptomatic diagnosis, advanced stage, larger tumour, HER2-positive, and hormone receptor-negative groups. Pacific ethnicity was associated with a lower adjuvant radiotherapy rate, compared to Other ethnicity, in both invasive and DCIS groups, along with older age, symptomatic diagnosis, and lower grade tumour in the invasive group. Both mastectomy and adjuvant radiotherapy rates decreased over time. For those who did not receive radiotherapy, non-referral by a clinician was the most common documented reason (8%), followed by patient decline after being referred (5%).

Conclusion

Rates of radiotherapy use are high by international standards. Further research is required to understand differences by ethnicity in both rates of mastectomy and lower rates of radiotherapy after BCS for Pacific women, and the reasons for non-referral by clinicians.
Trajectories and determinants of ageing in Portugal: insights from EpiDoC, a nationwide population-based cohort
Authors: Lopes David G. , Mendonça Nuno , Henriques Ana Rita , Branco Jaime , Canhão Helena , Rodrigues Ana M
Published: August 2023

Introduction

The population in Portugal is ageing due to increased life expectancy and reduced fertility rates. We aimed to estimate the health trajectories of Portuguese older adults (60 + years old) in a 10-year period and to assess associated sociodemographic, lifestyle factors and multimorbidity status.

Methods

Using the population-based EpiDoC cohort, we estimated the trajectories of health-related quality of life and physical function of 4135 Portuguese older adults over 10 years using linear mixed models. Factors associated to health-related quality of life and physical function were assessed using linear mixed models and random intercept tobit regression, respectively.

Results

The physical disability of participants increased by 0.263 (0.240, 0.286), and health-related quality of life declined by 0.074 (-0.084, -0.063), over 10 years. With advancing age, older adults reported a faster reduction in health-related quality of life and faster increase in physical disability. In general, women were in worse health than men at baseline, albeit with a similar rate of change throughout the follow-up. Higher education and regular exercise were associated with better health-related quality of life and physical function while multimorbidity and excess weight were associated with worse reporting of these outcomes.

Conclusions

These findings, based on longitudinal data with 10 years of follow-up, are essential to effectively plan resource allocation, plan better healthcare and design informed public health policies in Portugal.

Brief summary

This study characterizes ageing in Portugal showing increased physical disability and decreased health-related quality of life with advancing age older adults, helping to develop public health policies.
Carbapenem alternatives for treatment of bloodstream infections due to AmpC producing enterobacterales
Authors: Ávila-Núñez M. , Lima O. , Sousa A. , Represa M. , Rubiñán P. , Celestino P. , Garrido-Ventín M. , García-Formoso L. , Vasallo-Vidal F. , Martinez-Lamas L. , Pérez-Landeiro A. , Rubianes M , Pérez-Rodríguez MT.
Published: August 2023

Introduction

Carbapenems (CR) have traditionally been the first line treatment for bacteremia caused by AmpC-producing Enterobacterales. However, CR have a high ecological impact, and carbapenem-resistant strains continue rising. Thus, other treatment alternatives like Piperacillin-Tazobactam (P-T) or Cefepime (CEF) and oral sequential therapy (OST) are being evaluated.

Methods

We conducted a retrospective, single-centre observational study. All adult patients with AmpC-producing Enterobacterales bacteremia were included. The primary endpoint was clinical success defined as a composite of clinical cure, 14-day survival, and no adverse events. We evaluated the evolution of patients in whom OST was performed.

Results

Seventy-seven patients were included, 22 patients in the CR group and 55 in the P-T/CEF group (37 patients received CEF and 18 P-T). The mean age of the patients was higher in the P-T/CEF group (71 years in CR group vs. 76 years in P-T/CEF group, p = 0.053). In the multivariate analysis, age ≥ 70 years (OR 0.08, 95% CI [0.007–0.966], p = 0.047) and a Charlson index ≥ 3 (OR 0.16, 95% CI [0.026–0.984], p = 0.048), were associated with a lower clinical success. Treatment with P-T/CEF was associated with higher clinical success (OR 7.75, 95% CI [1.273–47.223], p = 0.026). OST was performed in 47% of patients. This was related with a shorter in-hospital stay (OST 14 days [7–22] vs. non-OST 18 days [13–38], p = 0.005) without difference in recurrence (OST 3% vs. non-OST 5%, p = 0.999).

Conclusions

Targeted treatment with P-T/CEF and OST could be safe and effective treatments for patients with AmpC-producing Enterobacterales bacteremia.
A machine-learning workflow to integrate high-resolution core-based facies into basin-scale stratigraphic models for the Wolfcamp and Third Bone Spring Sand, Delaware Basin
Authors: Larson Toti E. , Sivil J. Evan , Periwal Priyanka , Melick Jesse
Published: August 2023

The characterization of subsurface reservoirs that are dominated by mudrock facies is hindered by the inherent heterogeneity and high degree of spatial variability typical of mudrock depositional systems. Subsurface reservoir properties that include porosity and permeability, fluid saturations, stratigraphic thicknesses of reservoir units, and source rock potential are ultimately controlled by the spatial distribution of sedimentary rock facies, which supports efforts to improve subsurface characterization workflows. Although core-based data provide direct measurements of rock attributes that are used to inform static reservoir models, capturing high-resolution core-based rock facies and downscaling these observations to tie to lower-resolution wireline logs remains a challenge. The effort to integrate core-based facies to reservoir-scale models is especially difficult when trying to capture thin-bedded heterogeneity that is common to mudrock systems. Herein, a workflow is developed and applied to visualize and integrate multivariate and spatially complex core-based data sets with wireline logs. Formation-specific core-based chemofacies training data sets are developed by integrating core descriptions with chemofacies clusters developed from high-resolution X-ray fluorescence core scanning. Core-based rock attribute data (e.g., XRD mineralogy, total porosity, and total organic matter content) are used to describe the chemofacies, providing a means to upscale low-resolution rock attribute measurements to high-resolution core-based chemofacies. Supervised core-based chemofacies training data sets are then used with neural network multiclass classification machine-learning tools to train triple combo wireline logs (gamma ray, deep resistivity, bulk density, and neutron porosity) to predict rock facies from wireline logs, providing a new approach to apply core-based facies classifications to wireline log studies. A basin-scale case study that applies this workflow is described for the Third Bone Spring Sand and units of the Wolfcamp Formation in the Delaware Basin of West Texas, United States.
Untangling Concepts of Objectivity in Nineteenth-Century Social Reform: Harriet Martineau and Henry Mayhew Observe Urban Poverty
Authors: Forget Evelyn L.
Published: August 2023

This article examines emerging concepts of objectivity in the work of Harriet Martineau and Henry Mayhew. It focuses on Martineau's How to Observe Morals and Manners (1838) and Mayhew's London Labour and the London Poor (1861), documenting how ideas about objectivity appeared in journalism and popular writing by these two prolific nineteenth-century social commentators.
Foreign Language in Elementary School: Learning Difficulties and Ways to Eliminate Them (Part 2)
Authors: Gabeeva K.
Published: August 2023

The article reveals the educational potential of the subject “Foreign Language”, discusses the educational goals of its study by younger schoolchildren. The problems faced by schoolchildren in the process of mastering a foreign (English) language are analyzed, their causes are established: the inability to perceive a foreign text, to carry out textual activity, insufficient knowledge of semantic reading skills. Examples of exercises are given that help prevent and eliminate the difficulties that younger schoolchildren have when learning English.
Paid Parental Leave Reforms and Mothers’ Employment in Austria, France and Hungary
Authors: Makay Zsuzsanna
Published: August 2023

This study focuses on changes in the length of paid parental leave in Austria, France and Hungary between the 1960s and the first decade of the 2000s. Its aim is to analyse to what extent extensions and reductions of the duration of paid parental leave affect mothers’ labour market entry after childbirth. For each country, periods according to the different policy reforms are analysed and data from the Generations and Gender Survey are used to account for changes in mothers’ labour market entry.

Scholars have argued that too long periods of paid parental leave might act as work-reducing policy in that they hinder women’s labour market entry while short leaves have positive effects on labour market participation and wages. This phenomenon is studied in three countries with very different conciliation policies.

Results for Austria show that the introduction of more flexibility into the leave legislation in 2008 increased mothers’ relative risks of labour market entry especially among higher educated women. In France, the extension of paid leave for second born children in 1994 reduced labour market entry. We found however, no significant effect of the 1986 reform for third children and the 2004 reform introducing a paid leave of six months for first-born children. In Hungary, labour market entry of mothers was influenced by structural changes which accompanied the political transition of 1989 and resulted in longer leave take up of mothers. Labour market entry before the transition was more intensive than ever since that.

* This article belongs to a special issue on “Demographic Developments in Eastern and Western Europe Before and After the Transformation of Socialist Countries”.
„Papierowa wojna” – czyli o mniej znanych aspektach pewnej znanej klęski wojennej propagandy
Authors: Mazur Wojciech
Published: August 2023

‘PAPER WAR’ – OR THE LESSER-KNOWN ASPECTS OF A CERTAIN WELL-KNOWN FAILURE OF WARTIME PROPAGANDA
The article presents examples of the construction of a war narrative aimed not so much at accurately informing the public about key decisions for the state, but at ways of constructing messages to achieve strategic objectives, which do not necessarily prove to be effective.
Dziecko-uchodźca w polskiej edukacji
Authors: Łosiak-Pilch Julia , Weżgowiec Barbara
Published: August 2023

STRESS OF WAR AND MIGRATION – CONSEQUENCES FOR CHILDREN AND ADOLESCENTS
Stress caused by war and forced migration is an extremely traumatic experience for everyone, both adults and children, consequently causing impairment in general functioning and negative changes in mental health. Children and youth are especially vulnerable to negative effects of traumatic stress and data collected by UN indicate, that, in different parts of the world, millions of children experienced traumatic events, witnessing death of a close relative or being exposed to physical violence. Post traumatic stress disorder is the most frequently observed mental disorder in such circumstances as well as depression and anxiety disorders. Moreover some traumatized children exhibit impairment in school performance and difficulties in social functioning. This article presents a review of literature on traumatic war experiences of children and youth from different countries as well as on consequences of trauma – post traumatic stress disorder, other disorders and impairment in functioning.
Pedagogical Ideas of Borys Korotiaiev in the Concept of the «New Ukrainian School»
Authors:   State Institution Luhansk Taras Shevchenko National University, Moroz Yana
Published: August 2023

In the article a comparative analysis of the pedagogical ideas of the famous Ukrainian teacher, practitioner, Borys Ivanovych Korotiaiev, with the concept of the New Ukrainian School has been performed. It has been revealed that many aspects reflected in the concept resonate with the leading ideas of the scientist. Including the following: pedagogical creativity, the development of a harmonious personality, child-centeredness, the education of a thinking and independent personality, the cult of reading, partnership pedagogy, reformation of the goal of education and the system of control, school autonomy. Pedagogical ideas of Borys Korotiaiev are aimed at forming a healthy, creative personality, taking into account all its life needs, which would work for the benefit of itself, the Motherland and society as a whole. His pedagogical system is consistent with the key reform of the «New Ukrainian School», the main direction of which is also the preservation of childhood values, humanization of learning, personal approach, creation of a comfortable educational and subject environment that promotes the expression of children’s creativity. A brief review of individual ideas of the teacher confirms the timeliness and significance of the scientific and pedagogical work of the scientist and encourages the adaptation of other innovative ideas that can become a reliable basis for the construction of national education and the development of the New Ukrainian School.
Ankle fracture internal fixation performed by cadaveric simulation-trained versus standard-trained orthopaedic trainees: a preliminary, multicentre randomized controlled trial
Authors: James Hannah K. , Griffin Damian R. , Griffin James , Fisher Joanne D. , Pattison Giles T. R.
Published: August 2023

Aims

Ankle fracture fixation is commonly performed by junior trainees. Simulation training using cadavers may shorten the learning curve and result in a technically superior surgical performance.

Methods

We undertook a preliminary, pragmatic, single-blinded, multicentre, randomized controlled trial of cadaveric simulation versus standard training. Primary outcome was fracture reduction on postoperative radiographs.

Results

Overall, 139 ankle fractures were fixed by 28 postgraduate year three to five trainee surgeons (mean age 29.4 years; 71% males) during ten months' follow-up. Under the intention-to-treat principle, a technically superior fixation was performed by the cadaveric-trained group compared to the standard-trained group, as measured on the first postoperative radiograph against predefined acceptability thresholds. The cadaveric-trained group used a lower intraoperative dose of radiation than the standard-trained group (mean difference 0.011 Gym2, 95% confidence interval 0.003 to 0.019; p = 0.009). There was no difference in procedure time.

Conclusion

Trainees randomized to cadaveric training performed better ankle fracture fixations and irradiated patients less during surgery compared to standard-trained trainees. This effect, which was previously unknown, is likely to be a consequence of the intervention. Further study is required.

Cite this article: Bone Jt Open 2023;4(8):594–601.
A Kentucky State of Mind: bell hooks' Feminist Geography of Subjectivity
Authors: McGuffey C. Shawn
Published: August 2023

abstract: This research applied a feminist geographical framework to analyze the significance of Kentucky in bell hooks' Black feminist theorization. Utilizing narrative inquiry and the constant comparative method to analyze her memoir, Bone Black , poetry collection, Appalachian Elegy , and a collection of essays called Belonging , the findings illuminate the conditions, interactions, and consequences of homemaking for the politics of location. These findings reveal the process of becoming a subject, suggest a feminist geographic approach as an alternative to more abstract understandings of margin and center, and provide a more nuanced understanding of the significance of movement and stillness in knowledge production. The article concludes by suggesting that Kentucky is central to hooks' feminist visions and theories.
Automatic detection and classification of lung cancer CT scans based on deep learning and ebola optimization search algorithm
Authors: Mohamed Tehnan I. A. , Oyelade Olaide N. , Ezugwu Absalom E.
Published: August 2023

Recently, research has shown an increased spread of non-communicable diseases such as cancer. Lung cancer diagnosis and detection has become one of the biggest obstacles in recent years. Early lung cancer diagnosis and detection would reliably promote safety and the survival of many lives globally. The precise classification of lung cancer using medical images will help physicians select suitable therapy to reduce cancer mortality. Much work has been carried out in lung cancer detection using CNN. However, lung cancer prediction still becomes difficult due to the multifaceted designs in the CT scan. Moreover, CNN models have challenges that affect their performance, including choosing the optimal architecture, selecting suitable model parameters, and picking the best values for weights and biases. To address the problem of selecting optimal weight and bias combination required for classification of lung cancer in CT images, this study proposes a hybrid metaheuristic and CNN algorithm. We first designed a CNN architecture and then computed the solution vector of the model. The resulting solution vector was passed to the Ebola optimization search algorithm (EOSA) to select the best combination of weights and bias to train the CNN model to handle the classification problem. After thoroughly training the EOSA-CNN hybrid model, we obtained the optimal configuration, which yielded good performance. Experimentation with the publicly accessible Iraq-Oncology Teaching Hospital / National Center for Cancer Diseases (IQ-OTH/NCCD) lung cancer dataset showed that the EOSA metaheuristic algorithm yielded a classification accuracy of 0.9321. Similarly, the performance comparisons of EOSA-CNN with other methods, namely, GA-CNN, LCBO-CNN, MVO-CNN, SBO-CNN, WOA-CNN, and the classical CNN, were also computed and presented. The result showed that EOSA-CNN achieved a specificity of 0.7941, 0.97951, 0.9328, and sensitivity of 0.9038, 0.13333, and 0.9071 for normal, benign, and malignant cases, respectively. This confirms that the hybrid algorithm provides a good solution for the classification of lung cancer.
Young African diaspora: Global African narratives, media consumption and identity formation
Authors: Mukhongo L. Lusike , Mano Winston , Chuma Wallace
Published: August 2023

This study focused on identity formation and media consumption among first-generation young Africans in the diaspora. It investigated what it means to be African and the impact of multiple identities and forms of belonging within diasporic communities. Emphasis was on how they experience the diaspora as liminal spaces and subsequently negotiate relationships with other Africans in indeterminate diasporic spaces to construct, redefine, negotiate and even contest identities. Using snowballing and purposive sampling, the study analysed first-hand accounts and interviews informed by personal histories and lived experiences of (1) what they know about Africa; (2) their sense of belonging to Africa; (3) how Africa is represented in the media and (4) their views/attitudes on markers of African identity. Findings indicate that young Africans in the diaspora have a strong sense of belonging to Africa and are actively engaged with different forms of African media such as music and films.
Landscape and autopsy: Photography and the natural history of capital
Authors: Toscano Alberto
Published: August 2023

This article takes inspiration from Allan Sekula’s remarks on New Topographics photography, as well as his own ‘geography lessons’, to interrogate how photographs of ‘man-altered landscapes’ give visual form to the problems of temporality, natural history and historical agency that mark life in the Capitalocene. It proposes that combining Fredric Jameson’s analysis of the way that capital congeals ‘quantities of the past’ into dead labour with Andreas Malm’s diagnosis of our ‘warming condition’ allows us both to diagnose and counter the temptation to a sublime inhumanity that so often haunts contemporary panoramas of ecological devastation.
‘Negative’
Authors: Lee Jimmy
Published: August 2023

This publication presents a selection from ‘Negative’: a landscape project on the aftermath of the recent political unrest in Hong Kong.
Loss of vision: On emotional affects caused by the representation of violence in Russia’s war against Ukraine and beyond
Authors: Ridnyi Mykola
Published: August 2023

The essay is concentrated on emotional affects caused by representation of violence in the case of Russia’s war against Ukraine and beyond. Instant accessibility to first-hand visual information created fertile soil for planting and then multiplying manipulative strategies of one or another political interest. Meanwhile, the demand for shocking content continues to steadily rise because it guarantees popularity, spectacle and even a form of pleasure. This, in turn, supports a very propagandistic version of reality where violence plays a central role in the overall design and transmission of contents, which is driven by shock as an affective medium. Blind Spot, Gradual Loss of Vision and Speck in the Eye represent a body of works by Mykola Ridnyi, address the question of what potential response(s) could be given by artistic interventions understood as a dialectical and critical framework able to face and make visible the problem of dehumanization through violence?