bluuebunny/crossref_metadata_2025 huggingface dataset:
Az egyházi kommunió mintája és forrása a Szentháromság
Authors: Kiss Imre
Published: July 2023

A keresztény hit legtipikusabb vonása, hogy Isten Szentháromság. Az Újszövetség könyveiben bőséges tanítást találunk az Atyáról, a Fiúról és a Szentlélekről, különösen a János evangéliumban. Maga a Szentháromság (trias, trinitas) a Bibliában nem fordul elő. Teológiai terminus, ami csak a II. század közepén jelenik meg. A Niceai Zsinat (325) és a Konstantinápolyi zsinat (381) dogmái világosan megfogalmazták és kötelezővé tették a Szentháromságról szóló tanítást, ami a Zsinat által deklarált Hitvallásból minden keresztény számára jól ismert. Ez a tanítás, illetve a Szentháromság hite az egyház számára életprogram is. Jézus Utolsó vacsorán mondott imája, hogy tanítványai úgy legyenek egy, amint az Atya és a Fiú egy, a jeruzsálemi Egyház életében testet öltött, hiszen „a sok hívő mind egy szív, egy lélek volt, és mindenük közös volt” (vö. ApCsel 4,32). A szentháromságos élet valamilyen megnyilvánulása az Egyház történelmében végig húzódik, ha nem is mindig egyformán releváns és hangsúlyos. A II. Vatikáni zsinat a teológiában szentháromságos fordulatot hozott, és az utána következő tanító hivatali megnyilatkozások konkrét útmutatást is nyújtottak az Egyház életére vonatkozóan. A kommunió lelkiségének, ami a szentháromságos élet lelkisége, kiemelkedő tanítója Szent II. János Pál pápa, különösen a Novo Millenio Ineunte apostoli levelében. A szentháromságos élet alapja és útja a kölcsönös szeretet Új parancsolatának megvalósítása. Ennek egyik lényegi vonása a kölcsönösség. Ötvenháromszor található az „egymás” kifejezés, mely az oda-vissza áramló szeretet megannyi formáját írja le. A kommunió, a szentháromságos közösség nemcsak az Egyház belső életét jelenti, hanem küldetés is fakad belőle. Az Egyház feladata, hogy erre a kommunióra meghívja az embereket, illetve ezt a kommuniót bevigye a társadalom életébe.
THE RELEVANCE OF ENVIRONMENTAL AUDIT TODAY
Authors: Misirov Komoliddin
Published: July 2023

This article discusses the experience of economically developed countries in ensuring sustainable socio-economic development of the countries of the world through environmental audit, reducing the anthropogenic impact on the environment, eliminating environmental problems and sustainable development of the country's economy.
THEORETICAL VIEWS ON THE DEVELOPMENT OF THE SYSTEM FOR ASSESSING THE QUALITY OF HIGHER EDUCATION SERVICES
Authors: Salohitdinov Sherzod
Published: July 2023

This article discusses the directions of development of the system for assessing the quality of services in higher education institutions and the theoretical foundations of its practical significance.
Commentary: What, exactly, is 'online' education?
Authors: Nichols Mark
Published: July 2023

As responsible educators, it is time we admitted that we do not know what 'online' education is. We also need to confront the discomforting realisation that no one else does, either.
The term 'online' has reached the stage where it is now so inclusive as to be meaningless. In embracing too much, it describes nothing. What was once a useful term to describe using the internet as part of asynchronous distance education is now used universally, to describe almost anything. Lectured, synchronous classes are now 'online' (Johnson et al., 2022). Emergency remote teaching and learning during the Covid-19 pandemic was 'online'. Including additional resources on an LMS for students to refer to after class is considered ‘online’. Across much of the educational spectrum, to be 'online' now is far from unusual.
In this commentary I make the case that the term 'online' needs a forced retirement, or, at the least, additional context when it is applied.
Research on the employment of college students in Shanghai under the normalization of COVID-19 control
Authors: Lingyan CHEN , Juan GAO , Yuqing GENG
Published: July 2023

Since the outbreak of COVID-19, the domestic and foreign economies have been facing downward pressure, and employers' demand for the labor force has declined, reducing the number of jobs recruited for college graduates. With COVID-19 control becoming the requirement of normalization, the epidemic's impact on the employment of college graduates will continue. In this regard, this paper analyzes the employment problems and relevant countermeasures of Shanghai college graduates under the current normalization of COVID-19 control. It then puts forward countermeasures and suggestions for employment problems from the perspective of the government and colleges.
Some observations on a clopen version of the Rothberger property
Authors: Bhardwaj Manoj , Osipov Alexander V.
Published: July 2023

In this paper, we prove that a clopen version $S_1(\mathcal{C}_\mathcal{O}, \mathcal{C}_\mathcal{O})$ of the Rothberger property and Borel strong measure zeroness are independent. For a zero-dimensional metric space $(X,d)$, $X$ satisfies $S_1(\mathcal{C}_\mathcal{O}, \mathcal{C}_\mathcal{O})$ if, and only if, $X$ has Borel strong measure zero with respect to each metric which has the same topology as $d$ has. In a zero-dimensional space, the game $G_1(\mathcal{O}, \mathcal{O})$ is equivalent to the game $G_1(\mathcal{C}_\mathcal{O}, \mathcal{C}_\mathcal{O})$ and the point-open game is equivalent to the point-clopen game. Using reflections, we obtain that the game $G_1(\mathcal{C}_\mathcal{O}, \mathcal{C}_\mathcal{O})$ and the point-clopen game are strategically and Markov dual. An example is given for a space on which the game $G_1(\mathcal{C}_\mathcal{O}, \mathcal{C}_\mathcal{O})$ is undetermined.
Perceptions of nurses on obesity treatment options
Authors: Thomas Boansi Gyamerah  , Kwadwo Ameyaw Korsah  , Gloria Achempim-Ansong  , Bonney Osei  , Samson Kofie  , Samuel William Dodoo  , Samuel Darko Opoku
Published: July 2023

Background: Obesity is described as deviation from normal fat accumulation which endangers the health of an individual. The Body Mass Index (BMI) is normally used to indicate whether an individual is obese or otherwise. Different options of treatments are used in obesity reduction. Nurses play a significant role in providing medical care in obesity reduction. Objectives: The study aimed at exploring the perceptions nurses have on obesity treatment options at the Korle-Bu Teaching Hospital, in the Greater Accra Region of Ghana. Methods: The study used is an exploratory, descriptive qualitative design. Twelve (12) participants (nurses) were purposively sampled for the study. A semi-structured interview was also used to collect data from the participants. All the interviews were audio recorded, transcribed verbatim and analyzed using thematic content analysis, coding and categorization. Findings: Findings show that 7 (58.3%) of the participants hold the view that obesity treatment options help to reduce weight and prolong the lifespan of patients. Conversely, 4 (33.3%) of participants argue that treatment options such as exercise, surgery, diet and herbal preparations might be costly or cheap. Conclusions: Based on the findings, the need for food and exercise policies in all hospital settings was recommended. The need for workshops and specialists’ courses to train nurses on obesity treatments was also emphasized.
Nefritis tubulointersticial aguda por uso de diclofenaco tópico en paciente pediátrico
Authors: Peláez Cristancho Cristhian David , Castillo Arteaga Mariangel , Rueda Soto Andrea Carolina , Ortiz Ramírez Santiago
Published: July 2023

Introduction: Tubulointerstitial nephritis (TIN) is a histological diagnosis that can manifest with the classic triad: fever, rash, and eosinophilia. Among the leading causes is consuming non-steroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase 2 (COX2) inhibitors. We present an unusual case of TIN development with topical NSAID exposure in an adolescent.
Clinical case: 16-year-old woman admitted for the study of acute abdomen with repeated emetic episodes. During hospitalization, he developed non-oliguric acute renal failure, hyperphosphatemia, proteinuria, metabolic acidosis, hyperuricemia, hyperparathyroidism, decreased vitamin D, and developed arterial hypertension.
Evolution: The patient required vitamin D, antihypertensives, allopurinol, and parenteral hydration. She did not require hemodialysis or steroids. Progressively, the patient improved and was discharged. The renal biopsy report was confirmed in the outpatient clinic as acute patchy tubulointerstitial nephritis.
Conclusion: It is essential to know that all NSAIDs have the potential risk of generating tubulointerstitial nephritis. This rule-out diagnosis should not be underestimated in clinical practice, even with topical NSAID treatment.
Desain Media Pembelajaran Online Menggunakan Aplikasi Padlet pada Mata Pelajaran Simulasi dan Komunikasi Digital di SMK Swasta Muhammadiyah Singkil
Authors: Khairuman Khairuman , Zakir Supratman , Sesmiarni Zulfani , Aprison Wedra
Published: July 2023

Penelitian dilatarbelakangi terkait persoalan proses belajar mengajar yang masih melakukan pembelajaran secara konvensional. Pembelajaran dilakukan dengan metode tatap muka dan membagi siswa kedalam beberapa shif sehingga mengurangi penularan Covid-19. Keterbatasan pada sharing atau berbagai file/modul pembelajaran ketika pandemi covid-19 dan disaat guru atau siswa berhalangan hadir masih sulit dilakukan. Penelitian ini bertujuan untuk mengembangkan dan menghasilkan media pembelajaran online pada mata pelajaran simulasi & komunikasi digital yang tervalidasi dan mendeskripsikan kevalidan, kepraktisan dan keefektifannya. Penelitian ini merupakan Research and Development dengan lima tahapan (ADDIE) yaitu Analisis, Desain, Pengembangan, Implementasi dan Evaluasi. Pada tahap development model pengembangan media pembelajaran yang digunakan versi Luther Sutopo yang terdiri dari enam tahap,  yaitu  concept, design, materil collecting, assembly, testing & distribution. Hasil penelitian menunjukkan bahwa (1) uji validitas dari 3 orang ahli dibidang sistem komputer menunjukkan nilai 0,75 dengan kategori valid;  (2)  uji praktikalitas dari 1 orang ahli materi dan 2 siswa menunjukkan nilai 93 dengan kategori sangat praktis; (3) uji efektifitas dari 3 orang siswa pada pembelajaran komputer dan jaringan dasar menunjukkan nilai 0,88 dengan kategori efektifitas tinggi. Berdasarkan hasil uji validitas, praktikalitas dan efektifitas, maka produk desain media pembelajaran online dinilai layak dan dapat digunakan pada pembelajaran mata pelajaran simulasi dan komunikasi digital, sehingga disarankan guru dan siswa dapat memanfaatkannya sebagai salah satu alternative media pembelajaran.
Das Recht auf Wasser im Lieferkettensorgfaltspflichtengesetz
Authors: Holbach Selina
Published: July 2023

The Act on Corporate Due Diligence Obligations in Supply Chains (Supply Chain Act) represents a new type of human rights protection that makes German companies responsible for production conditions worldwide through national requirements. Due to its novelty, numerous questions arise, and this work offers initial suggestions in selected areas to answer them. The focus is on the extent to which a possible human right to (drinking) water is protected by the Supply Chain Act and how the legal requirements for the internal implementation of the due diligence obligations of the Act affect this. Specific aspects of the right to water as well as general facets of the Act are discussed.
Direct lookup and hash-based metadata placement : impact on architecture, performance and scalability of local and distributed file systems
Authors:   , Lensing Paul Hermann
Published: July 2023

New challenges to file systems’ metadata performance are imposed by the continuously growing average number of files existing in file systems. The traditional component based lookup approach can become a performance bottleneck for many workloads.

An alternative to component-based lookup is the direct lookup approach. It uses hash-based metadata placement to enable direct computation of the metadata location and to completely skip component traversal.

This thesis evaluates the implications of the direct lookup approach on file system architecture, performance and scalability.

It includes an analysis of file system traces focusing on the frequency and characteristics of hierarchical operations. These properties had not been sufficiently explored in existing literature and are fundamental to the direct lookup design.

Full direct lookup file systems are implemented and evaluated for both local and distributed scenarios.

El rendimiento de los metadatos de los sistemas de ficheros impone nuevos desafíos debido a que el número promedio de ficheros está en constante crecimiento. El enfoque de búsqueda tradicional basado en ir atravesando los diferentes componentes puede convertirse en un cuello de botella de rendimiento para muchas cargas de trabajo. Una alternativa a la búsqueda basada en componentes consiste en la búsqueda directa. Esta búsqueda utiliza la ubicación de metadatos basada en hash para permitir el cálculo directo de la ubicación de los metadatos y omitir así completamente el recorrido de componentes. Esta tesis evalúa las implicaciones del enfoque de búsqueda directa en la arquitectura, el rendimiento y la escalabilidad del sistema de ficheros. Incluye un análisis de las trazas del sistema de ficheros que se centran en la frecuencia y las características de las operaciones jerárquicas. Estas propiedades no han sido suficientemente exploradas en la literatura existente y son fundamentales para el diseño de búsqueda directa. Los sistemas de archivos de búsqueda directa completa se implementan y evalúan para escenarios locales y distribuidos.
Deep learning that scales: leveraging compute and data
Authors:   , Campos Camúñez Víctor
Published: July 2023

Deep learning has revolutionized the field of artificial intelligence in the past decade. Although the development of these techniques spans over several years, the recent advent of deep learning is explained by an increased availability of data and compute that have unlocked the potential of deep neural networks. They have become ubiquitous in domains such as natural language processing, computer vision, speech processing, and control, where enough training data is available. Recent years have seen continuous progress driven by ever-growing neural networks that benefited from large amounts of data and computing power.
This thesis is motivated by the observation that scale is one of the key factors driving progress in deep learning research, and aims at devising deep learning methods that scale gracefully with the available data and compute. We narrow down this scope into two main research directions. The first of them is concerned with designing hardware-aware methods which can make the most of the computing resources in current high performance computing facilities. We then study bottlenecks preventing existing methods from scaling up as more data becomes available, providing solutions that contribute towards enabling training of more complex models.
This dissertation studies the aforementioned research questions for two different learning paradigms, each with its own algorithmic and computational characteristics. The first part of this thesis studies the paradigm where the model needs to learn from a collection of examples, extracting as much information as possible from the given data. The second part is concerned with training agents that learn by interacting with a simulated environment, which introduces unique challenges such as efficient exploration and simulation.
Wireless multimedia sensor networks, security and key management
Authors:   , Almalkawi Islam
Published: July 2023

Wireless Multimedia Sensor Networks (WMSNs) have emerged and shifted the focus from the typical scalar wireless sensor networks to networks with multimedia devices that are capable to retrieve video, audio, images, as well as scalar sensor data. WMSNs are able to deliver multimedia content due to the availability of inexpensive CMOS cameras and microphones coupled with the significant progress in distributed signal processing and multimedia source coding techniques.
These mentioned characteristics, challenges, and requirements of designing WMSNs open many research issues and future research directions to develop protocols, algorithms, architectures, devices, and testbeds to maximize the network lifetime while satisfying the quality of service requirements of the various applications. In this thesis dissertation, we outline the design challenges of WMSNs and we give a comprehensive discussion of the proposed architectures and protocols for the different layers of the communication protocol stack for WMSNs along with their open research issues. Also, we conduct a comparison among the existing WMSN hardware and testbeds based on their specifications and features along with complete classification based on their functionalities and capabilities. In addition, we introduce our complete classification for content security and contextual privacy in WSNs. Our focus in this field, after conducting a complete survey in WMSNs and event privacy in sensor networks, and earning the necessary knowledge of programming sensor motes such as Micaz and Stargate and running simulation using NS2, is to design suitable protocols meet the challenging requirements of WMSNs targeting especially the routing and MAC layers, secure the wirelessly exchange of data against external attacks using proper security algorithms: key management and secure routing, defend the network from internal attacks by using a light-weight intrusion detection technique, protect the contextual information from being leaked to unauthorized parties by adapting an event unobservability scheme, and evaluate the performance efficiency and energy consumption of employing the security algorithms over WMSNs.
PENGELOLAAN PENDIDIKAN BERBASIS AGAMA, FILSAFAT, PSIKOLOGI DAN SOSIAL STUDY KASUS PADA SEKOLAH TINGGI ILMU KESEHATAN X JAKARTA SELATAN
Authors: Pratiwi Arsita
Published: July 2023

Penelitian ini bertujuan untuk mendeskripsikan dan menganalisis apa, mengapa, dan bagaimana pengelolaan pendidikan berbasis agama, filsafat, psikologi, dan sosiologi study kasus pada sekolah tinggi ilmu Kesehatan x Jakarta selatan. Dari penelitian ini dihasilkan bahwa pengelolaan pendidikan adalah perencanaan, pelaksanaan, dan pengawasan sumber daya pendidikan yang berbasis agama berarti berpijak pada ajaran Tuhan yang mewajibkanpengaturan yang menyeluruh, dengan cara perencanaan, pelaksanaan, dan pengawasan yang tepat dan akurat; berbasis filsafat berarti berpijak pada kajian alam dan makna kehidupan yang realistis, dengan cara berpikir rasional, natural illmiah, harmoni, dan kritis; berbasis psikologi berarti berpijak pada kajian ilmiah pikiran dan perilaku manusia yang menyeluruh, dengan cara introspeksi, eksperimen, dan komparasi; dan berbasis sosiologi berarti berpijak pada kajian ilmiah kemasyarakatan yang menghendaki kemajuan,dengan cara pandang masyarakatyang progresif, rasional, dan sadar.
Nivel de conocimientos sobre diabetes mellitus tipo II asociado a estilo de vida de los pacientes diabéticos en el consultorio externo de endocrinología del hospital San José de Chincha2019
Authors:   , Valenzuela Delgado Esmith
Published: July 2023

La diabetes mellitus tipo II es una de las enfermedades más frecuentes a nivel mundial; su incidencia se debe entre otros factores a la desinformación sobre el uso correcto del medicamento y la fisiopatología de la enfermedad que involucra al estilo de vida de los pacientes. Objetivo: Determinar la asociación de nivel de conocimientos, sobre diabetes mellitus tipo II y el estilo de vida de los pacientes diabéticos por consulta externa de endocrinología del HSJCH 2019. Material y métodos: Es un estudio descriptivo, correlacional, transversal y retrospectivo. Con una población de 504 pacientes con diabetes mellitus tipo II, considerando como muestra a 111 pacientes que si cumplían con los criterios de inclusión. Resultados: Se encontró del total de pacientes (111), el 45.0 % si tiene un nivel de conocimientos (General y específico) sobre diabetes mellitus tipo II, el tipo de estilo más frecuente fue el poco saludable con un 58.6%. En el caso de la edad predominante se presenta en el rango de 40-49 años con un 19.8%, el sexo de predominio de la muestra fue el femenino con 28.8% y el nivel de instrucción predominante fue secundaria con 23.4%. Respecto a la asociación entre nivel de conocimientos generales y estilo de vida, se encontró un valor de p≤0.05, las asociaciones entre edad, sexo, nivel de instrucción versus nivel de conocimientos (General y especifico) presentó valores de p≤0.05. Conclusiones: Nuestros resultados sugieren que existe asociación estadísticamente significativa entre nivel de conocimientos (General y específico), edad, sexo y nivel de instrucción frente al estilo de vida en pacientes diabéticos.
Determinantes del conocimiento sobre la vacuna contra la influenza en madres de niños menores de 5 años atendidos en el hospital San Juan de Dios de Pisco octubre a diciembre 2019
Authors:   , Yauri Muñoz Liz María Pía
Published: July 2023

Objetivo: Precisar los determinantes del conocimiento sobre la vacuna contra la influenza en madres de niños con menos de 5 años atendidos en el Hospital San Juan de Dios de Pisco octubre a diciembre 2019. Metodología. Observacional, transversal, prospectiva, analítica. En 120 madres que tiene hijos menores de 5 años. Resultados. Los factores influyentes sobre el nivel de información cognitiva sobre la vacuna de la influenza son la edad menor de 20 años, el nivel de instrucción primaria, y el tener un solo hijo como factores negativos para la información sobre los efectos de la vacuna y su utilidad, mientras que el estado civil no tiene influencia en el conocimiento. La edad de la madre es un determinante que influye en el conocimiento sobre la vacuna contra la influenza. El grado de instrucción es un determinante materno que influye en el conocimiento sobre la vacuna contra la influenza. El estado civil no es un determinante materno que influye en el conocimiento sobre de la vacuna contra la influenza. El número de hijos menores de 5 años es un determinante materno que influye en el conocimiento sobre la vacuna contra la influenza. Conclusiones. Los factores influyentes sobre el nivel de conocimiento sobre la vacuna de la influenza son la edad menor de 20 años, el nivel de instrucción primaria, y el tener un solo hijo como factores negativos para la información sobre los efectos de la vacuna y su utilidad, mientras que el estado civil no tiene influencia en el nivel de conocimiento.
Peritaje antropológico a través de imágenes y su aplicación en los delitos de robo agravado en la dirección de criminalistica – Lima 2020
Authors:   , Jara Gómez Carlos Augusto , Mendoza Castro Edgard Joel
Published: July 2023

La investigación tiene como objetivo principal, definir de qué manera el peritaje antropológicoa través de imágenes, se aplica en los delitos de robo agravado, para la identificación de personas a través de sus rasgos fisonómicos que hayan sido registradas por cámaras de seguridad cometiendo un ilícito penal, el periodo de estudio corresponde al año 2020 y se realizó en la Dirección de Criminalística, Sección de Antropología Forense de la Policía Nacional del Perú, el trabajo se enmarca dentro de la rama del Derecho Penal y es de tipo aplicativo, puesto que busca resolver un problema práctico, en este caso el de identificar a personas mediante el análisis y estudio de imágenes; la investigación es de tipo descriptiva, dado que se va a describir el objeto social del estudio, asimismo se encuentra enfocado desde el método hipotético deductivo debido a que se formularon hipótesis de investigación, las mismas que serán objeto de contrastación, dentro de este contexto el presente trabajo de investigación, pretende servir como herramienta o instrumento de orientación para los operadores de justicia, peritos, investigadores, abogados, etc. a fin de velar y garantizar un proceso justo, para las partes que se vean involucradas en procesos legales de este tipo y de esta forma contribuir con la correcta administración de justicia en nuestro país. Los resultados del trabajo, demuestran que ante un alto índice de inseguridad ciudadana urgente por resolver en nuestro país, el peritaje antropológico forense a través de imágenes, se ha convertido en una herramienta o instrumento que permite a la PNP, identificar plenamente al autor de un hecho delictivo, para lo cual, mediante el método científico de homologación de imágenes, el perito verifica características faciales y antropométricas de tipo general y particular que guardan correspondencia o similitud entre la persona que se visualiza en el video incriminado y las imágenes de comparación de la persona sindicada como presunto autor del hecho delictivo de robo agravado, a fin de llegar a una identificación positiva o en su defecto para descartar al sospechoso del caso
Expresión de TRPM8 en el glioblastoma
Authors: Jorge Sálamo Dante Noah , Plata-Bello Julio
Published: July 2023

El glioblastoma es el tumor cerebral primario maligno más común y agresivo. EL TRPM8 es un canal que podría tener relación con este tumor. También se estudió la relación entre el TRPM8, el AR y el glioblastoma
Some Fixed Point Theorems in e- Complete E-Metric Space
Authors: Manoj K. , Hussain R. Jahir
Published: July 2023

.In this study, we present fixed-point results for various contractions in E - Metric Space along with severalcorollaries. Finding a fixed point result in E - Metric Space can also be done via implicit relations. In theinvestigation of our primary result stands, all the theorems will be in non-solid cone and we cannot assumeinterior point is non-empty.
Analysis of seismic damage mechanism of simply supported girder bridges at near‐fault liquefaction sites
Authors: He Jing , Huang Yong , Zu Lin
Published: July 2023

This work uses the Yematan Bridge as an example to explore the seismic damage mechanism of simply supported girder bridges at near‐fault liquefaction site. It analyzes the bridge from the local portion to the complete bridge, considering the effects of the near‐fault and liquefied soil layers. First, a three‐dimensional model of the pile‐soil seismic action of Pier No.17 was created using simulated near‐field ground motion, and analysis was performed to simulate the action of the liquefied soil layers on the pile foundation, getting pile‐soil dynamic p‐y curves. After that, the accuracy of the pile spring parameters was verification by doing an equivalent static analysis. Finally, to identify the seismic damage mechanism of high‐damping rubber (HDR) bearings and the dynamic unseating process of the Yematan Bridge, a finite element model of the complete bridge was developed. During this procedure, the near‐field ground motion amplitude and soil spring parameters were iterated and optimized continually, such that the simulated earthquake damage was identical to the real one. The findings suggest that the bridge was destroyed by significant structural vibration. The near‐fault impulse effect and lack of equivalent limiting measures induced the entire collapsing girders to move consistently and destroyed the HDR bearings. Liquefied soil can cause some damage to pile foundations, and lateral spreading can cause the piers of the same span to perform differently.
Efficacy of a brief web‐based tonic immobility psychoeducation intervention among trauma‐exposed adults: A randomized clinical trial
Authors: Morabito Danielle M. , Schmidt Norman B.
Published: July 2023

Tonic immobility (TI) is a defensive response that may occur during traumatic events. Although TI is adaptive in certain circumstances, it has been shown to contribute to increased trauma‐related symptoms and poorer recovery. However, current frontline treatments for posttraumatic stress disorder (PTSD) have not focused significant attention on the experience of TI. Thus, the aim of this study was to develop and test the impact of a brief TI‐focused psychoeducation (TIP) intervention on posttraumatic cognitions and PTSD symptoms relative to a health education control intervention. The sample included 46 adults with elevated PTSD symptoms who endorsed prior TI episodes. After providing informed consent, participants were randomly assigned to either the active or control intervention and completed self‐report questionnaires including the tonic immobility questionnaire (TIQ‐R), Life Events Checklist for DSM‐5 (LEC‐5), Posttraumatic Stress Checklist for DSM‐5 (PCL‐5), Posttraumatic Cognitions Inventory (PTCI), and Positive and Negative Affect Schedule (PANAS) at baseline, 1‐week, and 1‐month follow‐up assessments. Results from linear mixed effects models indicated that participants in the TIP condition reported significantly larger reductions in posttraumatic cognitions and PTSD symptoms at 1‐week, ds = 0.48 and 0.84, respectively, and 1‐month, ds = 0.67 and 0.74. The findings suggest that TIP is a promising intervention that may be used to reduce posttraumatic cognitions and PTSD symptoms associated with TI. Given the ease of access, TIP could be used as a standalone intervention or as an add‐on to existing evidence‐based treatments for PTSD.
Symptom validity indices in the Posttraumatic Stress Disorder Checklist for DSM‐5
Authors: Shura Robert D. , Rowland Jared A. , Miskey Holly M. , Ord Anna S. , Magnante Anna T. ,   the VA Mid‐Atlantic MIRECC Workgroup, Martindale Sarah L.
Published: July 2023

The use of symptom validity tests (SVTs) is standard practice in psychodiagnostic assessments. Embedded measures are indices within self‐report measures. To date, no embedded SVTs have been identified in the Posttraumatic Stress Disorder Checklist for DSM‐5 (PCL‐5). This research aimed to develop and validate PCL‐5 SVTs in two samples of veterans. Participants completed one of two prospective research studies that included cognitive and psychological tests. Participants in Study 1 were veterans (N = 464) who served following the September 11, 2001, terrorist attacks; participants in Study 2 were veterans or service members (N = 338) who had been deployed to Iraq and/or Afghanistan. Both studies included the PCL‐5 and the Structured Inventory of Malingered Symptomatology (SIMS), the latter of which served as the criterion for identifying PCL‐5 SVTs. For Study 1, two separate SVTs were developed: the PCL‐5 Symptom Severity scale (PSS), based on the PCL‐5 total score, and the PCL‐5 Rare Items scale (PRI), based on PCL‐5 items infrequently endorsed at the highest item ratings. At the most conservative SIMS cutoff score, the PSS achieved excellent discrimination for both the Study 1, AUC = .840, and Study 2 samples, AUC = .858, with specific cutoff scores of ≥ 51 and ≥ 56 maximizing sensitivity while maintaining a specificity of .90. The PRI achieved good discrimination, AUCs = .760 and.726, respectively, with a cutoff score of 2 or higher indicated by both studies. The results of these two studies provide provisional support for these two embedded SVTs in the PCL‐5.
Investigation on the properties of chemically treated flexible parts fabricated through material extrusion based additive manufacturing technology
Authors: Dixit Nidhi , Jain Prashant K.
Published: July 2023

The poor strength and surface texture of the additively manufactured components has restricted its usage as a functional part. The post processing methods can overcome this limitation and open new opportunities in different application areas. In the present study, chemical finishing process has been employed for the flexible components build through material extrusion based additive manufacturing technology. Thermoplastic polyurethane (TPU) has been chosen as the material for printing flexible parts. Taguchi orthogonal array‐based design of experiments has been employed. Three process parameters that is, solvent type, infill density and immersion time have been selected for the study. The percentage improvement in the surface roughness as physical property and compressive strength as mechanical property has been chosen as the response parameters. The dimensional deviation was investigated by measuring the change in the dimensions of the manufactured components. It has been observed from ANOVA analysis that the improvement in surface roughness and compressive strength depends significantly on the immersion time. The Dimethyl sulfoxide (DMSO) solvent and immersion time of 125 s has been found significant for different properties of the chemically treated TPU parts.
Psychogenic and Neurogenic Components in Patients with Psychogenic or Neuropathic Pruritus: Prurineuro: A Non-Interventional Single-Centre Prospective Assay
Authors: Orliaguet Marie , Brenaut Emilie , Ficheux Anne-Sophie , Boisramé Sylvie , Misery Laurent
Published: July 2023

Background

The causes of pruritus are multiple and commonly classified into six different categories: dermatological, systemic, neuropathic, psychogenic, mixed and idiopathic. In clinical practice, psychogenic and neurogenic mechanisms tend to be separated in the etiological diagnosis of neuropathic or psychogenic disorders; nevertheless, studies investigating the respective psychogenic and neurogenic components are lacking.

Objective

The main objective of this work was to highlight the differences and potential common characteristics between psychogenic pruritus and neuropathic pruritus.

Methods

This study was a noninterventional single-centre prospective assay. Patients with neuropathic (NP) or psychogenic (PP) pruritus were proposed to participate. The psychogenic and neurogenic components of pruritus in these patients were evaluated using six validated questionnaires or criteria, namely, the diagnosis criteria of psychogenic pruritus, the NP5 questionnaire, the Brest Pruritus Qualitative Assessment Questionnaire, Hospital Anxiety and Depression Scale, Toronto Alexithymia Scale, and DN4i.

Results

Twenty-five patients with NP and 15 with PP were included. A difference between the two groups was observed for NP5, with mean scores of 2.8 ± 0.9 and 1.4 ± 1 for the NP and PP groups, respectively (p < 0.0001). For depression, the average score was 3.5 ± 3.9 for the NP group and 7.5 ± 5.1 for the PP group (p < 0.02).

Conclusion

While neuropathic and psychogenic disorders are different diagnoses, neuropathic and psychogenic components may exist simultaneously in patients with NP or PP.
Efficacy and safety of dofetilide and sotalol in patients with hypertrophic cardiomyopathy
Authors: Chen Chris , Lal Mallika , Burton Yunwoo , Chen Hongya , Stecker Eric , Masri Ahmad , Nazer Babak
Published: July 2023

Background

Professional society practice guidelines conflict regarding their recommendations of dofetilide (DOF) and sotalol (STL) for treatment of arrhythmias in hypertrophic cardiomyopathy (HCM), and supporting data is sparse. We aim to assess safety and efficacy of DOF and STL on arrhythmias in HCM.

Methods

This was an observational study of HCM patients treated with DOF or STL for atrial fibrillation (AF) and ventricular arrhythmias (VA). Outcomes of drug discontinuation and arrhythmia recurrence were compared at 1 year and latest follow-up by Kaplan–Meier analysis. Predictors of drug failure were studied using uni- and multi-variable analyses. Drug-related adverse events were quantitated.

Results

Here we show that of our cohort of 72 patients (54 ± 14 years old, 75% male), 21 were prescribed DOF for AF, 52 STL for AF, and 18 STL for VA. At 1 year, discontinuation and recurrence rates were similar for DOF-AF (38% and 43%) and STL-AF (29% and 44%) groups. Efficacy data was similar at long-term follow-up of 1603 (IQR 994–4131) days, and for STL-VA. Drug inefficacy was the most common reason for discontinuation (28%) followed by side-effects (13%). Incidences of heart failure hospitalization (5%) and mortality (3%) were low. One STL-AF patient developed non-sustained torsades de pointes in the setting of severe pneumonia and acute kidney injury, but there were no other drug-related serious adverse events.

Conclusions

DOF and STL demonstrate modest efficacy and satisfactory safety when used for AF and VA in HCM patients.
Structural and kinetic adjustments of Zr-based high-entropy alloys with Laves phases by substitution of Mg element
Authors: Yin Fuhu , Chang Yu , Si Tingzhi , Chen Jing , Li Hai-Wen , Li Yongtao , Zhang Qingan
Published: July 2023

The Zr2MgV2−xFexCrNi high-entropy alloys exhibit better hydrogen sorption properties at room temperature than those without Mg-substitution.
Vehicle clustering based edge caching scheme in internet of vehicles
Authors: Yang Jian , Tan Yuhao , Xie Jinlong , Teng Binze , Dong Siwen
Published: July 2023

With the development of mobile edge computing technology, edge caching provides a feasible solution for low‐latency and high‐reliability data forwarding in the Internet of Vehicles (IoV). Due to the limited number and storage capacity of the edge servers, and the limited communication range of a single vehicle, the delay and connection requirements are hard to be satisfied. A vehicle clustering based edge caching scheme is proposed in this paper, aiming at minimizing the content acquisition delay of the requesting vehicles (RVs) within the communication range of the edge servers. After getting the optimal vehicle association results, the minimization of content acquisition delay is transformed into a knapsack problem, which is then solved by a dynamic programming algorithm to obtain the optimal cache decisions. Simulation results show that the proposed scheme reduces task acquisition delay by at least about 100 s and increases the cache hit rate by about 50%, compared with the random cache scheme.
CNN‐LSTM based power grid voltage stability emergency control coordination strategy
Authors: Zhang Zhe , Qin Boyu , Gao Xin , Ding Tao
Published: July 2023

The occurrence of cascading failure and small probability contingency in hybrid AC/DC power grid aggravates the mismatch risk of traditional emergency control with offline‐predetermination–online‐practice (ODOP) mode. To ensure the voltage stability of power grid under large disturbances, this paper proposes a voltage stability emergency control coordination strategy based on convolutional neural network (CNN) and long short‐term memory (LSTM) network. First, the mismatch mechanism of traditional emergency control is revealed under the variation of operating conditions. Second, the start criterion of complementary emergency control with ODOP mode is proposed, and the CNN‐LSTM network is established to quantitatively evaluate the voltage stability margin. Finally, the emergency control sensitivity index is proposed to predict the stability margin enhancement under alternative emergency control measures, and the optimal ODOP‐based emergency control strategy is determined to coordinate multiple voltage stability emergency control measures. Case studies are performed in the actual Northwest China local region hybrid AC/DC power grid with voltage instability problems, and the simulation results verify the effectiveness of the proposed method.
Septal Reposition during Intermediate Cleft Rhinoplasty: A Second Chance for Correcting Caudal Septal Deviation
Authors: Kim Young Chul , Kwon Jin Geun , Koh Kyung S.
Published: July 2023

Background:

The authors investigated postoperative nasal morphologic changes in patients undergoing secondary correction of cleft-lip nose with septal repositioning and alar cartilage suspension during preschool age.

Methods:

The authors performed a retrospective review of 77 patients who underwent secondary correction of cleft-lip nose. The patients were 5 to 6 years of age and underwent intermediate rhinoplasty by alar cartilage suspension, with or without septal repositioning. They were divided into 2 groups based on time, encompassing septal repositioning (September of 2015 through November of 2017) and control (November of 2009 through August of 2015) groups. The authors performed a photogrammetric comparison by assessing the postoperative nasal morphologic changes using linear and angular measures. The cleft–to–noncleft-side ratio of each parameter was measured for the nostril width and height, nostril area, and caudal septal deviation angle.

Results:

Among the 77 patients, 43 were selected as the septal repositioning group and 34 as the control group. Evaluation timing was 5.32 ± 0.45 years of age for the preoperative period (T0), 6.57 ± 0.5 years of age for short-term follow-up (T1), and 9.28 ± 0.65 years of age for long-term follow-up (T2). The septal repositioning group showed significantly improved nostril width ratio and caudal septal deviation angle in the T1 and T2 periods. Septal repositioning significantly decreased the nostril area ratio in the T1 and T2 periods due to decreased cleft-side and increased noncleft-side nostril area.

Conclusion:

The secondary correction of cleft-lip nose with septal repositioning during preschool age offers a second chance to correct nasal appearance by balancing the nostril symmetry and correcting the caudal septal deviation.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
The Effects of Growth Hormone on Nerve Regeneration and Alloimmunity in Vascularized Composite Allotransplantation
Authors: Rath Jennifer , Zhou Xianyu , Lee Erica B. , Hanwright Philip , Amin Neha , von Guionneau Nicholas , Pinni Sai , Kambarashvili Keti , Harris Thomas G. W. , Beck Sarah , Lee W. P. Andrew , Brandacher Gerald , Tuffaha Sami
Published: July 2023

Background:

Poor outcomes in functional recovery after upper extremity transplantation are largely attributable to denervation-induced muscle atrophy that occurs during the prolonged period of nerve regeneration. Growth hormone (GH) has well-established trophic effects on neurons, myocytes, and Schwann cells, and represents a promising therapeutic approach to address this challenge. This study sought to confirm the positive effects of GH treatment on nerve regeneration and functional recovery and to evaluate the effects of GH treatment on the immune response in the setting of vascularized composite allotransplantation.

Methods:

Rats underwent orthotopic forelimb transplantation across a full major histocompatibility complex mismatch and received either porcine-derived growth hormone or no treatment (n = 18 per group). Functional recovery was measured using electrically stimulated grip strength testing. Animals were monitored for clinical and subclinical signs of rejection.

Results:

Neuromuscular junction reinnervation and grip strength were improved in GH-treated animals (P = 0.005, P = 0.08, respectively). No statistically significant differences were seen in muscle atrophy, degree of myelination, axon diameter, or axon counts between groups. The rates of clinical and histologic rejection did not differ significantly between groups.

Conclusions:

The findings alleviate concern for increased risk of transplant rejection during GH therapy and support the translation of GH as a therapeutic method to promote improved functional recovery in upper extremity transplantation.

Clinical Relevance Statement:

The authors’ findings suggest that growth hormone is a promising therapeutic option to improve motor functional recovery in upper extremity transplantation without increased risk of rejection.
Low Surgical Skill Rating of Surgeons Increased Complication Rates of Patients after Coronary Artery Bypass Graft
Authors: Yuan Xin , Chen Kai , Chu Qing , Sun Hansong , Song Yunhu , Liu Sheng , Feng Wei , Wang Xiangqiang , Wang Shuiyun , Wang Liqing , Wang Xin , Xu Fei , Wang Yang , Zhao Yanyan , Hu Shengshou
Published: July 2023

Objectives

It is not well characterized how surgeon-level factors affect surgical outcomes. This study aimed to determine the relationship between surgical skill rating of a cardiac surgeon and complication rates after coronary artery bypass grafting (CABG).

Methods

Video-based evaluations of CABG performed by 46 senior surgeons were conducted by 13 blinded expert cardiac surgeons. The evaluations were carried out using a rating score sheet including 7 domains of skills in surgical skills. Other surgeon-level factors such as the demographic information, Myers-Briggs Type Indicator (MBTI) test and the ratio of low frequency and high frequency of heart rate variability (LF/HF) during operation were also collected. The association between surgical skill rating along with surgeon-level factors and surgical outcomes was examined using prospectively collected data. The primary outcome was major adverse cardiac and cerebrovascular event (MACCE), included mortality, myocardial infarction and stroke within 30-day after surgery. The secondary outcome included skill-related complications and all complications. Multivariable generalized linear mixed models were employed for surgical skill rating on MACCE, skill-related complications and all complications.

Results

From 2018 to 2021, the participants performed a total of 9,844 isolated CABGs. All participant surgeons were male with a median of CABG volume of 702. Based on three reviewers per video and with a maximum surgical skill score of 5, the average surgical skill scores ranged from 3.10 to 4.81. After adjusted with the risk factors of the patients, compared to the patients of the top quartile rating surgeons, the patients of bottom quartile rating surgeons had 1.381 times of risk in MACCE (95%CI, 1.098-1.735, p=0.006), 1.528 times of risk in skill-related complication (95%CI, 1.340-1.743, p<0.001) and 1.286 times of risk in all complication (95%CI, 1.131-1.463, p<0.001). Surgeons in the top quartile of skill rating had an older age (57.9±4.4 vs. 49.7±5.7, p=0.002), higher rate of “sensing” characteristics of MBTI (72.7% vs. 33.3, p=0.046), lower rate of “thinking” characteristics of MBTI (54.5% vs. 83.3%, p=0.013), higher mean annual volumes of CABG (109.3±57.7 vs. 41.5±25.0 p=0.001), and lower LF/HF (2.3±0.1 vs. 4.9±1.4 p<0.01) than in the bottom quartile of skill rating.

Conclusion

Lower surgical skill rating of cardiac surgeon appeared to be associated with higher complication rates for CABGs. The surgical skill rating correlated well with a series of surgeon-level factors. Efforts to improve surgeon surgical skills may result in better patient outcomes and surgeon characteristics may serve as the target of intervention for quality improvements.
Rhizobium etli has two L-asparaginases with low sequence identity but similar structure and catalytic center
Authors: Loch Joanna I. , Worsztynowicz Paulina , Sliwiak Joanna , Grzechowiak Marta , Imiolczyk Barbara , Pokrywka Kinga , Chwastyk Mateusz , Gilski Miroslaw , Jaskolski Mariusz
Published: July 2023

The genome of Rhizobium etli, a nitrogen-fixing bacterial symbiont of legume plants, encodes two L-asparaginases, ReAIV and ReAV, that have no similarity to the well characterized enzymes of class 1 (bacterial type) and class 2 (plant type). It has been hypothesized that ReAIV and ReAV might belong to the same structural class 3 despite their low level of sequence identity. When the crystal structure of the inducible and thermolabile protein ReAV was solved, this hypothesis gained a stronger footing because the key residues of ReAV are also present in the sequence of the constitutive and thermostable ReAIV protein. High-resolution crystal structures of ReAIV now confirm that it is a class 3 L-asparaginase that is structurally similar to ReAV but with important differences. The most striking differences concern the peculiar hydration patterns of the two proteins, the presence of three internal cavities in ReAIV and the behavior of the zinc-binding site. ReAIV has a high pH optimum (9–11) and a substrate affinity of ∼1.3 mM at pH 9.0. These parameters are not suitable for the direct application of ReAIV as an antileukemic drug, although its thermal stability and lack of glutaminase activity would be of considerable advantage. The five crystal structures of ReAIV presented in this work allow a possible enzymatic scenario to be postulated in which the zinc ion coordinated in the active site is a dispensable element. The catalytic nucleophile seems to be Ser47, which is part of two Ser–Lys tandems in the active site. The structures of ReAIV presented here may provide a basis for future enzyme-engineering experiments to improve the kinetic parameters for medicinal applications.