bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep transfer learning–based fully automated detection and classification of Alzheimer’s disease on brain MRI
Authors: Ghaffari Hamed , Tavakoli Hassan , Pirzad Jahromi Gila
Published: May 2022

Objectives:

To employ different automated convolutional neural network (CNN)-based transfer learning (TL) methods for both binary and multiclass classification of Alzheimer’s disease (AD) using brain MRI.

Methods:

Herein, we applied three popular pre-trained CNN models (ResNet101, Xception, and InceptionV3) using a fine-tuned approach of TL on 3D T  1-weighted brain MRI from a subset of ADNI dataset (n = 305 subjects). To evaluate power of TL, the aforementioned networks were also trained from scratch for performance comparison. Initially, Unet network segmentedthe MRI scans into characteristic components of gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF). The proposed networks were trained and tested over the pre-processed and augmented segmented and whole images for both binary (NC/AD + progressive mild cognitive impairment (pMCI)+stable MCI (sMCI)) and 4-class (AD/pMCI/sMCI/NC) classification. Also, two independent test sets from the OASIS (n = 30) and AIBL (n = 60) datasets were used to externally assess the performance of the proposed algorithms.

Results:

The proposed TL-based CNN models achieved better performance compared to the training CNN models from scratch. On the ADNI test set, InceptionV3-TL achieved the highest accuracy of 93.75% and AUC of 92.0% for binary classification, as well as the highest accuracy of 93.75% and AUC of 96.0% for multiclass classification of AD on the whole images. On the OASIS test set, InceptionV3-TL outperformed two other models by achieving 93.33% accuracy with 93.0% AUC in binary classification of AD on the whole images. On the AIBL test set, InceptionV3-TL also outperformed two other models in both binary and multiclass classification tasks on the whole MR images and achieved accuracy/AUC of 93.33%/95.0% and 90.0%/93.0%, respectively. The GM segment as input provided the highest performance in both binary and multiclass classification of AD, as compared to the WM and CSF segments.

Conclusion:

This study demonstrates the potential of applying deep TL approach for automated detection and classification of AD using brain MRI with high accuracy and robustness across internal and external test data, suggesting that these models can possibly be used as a supportive tool to assist clinicians in creating objective opinion and correct diagnosis.

Advances in knowledge:

We used CNN-based TL approaches and the augmentation techniques to overcome the insufficient data problem. Our study provides evidence that deep TL algorithms can be used for both binary and multiclass classification of AD with high accuracy.
Overcoming challenges of translating deep-learning models for glioblastoma: the ZGBM consortium
Authors: Shuaib Haris , Barker Gareth J , Sasieni Peter , De Vita Enrico , Chelliah Alysha , Andrei Roman , Ashkan Keyoumars , Beaumont Erica , Brazil Lucy , Rowland-Hill Chris , Lau Yue Hui , Luis Aysha , Powell James , Swampillai Angela , Tenant Sean , Thust Stefanie C , Wastling Stephen , Young Tom , Booth Thomas C ,   ZGBM consortium, Brock Juliet , Currie Stuart , Fatani Kavi , Foweraker Karen , Glendenning Jennifer , Hoggard Nigel , Kanodia Avinash K , Krishnan Anant , Thurston Mark DV , Lewis Joanne , Linares Christian , Mathew Ryan K , Ramalingam Satheesh , Sawlani Vijay , Welsh Liam , Williams Matt
Published: May 2022

Objective:

To report imaging protocol and scheduling variance in routine care of glioblastoma patients in order to demonstrate challenges of integrating deep-learning models in glioblastoma care pathways. Additionally, to understand the most common imaging studies and image contrasts to inform the development of potentially robust deep-learning models.

Methods:

MR imaging data were analysed from a random sample of five patients from the prospective cohort across five participating sites of the ZGBM consortium. Reported clinical and treatment data alongside DICOM header information were analysed to understand treatment pathway imaging schedules.

Results:

All sites perform all structural imaging at every stage in the pathway except for the presurgical study, where in some sites only contrast-enhanced T  1-weighted imaging is performed. Diffusion MRI is the most common non-structural imaging type, performed at every site.

Conclusion:

The imaging protocol and scheduling varies across the UK, making it challenging to develop machine-learning models that could perform robustly at other centres. Structural imaging is performed most consistently across all centres.

Advances in knowledge:

Successful translation of deep-learning models will likely be based on structural post-treatment imaging unless there is significant effort made to standardise non-structural or peri-operative imaging protocols and schedules.
Optimized Structure, in Silico interaction and Molecular Docking Analysis of Two Benzimidazole-2-Thione Derivatives
Authors: Singh Mulveer , Murugavel Saminathan , Chandrasekaran Ravikumar , Kant Rajni
Published: May 2022

The nitrogen containing heterocyclic compounds play a very important role in defining their biological and pharmacological properties. Two such important compounds having known crystal structure, viz. 5-Methoxy-1H-benzo[d]imidazole-2(3H)-thione (M1) and 4, 5- Dimethylbenzimidazolene-2-thione (M2), have been investigated for their optimal molecular geometry, atomic Mulliken charges, molecule electrostatic potential, HOMO (highest occupied molecular orbital)-LUMO (lowest unoccupied molecular orbital), and associated molecular characteristics using DFT (density functional theory). The optimized geometry of (M1) and (M2), slightly deviates from the X-ray structure. The N-H...S and N-H...O hydrogen bonding contribute to the Hirshfeld surface in the molecular structure M1 [24.2 % and 7.1 % of the overall contribution, respectively] while the N-H...S hydrogen bonding contribution is 25.4% in M2. The crystal void analysis has also been reported, besides the energy frameworks built using distinct intermolecular interaction energies. The computational antibacterial activity of both structures has been analyzed in silico with Staphylococcus epidermidis bacterial protein (PDB ID: 4EJV). The results indicate that M1 and M2 possess higher binding energy with more interactions as compared to the standard drug chloramphenicol with receptor complex and this observation leads us to the state that these two derivatives could be the potential candidates for the antibacterial drug development process. KEYWORDS: Crystal voids; Density Functional Theory; Hirshfeld surface; Interaction energy; Mulliken charges; Molecular orbital energy; Molecular docking
Influence of Heat Treatment on Chemical and Mechanical Properties of Toona ciliata M. Roem. Wood
Authors: Sharma Vibha , Kumar Rajneesh , Dutt Bhupender , Attri Varun
Published: May 2022

Thermal modification or heat treatment was performed on the samples of Toonaciliataat various temperatures (80°C, 120°C, 160°C, 200°C) and durations (2h, 4h, and 6h) which revealed that chemical and mechanical properties of the wood improved at particular temperature with certain time duration. These results suggest that thermal treatment considerably improves wood properties like dimensional stability and durability. Vacuumoven was used to assess the process of thermal modification and different procedures were used to study the chemicaland mechanical properties of Toona wood. In chemical properties the maximum value of holocellulose content (71.73%) and lignin content (27.52%), were observed at 200°C. While, the minimum value of holocellulose content (61.29%) and lignin content (24.42%), were found to be at 200°C and at control, respectively. In mechanical properties the maximum value of tensile strength (0.072), bending strength 0.022), compression parallel to the grain (0.052) and compression perpendicular (0.039) to the grain was observed at 120°C. Whereas, the minimum tensile strength (0.039), bending strength (0.008), compression parallel (0,041) the grain and perpendicular (0.027) to the grain was found at 200°C.All the chemical and mechanical properties of Toona wood improved after heat treatment at particular temperature and duration.
Intrathecal baclofen overdose mimicking brainstem death during deep brain stimulation surgery for pain
Authors: Alamri A , Mostofi A , Aziz T , Pereira E
Published: May 2022

We describe a unique case of intrathecal baclofen overdose mimicking brainstem death, during bilateral anterior cingulate cortex deep brain stimulation (DBS) for pain. A 37-year-old man with chronic regional pain syndrome requiring an intrathecal baclofen pump underwent DBS under general anaesthesia and experienced an intraoperative generalised tonic–clonic seizure on dural opening. Once the operation was completed, the patient was noted to have fixed, dilated pupils bilaterally and was transferred for an emergency computed tomography scan of the head, which did not reveal any acute intracranial pathology. The patient was transferred to the intensive care unit for management of concurrent hypotension, bradycardia and supportive management of his low Glasgow Coma Scale (GCS) score. A trial of atropine to counter the bradycardia was unsuccessful. Intrathecal baclofen toxicity was suspected as a diagnosis of exclusion, necessitating urgent aspiration of the baclofen pump. The patient’s GCS score improved after pump aspiration and he was discharged home several days later. It was noted that the intrathecal baclofen pump had been refilled several days previously and the patient had reported intermittent episodes of somnolence. In perioperative patients with intrathecal baclofen pumps in situ, baclofen toxicity should always be considered as a differential in perioperative complications, even if it is considered a rare event.
The effect of anaesthetic use on healing in sub cutaneous abscess management: a retrospective before and after cohort study
Authors: Elkadi HH , Dodd E , Poulton T , Bolton W , Burke JR , Tiernan J , Jayne D
Published: May 2022

Introduction

There is wide variation in the management of simple subcutaneous abscesses in the UK and no national guidelines describing best practice. During the SARS-CoV-2 pandemic, regional or local anaesthesia (LA) use was recommended instead of general anaesthesia. This study aimed to assess the effect of anaesthetic use on outcomes following incision and drainage (I&D) of simple subcutaneous abscesses.

Methods

Two cohorts of patients undergoing abscess incision and drainage at St. James’ University Hospital in Leeds were identified retrospectively over a 14-week period before (P1) and after (P2) the introduction of the COVID-19 anaesthetic guidelines. The number of follow-up appointments for repacking and representation to healthcare services 30 days after I&D were used as surrogate endpoints for wound healing.

Results

A total of 133 patients were included (n=70, P1 and n=63, P2). Significantly more procedures were performed under LA after the intervention (84.1% vs 5.7%; p<0.0001) with a significant reduction in wound packing (68.3% vs 87.1%; p=0.00473). Follow-up analysis found no significant difference in the median number of follow-up appointments (7.46 vs 5.11; p=0.0731) and the number of patients who required ongoing treatment after 30 days (n=14, P1 vs n=14, P2; p=0.921).

Conclusions

Drainage of simple subcutaneous abscess under 5cm in diameter is safe under LA, with no significant difference in surrogate endpoints of wound healing observed in this patient cohort. Recurrent packing may not be required. Future work should explore patient-reported outcomes, including pain management, cosmesis and the cost and sustainability implications of a change in this common procedure.
Predictors of mortality and nephrectomy in emphysematous pyelonephritis: a tertiary care centre study
Authors: Aggarwal D , Mandal S , Parmar K , Manoharan V , Singh S , Yadav AK , Kumar S , Sharma AP , Singh SK
Published: May 2022

Introduction

Emphysematous pyelonephritis (EPN) is a deadly disease due to its associated morbidity and mortality. Attempts have been made to identify predictors of severity, mortality and need for nephrectomy in EPN with little success.

Methods

We conducted an ambispective study of EPN patients between March 2014 and September 2019. Retrospective data were collected which included age, sex, comorbidities, symptoms, signs, laboratory investigations including imaging, need for dialysis, management and any complications. All patients were then followed prospectively for renal dynamic scan, stone surgery or nephrectomy. Univariate analysis was performed to identify factors affecting mortality and need for elective nephrectomy.

Results

In total, 112 patients were included. Mean patient age was 50.01 years, 55% were female and 5% had bilateral involvement. Fever and flank pain were the most common symptoms. Diabetes was seen in 75% of cases and 30% of cases required haemodialysis at initial presentation. About 60% of patients improved with pigtail drainage. Need for nephrectomy was greater in Huang–Tseng stage 3a (14.8%). Huang–Tseng stages 3b and 4 had higher mortality rates (25%) than the other stages (2.2%). Twelve of 99 patients had non functional kidney on follow-up and underwent elective nephrectomy. Low platelet counts, high body mass index, septic shock, dialysis and higher Huang–Tseng stage were found to be predictive of mortality and renal parenchymal thickness on computed tomography scan was predictive of follow-up nephrectomy.

Conclusions

Thrombocytopaenia, high body mass index, septic shock, haemodialysis and higher Huang–Tseng stage are predictors of mortality and renal parenchymal thickness <5mm is a predictor of poor salvage of affected kidney on follow-up.
Optimising the use of physiotherapy resources after manipulation under anaesthetic for frozen shoulder
Authors: Castelhano R , Woods J , Akehurst H , Mitra A , James M , Berntzen B , Dacombe P , Tasker A , Woods D
Published: May 2022

Introduction

Manipulation under anaesthetic (MUA) is a successful treatment for frozen shoulder (FS), and the recovery period and recurrence rates may be reduced by postoperative physiotherapy. This study evaluates two physiotherapy pathways for patients undergoing MUA for FS.

Methods

Between 2016 and 2018, 248 age- and sex-matched patients presented to either a NHS secondary care upper limb service or the lead author’s independent practice with a diagnosis of FS. The patients had differential access to postprocedure physiotherapy based on which service they presented to. In Group 1, physiotherapy advice only was given to the patient. In Group 2, supervised hydrotherapy and physiotherapy occurred postoperatively. Pre- and postprocedure Oxford Shoulder Scores (OSS) were collected for each group. Analysis of covariance (ANCOVA) was used to measure the effect of physiotherapy on postoperative OSS.

Results

Group 2 showed a significantly greater improvement in postprocedure OSS when compared with Group 1 (18.2 vs 16.7) p<0.001). The estimated maximum effect of physiotherapy on postoperative OSS was an increase of 3.2.

Conclusion

Following MUA for FS, a statistically significant increase in OSS was detected in patients receiving postprocedure physiotherapy compared with advice alone. There was no difference in recurrence rates. The increase in OSS (3.2) is below the minimal clinically important difference, raising questions regarding the relative importance of postprocedure physiotherapy in a resource-limited environment.
Determination of quality attributes and ripening stage using vis-nir spectroscopy in intact seriguela and umbu fruits
Authors: De Araujo Souza Patrícia , Ferreira Iara Jeanice Souza , Costa Daniel dos Santos
Published: May 2022

To produce seriguela and umbu on a large scale, it is important to detect the ripening stages and quality attributes of the fruits, to define the ideal harvest point. Thus, this study aimed to determine, in a non-destructive way, the quality attributes and ripening stages of intact seriguela and umbu fruits using Vis-NIR spectroscopy. A total of 150 seriguela fruits and 150 umbu fruits were used, at different ripening stages, and subjected to spectral analysis and reference laboratory testing to determine total soluble solids (TSS) and firmness. Spectral data were subjected to different pre-processing techniques. Regression and classification models were created through the statistical learning and machine learning methods. The models with the best performance for TSS were RF (R2P = 0.94) and PLSR (R2P = 0.68), and for firmness were PLSR (R2P = 0.92) and RF (R2P = 0.58), for seriguela and umbu, respectively. The model with the best performance in the classification was LDA, with a precision greater than 95% to discriminate the ripening stages of both fruits. Therefore, the Vis-NIR spectroscopy is a potential tool to determine the quality attributes and ripening stages, in a non-destructive way, of intact seriguela and umbu fruits.
‘I see a wall… then I cannot reach my son.’ Coercive control tactics by one parent alienate the child from the other
Authors: Dijkstra Sietske
Published: May 2022

This article, drawing from practice-based research, explores the impact of coercive control tactics used by one parent against the other to alienate the affections of the child from the other parent. Such tactics tend to corrupt the child and disempower the victimised parent. In the first of three sections is a research-based consideration of relevant terms and meanings. In the second part, the results of the qualitative research based on interviews with ten victimised mothers are presented. Analysis of these interviews illuminates some gendered ways in which the dominant partner can sabotage the relationship between the other parent and the child(ren), employing a pattern of coercive tactics. The interviews also reveal how social professionals can be manipulated to misperceive the situation, assuming without sufficient evidence that the two divorced partners have equivalent power, when in fact the power relationship is asymmetrical, with emotional violence happening under the surface. In such situations, the poisoning of parent–child relationships can lead to the alienated parent’s losing direct and even indirect contact with the child(ren). In the third and last section, recommendations pay particular attention to gendered manifestations of child–parent alienation such as diminishing space for action, distorted views and fraying bonds of affection.

The article concludes with a plea for more awareness of asymmetrical and gendered parental relationships after divorce and the relationship between coercive control, gender and alienation of affection.
Why does Applied Optics publish feature and institutional issues?: editorial
Authors: Bennett Gisele
Published: May 2022

Editor-in-Chief Gisele Bennett discusses the intent and motivations for organizing feature issues and institutional issues.
Retinal magnification factors at the fixation locus derived from schematic eyes with four individualized surfaces
Authors: Huang Xiaojing , Anderson Trevor , Dubra Alfredo
Published: May 2022

Retinal magnification factors (RMFs) allow the conversion of angles to lengths in retinal images. In this work, we propose paraxial and non-paraxial RMF calculation methods that incorporate the individual topography and separation of the anterior and posterior surfaces of the cornea and crystalline lens, assuming homogeneous ocular media. Across 34 eyes, the two RMF methods differ by 0.1% on average, due to surface tilt, decenter, and lack of rotational symmetry in the non-paraxial modeling, which results in up to 2.2% RMF variation with retinal meridian. Differences with widely used individualized RMF calculation methods are smallest for eyes with ∼24 mm axial length, and as large as 7.5% in a 29.7 mm long eye (15D myope). To better model the capture of retinal images, we propose the tracing of chief rays, instead of the scaling of posterior nodal or principal distances often used in RMF definitions. We also report that RMF scale change is approximately proportional to both refractive error and axial separation between the ophthalmoscope’s exit pupil and the eye’s entrance pupil, resulting in RMF changes as large as 13% for a 1cm displacement in a 15D myopic eye. Our biometry data shows weak correlation and statistical significance between surface radii and refractive error, as well as axial length, whether considering all eyes in the study, or just the high myopes, defined as those with refractive error sphere equivalent ≤ -4D. In contrast, vitreous thicknesses show a strong correlation (r ≤ -0.92) and significance (p ≤ 10−13) with refractive error when considering all eyes or just high myopes (r ≤ -0.95; p ≤ 10−5). We also found that potential RMF change with depth of cycloplegia and/or residual accommodation is smaller than 0.2%. Finally, we propose the reporting of individual ocular biometry data and a detailed RMF calculation method description in scientific publications to facilitate the comparison of retinal imaging biomarker data across studies.
GLUT1, LDHA, and MCT4 Expression Is Deregulated in Cervical Cancer and Precursor Lesions
Authors: Reyna-Hernández Ma. A. , Alarcón-Romero Luz del C. , Ortiz-Ortiz Julio , Illades-Aguiar Berenice , Jiménez-López Marco A. , Ocampo-Bárcenas Azucena , Morrugares-Ixtepan Martin O. , Torres-Rojas Francisco I.
Published: May 2022

Metabolic reprogramming is typical in cancerous cells and is required for proliferation and cellular survival. In addition, oncoproteins of high-risk human papillomavirus (HR-HPV) are involved in this process. This study evaluated the relationship between glucose transporter I (GLUT1), lactate dehydrogenase A (LDHA), and monocarboxylate transporter type 4 (MCT4) expression and cervical intraepithelial neoplasia (CIN) and invasive cervical carcinoma (ICC) with HR-HPV infection. The protein expression was evaluated in women with CIN I ( n=20), CIN II/III ( n=16), or ICC ( n=24) by immunohistochemistry. The protein expression was analyzed qualitatively by van Zummeren score and quantitatively by Image ProPlus 6 software. LDHA expression increases in HPV-16 infection. In the CIN I group, GLUT1 immunostaining has a 35% protein expression at the membrane level at more than two thirds of the epithelium, which increased by 21.25% more in CIN II/III in more than two thirds of the epithelium. While LDHA and MCT4 in CIN I mostly do not present immunostaining, or this was only limited to the basal stratum, this expression is increased in CIN II/III and ICC cases. The GLUT1, LDHA, and MCT4 expression increased in ICC. The overexpression in high-grade CIN with HR-HPV infection shows a higher risk for cervical carcinoma progression.
The ESCAPE trial for older people with chronic low back pain: Protocol of a randomized controlled trial
Authors: Silva Hytalo de Jesus , Fonseca Leticia Soares , Mascarenhas Rodrigo Oliveira , Miranda Júlio Pascoal de , Almeida Paulo André , Souza Mateus Bastos , Pereira Leani Souza Maximo , Oliveira Murilo Xavier , Oliveira Vinicius Cunha
Published: May 2022

Background

Low-back pain is one of the most common health conditions worldwide. It is defined as pain below the costal margin and above the inferior gluteal folds. Current guidelines recommend management of chronic health (e.g., low back pain) conditions in older people at primary health care settings using active strategies (e.g., exercise). In non-specific low back pain, high quality evidence supports active strategies for general population. However, the management of non-specific low back pain in the older people has been overlooked and evidence is limited to a small number of low powered randomized controlled trials with high risk of bias.

Methods

This is a prospectively registered, open, two-arm randomised controlled trial comparing the group-based exercise and waiting list in pain intensity (11-item Pain Numerical Rating Scale) and disability (Roland Morris questionnaire) of older people (i.e., 60 years old or over) with chronic non-specific low back pain. One hundred and twenty patients will be recruited from Diamantina, Brazil. Follow-ups will be conducted in post-treatment (8 week) and 6- and 12-months post-randomisation.

Discussion

Our hypothesis is that group-based exercise will be better than waiting list in reducing pain intensity and disability in older people with chronic non-specific low back pain.

Impact

The practice of individualized exercise has been studied for the management of chronic non-specific low back pain in older people. However, the group exercise, even showing high quality evidence for the improvement of several important outcomes in this population, has been ignored until now. Thus, the results of this study have the potential to indicate a viable and accessible strategy for managing chronic non-specific low back pain in the older people.

Trial registration

The study was prospectively registered at www.ensaiosclinicos.gov.br (RBR-9j5pqs). Date-11/18/2020.
Understanding the interaction among enablers of quality enhancement of higher business education in Pakistan
Authors: Abbass Kashif , Asif Muhammad , Niazi Abdul Aziz Khan , Qazi Tehmina Fiaz , Basit Abdul , Al-Muwaffaq Ahmed Faroq Abdulkarem
Published: May 2022

This study aims to generate a list of enablers of quality enhancement of higher business education in Pakistan and build a structural model of enablers to prioritize them. It also intends to impose direction and hierarchy on the inter-relationships of the enablers. The study’s design consists of a literature review, data collection from primary sources, and qualitative analysis. Interpretive Structural Modeling (ISM) coupled with Matriced’ Impacts Cruise’s Multiplication Appliquée a UN Classement (MICMAC) is used as a research methodology. The classical procedure of ISM and MICMAC is applied to primary data collected by a field survey from a panel of experts recruited from folks of stakeholders of business education. Results of the literature show that eighteen critical enablers enhance the quality of higher business education in Pakistan. Results of ISM show that the enabler ’job placement of graduates’ occupies the top-level of the ISM model being least critical. In contrast, the enabler ’intra-academia linkages’ occupying the bottom of the model is the most vital. Results of MICMAC show that all enablers, except ’job placement of graduates, are classified into linkage clusters, whereas ‘job placement of graduates’ is classified as an independent cluster. Overall results of the study show that enablers of quality enhancement of higher business education in Pakistan are agile and not settled. The study has profound theoretical, managerial, and practical implications for all stakeholders of business education. It also provides a research framework for future studies concerning subject phenomena. The discussion about the structural model culminates into policy guidelines for the regulators. The study is subject to some methodological/data/resources limitations like the limited review of literature, collection of data from a medium-size panel of experts from Pakistan only, using majority rule for aggregating responses, answering only that what is related to what, other common limitations of qualitative studies, shot period and absence of financial support. The authors conduct this study in a real-life field setting is built on the original dataset and address the efficient issue of phenomenon understudy differently. It is theory-building research, therefore, does not require prior theory. It exploits simple elementary concepts of Boolean algebra, set theory, and graph theory that generates new in-depth information for stakeholders.
A potential mechanism for low tolerance feedback loops in social media flagging systems
Authors: Westermann Camilla Jung , Coscia Michele
Published: May 2022

Many people use social media as a primary information source, but their questionable reliability has pushed platforms to contain misinformation via crowdsourced flagging systems. Such systems, however, assume that users are impartial arbiters of truth. This assumption might be unwarranted, as users might be influenced by their own political biases and tolerance for opposing points of view, besides considering the truth value of a news item. In this paper we simulate a scenario in which users on one side of the polarity spectrum have different tolerance levels for the opinions of the other side. We create a model based on some assumptions about online news consumption, including echo chambers, selective exposure, and confirmation bias. A consequence of such a model is that news sources on the opposite side of the intolerant users attract more flags. We extend the base model in two ways: (i) by allowing news sources to find the path of least resistance that leads to a minimization of backlash, and (ii) by allowing users to change their tolerance level in response to a perceived lower tolerance from users on the other side of the spectrum. With these extensions, in the model we see that intolerance is attractive: news sources are nudged to move their polarity to the side of the intolerant users. Such a model does not support high-tolerance regimes: these regimes are out of equilibrium and will converge towards empirically-supported low-tolerance states under the assumption of partisan but rational users.
Analysis of cathepsin S expression in gastric adenocarcinoma and in Helicobacter pylori infection
Authors: Costa Adriano C. , Santa-Cruz Fernando , Araújo Raphael L. C. , Leitão Glauber , Figueiredo José-Luiz , Ferraz Álvaro A. B.
Published: May 2022

Background

Recent experimental studies have suggested a potential link between cathepsin S (CTTS) and gastric adenocarcinoma progression. Herein, we aimed to evaluate the expression of CTTS in gastric adenocarcinoma in patients who underwent curative-intent surgical resection.

Methods

This was a cross-sectional study that included two groups: gastric adenocarcinoma (n = 42) and gastritis (n = 50). The gastritis group was then subdivided into H. pylori-positive (n = 25) and H. pylori-negative (n = 25) groups. Gastric tissue samples were analysed to determine CTTS expression through immunohistochemistry. Samples were obtained by oesophagogastroduodenoscopy or surgical specimens.

Results

In patients with gastritis, the age ranged from 18 to 78 years. Among them, 34% were male, and 66% were female. In patients with gastric adenocarcinoma, the age ranged from 37 to 85 years. Among them, 50% were male. When comparing the expression of CTTS between the two groups, only 16% of the gastritis samples had an expression higher than 25%. Alternatively, among patients with gastric adenocarcinoma, 19% had expression between 25–50%, 14.3% between 51–75%, and 26.2% had expression higher than 75% (p < 0.001). In the gastritis group, CTTS expression was significantly higher in patients with a positive test for H. pylori than negative test for H. pylori: 87.5% and 38.5%, respectively (p<0.001). There was no statistically significant association between CTTS positivity and clinicopathological variables, including tumour staging, histological type, angiolymphatic invasion, recurrence, current status and death.

Conclusion

CTTS expression is higher in gastric adenocarcinoma samples. Patients with gastritis due to H. pylori also show a higher expression of CTTS than patients with negative results for this bacterium.
Cut-off value for exercise-induced bronchoconstriction based on the features of the airway obstruction
Authors: Kang Noeul , Koh Eunsil , Lee Jin-Young , Song Woo-Jung , Choi Dong-Chull , Lee Byung-Jae
Published: May 2022

The current cut-off value for diagnosing exercise-induced bronchoconstriction (EIB) in adults—percent fall in FEV1(ΔFEV1) ≥ 10% after exercise challenge test (ECT)—has low specificity and weak evidences. Therefore, this study aimed to identify the cut-off value for EIB that provides the highest diagnostic sensitivity and specificity. Participants who underwent the ECT between 2007 and 2018 were categorized according to ΔFEV1: definite EIB (ΔFEV1≥ 15%), borderline (10% ≤ ΔFEV1< 15%), and normal (ΔFEV1< 10%). Distinct characteristics of the definite EIB group were identified and explored in the borderline EIB group. A receiver operating characteristic curve was plotted to determine the optimal cut-off value. Of 128 patients, 60 were grouped as the definite EIB group, 23 as the borderline group, and 45 as the normal group. All participants were men, with a median age of 20 years (interquartile range [IQR:] 19–23 years). The definite EIB group exhibited wheezing on auscultation (P< 0.001), ΔFEV1/FVC ≥ 10% (P< 0.001), and ΔFEF25–75%≥ 25% (P< 0.001) compared to other groups. Eight (8/23, 34.8%) patients in the borderline group had at least one of these features, but the trend was more similar to that of the normal group than the definite EIB group. A cut-off value of ΔFEV1≥ 13.5% had a sensitivity of 98.5% and specificity of 93.5% for EIB. Wheezing on auscultation, ΔFEV1/FVC ≥ 10%, and ΔFEF25–75%≥ 25% after ECT may be useful for the diagnosis of EIB, particularly in individuals with a ΔFEV1of 10–15%. For EIB, a higher cut-off value, possibly ΔFEV1≥ 13.5%, should be considered as the diagnostic criterion.
Dominant expansion of CD4+, CD8+ T and NK cells expressing Th1/Tc1/Type 1 cytokines in culture-positive lymph node tuberculosis
Authors: Kathamuthu Gokul Raj , Sridhar Rathinam , Baskaran Dhanaraj , Babu Subash
Published: May 2022

Lymph node culture-positive tuberculosis (LNTB+) is associated with increased mycobacterial antigen-induced pro-inflammatory cytokine production compared to LN culture-negative tuberculosis (LNTB-). However, the frequencies of CD4+, CD8+ T cells and NK cells expressing Th1/Tc1/Type 1 (IFNγ, TNFα, IL-2), Th17/Tc17/Type 17 (IL-17A, IL-17F, IL-22) cytokines and cytotoxic (perforin [PFN], granzyme [GZE] B, CD107a) markers in LNTB+ and LNTB- individuals are not known. Thus, we have studied the unstimulated (UNS) and mycobacterial antigen-induced frequencies of CD4+, CD8+ T and NK cells expressing Th1, Th17 cytokines and cytotoxic markers using flow cytometry. The frequencies of CD4+, CD8+ T and NK cells expressing cytokines and cytotoxic markers were not significantly different between LNTB+ and LNTB- individuals in UNS condition. In contrast, upon Mtb antigen stimulation, LNTB+ individuals are associated with significantly increased frequencies of CD4+ T cells (PPD [IFNγ, TNFα], ESAT-6 PP [IFNγ, TNFα], CFP-10 PP [IFNγ, TNFα, IL-2]), CD8+ T cells (PPD [IFNγ], ESAT-6 PP [IFNγ], CFP-10 PP [TNFα]) and NK cells (PPD [IFNγ, TNFα], ESAT-6 PP [IFNγ, TNFα], CFP-10 PP [TNFα]) expressing Th1/Tc1/Type 1, but not Th17/Tc17/Type 17 cytokines and cytotoxic markers compared to LNTB- individuals. LNTB+ individuals did not show any significant alterations in the frequencies of CD4+, CD8+ T cells and NK cells expressing cytokines and cytotoxic markers compared to LNTB- individuals upon HIV Gag PP and P/I antigen stimulation. Increased frequencies of CD4+, CD8+ T and NK cells expressing Th1/Tc1/Type 1 cytokines among the LNTB+ group indicates that the presence of mycobacteria plays a dominant role in the activation of key correlates of immune protection or induces higher immunopathology.
Development and delivery of an allied health team intervention for older adults in the emergency department: A process evaluation
Authors: Cassarino Marica , Cronin Úna , Robinson Katie , Quinn Rosie , Boland Fiona , Ward Marie E. , McNamara Rosa , O’Connor Margaret , McCarthy Gerard , Ryan Damien , Galvin Rose
Published: May 2022

Background

There is encouraging evidence that interdisciplinary teams of Health and Social Care Professionals (HSCPs) can enhance patient care in the Emergency Department (ED), especially for older adults with complex needs. However, no formal process evaluations of implementations of ED-based HSCP interventions are available. The study aimed to evaluate the development and delivery of a HSCP team intervention for older adults in the ED of a large Irish teaching hospital.

Methods

Using the Medical Research Council (MRC) Framework for process evaluations, we investigated implementation and delivery, mechanisms of impact, and contextual influences on implementation by analysing the HSCP team’s activity notes and participant recruitment logs, and by carrying out six interviews and four focus groups with 26 participants (HSCP team members, ED doctors and nurses, hospital staff). Qualitative insights were analysed thematically.

Results

The implementation process had three phases (pre-implementation, piloting, and delivery), with the first two described as pivotal to optimise care procedures and build positive stakeholders’ involvement. The team’s motivation and proactive communication were key to promote acceptability and integration in the ED (Theme 1); also, their specialised skills and interdisciplinary approach enhanced patient and staff’s ED experience (Theme 2). The investment and collaboration of multiple stakeholders were described as essential contextual enablers of implementation (Theme 4). Delivering the intervention within a randomised controlled trial fostered credibility but caused frustration among patients and staff (Theme 3).

Discussion

This process evaluation is the first to provide in-depth and practical insights on the complexities of developing and delivering an ED-based HSCP team intervention for older adults. Our findings highlight the importance of establishing a team of HSCPs with a strong interdisciplinary ethos to ensure buy-in and integration in the ED processes. Also, actively involving relevant stakeholders is key to facilitate implementation.

Trial registration

ClinicalTrials.gov, NCT03739515; registered on 12th November 2018.
Liberais ao estilo populista
Authors: Brodbeck Pedro de Souza Lima , Prudencio Kelly Cristina de Souza
Published: May 2022

O uso das redes digitais para a profusão de mensagens populistas tem repercutido de forma importante na comunicação política e a argumentação tem um papel central nesta estratégia. A partir de 2015, o Movimento Brasil Livre se estabeleceu como um dos principais representantes da nova direita do país, sobretudo, pelo sucesso das publicações nas redes sociais. Para investigar como o movimento se comunica na internet, o trabalho faz uma análise argumentativa dos vídeos do MBL no YouTube que tratam sobre a prisão após decisão em segunda instância e a reforma da previdência. A análise classifica os elementos argumentativos em populistas ou tecnocratas de acordo com o conceito de estilo político proposto por Benjamin Moffitt e identifica que o MBL compõe os elementos argumentativos como forma de dramatizar e polarizar a performance comunicativa para envolver e convencer a audiência.
Na linha de fogo
Authors: Novais Rui Alexandre
Published: May 2022

Mediante uma incursão na área inexplorada do nível de adversatividade da reportagem de investigação sobre o populismo de extrema-direita este estudo visa identificar os tipos de críticas presentes na cobertura noticiosa e determinar quais dessas críticas correspondem à iniciativa jornalística. Recorrendo a um método misto que combina a análise de conteúdo e a biografia reconstrutiva, conclui que as dinâmicas mediáticas relacionadas com a iniciativa jornalística e as particularidades da reportagem de investigação explicam tanto a frequência como a severidade das críticas endógenas e exógenas constantes no tratamento noticioso do partido Chega. Para além de originadores da cobertura noticiosa, os repórteres de investigação assumem a liderança na expressão de críticas confirmando tanto a iniciativa jornalística como a faceta adversativa do jornalismo de investigação relativamente ao populismo.
A pandemia Covid-19 enfraqueceu o populismo?
Authors: Serrano Estrela
Published: May 2022

Este artigo analisa a evolução do discurso político do líder do partido populista português, André Ventura, após a sua eleição como deputado em 2019 e nos anos de 2020 e 2021, marcados pela pandemia Covid-19 e pelas eleições presidenciais, nas quais obteve um resultado muito superior ao obtido pelo seu partido nas eleições legislativas anteriores. Com base na literatura académica sobre populismo e situações de crise (Brubaker, 2021; Seedhouse, 2020) e em ensaios de académicos publicados em media internacionais (Jenning, 2020; Luciano, 2020), o artigo passa em revista o efeito da pandemia Covid-19 no apoio aos governos a nível internacional independentemente da sua ideologia, e detém-se na circunstância de em Portugal, apesar dos elevados índices de apoio ao governo socialista, o partido populista Chega, na oposição, ter sido o único a crescer. Usando uma metodologia qualitativa baseada na análise de conteúdo de um conjunto de intervenções públicas do líder populista português em momentos-chave do seu percurso político, emitidas em formatos mediáticos diversificados, o artigo conclui que o discurso de André Ventura se manteve focado nos temas nucleares do seu programa populista, independentemente do contexto pandémico. A análise identifica inconsistência e volatilidade no seu discurso e nas suas posições sobre a pandemia Covid-19, com posições ambíguas entre aceitação inicial e negação posterior de restrições e vacinas, adaptando as suas posições às reacções dos seus apoiantes e de grupos inorgânicos, como os negacionistas.
Presidenciais portuguesas de 2021 e o populismo
Authors: Cunha Isabel Ferin
Published: May 2022

As eleições presidenciais portuguesas de 2021 foram palco de fenómenos políticos inéditos. A pandemia e a campanha antissistema de um dos candidatos motivaram comportamentos incomuns. O debate radicalizou-se e aprofundou-se a conflitualidade entre candidatos/as e entre estes/estas, o Governo e o Presidente da República (PR). Tendo como quadro teórico diversas perspetivas da Democracia e do Populismo, exploram-se indicadores de populismo na cobertura jornalística televisiva da campanha eleitoral. O estudo permitiu identificar elementos de comunicação política que oscilam entre o registo populista e o popular. Verificou-se que a comunicação política populista encontrou a sua expressão máxima nos discursos do candidato apoiado pelo partido de extrema-direita. Os/as outros/as candidatos/as, embora com matizes, incorporam elementos discursivos nas suas campanhas que deslizam entre o populista e o popular.
L’Adriatique, golfe de Venise? Commerce, ports et relations à la fin du Moyen Âge
Authors: Hocquet Jean-Claude
Published: May 2022

Aux xive et xve siècles, Venise, placée favorablement en Méditerranée, à proximité des grands fleuves et de cols alpins qui conduisent en Lombardie ou en Allemagne et en Flandre, tente d’imposer un monopole de navigation et de commerce à la mer Adriatique considérée comme son Golfe. Elle bénéficie de son avance technique et de son organisation (l’Arsenal), de ses bateaux (nefs coques, galères), de ses connaissances financières, de sa richesse et de l’expérience acquise par ses marchands sur les places du Levant comme à l’Ouest. Cité sans campagne (ville sans contado), elle fait venir de l’extérieur, par la mer ou par les fleuves, tout ce qui est nécessaire à sa population (matériaux de construction, bois de chauffage, et tout le vivre, céréales, vin, huile et bétail) et à son industrie navale ou textile (draperie et soierie), elle craint de manquer et met à contribution une vaste partie de l’Europe, Pourtant, elle se heurte à de graves difficultés en Adriatique même, à la piraterie, aux puissances riveraines, aux ports concurrents, Raguse et Ancône, à l’intrusion du capital et de marchands toscans dans les ports de Dalmatie, elle cherche à appliquer son monopole aux territoires qu’elle domine politiquement et qui constituent son empire, mais, par peur de la contrebande qui ruinerait ses recettes douanières et fiscales, elle réduit l’activité maritime et commerciale de ses territoires-sujets. Les marchands vénitiens font certes commerce où ils veulent mais dès qu’ils entrent en Adriatique, ils doivent se rendre à Venise avec leurs marchandises et non dans un autre port. Venise semble forte de sa puissance assise sur des points d’appui solides et sur la faiblesse de ses adversaires : si Gênes n’est plus une menace, de nouveaux dangers menacent en Adriatique même, les Turcs ottomans contre qui Venise commence à mener d’épuisantes guerres.
Comercio internacional y especialización portuaria: las relaciones entre Bristol y la bahía guipuzcoana de Pasaia a fines de la Edad Media
Authors: Irixoa Cortés Iago
Published: May 2022

El papel de los vascos en el comercio marítimo medieval ha sido subrayado en numerosas ocasiones. Tanto los investigadores nacionales como internacionales han remarcado su desarrollo e importancia como transportistas. Se les ha colocado en numerosos lugares a la vez, tanto en el Mediterráneo como en el Atlántico, con una intensidad destacada. No obstante, esta visión global debe ser matizada. No todas las poblaciones costeras vascas tuvieron el mismo grado de desarrollo marítimo, ni se dedicaron a todas y a cada una de las actividades con la misma fuerza. Aunque integradas en un marco general condicionado en gran medida por las relaciones internacionales y sin olvidar la colaboración y relaciones con las poblaciones vecinas, cabe reflexionar si las comunidades repartidas a lo largo de la costa guipuzcoana y vizcaína no trazaron recorridos singulares entre los que también figuraba la preferencia por determinadas rutas; dicho de otra manera, si no experimentaron cierta especialización geográfica en cuanto a los destinos. Las fuentes locales nos pueden ayudar a perfilar unas líneas al respecto, pero son incompletas y, sobre todo, tardías. En esta tesitura, la documentación extranjera constituye un interesante soporte, especialmente en aquellos lugares donde los registros portuarios son relativamente tempranos y son cuantitativamente remarcables. Uno de esos casos lo constituye la ciudad inglesa de Bristol, que, en líneas generales, cuenta con registros portuarios a partir de la década de 1460; la localidad, además, fue un importante destino para el hierro vasco. Sin embargo, una aproximación geográfica a los datos arrojados por sus documentos constata que el transporte de mercancías protagonizado por los barcos vascos estuvo concentrado en determinada zona guipuzcoana, la comprendida por la bahía de Pasaia y las diversas comunidades asentadas en ella; unos nexos que se atisban en la documentación local, pero que aparecen mucho más nítidos en las fuentes inglesas. A través de las siguientes líneas abordaremos ese caso, realizando una primera aproximación mediante un análisis geográfico de las embarcaciones vascas que aparecen en los registros de Bristol.
De Ayala, C., García Fitz, F. y Palacios, J. S. (Coords.) (2021). Memoria y fuentes de la guerra santa peninsular (siglos X-XV). Gijón: Ediciones Trea. 483 pp. ISBN: 978-84-18105-48-7
Authors: Vital Fernández Sonia
Published: May 2022

Reseña: De Ayala, C., García Fitz, F. y Palacios, J. S. (Coords.) (2021). Memoria y fuentes de la guerra santa peninsular (siglos X-XV). Gijón: Ediciones Trea. 483 pp. ISBN: 978-84-18105-48-7
Furió, A., Guia, L. y García Marsilla, J.V. (Eds.) (2021). La veu del Regne. 600 anys de la generalitat valenciana. Universitat de València i Generalitat Valenciana, 3 vols. 127 pp. 455 pp. y 323 pp. ISBN: 978-84-9134-596-1
Authors: Cañizares Gómez María José
Published: May 2022

Reseña: Furió, A., Guia, L. y García Marsilla, J.V. (Eds.) (2021). La veu del Regne. 600 anys de la generalitat valenciana. Universitat de València i Generalitat Valenciana, 3 vols. 127 pp. 455 pp. y 323 pp. ISBN: 978-84-9134-762-0 ISBN: 978-84-9134-597-8 ISBN: 978-84-9134-878-8