bluuebunny/crossref_metadata_2025 huggingface dataset:
An Evaluation Model of English Normal Students’ Informatization Teaching Ability Based on Technical Pedagogical Content Knowledge and Few-Shot Learning
Authors: Zeng Honghong , Tan Ronghua
Published: July 2022

Information-based instruction is the most important and recently altered sort of instruction. Numerous changes in educational techniques have emerged from the ongoing growth of science and technology. Teachers must also grasp and enhance their capacity to educate with information on a regular basis. The goal of this research is to look at how to use the TPACK model and computational intelligence to build and explain a model for evaluating English normal students’ informatization teaching skills. To measure information-based teaching competence, this research recommends using the Technical Pedagogical Content Knowledge model and Few-Shot Learning technology. As a result, this paper covers the principles and related algorithms of both, as well as constructing and assessing the case design and analysis of the information-based teaching ability evaluation model. According to the experimental data, the average CK of normal students’ subject material knowledge is 3.522, which is the highest among the seven dimensions. The subject content is well-understood by ordinary students. When compared with teaching abilities, the competence level is low, and the performance of the integration of technology and teaching content needs to be improved.
Financial Automation Audit Method Based on Blockchain Technology
Authors: Gai Weidong , Gu Yue , Qin Jiaming
Published: July 2022

Blockchain (BC) maintains a continuously growing database in a “decentralized” way, and its impact on the financial auditing industry is becoming increasingly significant. This paper aims to study the research on financial automation auditing methods supported by blockchain technology and proposes the related concepts of blockchain technology, hash function, financial auditing analysis, and the impact of BP Neural Network (BPNN) and its algorithms on financial automation auditing methods. Simultaneously, this paper likewise disperses the poll overview to definite individuals, for example, endeavor, monetary work force, focus and ranking directors, university researchers, and specialists, who have pragmatic support in the execution and use of monetary review. The experimental results of this paper show that speculation based on the interconnected environment is the most basic natural factor for understanding this idea, and its score is also the largest at 4.36 points.
Facts and Hopes in Immunotherapy of Endometrial Cancer
Authors: Marín-Jiménez Juan A. , García-Mulero Sandra , Matías-Guiu Xavier , Piulats Josep M.
Published: July 2022

Immunotherapy with checkpoint inhibitors has changed the paradigm of treatment for many tumors, and endometrial carcinoma is not an exception. Approved treatment options are pembrolizumab or dostarlimab for mismatch repair deficient tumors, pembrolizumab for tumors with high mutational load, and, more recently, pembrolizumab/lenvatinib for all patients with endometrial cancer. Endometrial cancer is a heterogeneous disease with distinct molecular subtypes and different prognoses. Differences between molecular subgroups regarding antigenicity and immunogenicity should be relevant to develop more tailored immunotherapeutic approaches. In this review, we aim to summarize and discuss the current evidence—Facts, and future opportunities—Hopes—of immunotherapy for endometrial cancer, focusing on relevant molecular and tumor microenvironment features of The Cancer Genome Atlas endometrial cancer subtypes.
Colonoscopy after a Positive Stool-based Test for Colon Cancer Screening: Moving Toward a Better Understanding of What to Expect
Authors: Krigel Anna , Wan David W.
Published: July 2022

Stool-based tests for colorectal cancer, including fecal immunochemical testing (FIT) and multitarget stool DNA testing (mt-sDNA), are among the recommended first-line screening options for patients at average risk for colorectal cancer and offer advantages over colonoscopy. However, stool-based tests have high false-positive rates, and the expected yield of colonoscopy after positive FIT compared with positive mt-sDNA is not well studied. As discussed in this issue of Cancer Prevention Research, the presence of a precancerous lesion in the majority of cases with either positive stool-based test is expected. In addition, a positive mt-sDNA is associated with a higher risk for finding any neoplasia on colonoscopy compared with positive FIT, and particularly associated with higher prevalence of clinically relevant serrated polyps compared with positive FIT. Further research is needed on what to expect from positive stool-based testing on average risk 45–49 years old patients, the newest cohort indicated for colorectal cancer screening.

See related article, p. 455
Preliminary Study of Genome-Wide Association Identified Novel Susceptibility Genes for Hemorheological Indexes in a Chinese Population
Authors: Sun Yuxiao , Cheng Zhaoyun , Guo Zhiping , Dai Guoyou , Li Yongqiang , Chen Yan , Xie Ruigang , Wang Xianqing , Cui Mingxia , Lu Guoqing , Wang Aifeng , Gao Chuanyu
Published: July 2022

Background: Genome-wide association studies for various hemorheological characteristics have not been reported. We aimed to identify genetic loci associated with hemorheological indexes in a cohort of healthy Chinese Han individuals. Methods: Genotyping was performed using Applied Biosystems Axiom™ Precision Medicine Diversity Array in 838 individuals, and 6,423,076 single nucleotide polymorphisms were available for genotyping. The relations were examined in an additive genetic model using mixed linear regression and combined with identical by descent matrix. Results: We identified 38 genetic loci (p < 5 × 10−6) related to hemorheological traits. In which, LOC102724502-OLIG2 rs28371438 was related to the levels of nd30 (p = 8.58 × 10−07), nd300 (p = 1.89 × 10−06), erythrocyte rigidity (p = 1.29 × 10−06), assigned viscosity (p = 6.20 × 10−08) and whole blood high cut relative (p = 7.30 × 10−08). The association of STK32B rs4689231 for nd30 (p = 3.85 × 10−06) and nd300 (p = 2.94 × 10−06) and GTSCR1-LINC01541 rs11661911 for erythrocyte rigidity (p = 9.93 × 10−09) and whole blood high cut relative (p = 2.09 × 10−07) was found. USP25-MIR99AHG rs1297329 was associated with erythrocyte rigidity (p = 1.81 × 10−06) and erythrocyte deformation (p = 1.14 × 10−06). Moreover, the association of TMEM232-SLC25A46 rs3985087 and LINC00470-METTL4 rs9966987 for fibrinogen (p = 1.31 × 10−06 and p = 4.29 × 10−07) and plasma viscosity (p = 1.01 × 10−06 and p = 4.59 × 10−07) was found. Conclusion: These findings may represent biological candidates for hemorheological indexes and contribute to hemorheological study.
A politização de objetos esportivos: redistribuições simbólicas do consumo a partir da vinculação de atletas a causas sociais
Authors: Casadei Eliza Bachega , Scabin Nara Lya Cabral , Storel Thalita
Published: July 2022

Diante de um contexto em que manifestações públicas de atletas sobre causas sociais têm sido cada vez mais frequentes, o objetivo deste artigo é debater como se dá o processo de politização dos objetos esportivos. Com base em Rancière, entendemos a politização de objetos esportivos como uma redistribuição simbólica de um bem de consumo que tem seus sentidos deslocados do campo da polícia para um espaço de dissenso. A discussão proposta estrutura-se em três tempos: 1. revisão de literatura sobre o ativismo esportivo; 2. recuperação de práticas recentes de ativismo de atletas e objetos esportivos politizados; e 3. mapeamento de processos semióticos a partir dos quais podemos delimitar e definir a politização dos objetos esportivos.
Apresentação
Authors: Vicente Eduardo
Published: July 2022

Apresentação
Cause‐Specific Mortality in Patients During Long‐Term Follow‐Up After Atrial Switch for Transposition of the Great Arteries
Authors: Jensen Annette Schophuus , Jørgensen Troels Højsgaard , Christersson Christina , Nagy Edit , Sinisalo Juha , Furenäs Eva , Gjesdal Ola , Eriksson Peter , Vejlstrup Niels , Johansson Bengt , Hlebowicz Joanna , Greve Gottfried , Dellborg Mikael , Skulstad Helge , Kvidal Per , Jokinen Eero , Sairanen Heikki , Thilén Ulf , Søndergaard Lars
Published: July 2022

Background

Little is known about the cause of death (CoD) in patients with transposition of the great arteries palliated with a Mustard or Senning procedure. The aim was to describe the CoD for patients with the Mustard and Senning procedure during short‐ (<10 years), mid‐ (10–20 years), and long‐term (>20 years) follow‐up after the operation.

Methods and Results

This is a retrospective, descriptive multicenter cohort study including all Nordic patients (Denmark, Finland, Norway, and Sweden) who underwent a Mustard or Senning procedure between 1967 and 2003. Patients who died within 30 days after the index operation were excluded. Among 968 patients with Mustard/Senning palliated transposition of the great arteries, 814 patients were eligible for the study, with a mean follow‐up of 33.6 years. The estimated risk of all‐cause mortality reached 36.0% after 43 years of follow‐up, and the risk of death was highest among male patients as compared with female patients (
P
=0.004). The most common CoD was sudden cardiac death (SCD), followed by heart failure/heart transplantation accounting for 29% and 27%, respectively. During short‐, mid‐, and long‐term follow‐up, there was a change in CoD with SCD accounting for 23.7%, 46.6%, and 19.0% (
P
=0.002) and heart failure/heart transplantation 18.6%, 22.4%, and 46.6% (
P
=0.0005), respectively.

Conclusions

Among patients corrected with Mustard or Senning transposition of the great arteries, the most common CoD is SCD followed by heart failure/heart transplantation. The CoD changes as the patients age, with SCD as the most common cause in adolescence and heart failure as the dominant cause in adulthood. Furthermore, the risk of all‐cause mortality, SCD, and death attributable to heart failure or heart transplantation was increased in men >10 years after the Mustard/Senning operation.
Trends in Medicare Payments for Beneficiaries With Aortic Stenosis
Authors: van Bakel Pieter A. J. , Ahmed Yunus , Hou Hechuan , Sukul Devraj , Likosky Donald S. , van Herwaarden Joost A. , Patel Himanshu J. , Thompson Michael P.
Published: July 2022

Background

Aortic stenosis (AS) is the most common form of valvular heart disease with an increasing prevalence. Management of AS has changed dramatically with the introduction of transcatheter aortic valve replacement (AVR). The shift in management of AS, combined with an aging population, may increase the cost of patients with AS in the US health care system.

Methods and Results

We performed a retrospective cohort study, using inpatient, carrier, and outpatient data from a 20% Medicare fee‐for‐service beneficiaries' sample from 2008 to 2019 and included beneficiaries, aged ≥65 years. We identified beneficiaries with a diagnosis of AS and stratified the sample into 3 age groups: 66 to 74, 75 to 84, and ≥85 years. We evaluated the crude and adjusted changes in annual Medicare payments (total and component) per beneficiary. We identified 1 887 340 (1.6%) Medicare beneficiaries diagnosed with AS. The average annual spending for Medicare beneficiaries with AS was $19 241 in 2010 and increased annually by $301 to $23 174 in 2019 (
P
<0.0001). Annual Medicare payments on patients with AS increased from $2 894 995 131 in 2010 to $4 619 077 182 in 2019, a difference of >1.7 billion dollars. Inpatient spending increased 1.1% per year, with the highest increase in patients aged ≥85 years (1.9%). The percentage of beneficiaries undergoing surgical AVR decreased from 3.7% to 1.6%, and annual spending on surgical AVR decreased an average of 7.2% per year. The percentage of beneficiaries undergoing transcatheter AVR increased from 0% in 2010 to 3.8% in 2019, and annual spending for transcatheter AVR increased by 458.7% per year.

Conclusions

Although average annual Medicare spending per beneficiary modestly increased over the study period, the increase in the prevalence of AS and the proportion of beneficiaries undergoing (transcatheter) interventions for AS led to a substantial increase in overall Medicare spending among patients with AS.
Wollo: A Land of Religious and Ethnic Amalgamation
Authors: Melaku Misganaw Tadesse
Published: July 2022

Wollo is a province in Ethiopia where many ethnic, religious, and cultural groups live in harmony. The religious demography of the province, which has an almost equal number of Muslims and Christians living together intermingled, made social interaction inevitable. As a result, the community has a unique history of tolerance, peaceful coexistence, and a strong sense of togetherness. The people share many customary, cultural, and ritual practices. This paper thus examines the interaction and integration between the different ethnic and religious groups in Wollo that led to the emergence of a unique genetic amalgam and cultural hybridity in the province.
‘Sacrament of (Be)longing’: Analysis of Finnish Lutheran and Orthodox Christian Eucharistic Practices amid Absence and Estrangement
Authors: Ahonen Talvikki , Mikkola Sini , Kallatsa Laura , Metso Pekka
Published: July 2022

This article addresses eucharistic and communal transformations of two local Finnish churches, the Evangelical Lutheran Church of Finland (ELCF) and the Orthodox Church of Finland (OCF), amid the COVID-19 pandemic and precautions. We analyze how eucharistic practices have transformed in the ELCF and the OCF and the ways these transformations are reflected in the experiences of both parishioners and pastors. The data consist of four questionnaires (N = 739) collected from Lutheran and Orthodox believers and Lutheran vicars during the pandemic. Our results indicate that the significance of belonging was emphasized during the time of social distancing. While among those in the ELCF, experiences of belonging were manifested in terms of Eucharist, among those in the OCF, belonging was most often reflected in relation to liturgical community. The differences in eucharistic theologies of the OCF and the ELCF have perhaps become more visible in exceptional circumstances.
The Internal Discussions in the Belarusian Orthodox Church on Identity and Policy Issues
Authors: Mudrov Sergei , Zakharov Nikolay
Published: July 2022

Based on extensive fieldwork across Belarus, this article analyses an ongoing discussion within the Belarusian Orthodox Church (BOC) regarding various issues that are key in assessing the country’s identity politics and politico-ideological developments. Since the independence of Belarus in 1991, the Church has continuously played an important public and societal function. A special agreement, signed between the Church and Belarusian Government in 2003, has fostered Church cooperation with various governmental institutions, including educational establishments. Discussing the contribution of the BOC to the construction of a distinct Belarusian national identity, we will address the national language, relationships with the state, foreign policy orientation and the Church’s autocephaly. The empirical part of this study is based on seventeen in-depth interviews with clergymen and laypeople from the BOC. Our study shows that Church representatives have not hesitated to develop their profound perspectives on the important issues of identity politics and the relationships of the BOC and state, and these perspectives were often reflective of wider debates within Belarusian intellectual circles.
Early Quaker Identity from the Perspective of Some Ecclesiastical Anti-Quakers
Authors: Roads Judith
Published: July 2022

This empirical case study provides a new approach to the understanding of discursively constructed Quaker identity in the seventeenth century, from the point of view of those opposed to the dissenting Christian movement. This article asks how others may have viewed adherents to the Quaker communities in England. The findings illustrate a range of negative and denigrating discourses that go beyond abstract religious controversy to sow manufactured fear of the Quaker community. Overt and covert linguistic mechanisms used by anti-Quaker writers reveal expressions of emerging moral panic underlying unsubstantiated accusations attacking the minority Quaker community.
Biodynamic Wine-Crafting and the Spiritualization of the Workplace
Authors: Grandjean Alexandre
Published: July 2022

In recent years, the involvement of Swiss wine-crafters (vignerons) with ‘holistic spiritualities’ has become more visible. Through the use of esoterically driven preparations, energetic crystals, and neo-shamanic ‘vision questing’ practices, vignerons have incorporated alternative self-healing practices in their workplace. Under the umbrella term ‘biodynamic farming,’ vignerons are experimenting and delineating a new professional and relational ethos, be it with humans or nonhumans (e.g., grapevines). In the context of the Swiss vineyards, however, the engagement of vignerons with ‘holistic spiritualities’ has also forced them to grapple with potential social stigmas. This article examines the social uses, dynamics, and dilemmas resulting from the gradual ‘spiritualization’ of vignerons’ workplaces.
Mass Atrocities in Ethiopia and Myanmar: The Case for ‘Harm Mitigation’ in R2P Implementation
Authors: Wight Patrick , Cowper-Smith Yuriko
Published: July 2022

By combining insights from the three dominant perspectives in International Relations – liberalism, realism, and anti-imperialism – a novel approach is put forward, that of ‘harm mitigation’. A comparative analysis of Ethiopia and Myanmar reveals that the international community still does not possess the mechanisms to halt mass atrocities in real time. When enforcing R2P, none of the available non-coercive and coercive policy options are pragmatically or ethically unassailable. The non-coercive tools that can be labelled as ‘ethical’, such as diplomacy, humanitarian assistance, and documenting atrocities, while important, are largely ineffective at stopping atrocities as they happen. Much like UN peacekeeping, these non-coercive actions are limited by targeted governments invoking the principle of state sovereignty. Meanwhile, actions that are potentially expedient, such as economic sanctions, military intervention, and supporting rebel groups, are ethically thorny. The conclusions speak to the reality that both non-intervention and intervention have the potential to cause human suffering.
Anatomical and topochemical features of the genera Acacia, Acaciella, Senegalia and Vachellia
Authors: Lewandrowski Tim , Koch Gerald , Haag Volker
Published: July 2022

Molecular research has shown that the genus Acacia is in fact polyphyletic. The discussion about grouping the species of Acacia s.l. into monophyletic genera kept two International Botanical Congresses (Congresses 17 and 18) occupied and resulted in the general acceptance of the genera Acacia, Acaciella, Mariosousa, Senegalia and Vachellia. This raises questions about whether the wood of these new genera can be distinguished using established wood identification methods. Anatomical features of members from Acacia, Acaciella, Senegalia and Vachellia were examined and compared using transmission light microscopy. Topochemical characteristics were investigated using UV microspectrophotometry (UMSP) to identify differences in the distribution of phenolic compounds and cell wall lignification. The current study shows that the presence as well as the arrangement and dimensions of the axial parenchyma, as well as the height and width of the wood rays and fibre dimensions allow anatomical differentiation of the species studied. UMSP revealed the presence and distribution of phenolic compounds and differences in the degree of lignification between the genera. The aim of this paper is to highlight the potential of the applied methods to differentiate between the genera.
Unharnessed Potential
Authors: Hill Phoebe , Apeland Gry , Scanlan Mark
Published: July 2022

Theological reflection is a much discussed and written about form of theological practice within youth ministry and is taught as a core component in theological training in the UK. This article discusses research into the practice of theological reflection by Christian youth workers in the UK. It compares and contrasts the understanding and use of theological reflection by those with and without formal training. The research reveals similar attitudes toward and practices of theological reflection by both groups, but more regular usage by those with training. Further, the research showed limited forms of theological reflection were being used and as such this article explores the implications of this and makes several recommendations for developing both training and practice of Christian youth workers.
Overcoming Inequality of Access and Participation Through Institutional, International, and Governmental Collaboration: a Case Study
Authors: Martin George E. , Morris Caroline S.
Published: July 2022

On October 27, 2021, the U.S. Department of State’s Bureau of Educational and Cultural Affairs (eca) named St. Edward’s University as one of only 35 Fulbright hsi Leaders. On the same day, eca recognized St. Edward’s as a Top Producing Institution during the past 20 years in the Benjamin A. Gilman International Scholarship Program, which funds low-income American students studying abroad. How did this happen at a small, Hispanic-Serving, majority-minority university, with a large percentage of low-income students (44% Federal Pell Grant recipients)? The answer lies in the decision by St. Edward’s to strategically create and foster a network of internal partnerships, and national and international partnerships with other universities and government-sponsored organizations, to significantly improve the quality of the educational experience for all students (especially low-income and students of color) and to multiply opportunities for them to contend and achieve in the most competitive national and international student competitions.
A comparative analysis of Inventor Patent Classification Coupling between the first-inventor and all-inventor: Taking 3D printing as an example
Authors: Song Yanhui , Lei Lixin
Published: July 2022

This article takes 43,753 patents collected in the Derwent database from 2011 to 2020 as data samples and studies the intellectual structure and evolution of the three-dimensional (3D) printing field in two time periods of 2011–2015 and 2016–2020. We compare the performance of the first-inventor patent classification codes coupling analysis and all-inventor patent classification codes coupling analysis in detecting the intellectual structure of the technical domain. We obtain the following findings: (1) Both methods, the first-inventor patent classification codes coupling analysis and the all-inventor patent classification codes coupling analysis, can show the intellectual structure of the 3D printing field. However, the first-inventor patent classification codes coupling analysis outperforms all-inventor patent classification codes coupling analysis in the detection of basic research; while all-inventor patent classification codes coupling analysis is more sensitive in emerging and interdisciplinary topics. (2) Three-dimensional printing has been evolving in the last decade. While the field has retained the research themes of the previous phase in the last 5 years, several new research themes have also emerged. The most prominent feature of this field is the development and integration of the previous phase’s topics. (3) The research direction of the top 20 inventors in the average coupling frequency ranking is consistent. A small number of researchers continue to work on their previous research, while most inventors move to popular technical topics or combine multiple topics at the same time.
Submucosal Clustered Brownish Microvessels Based on NBI Endoscopy: A Characteristic of LPR
Authors: Xie Meng , Zhang Qing‐Qing , Liu Xiao‐Hong , Guo Rui‐Xin , Chen Yang‐Juan , Ma Si‐Jing , Liu Hai‐Qin , Ren Xiao‐Yong , Luo Hua‐Nan
Published: July 2022

Objective

This study aimed to analyze the characteristics of laryngopharyngeal reflux (LPR) by using narrow band imaging (NBI) endoscopy.

Study Design

A prospective study.

Setting

A large‐volume practice with tertiary care providers.

Methods

A total of 67 patients with suspected LPR who underwent 24‐hour multichannel intraluminal impedance–pH monitoring were included from June 2020 to March 2022. Manifestations of NBI endoscopy included submucosal clustered brownish microvessels (CBMs), spotted brownish microvessels, and no special microvessels; the latter 2 formed the non‐CBM group. The manifestations of all patients and their changes were observed after 8 weeks of proton pump inhibitor and symptomatic treatment for patients with LPR, and symptomatic treatment for patients without LPR.

Results

According to the results of 24‐hour multichannel intraluminal impedance–pH monitoring, the incidence of submucosal CBMs was significantly higher in patients with LPR (30 cases) than in those without LPR (37 cases, P < .001), particularly in the posterior cricoid area (P < .001). Besides Reflux Finding Score, the incidence of signs such as subglottic edema and vocal fold edema was significantly higher in the CBM group than the non‐CBM group (P < .05). Finally, 22 patients with LPR (91.7%) and only 2 patients without LPR (28.6%) underwent a transformation from CBMs to spotted brownish microvessels after continuous medication for 8 weeks in the CBM group (χ2 = 15.916, P < .001), while no significant change was observed in patients with or without LPR in the non‐CBM group (P > .05).

Conclusion

Submucosal CBMs in the posterior cricoid area under NBI endoscopy may be a characteristic of LPR.

Level of Evidence: 4.
Effects of Medicaid Automatic Enrollment on Disparities in Insurance Coverage and Caregiver Burden for Children with Special Health Care Needs
Authors: Rennane Stephanie , Dick Andrew
Published: July 2022

We analyze how Medicaid automatic enrollment policies for children with special health care needs (CSHCN) who are enrolled in Supplemental Security Income (SSI) reduce disparities in health insurance coverage and caregiving burden. Using the 2009–2010 National Survey of Children with Special Health Care Needs, we implement a difference-in-differences regression model comparing insurance enrollment rates between CSHCN receiving SSI and CSHCN not receiving SSI, in states with and without automatic enrollment policies. We find that Medicaid automatic enrollment has a meaningful impact on insurance enrollment for low-income CSHCN who participate in SSI and can be an effective method for mitigating disparities in insurance coverage (reducing uninsurance by 38%). Medicaid automatic enrollment also reduces caregiver burden among socioeconomically disadvantaged families with CSHCN. The effects of these policies are largest families who might be on the margin of eligibility or who face high administrative burden.
Medium-Temperature-Oxidized GeOx Resistive-Switching Random-Access Memory and Its Applicability in Processing-in-Memory Computing
Authors: Udaya Mohanan Kannan , Cho Seongjae , Park Byung-Gook
Published: July 2022

Processing-in-memory (PIM) is emerging as a new computing paradigm to replace the existing von Neumann computer architecture for data-intensive processing. For the higher end-user mobility, low-power operation capability is more increasingly required and components need to be renovated to make a way out of the conventional software-driven artificial intelligence. In this work, we investigate the hardware performances of PIM architecture that can be presumably constructed by resistive-switching random-access memory (ReRAM) synapse fabricated with a relatively larger thermal budget in the full Si processing compatibility. By introducing a medium-temperature oxidation in which the sputtered Ge atoms are oxidized at a relatively higher temperature compared with the ReRAM devices fabricated by physical vapor deposition at room temperature, higher device reliability has been acquired. Based on the empirically obtained device parameters, a PIM architecture has been conceived and a system-level evaluations have been performed in this work. Considerations include the cycle-to-cycle variation in the GeOx ReRAM synapse, analog-to-digital converter resolution, synaptic array size, and interconnect latency for the system-level evaluation with the Canadian Institute for Advance Research-10 dataset. A fully Si processing-compatible and robust ReRAM synapse and its applicability for PIM are demonstrated.

Graphical Abstract
Associations of multicomponent exercise and aspects of physical performance with frailty trajectory in older adults
Authors: Chiu Tzu-Ying , Yu Hsiao-Wei
Published: July 2022

Background

Previous research has shown that frailty leads to falls, institutionalization, hospitalization, and the loss of functional capacity. While numerous intervention methods aim to reverse frailty, the most effective in older adults is multicomponent exercise. Physical performance has been highlighted as a key factor in mobility, independence, and the burden of chronic disease. Several studies have demonstrated an association between physical performance and frailty; however, the relation between the two over the long term has not yet been fully investigated. Therefore, the current study aims to examine how aspects of physical performance are associated with frailty in the long run for older adults in Taiwan.

Methods

This nine-month longitudinal study employed the generalized estimating equation (GEE) modeling to identify measures associated with frailty trajectory. A sample of 159 community-dwelling older adults was recruited through purposive sampling in 12 community care centers in Taiwan. A quasi-experimental approach was adopted in which participants were assigned to the control group or to receive a multicomponent exercise intervention and examined sociodemographic, physical performance, and other factors at the baseline, post intervention (3 months), and follow up (6 months) levels. The multicomponent exercise program was designed based on the principles of the American College of Sports Medicine and comprised aerobic exercise, muscle-strengthening activities, balance training, and stretching exercises once per week for 2 h per session for 12 weeks.

Results

After intervention, we found that the multicomponent exercise group exhibited better performance in the 2-minute step test than the control group (p < 0.05). Regarding long-term effects on frailty trajectories, the study finds that age progression, being female, and longer completion time in the timed up and go test increase the probability of frailty (p < 0.05). Conversely, more steps in the 2-minute step test and undertaking the multicomponent exercise program reduced the long-term probability of frailty (p < 0.05).

Conclusions

This study is the first to explore the relation between indicators of physical performance and frailty trajectory among older adults in Taiwan. Furthermore, we provided support for the efficacy of the multicomponent exercise program in improving frailty status.
The patient’s relationship with the General Practitioner before and after Advance Care Planning: pre/post-implementation study
Authors: van der Plas Annicka G. M. , Schellekens Julia E. A. P. , Glaudemans Jolien J. , Onwuteaka-Philipsen Bregje D.
Published: July 2022

Background

General Practitioners (GPs) are central in the care of Dutch older people and in a good position to have Advance Care Planning (ACP) conversations. Interview studies reveal that the doctor-patient relationship is important when initiating ACP conversations and can also be influenced by ACP conversations. We aimed to examine the association between having an ACP conversation and the patient feeling the GP knows him or her and the patient trusting the GP and vice versa.

Methods

Implementation of ACP in primary care was evaluated in a pre-and post design. Questionnaires before implementation of ACP and 14 months later were sent to patients aged 75 years or older within 10 GP-practices and 2 care homes. Multivariable logistic regression was used to model the relationship between ACP conversations during implementation and the patient-GP relationship before implementation. Odds ratios were adjusted for potential confounders. Generalized ordered logistic regression was used to model the relationship between the changes in patient-GP relationship before and after implementation and ACP conversations during implementation.

Results

Four hundred fifty-eight patients filled out the pre- and post-test questionnaire. There was no association between the GP knowing the patient and trust in the pre-test and having an ACP conversation during the implementation. For people who had had an ACP conversation at the end of the implementation period their trust remained more often the same or was higher after implementation (trust to provide good care OR 2.93; trust to follow their wishes OR 2.59), compared to patients who did not have an ACP conversation. A reduction in trust was less likely to happen to patients who had an ACP conversation compared to patients who did not have an ACP conversation.

Conclusions

Although we have not found evidence for trust as a prerequisite for ACP conversations, this paper shows that ACP conversations can be beneficial for the doctor—patient relationship.
Predictors of retirement satisfaction in the older adults of Urmia: a cross-sectional study
Authors: Honarvar Mojtaba , Rasouli Javad , Amirzadeh-Iranagh Jamileh
Published: July 2022

Background

Retirement is a challenge that, as a process, influences the individual’s role, status, life patterns, expectations, and available resources. Therefore, the present study aims at determining the predictors of retirement satisfaction among men in the city of Urmia.

Methods

In this descriptive-analytical study, 140 retired men living in Urmia were selected by multi-stage sampling method. The instruments used are the Retirement Satisfaction Scale, life satisfaction, and quality of life questionnaires. Data were analyzed in SPSS v.21 using descriptive statistics, one-way ANOVA, and regression at a significance level of p ≤ 0.05.

Results

Based on the results of this study, the mean score of retirement satisfaction was 115.37 + 10.13 and there was no significant difference (p = .068) in retirement satisfaction of the retired men based on level of education. Also, the retrospective multiple linear regression model indicated that 44.4% of the variance of retirement satisfaction score is predicted by two subscales of life satisfaction and quality of life.

Conclusion

According to the results, it seems that life satisfaction and quality of life are inseparable, effective factors in retirement satisfaction, so, to promote retirement satisfaction in all of its scales and subscales, it is recommended to improve these two factors.
An analysis of the correlation between diabetic retinopathy and preretinal oxygen tension using three-dimensional spoiled gradient-recalled echo sequence imaging
Authors: Zhou Min-Jie , Shao Ju-Wei , Pu Jian , Xiang Shu-Tian , Liang Yi , He Qian , Su Wei , Liu Cheng
Published: July 2022

Background

The aims of this study were to evaluate the levels of preretinal oxygen tension in patients with diabetes who did not have hypertension by using three-dimensional spoiled gradient-recalled (3D-SPGR) echo sequence imaging and to explore the correlation between diabetic retinopathy (DR) and changes in preretinal oxygen tension.

Method

This study involved 15 patients with type 2 diabetes without hypertension, who were divided into a diabetic retinopathy (DR) group (n = 10 eyes) and a diabetic non-retinopathy (NDR) group (n = 20 eyes), according to the results of a fundus photography test. Another healthy control group (n = 14 eyes) also participated in the study. The preretinal vitreous optic disc area, nasal side, and temporal side signal intensity of the eyes was assessed before and after oxygen inhalation with the use of 3D-SPGR echo magnetic resonance imaging (MRI). The signal acquisition time was 10, 20, 30, 40, and 50 min after oxygen inhalation.

Results

The results showed that, in the DR and NDR groups, the preretinal vitreous oxygen tension increased rapidly at 10 min after oxygen inhalation and peaked at 30–40 min, and the increased slope of the DR group was higher than that of the NDR group. The oxygen tension of the preretinal vitreous gradually increased after oxygen inhalation, and the difference between the DR and NDR groups and the control group was statistically significant (P < 0.05). The preretinal vitreous oxygen tension was higher in the optic disc, temporal side, and nasal side in the NDR group than in the control group, and the difference was statistically significant (P < 0.05). The maximum slope ratios of the optic disc and the temporal side of the DR group were greater than those of the control group, and the difference was statistically significant (P < 0.05).

Conclusion

Three-dimensional-SPGR echo MRI sequencing technology is useful for detecting preretinal oxygen tension levels in patients with diabetes. It can be used as one of the functional and imaging observation indicators for the early diagnosis of DR.
Topology optimization search of deep convolution neural networks for CT and X-ray image classification
Authors: Louati Hassen , Louati Ali , Bechikh Slim , Masmoudi Fatma , Aldaej Abdulaziz , Kariri Elham
Published: July 2022

Covid-19 is a disease that can lead to pneumonia, respiratory syndrome, septic shock, multiple organ failure, and death. This pandemic is viewed as a critical component of the fight against an enormous threat to the human population. Deep convolutional neural networks have recently proved their ability to perform well in classification and dimension reduction tasks. Selecting hyper-parameters is critical for these networks. This is because the search space expands exponentially in size as the number of layers increases. All existing approaches utilize a pre-trained or designed architecture as an input. None of them takes design and pruning into account throughout the process. In fact, there exists a convolutional topology for any architecture, and each block of a CNN corresponds to an optimization problem with a large search space. However, there are no guidelines for designing a specific architecture for a specific purpose; thus, such design is highly subjective and heavily reliant on data scientists’ knowledge and expertise. Motivated by this observation, we propose a topology optimization method for designing a convolutional neural network capable of classifying radiography images and detecting probable chest anomalies and infections, including COVID-19. Our method has been validated in a number of comparative studies against relevant state-of-the-art architectures.
Development of a patient decision aid for discharge planning of hospitalized patients with stroke
Authors: Prick J. C. M. , van Schaik S. M. , Deijle I. A. , Dahmen R. , Brouwers P. J. A. M. , Hilkens P. H. E. , Garvelink M. M. , Engels N. , Ankersmid J. W. , Keus S. H. J. , The R. , Takahashi A. , van Uden-Kraan C. F. , van der Wees P. J. , Van den Berg-Vos R. M. ,   On behalf of the Santeon VBHC STROKE group, van Schaik S.M. , Brouwers P.J.A.M. , Hilkens P.H.E. , van Dijk G.W. , Gons R.A.R. , Saxena R. , Schut E.S.
Published: July 2022

Background

Patient involvement in discharge planning of patients with stroke can be accomplished by providing personalized outcome information and promoting shared decision-making. The aim of this study was to develop a patient decision aid (PtDA) for discharge planning of hospitalized patients with stroke.

Methods

A convergent mixed methods design was used, starting with needs assessments among patients with stroke and health care professionals (HCPs). Results of these assessments were used to develop the PtDA with integrated outcome information in several co-creation sessions. Subsequently, acceptability and usability were tested to optimize the PtDA. Development was guided by the International Patient Decision Aids Standards (IPDAS) criteria.

Results

In total, 74 patients and 111 HCPs participated in this study. A three-component PtDA was developed, consisting of:

1) a printed consultation sheet to introduce the options for discharge destinations, containing information that can be specified for each individual patient;

2) an online information and deliberation tool to support patient education and clarification of patient values, containing an integrated “patients-like-me” model with outcome information about discharge destinations;

3) a summary sheet to support actual decision-making during consultation, containing the patient’s values and preferences concerning discharge planning.

In the acceptability test, all qualifying and certifying IPDAS criteria were fulfilled. The usability test showed that patients and HCPs highly appreciated the PtDA with integrated outcome information.

Conclusions

The developed PtDA was found acceptable and usable by patients and HCPs and is currently under investigation in a clinical trial to determine its effectiveness.
Association between the second-stage duration of labor and perinatal outcomes in women with a prior cesarean delivery
Authors: Li Yulian , Zhang Lizi , Huang Lijun , Liang Yingyu , Chen Jingsi , Bi Shilei , Deng Weinan , Lin Lin , Wang Xiaoyi , Ren Luwen , Zeng Shanshan , Huang Minshan , Huang Baoying , Zhang Yijian , Xie Sushan , Du Lili , Chen Dunjin
Published: July 2022

Background

The cesarean delivery (CD) rate has been increasing globally. Trial of labor after cesarean delivery (TOLAC) has been used as a key method for the reduction of the CD rate. Little is known, however, about the association between the second-stage duration of TOLAC and adverse maternal and neonatal outcomes. This study evaluated the association between perinatal outcomes and the duration of second-stage labor in women undergoing TOLAC.

Methods

A 10-year retrospective cohort study was performed at the Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, between January 2010 and January 2020. Women undergoing TOLAC who reached the second stage of labor were included in this study. Duration of the second stage of labor was examined as a categorical variable (group I: <0.5 h, group II: 0.5–2 h and group III: ≥2 h) and as a continuous variable to evaluate the association with adverse perinatal outcomes by using multivariable regression models and a Cox proportional hazards regression model adjusting for potential confounders.

Results

Of the 1,174 women who met the inclusion criteria, the median (interquartile range) length of the second stage was 0.5 h (0.3–0.9 h). Among them, 1,143 (97.4%) delivered vaginally and 31 underwent an unplanned CD. As the second-stage duration increased, operative vaginal delivery (OVD), CD, and postpartum hemorrhage (PPH) rates increased. Women in group III had higher risks of OVD (aOR = 11.34; 95% CI [5.06–25.41]), CD (aOR = 4.22; 95% CI [1.32–13.43]), and PPH (aOR = 2.43; 95% CI [1.31–4.50]) compared with group I. Correspondingly, blood loss and the oxytocin used to treat PPH increased significantly, while the postpartum hemoglobin reduced significantly in group III compared with group I. The incidence of uterine rupture, uterine atony, cervical laceration, red blood cell transfusion, and intensive care unit admission were similar in all three groups. Neonatal outcomes were not affected by the second-stage duration.

Conclusions

Women undergoing TOLAC with second-stage duration of ≥2 h have higher odds of OVD, unplanned intrapartum CD, and PPH.
Determination of essential biomarkers in lung cancer: a real-world data study in Spain with demographic, clinical, epidemiological and pathological characteristics
Authors: Provencio Mariano , Cobo Manuel , Rodriguez-Abreu Delvys , Calvo Virginia , Carcereny Enric , Cantero Alexandra , Bernabé Reyes , Benitez Gretel , Castro Rafael López , Massutí Bartomeu , del Barco Edel , García Campelo Rosario , Guirado Maria , Camps Carlos , Ortega Ana Laura , González Larriba Jose Luis , Sánchez Alfredo , Casal Joaquín , Sala M. Angeles , Juan-Vidal Oscar , Bosch-Barrera Joaquim , Oramas Juana , Dómine Manuel , Trigo Jose Manuel , Blanco Remei , Calzas Julia , Morilla Idoia , Padilla Airam , Pimentao Joao , Sousa Pedro A. , Torrente Maria
Published: July 2022

Background

The survival of patients with lung cancer has substantially increased in the last decade by about 15%. This increase is, basically, due to targeted therapies available for advanced stages and the emergence of immunotherapy itself. This work aims to study the situation of biomarker testing in Spain.

Patients and methods

The Thoracic Tumours Registry (TTR) is an observational, prospective, registry-based study that included patients diagnosed with lung cancer and other thoracic tumours, from September 2016 to 2020. This TTR study was sponsored by the Spanish Lung Cancer Group (GECP) Foundation, an independent, scientific, multidisciplinary oncology society that coordinates more than 550 experts and 182 hospitals across the Spanish territory.

Results

Nine thousand two hundred thirty-nine patients diagnosed with stage IV non-small cell lung cancer (NSCLC) between 2106 and 2020 were analysed. 7,467 (80.8%) were non-squamous and 1,772 (19.2%) were squamous. Tumour marker testing was performed in 85.0% of patients with non-squamous tumours vs 56.3% in those with squamous tumours (p-value < 0.001). The global testing of EGFR, ALK, and ROS1 was 78.9, 64.7, 35.6% respectively, in non-squamous histology. PDL1 was determined globally in the same period (46.9%), although if we focus on the last 3 years it exceeds 85%. There has been a significant increase in the last few years of all determinations and there are even close to 10% of molecular determinations that do not yet have targeted drug approval but will have it in the near future. 4,115 cases had a positive result (44.5%) for either EGFR, ALK, KRAS, BRAF, ROS1, or high PDL1.

Conclusions

Despite the lack of a national project and standard protocol in Spain that regulates the determination of biomarkers, the situation is similar to other European countries. Given the growing number of different determinations and their high positivity, national strategies are urgently needed to implement next-generation sequencing (NGS) in an integrated and cost-effective way in lung cancer.