bluuebunny/crossref_metadata_2025 huggingface dataset:
Διερεύνηση ομοαξονικών ροών με περιδίνηση
Authors: Ναξάκης Ανδρέας
Published: June 2021

Σε αυτήν την διδακτορική εργασία, παρουσιάζεται η πειραματική μελέτη της αλληλεπίδρασης μιας περιδινούμενης δέσμης εκροής με μια περιδινούμενη δακτυλιοειδή ροή, που εκρέουν από ομοαξονικούς σωλήνες. Σκοπός της διατριβής είναι να συμβάλλει στη διερεύνηση και κατανόηση των περιδινούμενων ροών κοντά σε συνθήκες δημιουργίας και αποδόμησης στροβίλων και να αποτελέσει μια συνέχεια της μελέτης πάνω στο θέμα, που πραγματοποιείται για μεγάλο χρονικό διάστημα από το εργαστήριο Τεχνικής Θερμοδυναμικής του Πανεπιστημίου Πατρών.Ένα χαρακτηριστικό φαινόμενο εμφανίζεται σε ροές αυτού του τύπου είναι η αποδόμηση αξονικού μακροστροβίλου (Vortex Breakdown). Η ονομασία οφείλεται στο ότι δομή του αξονικού στροβίλου περιδίνησης, αναπτύσσει ένα σημείο ανακοπής επάνω στον άξονα που ακολουθείται κατάντι από μια περιοχή ροής ανακυκλοφορίας με πεπερασμένο μήκος. Το γεγονός ότι οι περιδινούμενες απαντώνται πολύ συχνά στη φύση και χρησιμοποιούνται ευρέως για τεχνολογικούς σκοπούς επειδή βελτιώνουν την ανάμιξη, ενισχύουν τη διάχυση, και συμβάλουν στη σταθεροποίηση της ροής, αποτελεί το κίνητρο αυτής της μελέτης.Στη πειραματική διάταξη που χρησιμοποιήθηκε μπορούσε να εφαρμοστεί περιδίνηση και στα δυο ρεύματα (εσωτερικό και δακτυλιοειδές), ενώ η οπτική της προσπελασιμότητα έδινε την δυνατότητα χρήσης της πειραματικής τεχνικής Stereo PIV. Στο πρώτο σετ πειραμάτων, όπου εφαρμόζεται περιδίνηση μόνο στην εσωτερική ροή και η δακτυλιοειδής ροή παραμένει ακίνητη, τα αποτελέσματα δείχνουν ότι μία φυσαλίδα ανακυκλοφορίας, σταθεροποιημένη μετά την έξοδο του εσωτερικού ακροφυσίου περιδίνησης, είναι η κυρίαρχη συνεκτική δομή που σχηματίζεται λόγω της διαστολής της περιδινούμενης δέσμης εκροής. Στο δεύτερο σετ πειραμάτων, όπου οι συνθήκες εισόδου περιλαμβάνουν αρκετές παροχές και αρκετές περιστροφές της εσωτερικής και δακτυλιοειδούς ροής, εμφανίζονται τέσσερις ξεχωριστοί τύποιxροής που χαρακτηρίζονται ως "πρόσω ροή πυρήνα" (downstream core flow) (DCF), "κλειστής φυσαλίδας" (closed bubble) (CB), "ασύμμετρης ανακυκλοφορίας" (asymmetric recirculation) (AR) και "έντονης ανακυκλοφορίας" (intense recirculation) (IR).Από την ανασκόπηση της βιβλιογραφίας, γίνεται αντιληπτό ότι μεγάλη έμφαση δίνεται στους αδιάστατους αριθμούς που χρησιμοποιούνται από τους ερευνητές για την εξαγωγή των πειραματικών τους συμπερασμάτων. Αναδεικνύεται η ανάγκη ορισμού ενός νέου αριθμού περιδίνησης (Swirl number) για να συμβάλει στην περιγραφή των τάσεων που δημιουργούνται στο ροϊκό πεδίο, αφού αποδεικνύεται ότι ο αριθμός Rossby (για αυτή την εργασία εισάγεται κατάλληλη τροποποιημένη μορφή του) από μόνος του δεν είναι επαρκής για να περιγράψει μονοσήμαντα τις αναπτυσσόμενες τάσεις και να προσδιορίσει του τύπους ροής. Ένας χάρτης τύπων ροής δημιουργείται, μέσα στον οποίο εντάσσονται όλα τα πειραματικά αποτελέσματα και ταξινομούνται σε κατηγορίες. Ανάλυση αβεβαιοτήτων των μετρήσεων παρουσιάζεται για τα δύο σετ πειραμάτων.
Μοντέλο ανάλυσης εικόνων για μαθητές Δημοτικού Σχολείου: ένα εργαλείο για την προώθηση κριτικού οπτικού γραμματισμού
Authors: Καραγιαννάκη Ευανθία
Published: June 2021

Το παρόν άρθρο παρουσιάζει μια συστηματική διδακτική πορεία μύησης μικρών μαθητών Δημοτικού Σχολείου στην ανάγνωση εικόνων. Η εν λόγω προσέγγιση, η οποία συνιστά έρευνα δράσης, έλαβε χώρα στο πλαίσιο πολιτιστικών προγραμμάτων, που υλοποιήθηκαν κατά τις ώρες Ευέλικτης Ζώνης, στην Α΄ και Β΄ τάξη Δημοτικού Σχολείου Δυτικής Θεσσαλονίκης. Επισημαίνεται ότι η ομάδα των μαθητών που συμμετείχε στην εν λόγω έρευνα είναι σταθερή, καθώς η δράση-παρέμβαση εξελίχθηκε από το ένα σχολικό έτος στο άλλο. Το κειμενικό υλικό που αξιοποιήθηκε αντλήθηκε, αφενός, από την εικονογράφηση των δημοφιλέστερων παραμυθιών των μαθητών της Α΄ τάξης Δημοτικού και, αφετέρου, από αγαπημένους πίνακες ζωγραφικής των μαθητών της Β΄ τάξης Δημοτικού. Η δημοτικότητα του κειμενικού υλικού αναδείχθηκε μέσα από σύντομες συνεντεύξεις με τα παιδιά. Η προσέγγιση των εικόνων βασίστηκε στο μοντέλο των Kress & van Leeuwen, το οποίο η εκπαιδευτικός-ερευνήτρια μετασχημάτισε σε μοντέλο ανάλυσης εικόνων για παιδιά, ώστε να είναι προσιτό στους μικρούς μαθητές της. Επίσης, κατά την ανάλυση των εικόνων, η ερευνήτρια έλαβε υπόψη της στοιχεία κοινωνικής σημειωτικής, ώστε η ανάγνωσή τους να λάβει κριτικό χαρακτήρα. Τέλος, για μια πιο αποτελεσματική μελέτη των εικόνων, η ερευνήτρια δημιούργησε έναν κατάλογο σχημάτων οπτικού λόγου. Η προσέγγιση ήταν δραστηριοκεντρική, εκκινώντας πάντα από μια εικόνα, η οποία αποτελούσε τη βάση για προφορικές διεπιδράσεις κριτικής εμβάθυνσης, ενώ στη συνέχεια η διδασκαλία εμπλουτιζόταν με θεατρικά παιχνίδια και εικαστικές δημιουργίες. Η αξιολόγηση των παρεμβάσεων απέδειξε ότι η προσέγγιση που υιοθετήθηκε στάθηκε αποτελεσματική για τους μικρούς μαθητές, καθώς πλέον ήταν σε θέση να αποκωδικοποιούν τις εικόνες και να εμβαθύνουν σε αυτές. Βασικό συμπέρασμα της εν λόγω έρευνας ήταν ότι η εικόνα που αντιστοιχεί είτε σε εικονογράφηση παραμυθιού είτε σε πίνακα ζωγραφικής συνιστά πολύτιμο και πολύπλευρο διδακτικό και εποπτικό εργαλείο, καθώς, μέσα από την κατάλληλη αξιοποίησή της, συντελεί πρωτίστως στην προώθηση του οπτικού γραμματισμού και της κριτικής οπτικής επίγνωσης, καθώς επίσης στην όξυνση της κριτικής σκέψης και στην παραγωγή πλούσιου  προφορικού λόγου σε διάφορες μορφές (περιγραφή, αφήγηση, επιχειρηματολογία, επεξήγηση). Παράλληλα δε, αποτελεί μοναδική πηγή έμπνευσης για θεατρικά δρώμενα και εικαστικές δημιουργίες, σε ένα πλαίσιο δόμησης και αναδόμησης του αρχικού οπτικού κειμένου.
Case Report: Delayed treatment of tuberculosis of the elbow joint
Authors: Desdiani Desdiani , Rizal Hidayat , Basuki Anindita , Fadilah Fadilah
Published: June 2021

Extrapulmonary tuberculosis (TB) is known to occur in the musculoskeletal system, including the elbow joints. These cases are rarely found because the signs and symptoms are not specific to extrapulmonary TB or other diseases. We report a case of a 24-year-old male, who complained about pain in his left elbow and noticed swelling. Initially, he complained about pain all over his left arm, after several reflexology massages to alleviate his toothache. However, instead of seeking medical treatment, he visited a traditional massage therapist every week without improvement in his left arm pain for almost one year. Examination showed skin perforation with discharge. He also had fever during the first few days when the elbow became swollen. Weight loss and a decreased appetite were also noticed by the patient. The patient went to the orthopedic department and underwent surgery. Radiological examination indicated bone erosion on the left humerus and radius, while posteroanterior chest X-ray did not show any abnormality. Histopathological examinations from biopsy and fluid aspiration showed granulomas and datia Langhans cells. Mycobacterium tuberculosis was found on acid-fast bacteria smear and culture. The patient was administered multidrug tuberculosis therapy, which consisted of two months of an intensive phase and seven months of a continuation phase, in accordance with the World Health Organization’s guidelines for extrapulmonary tuberculosis treatment. He has currently undergone the continuation phase of the treatment and his condition has improved. Early detection of tuberculosis of the elbow can prevent damage to joint structure and impairment of joint function.
Suspected botulism outbreak after the consumption of vegetarian pâté in the south of Viet Nam
Authors: Hung Le Quoc , Tho Vo Ngoc Anh , Khanh Do Thi Ngoc , Hien Vo Thi Thanh , Day Jeremy N. , Sang Nguyen Ngoc , Tam Hua Thoai , Thanh Ho Thi Chi , Ngan Nguyen Thi Thuy
Published: June 2021

Botulism and other botulinum neurotoxins-producing clostridia  are potentially life-threatening diseases caused by toxins produced by Clostridium botulinum. Here we reported a case series of six patients who presented with botulism following ingestion of commercially made pâté. The key features of presentation were acute onset of bilateral cranial nerve palsies and symmetrical descending weakness in the absence of fever resulting in the need for mechanical ventilation in all six patients. The clinical diagnosis of botulism was confirmed through the identification of C. botulinum from the suspected food source.  Given that botulinum antitoxin was not available in Vietnam at the time, and their severe status, all patients received a trial of plasma exchange therapy, but no clear benefit was seen.

Due to its rarity, diagnosing botulism is a challenge, demanding high clinical suspicion. Successful outcomes depend upon early recognition and rapid initiation of specific treatment with botulinum antitoxin. There is a need to improve global access to antitoxin.  These cases, the first in Viet Nam, serve as a reminder of the need to maintain the highest possible food hygiene and preservation practices.
Impact of COVID-19 on non-COVID intensive care unit service utilization, case mix and outcomes: A registry-based analysis from India
Authors:   Indian Registry of IntenSive care (IRIS), KJ Adhikari Neill , Beane Abi , Devaprasad Dedeepiya , Fowler Robert , Haniffa Rashan , James Augustian , Jayakumar Devachandran , Kodippily Chamira , Aravindakshan Kooloth Rohit , Laxmappa Rakesh , Mangal Kishore , Mani Ashwin , Mathew Meghena , Pari Vrindha , Patodia Sristi , Pattnaik Rajyabardhan , Priyadarshini Dilanthi , Pulicken Mathew , Rabindrarajan Ebenezer , Ramachandran Pratheema , Ramesh Kavita , Rani Usha , Ramaiyan Ananth , Ramakrishnan Nagarajan , Ranganathan Lakshmi , Rashan Aasiyah , Dominic Savio Raymond , Selva Jaganathan , Tirupakuzhi Vijayaraghavan Bharath Kumar , Tripathy Swagata , Udayanga Ishara , Venkataraman Ramesh
Published: June 2021

Background: Coronavirus disease 2019 (COVID-19) has been responsible for over 3.4 million deaths globally and over 25 million cases in India. As part of the response, India imposed a nation-wide lockdown and prioritized COVID-19 care in hospitals and intensive care units (ICUs). Leveraging data from the Indian Registry of IntenSive care, we sought to understand the impact of the COVID-19 pandemic on critical care service utilization, case-mix, and clinical outcomes in non-COVID ICUs. 

Methods: We included all consecutive patients admitted between 1st October 2019 and 27th September 2020. Data were extracted from the registry database and included patients admitted to the non-COVID or general ICUs at each of the sites. Outcomes included measures of resource-availability, utilisation, case-mix, acuity, and demand for ICU beds. We used a Mann-Whitney test to compare the pre-pandemic period (October 2019 - February 2020) to the pandemic period (March-September 2020). In addition, we also compared the period of intense lockdown (March-May 31st 2020) with the pre-pandemic period.

Results: There were 3424 patient encounters in the pre-pandemic period and 3524 encounters in the pandemic period. Comparing these periods, weekly admissions declined (median [Q1 Q3] 160 [145,168] to 113 [98.5,134]; p=0.00002); unit turnover declined (median [Q1 Q3] 12.1 [11.32,13] to 8.58 [7.24,10], p<0.00001), and APACHE II score increased (median [Q1 Q3] 19 [19,20] to 21 [20,22] ; p<0.00001). Unadjusted ICU mortality increased (9.3% to 11.7%, p=0.01519) and the length of ICU stay was similar (median [Q1 Q3] 2.11 [2, 2] vs. 2.24 [2, 3] days; p=0.15096).

Conclusion: Our registry-based analysis of the impact of COVID-19 on non-COVID critical care demonstrates significant disruptions to healthcare utilization during the pandemic and an increase in the severity of illness.
The association of preoperative blood markers with postoperative readmissions following arthroplasty
Authors: Khoshbin Amir , Hoit Graeme , Nowak Lauren Leone , Daud Anser , Steiner Martine , Juni Peter , Ravi Bheeshma , Atrey Amit
Published: June 2021

Aims

While preoperative bloodwork is routinely ordered, its value in determining which patients are at risk of postoperative readmission following total knee arthroplasty (TKA) and total hip arthroplasty (THA) is unclear. The objective of this study was to determine which routinely ordered preoperative blood markers have the strongest association with acute hospital readmission for patients undergoing elective TKA and THA.

Methods

Two population-based retrospective cohorts were assembled for all adult primary elective TKA (n = 137,969) and THA (n = 78,532) patients between 2011 to 2018 across 678 North American hospitals using the American College of Surgeons National Quality Improvement Programme (ACS-NSQIP) registry. Six routinely ordered preoperative blood markers - albumin, haematocrit, platelet count, white blood cell count (WBC), estimated glomerular filtration rate (eGFR), and sodium level - were queried. The association between preoperative blood marker values and all-cause readmission within 30 days of surgery was compared using univariable analysis and multivariable logistic regression adjusted for relevant patient and treatment factors.

Results

The mean TKA age was 66.6 years (SD 9.6) with 62% being females (n = 85,163/137,969), while in the THA cohort the mean age was 64.7 years (SD 11.4) with 54% being female (n = 42,637/78,532). In both cohorts, preoperative hypoalbuminemia (< 35 g/l) was associated with a 1.5- and 1.8-times increased odds of 30-day readmission following TKA and THA, respectively. In TKA patients, decreased eGFR demonstrated the strongest association with acute readmission with a standardized odds ratio of 0.75 per two standard deviations increase (p < 0.0001).

Conclusion

In this population level cohort analysis of arthroplasty patients, low albumin demonstrated the strongest association with acute readmission in comparison to five other commonly ordered preoperative blood markers. Identification and optimization of preoperative hypoalbuminemia could help healthcare providers recognize and address at-risk patients undergoing TKA and THA. This is the most comprehensive and rigorous examination of the association between preoperative blood markers and readmission for TKA and THA patients to date. Cite this article: Bone Jt Open 2021;2(6):388–396.
Ion dynamics at the energy-deprived tripartite synapse
Authors: Kalia Manu , Meijer Hil G. E. , van Gils Stephan A. , van Putten Michel J. A. M. , Rose Christine R.
Published: June 2021

The anatomical and functional organization of neurons and astrocytes at ‘tripartite synapses’ is essential for reliable neurotransmission, which critically depends on ATP. In low energy conditions, synaptic transmission fails, accompanied by a breakdown of ion gradients, changes in membrane potentials and cell swelling. The resulting cellular damage and cell death are causal to the often devastating consequences of an ischemic stroke. The severity of ischemic damage depends on the age and the brain region in which a stroke occurs, but the reasons for this differential vulnerability are far from understood. In the present study, we address this question by developing a comprehensive biophysical model of a glutamatergic synapse to identify key determinants of synaptic failure during energy deprivation. Our model is based on fundamental biophysical principles, includes dynamics of the most relevant ions, i.e., Na+, K+, Ca2+, Cl−and glutamate, and is calibrated with experimental data. It confirms the critical role of the Na+/K+-ATPase in maintaining ion gradients, membrane potentials and cell volumes. Our simulations demonstrate that the system exhibits two stable states, one physiological and one pathological. During energy deprivation, the physiological state may disappear, forcing a transit to the pathological state, which can be reverted when blocking voltage-gated Na+and K+channels. Our model predicts that the transition to the pathological state is favoured if the extracellular space fraction is small. A reduction in the extracellular space volume fraction, as, e.g. observed with ageing, will thus promote the brain’s susceptibility to ischemic damage. Our work provides new insights into the brain’s ability to recover from energy deprivation, with translational relevance for diagnosis and treatment of ischemic strokes.
A zero inflated log-normal model for inference of sparse microbial association networks
Authors: Prost Vincent , Gazut Stéphane , Brüls Thomas
Published: June 2021

The advent of high-throughput metagenomic sequencing has prompted the development of efficient taxonomic profiling methods allowing to measure the presence, abundance and phylogeny of organisms in a wide range of environmental samples. Multivariate sequence-derived abundance data further has the potential to enable inference of ecological associations between microbial populations, but several technical issues need to be accounted for, like the compositional nature of the data, its extreme sparsity and overdispersion, as well as the frequent need to operate in under-determined regimes.

The ecological network reconstruction problem is frequently cast into the paradigm of Gaussian Graphical Models (GGMs) for which efficient structure inference algorithms are available, like the graphical lasso and neighborhood selection. Unfortunately, GGMs or variants thereof can not properly account for the extremely sparse patterns occurring in real-world metagenomic taxonomic profiles. In particular, structural zeros (as opposed to sampling zeros) corresponding to true absences of biological signals fail to be properly handled by most statistical methods.

We present here a zero-inflated log-normal graphical model (available athttps://github.com/vincentprost/Zi-LN) specifically aimed at handling such “biological” zeros, and demonstrate significant performance gains over state-of-the-art statistical methods for the inference of microbial association networks, with most notable gains obtained when analyzing taxonomic profiles displaying sparsity levels on par with real-world metagenomic datasets.
Diagnosis of central serous chorioretinopathy by deep learning analysis of en face images of choroidal vasculature: A pilot study
Authors: Aoyama Yukihiro , Maruko Ichiro , Kawano Taizo , Yokoyama Tatsuro , Ogawa Yuki , Maruko Ruka , Iida Tomohiro
Published: June 2021

Purpose

To diagnose central serous chorioretinopathy (CSC) by deep learning (DL) analyses of en face images of the choroidal vasculature obtained by optical coherence tomography (OCT) and to analyze the regions of interest for the DL from heatmaps.

Methods

One-hundred eyes were studied; 53 eyes with CSC and 47 normal eyes. Volume scans of 12×12 mm square were obtained at the same time as the OCT angiographic (OCTA) scans (Plex Elite 9000 Swept-Source OCT®, Zeiss). High-quality en face images of the choroidal vasculature of the segmentation slab of one-half of the subfoveal choroidal thickness were created for the analyses. The 100 en face images were divided into 80 for training and 20 for validation. Thus, we divided it into five groups of 20 eyes each, trained the remaining 80 eyes in each group, and then calculated the correct answer rate for each group by validation with 20 eyes. The Neural Network Console (NNC) developed by Sony and the Keras-Tensorflow backend developed by Google were used as the software for the classification with 16 layers of convolutional neural networks. The active region of the heatmap based on the feature quantity extracted by DL was also evaluated as the percentages with gradient-weighted class activation mapping implemented in Keras.

Results

The mean accuracy rate of the validation was 95% for NNC and 88% for Keras. This difference was not significant (P >0.1). The mean active region in the heatmap image was 12.5% in CSC eyes which was significantly lower than the 79.8% in normal eyes (P<0.01).

Conclusions

CSC can be automatically diagnosed by DL with high accuracy from en face images of the choroidal vasculature with different programs, convolutional layer structures, and small data sets. Heatmap analyses showed that the DL focused on the area occupied by the choroidal vessels and their uniformity. We conclude that DL can help in the diagnosis of CSC.
Formulation of tunable size PLGA-PEG nanoparticles for drug delivery using microfluidic technology
Authors: Mares Adrianna Glinkowska , Pacassoni Gaia , Marti Josep Samitier , Pujals Silvia , Albertazzi Lorenzo
Published: June 2021

Amphiphilic block co-polymer nanoparticles are interesting candidates for drug delivery as a result of their unique properties such as the size, modularity, biocompatibility and drug loading capacity. They can be rapidly formulated in a nanoprecipitation process based on self-assembly, resulting in kinetically locked nanostructures. The control over this step allows us to obtain nanoparticles with tailor-made properties without modification of the co-polymer building blocks. Furthermore, a reproducible and controlled formulation supports better predictability of a batch effectiveness in preclinical tests. Herein, we compared the formulation of PLGA-PEG nanoparticles using the typical manual bulk mixing and a microfluidic chip-assisted nanoprecipitation. The particle size tunability and controllability in a hydrodynamic flow focusing device was demonstrated to be greater than in the manual dropwise addition method. We also analyzed particle size and encapsulation of fluorescent compounds, using the common bulk analysis and advanced microscopy techniques: Transmission Electron Microscopy and Total Internal Reflection Microscopy, to reveal the heterogeneities occurred in the formulated nanoparticles. Finally, we performed in vitro evaluation of obtained NPs using MCF-7 cell line. Our results show how the microfluidic formulation improves the fine control over the resulting nanoparticles, without compromising any appealing property of PLGA nanoparticle. The combination of microfluidic formulation with advanced analysis methods, looking at the single particle level, can improve the understanding of the NP properties, heterogeneities and performance.
Post-consumer food waste generation while dining out: A close-up view
Authors: Zeineddine Myra , Kharroubi Samer , Chalak Ali , Hassan Hussein , Abiad Mohamad G.
Published: June 2021

Food loss and food waste occur along the food supply chain, negatively impacting the environment, global economy, and food security. There is a growing global interest in tackling this issue to mitigate or handle the waste generated and limit its repercussions, as one in eight people suffer from undernourishment worldwide. In the Arab world, where there is a high dependency on imports and limited potential of increasing local food production, addressing food loss and waste becomes substantial. Research has mainly been focused on household food waste generation, while data on post-consumer plate food waste in the foodservice sector remains scarce. In this study, managers from a representative sample of 222 restaurants located in Municipal Beirut, Lebanon, were surveyed about food waste generation. Plate food waste was measured to establish baseline information. Multiple Tobit regression analyses were performed to explore the determinants for plate food waste generation. Plate waste generation was also compared between Lebanese and non-Lebanese cuisine restaurants. Results revealed that 1,620 tons of plate food waste are generated per year in Beirut, equivalent to 0.15% of Lebanon’s total organic waste. Furthermore, Lebanese cuisine restaurants serving Mediterranean Mezze were found to generate 34 kg of organic waste per day more than restaurants that serve international non-Lebanese cuisine. The type of cuisine, kind of service, and menu planning were significantly associated with post-consumer food waste generation. This study revealed an increasing concern towards the amount of plate waste generated in Beirut, and thereby further research is needed to create baseline information at the national level.
“I decide myself”- A qualitative exploration of end of life decision making processes of patients and caregivers through Advance Care Planning
Authors: Lall Priya , Dutta Oindrila , Tan Woan Shin , Patinadan Paul Victor , Kang Natalie Q. Y. , Low Chan Kee , Car Josip , Ho Andy Hau Yan
Published: June 2021

Background

The Singapore national Advance Care Planning (ACP) programme was launched in 2011 with the purpose of ensuring that healthcare professionals are fully aware of patients’ treatment preferences. There is little research assessing the performance of such programmes in ethnically diverse Asian countries; hence, the purpose of this study was to qualitatively examine patients and caregivers’ experiences with the ACP programme.

Method

We conducted interviews with 28 participants, thirteen of whom identified as proxy decision makers (PDMs) and the remainder as patients. Interviews focused on respondents’ experiences of chronic illness and of participating in the ACP programme. Textual data was analysed through a framework analysis approach.

Results

Participants’ narratives focused on four major themes with 12 subthemes: a) Engagement with Death, factors influencing respondents’ acceptance of ACP; b) Formation of Preferences, the set of concerns influencing respondents’ choice of care; c) Choice of PDM, considerations shaping respondents’ choice of nominated health spokesperson; and d) Legacy Solidification, how ACP is used to ensure the welfare of the family after the patient passes. These findings led to our development of the directive decision-making process framework, which delineates personal and sociocultural factors influencing participants’ decision-making processes. Respondents’ continual participation in the intervention were driven by their personal belief system that acted as a lens through which they interpreted religious doctrine and socio-cultural norms according to their particular needs.

Conclusion

The directive decision-making process framework indicated that ACP could be appropriate for the Asian context because participants displayed an awareness of the need for ACP and were able to develop a concrete treatment plan. Patients in this study made decisions based on their perceived long-term legacy for their family, who they hoped to provide with a solid financial and psychological foundation after their death.
Resource utilization and outcomes in emergency general surgery during the COVID19 pandemic: An observational cost analysis
Authors: Hessheimer Amelia J. , Trapero-Bertran Marta , Borin Alex , Butori Eugenia , Curell Anna , Espinoza Arlena Sofía , Jensen Joaquín , Turrado Víctor , Morales Xavier , de Lacy Antonio María , Fondevila Constantino
Published: June 2021

Background

Over the course of the COVID19 pandemic, global healthcare delivery has declined. Surgery is one of the most resource-intensive area of medicine; loss of surgical care has had untold health and economic consequences. Herein, we evaluate resource utilization, outcomes, and healthcare costs associated with unplanned surgery admissions during the height of the pandemic in 2020 versus the same period in 2019.

Methods

Retrospective analysis on patients ≥18 years admitted from the emergency department to General & Digestive and Gastrointestinal Surgery Services between February and May 2019 and 2020 at our center; clinical outcomes and unadjusted and adjusted per-person healthcare costs were analyzed.

Results

Consults and admissions to surgery declined between February and May 2020 by 37% and 19%, respectively, relative to the same period in 2019, with even greater relative decline during late March and early April. Time between onset of symptoms to diagnosis increased from 2±3 days 2019 to 5±22 days 2020 (P = 0.01). Overall hospital stay was two days less in 2020 (P = 0.19). Complications (Comprehensive Complication Index 10.3±23.7 2019 vs. 13.9±25.5 2020, P = 0.10) and mortality rates (3% vs. 4%, respectively, P = 0.58) did not vary. Mean unadjusted per-person costs for patients in the 2019 and 2020 cohorts were 5,886.72€±12,576.33€ and 5,287.62±7,220.16€, respectively (P = 0.43). Following multivariate analysis, costs remained similar (4,656.89€±390.53€ 2019 vs. 4,938.54±406.55€ 2020, P = 0.28).

Conclusions

Healthcare delivery and spending for unplanned general surgery admissions declined considerably due to COVID19. These results provide a small yet relevant illustration of clinical and economic ramifications of this healthcare crisis.
Evaluation of an integrated intervention to reduce psychological distress and intimate partner violence in refugees: Results from the Nguvu cluster randomized feasibility trial
Authors: Greene M. Claire , Likindikoki Samuel , Rees Susan , Bonz Annie , Kaysen Debra , Misinzo Lusia , Njau Tasiana , Kiluwa Shangwe , Turner Rachael , Ventevogel Peter , Mbwambo Jessie K. K. , Tol Wietse A.
Published: June 2021

Introduction

The complex relationship between intimate partner violence and psychological distress warrants an integrated intervention approach. In this study we examined the relevance, acceptability, and feasibility of evaluating a multi-sectoral integrated violence- and mental health-focused intervention (Nguvu).

Methods

We enrolled 311 Congolese refugee women from Nyarugusu refugee camp in Tanzania with past-year intimate partner violence and elevated psychological distress in a feasibility cluster randomized trial. Women were recruited from local women’s groups that were randomized to the Nguvu intervention or usual care. Participants from women’s groups randomized to Nguvu received 8 weekly sessions delivered by lay refugee incentive workers. Psychological distress, intimate partner violence, other wellbeing, and process indicators were assessed at baseline and 9-weeks post-enrollment to evaluate relevance, acceptability, and feasibility of implementing and evaluating Nguvu in refugee contexts.

Results

We found that Nguvu was relevant to the needs of refugee women affected by intimate partner violence. We found reductions in some indicators of psychological distress, but did not identify sizeable changes in partner violence over time. Overall, we found that Nguvu was acceptable and feasible. However, challenges to the research protocol included baseline imbalances between study conditions, differential intervention completion related to intimate partner violence histories, differences between Nguvu groups and facilitators, and some indication that Nguvu may be less beneficial for participants with more severe intimate partner violence profiles.

Conclusions

We found evidence supporting the relevance of Nguvu to refugee women affected by partner violence and psychological distress and moderate evidence supporting the acceptability and feasibility of evaluating and implementing this intervention in a complex refugee setting. A definitive cluster randomized trial requires further adaptations for recruitment and eligibility screening, randomization, and retention.

Trial registration

ISRCTN65771265, June 27, 2016.
Intestinal iron absorption is appropriately modulated to match physiological demand for iron in wild-type and iron-loaded Hamp (hepcidin) knockout rats during acute colitis
Authors: Flores Shireen R. L. , Nelson Savannah , Woloshun Regina R. , Wang Xiaoyu , Ha Jung-Heun , Lee Jennifer K. , Yu Yang , Merlin Didier , Collins James F.
Published: June 2021

Mucosal damage, barrier breach, inflammation, and iron-deficiency anemia (IDA) typify ulcerative colitis (UC) in humans. The anemia in UC appears to mainly relate to systemic inflammation. The pathogenesis of this ‘anemia of inflammation’ (AI) involves cytokine-mediated transactivation of hepatic Hamp (encoding the iron-regulatory hormone, hepcidin). In AI, high hepcidin represses iron absorption (and iron release from stores), thus lowering serum iron, and restricting iron for erythropoiesis (causing anemia). In less-severe disease states, inflammation may be limited to the intestine, but whether this perturbs iron homeostasis is uncertain. We hypothesized that localized gut inflammation will increase overall iron demand (to support the immune response and tissue repair), and that hepatic Hamp expression will decrease in response, thus derepressing (i.e., enhancing) iron absorption. Accordingly, we developed a rat model of mild, acute colitis, and studied iron absorption and homeostasis. Rats exposed (orally) to DSS (4%) for 7 days had intestinal (but not systemic) inflammation, and biomarker analyses demonstrated that iron utilization was elevated. Iron absorption was enhanced (by 2-3-fold) in DSS-treated, WT rats of both sexes, but unexpectedly, hepatic Hamp expression was not suppressed. Therefore, to gain a better understanding of regulation of iron absorption during acute colitis, Hamp KO rats were used for further experimentation. The severity of DSS-colitis was similar in Hamp KOs as in WT controls. In the KOs, increased iron requirements associated with the physiological response to colitis were satisfied by mobilizing hepatic storage iron, rather than by increasing absorption of enteral iron (as occurred in WT rats). In conclusion then, in both sexes and genotypes of rats, iron absorption was appropriately modulated to match physiological demand for dietary iron during acute intestinal inflammation, but regulatory mechanisms may not involve hepcidin.
Nitrogen fertilizer application rate impacts eating and cooking quality of rice after storage
Authors: Liang Hanling , Tao Dongbing , Zhang Qi , Zhang Shuang , Wang Jiayi , Liu Lifei , Wu Zhaoxia , Sun Wentao
Published: June 2021

The effect of nitrogen fertilizer application on the quality of rice post-storage is not well understood. The eating and cooking quality (ECQ) of rice treated with 0 (CK, control), 160 (IN, insufficient nitrogen), 260 (AN, adequate nitrogen), and 420 (EN, excessive nitrogen) kg N/ha was analyzed over 12 months of storage. Results showed that the rate of nitrogen fertilizer application had no significant impact on the changes in taste value during storage. However, EN application significantly increased the hardness (p < 0.05), reduced the gumminess (p < 0.05), and delayed the decline in the viscosity of rice paste by two months after one-year storage, compared with other treatments. In conclusion, although EN application resulted in an inferior texture of rice, it delayed the quality change by two months during storage. It was demonstrated that a rational nitrogen application rate (0–260 kg N/ha) for rice cultivation is particularly important to obtain high ECQ; however, EN may be beneficial for the stability of the ECQ during storage.
Genetic parameters for milk urea and its relationship with milk yield and compositions in Holstein dairy cows
Authors: Atashi Hadi , Hostens Miel ,   the GplusE consortium
Published: June 2021

The aim was to estimate genetic parameters for milk urea (MU) concentration and its relationship with milk yield and compositions in Holstein dairy Cows. Edited data were 90,594 test-day records of milk yield and composition collected during 2015 to 2018 on 13,737 lactations obtained from 7,850 Holstein cows in 50 herds. Random regression test-day model was used to estimate genetic parameters. (Co)variance components were estimated with the Bayesian Gibbs sampling method using a single chain of 400,000 iterates. The first 50,000 iterates of each chain were regarded as a burn-in period. Mean (SD) of MU was 23.03 (5.99) and 22.41 (5.74) mg/dl in primiparous and multiparous cows, respectively. Average heritability estimates for daily MU was 0.33 (SD = 0.02) ranged 0.29 to 0.36 and 0.32 (SD = 0.03) ranged 0.27 to 0.34, respectively, for primiparous and multiparous cows. The mean (SD) genetic correlation between MU and milk yield, fat yield, protein yield, lactose yield, fat percentage, protein percentage, lactose percentage, and somatic cell score was, respectively, -0.02 (0.03), -0.02 (0.01), 0.01 (0.04), 0.01 (0.03), 0.00 (0.07), -0.03 (0.04), 0.00 (0.01), -0.11 (0.06) in primiparous cows. The corresponding values in multiparous cows were -0.01 (0.02), -0.01 (0.03), -0.04 (0.04), -0.04 (0.04), 0.04 (0.04), 0.04 (0.07), -0.03 (0.09), 0.06 (0.11), respectively. The results indicate that selection on MU is possible with no effect on milk yield or compositions, however, relationships between MU and other important traits such as longevity, metabolic diseases, and fertility are needed.
Young-parent communication on sexual and reproductive health issues among young female night students in Amhara region, Ethiopia: Community-based cross-sectional study
Authors: Mihretie Gedefaye Nibret , Muche Liyeh Tewachew , Ayalew Goshu Yitayal , Gebrehana Belay Habtamu , Abe Tasew Habitamu , Belay Ayalew Abeba
Published: June 2021

Background

Young is a key stage in rapid biological and psychosocial changes affecting every aspect of the lives and an important time to set the foundation for good health in adulthood. Adolescent-parent communication is a potential path for improving sexual and reproductive health outcomes for adolescents, most of parents did not teach their adolescents about sexual and reproductive health. Even though, some researches have been done on day time students, there is no study conducted focusing on young girls attending night school in Ethiopia.

Objective

This study aimed to assess young-parent communication on sexual and reproductive health issues and associated factors among night female students in Amhara Region, Ethiopia, 2018.

Method

School based quantitative cross-sectional study was employed in Amhara region among 1640 young female night students from September 15 to November 15/2018. Face-to-face interview-administered questionnaires were used to collect the data. Bi-variable and multi-variable logistic regression model were used. Odds ratio (OR) with 95% confidence interval (CI) were computed to determine the strength of association between predictor and outcome variables. P-values less than 0.05 considered as level of significance.

Results

One hundred ten (37.5%) of the students had communication with their parents on at least two issues of sexual and reproductive health (SRH) issues in the last 6 months. Grade level (adjusted odd ratio (AOR) = 2.61, 95% CI (2.04, 3.34)), marital status (AOR = 1.29, 95% CI (1.03, 1.63), living arrangement (AOR = 1.50(1.13, 2.00)), utilization of youth friendly sexual and reproductive health services (AOR = 1.80, 95% CI (1.41, 2.30)), students ever had sexual intercourse (AOR = 1.50, 95% CI (1.23, 1.96)), Information about sexual and reproductive health services (AOR = 1.45(1.16, 1.80)) were associated young-parents communication on sexual and reproductive health issues.

Conclusion

In this study young-parent communications on sexual and reproductive health (SRH) issues was found to be limited. Therefore, teachers, health extension workers, and health professionals should strengthen comprehensive SRH education for students in school, churches, mosques, health facilities and encouraging them to participate in different health clubs in school. Parent should give education for their children sexual and reproductive health during the era of young age.
Effect of resistance training with blood flow restriction on muscle damage markers in adults: A systematic review
Authors: de Queiros Victor Sabino , dos Santos Ísis Kelly , Almeida-Neto Paulo Francisco , Dantas Matheus , de França Ingrid Martins , Vieira Wouber Hérickson de Brito , Neto Gabriel Rodrigues , Dantas Paulo Moreira Silva , Cabral Breno Guilherme de Araújo Tinôco
Published: June 2021

Background

The purpose of this review was to systematically analyze the evidence regarding the occurrence of muscle damage (changes in muscle damage markers) after resistance training with blood flow restriction sessions.

Materials and methods

This systematic review was conducted in accordance with the PRISMA recommendations. Two researchers independently and blindly searched the following electronic databases: PubMed, Scopus, Web of Science, CINAHL, LILACS and SPORTdicus. Randomized and non-randomized clinical trials which analyzed the effect of resistance training with blood flow restriction on muscle damage markers in humans were included. The risk of bias assessment was performed by two blinded and independent researchers using the RoB2 tool.

Results

A total of 21 studies involving 352 healthy participants (men, n = 301; women, n = 51) were eligible for this review. The samples in 66.6% of the studies (n = 14) were composed of untrained individuals. All included studies analyzed muscle damage using indirect markers. Most studies had more than one muscle damage marker and Delayed Onset Muscle Soreness was the measure most frequently used. The results for the occurrence of significant changes in muscle damage markers after low-load resistance training with blood flow restriction sessions were contrasting, and the use of a pre-defined repetition scheme versus muscle failure seems to be the determining point for this divergence, mainly in untrained individuals.

Conclusions

In summary, the use of sets until failure is seen to be determinant for the occurrence of significant changes in muscle damage markers after low-load resistance training with blood flow restriction sessions, especially in individuals not used to resistance exercise.

Trial registration

Register number: PROSPERO number: CRD42020177119.
Association between serum magnesium levels and abdominal aorta calcification in patients with pre-dialysis chronic kidney disease stage 5
Authors: Ito Mayumi , Yamaguchi Makoto , Katsuno Takayuki , Nobata Hironobu , Iwagaitsu Shiho , Sugiyama Hirokazu , Kinashi Hiroshi , Banno Shogo , Ando Masahiko , Kubo Yoko , Ishimoto Takuji , Ito Yasuhiko
Published: June 2021

Background

Several studies have revealed the relationship between serum magnesium levels and vascular calcification in chronic kidney disease patients. Despite excellent predictability of abdominal aorta calcification for cardiovascular disease events, the relationship between serum magnesium levels and abdominal aorta calcification, as evaluated by quantitative methods, in pre-dialysis patients remains unclear. This study aimed to determine the abdominal aorta calcification volume using computerized tomography and its association with serum magnesium levels in pre-dialysis chronic kidney disease stage 5 patients.

Methods

This single-center cross-sectional study included 100 consecutive patients with pre-dialysis chronic kidney disease stage 5 between January 2016 and May 2020 at Aichi Medical University Hospital, Japan. The relationships between serum magnesium levels and the abdominal aorta calcification volume were assessed using multiple linear regression models after adjusting for clinically relevant factors. We also assessed clinical factors that affect serum magnesium levels.

Results

The mean serum magnesium level was 2.0 mg/dL (interquartile range, 1.8 to 2.3). Multivariate analyses revealed that a higher serum magnesium level (stand. β = -0.245, p = 0.010) was significantly associated with a reduced abdominal aorta calcification volume, and that a history of cardiovascular disease (stand. β = 0.3792, p < 0.001) and older age (stand. β = 0.278, p = 0.007) were significantly associated with an increased abdominal aorta calcification volume. Moreover, multivariate analysis showed that the use of proton pump inhibitor or potassium-competitive acid blocker was significantly associated with lower serum magnesium levels (stand. β = -0.246, p = 0.019).

Conclusions

The present study revealed that the higher Mg level was significantly associated with lower volume of abdominal aorta calcification in pre-dialysis chronic kidney disease stage 5 patients. Further studies should be undertaken to determine the appropriate magnesium level to suppress vascular calcification.
A journey of gender in health: Transforming health by promoting gender considerations through comic art
Authors: Joy Phillip , Cosma Alina , Goodliffe Samantha , Hiltner Sarah , Magnée Tessa , Plug Ilona
Published: June 2021

Sex and gender are determinants of health outcomes across an individual’s life course. However, often in health research and practice, sex and gender considerations are either overlooked or confounded. Recent developments in health research and practice ask for the inclusion of sex and gender considerations within health research and practice. This article is a reaction to these calls. It explores the ways in which an international team of health researchers created a comic book that highlighted the impact of gender in many areas of health across an individual’s life course. The creative processes are critically explored, as well as selected images. Through this work, it is proposed that comic art knowledge mobilization projects can be viewed as means to transform health research and practice by critiquing and disrupting dominant cis-heteronormative sex and gender discourses.
Winner of the 2021 Journal of Curatorial Studies Emerging Writer Award and My Body Holds Its Shape
Authors: Lai Mankit
Published: June 2021

Review of: Winner Of The 2021 Journal Of Curatorial Studies Emerging Writer Award

My Body Holds Its Shape

Curated by Xue Tan, Tai Kwun Contemporary, Hong Kong, 25 May–27 September 2020
Gregor Schneider, Tote Räume
Authors: Chatzirafailidis Dinos
Published: June 2021

Review of: Gregor Schneider, Tote Räume

Curated by Marie-José Sondeijker, West Den Haag, The Hague, 29 August 2020–7 March 2021
Will Kwan, Terra Economicus
Authors: Burns Maya
Published: June 2021

Review of: Will Kwan, Terra Economicus

Curated by Leila Timmins, Robert McLaughlin Gallery, Oshawa, 2 October 2020–21 August 2021
Transdisciplinarity in extended reality (XR) research design: Technological transformation and social good (co-creation session at XR + Creativity Symposium, University of Newcastle, 2020)
Authors: Orr Nikolas , Matthews Benjamin , See Zi Siang , Burrell Andrew , Day Jamin , Seengal Divya
Published: June 2021

This article collates and synthesizes the discussion results of a collaborative research exercise, known as a ‘co-creation session’, formed of a multi-disciplinary group of extended reality (XR) researchers and practitioners. The session sought to develop and theorize the concept of ‘transformative technologies for good’ in creative, applied and clinical contexts. Notions of ‘cutting-edge’ practice were visited from a critical standpoint; participants established that innovation, when measured in terms of social good, challenges technological and economic paradigms of progress. Conversation between participants centred on four key areas: skills and knowledge for effective XR research, appropriate methods and sites for diffusion of XR research, the future of the field, and the possible contributions of XR and associated research to problems arising from COVID-19. The session offered further insights into research design related to composition of participant groups in terms of disciplinary knowledge, activity design, and remote digital interfaces.
Morreu o meu Último Professor
Authors: Torgal Luís Reis
Published: June 2021

Não tenho do meu curso de História, na época de 1960 a 1966, ano em que defendi a tese de licenciatura, uma imagem essencialmente positiva, conforme já o disse num livro, História… Que História?, publicado pela editora Temas e Debates em 2015. A nossa ciência era então vista de uma forma “narrativista” e “acontecimental”. As cadeiras que estimulavam a minha reflexão crítica —aprendida no liceu com Alberto Martins de Carvalho — fui buscá-las particularmente à Filosofia e à História da Cultura, em que ensinavam professores, de diversas concepções, oriundos de outras áreas: Sílvio Lima (em 1935 demitido por Salazar, mas que pudera regressar nos anos 40), o qual reflectia, nas suas lições inesquecíveis, sobre os princípios da teoria da História
Interacción en los ecosistemas tecnológicos de aprendizaje
Authors: García-Peñalvo Francisco José
Published: June 2021

En julio de 2018 se celebró en Las Vegas la segunda edición de la sesión especial sobre Interacción en los ecosistemas tecnológicos de aprendizaje, en el contexto del congreso HCI International 2018, 20th International Conference on Human-Computer Interaction. Se va a hacer un breve repaso de los tópicos más importantes que allí se trataron.