bluuebunny/crossref_metadata_2025 huggingface dataset:
Volatility Puzzle: Long Memory or Antipersistency
Authors: Shi Shuping , Yu Jun
Published: November 2022

The log realized volatility (RV) is often modeled as an autoregressive fractionally integrated moving average model ARFIMA([Formula: see text]). Two conflicting empirical results have been found in the literature. One stream shows that log RV has a long memory (i.e., the fractional parameter d > 0). The other stream suggests that the autoregressive coefficient α is near unity with antipersistent errors (i.e., d < 0). This paper explains how these conflicting empirical findings can coexist in the context of ARFIMA([Formula: see text]) model by examining the finite sample properties of popular estimation methods, including semiparametric methods and parametric maximum likelihood methods. The finite sample results suggest that it is challenging to distinguish [Formula: see text] (ARFIMA([Formula: see text]) with α close to 0 and d close to 0.5) from [Formula: see text] (ARFIMA([Formula: see text]) with α close to unity and d close to –0.5). An intuitive explanation is given. For the 10 financial assets considered, despite that no definitive conclusions can be drawn regarding the data-generating process, we find that the frequency domain maximum likelihood (or Whittle) method can generate the most accurate out-of-sample forecasts.

This paper was accepted by Lukas Schmid, finance.

Funding: S. Shi acknowledges research support from the Australian Research Council [Project DE190100840]. J. Yu acknowledges financial support from the Ministry of Education–Singapore Tier 2 Academic Research Fund [Project MOE-T2EP402A20-0002] and the Lee Foundation.

Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2022.4552 .
The Happiness for Italy's Victory at the European Soccer Championships Costs a “Happy Heart Syndrome”
Authors: Fazzini Luca , Marchetti Maria Francesca , Biddau Mattia , Aste Francesca , Maiani Silvia , Montisci Roberta
Published: November 2022

Takotsubo syndrome (TTS) is usually caused by physical or emotional negative stressors. Sometimes positive emotions trigger a rare form of Takotsubo syndrome, called the “happy heart” syndrome. We discuss the management of a 52-year-old female with happy heart syndrome, the differences between these stress cardiomyopathies and the relationship with hyperthyroidism.
The role of the nurse in screening people with suspected dementia
Authors: Muir Nita , Wilson James
Published: November 2022

James Wilson and Dr Nita Muir looks at how staff in primary care can diagnose dementia
Exploration of Prospective Mathematics Teachers’ Mathematical Connections When Solving the Integral Calculus Problems Based on Prior Knowledge
Authors: Pambudi Didik Sugeng
Published: November 2022

Mathematical connection ability is very important to be mastered by prospective mathematics teacher students as competency to teach in secondary schools. However, the facts show that there are still many students who have weak mathematical connection abilities. This qualitative descriptive study aimed to explore how the process, and product of the mathematical connection made by prospective mathematics teacher students when solving the integral calculus problems based on their prior knowledge. The research subjects were 58 students who were prospective high school mathematics teachers at the University of Jember, Indonesia. Data were collected using documentation, questionnaire, test, and interview methods. After the test results of all subjects were analyzed, six students were interviewed. To find the match between the results of the written test and the results of the interview, a triangulation method was carried out. Data analysis used descriptive qualitative analysis with steps of data categorization, data presentation, interpretation, and making conclusions. The results show that the research subjects have connected and used mathematical ideas in the form of procedures, facts, concepts/principles, and representations in solving integral calculus problems. Students with high prior knowledge abilities can make better mathematical connections than students with moderate and low prior abilities. From these results, it is recommended that lecturers need to improve students' prior knowledge and train the students more intensely to solve integral calculus problems so all students can develop their mathematical connection abilities into very strong categories.
Mathematics Lecturers Professional Learning on the Topic of Even and Odd Functions through Lesson Study
Authors: Gholami Hosseinali
Published: November 2022

A mathematics instructor with limited knowledge of content and pedagogy has little room for improvement or novelty in the classroom or the ability to arouse students' interest in learning mathematics. This case study was conducted in a foundation center of one of the public universities in Malaysia. The target of current research was to investigate the influence of lesson study (LS) on lecturers’ pedagogical content and content knowledge. The LS group comprises of seven lecturers of the mathematics group and the researcher. The group collaboratively prepared a research lesson on the subject of even and odd functions. Data gathered through interviews and observations on the lecturers’ activities in discussion meetings. Data from observations and interviews were analyzed descriptively and through thematic analysis method respectively. The results of this study show lecturers improved their knowledge in content and pedagogy considerably about even and odd functions. They enhanced their teaching knowledge through collaborative work and sharing of experiences. It seems the findings of this research not only help lecturers to have better performance in teaching the even and odd functions but also encourage them to experience the LS approach in teaching other mathematical concepts.
Morphological and Physiological Responses of Grafted Melon Subjected to Fusarium Wilt and Water Stress
Authors: Ozbahce Aynur , Kosker Yakup , Gultekin Rohat , Gorgisen Ceren , Avag Kadri , Demir Yasemin , Yucel Seral
Published: November 2022

This study aimed to determine the effects of different rootstocks on crop water stress index (CWSI), some morphological and physiological parameters of grafted melon under soil-borne pathogen (Fusarium oxysporum f.sp.melonis) and water stress conditions. The study was carried out in Çumra District of Konya Province in Türkiye for two years. The main plots consisted of three different irrigation levels and the sub plots consisted of subjects with melon plants with different rootstocks. The experiment was carried out in a split-plot design with three replications. In the study, four different rootstocks; 1-Ungrafted, 2-Ferro, 3-Maximus and TZ 148 were used. Edalı F1 variety (Cucumis melo var. Edalı F1) was used as a scion in the experiment. Irrigation was done in the four vegetation periods (early vegetative, late vegetative, flowering-fruit setting and ripening) of plant. Irrigation consisted of issues to increase soil depth from 0-90 cm to field capacity (I100), 50% (I50) of soil available water field capacity and rainfed (I0). As a result of the experiment, while leaf water potential (LWP) and leaf relative water content (RWC) increased with the increase of irrigation water in both years, the chlorophyll content was higher in I100, stomatal conductance was the highest in I50 of irrigation water, while the increase in irrigation water decreased stomatal conductance. In terms of physiological parameters measured in the plant, chlorophyll content and RWC values in the first year, Ferro, TZ-148 and Maximus rootstock, respectively, in the second year, Maximus rootstock reached the best value stem diameter in both years. CWSI was also affected by the applications.
The Eff ect of Pregelatinized Starch on the Properties of Poly (Vinyl Alcohol) Film for the Water-Soluble Laundry Bag
Authors:   Department of Materials Science and Engineering, Faculty of Engineering and Industrial Technology, Silpakorn University, Nakhon Pathom 73000, Thailand, Sangthongdee Montree , Phattarateera Supanut ,   National Metal and Materials Technology Center, National Science and Technology Development Agency, Thailand Science Park, Pathum Thani 12120, Thailand, Threepopnatkul Poonsub ,   Department of Materials Science and Engineering, Faculty of Engineering and Industrial Technology, Silpakorn University, Nakhon Pathom 73000, Thailand
Published: November 2022

The goal of this study was to develop pregelatinized starch (P-St) and polyvinyl alcohol (PVOH) fi lms as water-soluble laundry plastic bags to avoid having contact with COVID-19 infected clothes by extrusion method. The effects of pregelatinized starch (P-St) content on the properties of polyvinyl alcohol (PVOH) fi lms were examined. PVOH and P-St blend were compounded by twin- screw extruder with various P-St content of 0, 10, 20, 30, and 40% by weight with fi xed glycerol content of 20 phr. The blend fi lms were produced by blown fi lm extrusion. The chemical structure, thermal properties, water-solubility, mechanical properties, and the cross-sections morphological properties of PVOH/G/P-St were characterized. As a result, the formation of intermolecular interactions between PVOH, glycerol and P-St was confi rmed by FTIR. Moreover, the addition of P-St on PVOH could reduce the thermal stability due to the content of P-St with amylose, a substance of amorphous structure, affecting the chains fl exibility of PVOH/G/P-St. From the differential scanning calorimeter result, the glass transition temperature was increased with the increment of P-St content because the chains entanglement between PVOH and P-St had affected the reduction in crystallinity and led to the decrement of the melting temperature. Furthermore, the water solubility would strongly be dependent on the percentage of the gelatinized starch (%GS). The solubility decreased as the percentage of the GS increased. In addition, PVOH with 20% of P-St fi lm possessed the highest value in tensile strength and modulus, and the particles of P-St have a good distribution in PVOH/G indicating to stronger interaction of P-St and PVOH/G.
Designed and Produced the Rotary Substrate Holder and Its Optimized in Angular DC Magnetron Co-Sputtering System
Authors:   Ph.D. Degree Program in Industrial Engineering, Department of Industrial Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai 50200, Thailand, Changyom Preecha ,   Department of Industrial Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai 50200, Thailand, Leksakul Komgrit ,   Department of Industrial Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai 50200, Thailand, Charoenchai Nivit ,   Department of Industrial Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai 50200, Thailand, Boonyawan Dheerawan ,   Department of Physics and Materials Science, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand
Published: November 2022

We report the design approach of a home-built rotary substrate holder on simple rotation stages for low-pressure vacuum applications. The result of designing and fabricating the rotary substrate holder that it can be successfully used to rotate the substrate in a low-pressure vacuum application without pressure fl uctuations and leakage. Then we investigated the suitable thin fi lm deposition by fabricating optimal multilayer coatings under three variable operating conditions: Speed of substrate, deposition time, and discharge voltage. The thin film deposition result of three copper targets was mounted on each magnetron gun, providing a total of three magnetron guns. The thin fi lm was deposited on a glass slide at room temperature using a custom-built angular DC magnetron co-sputtering system. Analysis of variance for the response surface regression model of film thickness as a function of the three independent variables shows that substrate rotation speed, sputtering time, sputtering voltage, and coeffi cient of squared sputtering time are the most signifi cant factors in determining the optimum film thickness. The optimum thin-film deposition with substrate rotation speed, sputtering time, and sputtering voltage of 10 rpm, 8.61 min, and 200%V, respectively, maximizes the thickness of 72.036 nm.
Data labour as alienated or liberated labour? Proposals for radical economic change from the Silicon Valley in the light of technological reification
Authors: Nowak Jörg
Published: November 2022

This article delivers a critical analysis of the proposal to pay wages or royalties to data providers for any form of provision of digital data. It has been developed primarily by researchers of the Microsoft research department. The proposal to create mediators of individual data as trade unions of data providers aims at economic inclusion of everyday users of computers and smartphones. The article analyses the shortcomings of the proposal which does not consider the issue that many workers are obliged to provide data at their workplaces, and the problem of increasing digital tracking of workers’ productive activities. Furthermore, the proposal to pay wages for everyday activities lacks any strategy or vision to create more meaningful and satisfying work relations.
QoT estimation using EGN-assisted machine learning for multi-period network planning
Authors: Müller Jasper , Patri Sai Kireet , Fehenberger Tobias , Griesser Helmut , Elbers Jörg-Peter , Mas-Machuca Carmen
Published: November 2022

The rapidly growing traffic demands in fiber-optical networks require flexibility and accuracy in configuring lightpaths, for which fast and accurate quality of transmission (QoT) estimation is of pivotal importance. This paper introduces a machine learning (ML)-based QoT estimation approach that meets these requirements. The proposed gradient-boosting ML model uses precomputed per-channel self-channel-interference values as representative and condensed features to estimate non-linear interference in a flexible-grid network. With an enhanced Gaussian noise (GN) model simulation as the baseline, the ML model achieves a mean absolute signal-to-noise ratio error of approximately 0.1 dB, which is an improvement over the GN model. For three different network topologies and network planning approaches of varying complexities, a multi-period network planning study is performed in which ML and GN are compared as path computation elements (PCEs). The results show that the ML PCE is capable of matching or slightly improving the performance of the GN PCE on all topologies while reducing significantly the computation time of network planning by up to 70%.
Towards retrieving dispersion profiles using quantum-mimic optical coherence tomography and machine learning
Authors: Maliszewski Krzysztof A. , Kolenderski Piotr , Vetrova Varvara , Kolenderska Sylwia M.
Published: November 2022

Artefacts in quantum-mimic optical coherence tomography are considered detrimental because they scramble the images even for the simplest objects. They are a side effect of autocorrelation, which is used in the quantum entanglement mimicking algorithm behind this method. Interestingly, the autocorrelation imprints certain characteristics onto an artefact – it makes its shape and characteristics depend on the amount of dispersion exhibited by the layer that artefact corresponds to. In our method, a neural network learns the unique relationship between the artefacts’ shape and GVD, and consequently, it is able to provide a good qualitative representation of object’s dispersion profile for never-seen-before data: computer-generated single dispersive layers and experimental pieces of glass. We show that the autocorrelation peaks – additional peaks in the A-scan appearing due to the interference of light reflected from the object – affect the GVD profiles. Through relevant calculations, simulations and experimental testing, the mechanism leading to the observed GVD changes is identified and explained. Finally, the network performance is tested in the presence of noise in the data and with the experimental data representing single layers of quartz, sapphire and BK7.
Harmonically mode-locked laser pulse accumulation in a self-resonating optical cavity
Authors: Koshiba Yuya , Otsuka Seiya , Yamashita Koki , Fukushima Chikara , Araki Sakae , Aryshev Alexander , Omori Tsunehiko , Popov Konstantin , Takahashi Tohru , Terunuma Nobuhiro , Uesugi Yuuki , Urakawa Junji , Washio Masakazu
Published: November 2022

Optical enhancement cavities enabling laser pulses to be coherently stacked in free space are used in several applications to enhance accessible optical power. In this study, we develop an optical cavity that accumulates harmonically mode-locked laser pulses with a self-resonating mechanism for X-ray sources based on laser-Compton scattering. In particular, a Fabry-Perot cavity composed of 99% reflectance mirrors maintained the optical resonance in a feedback-free fashion for more than half an hour and automatically resumed the accumulation even if the laser oscillation was suspended. In contrast to conventional optical enhancement cavity systems with a dedicated feedback controller, this characteristic is highly beneficial in practical applications, such as for laser-Compton scattering X-ray sources. Lastly, upscaling and adoption of the proposed system might improve the operability and equipment use of laser Compton-scattering X-ray sources.
Fast combined-frequency phase extraction for phase shifting profilometry
Authors: Lee Yong , Mao Ya , Chen Zuobing
Published: November 2022

Due to the nonlinearity in phase shifting profilometry (PSP) system, the captured images are often distorted with fringe harmonics, resulting in inaccurate phase map and measurement. Considering the fact that the phase error can be significantly reduced by modeling high-order fringe harmonics, this work formulates the phase extraction problem — with different frequency images and high-order fringe harmonic model — as a maximum likelihood estimation (MLE). To optimize it efficiently, we thus propose a combined-frequency phase extraction (CFPE) solution by introducing a latent phase map and incorporating the famous expectation-maximization (EM) framework. As a result, our CFPE method only needs ∼5% execution time of a high-order baseline, whilst keeps the high-order accuracy. Tested on synthetic images as well as practical measurements, our CFPE method demonstrated its performance improvement of efficiency and accuracy. In addition, our detailed implementation with experimental arrangement is also provided for interested researchers.
Visibility enhancement of underwater images based on polarization common-mode rejection of a highly polarized target signal
Authors: Li Haoxiang , Zhu Jingping , Deng Jinxin , Guo Fengqi , Yue Liu , Sun Jian , Zhang Yunyao , Hou Xun
Published: November 2022

Underwater active polarization imaging is promising due to its effect of significantly descattering. Polarization-difference is commonly used to filter out backscattered noise. However, the polarization common-mode rejection of target signal has rarely been utilized. In this paper, via taking full advantage of this feature of Stokes vectors S2 which ably avoids interference from target light, the spatial variation of the degree of polarization of backscattered light is accurately estimated, and the whole scene intensity distribution of background is reconstructed by Gaussian surface fitting based on least square. Meanwhile, the underwater image quality measure is applied as optimization feedback, through iterative computations, not only sufficiently suppresses backscattered noise but also better highlights the details of the target. Experimental results demonstrate the effectiveness of the proposed method for highly polarized target in strongly scattering water.
Decision-free downsampling method assisted via channel-transfer information to improve the reliability of holographic data storage systems
Authors: Zhao Yahui , Wu Fei , Lin Xiao , Tan Xiaodi , Xie Changsheng
Published: November 2022

A decision-free downsampling method (DFDS) assisted by channel-transfer information for phase-modulated holographic data storage is proposed. DFDS is used to address the issue of the accumulation of decision errors induced by traditional downsampling. The issue degrades the downsampling accuracy. DFDS comprises two functional segments: acquiring the channel-transfer information offline and performing decision-free downsampling online. With the assistance of the channel-transfer information, DFDS uses Bayesian posterior probabilities instead of traditional decision results to avoid the accumulation of decision errors and achieve more accurate downsampling. The simulation and experimental results show that DFDS reduces the phase error rate, thereby improving the reliability of the holographic data storage system.
Graphene multilayers for coherent perfect absorption: effects of interlayer separation
Authors: Pandey Devashish , Xiao Sanshui , Wubs Martijn
Published: November 2022

We present a model study to estimate the sensitivity of the optical absorption of multilayered graphene structure to the subnanometer interlayer separation. Starting from a transfer-matrix formalism we derive semi-analytical expressions for the far-field observables. Neglecting the interlayer separation, results in upper bounds to the absorption of 50% for real-valued sheet conductivities, exactly the value needed for coherent perfect absorption (CPA), while for complex-valued conductivities we identify upper bounds that are always lower. For pristine graphene the number of layers required to attain this maximum is found to be fixed by the fine structure constant. For finite interlayer separations we find that this upper bound of absorption only exists until a particular value of interlayer separation (Dlim) which is less than the realistic interlayer separation in graphene multilayers. Beyond this value, we find a strong dependence of absorption with the interlayer separation. For an infinite number of graphene layers a closed-form analytical expression for the absorption is derived, based on a continued-fraction analysis that also leads to a simple expression for Dlim. Our comparison with experiments illustrates that multilayer Van der Waals crystals suitable for CPA can be more accurately modelled as electronically independent layers and more reliable predictions of their optical properties can be obtained if their subnanometer interlayer separations are carefully accounted for.
Nonlinearity aware bisection-based sphere shaping for optical digital subcarrier multiplexing systems
Authors: Gan Zelin , Li Xiang , Savory Seb J.
Published: November 2022

In this paper, a nonlinearity-tolerant sphere shaping is proposed based on the parallel bisection structure. Compared to enumerative sphere shaping (ESS), the bisection-based sphere shaping (BS-SS) can achieve a lower average energy and rate loss at the same blocklength by selecting all preferential sequences. The nonlinearity-tolerant BS-SS (BS-SS-NLI) can mitigate the fiber nonlinearity by reducing the energy variation, which is demonstrated in the simulations with probabilistically shaped, single channel, dual-polarization 64-ary quadrature amplitude modulation (DP-64QAM) for a multi-span long-haul transmission over 2500 km of standard single-mode fiber (SSMF) applying digital subcarrier multiplexing (SCM), comparing with recent literature kurtosis-limited ESS (K-ESS) and list-encoding constant composition distribution matching (L-CCDM). The BS-SS-NLI can provide 0.25 dB effective signal-to-noise ratio (SNR) gain over ESS and 0.39 dB gain over L-CCDM. The achievable information rate (AIR) can be improved ∼0.1 bits/4D-symbol by BS-SS-NLI over ESS.
Evaluation and analysis of optically injection-locked semiconductor laser characteristics for optical complex signal generation
Authors: Talebzadeh Seyyedeh Ladan , Yadipour Reza
Published: November 2022

In this paper, we present an investigation of the optical injection-locked parameters which utilize an approach to creating optical complex signals using optically injection-locked (OIL) semiconductor lasers. Subsequently, we discuss the impact of the OIL parameters on the locking map, manufacturing the corresponding complex signal area, pole-zero diagram, and frequency response of the system. The steady-state analysis of the rate equations indicates that changing OIL parameters can result in simultaneous optical AM and PM of the OIL laser while preserving the injection locking state. Based on the simulation results, we found that using strong R
inj
and high negative Δfinj (which are mandatory for generating high-quality complex modulation) along with α = 3; can improve the performance in producing complex signal area as well as the frequency response, while using other settings does not lead to the development of both. Therefore, we achieve the maximum generated complex signal area and the -3dB frequency by using an adjusted parameter value for the system, which results in a faster modulation speed and higher quality of the optical complex modulation.
A structural dynamics model for how CPEB3 binding to SUMO2 can regulate translational control in dendritic spines
Authors: Gu Xinyu , Schafer Nicholas P. , Bueno Carlos , Lu Wei , Wolynes Peter G.
Published: November 2022

A prion-like RNA-binding protein, CPEB3, can regulate local translation in dendritic spines. CPEB3 monomers repress translation, whereas CPEB3 aggregates activate translation of its target mRNAs. However, the CPEB3 aggregates, as long-lasting prions, may raise the problem of unregulated translational activation. Here, we propose a computational model of the complex structure between CPEB3 RNA-binding domain (CPEB3-RBD) and small ubiquitin-like modifier protein 2 (SUMO2). Free energy calculations suggest that the allosteric effect of CPEB3-RBD/SUMO2 interaction can amplify the RNA-binding affinity of CPEB3. Combining with previous experimental observations on the SUMOylation mode of CPEB3, this model suggests an equilibrium shift of mRNA from binding to deSUMOylated CPEB3 aggregates to binding to SUMOylated CPEB3 monomers in basal synapses. This work shows how a burst of local translation in synapses can be silenced following a stimulation pulse, and explores the CPEB3/SUMO2 interplay underlying the structural change of synapses and the formation of long-term memories.
Network topology metrics explaining enrichment of hybrid epithelial/mesenchymal phenotypes in metastasis
Authors: Rashid Mubasher , Hari Kishore , Thampi John , Santhosh Nived Krishnan , Jolly Mohit Kumar
Published: November 2022

Epithelial to Mesenchymal Transition (EMT) and its reverse—Mesenchymal to Epithelial Transition (MET) are hallmarks of metastasis. Cancer cells use this reversible cellular programming to switch among Epithelial (E), Mesenchymal (M), and hybrid Epithelial/Mesenchymal (hybrid E/M) state(s) and seed tumors at distant sites. Hybrid E/M cells are often more aggressive and metastatic than the “pure” E and M cells. Thus, identifying mechanisms to inhibit hybrid E/M cells can be promising in curtailing metastasis. While multiple gene regulatory networks (GRNs) based mathematical models for EMT/MET have been developed recently, identifying topological signatures enriching hybrid E/M phenotypes remains to be done. Here, we investigate the dynamics of 13 different GRNs and report an interesting association between “hybridness” and the number of negative/positive feedback loops across the networks. While networks having more negative feedback loops favor hybrid phenotype(s), networks having more positive feedback loops (PFLs) or many HiLoops–specific combinations of PFLs, support terminal (E and M) phenotypes. We also establish a connection between “hybridness” and network-frustration by showing that hybrid phenotypes likely result from non-reinforcing interactions among network nodes (genes) and therefore tend to be more frustrated (less stable). Our analysis, thus, identifies network topology-based signatures that can give rise to, as well as prevent, the emergence of hybrid E/M phenotype in GRNs underlying EMP. Our results can have implications in terms of targeting specific interactions in GRNs as a potent way to restrict switching to the hybrid E/M phenotype(s) to curtail metastasis.
Mothers’ experiences of using Facebook groups for local breastfeeding support: Results of an online survey exploring midwife moderation
Authors: Morse Holly , Brown Amy
Published: November 2022

It is established that access to ongoing informational, emotional and social support from trained health professionals including midwives assists mothers in meeting their breastfeeding goals. Social media is increasingly being used to offer this support. Research has demonstrated that support via platforms such as Facebook can improve maternal knowledge and self-efficacy and ultimately breastfeeding duration. One specific form of support that is under researched is the use of Breastfeeding Support Facebook (BSF) groups that are aimed at supporting women in specific local areas, often with links to face to face support. Initial research highlights that mothers’ value these groups but the role that midwives play in offering support to local mothers through these groups has not been examined. The aim of this study was therefore to examine mothers’ perceptions of midwifery support for breastfeeding delivered through these groups, specifically when midwives played an active role in being a group ‘moderator’ or leader. An online survey was completed by 2028 mothers who were part of local BSF groups comparing the experiences of those participating in groups moderated by midwives versus other moderators such as peer supporters. Moderation was an important factor in mothers’ experiences, with trained support associated with greater engagement and more frequent visits, impacting on perceptions of group ethos, reliability and inclusivity. Midwife moderation was uncommon (5% of groups) but valued: midwife moderators offered a high level of support to mothers in their groups, with 87.5% having received midwife support often or sometimes and 97.8% rating this useful or very useful. Access to a midwife moderated group was also associated with viewing local face to face midwifery support for breastfeeding more positively. This is a significant finding, highlighting that online support complements face-to-face support in local settings (67% of groups were linked to a physical group), and improves continuity of care (14% of mothers who had midwife moderators received care from them). As such midwife moderated or supported groups have the potential to add value to local face to face services and improve breastfeeding experiences in communities. The findings have important implications to support the development of integrated online interventions to improve public health.
Cannabinoids activate the insulin pathway to modulate mobilization of cholesterol in C. elegans
Authors: Hernandez-Cravero Bruno , Gallino Sofia , Florman Jeremy , Vranych Cecilia , Diaz Philippe , Elgoyhen Ana Belén , Alkema Mark J. , de Mendoza Diego
Published: November 2022

The nematode Caenorhabditis elegans requires exogenous cholesterol to survive and its depletion leads to early developmental arrest. Thus, tight regulation of cholesterol storage and distribution within the organism is critical. Previously, we demonstrated that the endocannabinoid (eCB) 2-arachidonoylglycerol (2-AG) plays a key role in C. elegans since it modulates sterol mobilization. However, the mechanism remains unknown. Here we show that mutations in the ocr-2 and osm-9 genes, coding for transient receptors potential V (TRPV) ion channels, dramatically reduce the effect of 2-AG in cholesterol mobilization. Through genetic analysis in combination with the rescue of larval arrest induced by sterol starvation, we found that the insulin/IGF-1signaling (IIS) pathway and UNC-31/CAPS, a calcium-activated regulator of neural dense-core vesicles release, are essential for 2-AG-mediated stimulation of cholesterol mobilization. These findings indicate that 2-AG-dependent cholesterol trafficking requires the release of insulin peptides and signaling through the DAF-2 insulin receptor. These results suggest that 2-AG acts as an endogenous modulator of TRPV signal transduction to control intracellular sterol trafficking through modulation of the IGF-1 signaling pathway
wnt16 regulates spine and muscle morphogenesis through parallel signals from notochord and dermomyotome
Authors: Watson Claire J. , Tang W. Joyce , Rojas Maria F. , Fiedler Imke A. K. , Morfin Montes de Oca Ernesto , Cronrath Andrea R. , Callies Lulu K. , Swearer Avery Angell , Ahmed Ali R. , Sethuraman Visali , Addish Sumaya , Farr Gist H. , Gómez Arianna Ericka , Rai Jyoti , Monstad-Rios Adrian T. , Gardiner Edith M. , Karasik David , Maves Lisa , Busse Bjorn , Hsu Yi-Hsiang , Kwon Ronald Young
Published: November 2022

Bone and muscle are coupled through developmental, mechanical, paracrine, and autocrine signals. Genetic variants at theCPED1-WNT16locus are dually associated with bone- and muscle-related traits. WhileWnt16is necessary for bone mass and strength, this fails to explain pleiotropy at this locus. Here, we showwnt16is required for spine and muscle morphogenesis in zebrafish. In embryos,wnt16is expressed in dermomyotome and developing notochord, and contributes to larval myotome morphology and notochord elongation. Later,wnt16is expressed at the ventral midline of the notochord sheath, and contributes to spine mineralization and osteoblast recruitment. Morphological changes inwnt16mutant larvae are mirrored in adults, indicating thatwnt16impacts bone and muscle morphology throughout the lifespan. Finally, we show thatwnt16is a gene of major effect on lean mass at theCPED1-WNT16locus. Our findings indicate that Wnt16 is secreted in structures adjacent to developing bone (notochord) and muscle (dermomyotome) where it affects the morphogenesis of each tissue, thereby renderingwnt16expression into dual effects on bone and muscle morphology. This work expands our understanding ofwnt16in musculoskeletal development and supports the potential for variants to act throughWNT16to influence bone and muscle via parallel morphogenetic processes.
mHealth intervention to improve quality of life in patients with chronic diseases during the COVID-19 crisis in Paraguay: A study protocol for a randomized controlled trial
Authors: Escrivá-Martínez Tamara , Vara Mª Dolores , Czeraniuk Nadia , Denis Matías , Núñez-Benjumea Francisco J. , Fernández-Luque Luis , Jiménez-Díaz Alba , Traver Vicente , Llull Juan José , Martínez-Millana Antonio , Garcés-Ferrer Jorge , Miragall Marta , Herrero Rocío , Enríquez Analía , Schaefer Verena , Cervera-Torres Sergio , Villasanti Cecilia , Cabral Carmen V. , Fernández Irene , Baños Rosa Mª
Published: November 2022

Background

Patients with chronic disease represent an at-risk group in the face of the COVID-19 crisis as they need to regularly monitor their lifestyle and emotional management. Coping with the illness becomes a challenge due to supply problems and lack of access to health care facilities. It is expected these limitations, along with lockdown and social distancing measures, have affected the routine disease management of these patients, being more pronounced in low- and middle-income countries with a flawed health care system.

Objectives

The purpose of this study is to describe a protocol for a randomized controlled trial to test the efficacy of the Adhera® MejoraCare Digital Program, an mHealth intervention aimed at improving the quality of life of patients with chronic diseases during the COVID-19 outbreak in Paraguay.

Method

A two-arm randomized controlled trial will be carried out, with repeated measures (baseline, 1-month, 3-month, 6-month, and 12-month) under two conditions: Adhera® MejoraCare Digital Program or waiting list. The primary outcome is a change in the quality of life on the EuroQol 5-Dimensions 3-Levels Questionnaire (EQ-5D-3L). Other secondary outcomes, as the effect on anxiety and health empowerment, will be considered. All participants must be 18 years of age or older and meet the criteria for chronic disease. A total of 96 participants will be recruited (48 per arm).

Conclusions

It is expected that the Adhera® MejoraCare Digital Program will show significant improvements in quality of life and emotional distress compared to the waiting list condition. Additionally, it is hypothesized that this intervention will be positively evaluated by the participants in terms of usability and satisfaction. The findings will provide new insights into the viability and efficacy of mHealth solutions for chronic disease management in developing countries and in times of pandemic.

Trial registration

ClinicalTrials.gov NCT04659746.
Discussing spiritual health in primary care and the HOPE tool—A mixed methods survey of GP views
Authors: Whitehead Ishbel Orla , Jagger Carol , Hanratty Barbara
Published: November 2022

Background

In the UK, the General Medical Council (GMC) and Royal College of General Practitioners (RCGP) require doctors to consider spiritual health in their consultations. There are documented barriers to discussion of spiritual health, and suggested tools to help overcome them.

Aim

To investigate how comfortable general practitioners (GPs) feel about discussing spiritual health in the consultation, and whether a structured tool (the HOPE tool) would be helpful.

Design and setting

A mixed-methods online survey completed by GPs in England.

Method

A mixed methods online survey of practicing GPs in England asked about current comfort with the topic of spiritual health and use of spiritual history-taking tools. The acceptability of the HOPE tool was investigated using patient vignettes drawn from clinical practice.

Results

177 GPs responded. 88 (49.71%) reported that they were comfortable asking patients about spiritual health. GPs felt most comfortable raising the topic after a patient cue (mean difference between pre and post cue 26%). The HOPE tool was viewed as acceptable to use with patients by 65% of participants, although its limitations were acknowledged. Qualitative data showed concerns about regulator (the GMC) and peer disapproval were major barriers to discussions, especially in the case of discordance between patient and doctor background.

Conclusion

Only half of GPs are comfortable discussing spiritual health. Dedicated training, using a structured approach, with regulatory approval, may help overcome barriers to GPs discussing spiritual health. Further research into the benefits, and risks, of discussion of spiritual health in the GP consultation is recommended.
Proteome expression profiling of red blood cells during the tumorigenesis of hepatocellular carcinoma
Authors: Wang Shufang , Wang Guibin , Lu Shichun , Zhang Jiaying , Zhang Wenwen , Han Yuanyuan , Cai Xiaoyu , Zhuang Yuan , Pu Fei , Yan Xin , Tu Zhiwei , Wang Liang , Huang Xirui , Fan Bin , Wang Deqing , Zhang Zhaojun
Published: November 2022

The early diagnosis of hepatocellular carcinoma (HCC) has not been clinically elucidated, leading to an increased mortality rate in patients with HCC. HCC is a systemic disease related to disorders of blood homeostasis, and the association between red blood cells (RBCs) and HCC tumorigenesis remains elusive. We performed data-independent acquisition proteomic analyses of 72 clinical RBC samples, including HCC (n = 30), liver cirrhosis (LC, n = 17), and healthy controls (n = 25), and characterized the clinical relevance of RBCs and tumorigenesis in HCC. We observed dynamic changes in RBCs during HCC tumorigenesis, and our findings indicate that, based on the protein expression profiles of RBCs, LC is a developmental stage closely approaching HCC. The expression of hemoglobin (HbA and HbF) in peripheral blood dynamically changed during HCC tumorigenesis, suggesting that immature erythroid cells exist in peripheral blood of HCC patients and that erythropoiesis is influenced by the onset of LC. We also identified the disrupted autophagy pathway in RBCs at the onset of LC, which persisted during HCC tumorigenesis. The oxytocin and GnRH pathways were disrupted and first identified during the development of LC into HCC. Significantly differentially expressed SMIM1, ANXA7, HBA1, and HBE1 during tumorigenesis were verified as promising biomarkers for the early diagnosis of HCC using parallel reaction monitoring technology. This study may enhance the understanding of HCC tumorigenesis from a different point of view and aid the early diagnosis of HCC.
Adherence trajectory as an on-treatment risk indicator among drug-resistant TB patients in the Philippines
Authors: Huddart Sophie , Geocaniga-Gaviola Donna Mae , Crowder Rebecca , Lim Alexander Rupert , Lopez Evanisa , Valdez Chelsea Lyn , Berger Christopher A. , Destura Raul , Kato-Maeda Midori , Cattamanchi Adithya , Garfin Anna Marie Celina
Published: November 2022

Introduction

High levels of treatment adherence are critical for achieving optimal treatment outcomes among patients with tuberculosis (TB), especially for drug-resistant TB (DR TB). Current tools for identifying high-risk non-adherence are insufficient. Here, we apply trajectory analysis to characterize adherence behavior early in DR TB treatment and assess whether these patterns predict treatment outcomes.

Methods

We conducted a retrospective analysis of Philippines DR TB patients treated between 2013 and 2016. To identify unique patterns of adherence, we performed group-based trajectory modelling on adherence to the first 12 weeks of treatment. We estimated the association of adherence trajectory group with six-month and final treatment outcomes using univariable and multivariable logistic regression. We also estimated and compared the predictive accuracy of adherence trajectory group and a binary adherence threshold for treatment outcomes.

Results

Of 596 patients, 302 (50.7%) had multidrug resistant TB, 11 (1.8%) extremely drug-resistant (XDR) TB, and 283 (47.5%) pre-XDR TB. We identified three distinct adherence trajectories during the first 12 weeks of treatment: a high adherence group (n = 483), a moderate adherence group (n = 93) and a low adherence group (n = 20). Similar patterns were identified at 4 and 8 weeks. Being in the 12-week moderate or low adherence group was associated with unfavorable six-month (adjusted OR [aOR] 3.42, 95% CI 1.90–6.12) and final (aOR 2.71, 95% 1.73–4.30) treatment outcomes. Adherence trajectory group performed similarly to a binary threshold classification for the prediction of final treatment outcomes (65.9% vs. 65.4% correctly classified), but was more accurate for prediction of six-month treatment outcomes (79.4% vs. 60.0% correctly classified).

Conclusions

Adherence patterns are strongly predictive of DR TB treatment outcomes. Trajectory-based analyses represent an exciting avenue of research into TB patient adherence behavior seeking to inform interventions which rapidly identify and support patients with high-risk adherence patterns.
A multisite randomized controlled trial of an early palliative care intervention in children with advanced cancer: The PediQUEST Response Study Protocol
Authors: Dussel Veronica , Orellana Liliana , Holder Rachel , Porth Rachel , Avery Madeline , Wolfe Joanne
Published: November 2022

Background

The Pediatric Quality of Life and Evaluation of Symptoms Technology Response to Pediatric Oncology Symptom Experience (PQ-Response) intervention aims to integrate specialized pediatric palliative care into the routine care of children, adolescents, and young adults (AYAs) with advanced cancer.

Aims

To evaluate whether PQ-Response, compared to usual care, improves patient’s health related quality of life (HRQoL) and symptom burden (aim 1), parent psychological distress and symptom-related stress (aim 2), and family and symptom treatment activation (aim 3).

Design

Multisite, randomized (1:1), controlled, un-blinded, effectiveness trial comparing PediQUEST Response (intervention) vs usual cancer care (control).

Setting

Five US large, tertiary level pediatric cancer centers.

Participants

Children (≥2 years old)/AYAs who receive care at any of the participating sites because of advanced cancer or any progressive/recurrent solid or brain tumor and are palliative care “naïve.” Target: 200 enrolled patient-parent dyads (minimum goal: 136 dyads randomized, N = 68/arm).

Interventions

PediQUEST Response: combines patient-mediated activation (weekly feedback of patient- and parent-reported symptoms and HRQoL to families and providers using the PediQUEST web system) with integration of the palliative care team. Usual Cancer Care: participants receive usual care, which can include palliative care consultation, and use PediQUEST web to answer surveys, with no feedback.

Methods

Following enrollment, patients (if ≥5 years) and one parent receive weekly PediQUEST-Surveys assessing HRQoL (Pediatric Quality of Life Inventory 4.0) and symptom burden (PediQUEST-Memorial Symptom Assessment Scale). After a 2-week run-in period, dyads who answer ≥2 PediQUEST surveys per participant (responders), are randomized (concealed allocation) and followed up for 16-weeks. Parents answer six additional surveys (parent outcomes).

Outcomes

Primary: mean patient HRQoL score over 16-weeks as reported by a) the parent; and b) the patient if ≥5 years-old. Secondary: patient’s symptom burden; parent’s anxiety, depressive symptoms, symptom-related stress; family activation; and symptom treatment activation.

Trial registration

ClinicalTrials.gov (NCT03408314) 1/24/18. https://clinicaltrials.gov/ct2/show/NCT03408314.
Clinical course and risk factors for sleep disturbance in patients with ischemic stroke
Authors: Tsai Hui-Ju , Wong Yi-Sin , Ong Cheung-Ter
Published: November 2022

Background

Studies on insomnia in patients with ischemic stroke, particularly in the acute phase, are limited. The proportion of patients with sleep disturbance during the acute stroke period who are likely to develop insomnia in subacute and chronic stages of stroke is unknown. This study aimed to investigate the risk factors for sleep disturbance and the clinical course of the disease in patients with acute ischemic stroke.

Methods

This prospective observational study included patients diagnosed with ischemic stroke between July 1, 2020, and October 31, 2021. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) for insomnia and the eight-item Athens Insomnia Scale (CAIS-8) were used to diagnose insomnia. Beck Depression Inventory (BDI) was applied to evaluate the mood of patients. Patient reported their sleeping conditions, before stroke onset and during the acute (within 7 days) and chronic (3 months after presentation) stroke periods.

Results

In total, 195 patients with ischemic stroke were included in this study. Of these, 34.3% (67), 37.4% (73), and 29.7% (58) presented with sleep disturbance before stroke onset and during the acute and chronic stroke periods, respectively. Of the 128 patients without insomnia before stroke onset, 15.6% (20/128) presented with insomnia symptoms 3 months after stroke onset. Moreover, 13 (12.7%) of the 102 patients without sleep disturbance during the acute stroke period developed insomnia 3 months after stroke onset. Of the 67 patients with insomnia before stroke onset 29 (43.3%) did not develop the condition 3 months after stroke onset. A higher risk of sleep disturbance was associated with atrial fibrillation, hypertension, and mood disturbance in the acute stroke period, and a higher risk of insomnia was associated with low education and mood disturbance in the chronic stroke period.

Conclusion

The prevalence rates of sleep disturbance before and during the acute and chronic stroke periods were 34.3%, 37.4%, and 29.7%, respectively. The incidence of stroke-related insomnia was 15.6%. Patients with insomnia before stroke may recover after the stroke. Atrial fibrillation, hypertension, and mood disturbance were associated with a higher risk of sleep disturbance in the acute stroke period, whereas low education and mood disturbance were associated with insomnia in the chronic stroke period.