bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing six multi-month dispensing of antiretroviral therapy in Ethiopia: perspectives of clients and healthcare workers
Authors: Mantell Joanne E. , Zech Jennifer M. , Masvawure Tsitsi B. , Assefa Tamrat , Molla Mitike , Block Laura , Duguma Dereje , Yirsaw Zenebe , Rabkin Miriam
Published: May 2023

Background

Multi-month dispensing (MMD) of antiretroviral therapy (ART) is an integral component of differentiated HIV service delivery for people living with HIV (PLHIV). Although many countries have scaled up ART dispensing to 3-month intervals, Ethiopia was the first African country to implement six-month dispensing (6-MMD) at scale, introducing its Appointment Spacing Model (ASM) for people doing well on ART in 2017. As of June 2021, 51.4% (n = 215,101) of PLHIV on ART aged ≥ 15 years had enrolled in ASM. Since little is known about the benefits and challenges of ASM perceived by Ethiopian clients and their healthcare workers (HCWs), we explored how the ASM was being implemented in Ethiopia’s Oromia region in September 2019.

Methods

Using a parallel convergent mixed-methods study design, we conducted 6 focus groups with ASM-eligible enrolled clients, 6 with ASM-eligible non-enrolled clients, and 22 in-depth interviews with HCWs. Data were audio-recorded, transcribed and translated into English. We used thematic analysis, initially coding deductively, followed by inductive coding of themes that emerged from the data, and compared the perspectives of ASM-enrolled and non-enrolled clients and their HCWs.

Results

Participants enrolled in ASM and HCWs perceived client-level ASM benefits to include time and cost-savings, fewer work disruptions, reduced stigma due to fewer clinic visits, better medication adherence and improved overall health. Perceived health system-level benefits included improved quality of care, decongested facilities, reduced provider workloads, and improved record-keeping. Although non-enrolled participants anticipated many of the same benefits, their reasons for non-enrollment included medication storage challenges, concerns over less frequent health monitoring, and increased stress due to the large quantities of medicines dispensed. Enrolled participants and HCWs identified similar challenges, including client misunderstandings about ASM and initial ART stock-outs.

Conclusions

ASM with 6-MMD was perceived to have marked benefits for clients and health systems. Clients enrolled in the ASM and their HCWs had positive experiences with the model, including perceived improvements in efficiency, quality and convenience of HIV treatment services. The concerns of non-ASM enrolled participants suggest the need for enhanced client education about the model and more discreet and efficiently packaged ART and highlight that ASM is not ideal for all clients.
The impact of diabetes on the relationship of coronary artery disease and outcome: a study using multimodality imaging
Authors: Mäenpää Matias , Kujala Iida , Harjulahti Esa , Stenström Iida , Nammas Wail , Knuuti Juhani , Saraste Antti , Maaniitty Teemu
Published: May 2023

Background

Patients with prediabetes or diabetes are at increased risk of developing cardiovascular disease and adverse outcomes. First-line coronary computed tomography angiography (CTA) followed by selective use of positron emission tomography (PET) myocardial perfusion imaging is a feasible strategy to diagnose and risk-stratify patients with suspected coronary artery disease (CAD). The aim of the present study was to study whether diabetes changes the relationship of CAD and long-term outcome.

Methods

We retrospectively identified consecutive symptomatic patients who underwent coronary CTA for suspected CAD. In patients with suspected obstructive CAD on CTA, myocardial ischemia was evaluated by 15O-water PET myocardial perfusion imaging. The relationship of the phenotype of CAD and long-term outcome in patients with no diabetes, prediabetes, or type 2 diabetes was investigated. A composite endpoint included all-cause mortality, myocardial infarction (MI), and unstable angina pectoris (UAP).

Results

A total of 1743 patients were included: 1214 (70%) non-diabetic, 259 (15%) prediabetic, and 270 (16%) type 2 diabetic patients. During 6.43 years of median follow-up, 164 adverse events occurred (106 deaths, 41 MIs, 17 UAPs). The prevalence of normal coronary arteries on CTA was highest in the non-diabetic patients (39%). The prevalence of hemodynamically significant CAD (abnormal perfusion) increased from 14% in non-diabetic patients to 20% in prediabetic and 27% in diabetic patients. The event rate was lowest in patients with normal coronary arteries and highest in patients with concomitant type 2 diabetes and hemodynamically significant CAD (annual event rate 0.2% vs. 4.7%). However, neither prediabetes nor diabetes were independent predictors of the composite adverse outcome after adjustment for the clinical risk factors and imaging findings.

Conclusions

Coronary CTA followed by selective downstream use of PET myocardial perfusion imaging predicts long-term outcome similarly in non-diabetic and diabetic patients.
Exploring views of members of the public and policymakers on the acceptability of population level dietary and active-travel policies: a qualitative study
Authors: Toumpakari Z , Valerino-Perea S. , Willis K. , Adams J. , White M. , Vasiljevic M. , Ternent L. , Brown J. , Kelly M. P. , Bonell C. , Cummins S. , Majeed A , Anderson S. , Robinson T. , Araujo-Soares V. , Watson J. , Soulsby I. , Green D. , Sniehotta F. F. , Jago R.
Published: May 2023

Background

There is limited evidence on what shapes the acceptability of population level dietary and active-travel policies in England. This information would be useful in the decision-making process about which policies should be implemented and how to increase their effectiveness and sustainability. To fill this gap, we explored public and policymakers’ views about factors that influence public acceptability of dietary and active-travel policies and how to increase public acceptability for these policies.

Methods

We conducted online, semi-structured interviews with 20 members of the public and 20 policymakers in England. A purposive sampling frame was used to recruit members of the public via a recruitment agency, based on age, sex, socioeconomic status and ethnicity. Policymakers were recruited from existing contacts within our research collaborations and via snowball sampling. We explored different dietary and active-travel policies that varied in their scope and focus. Interviews were transcribed verbatim and analysed using thematic reflexive analysis with both inductive and deductive coding.

Results

We identified four themes that informed public acceptability of dietary and active-travel policies: (1) perceived policy effectiveness, i.e., policies that included believable mechanisms of action, addressed valued co-benefits and barriers to engage in the behaviour; (2) perceived policy fairness, i.e., policies that provided everyone with an opportunity to benefit (mentioned only by the public), equally considered the needs of various population subgroups and rewarded ‘healthy’ behaviours rather than only penalising ‘unhealthy’ behaviours; (3) communication of policies, i.e., policies that were visible and had consistent and positive messages from the media (mentioned only by policymakers) and (4) how to improve policy support, with the main suggestion being an integrated strategy addressing multiple aspects of these behaviours, inclusive policies that consider everyone’s needs and use of appropriate channels and messages in policy communication.

Conclusions

Our findings highlight that members’ of the public and policymakers’ support for dietary and active-travel policies can be shaped by the perceived effectiveness, fairness and communication of policies and provide suggestions on how to improve policy support. This information can inform the design of acceptable policies but can also be used to help communicate existing and future policies to maximise their adoption and sustainability.
Metastasis from follicular lymphoma to an ovarian mature teratoma: a case report of tumor-to-tumor metastasis
Authors: Sato Yusuke , Yano Mitsutake , Eto Satoshi , Takano Kuniko , Nasu Kaei
Published: May 2023

Background

Tumor-to-tumor metastasis (TTM) is a rare but well-established phenomenon where histologically distinct tumors metastasize within each other. Here we report the first “known” case of follicular lymphoma that metastasized and extended to a mature ovarian teratoma.

Case
presentation

A
59-year-old Japanese postmenopausal woman visited our hospital for a detailed
examination of an ovarian tumor. Clinical imaging suggested it to be either
teratoma-associated ovarian cancer with multiple lymph node metastases, or
tumor-to-tumor metastasis from malignant lymphoma to ovarian teratoma. A
bilateral adnexectomy and retroperitoneal lymph node biopsy were performed.
Lined with squamous epithelium, the cyst constituted a mature ovarian teratoma,
and the solid part showed diffuse proliferation of abnormal lymphoid cells.
Immunohistochemically, the abnormal
lymphoid cells were negative for CD5, MUM1, and CyclinD1, and positive
for CD10, CD20, CD21, BCL2, and BCL6. Genetic analysis using G-banding and
fluorescence in situ hybridization identified a translocation of t(14;18)
(q32;q21), and we diagnosed tumor-to-tumor metastasis from nodal follicular lymphoma
to mature ovarian teratoma. Twelve months after surgery, the patient showed no
progression without adjuvant therapy.

Conclusions

The present case suggests that
molecular approaches are useful in the diagnosis of TTM in mature ovarian
teratomas when morphologic and immunohistochemical findings alone are insufficient
for diagnoses.
Impact of macrolide treatment on long-term mortality in patients admitted to the ICU due to CAP: a targeted maximum likelihood estimation and survival analysis
Authors: Reyes Luis Felipe , Garcia Esteban , Ibáñez-Prada Elsa D. , Serrano-Mayorga Cristian C. , Fuentes Yuli V. , Rodríguez Alejandro , Moreno Gerard , Bastidas Alirio , Gómez Josep , Gonzalez Angélica , Frei Christopher R. , Celi Leo Anthony , Martin-Loeches Ignacio , Waterer Grant
Published: May 2023

Introduction

Patients with community-acquired pneumonia (CAP) admitted to the intensive care unit (ICU) have high mortality rates during the acute infection and up to ten years thereafter. Recommendations from international CAP guidelines include macrolide-based treatment. However, there is no data on the long-term outcomes of this recommendation. Therefore, we aimed to determine the impact of macrolide-based therapy on long-term mortality in this population.

Methods

Registered patients in the MIMIC-IV database 16 years or older and admitted to the ICU due to CAP were included. Multivariate analysis, targeted maximum likelihood estimation (TMLE) to simulate a randomised controlled trial, and survival analyses were conducted to test the effect of macrolide-based treatment on mortality six-month (6 m) and twelve-month (12 m) after hospital admission. A sensitivity analysis was performed excluding patients with Pseudomonas aeruginosa or MRSA pneumonia to control for Healthcare-Associated Pneumonia (HCAP).

Results

3775 patients were included, and 1154 were treated with a macrolide-based treatment. The non-macrolide-based group had worse long-term clinical outcomes, represented by 6 m [31.5 (363/1154) vs 39.5 (1035/2621), p < 0.001] and 12 m mortality [39.0 (450/1154) vs 45.7 (1198/2621), p < 0.001]. The main risk factors associated with long-term mortality were Charlson comorbidity index, SAPS II, septic shock, and respiratory failure. Macrolide-based treatment reduced the risk of dying at 6 m [HR (95% CI) 0.69 (0.60, 0.78), p < 0.001] and 12 m [0.72 (0.64, 0.81), p < 0.001]. After TMLE, the protective effect continued with an additive effect estimate of − 0.069.

Conclusion

Macrolide-based treatment reduced the hazard risk of long-term mortality by almost one-third. This effect remains after simulating an RCT with TMLE and the sensitivity analysis for the HCAP classification.
STING mediates experimental osteoarthritis and mechanical allodynia in mouse
Authors: Shin Youngnim , Cho Deborah , Kim Seul Ki , Chun Jang-Soo
Published: May 2023

Background

This study was performed to develop therapeutic targets of osteoarthritis (OA) that can be targeted to alleviate OA development (i.e., cartilage destruction) and relieve the OA-associated joint pain.

Methods

The candidate molecule, STING (stimulator of interferon genes, encoded by Sting1), was identified by microarray analysis of OA-like mouse chondrocytes. Experimental OA in mice was induced by destabilization of the medial meniscus (DMM). STING functions in OA and hindpaw mechanical allodynia were evaluated by gain-of-function (intra-articular injection of a STING agonist) and loss-of-function (Sting1−/− mice) approaches.

Results

DNA damage was observed in OA-like chondrocytes. Cytosolic DNA sensors, STING and its upstream molecule, cGAS (cyclic GMP-AMP synthase), were upregulated in OA chondrocytes and cartilage of mouse and human. Genetic ablation of STING in mice (Sting1−/−) alleviated OA manifestations (cartilage destruction and subchondral bone sclerosis) and hindpaw mechanical allodynia. In contrast, stimulation of STING signaling in joint tissues by intra-articular injection of cGAMP exacerbated OA manifestations and mechanical sensitization. Mechanistic studies on the regulation of hindpaw mechanical allodynia revealed that STING regulates the expression of peripheral sensitization molecules in the synovium and meniscus of mouse knee joints.

Conclusion

Our results indicated that STING, which senses damaged cytosolic DNA and accordingly activates the innate immune response, regulates OA pathogenesis and hindpaw mechanical allodynia. Therefore, inhibition of STING could be a therapeutic approach to inhibit OA cartilage destruction and relieve the associated mechanical sensitization in model mice.
A relation-theoretic set-valued version of Prešić-Ćirić theorem and applications
Authors: Shukla Satish , Rai Shweta , Shukla Rahul
Published: May 2023

In this paper, we establish a relation-theoretic set-valued version of the fixed point result of Ćirić and Prešić (Acta Math. Univ. Comen. LXXVI(2):143–147, 2007) on metric spaces endowed with an arbitrary binary relation. The results of this paper, generalize and unify the fixed point results of Ćirić and Prešić (Acta Math. Univ. Comen. LXXVI(2):143–147, 2007), Shukla and López (Quaest. Math. 45(3):1–16, 2019), and Shukla and Radenović (An. Ştiinţ. Univ. ‘Al.I. Cuza’ Iaşi, Mat. 63(2):339–350, 2017) in product spaces. Some examples are provided that justify and establish the importance of our results. As applications of our main result, we have established the existence of solutions to differential inclusion problems and the weak asymptotical stability and a global attractivity of the equilibrium point of a difference inclusion problem. The use of arbitrary binary relations in our results permits us to apply the results to the differential inclusion problems and difference inclusion problems with weaker assumptions than those used in the papers mentioned above.
Jointly improving energy efficiency and smoothing power oscillations of integrated offshore wind and photovoltaic power: a deep reinforcement learning approach
Authors: Yin Xiuxing , Lei Meizhen
Published: May 2023

This paper proposes a novel deep reinforcement learning (DRL) control strategy for an integrated offshore wind and photovoltaic (PV) power system for improving power generation efficiency while simultaneously damping oscillations. A variable-speed offshore wind turbine (OWT) with electrical torque control is used in the integrated offshore power system whose dynamic models are detailed. By considering the control system as a partially-observable Markov decision process, an actor-critic architecture model-free DRL algorithm, namely, deep deterministic policy gradient, is adopted and implemented to explore and learn the optimal multi-objective control policy. The potential and effectiveness of the integrated power system are evaluated. The results imply that an OWT can respond quickly to sudden changes of the inflow wind conditions to maximize total power generation. Significant oscillations in the overall power output can also be well suppressed by regulating the generator torque, which further indicates that complementary operation of offshore wind and PV power can be achieved.
Gait analysis of patients with Parkinson-plus syndromes: a research article
Authors: Tandon Ruchika , Yadav Ganesh , Singh Balendra Pratap , Gupta Anil Kumar
Published: May 2023

Background

Aim of the observational study was to assess which of the gait and balance parameters are most affected in Parkinson-plus syndromes patients with falling tendencies as compared to healthy individuals.

Methods

Authors studied levodopa-responsive patients of multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) who had falling tendencies early in the disease and healthy controls and evaluated the spatiotemporal gait parameters using BTS G WALK and balance parameters by Limits of Stability test on BIODEX Balance system SD in the Gait and Motion Analysis Lab.

Results

In comparison to controls, Parkinson-plus syndromes patients had significantly different gait and balance parameters, apart from stride time and stance time, pelvic obliquity and pelvic tilt, cadence, hip abduction–adduction and hip rotation, foot progression, gait profile score, gait variable hip abduction–adduction, rotation, gait variable flexion–extension and gait deviation index (p-values < 0.05). Also, in comparison to MSA patients, PSP patients had significantly greater values of all static parameters except for swing time, step width, pelvic tilt and rotation, hip rotation and ankle dorsiflexion-plantarflexion, gait profile score of right limbs and all gait variable parameters except for pelvic tilt and hip flexion–extension, foot progression and gait deviation index of right limb. However, balance parameters were similar in MSA and PSP. Duration of disease and duration since falls may not significantly affect gait and balance parameters in Parkinson-plus syndromes patients.

Conclusions

Hence, gait differentiates between Parkinson-plus patients and healthy controls and between MSA and PSP patients with falling tendencies and gait and balance parameters may also help in planning rehabilitative strategies.
Therapy Sequencing in Patients With Advanced Neuroendocrine Neoplasms
Authors: Riechelmann Rachel P. , Taboada Rodrigo G. , de Jesus Victor Hugo F. , Iglesia Michael , Trikalinos Nikolaos A.
Published: May 2023

Neuroendocrine neoplasms (NENs) comprise a beautifully complicated, exciting landscape of histologies and clinical behaviors. However, the nuanced complexity of low- and high-grade variants can easily overwhelm both patients and providers. In this chapter, we review the ever-expanding literature on both functioning and nonfunctioning small bowel and pancreatic NENs, touching on somatostatin analogs, hepatic-directed therapies, small molecules, radiopharmaceuticals, immunotherapy, cytotoxic chemotherapy, and new promising agents. Furthermore, we suggest some strategies to address the most challenging scenarios seen in clinical practice, including sequencing of agents, treatment of carcinoid syndrome, and options for well-differentiated high-grade disease.
Core Books and Post-Pandemic Pedagogy
Authors: Garcia Ruth G. , Rosen Jody R.
Published: May 2023

Responses to the COVID-19 pandemic have increased feelings of isolation and lack of support among faculty. Grounded in collaborative curriculum and professional development, the Core Books at CUNY project offers faculty the opportunity to work together to incorporate texts from Columbia University's core curriculum into first-year writing (FYW) courses. The project invites faculty to collaboratively develop, implement, and reflect on the shared curriculum. As an Open Educational Resource (OER), the resulting curriculum was well positioned to become part of CUNY's Model Course Initiative that makes consistent curriculum easily shareable on the college's OpenLab, an open platform for teaching, learning, and collaboration. This curriculum provides the agility necessary for post-pandemic teaching as it builds a sustained community among participating contingent and full-time faculty and across community-building initiatives. It provides support on multiple levels, is flexible and adaptable for new situations—pandemic or otherwise—and ameliorates the isolation of teaching. Community through shared curriculum is therefore a way forward and a model for English departments in the post-pandemic future.
“An Excellent Adventure . . . ”
Authors: Glasgow Sara M.
Published: May 2023

Where do our most cherished teaching principles derive? How do we deploy them in ways that motivate students and nurture their critical engagement with the wider world? Drawing on insights gleaned from the film Bill and Ted's Excellent Adventure, this reflection explores how the development of two key strategies—engaging students through blended academic and pop-culture approaches and guiding their recognition and critical response to discursive power structures—transformed the author's pedagogical approach into one that is more student-centric and practically focused. Developed in the context of political science courses, but applicable especially to English and its instruction, these strategies decenter the instructor to promote more authentic engagement between students and the content they encounter, as well as with each other and the instructor. The strategies themselves, however, derive from a recognition that even the most light-hearted fare (such as Bill and Ted) may offer thoughtful insight into the craft of teaching: first, by recognizing that joy, passion, and creativity matter when structuring engaging learning experiences; and second, by clarifying how our attunement and response to subtle exercises of power—in the case of the film, pedagogical norms around acceptable academic projects—are instrumental in navigating a complex world.
Πολιτιστική αξία ως οικονομική αξία
Authors: Κουμουτσέα Αικατερίνη
Published: May 2023

Η παρούσα διδακτορική διατριβή εστιάζει στο ρόλο της πολιτιστικής κληρονομιάς στην ελληνική οικονομία και εξερευνά τις αναπτυξιακές της δυνατότητες ως παράγοντα βιώσιμης ανάπτυξης. Η σύνδεση θεωρητικής και εμπειρικής τεκμηρίωσης καταδεικνύει τη σπουδαιότητα της πολιτιστικής κληρονομιάς στην οικονομική μεγέθυνση της Ελλάδας. Η αποτελεσματικότητα των οικονομικών πολιτικών που εφαρμόζονται σε μια χώρα επηρεάζουν άμεσα την οικονομική της ανάπτυξη και για το λόγο αυτό στην παρούσα διατριβή εξετάζεται η αποτελεσματικότητα των πολιτιστικών πολιτικών που ακολουθούνται σε όλα τα επίπεδα - εθνικό, τοπικό, έργου.Ο καθορισμός της αξίας των πολιτιστικών αγαθών ήταν ένα ζήτημα αμφιλεγόμενο στο παρελθόν, τα τελευταία χρόνια όμως στον κλάδο των οικονομικών της πολιτιστικής κληρονομιάς έχει σημειωθεί τεράστια πρόοδος. Η οικονομική αξία της πολιτιστικής κληρονομιάς έχει μελετηθεί εκτενώς από την επιστημονική κοινότητα, με αντικείμενα ενδιαφέροντος τη διατύπωση εννοιών και την εξεύρεση κατάλληλων τεχνικών αξιολόγησης. Η κατανόηση της έννοιας της αξίας των περιουσιακών στοιχείων της πολιτιστικής κληρονομιάς είναι θεμελιώδης, για το λόγο αυτό η διατριβή αυτή πραγματεύεται την αξία της πολιτιστικής κληρονομιάς στην Ελλάδα.Αρχικά, αποτυπώνεται αναλυτικά η υπάρχουσα τάξη πραγμάτων της πολιτιστικής οικονομίας στην Ελλάδα (Κεφάλαιο 1 και 2) μέσα από τη βιβλιογραφική επισκόπηση των οικονομικών του πολιτισμού, αλλά και διά της εφαρμογής της δομικής ανάλυσης και οικονομικού μεγέθους, όπως περιγράφεται από τη Eurostat. Εν συνεχεία, αναζητώντας τους βαθύτερους παράγοντες που είναι αναγκαίοι για τη δημιουργία μιας βιώσιμης ανάπτυξης στην Ελλάδα μέσω του κλάδου του πολιτισμού, αναλύονται με τη μέθοδο των πολλαπλασιαστών οι διασυνδέσεις της ελληνικής οικονομίας με την πολιτιστική κληρονομιά και αξιολογούνται τρία σενάρια επενδύσεων, με επικρατέστερο την αύξηση των δημοσίων επενδύσεων στον κλάδο του πολιτισμού (Κεφάλαιο 3).Με στόχο μια ολιστική προσέγγιση των επενδύσεων του πολιτισμού, η μέθοδος των πολλαπλασιαστών εφαρμόζεται στη συνέχεια σε περιφερειακό επίπεδο και πιο συγκεκριμένα στην περιφέρεια Πελοποννήσου (Κεφάλαιο 4). Στόχος της μελέτης αυτής είναι η δημιουργία ενός Πολιτιστικού Στρατηγικού Σχεδίου βασισμένου σε ποσοτικές αναλύσεις, σύμφωνα με τις βέλτιστες πρακτικές παγκοσμίως, λαμβάνοντας υπόψη τις τοπικές ιδιαιτερότητες.Η τελευταία εμπειρική έρευνα της διατριβής αφορά στην ανάλυση των επιπτώσεων του Διεθνούς Φεστιβάλ Χορού της Καλαμάτας μέσω της μεθόδου Contigent Valuation (Κεφάλαιο 5). Πρόκειται για ένα πολιτιστικό δρώμενο τοπικού ενδιαφέροντος, που όμως συμβάλλει σημαντικά στην οικονομική ευημερία και κοινωνική συνοχή.Μέσα από τα αποτελέσματα και των τριών μελετών, η παρούσα διατριβή ευελπιστεί να συμβάλει αφενός στην ενίσχυση της συνειδητοποίησης όλων των εμπλεκομένων στην Ελλάδα ότι ο Κλάδος Πολιτισμού και Δημιουργικότητας (ΚΠΔ) μπορεί να οδηγήσει τη χώρα σε μια βιώσιμη ανάπτυξη χωρίς αποκλεισμούς, και αφετέρου στην έναρξη εποικοδομητικού διαλόγου σχετικά με τη δημιουργία ολιστικών Πολιτιστικών Στρατηγικών Σχεδίων βασισμένων σε ποσοτικά δεδομένα.
In vitro μελέτη της αιμοστατικής λειτουργίας των επεξεργασμένων με ριβοφλαβίνη αιμοπεταλίων αφαίρεσης
Authors: Πέτρου Ελένη
Published: May 2023

Μια από τις μεγαλύτερες προκλήσεις που έχει να αντιμετωπίσει η σύγχρονη ιατρική των μεταγγίσεων, είναι ο περιορισμός του κινδύνου μετάδοσης παθογόνων κατά τη διαδικασία της μετάγγισης. Ανάμεσα στα μέτρα που προτείνονται προκειμένου να επιτευχθεί κάτι τέτοιο, κυρίαρχη θέση κατέχουν τα συστήματα αδρανοποίησης (PRT). Η τεχνολογία Mirasol εφαρμόζεται στην αδρανοποίηση πλάσματος και αιμοπεταλίων όπου η ριβοφλαβίνη σε συνδυασμό με υπεριώδη ακτινοβολία αναστέλλει τον πολλαπλασιασμό των παθογόνων και των λευκών αιμοσφαιρίων. Η διαδικασία της αδρανοποίησης πιθανόν επιταχύνει ή δημιουργεί αλλοιώσεις που ενδεχομένως ευθύνονται για τη μειωμένη βιωσιμότητα των αιμοπεταλίων. Τα επεξεργασμένα αιμοπετάλια παρουσιάζουν ενδείξεις αυξημένης κυτταρικής δραστηριότητας, αύξηση του μεταβολισμού τους και μεταβολές της αιμοστατικής τους ικανότητας. Σκοπός της μελέτης ήταν η διερεύνηση της επίδρασης της αδρανοποίησης στην αιμοστατική ικανότητα των αιμοπεταλίων. Δέκα ασκοί αιμοπεταλίων αφαίρεσης χωρίστηκαν σε ισομεγέθη μερίσματα προκύπτοντας συνολικά είκοσι ασκοί. Από αυτούς οι μισοί αδρανοποιήθηκαν με το σύστημα Mirasol και οι άλλοι μισοί παράμειναν χωρίς επεξεργασία ως μάρτυρες. Τα αιμοπετάλια, αδρανοποιημένα και μη, αξιολογήθηκαν in vitro τις ημέρες 1, 3 και 5 μετά τη συλλογή για μεταβολικές και αιμοστατικές παραμέτρους, λειτουργικότητα και προπηκτική δραστηριότητα. Διαπιστώθηκε ότι η αδρανοποίηση επέδρασε δυσμενώς στο μεταβολικό και αιμοστατικό προφίλ των αιμοπεταλίων με χρονοεξαρτώμενο τρόπο. Τα αδρανοποιημένα αιμοπετάλια εμφάνισαν αυξημένη ενεργοποίηση και αυξημένη προπηκτική δραστηριότητα ιδιαίτερα στο τέλος της αποθηκευτικής ζωής. Η αδρανοποίηση επομένως οδήγησε σε εξάντληση της αιμοστατικής διαδικασίας ειδικά στο τέλος του αποθηκευτικού χρόνου. Είναι απαραίτητη η διενέργεια καλά σχεδιασμένων κλινικών μελετών προκειμένου να διαπιστωθεί αν αυτή η in vitro μειωμένη λειτουργικότητα αντανακλάται και in vivo.
Assessment of forest parameters using modern remote sensing approaches
Authors: Παναγιωτίδης Δημήτριος
Published: May 2023

Τα τελευταία χρόνια, οι ταχείς ρυθμοί τεχνολογικής ανάπτυξης στους ηλεκτρονικούς υπολογιστές έχουνε δώσει τη δυνατότητα για πρακτικές και σύγχρονες προσεγγίσεις τηλεπισκόπησης στην απόκτηση δεδομένων, όπως εμπορικές κάμερες, σαρωτές λέιζερ κ.λ.π. παίζοντας καθοριστικό ρόλο σε πολλές δασικές εφαρμογές. Η συγκεκριμένη διατριβή ολοκληρώθηκε μέσα απο μια συλλογή τεσσάρων επιστημονικών εργασιών. Πιο συγκεκριμένα, τα άρθρα I, II, III, διερεύνησαν τη δυνατότητα ακριβούς ανακατασκευής τρισδιάστατων δασικών μοντέλων που χρησιμοποιούν δομή από αλγόριθμους κίνησης (structure from motion), βασισμένα σε σύγχρονες προσεγγίσεις τηλεπισκόπησης (εξοπλισμένα με οπτικές κάμερες και άλλους επίγειους αισθητήρες) για έμμεσες εκτιμήσεις δασικών παραμέτρων σε ατομικό επίπεδο. Επιπλέον, το άρθρο IV παρουσιάζει μια νέα μέθοδος αξιολόγησης για την κατανομή των κυρίαρχων δασοπονικών ειδών ή τύπου δάσους, χρησιμοποιώντας αλγόριθμους όπως data mining, εξαρτώμενες από ενσωμάτωση τηλεπισκόπησης (φασματική) με βοηθητικά (περιβαλλοντικά) δεδομένα. Τα αποτελέσματα έδειξαν την ευελιξία και τις υψηλές δυνατότητες που προσφέρει η τηλεπισκόπηση για ακριβή εκτίμηση των δασικών παραμέτρων, εφαρμοσμένες σε μεγάλες δασικές εκτάσεις. Μεταξύ όλων των αλγορίθμων που δοκιμάστηκαν ο πιο σημαντικός ήταν ο random forest (RF), καθώς επίσης και τοπογραφικοί παραμέτροι όπως το υψόμετρο και η ηλιακή ακτινοβολία, όπου είχαν τη μεγαλύτερη επίδραση στην κατανομή των δασοπονικών ειδών. Σχετικά με τα άρθρα, I, II,III, για τον προσδιορισμό διαφόρων δασικών παραμέτρων όπως το ύψος, στήθιαία διάμετρο και διάμετρο κόμης, τα συνολικά αποτελέσματα έδειξαν ότι μέσα από μη βαθμονομημένη ακολουθία εικόνων είναι δυνατή η ανακατασκευή ρεαλιστικών τρισδιάστατων μοντέλων δέντρων χρησιμοποιώντας κοινές εμπορικές φωτογραφικές μηχανές, με ικανοποιητική ακρίβεια και συσχέτιση μεταξύ εκτιμώμενων και μετρoύμενων μεταβλητών έχοντας ως βάση την στατιστική αξιολόγηση.
Health professionals KAP study on rabies exposure assessment and NTV administration in Ethiopia
Authors: Aga Abebe M. , Mulugeta Demise , Tesera Yeweynshet , Hurisa Birhanu , Lemma Hailu , Bizuneh Ayele , Mohammed Jemal , Beyene Mekoro , Mulugeta Yimer , Ashenafi Bayeh , Woldekidan Samuel , Nigussie Dereje
Published: May 2023

Background: Globally, it’s estimated 60,000 human deaths occur due to rabies with 95% of cases occurring in Africa and Asia. Annually, thousands of people are infected with rabies in Ethiopia and more than 2700 people die. In Ethiopia, the neural-based vaccine has been used since the 1950’s. Due to the old method of production, low immunogenicity and vaccine associated adverse events, WHO discourage the use of this vaccine and recommend replacing it with a safe and effective modern cell culture vaccine. There was no specific guidelines and training for this vaccine and health professional mismanage the nerve tissue vaccine (NTV) with cell culture vaccine resulting in vaccination failure. This study identifies professional knowledge, attitude and practice (KAP), vaccine related adverse events and the burden of rabies cases in humans.

Methods: Data were collected from health professionals in selected health facilities using structured questionnaire to identify the level of KAP.

Results: The study identified overall gaps in the professionals KAP as below standard which is not more than 25%. The majority of the respondents (97%) reported vaccine associated local adverse events followed by 20% systemic complications during vaccination. Only 2.4% of the respondents reported post-vaccine complications. Rabies cases in humans at those covered health facilities were reported to be 32 during the one-year study period with an average of two cases at each facility.

Conclusions: Gaps identified in the professional KAP result indicate the need to provide specific training based on standard guidelines. Generally, the study indicates the need to strengthen rabies prevention and control efforts through inter-sectoral collaboration, and facilitating the establishment of facility-based rabies palliative care centers. In addition, it is recommended to work on technology transfer to replace old method of NTV production with safe and effective modern cell culture based anti-rabies vaccine production for effective rabies PEP.
Unusual presentation of asymptomatic subacute lead-related ventricular perforation beyond the pericardium without pericardial effusion: a case report
Authors: Son Jihee , Jung Lae-Young
Published: May 2023

The clinical manifestations of subacute pacemaker lead-related cardiac perforations are highly variable. Patients with subacute perforations can present with a variety of symptoms, whereas those with acute perforations usually present with cardiac tamponade that necessitates emergent pericardiocentesis. A 32-year-old woman underwent pacemaker implantation for sick sinus syndrome. An active-fixation atrial lead was fixed to the right atrial appendage, and a ventricular lead was fixed to the right ventricle (RV) apex, with acceptable parameters. Two weeks postoperative, the patient visited the clinic for routine examination of the pacemaker parameters. Chest X-ray showed migration of the RV lead beyond the cardiac silhouette. Echocardiography revealed no evidence of pericardial effusion or tamponade. Computed tomography revealed that the RV lead was positioned beyond the RV and pericardium and into the anterior chest wall. Procedural lead revision was performed with cardiothoracic surgery backup. The lead was retracted after loosening the active-fixation screw and inserting the stylet. The lead was placed in the RV septum with active fixation. The procedure was completed without complications, and the patient was discharged after 3 days. Subacute lead perforations can present with various symptoms, and some patients may be asymptomatic without pericardial effusion. Altered lead parameters frequently provide the first indication for the diagnosis of cardiac perforation. Transvenous lead revision with surgical backup is an alternative to surgical extraction.
The influence of the gut microbiome on polycystic ovary syndrome - literature review
Authors: Cholewa Małgorzata Maria , Zapała Magdalena Alicja , Łapaj Monika , Cichoń Katarzyna , Kromer Agata , Wilk Joanna , Czarnota Julia , Gawryś Agnieszka , Chyćko Małgorzata , Środoń Agnieszka
Published: May 2023

The intestinal microbiome is an integral part of our body, and a normal intestinal microflora allows the body to maintain homeostasis. Dysbiosis can contribute to the development of many cardiovascular diseases, can affect the development of cancer, gynecological diseases. Polycystic ovary syndrome affects many women of reproductive age and leads to a decrease in the quality of life of patients facing this problem. The main symptoms of PCOS are: menstrual disorders, problems with getting pregnant, skin problems (acne, hirsutism), obesity. The mainstay of treatment is hormonal medication, metformin. There are reports of supplementing drug therapy with diet, a healthy lifestyle. In recent years, there have been a number of studies looking for a relationship between the state of the intestinal microflora and polycystic ovary syndrome. In our work, we reviewed the available literature in the PuBMed database from 2019 to 2023 with key words on the studies related to our topic.
Efficiency of mobile apps for monitoring and management of mental health - review article
Authors: Jędrzejewska Barbara , Borycka Aleksandra , Kotulska Maria , Laskus Paulina , Lichman Martyna , Lubczyńska Zuzanna , Potocka Zofia , Przeradzki Jakub , Rząd Katarzyna
Published: May 2023

Introduction and purpose
Mobile health apps are becoming increasingly popular. Many of them deal with improving mental well-being. This work aims to determine the effectiveness of using self-help forms of mental health care using mobile phones.
Material and Methods
The literature on mobile applications for mental health was reviewed using the databases of PubMed and Google Scholar.
State of knowledge
Mental illness is a severe problem for a large part of society. There is often effective treatment for them, but access to health care resources is limited. There are many applications that offer users psychoeducation and elements of psychotherapy. Many studies have shown their effectiveness in treating depression, anxiety disorders and dealing with excessive stress. Some research papers show the usefulness of mobile services in coping with distorted body image in body dysmorphic disorder, as well as in controlling physical activity and sleep time in the case of insomnia. Some of the programs seem to be useful in the functioning of people suffering from bipolar affective disorder, but their effectiveness in this disease is limited and still being analyzed.
Summary
Mobile health applications for monitoring and improving mental health are a promising form of helping patients. Some of them have been proven to work, but more research is needed on specific programs. It is important to remember that apps are used to supplement treatment, and do not fully replace contact with psychiatrists and psychologists.
Síndrome de HELLP y rotura hepática en un embarazo gemelar: reporte de un caso
Authors: YBASETA-MEDINA JORGE , HUAMAN-CORONADO RAÚL , YBASETA-SOTO MARJORIE
Published: May 2023

Introducción: El síndrome de Hellp y rotura hepática es una complicación poco frecuente especialmente en casos de embarazo gemelar, presentamos el caso de un hematoma subcapsular hepático roto por síndrome de HELLP que complicó un embarazo gemelar que requirió cesárea de emergencia y para el manejo de la hipovolemia el empaquetamiento hepático.Presentación del caso: Femenina, 41 años, gestación gemelar de 35 semanas, acude a emergencia por contracciones uterina y ausencia de movimientos fetales. Ante bradicardia severa de ambos fetos, se decide cesárea de urgencia. Al abrir la cavidad abdominal se encuentra hemoperitoneo, se logra extraer ambos fetos vivos. Se realiza laparotomía media, supra e infraumbilical exploradora (postcesárea) y se halla rotura hepática del lóbulo derecho. Se procede a empaquetamiento hepático con 11 compresas de gasas, colocación de 4 drenes Penrose laminares y cierre temporal abdominal, el manejo del shock hipovolémico y la preeclampsia se continuó en la Unidad de Cuidados Intensivos la paciente se fue de alta en buenas condiciones a los 21 días. Conclusión: El síndrome de HELLP produce complicaciones graves como rotura hepática que si no es tratada correctamente en forma temprana y multidisciplinaria puede llevar a producir mortalidad materno perinatal.
Neuroprotective factors in schizophrenia: BDNF, NGF, NT3, GDNF and their connection to the pathogenesis of schizophrenia. A narrative review
Authors: Sikorski Piotr , Sikorska Ewa , Michalska Milena , Stec Albert , Kasarełło Kaja , Fudalej Sylwia
Published: May 2023

Introduction: There are several hypotheses of schizophrenia pathogenesis, including the neurodegenerative theory, which is supported by evidence for the decrease of neuroprotective factors’ serum levels. The proteins, that exert a protective effect on neurons and are researched concerning schizophrenia pathogenesis, include the brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), neurotrophin 3 (NT3), and glial cell line-derived neurotrophic factor (GDNF). This review aims to discuss the role of neuroprotective factors in the development of schizophrenia and their relevance in clinical trials.
Material and methods: This review was performed by search of the PubMed, Google Scholar, and Science Direct databases from December 25th, 2022, through January 31st, 2023, using keywords: ‘schizophrenia’, ‘schizophrenia pathogenesis’, ‘neuroprotection’, ‘neurodegeneration’, ‘BDNF’, ‘NGF’, ‘NT3’, and ‘GDNF’. We considered original research papers and systematic reviews published in English or Polish. Additionally, clinical trials, which included the assessment of neuroprotective factors’ levels in schizophrenia as outcome measures, were searched for on clinicaltrials.gov.
Results: Lower levels of serum BDNF have been linked to cognitive impairment in schizophrenia. In clinical trials, the assessment of serum BDNF is used as a clinical outcome measure for novel schizophrenia therapies. Schizophrenia has also been associated with reduced peripheral NGF levels. During remission, lower NGF levels correlate with higher severity of negative symptoms. Decreased NT3 and GDNF levels can also be seen, but literature reports are inconsistent.
Conclusions: Neuroprotective factors are most likely related to the pathogenesis of schizophrenia. Assessing the serum level of these proteins may prove to be an invaluable element of schizophrenia management.

Keywords: schizophrenia, brain-derived neurotrophic factor, nerve growth factor,neurotrophin 3, glial cell line-derived neurotrophic factor
EM DIREÇÃO À ECONOMIA DONUT?
Authors: Zotesso Jaqueline Pirão
Published: May 2023

Partindo-se do princípio de que a forma como a atividade econômica é contabilizada não leva em consideração os limites físicos de resiliência da biosfera, é urgente a necessidade de inovações econômicas, políticas e sociais que superem a dependência estrutural em crescimento do PIB. Nesse sentido, esse trabalho buscou abordar como a Economia Donut vem se desenvolvendo mundialmente ao longo da última década, bem como discutir como a disparidade de poderes existente entre os diferentes setores da sociedade limita a inserção de novos modelos econômicos. Apesar de ainda ser um modelo em criação, pode-se dizer que a Economia Donut possui um potencial transformador pelo fato de algumas cidades já terem manifestado interesse em aplicá-la. Entretanto, a inserção de novos modelos econômicos exige uma mudança na visão e na forma de ensino da economia, bem como o rompimento das estruturas do atual sistema em que vivemos, o que seria, de fato, uma grande inovação.
Highlighting the latest research: May 2023
Authors: Palmer Sarah Jane
Published: May 2023

Sarah Jane Palmer presents a selection of recently published articles of interest to nurses working in cardiovascular nursing. The aim of this roundup is to provide a brief overview of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
Evaluation of a termination of pregnancy education programme in the Republic of Ireland: part 1
Authors: Fletcher Antoinette , Cowman Triona , Cazzini Hazel , Fleming Judith , Healy Niamh
Published: May 2023

Background/Aims

The extension of termination of pregnancy services in the Republic of Ireland represents a significant change to practice. Education is required so that nurses and midwives can fulfil their expanded role. The aim of this study was to provide an evaluation of a national termination of pregnancy education programme for midwives and nurses in the Republic of Ireland.

Methods

Kirkpatrick's framework for evaluation was used to create an online questionnaire that captured nurses' and midwives' reactions to a training experience at a termination of pregnancy education programme and their self-assessed knowledge before and after training.

Results

Participation in the training programme increased the participants' knowledge and confidence in caring for women having a termination. Participants reported that the training was relevant, met their expectations and new knowledge would be used. Recommendations for programme enhancement were also received.

Conclusions

Participants were satisfied with the education that they received. The positive impact that a short educational intervention had on participants' knowledge and confidence in providing care for women choosing termination of pregnancy was demonstrated.
It was the anarchists: The quest for the truth about Italy’s bombs
Authors: Scalia Vincenzo
Published: May 2023

On 12 December 1969 a bomb exploded in Piazza Fontana, in Milan, killing 17 people and wounding 84. This paper uses critical and activist criminology, and explores, through a resistance lens, the struggle for truth that followed. On the one hand, denial through a strategy of manipulation was carried out by both the Italian government and mainstream media, which placed the blame on the anarchist movement, laying the groundwork for an authoritarian upheaval. On the other hand, the mobilization of both the old and the new left solidified to counter this denial by illuminating state responsibility for the Piazza Fontana bombing. This paper models the specific species of state crime denial used by a transnational coalition of far-right forces operating in and around the Italian state, and the forms of resistance within left civil society that helped counter denial and stall the authoritarian drift. It also looks to expand the literature on resistance to state crime, by documenting a still poorly understood episode in Italian history where civic opposition to state violence helped abort the further institutionalization of authoritarian politics. This paper will shed a light on the dialectical process between state crime and resistance, as theorized by Green and Ward. Moreover, an analysis of resistance stages through the use of Stanley and McCulloch’s work, will allow me to carry out an in-depth analysis of the mobilization process that took place after the Piazza Fontana bombing.
Invariant convolutional neural network for robust and generalizable QoT estimation in fiber-optic networks
Authors: Wang Qihang , Cai Zhuojun , Lau Alan Pak Tao , Li Yang , Nadeem Khan Faisal
Published: May 2023

Accurately estimating the quality of transmission (QoT) in modern transport optical networks has been regarded as one of the most critical factors to reduce the design margins. In recent years, machine learning (ML) based models have exhibited a powerful capacity for various kinds of QoT estimation tasks. However, the existing ML-based QoT estimators suffer from two kinds of phenomena that are hard to bypass in real optical networks. The first conundrum is the variation of the number of parameters in transmission features introduced by the changeable link configurations. The second conundrum is the distribution drift of the transmission parameters relative to the training dataset. To mitigate the above two problems, we propose an invariant convolutional neural network predictor (ICNNP), which consists of a fixed-length encoder for encoding variable-length link features, and a robust neural network predictor, which can adapt to the changing transmission conditions with limited additional data. To alleviate the time dependence and link length dependence of the QoT estimator, we trained the model with a joint training algorithm. We validate our method experimentally by collecting datasets under different transmission configurations. The proposed ICNNP exhibits significant advantages in comparison with the four benchmark algorithms. When the span numbers vary from 9 to 12 and the evaluation period is expanded from 12 to 72 h, the standard deviation of the signal-to-noise ratio prediction error of our model holds below 0.4 dB and 0.25 dB, respectively. We also propose a continual learning workflow with an evaluation-update framework, with which our model can perform QoT estimation with the highest efficiency and the lowest training cost. The ensemble of components in this paper builds a deployment-oriented reliable QoT estimation tool.
Super-resolution computational saturated absorption microscopy
Authors: Murray Gabe , Stockton Patrick A. , Field Jeff , Pezeshki Ali , Squier Jeff , Bartels Randy A.
Published: May 2023

Imaging beyond the diffraction limit barrier has attracted wide attention due to the ability to resolve previously hidden image features. Of the various super-resolution microscopy techniques available, a particularly simple method called saturated excitation microscopy (SAX) requires only simple modification of a laser scanning microscope: The illumination beam power is sinusoidally modulated and driven into saturation. SAX images are extracted from the harmonics of the modulation frequency and exhibit improved spatial resolution. Unfortunately, this elegant strategy is hindered by the incursion of shot noise that prevents high-resolution imaging in many realistic scenarios. Here, we demonstrate a technique for super-resolution imaging that we call computational saturated absorption (CSA) in which a joint deconvolution is applied to a set of images with diversity in spatial frequency support among the point spread functions (PSFs) used in the image formation with saturated laser scanning fluorescence microscopy. CSA microscopy allows access to the high spatial frequency diversity in a set of saturated effective PSFs, while avoiding image degradation from shot noise.