bluuebunny/crossref_metadata_2025 huggingface dataset:
Images of Sofia in Bulgarian Poetry in the Late Twentieth and Early Twenty-First Centuries
Authors: Gołek-Sepetliewa Dorota
Published: January 2023

This article is devoted to the image of Sofia in Bulgarian poetry in the late twentieth and early twenty-first centuries. The study analyses and interprets poems of four well-known Bulgarian poets: Zlatomir Zlatanov (b. 1953), Ani Ilkov (b. 1957), Edvin Sugarev (b. 1953) and Vladimir Sabourin (b. 1967). The starting point is a synthetic presentation of the genesis and evolution of the Sofia motif in Bulgarian literary works from between the mid-eighteenth century and the 1970s. The motif of the capital city initially functions in opposition to the rural theme. Urban space is a sphere of foreign Western European influences and threatens traditional patriarchal culture. The evolution of the city motif takes place in the context of the developing new literary trends and tendencies in the interwar period (including expressionism and avant-garde). Images of the capital city as a place where the bourgeoisie lives and where poverty and social injustice reign, come from literature entangled in ideological and political contexts (the leftist poetry of the 1920s). Contemporary poets draw on traditional themes of the alienation of the city and the problematic situation of its inhabitants. Still, their thoughts are framed by postmodern philosophical reflection and native cultural and historical contexts. The subjective experience of the city of Sofia creates its various dimensions – physical, cultural, symbolic, social, mythical. A common experience for the poets is the signs of the communist ideological legacy. The periphery of the city undergoes a process of degradation and disintegration. In an existentialist perspective, Sofia’s lyrical conceptualisation points to the constant presence of irresolvable contrasts, paradoxes, and a sense of the scandalous absurdity of existence.
Free Electrothermo-Convective Instability in a Dielectric Oldroydian Nanofluid Layer in a Porous Medium
Authors: Gautam Poonam Kumari , Rana Gian C. , Saxena Hemlata
Published: January 2023

For the last few years, thermal instability of non-Newtonian nanofluids becomes a prominent field of research because it has various applications in automotive industries, energy-saving, nuclear reactors, transportation, electronics etc. and suspensions of nanoparticles are being developed
in medical applications including cancer therapy. In this paper, a free electrothermo-convective instability in a dielectric nanofluid layer in a porous medium is studied. An Oldroyd’s constitutive equation is used to describe the behaviour of nanofluid and for porous medium, the Darcy
model is employed. The equation of conservation of momentum of fluid is stimulated due to the presence of an AC electric field, stress-relaxation parameter and strain-retardation parameter. The stability of the system is discussed in stationary and oscillatory convections for free–free
boundaries. For the case stationary convection, it is found that the Oldroydian Nanofluid behaves like an ordinary nanofluid as the stationary Rayleigh number is independent of the stress-relaxation parameter, the strain-retardation parameter and Vadasz number. The effect of stress-relaxation-time
parameter, strain-retardation-time parameter, Vadasz number, nanoparticles Rayleigh number, modified diffusivity ratio, medium porosity, Lewis number and electric Rayleigh number examined numerically and graphs have been plotted to analyse the stability of the system. It is observed that the
electrical Rayleigh number has destabilizing influence whereas nanoparticles Rayleigh number, porosity and modified diffusivity ratio have stabilizing effect on the system. The oscillatory convection is possible for the values of the stress-relaxation parameter less than the strain-retardation
parameter for both top-heavy/bottom-heavy distributions of nanoparticles.
Augmenting the Energy Transport Through Magnetic Ferrofluid Filled Inside the I-Shaped Cavity Under the Influence of Thermal Radiation
Authors: Siddiqui Muhammad Arshad , Javed Tariq , Iftikhar Babar
Published: January 2023

The effects of heat generation/absorption and thermal radiation on MHD natural convective flow inside the I-shaped cavity saturated with ferrofluid have been investigated in this study. The Cobalt-kerosene type of ferrofluid has been used with solid volume fractions (Φ =
0∼0.06). The penalty finite element technique with Galerkin weighted method has been used to attain the solution of highly non-linear governing PDE’s. Simulations are carried out in terms of stream lines, heat-lines, isotherms contours and local Nusselt number for wide range of physical
flow parameters including thermal radiation (NR = 0∼10), heat generation/absorption (ξ = −5∼5), Hartmann (Ha = 0∼10), Rayleigh (Ra = 103∼106), Prandtl (Pr = 6.83), Eckert (Ec = 10−5)
and Magnetic number (Mn = 5 * 102). The obtained results show that increasing the concentration of solid volume friction (Φ) from 0 (pure base fluid) to 0.06 has improved heat transfer by 28% and velocity profiles by 23%. Increasing the Rayleigh number from 103
to 106 has significantly improved the total heat transfer rate along the bottom wall from 1.12 to 8.842. It is also noted that the intensity of circulation cells of streamlines and headlines has decreased with increasing Hartmann number (Ha).
Entropy Generation and Radiation Analysis on Peristaltic Transport of Hyperbolic Tangent Fluid with Hybrid Nanoparticle Through an Endoscope
Authors: Asha S. K. , Talawar Vijaylaxmi T. , Bhatti M. M.
Published: January 2023

The current study explores the impact of entropy generation, thermal jump, radiation, and inclined magnetic field on the peristaltic transport of hyperbolic tangent fluid containing molybdenum disulfide and silver nanoparticles through an endoscope with a long wavelength and low Reynolds number assumptions. Between two coaxial tubes, a non-Newtonian hyperbolic tangent fluid with silver nanoparticles is considered. The Second law of thermodynamics is used to examine the entropy generation. The Homotopy perturbation method (HPM) is applied to describe the solution of nonlinear partial differential equations. We were able to arrive at analytical solutions for velocity, temperature, and nanoparticle concentration. In the end, the impact of various physical parameters on temperature, nanoparticle concentration, velocity, entropy generation, and Bejan number was graphically depicted. The significant outcome of the present study is that the impact of Hartmann number and Brownian motion parameter declines the velocity profile, but the thermal Grashoff number enhances velocity, whereas Platelet-shaped nanoparticles achieve a higher speed as compare to Spherical-shaped nanoparticles.
Impact of COVID-19 Pandemic on Academic Activities of Academicians in Nepal
Authors: Joshi Dirgha Raj , Neupane Umesh , Singh Jitendra K. , Khanal Bishnu , Belbase Shashidhar
Published: January 2023

This study explored the academic activities of academicians during the COVID-19 pandemic in Nepal. An online questionnaire was used to collect quantitative data from 361 academicians about changes in academic and extracurricular activities. The findings showed that the majority of participants (69% and 72%) agreed that both academic and extracurricular activities, respectively, were adversely affected by the lockdown during the pandemic. The results also showed that the study hours, sleeping hours, and social networking increased while concentration on academic activities decreased during the lockdown due to the COVID-19 pandemic.
Changes in breast cancer staging trends among Egyptian women after COVID-19: A retrospective single-center study
Authors: Abd El Wahab Mostafa H , Ibrahim Ahmed H , Gado Omar , Bahbah Ali M , Fadlalla Waleed , Fakhry Sherihan , Mamdouh Mona M , Kamel Mahmoud M , Moaz Inas , Rabea Ahmed , Helal Amany M
Published: January 2023

Objectives

Since being declared a global pandemic, the SARS-CoV-2 virus had a significant impact on the entire globe. The pandemic has placed a heavy burden on healthcare systems worldwide, and cancer patients are particularly prone. Despite the fact that initial international reports suggest delays in breast cancer (BC) diagnosis and screening programs, the Egyptian context requires additional research on this topic. To examine whether COVID-19 has changed the pattern of disease presentation before and after the pandemic, focusing on the tumor, node, and metastasis (TNM) staging of the disease at the initial presentation

Methods

This single-center, retrospective study of female BC patients initially diagnosed at Baheya Foundation was conducted during the following time frames: from Jan 2019 to Jan 2020 (Pre COVID-19 cohort) and from Mar 2020 to Mar 2021 (post–COVID-19 cohort). We compared the two cohorts in terms of clinical characteristics, tumor characteristics, and the number of days from presentation to treatment. Our primary endpoint was the difference in the TNM stage of BC at the initial presentation.

Results

This analysis included 710 BC patients, 350 from the pre-COVID cohort and 360 from the post-COVID group. We detected a 27.9% increase in late-stage BC (stages III-IV) in the post-pandemic cohort compared to the pre-pandemic (60.1% vs. 47%, p < 0.001). The time from diagnosis to commencement of treatment was significantly longer (28.34 ± 18.845 vs 36.04 ± 23.641 days, p < 0.001) in the post-COVID cohort (mean difference = 7.702, 95% CI 4.54–10.85, p < 0.001). A higher percentage of patients in the post-pandemic cohort received systemic neoadjuvant therapy ( p-value for Exact’s test for all treatment options = 0.001).

Conclusions

The number of patients requiring systemic neoadjuvant chemotherapy increased dramatically in the post-pandemic group with advanced stages of BC at presentation. This study highlights the need for proper management of cancer patients during any future pandemic.
Outcomes of COVID-19 in peritoneal dialysis patients: A report by the European Renal Association COVID-19 Database
Authors: Abrahams Alferso C , Noordzij Marlies , Goffin Eric , Sanchez J Emilio , Franssen Casper FM , Vart Priya , Jager Kitty J , van Agteren Madelon , Covic Adrian , Mitra Sandip , Basile Carlo , Konings Constantijn , Hemmelder Marc H , Duivenvoorden Raphaël , Hilbrands Luuk B , Gansevoort Ron T ,   ERACODA Collaborators
Published: January 2023

Background:

The clinical course of COVID-19 in peritoneal dialysis (PD) patients has so far only been analysed in relatively small, often single-centre case series. Therefore, we studied patient- and disease-related characteristics and outcomes of COVID-19 in a larger European cohort of PD patients.

Methods:

We used data from the European Renal Association COVID-19 Database (ERACODA) on PD and haemodialysis (HD) patients with COVID-19 (presentation between February 2020 and April 2021). Hazard ratios (HR) for mortality at 3 months were calculated using Cox proportional-hazards regression. In addition, we examined functional and mental health status among survivors at this time point as determined by their treating physician.

Results:

Of 216 PD patients with COVID-19, 80 (37%) were not hospitalised and 136 (63%) were hospitalised, of whom 19 (8.8%) were admitted to an intensive care unit. Mortality at 3 months for these subgroups was 18%, 40%, and 37%, respectively ( p = 0.0031). Compared with HD patients, PD patients had higher mortality (crude HR: 1.49; 95% CI: 1.33–1.66), even when adjusted for patient characteristics and disease severity (adjusted HR: 1.56; 95% CI: 1.39–1.75). Follow-up data on 67 of 146 patients who survived COVID-19 showed functional recovery to pre-COVID-19 levels in 52 (78%) and mental recovery in 58 patients (87%) at 3 months after the COVID-19 diagnosis.

Conclusion:

The mortality rate in the first 3 months after presentation with COVID-19 is high, especially among PD patients who were hospitalised. PD patients with COVID-19 had a higher mortality risk than HD patients. The majority of surviving patients recovered both functionally and mentally from COVID-19 within 3 months.
An integrated three-dimensional powertrain-vehicle dynamics model for tracked vehicle analysis
Authors: Mahalingam Ilango , Padmanabhan Chandramouli
Published: January 2023

A tracked vehicle employs a special transmission to generate a speed difference between the inner and outer tracks for steering. In this paper, the dynamic model of one of the most widely used steering transmissions called double differential steering has been derived and integrated with a multi-body tracked vehicle model. A simplified multi-body model for tracks has been proposed to reduce the computational and numerical difficulties arising from a detailed three-dimensional multi-body model. The accuracy of the proposed model is demonstrated by extensive comparison with a detailed multi-body model developed using the Tracked Vehicle module of the commercial software ADAMS. Simulations are carried out using the integrated tracked vehicle model to demonstrate the effects of changes in three-dimensional vehicle dynamic performance with design changes in powertrain systems.
Predicting kidney outcomes among Latin American patients with lupus nephritis: The prognostic value of interstitial fibrosis and tubular atrophy and tubulointerstitial inflammation
Authors: Rodelo Joaquín , Aguirre Lina , Ortegón Katherine , Ustáriz José , Calderon Ligia , Taborda Alejandra , Arias Luis Fernando , González Luis Alonso
Published: January 2023

Objective

To assess the effect of tubulointerstitial inflammation (TII) and interstitial fibrosis and tubular atrophy (IFTA) on kidney survival in lupus nephritis (LN).

Methods

Two hundred eighty five patients with biopsy-proven LN were retrospectively studied. Kidney survival was defined as the time from initial biopsy to end-stage kidney disease (ESKD), dialysis, or transplant. Kidney survival analysis was performed by the Kaplan–Meier method and the statistical difference between survival curves compared by the log-rank test. Cumulative incidence functions with competing risk of death for kidney survival were also graphed. Multivariable Cox proportional hazards regression and competing-risk analyses were performed to identify independent predictors of ESKD.

Results

Fifty-seven patients (20%) progressed to ESKD during a median time of 4.2 (2.0–55.2) months after biopsy. TII was present in 206 (72.3%) biopsies, while IFTA in 99 (34.7%) biopsies. Patients with moderate-to-severe IFTA had worse kidney survival than those with none or mild IFTA in both the Kaplan–Meier ( p = 0.018) and the competing-risk analyses ( p = 0.017). Patients with class IV ± V LN had worse kidney survival than those with non-class IV LN by the Kaplan–Meier method ( p = 0.050), but not in the competing-risk analysis ( p = 0.154). Worse kidney survival was also found among those with fibrous crescents than those without, in both the Kaplan–Meier ( p = 0.010) and the competing-risk ( p = 0.011) analyses. By multivariable Cox regression analysis, older age (HR 1.04, 95% CI 1.01–1.07) and class IV ± V LN (HR 5.06, 95% CI 1.82–14.09) were associated with higher risk of ESKD after adjusting for sex, ethnicity, TII, and IFTA. By competing-risk analyses, class IV ± V LN (SHR 3.32, 95% CI 1.25–8.83) and no response to immunosuppressive therapy (SHR 4.55, 95% CI 1.54–13.41) were associated with a higher risk of ESKD, while eGFR >90 mL/min/1.73 m2 (SHR 0.98 for each ml/min/1.73 m 2 , 95% 0.97–0.99) with a lower risk.

Conclusions

Patients with moderate-to-severe IFTA had worse kidney survival than those with none or mild IFTA. Worse kidney survival was also found among those with class IV LN and fibrous crescents versus those without IV LN and fibrous crescents, respectively.
The effects of colchicine on hospitalized COVID-19 patients: A randomized, double-blind, placebo-controlled clinical trial
Authors: Kasiri Hossein , Ghazaiean Mobin , Rouhani Nima , Naderi-behdani Fahimeh , Ghazaeian Monireh , Ghodssi-Ghassemabadi Robabeh
Published: January 2023

This study was designed to evaluate the effects of colchicine in the improvement of clinical outcomes of hospitalized COVID-19 patients. This prospective, randomized, double-blind, placebo-controlled clinical trial was conducted on adult patients (>18 years) with severe COVID-19. The included patients were randomly (1:1) assigned to the colchicine (2 mg loading dose followed by 0.5 mg twice daily for 7 days) or placebo group. Both groups received remdesivir and interferon beta-1b. The primary outcome of the study was to receive clinical response as ordinal scale of 1 or 2. Secondary outcomes were hospital complications and 28-day mortality. Between February and May 2021, 110 patients were included and 106 of them were analyzed. Baseline clinical characteristics and demographics were not significantly different. According to the ordinal scale, 30 patients in the control group (58.8%) responded to treatment within 7 days, while 35 patients (63.6%) in the colchicine group showed the same response (p = 0.61, odds ratio (OR) = 1.23, 95% CI [0.560–2.68]). On the 14th day, 87.3% of the colchicine group (n = 48) and 82.4% of the control group (n = 42) responded (p = 0.48, OR = 1.47, 95% CI [0.50.3–4.29]. In addition, 28-day mortality, intensive care unit admission, and hospital duration were not different between the groups (p = 0.99, 0.59, 0.06). Diarrhea and nausea were the major side effects dominant in the colchicine group. Colchicine showed no beneficial effects on clinical improvement and hospital complications in patients with COVID-19. Moreover, in case of prescription, the safety concerns of colchicine, specially gastrointestinal side effects, should be taken into account.
Novel Finding of Urinary Erythropoietin as an Early Biomarker of Cisplatin-Induced Nephrotoxicity
Authors: Bulacio Romina P. , Torres Adriana M.
Published: January 2023

Cisplatin is a chemotherapeutic drug used to treat a great variety of solid tumors. Its dose is commonly limited by its nephrotoxicity, manifested as acute kidney injury (AKI). Erythropoietin (Epo) is a glycoprotein hormone that regulates the production of red blood cells. This study was performed to evaluate the presence of endogenous Epo in male Wistar rat urine and to analyse changes in urinary Epo levels in response to cisplatin- induced AKI. Dose-dependent studies and time-dependent experiments were performed to evaluate changes in urea nitrogen and creatinine in plasma as well as Epo, neutrophil gelatinase-associated lipocalin (NGAL), alkaline phosphatase (AP) activity, creatinine and total proteins in urine at 2 days post-dosing. Rats received 2, 5 or 10 mg/kg b.w., i.p. of cisplatin. At 5 mg/kg b.w., i.p. cisplatin, significant increases in urinary Epo were detected. Significant increases in urea nitrogen and creatinine in plasma, NGAL, AP, proteins, and Epo were observed in urine from rats that received 10 mg/kg b.w., i.p. of cisplatin. In the time-dependent experiments, rats were injected with a dose of 5 mg/kg b.w., i.p. of cisplatin, and sampling occurred 2, 4, and 14 days post-dosing. In these animals, there were significant increases in urea nitrogen and creatinine in plasma and total proteins, AP activity, Epo, and NGAL in urine on day 4. Urinary Epo was also detected on day 2. Taken together, these findings provide weight of evidence for urinary Epo as a promising early biomarker of cisplatin-induced AKI in male rats.
Prevalence of lactational oestrus in cats and consequences for kittens
Authors: Furthner Etienne
Published: January 2023

Objectives

Although lactation and suckling suppresses fertility in most mammals, some feline breeders have reported spontaneous oestrus during lactation, causing distress to kittens. This led the Official French Feline Pedigree Registry (Livre Officiel des Origines Félines – LOOF) to send a questionnaire to cat breeders requesting data on their last three litters. The aim of this study was to investigate the prevalence of lactational oestrus, its impact on litters and potential associations with litter size, age, parity, breed and seasonality.

Methods

Answers from 108 breeders were collected, providing data on 238 litters in 23 different breeds. Data were also collected on successive litters from multiparous queens (n = 20) and were analysed separately from the 195 independent births.

Results

Of the 195 independent births with complete data sets, 96 (49%) queens came into oestrus during lactation, 37 (38%) of which were associated with loss of maternal interest (n = 20), milk quality variation (n = 2), clotted milk (n = 3), reduced milk quantity (n = 13), which in kittens led to reduced weight (n = 6), diarrhoea (n = 9), vomiting (n = 4), nausea (n = 2) or death (n = 4), and bottle feeding (n = 2), early weaning (n = 4) or modified litter behaviour (n = 1). A significant association was found between small litter size (one or two kittens) and the onset of lactational oestrus ( P = 0.007) and between births occurring in February, March and April and lactational oestrus ( P = 0.005); there was no association with age or breed.

Conclusions and relevance

Breeders perceived a relationship in 38% of cases of lactational oestrus with maternal disinterest, clotted milk, reduced milk yield and in kittens, weight loss, vomiting, diarrhoea or even death. An association between small litter size and lactational oestrus was found, as well as with births occurring between February and April. Breeders presenting with at-risk females should be warned. Conservative and preventive measures such as contraceptive options are discussed as a possible therapy.
Desire’s misrecognitions, or the promise of mutable attachments
Authors: Zhang Vickie
Published: January 2023

Desire orients us to how attachments are dis/re/organised in lived time. This commentary responds to Anderson's article on attachments and promises by speculating on a version of attachment that starts from Berlant's writing on desire, supplementing the geography of promises that Anderson situates at the heart of attachment. By generating scrambled surfaces and mixed temporalities, attachment through desire emerges as something organised less by form and more by sensation, less by optimism and more by fantasy, less by endurance and more by excess. Desire unfolds heartlessly, without a centre. It doesn’t just recognise; it misrecognises. Subject to desire, attachments don’t always add up. Instead, desire leaves a gap – a gap that is also its promise.
Efficacy of interferential current transcutaneous electrical sensory stimulation through the neck skin for treating dysphagia in children with disabilities: A case series
Authors: Funato Michinori , Maruta Kanako , Yano Mitsuru , Kai Mitsue , Umezawa Yaeko , Yasuda Kunihiko , Ohta-Noda Emi , Gen Keika
Published: January 2023

Finding a suitable treatment for dysphagia has been challenging and the efficacy of neuromuscular electrical stimulation has been recognized. Moreover, the beneficial effect of interferential current transcutaneous electrical sensory stimulation has recently been described. However, the efficacy of interferential current transcutaneous electrical sensory stimulation in children with disabilities is unknown. Therefore, the aim of this study was to confirm the efficacy of interferential current transcutaneous electrical sensory stimulation in children with disabilities. Four children with disabilities of various types underwent interferential current transcutaneous electrical sensory stimulation once a week. All patients showed improved symptoms after interferential current transcutaneous electrical sensory stimulation treatment. Videoendoscopic examination showed reduced accumulation of secretion in all patients and decreased residual bolus in two. We also felt an increased forcefulness when swallowing in two. In addition, the questionnaire results regarding dysphagia indicated improvements. No significant side effects were observed. The interferential current transcutaneous electrical sensory stimulation treatment may be effective and safe in children with disabilities. The effect of this treatment on swallowing ability needs to be further investigated by studying more cases.
Pembrolizumab-induced encephalitis in a patient with renal cell carcinoma post nephrectomy: A case report
Authors: Sharma Amit , Chapagain Akhil , Kharel Sanjeev , Giri Subarna , Regmi Arju , Yadav Rupesh Kumar , Thapaliya Sahil
Published: January 2023

A new category of immune-related adverse effects has been identified due to increasing use of immune checkpoint inhibitor therapy to treat solid organ cancers. Pembrolizumab approved for renal cell carcinoma also has neurological immune-related adverse effects causing long-term morbidity. We here present a case of renal cell carcinoma post nephrectomy with suspected pembrolizumab (anti-PD-1)-induced encephalitis presenting as light headedness and dizziness treated with high dose of corticosteroid and intravenous immunoglobulin. Lumbar puncture was performed which showed elevated protein, nucleated cells with lymphocyte predominant, suggestive of chemical meningitis. Scans were found to be normal while electroencephalogram showed diffuse cerebral dysfunction indicating encephalopathy. The patient was under pembrolizumab treatment so encephalitis was suspected. Clinical attention is necessary when patients receiving immune checkpoint inhibitors appear with new neurological symptoms to prevent long-term morbidity or even possible mortality.
Family Planning Among Canadian Plastic Surgeons and Trainees
Authors: Kemp Austin , Garland Katie , Graham Elise , Simpson Andrew , Symonette Caitlin
Published: January 2023

Introduction: Despite increasing advocacy for family leave policies, few studies have described the current landscape and attitudes around family planning in Canadian plastic surgery. The purpose of this study was to survey Canadian plastic surgeons and trainees to examine their experience with family planning, parental leave, and breastfeeding. Methods: An anonymized survey was distributed to all members of the Canadian Society of Plastic Surgeons and all Canadian Plastic Surgery residents through their program administrators. Survey responses were recorded and analyzed through a customized REDCap™ database. Results were reported using descriptive statistics. Results: A total of 87 plastic surgeons and trainees completed the surgery. We found 72.3% of respondents had children; 67.8% felt their colleagues were supportive of parental leave; 45.6% felt that financial concerns affected their decision to take parental leave; 61.6% felt that their career did not influence the number of children they chose to have; 21.0% accessed fertility services and 9.8% used assisted-reproductive technologies; 80% of respondents who breastfeed felt they did not have enough time to pump at work, however, 79% did not experience any discrimination or criticism for pumping at work. Conclusion: Canadian plastic surgeons most often have children after completing training and choose to take shorter parental leaves as their careers progress. Parental leave and breastfeeding practices in the workplace are reported to have increased support from colleagues compared to previous literature. However, Canadian plastic surgeons continue to struggle with infertility and seek fertility services at rates higher than the general population.
Teacher attitudes toward evidence-based practices: Exploratory and confirmatory analyses of the school-adapted evidence-based practice attitude scale
Authors: Merle James L. , Cook Clayton R. , Locke Jill J. , Ehrhart Mark G. , Brown Eric C. , Davis Chayna J. , Lyon Aaron R.
Published: January 2023

Background

The Evidence-Based Practice Attitudes Scale (EBPAS) is widely used in implementation research, but it has not been adapted and validated for use among general education teachers, who are most likely to deliver evidence-based prevention programs in schools, the most common setting where youth access social, emotional, and behavioral health services.

Method

School-based stakeholders and a research team comprised of experts in the implementation of evidence-based practices in schools adapted the EBPAS for teachers (the S-EBPAS). The adapted instrument was administered to a representative sample ( n = 441) of general education teachers (grades K—5) to assess the reliability and internal consistency via factor analyses. The S-EBPAS included two forms (i.e., EBP-agnostic and EBP-specific item referents), therefore, a multiple-group confirmatory factor analysis (CFA) was also performed to establish measurement invariance between the two forms.

Results

After adaptation and refinement, a 9-item, 3-factor structure was confirmed, with the final model supporting three first-order factors that load onto a second-order factor capturing attitudes toward adopting evidence-based practices. Multiple-group CFA analyses of measurement invariance indicated there were no significant differences between the two forms.

Conclusions

Overall, this study provides a brief, flexible instrument capturing attitudes toward adopting EBPs that has high reliability and internal consistency, which support its use among general education teachers in school settings implementing evidence-based practices.
Geometry optimization of an electrochemical reactor for bleaching kaolin
Authors: Cobos-Murcia José Angel , Hernández-Aguilar Eduardo , Trujillo-Estrada Ariadna , Gallegos-Ortega Grisell , Reyes-Cruz Victor Esteban
Published: January 2023

High-whiteness kaolinite mining reserves are scarce. In some locations, it is necessary to remove material to access them (adding to the cost). Therefore, processes have been developed to eliminate contaminants, such as iron, and provide alternatives to the used contaminated materials that, after being treated, meet quality criteria. In our previous research, we developed an electrochemical process for kaolin whitening at the laboratory level and bench scale, demonstrating the reaction mechanisms that occur during the removal of iron from kaolin. However, the geometry used at the laboratory level does not present the most suitable position for the electrodes. Therefore, in the present study, we focused on the geometry and the function of the electrodes. This is necessary during the escalation process to reach the pilot-scale level. The study was carried out using computer-aided engineering in the COMSOL Multiphysics computer program and by analysing the distribution of the electric potential and the electric current of the geometries considered while performing the scaling. The results indicated that the change in the anode position from perpendicular to parallel to the discs improved the distribution of electric current density on the cathode surface and so increased the elimination of iron through electrochemical deposition. Similarly, to reduce the amount of material used in the construction of the reactor, the anode-size effect was analysed, revealing that relatively small anodes improved the distribution of electric current density over the entire surface of the electrode and not only at the edges.
Genomic and immunogenomic analysis of three prognostic signature genes in LUAD
Authors: Feng Hai-Ming , Zhao Ye , Yan Wei-Jian , Li Bin
Published: January 2023

Background

Searching for immunotherapy-related markers is an important research content to screen for target populations suitable for immunotherapy. Prognosis-related genes in early stage lung cancer may also affect the tumor immune microenvironment, which in turn affects immunotherapy.

Results

We analyzed the differential genes affecting lung cancer patients receiving immunotherapy through the Cancer Treatment Response gene signature DataBase (CTR-DB), and set a threshold to obtain a total of 176 differential genes between response and non-response to immunotherapy. Functional enrichment analysis found that these differential genes were mainly involved in immune regulation-related pathways. The early-stage lung adenocarcinoma (LUAD) prognostic model was constructed through the cancer genome atlas (TCGA) database, and three target genes (MMP12, NFE2, HOXC8) were screened to calculate the risk score of early-stage LUAD. The receiver operating characteristic (ROC) curve indicated that the model had good prognostic value, and the validation set (GSE50081, GSE11969 and GSE42127) from the gene expression omnibus (GEO) analysis indicated that the model had good stability, and the risk score was correlated with immune infiltrations to varying degrees. Multi-type survival analysis and immune infiltration analysis revealed that the transcriptome, methylation and the copy number variation (CNV) levels of the three genes were correlated with patient prognosis and some tumor microenvironment (TME) components. Drug sensitivity analysis found that the three genes may affect some anti-tumor drugs. The mRNA expression of immune checkpoint-related genes showed significant differences between the high and low group of the three genes, and there may be a mutual regulatory network between immune checkpoint-related genes and target genes. Tumor immune dysfunction and exclusion (TIDE) analysis found that three genes were associated with immunotherapy response and maybe the potential predictors to immunotherapy, consistent with the CTR-DB database analysis.

Conclusions

From the perspective of data mining, this study suggests that MMP12, NFE2, and HOXC8 may be involved in tumor immune regulation and affect immunotherapy. They are expected to become markers of immunotherapy and are worthy of further experimental research.
A new and efficient enrichment method for metagenomic sequencing of Monkeypox virus
Authors: Aja-Macaya Pablo , Rumbo-Feal Soraya , Poza Margarita , Cañizares Angelina , Vallejo Juan A. , Bou Germán
Published: January 2023

Background

The methodology described in previous literature for Monkeypox virus (MPXV) sequencing shows low efficiency when using metagenomic approaches. The aim of the present study was to evaluate a new fine-tuned method for extraction and enrichment of genomic MPXV DNA using clinical samples and to compare it to a non-enrichment metagenomic approach.

Results

A new procedure that allows sample enrichment in MPXV DNA, avoiding wasting the sequencing capacity in human DNA, was designed. This procedure consisted of host DNA depletion using a saponin/NaCl combination treatment and DNase, together with high g-force centrifugations. After typical quality control, samples using the enrichment method contained around 96% of reads not classified as human DNA, while the non-enrichment protocol showed around 5-10%. When reads not belonging to Orthopoxvirus were removed, enriched samples kept about 50% of the original read counts, while non-enriched ones kept only 2-7%.

Conclusions

Results showed a very significant improvement in sequencing efficiency, increasing the number of reads belonging to MPXV, the depth of coverage and the trustworthiness of the consensus sequences. This, in turn, allows for more samples to be included in a single cartridge, reducing costs and time to diagnosis, which can be very important factors when dealing with a contagious disease.
Treatment outcomes and associated factors among chronic ambulatory heart failure patients at Jimma Medical Center, South West Ethiopia: prospective observational study
Authors: Assefa Erkihun , Tegene Elsah , Abebe Abinet , Melaku Tsegaye
Published: January 2023

Background

Heart failure has been one of the major causes of hospitalization across the world. Focusing on the treatment outcomes of ambulatory heart failure patients will reduce the burden of heart failure such as hospitalization and improve patient quality of life. Even if research is conducted on acute heart failure patients, there is limited data about treatment outcomes of chronic ambulatory heart failure patients. Therefore, this study aimed to assess treatment outcomes and associated factors of chronic ambulatory heart failure patients at Jimma Medical Center, South West Ethiopia.

Methods

A hospital-based prospective observational study was conducted on 242 chronic ambulatory heart failure patients at Jimma Medical Center from November 2020 to June 2021. The data were collected with pretested data collection format, and analyzed with Statistical Package for Social Sciences version 23. Both univariate and multivariate logistic regression model were used to identify factors associated with treatment outcomes of outpatient heart failure, and with a reported p value < 0.05, 95% confidence interval (CI) was considered statistical significance.

Result

From 242 patients, 126 (52.1%) were males and 121 (50.0%) patients were aged between 45 and 65 years. Regarding treatment outcomes, 51 (21.1%) of patients were hospitalized, and 58 (24.0%) and 28 (11.6%) of patients had worsened and improved clinical states respectively. Clinical inertia [AOR = 2.820; 95% CI (1.301, 6.110), p = 0.009], out-of-pocket payment [AOR = 2.790; 95% CI (1.261, 6.172), p = 0.011] and New York Heart Association class II [AOR = 2.534; 95% CI (1.170, 5.488), p = 0.018] were independent predictors of hospitalization.

Conclusion

Hospitalization of ambulatory heart failure patients was relatively high. More than half of the patients had clinical inertia. And also, this study showed most ambulatory HF patients had inadequate self-care. Clinical inertia, out-of-pocket payment, and New York Heart Association class II were independent predictors of hospitalization in ambulatory heart failure patients. Therefore, it is better to give more attention to ambulatory heart failure patients to prevent hospitalization and the burden of heart failure.
GPs’ prescription patterns, experience, and attitudes towards medicinal cannabis—a nationwide survey at the early stage of the Danish test scheme
Authors: Rosenbæk F. , Riisgaard H. , Nielsen J. B. , Wehberg S. , Waldorff F. B. , Pedersen L. B. , Søndergaard J.
Published: January 2023

Background

On 1 January 2018 a four-year test scheme concerning use of medicinal cannabis (MC) was enacted. It has recently been extended for four more years by the Danish Parliament permitting all Danish physicians to prescribe MC to their patients. Previous studies have shown that general practitioners (GPs) have varying prescription experience, little knowledge, and mixed attitudes about MC. However, the present evidence is still limited, and no studies exist about Danish GPs’ prescription experience, knowledge, and attitudes towards MC. Therefore, our aim was to examine Danish GPs’ prescription experience, knowledge, and attitudes towards MC.

Methods

A national online survey-based study addressing Danish GPs was performed from September 2018 to July 2019. We performed separate multivariable logistic regression analyses including GPs’ prescription experience, knowledge, and attitudes towards MC as outcome variables.

Results

A total of 427 (38.4%) of 1112 GPs completed the questionnaire. Of these, 37 (8.7%) had experience in prescribing MC. The majority had little or no knowledge about MC (80.6%) as well as a negative view on prescription of MC (71.4%) to patients. Factors associated with prescribing MC to patients were: Single-handed practices (OR = 1.6, 95% CI 1.1;1.8) and perception of having quite some knowledge about MC (OR = 4.8, 95% CI 2.2;10.4). Factors associated with having quite some knowledge about MC were: having a positive attitude towards prescribing MC (OR = 5.2, 95% CI 1.9;14.0), being male (OR = 1.7, 95% CI 1.4;1.8), and being at least 60 years of age (OR = 2.8, 95% CI 1.3;6.0). Factors associated with having a positive attitude towards prescribing MC were: having quite some knowledge about MC (OR = 5.2, 95% CI 2.2;12.5) and GPs being male (OR = 1.7, 95% CI 1.1;1.9).

Conclusion

In this first study on prescription experience, knowledge, and attitudes about MC among Danish GPs, conducted one year after the Danish test scheme was enacted, we find a very low proportion of prescribers, little knowledge, and an overall negative attitude towards MC. Among the prescribing GPs, four in ten have little to no knowledge and a negative attitude towards MC. We stress that prescribing patterns, knowledge, and attitudes may change throughout the remaining time of the test scheme.
Real-time analysis of hospital length of stay in a mixed SARS-CoV-2 Omicron and Delta epidemic in New South Wales, Australia
Authors: Tobin Ruarai J. , Wood James G. , Jayasundara Duleepa , Sara Grant , Walker Camelia R. , Martin Genevieve E. , McCaw James M. , Shearer Freya M. , Price David J.
Published: January 2023

Background

The distribution of the duration that clinical cases of COVID-19 occupy hospital beds (the ‘length of stay’) is a key factor in determining how incident caseloads translate into health system burden. Robust estimation of length of stay in real-time requires the use of survival methods that can account for right-censoring induced by yet unobserved events in patient progression (e.g. discharge, death). In this study, we estimate in real-time the length of stay distributions of hospitalised COVID-19 cases in New South Wales, Australia, comparing estimates between a period where Delta was the dominant variant and a subsequent period where Omicron was dominant.

Methods

Using data on the hospital stays of 19,574 individuals who tested positive to COVID-19 prior to admission, we performed a competing-risk survival analysis of COVID-19 clinical progression.

Results

During the mixed Omicron-Delta epidemic, we found that the mean length of stay for individuals who were discharged directly from ward without an ICU stay was, for age groups 0–39, 40–69 and 70 +, respectively, 2.16 (95% CI: 2.12–2.21), 3.93 (95% CI: 3.78–4.07) and 7.61 days (95% CI: 7.31–8.01), compared to 3.60 (95% CI: 3.48–3.81), 5.78 (95% CI: 5.59–5.99) and 12.31 days (95% CI: 11.75–12.95) across the preceding Delta epidemic (1 July 2021–15 December 2021). We also considered data on the stays of individuals within the Hunter New England Local Health District, where it was reported that Omicron was the only circulating variant, and found mean ward-to-discharge length of stays of 2.05 (95% CI: 1.80–2.30), 2.92 (95% CI: 2.50–3.67) and 6.02 days (95% CI: 4.91–7.01) for the same age groups.

Conclusions

Hospital length of stay was substantially reduced across all clinical pathways during a mixed Omicron-Delta epidemic compared to a prior Delta epidemic, contributing to a lessened health system burden despite a greatly increased infection burden. Our results demonstrate the utility of survival analysis in producing real-time estimates of hospital length of stay for assisting in situational assessment and planning of the COVID-19 response.
Autonomic dysfunction after mild acute ischemic stroke and six months after: a prospective observational cohort study
Authors: Damkjær Mathias , Simonsen Sofie Amalie , Heiberg Adam Vittrup , Mehlsen Jesper , West Anders Sode , Jennum Poul , Iversen Helle Klingenberg
Published: January 2023

Introduction

Autonomic dysfunction is prevalent in ischemic stroke patients and associated with a worse clinical outcome. We aimed to evaluate autonomic dysfunction over time and the tolerability of the head-up tilt table test in an acute stroke setting to optimize patient care.

Patients and method

In a prospective observational cohort study, patients were consecutively recruited from an acute stroke unit. The patients underwent heart rate and blood pressure analysis during the Valsalva maneuver, deep breathing, active standing, and head-up tilt table test if active standing was tolerated. In addition, heart rate variability and catecholamines were measured. All tests were performed within seven days after index ischemic stroke and repeated at six months follow-up.

Results

The cohort was comprised of 91 acute stroke patients, mean (SD) age 66 (11) years, median (IQR) initial National Institute of Health Stroke Scale 2 (1–4) and modified Ranking Scale 2 (1–3). The head-up tilt table test revealed 7 patients (10%) with orthostatic hypotension. The examination was terminated before it was completed in 15%, but none developed neurological symptoms. In the acute state the prevalence of autonomic dysfunction varied between 10–100% depending on the test. No changes were found in presence and severity of autonomic dysfunction over time.

Conclusion

In this cohort study of patients with mild stroke, autonomic dysfunction was highly prevalent and persisted six months after index stroke. Head-up tilt table test may be used in patients who tolerate active standing. Autonomic dysfunction should be recognized and handled in the early phase after stroke.
Detection of pancreatic cancer with two- and three-dimensional radiomic analysis in a nationwide population-based real-world dataset
Authors: Chang Dawei , Chen Po-Ting , Wang Pochuan , Wu Tinghui , Yeh Andre Yanchen , Lee Po-Chang , Sung Yi-Hui , Liu Kao-Lang , Wu Ming-Shiang , Yang Dong , Roth Holger , Liao Wei-Chih , Wang Weichung
Published: January 2023

Background

CT is the major detection tool for pancreatic cancer (PC). However, approximately 40% of PCs < 2 cm are missed on CT, underscoring a pressing need for tools to supplement radiologist interpretation.

Methods

Contrast-enhanced CT studies of 546 patients with pancreatic adenocarcinoma diagnosed by histology/cytology between January 2005 and December 2019 and 733 CT studies of controls with normal pancreas obtained between the same period in a tertiary referral center were retrospectively collected for developing an automatic end-to-end computer-aided detection (CAD) tool for PC using two-dimensional (2D) and three-dimensional (3D) radiomic analysis with machine learning. The CAD tool was tested in a nationwide dataset comprising 1,477 CT studies (671 PCs, 806 controls) obtained from institutions throughout Taiwan.

Results

The CAD tool achieved 0.918 (95% CI, 0.895–0.938) sensitivity and 0.822 (95% CI, 0.794–0.848) specificity in differentiating between studies with and without PC (area under curve 0.947, 95% CI, 0.936–0.958), with 0.707 (95% CI, 0.602–0.797) sensitivity for tumors < 2 cm. The positive and negative likelihood ratios of PC were 5.17 (95% CI, 4.45–6.01) and 0.10 (95% CI, 0.08–0.13), respectively. Where high specificity is needed, using 2D and 3D analyses in series yielded 0.952 (95% CI, 0.934–0.965) specificity with a sensitivity of 0.742 (95% CI, 0.707–0.775), whereas using 2D and 3D analyses in parallel to maximize sensitivity yielded 0.915 (95% CI, 0.891–0.935) sensitivity at a specificity of 0.791 (95% CI, 0.762–0.819).

Conclusions

The high accuracy and robustness of the CAD tool supported its potential for enhancing the detection of PC.