bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome-Based Decision-Making Algorithm for Treating Patients with Primary Aldosteronism
Authors: Kim Jung Hee , Ahn Chang Ho , Kim Su Jin , Lee Kyu Eun , Kim Jong Woo , Yoon Hyun-Ki , Lee Yu-Mi , Sung Tae-Yon , Kim Sang Wan , Shin Chan Soo , Koh Jung-Min , Lee Seung Hun
Published: April 2022

Background: Optimal management of primary aldosteronism (PA) is crucial due to the increased risk of cardiovascular and cerebrovascular diseases. Adrenal venous sampling (AVS) is the gold standard method for determining subtype but is technically challenging and invasive. Some PA patients do not benefit clinically from surgery. We sought to develop an algorithm to improve decision- making before engaging in AVS and surgery in clinical practice.Methods: We conducted the ongoing Korean Primary Aldosteronism Study at two tertiary centers. Study A involved PA patients with successful catheterization and a unilateral nodule on computed tomography and aimed to predict unilateral aldosterone-producing adenoma (n=367). Study B involved similar patients who underwent adrenalectomy and aimed to predict postoperative outcome (n=330). In study A, we implemented important feature selection using the least absolute shrinkage and selection operator regression.Results: We developed a unilateral PA prediction model using logistic regression analysis: lowest serum potassium level ≤3.4 mEq/L, aldosterone-to-renin ratio ≥150, plasma aldosterone concentration ≥30 ng/mL, and body mass index <25 kg/m2 (area under the curve, 0.819; 95% confidence interval, 0.774 to 0.865; sensitivity, 97.6%; specificity, 25.5%). In study B, we identified female, hypertension duration <5 years, anti-hypertension medication <2.5 daily defined dose, and the absence of coronary artery disease as predictors of clinical success, using stepwise logistic regression models (sensitivity, 94.2%; specificity, 49.3%). We validated our algorithm in the independent validation dataset (n=53).Conclusion: We propose this new outcome-driven diagnostic algorithm, simultaneously considering unilateral aldosterone excess and clinical surgical benefits in PA patients.
Akomodasi Filsafat Pragmatisme dalam Pendidikan Agama Kristen untuk Menjawab Tantangan Pembelajaran di Era Digital
Authors: Simanjuntak Ramses , Jatmiko Bakhoh , Pa Anthoneta Ratu , Siswoyo Hadi , Langke Albert Yusuf
Published: April 2022

The spirit of society 5.0 era demands the mastery and utilization of technology along with digital literation in every area of life. This development and challenges also occur in the education sector. A similar challenge is wrestled by Christian Education (CE) to be relevant knowledge within this era. CE must improve itself amid limitations within it. What innovations can be made to make CE relevant and fit to answer the needs of this digital era? This research aims to integrate positive contributions of pragmatism education philosophy toward CE in answering the needs of this era. The pragmatism thinking emphasizes practice and relevant learning outcomes as well as applicative skills. CE needs this utility in the learning process within this pragmatic era. This research applied a qualitative descriptive method with a literature research approach. The founding of this research is a proposal of accommodation of pragmatism philosophy toward CE using project based learning, collaborative learning, and creative problem solving learning approach.Era digital merupakan perkembangan peradaban yang tidak mungkin dihindari. Perkembangan teknologi dan digitalisasi berbasis internet telah memberikan kontribusi signifikan di dalam dunia pendidikan. Sebagaimana semangat society 5.0 yang menekankan kegunaan teknologi dan keilmuan bagi kebaikan manusia, dunia pendidikan secara khusus dalam Pendidikan Agama Kristen (PAK) harus ikut berbenah diri ditengah keterbatasan dan ketertinggalan yang dihadapi. Inovasi apa yang dapat dilakukan guna membuat keilmuan ini tetap releven dan menjawab kebutuhan di era digital ini? Pemikiran pragmatisme yang menekankan pada capaian pembelajaran yang praktis, relevan, dan berorientasi pada keterampilan aplikatif (utilitas) adalah hal yang diperlukan di dalam konteks PAK di dalam proses pembelajaran di era pragmatis ini. Penelitian ini menggunakan pendekatan deskriptif kualitatif, dan jenis penelitian yang digunakan adalah penelitian kepustakaan dengan mengumpulkan data atau karya tulis ilmiah yang berkaitan dengan obyek penelitian atau pengumulan data yang bersifat kepustakaan. Kajian di dalam penelitian ini mengusulkan akomodasi filsafat pragmatism di dalam PAK dengan pendekatan pembelajaran yang berupa project based learning, collaborative learning, dan creative problem solving.
Kontroversi Bohong dalam Keluaran 1:8-22
Authors: Ngesthi Yonathan Salmon Efrayim , Dwikoryanto Matius I Totok , Zega Fatiaro
Published: April 2022

AbstractMany people today tolerate the truth of the word by considering that lying for the sake of goodness becomes a natural thing. Through the history of Sifra and Pua, the writer wants to describe the purpose of writing this article to provide an understanding in a biblical context using descriptive qualitative methods and literature study approaches, it can be concluded in the study of the light of the Bible, that lying white or lying for good fulfills all the criteria for action which is included in lying or witness to lies. Because white lies are part of lies or witnesses to lies that God consistently forbids in the Bible, white lies should not be done by believers. It cannot be denied that the practice of white lying has become a habit and is considered normal and commonplace in today's society. But this does not mean that believers can simply join society at large to approve and practice white lies. Furthermore, the Church must act proactively in providing Christian ethics education, especially in relation to the topic of white lies or lying for good so that members of the congregation have a clear and stable understanding of this issue AbstrakMasayarakat saat ini banyak yang toleransi terhadap kebenaran firman dengan mengangap bahwa kebohongan demi kebaikan menjadi hal yang wajar. Melalui sejarah Sifra dan Pua penulis ingin menjabarkan tujuan penulisan artikel ini memberikan pemahaman dalam kontek Alkitabiah menggunakan metode kualitatif deskriptif dan pendekatan studi Pustaka, dapat disimpulkan dalam kajian dari terang Alkitab, bahwa bohong putih atau bohong untuk kebaikan memenuhi semua kriteria tindakan yang termasuk dalam kebohongan atau saksi dusta. Karena bohong putih termasuk bagian dari kebohongan atau saksi dusta yang dilarang Allah secara konsisten di dalam Alkitab, maka bohong putih tidak boleh dilakukan oleh orang percaya. Memang tidak dapat disangkal bahwa praktek bohong putih sudah menjadi kebiasaan dan dianggap wajar dan lumrah dalam masyarakat hari ini. Namun ini tidak berarti orang percaya boleh begitu saja menggabungkan diri dengan masyarakat pada umumnya untuk menyetujui dan mempraktekkan bohong putih. Selanjutnya Gereja harus bertindak proaktif menyelenggarakan pendidikan etika Kristen, khususnya yang berhubungan dengan topik bohong putih atau bohong untuk kebaikan sehingga anggota jemaat memiliki pengertian yang jelas dan mantap tentang persoalan ini
Emission-line Outflows from the Circumnuclear to Circumgalactic Scales in a Partially Obscured Quasar
Authors: Li Zhenzhen , Jiang Peng , Hao Lei , Dai Xuejie , Zhou Yipeng , Ji Tuo , Pan Xiang , Xiong Yifei , Zhou Hongyan
Published: April 2022

We present a detailed analysis of the rest-frame UV and optical emission-line spectrum of the partially obscured quasar J121704.70+023417.1 (hereafter J1217+0234). Here the obscuring material, very likely the dusty torus invoked by the AGN unification models, acts as a natural coronagraph, which greatly suppresses both the continuum and broad-line emission in the UV and enables a clear detection of three emission-line components at and beyond the dusty torus scale: (1) The component, with a blueshift of v ≈ 1200 km s−1 and a line width of FWHM ≈ 2600 km s−1, shows exceptionally large intensity ratios, such as N v/Lyα ≈ 2.3 and O vi/Lyα ≈ 1.4, indicating that the emitting gas is highly ionized and has a very high density up to n
H ∼ 1013 cm−3, possibly associated with the dusty torus. (2) The largely unshifted narrow-line component, with FWHM ≈ 510 km s−1, is completely absent in all UV lines but Lyα and is significantly detected in the forbidden lines of [O iii], [O ii], and [Ne iii] in the optical, implying massive low-density (n
H ∼ 102 cm−3) gas ∼40 kpc from the galactic center. (3) The intermediate component is only detected in [O iii] with a blueshift and line width between (1) and (2), which might bridge the gases from the circumnuclear to the circumgalactic scales. Follow-up observations with high spatial resolution and high sensitivity are needed to confirm the speculation and are helpful to reveal outflows at multiscales in J1217+0234.
Validation of the Premise Score after Addition of Recurrent Stroke Variable to Predicting Early Mortality in Acute Ischemic Stroke Patients
Authors: Nasution Iskandar , Hutagalung Haflin Soraya , Irawan Engki
Published: April 2022

BACKGROUND: Predicting Early Mortality of Acute Ischemic Stroke (PREMISE) score is a recent scoring derived from the Austrian Stroke Unit Registry. Internal validation assigned by Haji Adam Malik General Hospital Medan in 2020 stated that the performance of its discrimination was not strong enough and leads to a further necessity for an improvement by an addition of another variable.
AIM: This study aims to assess the calibration and discrimination performance of the PREMISE score after addition of recurrent stroke variable to predicting early mortality in acute ischemic stroke patients.
METHODS: Retrospective cohort study was performed in a population of ischemic stroke patients admitted to Haji Adam Malik General Hospital Medan from January to December 2019. The score’s calibration was calculated by the Hosmer–Lemeshow goodness-of-fit test and its discriminatory power by calculating the area under curve (AUC) after adding the recurrent stroke variable.
RESULTS: In total, 223 ischemic stroke patients were included in the analysis, there were 69 patients with recurrent stroke (30.9%). The PREMISE score showed good calibration (Hosmer–Lemeshow p = 0.331) and a strong enough discrimination power with an AUC value of 0.783. The addition of the recurrent stroke variable to the PREMISE score showed an increase score’s calibration with Hosmer–Lemeshow p = 0.575 and discrimination power with an AUC value of 0.806.
CONCLUSION: The PREMISE score after the addition of the recurrent stroke variable showed an increase calibration and discrimination performance to predicting early mortality in acute ischemic stroke patients.
Quantifying troglomorphism in hyperspace
Authors: Mammola Stefano , Pavlek Martina , Arnedo Miquel , Milano Filippo , Milione Roberto , Tolve Marco , Isaia Marco , Cardoso Pedro
Published: April 2022

Many ecological and evolutionary studies require to quantify the degree of adaptation of subterranean species to caves or other subterranean systems. In 1962, Kenneth A. Christiansen (1924–2017) coined the term “troglomorphism” to illustrate the process of subterranean adaptation and the suite of adaptive traits of organisms (“troglomorphic traits” or “troglomorphies”) (Christiansen 1962). Although this term was proposed in a paper published in French, “troglomorphism” and its derivatives (e.g. “troglobiomorphism”) became widely adopted jargon in subterranean biology. Yet, after decades of work and countless discussions around the subtle meanings of the term, there is still no consensus on how to best quantify troglomorphism in a simple operational way to support eco-evolutionary research. In a recent interview, Boris Sket made the excellent point that “nothing [makes] sense in speleobiology without a comparison of cave animals with the 'normal' epigean ones” (Lučić 2021). Building on this idea, we contend that one could quantify troglomorphism on a continuous scale within a given group of organisms (e.g., family or genus) as the functional distance of each species to the phylogenetically closest surface species or the “average” surface species (depending on whether phylogenetic information is available or not). We illustrate this approach using subterranean spiders in the genus Troglohyphantes, a well-studied group for which both a phylogeny and functional traits are available (Isaia et al. 2017, Mammola et al. 2020). We tested two approaches: i) quantifying adaptation as the morphological distance of each species to the phylogenetically closest surface-dwelling relative; ii) using a kernel density n-dimensional hypervolume (sensu Blonder et al. 2014) to construct the morphospace occupied by all surface-dwelling species of Troglohyphantes, and quantifying the degree of adaptation of subterranean species as their distance from the centroid of this “average” surface species. To test the effectiveness of these alternative methods, we compare how functional distance varies in relation the habitat occupied by each species (deep caves vs cave entrances vs interstitial habitats) and its range size. We suggest our approach could be applied to any group of subterranean organisms for which a surface relative is known, allowing to explore a range of questions on the degree to which the specialization of a given community relates to local environmental conditions, interspecific interactions, and more.
European Association of Science Editors statement in support of Ukraine
Authors: Nicholas Duncan
Published: April 2022

The European Association of Science Editors statement on the invasion of Ukraine includes details of support for the Association's Ukrainian members and all peoples of Ukraine, condemnation of the Russian invasion, and advocacy for research and scholarly publishing industry initiatives to support continued academic activity.
Morphological and phylogenetic analyses reveal two new species of Sporocadaceae from Hainan, China
Authors: Zhang Zhaoxue , Liu Rongyu , Liu Shubin , Mu Taichang , Zhang Xiuguo , Xia Jiwen
Published: April 2022

Species of Sporocadaceae have often been reported as plant pathogens, endophytes or saprophytes and are commonly isolated from a wide range of plant hosts. The isolated fungi were studied through a complete examination, based on multilocus phylogenies from combined datasets of ITS/tub2/tef1, in conjunction with morphological characteristics. Nine strains were isolated from Ficus microcarpa, Ilex chinensis and Schima superba in China which represented four species, viz., Monochaetia schimaesp. nov., Neopestalotiopsis haikouensissp. nov., Neopestalotiopsis piceana and Pestalotiopsis licualicola. Neopestalotiopsis piceana was a new country record for China and first host record from Ficus macrocarpa. Pestalotiopsis licualicola was first report from Ilex chinensis in China.
Mammalian petrosal from the Lower Cretaceous high paleo-latitude Teete locality (Yakutia, Eastern Russia)
Authors: Schultz Julia A. , Schellhorn Rico , Skutschas Pavel P. , Vitenko Dmitry D. , Kolchanov Veniamin V. , Grigoriev Dmitry V. , Kuzmin Ivan T. , Kolosov Petr N. , Lopatin Alexey V. , Averianov Alexander O. , Martin Thomas
Published: April 2022

Abstract

A mammalian petrosal from the Lower Cretaceous Teete locality in Yakutia (Russia) shows a prominent and complex system of venous channels in the bony wall of the pars cochlearis surrounding the straight cochlear canal. This complex venous system is distinctive and more strongly developed than in other mammalian petrosals. A bony ridge is present on the ventral side of the cochlear canal endocast, continuing from between fenestra vestibuli and fenestra cochleae in anterior direction. This ridge corresponds to the position of the scala tympani, and is similar to the secondary bony lamina of crown therians, but lacks the sharp laminar edge. The fenestra cochleae is separate from the canal for the aquaeductus cochleae (derived), but the fenestra retains a deep sulcus that resembles the perilymphatic sulcus (plesiomorphic). The fenestra cochleae is oval shaped and deep. The straight cochlear canal with a ridge on the ventral side strongly resembles that of eutriconodontans like Priacodon fruitaensis from the Upper Jurassic of North America. However, thick and extensive venous channels in the pars cochlearis are otherwise known from docodontans. In the Teete petrosal the channels are even more developed, and resemble the pattern recently reported from possible haramiyidan petrosals from the Middle Jurassic of western Siberia (Russia). Both eutriconodontan and haramiyidan dental remains are known from the Teete locality beside that of tritylodontids and docodontans.
Jean Izoulet : une sociologie antidurkheimienne ?
Authors: de Vitry Alexandre
Published: April 2022

Cet article examine la pensée de Jean Izoulet (1854-1929), « philosophe social » proche des milieux républicains modérés, professeur au Collège de France où il fut nommé en grande partie pour faire contrepoids au succès grandissant de Durkheim. La pensée d’Izoulet, à la scientificité discutable, pensée de la hiérarchie sociale et de la légitimité de l’élite, se construit explicitement contre celle de Durkheim : à la fois contre La Division du travail social puis contre Les Formes élémentaires de la vie religieuse. La polémique à sens unique que développe Izoulet contre son collègue repose sur une confusion épistémologique : le concept même de « société », chez lui, est entièrement confondu avec celui de « cité » ou de polis, signe qu’il n’a pas vu la spécificité méthodologique de la sociologie émergente. Sur le plan idéologique, le cas d’Izoulet concentre les réticences du républicanisme le plus conservateur contre le socialisme en développement ; on en retrouvera des traces dans le pétainisme.
Psychologie et recrutement
Authors: Bertolino Marilena , Steiner Dirk D.
Published: April 2022

Résumé La validité apparente fait référence à la pertinence perçue par le candidat par rapport à la méthode de sélection et au poste pour lequel il est candidat. Les perceptions de justice des candidats sont importantes parce qu’elles peuvent avoir une influence sur l’attrait organisationnel, l’auto-efficacité et la motivation à réussir le test, entre autres. D’ailleurs, les perceptions négatives des candidats concernant une méthode de sélection peuvent les amener à être moins satisfaits et moins intéressés par des propositions d’embauche. D’un point de vue international, les résultats des recherches montrent l’existence de similarité de perceptions dans plusieurs pays. Par exemple, les entretiens et les essais professionnels sont évalués favorablement aux Pays-Bas, en Italie, en France… Alors que les méthodes perçues négativement dans tous les pays sont la graphologie et les contacts personnels. Un recrutement efficace se base sur des techniques de sélection valides mais également sur l’acceptabilité de ces méthodes par les utilisateurs.
Psychologie et recrutement
Authors: Krings Franciska , Bollmann Grégoire , Kluge Annette
Published: April 2022

Résumé Lorsqu’il postule pour un poste de cadre, un candidat âgé de 48 à 50 ans a sept fois moins de chance d’être invité à un entretien qu’un candidat âgé de 28 à 30 ans. Or le nombre de travailleurs âgés sur le marché du travail va augmenter, et l’âge est aujourd’hui cité par les candidats comme le motif principal de discrimination à l’embauche. Les supérieurs de tout âge ont tendance à juger la performance et l’efficacité de leurs employés âgés comme plus basse que celle des jeunes. Contrairement à cette idée reçue, l’âge n’a pas d’impact sur la performance au travail. Différentes approches théoriques mettent en avant la fonction des stéréotypes, qui serait de protéger l’individu des notions menaçantes liées au vieillissement, l’interaction des normes liées à un poste avec les stéréotypes et préjugés liés à un candidat ou encore les attitudes liées aux rapports entre générations au sein des organisations. La lutte contre la discrimination liée à l’âge a lieu, au niveau institutionnel, par l’introduction de législations européennes mais aussi au niveau organisationnel par des actions positives pour les minorités et des programmes de sensibilisation à la diversité.
Guidimakha : la gestion des ressources naturelles au cœur d’enjeux politiques, alimentaires et sécuritaires
Authors: Secco Charlotte
Published: April 2022

Le Guidimakha est une région située au sud de la Mauritanie, enclavée entre le Mali et le Sénégal. Ce territoire est au carrefour entre le désert et le Sahel. L’ensemble des terres arables du pays ne représente que 1 % de la superficie de la Mauritanie. Le Guidimakha a un potentiel agro-sylvo-pastoral relativement élevé par rapport au reste du pays. Cependant, les conditions climatiques se détériorent et affectent les capacités productives de la région. La production agroalimentaire nationale ne couvre que 30 % de la consommation du pays (GRDR, Groupe de Recherche et de Réalisation pour le Développement Rural 2017) 1 . La dépendance à l’importation est un facteur important de l’insécurité alimentaire. La gestion des ressources naturelles est désormais primordiale dans cette région afin d’optimiser au maximum, et de manière durable, son potentiel productif. La question environnementale est désormais au cœur de nombreux projets de développement ayant comme objectif la gestion durable des ressources naturelles qui constitue, pour les acteurs du développement, l’un des leviers de la réduction de la vulnérabilité alimentaire des ménages.
L’affirmation des territoires ruraux par le management de projet : préparer le retour plutôt que la revanche
Authors: Caitucoli Paul-Mathieu , Larceneux Fabrice , Simon Arnaud
Published: April 2022

Cette introduction interroge l’influence réciproque du management de projet dans le développement rural, et de l’impact de la ruralité sur les pratiques managériales. Recourant aujourd’hui davantage aux méthodes et techniques de gestion, comme la marque ou le projet, les managers ruraux tentent d’articuler les différentes parties prenantes et de valoriser au mieux les potentialités rurales. Pour ce faire, un cadre institutionnel favorable leur est nécessaire. Les dispositifs LEADER et TZCLD, abordés dans ce numéro spécial, présentent deux approches institutionnelles visant ainsi à aider à la mobilisation du capital endogène. Ne se limitant pas à un ensemble de techniques, le management rural présente également un versant symbolique. Il s’affirme en phase avec les aspirations contemporaines, environnementales notamment. Évitant les positions revanchardes, il doit prendre en compte les interactions multiples avec le monde urbain pour être efficace.
Mobiliser le programme LEADER dans un contexte de décroissance : stratégies locales d’adaptation à une politique européenne de développement rural
Authors: Lécuyer Joséphine
Published: April 2022

Cet article porte sur un Land rural du nord-est de l’Allemagne, à la fois concerné par un héritage socialiste et des logiques de périphérisation, définie comme les effets conjoints de départs de population, décrochage économique, dépendance politique et stigmatisation. L’article examine dans quelle mesure ces facteurs sont déterminants dans la capacité de ce Land à mobiliser LEADER. À travers l’analyse de trois régions LEADER, il pose l’hypothèse d’une inadéquation entre le programme et les territoires étudiés, en ce que les régions combinant trop de difficultés ne sont pas aptes à s’en saisir. En effet, la compétition entre régions accroît les inégalités entre mais également au sein de celles-ci. Après une étude des différents profils d’acteurs de LEADER dans les régions d’étude, les stratégies de contournement et d’instrumentalisation des règles du programme sont mises en évidence.
Instability results for the logarithmic Sobolev inequality and its application to related inequalities
Authors: Kim Daesung
Published: April 2022

We show that there are no general stability results for the logarithmic Sobolev inequality in terms of the Wasserstein distances and \begin{document}$ L^{p}(d\gamma) $\end{document} distance for \begin{document}$ p>1 $\end{document}. To this end, we construct a sequence of centered probability measures such that the deficit of the logarithmic Sobolev inequality converges to zero but the relative entropy and the moments do not, which leads to instability for the logarithmic Sobolev inequality. As an application, we prove instability results for Talagrand's transportation inequality and the Beckner–Hirschman inequality.
On a global climate model with non-monotone multivalued coalbedo
Authors: Hidalgo Arturo , Tello Lourdes
Published: April 2022

We are concerned with a global energy balance climate model formulated through a parabolic equation whose space domain is a manifold which simulates the Earth surface. The climate energy balance model includes the effect of coalbedo as one of the mean temperature feedback. We extend some mathematical results proved for maximal monotone coalbedo to the case where the coalbedo has not a monotone dependency on temperature. Numerical approximation is performed by the Finite Volume Method which allows to obtain and compare numerical solutions with different values of the coalbedo.
Mathematical analysis of an abstract model and its applications to structured populations (I)
Authors: Boulanouar Mohamed
Published: April 2022

The first part of this works deals with an integro–differential operator with boundary condition related to the interior solution. We prove that the model is governed by a strongly continuous semigroup and we precise its growth inequality. In the second part of this works, we model the proliferation-quiescence phases through a system of first order equations. We also prove that the proliferation-quiescence model is governed by a strongly continuous semigroup and we precise its growth inequality. In the last part, we give some applications in Demography and Biology.
Pathfinding algorithm based on rotated block AOR technique in structured environment
Authors: Dahalan A'qilah Ahmad , Saudi Azali
Published: April 2022

Harmonic potential fields are commonly used as guidance in a global approach for self-directed robot pathfinding. These harmonic potentials are generated using Laplace's equation solutions. The computation of these harmonic potentials often requires the use of immense amounts of computing resources. This study introduces a numerical technique called Rotated Block Accelerated Over-Relaxation (AOR), also known as Explicit Decoupled Group AOR (EDGAOR), to deal with pathfinding problem. Several robot navigation simulations were performed in a static, structured, known indoor environment to validate the efficiency of the suggested approach. The paths generated by the simulations are shown using several different starting and target positions. The performance of the proposed approach in computing harmonic potentials for solving pathfinding problems is also discussed.
Study of multi term delay fractional order impulsive differential equation using fixed point approach
Authors: Ali Amjad , Shah Kamal , Ahmad Dildar , Rahman Ghaus Ur , Mlaiki Nabil , Abdeljawad Thabet
Published: April 2022

This manuscript is devoted to investigate a class of multi terms delay fractional order impulsive differential equations. Our investigation includes existence theory along with Ulam type stability. By using classical fixed point theorems, we establish sufficient conditions for existence and uniqueness of solution to the proposed problem. We develop some appropriate conditions for different kinds of Ulam-Hyers stability results by using tools of nonlinear functional analysis. We demonstrate our results by an example.
Nonlocal multiscale modelling of tumour-oncolytic viruses interactions within a heterogeneous fibrous/non-fibrous extracellular matrix
Authors: Alsisi Abdulhamed , Eftimie Raluca , Trucu Dumitru
Published: April 2022

In this study we investigate computationally tumour-oncolytic virus (OV) interactions that take place within a heterogeneous extracellular matrix (ECM). The ECM is viewed as a mixture of two constitutive phases, namely a fibre phase and a non-fibre phase. The multiscale mathematical model presented here focuses on the nonlocal cell-cell and cell-ECM interactions, and how these interactions might be impacted by the infection of cancer cells with the OV. At macroscale we track the kinetics of cancer cells, virus particles and the ECM. At microscale we track (i) the degradation of ECM by matrix degrading enzymes (MDEs) produced by cancer cells, which further influences the movement of tumour boundary; (ii) the re-arrangement of the microfibres that influences the re-arrangement of macrofibres (i.e., fibres at macroscale). With the help of this new multiscale model, we investigate two questions: (i) whether the infected cancer cell fluxes are the result of local or non-local advection in response to ECM density; and (ii) what is the effect of ECM fibres on the the spatial spread of oncolytic viruses and the outcome of oncolytic virotherapy.
Mandatory COVID-19 vaccination for healthcare professionals: ethical perspectives
Authors: Rimedio Antonio , Galante Gabriel Ion , Picozzi Mario
Published: April 2022

Following the availability of new vaccines against COVID-19, in 2021, some countries introduced mandatory vaccination for healthcare professionals caring for patients and frail people. This work highlights the principles of public ethics which, reinforced by some fundamental ethical precepts, make mandatory vaccination legally acceptable. However, there are also problems, linked to the presence of the phenomenon of vaccine hesitancy among health professionals, in low percentages but with high incidence. In the context of the care relationship, the ethical tension between the autonomy claimed by the healthcare provider and the patient’s right to safety emerges. Vaccination does not provide absolute protection, but it makes an important contribution to the safety of the care environment. We believe that mandatory vaccination of healthcare professionals is compatible with the ethical precept of protecting the health of the community and the patients entrusted to their care. Individual freedom cannot increase the risk of patients. The ethical perspective suggests that public decision-makers should encourage spontaneous adherence to vaccines as much as possible and adopt the strategy of progressive intervention, inspired by the principle of proportionality.
Ingiustizia epistemica tra medicina e società. Annotazioni in tempi di pandemia
Authors: Refolo Pietro , Giardina Simona , Spagnolo Antonio G.
Published: April 2022

Provvisorietà di ogni forma di conoscenza e ineliminabilità del soggetto dal discorso scientifico rappresentano due acquisizioni fondamentali e – si potrebbe forse dire – oramai indiscutibili, del modo di concepire la scienza nella contemporaneità. La Medicina ha faticato non poco a metabolizzare questi passaggi. Se, in riferimento al secondo aspetto, sono oggi ravvisabili tentavi tangibili di superare la discriminazione epistemica di cui il paziente è stato da sempre vittima, in riferimento al primo aspetto, l’uso disinvolto del concetto di “evidenza”, così come una inesatta interpretazione dei risultati che la c.d. “Evidence-based medicine” (EBM) è in grado di garantire rischiano di far di risorgere i “miti” del verificazionismo e dell’oggettivismo nella scienza. In questo “gioco” di potenziamento e depotenziamento a cui è sottoposta la prospettiva del paziente, va da sé che si possano generare contraddizioni, le stesse alla base di alcune lacerazioni oggi presenti nella società, come quelle che stanno riguardano la limitazione delle libertà individuali, l’obbligo del green pass, l’obbligo del vaccino, ecc. Obiettivo del presente del contributo è quello di svolgere una breve disanima del ruolo delle evidenze e della prospettiva del paziente nell’epistemologia medica. Il fine ultimo è quello di provare ad offrire qualche suggerimento per superare alcune delle contraddizioni che si sono venute a determinare.
Pattern of Practices of Oncologists of Bangladesh in the COVID-19 Era
Authors: Chowdhury Arman Reza , Banu Parvin Akhter , Rahman Md. Arifur , Trapani Dario
Published: April 2022

Purpose:

The aim of this study was to investigate the impact of coronavirus disease-2019 (COVID-19) on the practice of oncology care in Bangladesh during the first pandemic surge in 2020.

Materials and Methods:

This was a cross-sectional survey-type study, based on a questionnaire, which was shared via email to national oncologists and enhanced by snowballing in April–May 2020.

Results:

A total of 48 responders joined the survey, mostly clinical and radiation oncologists practicing in specialized cancer centers of the major cities. Patients’ triage for COVID-19 was implemented in 60% of the settings surveyed, and an impact on the clinical care was unanimously reported. Delays and interruptions in cancer treatments were common, as was a reduction of patient volume treated with radiation therapy (RT). Mechanisms for priority-setting to inform clinical decisions were set by 80% of the oncologists, including changes in the treatment protocols––more commonly for palliative care interventions and regarding the RT fractionation; also, alternative therapeutic options were more commonly discussed, particularly when patients were candidate to multimodal treatments. Value-driven and choose-wisely approaches were emphasized. Telemedicine was identified as a mechanism to reduce access to hospitals, but only for selected services (e.g., follow-up) by 78%. Protecting hospitals and health workers were identified as priority interventions to shape effective COVID-19 responses.

Conclusion:

This survey serves as a case study of adaptations of cancer care during COVID-19 in low- and middle-income countries. Elements of priority-settings and value-driven decision-making emerged, although the long-term impact cannot be stated, at this time.
Clinical and Genetic Characteristics of Ectodermal Dysplasia in Four Indian Children
Authors: Kamat Divya , Mahajan Rahul , Chatterjee Debajyoti , Yadav Jaivinder , Kumar Rakesh , Dayal Devi , De Dipankar , Handa Sanjeev
Published: April 2022

Introduction:

Ectodermal dysplasias (EDs) affect structures derived from the ectoderm such as skin, its appendages, nail, and teeth. In this series, we describe four patients presenting with a clinical phenotype of dysplasia of one or more ectodermal structures who underwent next-generation sequencing for mutational analysis.

Case Series:

The clinical phenotype of three patients was hypohidrotic ectodermal dysplasia (HED) and one patient was diagnosed with autoimmune polyglandular syndrome (APS) type 1. Two patients with classical clinical features of X-linked HED (XLHED) had mutations in EDA gene; variant c.924+ 8C>G (5′ proximal splice site) and c.760C>T (p.Gln254Ter). Case 3 had clinical phenotype of HED with urticaria pigmentosa, which was confirmed on skin biopsy and immunohistochemistry. This patient was found to have mutation in C1orf172; c.449G>A (p.Arg150Gln) which has not been reported previously. Case 4 was diagnosed to have APS type 1 with cutaneous features of discoloration of teeth and chronic mucocutaneous candidiasis. This patient had a compound heterozygous mutation of AIRE gene. The two variants detected were c.169C>T (p.Gln57Ter) and c.47C>T (p.Thr16Met).

Conclusion:

The present series highlights the clinic-genetic correlation in four patients with features of ED. Two variants of uncertain significance and two previously unreported variants were also found in this study.
Intralesional Purified Protein Derivative of Tuberculin Versus Intralesional Mycobacterium W Vaccine in Treatment of Recalcitrant Extragenital Warts
Authors: Mohta Alpana , Jain Suresh Kumar , Mehta Rajesh Dutt , Arora Aakanksha
Published: April 2022

Introduction:

Of late, immunotherapy has emerged as a promising therapeutic modality for the treatment of recalcitrant and difficult to treat warts. Purified protein derivative of tuberculin (PDD) and mycobacterium w (Mw) vaccine hold promising prospects for the treatment of verruca, especially in a country like ours where a majority of the population is already sensitized to mycobacterium tuberculosis both due to disease endemicity and Bacillus Calmette-Guérin (BCG) vaccination.

Aims and Objectives:

We aimed at evaluating the treatment outcome of intralesional PPD tuberculin and Mw vaccine in the treatment of recalcitrant extragenital warts in immunocompetent subjects.

Materials and Methods:

The patients included immunocompetent subjects between the ages of 16 and 65 years with two or more extragenital warts. The patients were randomized into two groups, namely A (PPD Tuberculin) and B (Mw vaccine). In both groups, 0.1 mL of active intralesional immunogen was injected at the base of the largest wart. The doses were repeated at 4 weeks' intervals for a maximum of 5 injections. Additionally, the improvement in quality of life was measured using the Hindi-validated version of the Dermatology Quality of Life Index (DLQI) questionnaire.

Results:

Ninety-seven patients completed the study, with 46 in group A and 51 in group B. In group A, 24 (52.17%) patients had complete clearance in all warts, and in group B, 32 (62.75%) (P = 0.38). The most common adverse event in patients of group A was transient injection site erythema and swelling, whereas that in group B was mild transient fever. None of the patients showed any signs of recurrence in the ensuing follow-up period. There was a statistically significant improvement in the mean DLQI scores after treatment in both groups (P < 0.0001).

Conclusion:

Both PPD Tuberculin and Mw vaccine are effective in the treatment of recalcitrant warts with minimal recurrence rate. The safety profile of PPD is superior to Mw vaccine. We suggest both to be used as first-line therapy in the treatment of difficult to treat warts.
Frequency of Genotypes and Allelic Polymorphisms of Vitamin D Receptor in Egyptian Psoriatic Patients and Their Association With Disease Severity, Immune Modulation of IL-22 Levels and The Response to Topical Calcipotriol Treatment
Authors: A. Anani Haneya A. , Khalifa Warda A. , Althoqapy Azza Ali , Maklad Soheir S. , Kamal Hoda , Sabry Dina , Samir Mai
Published: April 2022

Objective:

This study was performed to determine the genotype and allelic frequencies (polymorphisms) of the four genes of vitamin D receptor (VDR) among Egyptian psoriatic patients and healthy controls to explore their association with disease severity (PASI) score and immune modulation of IL-22 cytokine and to predict the response to topical calcipotriol treatment.

Patients and Methods:

The frequencies of the four VDR gene polymorphisms (FokI, ApaI, TaqI, and BsmI) in blood samples of 51 adult Egyptian patients with psoriasis vulgaris and 50 healthy controls were evaluated using restriction fragment length polymorphism (RFLP)-PCR. Serum levels of IL-22 were measured by ELISA.

Results:

The most frequent genotype (wild) in the studied patients was Apa1; AA (88.2%) followed by Fok1; FF (47.1%) and Taq1; TT (47%), while Bsm1; BB genotype was (27.7%). The most frequent allele polymorphisms either in one allele (Bb) or both alleles (bb) in psoriatic patients were 72.5%, followed by Ff, ff (52.9%) and Tt, tt (52.9%). The less frequent allelic polymorphism was Aa, aa (27.7%). Insignificant differences in the frequency of genotype (wild) and allelic polymorphisms were detected between patients and controls (P > 0.05). A significantly higher serum concentration of IL-22 (ng/mL) was detected in patients than controls (P = 0.001). Further, 66.6% of patients displayed a clinical response, while 33.4% were non-responders. A significantly higher expression of TaqI polymorphism was detected in (100%) of non-responders (P < 0.001), which was also correlated with disease severity (r = 0.515, P < 0.01).

Conclusion:

These results suggest that the VDR TaqI polymorphism is the only gene correlated to psoriasis susceptibility in the Egyptian population, and affects the response to topical calcipotriol treatment but does not affect IL-22 immune modulation.
Risk Factors for Actinic Keratoses
Authors: Li Yongshuang , Wang Jinhua , Xiao Weimian , Liu Jing , Zha Xushan
Published: April 2022

Objective:

To integrate evidence and assess the risk factors associated with actinic keratosis (AK).

Methods:

Unrestricted searches were conducted on five electronic databases, with an end-date parameter of September 2021. We summarized the study characteristics and pooled the results from individual studies by using a random-effects model. The risk of bias was estimated using the Cochrane Risk of Bias Tool, and the quality of evidence was estimated according to the Newcastle–Ottawa Scale.

Results:

Sixteen studies were included in final analysis, and we assessed the AK risk among a variety of risk factors. Overall, the male sex (odds ratio (OR): 2.51; 95% confidence interval (CI): 1.94–3.25; P < 0.01), age >45 years (OR = 7.65, 95% CI: 2.95–19.86; P < 0.01), light Fitzpatrick skin phototype (OR = 2.32, 95% CI: 1.74–3.10; P < 0.01), light hair color (OR = 2.17, 95% CI: 1.40–3.36; P < 0.01), light eye color (OR = 1.67, 95% CI: 1.03–2.70; P = 0.04), freckles on face/arms (OR = 1.88, 95% CI: 1.37–2.58; P < 0.01), suffered positive history of other types of non-melanoma skin cancer (OR = 4.46, 95% CI: 2.71–7.33; P < 0.01), sunburns in childhood (OR = 2.33, 95% CI: 1.47–3.70; P < 0.01) and adulthood (OR = 1.50, 95% CI: 1.12-2.00; P < 0.01), severe sunburn (OR = 1.94, 95% CI: 1.62–2.31; P < 0.01), and chronic occupational and/or recreational sun exposure (OR = 3.22, 95% CI: 2.16–4.81; P < 0.01) increased the risk of AK. Moreover, sunscreen use (OR = 0.51, 95% CI: 0.34–0.77; P < 0.01) and history of atopy reduced the risk of AK. Sensitivity analysis yielded consistent results. The included studies showed a high risk of bias.

Conclusion:

We confirm several well-known AK risk factors and their quantitative data, and summarized the uncommon risk factors and protective factors. Our results may inform on the design and implementation of AK screening and educational programs.
A systemic review of association between UDP glucuronosyltransferase family 1 member A1 (UGT1A1) polymorphisms in Gilbert's syndrome in Sickle Cell Disease
Authors: Sachdeva Sanya , Bodade Ragini , Bodade Anand
Published: April 2022

Gilbert's syndrome (GS) is a benign hereditary disorder of bilirubin metabolism due to a mutation in the UDP glucuronosyltransferase family 1 member A1 (UGT1A1) gene which results in hyperbilirubinaemia and related complications mainly cholelithiasis. It can be co-inherited along with sickle cell anaemia, thalassaemias and other haemoglobinopathies including glucose-6-phosphate dehydrogenase deficiency, hereditary spherocytosis and cystic fibrosis. More than 100 mutations have been reported in UGT1A1 gene and the most common as insertion of extra (TA) nucleotides in the promoter region of TATA box. The more the number of TA repeats, the higher is the bilirubin levels. These mutations result in a 10%–35% reduction in the UGT1A1 enzyme activity resulting in mild to moderate unconjugated hyperbilirubinaemia and related complications. For diagnosis the mode of inheritance is more important than testing in the patients. However; the inheritance pattern of GS differs in ethnicities. For early diagnosis to prevent worsening of the symptoms and for timely management one should be aware of the inheritance pattern in patient. In this systemic analysis we studied the association between complications in GS with the genotypes and complications. It was found that TA7/7 is more significant in GS with sickle cell disease (SCD) group when compared to healthy controls with 2.2% chances of having this genotype in GS with SCD than healthy controls. The significance of having TA7/7 genotype is similar in GS with SCD and α-thalasaemia group. However, there is a high recommendation to carry out multicentre studies and conduct meta-analyses for establishing universal recommendations.
Unanticipated catastrophe during pre-operative routine check of anaesthesia workstation - Water in rotameter
Authors: Valasareddy Sunil Kumar , Segaran Siva Kumar , Ranjan R. V.
Published: April 2022

Medical gas production, supply and distribution is a closely regulated process with its intrinsic safety designs and procedure along with this anaesthesia work station designed with utmost safety for delivering anaesthetic gases to patients during the peri-operative period. The ingress of condensed water into anaesthesia machine from central medical gas pipeline can lead to catastrophic incidents.
Number fields with prescribed norms (with an appendix by Yonatan Harpaz and Olivier Wittenberg)
Authors: Frei Christopher , Loughran Daniel , Newton Rachel
Published: April 2022

We study the distribution of extensions of a number field

k

with fixed abelian Galois group

G

, from which a given finite set of elements of

k

are norms. In particular, we show the existence of such extensions. Along the way, we show that the Hasse norm principle holds for 100% of

G

-extensions of

k

, when ordered by conductor. The appendix contains an alternative purely geometric proof of our existence result.
Rationality of even-dimensional intersections of two real quadrics
Authors: Hassett Brendan , Kollár János , Tschinkel Yuri
Published: April 2022

We study rationality constructions for smooth complete intersections of two quadrics over nonclosed fields. Over the real numbers, we establish a criterion for rationality in dimension four.
Residents as Research Subjects: Balancing Resident Education and Contribution to Advancing Educational Innovations
Authors: Thibault Louis-Philippe , Bourque Claude Julie , Luu Thuy Mai , Huot Celine , Cardinal Genevieve , Carriere Benoit , Dupont-Thibodeau Amelie , Moussa Ahmed
Published: April 2022

Background

Research in education advances knowledge and improves learning, but the literature does not define how to protect residents' rights as subjects in studies or how to limit the impact of their participation on their clinical training.

Objective

We aimed to develop a consensual framework on how to include residents as participants in education research, with the dual goal of protecting their rights and promoting their contributions to research.

Methods

A nominal group technique approach was used to structure 3 iterative meetings held with the pre-existing residency training program committee and 7 invited experts between September 2018 and April 2019. Thematic text analysis was conducted to prepare a final report, including recommendations.

Results

Five themes, each with recommendations, were identified: (1) Freedom of participation: participation, non-participation, or withdrawal from a study should not interfere with teacher-learner relationship (recommendation: improve recruitment and consent forms); (2) Avoidance of over-solicitation (recommendation: limit the number of ongoing studies); (3) Management of time dedicated to participation in research (recommendations: schedule and proportion of time for study participation); (4) Emotional safety (recommendation: requirement for debriefing and confidential counseling); and (5) Educational safety: data collected during a study should not influence clinical assessment of the resident (recommendation: principal investigator should not be involved in the evaluation process of learners in clinical rotation).

Conclusions

Our nominal group technique approach resulted in raising 5 specific issues about freedom of participation of residents in research in medical education, over-solicitation, time dedicated to research, emotional safety, and educational safety.