bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges and opportunities for implementation and dissemination of a task- sharing counselling intervention for depression at primary health care level in South Africa
Authors: Selohilwe One , Fairall Lara , Bhana Arvin , Kathree Tasneem , Zani Babalwa , Folb Naomi , Lund Crick , Thornicroft Graham , Petersen Inge
Published: March 2023

Background

The treatment gap for mental health services is a growing public health concern. A lay-counselling service located at primary health care (PHC) level could potentially help to close the large treatment gap for common mental disorders in South Africa. The aim of this study was to understand multilevel factors contributing to implementation and potential dissemination of such a service for depression at PHC level.

Methods

Process qualitative data of the lay-counselling service for patients with depressive symptoms was collected alongside a pragmatic randomized controlled trial evaluating a collaborative care model that included a lay-counselling service for patients with depressive symptoms. Semi-structured key informant interviews (SSI) were conducted with a purposive sample of PHC providers (lay-counsellors, nurse practitioners, operational managers), lay-counsellor supervisors, district and provincial managers, and patients in receipt of services. A total of 86 interviews were conducted. The Consolidated Framework for Implementation Research (CFIR) was used to guide data collection as well as Framework Analysis to determine barriers and facilitators for implementation and dissemination of the lay-counselling service.

Results

Facilitators identified include supervision and support available for counsellors; person focused counselling approach; organizational integration of the counsellor within facilities. Barriers included lack of organizational support of the counselling service, including lack of counselling dedicated space; high counsellor turnover, resulting in a counsellor not available all the time; lack of an identified cadre to deliver the intervention in the system; and treatment of mental health conditions including counselling not included within mental health indicators.

Conclusions

Several system level issues need to be addressed to promote integration and dissemination of lay-counselling services within PHC facilities in South Africa. Key system requirements are facility organizational readiness for improvement of integration of lay-counselling services; formal recognition of counselling services provided by lay counsellors as well as inclusion of lay counselling as a treatment modality within mental health treatment data element definitions and the need for diversification of the roles of psychologists to include training and supervision of lay counsellors was also emphasized.
Early introduction of 3D modeling modules promotes the development of simulation skills in downstream biomedical engineering curricula
Authors: Jia Mary S. , Rao Raj R. , Elsaadany Mostafa
Published: March 2023

Background

Recent advancements in additive manufacturing have made 3D design a desirable skill in combating the historically slow development of biomedical products. Due to the broad applicability of additive manufacturing to biomedical engineering, 3D design and 3D printing are attractive educational tools for biomedical engineering students. However, due to the multidisciplinary nature of biomedical engineering, finding a suitable spot in the curriculum to teach students basic and application-based skills for 3D manufacturing is difficult. Furthermore, prior training in fundamental 3D design skills may be needed to support the use of application-based supplementary content.

Results

We designed a SolidWorks Simulations toolkit to complement a sophomore (2nd-year)-level Biomechanics course and distributed this assignment to students with and without prior training in 3D design delivered in an introductory biomedical engineering course. Using short videos, example-based problem solving, and step-by-step tutorials, students completed this as an extra-credit assignment and completed a survey gauging student opinion on SolidWorks and 3D design, confidence in each target skill, and the effectiveness of assignment delivery. The compilation of survey responses suggests that the assignment effectively increased positive responses in student opinion on interest in and likeliness to use SolidWorks in both groups. However, confidence in the target assignment skills was higher in the trained group and fewer problems occurred in operating SolidWorks for trained students. Further, analyzing the distribution of student grades with respect to survey responses suggests that responses had no relationship with initial class grade.

Conclusion

These data collectively indicate that prior training provided to the students had a positive impact on the effectiveness of the assignment although increases in student opinion on the utility of 3D design were observed in both trained and untrained students. Our work has generated and identified a useful educational supplement to enrich existing biomedical engineering course materials with practical skills.
Menstrual characteristics and dysmenorrhea among Palestinian adolescent refugee camp dwellers in the West Bank and Jordan: a cross-sectional study
Authors: Ghandour Rula , Hammoudeh Weeam , Stigum Hein , Giacaman Rita , Fjeld Heidi , Holmboe-Ottesen Gerd
Published: March 2023

Background

Women and girls experience menstruation throughout their reproductive years. Normal adolescent menstrual cycles gauge current and future reproductive health. Dysmenorrhea (painful menstruation) is the most prevalent menstrual disturbance in adolescents that can be debilitating. This study examines the menstrual characteristics of adolescent girls living in Palestinian refugee camps in the West Bank of the Israeli-occupied Palestinian territory and Jordan, including estimates of dysmenorrhea levels and associated factors.

Methods

A household survey of 15 to 18-year-old adolescent girls was conducted. Trained field workers collected data on general menstrual characteristics and dysmenorrhea level using Working ability, Location, Intensity, Days of pain Dysmenorrhea scale (WaLIDD), in addition to demographic, socio-economic, and health characteristics. The link between dysmenorrhea and other participant characteristics was assessed using a multiple linear regression model. Additionally, data on how adolescent girls cope with their menstrual pain was collected.

Results

2737 girls participated in the study. Mean age was 16.8 ± 1.1 years. Mean age-at-menarche was 13.1 ± 1.2; mean bleeding duration was 5.3 ± 1.5 days, and mean cycle length was 28.1 ± 6.2 days. Around 6% of participating girls reported heavy menstrual bleeding. High dysmenorrhea levels were reported (96%), with 41% reporting severe symptoms. Higher dysmenorrhea levels were associated with older age, earlier age-at-menarche, longer bleeding durations, heavier menstrual flow, skipping breakfast regularly, and limited physical activity patterns. Eighty nine percent used non-pharmacological approaches to ease menstrual pain and 25% used medications.

Conclusion

The study indicates regular menstrual patterns in terms of length, duration, and intensity of bleeding and a slightly higher age-at-menarche than the global average. However, an alarmingly high prevalence of dysmenorrhea among participants was found that tends to vary with different population characteristics, some of which are modifiable and can be targeted for better menstrual health.This research emphasizes the need for integrated efforts to assist adolescents with menstrual challenges such as dysmenorrhea and irregular periods to achieve informed recommendations and effective actions.
Reported health, social support, stress and associations with choline intake in pregnant women in central South Africa: the NuEMI study 2018–2019
Authors: Robb Liska , Jordaan Elizabeth Margaretha , Joubert Gina , Ngounda Jennifer , Walsh Corinna May
Published: March 2023

Background

The health and well-being of pregnant women can influence pregnancy outcomes and are closely associated with social support and experiences of stress. Poor nutrition predisposes to poor health with choline intake affecting pregnancy outcome. This study determined reported health, social support, and stress and how these factors are associated with choline intake in pregnancy.

Methods

A cross sectional study was performed. Pregnant women in their second and third trimesters attending a high-risk antenatal clinic at a regional hospital in Bloemfontein, South Africa, were included. Trained fieldworkers obtained information during structured interviews using standardised questionnaires. Logistic regression with backward selection (p < 0.05) was used to select significant independent factors associated with choline intake. Variables with a p-value < 0.15 in bivariate analysis were considered for inclusion in the model.

Results

Median age and gestation in the sample (N = 682) were 31.8 years and 32.0 weeks, respectively. Most participants (84.7%) consumed less than the adequate intake (AI) of 450 mg of choline per day. Most participants (69.0%) were either overweight or obese. One in eight participants (12.6%) reported not having anyone that could help them in times of need, more than one third (36.0%) reported having unpayable debt and one in twelve (8.4%) reported experiencing physical abuse by their partners. Normotensive participants and those using anti-retroviral therapy (ART) (thus HIV-infected), were more likely to consume choline in amounts below the AI (p = 0.042 and p = 0.011, respectively). Logistic regression analysis showed that the odds of consuming choline in amounts below the AI were lower for participants that were not using ART versus those using ART, with an odds ratio of 0.53.

Conclusion

HIV-infected participants were more likely to consume choline in levels below the AI. This vulnerable group should be the focus of targeted efforts to improve choline intake.
An enhanced random forest approach using CoClust clustering: MIMIC-III and SMS spam collection application
Authors: Ilhan Taskin Zeynep , Yildirak Kasirga , Aladag Cagdas Hakan
Published: March 2023

The random forest algorithm could be enhanced and produce better results with a well-designed and organized feature selection phase. The dependency structure between the variables is considered to be the most important criterion behind selecting the variables to be used in the algorithm during the feature selection phase. As the dependency structure is mostly nonlinear, making use of a tool that considers nonlinearity would be a more beneficial approach. Copula-Based Clustering technique (CoClust) clusters variables with copulas according to nonlinear dependency. We show that it is possible to achieve a remarkable improvement in CPU times and accuracy by adding the CoClust-based feature selection step to the random forest technique. We work with two different large datasets, namely, the MIMIC-III Sepsis Dataset and the SMS Spam Collection Dataset. The first dataset is large in terms of rows referring to individual IDs, while the latter is an example of longer column length data with many variables to be considered. In the proposed approach, first, random forest is employed without adding the CoClust step. Then, random forest is repeated in the clusters obtained with CoClust. The obtained results are compared in terms of CPU time, accuracy and ROC (receiver operating characteristic) curve. CoClust clustering results are compared with K-means and hierarchical clustering techniques. The Random Forest, Gradient Boosting and Logistic Regression results obtained with these clusters and the success of RF and CoClust working together are examined.
Randomized Double-Blind Placebo-Controlled Study of Olanzapine for Chemotherapy-Related Anorexia in Patients With Locally Advanced or Metastatic Gastric, Hepatopancreaticobiliary, and Lung Cancer
Authors: Sandhya Lakshmi , Devi Sreenivasan Nirmala , Goenka Luxitaa , Dubashi Biswajit , Kayal Smita , Solaiappan Manikandan , Govindarajalou Ramkumar , KT Harichandrakumar , Ganesan Prasanth
Published: March 2023

PURPOSE

Anorexia occurs in 30%-80% of patients with advanced malignancies, which may be worsened with chemotherapy. This trial assessed the efficacy of olanzapine in stimulating appetite and improving weight gain in patients receiving chemotherapy.

METHODS

Adults (≥18 years) with untreated, locally advanced, or metastatic gastric, hepatopancreaticobiliary (HPB), and lung cancers were randomly assigned (double-blind) to receive olanzapine (2.5 mg once a day for 12 weeks) or placebo along with chemotherapy. Both groups received standard nutritional assessment and dietary advice. The primary outcomes were the proportion of patients with weight gain > 5% and the improvement in appetite (assessed by the visual analog scale [VAS] and the Functional Assessment of Chronic Illness Therapy system of Quality-of-Life questionnaires Anorexia Cachexia subscale [FAACT ACS]). Secondary end points were change in nutritional status, quality of life (QOL), and chemotherapy toxicity.

RESULTS

We enrolled 124 patients (olanzapine, 63 and placebo, 61) with a median age of 55 years (18-78 years), of whom 112 (olanzapine, 58 and placebo, 54) were analyzable. The majority (n = 99, 80%) had metastatic cancer (gastric [n = 68, 55%] > lung [n = 43, 35%] > HPB [n = 13, 10%]). The olanzapine arm had a greater proportion of patients with a weight gain of > 5% (35 of 58 [60%] v 5 of 54 [9%], P < .001) and improvement in appetite by VAS (25 of 58 [43%] v 7 of 54 [13%], P < .001) and by FAACT ACS (scores ≥37:13 of 58 [22%] v 2 of 54 [4%], P = .004). Patients on olanzapine had better QOL, nutritional status, and lesser chemotoxicity. Side effects attributable to olanzapine were minimal.

CONCLUSION

Low-dose, daily olanzapine is a simple, inexpensive, well-tolerated intervention that significantly improves appetite and weight gain in newly diagnosed patients on chemotherapy.
Randomized Phase III Study of Enzalutamide Compared With Enzalutamide Plus Abiraterone for Metastatic Castration-Resistant Prostate Cancer (Alliance A031201 Trial)
Authors: Morris Michael J. , Heller Glenn , Hillman David W. , Bobek Olivia , Ryan Charles , Antonarakis Emmanuel S. , Bryce Alan H. , Hahn Olwen , Beltran Himisha , Armstrong Andrew J. , Schwartz Lawrence , Lewis Lionel D. , Beumer Jan H. , Langevin Brooke , McGary Eric C. , Mehan Paul T. , Goldkorn Amir , Roth Bruce J. , Xiao Han , Watt Colleen , Taplin Mary-Ellen , Halabi Susan , Small Eric J.
Published: March 2023

PURPOSE

Enzalutamide and abiraterone both target androgen receptor signaling but via different mechanisms. The mechanism of action of one drug may counteract the resistance pathways of the other. We sought to determine whether the addition of abiraterone acetate and prednisone (AAP) to enzalutamide prolongs overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) in the first-line setting.

PATIENTS AND METHODS

Men with untreated mCRPC were randomly assigned (1:1) to receive first-line enzalutamide with or without AAP. The primary end point was OS. Toxicity, prostate-specific antigen declines, pharmacokinetics, and radiographic progression-free survival (rPFS) were also examined. Data were analyzed using an intent-to-treat approach. The Kaplan-Meier estimate and the stratified log-rank statistic were used to compare OS between treatments.

RESULTS

In total, 1,311 patients were randomly assigned: 657 to enzalutamide and 654 to enzalutamide plus AAP. OS was not statistically different between the two arms (median, 32.7 [95% CI, 30.5 to 35.4] months for enzalutamide v 34.2 [95% CI, 31.4 to 37.3] months for enzalutamide and AAP; hazard ratio [HR], 0.89; one-sided P = .03; boundary nominal significance level = .02). rPFS was longer in the combination arm (median rPFS, 21.3 [95% CI, 19.4 to 22.9] months for enzalutamide v 24.3 [95% CI, 22.3 to 26.7] months for enzalutamide and AAP; HR, 0.86; two-sided P = .02). However, pharmacokinetic clearance of abiraterone was 2.2- to 2.9-fold higher when administered with enzalutamide, compared with clearance values for abiraterone alone.

CONCLUSION

The addition of AAP to enzalutamide for first-line treatment of mCRPC was not associated with a statistically significant benefit in OS. Drug-drug interactions between the two agents resulting in increased abiraterone clearance may partly account for this result, although these interactions did not prevent the combination regimen from having more nonhematologic toxicity.
Two Aspects of Language, Two Types of Comparison
Authors: Hutchinson Ben
Published: March 2023

This article revisits the emergence of “comparative” and “world” literature within the early nineteenth century, arguing that we can only understand the full normative force of the two terms if we read them rhetorically. In order to do this, the article draws on Roman Jakobson’s classic essay “Two Aspects of Language and Two Types of Aphasic Disturbances” (1956). Jakobson makes a number of claims in this essay, the most celebrated of which is his distinction between the two poles of “metaphoric” and “metonymic” language. The motor of metaphor, Jakobson reminds us, is similarity (one thing is like another); the motor of metonymy, on the other hand, is contiguity (one thing is next to, or part of another). Jakobson’s distinction, this article suggests, maps instructively onto the mechanisms of comparative and world literature: where the former compares one text to another, the latter situates one text within the global field of others. For comparison to be possible, initially, the things being compared must stand apart; to claim the status of world literature for a given work, conversely, is to make it part of a broader whole. Comparative and world literature may thus be said to function as a mobile army of metaphors and metonymies.
Wikipedia's Race and Ethnicity Gap and the Unverifiability of Whiteness
Authors: Mandiberg Michael
Published: March 2023

Although Wikipedia has a widely studied gender gap, almost no research has attempted to discover if it has a comparable race and ethnicity gap among its editors or its articles. No such comprehensive analysis of Wikipedia's editors exists because legal, cultural, and social structures complicate surveying them about race and ethnicity. Nor is it possible to precisely measure how many of Wikipedia's biographies are about people from indigenous and nondominant ethnic groups, because most articles lack ethnicity information. While it seems that many of these uncategorized biographies are about white people, these biographies are not categorized by ethnicity because policies require reliable sources to do so. These sources do not exist for white people because whiteness is a social construct that has historically been treated as a transparent default. Thus, these biographies cannot be categorized as white because whiteness is unverifiable in Wikipedia's white epistemology. In the absence of a precise analysis of the gaps in its editors or its articles, I present a quantitative and qualitative analysis of these structures that prevent such an analysis. I examine policy discussions about categorization by race and ethnicity, demonstrating persistent anti-Black racism. Turning to Wikidata, I reveal how the ontology of whiteness shifts as it enters the database, functioning differently than existing theories of whiteness account for. While the data does point toward a significant race and ethnicity gap, the data cannot definitively reveal meaning beyond its inability to reveal quantitative meaning. Yet the unverifiability of whiteness is itself an undeniable verification of Wikipedia's whiteness.
Recovery from COVID-19 in Adult Recreational Athletes: A Survey of American Triathletes
Authors: Schroeder Allison N. , Getzin Andrew R. , Creswell Lawrence L. , Asplund Chad A.
Published: March 2023

Introduction/Purpose

Little is currently known regarding coronavirus disease 2019 (COVID-19) symptomatology and return to exercise, training, and fitness after COVID-19 in adult recreational athletes. The purpose of this study was to determine which COVID-19-related symptoms are associated with prolonged return to sport in U.S. triathletes.

Methods

This was an online survey cohort study of USA Triathlon members (104 participants). Self-reported participant demographics, comorbid conditions, symptoms, and complications experienced with COVID-19 were assessed. Time required for the athlete to return to exercise, training, and normal fitness and whether symptoms worsened upon return to training were determined.

Results

Survey respondents were predominantly male (average age, 44.5 ± 1.9 yr) and healthy at baseline (91.0% had no risk factors for COVID-19 and 76.9% had no potential risk factors). After COVID-19, 50% of athletes returned to exercise in <1 wk, 30% returned to training in <1 wk, and 39% returned to normal fitness in <1 month. Thirty-five athletes (33.7%) felt worse upon return to training. Return to training took >14 d in more than 50% of athletes, and only 13% took >8 wk to return to normal fitness. Fever, shortness of breath, fatigue, and headache were all associated with prolonged return to exercise, training, and fitness (all P < 0.05).

Conclusions

Triathletes with COVID-19 who experienced fever, shortness of breath, headache, and fatigue should be counseled that they may have a more prolonged return to exercise, training, and normal fitness compared with those with less severe symptoms.
Προηγμένες υπηρεσίες μεσολάβησης για συστήματα ηλεκτρονικών αγορών βασισμένες σε οντολογίες και τεχνικές πρακτόρων
Authors: Τσιάρα Αικατερίνη
Published: March 2023

Το αντικείμενο της διατριβής άπτεται της ανάπτυξης προηγμένων υπηρεσιών μεσολάβησης για συστήματα Ηλεκτρονικών Αγορών. Από τη μία, έχει γίνει έρευνα προς την κατεύθυνση ανάπτυξης αρχιτεκτονικών με τη χρήση ευφυών πρακτόρων για τον τομέα των Ηλεκτρονικών Αγορών. Οι αρχιτεκτονικές αυτές ήταν αποτέλεσμα μελέτης πάνω στη τεχνολογία των ευφυών πρακτόρων σε συνδυασμό με τις προκλήσεις που έχουν ανακύψει στο τομέα του Ηλεκτρονικού Εμπορίου λόγω της Παγκοσμιοποίησης. Επιλέγεται η χρήση τεχνολογίας ευφυών πρακτόρων η οποία αποτελεί μια νέα μεθοδολογία στην ανάπτυξη λογισμικού. Τα χαρακτηριστικά αυτής της τεχνολογίας (αυτονομία, κινητικότητα, προσαρμοστικότητα κλπ.) την καθιστούν ικανή για την ανάπτυξη λύσεων που αφορούν τον τομέα των Ηλεκτρονικών Αγορών.Από την άλλη, έχει πραγματοποιηθεί έρευνα πάνω στην παροχή υπηρεσιών μεσολάβησης στα πλαίσια μιας Ηλεκτρονικής Αγοράς με τη χρήση Οντολογιών. Επιλέγεται η προσέγγιση της χρήσης οντολογιών, ως επιμέρους λύση στο πρόβλημα της σημασιολογικής ετερογένειας. Στα πλαίσια αυτά προτείνεται η αρχιτεκτονική μιας πλατφόρμας Μεσολάβησης για Hλεκτρονικές Aγορές η οποία χρησιμοποιεί προτυποποιημένες διεπαφές με τα συνεργαζόμενα υποσυστήματα και οντολογίες και για την εξασφάλιση της δια-λειτουργικότητας των συστημάτων. Ο πυρήνας του συστήματος είναι ο Μεσολαβητής, το υποσύστημα λογισμικού που ενώνει τα υπόλοιπα υποσυστήματα και γεφυρώνει το κενό ανάμεσα σε ερωτήματα χρηστών και σε διαθέσιμες υπηρεσίες στα πληροφοριακά συστήματα των προμηθευτών, παρέχοντας υπηρεσίες μεσολάβησης και προς τις δύο εμπλεκόμενες πλευρές. Ο ρόλος των οντολογιών είναι πολλαπλός. Από την μία αποτελούν το σημασιολογικό λεξικό που χρειάζεται, ώστε να ερμηνευθούν ερωτήματα σε φυσική γλώσσα, από την άλλη κωδικοποιούν το πολύπλοκο επιχειρησιακό μοντέλο και τους κανόνες λογικής που είναι απαραίτητοι για την παροχή μιας σειράς «έξυπνων» υπηρεσιών μεσολάβησης προς τον τελικό χρήστη. Οι υπηρεσίες αυτές περιλαμβάνουν τη σύνθεση πακέτων υπηρεσιών, τις υπηρεσίες καταλόγου, τη διαχείριση διαλόγου και το σημασιολογικό προφίλ χρήστη.
Amplification and oscillations in the curvature power spectrum from features in the inflaton potential
Authors: Κονταξής Γεώργιος
Published: March 2023

Στη διδακτορική διατριβή γίνεται μελέτη των χαρακτηριστικών του πληθωριστικού δυναμικού που προκαλούν σημαντική ενίσχυση, καθώς και ταλαντώσεις, στο φάσμα διαταραχών καμπυλότητας. Τα χαρακτηριστικά που παρουσιάζουν ιδιαίτερο ενδιαφέρον είναι οι απότομες μεταπτώσεις (σκαλοπάτια) στο δυναμικό και οι στροφές στον εσωτερικό χώρο πολλών πεδίων. Και στις δύο περιπτώσεις δίνεται ιδιαίτερη έμφαση στην αθροιστική επίδραση περισσότερων του ενός τέτοιων χαρακτηριστικών, ενώ η ανάλυση που διεξάγεται είναι τόσο αριθμητική όσο και αναλυτική. Στην περίπτωση του πληθωρισμού από ένα πεδίο γίνεται μελέτη συγκεκριμένων μοντέλων εμπνευσμένων από το πλαίσιο των α-attractors. Σε πολλές από τις μελετώμενες περιπτώσεις η αύξηση του φάσματος διαταραχών καμπυλότητας είναι αρκετή ώστε να οδηγεί σε σημαντική παραγωγή αρχέγονων μελανών οπών καθώς και στοχαστικών βαρυτικών κυμάτων, πιθανά ανιχνεύσιμων στο μέλλον. Οι ταλαντώσεις στο φάσμα διαταραχών καμπυλότητας αποτυπώνονται στο φάσμα των στοχαστικών βαρυτικών κυμάτων.
Deep reinforcement learning algorithms for intelligent agents in virtual environments
Authors: Γιαννακόπουλος Πέτρος
Published: March 2023

Αντικείμενο της παρούσης διατριβής είναι η δημιουργία ευφυών πρακτόρων, βασισμένων σε μεθόδους βαθιάς ενισχυτικής μάθησης, και η εφαρμογή τους σε εικονικά περιβάλλοντα που αφορούν τους τομείς εικόνας, ήχου και πινάκων. Στο τομέα της εικόνας, εφαρμόσαμε βαθιά ενισχυτική μάθηση σε συνδυασμό με νευρωνική αφαιρετική μέθοδο καταστάσεων για τη δημιουργία ενός πράκτορα ικανού να περιηγείται σε περιβάλλον λαβύρινθου βασισμένου στο Minecract, χρησιμοποιώντας μόνο ακατέργαστη οπτική πληροφορία. Περαιτέρω, εφηύραμε μία βελτιωμένη εκδοχή της ε-greedy εξερεύνησης, βασισμένη σε ανταγωνιστικά νευρωνικά δίκτυα, και δείξαμε ότι ένας πράκτορας βαθιάς ενισχυτικής μάθησης που χρησιμοποιεί αυτή τη μέθοδο εξερεύνησης μπορεί να περιηγηθεί πιο αποδοτικά σε περιβάλλοντα λαβύρινθου του Minecraft και να παίζει το δισδιάστατο παιχνίδι πλατφόρμας Super Mario Bros. Στο τομέα του ήχου, δημιουργήσαμε ένα περιβάλλον, χρησιμοποιώντας τη μηχανή του Unity, όπου ομιλητές είναι παρόντες σε διάφορα σημεία μέσα σε ένα δωμάτιο, και επίσης δημιουργήσαμε έναν πράκτορα βαθιάς ενισχυτικής μάθησης ικανό να περιηγείται σε αυτό το δωμάτιο και να οδηγεί τον εαυτό του πρός κάποιον καθορισμένο ομιλητή χρησιμοποιώντας μόνο ακουστική πληροφορία. Στο τομέα των πινάκων, εφαρμόσαμε βαθιά ενισχυτική μάθηση σε συνδυασμό με μια τεχνική εκπαίδευσης μεταβλητού μεγέθους συστάδας για τη δημιουργία ενός πράκτορα ικανού για την επίτευξη τέλειου παιξίματος στο επιτραπέζιο παιχνίδι L-Game, δοθέντος ενός πίνακα με την κατάσταση του παιχνιδιού μετά την κίνηση κάθε παίκτη, ενώ απαιτεί λιγότερα δεδομένα για την εκπαίδευσή του. Συνδυάζοντας τους τομείς του ήχου και των πινάκων, εκφράσαμε το πρόβλημα της βελτιστοποίησης των παραμέτρων της στοίβας μετα-επεξεργασίας που εφαρμόζεται στις προβλέψεις ενός συστήματος Ανίχνευσης Ακουστικών Συμβάντων ως μία Μαρκοβιανή Διεργασία Αποφάσεων. Εφαρμόσαμε βαθιά ενισχυτική μάθηση ως έναν τρόπο εξερεύνησης του χώρου των παραμέτρων, με σκοπό την εύρεση των τιμών για κάθε παράμετρο οι οποίες μεγιστοποιούν την τελική απόδοση κατηγοριοποίησης ακουστικών συμβάντων του συστήματος ανίχνευσης, δοθέντος ενός πίνακα με τις προβλέψεις του συστήματος.
Malaria: an update for nurses in general practice
Authors: Grieve Sandra
Published: March 2023

Malaria is a mosquito-borne, potentially fatal disease that is distributed throughout the tropics. Malaria is caused by the parasite Plasmodium, transmitted to humans by the bite of a female Anopheles mosquito, most active between dusk and dawn. Insect bite avoidance is crucial to prevent bites from infected mosquitoes causing infection. All travellers visiting malaria endemic areas are at risk of exposure. Conducting a pre-travel risk assessment and providing appropriate advice to the individual is essential. The malaria prevention guidance emphasises that effective bite prevention should be the first line of defence against malaria infection, even when chemoprophylaxis is used. Recommendations for antimalarials should be appropriate for the destination, tailored to the individual, and account for the risks and benefits to the traveller.

Malaria is a preventable, but potentially fatal illness. Sandra Grieve provides an update for those providing travel consultations in general practice
Green Synthesis and Characterization of Nickel Nanoparticles using Aqueous Extract of Moringa oleifera Flower
Authors: C. F. Simple Lotus  , Jino John  , S. Ramesh Kumar
Published: March 2023

An attempt has been made in this work to green synthesize nickel nanoparticles using the aqueous flower extract of Moringa oleifera, a common plant in which all parts are edible and rich in iron content, through the biosynthesis method. The synthesized Moringa oleifera flower extract nanorods were characterized by UV–Vis. spectroscopy, Fourier Transform Infrared spectroscopy, X-Ray Diffraction analysis and Transmission Electron Microscopy. In addition, the antimicrobial activity of the nanorods was evaluated. The nanorods were found to be crystalline in nature with rod-like structures having a mean particle size of 35 nm.
Case Series – Osteochondromas at Rare Locations
Authors: Khodnapur Gireesh , Kulkarni Shreepad , Patil Vijaykumar , Venkat Mallipudi , M K Basavaraj
Published: March 2023

Introduction: Osteochondromas are very common. They are typically seen in long bones and rarely seen in smaller bones. Some of the rare presentations include flat bones, the body of pelvis, scapula, skull, and small bones of the hand and foot. Their presentation also varies according to the site of presentation. Case Reports: We have included five cases of osteochondromas occurring at rare locations with variable presentations and their management. We have included one case of metacarpal, one case of skull exostosis, two cases of scapula exostosis, and one case of fibula exostosis. Conclusion: Osteochondromas can rarely occur at unusual locations. It is important to thoroughly evaluate all patients presenting with swelling and pain over bony regions to accurately diagnose osteochondromas and manage accordingly. Keywords: Scapula, metacarpal, fibula, skull, excision.
The Right to Science: Centering People With Intellectual Disability in the Process and Outcomes of Science
Authors: Shogren Karrie A.
Published: March 2023

The right to science has been identified in multiple human rights treaties; however, there has not been a clear framework for how governments or research organizations can advance this right particularly ensuring equitable engagement of people with intellectual disability (ID) in the process of scientific research. Although the feasibility and impacts of engaging people with ID in the process of science have been repeatedly demonstrated there remain systemic barriers including ableism, racism, and other systems of oppression that sustain inequities. Researchers in the ID field must take steps to dismantle systemic barriers and advance participatory approaches that advance equity in the process and outcomes of science.
Matrices characterizing non-local OAM transformations of light beams
Authors: Raveh David , Pokharel Sushil , Korotkova Olga
Published: March 2023

Matrices characterizing the orbital angular momentum (OAM) transformations of deterministic and random light beams by commonly used OAM-modulating optical systems are revealed. Such matrices are the counterparts of the Jones and the Mueller matrices in polarization optics defined for the input and output OAM indices and the radial variables. In particular, matrices of systems leading to OAM mode shift, dispersion, and coupling are discussed.
Temporal negative refraction [Invited]
Authors: Lasri Or , Sirota Lea
Published: March 2023

Negative refraction is a peculiar wave propagation phenomenon that occurs when a wave crosses a boundary between a regular medium and a medium with both constitutive parameters negative at the given frequency. The phase and group velocities of the transmitted wave then turn anti-parallel. Here we propose a temporal analogue of the negative refraction phenomenon using time-dependent media. Instead of transmitting the wave through a spatial boundary, we transmit it through an artificial temporal boundary created by switching both parameters from constant to dispersive with frequency. We show that the resulting dynamics are sharply different from the spatial case, featuring both reflection and refraction in positive and negative regimes simultaneously. We demonstrate our results analytically and numerically using an electromagnetic medium. In addition, we show that by targeted dispersion tuning, the temporal boundary can be made nonreflecting while preserving both positive and negative refraction.
Design and simulation of a dynamically tunable 1× 2 power splitter using MZI configuration in the telecom regime
Authors: Arik Kamalodin , Akbari Mahmood , Khavasi Amin
Published: March 2023

We propose an ultra-broadband, ultra-compact and a dynamically tunable power splitter on a silicon on Insulator (SOI) platform with a 220 nm thick silicon light-guiding layer, using two multimode interference (MMI) couplers connected with graphene-based waveguides as the phase-tuning section through a Mach-Zehnder Interferometer (MZI) configuration. First, we theoretically present and demonstrate a novel design for the MMI couplers by combining the plane wave expansion method (PWEM) and the mode expansion conjecture concept. To verify the proposed theory, a center-fed MMI coupler and a MMI coupler, respectively, as the input and output sections of our proposed device, are designed and simulated. The simulation results achieved by Lumerical FDTD show good agreement with the design theory. Then, a highly tunable graphene-embedded silicon waveguide, for the highly efficient modulation of the effective mod index (EMI), is duly designed using Lumerical Mode Solutions. As the two MZI arms, a pair of the proposed waveguides is introduced into the middle of the cascaded MMI couplers. Accordingly, the integration properties of the analytically designed MMI couplers and the numerically designed waveguide is demonstrated through our proposed device for the aim of achieving any wanted power splitting ratio. To this end, we consider the case that the real part of the EMI of the waveguide in the lower MZI arm is modulated by varying the graphene Fermi level values, being the same for all the layers belonging to the same waveguide, while that of the upper arm is constant. The corresponding power splitting ratio can be dynamically tuned in the range of All reported results assume TE polarization. The designed MZI-based splitter possesses a bandwidth of over the wavelength range from to for various power splitting ratios, maintaining the averaged insertion loss and the averaged power imbalance, respectively, below as low as and The overall footprint of the proposed device is also highly small, i.e., about
Development of sandwich ELISA and lateral flow assay for the detection of Bungarus multicinctus venom
Authors: Nong Ji-Fei , Huang Zhou , Huang Zheng-Zhuang , Yang Jie , Li Jin-Cheng , Yang Feng , Huang Dong-Ling , Wang Fan , Wang Wei
Published: March 2023

Snakebite envenoming adversely affects human health and life worldwide. Presently, no suitable diagnostic tools for snakebite envenoming are available in China. Therefore, we sought to develop reliable diagnostic tests for snakebite management. We conducted affinity purification experiments to prepare species-specific antivenom antibody (SSAb). In brief, affinity chromatography with an antibody purification column (Protein A) was conducted to purify immunoglobulin G from Bungarus multicinctus (BM) venom hyperimmunized rabbit serum. The cross-reactive antibodies were removed from commercial BM antivenin by immune adsorption on the affinity chromatography columns of the other three venoms, Bungarus Fasciatus (FS), Naja atra (NA), and O. hannah (OH), generating SSAb. The results of western blot analysis and enzyme-linked immunosorbent assay (ELISA) showed the high specificity of the prepared SSAb. The obtained antibodies were then applied to ELISA and lateral flow assay (LFA) to detect BM venom. The resulting ELISA and LFA could specifically and rapidly detect BM venom in various samples with the limits of quantification as 0.1 and 1 ng/ml, respectively. This method could effectively detect snake venom in experimentally envenomed rats (simulating human envenomation), which could distinguish positive and negative samples within 10–15 min. This method also showed promise in serving as a highly useful tool for a rapid clinical distinguishing of BM bites and rational use of antivenom in emergency centers. The study also revealed cross-reactivity between BM and heterogenous venoms, suggesting that they shared common epitopes, which is of great significance for developing detection methods for venoms of the snakes belonging to the same family.
Utopia for Norwegian helicopter emergency medical services: Estimating the number of bases needed to radically bring down response times, and lives needed to be saved for cost effectiveness
Authors: Jagtenberg Caroline Jeanne , Uleberg Oddvar , Waaler Bjørnelv Gudrun Maria , Røislien Jo
Published: March 2023

Objectives

Helicopter Emergency Medical Services (HEMS) throughout Europe are generally on scene within 10–15 minutes. In Norway, however, with its 13 HEMS bases, only 75% of the population can currently be reached within half an hour. We estimate the number of HEMS bases needed to reach the full Norwegian population within 10–15 minutes, and discuss implications regarding cost effectiveness.

Methods

Using geographic location and population characteristics from Norway’s 428 municipalities as input to the Maximal Covering Location Problem–a mathematical location optimization model–we estimate the number of HEMS bases required along with accompanying personnel and healthcare costs. We estimate the minimum number of lives that would have to be saved to achieve a net social benefit of zero.

Results

To reach 99% or 100% of the Norwegian population by HEMS within 15 minutes 78 or 104 bases are needed, respectively. The incremental need for personnel going from 20 to 15 minutes for 99/100% of the population is 602/728, with an accompanying incremental cost of 228/276 million EURO per year. A yearly total of 280/339 additional lives would have to be saved to obtain a net social benefit of zero. Then, the HEMS-system as a whole would be cost effective although the least efficient bases still would not be.

Conclusions

Reducing Norwegian HEMS response times to 10–15 minutes requires a drastic increase in the number of HEMS bases needed. Choice of ethical philosophy (utilitarianism or egalitarianism) determines when the expansion might be considered cost effective.
Effects of co-occurrence and intra- and interspecific interactions between Drosophila suzukii and Zaprionus indianus
Authors: de Paiva Mendonça Larine , Haddi Khalid , Godoy Wesley Augusto Conde
Published: March 2023

In drosophilids, competition and coexistence can impact survivorship, growth, and reproductive output. Here, we evaluated direct competition between two co-occurring fruit flies, the spotted-wing drosophilaDrosophila suzukiiand the African fig flyZaprionus indianus, comparing results from field collections with laboratory experiments. Field collections were conducted to evaluate co-occurrence between species. In the laboratory, different densities of eggs of each species were provided an artificial diet, and intra- and interspecific densities were evaluated regarding biological traits such as development and fecundity. Field collections showed a prevalence ofZ.indianus, followed by other drosophilid species, includingD.suzukii. Pupal survival and adult emergence were higher inD.suzukiithan inZ.indianusat both intra- and interspecific densities, with decreasing values in response to increased densities. Fecundity did not differ significantly for either species at different intraspecific densities, but when reared together at different densities,Z.indianuswas significantly more fecund thanD.suzukii. Development time showed no significant difference at intraspecific densities, but when reared together,Z.indianushad longer development times thanD.suzukii. Leslie Matrix projections indicated thatD.suzukiishowed practically the same dynamics at intraspecific and interspecific densities, with increasing oscillations at low and intermediate densities and decreasing oscillations at high densities.Zaprionus indianusshowed a similar oscillation toD.suzukii, except at intermediate intraspecific densities, when the pattern was cyclic. Low interspecific densities resulted in decreasing oscillations. In the two-choice oviposition bioassays,D.suzukiifemales showed no significant preference for diets previously infested or not with either conspecific or heterospecific eggs at different densities. Understanding competitive interactions between co-occurring heterospecific species should be considered when establishing management tactics for spotted-wing drosophila.
Analysis of the impact of expressway construction on soil moisture in road areas
Authors: Li Yongyi , Xiao Zhan , Li Zhihao , Jiao Zexuan , Jia Xingli
Published: March 2023

To reveal the effect pattern of expressways on regional soil moisture, in this study, using trend analysis and buffer zone analysis methods, the data of VSWI (vegetation supply water index) in central Zhejiang Province from 2005 to 2016 were extracted from landsat7 satellite data using a single window algorithm, and spatial analysis was used to investigate the law of its differentiation. The results show that the multi-year average is 0.01879, between 0.01035–0.02774, showing a gentle decreasing trend, and there are obvious regional variations in space. We found that the impact of the new expressway and interchange on the VSWI in the buffer zone lasted for more than two years, and the VSWI increased in space farther away from the road, and this trend returned to normal at 8 km. Finally, the development patterns of the VSWI in the buffer zone of the newly established expressway and the interchange are approximately the same.
Modeling for strain-softening rocks with lateral damage based on statistical physics
Authors: Li Xiaoming , Wang Mingwu , Shen Fengqiang , Zhang Hongfei
Published: March 2023

Statistical physics is widely used to study the nonlinear mechanical behaviors of rock. For the limitations of existing statistical damage models and Weibull distribution, a new statistical damage with lateral damage is established. In addition, by introducing the maximum entropy distribution function and the strict constraint on damage variable, a expression of the damage variable matching the proposed model is obtained. Through comparing with the experimental results and the other two statistical damage models, the rationality of the maximum entropy statistical damage model is confirmed. The proposed model can better reflect the strain-softening behavior for rocks and respond to the residual strength, which provides a theoretical reference for practical engineering construction and design.
Subjective individuals’ perception during evacuation in road tunnels: Post-experiment survey results
Authors: Schmidt-Polończyk Natalia
Published: March 2023

The aim of the research was to analyse the process of evacuation from the point of view of the individual’s perception, behaviour and decision making. The study used a survey method that was conducted during two real-scale evacuation experiments in real road tunnels under smoky conditions. All experiments, with fire scenarios and procedures were very similar to real accident. Respondents’ observations and important aspects affecting the evacuation process were verified, including decision-making during evacuation, loss of bearing in smoky conditions and group evacuation. The results indicate that participants in the experiments had started the evacuation due to smoke in the tunnel and fire drill. The evacuees observed decreased visibility on the escape route as well as a loss of bearing in the tunnel when smoke levels were high (extinction coefficient Cs > 0,7 m-1). The participants in the experiment evacuated in a group (when the tunnel infrastructure was unknown and there was no instruction as to what to do) and in twos under the smokiest conditions (extinction coefficient Cs~1.0–1.1m-1). During the experiments, the large impact of herding behaviour and following the group was noticed. The results of such studies based on real-scale evacuation experiments in road tunnels are essential to improve the level of safety in the road tunnel. In the surveys, the participants pointed to important issues related to evacuation, which require particular attention during the design, implementation and acceptance of this type of construction. The results of the study provide a better understanding of the behaviour of evacuees and indicate areas where tunnel infrastructure needs to be improved.
Finding a safe space for learning and exploration: A qualitative study of recently diagnosed men’s experiences of peer support for HIV in Sweden
Authors: N’Diaye Arielle , Herder Tobias , Agardh Anette
Published: March 2023

In Sweden men account for most new HIV cases, and little is known about the peer support needs of people living with HIV in Sweden. This qualitative study explored how recently diagnosed men perceive and experience peer support in Sweden. Purposively sampled from HIV patient organizations and infectious disease clinics throughout Sweden, data was collected through in-depth individual interviews with 10 men living with HIV, who have experience participating in peer support. Latent and manifest qualitative content analysis produced the overarching theme of Finding a safe space for learning and exploration. Participants used peer support to access key information and skills and as a space to safely explore life with HIV. Participants perceived successful peer support as having the right peer while also receiving support at the right location. Study recommendations include further research on how a peer is defined within the U = U era, further research on the peer support needs of young adults, and further research on the accessibility of peer support.
Therapeutic effect and mechanism of Daikenchuto in a model of methotrexate-induced acute small intestinal mucositis
Authors: Li Peilin , Inoue Yusuke , Miyamoto Daisuke , Adachi Toshiyuki , Okada Satomi , Adachi Tomohiko , Soyama Akihiko , Hidaka Masaaki , Kanetaka Kengo , Ito Shinichiro , Sadatomi Daichi , Mogami Sachiko , Fujitsuka Naoki , Gu Weili , Eguchi Susumu
Published: March 2023

Background

Daikenchuto (DKT) has positive therapeutic effects on improving various gastrointestinal disorders. The present study investigated whether or not DKT has a potential therapeutic effect on chemotherapy-induced acute small intestinal mucositis (CIM) in a rat model.

Methods

Intraperitoneal injection of 10 mg/kg methotrexate (MTX) every 3 days for a total of 3 doses was used for induction of CIM in a rat model. The MTX and DKT-MTX groups were injected with MTX as above from the first day, and the DKT-MTX and DKT groups were administered 2.7% DKT via the diet at the same time. The rats were euthanized on day 15.

Results

The DKT-MTX group showed an improvement in the body weight and conditions of gastrointestinal disorders as well as increased levels of diamine oxidase in plasma and in the small intestinal villi. The pathology results showed that small intestinal mucosal injury in the DKT-MTX group was less severe than that in the MTX group. Immunohistochemistry for myeloperoxidase and malondialdehyde and quantitative real-time polymerase chain reaction (RT-qPCR) for TGF-β1 and HIF-1α showed that DKT attenuated peroxidative damage. The crypts in the DKT-MTX group contained more Ki-67-positive cells than MTX group. The zonula occluden-1 and claudin-3 results showed that DKT promoted repair of the mucosal barrier. RT-qPCR for the amino acid transporters EAAT3 and BO+AT also confirmed that DKT promoted mucosal repair and thus promoted nutrient absorption.

Conclusion

DKT protected against MTX-induced CIM in a rat model by reducing inflammation, stimulating cell proliferation, and stabilizing the mucosal barrier.