bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute gastrointestinal bleeding in Egyptian elderly patients: real-life experience
Authors: Hossam Maha , Abdel-Fattah Soheir , Elkholy Shaimaa , Khaled Yomna , Awad Abeer
Published: June 2022

Background

Elderly people are a vulnerable group of patients subjected to multiple health problems. Upper gastrointestinal bleeding (UGIB) in older adults is a frequent cause of hospital admissions. The presence of multiple comorbidities and greater medication use influence the clinical outcome.

Aim

The aim of our work was to analyze the etiology, precipitating factors, management, and outcome of the elderly Egyptian patients (> 65 years old) presenting with acute UGIB.

Methods

Three hundred thirty-two patients presenting with acute UGIB. The patients were classified into two groups according to age (elderly, above 65 years old, and young, below 65 years old). Clinical assessment, laboratory tests, and upper endoscopy were done for all patients. They were followed for 1 month.

Results

Elderly females showed higher incidence of acute UGIB (45.8% versus 28.9%) with significant P-value (0.001). The incidence of esophageal varices was high in young patients than in the elderly (46.4% vs 35.5%) with P-value (0.045), while the elderly patients showed a higher incidence of esophageal ulcers and gastric mass than the young patients (7.8% vs 2.4%), (6% vs 0%) with P-value (0.025 and 0.013) respectively. Also, there was a higher incidence of peptic ulcer in elderly than young patients but does not reach a significant value with P-value (0.067), while there was no difference between both groups as regards presence of (fundal varix, erosive gastritis, moniliasis, portal hypertensive gastropathy, antral gastritis, bulb duodenitis, post band ulcer, dieulafoy, gastric polyp, and angiodysplasia). Rockall score, duration of hospital stay, and mortality incidence (33.1% vs 15.7%) were high in the elderly than young patients with P-value (< 0.001).

Conclusion

The elderly are vulnerable groups who are at high risk of adverse outcome and mortality following acute upper gastrointestinal bleeding.
Novel Imaging Biomarkers to Assess Oncologic Treatment–Related Changes
Authors: Viswanathan Vidya Sankar , Gupta Amit , Madabhushi Anant
Published: June 2022

Cancer therapeutics cause various treatment-related changes that may impact patient follow-up and disease monitoring. Although atypical responses such as pseudoprogression may be misinterpreted as treatment nonresponse, other changes, such as hyperprogressive disease seen with immunotherapy, must be recognized early for timely management. Radiation necrosis in the brain is a known response to radiotherapy and must be distinguished from local tumor recurrence. Radiotherapy can also cause adverse effects such as pneumonitis and local tissue toxicity. Systemic therapies, like chemotherapy and targeted therapies, are known to cause long-term cardiovascular effects. Thus, there is a need for robust biomarkers to identify, distinguish, and predict cancer treatment–related changes. Radiomics, which refers to the high-throughput extraction of subvisual features from radiologic images, has been widely explored for disease classification, risk stratification, and treatment-response prediction. Lately, there has been much interest in investigating the role of radiomics to assess oncologic treatment–related changes. We review the utility and various applications of radiomics in identifying and distinguishing atypical responses to treatments, as well as in predicting adverse effects. Although artificial intelligence tools show promise, several challenges—including multi-institutional clinical validation, deployment in health care settings, and artificial-intelligence bias—must be addressed for seamless clinical translation of these tools.
Beyond Checkpoint Inhibitors: Enhancing Antitumor Immune Response in Lung Cancer
Authors: Sanborn Rachel E. , Schneiders Famke L. , Senan Suresh , Gadgeel Shirish M.
Published: June 2022

The introduction of immune checkpoint inhibitors has dramatically changed the treatment landscape and improved survival for many patients with thoracic malignancies. Although some patients may experience prolonged survival benefit with immune checkpoint inhibitors, a majority do not experience disease control or benefit, supporting the need for research and development of improved approaches for facilitating immune recognition. Additionally, many patients will experience toxicity with the current approaches to immunotherapy, supporting the need for developing treatment strategies with less risk of adverse events. An extensive array of different strategies are currently under investigation, including novel combinations of checkpoint inhibitors or immunotherapies; novel agents beyond checkpoint inhibitors (e.g., bispecific antibodies, vaccine strategies, cytokine therapies); and different approaches for use of radiation to augment systemic immunotherapy agents. With each strategy, researchers are evaluating the potential for augmenting antitumor responses and ensuring more sustained antitumor effects. This article highlights areas of active research, reviewing the rationale for different investigative strategies, as well as currently available clinical data.
Oblique propagation of ion-acoustic solitary waves in magnetized electron-positron-ion plasma with Cairns distribution
Authors: Khalid Muhammad , Ullah Azmat , Kabir Abdul , Khan Hilal , Irshad Muhammad , Shah Syed Mohsin
Published: June 2022

The propagation of ion-acoustic (IA) solitary waves (SWs) is investigated in a magnetized electron-positron-ion (EPI) plasma with Cairns distributed electrons and positrons. The Korteweg-de Vries (KdV) and modified KdV (mKdV) equations are derived for the potential by employing the reductive perturbation technique (RPT) and its solitary wave (SW) solutions are analyzed. The effects of relevant plasma parameters (viz., nonthermality parameter β, positron concentration

, ion thermality δ and magnetic field strength Ω) on the characteristics of IA solitary structures are discussed in detail.
Linear and nonlinear combined aerodynamic reduced order model based on residual network framework
Authors: Qi Hui , Yu Jiaming , Jiang Jingjiang , Guo Jing
Published: June 2022

Residual convolutional neural network (ResNet) is a rising technology in the field of artificial intelligence due to its advantages of easy optimization, high accuracy, information fidelity and no gradient disappearance. Based on the powerful ability of machine learning to learn from big data features, a residual network aerodynamic reduced order model (ROM) framework based on CFD sample data was proposed. In this letter, a binary airfoil is taken as the research object, and the displacement information representing the movement characteristics of the flow field can be transmitted by two ways: one is that the input information is continuously captured and extracted by the deep convolution layer; the other is that the input information is directly transmitted around the convolutional layer. Then the characteristic information of the two approaches is integrated and activated through the output layer to complete the regression prediction of the wing aerodynamic characteristics. Finally, the ROM frame is used to predict the strongly nonlinear hysteresis loops of airfoil under pitching motion, and the results show that the ROM frame is effective. In addition, the framework can be applied to qualitative interpretation of complex flow phenomena and aeroelastic analysis.
Energy States
Authors: Dawson Ashley , Gómez-Barris Macarena
Published: June 2022

This article works with a comparative, hemispheric approach to address potential sites, propositions, and sources for postextractive energy transitions. Specifically, the focus is on case studies from within the United States and Latin America to consider energy paradigms and their future in relation to the “energy state,” or the centralized governance apparatus that has historically organized power infrastructures. Like the physics term that references any discrete value of total energy that remains fixed, but that is potentially mutable because of its transitive properties, the modern energy state is addressed as an entity that has the capacity to undergo massive reconfiguration and transition. The energy state is not discrete, however, and is embedded within a global infrastructure of capitalist dominance, power inequalities, and commodity contingencies. Despite its current imbrication with the colonial/modern infrastructures of petrol extraction, the energy state, it is argued here, has the capacity to be reimagined and remade. By focusing on popular movements within the western hemisphere, and by learning from the lessons of energy pasts, presents, and futures, the article proposes the move to radical interdependency, which could be legislated by a substantially altered state apparatus during the implementation of a new energy paradigm. Unsurprisingly, land rights, social and multispecies justice, and antiracist social movements are central to enlivening the new energy state.
State-of-the-art imaging in oesophago-gastric cancer
Authors: Withey Samuel J , Goh Vicky , Foley Kieran G
Published: June 2022

Radiological investigations are essential in the management of oesophageal and gastro-oesophageal junction cancers. The current multimodal combination of CT, 18F-fluorodeoxyglucose positron emission tomography combined with CT (PET/CT) and endoscopic ultrasound (EUS) has limitations, which hinders the prognostic and predictive information that can be used to guide optimum treatment decisions. Therefore, the development of improved imaging techniques is vital to improve patient management. This review describes the current evidence for state-of-the-art imaging techniques in oesophago-gastric cancer including high resolution MRI, diffusion-weighted MRI, dynamic contrast-enhanced MRI, whole-body MRI, perfusion CT, novel PET tracers, and integrated PET/MRI. These novel imaging techniques may help clinicians improve the diagnosis, staging, treatment planning, and response assessment of oesophago-gastric cancer.
‘Comparison and correlation of the maxillary sinus dimensions in various craniofacial patterns: A CBCT Study’
Authors: Atul Kumar Harshit , Nayak U S Krishna , Kuttappa M N
Published: June 2022

Background: To compare and correlate the maxillary sinus dimensions and basal bone height among various facial patterns using CBCT for advanced diagnosis and treatment planning in Orthodontics.

Methods: 66 CBCT images within age group of 18-30 years were divided into horizontal (Group 1), average (Group 2) and vertical (Group 3) facial growth patterns. Maxillary sinus dimensions were compared and correlated in all three groups. The sinus height and basal bone height were recorded at 3 locations-between 1st premolar and 2nd premolar (PM1-PM2), between 2nd premolar and 1st Molar (PM2-M1) and between 1st and 2nd molar (M1-M2).

Results: Overall reduction in sinus height and significantly reduced sinus volume was seen in Group-1. Longest maxillary sinus height in M1-M2 region and shortest in PM1-PM2 region was seen in Group-3. The basal bone height in PM1-PM2 region was significantly longer in Group-3 than in Group-1(p<.05).Shortest basal bone height in M1-M2 region was seen in Group-3. A significant negative correlation was seen between the maxillary sinus height and the basal bone height in Group-1 and Group-3(p<.05).

Conclusion: There is a correlation between the maxillary sinus height and basal bone height with that of facial pattern which needs to be considered during orthodontic treatment planning and while carrying out facial growth modification procedures in younger patients.
The experiences of homecare workers in navigating the COVID-19 pandemic: a protocol for a qualitative study
Authors: Moynan Eva , Lavelle Caitriona , Robinson Katie , Boland Pauline , Meskell Pauline , Galvin Rose , Fitzgerald Christine
Published: June 2022

Background: Globally, there have been over 400 million confirmed cases of coronavirus disease 2019 (COVID–19), including over 6 million deaths, reported to the World Health Organization. Older adults have been disproportionally affected by COVID-19 in terms of morbidity and mortality. Homecare workers continue to play a key role in supporting vulnerable people to live in their own homes. Unlike other health professionals, whose interactions with patients are relatively brief, homecare workers sometimes spend hours with clients assisting with caregiving and functional tasks. In addition, these workers frequently provide companionship and emotional support. The COVID-19 pandemic has resulted in many challenges to this caregiving role given the risk of virus transmission to both clients and homecare workers in the community. Despite the vital role homecare workers have played, qualitative research exploring perspectives of homecare workers experiences’ of providing help and care to older adults during the pandemic is sparse. This study aims to explore the experiences of homecare workers in navigating the COVID-19 pandemic.

Methods: A qualitative interpretative approach will be applied in this study through the facilitation of focus groups with homecare workers. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines will be used to standardise the conduct and reporting of the research. Homecare workers will be recruited from a provider of homecare services in the Mid-West of Ireland (Clarecare) by a gatekeeper. Focus groups will be transcribed and analysed using a reflexive thematic approach supported by the use of NVIVO software package (Version 12).

Conclusion: This study represents a necessary first step in the development of an evidence base for clinical, education, and support needs of homecare workers.
Innovaciones en el procedimiento administrativo común y el régimen jurídico del sector público
Authors: López Menudo Francisco
Published: June 2022

El presente libro se ofrece no sólo a quienes se dedican al Derecho. Su destinatario es, por extensión, un universo muy amplio de estudiosos y lectores, dada la fuerte incidencia de la acción administrativa en la esfera de los particulares. Esto ha quedado patente una vez más con la reciente entrada en vigor de las Leyes 39 y 40/2015 de 1 de octubre, mediante la cual se operan reformas en aspectos tan esenciales como la organización administrativa, el régimen jurídico de sus actos y el procedimiento administrativo común. Los temas seleccionados en esta obra representan lo principal de dicha reforma. En el libro se presta especial atención a esa "Administración electrónica" que constituye el inicio de una nueva era en las relaciones entre el poder público y los ciudadanos. En sus páginas pueden encontrarse respuestas a los interrogantes que este nuevo reto plantea al Derecho Administrativo.
Primeiro Comando da Capital and Comando Vermelho
Authors: Jański Kamil
Published: June 2022

The era of the military junta left a legacy of draconian laws and inhumane prison conditions. The lack of effective reforms led to the rise of the prison gangs Comando Vermelho in the city of Rio de Janeiro and Primeiro Comando da Capital in the city of São Paulo. Ineffective state government policies based on relocation of problem prisoners and initial denial of their existence not only accelerated the expansion of the CV and PCC gangs in the prisons themselves but also enabled them to infiltrate the favelas. Members of the Comando Vermelho and the Primeiro Comando da Capital gangs took advantage of inequalities and racial discrimination that had existed since colonial times to maintain a negative image of the state and white elites while gaining support and potential recruits. The cocaine boom of the 1980s and the associated development of the narco-business provided the gangs with a lucrative source of income, but at the same time became a flashpoint between them, generating conflicts. Parallel with the emergence of organized crime, a multidimensional phenomenon called narco-culture arose and began to permeate popular culture. Though it, members of gangs and drug cartels sought to legitimize and gain social acceptance for narco-business, drug consumption, and their own criminal operations at the expense of lowering the authority of the state.
Food Is Different During the Pandemic
Authors: Jastrzębiec-Witowska Anna
Published: June 2022

The COVID-19 pandemic has left no area of human life unaffected and the food system in its global, regional, or micro manifestations is not an exception. The images of empty store shelves caused by lockdowns stirred a lot of anxiety among consumers in the so-called First World. At the same time, thousands of miles away, in the developing and underdeveloped countries, where having a meal is never taken for granted, people suffered the harshest consequences of any pandemic-related instability in the food system. Both these realities deserve intellectual reflection, with the former being far more intricate than its media portrayals and therefore will be explored further in this work. This paper aims to study the COVID-19 impact on food systems in developed countries such as the United States and Canada, as well as the challenges to the food security they face during the pandemic. It offers a top-down approach, starting with the definition of food security, and highlighting some crucial aspects of food access and food availability, which has been compromised by the spread of coronavirus in the two countries. Detailed analysis of responses to the pandemic-related food security problems in both countries will be offered as well. The right to food is presented here as a human right, and the links between that right and the concept of food security are brought out. The pandemic wreaked havoc on food security in many parts of the world, including the affluent, but at the same time revealed its fragility and the need for continuous monitoring, re-assessment, and improvement through more effective food programs. The emerging sliver of hope for a more just postpandemic food system should not be ignored.
Post-9/11 Dilemma over the Priority of National Security or Civil Liberties in Marvel Comics (2001-2004)
Authors: Przywalny Dawid
Published: June 2022

The article contains an analysis of comics from Marvel Comics, published between the second half of 2001 and the end of 2004. With the mixed methods approach (quantitative and qualitative research), the criterion for the analysis is appearance of and references to the socio-political dilemma of the conflict between ensuring national security and respecting civil liberties. It was one of the most important topics of debate for American society after the terrorist attacks of 9/11 in the sphere of politics and law in the US. The analysis aims to discover the number of comics that dealt with the subject of this post-9/11 dilemma, as well as to categorize individual stories, with the use of Jonathan Culler’s over-interpretation, as supporting the priority of national security or advocating for the importance of civil liberties. With these data, it will be possible to determine the political tone of individual comics, as well as to establish the views of the artists working for Marvel Comics and their attitudes to the policy pursued by the administration of President George W. Bush. The article uses studies conducted as part of doctoral research from the unpublished dissertation Terrorism, politics, and civil liberties in the American comics after September 11, 2001, based on a comics analysis of Marvel Comics, DC Comics, and Image Comics.
Marilyn Monroe’s On-screen Spectrum of Femininity: Types and Nature of Her Movie Characters
Authors: Szymkowska-Bartyzel Jolanta
Published: June 2022

The article makes an attempt to create a typology of movie characters played by Marilyn Monroe. Her film roles are classic examples of typecasting. Since Monroe was a type of a sexy blonde, that was what she played in her movies. Whether it was a comedy or drama, her sexiness defined the entire character. However, the attributes of the sex bomb Marilyn combined with other features: of an innocent child, a lost and helpless girl, a sensitive and tender woman. These three types of characters: a child-woman, a female buddy, and a woman-partner, make up the full picture of Monroe’s femininity with which viewers interact during the cinematic mystery and which create an artistic, social and cultural phenomenon called ‘Marilyn Monroe.’
Stochastic RWA and Lightpath Rerouting in WDM Networks
Authors: Daryalal Maryam , Bodur Merve
Published: June 2022

In a telecommunication network, routing and wavelength assignment (RWA) is the problem of finding lightpaths for incoming connection requests. When facing a dynamic traffic, greedy assignment of lightpaths to incoming requests based on predefined deterministic policies leads to a fragmented network that cannot make use of its full capacity because of stranded bandwidth. At this point, service providers try to recover the capacity via a defragmentation process. We study this setting from two perspectives: (i) while granting the connection requests via the RWA problem and (ii) during the defragmentation process by lightpath rerouting. For both problems, we present the first two-stage stochastic integer programming model incorporating incoming request uncertainty to maximize the expected grade of service. We develop a decomposition-based solution approach, which uses various relaxations of the problem and a newly developed problem-specific cut family. Simulation of two-stage policies for a variety of instances in a rolling-horizon framework of 52 stages shows that our stochastic models provide high-quality solutions when compared with traditionally used deterministic ones. Specifically, the proposed provisioning policies yield improvements of up to 19% in overall grade of service and 20% in spectrum saving, while the stochastic lightpath rerouting policies grant up to 36% more requests, using up to just 4% more bandwidth spectrum.

Summary of Contribution: For handling the intrinsic uncertainty of demand in the telecommunications industry, this paper proposes novel stochastic models and solution methodology for two fundamental problems in telecommunications at operational level: (i) routing and wavelength assignment (RWA) and (ii) lightpath rerouting problem. Despite the vast literature on the RWA problem, stochastic optimization has not been considered as a viable solution for resource allocation in optical networks. We propose two-stage stochastic programming models for both problems and design efficient decomposition-based solution methods that use various relaxations of the models and a new family of cutting planes. Our extensive and rigorous numerical experiments show the significant merit of incorporating uncertainty into decision making, as well as the effectiveness of the decomposition framework and our newly designed family of cuts in enhancing the solvability of both models. This work opens new avenues to explore where the powerful stochastic programming literature can be leveraged to make operational decisions in telecommunications problems, a field that currently relies mostly on deterministic and heuristic solution methods.
Technical Note—On the Strength of Relaxations of Weakly Coupled Stochastic Dynamic Programs
Authors: Brown David B. , Zhang Jingwei
Published: June 2022

Many sequential decision problems have a weakly coupled structure in that a set of linking constraints couples an otherwise independent collection of subproblems. This structure arises in a wide variety of applications, such as network revenue management, online advertising, assortment planning, interactive marketing, optimization of power systems, and multilocation inventory management to name only a few. Such problems can be modeled as dynamic programs but are quite difficult to solve. Two widely studied approximation methods are approximate linear programs, which involve finding a best approximation of total value that is additive across the subsystems, and Lagrangian relaxations, which involve relaxing the linking constraints. It is well known that both of these approaches provide upper bounds to the optimal value, and the approximate linear programming approach is a better bound but also, more difficult to compute. In this paper, we provide a detailed theoretical analysis of these two approximations and show that, under fairly broad conditions, these two approximations lead to upper bounds that are very close and often identical. Our theory suggests that, between these two approximations, Lagrangian relaxations should usually be the preferred choice for researchers studying applications involving weakly coupled dynamic programs.
Collective Attention and Collective Intelligence: The Role of Hierarchy and Team Gender Composition
Authors: Woolley Anita Williams , Chow Rosalind M. , Mayo Anna T. , Riedl Christoph , Chang Jin Wook
Published: June 2022

Collective intelligence (CI) captures a team’s ability to work together across a wide range of tasks and can vary significantly between teams. Extant work demonstrates that the level of collective attention a team develops has an important influence on its level of CI. An important question, then, is what enhances collective attention? Prior work demonstrates an association with team composition; here, we additionally examine the influence of team hierarchy and its interaction with team gender composition. To do so, we conduct an experiment with 584 individuals working in 146 teams in which we randomly assign each team to work in a stable, unstable, or unspecified hierarchical team structure and vary team gender composition. We examine how team structure leads to different behavioral manifestations of collective attention as evidenced in team speaking patterns. We find that a stable hierarchical structure increases more cooperative, synchronous speaking patterns but that unstable hierarchical structure and a lack of specified hierarchical structure both increase competitive, interruptive speaking patterns. Moreover, the effect of cooperative versus competitive speaking patterns on collective intelligence is moderated by the teams’ gender composition; majority female teams exhibit higher CI when their speaking patterns are more cooperative and synchronous, whereas all male teams exhibit higher CI when their speaking involves more competitive interruptions. We discuss the theoretical and practical implications of our findings for enhancing collective intelligence in organizational teams.

Funding: This work was supported by the National Science Foundation [Grant VOSS-1322254], Division of Information and Intelligent Systems [Grant 1322241], Army Research Office [Grant W911NF-20-1-0006], Defense Advanced Research Projects Agency [Grant W911NF-20-1-0006], and Army Research Laboratory [Grant W911NF-19-2-0135].

Supplemental Material: The e-companion is available at https://doi.org/10.1287/orsc.2022.1602 .
Achieving congruence in ‘being and doing’ community nursing
Authors: Dickson Caroline AW
Published: June 2022

Conceptual and theoretical frameworks for person-centred community nursing practices have not yet been fully developed. There is a need to explore this further in order to guide future district nursing, which forms part of the community nursing discipline in the UK. The contemporary district nursing role is undergoing change, although there appears to be little consensus about the district nurse's (DN) vision across the UK, and little indication of the theoretical position underpinning this change. Meeting strategic requirements ( National Health Service (NHS), 2019 ; Scottish Government (SG), 2017a & b ), DNs have advancing clinical expertise and are recognised for their technical skills. However, one may contend that this emphasis on ‘doing’ in practice contributes to practice decisions made exclusively on task performance by strategic decision-makers, and DNs continually viewing themselves as invisible ( National Assembly for Wales,, 2019 ; Queens Nursing Institute (QNI), 2006 ; Dickson 2018 ; 2020 ). District nursing education may contribute to this lack of clarity as curricula are based on borrowed theory from other disciplines that continue to focus on ‘how to do’, with little emphasis on ‘how to be’ a DN, and the continued decrease in DN numbers across the UK may be a consequence. In this paper, I explore current evidence that underpins district nursing practice, education and research in the UK, and advocate the use of the Person-centred Practice Framework (PCPF) ( McCormack and McCance, 2017 ) as a means of unifying and guiding ‘being a person-centred DN.’ This will enable practitioners who can draw on multiple forms of evidence to inform their advancing practice. This article offers philosophical and pedagogical principles to underpin person-centred education going forward. I argue this will promote congruence between ‘doing’ and ‘being’ a DN, giving a voice to DNs, and direction to their specialism.
Catheter valves: are they useful in supporting patients in a trial without catheter?
Authors: McNaughton Joanne , Fairley-Murdoch Marianne
Published: June 2022

A trial without catheter (TWOC) is a common urological procedure undertaken to remove an indwelling urinary catheter when no longer clinically indicated. An appropriately trained practitioner should undertake a TWOC in a controlled environment to ensure that a further urinary retention does not occur. Indwelling urinary catheters are commonly used with a free drainage system such as a leg bag, which continually empties the bladder. This article examines the potential benefits of using a catheter valve as an alternative to free drainage, prior to undertaking a TWOC, to optimise clinical outcomes and patient experience. This article will guide nurses to increase their knowledge of catheter valves to promote person-centred informed decision-making.
Diabetic leg and foot ulcers: how district nurses can promote wound healing through blood glucose control
Authors: Winterbottom Chelsea
Published: June 2022

Diabetes is a chronic and often life-long condition that is a consequence of the blood glucose level being too high ( National Institute for Health and Clinical Excellence (NICE), 2019 ). Diabetes covers a range of conditions such as type 1 diabetes, type 2 diabetes and gestational diabetes. It has been well documented that uncontrolled blood glucose levels can lead to further circulatory damage, which impedes the wound healing process and often results in chronic wounds that do not heal. This article uses data collected from an audit and explores how district nursing teams can improve wound healing for those living at home with diabetic ulcers (DUs) by regularly monitoring blood glucose levels. This is followed by a discussion on how district nurses can support their team to adapt best practice, and the benefits of regularly checking blood glucose levels, even for service users that manage their diabetes with diet or oral medication. The article also explores how the multidisciplinary team can be accessed and used efficiently and how leadership skills can improve service user care and safety.
Interventions for the treatment and prevention of pressure ulcers
Authors: Hill James Edward , Edney Sarah , Hamer Oliver , Williams Alexandra , Harris Catherine
Published: June 2022

Pressure ulcers can affect multiple aspects of an individual's life. Though preventable, pressure ulcers place a substantial economic burden on healthcare services. Countries around the world have set pressure ulcer prevention and treatment as a high priority. National Clinical Guidelines recommend a wide range of preventative and curative treatments. However, there is still much uncertainty regarding the effectiveness of preventative and curative treatments. This overview of systematic reviews aims to describe the findings of 15 Cochrane reviews on the treatment and prevention of pressure ulcers included in a previous umbrella review and to expand upon their findings in the context of clinical practice.
Becoming more environmentally friendly
Authors: Hewson Claire
Published: June 2022

With up to a million animal and plant species facing extinction within the next few decades, it is vital that children understand from an early age how to look after our planet. 1 If we show children, through our everyday habits, how we protect the planet then it is more likely they will do so too.
Art enriching the early years
Authors: Celinska Angelica
Published: June 2022

Abigail Horn, atelierista and early years teacher, shares with us how working in the arts and with children have come together for her, explaining that the two practices inform and enrich each other.
Relaxing ratios will create problems, not solutions
Authors: Leitch Neil
Published: June 2022

To say that the early years sector has had a challenging few years would be an understatement. Neil Leitch discusses how the added strain of even considering the relaxation of ratios will impact the sector.
Mind your language!
Authors: Conkbayir Mine
Published: June 2022

Tantrum – What's the fuss? Let's talk about words. Spastic. Retard. Retarded. All terms used in the globally renowned Diagnostic and Statistical Manual of Mental Disorders (DSM) until recently, to describe a neurodivergent person. It is thanks to the former President of America, Barrack Obama (2010), that such terms were replaced – only in 2013. Did the inclusion of these terms in this clinicians' and psychiatrists' handbook make it acceptable?
Childcare agencies can help more
Authors: Midgley Laura
Published: June 2022

Laura Midgley reflects on the Nursery World article Business Challenges: Part 1 - Let it flow, suggesting how childcare agencies can step up to support early years settings at the time when cashflow and budgeting is proving to be an impossible task.
Understanding pelvic organ prolapse and urinary incontinence in women
Authors: Dwyer Lucy
Published: June 2022

Pelvic organ prolapse and urinary incontinence are common but under-treated conditions in women. Lucy Dwyer explains how to assess and manage the conditions in primary care

Pelvic organ prolapse (POP) and urinary incontinence (UI) are extremely common yet under-reported and, therefore, under-treated conditions. Women may disclose symptoms of POP or UI to practice nurses and other healthcare professionals working in primary care. Therefore, this article aims to provide a background to both conditions and explain how to assess and manage POP and UI in primary care, utilising NICE guidelines to ensure practice nurses feel confident in their provision of evidence-based care.
Improving outcomes for people living with breathlessness
Authors: Tymon Lucy , Best Catherine
Published: June 2022

Breathlessness affects many people living in the community. Lucy Tymon and Catherine Best look at how practice nurses can improve outcomes in those living with this distressing symptom

The need for a holistic assessment is an essential element in the management of breathlessness in both chronic and advanced disease and requires a multidisciplinary and multifactorial approach to the safe and effective delivery of quality patient care. Although a multitude of potential interventions exist, these should be considered carefully alongside the need to maintain comfort and the patient's wishes. With this in mind, this article explores a number of pharmacological and non-pharmacological approaches to patient care in chronic and advanced disease, the emphasis being on patient choice, patient understanding and the need for compassion, often at a time when patients are living through, what could potentially be, their last few months of life.
Effect of IL6 -174 G/C Gene Polymorphism on Response to Interleukin-6 Blocking Therapy in Systemic Juvenile Idiopathic Arthritis
Authors: Nada Doaa Waseem , Allam Abdallah El Sayed , Aziz Hanout Heba Abdel , Gaber Rasha Ahmed , Alunno Alessia , Salem Mohamed Labib , Al Ashkar Doaa Shawky
Published: June 2022

Objective: The main objective of this study was to evaluate the association of IL6-174 G/C gene polymorphisms and the response to tocilizumab (TCZ) in patients with systemic juvenile idiopathic arthritis (s-JIA).

Methods: Sixty patients with s-JIA (37 males and 23 females with median age at onset of 5.2 years) who received TCZ were recruited. Basic demographic, laboratory and clinical data were collected alongside the IL-6 haplotype status. The overall response to treatment with TCZ was assessed according to a number of variables including the extent of disease activity reduction, the achievement of clinically inactive disease, the necessity to switch to another biologic disease modifying anti-rheumatic drug (bDMARD) and the achievement of a glucocorticoid-free state.

Results: Three IL6 -174 genotypes, including, GG, GC, and CC were found with higher frequencies of GC genotype. These genotypes had non-significant association with the response of s-JIA patients to IL-6 blockade in this cohort study. However, a longer time frame from disease onset to diagnosis was associated with poorer long-term treatment response.

Conclusion: We observed no significant impact of IL6 -174 G/C gene polymorphisms on treatment response to TCZ in s-JIA Egyptian patients. The observation that a shorted timeframe between symptom onset and diagnosis is associated with better long-term response to TCZ provides evidence for a therapeutic “window of opportunity” in patients with s-JIA.
Exploring value change
Authors: de Wildt Tristan Emile , Jine Schweizer Vanessa
Published: June 2022

This article aims to explore the use of cross-impact balances (CIB) to identify scenarios of value change. The possibility of value change has received little attention in the literature on value-sensitive design (VSD). Examples of value change include the emergence of new values and changes in the relative importance of values. Value change could lead to a mismatch between values embedded in technology and the way they are currently considered in society. Such a mismatch could result in a lack of acceptability of technologies, increasing social tensions and injustices. However, methods to study value change in the VSD literature are rare. CIB is a scenario tool that can study systems characterized by feedback loops that are hard to describe mathematically. This is often the case when aiming to define values and their relationships. We demonstrate the use of CIB to identify scenarios of value change using two cases: digital voice assistants and gene drive organisms. Our findings show that CIB is helpful in building scenarios of value change, even in instances where the operationalization of values is complex. CIB also helps us to understand the mechanisms of value change and evaluate when such mechanisms occur. Finally, we find that CIB is particularly useful for social learning and explanatory modelling. CIB can therefore contribute to the design of value-sensitive technologies.
Techno-moral change through solar geoengineering: How geoengineering challenges sustainability
Authors: Hofbauer Benjamin
Published: June 2022

This article brings a new perspective to the ethical debate on geoengineering through stratospheric aerosol injection (SAI), incorporating the emerging techno-moral change scholarship into the discussion surrounding sustainability. The techno-moral change approach can help us understand different ways in which technology might shape society. First, it helps highlight how values and norms are interrelated. Second, it shows that techno-moral change can happen even if the technology is in no way realized. Through the introduction of two techno-moral vignettes, two diametrically opposed ways in which SAI forces us to rethink sustainability and our relationship with nature are suggested. SAI could lead to a situation of entrenchment, wherein sustainability as a norm is undermined, or transformation where the necessity of acting according to sustainability is highlighted.
Future value change: Identifying realistic possibilities and risks
Authors: Hopster Jeroen
Published: June 2022

The co-shaping of technology and values is a topic of increasing interest among philosophers of technology. Part of this interest pertains to anticipating future value change, or what Danaher (2021) calls the investigation of ‘axiological futurism’. However, this investigation faces a challenge: ‘axiological possibility space’ is vast, and we currently lack a clear account of how this space should be demarcated. It stands to reason that speculations about how values might change over time should exclude farfetched possibilities and be restricted to possibilities that can be dubbed realistic. But what does this realism criterion entail? This article introduces the notion of ‘realistic possibilities’ as a key conceptual advancement to the study of axiological futurism and offers suggestions as to how realistic possibilities of future value change might be identified. Additionally, two slight modifications to the approach of axiological futurism are proposed. First, axiological futurism can benefit from a more thoroughly historicized understanding of moral change. Secondly, when employed in service of normative aims, the axiological futurist should pay specific attention to identifying realistic possibilities that come with substantial normative risks.
Thermally controlled optical resonator for vacuum squeezed states separation
Authors: Nguyen C. , Bréelle E. , Barsuglia M. , Capocasa E. , De Laurentis M. , Sequino V. , Sorrentino F.
Published: June 2022

Future gravitational-wave detectors will use frequency-dependent squeezed vacuum states to obtain broadband reduction of quantum noise. Quantum noise is one of the major limitations to the sensitivity of these detectors. Advanced LIGO+, Advanced Virgo+, and KAGRA plan to generate frequency-dependent squeezed states by coupling a frequency-independent squeezed light state with a filter cavity. An alternative technique is under consideration, based on conditional squeezing with quantum entanglement: Einstein–Podolsky–Rosen (EPR) squeezing. In the EPR scheme, two vacuum entangled states, the signal field at

ω
0

and the idler field at

ω
0

+
Δ

, must be spatially separated with an optical resonator and sent to two separate homodyne detectors. In this framework, we have designed and tested a solid Fabry–Perot etalon, to be used in an EPR table-top experiment prototype, thermally controlled without the use of a control probe optical beam. This device can also be used in optical experiments where the use of a bright beam to control an optical resonator is not possible, or where a simpler optical device is preferred.
Calibration and comparison of detection efficiency for free-space single-photon avalanche diodes at 850  nm
Authors: Jin Jeongwan , Gerrits Thomas , Gamouras Angela
Published: June 2022

A detection efficiency measurement system for free-space single-photon detectors has been established at the National Research Council (NRC) Canada. This measurement apparatus incorporates an 850 nm fiber laser source and utilizes a double-attenuation and substitution calibration technique. Detection efficiency calibrations of silicon single-photon avalanche photodiodes (SPADs) at incident photon rates in the range of

1.0
×

10
5

photon counts per second (Cts/s) (36 fW) to

2.1
×

10
6

C
t
s

/

s

(734 fW) are SI-traceable through the substitution configuration with a silicon transfer standard detector, calibrated directly using the NRC absolute cryogenic radiometer. The measurement approach taken by the NRC was compared with the SPAD calibration technique implemented at the National Institute of Standards and Technology (NIST) in the United States. The count-rate-dependent detection efficiency of a silicon SPAD was measured at NIST and compared with results from the same SPAD measured at NRC within the range of incident photon rates from

1
×

10
5

C
t
s

/

s

to

5
×

10
5

C
t
s

/

s

. Comparison of the calibration results shows agreement between the two laboratories within the combined measurement uncertainties.
Investigation of number density, temperature, and kinetic energy of nanosecond laser-induced Zr plasma species for self-generated electric and magnetic fields in axial expansion of plume
Authors: Sajid Tayyaba , Bashir Shazia , Akram Mahreen , Razzaq Maira , Javed Mubashir , Mahmood Khaliq
Published: June 2022

The number density, temperature, and kinetic energy of laser-induced Zr plasma species have been evaluated experimentally under ultra-high vacuum conditions as a function of 1 to 4 cm axial distances of the plume at laser irradiances ranging from 4.5 to

11.7

G
W

c

m

−
2

. Zr plasma parameters have been evaluated using time-of-flight (ToF) measurements by using a Faraday cup (FC) as a diagnostic technique. The amplitudes of the signals as well as the number density and temperature are strongly dependent upon laser irradiance and axial distances. With increasing laser irradiance the laser-induced plasma (LIP) parameters show an increasing trend. The increasing trend of the plasma parameters along with increasing laser irradiance is attributed to an enhanced energy deposition per atom, which is responsible for an enhanced ablation rate, surface temperature, and ablation/shock pressures. However, a decreasing trend is obtained with increasing axial distances, which is explainable based on adiabatic expansion, cooling, and recombination losses. The LIP electron and ion number densities vary from

3.13

×

1

0

13

to

6.81

×

1

0

13

c

m

−
3

and

1.84

×

1

0

13

to

4.41

×

1

0

13

c

m

−
3

, respectively. The electron temperature varies from 1.54 to 125 eV, whereas the kinetic energy of the ions varies from 1.2 to 34 keV. The maxima of Zr plasma parameters are achieved away from the target surface. In order to correlate the charge particle distribution and their energies with self-generated electric and magnetic fields (SGEMFs), the measurements have been performed by employing electric and magnetic probes, respectively. The signal profiles of the SGEMFs reveal the quadrupolar distribution, which is attributed to two oppositely generated dipoles whose contribution is strongly dependent upon axial distances and laser irradiances. The strength of both SGEMFs shows an increasing trend with increasing laser irradiance, and a decreasing trend is obtained with increasing probe-target distance. For overall plume axial expansion, the LIP electric and magnetic fields vary from 30 to 3140 V/m and 0.2 to 0.4 T, respectively. Similar trends of the SGEMFs and the axial gradients of the electron-ion number density confirm the quadrupolar structure of plasma, which corresponds to the electron-ion charge separation. This charge separation is due to the spatially evolved number density and temperature gradients in the plasma. Their correlation and optimization will be helpful for using LIP as a powerful source of electric and magnetic fields in ion acceleration and inertial confinement fusion.