bluuebunny/crossref_metadata_2025 huggingface dataset:
Alignment adjustment using the Valgus stress technique can increase the surgical accuracy of novice surgeons during medial opening-wedge high Tibial osteotomy
Authors: Kim Man Soo , Koh In Jun , Sung Yong Gyu , Park Dong Chul , Han Sung Bin , In Yong
Published: June 2021

Background

The purpose of this study was to compare the degree of accuracy of coronal alignment correction with use of the “alignment adjustment under valgus stress technique” between expert and novice surgeons during medial opening-wedge high tibial osteotomy (MOWHTO).

Methods

Forty-eight patients who underwent MOWHTO performed by an expert surgeon (expert group) and 29 by a novice surgeon (novice group) were enrolled in analysis. During surgery, lower-extremity alignment was corrected using the “alignment adjustment under valgus stress technique”. Normocorrection was defined as a weight-bearing line ratio between 55 and 70% and the correction accuracy was compared between expert and novice groups using the ratio of normocorrection to outliers. The clinical outcomes were also compared using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 1 year after surgery.

Results

The undercorrection rate was 14.6% in the expert group and 13.8% in the novice group, while the overcorrection rate was 2.1% in the expert group and 3.4% in the novice group. In the ratio of normocorrection to outliers, no difference was found between the two groups at the one-year follow-up visit (83.3% in the expert group vs. 82.8% in the novice group; p > 0.05). Also, no significant differences were seen in WOMAC subscores immediately preoperatively and at 1 year after surgery (all p > 0.05).

Conclusion

Adhering to the “alignment adjustment under valgus stress technique” protocol enabled novice surgeons to achieve similar surgical accuracy as that of an expert surgeon in coronal alignment during MOWHTO.

Level of evidence

Level III.
How do breastfeeding workplace interventions work?: a realist review
Authors: Litwan Kathrin , Tran Victoria , Nyhan Kate , Pérez-Escamilla Rafael
Published: June 2021

Background

Women are representing an increasing share of the labor force, thus, raising the need to accommodate breastfeeding working mothers at the workplace. While there is an emerging body of evidence supporting the positive influence of workplace lactation programs on breastfeeding outcomes, there is a lack of literature on the mechanisms underlying those interventions. Aims of this realist review were three-fold: to uncover underlying mechanisms, determine who benefits the most from such interventions and important contextual factors influencing uptake.

Methods

Purposive bibliographic searches on Medline, Web of Science Core Collection, CINAHL, Global Health, LILACS, Global Index Medicus, Business Source Complete, Proquest Dissertations and Theses and Open Access Theses and Dissertations were conducted to identify relevant publications. Included publications (qualitative and quantitative) described interventions aiming to improve the breastfeeding behavior of working mothers, that were initiated by the employer, reported on breastfeeding outcomes and had a clearly defined workplace. Publications only focusing on maternity leave or that were not published in English, Spanish, Portuguese or German were excluded. A realist approach was followed to identify how workplace interventions work, who benefits the most and the important contextual factors.

Results

The bibliographic search yielded a total of 4985 possible publications of which 37 publications were included in the realist analysis. Effective workplace breastfeeding interventions activate three mechanisms: 1) awareness of the intervention, 2) changes in workplace culture, manager/supervisor support, co-worker support and physical environments, and 3) provision of time. Contextual factors such as the distance between the workplace and the infant and the type of workplace may influence the degree of activation of the underlying mechanisms for programs to positively impact breastfeeding outcomes.

Conclusions

In order to be effective, workplace breastfeeding interventions need to: raise awareness of the intervention(s) available among working mothers as well as their work environment, change the workplace culture, foster manager/supervisor support and co-workers support, provide enough time and adequate space and facilities for women to breastfeed or express breastmilk during the workday.
Risk factors of symptomatic anastomotic leakage and its impacts on a long-term survival after laparoscopic low anterior resection for rectal cancer: a retrospective single-center study
Authors: Qi Xinyu , Liu Maoxing , Xu Kai , Gao Pin , Tan Fei , Yao Zhendan , Zhang Nan , Yang Hong , Zhang Chenghai , Xing Jiadi , Cui Ming , Su Xiangqian
Published: June 2021

Background

Postoperative symptomatic anastomotic leakage (AL) is a serious complication after low anterior resection (LAR) for rectal cancer. AL can potentially affect short-term patient outcomes and long-term prognosis. This study aimed to explore the risk factors and long-term survival of symptomatic AL after laparoscopic LAR for rectal cancer.

Methods

From May 2009 to May 2015, 298 consecutive patients who underwent laparoscopic LAR for rectal cancer with or without a defunctioning stoma were included in this study. Univariate and multivariate logistic regression analyses were used to explore independent risk factors for symptomatic AL. Survival analysis was performed using Kaplan–Meier curves, and log-rank tests were used for group comparisons.

Results

Among the 298 patients enrolled in this study, symptomatic AL occurred in eight (2.7%) patients. The univariate analysis showed that age of ≤65 years (P = 0.048), neoadjuvant therapy (P = 0.095), distance from the anal verge (P = 0.078), duration of operation (P = 0.001), and pathological tumor (T) category (P = 0.004) were associated with symptomatic AL. The multivariate analysis demonstrated that prolonged duration of operation (P = 0.010) was an independent risk factor for symptomatic AL after laparoscopic LAR for rectal cancer. No statistically significant differences were observed in the 3-year (P = 0.785) and 5-year (P = 0.979) overall survival rates.

Conclusions

A prolonged duration of operation increased the risk of symptomatic AL after laparoscopic LAR for rectal cancer. An impact of symptomatic AL on a long-term survival was not observed in this study; however, further studies are required.

Trial registration

This study was registered in the Chinese Clinical Trial Registry (ChiCTR2000033413) on May 31, 2020.
Key role of the CCR2-CCL2 axis in disease modification in a mouse model of tauopathy
Authors: Ben-Yehuda Hila , Arad Michal , Peralta Ramos Javier María , Sharon Efrat , Castellani Giulia , Ferrera Shir , Cahalon Liora , Colaiuta Sarah Phoebeluc , Salame Tomer-Meir , Schwartz Michal
Published: June 2021

Background

For decades, dementia has been characterized by accumulation of waste in the brain and low-grade inflammation. Over the years, emerging studies highlighted the involvement of the immune system in neurodegenerative disease emergence and severity. Numerous studies in animal models of amyloidosis demonstrated the beneficial role of monocyte-derived macrophages in mitigating the disease, though less is known regarding tauopathy. Boosting the immune system in animal models of both amyloidosis and tauopathy, resulted in improved cognitive performance and in a reduction of pathological manifestations. However, a full understanding of the chain of events that is involved, starting from the activation of the immune system, and leading to disease mitigation, remained elusive. Here, we hypothesized that the brain-immune communication pathway that is needed to be activated to combat tauopathy involves monocyte mobilization via the C-C chemokine receptor 2 (CCR2)/CCL2 axis, and additional immune cells, such as CD4+ T cells, including FOXP3+ regulatory CD4+ T cells.

Methods

We used DM-hTAU transgenic mice, a mouse model of tauopathy, and applied an approach that boosts the immune system, via blocking the inhibitory Programmed cell death protein-1 (PD-1)/PD-L1 pathway, a manipulation previously shown to alleviate disease symptoms and pathology. An anti-CCR2 monoclonal antibody (αCCR2), was used to block the CCR2 axis in a protocol that partially eliminates monocytes from the circulation at the time of anti-PD-L1 antibody (αPD-L1) injection, and for the critical period of their recruitment into the brain following treatment.

Results

Performance of DM-hTAU mice in short-term and working memory tasks, revealed that the beneficial effect of αPD-L1, assessed 1 month after a single injection, was abrogated following blockade of CCR2. This was accompanied by the loss of the beneficial effect on disease pathology, assessed by measurement of cortical aggregated human tau load using Homogeneous Time Resolved Fluorescence-based immunoassay, and by evaluation of hippocampal neuronal survival. Using both multiparametric flow cytometry, and Cytometry by Time Of Flight, we further demonstrated the accumulation of FOXP3+ regulatory CD4+ T cells in the brain, 12 days following the treatment, which was absent subsequent to CCR2 blockade. In addition, measurement of hippocampal levels of the T-cell chemoattractant, C-X-C motif chemokine ligand 12 (Cxcl12), and of inflammatory cytokines, revealed that αPD-L1 treatment reduced their expression, while blocking CCR2 reversed this effect.

Conclusions

The CCR2/CCL2 axis is required to modify pathology using PD-L1 blockade in a mouse model of tauopathy. This modification involves, in addition to monocytes, the accumulation of FOXP3+ regulatory CD4+ T cells in the brain, and the T-cell chemoattractant, Cxcl12.
Is hypnosis a valid alternative to spontaneous breathing general anesthesia for claustrophobic patients undergoing MR exams? A preliminary retrospective study
Authors: Rizzo Stefania , Ferrera Nicole , Pravatà Emanuele , Guggenberger Roman , Stern Steven , Del Grande Filippo
Published: June 2021

Background

The purpose of our retrospective study was to assess the termination rate and the image quality of MR exams performed in claustrophobic patients under medical hypnosis, as compared to patients undergoing MR under spontaneous breathing general anesthesia.

Methods

Our study was approved by the ethics committee. The “hypnosis group” included consecutive patients that had previously interrupted an MR exam because of claustrophobia. The “control group” included patients undergoing MR under pharmacologic sedation. Two experienced radiologists assessed, randomly, independently and blinded the image quality of the two groups using a symmetrical Likert scale: 0 = non-diagnostic images; 1 = bad image quality; 2 = fair image quality; 3 = good image quality; 4 = very good image quality. Descriptive statistics was performed.

Results

Eighty patients were included, equally distributed between the two groups. Every patient was able to complete the MR exam. Ratings 3 and 4 represented the majority of ratings. Both readers rated the MR exams with score 3 or 4 in 66.25% (53/80) of MR exams. Only 5% (4/80) of MR exams were rated below score 2. The majority of the MR exams showed good or very good image quality. No significant difference was found in image quality between the two (p = 0.06) groups. The agreement between the two readers according to the k score was 0.105.

Conclusions

Medical hypnosis is a valid alternative to spontaneous breathing general anesthesia in patients unable to undergo MR due to claustrophobia, allowing good quality images.
Nicotinamide promotes pancreatic differentiation through the dual inhibition of CK1 and ROCK kinases in human embryonic stem cells
Authors: Zhang Yumeng , Xu Jiaqi , Ren Zhili , Meng Ya , Liu Weiwei , Lu Ligong , Zhou Zhou , Chen Guokai
Published: June 2021

Background

Vitamin B3 (nicotinamide) plays important roles in metabolism as well as in SIRT and PARP pathways. It is also recently reported as a novel kinase inhibitor with multiple targets. Nicotinamide promotes pancreatic cell differentiation from human embryonic stem cells (hESCs). However, its molecular mechanism is still unclear. In order to understand the molecular mechanism involved in pancreatic cell fate determination, we analyzed the downstream pathways of nicotinamide in the derivation of NKX6.1+ pancreatic progenitors from hESCs.

Methods

We applied downstream modulators of nicotinamide during the induction from posterior foregut to pancreatic progenitors, including niacin, PARP inhibitor, SIRT inhibitor, CK1 inhibitor and ROCK inhibitor. The impact of those treatments was evaluated by quantitative real-time PCR, flow cytometry and immunostaining of pancreatic markers. Furthermore, CK1 isoforms were knocked down to validate CK1 function in the induction of pancreatic progenitors. Finally, RNA-seq was used to demonstrate pancreatic induction on the transcriptomic level.

Results

First, we demonstrated that nicotinamide promoted pancreatic progenitor differentiation in chemically defined conditions, but it did not act through either niacin-associated metabolism or the inhibition of PARP and SIRT pathways. In contrast, nicotinamide modulated differentiation through CK1 and ROCK inhibition. We demonstrated that CK1 inhibitors promoted the generation of PDX1/NKX6.1 double-positive pancreatic progenitor cells. shRNA knockdown revealed that the inhibition of CK1α and CK1ε promoted pancreatic progenitor differentiation. We then showed that nicotinamide also improved pancreatic progenitor differentiation through ROCK inhibition. Finally, RNA-seq data showed that CK1 and ROCK inhibition led to pancreatic gene expression, similar to nicotinamide treatment.

Conclusions

In this report, we revealed that nicotinamide promotes generation of pancreatic progenitors from hESCs through CK1 and ROCK inhibition. Furthermore, we discovered the novel role of CK1 in pancreatic cell fate determination.
Non-protected carotid artery stenting for symptomatic carotid stenosis in low resource settings
Authors: El-Sudany Ayman H. , Georgy Shady S. , Zaki Amr S. , Bedros Rady Y. , El-Bassiouny Ahmed
Published: June 2021

Background

The use of a distal cerebral protection device during extracranial carotid artery stenting is still a matter of debate. The aim of this work was to evaluate the safety of performing carotid artery stenting procedure without the use of cerebral protection device in patients with symptomatic carotid stenosis. A retrospective study was performed during the period from September 2015 till March 2020 including 91 patients with symptomatic carotid artery stenosis. All patients were treated with a single stent type (Wall stent® - Boston scientific) without the use of cerebral protection device. Pre- and post-procedural clinical assessment with the national institute of health stroke scale (NIHSS). Post procedure brain diffusion-weighted magnetic resonance imaging (DW-MRI) if clinically indicated within 24 h was used to determine periprocedural cerebral embolization.

Results

A low complication rate was found as only one case (1%) showed mild deterioration in NIHSS and new acute cerebral emboli were detected with brain DW-MRI.

Conclusion

Carotid artery stenting can be performed safely without the use of cerebral protection device.
Parenthood Rates and Use of Assisted Reproductive Techniques in Younger Hodgkin Lymphoma Survivors: A Danish Population-Based Study
Authors: Øvlisen Andreas K. , Jakobsen Lasse H. , Eloranta Sandra , Kragholm Kristian H. , Hutchings Martin , Frederiksen Henrik , Kamper Peter , Dahl-Sørensen Rasmus Bo , Stoltenberg Danny , Weibull Caroline E. , Entrop Joshua P. , Glimelius Ingrid , Smedby Karin E. , Torp-Pedersen Christian , Severinsen Marianne T. , El-Galaly Tarec C.
Published: June 2021

PURPOSE

The majority of young adults with Hodgkin lymphoma (HL) are cured, but chemotherapy-induced infertility can have profound psychosocial consequences. Providing data on parenthood rates and use of assisted reproductive techniques (ARTs) after contemporary HL treatment is important for patient counseling and survivorship care.

MATERIALS AND METHODS

All Danish patients with HL diagnosed during 2000-2015 at the ages 18-40 years who achieved remission after first-line therapy were included and matched on age, sex, and parenthood status to five random persons from the general population. Parenthood rates were defined as the rate of first live birth per 1,000 person years, starting 9 months after HL diagnosis. Nationwide birth and patient registers were used to capture parenthood outcomes and ARTs use.

RESULTS

A total of 793 HL survivors and 3,965 comparators were included (median follow-up 8.7 years). Similar parenthood rates were observed for male and female HL survivors when compared with matched comparators (56.2 v 57.1; P = .871 for males and 63.8 v 61.2; P = .672 for females). For male HL survivors, BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) therapy was associated with lower parenthood rates as compared to the matched comparators (28.1 v 60.8; P = .020). Live birth after ARTs were more common for HL survivors than for comparators (males 21.6% v 6.3%; P < .001; females 13.6% v 5.5%; P = .001). There were no differences in gestational age, Apgar score, or newborn measurements between HL survivors and matched comparators.

CONCLUSION

The parenthood rates for HL survivors who have not experienced relapse were generally similar to the general population. However, ARTs were used more often before the first live birth in HL survivors, which is relevant information when discussing possible long-term side effects and fertility-preserving treatment options.
Advances in Immunotherapy and Implications for Current Practice in Non–Small-Cell Lung Cancer
Authors: Steuer Conor E. , Ramalingam Suresh S.
Published: June 2021

Treatment options for patients with non–small-cell lung cancer (NSCLC) have improved dramatically in recent years. For decades, harnessing a person's own immune system to fight cancer has been a major area of research in oncology. Recently, these efforts have proven successful with the development of immune checkpoint inhibitors; these agents have now become part of the routine care of NSCLC. Presently, five programmed cell death-1 and programmed cell death-1 ligand 1 inhibitors and one anti–cytotoxic T-cell lymphocyte-4 inhibitor are US Food and Drug Administration–approved in the treatment of NSCLC. These drugs have made a dramatic difference in the lives of patients with NSCLC, although durable benefits are limited to a subset of patients. In this review, we highlight the trials that led to our current treatment practices, discuss areas of active research, and address common clinical issues that have risen as immune therapy has become a mainstay of treatment in NSCLC.
High-fat Diet Alters Male Seminal Plasma Composition to Impair Female Immune Adaptation for Pregnancy in Mice
Authors: Schjenken John E , Moldenhauer Lachlan M , Sharkey David J , Chan Hon Y , Chin Peck Y , Fullston Tod , McPherson Nicole O , Robertson Sarah A
Published: June 2021

Paternal experiences and exposures before conception can influence fetal development and offspring phenotype. The composition of seminal plasma contributes to paternal programming effects through modulating the female reproductive tract immune response after mating. To investigate whether paternal obesity affects seminal plasma immune-regulatory activity, C57Bl/6 male mice were fed an obesogenic high-fat diet (HFD) or control diet (CD) for 14 weeks. Although HFD consumption caused only minor changes to parameters of sperm quality, the volume of seminal vesicle fluid secretions was increased by 65%, and the concentrations and total content of immune-regulatory TGF-β isoforms were decreased by 75% to 80% and 43% to 55%, respectively. Mating with BALB/c females revealed differences in the strength and properties of the postmating immune response elicited. Transcriptional analysis showed >300 inflammatory genes were similarly regulated in the uterine endometrium by mating independently of paternal diet, and 13 were dysregulated by HFD-fed compared with CD-fed males. Seminal vesicle fluid factors reduced in HFD-fed males, including TGF-β1, IL-10, and TNF, were among the predicted upstream regulators of differentially regulated genes. Additionally, the T-cell response induced by mating with CD-fed males was blunted after mating with HFD-fed males, with 27% fewer CD4+ T cells, 26% fewer FOXP3+CD4+ regulatory T cells (Treg) cells, and 19% fewer CTLA4+ Treg cells, particularly within the NRP1+ thymic Treg cell population. These findings demonstrate that an obesogenic HFD alters the composition of seminal vesicle fluid and impairs seminal plasma capacity to elicit a favorable pro-tolerogenic immune response in females at conception.
Single-cell transcriptomics of the early developing mouse cerebral cortex disentangle the spatial and temporal components of neuronal fate acquisition
Authors: Moreau Matthieu X. , Saillour Yoann , Cwetsch Andrzej W. , Pierani Alessandra , Causeret Frédéric
Published: June 2021

In the developing cerebral cortex, how progenitors that seemingly display limited diversity end up producing a vast array of neurons remains a puzzling question. The prevailing model suggests that temporal maturation of progenitors is a key driver in the diversification of the neuronal output. However, temporal constraints are unlikely to account for all diversity, especially in the ventral and lateral pallium where neuronal types significantly differ from their dorsal neocortical counterparts born at the same time. In this study, we implemented single-cell RNAseq to sample the diversity of progenitors and neurons along the dorso-ventral axis of the early developing pallium. We first identified neuronal types, mapped them on the tissue and determined their origin through genetic tracing. We characterised progenitor diversity and disentangled the gene modules underlying temporal versus spatial regulations of neuronal specification. Finally, we reconstructed the developmental trajectories followed by ventral and dorsal pallial neurons to identify lineage-specific gene waves. Our data suggest a model by which discrete neuronal fate acquisition from a continuous gradient of progenitors results from the superimposition of spatial information and temporal maturation.
Superradiant lasing in inhomogeneously broadened ensembles with spatially varying coupling
Authors: Bychek Anna , Hotter Christoph , Plankensteiner David , Ritsch Helmut
Published: June 2021

Background: Theoretical studies of superradiant lasing on optical clock transitions predict a superb frequency accuracy and precision closely tied to the bare atomic linewidth. Such a superradiant laser is also robust against cavity fluctuations when the spectral width of the lasing mode is much larger than that of the atomic medium. Recent predictions suggest that this unique feature persists even for a hot and thus strongly broadened ensemble, provided the effective atom number is large enough.

Methods: Here we use a second-order cumulant expansion approach to study the power, linewidth and lineshifts of such a superradiant laser as a function of the inhomogeneous width of the ensemble including variations of the spatial atom-field coupling within the resonator.

Results: We present conditions on the atom numbers, the pump and coupling strengths required to reach the buildup of collective atomic coherence as well as scaling and limitations for the achievable laser linewidth.

Conclusions: We show how sufficiently large numbers of atoms subject to strong optical pumping can induce synchronization of the atomic dipoles over a large bandwidth. This generates collective stimulated emission of light into the cavity mode leading to narrow-band laser emission at the average of the atomic frequency distribution. The linewidth is orders of magnitudes smaller than that of the cavity as well as the inhomogeneous gain broadening and exhibits reduced sensitivity to cavity frequency noise.
Flamenco y canción española
Authors: Luna López Inés María
Published: June 2021

Tanto por sus encuentros como por sus desencuentros la historia del flamenco no puede realizarse sin la historia de la canción española. Atendemos al recorrido común que desarrollan durante dos siglos, un camino de mutuas influencias, imprescindible para conocer estas manifestaciones artísticas y la evolución que mantienen a lo largo del tiempo. Algunos momentos son de especial relevancia: una tradición costumbrista heredada de los siglos XVIII y XIX; la copla popular desde el modernismo y desde una nueva visión de Andalucía; la influencia de ésta en el cuplé de principios de siglo y nacimiento de la canción andaluza; la conformación definitiva de la canción española en los años treinta; el maridaje en las décadas siguientes de dichos géneros, así como de artistas de uno y otro mundo; el alejamiento del flamenco de la cultura teatral en los años cincuenta; y la reivindicación popular, ya en los ochenta, de una canción española sobria y distanciada de las connotaciones ideológicas del franquismo.
Regional Differences in Postnatal Care Service Utilisation and Child Morbidity in Nigeria: Evidence from 2018 Nigeria Demographic and Health Survey (NDHS)
Authors: Uzobo Endurance , Ayinmoro Aboluwaji D.
Published: June 2021

Modern Postnatal Care (PNC) Services in Nigeria is a vital tool for providing quality health for mothers and newborns. Nonetheless, many Nigeria regions are still struggling to achieve optimum utilisation of Postnatal Care Services due to variations in mothers' associated socio-economic factors based on their specific locations. This study aims at assessing regional socio-economic factors associated with Postnatal Care Services utilisation and its relationship with child morbidity in Nigeria. Data for this study was extracted from the Nigeria Demographic and Health Survey (NDHS) 2018 birth recoded file dataset, with a sample size of 30,713 women (aged 15-49). Data were analysed using descriptive statistics, Chi-Square Test, and logistic regression reporting the result in odds-ratios (OR). The primary predictor variable was the region, while others included the type of Postnatal Care Services utilised and various demographic variables of the respondents – age, education, type of residence, religion, and ethnicity. The average age of the respondents was 29.5±6.8. The use of modern Postnatal Care Services ranged from South-West (20.3%), South-South (10.9%), South-East (23.0%), North-Central (22.0%), North-East (13.0%) to North-West (10.9%). The prevalence of child morbidity ranged from South-West (8.5%), South-South (9.8%), South-East (11.4%), North-Central (15.3%), North-East (26.3%) to North-West (28.7%). Child morbidity is significantly higher in the South-South (OR=1.46, 95% Confidence Interval [CI] = 1.316 – 1.611; p =0.01), South-East (OR=1.50), North-Central (OR=1.13), North-East (OR=2.31) and North-West (OR=1.35) compared to the South-West. The majority of women in Nigeria are not using modern PNC services. Regional variations in the use of PNC services and mothers' socio-demographic characteristics influence child morbidity in Nigeria. There should be region-specific sensitisation of women on the need for the benefit of modern health care for both antenatal care and postnatal care services.
Social Media A Tool for Social and Political Inclusion among Youth: A Study of Indian University Students
Authors: Kumar Satish , Sharma Amit , Verma Varinder
Published: June 2021

Social Media is an important tool for sharing information and communication among the people. Mobile Applications enable these social networking sites (SNS) to send and receive info-content to the target audience. Especially, University students in the country today use SNS extensively for information and entertainment needs. Social media is playing a crucial role in social and political awareness for inclusive development. The study focuses on how social networking apps help in fulfilling the social needs of youth? What are the effects of social media on studies of university students? How do political parties use SNS apps for youth? And how mobile apps are contributing to the Digital India movement? A survey method was used for quantitative research methodology with a stratified random sampling of 100 university students of two state university of Haryana. The study reveals that students consider mobile apps help in socially connected with well known, to whom they are meeting personally and they feel happy for sharing their thoughts. It also explains the use of social media can create a negative effect on studies. Political parties and political leaders are targeting youth for their propaganda and agenda-setting through mobile apps. In the Digital India movement mobile apps are empowering youth for inclusive development.
Incomplete Fiscal Decentralisation: An Impediment for Local Economic Development in Ghana
Authors: Amoah Audrey Smock , Braimah Imoro , Baah-Ennumh Theresa Yaba
Published: June 2021

For the past three decades Ghana’s democratic decentralisation policy has sought in vein to establish a local government system capable of pursuing Local Economic Development (LED). One of the major impediments has been the insincere implementation of fiscal decentralisation for the local government to provide the enabling environment for LED. This paper employed primary and secondary data from the Wassa East District Assembly (WEDA) to assess the progress so far in Ghana’s fiscal decentralisation and its effect on LED. The paper highlights the potential benefits of LED and the incapacitation of the District Assembly by the Central government for LED financing. The paper again reveals the effects of the constraints of fiscal decentralisation on LED at the local government level and makes policy recommendations towards effective fiscal decentralisation for improvement in LED.
Visualization of the Values of Requirements Attributes with Goal Models
Authors: Pimentel João Henrique Correia , Lencastre Maria , Freire Luiza
Published: June 2021

Attributes such as cost, risk, priority, and customer satisfaction are integral components of requirements specifications, helping with decision-making during the software development process. Moreover, requirements status and stability are relevant meta-information for requirements management. Even though goal modelling is a visual approach for requirements engineering that enables expressing and reasoning about goals, qualities, tasks and resources, existing approaches do not include the aforementioned attributes as part of the visualization of the models. This paper presents a set of strategies for visually representing requirements attributes over goal models, aiming at minimizing the cognitive effort required in their analysis. The proposal is supported by a tool that implements the visualization strategies here defined. Empirical evaluation of the effectiveness of the proposal, however, is expected to be carried out as future work.
Survey Evaluation of an Approach for Dynamic Software Product Lines
Authors: Guedes Gabriela , Silva Carla , Soares Monique
Published: June 2021

In Dynamic Software Product Lines (DSPLs) product configuration occurs at runtime. Modelling variability and configuring the product in DSPLs should consider the context and non-functional requirements (NFRs) satisfaction. ConG4DaS (Contextual Goal models For Dynamic Software product lines) is a Requirements Engineering (RE) approach for DSPL which supports (i) modelling of variability with goals, NFRs, contexts and the relationship be-tween them; and (ii) offers a product configuration based on contexts, NFRs and their priority and interactions. In this paper, we present a survey evaluation of ConG4DaS with RE and DSPL researchers in regard to the perceived usefulness. In the survey, both RE and DSPL researchers perceived ConG4DaS as useful for modelling and configuring DSPLs. However, the RE group gave more positive answers than the DSPL group.
Reducing variations in clinical nurse educator roles: a service improvement project standardising roles and career pathways
Authors: Lanada Jose Ariel , Forde-Johnston Carol
Published: June 2021

Background:

There is limited research evaluating the implementation and effectiveness of clinical nurse educator (CNE) roles in clinical practice. UK employers tend to use generic nursing job profiles, although the definition, expectations and implementation of nurse educator roles are interpreted differently between employers.

Aim:

This project intended to reduce variation and standardise job titles, job descriptions and job plans for CNEs ranging from band 5 to band 7 and identify the academic requirements and professional experience required of each band.

Methods:

An evaluative service review of existing CNE roles was conducted across a large division of a major NHS hospital trust. Focus group interviews were conducted to identify CNEs' and matrons' perceptions of the role.

Findings:

Themes identified from the coding of narrative data included: the importance of the role; variations in expectations of the role, job titles, job descriptions and plans; and a lack of career progression pathways.

Conclusion:

This service improvement project demonstrates that a standardised approach to the implementation of CNE roles can be achieved with the support of a unified senior nursing team. Clearer role definition and career progression pathways would improve job satisfaction and may help retain CNEs in post.
Can we reduce the risk of burnout?
Authors: Foster Sam
Published: June 2021

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the concerns raised regarding staff shortages, excessive workloads and burnout, exacerbated by the COVID-19 pandemic
Self-harm wounds: assessment and management
Authors: Mitchell Aby
Published: June 2021

The management of self-harm (SH) wounds requires a non-judgemental holistic approach on the part of the health professional. It is important that SH wounds are assessed, and that interventions are agreed between the health professional and the patient. This article looks at definitions of SH and provides guidance on how health professionals can make an accurate assessment of the wound and, in addition to agreement treatment with the patient, provide patient education and guidance on self-care.
Role of the clinical nurse specialist as a non-medical prescriber in managing the palliative care needs of individuals with advanced lung cancer
Authors: Osborne Jenny , Kerr Helen
Published: June 2021

Background:

Rapid identification of the palliative care needs of individuals with a diagnosis of advanced lung cancer is crucial to maximise the patient's quality of life by upholding exemplary standards of patient-centred holistic care. The clinical nurse specialist is in an ideal position to contribute to the identification and management of the palliative care needs of individuals with advanced lung cancer through the assessment and timely prescribing of medications to manage distressing symptoms.

Aim:

This paper reviews and critiques the role of the clinical nurse specialist as an independent non-medical prescriber in the management of palliative symptoms in end-of-life care for patients with advanced lung cancer.

Results:

Published literature highlights the positive impact the clinical nurse specialist has as a non-medical prescriber in addressing the palliative needs of individuals with lung cancer. However, there are barriers and challenges, and to overcome these, maximising resources and the availability of support is required to ensure the delivery of timely, person-centred care.

Conclusion:

The clinical nurse specialist as a non-medical prescriber is an evolving role. There are a range of factors that may influence the clinical nurse specialist to confidently and competently undertake this role. These include the perception that there will be an escalation in the workload, concerns about increased accountability and inadequate mentoring for this new role. To incentivise this role, multidisciplinary support is essential in promoting the clinical nurse specialist's confidence for developing this service to individuals with advanced lung cancer.
Characterising end-of-life decision-making of life-sustaining treatment among Japanese nurses
Authors: Shaku Fumio , Yada Yoichi , Tsutsumi Madoka , Kim Woe Sook
Published: June 2021

Background:

Often, nurses are closer to end-of-life (EOL) patients than other medical professionals, due to the time they spend with them at their bedside, which leads them to understand patients' care goals.

Aims:

To investigate the importance of EOL preferences by examining nurses' EOL decision-making regarding life-sustaining treatment (LST).

Methods:

In this cross-sectional study, 559 self-reported questionnaires of Japanese nurses were examined. Marital status, age and decision-making regarding LST for themselves were investigated.

Findings:

Unmarried participants from all age groups had a higher percentage of ‘no preference for LST’ than married groups. Differences between the percentages were higher in the 20s age group. Married participants increasingly preferred to receive no LST as their age increased, unlike single participants.

Conclusion:

Marital status influences Japanese nurses' EOL decision-making regarding LST. Therefore, it is necessary to consider a patient's marital status to facilitate better decision-making.
Research Roundup
Authors: Heggs Karen
Published: June 2021

Synopses of a selection of recently published research articles of relevance to palliative care
The Place and Effects of Technology in the Visual Arts Course
Authors: Tetikci Ismail , Erim Gonca , Halaclar Busra Bozlak
Published: June 2021

Individuals’ levels of access to contemporary education affect the development level of the societies they live in. Changes and developments in the field of education are important in this sense. Technological advancements experienced in the general field of education have also affected visual arts education, and different points of view have emerged in this field. In this study, it is aimed to determine the interaction of art education in parallel to the dynamism of the age with technology according to the opinions of visual arts course teachers. For this purpose, the study uses the qualitative research method of case study. The participants of the study consist of a total of 8 visual arts teachers including 5 female and 3 teachers actively working at secondary schools in the academic year of 2019-2020. Observation and semi-structured interview forms are used in the data collection process. By analyzing the obtained findings with the thematic analysis method, the findings are collected under the themes of reflections and usage methods. In line with the results of the study obtained from the data, positive and negative results of using technology as a material in art education are reached. As in all areas of education, the use of technology in the visual arts course is important for its positive effects such as providing ease of learning for the student. While the study has been completed before the COVID-19 pandemic period, the compulsory nature of technology use today has increased the significance of the study.
Identification of Mathematics Prospective Teachers’ Conceptual Understanding in Determining Solutions of Linear Equation Systems
Authors: Dewi Irmawati Liliana Kusuma , Zaenuri Zaenuri , Dwijanto Dwijanto , Mulyono Mulyono
Published: June 2021

This research is motivated by a linear equations system, which is the basis for studying necessary linear algebra materials, such as rank, range, linear independent/dependent, linear transformations, characteristic values and vectors. There are still prospective mathematics teachers who have difficulty solving linear equations system and understanding the form of row echelon and reduced row echelon forms. In this study, subjects were three prospective mathematics teachers from Swadaya Gunung Jati University Cirebon who were taking matrix algebra courses. This study aims to reveal the conceptual understanding of prospective mathematics teachers in determining the solution to systems of linear equations. The results show that there are still prospective mathematics teachers who only use memory about the properties and procedures in determining whether a matrix is said to be a row echelon form or a reduced row echelon form. Then, there is still weakness in building the algorithms' relationship due to the immature knowledge of the concepts. Researchers found that many prospective mathematics teachers were more comfortable solving problems that were performed procedurally. Further research is needed to determine how the mental construction process and mathematical conceptual knowledge of prospective mathematics teachers are through meaningful learning so that conceptual understanding is maximized.
The Welfare State and the Gender Dissimilarity Index in Homelessness: A Comparison of Norway, Belgium and Poland
Authors:   Faculty of Geography and Regional Studies, University of Warsaw, Poland, Mostowska Magdalena
Published: June 2021

This article investigates the structural underpinnings of gender dissimilarities in homelessness from a comparative perspective. The Gender Dissimilarity Index is introduced as a simple measure for quantifying the unevenness of the distribution of men and women across the ETHOS-light categories. Three gendered aspects of the welfare state are considered and compared for Norway, Belgium, and Poland: employment and childcare, housing, and homelessness policies. Based on available data, it appears that the most uneven distribution of genders may indicate a combination of the promotion of the male breadwinner model and relatively broad support for people who are homeless, but also the shortage of affordable housing. A more gender-balanced homeless population may be the result of a combination of housing-led approaches and degenderising policies. However, a similar distribution may be attributed to states with implicitly genderising policies coupled with ‘traditional’ attitudes towards gender roles and a lack of adequate responses to women’s needs.
Investigating Green Marketing Implementation with the Hedonic Price Model in Residential Projects: The Case of Istanbul
Authors:   Construction Technology Department, Dogus University, Istanbul, Turkey, Tuz Ahmet ,   Department of Architecture, Project and Construction Management Program, Istanbul  Technical University, Istanbul, Turkey, Sertyesilisik Begum ,   Department of Architecture, Izmir Democracy University, Izmir, Turkey
Published: June 2021

The strategic importance of green marketing (GM) in value creation for the end customer (VCEC) and the contribution of the spatial and structural characteristics of a residential project (RP) to the final price have been acknowledged in the literature. However, GM features that can lead to price increases have not been evaluated from the VCEC perspective. This study examines the impacts of GM strategies on RPs. This study applies Hedonic Price Modelling to newly built RPs in Istanbul and evaluates the results from the perspective of the Attractive Quality Attributes Theory. The results showed that the total price of the RPs was affected more by design-related sustainable features of RPs and revealed that there is a relationship between GM and sustainable design. The study highlights the importance of GM, which companies can use to operate effectively in a competitive market and increase the satisfaction of end customers through value creation. The study’s findings can be considered useful information for policies on creating a sustainable built environment.
Airbnb and Amenity: Is Short-Term Letting Reshaping How We Live in the City?
Authors:   School of Built Environment, UNSW Sydney, Australia, Crommelin Laura , Parkinson Sharon ,   Centre for Urban Transitions, Swinburne University, Australia, Martin Chris ,   City Futures Research Centre, UNSW Sydney, Australia, Troy Laurence ,   School of Architecture, Design and Planning, University of Sydney, Australia
Published: June 2021

The popularity of short-term letting (STL) platforms like Airbnb has created housing and planning challenges for cities worldwide, including the potential impact of STL on the quality of life of nearby residents and communities. Underpinning this concern is an inherent tension in urban living between the rights and interests of individual residents and the collective rights and interests of neighbours. Through interviews with Australian Airbnb hosts, this paper examines how STL hosts navigate this tension, including how they frame their rights, how they seek to minimise impacts on neighbours, and how they perceive the role of regulation in balancing individual and community rights. In doing so, the paper contributes to both theory and policy debates about urban property rights and how ‘compact city’ planning orthodoxies are reshaping the lived experience of urban residents worldwide.
Challenging the Discourse around the Impacts of Airbnb through Suburbs Not Cities: Lessons from Australia and COVID-19
Authors:   University of Sydney, Australia, Buckle Caitlin , Phibbs Peter ,   Henry Halloran Trust, University of Sydney, Australia
Published: June 2021

Supporters of short-term rental (STR) platforms state that STRs represent a small fraction of the housing market of major cities and therefore have little impact on rents. However, there is emerging evidence that suggests that STRs have highly localised impacts. In this article, we use the natural experiment of the pause in tourism caused by the COVID-19 pandemic to highlight the impact of a decrease in STR listings on rental markets in the case study city of Hobart, Australia. We find that rental affordability has improved in Hobart’s STR-dense suburbs with the increased vacancies from the underutilised STR properties. These results provide evidence of the impact of STRs on local housing markets when analysed on a finer scale than the whole-of-city approach. The focus on local housing markets helps local communities and city governments build an argument for the impact of STRs on tight housing markets.
Design and control of highly spectrally efficient photonic networks enabled by fiber-granular routing on overlaid ring-shaped topologies
Authors: Shiraki Ryuta , Mori Yojiro , Hasegawa Hiroshi , Sato Ken-Ichi , Monti Paolo
Published: June 2021

We propose an ultradense wavelength-division-multiplexing (WDM) network architecture that dramatically enhances channel accommodation density to achieve extremely high spectral efficiency. The trade-offs between high spectral efficiency and severe signal impairment due to optical filtering are resolved by network optimization of the overlaid subnetworks based on fiber-granular routing and wavelength-granular add/drop operations. The spectrum narrowing induced by node operations is well controlled by the impairment-suppressing routing and wavelength assignment (RWA) method. Numerical simulations on several metro-scale network topologies verify that the proposal enhances the spectral efficiency by up to 31.0% compared to comparable dense WDM networks.
About copying a free-space electromagnetic field by an invisible object
Authors: Dolin Lev S.
Published: June 2021

The structure of a monochromatic electromagnetic field inside a spherical object that does not distort the wave field of external sources outside its surface has been studied using transformation optics methods. It is assumed that the object is made of isotropic materials with equal values of permittivity and permeability and consists of a spherical volume of material with a positive spatially uniform refractive index and an adjacent spherical layer of material with a negative inhomogeneous refractive index (i.e., it is a spherical superlens made of isotropic materials). It is shown that the field inside a sphere with a positive refractive index is the reduced-size copy of the field in which the object was located. This copy contains information about the radiation field of external sources in a spherical free-space volume whose radius depends on the object parameters and can be significantly larger than the radius of the object. It is shown that the copying properties of the object with given dimensions can be fully preserved if its outer layer is made of anisotropic materials.