bluuebunny/crossref_metadata_2025 huggingface dataset:
PARP inhibitors and immunotherapy in ovarian and endometrial cancers
Authors: Miller Rowan E , Lewis Amy J , Powell Melanie E
Published: April 2021

Advanced ovarian and endometrial cancers have historically been associated with poor prognosis and few treatment options, limited to single or doublet chemotherapy regimens. The introduction of novel target therapies has transformed the management of these cancers. In contrast to chemotherapy, which inhibits DNA replication and mitosis, targeted therapies target cancer signalling pathways, stroma, immune-microenvironment and vasculature in tumour tissues. The most notable advances in gynaecological cancers have come from the introduction of PARP inhibitors and immune checkpoint inhibitors for ovarian and endometrial cancer, respectively. Several PARP inhibitors, which target defective DNA repair, have been approved as maintenance therapy for advanced ovarian cancer in both the first line and platinum-sensitive relapsed settings. Immune checkpoint inhibitors such as anti-PD-1/PD-L1 antibodies have proven successful in advanced mismatch repair deficient endometrial cancers with use now being investigated beyond this population. This review will explore the biological rationale and clinical evidence behind the use of PARP inhibitors and immunotherapy in ovarian and endometrial cancers.
Radiomics in radiation oncology for gynecological malignancies: a review of literature
Authors: Michalet Morgan , Azria David , Tardieu Marion , Tibermacine Hichem , Nougaret Stéphanie
Published: April 2021

Radiomics is the extraction of a significant number of quantitative imaging features with the aim of detecting information in correlation with useful clinical outcomes. Features are extracted, after delineation of an area of interest, from a single or a combined set of imaging modalities (including X-ray, US, CT, PET/CT and MRI). Given the high dimensionality, the analytical process requires the use of artificial intelligence algorithms. Firstly developed for diagnostic performance in radiology, it has now been translated to radiation oncology mainly to predict tumor response and patient outcome but other applications have been developed such as dose painting, prediction of side-effects, and quality assurance. In gynecological cancers, most studies have focused on outcomes of cervical cancers after chemoradiation. This review highlights the role of this new tool for the radiation oncologists with particular focus on female GU oncology.
18F-FDG PET-CT postoperative changes after maxillectomy: Findings and pitfalls in interpretation
Authors: Davidson Tima , Nissan Johnatan , Krichmar Maria , Lotan Eyal , Shrot Shai , Gluck Iris , Lawson Paul , Yahalom Ran , Duvdevani Shay
Published: April 2021

Objective:

We investigated the findings and pitfalls of FDG-PET/CT scanning after maxillectomy with reconstruction/rehabilitation procedures, in patients with head and neck malignancies treated during nine years at one tertiary medical centre.

Methods:

Fourteen patients (10 males), aged 22–84 years, underwent 17 reconstruction/rehabilitation maxillectomy surgeries and 35 PET/CT scans. Postoperative PET/CT findings were correlated with clinical and imaging follow-up.

Results:

Increased FDG uptake, mean SUVmax 2.4 ± 1.4 (range 0.3–4.3), was observed at the postoperative bed following 12 of 17 surgeries (71%; 10 obturators, two mesh reconstructions). Following the remaining 5/17 surgeries (three with a fat flap and two without any reconstructions), abnormal FDG uptake was not observed at the postoperative bed. CT features of postoperative sites included: non-homogeneous mixed iso/hyperdense structures (hollow or filled) with multiple surrounding and/or inside air bubbles (“sponge appearance”) and mucosal thickening along the postoperative bed wall (in all cases with obturator implants); rich fat density material in reconstructions with a fat flap and in closures without reconstruction, and radiopaque elongated structures in mesh reconstructions. No correlation was found of the mean SUVmax in initial scans, with the time from the surgery date (10 ± 6 months; r=0.04, P=0.90), or with the mean SUVmax in final scans (at 25± 17 months, P=0.17).

Conclusions: :

Increased FDG uptake, together with corresponding non-specific CT features, may persist for a prolonged period after surgery with obturators and mesh implantations, mimicking malignancy or infection. Awareness of variations in postoperative PET-CT appearance can help avoid false interpretations and redundant invasive procedures.
Evaluating the effect of Ramadan Fasting on patients with chronic diseases
Authors: Zeren Öztürk Güzin , Egici Memet Taşkın , Sağsöz Osman , Bukhari Mulazim Hussain
Published: April 2021

Objective: The study aimed to investigate the effect of Ramadan Fasting on Patients with Chronic Diseases and their experience during fasting.

Methods: This study was a descriptive research that used a researcher-designed questionnaire in face-to-face interviews with individuals who have at least one chronic disease and visit, for any reason, the Istanbul Sisli Etfal Training and Research Hospital polyclinics. We first asked each participant about fasting during Ramadan. If the participant was not fasting, we asked only the reason(s) and collected socio-demographic data. If a participant was fasting, we administered a researcher-designed questionnaire in face-to-face interviews. Our survey consisted of 19 questions that were designed to evaluate the fasting behaviors, current chronic disease and treatment status of individuals, encountered complications during fasting and their socio-demographic data.

Results: The study participants were 253 people (168 females [66.4%]; mean age: 58.06 ± 11,13) with non-infectious diseases. One hundred sixty (63.2%) participants were fasting during Ramadan and 33 of them (20.6%) had consulted a doctor before fasting, 62.5% (n = 100) said they never faced any symptoms during fasting. Most experienced symptom during fasting was fatigue (56.7%; n = 34). A significant relationship occurred between experiencing symptoms while fasting and gender (p = 0.023) and waking regularly for sahur (p = 0.029).

Conclusions: Many people with chronic diseases fast and experience symptoms while fasting. Being woman and not waking up for sahur was related with the symptoms during Ramadan fasting. Most participants with NIDs fasted during Ramadan without consulting their doctors.

doi: https://doi.org/10.12669/pjms.37.4.3199

How to cite this:Ozturk GZ, Egici MT, Sagsoz O, Bukhari MH. Evaluating the effect of Ramadan Fasting on patients with chronic diseases. Pak J Med Sci. 2021;37(4):1042-1047. doi: https://doi.org/10.12669/pjms.37.4.3199

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case Report: Rare presentation of adult intussusception at Orotta National Referral Hospital, Eritrea
Authors: Iyassu Senay , Abraha Million
Published: April 2021

A 38-year-old woman presented at Orotta National Referral Hospital emergency department in May 2017 with pain in the epigastric region and vomiting. Physical examination revealed no pertinent findings. Blood and urine tests were normal, and erect abdominal x-ray revealed a distended small intestine with multiple layers of “air-fluid levels”. CT scan and MRI were not done due to their temporary unavailability. During laparotomy a large mass of 20x20 cm in size was detected in the mid-jejunum of the small intestine. This leading tumor caused intussusception and coiling of the small intestine. As there are no typical symptoms of intussusception, it is very important to do CT scan for patients with long-standing abdominal pain and vomiting to achieve a definitive diagnosis of intussusception.
Factors influencing the utilization of dental services in East Java, Indonesia
Authors: Hariyani Ninuk , Setyowati Dini , Sari Multia Ranum , Maharani Diah Ayu , Nair Rahul , Sengupta Kaushik
Published: April 2021

Background : Despite high levels dental issues and insurance coverage in the East Java province Indonesia, the utilization of dental services is still low. This research aims to test whether certain individual-level sociodemographic, behavioural, and clinical characteristics influenced the current level of dental services utilization by East Java residents.

Methods : A secondary analysis was undertaken using data on the East Java province from the Indonesian Basic Health Research 2013, which included 90,551 randomly selected respondents aged 5–100 years old. Socio-demographic characteristics (age, sex, education and residential location), dental behavior (tooth brushing habit), and clinical (dental) condition were self-reported through a questionnaire. Multivariable models were generated to estimate prevalence ratios (PR), and 95% confidence intervals (95% CI).

Results : Prevalence of dental service utilization during the last 12 months in East Java province is only 9 %. Respondents 25–<50 years old showed the highest utilization of dental services. Being male, having lower education and living in a district (as opposed to municipalities) were indicators for having lower utilization of dental treatment (PR [95% CI] = 0.81 [0.79–0.84], PR [95% CI] = 0.89 [0.86–0.93] and PR [95% CI] = 0.91 [0.88–0.95], respectively). Respondents with poor tooth brushing habit showed lower utilization of dental services. Having teeth was associated with higher utilization of dental treatment (PR [95% CI] = 1.39 [1.16–1.66).

Conclusions : Age, sex, education and residential location influence the utilization of dental services among Indonesia’s East Java residents. Poor tooth brushing habits and being edentulous are also indicators of lesser utilization. These results call for urgent public health interventions to increase equitable dental care services utilization.
Protocol for a randomised controlled trial of a primary care intervention to Reverse Frailty and Enhance Resilience through Exercise and dietary protein Education (REFEREE) in community-dwelling adults aged 65 and over
Authors: Travers John , Romero-Ortuno Roman , Power Dermot , Doran Peter , Langan John , MacNamara Fergal , McCormack Darren , McDermott Christopher , McEntire Jude , McKiernan Joanne , Vencken Sebastian , Murphy Andrew W. , Murphy Patrick J. , Ní Shé Éidin , O'Shea Diarmuid , Cooney Marie-Therese
Published: April 2021

Introduction: Resistance exercises and dietary protein have been shown to reverse frailty, yet they are not commonly offered in clinical practice. We aim to measure changes in health outcomes, including physical frailty status (SHARE-FI), clinical frailty status (CFS) and muscle mass, as a result of an optimised exercise and dietary intervention versus usual care in a primary care (PC) setting. The intervention has been derived from our systematic review and meta-analysis findings and optimised through patient and public involvement and multidisciplinary team input.

Methods: This study is a multicentre randomised controlled parallel arm trial with a three month follow up. 210 eligible people aged 65 and over, no more than mildly frail, will be recruited in seven PC practices in Ireland and randomly assigned to ‘intervention’ or ‘usual care’. Intervention participants will be provided a leaflet with strength exercises, protein dietary guidance and educational discussion. Baseline measurements will include demographics, health indicators, comorbidities, malnutrition universal screening tool (MUST), frailty status (SHARE-FI, CFS) and muscle mass (bioelectrical impedance). Primary outcome will be frailty status measured by SHARE-FI at three months. Secondary outcomes include CFS, muscle mass, in-patient hospitalisation, long term care admission, and subjective ease of intervention and difference to general health. Statistical analysis will be undertaken by an independent statistician.

Discussion: The diversity of tested frailty interventions and lack of clear guidance may contribute to low implementation rates. The REFEREE trial focusses on an optimised intervention for a syndrome that poses growing individual and societal challenges. It is hoped results can encourage mainstream adoption of interventions to reverse clinical frailty and build resilience in primary care.

Trial registration: ClinicalTrials.gov ID NCT04628754; registered on 13 November 2020.
Building long-term vision for rural areas through multi-actor platforms: a preliminary study in the Emilia-Romagna region
Authors: Pellegrini Emilia , Raggi Meri , Viaggi Davide , Targetti Stefano
Published: April 2021

Developing long-term visions through participatory approaches can be very useful to explore different possible scenarios and pathways to reach desirable futures. This brief report describes a participatory process carried out in the Emilia-Romagna region (Italy) to develop a long-term vision for rural areas by 2040. This approach consisted of: (i) interviews and a focus group carried out with a multi-actor platform (MAP) composed of experts from science-society-policy sectors, and (ii) an on-line questionnaire addressing a larger number of rural stakeholders of the region. Mixing expert-based consultation through the MAP with a more inclusive consultation approach resulted in an effective method to build long-term visions in the very heterogeneous rural context of the Emilia-Romagna. However, this study only constitutes a preliminary step into a more elaborated backcasting approach.
REal-time Assessment of Community Transmission (REACT) of SARS-CoV-2 virus: Study protocol
Authors: Riley Steven , Atchison Christina , Ashby Deborah , Donnelly Christl A. , Barclay Wendy , Cooke Graham S. , Ward Helen , Darzi Ara , Elliott Paul ,   REACT study group
Published: April 2021

Background: England, UK has one of the highest rates of confirmed COVID-19 mortality globally. Until recently, testing for the SARS-CoV-2 virus focused mainly on healthcare and care home settings. As such, there is far less understanding of community transmission.

Protocol: The REal-time Assessment of Community Transmission (REACT) programme is a major programme of home testing for COVID-19 to track progress of the infection in the community.

REACT-1 involves cross-sectional surveys of viral detection (virological swab for RT-PCR) tests in repeated samples of 100,000 to 150,000 randomly selected individuals across England. This examines how widely the virus has spread and how many people are currently infected. The age range is 5 years and above. Individuals are sampled from the England NHS patient list.

REACT-2 is a series of five sub-studies towards establishing the seroprevalence of antibodies to SARS-CoV-2 in England as an indicator of historical infection. The main study (study 5) uses the same design and sampling approach as REACT-1 using a self-administered lateral flow immunoassay (LFIA) test for IgG antibodies in repeated samples of 100,000 to 200,000 adults aged 18 years and above. To inform study 5, studies 1-4 evaluate performance characteristics of SARS-CoV-2 LFIAs (study 1) and different aspects of feasibility, usability and application of LFIAs for home-based testing in different populations (studies 2-4).

Ethics and dissemination: The study has ethical approval. Results are reported using STROBE guidelines and disseminated through reports to public health bodies, presentations at scientific meetings and open access publications.

Conclusions: This study provides robust estimates of the prevalence of both virus (RT-PCR, REACT-1) and seroprevalence (antibody, REACT-2) in the general population in England. We also explore acceptability and usability of LFIAs for self-administered testing for SARS-CoV-2 antibody in a home-based setting, not done before at such scale in the general population.
Speeding Up Paulson’s Procedure for Large-Scale Problems Using Parallel Computing
Authors: Zhong Ying , Liu Shaoxuan , Luo Jun , Hong L. Jeff
Published: April 2021

With the rapid development of computing technology, using parallel computing to solve large-scale ranking-and-selection (R&S) problems has emerged as an important research topic. However, direct implementation of traditionally fully sequential procedures in parallel computing environments may encounter various problems. First, the scheme of all-pairwise comparisons, which is commonly used in fully sequential procedures, requires a large amount of computation and significantly slows down the selection process. Second, traditional fully sequential procedures require frequent communication and coordination among processors, which are also not efficient in parallel computing environments. In this paper, we propose three modifications on one classical fully sequential procedure, Paulson’s procedure, to speed up its selection process in parallel computing environments. First, we show that if no common random numbers are used, then we can significantly reduce the computation spent on all-pairwise comparisons at each round. Second, by batching different alternatives, we show that we can reduce the communication cost among the processors, leading the procedure to achieve better performance. Third, to boost the procedure’s final-stage selection, when the number of surviving alternatives is less than the number of processors, we suggest to sample all surviving alternatives to the maximal number of observations that they should take. We show that, after these modifications, the procedure remains statistically valid and is more efficient compared with existing parallel procedures in the literature.

Summary of Contribution: Ranking and selection (R&S) is a branch of simulation optimization, which is an important area of operations research. In recent years, using parallel computing to solve large-scale R&S problems has emerged as an important research topic, and this research topic is naturally situated in the intersection of computing and operations research. In this paper, we consider how to improve a fully sequential R&S procedure, namely, Paulson’s procedure, to reduce the high computational complexity of all-pairwise comparisons and the burden of frequent communications and coordination, so that the procedure is more suitable and more efficient in solving large-scale R&S problems using parallel computing environments that are becoming ubiquitous and accessible for ordinary users. The procedure designed in this paper appears more efficient than the ones available in the literature and is capable of solving R&S problems with over a million alternatives in a parallel computing environment with 96 processors. The paper also extended the theory of R&S by showing that the all-pairwise comparisons may be decomposed so that the computational complexity may be reduced significantly, which drastically improves the efficiency of all-pairwise comparisons as observed in numerical experiments.
Do we achieve the Montgomery standard for consent in orthopaedic surgery?
Authors: Tonge Xenia N , Crouch-Smith Henry , Bhalaik Vijay , Harrison William D
Published: April 2021

Aims/Background

The Montgomery v Lanarkshire Health Board (2015) case set a precedent that has driven the modernisation of consenting practice. Failure to demonstrate informed consent is a common source of litigation. This quality improvement project aimed to provide pragmatic guidance for surgeons on consent and to improve the patient experience during decision making.

Methods

Elective orthopaedic patients were assessed and the quality of documented consent was recorded. Data were collected over two discrete cycles, with cycle 1 used as a baseline in practice. The following criteria were reviewed: grade of consenting clinician, alternative treatment options, description of specific risks, place and timing of consent and whether the patient received written information or a copied clinic letter. Cycle 1 results were presented to clinicians; a teaching session was provided for clinicians on the standard of consent expected and implementation of a change in practice was established with a re-audit in cycle 2.

Results

There were 111 patients included in cycle 1, and 96 patients in cycle 2. Consent was undertaken mostly by consultants (54%). Specific patient risks were documented in 50% of patients in cycle 1 and 60% in cycle 2. Risks associated with a specific procedure were documented in 42% in cycle 1 and 76% in cycle 2, alternative options in 48% (cycle 1) and 66% (cycle 2). A total of 14% of patients in cycle 1 and 8% in cycle 2 had documented written information provision. Copied letters to patients was only seen in 12% of all cycles. Documentation from dedicated consenting clinics outperformed standard clinics.

Conclusions

Highlighting poor documentation habits and refining departmental education can lead to improvements in practice. The use of consenting clinics should be considered and clinicians should individually reflect on how to address their own shortcomings. Other units should strongly consider a similar audit. This article provides stepwise advice to improve consent and specifics from which to audit.
Family structure and children’s cognitive development
Authors: Lee Kristen Schultz , Artis Julie E. , Yuan Yaqi , Zhao Sibo
Published: April 2021

Previous research on family structure and child development has largely focused on the disadvantages faced by children who transitioned out of married families. However, we know less about how family structure affects child outcomes for children starting out in single-mother families. In this article, we use the kindergarten cohort of the Early Childhood Longitudinal Study to analyse children’s academic outcomes between kindergarten and eighth grade. We found that living in single-mother or step-families was clearly associated with lower test scores for children starting kindergarten in married biological-parent families, but the same disadvantages associated with living outside a married biological-parent family structure were not found for children starting kindergarten in single-mother families. We also found preliminary evidence of a buffering effect of maternal education in the relationship between family structure and children’s academic outcomes.
Exact reconstruction condition for angle-limited computed tomography of chemiluminescence
Authors: Wang Jia , Li Mingzhe , Cheng Junxia , Guo Zhenyan , Li Dangjuan , Wu Shenjiang
Published: April 2021

Computed tomography of chemiluminescence (CTC) is an effective
technique for three-dimensional (3D) combustion diagnostics. It
reconstructs the 3D concentrations of intermediate species or 3D
images of flame topology by multiple chemiluminescence projections
captured from different perspectives. In the previous studies of CTC
systems, it was assumed that projections from arbitrary perspectives
are available. However, for some practical applications, the range of
view angles and the number of projections might be restricted due to
the optical access limitation, greatly affecting the reconstruction
quality. In this paper, the exact reconstruction condition for
angle-limited computed tomography of chemiluminescence was studied
based on Mojette transform theories, and it was demonstrated by
numerical simulations and experiments. The studies indicate that the
object tested within limited angles can be well reconstructed when the
number of grids, the number of projections, and the sampling rate of
projections satisfy the exact reconstruction condition. By increasing
the sampling rate of projections, high-quality tomographic
reconstruction can be achieved by a few projections in a small angle
range. Although this technique is discussed under combustion
diagnostics, it can also be used and adapted for other tomography
methods.
Sub-kilohertz linewidth fiber laser by using Bragg grating filters
Authors: Wen Qiao , Sun Zhihao , Gan Yiyu , Li Ji
Published: April 2021

A single-frequency (SF) fiber laser is widely applied in many fields. A superior ultra-narrow-bandwidth fiber filter, which consists of an in-series commercial common fiber Bragg grating (FBG) filters with a partial overlap in their reflection spectrum, is presented in this paper. The bandwidth of the filter with a center reflection wavelength of 1549.83 nm reaches 0.024 nm at 3 dB reflection, a remarkable reduction of approximately 300% by combination usage narrower than a single FBG used bandwidth. We also demonstrate a method to further narrowing of the filter bandwidth by increasing the usage times of filters, and the bandwidth can reach 0.0025 nm at 3 dB reflection. A long linear cavity single-frequency fiber laser with an entire cavity of 30 cm is implemented with the linewidth of 941 Hz at 3 dB, which is about 210% narrower than the previous record of SF fiber laser based on FBG filters in a linear cavity. This research may open a new door toward ultra-narrow-bandwidth filters and SF fiber lasers.
Turbulence scale effects and resolution requirements in aero-optics
Authors: Mathews Edwin , Wang Kan , Wang Meng , Jumper Eric J.
Published: April 2021

While optical aberrations caused by atmospheric turbulence have been
extensively investigated and well characterized, recent research has
identified structural differences in optical phase distortions caused
by aircraft-induced, compressible turbulence. These so-called
aero-optical distortions can be a critical obstacle in the development
of airborne optical systems and reduce the fidelity and on-target
intensity of optical beams. Using a model index-of-refraction spectrum
that accounts for changes in density due to both temperature and
pressure fluctuations in aero-optically active flow fields,
expressions for the two-dimensional phase distortion over an aperture
are developed. From these results, relations among

O
P
D

r
m
s

, turbulent flow scales, and aperture
size are examined while accounting for the effects of piston and
tip/tilt corrections. Additionally, using the model spectrum,
resolution requirements for wavefront sensors and numerical
simulations of aero-optical flows are examined.
Towards a standard operating procedure for revealing hidden volatile organic compounds in breath: the Fourier-transform IR spectroscopy case
Authors: Apolonski Alexander , Maiti Kiran Sankar
Published: April 2021

Human breath contains a large amount of small volatile organic compounds (VOCs) and could therefore be used as a carrier of metabolic information for medical diagnostics. Still, in spite of several promising techniques that have been applied during the last decades to study breath content, there is a lack of breath-based diagnostic tools available for physicians. Among several promising techniques, infrared (IR) spectroscopy has already proved its potential for reliable detection of VOCs in the breath. However, due to the large dynamic range of molecular concentrations and overlapping absorption spectra of different VOCs, many low-absorption molecules stay hidden in spectroscopic measurements. To overcome this obstacle, we propose the Matryoshka method for removing masking effects and revealing the buried spectral structures in any bio-fluid in the gas phase. By exploiting both physical and digital removal steps, we demonstrate how the method reveals methane, acetone, aldehyde, and methyl butyrate in a real breath.
Flat spectral response of a CMOS photodiode using wedge structures in back-end SiO2
Authors: Kusar Primoz , Jessenig Stefan , Morecroft Deborah , Eilmsteiner Gerhard
Published: April 2021

CMOS photodiodes are used in many light sensing applications; however, the performance can be limited by oscillations in the spectral response caused by light interference from the back-end oxide. Gray-scale lithography has been used to fabricate wedge-like structures in the back-end oxide, which reduces the light interference and oscillations over the entire silicon sensitivity range. Dielectric filter stacks have been deposited on top of the structures, demonstrating an improved spectral response over photodiodes, with filters deposited directly on silicon. The present approach is suitable for mass production and fully compatible with CMOS.
Rigorous modeling of twisted anisotropic optical fibers with transformation optics formalism
Authors: Napiorkowski Maciej , Urbanczyk Waclaw
Published: April 2021

In this study, we show that transformation optics formalism can be used to rigorously model a wide range of twisted anisotropic fibers, which could only be analyzed using perturbative methods. If the material anisotropy of fibers has an intrinsic origin or is induced by axially or helically symmetric physical factors, then they can be transformed into a form usable in rigorous two-dimensional (2D) modeling. We demonstrate the effectiveness of the proposed approach in 2D modeling of the propagation characteristics of first-order eigenmodes in twisted and spun fibers with high linear birefringence. We derive the equivalent electric permittivity tensors for such fibers in the helical coordinate system and study the evolution of the first-order modes toward vortex modes with increasing twist rate. The obtained results confirm that the proposed method can reveal phenomena that cannot be predicted by analytical approaches.
Design of steering wheel-type ring depressed-core 10-mode fiber with fully improved mode spacing
Authors: Xie Yuheng , Pei Li , Zheng Jingjing , Zhao Qi , Ning Tigang , Li Jing
Published: April 2021

We present a steering wheel-type ring depressed-core few-mode fiber (SWTR-DC-FMF) that features a central depressed step-index core and a novel SWTR structure consisted of two symmetrical high-index parts and low-index parts, respectively. The DC and SWTR make great contribution to separate the non-degenerated LP modes and spatial modes in the circular symmetry core, resulting in fully improved mode spacing. The designed fiber is able to support 10 spatial modes with the minimum effective index difference (Min Δneff) between adjacent spatial modes larger than 1.93 × 10−4 and the Min Δneff between adjacent LP modes above 1.51 × 10−3 at the same time, facilitating potential fiber spatial mode multiplexing transmission with less multiple-input multiple-output (MIMO-less) digital signal processing technique. The broadband performance including n
eff
, Δneff, effective mode area (A
eff
) and differential mode delay (DMD) is comprehensively investigated over the whole C and L band. Moreover, the birefringence and fabrication tolerance are discussed. The designed fiber targets emerging applications in short-reach weakly coupled space-division multiplexing (SDM) optical networking to increase transmission capacity and spectral efficiency and further reduce the system complexity effectively.
Laser-printed hemispherical silicon Mie resonators
Authors: Syubaev Sergey , Mitsai Eugeny , Starikov Sergey , Kuchmizhak Aleksandr
Published: April 2021

Subwavelength nanostructures made of high-index low-loss materials have revolutionized the fields of linear and nonlinear nanophotonics, stimulating growing demands for efficient and inexpensive fabrication technologies. Here, we demonstrate high-precision and reproducible printing of hemispherical Si nanoparticles (NPs) via controllable dewetting of glass-supported

α

-Si films driven by a single femtosecond laser pulse. The diameter of the formed nanocrystalline NPs can be fully controlled by initial

α

-Si film thickness as well as lateral size of the laser spot and can be predicted by a simple empirical model based on conservation of energy and mass. A resonant optical response associated with Mie-type resonances supported by hemispherical NPs was confirmed by combining numerical modeling with optical microspectroscopy. Inexpensive and high-performing direct laser printing of nanocrystalline Si Mie resonators with a user-defined arrangement opens a pathway for various applications in optical sensing and nonlinear nanophotonics.
Categorisation of culturable bioaerosols in a fruit juice manufacturing facility
Authors: Theisinger Shirleen M. , de Smidt Olga , Lues Jan F. R.
Published: April 2021

Bioaerosols are defined as aerosols that comprise particles of biological origin or activity that may affect living organisms through infectivity, allergenicity, toxicity, or through pharmacological or other processes. Interest in bioaerosol exposure has increased over the last few decades. Exposure to bioaerosols may cause three major problems in the food industry, namely: (i) contamination of food (spoilage); (ii) allergic reactions in individual consumers; or (iii) infection by means of pathogenic microorganisms present in the aerosol. The aim of this study was to characterise the culturable fraction of bioaerosols in the production environment of a fruit juice manufacturing facility and categorise isolates as harmful, innocuous or potentially beneficial to the industry, personnel and environment. Active sampling was used to collect representative samples of five areas in the facility during peak and off-peak seasons. Areas included the entrance, preparation and mixing area, between production lines, bottle dispersion and filling stations. Microbes were isolated and identified using 16S, 26S or ITS amplicon sequencing. High microbial counts and species diversity were detected in the facility. 239 bacteria, 41 yeasts and 43 moulds were isolated from the air in the production environment. Isolates were categorised into three main groups, namely 27 innocuous, 26 useful and 39 harmful bioaerosols. Harmful bioaerosols belonging to the genera Staphylococcus, Pseudomonas, Penicillium and Candida were present. Although innocuous and useful bioaerosols do not negatively influence human health their presence act as an indicator that an ideal environment exists for possible harmful bioaerosols to emerge.
Population density and basic reproductive number of COVID-19 across United States counties
Authors: Sy Karla Therese L. , White Laura F. , Nichols Brooke E.
Published: April 2021

The basic reproductive number (R0) is a function of contact rates among individuals, transmission probability, and duration of infectiousness. We sought to determine the association between population density and R0 of SARS-CoV-2 across U.S. counties. We conducted a cross-sectional analysis using linear mixed models with random intercept and fixed slopes to assess the association of population density and R0, and controlled for state-level effects using random intercepts. We also assessed whether the association was differential across county-level main mode of transportation percentage as a proxy for transportation accessibility, and adjusted for median household income. The median R0 among the United States counties was 1.66 (IQR: 1.35–2.11). A population density threshold of 22 people/km2 was needed to sustain an outbreak. Counties with greater population density have greater rates of transmission of SARS-CoV-2, likely due to increased contact rates in areas with greater density. An increase in one unit of log population density increased R0 by 0.16 (95% CI: 0.13 to 0.19). This association remained when adjusted for main mode of transportation and household income. The effect of population density on R0 was not modified by transportation mode. Our findings suggest that dense areas increase contact rates necessary for disease transmission. SARS-CoV-2 R0 estimates need to consider this geographic variability for proper planning and resource allocation, particularly as epidemics newly emerge and old outbreaks resurge.
T-staging of rectal cancer: Utility of single-shot turbo spin-echo diffusion-weighted imaging with T2-weighted images and fusion images
Authors: Ogawa Masaki , Urano Misugi , Takaishi Taku , Kan Hirohito , Arai Nobuyuki , Takahashi Hiroki , Hara Masayasu , Saito Miki , Shibamoto Yuta
Published: April 2021

Purpose

The purpose of this study was to evaluate the usefulness of turbo spin-echo (TSE) DWI with fusion images in the T-staging compared with T2-weighted imaging (T2WI) alone and conventional echo-planner imaging (EPI) DWI.

Methods

In this prospective study, 4-mm-thick axial EPI-DWI, TSE-DWI, and T2WI were performed with the same slice locations for 20 patients with rectal cancer. Fusion images of DWI and T2WI were created for both EPI-DWI and TSE-DWI. Ten readers independently diagnosed the T-stages and scored the degree of confidence referring to T2WI alone and then to DWI, T2WI, and fusion images (DWI+T2WI) for each EPI-DWI and TSE-DWI. Visual score assessments of image quality were performed for each DWI.

Results

Inter-observer agreement of T-staging for 10 readers was slight on T2WI alone but fair on EPI-DWI+T2WI and excellent on TSE-DWI+T2WI images. No readers gave higher confidence scores for T2WI compared to EPI/TSE-DWI+T2WI and for EPI-DWI+T2WI compared to TSE-DWI+T2WI. In seven pathologically-proven cases, poor, poor to slight, and fair to perfect agreements with the pathological T-stage were observed with T2WI alone, EPI-DWI+T2WI, and TSE-DWI+T2WI, respectively. All readers gave higher scores regarding image distortion and lower scores regarding image noise for TSE-DWI compared to EPI-DWI. For DWI utility, higher scores were assigned for TSE-DWI compared to EPI-DWI in 7 readers and there were no significant differences in the other 3 readers.

Conclusion

TSE-DWI images might be more appropriate for image fusion with T2WI and rectal cancer T-staging compared with EPI-DWI and T2WI alone.
Bodyweight change and cognitive performance in the older population
Authors: Kronschnabl Judith M. , Kneip Thorsten , Weiss Luzia M. , Bergmann Michael
Published: April 2021

Preservation of cognitive function is one of the major concerns in contemporary ageing societies. At the same time, overweight and obesity, which have been identified as risk factors for poor health development, have been increasing in many countries all over the world. This study examines the relationship between bodyweight change and cognitive decline in old age and it aims to determine whether and how changes in body mass index (BMI) affect the development of cognitive functioning in old age. Using longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE), covering four waves between 2006 and 2016 with 58,389 participants from 15 countries aged 50+, we estimated asymmetric fixed effects models by gender, adding possible confounding variables such as age, grip strength, health conditions, and physical activity. Additionally, we investigated possible heterogeneity in the BMI-cognition relation. We found a positive association between BMI change and change in cognitive performance, which was dominantly driven by BMI decrease. Weight loss was typically negatively related to cognition, particularly at low levels of BMI and mainly due to health conditions affecting both bodyweight and cognitive performance. Weight gain was, on average, not significantly related to cognitive performance; only respondents with preceding weight loss profited from small increases in BMI. Our analyses provide no support for an “obesity paradox” in cognition, according to which higher weight preserves cognition in old age. The association between weight change and cognitive performance in older age is based on weight changes being related to illness and recovery.
Psychosocial factors associated with the self-reported frequency of cell phone use while driving in Iran
Authors: Kalantari Amir Hossein , Monavar Yazdi Seyedeh , Hill Tetiana , Mohammadzadeh Moghaddam Abolfazl , Ayati Esmaeel , Sullman Mark J. M.
Published: April 2021

Cell phone use while driving is a common contributing factor in thousands of road traffic injuries every year globally. Despite extensive research investigating the risks associated with cell phone use while driving, social media campaigns to raise public awareness and a number of laws banning phone use while driving, this behaviour remains prevalent throughout the world. The current study was conducted in Iran, where road traffic injuries are the leading causes of death and disability, and where drivers continue to use their cell phones, despite legislative bans restricting this behaviour. A total of 255 drivers in the city of Mashhad (male = 66.3%; mean age = 30.73 years; SD = 9.89) completed either an online or a paper-based survey assessing the self-reported frequency of using a cell phone while driving. Psychosocial factors contributing to cell phone use while driving and support for legislation restricting this behaviour, as well as the Big Five personality traits, were also measured. Overall, the results showed that almost 93% of drivers use their cell phones while driving at least once a week, with 32.5% reporting they always use their cell phones while driving. Ordinal logistic regression revealed that the presence of a child passenger, age, perceived benefits and risks of using cell phones while driving, as well as the perceived ability to drive safely while using a cell phone, were strongly associated with the frequency of cell phone use while driving. As for personality traits—extraversion, agreeableness and conscientiousness significantly predicted the frequency of cell phone use in this sample of Iranian drivers.
4-phenylbutyrate exerts stage-specific effects on cardiac differentiation via HDAC inhibition
Authors: Li Yanming , Weng Xiaofei , Wang Pingping , He Zezhao , Cheng Siya , Wang Dongxing , Li Xianhui , Cheng Guanchang , Li Tao
Published: April 2021

4-phenylbutyrate (4-PBA), a terminal aromatic substituted fatty acid, is used widely to specifically attenuate endoplasmic reticulum (ER) stress and inhibit histone deacetylases (HDACs). In this study, we investigated the effect of 4-PBA on cardiac differentiation of mouse embryonic stem (ES) cells. Herein, we found that 4-PBA regulated cardiac differentiation in a stage-specific manner just like trichostatin A (TSA), a well-known HDAC inhibitor. 4-PBA and TSA favored the early-stage differentiation, but inhibited the late-stage cardiac differentiation via acetylation. Mechanistic studies suggested that HDACs exhibited a temporal expression profiling during cardiomyogenesis. Hdac1 expression underwent a decrease at the early stage, while was upregulated at the late stage of cardiac induction. During the early stage of cardiac differentiation, acetylation favored the induction of Isl1 and Nkx2.5, two transcription factors of cardiac progenitors. During the late stage, histone acetylation induced by 4-PBA or TSA interrupted the gene silence of Oct4, a key determinant of self-renewal and pluripotency. Thereby, 4-PBA and TSA at the late stage hindered the exit from pluripotency, and attenuated the expression of cardiac-specific contractile proteins. Overexpression of HDAC1 and p300 exerted different effects at the distinct stages of cardiac induction. Collectively, our study shows that timely manipulation of HDACs exhibits distinct effects on cardiac differentiation. And the context-dependent effects of HDAC inhibitors depend on cell differentiation states marked by the temporal expression of pluripotency-associated genes.
Patterns of metformin monotherapy discontinuation and reinitiation in people with type 2 diabetes mellitus in New Zealand
Authors: Horsburgh Simon , Sharples Katrina , Barson David , Zeng Jiaxu , Parkin Lianne
Published: April 2021

Aim

To describe the patterns of discontinuation and reinitiation in new users of metformin monotherapy in New Zealand, overall and according to person- and healthcare-related factors.

Materials and methods

We created a cohort (n = 85,066) of all patients in New Zealand with type 2 diabetes mellitus who initiated metformin monotherapy between 1 January 2006 and 30 September 2014 from the national data collections, and followed them until the earlier of their death or 31 December 2015. Discontinuation was defined as a gap in possession of metformin monotherapy of ≥90 days. We explored patterns of discontinuation and reinitiation using competing risks methods.

Results

After 1 year of follow-up, 28% of cohort members had discontinued metformin monotherapy at least once; the corresponding figures after 2 and 5 years were 37% and 46%. The proportions who reinitiated metformin monotherapy within 1, 2, and 5 years of their first discontinuation were 23%, 49%, and 73%. Discontinuation after the first reinitiation was common (48% after 1 year). Discontinuation and reinitiation varied by age, ethnicity, and other person- and healthcare-related factors.

Discussion

Our findings highlight the dynamic nature of metformin monotherapy use, show that substantial periods of non-use are common, and identify priority populations for interventions to facilitate adherence.
Dynamic acceleration response of a rock slope with a horizontal weak interlayer in shaking table tests
Authors: Liu Hanxiang , Qiu Tong , Xu Qiang
Published: April 2021

The weak interlayer in a rock slope often plays a significant role in seismic rockslides; however, the effect of weak interlayer on the seismic slope response and damage process is still not fully understood. This study presents a series of shaking test tests on two model slopes containing a horizontal weak interlayer with different thicknesses. A recorded Wenchuan earthquake ground motion was scaled to excite the slopes. Measurements from accelerometers embedded at different elevations of slope surface and slope interior were analyzed and compared. The effect of the weak interlayer thickness on the seismic response was highlighted by a comparative analysis of the two slopes in terms of topographic amplification, peak accelerations, and deformation characteristics as the input amplitude increased. It was found that the structure deterioration and nonlinear response of the slopes were manifested as a time lag of the horizontal accelerations in the upper slope relative to the lower slope and a reduction of resonant frequency and Fourier spectral ratio. Test results show that under horizontal acceleration, both slopes exhibited significant topographic amplification in the upper half, and the difference in amplification between slope face and slope interior was more pronounced in Slope B (with a thin weak interlayer) than in Slope A (with a thick weak interlayer). A four-phased dynamic response process of both slopes was observed. Similar deformation characteristics including development of strong response zone and macro-cracks, vertical settlement, horizontal extrusion and collapse in the upper half were observed in both slopes as the input amplitude increased; however, the deformations were more severe in Slope B than in Slope A, suggesting an energy isolation effect of the thick interlayer in Slope A.
‘Companioning’ in artistic inquiry: Warren Lett and the role of personal process in research
Authors: McNiff Shaun
Published: April 2021

This article explores the unique features of Warren Lett’s practice of companioning and its significance within the international community of artistic inquiry. Emphasis is given to the role of personal process as research content and its inseparable relationship to reality. The author’s experiences with this aspect of research are compared to Lett’s work. The article also explores the parallel developments of integrated arts therapy in the United States and multimodal arts therapy in Australia, both grounded in an integral, multisensory and whole art experience that contrasts to the silos of specialized arts therapy disciplines.
Vállalatok nemzetköziesedésének szervezeti keretei és az emberierőforrás-menedzsment funkció
Authors: Poór József
Published: April 2021

A modern nemzetközi vállalatok a második világháborút követően jöttek létre. A nagy amerikai vállalatok felvásárlásokkal, vegyes vállalatok létrehozásával vagy zöldmezős beruházásokkal kiléptek a nemzetközi porondra. AII. világháború után kibontakozott nemzetköziesedési tendenciákat nagyban segítették többek között: a technológia ugrásszerű fejlődése, a Marshall program, a GATT tárgyalások, valamint az 1957-ben megkötött Római Szerződés életbelépése. Az amerikai cégek gyors nemzetközi térnyerését nem mindenhol fogadták osztatlan örömmel. A francia Servan-Schreiber 1967-ben megjelent American Challenge címû könyvében felhívta az európai cégek figyelmét saját erôik koncentrálására és a megfelelő válasz kidolgozására az amerikai kihívással szemben. A szerző cikkében áttekinti a nemzetközi vállalatok szervezeti kereteinek és formáinak átalakulását, továbbá megvizsgálja, hogy az emberierőforrás- menedzsment (HRM) milyen helyet foglal el az ilyen szervezeteken belül.