bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical outcomes of screen-positive genome-wide cfDNA cases for trisomy 20: results from the global expanded NIPT Consortium
Authors: Soster Erica , Mossfield Tamara , Menezes Melody , Agenbag Gloudi , Dubois Marie-Line , Gekas Jean , Hardy Tristan , Loggenberg Kelly ,   on behalf of the Global Expanded NIPT Consortium
Published: April 2024

Trisomy 20 has been shown to be one of the most frequent rare autosomal trisomies in patients that undergo genome-wide noninvasive prenatal testing. Here, we describe the clinical outcomes of cases that screened positive for trisomy 20 following prenatal genome-wide cell-free (cf.) DNA screening. These cases are part of a larger cohort of previously published cases. Members of the Global Expanded NIPT Consortium were invited to submit details on their cases with a single rare autosomal aneuploidy following genome-wide cfDNA screening for retrospective analysis. Clinical details including patient demographics, test indications, diagnostic testing, and obstetric pregnancy outcomes were collected. Genome-wide cfDNA screening was conducted following site-specific laboratory procedures. Cases which screened positive for trisomy 20 (n = 10) were reviewed. Clinical outcome information was available for 90% (9/10) of our screen-positive trisomy 20 cases; the case without diagnostic testing ended in a fetal demise. Of the nine cases with outcome information, one was found to have a mosaic partial duplication (duplication at 20p13), rather than a full trisomy 20. Only one case in the study cohort had placental testing; therefore, confined placental mosaicism could not be ruled out in most cases. Adverse pregnancy outcomes were seen in half of the cases, which could suggest the presence of underlying confined placental mosaicism or mosaic/full fetal trisomy 20. Based on our limited series, the likelihood of true fetal aneuploidy is low but pregnancies may be at increased risk for adverse obstetric outcomes and may benefit from additional surveillance.
Integration of single-cell RNA-seq and bulk RNA-seq data to construct and validate a cancer-associated fibroblast-related prognostic signature for patients with ovarian cancer
Authors: Shen Liang , Li Aihua , Cui Jing , Liu Haixia , Zhang Shiqian
Published: April 2024

Background

To establish a prognostic risk profile for ovarian cancer (OC) patients based on cancer-associated fibroblasts (CAFs) and gain a comprehensive understanding of their role in OC progression, prognosis, and therapeutic efficacy.

Methods

Data on OC single-cell RNA sequencing (scRNA-seq) and total RNA-seq were collected from the GEO and TCGA databases. Seurat R program was used to analyze scRNA-seq data and identify CAFs clusters corresponding to CAFs markers. Differential expression analysis was performed on the TCGA dataset to identify prognostic genes. A CAF-associated risk signature was designed using Lasso regression and combined with clinicopathological variables to develop a nomogram. Functional enrichment and the immune landscape were also analyzed.

Results

Five CAFs clusters were identified in OC using scRNA-seq data, and 2 were significantly associated with OC prognosis. Seven genes were selected to develop a CAF-based risk signature, primarily associated with 28 pathways. The signature was a key independent predictor of OC prognosis and relevant in predicting the results of immunotherapy interventions. A novel nomogram combining CAF-based risk and disease stage was developed to predict OC prognosis.

Conclusion

The study highlights the importance of CAFs in OC progression and suggests potential for innovative treatment strategies. A CAF-based risk signature provides a highly accurate prediction of the prognosis of OC patients, and the developed nomogram shows promising results in predicting the OC prognosis.
Optimizing remote and rural prehospital resources using air transport of thrombectomy candidates
Authors: Vuorinen Pauli , Setälä Piritta , Hoppu Sanna
Published: April 2024

Background

In Finland, the yearly number of mechanical thrombectomies for acute stroke is increasing and more patients are transported over 100 km to the comprehensive stroke centre (CSC) for definitive care. This leaves the rural townships without immediate emergency medical services (EMS) for hours. In this study we compare the EMS’ estimated return times to own station after the handover of a thrombectomy candidate between two transport methods: (1) using ground transportation with an ambulance to the CSC or (2) using a hydrid strategy starting the transportation with an ambulance and continuing by air with a helicopter emergency medical services unit (HEMS).

Methods

We reviewed retrospectively all thrombectomy candidates’ transportations from the hospital district of South Ostrobothnia to definitive care at the nearest CSC, Tampere University Hospital from June 2020 to October 2022. The dispatch protocol stated that a thrombectomy candidate’s transport begins immediately with an ambulance and if the local HEMS unit is available the patient is handed over to them at a rendezvous. If not, the patient is transported to the CSC by ground. Transport times and locations of the patient handovers were reviewed from the CSC’s EMS database and the driving time back to ambulance station was estimated using Google maps. The HEMS unit’s pilot’s log was reviewed to assess their mission engagement time.

Results

The median distance from the CSC to the ambulances’ stations was 188 km (IQR 149–204 km) and from the rendezvous with the HEMS unit 70 km (IQR 51–91 km, p < 0.001). The estimated median driving time back to station after the patient handover at the CSC was 145 min (IQR 117–153 min) compared to the patient handover to the HEMS unit 53 min (IQR 38–68 min, p < 0.001). The HEMS unit was occupied in thrombectomy candidate’s transport mission for a median of 136 min (IQR 127–148 min).

Conclusion

A hybrid strategy to transport thrombectomy candidates with an ambulance and a helicopter reallocates the EMS resources markedly faster back to their own district.
Contribution of electrical impedance tomography to personalize positive end-expiratory pressure under ECCO2R
Authors: Pequignot Benjamin , Combes Alain , Lescroart Mickael , Levy Bruno , Koszutski Matthieu
Published: April 2024

Extracorporeal Carbon Dioxide Removal (ECCO2R) is used in acute respiratory distress syndrome (ARDS) patients to facilitate lung-protective ventilatory strategies. Electrical Impedance Tomography (EIT) allows individual, non-invasive, real-time, bedside, radiation-free imaging of the lungs, providing global and regional dynamic lung analyses. To provide new insights for future ECCO2R research in ARDS, we propose a potential application of EIT to personalize End-Expiratory Pressure (PEEP) following each reduction in tidal volume (VT), as demonstrated in an illustrative case. A 72-year-old male with COVID-19 was admitted to the ICU for moderate ARDS. Monitoring with EIT was started to determine the optimal PEEP value (PEEPEIT), defined as the intersection of the collapse and overdistention curves, after each reduction in VT during ECCO2R. The identified PEEPEIT values were notably low (< 10 cmH2O). The decrease in VT associated with PEEPEIT levels resulted in improved lung compliance, reduced driving pressure and a more uniform ventilation pattern. Despite current Randomized Controlled Trials showing that ultra-protective ventilation with ECCO2R does not improve survival, the applicability of universal ultra-protective ventilation settings for all patients remains a subject of debate. Inappropriately set PEEP levels can lead to alveolar collapse or overdistension, potentially negating the benefits of VT reduction. EIT facilitates real-time monitoring of derecruitment associated with VT reduction, guiding physicians in determining the optimal PEEP value after each decrease in tidal volume. This original description of using EIT under ECCO2R to adjust PEEP at a level compromising between recruitability and overdistention could be a crucial element for future research on ECCO2R.
Schema therapy versus treatment as usual for outpatients with difficult-to-treat depression: study protocol for a parallel group randomized clinical trial (DEPRE-ST)
Authors: Arendt Ida-Marie T. P. , Gondan Matthias , Juul Sophie , Hastrup Lene Halling , Hjorthøj Carsten , Bach Bo , Videbech Poul , Jørgensen Martin Balslev , Moeller Stine Bjerrum
Published: April 2024

Background

About one third of patients with depression are in a condition that can be termed as “difficult-to-treat”. Some evidence suggests that difficult-to-treat depression is associated with a higher frequency of childhood trauma and comorbid personality disorders or accentuated features. However, the condition is understudied, and the effects of psychotherapy for difficult-to-treat depression are currently uncertain. The aim of this trial is to investigate the beneficial and harmful effects of 30 sessions of individual schema therapy versus treatment as usual for difficult-to-treat depression in the Danish secondary, public mental health sector.

Methods

In this randomized, multi-centre, parallel-group, superiority clinical trial, 129 outpatients with difficult-to-treat depression will be randomized (1:1) to 30 sessions of individual schema therapy or treatment as usual; in this context mainly group-based, short-term cognitive behaviour or psychodynamic therapy. The primary outcome is the change from baseline in depressive symptoms 12 months after randomization, measured on the observer-rated 6-item Hamilton Rating Scale for Depression. The secondary outcomes are health-related quality of life assessed with the European Quality of Life 5 Dimensions 5 Level Version, functional impairment assessed with the Work and Social Adjustment Scale, psychological wellbeing assessed with the WHO-5 Well-being Index, and negative effects of treatment assessed with the Negative Effects Questionnaire. Exploratory outcomes are improvement on patient self-defined outcomes, personal recovery, anxiety symptoms, anger reactions, metacognitive beliefs about anger, and perseverative negative thinking. Outcomes will be assessed at 6, 12, and 24 months after randomization; the 12-month time-point being the primary time-point of interest. Outcome assessors performing the depression-rating, data managers, statisticians, the data safety and monitoring committee, and conclusion makers for the outcome article will be blinded to treatment allocation and results. To assess cost-effectiveness of the intervention, a health economic analysis will be performed.

Discussion

This trial will provide evidence on the beneficial and harmful effects, as well as the cost-effectiveness of schema therapy versus treatment as usual for outpatients with difficult-to-treat depression. The results can potentially improve treatment for a large and understudied patient group.

Trial registration

ClinicalTrials.gov NCT05833087. Registered on 15th April 2023 (approved without prompts for revision on 27th April 2023).
Look4LTRs: a Long terminal repeat retrotransposon detection tool capable of cross species studies and discovering recently nested repeats
Authors: Garza Anthony B. , Lerat Emmanuelle , Girgis Hani Z.
Published: April 2024

Plant genomes include large numbers of transposable elements. One particular type of these elements is flanked by two Long Terminal Repeats (LTRs) and can translocate using RNA. Such elements are known as LTR-retrotransposons; they are the most abundant type of transposons in plant genomes. They have many important functions involving gene regulation and the rise of new genes and pseudo genes in response to severe stress. Additionally, LTR-retrotransposons have several applications in biotechnology. Due to the abundance and the importance of LTR-retrotransposons, multiple computational tools have been developed for their detection. However, none of these tools take advantages of the availability of related genomes; they process one chromosome at a time. Further, recently nested LTR-retrotransposons (multiple elements of the same family are inserted into each other) cannot be annotated accurately — or cannot be annotated at all — by the currently available tools. Motivated to overcome these two limitations, we built Look4LTRs, which can annotate LTR-retrotransposons in multiple related genomes simultaneously and discover recently nested elements. The methodology of Look4LTRs depends on techniques imported from the signal-processing field, graph algorithms, and machine learning with a minimal use of alignment algorithms. Four plant genomes were used in developing Look4LTRs and eight plant genomes for evaluating it in contrast to three related tools. Look4LTRs is the fastest while maintaining better or comparable F1 scores (the harmonic average of recall and precision) to those obtained by the other tools. Our results demonstrate the added benefit of annotating LTR-retrotransposons in multiple related genomes simultaneously and the ability to discover recently nested elements. Expert human manual examination of six elements — not included in the ground truth — revealed that three elements belong to known families and two elements are likely from new families. With respect to examining recently nested LTR-retrotransposons, three out of five were confirmed to be valid elements. Look4LTRs — with its speed, accuracy, and novel features — represents a true advancement in the annotation of LTR-retrotransposons, opening the door to many studies focused on understanding their functions in plants.
Effectiveness and safety of manual therapy when compared with oral pain medications in patients with neck pain: a systematic review and meta-analysis
Authors: Makin Joshua , Watson Lauren , Pouliopoulou Dimitra V , Laframboise Taylor , Gangloff Bradley , Sidhu Ravinder , Sadi Jackie , Parikh Pulak , Gross Anita , Langevin Pierre , Gillis Heather , Bobos Pavlos
Published: April 2024

Background

This systematic review and meta-analysis seeks to investigate the effectiveness and safety of manual therapy (MT) interventions compared to oral pain medication in the management of neck pain.

Methods

We searched from inception to March 2023, in Cochrane Central Register of Controller Trials (CENTRAL), MEDLINE, EMBASE, Allied and Complementary Medicine (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO) for randomized controlled trials that examined the effect of manual therapy interventions for neck pain when compared to medication in adults with self-reported neck pain, irrespective of radicular findings, specific cause, and associated cervicogenic headaches. We used the Cochrane Risk of Bias 2 tool to assess the potential risk of bias in the included studies, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach to grade the quality of the evidence.

Results

Nine trials (779 participants) were included in the meta-analysis. We found low certainty of evidence that MT interventions may be more effective than oral pain medication in pain reduction in the short-term (Standardized Mean Difference: -0.39; 95% CI -0.66 to -0.11; 8 trials, 676 participants), and moderate certainty of evidence that MT interventions may be more effective than oral pain medication in pain reduction in the long-term (Standardized Mean Difference: − 0.36; 95% CI − 0.55 to − 0.17; 6 trials, 567 participants). We found low certainty evidence that the risk of adverse events may be lower for patients that received MT compared to the ones that received oral pain medication (Risk Ratio: 0.59; 95% CI 0.43 to 0.79; 5 trials, 426 participants).

Conclusions

MT may be more effective for people with neck pain in both short and long-term with a better safety profile regarding adverse events when compared to patients receiving oral pain medications. However, we advise caution when interpreting our safety results due to the different level of reporting strategies in place for MT and medication-induced adverse events. Future MT trials should create and adhere to strict reporting strategies with regards to adverse events to help gain a better understanding on the nature of potential MT-induced adverse events and to ensure patient safety.

Trial registration

PROSPERO registration number: CRD42023421147.
GLUT1-mediated microglial proinflammatory activation contributes to the development of stress-induced spatial learning and memory dysfunction in mice
Authors: Wang Xue , Wu Yuhan , Tian Yingrui , Hu Hui , Zhao Yun , Xue Binghua , Sun Zhaowei , Wei Aijun , Xie Fang , Qian Ling-Jia
Published: April 2024

Background

Stress is a recognized risk factor for cognitive decline, which triggers neuroinflammation involving microglial activation. However, the specific mechanism for microglial activation under stress and affects learning and memory remains unclear.

Methods

The chronic stress mouse model was utilized to explore the relationship between microglial activation and spatial memory impairment. The effect of hippocampal hyperglycemia on microglial activation was evaluated through hippocampal glucose-infusion and the incubation of BV2 cells with high glucose. The gain-and loss-of-function experiments were conducted to investigate the role of GLUT1 in microglial proinflammatory activation. An adeno-associated virus (AAV) was employed to specifically knockdown of GLUT1 in hippocampal microglia to assess its impact on stressed-mice.

Results

Herein, we found that chronic stress induced remarkable hippocampal microglial proinflammatory activation and neuroinflammation, which were involved in the development of stress-related spatial learning and memory impairment. Mechanistically, elevated hippocampal glucose level post-stress was revealed to be a key regulator of proinflammatory microglial activation via specifically increasing the expression of microglial GLUT1. GLUT1 overexpression promoted microglial proinflammatory phenotype while inhibiting GLUT1 function mitigated this effect under high glucose. Furthermore, specific downregulation of hippocampal microglial GLUT1 in stressed-mice relieved microglial proinflammatory activation, neuroinflammation, and spatial learning and memory injury. Finally, the NF-κB signaling pathway was demonstrated to be involved in the regulatory effect of GLUT1 on microglia.

Conclusions

We demonstrate that elevated glucose and GLUT1 expression induce microglia proinflammatory activation, contributing to stress-associated spatial memory dysfunction. These findings highlight significant interplay between metabolism and inflammation, presenting a possible therapeutic target for stress-related cognitive disorders.
The chain of survival and rehabilitation for sepsis: concepts and proposals for healthcare trajectory optimization
Authors: Jouffroy Romain , Djossou Félix , Neviere Rémi , Jaber Samir , Vivien Benoît , Heming Nicholas , Gueye Papa
Published: April 2024

This article describes the structures and processes involved in healthcare delivery for sepsis, from the prehospital setting until rehabilitation. Quality improvement initiatives in sepsis may reduce both morbidity and mortality. Positive outcomes are more likely when the following steps are optimized: early recognition, severity assessment, prehospital emergency medical system activation when available, early therapy (antimicrobials and hemodynamic optimization), early orientation to an adequate facility (emergency room, operating theater or intensive care unit), in-hospital organ failure resuscitation associated with source control, and finally a comprehensive rehabilitation program. Such a trajectory of care dedicated to sepsis amounts to a chain of survival and rehabilitation for sepsis. Implementation of this chain of survival and rehabilitation for sepsis requires full interconnection between each link. To date, despite regular international recommendations updates, the adherence to sepsis guidelines remains low leading to a considerable burden of the disease. Developing and optimizing such an integrated network could significantly reduce sepsis related mortality and morbidity.
Ludicidade no desenvolvimento de hábitos alimentares saudáveis: uma vivência curricular da extensão
Authors: Magalhães Laryssa Alves , De Almeida Loureto Larissa , Silva Sombra Karen Yasmin , Carvalho de Oliveira João Wallace , De Andrade Kunhen dos Santos Lara , Marques Fernandes Joseane
Published: April 2024

A alimentação adequada se constrói baseada em práticas alimentares que se estabelecem de forma geracional, portanto incentivar o consumo alimentar que conduza a um bom aporte energético e nutricional significa trabalhar a qualidade de vida da população. O objetivo deste artigo é relatar a experiência vivenciada em uma atividade curricular de extensão acerca da utilização da ludicidade na construção de hábitos alimentares saudáveis. A atividade foi voltada para o público adulto e para o público infantil e teve uma excelente aceitação da comunidade, mostrando que muitos entediam a importância da temática. Por fim, demonstrou-se a importância do ensino-comunidade no processo de transformação e melhoria do estilo de vida, favorecendo a melhora dos hábitos alimentares na comunidade.
Multifactorial analysis of willingness to undergo subcutaneous allergen immunotherapy in pediatric patients
Authors: Ding Bo , Zhong Jie , Jiang Chun , Ma Tian , Shen Qiuzhi , Lu Yanming
Published: April 2024

Objective: To explore factors influencing the acceptance of allergen immunotherapy (AIT) for the treatment of allergic respiratory diseases by pediatric patients and their families.

Methods: A total of 406 children (210 males and 196 females) attending the pediatric outpatient clinics and wards of the Renji Hospital, Shanghai Jiao Tong University School of Medicine from June 2020 to April 2022. Those who met the criteria for the AIT treatment, were included in the survey. An online 20-item questionnaire was developed. Data on patient’s general characteristics, allergic disease status, family history of allergies, general family information, parental knowledge of allergic diseases, and whether the AIT treatment was recommended by a physician, were collected. The patients were divided into two groups according to their willingness to receive AIT: a reluctant or neutral group (n = 182), and a willing group (n = 224). A univariate analysis of the willingness to undergo AIT was done to detect parameters that significantly differed between the groups, and the identified factors were used as independent variables in the multifactorial logistic regression analysis.

Results: The severity of allergic disease, presence of drug allergy, occurrence of severe allergic reactions, mother’s education, distance from home to the hospital, parental knowledge of allergic diseases, and whether the doctor recommended AIT were all statistically different between the groups (p < 0.05). Multifactorial logistic regression analysis showed that the degree of allergic rhinitis (AR), or asthma (AS), parental knowledge of allergic diseases, and doctor’s recommendation of AIT were the factors that influenced the willingness of pediatric patients to receive AIT.

Conclusions: The severity of AR and AS, parental knowledge of allergic diseases, and doctor’s recommendation influenced the willingness of pediatric patients to receive AIT.

doi: https://doi.org/10.12669/pjms.40.5.8581

How to cite this: Ding B, Zhong J, Jiang C, Ma T, Shen Q, Lu Y. Measurement of Service Quality Gaps in Dental Services using SERVQUAL in Public Hospitals of Rawalpindi. Pak J Med Sci. 2024;40(5):820-828. doi: https://doi.org/10.12669/pjms.40.5.8581

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.
‘Not finding causal effect’ is not ‘finding no causal effect’ of school closure on COVID-19
Authors: Endo Akira
Published: April 2024

In a paper recently published in Nature Medicine, Fukumoto et al. tried to assess the government-led school closure policy during the early phase of the COVID-19 pandemic in Japan. They compared the reported incidence rates between municipalities that had and had not implemented school closure in selected periods from March–May 2020, where they matched for various potential confounders, and claimed that there was no causal effect on the incidence rates of COVID-19. However, the effective sample size (ESS) of their dataset had been substantially reduced in the process of matching due to imbalanced covariates between the treatment (i.e. with closure) and control (without closure) municipalities, which led to the wide uncertainty in the estimates. Despite the study title starting with “No causal effect of school closures”, their results are insufficient to exclude the possibility of a strong mitigating effect of school closure on incidence of COVID-19. In this replication/reanalysis study, we showed that the confidence intervals of the effect estimates from Fukumoto et al. included a 100% relative reduction in COVID-19 incidence. Simulations of a hypothetical 50% or 80% mitigating effect hardly yielded statistical significance with the same study design and sample size. We also showed that matching of variables that had large influence on propensity scores (e.g. prefecture dummy variables) may have been incomplete.
Dyskusje o archiwach, archiwaliach i archiwistach w Sejmie Ustawodawczym 1919–1922
Authors: Kilkowska Joanna
Published: April 2024

Artykuł poświęcony jest przedstawieniu wyników przeglądu historycznej dokumentacji parlamentarnej zgromadzonej w zasobach Biblioteki Sejmowej, dotyczącej prac Sejmu Ustawodawczego, którego rolą dziejową było opracowanie i uchwalenie Konstytucji marcowej. Niespełna cztery lata działalności Sejmu to okres intensywnych prac legislacyjnych i regulowania wielu obszarów życia gospodarczego, które w dopiero organizującym swą administrację odrodzonym Państwie Polskim wymagały stworzenia na nowo, aby urzeczywistnił się proces kształtowania podstaw ustroju Drugiej Rzeczypospolitej. Okres ten to również praca nad organizowaniem zasad nowoczesnej służby archiwalnej. Dlatego w poszukiwaniu odniesień do archiwów, archiwaliów i archiwistów autor dokonał przeglądu i analizy dokumentacji wytworzonej w całym okresie prac Sejmu Ustawodawczego 1919–1922, w tym sprawozdań z posiedzeń plenarnych Sejmu, druków sejmowych, interpelacji poselskich, w których poszukiwano odniesienia do tematu archiwów i ich organizacji, archiwistów oraz archiwaliów. Początkowymi założeniami dla analizy i przeglądu dokumentacji były kwestie tego, czy obszar archiwów i archiwaliów został potraktowany przez władzę ustawodawczą z należytą atencją oraz czy w debatach sejmowych temat ten w ogóle był przedmiotem rozważań.
Archiwizacja gier komputerowych - wstęp do problematyki
Authors: Palmąka Michał , Piłat Michał
Published: April 2024

Celem artykułu jest podjęcie refleksji nad pomysłem archiwizacji gier komputerowych oraz wskazanie rozwiązań, umożliwiających ten proces, na podstawie istniejących badań z zakresu metodyki archiwalnej oraz praktycznych rozwiązań stosowanych wobec gier. Autorzy, zaczynając od krótkiego zarysu rozwoju techniki gier komputerowych, wskazali na zasadność i konieczność ich archiwizacji. Krótko poruszyli także kwestię powstania gier jako procesu aktotwórczego. Rozważono także problemy związane z instytucją gromadzącą, miejscem i warunkami przechowywania, udostępniania i prawami autorskimi twórców gier. Przedstawienie znanych praktyk archiwizacji gier oraz konsekwencji ich zaniechania stanowi dodatkowe uzasadnienie tej problematyki. Przeanalizowano na jakie wątki kładą nacisk niemieckie i polskie akty prawne. Zwrócono uwagę na te cechy, które wyróżniają gry od innej dokumentacji, a więc uchwycenie dzięki technologii aspektów niedostępnych dla tradycyjnych form dokumentacji. Na podstawie tych informacji oraz kryteriów ogólnych selekcji znanych w metodyce archiwalnej, zaproponowano kryteria szczegółowe, na które powinno się zwracać uwagę przy ocenie wartości gry. Podjęto także tematykę ustalania listy archiwotwórców jako uszczegółowienie problemu gromadzenia gier. Następnie wykorzystując dorobek metodyki archiwalnej wobec filmów, nagrań, relacji ustnych, a także niemieckojęzyczną analizę archiwizacji gier opisano kolejne etapy ich opracowania. Propozycja standardu opisu gry jako jednostki archiwalnej stanowi zwieńczenie naszych rozważań, wypracowanych głównie za pomocą metody porównawczej. Wykorzystano w tym celu rozwiązania z innych obszarów geograficznych i formalnych (dokumentacja audiowizualna, standard opisu relacji ustnych i FOPAR). Autorzy zastrzegli, że niniejsza problematyka jest nowością, dlatego stanowi zarys i zachętę do rozważań wobec przedstawionych przez siebie zaleceń.
Maintaining Healthcare Capacity in Rural America by Replenishing Personal Protective Equipment: The Case from West Virginia
Authors: Price Bradley S. , Saldanha John P. , Quiroga Bernardo F. , Hodder Sally L.
Published: April 2024

Faced with a worldwide shortage of PPE with the COVID-19 pandemic, we describe approaches for supplying hard-to-forecast PPE demand in West Virginia under challenging replenishment conditions. We describe the implementation of these approaches under the aegis of a joint inter-agency task force convened by the West Virginia State Administration.
Robust-to-Dynamics Optimization
Authors: Ahmadi Amir Ali , Günlük Oktay
Published: April 2024

A robust-to-dynamics optimization (RDO) problem is an optimization problem specified by two pieces of input: (i) a mathematical program (an objective function [Formula: see text] and a feasible set [Formula: see text]) and (ii) a dynamical system (a map [Formula: see text]). Its goal is to minimize f over the set [Formula: see text] of initial conditions that forever remain in [Formula: see text] under g. The focus of this paper is on the case where the mathematical program is a linear program and where the dynamical system is either a known linear map or an uncertain linear map that can change over time. In both cases, we study a converging sequence of polyhedral outer approximations and (lifted) spectrahedral inner approximations to [Formula: see text]. Our inner approximations are optimized with respect to the objective function f, and their semidefinite characterization—which has a semidefinite constraint of fixed size—is obtained by applying polar duality to convex sets that are invariant under (multiple) linear maps. We characterize three barriers that can stop convergence of the outer approximations to [Formula: see text] from being finite. We prove that once these barriers are removed, our inner and outer approximating procedures find an optimal solution and a certificate of optimality for the RDO problem in a finite number of steps. Moreover, in the case where the dynamics are linear, we show that this phenomenon occurs in a number of steps that can be computed in time polynomial in the bit size of the input data. Our analysis also leads to a polynomial-time algorithm for RDO instances where the spectral radius of the linear map is bounded above by any constant less than one. Finally, in our concluding section, we propose a broader research agenda for studying optimization problems with dynamical systems constraints, of which RDO is a special case.

Funding: O. Günlük was partially supported by the Office of Naval Research [Grant N00014-21-1-2575]. This work was partially funded by the Alfred P. Sloan Foundation, the Air Force Office of Scientific Research, Defense Advanced Research Projects Agency [Young Faculty Award], the National Science Foundation [Faculty Early Career Development Program Award], and Google [Faculty Award].
Disseminated melioidosis presenting as sepsis, neurological melioidosis, liver and prostate abscess in United Arab Emirates
Authors: Maria Hasani Maria Hasani , Sadia Rounak Shriya Sadia Rounak Shriya , Thahira Mariyam , Haque Saima , Khan Saima Liyakat , Azza Shaloob Azza Shaloob , Sara Osman Sara Osman
Published: April 2024

Background: Melioidosis is an infection caused by Burkholderia pseudomallei, a Gram-negative bacterium. It is a disease endemic to Southeast Asia and northern Australia although its global incidence has been rising. It most commonly infects people with certain identified risk factors such as diabetes, alcoholism, thalassemia, and underlying chronic disease involving lungs, kidney and liver. This bacterium is capable of producing a wide array of clinical manifestations ranging from asymptomatic disease to localised infections such as in the lung, bone or skin to disseminated infection. Case description: This is a case, from United Arab Emirates, of a 40-year-old male recently diagnosed with diabetes who presented with multiple abscesses and was eventually diagnosed with disseminated melioidosis. He was treated successfully with antibiotics and drainage of abscesses. Conclusion: In non-endemic regions, melioidosis can be easily missed in common diagnostic approaches. This gap of awareness could delay the diagnosis and allow further deterioration of the patient due to complications. Thus, case reports like this can enlighten internists about changing incidences and complexity of clinical presentations, thus preparing them to better handle such patients in the future.
Group B Streptococcus meningitis in an adult woman with type 2 diabetes and ethmoid roof defect. Impact on “frontal” cognitive functions
Authors: Vicinanza Roberto , Miscetti Alice , Magistrato Cesare , Castiglione Melina , Frizza Alessandro
Published: April 2024

Background: Community-acquired bacterial meningitis in adults represents one of the most severe infectious diseases worldwide with potentially life-threatening medical complications. Several infectious agents can cause acute meningitis. Although group B Streptococcus is more prevalent in newborns, infection can also lead to meningitis in older adults, particularly those with underlying health issues. Case Description: A 53-year-old woman with a body mass index of 28.7 kg/m2, type 2 diabetes mellitus, and dyslipidaemia presented to the emergency department of Santa Maria della Stella Hospital (Orvieto, Italy) with confusion, low-grade fever, echolalia, and hyperglycaemia. Computed tomography scans of the brain revealed a hypodensity in the left anterior frontal lobe and an osteodural defect of the rhinobase. Meningitis was suspected and empiric broad-spectrum antibiotic therapy with corticosteroids and insulin were administered while the results of the cerebrospinal fluid analysis confirmed the diagnosis of group B Streptococcus meningitis. Repeat imaging at 48 hours revealed enlargement of the hypodense lesion. The frontal assessment battery indicated deficits in executive functions. Prompt treatment led to rapid clinical improvement. Following the restoration of euglycemic status and hemodynamic stabilization, a follow-up magnetic resonance imaging confirmed the ischaemic lesion and showed cerebrospinal fluid in the sella turcica. The patient was then transferred to neurorehabilitation. Conclusions: The complex interactions among multiple risk factors resulted in an atypical clinical case of group B Streptococcus meningitis, which was promptly treated with empiric antibiotic therapy to mitigate neurocognitive deficits.
Allergies: Schools need to be better prepared and equipped
Authors: Lepkowska Dorothy
Published: April 2024

A new report published by the Benedict Blythe Foundation suggests that most schools in England are inadequately equipped to protect children with food allergies. Dorothy Lepkowska explains
Online safety: Protecting young people from online abuse
Authors: Collard Richard
Published: April 2024

The Online Safety Act is landmark legislation but the fight to keep young people safe online is not over. Richard Collard considers the provisions of the Act and looks how schools can protect young people online and spot the signs of online abuse
Social media: Looking at the impact on body image and school nurses' role
Authors: Walker Phoebe
Published: April 2024

Social media use among children and young people is a key part of contemporary life and on the rise; yet, this increased exposure has been associated with reduced body satisfaction and worse mental health outcomes. This article explores the impact of social media on body image in young adolescents at a vulnerable time in their development, as well as how school nurses and other professionals working with children and young people can support them to improve their body image.
Thoracic spine infection caused by Pseudomonas fluorescens: A case report and review of literature
Authors: Li Liang , Zhang Bao-Hua , Cao Jin-Feng , Zhang Li-Jin , Guo Ling-Ling
Published: April 2024

BACKGROUND

The clinical incidence of spinal infection is gradually increasing, and its onset is insidious, easily leading to missed diagnosis and misdiagnosis, which may lead to serious complications such as nervous system dysfunction, spinal instability and/or deformity, and cause a huge burden on society and families. Early identification of the causative agent and precision medicine will greatly reduce the suffering of patients. At present, the main pathogenic bacteria that cause spinal infection are Staphylococcus aureus , Streptococcus, Pneumococcus, Escherichia coli , and Klebsiella. There are no reports of spinal infection caused by Pseudomonas fluorescens .

CASE SUMMARY

We report a 32-year-old female patient with spinal infection. She presented with flank pain, initially thought to be bone metastases or bone tuberculosis, and had a family background of tumors. Her clinical features and changes in imaging and laboratory tests led to the suspicion of thoracic spine infection. Histopathology of the lesion showed inflammation, tissue culture of the lesion was negative several times, and the possible pathogen - Pseudomonas fluorescens was found after gene sequencing of the lesion. The patient recovered completely after a full course of antibiotic treatment.

CONCLUSION

This report increases the range of pathogens involved in spinal infections, highlights the unique advantages of gene sequencing technology in difficult-to-diagnose diseases, and validates conservative treatment with a full course of antibiotics for spinal infections without complications.
“This sea which utters me”: Reading W. S. Graham’s “The Nightfishing” in the Theological Wake of G. M. Hopkins’s “The Wreck of the Deutschland”
Authors: Brewbaker Will
Published: April 2024

Abstract: Despite the scant attention paid to his poetic oeuvre in U.S. academic circles, the Scottish poet W. S. Graham stands as one of the most theologically enigmatic poets of the mid-twentieth century. In this essay, I read his major poem, “The Nightfishing” (1955), as a response to G. M. Hopkins’s own seafaring poem, “The Wreck of the Deutschland.” By considering Graham alongside Hopkins, I attempt to draw out the former’s “minimal” theological poetics. More specifically, I consider the way that Graham’s poem both sustains and develops a set of theological questions that stand, too, at the core of Hopkins’s poem.
Havelock Ellis and Decadent Conversion
Authors: Murray Alex
Published: April 2024

Abstract: Many Decadent writers of the fin de siècle underwent religious conversions, yet the frameworks we have for reading those conversions tend to focus on sexuality and continuity. This essay argues that Havelock Ellis can offer us an alternative means of reading conversion as a much more fundamental revolution of the self’s relationship to the universe. Drawing on Ellis’s literary criticism, his writing on religion, and his biography, and also on William James and Charles Taylor, I develop an understanding of Decadent conversion that is far more capacious and transformational.
Hazel Motes and Midcult Religion in Flannery O’Connor’s Wise Blood
Authors: Love Jack
Published: April 2024

Abstract: Flannery O’Connor’s literary career often focused on Christian religion in the post-war United States. Not only did she seek to convert her audience to Catholicism, but she also frequently critiqued the growing post-war religious awakenings associated with various Protestant denominations. Such critiques are evident in her novel Wise Blood and can be connected to other critical concerns of mass culture among literary figures like Dwight Macdonald. In this paper, I seek to connect Dwight Macdonald’s conception of masscult and midcult to Flannery O’Connor’s criticism of post-war religion in the United States.
Marshallese Women and Oral Traditions: Navigating a Future for Pacific History
Authors: LaBriola Monica C
Published: April 2024

Abstract: First published just over three decades ago, Teresia Teaiwa's "Microwomen: US Colonialism and Micronesian Women Activists" calls attention to the absence of Micronesian women in academic histories. The paper came out of a Pacific History Association conference panel aimed at amplifying the voices of women in histories of Micronesia, which, Teaiwa argued, remained "deafeningly silent on women" (1992, 126). While progress has been made in the thirty years since, Micronesian women remain underrepresented in academic histories. Using Marshallese oral traditions as a guide, this article argues that re-centering women in histories of Micronesia remains essential to the decolonization of Pacific Islands history, not only for the sake of representation but also as a necessary step in the ongoing development of historical methods more reflective of Indigenous historicities.
"It Will Be Like a Town Here, Things Are Really Coming Up!": Inequality in Village-Based Cruise Ship Tourism in the Trobriand Islands
Authors: MacCarthy Michelle
Published: April 2024

Abstract: Cruise ship tourism is a major player in the international tourism industry. This article examines the sociocultural ramifications of large-scale cruise ship tourism in the context of the Trobriand Islands, where unequal access to both the benefits and problematic aspects of this kind of tourism have implications for the reciprocal relations that are embedded in Trobriand society. It considers the "wicked problems" inherent in the discourses and practice of tourism as development, addressing the paradoxes and complexities that arise, especially where inequalities (between Trobriand Islanders and visitors and among Trobrianders from across the archipelago) are most apparent and difficult to resolve.
The Only Child
Authors: Doyle Emily
Published: April 2024

Abstract: Ploughshares Spring 2024 The Spring 2024 Issue. Ploughshares is an award-winning journal of new writing. Since 1971, Ploughshares has discovered and cultivated the freshest voices in contemporary American literature, and now provides readers with thoughtful and entertaining literature in a variety of formats. Find out why the New York Times named Ploughshares "the Triton among minnows." The Spring 2024 Issue, guest-edited by Laila Lalami, features poetry and prose by Mosab Abu Toha, Nathalie Handal, January Gill O'Neil, Farah Abdessamad, Francisco Goldman, Tommy Orange, and more.
Nocturnal
Authors: Schulten Emily
Published: April 2024

Abstract: Ploughshares Spring 2024 The Spring 2024 Issue. Ploughshares is an award-winning journal of new writing. Since 1971, Ploughshares has discovered and cultivated the freshest voices in contemporary American literature, and now provides readers with thoughtful and entertaining literature in a variety of formats. Find out why the New York Times named Ploughshares "the Triton among minnows." The Spring 2024 Issue, guest-edited by Laila Lalami, features poetry and prose by Mosab Abu Toha, Nathalie Handal, January Gill O'Neil, Farah Abdessamad, Francisco Goldman, Tommy Orange, and more.
Speaker Phone: Our Father, the Great Plains
Authors: Shapiro Rob
Published: April 2024

Abstract: Ploughshares Spring 2024 The Spring 2024 Issue. Ploughshares is an award-winning journal of new writing. Since 1971, Ploughshares has discovered and cultivated the freshest voices in contemporary American literature, and now provides readers with thoughtful and entertaining literature in a variety of formats. Find out why the New York Times named Ploughshares "the Triton among minnows." The Spring 2024 Issue, guest-edited by Laila Lalami, features poetry and prose by Mosab Abu Toha, Nathalie Handal, January Gill O'Neil, Farah Abdessamad, Francisco Goldman, Tommy Orange, and more.
Scalable narrow linewidth high power laser for barium ion optical qubits
Authors: Ahmadi Morteza , Dutta Tarun , Mukherjee Manas
Published: April 2024

The linewidth of a laser plays a pivotal role in ensuring the high fidelity of ion trap quantum processors and optical clocks. As quantum computing endeavors scale up in qubit number, the demand for higher laser power with ultra-narrow linewidth becomes imperative, and leveraging fiber amplifiers emerges as a promising approach to meet these requirements. This study explores the effectiveness of thulium-doped fiber amplifiers (TDFAs) as a viable solution for addressing optical qubit transitions in trapped barium ion qubits. We demonstrate that by performing high-fidelity gates on the qubit while introducing minimal intensity noise, TDFAs do not significantly broaden the linewidth of the seed lasers. We employed a Voigt fitting scheme in conjunction with a delayed self-heterodyne method to accurately measure the linewidth independently, corroborating our findings through quadrupole spectroscopy with trapped barium ions. Our results show linewidth values of 160 ± 15 Hz and 156 ± 16 Hz, respectively, using these two methods, underscoring the reliability of our measurement techniques. The slight variation within the error-bars of the two methods can be attributed to factors such as amplified spontaneous emission in the TDFA or the influence of 1/f noise within the heterodyne setup delay line. These contribute to advancing our understanding of laser linewidth control in the context of ion trap quantum computing as well as stretching the availability of narrow linewidth, high-power tunable lasers beyond the C-band.
How robust are estimates of key parameters in standard viral dynamic models?
Authors: Zitzmann Carolin , Ke Ruian , Ribeiro Ruy M. , Perelson Alan S.
Published: April 2024

Mathematical models of viral infection have been developed, fitted to data, and provide insight into disease pathogenesis for multiple agents that cause chronic infection, including HIV, hepatitis C, and B virus. However, for agents that cause acute infections or during the acute stage of agents that cause chronic infections, viral load data are often collected after symptoms develop, usually around or after the peak viral load. Consequently, we frequently lack data in the initial phase of viral growth, i.e., when pre-symptomatic transmission events occur. Missing data may make estimating the time of infection, the infectious period, and parameters in viral dynamic models, such as the cell infection rate, difficult. However, having extra information, such as the average time to peak viral load, may improve the robustness of the estimation. Here, we evaluated the robustness of estimates of key model parameters when viral load data prior to the viral load peak is missing, when we know the values of some parameters and/or the time from infection to peak viral load. Although estimates of the time of infection are sensitive to the quality and amount of available data, particularly pre-peak, other parameters important in understanding disease pathogenesis, such as the loss rate of infected cells, are less sensitive. Viral infectivity and the viral production rate are key parameters affecting the robustness of data fits. Fixing their values to literature values can help estimate the remaining model parameters when pre-peak data is missing or limited. We find a lack of data in the pre-peak growth phase underestimates the time to peak viral load by several days, leading to a shorter predicted growth phase. On the other hand, knowing the time of infection (e.g., from epidemiological data) and fixing it results in good estimates of dynamical parameters even in the absence of early data. While we provide ways to approximate model parameters in the absence of early viral load data, our results also suggest that these data, when available, are needed to estimate model parameters more precisely.