bluuebunny/crossref_metadata_2025 huggingface dataset:
Scoping Review of frequently highlighted attributes of Medical Professionalism in an Undergraduate Medical Education Context
Authors: Sattar Kamran , Yusoff Muhamad Saiful Bahri , Arifin Wan Nor , Yasin Mohd Azhar Mohd , Mat Nor Mohd Zarawi
Published: April 2021

Background and Objectives: Medical Professionalism (MP) establishes the trust between society and doctors. We aimed at finding frequently highlighted qualities of MP in the literature.

Methods: We searched PubMed and Scopus for attributes of MP, using terms, “Professionalism,” “Medical Students,” and “Undergraduate Medical Education”. We included English language, original research articles with MP attributes from the perspective of undergraduate medical education, any nationality, race, gender, and age range, as the central topic of the article. Papers published from January 1st 1986 to 29th February 2020 were included.

Results: From 1349 identified articles, finally, 18 were included, authored in 10 countries, collectively contributing to answering the scoping review question. Two themes were identified: (1) Nurturing of MP, 11 (61.11%) out of 18 included articles, highlighted “respect” as the most dominant attribute as it appeared in 6 (54.55%) out of 11 reviews, “communication” 5 (45.45 %) studies and “honesty” and “integrity” 4 (36.36%). (2) Assessment of MP, 7 (38.89%) studies, and majority, 4 (57.14 %) assessed MP using American Board of Internal Medicine’s elements of MP, viz, “altruism, accountability, excellence, duty, honor and integrity, respect for others.”

Conclusions: Themes exemplified MP’s most discoursed issues. The attributes are frequently used worldwide. MP deliberates as a commitment toward the individual patient, society, and necessitates transforming from its present generic form to more explicit details.

doi: https://doi.org/10.12669/pjms.37.4.4004

How to cite this:Sattar K, Yusoff MSB, Arifin WN, Yasin MAM, Nor MZM. Scoping Review of frequently highlighted attributes of Medical Professionalism in an Undergraduate Medical Education Context. Pak J Med Sci. 2021;37(4):1221-1229. doi: https://doi.org/10.12669/pjms.37.4.4004

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.
Observation on the Clinical Effect of Apatinib Combined with Chemotherapy in the Treatment of Advanced Non-Small Cell Lung Cancer
Authors: Cui Yu-jie , Liu Jia , Liu Miao-miao , Zhang Hong-zhen
Published: April 2021

Objectives: To evaluate the clinical effect of apatinib combined with chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC).

Methods: Eighty patients with advanced NSCLC treated in Hebei General Hospital from January 2017 to July 2020 were randomly divided into two groups: the experimental group and the control group, each with 40 cases. Patients in the control group were treated with conventional paclitaxel combined with cisplatin chemotherapy, while patients in the experimental group were treated with apatinib mesylate tablets based on the treatment of the control group. After treatment, tumor efficacy evaluation was conducted on all patients every two cycles, and the therapeutic effect, adverse drug reactions, improvement of quality-of-life scores prior to and after treatment, and changes of indicators such as tumor markers carcinoembryonic antigen (CEA) and carbohydrate antigen 153(CA153) were compared and analyzed between the two groups. 

Results: The total effective rate of the experimental group was 67.5%, which was significantly better than the 45% of the control group (p=0.04); The incidence of adverse drug reactions in the experimental group was 25%, while that in the control group was 37.5%, with no significant difference (p=0.23); Moreover, the improvement rate of quality of life scores in the experimental group was significantly higher than that in the control group (p=0.03), and the levels of CEA and CA153 in the experimental group were significantly lower after treatment than those in the control group, with a statistically significant difference (p=0.01).

Conclusion: Apatinib combined with conventional chemotherapy is effective in the treatment of advanced non-small cell lung cancer, the quality of life can be significantly improved, tumor markers can be significantly reduced, and adverse reactions will not be significantly increased.

doi: https://doi.org/10.12669/pjms.37.4.4066

How to cite this:Cui Y, Liu J, Liu M, Zhang H. Observation on the Clinical Effect of Apatinib Combined with Chemotherapy in the Treatment of Advanced Non-Small Cell Lung Cancer. Pak J Med Sci. 2021;37(4):1036-1041.   doi: https://doi.org/10.12669/pjms.37.4.4066

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.
Prevalence and associated risk factors among patients with overactive bladder syndrome in Pakistan
Authors: Rashid Sajid , Babur Muhammad Naveed , Khan Rehan Ramzan , Khalid Muhammad Usman , Mansha Haroon , Riaz Saima
Published: April 2021

Objectives: To determine the Prevalence and associated risk factors among patients with overactive bladder syndrome in Pakistan.

Methods: This was a community-based, face to face, cross sectional survey to calculate the prevalence and its associated risk factors. A sample of 1058 patients, women and men aged between 35 to 60 years having symptoms of overactive bladder was selected through convenience sampling from different cities of Pakistan during September to December 2020. Data was collected by using an Overactive Bladder Scoring System (OABSS) tool for prevalence and a developed questionnaire to rule out the risk factors.

Results: The prevalence was 27.4% (n=289) and it increased with age. The average ages for women and men were 44.60±7.88 and 46.14±7.69 years respectively. The OAB prevalence was the lowest among the participants aged 35-43 years 15.2% (n=55) while it was highest among those who were aged 53-60 years 49.6%, (n=127). The age, body mass index, diabetes mellitus, income, family history, parity and urinary tract infection were found to be significant associated risk factors for overactive bladder with p value <0.05.

Conclusion: The overall prevalence of overactive bladder was 27.4% and it does not differ by gender, hypertension, pelvic surgery, smoking, constipation and sleep while it has significant association with age, body mass index, diabetes mellitus, income, parity and urinary tract infections.

doi: https://doi.org/10.12669/pjms.37.4.4262

How to cite this:Rashid S, Babur MN, Khan RR, Khalid MU, Mansha H, Riaz S. Prevalence and associated risk factors among patients with overactive bladder syndrome in Pakistan. Pak J Med Sci. 2021;37(4):1185-1189. doi: https://doi.org/10.12669/pjms.37.4.4262

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.
Glycemic index and Glycemic load values
Authors: Ahmed Jameel , Riaz Musarrat , Imtiaz Rabia
Published: April 2021

doi: https://doi.org/10.12669/pjms.37.4.4555

How to cite this:Ahmed J, Riaz M, Imtiaz R. Glycemic index and Glycemic load values. Pak J Med Sci. 2021;37(4):1246-1247.doi: https://doi.org/10.12669/pjms.37.4.4555

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.
Development of a semi-empirical calibration method by using a LaBr3(Ce) scintillation detector for NORM samples analyses
Authors: Ntalla E. , Markopoulos A. , Karfopoulos K. , Potiriadis C. , Clouvas A. , Savidou A.
Published: April 2021

In this study, a semi-empirical calibration method for NORM samples measurement by using a LaBr3(Ce) scintillator was developed based on a combination of experimental gamma spectrometry measurements and MCNP-X simulations. The aim of this work is to provide us with full energy peak efficiency calibration curves in a wide photon energy range which is of particular importance when selected photon energies of 234Th, 214Pb, 214Bi, 228Ac, 208Tl and 226Ra are to be measured with accuracy.
Radiological Characterization of Contaminated Pipes of Different Dimensions and Densities
Authors: Mavrikis D. , Markopoulos A. , Ioannidou A. , Savidou A.
Published: April 2021

The present work concerns a preliminary study for development of a technique for radiological characterization and segregation of raw historical radioactive waste in different management routes. The efficiency of a 3x3 NaI (Tl) detector for a contaminated cylindrical pipe - detector configuration was evaluated by Monte Carlo simulations performed by using the MCNP code. The efficiency for detector source configuration as well as the measurement bias due to possible inhomogeneity in the distribution of the activity were examined for cylindrical pipes of different densities and dimensions. Cylinders of three different densities made by Pb, Fe, Al were examined. All studied cylinders keep the same ratio between length, diameter and thickness, although the absolute values are different, in order to study the difference in efficiencies of similar geometric objects
Hereditary myelopathies in dogs
Authors: Baka RD , POLIZOPOULOU ZS
Published: April 2021

The purpose of the current review is to summarize data regarding hereditary myelopathies in dogs. Canine degenerative myelopathy (DM) is a progressive disease prevalent in senior (≥8 years old), large breed-dogs, predominating in German shepherd dog. Neurolocalization indicates a thoracolumbar, upper motor neuron, lesion; it can progress to the thoracic limbs and later to lower motor neurons of all limbs resembling human amyotrophic lateral sclerosis (ALS). Tentative diagnosis is based on ruling out other progressive myelopathies. Clinical similarities between ALS and DM made superoxide dismutase 1 gene (SOD1) a viable candidate gene as an etiopathogenic factor. Α E40K missense mutation of the SOD1 has been linked to DM. A genetic test for DM exists, which will aid breeding programs to eliminate the disease. Exercise and physiotherapy are important to slow the progression of DM. Long-term prognosis is poor as dogs become non-ambulatory within 4-6 months from the time of diagnosis. Dystrophic myelopathies include Afgan hound myelopathy/hereditary necrotizing myelopathy in Kooikerhondje dogs, leukoencephalomyelopathy and neuroaxonal dystrophy in Rottweilers and spongiform leukoencephalomyelopathy. A similar myelopathy is Jack Russell and Fox terrier hereditary ataxia. Their etiology is suspected to be hereditary and they appear at a young age. They are diagnosed solely postmortem with histopathological examination. There is no etiologic treatment and the prognosis is poor except for Rottweiler neuroaxonal dystrophy and Jack Russel ataxia due to the extremely slow progression of symptoms. Syringomyelia is characterized by the formation of fluid filled cavities within the spinal cord and outside the central canal that may communicate with the central canal and it is caused mainly due to Chari-like malformation (CLM). The most important clinical sign is neuropathic pain and is localized in the cervical region of the spinal cord. Progression of the disease varies, there are severe disabilities due to pain or it can be an incidental finding. CT and MRI are the preferable ways to detect the lesions. For CLM, therapy includes surgical and medical management. Drugs can be divided into analgesics (non-steroidal anti-inflammatory, gabapentin, pregabalin, tramadol), drugs reducing cerebrospinal fluid (CSF) production (omeprazole, acetazolamide, furosemide) and corticosteroids. Medical therapy diminishes the severity of clinical signs but never succeeds full resolution.
A clinical survey on the electrocardiogram after intravenous granisetron hydrochloride administration in clinically normal dogs
Authors: GHAEMI H , SALARI SEDIGH H , SELK GHAFFARI M
Published: April 2021

Cardiac side effect of 5-hydroxytryptamine-3 receptor antagonists has been a concern for clinicians. There is a substantial need for greater clarity about the safety of granisetron hydrochloride, an antiemetic agent of this class used in oncological and parvoviral gastroenteritis with acute vomiting in dogs. This study aimed to assess the electrocardiographic effects of a single dose of intravenous granisetron. We randomly assigned 16 adult crossbreed female healthy dogs into two groups of intervention and control and injected them intravenously with granisetron and normal saline, respectively, at a dose of 0.5 ml/kg over one minute. Standard electrocardiography (ECG) was recorded at the baseline, as well as 5, 15, 30, 60, 120, 360, and 720 minutes after the intervention. Heart rate and ECG parameters (PR intervals, QRS duration, ST-segment, T-wave amplitudes, QT, JT, QTc and JTc intervals) were evaluated in lead II.No significant difference was observed between the intervention and the control groups in any of the measured variables at any of the time-points. Mean values of measured parameters showed no significant difference compared with baseline values in the control group, while the granisetron group saw statistically significant but clinically asymptomatic changes in heart rate, PR, QRS, QT, JT, and QTc at different time-points, compared to the baseline values (P<0.05). In conclusion, Granisetron administration was not associated with clinically significant adverse effects on ECG variables or heart rate. Thus, it can be regarded as a relatively safe drug.
The whole issue
Authors: Εταιρεία Ελληνική Κτηνιατρική
Published: April 2021

NO ABSTRACT AVAILABLE
Revisiting early-stage COVID-19 strategy options
Authors: Machanick Philip
Published: April 2021

Background: Early-stage interventions in a potential pandemic are important to understand as they can make the difference between runaway exponential growth that is hard to turn back and stopping the spread before it gets that far. COVID19 is an interesting case study because there have been very different outcomes in different localities. These variations are best studied after the fact if precision is the goal; while a pandemic is still unfolding less precise analysis is of value in attempting to guide localities to learn lessons of those that preceded them.

Methods: I examine two factors that could differentiate strategy: asymptomatic spread and the risks of basing strategy on untested claims, such as potential protective value of the Bacillus Calmette-Guerin (BCG) tuberculosis vaccine.

Results: Differences in disease progression as well as the possibility of alternative strategies to prevent COVID-19 from entering the runaway phase or damping it down later can be elucidated by a study of asymptomatic infection. An early study to demonstrate not only what fraction are asymptomatic but how contagious they are would have informed policy on nonpharmaceutical interventions but could still be of value to understand containment during vaccine roll out.

Conclusions: When a COVID-19 outbreak is at a level that makes accurate trace-and test possible, investigation of asymptomatic transmission is viable and should be attempted to enhance understanding of spread and variability in the disease as well as policy options for slowing the spread. Understanding mild cases could shed light on the disease in the longer term, including whether vaccines prevent contagiousness.
Atypical odontalgia and trigeminal neuralgia: psychological, behavioural and psychopharmacologic approach – an overview of the pathologies related to the challenging differential diagnosis in orofacial pain
Authors: Tizzoni Riccardo , Tizzoni Marta , Clerici Carlo Alfredo
Published: April 2021

Orofacial pain represents a challenge for dentists, especially if with a non-odontogenic basis. Orofacial neuropathic pain is chronic, arduous to localize and develops without obvious pathology. Comorbid psychiatric disorders, such as anxiety and depression, coexist and negatively affect the condition. This article presents one case of atypical odontalgia and one of trigeminal neuralgia treated with psychological and psychopharmacologic tailored and adapted therapies, after conventional medications had failed. 

In addition, an overview of the pathologies related to the challenging differential diagnosis in orofacial pain is given, since current data are insufficient.  

A 68-year-old male complained of chronic throbbing, burning pain in a maxillary tooth, worsening upon digital pressure. Symptoms did not abate after conventional amitriptyline therapy; psychological intervention and antianxiety drug were supplemented and antidepressant agent dosage incremented; the patient revealed improvement and satisfaction with the multidisciplinary approach to his pathology. A 72-year-old male lamented chronic stabbing, intermittent, sharp, shooting and electric shock-like pain in an upper tooth, radiating and following the distribution of the trigeminal nerve. Pain did not recur after psychological intervention and a prescription of antidepressant and antianxiety agents, while conventional carbamazepine therapy had not been sufficient to control pain. Due to concern with comorbid psychiatric disorders, we adopted a patient-centered, tailored and balanced therapy, favourably changing the clinical outcome. 

Comorbid psychiatric disorders have a negative impact on orofacial pain and dentists should consider adopting tailored therapies, such as psychological counselling and behavioural and psychopharmacologic strategies, besides conventional treatments. They also need to be familiar with the signs and symptoms of orofacial pain, recollecting a comprehensive view of the pathologies concerning the differential diagnosis. A prompt diagnosis prevents pain chronicity, avoiding an increase in complexity and a shift to orofacial neuropathic pain and legal claims.
Cost-effectiveness of patient navigation for lung cancer – a systematic review
Authors: Kass Benjamin , Dornquast Christina , Rieckmann Nina , Goerling Ute , Holmberg Christine , Reinhold Thomas
Published: April 2021

Background: Patient navigation (PN) programs have been shown to increase patient satisfaction and quality of life among patients with lung cancer and to decrease time to treatment. However, the general cost-effectiveness of such programs in the context of lung cancer remains unknown. Hence, the aim of the present systematic review was to analyze the scientific literature and quantitatively assess the level of evidence on the cost-effectiveness of PN programs for patients diagnosed with lung cancer. 

Methods: A systematic literature search was carried out in PubMed, EMBASE, CENTRAL, CINAHL and PsycINFO databases without time limitations. Randomized controlled trials written in English or German were eligible for inclusion if any results regarding the cost-effectiveness of personally delivered PN programs for patients after lung cancer diagnosis were reported. A manual search was carried out to supplement the systematic search. Additionally, the authors of ongoing or unpublished relevant research were contacted. The titles, abstracts and full texts of relevant citations were screened independently by two reviewers.  

Results: The initial search yielded 814 articles, including four papers identified manually. Twenty-one articles were included in the full text screening. However, no study met the inclusion criteria. Contacting the authors of ongoing or unpublished research and cross-cancer studies did not yield any studies that met the inclusion criteria.  

Conclusion: Since no study met the inclusion criteria, this study reveals a research gap in this area. Furthermore, no conclusive statement regarding the cost-effectiveness of patient navigation programs for patients diagnosed with lung cancer can be made. Since the implementation of new healthcare models such as PN at least partially depends on their cost-effectiveness, future attempts to evaluate PN programs for lung cancer patients should consider examining outcomes related to cost-effectiveness to overcome the identified research gap.
Signalling and putative therapeutic molecules on the regulation of synoviocyte signalling in rheumatoid arthritis
Authors: Ji Minjeong , Ryu Hee Jung , Hong Jeong Hee
Published: April 2021

Rheumatoid arthritis (RA) is an autoimmune disease characterized by symmetrical and chronic polyarthritis. Fibroblast-like synoviocytes are mainly involved in joint inflammation and cartilage and bone destruction by inflammatory cytokines and matrix-degrading enzymes in RA. Approaches that induce various cellular growth alterations of synoviocytes are considered as potential strategies for treating RA. However, since synoviocytes play a critical role in RA, the mechanism and hyperplastic modulation of synoviocytes and their motility need to be addressed. In this review, we focus on the alteration of synoviocyte signalling and cell fate provided by signalling proteins, various antioxidant molecules, enzymes, compounds, clinical candidates, to understand the pathology of the synoviocytes, and finally to achieve developed therapeutic strategies of RA.

Cite this article: Bone Joint Res 2021;10(4):285–297.
A framework to support the design and cultivation of embedded research initiatives
Authors: Ward Vicky , Tooman Tricia , Reid Benet , Davies Huw , O’ Brien Breid , Mear Liz , Marshall Martin
Published: April 2021

Background:

Embedded research involves co-locating researchers within non-academic organisations to better link research and practice. Embedded research initiatives are often complex and emergent with a range of underlying intents, structures and processes. This can create tensions within initiatives and contributes to ongoing uncertainty about the most suitable designs and the effectiveness of different approaches.

Aims and objectives:

We aimed to devise a practical framework to support those designing and cultivating embedded research by operationalising findings from an extensive study of existing initiatives.

Key conclusions:

The underpinning research on embedded initiatives – a literature review and scoping exercise of initiatives in health settings across the UK – showed that such initiatives share ten common sets of concerns in relation to their intent, structure and processes. We used these insights during a co-production workshop with embedded researchers and their managers that made use of a range of creative activities.

The workshop resulted in a practical framework (and associated web-based tools) that draw on the metaphor of a garden to represent the growing, emergent nature of embedded research initiatives and the active work which individuals and organisations need to put into planning and maintaining such initiatives. Each of the aspects is represented as a separate area within the garden using relevant visual metaphors. Building on this, we also present a series of reflective questions designed to facilitate discussion and debate about design features, and we link these to the wider literature, thereby helping those involved to articulate and discuss their preferences and expectations.
252. Trabalho precário, espaço precário: as plataformas digitais de transporte e os circuitos da economia urbana no Brasil
Authors: Tozi Fábio , Ribeiro Duarte Leandro , Rocha Castanheira Gabriel
Published: April 2021

O artigo analisa o fenômeno da expansão das plataformas digitais de transporte privado por aplicativo no Brasil, particularmente a partir do pioneirismo da Uber. Inicialmente, debate-se a uberização como resultado dos novos nexos históricos entre informação, espaço e trabalho. Em um segundo momento, recupera-se a teoria dos dois circuitos da economia urbana, desenvolvida por Milton Santos (1975) para compreender a ação local das plataformas digitais, com destaque para a pesquisa empírica conduzida em Belo Horizonte (MG). Finalmente, procura-se destacar o papel ativo do espaço nas estratégias das plataformas digitais de transporte, e argumenta-se que elas são dependentes das infraestruturas e usos do território historicamente constituídos. O texto propõe colaborar para o debate acerca da precarização do trabalho nestas plataformas digitais a partir da análise dos espaços precários nos quais ele se realiza.
Mediterranean transformations: From the security of mercantilist trading empires to a modern security regime.
Authors: Zwierlein Cornel
Published: April 2021

A l’edat moderna, les relacions dels estats europeus amb l’Imperi otomà i el món mediterrani es caracteritzaven per una complexa xarxa de consolats que gaudien de privilegis atorgats mitjançant capitulacions pel sultà o els deys i beys nord-africans. La qüestió de la «seguretat» era sobretot entesa com a tranquil·litat en la pràctica lliure dels negocis i del comerç. La transformació d’aquesta situació entre finals del segle XVIII i fins aproximadament 1840 es caracteritza per una complexa superposició de continuïtat i ruptura entre les realitats de l’època moderna i les de la contemporània: la infraestructura del sistema consular va persistir durant molt de temps, mentre que la invasió d’Egipte (1797), les guerres napoleòniques, la guerra d’independència grega (iniciada el 1822) i la invasió d’Algèria (1830) van canviar profundament la regió. «Seguretat», de la manera que la van concebre polítics liberals com Chateaubriand, Benjamin Constant i Jeremy Bentham, es va convertir en un terme central per ordenar les noves realitats emergents en termes de política nacional i internacional. Al mateix temps, mentre la invasió de Grècia pels aliats europeus podria ser concebuda com la primera intervenció humanitària moderna, un tipus d’intervenció militar semblant a Algèria es concep com el primer acte modern de colonització amb ús de forces militars per part de França. Aquesta dialèctica entre les dues cares de l’intervencionisme sota diferents etiquetes com a excepció en les regles del sistema de relacions internacionals posteriors al Congrés de Viena produïa noves concepcions sobre la seguretat dins i fora del Mediterrani.
Mediterranean horse cultures: Greek, Roman and Arabic equine texts in late medieval and early modern Andalusia.
Authors: Renton Kathryn
Published: April 2021

En les històries de la península ibèrica de l’edat mitjana i moderna les diferències entre la cavalleria islàmica i cristiana s’han convertit en una manera d’il·lustrar diferents formes d’organització social i significats culturals vinculats amb la relació entre cavall i genet. És a dir, les pràctiques de la cavalleria —com a conjunt d’estils, tècniques i funcions— també impliquen connotacions regionals, religioses i ètniques, i en efecte han acabat transformant el significat (la tradició eqüestre) en el significant (un element de distinció de territoris i identitats). Tanmateix, la frontera religiosa de la pràctica de la cavalleria musulmana ibèrica es mostra molt subtilment analitzada a la llum de la circulació recurrent d’equins, experts eqüestres i textos relacionats amb equins en un context circummediterrani. Replantejar les cultures del cavall ibèriques dins del marc de connectivitats mediterrànies més extenses posa en evidència un corpus comú de coneixements sobre el cavall, sovint constret de manera excessiva per denominacions regionals, imperials o etnicoreligioses i destaca els aspectes multifuncionals de cavalls, genets i textos sobre aquests animals. En centrarse en les pràctiques particulars que constitueixen les tradicions de la cavalleria, en lloc que en les identitats culturals que impliquen les seves etiquetes, el coneixement de les cultures mediterrànies del cavall pot ajudar els historiadors a entendre més a fons la diplomàcia i l’estratègia militar en el context de les fronteres cristianomusulmanes.
Bonds of sweetness: A political and intellectual history of citrus circulations across the Western Mediterranean during the Late Renaissance.
Authors: Montcher Fabien
Published: April 2021

El present article analitza com les converses polítiques i intel·lectuals sobre els intercanvis de fruita van afectar les relacions entre poder i coneixement a la Mediterrània occidental durant el Renaixement tardà. S’hi argumenta que les xarxes d’erudits van promoure el desenvolupament de la diplomàcia informal a través de l’ús del significat paradoxal dels cítrics nouvinguts per via de les monarquies ibèriques, i que aquesta comunicació política va estar articulada al voltant de conceptes com la tolerància i la dolçor. Així mateix, es demostra que a Espanya, Portugal i Roma les pràctiques polítiques i els discursos sobre cítrics van alimentar les lluites pel control de la cristiandat en un període que va estar marcat per contínues guerres i debats sobre l’estatus de les minories religioses.
Investigation of the pulse energy limits of actively Q-switched polarization-maintaining Tm3+-doped fiber lasers
Authors: Schneider Julian , Forster Patrick , Romano Clément , Eichhorn Marc , Kieleck Christelle
Published: April 2021

A diode-pumped actively Q-switched polarization-maintaining Tm3+-doped fiber laser is reported generating pulse energies of 630 μJ, minimum pulse widths of 42 ns, and a maximum peak power of 13.9 kW with linear polarized output and diffraction-limited beam quality at a wavelength of 2044 nm. The unpolarized fiber laser even reaches pulse energies of 800 μJ, pulse widths of 41 ns, and peak powers of 18.6 kW.
Spatiotemporal distribution of cutaneous leishmaniasis in Sri Lanka and future case burden estimates
Authors: Karunaweera Nadira D. , Senanayake Sanath , Ginige Samitha , Silva Hermali , Manamperi Nuwani , Samaranayake Nilakshi , Dewasurendra Rajika , Karunanayake Panduka , Gamage Deepa , de Silva Nissanka , Senarath Upul , Zhou Guofa
Published: April 2021

Background

Leishmaniasis is a neglected tropical vector-borne disease, which is on the rise in Sri Lanka. Spatiotemporal and risk factor analyses are useful for understanding transmission dynamics, spatial clustering and predicting future disease distribution and trends to facilitate effective infection control.

Methods

The nationwide clinically confirmed cutaneous leishmaniasis and climatic data were collected from 2001 to 2019. Hierarchical clustering and spatiotemporal cross-correlation analysis were used to measure the region-wide and local (between neighboring districts) synchrony of transmission. A mixed spatiotemporal regression-autoregression model was built to study the effects of climatic, neighboring-district dispersal, and infection carryover variables on leishmaniasis dynamics and spatial distribution. Same model without climatic variables was used to predict the future distribution and trends of leishmaniasis cases in Sri Lanka.

Results

A total of 19,361 clinically confirmed leishmaniasis cases have been reported in Sri Lanka from 2001–2019. There were three phases identified: low-transmission phase (2001–2010), parasite population buildup phase (2011–2017), and outbreak phase (2018–2019). Spatially, the districts were divided into three groups based on similarity in temporal dynamics. The global mean correlation among district incidence dynamics was 0.30 (95% CI 0.25–0.35), and the localized mean correlation between neighboring districts was 0.58 (95% CI 0.42–0.73). Risk analysis for the seven districts with the highest incidence rates indicated that precipitation, neighboring-district effect, and infection carryover effect exhibited significant correlation with district-level incidence dynamics. Model-predicted incidence dynamics and case distribution matched well with observed results, except for the outbreak in 2018. The model-predicted 2020 case number is about 5,400 cases, with intensified transmission and expansion of high-transmission area. The predicted case number will be 9115 in 2022 and 19212 in 2025.

Conclusions

The drastic upsurge in leishmaniasis cases in Sri Lanka in the last few year was unprecedented and it was strongly linked to precipitation, high burden of localized infections and inter-district dispersal. Targeted interventions are urgently needed to arrest an uncontrollable disease spread.
Reporting in clinical studies on platelet-rich plasma therapy among all medical specialties: A systematic review of Level I and II studies
Authors: Nazaroff Jaron , Oyadomari Sarah , Brown Nolan , Wang Dean
Published: April 2021

Background

The clinical practice of platelet-rich plasma (PRP) therapy has grown significantly in recent years in multiple medical specialties. However, comparisons of PRP studies across medical fields remain challenging because of inconsistent reporting of protocols and characterization of the PRP being administered. The purpose of this systematic review was to determine the quantity of level I/II studies within each medical specialty and compare the level of study reporting across medical fields.

Methods

The Cochrane Database, PubMed, and EMBASE databases were queried for level I/II clinical studies on PRP injections across all medical specialties. From these studies, data including condition treated, PRP processing and characterization, delivery, control group, and assessed outcomes were collected.

Results

A total of 132 studies met the inclusion and exclusion criteria and involved 28 different conditions across 8 specialties (cardiothoracic surgery, cosmetic, dermatology, musculoskeletal (MSK), neurology, oral maxillofacial surgery, ophthalmology, and plastic surgery). Studies on PRP for MSK injuries made up the majority of the studies (74%), with knee osteoarthritis and tendinopathy being most commonly studied. Of the 132 studies, only 44 (33%) characterized the composition of PRP used, and only 23 (17%) reported the leukocyte component. MSK studies were more likely to use patient-reported outcome measures to assess outcomes, while studies from other specialties were more likely to use clinician- or imaging-based objective outcomes. Overall, 61% of the studies found PRP to be favorable over control treatment, with no difference in favorable reporting between MSK and other medical specialties.

Conclusions

The majority of level I/II clinical studies investigating PRP therapy across all medical specialties have been conducted for MSK injuries with knee osteoarthritis and tendinopathy being the most commonly studied conditions. Inconsistent reporting of PRP composition exists among all studies in medicine. Rigorous reporting in human clinical studies across all medical specialties is crucial for evaluating the effects of PRP and moving towards disease-specific and individualized treatment.
Measuring entrepreneurship in adolescents at school: New psychometric evidence on the BEPE-A
Authors: Ortuño-Sierra Javier , Gargallo Ibort Esther , Ciarreta López Ana , Dalmau Torres Josep María
Published: April 2021

The economic situation worldwide demands individuals with entrepreneurial skills and aptitudes. The adolescence stage is a critical period in which these abilities could be developed and the school is a relevant setting for this purpose. To this end, instruments that allow assessing enterprising abilities are needed. Nonetheless, there remains a lack of instruments with adequate evidence of validity. The purpose of this study was, thus, to analyze the psychometric properties of the Battery for the Assessment of the Enterprising Personality-Adaptive (BEPE-A). The sample included a total of 1105 participants (men = 528; 47.4%) with an age range from 12 to 19 years (M =15.23 years;SD= 4.40). The BEPE-A and the Entrepreneurial Attitudes Scale for Students (EASS) were used in the study. The EFA, conducted in a subsample of 512 participants, revealed that each of the subscales of the BEPE-A were basically unidimensional. The CFA, conducted in a second subsample of 593 participants, showed that a bifactor model best fit the BEPE-A structure. In addition, measurement invariance was found both by gender and age. The BEPE-A was positively associated with other measures of entrepreneurship. Results found in the study contribute valuable information about new evidences of a battery that allows screening for entrepreneurship in a critical developmental period such as adolescence, and in a relevant setting like school.
Impact of postural variation on hand measurements: Three-dimensional anatomical analysis
Authors: Kwan Mei-ying , Yick Kit-lun , Chow Lung , Yu Annie , Ng Sun-pui , Yip Joanne
Published: April 2021

In this article, the impact of postural variations on hand anthropometry and distribution of skin strain ratios has been investigated. The literature suggests the glove fit directly affects hand functions. However, gloves currently manufactured based on a static posture failed to provide optimum fit. Workers often do not wear protective gloves due to discomfort caused by improper design, which increases the risk of hand injury. Full-color three-dimensional scans of the hands are captured with thirty healthy subjects (20 females, 10 males) to analyze the hand measurements and skin deformation with various postures. 42 of the 57 hand dimensions were found to have significant differences (p >0.05) related to hand posture. The skin strain ratios further suggest that the slant of the web space, dorsal-length and surface area should be increased, while the angles of the web space and length of the palm reduced to advance glove patterns. This research contributes to constructing gloves with optimum fit, performance, and comfort. Results show that in consideration of hand postures, the angle of the slant of web space between digits 2 and 5 and the finger length on the dorsal side should be increased, whilst the finger length on the palm side should be reduced in glove pattern design. Gloves currently constructed based on a splayed posture cannot provide a good fit. Consideration should be given to hand measurements in dynamic postures.
Study on the mechanical response of anticlastic cold bending insulating glass and its coupling effect with uniform load
Authors: Zhang Xide , Liang Jinzhi , Huang Dong
Published: April 2021

Cold bending is a characteristic of significance for the beautiful curved glass curtain walls, because it affects them in terms of energy-efficiency and cost-efficiency. The increasing engineering projects call for more special studies on the mechanical properties of cold-bent glass panels, especially when the walls are built by insulating glass that is currently widely used while its relevant research is very scarce. This paper is devoted to studying the mechanical properties of anticlastic cold-bent insulating glass while taking different factors into consideration, including glass thickness, cold-bent torsion rate and cavity thickness. 9 pieces of insulating glass were manufactured for anticlastic cold-bending test and their coupled effect with identical load is also studied, and numerical finite element analysis sessions were carried out to simulate the experimental results for each one of them. Further, we analyzed the stress distribution performance of the sample pieces under cold bending and a uniform load, followed by discussions about stress transfer controls in glass plates. The results showed that the cold-bent control stress is on the surface with direct loads from cold bending and close to the cold-bent corner on the short edge, and it is transferred from the parts around the corner to the center when the uniform load plays a leading role in generating stress. This transfer could occur under a relatively small load with a small cold-bent torsion rate. A higher cold-bent torsion rate in cold bending contributed mostly to greater center stress in the glass, and as the glass thickness grows, stress and deflection at the plate center would significantly drop. However, the effect of cavity thickness on the anticlastic mechanical response of insulating glass was found to be trivial.
Application of big-data for epidemiological studies of refractive error
Authors: Moore Michael , Loughman James , Butler John S. , Ohlendorf Arne , Wahl Siegfried , Flitcroft Daniel I.
Published: April 2021

Purpose

To examine whether data sourced from electronic medical records (EMR) and a large industrial spectacle lens manufacturing database can estimate refractive error distribution within large populations as an alternative to typical population surveys of refractive error.

Subjects

A total of 555,528 patient visits from 28 Irish primary care optometry practices between the years 1980 and 2019 and 141,547,436 spectacle lens sales records from an international European lens manufacturer between the years 1998 and 2016.

Methods

Anonymized EMR data included demographic, refractive and visual acuity values. Anonymized spectacle lens data included refractive data. Spectacle lens data was separated into lenses containing an addition (ADD) and those without an addition (SV). The proportions of refractive errors from the EMR data and ADD lenses were compared to published results from the European Eye Epidemiology (E3) Consortium and the Gutenberg Health Study (GHS).

Results

Age and gender matched proportions of refractive error were comparable in the E3 data and the EMR data, with no significant difference in the overall refractive error distribution (χ2= 527, p = 0.29, DoF = 510). EMR data provided a closer match to the E3 refractive error distribution by age than the ADD lens data. The ADD lens data, however, provided a closer approximation to the E3 data for total myopia prevalence than the GHS data, up to age 64.

Conclusions

The prevalence of refractive error within a population can be estimated using EMR data in the absence of population surveys. Industry derived sales data can also provide insights on the epidemiology of refractive errors in a population over certain age ranges. EMR and industrial data may therefore provide a fast and cost-effective surrogate measure of refractive error distribution that can be used for future health service planning purposes.
Neuraminidase-associated plasminogen recruitment enables systemic spread of natural avian Influenza viruses H3N1
Authors: Schön Jacob , Breithaupt Angele , Höper Dirk , King Jacqueline , Pohlmann Anne , Parvin Rokshana , Behr Klaus-Peter , Schwarz Bernd-Andreas , Beer Martin , Stech Jürgen , Harder Timm , Grund Christian
Published: April 2021

Repeated outbreaks due to H3N1 low pathogenicity avian influenza viruses (LPAIV) in Belgium were associated with unusually high mortality in chicken in 2019. Those events caused considerable economic losses and prompted restriction measures normally implemented for eradicating high pathogenicity avian influenza viruses (HPAIV). Initial pathology investigations and infection studies suggested this virus to be able to replicate systemically, being very atypical for H3 LPAIV. Here, we investigate the pathogenesis of this H3N1 virus and propose a mechanism explaining its unusual systemic replication capability. By intravenous and intracerebral inoculation in chicken, we demonstrate systemic spread of this virus, extending to the central nervous system. Endoproteolytic viral hemagglutinin (HA) protein activation by either tissue-restricted serine peptidases or ubiquitous subtilisin-like proteases is the functional hallmark distinguishing (H5 or H7) LPAIV from HPAIV. However, luciferase reporter assays show that HA cleavage in case of the H3N1 strain in contrast to the HPAIV is not processed by intracellular proteases. Yet the H3N1 virus replicates efficiently in cell culture without trypsin, unlike LPAIVs. Moreover, this trypsin-independent virus replication is inhibited by 6-aminohexanoic acid, a plasmin inhibitor. Correspondingly, in silico analysis indicates that plasminogen is recruitable by the viral neuraminidase for proteolytic activation due to the loss of a strongly conserved N-glycosylation site at position 130. This mutation was shown responsible for plasminogen recruitment and neurovirulence of the mouse brain-passaged laboratory strain A/WSN/33 (H1N1). In conclusion, our findings provide good evidence in natural chicken strains for N1 neuraminidase-operated recruitment of plasminogen, enabling systemic replication leading to an unusual high pathogenicity phenotype. Such a gain of function in naturally occurring AIVs representing an established human influenza HA-subtype raises concerns over potential zoonotic threats.
Shaping citizen’s freedom of social media interaction in Tanzania: The role of city policy experts in digital policy-making
Authors: Churk Josephine Philip , Volkmer Ingrid
Published: April 2021

Digital communication, especially social media interaction, has emerged as a key domain for civic debates specifically in urban areas of Tanzania. However, how policy-makers perceive these as opportunities for societal development is rarely assessed in research. This study will fill this gap through semi-structured interviews with policy-makers in Dar es Salaam and focus on assessing their perception of the role of social media in digital policy-making in society. Based on the study results, we suggest a new strategic approach for policy collaboration across African regions for building sustained policy capacity and to enable resilient public spheres as a core component of societal development in digital Africa.
A taxonomy of holes in lace
Authors: Reynolds Paul
Published: April 2021

This article presents a play script as a research artefact whose dialogue enquires into the holes found in Barbara Hepworth’s sculpture Epidauros II through the author’s practice of chemical-lace making; two makers who consider holes in very different media. This dialogue continues with the development of a taxonomy, not of a universe of holes but rather of the microcosm of an individual hole. This taxonomy counterpoints the different objects of discourse, which take form as four viewpoints: first person – the hole’s maker; second person – the hole’s user; third person – the hole’s viewer; and fourth person – the ontological hole.
Applauders and authors: Notes on the profits and losses of audience engagement
Authors: Purchase Sophie
Published: April 2021

Social practices, whether described as socially-engaged, participatory or community-based, share the potential to transform audience members into active participants in an artwork or project. However, the purpose of this public engagement is sometimes in conflict with the private experience of the viewer, constructing a complex relationship between audience, artist and gallery. Beginning by contextualizing the historic position of the audience in relation to the arts, the present article uses this as grounding to unpick elements of the dynamic which exist today. ‘The audience’ investigates the reported social benefits of engaging in the arts, questioning how evidence of these positive effects is reported and judged. This article exemplifies Marcelo Sánchez-Camus’ work with patients in palliative care and Spacemakers’ community-based projects as artworks intended to instigate positive social change. Further, ‘The artist’ explores the relationship between those facilitating these projects and their audience. By breaking down the term ‘audience’ into viewers, participants, collaborators and co-authors, one can use levels of agency to segment those involved and the differing experiences of their involvement. Petra Bauer’s long-term collaborative work with SCOT PEP is used to demonstrate how a group’s agency and stakes within an artwork can be enhanced by building relationships on equal terms. Finally, ‘The gallery’, uses the high-profile examples of Tate Group and Venice Biennale to demonstrate how the more powerful entities in the art world can misrepresent engagement and participation as quantitative markers of success or accessibility. This article ultimately aims to question what motivates the production of social practice and how these entities are important in constituting a successful process and outcome, for audience, artist and institute.