bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Dental and Medical School students on the awareness of Oral Cancer
Authors: Pintor Fernanda Emetério , Alves Maria Luisa Maciel
Published: December 2022

Oral cancer (OC) is a public health problem due to its high prevalence in the world po- pulation. Due to its late diagnosis, this pathology has been causing many sequelae for the patient and constitutes a risk of death when treated in advanced stages. One of the main aggravating factors is the difficulty in its early identification, both by health professio- nals and the population, since there are no explicit symptoms in the initial stages or the changes are often like other oral lesions, such as ulcers. Thus, they can go unnoticed by the individual and even by a health professional. This study evaluated the level of kno- wledge about OC in medical and dental students at the University of Santo Amaro. The study was carried out through a questionnaire with 38 (thirty-eight) questions. With that, we established a comparative parameter between both courses to show if the students were well prepared to deal with oral and oropharyngeal cancer. The survey also aimed to show how oral health is being neglected within medicine, making future physicians feel unprepared to care for their patients.
Patterns of immune-related adverse events in patients treated with immune checkpoint inhibitors: a Brazilian real-world analysis
Authors: Santos Maria Paula Furtado , Pereira Allan Andersson Lima , Weis Luiza Nardin , Diniz Ana Carolina de Aquino , Medeiros Rodrigo Bovolin de , Katz Artur , Morbeck Igor Alexandre Protzner , Fernandes Gustavo dos Santos , Munhoz Rodrigo Ramela , Barroso-Sousa Romualdo
Published: December 2022

Objectives: To report real-world data of a cohort of patients treated with immune-checkpoint inhibitors in Brazil, with focus in immune-related adverse events.

Material and Methods: In this retrospective study, we analyzed a cohort of patients with metastatic solid tumors treated at an oncology reference center with at least one dose of immune-checkpoint inhibitors (given as monotherapy or in combination with other agents). The safety profile was characterized through the incidence of adverse events, management and hospitalization.

Results: We included 185 patients. Immune-related adverse events were observed in 92 of the 185 study patients (49.7%), including 16 patients (8.6%) with such events of grade 3 or 4, and 28 patients (15.1%) requiring systemic corticosteroid therapy. Thyroid disorders (20%), rash (17.8%), pruritus (11.4%) and colitis (11.4%) were the most frequent immune-related adverse events. Five (2.7%) patients discontinued immune-checkpoint inhibitors and 15 (7.0%) were hospitalized due to immune-related adverse events. Development of immune-related adverse events and immune-checkpoint inhibitors used in the firstline setting were associated with prolonged progression-free survival and overall survival in the multivariate analysis. Moreover, age <75 years old and ECOG score 0 or 1 were positively associated with overall survival in the multivariate analysis.

Conclusion: This study based upon a Brazilian “real-world” data confirms the toxicity profile of immune-checkpoint inhibitors seen in clinical trials. In accordance with previous retrospective analyses, development of immune-related adverse events was associated with survival outcome of immune-checkpoint inhibitors treatment in patients with metastatic solid cancers.
Surface Microprocessing AISI-O1 by Pulsed Nd: YAG Laser
Authors: Guo Kelvii Wei
Published: December 2022

Due to tedious and time-consuming work put into the conventional mold/die microprocessing (about 37% of the total time of the entire mold/die production). Therefore, to improve or enhance the quality of mold/dies at the final step with a less number of trained and skilled operators or decrease the processing time to cut the overall cost dramatically, AISI-O1 cold work steel was micro-processed by Pulsed Nd: YAG laser. The influence of laser processing parameters on the evolution of the correlated surface morphology was investigated by a 3D profilometer, scanning electron microscopy (SEM), and optical microscopy (OM). The results show that when AISI-O1 specimens were irradiated with various parameters, the morphology of AISI-O1 cold work steel was changed correspondingly. It also demonstrates that the different kinds of micro-processed surface morphology could be established successfully to satisfy the later practical requirements for a given laser. Meanwhile, the effect of laser processing parameters on the relevant temperature was described, and the laser microprocessing temperature field was also proposed. It reveals that the influence of laser pulse feed rate was more prominent than that of other parameters on the relevant micro-processed surface morphology.
Fingertip Amputations Repair with V-Y Flap and Polyethylene Nail
Authors: ÖZDEMİR Bülent , ELMA Tarık
Published: December 2022

Background: Finger amputations are the most commonly encountered amputation injury in the upper extremities. It is important to avoid shortening and to preserve the length of the finger in fingertip amputations in order not to lose the functions of the hand. The aim of this study was to evaluate the results of our patients who underwent reconstruction using V-Y pulp flap and artificial nail in order to avoid donor site morbidity in fingertip defects.

Methods: The results of patients who underwent reparation with V-Y flap and polyethylene nails for exposed distal phalanx and partial nail bed defect after fingertip amputation were evaluated in this retrospective study. The data of 44 patients who underwent 44 V-Y advancement flap between January 2016 and January 2021 were retrospectively analyzed.

Results: A total of 44 patients, 5 female and 39 male, who were treated for fingertip amputation, with a mean follow-up period of 24.2 months (14-71) and a mean age of 34.75 (2-68) were included in the study. The mechanism of injury was guillotine-style, avulsion and crush injuries in 15 (34.1%), 11 (25%) and 18 (40.9%) patients, respectively. Among the patients, 25 (56.8%) had right hand injuries, while 19 (43.2%) had left hand injuries. The dominant hand was affected in 28 (63.6%) patients. In 5 patients, the distal phalanx was shortened to the level of the lost nail bed (shortening was maximum 5 mm). Nail formation had occurred in all patients and deformed nail structure was seen in 18 patients. Graft necrosis was seen in 2 patients.

Conclusion: It is difficult for surgeons to decide on the treatment method because of the fact that there are multiple surgical techniques in the literature and the results are reported differently. Success rates are high in our technique. Each techniq.ue has its own advantages and disadvantages.
International Cooperation of States in the Field of Information Security
Authors: Duben Andrei  Kirillovich
Published: December 2022

The article deals with topical issues related to the development of the international information security system and shows the main directions of the development of information security in international and information law. The cross-border nature of the use of information and telecommunication technologies makes it necessary to ensure a common and indivisible international information security. The lack of a uniform interpretation of the content of the concept of "information security" in the legislation of different States and in the international treaties concluded by them does not contribute to the development of a consistent terminology for the purposes of international cooperation at the universal level. It is concluded that the key role in the mechanism of ensuring international information security is played by legal norms adopted at the international and national level. At the same time, the problems of forming a system of legal regulation of information security have an interdisciplinary nature, including issues of the application of norms, rules and principles of responsible behavior of States designed to promote an open, safe, stable, accessible and peaceful information and communication environment. The main conclusions of the study are that international cooperation of states in the field of information security determines the further direction of development in the form of the adoption of new important international agreements on certain aspects of ensuring international information security, at the same time, in the context of information warfare, the priority is to combine efforts to ensure international and national information security. Determining the importance of ensuring information security in the context of modern challenges, threats and risks, we believe that interstate cooperation contributes to the further formation of coordination measures to respond to these threats and the development of legal support for information security in general.
THE ROLE OF THE GAPSHIMA DIALECT IN THE SYSTEM OF THE DARGIN LANGUAGES AND DIALECTS: MORPHOLOGICAL DATA
Authors: Mutalov Rasul Osmanovich
Published: December 2022

The Gapshima dialect is one of the least studied dialects of the Dargin language group of the East Caucasian languages and that is the reason why its role in the system of the Dargin languages and dialects still remains undefined. Meanwhile, there are many peculiar linguistic phenomena, revealed both in phonetics and in grammar and vocabulary. The article deals with the morphological peculiarities of the Gapshima dialect. Nominal parts of speech and verbal categories and auxiliary parts of speech are studied. The method of synchronous description of linguistic phenomena and methods of field linguistics are used in the study. In the course of the research, the grammatical categories of case, person, tense and mood, and also various forms of the verb were studied. With the aim of identifying the peculiarities of the dialect and its role in the linguistic classification, all the presented data is compared with the data of the other Dargin dialects - Akusha, Tsudahar, Sirkhya. As a result of the study, it was established that the Gapshima speech is close to the dialects of the Akusha type by its grammatical characteristics. The results of the study can be contributed to the further work of establishing the classification of the language units of the Dargin area and can be applicable to the teaching courses of the Dargin morphology and dialectology at the universities.
K-shell X-ray of Al produced by collisions of ions with near Bohr velocities
Authors: Zhou Xian-Ming , Wei Jing , Cheng Rui , Liang Chang-Hui , Chen Yan-Hong , Zhao Yong-Tao , Zhang Xiao-An ,   Ion beam and Optical Physics Laboratory, Xianyang Normal University, Xianyang 712000, China,   Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China,   School of Science, Xi’an Jiaotong University, Xi’an 710049, China
Published: December 2022

X-ray emissionproduced by highly charged ions with the energy range near the Bohr velocity involves complicated atomic process. However, duo to the limitation of experimental conditions, the relevant researches are nearly absent. It is unclear whether the existing theory is applicable in such an energy range. This needs further exploring. In the present work, K X-ray spectra of Al excited by H+, He2+ and highly charged heavy ions I22+ and Xe20+ are investigated by using an Si drift X-ray detector in the energy range near the Bohr velocity. The X-ray production cross sections are extracted from the X-ray counts and compared with the theoretical simulations from PWBA, ECPSSR and modified BEA model. It is indicated that the cross section increases with the augment of projectile energy. With the same incident energy per nucleon, the cross section induced by highly charged heavy ions is a factor of about 104 larger than that by light ions . With the impact of H+ and He2+ ions, the K-shell electrons are mainly knocked off through the direct Coulomb ionization, and the X-ray emission cross section can be well predicted by ECPSSR theory. For the bombardment of highly charged heavy ions I22+ and Xe20+, except for the Coulomb ionization, the orbital electrons can also be excited by electron capture. The BEA simulation after being modified by both Coulomb repulsion and effective charge can well predict the X-ray production cross section.
Multipole vector solitons in coupled nonlinear Schrödinger equation with saturable nonlinearity
Authors: Wen Jia-Mei , Bo Wen-Bo , Wen Xue-Kun , Dai Chao-Qing ,   Zhejiang A&F University, Lin’an 311300, China
Published: December 2022

We construct the coupled self-defocusing saturated nonlinear Schrödinger equation and obtain the dipole-dipole, tripole-dipole and dipole-tripole vector soliton solutions by changing the potential function parameters and using the square operator method of power conservation. With the increase of soliton power, the dipole-dipole, tripole-dipole and dipole-tripole vector solitons can all exist. The existence of the three kinds of vector solitons is obviously modulated by the potential function. The existence domain of three kinds of vector solitons, modulated by the potential function, is given in this work. The stability domains of three vector solitons are modulated by the soliton power of each component. The stability regions of three kinds of vector solitons expand with the increase of the power of two-component soliton. With the increase of saturation nonlinear strength, the power values of the tripole-dipole and dipole-tripole vector solitons at the critical points from stable state to unstable state decrease gradually, and yet the power of the soliton at the critical point from the stable state to the unstable state does not change.
El subjectil fotográfico. Esbozo desde una inflexión poshumana
Authors:   CONICET/ Centro de Investigación en Arte, Materia y Cultura IIAC-UNTREF/ UBA, Robles de la Pava Juliana
Published: December 2022

¿Qué es lo que salta a la vista en el objeto fotográfico? ¿Cuál es ese fondo sin fondo que constituye toda superficie fotográfica y que nos interpela, nos enfrenta y sobre la cual se sigue el desconcierto? Este artículo ensaya una perspectiva posthumana de acercamiento a un conjunto de artefactualidades fotográficas que desafían los órdenes de un constructivismo cultural imperante como paradigma de interpretación de dichos objetos y traza ciertos caracteres de una aproximación más allá de lo humano al medio fotográfico. En función de esto se aventurará un itinerario de vinculación con estos objetos técnicos desde la noción derridiana del subjectil como el lugar de nacencia de toda fotografía, su materialidad como horizonte y facticidad desde la cual toda fotografía se expresa. Trazar este recorrido implicará describir las intensidades de ciertos soportes fotográficos, la huida de la fotografía de un antropismo consustancial, de su condición de imagen cultural y visual para, finalmente, delinear los alcances de una materialidad fotográfica en los términos propuestos por la inflexión posthumana contemporánea.
Cosmoestética del afuera. Extranjeridad poshumana en dos obras de Claudia Fontes
Authors:   Conicet / UBA, Fleisner Paula
Published: December 2022

Este artículo se propone contribuir a la elaboración de una cosmoestética materialista posthumana que permita, por un lado, pensar la agencialidad propia de la materia involucrada en las obras de arte por fuera de la lógica artista/forma –material/formado; y por el otro, experimentar con opciones no antropocentradas para la imaginación y la percepción. Se presentan los lineamientos generales de una tal propuesta a partir de una relación con el concepto cosmopolítica y se plantea la prestación del arte en el contexto actual de descalabro de las escalas espacio-temporales. Finalmente, se analizan la serie de pequeñas estatuillas Foreigners y el Proposal for the High Line Plinth, que implicaba la producción de ese mismo tipo de figuras, pero de 6 metros de alto, de la artista argentina Claudia Fontes, con el objetivo de pensar en ellas la perspectiva ontológica relacional y la dimensión política involucrada en la diplomacia más-que-humana que proponen.
Arte y algoritmos
Authors:   UPV/EHU, Monasterio Astobiza Anibal
Published: December 2022

El uso de la tecnología para la creación artística ha sido recurrente a lo largo de la historia del arte. Artistas de todas las épocas han utilizado la tecnología como herramienta para nuevas formas de expresión. En este artículo, quiero diferenciar dos usos de la tecnología para ayudar a la creación artística: a) uso aumentativo y b) uso sustitutivo. Defiendo la idea de que la mayor parte de la relación histórica entre arte y tecnología ha sido enmarcada dentro de un uso aumentativo, es decir, la tecnología ha ayudado a los artistas en la creación, producción y distribución de su arte. Sin embargo, las tecnologías digitales (TICs) y en concreto el uso de sistemas de Inteligencia Artificial (IA) y algoritmos están provocando un cambio de paradigma de un uso aumentativo hacia un uso sustitutivo. El uso sustitutivo de ciertas tecnologías -sistemas de IA y algoritmos- supone una transformación radical en la naturaleza del arte, su valor y el papel del artista. Ahora, sistemas de IA y algoritmos pueden pintar, componer música y escribir textos de manera no-supervisada. En otras palabras, la creatividad o la creación de arte se pueden automatizar. Dicho esto, quiero reflexionar sobre las implicaciones filosóficas del progresivo uso sustitutivo de la tecnología en el arte para explorar cuestiones como: ¿Las maquinas pueden crear arte?, ¿Es posible hablar de creatividad de las máquinas?, ¿Puede una máquina exigir derechos de autor o propiedad intelectual de una obra?
Imaginar una forma neobarrotóxica de leer y escribir la materia. Aproximaciones al poemario Los ligámenes de Mauro Césari
Authors:   IDH, CONICET, UNC, Maccioni Franca
Published: December 2022

El presente trabajo propone una lectura del libro de poemas Los ligámenes de Mauro Césari. Parte de la “escena” de la catástrofe que el libro repone: el colapso de dos diques mineros en Minas Gerais y el avance de un alud de barro tóxico sobre el poblado y los ríos de la región. Desde allí, busca cartografiar la imaginación material propuesta por el poemario, indagando específicamente en la concepción de escritura de la materia que el libro despliega y en la máquina de lectura que ella supone. Con ese objetivo, recupera la tradición de lectura y escritura propuesta por el neobarroso en un intento por proponer una modulación neobarrotóxica para leer la singularidad de esta escritura.
Consideraciones sobre el imaginario estético astronómico en el ejemplo de Campo del cielo
Authors:   UBA- UNA - CONICET, Lucero Guadalupe
Published: December 2022

En este texto trabajaré con la madeja que enreda la tierra y el cielo, desde un punto de vista estético-imaginario. Para ello recorreré algunas discusiones contemporáneas que considero que pueden funcionar como puntas del ovillo en cuestión. Por un lado, revisaré algunas de las ideas de Peter Sloterdijk para pensar el problema de la globalización como particular declinación del viejo problema ontológico de la esfera. Por otro lado, recuperaré algunos elementos del horizonte de trabajo de la astronomía cultural, que permitirán describir la trama social del cielo y a la vez la relación material cielo-tierra. Es a partir de aquí que propondré una lectura que considero necesaria y novedosa en el contexto de las discusiones en torno al posthumanismo y los nuevos materialismos: la necesaria inclusión del cielo como problema material y posthumano. Basándome en este último enfoque, analizaré algunas obras de Faivovich y Goldberg que forman parte del proyecto en torno a Campo del cielo.
Tool for the integration of building performance information within the BIM process
Authors:   Civil Engineering School, Goiás Federal Institute of Science and Technology Education, Jataí (Brazil), Coelho dos Santos Francielle , Marques Carvalho Michele Tereza ,   Technology College, University of Brasilia, Brasília (Brazil), Gomes de Oliveira Brandstetter Maria Carolina ,   Civil and Environmental Engineering School, Goiânia (Brazil)
Published: December 2022

Decision-making regarding building performance in all construction project phases is a complex task. This article addresses the challenge of managing building performance information throughout construction project phases. It proposes a tool that assists in verifying the building performance requirements for different stakeholders and supports the integration of this information within the BIM process. The developed tool allows the launch, monitoring, and creation of a database with information about the project, the work, and the stakeholders. A practical study was chosen to test this tool. Its result is particularly meaningful to all stakeholders, as it prioritizes the information and underlying activities for the collaborative project development among the participants. In summary, the information integration related to the requirements to guarantee the building performance, co-related to the construction project development phases, is essential for improving internal processes. It is worth mentioning that managing this information is not a simple process and requires contextual knowledge, leadership, and management and communication skills.
Programa nacional de produção e uso do biodiesel: o selo combustível social como política para a agricultura familiar
Authors: da Silva Jéssica Gomes , Cardoso Lara de Souza , Geyer Mariana Curtinovi , Espindola Juliana da Silveira , Leonardi Alex
Published: December 2022

A importância mundial do biodiesel como combustível alternativo aos derivados de petróleo, bem como sua importância econômica, ambiental, social e a participação do Brasil entre os maiores produtores mundiais, mostram a necessidade de compreender melhor a influência dos programas governamentais na produção e no mercado do biodiesel no Brasil. Para isso, este estudo buscou explorar as diretrizes do Selo Combustível Social (SCS), ligado ao Programa Nacional de Produção e Uso do Biodiesel (PNPB). O trabalho teve como objetivo analisar a evolução da produção do biodiesel no Brasil, a fim de identificar como esse programa afetou o mercado de biodiesel ao longo do tempo e os impactos sobre a participação da agricultura familiar. Este estudo foi realizado a partir de questionários enviados a instituições relacionadas ao Programa, e se baseou em pesquisa bibliográfica e documental a partir de sites governamentais no âmbito do PNPB e do SCS. Os resultados permitem observar que as alterações progressivas na legislação reduzem as exigências às empresas de biodiesel em detrimento da agricultura familiar.
BEZPIECZEŃSTWO W BEZPRZEWODOWYCH SIECIACH SENSOROWYCH NA PRZYKŁADZIE WYBRANYCH ROZWIĄZAŃ
Authors: WILCZKIEWICZ Bartłomiej
Published: December 2022

W ramach artykułu przedstawiono podstawowe informacje na temat Internetu Rzeczy oraz bezprzewodowych sieci czujników. Następnie zaprojektowano prototypowy system IoT, opisano ogólnie jego działanie oraz przedstawiono dostępne zabezpieczeniatego typu systemów. Na przykładzie wybranych rozwiązań sprzętowo programowych przeanalizowano możliwości i narzędzia służące do zdalnego zarządzania, integracji oraz organizacji wymiany danych. Na tej podstawie przedstawiono opis wybranych, przykładowych rozwiązań praktycznych i zaproponowano metodykę selekcji, projektowania i programowania tego typu systemów. Zaprezentowanoschemat połączeń dla układu pojedynczego węzła sieciowego, omówiono pokrótce usługi uruchomione na serwerze oraz scharakteryzowano ogólnie protokół MQTT (wymiana danych za pośrednictwem sieci komputerowej). W opracowanym systemie zaimplementowano podstawowe zabezpieczenia. Całość komunikacji odbywała się bez szyfrowania informacji (dane przesyłane jawnym tekstem). Przedstawiono również wyniki podstawowych badań wykonanych z użyciem programu Wireshark oraz zwrócono uwagę na potencjalne formy ochrony systemów IoT. Głównym celem poniższego artykułu było pokazanie jak ogromne znaczenie ma bezpieczeństwo transmisji danych w tego typu systemach.
Violence against Women and Social Development in Rural Peru
Authors: Ramírez Ana Sophia Burgos
Published: December 2022

The present research aimed to determine the relationship between violence against women and social development in rural areas of La Libertad, 2022, for this I work with the type of basic research, with a quantitative approach, non-experimental design correlational level – descriptive cross-section, for this we analyzed 374 women from the province of Otuzco de la Libertad, by applying the questionnaire for both study variables. Therefore, as a result of the 374 women, 57% perceive violence against women at a high level, of which 2.9% perceived a fair level and 23.5% good and 0.55% deficient in relation to social development. On the other hand, it was possible to contrast the hypothesis where a Rho = 0.734 ** (high negative correlation) and a (p<0.05) was obtained for both cases, therefore the Ha is admitted and the Ho is refuted, therefore, it is evident that violence against women is related to social development in rural areas of La Libertad, 2022. Conclusion, it was demonstrated that if violence against women decreases, it would improve social development in rural areas of the province of Otuzco.
Study of Fibrinogen Level and Platelets Indices in Type 2 Diabetes Mellitus and their Relation with Microvascular Complications
Authors: El-Hashash Eman Essam , ElKholy Rasha Adel , Elbedewy Tamer Abd Elhamid , Elsheikh Ebaa Hussein
Published: December 2022

Background: Type 2 DM (T2DM), represents about 90% of all cases of diabetes mellitus (DM) and this is because of obesity and lack of exercise. It is marked by insulin resistance, high blood glucose, and a relative lack of insulin. The aim of this work was to assess the mean platelet volume, platelet distribution width, and platelet large cell ratio: (MPV, PDW, PL-cR) and fibrinogen in T2DM and their correlation with microvascular complications.

Methods: This case control study was carried out on 90 subjects who classified into three equal groups: Group (1) with type 2 diabetes mellitus without microvascular complications, group (2) with type 2 diabetes mellitus with microvascular complications. These complications are retinopathy, nephropathy and neuropathy, and group (3) as control group. All participants were subjected to serum fibrinogen evaluation, routine laboratory investigations and fundus examination.

Results: Fibrinogen was higher significantly in the complicated group compared to the other studied groups (p < 0.001). Regarding fibrinogen, at cut off level (301.5 mg/dL) the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were (73.3%, 93.3%,77.8% and 91.6%), respectively. Concerning platelet distribution width (PDW), at cut off level 17.65%, the sensitivity, specificity, NPV, and PPV of Platelet distribution width were (76.7%, 100%, 81.1%, and 100%), respectively. Additionally, platelet large cell ratio (PL-cR), at cut off level 0.338%, the sensitivity, specificity, PPV and NPV of Platelet distribution width were (76.7%, 100%, 100% and 81.1%), respectively.

Conclusions: Serum fibrinogen, platelet distribution width and platelet large cell ratio can be used as simple parameters to detect micro vascular complications in type 2 diabetes mellitus than mean platelet volume.
Membrane‐Fusion‐Mediated Multiplex Engineering of Tumor Cell Surface Glycans for Enhanced NK Cell Therapy
Authors: Zheng Chunxiong , Zhong Qingguo , Song Wantong , Yi Ke , Kong Huimin , Wang Haixia , Tao Yu , Li Mingqiang , Chen Xuesi
Published: December 2022

Natural killer (NK) cell therapies show potential for tumor treatment but are immunologically resisted by the overexpressed immunosuppressing tumor cell surface glycans. To reverse this glycan‐mediated immunosuppression, the surface NK‐inhibitory glycan expressions need to be downregulated and NK‐activating glycan levels should be elevated synchronously with optimal efficiency. Here, a core–shell membrane‐fusogenic liposome (MFL) is designed to simultaneously achieve the physical modification of NK‐activating glycans and biological inhibition of immunosuppressing glycans on the tumor cell surface via a membrane‐fusion manner. Loaded into a tumor‐microenvironment‐triggered‐degradable thermosensitive hydrogel, MFLs could be conveniently injected and controllably released into local tumor. Through fusion with tumor cell membrane, the released MFLs could simultaneously deliver sialyltransferase‐inhibitor‐loaded core into cytoplasm, and anchor NK‐activating‐glycan‐modified shell onto tumor surface. This spatially‐differential distribution of core and shell in one cell ensures the effective inhibition of intracellular sialyltransferase to downregulate immunosuppressing sialic acid, and direct presentation of NK‐activating Lewis X trisaccharide (LeX) on tumor surface simultaneously. Consequentially, the sialic acid‐caused immunosuppression of tumor surface is reprogrammed to be LeX‐induced NK activation, resulting in sensitive susceptibility to NK‐cell‐mediated recognition and lysis for improved tumor elimination. This MFL provides a novel platform for multiplex cell engineering and personalized regulation of intercellular interactions for enhanced cancer immunotherapy.
Defect‐Engineering‐Stabilized AgSbTe2 with High Thermoelectric Performance
Authors: Zhang Yu , Li Zhi , Singh Saurabh , Nozariasbmarz Amin , Li Wenjie , Genç Aziz , Xia Yi , Zheng Luyao , Lee Seng Huat , Karan Sumanta Kumar , Goyal Gagan K. , Liu Na , Mohan Sanghadasa Mf , Mao Zhiqiang , Cabot Andreu , Wolverton Christopher , Poudel Bed , Priya Shashank
Published: December 2022

Thermoelectric (TE) generators enable the direct and reversible conversion between heat and electricity, providing applications in both refrigeration and power generation. In the last decade, several TE materials with relatively high figures of merit (zT) have been reported in the low‐ and high‐temperature regimes. However, there is an urgent demand for high‐performance TE materials working in the mid‐temperature range (400–700 K). Herein, p‐type AgSbTe2 materials stabilized with S and Se co‐doping are demonstrated to exhibit an outstanding maximum figure of merit (zTmax) of 2.3 at 673 K and an average figure of merit (zTave) of 1.59 over the wide temperature range of 300–673 K. This exceptional performance arises from an enhanced carrier density resulting from a higher concentration of silver vacancies, a vastly improved Seebeck coefficient enabled by the flattening of the valence band maximum and the inhibited formation of n‐type Ag2Te, and ahighly improved stability beyond 673 K. The optimized material is used to fabricate a single‐leg device with efficiencies up to 13.3% and a unicouple TE device reaching energy conversion efficiencies up to 12.3% at a temperature difference of 370 K. These results highlight an effective strategy to engineer high‐performance TE material in the mid‐temperature range.
Association between depressive mood and chronic periodontitis among senior residents using the National Health Insurance Service‐Senior Cohort Database
Authors: Kim Yu‐Rin , Son Minkook , Nam Seoul‐Hee
Published: December 2022

Background

Bacteria involved in chronic periodontal disease induce inflammatory cytokines. These cytokines can enter the brain through systemic circulation and cause depression. In this study, we investigated the association between depressed mood and chronic periodontitis in older adults in Korea.

Methods

This study used data from the Life‐changing Period Health Checkup (2007–2008), performed only at 66 years of age, which is available from the National Health Insurance Service‐Senior Cohort Database. The depressed mood status was evaluated by three questions in the mental health examination. The definition of chronic periodontitis was determined based on the diagnosis and treatment codes for chronic periodontitis. Based on the three questions, we investigated the association between depressive mood and chronic periodontal disease by dividing the study population into 9622 depressed mood subjects (DMS) and 9091 non‐depressed mood subjects (NDMS). Multivariable‐adjusted logistic regression analysis was performed, and odds ratios (ORs) with 95% confidence intervals (95% CIs) were presented.

Results

Among the NDMS, 5390 patients with chronic periodontitis were identified, and among the DMS, 5964 patients with chronic periodontitis were identified. The crude OR (95% CI) for chronic periodontitis in DMS compared to NDMS was 1.12 (1.06–1.19). The adjusted OR (95% CI) for chronic periodontitis was 1.12 (1.06–1.19). As a result of confirming the effect of sex and comorbidity on the association between depressed mood and chronic periodontitis, a significant association was observed for women at 1.15 (1.07–1.25). In addition, the adjusted OR (95% CI) for depressive mood and chronic periodontitis was 1.15 (1.07–1.25) for patients with hypertension, 1.13 (1.03–1.25) for patients with diabetes, 1.12 (1.02–1.22) for patients with dyslipidemia, and 1.18 (1.04–1.34) for patients with heart disease.

Conclusions

This study confirmed the relationship between depressed mood and chronic periodontitis in older adults. Therefore, education to strengthen the emotional management of older adults, especially with respect to depression, would play an auxiliary role in preventing and treating periodontitis.
3D bioprinting and its innovative approach for biomedical applications
Authors: Tripathi Swikriti , Mandal Subham Shekhar , Bauri Sudepta , Maiti Pralay
Published: December 2022

3D bioprinting or additive manufacturing is an emerging innovative technology revolutionizing the field of biomedical applications by combining engineering, manufacturing, art, education, and medicine. This process involved incorporating the cells with biocompatible materials to design the required tissue or organ model in situ for various in vivo applications. Conventional 3D printing is involved in constructing the model without incorporating any living components, thereby limiting its use in several recent biological applications. However, this uses additional biological complexities, including material choice, cell types, and their growth and differentiation factors. This state‐of‐the‐art technology consciously summarizes different methods used in bioprinting and their importance and setbacks. It also elaborates on the concept of bioinks and their utility. Biomedical applications such as cancer therapy, tissue engineering, bone regeneration, and wound healing involving 3D printing have gained much attention in recent years. This article aims to provide a comprehensive review of all the aspects associated with 3D bioprinting, from material selection, technology, and fabrication to applications in the biomedical fields. Attempts have been made to highlight each element in detail, along with the associated available reports from recent literature. This review focuses on providing a single platform for cancer and tissue engineering applications associated with 3D bioprinting in the biomedical field.
SOX2‐positive retinal stem cells are identified in adult human pars plicata by single‐cell transcriptomic analyses
Authors: Wang Xiaotang , Fan Wei , Xu Zongren , Zhang Qi , Li Na , Li Ruonan , Wang Guoqing , He Siyuan , Li Wanqian , Liao Dan , Zhang Zhi , Shu Nan , Huang Jiaxing , Zhao Chenyang , Hou Shengping
Published: December 2022

Stem cell therapy is a promising strategy to rescue visual impairment caused by retinal degeneration. Previous studies have proposed controversial theories about whether in situ retinal stem cells (RSCs) are present in adult human eye tissue. Single‐cell RNA sequencing (scRNA‐seq) has emerged as one of the most powerful tools to reveal the heterogeneity of tissue cells. By using scRNA‐seq, we explored the cell heterogeneity of different subregions of adult human eyes, including pars plicata, pars plana, retinal pigment epithelium (RPE), iris, and neural retina (NR). We identified one subpopulation expressing SRY‐box transcription factor 2 (SOX2) as RSCs, which were present in the pars plicata of the adult human eye. Further analysis showed the identified subpopulation of RSCs expressed specific markers aquaporin 1 (AQP1) and tetraspanin 12 (TSPAN12). We, therefore, isolated this subpopulation using these two markers by flow sorting and found that the isolated RSCs could proliferate and differentiate into some retinal cell types, including photoreceptors, neurons, RPE cells, microglia, astrocytes, horizontal cells, bipolar cells, and ganglion cells; whereas, AQP1− TSPAN12− cells did not have this differentiation potential. In conclusion, our results showed that SOX2‐positive RSCs are present in the pars plicata and may be valuable for treating human retinal diseases due to their proliferation and differentiation potential.
Electrosonomyography: Avoiding the scalpel in traumatic nerve injury?
Authors: Simon Neil G. , Hannaford Andrew
Published: December 2022

See article on pages 204‐207 in this issue.
Evaluation of muscle loss by ultrasonography in critically ill patients
Authors: Mendes Jucicléia Nathália da Silva , Rodrigues Isa Galvão , Arcoverde Gabriela Maria Pereira Floro , Floro Caio Cesar Pereira , Fortunato Wenize Suyane Lopes , Lima Roberta Maria da Silva , Pinho Cláudia Porto Sabino
Published: December 2022

Background

Critically ill patients have intense muscle tissue mobilization, and attenuating protein catabolism may contribute to improved outcomes.

Objective

To evaluate short‐term muscle loss in critically ill patients.

Methods

In this prospective observational study, we evaluated the thickness of the rectus femoris muscle by ultrasonography in young and older adults of both sexes admitted to a cardiological intensive care unit within 48 h of admission (baseline) and after 7 days. The results were compared and correlated with anthropometric, clinical, and biochemical parameters. The significance level for all statistical analyses was 0.05.

Results

The final sample comprised 88 patients with a mean age of 66.2 ± 11.8 years. There was an average 13.5% reduction in rectus femoris muscle thickness over the study period (P < 0.001), regardless of the thigh circumference maintenance (P = 0.229). This reduction occurred even with improved clinical parameters (C‐reactive protein, Simplified Acute Physiology Score) and was greater in patients receiving mechanical ventilation and sedation and in those who died. Regarding nutrition status, malnourished and eutrophic individuals showed greater muscle loss than overweight individuals. There was also an inverse correlation of muscle loss (percentage) with body mass index, arm circumference, and calf circumference (P < 0.05), demonstrating that the lower these anthropometric measurements, the higher the muscle loss obtained by ultrasound.

Conclusion

Ultrasonography assessment detected muscle mass loss in the short‐term more sensitively than the anthropometric method. However, it demands caution and further studies demonstrating this analysis.
Innovative strategy to improve enteral nutrition in prone positioning with patients with COVID‐19
Authors: Powers Jan , Richardson Janette , Rechter Jennifer
Published: December 2022

Background

Enteral nutrition is essential to improve outcomes in patients who are critically ill. Patients in the prone position, including those diagnosed with coronavirus disease 2019 (COVID‐19) present additional challenges for enteral nutrition initiation.

Methods

A novel technique for placing feeding tubes while in the prone position was developed using an electromagnetic placement device and specialty trained clinical nurse specialists. Data were assessed retrospectively to determine effectiveness of this new practice.

Results

Sixty‐eight patients had feeding tubes placed while in the prone position; 75% were able to be placed through the postpyloric route, 22% were placed through the gastric route, and 3% unable to be placed. Use of this technique facilitated earlier initiation of feedings by 2 days from time of admission and almost half a day from intubation to feeding. There was no additional radiation exposure from using this technique.

Conclusion

Ability to place feeding tubes early while patients were prone reduced delays for starting enteral nutrition. Patients with COVID‐19 in the prone position were able to receive effective nutrition support earlier with no additional complications.
Value of social activities and prerequisites for continued participation of rural older adults: A qualitative study
Authors: Onishi Ryuta , Takashima Risa , Saeki Kazuko , Hirano Michiyo
Published: December 2022

Aims

To explore the value of social activities and the prerequisites for continuous participation among rural older adults based on their experiences.

Design

Qualitative, descriptive design.

Methods

Individual semi‐structured interviews were conducted with 14 older adults from voluntary community salons in a rural area in Japan. Participants were selected through purposeful sampling. Data were analyzed using qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) checklist were used.

Results

Four values of social activities were identified: “Mutual benefit connectedness,” “Preventing and coping with aging,” “Making life brilliant ‘now’,” and “Building a safety net.” Three prerequisites for activities were identified: “Do not overreach,” “Do not infringe on personal territory,” and “Do not go against community norms.” Social activities provide rural older adults with reciprocity ties, coping with aging, enhanced daily lives, and a social safety net. Continued participation in rural social activities requires adherence to cultural norms and moderation of relationship distances. Community and public health nurses are expected to promote social activities that incorporate these values and adhere to these prerequisites.
Remote motivational interviewing to improve patient self‐care and caregiver contribution to self‐care in heart failure (REMOTIVATE‐HF): Rationale, design, and methodology for a multicentre randomized controlled trial
Authors: Vellone Ercole , Rebora Paola , Iovino Paolo , Ghizzardi Greta , Baricchi Marina , Alvaro Rosaria , Sili Alessandro , Barello Serena , Ausili Davide , Trenta Alessia M. , Pedroni Cristina , Dellafiore Federica , Arrigoni Cristina , Riegel Barbara , Caruso Rosario
Published: December 2022

In patients with heart failure (HF), self‐care, and caregiver contribution to self‐care (i.e., the daily management of the disease by patients and caregivers) are essential for improving patient outcomes. However, patients and caregivers are often inadequate in their self‐care and contribution to self‐care, respectively, and struggle to perform related tasks. Face‐to‐face motivational interviewing (MI) effectively improves self‐care and caregiver contribution to self‐care, but the evidence on remote MI is scarce and inconclusive. The aims of this randomized controlled trial will be to evaluate whether remote MI performed via video call in patients with HF: (1) is effective at improving self‐care maintenance in patients (primary outcome); (2) is effective for the following secondary outcomes: (a) for patients: self‐care management, self‐care monitoring, and self‐efficacy; HF symptoms; generic and disease‐specific quality of life; anxiety and depression; use of healthcare services; and mortality; and (b) for caregivers: contribution to self‐care, self‐efficacy, and preparedness. We will conduct a two‐arm randomized controlled trial. We will enroll and randomize 432 dyads (patients and their informal caregivers) in Arm 1, in which patients and caregivers will receive MI or, in Arm 2, standard care. MI will be delivered seven times over 12 months. Outcomes will be assessed at baseline and 3 (primary outcome), 6, 9, and 12 months from enrollment. This trial will demonstrate whether an inexpensive and easily deliverable intervention can improve important HF outcomes. With the restrictions on in‐person healthcare professional interventions imposed by the COVID‐19 pandemic, it is essential to evaluate whether MI is also effective remotely.
An examination of primary health care nursing service evaluation using the Donabedian model: A systematic review
Authors: McCullough Kylie , Andrew Lesley , Genoni Angela , Dunham Melissa , Whitehead Lisa , Porock Davina
Published: December 2022

Nurses are key to the delivery of global primary health care services. However, there appears to be a lack of evaluation of primary health care nursing delivery models in the published literature. This evaluation is vital to the improvement of patient experiences, national and global health outcomes, and the justification of future investment in primary health care nursing services. The purpose of this review was to explore and analyze the literature that reports on the evaluation of primary health care nursing services, to ascertain the nature and utility of these evaluation methods, and identify opportunities for future research in this area. A systematic review of the published literature was conducted following PRISMA guidelines, using the databases CINAHL, Joanna Briggs Institute, MEDLINE, and Proquest. Thirty‐two articles published between 2010 and 2022 were selected. Results were organized using the Donabedian model. A paucity of research into the evaluation of nurse‐led primary health care services was noted. Where evident, evaluation of primary health care nursing services tended to reflect the medical model. Medical outcomes measures dominated evaluation criteria including diagnosis rates, prescription costs, and disease outcomes. Primary health care principles such as service accessibility, cultural appropriateness, and availability were rarely used. The perspectives and experiences of nurses were not sought in service evaluation, including most of the nurse‐led services. Development of an evidence‐base of nursing primary health care services that are informed by the nursing experience and apply a framework of universal primary health care principles across the structure, process, and outcomes aspects of the service is recommended.
Information for climate finance accountability regimes: Proposed framework and case study of the Green Climate Fund
Authors: Basak Rishi , Karlsson‐Vinkhuyzen Sylvia , Termeer Katrien J. A. M.
Published: December 2022

This paper addresses the role performance information plays in the accountability regimes of international climate change financing institutions and how this can be improved. It has been argued that the quality of the performance information of projects financed by public and private sources, as well as how that information is used, influences decisions made by the various actors in the accountability regimes, including the ability to hold actors to account. A theory‐based framework is developed to analyze and enable the improvement of the information produced and used in climate finance accountability regimes. The framework is tested by applying it to the Green Climate Fund via document analysis and key informant interviews. With the help of the framework, gaps are identified, and improvements are suggested so that account holders and account givers can better fulfill their respective roles in the given accountability regime.