bluuebunny/crossref_metadata_2025 huggingface dataset:
High adherence to national IPC guidelines as key to sustainable VRE control in Swiss hospitals: a cross-sectional survey
Authors: Vuichard-Gysin Danielle , Sommerstein Rami , Kronenberg Andreas , Buetti Niccolò , Eder Marcus , Piezzi Vanja , Gardiol Céline , Schlegel Matthias , Harbarth Stephan , Widmer Andreas ,   for Swissnoso
Published: January 2022

Background

Vancomycin resistant enterococci (VRE) are on the rise in many European hospitals. In 2018, Switzerland experienced its largest nosocomial VRE outbreak. The national center for infection prevention (Swissnoso) elaborated recommendations for controlling this outbreak and published guidelines to prevent epidemic and endemic VRE spread. The primary goal of this study was to evaluate adherence to this new guideline and its potential impact on the VRE epidemiology in Swiss acute care hospitals.

Methods

In March 2020, Swissnoso distributed a survey among all Swiss acute care hospitals. The level of adherence as well as changes of infection prevention and control (IPC) strategies in the years 2018 and 2019 after publication of the national guidelines were asked along with an inventory on VRE surveillance and outbreaks.

Results

Data of 97/146 (66%) participants were available, representing 81.6% of all acute care beds operated in Switzerland in 2019. The vast majority—72/81 (88%) responding hospitals—have entirely or largely adopted our new national guideline. 38/51 (74.5%) hospitals which experienced VRE cases were significantly more likely to have changed their IPC strategies than those 19/38 (50%) hospitals without VRE cases p = 0.017). The new IPC guidelines included (1) introduction of targeted admission screening in 89.5%, (2) screening of close contacts of VRE cases in 56%, and (3) contact precaution for suspected VRE cases 58% of these hospitals. 52 (54%) hospitals reported 569 new VRE cases in 2018 including 14 bacteremia, and 472 new cases in 2019 with 10 bacteremia. The ten largest outbreaks encountered between 2018 and 2019 included 671 VRE cases, of which most (93.4%) consisted of colonization events, 29 (4.3%) infections and 15 (2.2%) bacteremia.

Conclusion

Wide adoption of this VRE control guideline seemed to have a positive effect on VRE containment in Swiss acute care hospitals over two years, even if its long-term impact on the VRE epidemiology remains to be evaluated. Broad dissemination and strict implementation of a uniform national guideline may therefore serve as model for other countries to fight VRE epidemics on a national level.
Invited review: Remediation strategies for mycotoxin control in feed
Authors: Liu Meng , Zhao Ling , Gong Guoxin , Zhang Lei , Shi Lei , Dai Jiefan , Han Yanming , Wu Yuanyuan , Khalil Mahmoud Mohamed , Sun Lvhui
Published: January 2022

Mycotoxins are secondary metabolites of different species of fungi. Aflatoxin B1 (AFB1), deoxynivalenol (DON), zearalenone (ZEN) and fumonisin B1 (FB1) are the main mycotoxins contaminating animal feedstuffs. These mycotoxins can primarily induce hepatotoxicity, immunotoxicity, neurotoxicity and nephrotoxicity, consequently cause adverse effects on the health and performance of animals. Therefore, physical, chemical, biological and nutritional regulation approaches have been developed as primary strategies for the decontamination and detoxification of these mycotoxins in the feed industry. Meanwhile, each of these techniques has its drawbacks, including inefficient, costly, or impractically applied on large scale. This review summarized the advantages and disadvantages of the different remediation strategies, as well as updates of the research progress of these strategies for AFB1, DON, ZEN and FB1 control in the feed industry.
The emergence of Liu Kang’s new painting style (1950–1958): a multi-analytical approach for the study of the artist’s painting materials and technique
Authors: Lizun Damian , Kurkiewicz Teresa , Mądry Mateusz , Szczupak Bogusław
Published: January 2022

Liu Kang (1911–2004) was renowned Singapore artist trained in Shanghai and Paris, and known for his contributions to the Nanyang style—an art movement practised by migrant Chinese painters in Singapore between the late 1940s to the 1960s. The style depicts aspects of the tropical way of life, synthetising the artistic traditions of the School of Paris and Chinese ink painting with remarkable stylistic innovations. The aim of this study was to characterise Liu Kang’s painting materials and technique by way of ten paintings from a significant period in his oeuvre, 1950–1958, during which his Nanyang style emerged. The selected artworks are from the National Gallery Singapore. A broad range of analytical techniques was employed to study the painting supports and paint layers. The results indicate the prevailing use of commercially prepared linen canvases with double-layered oil-based ground. Single- and triple-layered structures of the ground, as well as semi-absorbent ground, were used sporadically. The identified group of pigments partially overlaps with those already known from Liu Kang’s earlier practice and also incorporates some noteworthy peculiarities like manganese, cerulean and phthalocyanine blues, phthalocyanine green, zinc yellow, and naphthol red AS-D. Some of these newly identified pigments made a distinctive appearance in the individual artworks, but ultimately Liu Kang was not convinced about increasing their role in his painting practice of the 1950s as presented in this research. This study highlights the significance of drawing and photography as integral elements of his artistic process. It also delves into the artist’s different painting approaches and discusses their evolution, which culminated in the stylistic innovation that became Liu Kang’s signature for decades to come. The obtained data may assist art historians and conservators in authenticity and attribution studies, evaluating the condition of artworks and designing conservation strategies. Moreover, this study contributes to the growing body of knowledge about twentieth-century artists’ materials, which are characterised by the complex mixtures of inorganic and organic compounds. It also provides information about the availability of art materials in Singapore in the 1950s.
Baseline MRI-based radiomics model assisted predicting disease progression in nasopharyngeal carcinoma patients with complete response after treatment
Authors: Bao Dan , Liu Zhou , Geng Yayuan , Li Lin , Xu Haijun , Zhang Ya , Hu Lei , Zhao Xinming , Zhao Yanfeng , Luo Dehong
Published: January 2022

Background

Accurate pretreatment prediction for disease progression of nasopharyngeal carcinoma is key to intensify therapeutic strategies to high-risk individuals. Our aim was to evaluate the value of baseline MRI-based radiomics machine-learning models in predicting the disease progression in nasopharyngeal carcinoma patients who achieved complete response after treatment.

Methods

In this retrospective study, 171 patients with pathologically confirmed nasopharyngeal carcinoma were included. Using hold-out cross validation scheme (7:3), relevant radiomic features were selected with the least absolute shrinkage and selection operator method based on baseline T2-weighted fat suppression and contrast-enhanced T1-weighted images in the training cohort. After Pearson’s correlation analysis of selected radiomic features, multivariate logistic regression analysis was applied to radiomic features and clinical characteristics selection. Logistic regression analysis and support vector machine classifier were utilized to build the predictive model respectively. The predictive accuracy of the model was evaluated by ROC analysis along with sensitivity, specificity and AUC calculated in the validation cohort.

Results

A prediction model using logistic regression analysis comprising 4 radiomics features (HGLZE_T2H, HGLZE_T1, LDLGLE_T1, and GLNU_T1) and 5 clinical features (histology, T stage, N stage, smoking history, and age) showed the best performance with an AUC of 0.75 in the training cohort (95% CI: 0.66–0.83) and 0.77 in the validation cohort (95% CI: 0.64–0.90). The nine independent impact factors were entered into the nomogram. The calibration curves for probability of 3-year disease progression showed good agreement. The features of this prediction model showed satisfactory clinical utility with decision curve analysis.

Conclusions

A radiomics model derived from pretreatment MR showed good performance for predicting disease progression in nasopharyngeal carcinoma and may help to improve clinical decision making.
An investigationof the inhibitory effects of dichloromethane and methanol extracts of Salvia macilenta, Salvia officinalis, Salvia santolinifola and Salvia mirzayanii on diabetes marker enzymes, an approach for the treatment diabetes
Authors: Javid Hasan , Moein Soheila , Moein Mahmoodreza
Published: January 2022

Background

Diabetes mellitus is a type of metabolic disease characterized by elevated blood sugar. The main strategy for its treatment is to inhibit carbohydrate-hydrolyzing enzymes, including α-amylase and α-glucosidase. The aim of the present study was to evaluate the efficacy of Salvia extracts in inhibiting diabetes marker enzymes.

Materials and methods

This experimental study was performed in vitro. The studied plants included Salvia mirzayanii, Salvia macilenta, Salvia officinalis and Salvia santolinifola and inhibitory effects of their methanolic and dichloromethane extracts were investigated. After calculating the percentage of α-amylase inhibition and IC50 of the extracts, Km and Vmax were also determined using prism7.Statistical analysis was performed employing with Graph Pad instat3 software.

Results

The results here in revealed that methanol extracts of Salvia santolinifola (with IC50 = 54.72 ± 9.6 μg / ml) and Salvia officinalis with (IC50 = 54.87 ± 5.7 μg / ml) and dichloromethane extract of Salvia officinalis with (IC50 = 71.20 ± 14.3 μg / ml) had the greatest inhibitory effect on α-amylase comparing to acarbose with (IC50 = 42.94 ± 3.8 μg / ml) as a standard. Tukey test results showed that there is a significant difference between IC50 of acarbose comparing to methanol extract of Salvia mirzayanii and dichloromethane extracts of Salvia mirzayanii and Salvia santolinifola with P value ˂0.001 in α-amylase inhibition.

Conclusion

The extracts had significant inhibitory effects on α-amylase inhibition. Among the extracts of the studied species, methanol extract of Salvia santolinifola demonstrated the greatest inhibitory effect on α-amylase.
SNP-based breeding for broiler resistance to ascites and evaluation of correlated production traits
Authors: Lee Katie Pepper , Anthony Nicholas B. , Orlowski Sara K. , Rhoads Douglas D.
Published: January 2022

Background

The goal of this study was to evaluate marker-assisted selection (MAS) in broiler chickens using previously mapped gene regions associated with ascites syndrome incidence. The second-generation MAS products were assessed for impact on ascites phenotype and whether there were associated changes in important production traits. Previously, we used whole genome resequencing (WGR) to fine-map 28 chromosomal regions as associated with ascites phenotype in our experimental ascites broiler line (Relaxed, REL) based on a hypobaric chamber challenge. Genotypes for single nucleotide polymorphisms (SNPs) in mapped regions on chromosomes 2 and 22, were used for MAS in our REL line. After two generations, birds homozygous for the genotypes associated with resistance for both chromosomal regions were established. The MAS F2 generation was then compared to the REL line for ascites susceptibility and 25 production traits.

Results

Selection based on SNPs in the carboxypeptidase Q (CPQ, Gga2) and leucine rich repeat transmembrane neuronal 4 (LRRTM4, Gga22) gene regions resulted in a sex- and simulated altitude- dependent reduction of ascites incidence in two F2 cohorts of the MAS line. Comparisons of the F2 MAS and REL lines for production traits when reared at ambient pressure found no significant negative impacts for feed intake (FI), feed conversion ratio (FCR), or deboned part yields for either sex for two F2 cohorts. There were, however, improvements in the MAS for full-trial body weight gain (BWG), FCR, absolute and relative tender weights, and relative drumstick weight.

Conclusions

These results validate the mapping of the 28 chromosomal regions and demonstrate that fine mapping by WGR is an effective strategy for addressing a complex trait; it also stands as the first successful SNP-based selection program against a complex disease trait, such as ascites. The MAS line is comparable and, in some instances, superior, in growth performance to the REL control while being more resistant to ascites. This study indicates that MAS based on WGR can provide significant breeding potential in agricultural systems.
Patient-specific 3D-printed helmet for post-craniectomy defect – a case report
Authors: Pang Sherby Suet-Ying , Fang Evan , Chen Kam Wai , Leung Matthew , Chow Velda Ling-Yu , Fang Christian
Published: January 2022

Background

Patients who undergo decompressive craniectomy (DC) are often fitted with a helmet that protects the craniectomy site from injury during rehabilitation. However, conventional “one-size-fits-all” helmets may not be feasible for certain craniectomy defects. We describe the production and use of a custom 3D-printed helmet for a DC patient where a conventional helmet was not feasible due to the craniectomy defect configuration.

Case presentation

A 65-year-old male with ethmoid sinonasal carcinoma underwent cranionasal resection and DC with free vastus lateralis flap reconstruction to treat cerebrospinal fluid leakage. He required an external helmet to protect the craniectomy site, however, the rim of a conventional helmet compressed the craniectomy site, and the straps compressed the vascular pedicle of the muscle flap. Computed topography (CT) scans of the patient’s cranium were imported into 3D modelling software and used to fabricate a patient-specific, strapless helmet using fused deposition modelling (FDM). The final helmet fit the patient perfectly and circumvented the compression issues, while also providing better cosmesis than the conventional helmet. Four months postoperatively, the helmet remains intact and in use.

Conclusions

3D printing can be used to produce low-volume, patient-specific external devices for rehabilitation where standardized adjuncts are not optimal. Once initial start-up costs and training are overcome, these devices can be produced by surgeons themselves to meet a wide range of clinical needs.
Quantification of organic volatile impurities in Oseltamivir phosphate drug substances by head space gas chromatography
Authors: Gudibanda Chandrasekhar Reddy , Pulipaka Shyamala , Rallabhandi Murali Krishna , Kapavarapu Maruthi Venkata Narayana Rao , Mannem Mannem Durga Babu
Published: January 2022

Background

The present work is aimed at quantification of organic volatile solvents like Methanol, Ethanol, Acetonitrile, Isopropyl alcohol (IPA), Dichloromethane (DCM), Methyl tert-butyl ether (MTBE), Hexane fractions, Ethyl acetate (EA), Tetra hydro furan (THF), 1,4-Dioxane, Dimethylformamide (DMF), and Toluene in Oseltamivir phosphate Active pharmaceutical ingredient (API) and pharmaceutical dosage forms. The method was developed using a thermal gradient elution program associated with a column having dimensions are DB-1,60 m × 0.32 mm × 5.0 μm with a flow rate of 1.0 mL/min and Nitrogen (N2) as a carrier gas. A flame ionization detector was used as a detector, and its temperature is at 290 °C whereas the injector temperature is at 180 °C. The total run time is 60.0 min. The developed method was validated according to International Council for Harmonization (ICH) guidelines.

Results

The linearity of the calibration curve for twelve impurities in the concentration range of Limit of Quantification (LOQ) to 150% was good. The curve was linear for twelve residual impurities of Oseltamivir phosphate. Relative standard deviation values for twelve residual impurities are not more than 15%. Limit of detection (LOD) and LOQ for twelve residual impurities were found to be very low-level concerning specification level. We found good results for all validated parameters for twelve residual impurities.

Conclusions

To quantify the residual organic volatile solvents (organic volatile impurities) in the Oseltamivir phosphate API, a novel, specific, and elevated sensitive headspace gas chromatography method was developed to separate twelve solvents that are accompanying with fifteen peaks. Out of fifteen peaks, critical components are Hexane fractions, Ethyl acetate, MTBE, and DCM. So, our method has capable of separating and simultaneous quantification such critical components. So, it can be successfully applied for routine analysis of quantification of these twelve residual impurities in Oseltamivir phosphate bulk and pharmaceutical dosage forms.
Incidence, Nature, and Consequences of Oncologists' Experiences With Sexual Harassment
Authors: Subbiah Ishwaria M. , Markham Merry Jennifer , Graff Stephanie L. , Matt-Amaral Laurie B. , Close Julia L. , Griffith Kent A. , Jagsi Reshma
Published: January 2022

PURPOSE

The incidence and impact of workplace sexual harassment (SH) of oncologists requires rigorous characterization.

METHODS

Oncologists identified by ASCO's Research Survey Pool and social media outreach completed validated measures of SH (encompassing gender harassment, unwanted sexual attention, and sexual coercion) and four outcomes (mental health, job satisfaction, turnover intentions, and sense of workplace safety) over the previous year. Multivariable regression models assess the impact of SH on the four outcomes.

RESULTS

Of 271 cisgender respondents (153 women and 118 men), 189 (70%) experienced SH in the past year alone by peers and/or superiors (80% of women v 56% of men, P < .0001). Specifically, 186 (69%) experienced gender harassment (79% of women, 55% of men, P < .0001), 45 (17%) unwanted sexual attention (22% of women, 9% of men, P = .005), and 7 (3%) sexual coercion (3% of women, 2% of men, P = .42). SH by patients and/or families in the past year was experienced by 143 (53% overall: 67% of women, 35% of men, P < .0001). Specifically, 141 (52%) experienced gender harassment (66% of women, 34% of men, P < .0001), 15 (6%) unwanted sexual attention (5% of women, 6% of men, P = .80), and 3 (1%) sexual coercion (1% of women, 1% of men, P = .72). Multivariable analysis showed that past-year SH by peers and/or superiors was significantly associated with decreased mental health (β = –0.45, P = .004), sense of workplace safety (β = –0.98, P < .001), and job satisfaction (β = –0.69, P = .001), along with increased turnover intentions (β = 0.93, P < .0001). Past-year SH by patients and/or families was significantly associated with decreased mental health (β = –0.41, P = .002), sense of workplace safety (β = –0.42, P = .014), and increased turnover intentions (β = 0.58, P = .0004). There were no significant interactions between the respondents' gender and the SH scores in any of the four outcome models, signifying no difference in impact between men and women oncologists.

CONCLUSION

This study using validated measures of SH to systematically characterize oncologists' workplace experience demonstrates substantial incidence of SH in the previous one year alone and its impact on men and women oncologists, informing the need for and design of effective protective and preventive measures.
Approach to the Patient With Treatment-resistant Acromegaly
Authors: Coopmans Eva C , van der Lely Aart J , Neggers Sebastian J C M M
Published: January 2022

Although most tumors in patients with acromegaly are benign and are cured or controlled by surgery and/or first-generation somatostatin receptor ligands therapy, some can behave more aggressively and are resistant to these standard therapies. Acromegaly, if left untreated, is a rare and chronic disorder, commonly caused by a GH-producing pituitary adenoma and is associated with significant comorbidities and an increased mortality. Transsphenoidal surgery is considered the mainstay of acromegaly management, but medical therapy has an increasingly important role. However, disease activity is not fully controlled in a significant number of patients treated with surgery and/or high-dose first-generation somatostatin receptor ligand monotherapy. In these circumstances, therefore, repeated surgery, second-line medical therapy, and radiotherapy, alone or combined as multimodal therapeutic strategies should be considered, in a patient-centered perspective.
Perioperative Management of a Patient With Cushing Disease
Authors: Varlamov Elena V , Vila Greisa , Fleseriu Maria
Published: January 2022

Patients with Cushing disease (CD) may present with both chronic and acute perioperative complications that necessitate multidisciplinary care. This review highlights several objectives for these patients before and after transsphenoidal surgery. Preoperative management includes treatment of electrolyte disturbances, cardiovascular comorbidities, prediabetes/diabetes, as well as prophylactic consideration(s) for thromboembolism and infection(s). Preoperative medical therapy (PMT) could prove beneficial in patients with severe hypercortisolism or in cases of delayed surgery. Some centers use PMT routinely, although the clinical benefit for all patients is controversial. In this setting, steroidogenesis inhibitors are preferred because of rapid and potent inhibition of cortisol secretion. If glucocorticoids (GCs) are not used perioperatively, an immediate remission assessment postoperatively is possible. However, perioperative GC replacement is sometimes necessary for clinically unstable or medically pretreated patients and for those patients with surgical complications. A nadir serum cortisol of less than 2 to 5µg/dL during 24 to 74 hours postoperatively is generally accepted as remission; higher values suggest nonremission, while a few patients may display delayed remission. If remission is not achieved, additional treatments are pursued. The early postoperative period necessitates multidisciplinary awareness for early diagnosis of adrenal insufficiency (AI) to avoid adrenal crisis, which may also be potentiated by acute postoperative complications. Preferred GC replacement is hydrocortisone, if available. Assessment of recovery from postoperative AI should be undertaken periodically. Other postoperative targets include decreasing antihypertensive/diabetic therapy if in remission, thromboprophylaxis, infection prevention/treatment, and management of electrolyte disturbances and/or potential pituitary deficiencies. Evaluation of recovery of thyroid, gonadal, and growth hormone deficiencies should also be performed during the following months postoperatively.
The Hox gene Antennapedia is essential for wing development in insects
Authors: Fang Chunyan , Xin Yaqun , Sun Tao , Monteiro Antónia , Ye Zhanfeng , Dai Fangyin , Lu Cheng , Tong Xiaoling
Published: January 2022

A long-standing view in the field of evo-devo is that insect forewings develop without any Hox gene input. The Hox gene Antennapedia (Antp), despite being expressed in the thoracic segments of insects, has no effect on wing development. This view has been obtained from studies in two main model species: Drosophila and Tribolium. Here, we show that partial loss of function of Antp resulted in reduced and malformed adult wings in Bombyx, Drosophila and Tribolium. Antp mediates wing growth in Bombyx by directly regulating the ecdysteriod biosynthesis enzyme gene (shade) in the wing tissue, which leads to local production of the growth hormone 20-hydroxyecdysone. Additional targets of Antp are wing cuticular protein genes CPG24, CPH28 and CPG9, which are essential for wing development. We propose, therefore, that insect wing development occurs in an Antp-dependent manner.

This article has an associated ‘The people behind the papers’ interview.
A novel yeast model detects Nrf2 and Keap1 interactions with Hsp90
Authors: Ngo Vy , Brickenden Anne , Liu Hansen , Yeung Cynthia , Choy Wing-Yiu , Duennwald Martin L.
Published: January 2022

Nrf2 is the master transcriptional regulator of cellular responses against oxidative stress. It is chiefly regulated by Keap1, a substrate adaptor protein that mediates Nrf2 degradation. Nrf2 activity is also influenced by many other protein interactions that provide Keap1-independent regulation. To study Nrf2 regulation, we established and characterized yeast models expressing human Nrf2 (also known as NFE2L2), Keap1 and other proteins that interact with and regulate Nrf2. Yeast models have been well established as powerful tools to study protein function and genetic and physical protein-protein interactions. In this work, we recapitulate previously described Nrf2 interactions in yeast and discover that Nrf2 interacts with the molecular chaperone Hsp90. Our work establishes yeast as a useful tool to study Nrf2 interactions and provides new insight into the crosstalk between the antioxidant response and the heat shock response.
Physiological effects of food availability times in higher vertebrates
Authors: Kumar Vinod , Sharma Aakansha , Tripathi Vatsala
Published: January 2022

Food availability is a crucial ecological determinant of population size and community structure, and controls various life-history traits in most, if not all, species. Food availability is not constant; there are daily and seasonal differences in food abundance. When coupled to appetite (urge to eat), this is expressed as the eating schedule of a species. Food availability times affect daily and seasonal physiology and behaviour of organisms both directly (by affecting metabolic homeostasis) and indirectly (by altering synchronization of endogenous rhythms). Restricted food availability times may, for example, constrain reproductive output by limiting the number or quality of offspring or the number of reproductive attempts, as has been observed for nesting frequency in birds. Consuming food at the wrong time of day reduces the reproductive ability of a seasonal breeder, and can result in quality–quantity trade-offs of offspring. The food availability pattern serves as a conditioning environment, and can shape the activity of the genome by influencing chromatin activation/silencing; however, the functional linkage of food availability times with epigenetic control of physiology is only beginning to emerge. This Review gives insights into how food availability times, affected by changes in eating schedules and/or by alterations in feeding environment or lifestyle, could have hitherto unknown consequences on the physiology and reproductive fitness of seasonally breeding vertebrates and those that reproduce year round.
Effect of Quadrupole of Nitrogen, as a Probe Molecule for Surface Area Estimation: XRD and HRMC Investigation
Authors: Bacilla Ana Carolina Cons , Futamura Ryusuke , Iiyama Taku
Published: January 2022

To obtain the properties of nanopores solids, N2 is usually used as probe molecule, however recently, IUPAC recommends using Ar instead. This study used experimental X-ray diffraction (XRD) analysis, Monte Carlo (MC), and hybrid reverse MC (HRMC) simulations to obtain information on the intermolecular structures of adsorbed N2 and Ar. Our results indicate that the quadrupole interaction between N2 molecules is relatively weak, and the N2 gives fairly good assessments as with Ar for porous carbons with low functional groups.
Enzyme Model-catalyzed Oxidative Copolymerization of Phenol while Continuously Adding an Endcap to Multi-branched Poly(phenylene oxide) Showing Low Dielectric Constant
Authors: Nakano Akiyuki , Kubota Yuto , Osaka Noboru , Higashimura Hideyuki
Published: January 2022

Oxidative copolymerization of phenol while continuously adding a small amount of 4-phenylphenol as an endcap was performed by using an enzyme model catalyst, followed by reprecipitation. Consequently, multi-branched poly(phenylene oxide)s were obtained with number-averaged molecular weights of 18,000–28,000, showing both high thermal stability beyond 470 °C and low dielectric constant of 2.43 @ 10 GHz.
Hospital Network Competition and Adverse Selection: Evidence from the Massachusetts Health Insurance Exchange
Authors: Shepard Mark
Published: January 2022

Health insurers increasingly compete on their networks of medical providers. Using data from Massachusetts’s insurance exchange, I find substantial adverse selection against plans covering the most prestigious and expensive “star” hospitals. I highlight a theoretically distinct selection channel: consumers loyal to star hospitals incur high spending, conditional on their medical state, because they use these hospitals’ expensive care. This implies heterogeneity in consumers’ incremental costs of gaining access to star hospitals, posing a challenge for standard selection policies. Along with selection on unobserved sickness, I find this creates strong incentives to exclude star hospitals, even with risk adjustment in place. (JEL D82, G22, H75, I11, I13, I18)
Towards an integrated tourism landscape analysis and evaluation
Authors: Γέροντα Χρυσαφίνα
Published: January 2022

Η διατριβή επιδίωξε να απαντήσει στην αυξανόμενη ανάγκη για θεωρητική και μεθοδολογική εμβάθυνση της έννοιας του τουριστικού τοπίου με μια διεπιστημονική προσέγγιση, με σκοπό τη βιώσιμη διαχείριση τόσο των υλικών, όσο και των άυλων στοιχείων και πολιτιστικών αξιών που το συνθέτουν. Η έρευνα διεξήχθη στα πλαίσια μιας διδακτορικής διατριβής στο πανεπιστήμιο της Πάδοβας (2013/2016) και επιχείρησε να προσφέρει μια σύνθετη ερμηνεία για την έννοια του τουριστικού τοπίου, όπως προέκυψε ύστερα από μελέτη διαφόρων ερευνητικών παραδειγμάτων από επιστημονικούς τομείς, όπως οι χωρικές επιστήμες, η οικολογία τοπίου, η περιβαλλοντική ψυχολογία και η πολιτιστική γεωγραφία.Η ερμηνεία του τουριστικού τοπίου βασισμένη σε τρεις βασικούς άξονες (φυσιογνωμικά χαρακτηριστικά τοπίου, κοινωνικοοικονομικοί και περιβαλλοντικοί παράγοντες και υποκειμενικές νοητικές εικόνες), οδήγησε στη δημιουργία ενός ολοκληρωμένου μεθοδολογικού πλαισίου για την απόκτηση πρωταρχικών αντικειμενικών και υποκειμενικών δεδομένων, περιγράφοντας έτσι πολλαπλές απτές και βιωματικές πτυχές του τουριστικού τοπίου.Το μεθοδολογικό πλαίσιο περιέλαβε τεχνικές εμπειρογνωμόνων (όπως ιστορική ανασκόπηση, τηλεπισκόπηση μέσω GIS, στατιστική ανάλυση, καθορισμός και εφαρμογή ενός συνόλου δεικτών μέτρησης τοπίου, αναπαράσταση διανυσματικών δεδομένων σε θεματικούς χάρτες), καθώς και μια εμπειρική μελέτη βασισμένη σε ερωτηματολόγιο.Προκειμένου να εφαρμοστεί το πλαίσιο και να επαληθευτεί η αποτελεσματικότητά του στην ανάλυση και αξιολόγηση ενός τουριστικού τοπίου, η περιοχή της Λίνδου στο νησί της Ρόδου υιοθετήθηκε ως μελέτη περίπτωσης.Η ενσωμάτωση των αποτελεσμάτων από τις τεχνικές εμπειρογνωμόνων και την εμπειρική μελέτη που ερεύνησε τις υποκειμενικές αντιλήψεις ενός σημαντικού αριθμού διεθνών τουριστών (385) για το τοπίο της Λίνδου, συνέβαλε στη διατύπωση προτάσεων για μια περισσότερο συνεκτική και βιώσιμη διαχείριση του τοπίου της Λίνδου. Τέλος, από αυτή τη μελέτη, προέκυψαν γενικά συμπεράσματα τόσο για τις δυνατότητες όσο και για τους περιορισμούς της εφαρμογής διεπιστημονικών ερευνητικών προσεγγίσεων, καθώς και της συγχώνευσης αντικειμενικών και υποκειμενικών δεδομένων για το τουριστικό τοπίο.
Ραδιοκυματική ανίχνευση και μελέτη κοσμικών καταιονισμών σε περιοχές αυξημένου ηλεκτρομαγνητικού θορύβου
Authors: Νόνης Σταύρος
Published: January 2022

Οι κοσμικές ακτίνες είναι φορτισμένα σωματίδια πολύ υψηλής ενέργειας προερχόμενα από γαλαξιακές και εξωγαλαξιακές πηγές. Η ανίχνευση των σωματιδίων αυτών γίνεται έμμεσα από τον καταιονισμό δευτερευόντων σωματιδίων που προκαλείται από την αλληλεπίδραση τους με πυρήνες της ατμόσφαιρας. Μια αναπτυσσόμενη νέα τεχνική ανίχνευσης του κοσμικού καταιονισμού στην ατμόσφαιρα στηρίζεται στην λήψη του ηλεκτρομαγνητικού κύματος που εκπέμπεται στην περιοχή των ραδιοκυμάτων RF. Στην παρούσα διατριβή έγιναν μελέτες για την δημιουργία ενός μοντέλου απόκρισης των κεραιών χρησιμοποιώντας το ενεργό μήκος (ΕΜ) τους και προσομοιώσεις του RF φάσματος από διαφορετικές περιπτώσεις κοσμικών καταιονισμών. Σκοπός είναι η εκτίμηση της διεύθυνσης άφιξης του αρχικού σωματιδίου συγκρίνοντας το φάσμα του καταγραφόμενου παλμού με το μοντέλο της κεραίας. Αρχικά χρησιμοποιήθηκαν δεδομένα των σταθμών Α και Β κατά την πρώτη φάση λειτουργίας του τηλεσκοπίου ενώ στην συνέχεια χρησιμοποιήθηκαν φάσματα από γεγονότα που καταγράφηκαν ταυτόχρονα από τις 4 κεραίες του σταθμού Α στην διάρκεια της δεύτερης φάσης λειτουργίας του. Και στις δυο περιπτώσεις δεδομένων έγινε σύγκριση των αποτελεσμάτων με τις μετρήσεις από τους σωματιδιακούς ανιχνευτές των σταθμών καθώς και με προσομοιώσεις. Επιπλέον έγινε μια συστηματική μελέτη για την καταγραφή των χρόνων άφιξης των παλμών στις κεραίες και ανακατασκευή της διεύθυνσης άφιξης του καταιονισμού από τον χρονισμό των κεραιών.
Ρυθμιστικός σχεδιασμός της υπαίθρου στην Ελλάδα
Authors: Βεζυριαννίδου Σουλτάνα
Published: January 2022

Έχει επισημανθεί στη θεωρία ότι, η χώρα μας υστερεί σημαντικά σε ζητήματα χρήσεων γης σε σχέση με άλλες ευρωπαϊκές χώρες. Η υστέρηση αυτή αναφέρεται στην απουσία Σχεδίων Χρήσεων Γης (ΣΧΓ) για το σύνολο της επικράτειας, καθώς το 2020 μόλις το 20% των δημοτικών ενοτήτων της χώρας διέθεταν ΣΧΓ, τα οποία υλοποιούνταν με τα Γενικά Πολεοδομικά Σχέδια (ΓΠΣ). Τα ΣΧΓ/ΓΠΣ θεωρούνται σημαντικά διότι αντιμετωπίζουν καίρια σύγχρονα ζητήματα ρύθμισης και ανάπτυξης του χώρου στο δημοτικό επίπεδο και καθορίζουν, μεταξύ άλλων, την οριοθέτηση περιβαλλοντικών και αναπτυξιακών ζωνών και τις χρήσεις γης στην ύπαιθρο με κύριο στόχο τη βιώσιμη ανάπτυξη ενός Δήμου. Στη σύγχρονη εποχή της οικονομικής κρίσης, που επιχειρείται μια εμφατική ενίσχυση της «ανάπτυξης» σε βάρος του «περιβάλλοντος», κρίνεται αναγκαία η ολοκλήρωση των ΣΧΓ/ΓΠΣ και συνακόλουθα ο καθορισμός των χρήσεων γης για την ύπαιθρο.Η παρούσα διατριβή επιχειρεί αρχικά, παρουσιάζοντας μία ιστορική αναδρομή του θεσμικού πλαισίου για τη χωροταξία-πολεοδομία στη χώρα μας σε συνδυασμό με τη νομοθεσία για την ανάπτυξη και το περιβάλλον, να καταδείξει ότι τα ΓΠΣ/ΣΧΟΟΑΠ του N.2508/97 αποτέλεσαν, μέχρι σήμερα, το πιο ολοκληρωμένο εργαλείο για τον καθολικό σχεδιασμό των αστικών, περιαστικών και αγροτικών περιοχών ενός Δήμου και βασική ρυθμιστική συνιστώσα στη σχέση ανάπτυξης/περιβάλλοντος.Ακολούθως, το εμπειρικό μέρος της διατριβής εξετάζει τα εγκεκριμένα ΓΠΣ/ΣΧΟΟΑΠ του Ν.2508/97 για το σύνολο της επικράτειας, καθώς αποτελούν τα μόνα ολοκληρωμένα εργαλεία που έχουν δοκιμασθεί στην πράξη, παρά τη μικρή εφαρμογή τους έως σήμερα, και διότι τα ισχύοντα σήμερα ΣΧΓ στο τοπικό χωροταξικό επίπεδο, τα Τοπικά Πολεοδομικά Σχέδια (ΤΠΣ), αποτελούν μετεξέλιξη αυτών κι έχουν παρόμοια χαρακτηριστικά.Μέσα από την εμπειρική έρευνα, επιχειρείται η καταγραφή, συστηματοποίηση και αξιολόγηση των εργαλείων που επιλέχθηκαν για τη ρύθμιση της υπαίθρου μέσω των ΓΠΣ/ΣΧΟΟΑΠ και εξετάζονται οι παράμετροι/μεταβλητές/παράγοντες που δυσχεραίνουν την υλοποίηση και ολοκλήρωσή τους μέχρι σήμερα. Ειδικότερα οι υποθέσεις εργασίας που διατυπώνονται και επαληθεύονται από τα αποτελέσματα της έρευνας εντοπίζουν δυσλειτουργίες σε τρεις βασικές συνιστώσες του ρυθμιστικού σχεδιασμού: α) στην κάθετη συνέργεια μεταξύ των επιπέδων σχεδιασμού β) στην οριζόντια συνέργεια των τομεακών πολιτικών και γ) στη συμβολή της διαβούλευσης στην ολοκλήρωση των ΣΧΓ. Εν τέλει, τα αποτελέσματα της έρευνας οδηγούν στην εξαγωγή συμπερασμάτων σχετικά με τον κύριο στόχο της διατριβής που αναφέρεται στην αδυναμία υλοποίησης της χωροταξκής πολιτικής στην ύπαιθρο µέσω των ΓΠΣ.Η διατριβή ολοκληρώνεται με τη διατύπωση προτάσεων/κατευθύνσεων πολιτικής για περαιτέρω διερεύνηση προοπτικών που θα συμβάλλουν στην ολοκλήρωση του ορθολογικού σχεδιασμού των χρήσεων γης και στην συνακόλουθη επίτευξη της βιώσιμης ανάπτυξης.
Applications of GIS and geospatial analyses in COVID-19 research: A systematic review
Authors: Ahasan Rakibul , Alam Md. Shaharier , Chakraborty Torit , Hossain Md. Mahbub
Published: January 2022

Background: Geographic information science (GIS) has established itself as a distinct domain and incredibly useful whenever the research is related to geography, space, and other spatio-temporal dimensions. However, the scientific landscape on the integration of GIS in COVID-related studies is largely unknown. In this systematic review, we assessed the current evidence on the implementation of GIS and other geospatial tools in the COVID-19 pandemic.

Methods: We systematically retrieved and reviewed 79 research articles that either directly used GIS or other geospatial tools as part of their analysis. We grouped the identified papers under six broader thematic groups based on the objectives and research questions of the study- environmental, socio-economic, and cultural, public health, spatial transmission, computer-aided modeling, and data mining.

Results: The interdisciplinary nature of how geographic and spatial analysis was used in COVID-19 research was notable among the reviewed papers. Geospatial techniques, especially WebGIS, have even been widely used to visualize the data on a map and were critical to informing the public regarding the spread of the virus, especially during the early days of the pandemic. This review not only provided an overarching view on how GIS has been used in COVID-19 research so far but also concluded that geospatial analysis and technologies could be used in future public health emergencies along with statistical and other socio-economic modeling techniques. Our review also highlighted how scientific communities and policymakers could leverage GIS to extract useful information to make an informed decision in the future.

Conclusions:  Despite the limited applications of GIS in identifying the nature and spatio-temporal pattern of this raging pandemic, there are opportunities to utilize these techniques in handling the pandemic. The use of spatial analysis and GIS could significantly improve how we understand the pandemic as well as address the underserviced demographic groups and communities.
Tailored PRISMA 2020 flow diagrams for living systematic reviews: a methodological survey and a proposal
Authors: Kahale Lara A. , Elkhoury Rayane , El Mikati Ibrahim , Pardo-Hernandez Hector , Khamis Assem M. , Schünemann Holger J. , Haddaway Neal R. , Akl Elie A.
Published: January 2022

Background: While the PRISMA flow diagram is widely used for reporting standard systematic reviews (SRs), it was not designed for capturing the results of continual searches for studies in living systematic reviews (LSRs). The objectives of this study are (1) to assess how published LSRs report on the flow of studies through the different phases of the review for the different updates; (2) to propose an approach to reporting on that flow.

Methods: For objective 1, we identified all LSRs published up to April 2021. We abstracted information regarding their general characteristics and how they reported on search results. For objective 2, we based our proposal for tailored PRISMA approaches on the findings from objective 1, as well as on our experience with conducting Cochrane LSRs.

Results: We identified 279 living publications relating to 76 LSRs. Of the 279 publications, 11% were protocols, 23% were base versions (i.e., the first version), 50% were partial updates (i.e., does not include all typical sections of an SR), and 16% were full updates (i.e., includes all typical sections of an SR). We identified six ways to reporting the study flow: base separately, each update separately (38%); numbers not reported (32%); latest update separately, all previous versions combined (20%); base separately, all updates combined (7%); latest update version only (3%); all versions combined (0%). We propose recording in detail the results of the searches to keep track of all identified records. For structuring the flow diagram, we propose using one of four approaches.

Conclusion: We identified six ways for reporting the study flow through the different phases of the review for the different update versions. We propose to document in detail the study flow for the different search updates and select one of our four tailored PRISMA diagram approaches to present that study flow.
COVID-19 home isolation and food consumption patterns: Investigating the correlates of poor dietary diversity in Lebanon: a cross-sectional study
Authors: Hoteit Maha , Mortada Hussein , Al-Jawaldeh Ayoub , Ibrahim Carla , Mansour Rania
Published: January 2022

Background: The unfurling COVID-19 pandemic has uncovered the defenselessness of the Lebanese food system leading to serious implication in maintaining a healthy sustainable lifestyle.

Aim: The main purpose of this study is to examine the impact of the COVID-19 pandemic on food consumption patterns and dietary diversity of the Lebanese people.

Methods: The online survey, completed between April and June 2020, consisted of a cross-sectional study on 2282 Lebanese participants (mean age: 29.36±12.221, 80.9% women) that was part of a survey across 38 different countries conducted by De Backer, C. et al. A food frequency questionnaire was used to investigate the consumption patterns along with the calculation of the Food Consumption Score (FCS), a proxy indicator of dietary diversity. Data collected on cooking attitudes, shopping, and food stock identify the community mitigation measures.

Results: Home isolation due to COVID-19 induced an increase in the consumption of legumes and pulses (3.2%, p-value=0.001) and whole wheat groups (2.8%, p-value=0.03). In contrast, a decrease of 5.4%, 6.9%, 5.8%, 5.1%, 3.1%, 3.4% and 2.8% was observed in the consumption of fruits (p-value=0), vegetables (p-value=0), processed meats, poultry, and fish (p-value=0), other dairy products (p-value=0), sweet snacks (p-value=0.001), sugared beverages (p-value=0), fats and oils (p-value=0.001), respectively. The FCS decreased by 4.6%. As food-related behaviors, most cooking attitudes, and practices (10 out of 13) showed an amelioration during the lockdown and the proportions of food stocked have been changing since the start of the pandemic seeing higher amounts of pasta, rice or other grains, flour, and legumes/pulses stocked.

Conclusion: To conclude, the hostile home isolation strategy followed to prevent the COVID-19 spread in Lebanon, came at a high nutritional cost, driving poor dietary diversity.
Using theory of change in child health service interventions: a scoping review protocol
Authors: Jones Benjamin , Nagraj Shobhana , English Mike
Published: January 2022

Background:The objective of this scoping review is to map the evidence of how child health service interventions use their theory of change. A theory of change is a hypothesis ofhowandwhyan intervention is intended to bring about change. It can be used as a program design, implementation, and evaluation tool. This scoping review will provide an overview of the evidence base for, and identify the way in which, theories of change in child health service interventions are defined, rationalised, developed, presented, and refined.

Methods:The inclusion criteria for this scoping review is any child health service intervention globally, that describes their theory of change or theory of change development process. Relevant exclusions include: logic models or logic frameworks that do not meet this review’s definition of theory of change, systematic reviews, behavioural change interventions that target patient’s behaviour, school-based interventions, and maternal health interventions not related to child health outcomes. This scoping review will follow the Joanna Briggs Institute Reviewer’s manual. Relevant publications will be first searched on selected electronic databases and grey literature. A search strategy will be developed. The search will be limited to articles written in the English language. Results of the search will be curated using Endnote and duplicates removed. Results will be imported to Rayyan. The inclusion criteria will be applied during the process of title and abstract screening, by two independent reviewers and disagreements resolved by a third independent reviewer. Full-texts will have the inclusion criteria applied via the same reviewer process. Data relevant to the research sub-questions will be extracted, analysed, charted and discussed.

Ethics and dissemination:Ethical approval is not required for this review as we will make use of already published data. We aim to publish the findings of our review in a peer-reviewed journal.
Mathematical modelling of activation-induced heterogeneity in TNF, IL6, NOS2, and IL1β expression reveals cell state transitions underpinning macrophage responses to LPS
Authors: Dey Shoumit , Boucher Dave , Pitchford Jon , Lagos Dimitris
Published: January 2022

Background: Despite extensive work on macrophage heterogeneity, the mechanisms driving activation induced heterogeneity (AIH) in macrophages remain poorly understood. Here, we aimed to develop mathematical models to explore theoretical cellular states underpinning the empirically observed responses of macrophages following lipopolysaccharide (LPS) challenge.

Methods: We obtained empirical data following primary and secondary responses to LPS in two in vitro cellular models (bone marrow-derived macrophages or BMDMs, and RAW 264.7 cells) and single-cell protein measurements for four key inflammatory mediators: TNF, IL-6, pro-IL-1β, and NOS2, and used mathematical modelling to understand heterogeneity.

Results: For these four factors, we showed that macrophage community AIH is dependent on LPS dose and that altered AIH kinetics in macrophages responding to a second LPS challenge underpin hypo-responsiveness to LPS. These empirical data can be explained by a mathematical three-state model including negative, positive, and non-responsive states (NRS), but they are also compatible with a four-state model that includes distinct reversibly NRS and non-responsive permanently states (NRPS). Our mathematical model, termed NoRM (Non-Responsive Macrophage) model identifies similarities and differences between BMDM and RAW 264.7 cell responses. In both cell types, transition rates between states in the NoRM model are distinct for each of the tested proteins and, crucially, macrophage hypo-responsiveness is underpinned by changes in transition rates to and from NRS.

Conclusions: Overall, we provide a mathematical model for studying macrophage ecology and community dynamics that can be used to elucidate the role of phenotypically negative macrophage populations in AIH and, primary and secondary responses to LPS.
Origin of eukaryotes: What can be learned from the first successfully isolated Asgard archaeon
Authors: Albers Sonja , Ashmore Jonathan , Pollard Thomas , Spang Anja , Zhou Jizhong
Published: January 2022

The origin of cellular complexity characterizing eukaryotic cells remains a central unresolved issue in the study of diversification of cellular life on Earth. The isolation by Imachi et al.1 of a member of the Asgard archaea2 – a contemporary relative of organisms thought to have given rise to eukaryotic cells about 2 billion years ago – now promises new insight. The complete genome sequence of the isolated Lokiarchaeum strain confirms that the eukaryotic signature proteins (ESPs) previously identified in the Lokiarchaeota3 and other Asgard archaea2 are indeed encoded by these archaeal genomes and do not represent contamination from eukaryotes. These ESPs encode homologs of eukaryotic actins, small GTPases and the ESCRT complex proteins and are required for the functioning of complex eukaryotic cells. The new, slowly growing, anaerobic laboratory strain allows a first direct look at these organisms and provides key insights into the morphology and metabolism of an Asgard archaeal organism. The work has provided valuable information for other laboratories that aim to isolate and characterize related organisms from other environments.