bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical significance of mucinous component in colorectal adenocarcinoma: a propensity score-matched study
Authors: Yan Chuanwang , Yang Hui , Chen Lili , Liu Ran , Shang Wei , Yuan Wenguang , Yang Fei , Sun Qing , Xia Lijian
Published: December 2021

Background

This study aims to investigate the clinical significance and prognostic value of mucinous component (MC) in colorectal adenocarcinoma (AC).

Methods

Patients with colorectal AC and AC with MC (ACMC) (1–100%) underwent surgical resection between January 2007 and February 2018 were retrospectively reviewed. Propensity score matching (PSM) was performed according to a 1:1 ratio. Receiver-operating characteristic (ROC) curve was used to identify the optimal cut-off value of MC ratio for prognostic prediction. The clinicopathological features and 3-year overall survival (OS) of AC patients, mucinous adenocarcinoma (MAC) (MC > 50%) patients, and ACMC (1–50%) patients were compared before and after matching. Multivariable analysis was used for analyzing independent risk factors related to prognosis.

Results

A total of 532 patients were enrolled in this study. Patients with AC, MAC, and ACMC (1–50%) exhibited different clinicopathological features. However, their 3-year OS rates were similar (82.00% vs. 74.11% vs. 81.48%, P = 0.38). After matching, ROC curve determined 70% as the optimal cut-off value. And patients with ACMC > 70% had a much poorer 3-year OS compared with ACMC (1–70%) patients and AC patients (47.37% vs. 86.15% vs. 79.76%, P < 0.001). In addition, ACMC > 70% was revealed as a risk factor for poor survival in univariate analysis (HR = 1.643, 95%CI = 1.025–2.635, P = 0.039), though not an independent risk factor in multivariable analysis (HR = 1.550, 95%CI = 0.958–2.507, P = 0.074).

Conclusions

MAC is usually diagnosed at an advanced stage. MAC has a similar survival with AC and ACMC (1–50%) patients before and after matching. Patients with ACMC > 70% exhibited a much poorer OS, and should be given more clinical attention.
Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica
Authors: Kamath Aruna M. , Thom Maximilian G. , Johanns Casey K. , Panhorst Harris Katie , Schwarzbauer Karla , Ochoa José C. , Zuniga-Brenes Paola , Rios-Zertuche Diego , Mokdad Ali H. , Hernandez Bernardo
Published: December 2021

Background

Intrapartum-related hypoxic events, or birth asphyxia, causes one-fourth of neonatal deaths globally and in Mesoamerica. Multidimensional care for asphyxia must be implemented to ensure timely and effective care of newborns. Salud Mesoamérica Initiative (SMI) is a performance-based program seeking to improve maternal and child health for low-income areas of Central America. Our objective was to assess the impact of SMI on neonatal asphyxia care in health centers and hospitals in the region.

Methods

A pre-post design. Two hundred forty-eight cases of asphyxia were randomly selected from medical records at baseline (2011–2013) and at second-phase follow-up (2017–2018) in Mexico (state of Chiapas), Honduras, Nicaragua, and Guatemala as part of the SMI Initiative evaluation. A facility survey was conducted to assess quality of health care and the management of asphyxia. The primary outcome was coverage of multidimensional care for the management of asphyxia, consisting of a skilled provider presence at birth, immediate assessment, initial stabilization, and appropriate resuscitation measures of the newborn. Data were analyzed using multivariable logistic regression.

Results

Management of asphyxia improved significantly after SMI. Proper care of asphyxia in intervention areas was better (OR = 2.4; 95% CI = 1.3–4.6) compared to baseline. Additionally, multidimensional care was significantly higher in Honduras (OR = 4.0; 95% CI = 1.4–12.0) than in Mexico. Of the four multidimensional care components, resuscitation showed the greatest progress by follow-up (65.7%) compared to baseline (38.7%).

Conclusion

SMI improved the care for neonatal asphyxia management across all levels of health care in all countries. Our findings show that proper training and adequate supplies can improve health outcomes in low-income communities. SMI provides a model for improving health care in other settings.
Treating alcohol use disorder in the absence of specialized services – evaluation of the moving inpatient Treatment Camp approach in Uganda
Authors: Ertl Verena , Groß Melissa , Mwaka Samuel Okidi , Neuner Frank
Published: December 2021

Background

The gap between service need and service provision for alcohol-related disorders is highest in resource-poor countries. However, in some of these contexts, local initiatives have developed pragmatic interventions that can be carried out with limited specialized personnel. In an uncontrolled treatment study, we aimed to evaluate the feasibility, acceptability, safety, costs and potential effects of an innovative locally developed community-based program (the Treatment Camp) that is based on an inpatient clinic that moves from community to community.

Methods

Out of 32 treatment-seeking individuals 25 took part in the one-week Treatment Camp that included detoxification and counseling components. Re-assessments took place 5 and 12 months after their participation. We explored the course of a wide range of alcohol-related indicators, using the Alcohol Use Disorders Identification Test (AUDIT) as primary outcome complemented by a timeline follow-back approach and the Obsessive Compulsive Drinking Scale. Additionally, we assessed impaired functioning, alcohol-related stigmatization, symptoms of common mental health disorders and indicators of family functioning as reported by participants’ wives and children.

Results

All alcohol-related measures decreased significantly after the Treatment Camp and remained stable up to the 12-month-assessment with high effect sizes ranging from 0.89 to 3.49 (Hedges’s g). Although 92% of the participants had lapsed at least once during the follow-up period, 67% classified below the usually applied AUDIT cutoff for hazardous drinking (≥ 8) and no one qualified for the dependent range (≥ 20) one year after treatment. Most secondary outcomes including impaired functioning, alcohol-related stigmatization, symptoms of depression and indicators of family functioning followed the same trajectory.

Conclusions

We found the Treatment Camp approach to be acceptable, feasible, safe and affordable (approx. 111 USD/patient) and we could obtain preliminary evidence of its efficacy. Due to its creative combination of inpatient treatment and monitoring by medical personnel with local mobility, the Treatment Camp appears to be more accessible and inclusive than other promising interventions for alcohol dependent individuals in resource-poor contexts. Effects of the approach seem to extend to interactions within families, including a reduction of dysfunctional and violent interactions.
Effect of educational program based on theory of planned behavior on promoting nutritional behaviors preventing Anemia in a sample of Iranian pregnant women
Authors: Khani Jeihooni Ali , Rakhshani Tayebeh , Harsini Pooyan Afzali , Layeghiasl Mehdi
Published: December 2021

Background

Iron deficiency anemia (IDA) is one of the most common problems during pregnancy. The aim of this research was to determine the effect of educational program based on Theory of Planned Behavior (TPB) on promoting nutritional behaviors preventing anemia in a pregnant woman in Shiraz city, Iran.

Methods

This quasi-experimental study was done on 150 pregnant women (75 experimental and 75 control groups) who were selected using randomly sampling method in in Shiraz city, Iran, in 2020–2021. The educational intervention for the experimental group included six educational sessions for 50 or 55 min-based TPB model. A questionnaire consisted of items about demographic information, TPB constructs (attitude, perceived behavioral control, subjective norms and behavioral intention) was used to measure the nutritional behaviours preventing iron deficiency anemia in pregnancy women before and 3 months after the intervention.

Results

The results showed that before the educational intervention, there was no significant difference between the two groups in terms of knowledge, attitude, perceived behavioral control, subjective norms, behavioral intention and nutritional performance; however, three months after the educational intervention, the experimental group showed a significant increase in each of the mentioned variables. For example the mean and standard deviation score of behavioral intention after intervention in the experimental group was significantly increased (25.57 ± 1.66, P = 0.001),and the mean and standard deviation score of performance after intervention in the experimental group was significantly increased (31.03 ± 2.19, P = 0.001), (P < 0.05).

Conclusions

After the educational intervention, the experimental group showed a significant increase in of the knowledge, attitude, perceived behavioral control, subjective norms, behavioral intention and nutritional performance. Therefore the results of the study showed positive effect of nutrition educational intervention program base on TPB model on improvement of iron deficiency anemia preventive behaviours in the pregnancy women.
Predictive value of D-dimer and analysis of risk factors in pregnant women with suspected pulmonary embolism after cesarean section
Authors: Zhang Limin , Chen Yunqiu , Liu Wenjuan , Wang Xinzhuo , Zhang Shuang , Zhang Wenyan , Zhao Shuai , Zhang Miaomiao , Zhang Su , Jiao Guangyu
Published: December 2021

Background

Acute pulmonary embolism (PE) is one of the leading causes of maternal mortality, and cesarean section is an established independent risk factor for PE. The diagnostic utility of D-dimer for PE in non-pregnant women has been well-established, but its role in women with suspected PE after cesarean section is unclear. Furthermore, the optimal threshold level in this patient population is unknown. Traditional D-dimer levels have low diagnostic specificity, resulting in many pregnant women being exposed to potentially harmful radiation despite negative diagnostic imaging results. This research aimed to optimize the clinical threshold for D-dimer to improve specificity while ensuring high sensitivity and to identify risk factors for PE after cesarean section.

Methods

This retrospective study of 289 women who underwent diagnostic imaging (ventilation/perfusion [V/Q] or computed tomographic pulmonary angiography [CTPA]) for suspected acute PE after cesarean delivery from 2010 to 2021 was conducted. Clinical data and laboratory indicators within 24 h postpartum including D-dimer levels were collected for analyses.

Results

The final analysis included 125 patients, among whom 33 were diagnosed with acute PE (incidence of 11.42%, 95% confidence interval 7.7–15.1). The receiver operating characteristic curve analysis suggested that a D-dimer cut-off value of 800 ng/mL had specificity of 25.26% and sensitivity of 100% for detecting PE. The cut-off value was adjusted to 1000 ng/mL with a specificity of 34.74% and a sensitivity of 96.67%. Using a D-dimer cut-off value of 800 ng/mL (instead of the conventional value of 500 ng/mL) increased the number of patients excluded from suspected PE from 9.6 to 18.4% without additional false-negative results. Of note, a history of known thrombophilia was significantly more common in patients with PE than in those without (P < 0.05). No other independent risk factors were noted in our study.

Conclusions

The D-dimer cut-off value of 800 ng/mL ensures high sensitivity and increases specificity compared to the conventional threshold of 500 ng/mL. Utilizing this higher threshold can reduce the number of unnecessary CT and subsequently unnecessary radiation exposure, in women after cesarean delivery. Prospective studies should also be conducted to verify these results.
Early contraceptive implants removal and its associated factors among women using implants at a National Referral Hospital, Kampala Uganda
Authors: Ssebatta Gerald , Kaye Dan Kabonge , Mbalinda Scovia Nalugo
Published: December 2021

Background

Early discontinuation of implant contraceptive methods and reasons for discontinuation remains a major concern for family planning programs. Early discontinuation is related to higher rates of the overall fertility rate, unwanted pregnancies leading to possibly induced abortion. There is paucity of data on the practice of discontinuation of contraceptives in developing countries. The objective of the study was to determine the magnitude of early implants discontinuation among women receiving implants services in the study area and the factors associated with it.

Methods

A cross-sectional study was conducted from 2nd January to 3rd March 2020. Data were collected from 207 women who had come to remove implants on socio-demographic characteristics, obstetric history, duration of implant, and reasons for wanting to remove the implant. We computed the proportion of those who removed the implant before 18 months (early discontinuation). To assess the factors associated with early discontinuation, we estimated the prevalence ratios with a generalized linear model of the poisson family with a log link and robust error variance.

Results

The proportion of early implant discontinuation was 87/207(42%). Factor associated with early implant discontinuation included; experience of side effects (PR = 1.1; 95% CI 1.03–1.24; P = 0.001), not having received pre-insertion counseling about the benefits and side effects of contraceptive implants (PR = 1.5; 95% CI 1.02–1.30; P = 0.019) and staying in rural areas (PR = 1.1; 95% CI 1.03–1.27; P = 0.014).

Conclusion

Nearly one in every two mothers have early discontinuation of contraceptive implants. Factors associated with early implant removal include; experience of side effects, lack of counseling services, and staying in rural areas. There is a need for intervention to address high prevalence of early contraceptive removal through improving on counselling services about possible side effects.
Foundation News: How SEG Foundation donors make a real difference
Authors: Burk Katie
Published: December 2021

Billions of dollars are raised every year to support great causes and to help millions of people through small personal gifts. Many nonprofits have been sustained primarily by the growth of small gifts, and the cash volume of online gifts in the United States reached a record level in 2020. Gifts of any size are worth much more than just the monetary value. The gift itself generates more gifts. Giving is driven by momentum, and nothing can create and grow momentum like small gifts.
Tupi Nodes pilot: A successful 4D seismic case for Brazilian presalt reservoirs
Authors: Cruz Nathalia Martinho , Cruz José Marcelo , Teixeira Leonardo Márcio , da Costa Mônica Muzzette , de Oliveira Laryssa Beatriz , Urasaki Eduardo Naomitsu , Bispo Thais Pontes , de Sá Jardim Manoel , Grochau Marcos Hexsel , Maul Alexandre
Published: December 2021

The oil and gas industry has established 4D seismic as a key tool to maximize oil recovery and operational safety in siliciclastic and low- to medium-stiffness carbonate reservoirs. However, for the stiffer carbonate reservoirs of the Brazilian presalt, the value of 4D seismic is still under debate. Tupi Field has been the stage of a pioneering 4D seismic project to field test the time-lapse technique's ability in monitoring production and water-alternating-gas (WAG) injection in the Brazilian presalt. Ocean-bottom node (OBN) technology was applied for the first time in the ultra-deep waters of Santos Basin, leading to the Tupi Nodes pilot project. We started with feasibility studies to forecast the presalt carbonate time-lapse responses. The minerals that constitute these carbonate rocks have an incompressibility modulus that is generally twice as large as those of siliciclastic rocks. This translates into discrete 4D signals that require enhanced seismic acquisition and processing techniques to be correctly detected and mapped. Consequently, two OBN seismic acquisitions were carried out. Time-lapse processing included the application of top-of-the-line processing tools, such as interbed multiple attenuation. The resulting 4D amplitude images demonstrate good signal-to-noise ratio, supporting both static and dynamic interpretations that are compatible with injection and production histories. To unlock the potential of 4D quantitative interpretation and the future employment of 4D-assisted history-matching workflows, we conducted a 4D seismic inversion test. Acoustic impedance variations of about 1.5% are reliably distinguishable beyond the immediate vicinity of the wells. These 4D OBN seismic surveys and interpretations will assist in identifying oil-bypassed targets for infill wells and calibrating WAG cycles, increasing oil recovery. We anticipate that studies of the entire Brazilian presalt section will greatly benefit from the results and conclusions already reached for Tupi Field.
Anti-drug Antibody Validation Testing and Reporting Harmonization
Authors: Myler Heather , Pedras-Vasconcelos João , Phillips Kelli , Hottenstein Charles Scott , Chamberlain Paul , Devanaryan Viswanath , Gleason Carol , Goodman Joanne , Manning Marta Starcevic , Purushothama Shobha , Richards Susan , Shen Honglue , Zoghbi Jad , Amaravadi Lakshmi , Barger Troy , Bowen Steven , Bowsher Ronald R. , Clements-Egan Adrienne , Geng Dong , Goletz Theresa J. , Gunn George R. , Hallett William , Hodsdon Michael E. , Janelsins Brian M. , Jawa Vibha , Kamondi Szilard , Kirshner Susan , Kramer Daniel , Liang Meina , Lindley Kathryn , Liu Susana , Liu ZhenZhen , McNally Jim , Mikulskis Alvydas , Nelson Robert , Ahbari Mohsen Rajabi , Qu Qiang , Ruppel Jane , Snoeck Veerle , Song An , Yan Haoheng , Ware Mark
Published: December 2021

Evolving immunogenicity assay performance expectations and a lack of harmonized anti-drug antibody validation testing and reporting tools have resulted in significant time spent by health authorities and sponsors on resolving filing queries. Following debate at the American Association of Pharmaceutical Sciences National Biotechnology Conference, a group was formed to address these gaps. Over the last 3 years, 44 members from 29 organizations (including 5 members from Europe and 10 members from FDA) discussed gaps in understanding immunogenicity assay requirements and have developed harmonization tools for use by industry scientists to facilitate filings to health authorities. Herein, this team provides testing and reporting strategies and tools for the following assessments: (1) pre-study validation cut point; (2) in-study cut points, including procedures for applying cut points to mixed populations; (3) system suitability control criteria for in-study plate acceptance; (4) assay sensitivity, including the selection of an appropriate low positive control; (5) specificity, including drug and target tolerance; (6) sample stability that reflects sample storage and handling conditions; (7) assay selectivity to matrix components, including hemolytic, lipemic, and disease state matrices; (8) domain specificity for multi-domain therapeutics; (9) and minimum required dilution and extraction-based sample processing for titer reporting.

Graphical Abstract
Is There a Link Between Hormone Use and Diabetes Incidence in Transgender People? Data From the STRONG Cohort
Authors: Islam Noreen , Nash Rebecca , Zhang Qi , Panagiotakopoulos Leonidas , Daley Tanicia , Bhasin Shalender , Getahun Darios , Sonya Haw J , McCracken Courtney , Silverberg Michael J , Tangpricha Vin , Vupputuri Suma , Goodman Michael
Published: December 2021

Background

Risk of type 2 diabetes mellitus (T2DM) in transgender and gender diverse (TGD) persons, especially those receiving gender-affirming hormone therapy (GAHT) is an area of clinical and research importance.

Methods

We used data from an electronic health record-based cohort study of persons 18 years and older enrolled in 3 integrated health care systems. The cohort included 2869 transfeminine members matched to 28 300 cisgender women and 28 258 cisgender men on age, race/ethnicity, calendar year, and site, and 2133 transmasculine members similarly matched to 20 997 cisgender women and 20 964 cisgender men. Cohort ascertainment spanned 9 years from 2006 through 2014 and follow-up extended through 2016. Data on T2DM incidence and prevalence were analyzed using Cox proportional hazards and logistic regression models, respectively. All analyses controlled for body mass index.

Results

Both prevalent and incident T2DM was more common in the transfeminine cohort relative to cisgender female referents with odds ratio and hazard ratio (95% CI) estimates of 1.3 (1.1-1.5) and 1.4 (1.1-1.8), respectively. No significant differences in prevalence or incidence of T2DM were observed across the remaining comparison groups, both overall and in TGD persons with evidence of GAHT receipt.

Conclusion

Although transfeminine people may be at higher risk for T2DM compared with cisgender females, the corresponding difference relative to cisgender males is not discernable. Moreover, there is little evidence that T2DM occurrence in either transfeminine or transmasculine persons is attributable to GAHT use.
GDF15 in Appetite and Exercise: Essential Player or Coincidental Bystander?
Authors: Klein Anders B , Kleinert Maximilian , Richter Erik A , Clemmensen Christoffer
Published: December 2021

Growth differentiation factor 15 (GDF15) has recently moved to the forefront of metabolism research. When administered pharmacologically, GDF15 reduces food intake and lowers body weight via the hindbrain-situated receptor GFRAL (glial cell–derived neurotrophic factor family receptor alpha-like). Endogenous GDF15 is a ubiquitous cellular stress signal that can be produced and secreted by a variety of cell types. Circulating levels are elevated in a series of disease states, but also in response to exogenous agents such as metformin, colchicine, AICAR, and cisplatin. Recently, exercise has emerged as a relevant intervention to interrogate GDF15 physiology. Prolonged endurance exercise increases circulating GDF15 to levels otherwise associated with certain pathological states and in response to metformin treatment. The jury is still out on whether GDF15 is a functional “exerkine” mediating organ-to-brain crosstalk or whether it is a coincidental bystander. In this review, we discuss the putative physiological implication of exercise-induced GDF15, focusing on the potential impact on appetite and metabolism.
Molecular Derangements and the Diagnosis of ACTH-Dependent Cushing’s Syndrome
Authors: Nieman Lynnette K
Published: December 2021

Endogenous Cushing’s syndrome (CS) is associated with morbidities (diabetes, hypertension, clotting disorders) and shortens life because of infections, pulmonary thromboembolism, and cardiovascular disease. Its clinical presentation is immensely variable, and diagnosis and treatment are often delayed. Thus, there are many opportunities for basic and clinical research leading to better tests, faster diagnosis, and optimized medical treatments. This review focuses on CS caused by excessive adrenocorticotropin (ACTH) production. It describes current concepts of the regulation of ACTH synthesis and secretion by normal corticotropes and mechanisms by which dysregulation occurs in corticotrope (termed “Cushing’s disease”) and noncorticotrope (so-called ectopic) ACTH-producing tumors. ACTH causes adrenal gland synthesis and pulsatile release of cortisol; the excess ACTH in these forms of CS leads to the hypercortisolism of endogenous CS. Again, the differences between healthy individuals and those with CS are highlighted. The clinical presentations and their use in the interpretation of CS screening tests are described. The tests used for screening and differential diagnosis of CS are presented, along with their relationship to cortisol dynamics, pathophysiology, and negative glucocorticoid feedback regulation in the two forms of ACTH-dependent CS. Finally, several gaps in current understanding are highlighted in the hope of stimulating additional research into this challenging disorder.
Concerted regulation of non-alcoholic fatty liver disease progression by microRNAs in apolipoprotein E-deficient mice
Authors: López-Pastor Andrea R. , Infante-Menéndez Jorge , González-Illanes Tamara , González-López Paula , González-Rodríguez Águeda , García-Monzón Carmelo , Vega de Céniga Melina , Esparza Leticia , Gómez-Hernández Almudena , Escribano Óscar
Published: December 2021

The prevalence of non-alcoholic fatty liver disease (NAFLD) is constantly increasing, and altered expression of microRNAs (miRNAs) fosters the development and progression of many pathologies, including NAFLD. Therefore, we explored the role of new miRNAs involved in the molecular mechanisms that trigger NAFLD progression and evaluated them as biomarkers for diagnosis. As a NAFLD model, we used apolipoprotein E-deficient mice administered a high-fat diet for 8 or 18 weeks. We demonstrated that insulin resistance and decreased lipogenesis and autophagy observed after 18 weeks on the diet are related to a concerted regulation carried out by miR-26b-5p, miR-34a-5p, miR-149-5p and miR-375-3p. We also propose circulating let-7d-5p and miR-146b-5p as potential biomarkers of early stages of NAFLD. Finally, we confirmed that circulating miR-34a-5p and miR-375-3p are elevated in the late stages of NAFLD and that miR-27b-3p and miR-122-5p are increased with disease progression. Our results reveal a synergistic regulation of key processes in NAFLD development and progression by miRNAs. Further investigation is needed to unravel the roles of these miRNAs for developing new strategies for NAFLD treatment.

This article has an associated First Person interview with the joint first authors of the paper.
Hematotoxicity and functional impacts related to chemotherapy with doxorubicin and cyclophosphamide for invasive ductal breast carcinoma: a study in clinical records
Authors: Kameo Simone Yuriko , Ramos Maria Júlia Oliveira , Lima Ricardo Barbosa , Amorim Bruno Ferreira , Costa Jéssica Dos Santos , Marinho Pabliane Matias Lordelo , Sawada Namie Okino , Silva Glebson Moura
Published: December 2021

Objective: To evaluate the occurrence of hematological and functional toxicities during chemotherapy with doxorubicin and cyclophosphamide in women with breast invasive ductal carcinoma. Methods: This was a descriptive, cross-sectional and quantitative study, involving the data collection in clinical records of 119 women undergoing chemotherapy for breast invasive ductal carcinoma in an oncology outpatient clinic, carried out between February 2014 and February 2015. Results: The investigated toxicities and their respectively occurrences in patients exposed to doxorubicin and cyclophosphamide were hemoglobinemia (26,5%), leukopenia (21,6%), neutropenia (10,8%), thrombocytopenia (none) and reduced hematocrit (28,4%), in addition to fatigue (93,1%), fever (20,6%), gain (35,3%) and weight loss (22,5%). In these variables, there were no significant differences between the exposed and not exposed patients. The association with taxanes showed a significant reduction in hematocrit values (p=0.019) and the toxicities distributed by age group were not significant within the exposed group. Conclusions: Exposure to doxorubicin and cyclophosphamide was not associated with an increase in the occurrence of hematotoxicities and functional impacts in women with breast ductal invasive carcinoma, except when associated with taxane agents.
Ο Θεός ως μέτρο όλων των πραγμάτων
Authors: Φραγκουλοπούλου-Γιόχανσεν Δέσποινα
Published: December 2021

Η παρούσα μελέτη επιδιώκει να φέρει στο προσκήνιο κάποιες όψεις και ιδέες της πλατωνικής φιλοσοφίας που δείχνουν την εξέχουσα σημασία της θεολογίας στο πλατωνικό έργο. Γίνεται προσπάθεια να αναδειχθεί και να εξεταστεί το πλατωνικό δόγμα ‘ο θεός είναι μέτρο όλων των πραγμάτων’ (Νόμοι, 716c4-6). Επίσης, γίνεται προσπάθεια να εξεταστούν κάποια στοιχειώδη θεολογικά ερωτήματα. Για την παρούσα μελέτη ως βασικά θεολογικά ερωτήματα θεωρούμε τρία: Πώς προσδιορίζεται ο θεός, οι θεοί, το θεϊκό στον Πλάτωνα. Η σχέση του θεού με τον άνθρωπο. Η σχέση του ανθρώπου με τον θεό. Και σε συνάρτηση με αυτά τα ερωτήματα, ποιος είναι ο ρόλος του θεού στην πλατωνική παιδεία, στις αρετές, στην πολιτική. Με την εξέταση επτά πλατωνικών έργων από την κάθε περίοδο της πλατωνικής συγγραφής, αναδεικνύεται η μεγάλη σημασία της σωφροσύνης, που συνδέεται με τη θεολογία και το δόγμα ‘μέτρο όλων ο θεός’. Η ομοίωση στον θεό επιτυγχάνεται με τη σωφροσύνη, σε συνδυασμό με τη φρόνηση και την οσιότητα. Η οσιότητα (ευσέβεια) υποστηρίζεται ότι αποτελεί μια αρετή που ενσωματώνει τις τέσσερις παραδοσιακές αρετές.
Delay - loss characteristics of future broadband networks
Authors: Σταματέλλος Γεώργιος
Published: December 2021

Στα μελλοντικά B-ISDN δίκτυα ευρέος φάσματος, υποστηρίζεται ένα μεγάλο εύρος χαρακτηριστικών τύπων κυκλοφορίας σε ένα ενιαίο περιβάλλον. Τα δίκτυα αυτά θα πρέπει να είναι ικανά όχι μόνο να λειτουργούν σε ένα ισχυρά ετερογενές περιβάλλον, αλλά και να προσφέρουν εγγυήσεις υπηρεσίας και να είναι ικανά να υποστηρίζουν συνδέσεις πολλαπλών σημείων πέρα από τις παραδοσιακές συνδέσεις δύο σημείων (point-to-point connections). Τα παρακάτω χαρακτηριστικά και ο συνολικός όγκος κυκλοφορίας πληροφορίας που θα υποστηρίζεται, καθιστούν το σχεδιασμό λειτουργικότητας και ελέγχου του μελλοντικού δικτύου, μιά πολύπλευρη πρόκληση. Σ’αυτό το πλαίσιο, εκτίμηση και αποφυγή συμφόρησης των ροών πληροφορίας, είναι μιά εξαιρετικά σπουδαία λειτουργικότητα. Στη συγκεκριμένη διδακτορική διατριβή εξετάζω μηχανισμούς ελέγχου αποδοχής κλήσεων που σκοπεύουν στην αποφυγή συμφόρησης με τον περιορισμό της πρόσβασης νέων αιτήσεων υπηρεσίας όταν προσεγγίζεται περιοχή συμφόρησης. Ο σχηματισμός και η βάση των μηχανισμών ελέγχου βασίζεται σε αναλυτικά αποτελέσματα που εξάγουμε και αφορούν τη λειτουργία χρονικής διαίρεσης πολυπλεκτών (TDM) όπως και υβριδικά TDM συστήματα τύπου “κινητού ορίου” (movable boundary).
Essays on new economic geography and international trade
Authors: Καραβίδας Διονύσιος
Published: December 2021

Η παρούσα διατριβή είναι μια συλλογή από δύο ανεξάρτητες μελέτες που συνεισφέρουν στον τομέα της Νέας Οικονομικής Γεωγραφίας και του Διεθνούς Εμπορίου. Η πρώτη μελέτη δείχνει ότι η γεωγραφική συσσώρευση των παραγωγικών συσντελεστών μέσα σε ένα σύστημα χωρών προέρχεται από το γεγονός ότι το εξωτερικό είναι πιο σημαντικό σε σχέση με την εγχώρια χώρα. Η δεύτερη μελέτη δείχνει ότι υπό τους ευέλικτους μισθούς, η βελτίωση της παραγωγικότητας μιας χώρας ωφελεί τον εμπορικό της εταίρο. Επιπλέον, αποδεικνύεται ότι η βελτίωση της παραγωγικότητας μιας αναπτυσσόμενης χώρας ωφελεί το σύνολοτης οικονομία. Ωστόσο, τα αποτελέσματα διαφέρουν όσον αφορά στον εμπορικό της εταίρο, αφού κάποιες ομάδες επηρεάζονται θετικά και κάποιες αρνητικά. Η τρέχουσα διδακτορική διατριβή απεικονίζει και ρίχνει φως στον ρόλο ορισμένων θεμελιωδών γνώσεων στον τομέα της Νέας Οικονομικής Γεωγραφίας και τών μοντέλων διεθνούς εμπορίου, γενικά.
Wild snapdragon plant pedigree sheds light on limited connectivity enhanced by higher migrant reproductive success in a fragmented landscape
Authors: Gervais Laura , Mouginot Pierick , Gibert Anais , Salles Oceane , Latutrie Mathieu , Piquet Jesaelle , Archambeau Juliette , Pujol Benoit
Published: December 2021

Background: In contrast with historical knowledge, a recent view posits that a non-negligible proportion of populations might respond positively to habitat fragmentation. Populations might thrive in a fragmented landscape if functional connectivity, i.e., the net flow of individuals or their genes moving among suitable habitat patches, is not restricted. Alternatively, functional connectivity might be typically limited but enhanced by a higher reproductive success of migrants.

Methods: We tested for this hypothesis in wild snapdragon plants inhabiting six patches separated by seawater in a fragmented Mediterranean scrubland landscape. We reconstructed their pedigree by using a parentage assignment method based on microsatellite genetic markers. We then estimated functional connectivity and the reproductive success of plants resulting from between-patch dispersal events.

Results: We found that wild snapdragon plants thrived in this fragmented landscape, although functional connectivity between habitat patches was weak (i.e. 2.9%). The progeny resulting from between-patch dispersal events had a higher reproductive success than residents.

Conclusion: Our findings expose a remarkable aspect of fragmented landscapes, where weak functional connectivity was enhanced by higher reproductive success after migration. This process might have the potential to compensate at least partly the negative impact of fragmentation.
Multiple ancient schwannomas of the ulnar nerve at distant sites: a case report
Authors: Yoon Taekeun , Hong Ki Yong
Published: December 2021

In rare cases, schwannoma—a benign peripheral nerve tumor—undergoes chronic degenerative changes and progresses to ancient schwannoma. Herein, we report the first case of ulnar nerve-derived multiple ancient schwannomas, which uncommonly developed in the extremities and major nerves. A 76-year-old female patient presented with tingling sensations in her left ring and small fingers. She had a gradually enlarging mass that had developed 40 years ago in the proximal upper arm and a new mass that had grown on the wrist for the past few years. Based on physical examination, ultrasonography, and magnetic resonance imaging, ancient schwannomas of the ulnar nerve were suspected. The older and larger mass in the upper arm was more entangled with nerve fascicles, having necrotic changes. Through meticulous dissection of the nerve fascicles, both masses were successfully enucleated, and pathological examination confirmed ancient schwannoma. As ancient schwannomas grow, they become more entangled with the nerves; thus, early surgical removal is recommended.
REVISTAS DE CORRIENTE PRINCIPAL: RELIME Y JCR - JOURNAL CITATION REPORTS
Authors: Cantoral Uriza Ricardo
Published: December 2021

Cerca de 40 años tiene de existencia el Journal Citation Reports (JCR) de Web of Science (WoS), cuyo fin es identificar a las revistas de corriente principal al nivel mundial analizando sus tendencias en el factor de impacto de sus citas y coadyuvando en su estrategia de publicación
Effective Online Order Acceptance Policies for Omnichannel Fulfillment
Authors: Jia Su , Karp Jeremy , Ravi R. , Tayur Sridhar
Published: December 2021

Problem definition: Omnichannel retailing has led to the use of traditional stores as fulfillment centers for online orders. Omnichannel fulfillment problems have two components: (1) accepting a certain number of online orders prior to seeing store demands and (2) satisfying (or filling) some of these accepted online demands as efficiently as possible with any leftover inventory after store demands have been met. Hence, there is a fundamental trade-off between store cancellations of accepted online orders and potentially increased profits because of more acceptances of online orders. We study this joint problem of online order acceptance and fulfillment (including cancellations) to minimize total costs, including shipping charges and cancellation penalties in single-period and limited multiperiod settings. Academic/practical relevance: Despite the growing importance of omnichannel fulfillment via online orders, our work provides the first study incorporating cancellation penalties along with fulfillment costs. Methodology: We build a two-stage stochastic model. In the first stage, the retailer sets a policy specifying which online orders it will accept. The second stage represents the process of fulfilling online orders after the uncertain quantities of in-store purchases are revealed. We analyze threshold policies that accept online orders as long as the inventories are above a global threshold, a local threshold per region, or a hybrid. Results: For a single period, total costs are unimodal as a function of the global threshold and unimodal as a function of a single local threshold holding all other local thresholds at constant values, motivating a gradient search algorithm. Reformulating as an appropriate linear program with network flow structure, we estimate the derivative (using infinitesimal perturbation analysis) of the total cost as a function of the thresholds. We validate the performance of the threshold policies empirically using data from a high-end North American retailer. Our two-location experiments demonstrate that local thresholds perform better than global thresholds in a wide variety of settings. Conversely, in a narrow region with negatively correlated online demand between locations and very low shipping costs, global threshold outperforms local thresholds. A hybrid policy only marginally improves on the better of the two. In multiple periods, we study one- and two-location models and provide insights into effective solution methods for the general case. Managerial implications: Our methods provide effective algorithms to manage fulfillment costs for online orders, demonstrating a significant reduction over policies that treat each location separately and reflecting the significant advantage of incorporating shipping in computing thresholds. Numerical studies provide insights as to why local thresholds perform well in a wide variety of situations.
Adoption of E-learning System in Higher Education Environments: Evidence from Modified UTAUT Model
Authors:   Department of Education and Learning Sciences, IQRA University Karachi-75300, Pakistan, Qazi Wasim , Raza Syed Ali ,   Department of Business Administration, IQRA University Karachi-75300, Pakistan, Khan Komal Akram ,   Department of Business Administration, IQRA University Karachi-75300, Pakistan, Salam Javeria ,   Department of Business Administration, IQRA University Karachi-75300, Pakistan
Published: December 2021

E-Learning has been an exceptional support for learners across the globe. Many people are using electronic media for different purposes. Hence, learners, especially students, can benefit from the electronic system as well. Therefore, the purpose of this study is to examine the adoption level of e-learning systems by using the extended model of UTAUT2. The data was collected using the survey method, and for this purpose, the five-point Likert scale has been used. The statistical techniques applied to the data set were confirmatory factor analysis and partial least square structural equation modeling. The results reveal that performance expectancy, effort expectancy, social influence, facilitating conditions, habit, knowledge acquisition, and knowledge sharing are positively linked with behavioral intention to use e-learning systems except for hedonic motivation. The modified model adds two new predictors: knowledge acquisition and knowledge sharing that influence students' acceptance of e-learning systems. Therefore, it will provide the educationists and policymakers a new insight into whether students are willing to adopt the E-learning system for daily use. Keywords: E-Learning System, Behavioral intention, Knowledge acquisition, Knowledge sharing, Higher education, PLS-SEM
Developing Communication Skills through Raising Intercultural Competence in EFL Classroom
Authors:   English Language Institute, Jazan University, Jazan, Saudi Arabia, Sharma Vipin
Published: December 2021

This article discusses the teaching of intercultural and transcultural awareness together with language learning in foreign language contexts. Ensuing a brief discussion of what language, culture and its forms mean, we illustrate the relationship between intercultural and transcultural competence, and the development of communication skills in the foreign language framework for teaching EFL (English as Foreign Language) students. The author draws attention to the importance of developing students’ intercultural research abilities utilizing the transcultural communication competence notion. We show how intercultural orientations and transcultural communication competence affect the students’ framework and their career dimensions. The author illuminates the activities and approaches that develop communication skills. The article concludes with an underscoring of the critical challenges that teachers encounter and their potential solutions. Keywords: Intercultural communication, Transcultural awareness, Social identity, Student attitudes, Cross cultural, EFL classrooms, diversity
Nice work if you can get it: the mercurial career of creative industries policy
Authors: Andrew Ross
Published: December 2021

Driven by the belief that culture-based enterprise can be promoted as a driver of economic development, governments all over the world have developed policies aimed at boosting their creative industries. These policies ought to present some new, long-term opportunities for cultural workers, but in practice they seem more likely to universalise the traditionally precarious work profile of artists. Focusing on the career of creative industry policy in the UK, the USA and China, this paper calls for an assessment of its model of job creation from the standpoint of quality of work life.
December 2021 Pulmonary Case of the Month: Interstitial Lung Disease with Red Knuckles
Authors:   Mayo Clinic Arizona, Scottsdale, AZ USA, Wesselius Lewis
Published: December 2021

No abstract available. Article truncated after 150 words. History of Present Illness A 56-year-old man was referred for a second opinion on recent onset of diffuse parenchymal lung disease. He had started noting mild dyspnea with yard work approximately in March 2021. His symptoms progressed over the next month with increasing shortness of breath and some fever. He presented to outside emergency department on April 17, 2021 and chest CT showing patchy ground-glass opacities with some areas of irregular consolidation (Figure 1). He was subsequently seen by an outside pulmonologist and started empirically on prednisone (50 mg/day). An outside lung biopsy had been performed which showed nonspecific interstitial pneumonitis. There was some improvement in his symptoms and his prednisone dose was reduced to 20 mg/day; however, his symptoms subsequently worsened with saturations noted to drop to 85% with any ambulation. He also had swelling of his left face and a biopsy of the parotid gland with the findings …
Effect of detection angle and substrate in the polarization analysis of 1D dipole emission
Authors: Dasallas Lean , Jaculbia Rafael , Balois-Oguchi Maria Vanessa , Garcia Wilson , Hayazawa Norihiko
Published: December 2021

We investigated the effects of detection angle and substrate in the analysis of the polarization properties of 1D dipole emission. Modifications were made to the analytical expression of dipole emission using transformation of coordinates. The consequences of different substrates (free space, dielectric substrate, and metallic substrate) and detection angle on the determination of dipole orientation were discussed. This work is helpful in analyzing the dipole emission signal, especially where an oblique detection angle is necessary such as in near-field optical spectroscopy based on scanning tunneling microscopy and atomic force microscopy.
Enhanced and tunable photonic spin Hall effect in metasurface bilayers
Authors: Cheng Min , Fu Ping , Chen Shengyu
Published: December 2021

We study theoretically the photonic spin Hall effect (PSHE) in metasurface bilayers with twisted adjacent two-dimensional material layers. When the coupling strength between adjacent twisted metasurfaces is strong, it can be found that the giant PSHE shifts of the reflected and transmitted beams exist at different types of topological transition points. For weakly coupling strength between metasurfaces, the PSHE shifts of reflected and transmitted beams present oscillations due to the Fabry–Perot resonance in metasurface bilayers. PSHE shifts can be manipulated by controlling physical parameters such as the twist angle of metasurface bilayers and the voltage applied to metasurfaces. By combining with the weak measurement method, these phenomena can be expected to provide a promising observation platform for investigating moire physics and twistronics in photonics.
Dynamics and timing-jitter of regenerative RF feedback assisted resonant electro-optic frequency comb
Authors: Peng Huanfa , Lei Peng , Xie Xiaopeng , Chen Zhangyuan
Published: December 2021

Optical frequency combs have impacted a wide range of applications. The optical cavity assisted resonant electro-optic (EO) comb features broad spectral bandwidth and deterministic repetition-rate. However, the optical pulse timing-jitter is limited by the phase noise of the external RF drive source. To overcome this limitation at high repetition-rate, a regenerative RF feedback assisted resonant EO comb has been experimentally developed, which shows low phase noise of the regenerative RF drive signal. However, yet to date, the nonlinear dynamics and timing-jitter of the resonant EO comb coupled with a regenerative RF feedback loop remain unexplored. Here, for the first time, we quantitatively investigate the dynamics and timing-jitter of the resonant EO comb generation coupled with an optoelectronic oscillator (OEO). Our model indicates the detuning of the seed laser and EO comb cavity resonance determines the nonlinear feedback RF gain of OEO. Numerical simulations reveal the emergence of the bifurcation behaviors of the regenerative RF signal and the distinct EO comb formation dynamics with the increasing feedback RF gain of OEO, which provide the guidelines to achieve stable regenerative resonant EO comb. Moreover, in the presence of the noisy nonlinear feedback RF gain induced by the laser-cavity detuning fluctuations, our timing-jitter model predicts the seed laser frequency noise will be converted to the regenerative RF phase noise and optical pulse timing-jitter under the stable oscillation state of OEO. We highlight the mechanism of the transduction of laser frequency noise to the RF phase noise is differ from the Mach-Zehnder modulator based OEO. Experimentally, we attain a 10 GHz resonant EO comb generation with phase noise of −130 dBc/Hz at 10 kHz offset for the regenerative 10 GHz RF signal and optical pulse timing-jitter of 52.8 fs with an integral range from 100 Hz to 1 MHz. The experimental results agree well with the theoretical models. Our findings offer the solid guidelines for the design of the regenerative RF feedback assisted stable resonant EO comb with an optimized timing-jitter performance.
Broadband titanium nitride disordered metasurface absorbers
Authors: Chang Chun-Chieh , Kuo Shin-Chun , Cheng Hsyi-En , Chen Hou-Tong , Yang Zu-Po
Published: December 2021

We experimentally demonstrate titanium nitride (TiN) broadband metasurface perfect absorbers by conformally coating plasmonic TiN films onto disordered anodic aluminum oxide (AAO) nanotemplates. The disordered metasurface absorbers exhibit polarization-insensitive and weak angle-dependent perfect absorption over the entire visible and near-infrared spectral regions (300 < λ < 2500 nm). We show from experimental results and numerical simulations that the light scattering induced by the strong disorder of the AAO nanopores and the strong absorption of the TiN deposited on their sidewall are of critical importance for achieving broadband perfect absorption. The TiN disordered metasurface perfect absorbers are superior to many other types of broadband perfect absorbers previously reported and are more suitable for practical applications especially in harsh environments. The device concept for broadband perfect absorption based on plasmonic metal-nitride film coated disordered dielectric media could potentially be extended to significantly enhance the efficiency of solar energy harvesting and the performance of hot-carrier based optoelectronics.