bluuebunny/crossref_metadata_2025 huggingface dataset:
Seasonal shifts in surface water-groundwater connections in a ferricrete-impacted stream estimated from electrical resistivity
Authors: Rickel Ariel , Hoagland Beth , Navarre-Sitchler Alexis , Singha Kamini
Published: May 2021

The efficacy of the hyporheic zone (HZ) — where surface water and groundwater mix — for processing nutrients or the uptake of metals is dependent on the streambed hydraulic conductivity and stream discharge, among other characteristics. Here, we have explored electrical resistivity tomography (ERT) of hyporheic exchange in Cement Creek near Silverton, Colorado, which is affected by ferricrete precipitation. To quantify flows through the HZ, we have conducted 4 h salt injection tracer tests and collected time-lapse ERT of the streambed and banks of Cement Creek at high and low flow. We have installed piezometers to conduct slug tests, which suggest a low-permeability zone at 44 cm depth likely composed of ferricrete that cemented the cobbles together. Based on the ERT, the tracer released into the stream is constrained within the shallow streambed with little subsurface flow through the banks. The tracer is detected in the HZ for a longer time at high flow compared to low flow, suggesting that more flow paths were available to connect the stream to the HZ. The tracer is confined above the ferricrete layer during the high- and low-flow tests. Mass transfer and storage area parameters are calculated from combined analysis of apparent bulk conductivity derived from ERT and numerical modeling of the tracer breakthrough curves. The hyporheic storage area estimated at low discharge ([Formula: see text]) is smaller than that at high discharge ([Formula: see text]) and residence times are 2.7 h at low discharge and 4.1 h at high discharge. During high discharge, in-stream breakthrough curves display slower breakthrough and longer tails, which is consistent with the time-lapse electrical inversions and 1D transport with inflow and storage modeling. Our findings indicate that ferricrete reduces the hydraulic conductivity of the streambed and limits the areal extent of the HZ, which may lower the potential for pollutant attenuation from the metal-rich waters of Cement Creek.
An open-source framework for the implementation of large-scale integral operators with flexible, modern high-performance computing solutions: Enabling 3D Marchenko imaging by least-squares inversion
Authors: Ravasi Matteo , Vasconcelos Ivan
Published: May 2021

Numerical integral operators of the convolution type form the basis of most wave-equation-based methods for the processing and imaging of seismic data. Because several of these methods require the solution of an inverse problem, multiple forward and adjoint passes of the modeling operator are generally required to converge to a satisfactory solution. We have highlighted the memory requirements and computational challenges that arise when implementing such operators on 3D seismic data sets and their use for solving large systems of integral equations. A Python framework is presented that leverages libraries for distributed storage and computing, and it provides a high-level symbolic representation of linear operators. A driving goal for our work is not only to offer a widely deployable, ready-to-use high-performance computing framework, but also to demonstrate that it enables addressing research questions that are otherwise difficult to tackle. To this end, the first example of 3D full-wavefield target-oriented imaging, which comprises two subsequent steps of seismic redatuming, is presented. The redatumed fields are estimated by means of gradient-based inversion using the full data set as well as spatially decimated versions of the data set as a way to investigate the robustness of both inverse problems to spatial aliasing in the input data set. Our numerical example shows that when one spatial direction is finely sampled, satisfactory redatuming and imaging can also be accomplished when the sampling in the other direction is coarser than a quarter of the dominant wavelength. Although aliasing introduces noise in the redatumed fields, they are less sensitive to well-known spurious artifacts compared to cheaper, adjoint-based redatuming techniques. These observations are shown to hold for a relatively simple geologic structure, and although further testing is needed for more complex scenarios, we expect them to be generally valid while possibly breaking down for extreme cases (e.g., highly heterogeneous/scattering media).
Nonsurgical Management of Melanoma Brain Metastasis: Current Therapeutics, Challenges, and Strategies for Progress
Authors: Makawita Shalini , Tawbi Hussein A.
Published: May 2021

This review aims to provide an overview of nonsurgical treatment strategies for central nervous system metastases in melanoma as well as discuss treatment challenges and future directions. Recent strategies for melanoma brain metastases have involved proving the intracranial activity of approved therapies as well as identifying novel drug targets. BRAF/MEK combination therapy has intracranial activity in those with BRAF V600 mutations, though disease control is shorter for intracranial than extracranial metastases. Immunotherapy and combination immunotherapies have emerged as providing durable responses in melanoma, and newer studies combining immunotherapy with targeted therapies are emerging. Continued challenges include penetration through the blood-brain barrier and development of resistance mechanisms. Novel therapeutic targets and methods to improve central nervous system penetrance are being identified through the application of deep DNA- and RNA-sequencing analyses. Radiation therapy approaches, especially stereotactic radiosurgery in combination or in sequence with systemic therapies, are also being investigated. Both targeted therapies and immunotherapies have revolutionized the field of melanoma treatment. Multimodality approaches with multidisciplinary teams will pave the way for the future of central nervous system disease treatment in melanoma.
Performance of the Aldosterone to Renin Ratio as a Screening Test for Primary Aldosteronism
Authors: Hung Annie , Ahmed Sumaiya , Gupta Ankur , Davis Alexandra , Kline Gregory A , Leung Alexander A , Ruzicka Marcel , Hiremath Swapnil , Hundemer Gregory L
Published: May 2021

Context

The aldosterone to renin ratio (ARR) is the guideline-recommended screening test for primary aldosteronism. However, there are limited data in regard to the diagnostic performance of the ARR.

Objective

To evaluate the sensitivity and specificity of the ARR as a screening test for primary aldosteronism.

Methods

We searched the MEDLINE, Embase, and Cochrane databases until February 2020. Observational studies assessing ARR diagnostic performance as a screening test for primary aldosteronism were selected. To limit verification bias, only studies where dynamic confirmatory testing was implemented as a reference standard regardless of the ARR result were included. Study-level data were extracted and risk of bias and applicability were assessed using the QUADAS-2 tool.

Results

Ten studies, involving a total of 4110 participants, were included. Potential risk of bias related to patient selection was common and present in half of the included studies. The population base, ARR positivity threshold, laboratory assay, and reference standard for confirmatory testing varied substantially between studies. The reported ARR sensitivity and specificity varied widely with sensitivity ranging from 10% to 100% and specificity ranging from 70% to 100%. Notably, 3 of the 10 studies reported an ARR sensitivity of <50%, suggesting a limited ability of the ARR to adequately identify patients with primary aldosteronism.

Conclusions

ARR performance varied widely based on patient population and diagnostic criteria, especially with respect to sensitivity. Therefore, no single ARR threshold for interpretation could be recommended. Limitations in accuracy and reliability of the ARR must be recognized in order to appropriately inform clinical decision-making.
FSH-stimulated Inhibin B (FSH-iB): A Novel Marker for the Accurate Prediction of Pubertal Outcome in Delayed Puberty
Authors: Chaudhary Shakun , Walia Rama , Bhansali Anil , Dayal Devi , Sachdeva Naresh , Singh Tulika , Bhadada Sanjay Kumar
Published: May 2021

Background

Clinicians have long been struggling to find an effective tool to predict onset of puberty.

Objective

To explore stimulability of inhibin B after exogenous FSH and its potential role for prediction of onset of puberty.

Design and participants

Study subjects were enrolled into “exploratory cohort” (n = 42) and “validation cohort” (n = 19). The exploratory cohort was further divided into group 1 (healthy children with spontaneous puberty [SP], n = 26) and group 2 (patients with hypogonadotropic hypogonadism [HH], n = 16). The validation cohort included children who presented with complaints of delayed puberty.

Intervention and outcome

Participants were subjected to FSH stimulation test and GnRH analogue stimulation test. Cutoffs derived from the exploratory cohort for basal and FSH stimulated inhibin B (FSH-iB) were applied on the validation cohort. Basal LH, GnRH analogue-stimulated LH, basal inhibin B, and FSH-iB were compared with clinical outcomes on a prospective follow-up for prediction of onset of puberty.

Results

There was statistically significant increment in inhibin B after exogenous FSH in group 1 (SP) in both male (188.8 pg/mL; P = 0.002) and female (1065 pg/mL; P = 0.023) subjects. The increment was not statistically significant in group 2 (HH) in both sexes. FSH-iB at a cutoff of 116.14 pg/mL in males and 116.50 pg/mL in females had 100% sensitivity and specificity for labelling entry into puberty. On application of these cutoffs on the validation cohort, FSH-iB had 100% positive predictive value, negative predictive value, and diagnostic accuracy for prediction of pubertal onset.

Conclusion

Inhibin B was stimulable in both male and female subjects. FSH-iB can be considered a novel and promising investigation for prediction of onset of puberty. Future studies are required for further validation.
A Unique Genotype of Pseudohypoaldosteronism Type 1b in a Highly Consanguineous Population
Authors: Alzahrani Ali S , Alswailem Meshael , Abbas Bassam Bin , Qasem Ebtesam , Alsagheir Afaf , Al Shidhani Azza , Al Sinani Aisha , Al Badi Maryam , Al-Maqbali Ali , Al Shawi Manal , Albunyan Abdulhameed , Bin Nafisah Abdulghani , Shi Yufei
Published: May 2021

Context

Pseudohypoaldosteronism (PHA) is a condition in which serum aldosterone level is normal or elevated but its action is deficient.

Objective

This study describes the molecular genetics of PHA 1b in the highly consanguineous population of 2 Arabian Gulf countries, Saudi Arabia and Oman.

Methods

This study enrolled 22 patients from 13 unrelated families (2 families with 5 patients from Oman and 11 families with 17 patients from Saudi Arabia). All of these patients had presented within the first 10 days of life with nausea and vomiting, hyponatremia, hyperkalemia, and hypotension. We isolated DNA from peripheral blood and PCR-sequenced all exons and exon-intron boundaries of SCNN1A and, if negative, SCNN1B and SCNN1G using the Dideoxy Chain termination method.

Results

We found a total of 8 mutations in 13 families as follows: 6 mutations in SCNN1A, 1 in SCNN1B, and 1 in SCNN1G. All of these mutations were novel except one. SCNN1A mutations were: c.1496A>G, p.Q499R (novel) in 1 patient; c.1453C>T, p.Q485X (novel) in 1 patient; c.1322_1322delA, p.N441Tfs*41 (novel) in 2 patients of 1 family; c.876 + 2 delGAGT (novel) in 3 patients of 1 family; c.203_204 delTC, p.I68Tfs*76 (a known mutation) in 8 patients of 5 families; and whole SCNN1A gene deletion (novel) in 2 patients of 2 families. In addition, a nonsense SCNN1B mutation c.1694C>A, p.S565X (novel) was found in 3 siblings from 1 Omani family, and an SCNN1G deletion mutation c.527_528 delCA, p.T176Rfs*9 (novel) in 2 siblings from another Omani family.

Conclusion

We characterized a unique genotype of PHA 1b with several novel gene structure–disrupting mutations in SCNN1A, SCNN1B, and SCNN1G in a highly consanguineous population.
Η τριτανακοπή στην κτηματολογική δίκη
Authors: Τσιλιγγερίδου Μαγδαληνή
Published: May 2021

Το παρόν έργο αποτελεί τη διδακτορική διατριβή υπό τον τίτλο: «Η τριτανακοπή στην κτηματολογική δίκη». Σε διαρκή διάλογο με τη νομολογία και τη θεωρία, το παρόν έργο διεισδύει σε όλα τα προβλήματα που σχετίζονται με τις πρώτες κτηματολογικές εγγραφές, με την ανακρίβειά τους, με την οφειλόμενη στην ανακρίβεια προσβολή, καθώς επίσης με τη διόρθωση των ανακριβειών μέσω των κτηματολογικών ενδίκων βοηθημάτων, ήτοι της αγωγής του άρθρου 6 § 2 ν. 2664/1998, της αίτησης του άρθρου 6 § 3 ν. 2664/1998 και της τριτανακοπής (586 ΚΠολΔ), η σπουδαιότητα και η αναγκαιότητα της οποίας αποκτά ιδιάζουσα σημασία σε επίπεδο αμφισβήτησης της ορθότητας των κτηματολογικών εγγραφών. Η μονογραφία εστιάζει στο πλέον ακανθώδες ζήτημα του τρόπου οριστικοποίησης των πρώτων κτηματολογικών εγγραφών και των δικονομικών δυνατοτήτων των θιγόμενων τρίτων προσώπων, προκρίνοντας ως καταλληλότερη και προσφορότερη την άμυνα αυτών δια του δικονομικού οχήματος της τριτανακοπής, τονίζοντας την αναγκαιότητά της. Η ανάλυση πραγματοποιείται, το πρώτον στην παρούσα διατριβή, της λειτουργίας, δηλαδή, του ενδίκου βοηθήματος της τριτανακοπής στο κτηματολογικό δικονομικό δίκαιο, τόσο κατά το στάδιο πριν, όσο και μετά την οριστικοποίηση των πρώτων κτηματολογικών εγγραφών. Αναδεικνύει και δικαιολογεί το βαθμό υποχώρησης του εναλλακτικού χαρακτήρα του ανωτέρω ενδίκου βοηθήματος και επιβεβαιώνει την προσφορότητα, όπως επίσης την αναγκαιότητά του, για την προάσπιση των έννομων συμφερόντων των θιγόμενων τρίτων στην κτηματολογική δίκη.
El interés por la sumillería en el siglo XIX: estudio del Manuel de sommelier ou instruction pratique sur la manière de soigner les vins de André Jullien
Authors: Luque Janodet Francisco
Published: May 2021

El presente trabajo se ocupa de analizar la figura y obra de uno de los pioneros en el ámbito de la enología del siglo XIX: André Jullien, inventor de varios artilugios como la cannelle aérifère y autor de una de las obras más importantes sobre el estado de todos los viñedos del mundo, Topographie de tous les vignobles connus, así como de uno de los primeros manuales de sumillería, obra que centrará el presente artículo. En este proyecto, se analizará el surgimiento e interés que comienza a generar la sumillería a finales del siglo XIX. Se abordará, además, la figura de Jullien y su producción científica para ahondar en su aportación a la sumillería con el Manuel du sommelier, obra pionera en este campo.
El género textual “etiqueta” y su dimensión multimodal
Authors: Policastro Ponce Gisella
Published: May 2021

El acto comunicativo, y más particularmente, el sistema lingüístico, tal y como lo conocemos hoy en día, se caracterizan por presentar una relación de dependencia entre todos los elementos de construcción expresiva destinados a cumplir determinadas funciones comunicativas dentro de un contexto sociocultural determinado y que concurren en un sincretismo multimodal (García Asensio et al., 2015). Los recientes avances en el campo de la Teoría Multimodal, motivados por los avances de la era de la digitalización, han estimulado la necesidad de profundizar en su conocimiento, así como en su aplicación a diferentes disciplinas, tales como la Lingüística, la Traducción, el Análisis del Discurso, la Semiótica, entre otras, en la medida que se observa una transformación de las estructuras discursivas por medio de múltiples articulaciones. Partiendo de la perspectiva multimodal del texto, el presente estudio tiene por objeto identificar la etiqueta como un género textual en sí mismo (Coutinho y Miranda, 2009) y poner de manifiesto la dimensión multimodal de la etiqueta. Atendiendo a estas consideraciones, se analizarán las particularidades que justifican la consideración de este microtexto como un género textual propiamente dicho y se identificará la dimensión multimodal de la etiqueta
Estudio de los procesos de creación léxica en el ámbito oleoturístico (francés-español)
Authors: Luque Janodet Francisco
Published: May 2021

El turismo es uno de los sectores más importantes de la economía española. Su diversidad ha propiciado la creación de rutas temáticas que potencian el turismo de interior y rural usando como eje central un determinado producto, como el aceite de oliva o el vino. Esto ha dado lugar a nuevos conceptos y realidades que las lenguas tratan de denominar a través de diferentes recursos léxicos. El presente artículo estudia la creación de neologismos en el ámbito del oleoturismo desde una perspectiva sincrónica a partir de un corpus textual comparable y bilingüe ad hoc y de un posterior extracto de términos. En esta contribución, tras haber presentado los dieciocho neologismos más destacables, se analizan los procesos de creación léxica más habituales en este sector turístico. Este estudio concluye que el procedimiento más usual en la creación de términos especializados en el par de lenguas de lenguas francés-español es la composición culta.
Due pittrici greche nel De mulieribus claris (I): Tamari (it)
Authors: Rodríguez Mesa Francisco José
Published: May 2021

Fra le centosei biografie muliebri che compongono il De mulieribus claris di Giovanni Boccaccio si annovera un certo gruppo di donne che spiccarono per la loro saggezza o per il loro virtuosismo in diverse arti. All’interno di questa categoria, il certaldese narra brevemente il talento di due pittrici che vissero nella Grecia dell’Antichità: Tamari, figlia di Micone (capitolo LVI), e Irene, figlia di Cratino (LIX). Il presente articolo – primo di due studi che prenderanno in analisi le due vite suddette – studia le particolarità del capitolo dedicato a Tamari (LVI) analizzando le fonti utilizzate dall’autore e la struttura della vita, che viene paragonata agli altri modelli presenti nella silloge, sia per quanto riguarda l’estensione, sia rispetto ai motivi per i quali eccelse la protagonista.
Los peligros de los videojuegos y el mundo virtual en la juventud. Análisis en torno a la novela Erebos de Ursula Poznanski
Authors: Sánchez Berbegal José Alberto
Published: May 2021

Erebos, novela juvenil del año 2010, galardonada con numerosos premios, narra la historia de unos jóvenes que se ven atrapados en el mundo de un videojuego. Los personajes sufren cambios en sus vidas, tales como la alimentación, las relaciones personales, la salud o los resultados académicos. Esto no es más que un reflejo de lo que ocurre en la actualidad a un gran número de adolescentes. El objetivo de este estudio es determinar en qué medida está relacionado Erebos con los cambios que suceden a los personajes de la novela, así como profundizar en otras consecuencias que podrían aparecer en personas con adicción a los videojuegos. Con este fin, la pregunta de investigación es la siguiente: ¿Hasta qué punto se pueden atribuir los cambios negativos en la vida de los personajes al uso que estos hacen del videojuego? La pregunta de investigación se responde mediante el análisis exhaustivo de los aspectos de la obra, así como también mediante el empleo de estudios contrastados pertenecientes a esta temática. Una vez alcanzados los resultados, se puede concluir que la obra manifiesta los principales peligros de los videojuegos en sus personajes, causados por Erebos. Esto, muy común en los adolescentes del siglo XXI, provoca principalmente desajustes en la salud y en el comportamiento. Por ello, un estudio sociológico y psicoanalítico de la obra podría ayudar a desentrañar más aspectos relacionados con esta temática.
La interpretación bilateral en el ámbito turístico: evaluación
Authors: Álvarez García Carmen , Limbach Chistiane
Published: May 2021

A partir de la matriz formativa para evaluar la interpretación consecutiva de Domínguez Araújo (2013) hemos elaborado una rúbrica específica para evaluar la interpretación bilateral y la hemos aplicado a un corpus de interpretaciones bilaterales con la intención de diseñar estrategias didácticas útiles en la formación en este tipo de interpretación. La evaluación del corpus, compuesto por 14 exámenes finales de interpretación bilateral en el turismo con la combinación lingüística alemán-español, ha permitido categorizar los elementos en los que se cometen con mayor frecuencia los errores que impiden la producción de una interpretación adecuada. Los resultados son positivos en cuanto a la expresión en lengua materna y en la resolución de problemas. No obstante, constatan la necesidad de establecer nuevas estrategias didácticas que busquen mejorar la expresión en la lengua extranjera. Además, hemos podido comprobar que los errores más frecuentes de los estudiantes son las omisiones de información relevante y los cambios de sentido respecto al mensaje original. El análisis muestra que la rúbrica elaborada para la evaluación de interpretaciones bilaterales puede ser útil tanto para la gestión y diseño de estrategias didácticas como para potenciar el autoaprendizaje por parte de los estudiantes.
Introducción Due pittrici greche nel De mulieribus claris (II): Irene
Authors: Rodríguez Mesa Francisco José
Published: May 2021

Fra le centosei biografie muliebri che compongono il De mulieribus claris di Giovanni Boccaccio si annoverano quelle di un certo gruppo di donne che spiccarono per la loro saggezza o per il loro virtuosismo in diverse arti. All’interno di questa categoria, il certaldese narra brevemente il talento di due pittrici che vissero nella Grecia dell’Antichità: Tamari, figlia di Micone (capitolo LVI), e Irene, figlia di Cratino (LIX). Il presente articolo – secondo di due studi che prendono in analisi le due vite suddette – studia le particolarità del capitolo dedicato a Irene (LIX) analizzando le fonti utilizzate dall’autore e la struttura della vita alla luce degli schemi narrativi usati dal certaldese.
Método científico. El papel del investigador y su responsabilidad en Leben des Galilei de Bertolt Brecht: Estudio analítico e interpretativo
Authors: Sánchez Berbegal José Alberto
Published: May 2021

l presente estudio constituye un ejercicio de recopilación de los principales aspectos que atañen al método científico y al papel del investigador y su responsabilidad en la obra Leben des Galilei de Bertolt Brecht. El núcleo del análisis se centra principalmente en la figura del protagonista, el científico italiano Galileo Galilei. En la actualidad, al igual que en el pasado, los científicos juegan un papel fundamental en la sociedad. Por este motivo, se antoja necesario conocer las responsabilidades que recaen sobre este colectivo, de manera que la humanidad sea consciente de la imperiosa necesidad de austeridad en este campo. El pasado siglo XX, marcado por encarnizadas guerras, supuso un enorme desarrollo para la tecnología. Pero, ¿con qué finalidad se desarrolló esta tecnología? Lo cierto es que el interés por su desarrollo estuvo marcado por numerosos motivos bélicos. Muchos fueron los científicos que pusieron sus conocimientos al servicio del poder sin llegar a pensar que estos se utilizarían para tales fines. El propio Albert Einstein, defensor del desarrollo de la bomba atómica, se arrepintió de ello tras cerciorarse del uso que se había hecho de ella en territorio nipón.
Construction of Acculturation-Oriented Teaching Pattern in College Foreign Languages Courses – From Cultural Experience Theory Perspective
Authors: Wang Shujun
Published: May 2021

Language is an integral part of culture and culture’s big role in language learning can never be exaggerated too much. With worldwide globalization development, it grows to be a heated topic on how to improve foreign language learning outcome by culture teaching. Based on Schumann’s Acculturation Model and Moran’s Cultural Experience Theory, attempts are made to shed more light on acculturation-oriented pattern construction from cultural experience perspective to guide college foreign language teaching in a more effective way. In addition, pedagogical implications are put forward as well.
Hypertrigliceridemic waist, physical activity and cardiovascular risk factors in schoolchildren
Authors: Guilherme Flávio Ricardo , Fiorillo Rodrigo Garcia , Santos Stevan Ricardo dos , Graça Ágatha , Fonseca Higor Santos , Nascimento Matheus Amarante do , Rinaldi Wilson
Published: May 2021

Este estudo teve como objetivo analisar a prevalência do fenótipo Cintura Hipertrigliceridêmica e suas associações com os níveis de atividade física, estado nutricional e perfil lipídico de escolares da rede pública de ensino. Os 448 escolares com idade entre 10 e 18 anos foram analisados pela massa corporal, estatura, índice de massa corporal (IMC), circunferência de cintura, triglicerídeos, colesterol total, HDL-C, LDL-C, colesterol não HDL, glicemia em jejum e tempo de atividade física semanal. Os resultados evidenciaram uma alta prevalência do fenótipo CHT nos escolares (n = 125; 27,9%). O grupo diagnosticado com fenótipo apresentou maior massa corporal, IMC, colesterol total, LDL-C e colesterol não HDL e menor nível de HDL-C em relação ao grupo sem o diagnóstico do fenótipo. Porém, para medidas de glicemia em jejum e tempo de atividade física os grupos não se diferiram. A análise de associação por meio de regressão logística, mostrou que o fenótipo CHT associou-se com o sexo, estado nutricional e colesterol total, onde os meninos apresentaram 2,0 (IC95%: 1,3 - 3,2); obesos 6,2 (IC95%: 2,7 - 17,2) e níveis de colesterol acima 150 mg/dL 3,5 (IC95%: 2,1 - 5,7) vezes mais chances de terem o fenótipo. Logo, essa pesquisa evidenciou uma alta prevalência de CHT em escolares da rede pública, sendo os meninos, obesos e escolares com níveis de colesterol total inadequado os sujeitos com maiores chances de terem o fenótipo. Todavia, destaca-se a importância do acompanhamento dessas variáveis ao longo do ano em todos os escolares, considerando o período de fortes mudanças pelas quais podem alterar rapidamente os elementos analisados.
Enteral nutrition and medication administration practices of nurses in a low-resource acute setting
Authors: Batalla Mary Grace Anne P , Quero Ryana Anjela , Maglalang Jessica Christel , Gardaya Danielle , Nunes Rophy Sly , Ginnique De Grato Ma. , Mananguit Izra , Pilar Danica Joy Christelle , Valdez Kathlyn Sharmaine , Anne De Leon Sheen
Published: May 2021

Background:

Despite the presence of evidence-based policies and guidelines, and in line with lingering issues in resource availability in low-income settings, inconsistencies are still being documented in the provision of adequate nutritional support and medication administration via the enteral route. Aims: The study aimed to, first, describe the practices of nurses in enteral nutrition and medication administration in the context of a low-resource setting and, second, explore the factors that are associated with the performance of such practices.

Methods:

The study used a descriptive correlational design. Quota sampling of nurses (n=138) working in wards and intensive care units of a tertiary hospital for adult patients requiring enteral nutritional support was performed. Enteral feeding and medication practices were assessed using a self-report survey. Ethical approval was obtained from an institutional review board.

Findings:

The majority of nurses correctly identified X-ray as the gold standard for determining tube placement (58.5%). However, only 13.5% correctly identified air insufflation as an unreliable method. Scores on knowledge and skills on enteral feeding and medication were found to have a significant, strong positive correlation (r=0.855, p<0.01).

Conclusions:

Strengthening of knowledge on standards of enteral nutrition and medication practices may improve the performance of the skill in actual bedside practice. Addressing documented gaps in practices and standards may have an impact on the provision of safe and quality nursing care.
Nursing jobs in a pandemic
Authors: Harrison Penny
Published: May 2021

Key points from the Royal College of Nursing review of the UK nursing labour market
How not to miss infective causes of hip pain in children
Authors: Oliver Emile , Sinha Pranab , Khwaja Murtaza , Thilagarajah Michael
Published: May 2021

A referral from accident and emergency for a child with hip pain is a scenario commonly faced by orthopaedic juniors on call. The list of differentials is vast and can make assessment and diagnosis challenging, with severe consequences if diagnosis is delayed or missed.

Three common causes of paediatric hip pain are septic arthritis, transient synovitis and osteomyelitis. These can all present as a child with atraumatic hip pain, irritability, fever and refusal to weight bear. Differentiating between them can be challenging. A thorough history and examination, combined with appropriate investigations and imaging, is essential. Early diagnosis and prompt treatment are key to reducing irreversible secondary sequelae of joint destruction and long-term functional impairment.
Effectiveness of e-learning to develop the ability to recognise and manage stroke
Authors: Mortimer Craig
Published: May 2021

Background:

With stroke continuing to affect people in the UK and around the world, the need to develop health professionals in the management of patients with the condition and ensuring staff can meet the requirements of guidelines is key.

Aim:

This study aimed to assess the effectiveness of e-learning to develop ambulance staff in the management of acute stroke and stroke mimics by looking at their engagement with the course and knowledge attainment.

Method:

A small-scale study focused on an e-learning course on stroke management and before and after questionnaires.

Results:

Participants demonstrated good engagement with the course. However, the before and after questionnaire results were mixed, with 46% of participants demonstrating an increase in their knowledge up to 6 weeks after undertaking the course, 32% remaining the same and 22% showing a decrease.

Conclusion:

The data suggest more around the general approach to e-learning rather than on the topic of stroke management. Regardless of the course's content and its overall effectiveness, if students do not afford a suitable amount of time to engage with the learning materials, their ability to develop is greatly diminished.
‘Fitting in’ as an NQP
Authors: Costello Barry
Published: May 2021

In his second column, Barry Costello reflects on what it was like to start out as an NQP and the lessons he has learned about how he can fit in while making his own mark
Silver linings of COVID
Authors: Sycamore Rhys
Published: May 2021

Through personal challenges experienced during the COVID-19 pandemic as an underpriveleged student paramedic, Rhys Sycamore shares his ‘silver linings’ from an unconventional placement to a bolstered drive to advocate for a more inclusive practice.
BEST SHARIA BANK IN INDONESIA: AN ANALYTICAL HIERARCHY PROCESS (AHP) APPROACH
Authors: Jihadi M. , Vilantika Elok , Sholichah Fatmawati , Arifin Zainal
Published: May 2021

This study aims to determine the performance of Islamic commercial banks in Indonesia using the following assessment criteria: capital, asset quality, efficiency, liquidity, Sharia Conformity & Profitability (SCnP), and the Maqasid Index. The sample includes the five best Sharia banks in Indonesia. All the data are obtained based on the annual reports of each bank taken from the bank's websites in 2019. Data were analyzed using the Analytical Hierarchy Process (AHP) method. This tool helps make decisions from several alternative choices of sharia bank institutions. The results show that Bank Muamalat Indonesia, Bank Syariah Mandiri, and BRI Syariah are the three best performing Sharia banks in 2019.
AN ALTERNATIVE FRAMEWORK FOR SOCIALLY RESPONSIBLE PORTFOLIOS OPTIMIZATION APPLIED TO THE MOROCCAN STOCK EXCHANGE
Authors: Hanine Yahya , Tkiouat Mohamed , Lahrichi Younes
Published: May 2021

The purpose of this article is to propose an alternative approach for portfolio optimization combining financial and ethical constraints in one hand, and objective and subjective investor’s preferences in the other hand. This approach intends to support investors in selecting and optimizing financial and social portfolio’s performances. More precisely, we introduce analytic hierarchy process (AHP) to measure the ethical performance (EP) score of each asset considering ethical criteria. For its part, fuzzy multiple criteria decision making (FMCDM) is used to determine the overall financial quality score of assets with respect to key financial criteria i.e., short term return, long term return, and risk. Besides, interactive fuzzy programming approach is applied to support the investor’s decision, considering its subjective preferences. The robustness of our approach is tested through an empirical study involving the case of the Casablanca Stock Exchange (CSE). The results give evidence that the Socially Responsible (SR) Portfolio have performed similar to the conventional one, as no significant differences were found in term of return. However, the SR portfolio allows the investor to achieve his ethical goal, against a slight financial sacrifice.
Pressure effect on structures and optoelectronic attributes of mixed halide CsPb(I/Br)3: a density functional theory study
Authors: Jbara Ahmed S. , Munir Junaid , Yousaf Masood , Saeed M. A.
Published: May 2021

The effect of pressure (up to 10 GPa) on the electronic and optical properties of bromine-substituted cesium lead iodide (

C
s
P
b
I

3

), as one promising inorganic halide perovskite, is investigated using modified Backe–Johnson (mBJ) potential for the first time to our knowledge. The lattice parameters, electronic bandgap, and imaginary and real parts of the dielectric function, along with the optical absorption coefficient, are calculated. Density functional perturbation theory is employed to compute the optical properties in the photon energy range from 0.0 to 30 eV. No structural or phase-type transformation is noticed under the applied pressure, which resulted in a uniform contraction of the unit cell. Bandgap variation is seen in all the structures, with the maximum (1.65 eV) and minimum (1.46 eV) decrease found for doped and undoped

C
s
P
b
B
r
I

2

, respectively. The present work provides useful information about the performance of

C
s
P
b
I

3
−
x

B
r

x

compounds under high pressure that can be utilized in designing solar cells and optoelectronics.
Solar cell simulations based on ab initio methods [Invited]
Authors: Quandt Alexander , Warmbier Robert
Published: May 2021

Solar cell simulations have become an essential tool for the design of more efficient types of photovoltaic devices. However, it is not widely known that in principle, the simulation of a solar cell can be done entirely on a computer, starting from a fundamental atomistic level and ending up with an accurate prediction of the J-V characteristics of the final device. We will illustrate the use of ab initio methods to study fundamental light-matter interactions, and we will point out how to combine these methods with simple model approaches and state-of-the-art device simulations to obtain powerful numerical tools that may be used alongside experimental studies. Being work in progress, the suggested approaches are marked by a variety of open technical problems, but they also provide interesting new opportunities to develop more accurate types of solar cell device simulations.
Profiles and outcomes in patients with COVID-19 admitted to wards of a French oncohematological hospital: A clustering approach
Authors: Bondeelle Louise , Chevret Sylvie , Cassonnet Stéphane , Harel Stéphanie , Denis Blandine , de Castro Nathalie , Bergeron Anne ,   on behalf of The Saint Louis CORE Team Group
Published: May 2021

Objectives

Although some prognostic factors for COVID-19 were consistently identified across the studies, differences were found for other factors that could be due to the characteristics of the study populations and the variables incorporated into the statistical model. We aimed to a priori identify specific patient profiles and then assess their association with the outcomes in COVID-19 patients with respiratory symptoms admitted specifically to hospital wards.

Methods

We conducted a retrospective single-center study from February 2020 to April 2020. A non-supervised cluster analysis was first used to detect patient profiles based on characteristics at admission of 220 consecutive patients admitted to our institution. Then, we assessed the prognostic value using Cox regression analyses to predict survival.

Results

Three clusters were identified, with 47 patients in cluster 1, 87 in cluster 2, and 86 in cluster 3; the presentation of the patients differed among the clusters. Cluster 1 mostly included sexagenarian patients with active malignancies who were admitted early after the onset of COVID-19. Cluster 2 included the oldest patients, who were generally overweight and had hypertension and renal insufficiency, while cluster 3 included the youngest patients, who had gastrointestinal symptoms and delayed admission. Sixty-day survival rates were 74.3%, 50.6% and 96.5% in clusters 1, 2, and 3, respectively. This was confirmed by the multivariable Cox analyses that showed the prognostic value of these patterns.

Conclusion

The cluster approach seems appropriate and pragmatic for the early identification of patient profiles that could help physicians segregate patients according to their prognosis.
Circulating levels of angiogenic factors and their association with preeclampsia among pregnant women at Mulago National Referral Hospital in Uganda
Authors: Nabweyambo Sheila , Sande Obondo James , McGovern Naomi , Bwanga Freddie , Ssekagiri Alfred , Keesiga Annette , Adroma Moses , Wasswa Ronald , Atuheirwe Maxine , Namugenyi Juliet , Castelnuovo Barbara , Nakimuli Annettee
Published: May 2021

Preeclampsia (PE) is a major cause of maternal and new-born morbidity and mortality. Angiogenic factors contribute a major role in the vascular dysfunction associated with PE. We investigated the circulating levels of vascular endothelial growth factor (VEGF), placental growth factor (PlGF) and soluble Feline McDonough Sarcoma (fms)—like tyrosine kinase-1 (sFlt1), their association with PE and diagnostic performance of disease among pregnant women in Uganda. Using a case-control study design, 106 women with PE and 106 with normal pregnancy were enrolled. Demographic and clinical characteristics, and anticoagulated blood samples were collected from participants. Plasma VEGF, PlGF and sFlt1 levels were measured using Luminex and enzyme linked immunosorbent assays (ELISA). Conditional logistic regression was used to explore association of angiogenic factors with PE and receiver operating characteristic analysis was performed to investigate PE diagnostic performance. Levels of VEGF and PIGF were significantly lower in cases compared to controls (VEGF: median = 0.71 pg/ml (IQR = 0.38–1.11) Vs 1.20 pg/ml (0.64–1.91), p-value<0.001 and PlGF: 2.20 pg/ml (1.08–5.86) Vs 84.62 pg/ml (34.00–154.45), p-value<0.001). Plasma levels of sFlt1 were significantly higher in cases than controls (median = 141.13 (71.76–227.10) x103 pg/ml Vs 19.86 (14.20–29.37) x103 pg/ml). Increasing sFlt1 levels were associated with increased likelihood of PE (aOR = 4.73; 95% CI, 1.18–19.01; p-value = 0.0287). The sFlt1/PlGF ratio and sFlt1 had a better performance for diagnosis of PE, with AUC = 0.95 (95% CI, 0.93–0.98) followed by PlGF with AUC = 0.94 (95% CI, 0.91–0.97). Therefore, sFlt1, sFlt1/PlGF ratio and PlGF are potential candidates for incorporation into algorithms for PE diagnosis in the Ugandan population.
Seeing faces, when faces can‘t be seen: Wearing portrait photos has a positive effect on how patients perceive medical staff when face masks have to be worn
Authors: Wiesmann Martin , Franz Christiane , Sichtermann Thorsten , Minkenberg Jan , Mathern Nathalie , Stockero Andrea , Iordanishvili Elene , Freiherr Jessica , Hodson Julian , Habel Ute , Nikoubashman Omid
Published: May 2021

Introduction

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, wearing surgical face masks has become mandatory for healthcare staff in many countries when interacting with patients. Recently, it has been shown that wearing face masks impairs social interaction by diminishing a person’s ability to read the emotion of their counterparts, an essential prerequisite to respond adequately in social situations. It is easily conceivable that this may have a tangible negative influence on the communication and relationship between patients and healthcare personnel. We therefore investigated whether it has an effect on how patients perceive healthcare professionals when physicians and nursing staff wear portrait photos with their smiling faces in addition to face masks.

Methods

During the study period of 16 days, the medical staff of our Department wore surgical face masks at all times during any kind of interaction with patients. In a pseudorandomized order, all members of our staff additionally affixed their portrait photos to their work clothes on 8 of the 16 days. After completion of their visit, 226 patients were interviewed anonymously in a cross-sectional study design using a questionnaire in which they rated the following three items: friendliness of staff, medical quality of treatment, and how well they felt taken care of during treatment in our Department.

Results

On days, on which staff wore photos, mean scores of the questionnaires were significantly higher than on non-photo days (p = 0.013; mean ± standard deviation = 92.8 ± 11.3 vs. 91.0 ± 12.6; median (range) = 97 (98) vs. 96 (76)). When analyzed separately, the increased scores were only significant for the item friendliness of staff (p = 0.009; mean ± standard deviation = 95.8 ± 6.3 vs. 92.2 ± 11.5; median (range) = 98 (39) vs. 97 (54)).

Conclusion

Our study suggests that the use of portrait photos with smiling faces has a positive effect on how patients perceive healthcare staff.
Chronic stimulation of group II metabotropic glutamate receptors in the medulla oblongata attenuates hypertension development in spontaneously hypertensive rats
Authors: Hsu Julia Chu-Ning , Sekizawa Shin-ichi , Tochinai Ryota , Kuwahara Masayoshi
Published: May 2021

Baroreflex dysfunction is partly implicated in hypertension and one responsible region is the dorsal medulla oblongata including the nucleus tractus solitarius (NTS). NTS neurons receive and project glutamatergic inputs to subsequently regulate blood pressure, while G-protein-coupled metabotropic glutamate receptors (mGluRs) play a modulatory role for glutamatergic transmission in baroreflex pathways. Stimulating group II mGluR subtype 2 and 3 (mGluR2/3) in the brainstem can decrease blood pressure and sympathetic nervous activity. Here, we hypothesized that the chronic stimulation of mGluR2/3 in the dorsal medulla oblongata can alleviate hypertensive development via the modulation of autonomic nervous activity in young, spontaneously hypertensive rats (SHRs). Compared with that in the sham control group, chronic LY379268 application (mGluR2/3 agonist; 0.40 μg/day) to the dorsal medulla oblongata for 6 weeks reduced the progression of hypertension in 6-week-old SHRs as indicated by the 40 mmHg reduction in systolic blood pressure and promoted their parasympathetic nervous activity as evidenced by the heart rate variability. No differences in blood catecholamine levels or any echocardiographic indices were found between the two groups. The improvement of reflex bradycardia, a baroreflex function, appeared after chronic LY379268 application. The mRNA expression level of mGluR2, but not mGluR3, in the dorsal medulla oblongata was substantially reduced in SHRs compared to that of the control strain. In conclusion, mGluR2/3 signaling might be responsible for hypertension development in SHRs, and modulating mGluR2/3 expression/stimulation in the dorsal brainstem could be a novel therapeutic strategy for hypertension via increasing the parasympathetic activity.
How recreational marathon runners hit the wall: A large-scale data analysis of late-race pacing collapse in the marathon
Authors: Smyth Barry
Published: May 2021

Introduction

In the marathon, how runners pace and fuel their race can have a major impact on race outcome. The phenomenon known as hitting the wall (HTW) refers to the iconic hazard of the marathon distance, in which runners experience a significant slowing of pace late in the race, typically after the 20-mile mark, and usually because of a depletion of the body’s energy stores.

Aim

This work investigates the occurrence of significant late-race slowing among recreational marathoners, as a proxy for runners hitting the wall, to better understand the likelihood and nature of such slowdowns, and their effect on race performance.

Methods

Using pacing data from more than 4 million race records, we develop a pacing-based definition of hitting the wall, by identifying runners who experience a sustained period of slowing during the latter stages of the marathon. We calculate the cost of these slowdowns relative to estimates of the recent personal-best times of runners and compare slowdowns according to runner sex, age, and ability.

Results

We find male runners more likely to slow significantly (hit the wall) than female runners; 28% of male runners hit the wall compared with 17% of female runners, χ2(1, N = 1, 928, 813) = 27, 693.35, p < 0.01, OR = 1.43. Such slowdowns are more frequent in the 3 years immediately before and after a recent personal-best (PB) time; for example, 36% of all runners hit the wall in the 3 years before a recent PB compared with just 23% in earlier years, χ2(1, N = 509, 444) = 8, 120.74, p < 0.01, OR = 1.31. When runners hit the wall, males slow more than females: a relative slowdown of 0.40 vs. 0.37 is noted, for male and female runners, when comparing their pace when they hit the wall to their earlier race (5km-20km) pace, with t(475, 199) = 60.19, p < 0.01, d = 0.15. And male runners slow over longer distances than female runners: 10.7km vs. 9.6km, respectively, t(475, 199) = 68.44, p < 0.01, d = 0.17. Although, notably the effect size of these differences is small. We also find the finish-time costs of hitting the wall (lost minutes) to increase with ability; r2(7) = 0.91, p < 0.01 r2(7) = 0.81, p < 0.01 for male and female runners, respectively.

Conclusions

While the findings from this study are consistent with qualitative results from earlier single-race or smaller-scale studies, the new insights into the risk and nature of slowdowns, based on the runner sex, age, and ability, have the potential to help runners and coaches to better understand and calibrate the risk/reward trade-offs that exist as they plan for future races.
'Nuestro criterio había de ser mucho más beneficioso para la ciencia’: Vives Escudero’s contribution to Phoenicio-Punic archaeology in the contemporary cultural context
Authors: Mauro Chiara Maria
Published: May 2021

Antonio Vives Escudero is a key figure in understanding the rising interest in antiquities in early 20th-century Spain. However, scholars have more frequently acknowledged his role as a collector or antiquarian rather than his involvement in contemporary intellectual debate. On the one hand, it is true that, at this stage, it is difficult to discern antiquarianism from archaeology; additionally, such a categorisation contributed to underlining some of Vives’ strong points (e.g. his commercial instinct). Conversely, this interpretation has undermined his intellectual role, reducing the importance of his contribution to the development of Phoenicio-Punic archaeology in Spain. Therefore, the general aim of this contribution is twofold. It contextualises Vives into the wider scenario of the rising interest in Phoenicio-Punic archaeology and addresses the central question of whether, behind his commercial and collecting interests, he made a real contribution to the development of Phoenicio-Punic archaeology in Spain.