bluuebunny/crossref_metadata_2025 huggingface dataset:
What proportion of couples with a history of recurrent pregnancy loss and with a balanced rearrangement in one parent can potentially be identified through cell-free DNA genotyping?
Authors: van Zutven Laura J. C. M. , Mijalkovic Jona , van Veghel-Plandsoen Monique , Goense Margaret , Polak Marike , Knapen Maarten F. C. M. , de Weerd Sabina , Joosten Marieke , Diderich Karin E. M. , Hoefsloot Lies H. , Van Opstal Diane , Srebniak Malgorzata I.
Published: September 2023

Background

Balanced chromosome aberrations are reported in about 1:30 couples with recurrent pregnancy loss (RPL). Karyotyping of both parents is necessary to identify these aberrations. Genome-wide non-invasive prenatal testing (NIPT) in case of recurrent pregnancy loss could be a more efficient way to identify couples at increased risk for carrying a balanced chromosome rearrangement. The aim of this study was to evaluate whether the potential fetal imbalances caused by parental balanced aberrations detected in our center are large enough to be detectable by genome-wide non-invasive prenatal testing (NIPT).

Material and methods

From January 1970 until May 2020 our laboratory received 30,863 unique requests for karyotyping due to RPL. We have identified 16,045 couples and evaluated all abnormal cytogenetic results to assess the minimal size of the involved chromosomal segments in potential unbalanced products of the rearrangements.

Results

In the presented cohort we detected 277 aberrant balanced translocations/inversions in females and 185 in males amongst 16,045 couples with RPL, which can be translated to a risk of 1:35 (2.9%, 95% CI 2.6–3.2%). Our study showed that the vast majority (98.7%, 95% CI 97.1–99.5%) of these balanced aberrations will potentially cause a fetal imbalance > 10 Mb, which is detectable with genome-wide NIPT if it was performed during one of the miscarriages.

Conclusions

Our study suggests that genome-wide NIPT is able to reveal most unbalanced products of balanced chromosomal rearrangements carried by couples with RPL and therefore can potentially identify balanced chromosomal aberration carriers. Moreover, our data suggest that these couples can be offered NIPT in case they decline invasive testing in future pregnancies.
Group comparisons of the individual electroretinogram time trajectories for the ascending limb of the b-wave using a raw and registered time series
Authors: Brabec Marek , Constable Paul A. , Thompson Dorothy A. , Marmolejo-Ramos Fernando
Published: September 2023

Objectives

The electroretinogram is a clinical test commonly used in the diagnosis of retinal disorders with the peak time and amplitude of the a- and b-waves used as the main indicators of retinal function. However, subtle changes that affect the shape of the electroretinogram waveform may occur in the early stages of disease or in conditions that have a neurodevelopmental or neurodegenerative origin. In such cases, we introduce a statistical approach to mathematically model the shape of the electroretinogram waveform that may aid clinicians and researchers using the electroretinogram or other biological signal recordings to identify morphological features in the waveforms that may not be captured by the time or time–frequency domains of the waveforms. We present a statistical graphics-based analysis of the ascending limb of the b-wave (AL-b) of the electroretinogram in children with and without a diagnosis of autism spectrum disorder (ASD) with a narrative explanation of the statistical approach to illustrate how different features of the waveform based on location and scale derived from raw and registered time series can reveal subtle differences between the groups.

Results

Analysis of the raw time trajectories confirmed findings of previous studies with a reduced and delayed b-wave amplitude in ASD. However, when the individual time trajectories were registered then group differences were visible in the mean amplitude at registered time ~ 0.6 suggesting a novel method to differentiate groups using registration of the ERG waveform.
Correlation between synthetic MRI relaxometry and apparent diffusion coefficient in breast cancer subtypes with different neoadjuvant therapy response
Authors: Jiang Wenhong , Du Siyao , Gao Si , Xie Lizhi , Xie Zichuan , Wang Mengfan , Peng Can , Shi Jing , Zhang Lina
Published: September 2023

Background

To evaluate the correlation between synthetic MRI (syMRI) relaxometry and apparent diffusion coefficient (ADC) maps in different breast cancer subtypes and treatment response subgroups.

Methods

Two hundred sixty-three neoadjuvant therapy (NAT)-treated breast cancer patients with baseline MRI were enrolled. Tumor annotations were obtained by drawing regions of interest (ROIs) along the lesion on T1/T2/PD and ADC maps respectively. Histogram features from T1/T2/PD and ADC maps were respectively calculated, and the correlation between each pair of identical features was analyzed. Meanwhile, features between different NAT treatment response groups were compared, and their discriminatory power was evaluated.

Results

Among all patients, 20 out of 27 pairs of features weakly correlated (r = – 0.13–0.30). For triple-negative breast cancer (TNBC), features from PD map in the pathological complete response (pCR) group (r = 0.60–0.86) showed higher correlation with ADC than that of the non-pCR group (r = 0.30–0.43), and the mean from the ADC and PD maps in the pCR group strongly correlated (r = 0.86). For HER2-positive, few correlations were found both in the pCR and non-pCR groups. For luminal HER2-negative, T2 map correlated more with ADC than T1 and PD maps. Significant differences were seen in T2 low percentiles and median in the luminal-HER2 negative subtype, yielding moderate AUCs (0.68/0.72/0.71).

Conclusions

The relationship between ADC and PD maps in TNBC may indicate different NAT responses. The no-to-weak correlation between the ADC and syMRI suggests their complementary roles in tumor microenvironment evaluation.

Critical relevance statement

The relationship between ADC and PD maps in TNBC may indicate different NAT responses, and the no-to-weak correlation between the ADC and syMRI suggests their complementary roles in tumor microenvironment evaluation.

Key points

• The relationship between ADC and PD in TNBC indicates different NAT responses.

• The no-to-weak correlations between ADC and syMRI complementarily evaluate tumor microenvironment.

• T2 low percentiles and median predict NAT response in luminal-HER2-negative subtype.

Graphical Abstract
Neuronal MHC-I complex is destabilized by amyloid-β and its implications in Alzheimer’s disease
Authors: Kim Min-Seok , Cho Kwangmin , Cho Mi-Hyang , Kim Na-Young , Kim Kyunggon , Kim Dong-Hou , Yoon Seung-Yong
Published: September 2023

Backgrounds

The expression of major histocompatibility complex I (MHC-I) in neurons has recently been shown to regulate neurite outgrowth and synaptic plasticity. However, its contribution to neurodegenerative diseases such as Alzheimer's disease (AD) remains largely unknown.

Methods

In this study, we investigated the relationship between impaired MHC-I-β2M complex and AD in vitro and human AD samples. Interaction between protein was identified by liquid chromatography-tandem mass spectrometry and confirmed by immunoprecipitation. Single-chain trimer of MHC-I-β2M was generated to study the effect of stabilization of MHC-I-β2M complex on NCAM1 signaling.

Results

MHC-I is destabilized in the brains of AD patients and neuronal cells treated with oligomeric β-amyloid (Aβ). Specifically, Aβ oligomers disassemble the MHC-I-β2-microglobulin (β2M) complex, leading to reduced interactions with neural cell adhesion molecule 1 (NCAM1), a novel interactor of neuronal MHC-I, and decreased signaling. Inhibition of MHC-I-β2M complex destabilization by non-dissociable MHC-I-β2M-peptide complex restored MHC-I-NCAM1 signaling in neuronal cells.

Conclusions

The current study demonstrated that disruption of MHC-1-NCAM1 signaling by Aβ induced disassembly of MHC-I-β2M complex is involved in the pathophysiology of AD. Moreover, our findings suggest modulation of MHC-I stability may be a potential therapeutic target for restoring synaptic function in AD.
Outcomes and time trends of acute respiratory distress syndrome patients with and without liver cirrhosis: an observational cohort
Authors: Pensier Joris , De Jong Audrey , Monet Clément , Aarab Yassir , Le Bihan Clément , Capdevila Mathieu , Lakbar Inès , Stock Lucas , Belafia Fouad , Chanques Gerald , Molinari Nicolas , Jaber Samir
Published: September 2023

Background

In studies prior to lung-protective ventilation, liver cirrhosis in acute respiratory distress syndrome (ARDS) was associated with high mortality rates. Since patients with cirrhosis have been excluded from many trials on ARDS, their outcome when treated with lung-protective ventilation is unclear. The objectives were to assess whether cirrhosis is associated with mortality in ARDS and trends over time in mortality and severity.

Methods

We conducted a retrospective analysis of a prospective observational cohort conducted in a 20-bed tertiary ICU from October 2003 to December 2021. All consecutive adult critically ill patients with ARDS were included. ARDS was defined by the Berlin criteria. The primary outcome was 90 day mortality, assessed with Kaplan–Meier curves and multivariate Cox analysis. Time trends were assessed on 90 day mortality, Sequential Organ-Function Assessment score (SOFA) and non-hepatic SOFA. Ventilation settings were compared between patients with and without cirrhosis.

Results

Of the 7155 patients screened, 863 had a diagnosis of ARDS. Among these ARDS patients, 157(18%) had cirrhosis. The overall 90 day mortality was of 43% (378/863), 57% (90/157) in patients with cirrhosis and 41% (288/706) in patients without cirrhosis (p < 0.001). On survival curves, cirrhosis was associated with 90 day mortality (p < 0.001). Cirrhosis was independently associated with 90 day mortality in multivariate analysis (hazard ratio = 1.56, 95% confidence interval 1.20–2.02). There was no change in mortality over time in ARDS patients with and without cirrhosis. SOFA (p = 0.04) and non-hepatic SOFA (p = 0.02) increased over time in ARDS patients without cirrhosis, and remained stable in ARDS patients with cirrhosis. Tidal volume, positive end-expiratory pressure, plateau pressure and driving pressure were not different between ARDS patients with and without cirrhosis.

Conclusions

Although ARDS management improved over the last decades, the 90 day mortality remained high and stable over time for both ARDS patients with (57%) and without cirrhosis (41%). Nevertheless, the severity of patients without cirrhosis has increased over time, while the severity of patients with cirrhosis has remained stable.

Graphical Abstract
Next-generation cyber attack prediction for IoT systems: leveraging multi-class SVM and optimized CHAID decision tree
Authors: Dalal Surjeet , Lilhore Umesh Kumar , Faujdar Neetu , Simaiya Sarita , Ayadi Manel , Almujally Nouf A. , Ksibi Amel
Published: September 2023

Billions of gadgets are already online, making the IoT an essential aspect of daily life. However, the interconnected nature of IoT devices also leaves them open to cyber threats. The quantity and sophistication of cyber assaults aimed against Internet of Things (IoT) systems have skyrocketed in recent years. This paper proposes a next-generation cyber attack prediction framework for IoT systems. The framework uses the multi-class support vector machine (SVM) and the improved CHAID decision tree machine learning methods. IoT traffic is classified using a multi-class support vector machine to identify various types of attacks. The SVM model is then optimized with the help of the CHAID decision tree, which prioritizes the attributes most relevant to the categorization of attacks. The proposed framework was evaluated on a real-world dataset of IoT traffic. The findings demonstrate the framework's ability to categorize attacks accurately. The framework may determine which attributes are most crucial for attack categorization to enhance the SVM model's precision. The proposed technique focuses on network traffic characteristics that can be signs of cybersecurity threats on IoT networks and affected Network nodes. Selected feature vectors were also created utilizing the elements acquired on every IoT console. The evaluation results on the Multistep Cyber-Attack Dataset (MSCAD) show that the proposed CHAID decision tree can significantly predict the multi-stage cyber attack with 99.72% accuracy. Such accurate prediction is essential in managing cyber attacks in real-time communication. Because of its efficiency and scalability, the model may be used to forecast cyber attacks in real time, even in massive IoT installations. Because of its computing efficiency, it can make accurate predictions rapidly, allowing for prompt detection and action. By locating possible entry points for attacks and mitigating them, the framework helps strengthen the safety of IoT systems.
Clinical significance of interleukin-6, total bilirubin, CD3 + CD4 + T cells counts in the acute exacerbation of connective tissue disease-associated interstitial lung disease: a cross-sectional study
Authors: Ma Chengxing , Meng Kaifang , Shi Shenyun , Zhao Tingting , Chen Shanshan , Zhou Xuan , Shu Ruilu , Ma Miao , Tian Mi , Ding Jingjing
Published: September 2023

Objective

Interstitial lung disease (ILD) is a severe complication of connective tissue disease (CTD) that can significantly impact patients' prognosis and quality of life. However, the current diagnostic arena lacks reliable biomarkers for detecting and monitoring the progression and exacerbation of CTD-ILD. This study aimed to investigate the clinical value of 12 serum cytokines in the diagnosis of CTD-ILD and prediction of the risk of acute exacerbation (AE) in this disease.

Methods

This study was a cross-sectional investigation. Ninety-one hospitalized CTD patients were allocated into two groups: CTD-ILD group (n = 61) and CTD-non-ILD group (n = 30), and 30 sex-age matched healthy volunteers were enrolled as controls. The serum concentrations of interferon (IFN)-α, IFN-γ, tumor necrosis factor (TNF)-α, interleukin (IL)-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, and IL-1β were measured by Luminex suspension arrays. Logistic regression was employed to determine the significance of variables in the occurrence of AE-CTD-ILD. A nomogram was constructed to visualize the independent variables.

Results

Elevated levels of IL-6, IL-8, and TNF-α were observed and compared in the CTD-ILD group with CTD-non-ILD (all P < 0.05). Similarly, the levels of IL-6, IL-8 and TNF-α were higher in the acute exacerbation (AE-CTD-ILD) group compared with stable CTD-ILD (S-CTD-ILD) (P < 0.001, P < 0.001, and P = 0.022). Significant correlations between serum IL-6 and PaO2/FiO2 ratio (r = − 0.463, P < 0.001), percent predicted forced vital capacity (FVC%; r = − 0.362, P < 0.05), and total ground-glass opacity (GGO) score (r = 0.439, P < 0.001) were observed in CTD-ILD patients. Multivariate logistic regression analysis revealed that elevated IL-6 levels, total bilirubin (TBil), and decreased CD3 + CD4 + T cells counts were independent risk factors for the occurrence of AE-CTD-ILD (OR = 1.121, P = 0.024; OR = 1.865, P = 0.047; OR = 0.983, P = 0.037, respectively). Furthermore, by employing these three variables in combination for the prediction of AE status, their collective impact surpasses the independent effects of any single biomarker.

Conclusions

Elevated levels of serum IL-6, IL-8, and TNF-α were associated with the complication of ILD in CTD patients and the occurrence of AE in CTD-ILD patients. IL-6 could be a promising serum biomarker of severity and the occurrence of AE in CTD-ILD patients. The combination of the three variables (IL-6 level, TBil and CD3 + CD4 + T cells) predicted the AE-CTD-ILD better.
Lectins as potential tools for cancer biomarker discovery from extracellular vesicles
Authors: Islam Md. Khirul , Khan Misba , Gidwani Kamlesh , Witwer Kenneth W. , Lamminmäki Urpo , Leivo Janne
Published: September 2023

Extracellular vesicles (EVs) have considerable potential as diagnostic, prognostic, and therapeutic agents, in large part because molecular patterns on the EV surface betray the cell of origin and may also be used to “target” EVs to specific cells. Cancer is associated with alterations to cellular and EV glycosylation patterns, and the surface of EVs is enriched with glycan moieties. Glycoconjugates of EVs play versatile roles in cancer including modulating immune response, affecting tumor cell behavior and site of metastasis and as such, paving the way for the development of innovative diagnostic tools and novel therapies. Entities that recognize specific glycans, such as lectins, may thus be powerful tools to discover and detect novel cancer biomarkers. Indeed, the past decade has seen a constant increase in the number of published articles on lectin-based strategies for the detection of EV glycans. This review explores the roles of EV glycosylation in cancer and cancer-related applications. Furthermore, this review summarizes the potential of lectins and lectin-based methods for screening, targeting, separation, and possible identification of improved biomarkers from the surface of EVs.
Retention properties and mechanism of agricultural waste maize whisker on atmospheric mercury
Authors: Zheng Guiling , Chen Qianxiu , Zhou Feng , Li Peng
Published: September 2023

Mercury (Hg) is a global pollutant transmitted mainly through the atmosphere, posing a serious threat to biological survival and human health. Porous materials, with high specific surface area, high porosity, and high adsorption, are particularly suitable for the purification of atmospheric Hg mixtures. However, plant porous materials are rarely directly used for atmospheric Hg purification. In this study, the properties and mechanism of maize whisker in removing atmospheric Hg were analyzed. The results show that the Hg content in the whiskers increases significantly as the initial Hg concentration increases, and 79.38% Hg can be removed by 0.2 g maize whiskers after 1 h exposure when the initial Hg concentration is 0.1 μg m−3, indicating that maize whiskers can accumulate atmospheric Hg rapidly and effectively. The hole diameter of the maize whisker is between 0.83 and 3.06 μm, which is suitable for the adsorption of small substances. Correlation analysis shows that maize whiskers have a significant correlation between atmospheric Hg retention and its specific surface area, pore size, medium pore ratio, and micropore ratio, suggesting that the maize whisker hole feature has a significant influence on its ability to retain atmospheric Hg. Compared with the energy profiles before and after Hg treatment, the peak of Mg decreased after Hg adsorption. Fourier infrared spectrometer analysis suggests that functional groups such as -OH, -COOH, and -O- are involved in the adsorption process. The change in pH value shows an obvious effect on the overall change in zeta potential in the adsorption process. Therefore, a variety of mechanisms, including physical adsorption, electrostatic adsorption, complexation, chelation, and ion exchange, are involved in Hg retention with the maize whisker. This study reveals the important potential value of agricultural waste maize whiskers in the purification of atmospheric heavy metal Hg.

Graphical Abstract
Liver metastasis composed of pure squamous cell carcinoma component from pancreatic pure ductal adenocarcinoma: a case report
Authors: Mano Yohei , Sugimachi Keishi , Shimagaki Tomonari , Tomino Takahiro , Onishi Emi , Lee Lingaku , Hisano Terumasa , Koga Yutaka , Taguchi Kenichi , Morita Masaru , Toh Yasushi
Published: September 2023

Background

Liver metastasis of pure squamous cell carcinoma (SCC) from pancreatic ductal adenocarcinoma has not been previously reported.

Case presentation

A 66-year-old man underwent a computed tomography scan 3 years after surgery for pancreatic head cancer, and the scan revealed a mass lesion in the right lobe of the liver. A liver tumor biopsy was performed, and SCC was diagnosed. Whole sections of the pancreatic head cancer were re-evaluated, but no areas of SCC-like differentiation were identified. Although the pathology differed between the pancreas and liver, metastasis of adenosquamous carcinoma was considered. Three courses of gemcitabine plus nab-paclitaxel were administered to treat the liver metastasis of pancreatic cancer, but no response was attained. Therefore, primary SCC of the liver was considered and hepatic resection was performed. The tumor had invaded the diaphragm, and S5/6 partial hepatic resection with right diaphragm resection was performed. Pathological examination showed pure SCC of the liver, which differed from the pancreatic cancer. KRAS mutations were evaluated in the pancreatic and liver tumor specimens, and Q61R mutation was identified in both specimens. This pure SCC of the liver was diagnosed as metastasis from pancreatic cancer not by histology but by genetic analysis.

Conclusions

This is the first reported case of pure SCC liver metastasis from pancreatic cancer without a squamous cell component in the primary tumor. Evaluation of KRAS mutations in both specimens was useful for diagnosis.
Implication of red meat consumption habits in serum uric acid levels and mood disorders among first-trimester pregnant women
Authors: Alharbi Mudi H. , Alharbi Nora H.J. , Brnawi Ibtihal A. , Atiq Elham H.
Published: September 2023

Background

Dietary pattern involving meat consumption has an association with serum uric acid level which subsequently has an impact on moods. However, this relationship is not clearly established in pregnant women, particularly those who are accustomed to daily meat consumption.

Objective

This study investigated the relationship between red meat consumption and uric acid level and the subsequent impact on mood disorders in 1st trimester pregnant women.

Methodology

A total of 92 pregnant women in their first trimester (8–12 weeks), were selected for this study. Socio-demographic characteristics including age, body mass index (BMI), educational qualification, sleep hours, blood pressure and exercise status were recorded. To assess meat consumption, classification based on the recruited population consumption was divided into low and high meat consumption groups. Serum uric acid level was estimated in plasma. Mood disorder, namely, depression and anxiety were assessed using a self-reported Hospital Anxiety and Depression Scale (HADS) questionnaire. Collected data was analysed using different statistical tools.

Results

Logistic regression analysis showed higher odds of depression (OR = 0.059, 95% CI 0.02–0.172, p < 0.001) and anxiety (OR = 0.144, 95% CI 0.055–0.375, p < 0.001) in the high meat consumption group. Further, the potential confounders, high BMI and less exercise increased the odds of depression and anxiety in high meat consumption groups. Linear regression analysis revealed a significant influence of meat consumption on uric acid level (F (1, 90) = 305.385, p < 0.01).

Conclusions

The study recommends regular clinical screening of mood disorders, and recommends reasonable consumption of lean meat and/or replacing some portions with fish, as well as, a commitment to eating a healthy, balanced diet. It also suggests extensive studies because it could be linked to postpartum mood disorders among those who consume red meat every day.
Optimal Policy for Macrofinancial Stability
Authors: Benigno Gianluca , Chen Huigang , Otrok Christopher , Rebucci Alessandro , Young Eric R.
Published: September 2023

There is a new and now large literature analyzing government policies for financial stability based on models with endogenous borrowing constraints. These normative analyses build upon the concept of constrained efficient allocation where the social planner is constrained by the same borrowing limit that agents face. In this paper, we show that there exists at least one set of tools implementing the constrained efficient allocation that can also be used by a Ramsey planner to replicate an unconstrained allocation, achieving higher welfare. Constrained efficiency may lead to inaccurate characterizations of welfare maximizing policies relative to Ramsey optimal policy. (JEL E32, E44, E61, G01, H21)
A pilot study of the perception of specialists from a Medical
Rehabilitation field regarding the efficiency of Marketing
Communication
Authors: Morcov Mirela , Gheorghe Iuliana Raluca , Morcov Maria Veronica , Purcărea Victor Lorin
Published: September 2023

The necessity to improve the quality of health services is a growing concern of all stakeholders involved in providing medical assistance. Effective communication establishes interpersonal relationships with patients, enabling timely and accurate treatment decisions. This study aimed to assess the perception of Medical Rehabilitation specialists regarding the usage of Marketing Communication principles. It was conducted in the The National Center of Neurorehabilitation for Children “ Dr. N. Robănescu” Bucharest, Romania and included 85 participants with the following positions: physicians, psychologists, physiotherapists and medical assistants. According to the findings, 80% of medical staff stated that all useful information is provided to patients in a clear and accurate manner, which is also the desired quality management. In the current study, “face-to-face” communication was found to be the most successful method of communication.
Nerve conduction assessments in patients with lumbar
radiculopathy – an observational study
Authors: Talinga Andreea-Ancuta , Mederle Alexandra Laura , Codreanu Ada-Maria , Onofrei Roxana Ramona , Borza Claudia
Published: September 2023

The main aim of this study was to identify the changes in nerve conduction parameters in cases of lumbar radiculopathy due to lumbar spondylosis and intervertebral disc pathology with no clinical neurologic deficit and to identify the potential of nerve conduction studies in the early diagnosis of these cases. Eleven patients aged between 41 and 78 years (mean age 58 ± 13.1 years; 4 males, 36.36%) met the inclusion criteria and agreed to participate in this study. Nerve conduction studies were performed with Neuro‐MEP‐Micro (Figure 1), a digital system designed to record electrical activity of muscles and nerves at 1 or 2‐channel stimulation, and to measure and analyze their parameters. Conduction velocity was reduced in 29.41% of the examined tibial nerves, and in none of the examined peroneal nerves. The registered amplitudes, for none of the tibial or peroneal nerve, have not been lower than the reference values. Patients with reduced tibial conduction velocity had a Grade 2 nerve root involvement on MRI. Nerve conduction studies should be used to complete the physical and imagistic assessment of patients with lumbar radiculopathy, to detect functional abnormalities not only structural ones provided by the MRI.
Επιπολιτισμός, άγχος, αυτοεκτίμηση και ακαδημαϊκή επίδοση μεταναστών μαθητών στο ελληνικό σχολείο
Authors: Σιαβίκη Χριστίνα
Published: September 2023

Η μετανάστευση αποτελεί ένα πολυδιάστατο φαινόμενο που επηρεάζει τόσο την κοινωνία όσο και τα άτομα και αποτελεί αντικείμενο ακαδημαϊκού ενδιαφέροντος διεθνώς. Παρόλο που η μετανάστευση είναι συχνά εκούσια, συνδέεται με δυσκολίες προσαρμογής των ατόμων στη χώρα φιλοξενίας, οι οποίες προκαλούνται από την έλλειψη επικοινωνιακών δεξιοτήτων, τις διαφορές μεταξύ της κουλτούρας της χώρας προέλευσης και εκείνης της χώρας φιλοξενίας, τις διακρίσεις σε βάρος των μεταναστριών/μεταναστών και την έλλειψη υποστηρικτικών κοινωνικών δικτύων. Η έννοια του επιπολιτισμού συνδέεται με τη διαδικασία της μετανάστευσης και αναφέρεται στις διεργασίες που συμβαίνουν κατά τη διάρκεια της διαπολιτισμικής επαφής διαφορετικών ομάδων και οδηγούν σε μετασχηματισμό των πολιτισμικών στοιχείων που διέπουν είτε μία είτε όλες τις ομάδες αυτές. Υπάρχουν πολλές θεωρίες και μοντέλα επιπολιτισμού που έχουν αναπτυχθεί. Η παρούσα ανάλυση παρουσιάζει τα αποτελέσματα μιας έρευνας σχετικά με τις επιλεγμένες στρατηγικές επιπολιτισμού 201 Αλβανίδων/Αλβανών εφήβων μαθητριών/μαθητών με μεταναστευτικό υπόβαθρο στην Ελλάδα, με βάση το μοντέλο επιπολιτισμού του Berry (1997), το οποίο περιγράφει τέσσερις στρατηγικές επιπολιτισμού: την εναρμόνιση, την αφομοίωση, το διαχωρισμό και την περιθωριοποίηση. Ακόμη, σκοπός της έρευνας είναι η διερεύνηση της πιθανής σχέσης μεταξύ της επιλεγόμενης στρατηγικής επιπολιτισμού, των επιπέδων άγχους και αυτοεκτίμησης και των ακαδημαϊκών επιδόσεων του δείγματος. Τα ευρήματα αποκαλύπτουν ότι το δείγμα επιλέγει την εναρμόνιση, δηλαδή να διατηρεί ταυτόχρονα τα χαρακτηριστικά της ελληνικής και της αλβανικής κουλτούρας, και ότι η στρατηγική επιπολιτισμού επηρεάζει τα επίπεδα αυτοεκτίμησης και τις ακαδημαϊκές επιδόσεις των μαθητριών/μαθητών, αλλά όχι τα επίπεδα άγχους τους.
Στα όρια της πραγματικότητας
Authors: Μπάστα Μαρία
Published: September 2023

Σκοπός της παρούσας έρευνας είναι η διερεύνηση της έννοιας του παράδοξου σώματος. Αφορμή για την ανάληψη της συγκεκριμένης έρευνας υπήρξε η διαπίστωση ότι τόσο στην ελληνιστική ποίηση όσο και μέσα στο κείμενο του De rerum natura παρατηρούνται μία σειρά από καινοφανείς και ριζοσπαστικές απόψεις για το μυθολογικό και το ανθρώπινο σώμα, απόψεις που ισορροπούν λεπτά ανάμεσα στην εκλογίκευση και την παραδοξότητα.
Survival status and predictors of mortality among mechanically ventilated COVID-19 patients in Addis Ababa COVID-19 Care Centers, Ethiopia: A survival analysis
Authors: Nega Girma , Sibhat Migbar , Mekonnen Altayework , Techane Tesfaye
Published: September 2023

Background: The COVID-19 pandemic has caused stress on the health care system of many countries worldwide. To accommodate the growing number of critically ill patients requiring mechanical ventilation, hospitals expanded and tried to meet overwhelming demands. Despite this, outcomes of patients after mechanical ventilation were devastating, with high mortality rates. Therefore, this study investigated the survival status and predictors of mortality among mechanically ventilated COVID-19 patients.

Methods: A retrospective cohort study was applied on the patient charts of 496 critically ill and mechanically ventilated COVID-19 patients at intensive care units of Addis Ababa COVID-19 Care Centers from September 2020 to October 2021. Data were collected using a data extraction checklist and entered into Epi data manager. Then, data were transferred to STATA V-14 for cleaning and analysis. The cox-proportional hazard regression model was used for analysis. Covariates with p-value ≤0.20 in the bivariate analysis were fitted to multivariate analysis after the model fitness test. Finally, statistical significance was decided at p-value <0.05, and hazard ratios were used to determine the strength of associations.

Results: Of the 496 patients, 63.3% had died. The incidence rate of mortality was 56.7 (95% CI: 50.80, 63.37) per 1,000 person-days of observation, with 5534 person-day observations recorded. Advanced age (>60 years old) (adjusted hazard ratio (AHR)=1.86; 95% CI: 1.09, 3.15) and being invasively ventilated (AHR=2.02; 95% CI: 1.25, 3.26) were associated with increased risk of mortality. Furthermore, presence of diabetes (AHR=1.50; 95% CI: 1.09, 2.08), shock (AHR=1.99; 95% CI: 1.12, 3.52), and delirium (AHR=1.60; 95% CI: 1.05, 2.44) were significantly associated with increased mortality.

Conclusions: Clear directions are needed in the recommendation of non-invasive versus invasive ventilation, especially among elderly patients. The controversy of when to intubate (early versus late) needs to be clarified as well. Early detection and prompt management of shock is paramount.
Immune system and tumor microenvironment in early-stage breast cancer: different mechanisms for early recurrence after mastectomy and chemotherapy on ductal and lobular types
Authors: Andrianto Andreas , Sudiana I Ketut , Suprabawati Desak Gede Agung , Notobroto Hari Basuki
Published: September 2023

Background: The most common type of breast cancer is the ductal type (IDC), followed by lobular type (ILC). Surgery is the main therapy for early-stage breast cancer. Adjuvant chemotherapy might be given to those at high risk of recurrence. We aimed to determine the mechanisms in early local recurrence in both types.

Methods: An observational case-controlled study was used. Early-stage IDC and ILC patients who received modified radical mastectomy (MRM) and adjuvant taxan and anthracycline base chemotherapy had recurrence within two years. We examined vimentin, α-smooth muscle actin (SMA), matrix metalloproteinase (MMP1), platelet-derived growth factor (PDGF), and clustered differentiation (CD95)

Results: In the ductal type group, there were 25 samples revealing local recurrence and 25 samples that did not recur. The lobular type group comprised six participants who did not have a recurrence, while seven subjects had a recurrence. There were significant differences in the expression of vimentin (p = 0.000 and 0.021, respectively), PDGF (p = 0.000 and 0.002), and CD95 (p = 0.000 and 0.045) in ductal and lobular cancer types, respectively. MMP1 (p = 0.000) and α-SMA (p = 0.000) only showed a significant difference in the ductal type. The pathway analysis showed that in the ductal type, the mechanism of recurrence was enabled by two factors: α-SMA and CD95. Meanwhile, for the lobular type, the recurrence mechanism was through the CD95 pathway.

Conclusions: The tumor microenvironment and immune system both affect recurrence in IDC, whereas the immune system is more important in ILC. This study suggests that immune system enhancement may be an option for treating cancer.
War damages compensation: a case study on Ukraine
Authors: Izarova Iryna , Hartman Yuliia , Nate Silviu
Published: September 2023

Russia's illegal, brazen and cynical full-scale invasion of Ukraine began on February 24th, 2022, and is still ongoing at the time of this research (July 2023). The damages incurred by Ukraine and its citizens during the years of occupation of the territories and the war are calculated in millions, although it is difficult to definitively determine both the methodology and specific numbers. To restore justice, it seems much more important to define a fair, transparent, and understandable procedure for compensating the losses suffered by citizens and businesses as a result of these events. This is especially important in the context of the need to implement the goals of sustainable development, in particular, ensuring equal access to justice for all. The article is devoted to these and related issues. To determine the procedure for compensating losses and damages caused by the war, we first determined what exactly can be compensated and who can apply for compensation. These and other factors determine the peculiarities of the procedure for the restoration of rights and compensation for damage caused by the war in Ukraine. In searching for an answer to the researched question, we analyzed the current legislation of Ukraine and draft laws proposed to regulate relations related to compensation for damages. We also conducted a comprehensive analysis of concepts such as losses, damages, compensation, reparations, and reimbursement as defined in national legislation and international treaties. The generalization of the case law of national courts (more than 200 analyzed decisions of the courts of the first and appeal and cassation instances for the period from February 20, 2014 to March 1, 2023, examples of which are presented in the study) indicates the presence of various approaches of compensation for damage, in understanding how to restore the violated rights of citizens.
Hysteresis effect between geomagnetic activity indices (Ap, Dst) and interplanetary medium
Authors: Kurazhkovskaya Nadezhda , Kurazhkovskii Alexander
Published: September 2023

We have studied the relationship of geomagnetic activity indices (Ap, Dst) on time intervals, equal to solar cycles (∼11 years), with solar activity indicators and heliospheric parameters. It is shown that the plots of the Ap and Dst indices versus solar activity indicators, as well as versus heliospheric parameters, i.e. solar wind and IMF parameters in the ascending and descending phases of solar activity cycles 21–24 do not coincide, which is indicative of the hysteresis phenomenon. The Ap and Dst indices form hysteresis loops with all parameters we analyze during cycles 21–24. The shape and area of the hysteresis loops, as well as the direction of rotation, clockwise or counterclockwise, depend significantly on indicators of solar activity, heliospheric parameters and change from cycle to cycle. We have found a tendency for the extension and area of the hysteresis loops to decrease from cycle 21 to cycle 24. Analysis of the variability in the shape and size of the hysteresis loops formed by the Ap and Dst indices with solar indicators and heliospheric parameters gives reason to believe that the obtained loops reflect the long-term evolution of the solar wind energy flux, which determines global geomagnetic activity and the magnetospheric ring current intensity in the ascending and descending phases of solar activity cycles 21‒24.
The characteristic and clinical profiles among COVID-19 patients at the National Emergency Hospital Wisma Atlet Jakarta in 2021
Authors: Misriani Misriani , Helmi Muchamat , Sujagat Arif , Syahbana Lutfi Rinaldi , Setiyowati Wahyu , Nurobi Tjahja , Budiman Budiman , Setyanti Tri , Sussanti Imelda , Sugiyo Dianita , Wandasari Noven Tri , Satria Faudyan Eka
Published: September 2023

The World Health Organization designated Covid-19, caused by SARS-COV-2, a worldwide pandemic on March 11, 2020, and it has been entering Indonesia since early March 2020. This study attempts to elucidate and map patients' profiles and essential emergency preparedness measures during a national crisis. This research used an exploratory descriptive technique with structured interviews to collect data on retrospective data from hospital patients. The ethical clearance was issued prior to data collection, and informed permission was in accordance with the ethical clearance. The total number of patients treated in the COVID-19 National Emergency Hospital Wisma Atlet Kemayoran (RSDCWAK) was 69,965, and structured interviews were conducted with 46,408 patients. Demographic data of the patients consisted of 49.06% female and 50.04% male patients. Patients were aged 20-49 years (68.08%), and 76.05% of patients had mild symptoms. Hypertension was the highest comorbid at 6.11%, with common symptoms experienced. Most patients received vaccines (34.14%) with the highest type of vaccine (Sinovac 22.26%). To minimize the spread of COVID-19, RSDC WAK has implemented a zoning policy in its building, including red for COVID-19 patients with a risk of severe infection, yellow for patients with risk of mild infection, and green for areas free of COVID-19 and forbidden for COVID-19 patients. The COVID-19 pandemic has become a global health problem. The COVID-19 pandemic has become a global health problem. No one knows when the COVID-19 pandemic will end because the virus constantly changes and creates new variants. Proper regulations and human resources are required to have the readiness to control COVID-19. Zoning is the most appropriate way to prevent the spread of COVID-19 at RSDCWAK.
Hubungan tingkat depresi dan kualitas hidup yang diukur menggunakan HRQol pada pasien hipertensi di Puskesmas Mantrijeron, Yogyakarta
Authors: Rahmawati Dwy , Solikhah Solikhah
Published: September 2023

Globally, hypertension remains a public health issue. Hypertension is a risk factor for other serious diseases such as heart disease. The inability to control blood pressure in some hypertensive patients can lead to depression and anxiety, lowering their quality of life. The purpose of this study was to see if there was a link between depression and quality of life as measured by HRQoL in hypertensive patients at the Mantrijeron Health Center. The study design was cross-sectional and the method used was analytic observational. The study's findings revealed that 323 patients (85.90%) had severe depression, with 349 (92.82%) having poor quality of life. According to the findings of the bivariate analysis, there is a link between depression and quality of life (95% CI:69,499 - 1401,397). The level of depression was related to occupation (95% CI: 0.209 - 20,096). Furthermore, income was related to quality in hypertensive patients (95% CI: 0.177 - 0.867). According to the findings of this study, the level of depression is related to the quality of life in hypertensive patients. Stress management, possibly through education, should be integrated into overall hypertension management to maintain patients' mental health.
ECG of the month
Authors: Bloe Charles
Published: September 2023

In this issue's ECG of the month, Charles Bloe presents the case of a 47-year-old man who presented with chest pain, which the patient initially believed was caused by muscle strain from painting a ceiling.
You give me (Hay) fever
Authors: Wake Charlotte
Published: September 2023

Charlotte Wake breaks down the misery that is Hay fever.

Aim

For dental nurses to have a better understanding of Hay fever, the treatments and support available to patients.

Objectives

To explain the signs, symptoms and treatments for Hay fever. To discuss Xerostomia and it's relationship to Hay fever. To explore the practical advice we can offer patients.
Brace yourself
Authors: Mayoh Alistair
Published: September 2023

Alistair Mayoh explains the importance of preparing patients for orthodontic treatment.
Rapid maxillary expansion: a clinical insight for the general dental practitioner
Authors: Slaymaker Jack , Woolley Julian , Hirani Sunil
Published: September 2023

Rapid maxillary expansion is an orthodontic treatment approach for corrections of transverse discrepancies, such as crossbites. Rapid maxillary expansion expands the palate by applying forces to the teeth and surrounding tissues to separate the mid-palatal suture, allowing for the correction of the indicated malocclusions. A general dental practitioner should be aware of the indications, treatment strategy and play an important role in the timely referral of patients for orthodontic assessment. This article offers a comprehensive overview of rapid maxillary expansion, expansion protocols, and an in-depth analysis of the prevalent characteristics associated with expansion, along with evidence-based recommendations for effective management.

CPD/Clinical relevance: This paper aims to give the general dental practitioner clinical insight into rapid maxillary expansion, the devices used and the indications for use.
Intervenciones eficaces para la mejora de las habilidades sociales en personas con trastorno del espectro autista de alto funcionamiento: una revisión sistemática
Authors: Castillo Bautista Juan Carlos , Sánchez-Suricalday Andrés
Published: September 2023

INTRODUCCIÓN. La intervención centrada en las habilidades sociales en personas con autismo, motivada en parte por la introducción del uso de dispositivos electrónicos, es un tema de interés en los últimos años Por ello, el presente trabajo se ha centrado en la revisión de las intervenciones más recientes llevadas a cabo en personas con trastorno del espectro autista para la mejora de sus habilidades sociales, con el objetivo de dar a conocer su eficacia y fomentar la creación de más programas de este tipo. MÉTODO. Para ello se realizó una revisión sistemática siguiendo el método PRISMA (Page, 2021), utilizando para ello las bases de datos Scopus y Web of Science. La estrategia de búsqueda se basó en una combinación de términos de búsqueda, filtros y criterios de inclusión específicos. RESULTADOS. Finalmente, tras la revisión, se seleccionó un total de 12 artículos para su análisis. Se codificaron los resultados atendiendo a: referencia, tipo de intervención, tamaño de la muestra, edad media de la muestra, número de sesiones y duración, instrumento de evaluación y los principales resultados encontrados. Entre las diferentes intervenciones para mejorar las habilidades sociales en personas con trastorno del espectro autista se encuentran: el uso del robot humanoide Nao, la realidad aumentada para recrear entornos virtuales de socialización, el modelado mediante vídeo, los entrenamientos grupales de habilidades sociales mediante instrucciones, con grupos de iguales, maestros, padres, y la realización de actividades con juegos de construcciones. CONCLUSIONES. Los resultados concluyeron que las técnicas utilizadas en las intervenciones analizadas muestran resultados positivos, aunque existen varias deficiencias metodológicas en la forma en que se llevan a cabo. Dado que las intervenciones han resultado eficaces a corto plazo, se deben realizar estudios centrados a medio y largo plazo.
Moving From Transactional to Relational: How Funders Can Work in Partnership With Black, Indigenous and People of Color Communities
Authors: Cameron Donald , Cameron Hazel , An Jackie , Byun Michael , Yamazaki Junko , Davis Dominique , Tagaleo'oa Naomi , Huizar Liz , Ortega Estela , Lally Denise Perez , Bashir Yusuf , Osman Abdulahi , Jurdy Cilia , Marsh Jaimée , Catague Emma , Munoza Haya , Glover Kendrick , Kwan Ginger , Sebe Joy , Stanton Jennifer , Gonzalez Josefina , Herrera-Páramo Virgina , B CHIMAERA , Faralanb Jordan , Brooks Russell , Castro Jennifer , Olanday Ruel , Park Alice , Shore Nancy
Published: September 2023

Abstract: Background: The Racial Equity Coalition (REC) formed to address persistent educational disparities. The coalition was composed of 14 Black, Indigenous and People of Color (BIPOC) organizations that provide culturally integrative youth services. Objectives: REC, with support from United Way of King County, engaged in participatory research to identify commonalities and shared struggles to inform collective action. Participatory research aligns with REC's commitment to equitable participatory processes. This article focuses on REC's experiences with funders. The objective was to understand what creates positive and challenging experiences with funders, and to identify recommendations for funders to become more culturally responsive. Methods: A research committee was formed including representatives of nine REC organizations and United Way of King County staff. The committee conducted interviews with each of the 14 REC organizations and conducted thematic analysis of interview transcripts. Through participatory analysis, the committee drafted narratives that were further refined through a series of research retreats attended by all REC organizations. Results: Recommendations were to incentivize collaboration, listen to communities to create culturally responsive definitions of success and measurement strategies, arrive at mutually agreed upon approaches with organizations, honor the connections BIPOC organizations have with their communities, and provide unrestricted funding to allow BIPOC organizations greater agency. Conclusions: A major challenge for BIPOC organizations is navigating White dominant culture that too often shows up in funding requirements. Having to fit dominant culture standards stifles BIPOC organizations' abilities to meet community needs and the responsiveness of their approaches. REC identified recommendations for funders to be more culturally responsive and community centered.