bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing surgical cancellations: a successful application of Lean Six Sigma in healthcare
Authors: Schretlen Stijn , Hoefsmit Paulien , Kats Suzanne , van Merode Godefridus , Maessen Jos , Zandbergen Reinier
Published: August 2021

Objective

The COVID-19 pandemic emphasises the need to use healthcare resources efficient and effective to guarantee access to high-quality healthcare in an affordable manner. Surgical cancellations have a negative impact on these. We used the Lean Six Sigma (LSS) methodology to reduce cardiac surgical cancellations in a University Medical Center in the Netherlands, where approximately 20% of cardiac surgeries were being cancelled.

Method

A multifunctional project team used the data-driven LSS process improvement methodology and followed the ‘DMAIC’ improvement cycle (Define, Measure, Analyse, Improve, Control). Through all DMAIC phases, real-world data from the hospital information system supported the team during biweekly problem-solving sessions. This quality improvement study used an ‘interrupted time series’ study design. Data were collected between January 2014 and December 2016, covering 20 months prior and 16 months after implementation. Outcomes were number of last-minute coronary artery bypass graft cancellations, number of repeated diagnostics, referral to treatment time and patient satisfaction. Statistical process control charts visualised the change and impact over time. Students two-sample t-test was used to test statistical significance. A p<0.05 was considered as statistically significant.

Results

Last-minute cancellations were reduced by 50% (p=0.010), repeated preoperative diagnostics (X-ray) declined by 67% (p=0.021), referral to treatment time reduced by 35% (p=0.000) and patient Net Promoter Score increased by 14% (p=0.005).

Conclusion

This study shows that LSS is an effective quality improvement approach to help healthcare organisations to deliver more safe, timely, effective, efficient, equitable and patient-centred care. Crucial success factors were the use of a structured data-driven problem-solving approach, focus on patient value and process flow, leadership support and engagement of involved healthcare professionals through the entire care pathway. Ongoing monitoring of key performance indicators is helpful in engaging the organisation to maintain continuous process improvement and sustaining long-term impact.
Change in cardiovascular risk assessment tool and updated Norwegian guidelines for cardiovascular disease in primary prevention increase the population proportion at risk: the Tromsø Study 2015–2016
Authors: Nilsen Amalie , Hanssen Tove Aminda , Lappegård Knut Tore , Eggen Anne Elise , Løchen Maja-Lisa , Selmer Randi Marie , Njølstad Inger , Wilsgaard Tom , Hopstock Laila A
Published: August 2021

Aims

To compare the population proportion at high risk of cardiovascular disease (CVD) using the Norwegian NORRISK 1 that predicts 10-year risk of CVD mortality and the Norwegian national guidelines from 2009, with the updated NORRISK 2 that predicts 10-year risk of both fatal and non-fatal risk of CVD and the Norwegian national guidelines from 2017.

Methods

We included participants from the Norwegian population-based Tromsø Study (2015–2016) aged 40–69 years without a history of CVD (n=16 566). The total proportion eligible for intervention was identified by NORRISK 1 and the 2009 guidelines (serum total cholesterol ≥8 mmol/L, systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg) and NORRISK 2 and the 2017 guidelines (serum total cholesterol ≥7 mmol/L, low density lipoprotein (LDL) cholesterol ≥5 mmol/L, systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg).

Results

The total proportion at high risk as defined by a risk score was 12.0% using NORRISK 1 and 9.8% using NORRISK 2. When including single risk factors specified by the guidelines, the total proportion eligible for intervention was 15.5% using NORRISK 1 and the 2009 guidelines and 18.9% using NORRISK 2 and the 2017 guidelines. The lowered threshold for total cholesterol and specified cut-off for LDL cholesterol stand for a large proportion of the increase in population at risk.

Conclusion

The population proportion eligible for intervention increased by 3.4 percentage points from 2009 to 2017 using the revised NORRISK 2 score and guidelines.
Onset of autumn senescence in High Arctic plants shows similar patterns in natural and experimental snow depth gradients
Authors: Gehrmann Friederike , Ziegler Camille , Cooper Elisabeth J.
Published: August 2021

Predicted changes in snow cover and temperature raise uncertainties about how the beginning and the end of the growing season will shift for Arctic plants. Snowmelt timing and temperature are known to affect the timing of bud burst, but their effects on autumn senescence are less clear. To address this, researchers have examined senescence under natural and experimental environmental gradients. However, these approaches address different aspects of plant responses and the extent to which they can be compared is poorly understood. In this study, we show that the effect of snowmelt timing on the timing of autumn senescence in High Arctic plants is the same between a natural and an experimental gradient in three out of four studied species. While the two approaches mostly produce comparable results, they give in combination greater insight into the phenological responses to predicted climate changes. We also showed that a short warming treatment in autumn delayed senescence by 3.5 days in Dryas octopetala L., which is a 10% extension of the growing season end for this species. Warming treatments have commonly been applied to the whole growing season, but here we show that even isolated autumn warming can be sufficient to affect plant senescence.
Fuzzy dark matter black holes and droplets
Authors: Batic D. , Abuhejleh D. Asem , Nowakowski M.
Published: August 2021

We consider the possibility of having Dark Matter (DM) black holes motivated by the Einasto density profile. This generalizes both the noncommutative mini black hole model and allows DM to enter as the matter constituent which makes up the black hole. We show that it is possible to construct a black hole solution for each value of the Einasto index and for different values of the mass parameter, provided that the we work with the energy–momentum tensor of an anisotropic fluid. In particular, we achieve that by first considering the equation of state (EOS)$$p_r=-\rho $$pr=-ρ. It turns out that the corresponding black hole solution exhibits a horizon structure similar to that of a Reissner–Nordström black hole and the central singularity is replaced by a regular de Sitter core. We also show that if the previous EOS is replaced by a nonlocal one, it is possible to construct a self-gravitating fuzzy DM droplet but also in this case, the radial pressure is negative. Finally, we contemplate scenarios of different dark matter black holes with moderate mass values which could have formed in galaxies. In particular, we probe the possibility whether such black holes could also be the central galactic objects.
Homotopy abelianity of the DG-Lie algebra controlling deformations of pairs (variety with trivial canonical bundle, line bundle)
Authors: Iacono Donatella , Manetti Marco
Published: August 2021

We investigate the deformations of pairs [Formula: see text], where [Formula: see text] is a line bundle on a smooth projective variety [Formula: see text], defined over an algebraically closed field [Formula: see text] of characteristic 0. In particular, we prove that the DG-Lie algebra controlling the deformations of the pair [Formula: see text] is homotopy abelian whenever [Formula: see text] has trivial canonical bundle, and so these deformations are unobstructed.
A remark on characterizations of Griffiths positivity through asymptotic conditions
Authors: Hosono Genki , Inayama Takahiro
Published: August 2021

In this paper, we study characterizations of Griffiths semi-positivity through [Formula: see text]-estimates of the [Formula: see text]-equation and [Formula: see text]-extension theorems for symmetric powers of a holomorphic vector bundle. We also investigate several versions of the converse of the Demailly–Skoda theorem.
Processing Electrocardiographic Signals Using a Custom Designed Sigma-Delta Modulator
Authors: Ocampo-Hidalgo Juan J. , Alducin-Castillo Javier , Molinar-Solis Jesus E.
Published: August 2021

This paper introduces the experimental results obtained after processing an electrocardiographic signal by a full-custom, low-complexity, Sigma-Delta Modulator integrated circuit, designed and fabricated using the C5N CMOS technology available through MOSIS. By exploiting a large oversampling ratio, it was possible to obtain an effective number of bits equal to 11 at the proposed single-bit modulator’s output. The resulting bitstream was captured with a logic-state analyzer and processed offline. After decimation and digital filtering, the electrocardiographic signal was reconstructed and plotted in the time domain. Commonly referred quality metrics over the retrieved signal were calculated. A total signal-to-noise and distortion ratio, superior to 66[Formula: see text]dB, was achieved by analyzing the entire system. The proposed approach shows the feasibility of processing electrocardiographic signals using low-cost and straightforward CMOS technology circuits. Since the proposed converter uses a single voltage supply of 1.5[Formula: see text]V, exhibits a power consumption of 38[Formula: see text][Formula: see text]W, and uses a silicon area of 0.052[Formula: see text]mm2, it is suitable for single battery-operated systems on a chip.
Machine Learning for the Study of Plankton and Marine Snow from Images
Authors: Irisson Jean-Olivier , Ayata Sakina-Dorothée , Lindsay Dhugal J. , Karp-Boss Lee , Stemmann Lars
Published: August 2021

Quantitative imaging instruments produce a large number of images of plankton and marine snow, acquired in a controlled manner, from which the visual characteristics of individual objects and their in situ concentrations can be computed. To exploit this wealth of information, machine learning is necessary to automate tasks such as taxonomic classification. Through a review of the literature, we highlight the progress of those machine classifiers and what they can and still cannot be trusted for. Several examples showcase how the combination of quantitative imaging with machine learning has brought insights on pelagic ecology. They also highlight what is still missing and how images could be exploited further through trait-based approaches. In the future, we suggest deeper interactions with the computer sciences community, the adoption of data standards, and the more systematic sharing of databases to build a global community of pelagic image providers and users.
A New Algorithm and Its Application in Detecting Community of the Bipartite Complex Network
Authors: Lei Zhongyi , Wang Haiying
Published: August 2021

The community division of bipartite networks is one frontier problem on the research of complex networks today. In this study, we propose a model of community detection of the bipartite network, which is based on the generalized suffix tree algorithm. First, extract the adjacent node sequences from the matrix of relation and use the obtained adjacent node sequences to build a generalized suffix tree; second, traverse the established generalized suffix tree to obtain the bipartite cliques; third, adjust the bipartite cliques; finally, dispose the isolated edges, get the communities, and complete the division of the bipartite network. This algorithm is different from the traditional community mining one since it uses edges as the community division medium and does not need to specify the number of the division of communities before the experiment. Furthermore, we can find overlapping communities by this new algorithm which can decrease the time complexity.
Prevalence of Antenatal Depression and Associated Factors among Pregnant Women Attending Antenatal Care at Health Institutions of Faafan Zone, Somali Region, Eastern Ethiopia
Authors: Keliyo Edao Tesa , Jibril Meka Kedir , Wodajo Girma Tadesse
Published: August 2021

Background. Depression is a common global mental health tragedy which affects more than 30 million people of all ages. Antenatal depression is higher among low-income countries where maternal and psychosocial factors act as determinant factors for its occurrence. Aim. This study is aimed at assessing the prevalence of antenatal depression and its associated factors among pregnant women attending health institutions of Faafan zone of Somali regional state, Eastern Ethiopia. Method. An institutional-based cross-sectional study design was conducted among randomly selected 403 pregnant women from January to September 2015. EPDS with 13 cutoff points was used to screen antenatal depression. Bivariate and multivariate logistic regressions were used to identify associated factors. Result. The study showed that 24.3% of women had antenatal depression. Marital status, educational status, chronic medical illness, previous depression history, and social support were factors associated with antenatal depression. Conclusion. The study revealed that the prevalence of antenatal depression was 24.3%. Ethiopia Federal Ministry of Health and Somali Regional Health Bureau should work very hard to create awareness on the importance of pregnancy planning and social support during pregnancy.
Numerical Simulation and Analysis of Tunnel Failure Mode by Stochastic Fracture Model
Authors: Xiao Fukun , Xu Lei , Liu Gang , Hou Zhiyuan , Xing Le
Published: August 2021

The dip angle, length, spacing, and fracture distance of rock fissure affect the morphology of roadway after collapse. The numerical simulation software CDEM is used to simulate the morphology of roadway collapse. The Monte Carlo model is used to simulate different types of crack models in two-dimensional plane and generate different crack models. The effects of crack angle, crack length, fracture distance, and spacing on the deformation of surrounding rock are analyzed. The influence of different rock burst on the failure strap-fall modes of fissure roadway and roadway in different sections is analyzed, and the stability law of roadway is studied. Under the condition of high stress, the roadway shape has little influence on the distribution of the principal stress difference of surrounding rock, but the equivalent excavation radius determines the distribution of the plastic zone of surrounding rock. The larger the ineffective reinforcement zone is, the larger the deformation around the roadway will be. The decrease of the angle between the structural plane and the vertical stress increases the failure range of the roadway under the gravity burst pressure. Under the horizontal tectonic stress type rock burst, when the structural plane inclination angle is 0°, the two-sided caving body fills the roadway and the roof caving range becomes smaller.
Deficits in Working Memory and Theory of Mind May Underlie Difficulties in Social Perception of Children with ADHD
Authors: Imanipour Samane , Sheikh Mahmood , Shayestefar Monir , Baloochnejad Tourandokht
Published: August 2021

Children with attention deficit hyperactivity disorder (ADHD) are prone to peer rejection and disliking due to difficulties in social perception and interaction. To address social perception impairments in ADHD, we examined children with ADHD in a noisy biological motion (BM) direction discrimination paradigm in association with sociocognitive factors including emotion regulation, theory of mind (TOM), and working memory compared to healthy controls. Our results showed that children with ADHD were poorer in discriminating BM direction in noisy environments (F (1, 36) = 4.655,

p
=
0.038

). Moreover, a significant correlation was found between working memory and TOM with BM discrimination in an ADHD group (r = 0.442,

p
=
0.01

, and r = 0.403,

p
=
0.05

, respectively). Our findings could suggest that social perception in noisy scenarios may be affected by memory and social cognitive abilities of children with ADHD.
Evaluation of Seismic Site Amplification Using 1D Site Response Analyses at Ba Dinh Square Area, Vietnam
Authors: Tran Ngoc-Long , Aaqib Muhammad , Nguyen Ba-Phu , Nguyen Duy-Duan , Tran Viet-Linh , Nguyen Van-Quang
Published: August 2021

This study presents a case study on ground response analysis of one of the important cultural heritages in Hanoi, Vietnam. One‐dimensional nonlinear and equivalent linear site response analyses which are commonly applied to solve the problem of seismic stress wave propagation are performed at the Ba Dinh square area. A measured in‐situ shear wave velocity profile and corresponding geotechnical site investigation and laboratory test data are utilized to develop the site model for site‐specific ground response analysis. A suite of earthquake records compatible with Vietnamese Design Code TCVN 9386: 2012 rock design spectrum is used as input ground motions at the bedrock. A few concerns associated with site‐specific ground response evaluation are analyzed for both nonlinear and equivalent linear procedures, including shear strains, mobilized shear strength, and peak ground acceleration along with the depth. The results show that the mean maximum shear strains at any soil layer are less than 0.2% in the study area. A deamplification portion within the soil profile is observed at the layer interface with shear wave velocity reversal. The maximum peak ground acceleration (PGA) at the surface is about 0.2 g for equivalent linear analysis and 0.16 g for nonlinear analysis. The ground motions are amplified near the site natural period 0.72 s. The soil factors calculated in this study are 1.95 and 2.07 for nonlinear and equivalent linear analyses, respectively. These values are much different from the current value of 1.15 for site class C in TCVN 9386: 2012. A comparison of calculated response spectra and amplification factors with the local standard code of practice revealed significant discrepancies. It is demonstrated that the TCVN 9386: 2012 soil design spectrum is unable to capture the calculated site amplification in the study area.
Network Pharmacology-Based Analysis of the Effects of Corydalis decumbens (Thunb.) Pers. in Non-Small Cell Lung Cancer
Authors: Liu Jun , He Zhibo , Li Shan , Huang Wenan , Ren Zhongjie
Published: August 2021

Non-small cell lung cancer (NSCLC) is one of the most malignant tumors worldwide. The main treatment for NSCLC is based on Western medicine; however, the overall effect is unsatisfactory. This study aimed to investigate the potential therapeutic targets and pharmacological mechanisms of action of the traditional Chinese medicine Corydalis decumbens (Thunb.) Pers. in NSCLC based on network pharmacology and bioinformatics. The overlapping genes between Corydalis decumbens (Thunb.) Pers. and NSCLCs were screened using Venn analysis. Cytoscape 3.7.1 software was used to analyze the overlapping target protein-protein interaction (PPI) network. Gene ontology and pathway enrichment analysis using the Kyoto Encyclopedia of Genes and Genomics database were performed to exploring biological functions of the overlapping genes. The gene expression profiling interactive analysis dataset was used to analyze the correlation between hub gene expression and disease. This study revealed 38 nodes with 191 edges, which may be therapeutic targets for NSCLC. PPI network analysis showed that the most likely association was between the genes AR and NCOA2, NCOA2, and RXRA and ESR1 and NCOA2. These overlapping genes were mainly enriched in the estrogen signaling pathway, calcium signaling pathway, cholinergic synapse, and PI3K-Akt signaling pathway. ESR2 mRNA levels were signiﬁcantly downregulated in patients with lung adenocarcinoma (LUAD) getting worse, and KDR levels were lower in lung squamous cell carcinoma (LUSC) than those in normal tissue. PTGS2 expression was correlated with the median survival time of LUAD, and ESR1 expression was correlated with the median survival time of LUSC. The application of network pharmacology revealed the potential mechanism underlying the effects of Corydalis decumbens (Thunb.) Pers. in NSCLC treatment and provided a theoretical basis for further in-depth research in this field.
Evolution of Characteristics of the Zone of Rock Loosening with Cross-Sectional Area
Authors: Liu Jun , Chen Liwei , Li Ning , Chen Xiangjun
Published: August 2021

Because of the large deformation of surrounding rock mass and the different deformation characteristics of roadways with different cross-sectional areas, it is difficult to determine the means of support of roadways and the hole-sealing depth of extraction boreholes, which will cause serious roadway deformation and reduce the gas drainage rate. In order to solve these problems, this paper studies the evolution law of the zone of rock loosening around the roadway at four different cross-sectional areas (15 m2, 20 m2, 25 m2, 30 m2) by means of the acoustic field tests and numerical simulation. The results revealed three key points: first, the zone of rock loosening around the roadway is symmetrically distributed around the center of the roadway, and its shape is approximately that of a “butterfly.” Second, field tests results indicate that the rock loose zone of 1302 North floor mining roadway is in the range of 2.3–2.4 m on the side of the roadway and is 2.7–2.9 m on the central auxiliary transportation roadway. The simulation results show that the rock loose zone of 1302 North floor mining roadway is 2.5 m on the side of the roadway and is 3.0 m on the central auxiliary transportation roadway. The simulation results under four different section areas matched the field test results well, and the range of the surrounding rock loosening zone increases with the increased cross-sectional area. Third, the loose zone at the top corner and side of the roadway has a linear relationship with the cross-sectional area, and the loose zone at the bottom corner of the roadway does not change significantly with the cross-sectional area. These results have significance for determining the cross-sectional area of mine roadways in the same geological conditions, the sealing depth of the borehole, and the surrounding rock support.
Experimental Investigations on Creep Behavior of Coal under Combined Compression and Shear Loading
Authors: Hou Rongbin , Xu Leige , Zhang Duoxin , Shi Yanke , Shi Luyang
Published: August 2021

The creep behavior of rock has received much attention for analyzing the long-term response and stability of underground rock engineering structures. Numerous studies have been carried out on the creep properties of various rocks under pure compression conditions. However, little attention has been paid to the creep behavior of rocks in a combined compression-shear loading state. In this work, a novel combined compression and shear test (C-CAST) system was used to carry out inclined uniaxial compression tests and creep tests for various inclination angles (0°, 5°, 10°, and 15°). The results revealed that the peak strength of the coal decreased with the inclination angle of the specimen, which could provide the basis for setting up a creep test scheme. Multistage compression-shear creep tests were carried out on specimens with different inclination angles. Based on the analysis of the creep test data, the creep behavior of the coal in a combined compression-shear state was studied. It was found that the specimen inclination affected the time-dependent deformation, long-term strength (LTS), and time to failure. Compared with the specimen under pure compression, the inclination specimens tend to produce large shear strain with time, while they were more prone to shear failure. The reduction of the long-term strength was closely associated with the increase of the specimen inclination angle when the angle was more than 5°. Moreover, the ratio of the peak strength to the LTS was not affected by the specimen inclination, which is considered an inherent characteristic. We anticipate that the results obtained will assist in pillar design and long-term stability analysis.
FDA Approval Summary: Nivolumab in Combination with Ipilimumab for the Treatment of Unresectable Malignant Pleural Mesothelioma
Authors: Nakajima Erica C. , Vellanki Paz J. , Larkins Erin , Chatterjee Somak , Mishra-Kalyani Pallavi S. , Bi Youwei , Qosa Hisham , Liu Jiang , Zhao Hong , Biable Missiratch , Hotaki Lauren Tesh , Shen Yuan-Li , Pazdur Richard , Beaver Julia A. , Singh Harpreet , Donoghue Martha
Published: August 2021

On October 2, 2020, FDA approved nivolumab with ipilimumab as first-line treatment for adult patients with unresectable malignant pleural mesothelioma (MPM). The approval was based on results from Study CA209743 (CHECKMATE-743), an open-label trial of patients with MPM randomized to receive nivolumab and ipilimumab for up to 2 years (n = 303) or six cycles of chemotherapy with cisplatin or carboplatin plus pemetrexed (n = 302). Overall survival (OS) was improved for patients who received nivolumab and ipilimumab, with a median OS of 18.1 months [95% confidence interval (CI), 16.8–21.5] compared with 14.1 months (95% CI: 12.5–16.2; HR, 0.74; 95% CI, 0.61–0.89; P = 0.002), for patients who received chemotherapy. The magnitude of benefit was larger for patients with non-epithelioid versus epithelioid histology. Additional clinical pharmacology data support an alternative dosing regimen of nivolumab than evaluated in the trial, which will reduce the number of required treatment visits. This application was reviewed under FDA's Project Orbis, in collaboration with Australia's Therapeutic Goods Administration, Switzerland's Swissmedic, Health Canada, and Brazil's National Health Surveillance Agency or ANVISA (Agência Nacional de Vigilância Sanitária). Nivolumab and ipilimumab is the first drug regimen approved by FDA for MPM since 2004.
The Effect of a Probiotic Complex on the Gut-Brain Axis: A Translational Study
Authors: Nobile Vincenzo , Giardina Silvana , Puoci Francesco
Published: August 2021

Background: The gut-brain axis refers to the network of connections that involve multiple biologic systems, allowing bidirectional communication between the gut and the brain. This communication is mainly mediated by gut microbiota, thanks to its ability to modulate several processes like the production of neurotransmitters. As such, keeping a balanced gut microbiota through probiotic intake could be a valid solution in supporting the right gut-brain communications. Methods: A two-step in vitro screening of five different probiotic strains was carried out to select the best performers in the modulation of stress markers. A first selection on SK-N-DZ neuronal cell lines was performed to evaluate the inhibition of the epigenetic enzyme LSD1, promotion of GABA, and expression of serotonin. Three out of five strains were tested for their ability to promote serotonin synthesis in the Caco2 cell line. As a result, Limosilactobacillus reuteri PBS072 and Bifidobacterium breve BB077 were selected as the best performing strains. To confirm their effects in humans, a proof-of-concept trial was carried out to evaluate stress-related parameters for 28 days of product intake in a group of 30 stressed students. Results: A significant improvement of cognitive functions, in terms of short-term memory, attention, and executive performance, as well as of psychophysiological markers, such as salivary cortisol level, skin conductance, sleep quality, and anxiety, were observed. Conclusions: According to the results, L. reuteri PBS072 and B. breve BB077 are potential probiotic candidates for improving stress resilience, cognitive functions, and sleep quality.
Hereditäre Netzhautdystrophien aufgrund von RPE65-Varianten: Von der genetischen Diagnostik zur Therapie
Authors: Aoun Manar , Passerini Ilaria , Chiurazzi Pietro , Karali Marianthi , De Rienzo Irene , Sartor Giovanna , Murro Vittoria , Filimonova Natalia , Seri Marco , Banfi Sandro
Published: August 2021

Die hereditären Netzhautdystrophien (IRD; inherited retinal diseases) sind eine heterogene Gruppe von Krankheiten – unter anderem Retinitis pigmentosa (RP), Lebersche kongenitale Amaurose (LCA) und Netzhautdystrophie mit frühem Krankheitsbeginn (EO[S]RD; early-onset [severe] retinal dystrophy) –, die sich hinsichtlich der Schwere der Krankheit und des Alters bei Krankheitsbeginn unterscheiden. IRD können durch Mutationen in >250 verschiedenen Genen hervorgerufen werden. Varianten des RPE65-Gens sind die Ursache für 0,6–6% aller Fälle von RP und für 3–16% der Fälle von LCA/EORD. Voretigen Neparvovec ist eine Gentherapie, die zur Behandlung von Patienten mit autosomal-rezessiver Retinadystrophie infolge biallelischer RPE65-Varianten (RPE65-IRD) zugelassen ist. Die korrekte molekulare Diagnostik ist daher bei RPE65-IRD von entscheidender Bedeutung, um therapeutisch nutzbare, d. h. potenziell von der Therapie profitierende Genotypen zu identifizieren, und sie ist eine tragende Säule des Patientenmanagements. Es sind bereits Hunderte von RPE65-Varianten bekannt, und während ein Teil als pathogen oder wahrscheinlich pathogen identifiziert werden konnte, ist die Signifikanz anderer Varianten noch unklar. In dieser Übersichtsarbeit beschreiben wir das erforderliche gendiagnostische Vorgehen, um diejenigen Patienten auszuwählen, die die Voraussetzungen für die Behandlung mit Voretigen Neparvovec erfüllen. Die sorgfältige klinische Charakterisierung der Patienten durch interdisziplinäre Expertenteams in Kombination mit der Verfügbarkeit von Next-Genera­tion-Sequenzierung kann den Zugang der Patienten zu verfügbaren Therapieoptionen beschleunigen.
Desenho universal para a aprendizagem e ensino inclusivo na educação infantil
Authors:   Universidade de São Paulo. Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Bettio Claudia Daiane Batista , Miranda Ana Carolina Arruda ,   Universidade de São Paulo. Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Schmidt Andréia ,   Universidade de São Paulo. Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto
Published: August 2021

Este livro tem por objetivo discutir os princípios do Desenho Universal para a Aprendizagem (DUA) e sua aplicação na Educação Infantil. A proposta é baseada na pergunta: como podemos planejar e desenvolver um ensino direcionado a todas as crianças de uma classe de Educação Infantil, levando em conta os conceitos do DUA e as características de cada criança? Parte-se, primeiramente, da abordagem sobre a Educação Inclusiva e suas características, visto que o DUA tem como pressuposto a educação como um direito de todas as crianças, sendo dever da escola proporcionar meios para o aluno aprender, pois não é o aluno que deve se adaptar ao que a escola tem para oferecer. Na sequência, são apresentados e discutidos os princípios do DUA. O objetivo desses exemplos não é sugerir atividades a serem aplicadas pelo professor em sua realidade, mas sim analisar como os princípios discutidos estão presentes em situações de ensino do dia a dia.
EPAS1 (Endothelial PAS Domain Protein 1) Orchestrates Transactivation of Endothelial ICAM1 (Intercellular Adhesion Molecule 1) by Small Nucleolar RNA Host Gene 5 (SNHG5) to Promote Hypoxic Pulmonary Hypertension
Authors: Wang Shouxian , Wang Yu , Liu Chang , Xu Gang , Gao Wenxiang , Hao Jiale , Zhang Mengjie , Wu Gang , Yang Yidong , Huang Jian , Ni Bing , Chen Dewei , Gao Yuqi
Published: August 2021

EPAS1 (endothelial PAS domain protein 1), as the major effect gene for the adaptation to chronic hypoxia, is required for hypoxic pulmonary hypertension (HPH). Downregulated EPAS1 ameliorates the development of HPH. We confirmed that EPAS1-specific inhibitor PT2385 ameliorated HPH features, as demonstrated by right ventricle hypertrophy, right ventricular systolic pressure, and pulmonary vascular remodeling. However, the mechanism of EPAS1 in HPH pathogenesis remains unclear. RNA sequencing in human pulmonary artery endothelial cells with EPAS1 knockdown identified EPAS1-regulated genes, including ICAM1 (intercellular adhesion molecule 1), which created a proinflammatory perivascular microenvironment associated with HPH by elevating leukocyte adhesion to the vascular endothelium. Chromatin immunoprecipitation assays revealed that EPAS1 directly bound to ICAM1 promoter. The long noncoding RNA small nucleolar RNA host gene 5 (SNHG5), significantly increased in acute exacerbation period of chronic obstructive pulmonary disease and hypoxic human pulmonary artery endothelial cells, also contributed to the regulation of ICAM1 expression. Endothelial-specific deletion of Snhg5 also rescued HPH in mice. Overexpression of EPAS1 or SNHG5 enhanced, while the depletion of EPAS1 or SNHG5 attenuated, ICAM1 transactivation. SNHG5 was directly regulated by EPAS1, and interestingly, the upregulated SNHG5 could further enhance the levels of EPAS1, which consequently led to hypoxia-induced ICAM1 transactivation. RNA pull-down assay followed by high-throughput sequencing demonstrated that miR-625-5p could bind to SNHG5. Manipulating miR-625-5p altered the levels of EPAS1 during hypoxia. Our data showed a positive feed-forward exists between EPAS1 and SNHG5 signaling during hypoxia-induced ICAM1 transactivation in endothelial cells. Targeting EPAS1 and SNHG5 may provide promising strategies for the prevention of HPH.
Ethnic Differences in Informal Caregiving After Stroke
Authors: Morgenstern Lewis B. , Hollenhorst Cecilia N. , Gallo Linda C. , Hsu Chia-Wei , Kim Sehee , Gibbs River , Case Erin , Lisabeth Lynda D.
Published: August 2021

Background and Purpose:

Informal (unpaid) caregiving usually provided by family is important poststroke. We studied whether the prevalence of informal caregiving after stroke differs between Mexican Americans (MAs) and non-Hispanic Whites (NHWs).

Methods:

Between October 2014 and December 2018, participants in the BASIC (Brain Attack Surveillance in Corpus Christi) project in Nueces County, Texas, were interviewed 90 days after stroke to determine which activities of daily living they required help with and whether family provided informal caregiving. Ethnic differences between MAs and NHWs were determined by logistic regression. The logistic models were stratified by formal (paid) care status. Odds ratios (95% CIs) are reported with NHW as the referent group. Fisher exact tests were used to assess the association of ethnicity with relationship of caregiver and with individual activities of daily living.

Results:

Eight hundred thirty-one patients answered the caregiving questions. Of these, 242 (29%) received family caregiving (33% of MAs and 23% of NHWs), and 142 (17%) received paid caregiving (21% of MAs and 10% of NHWs). There were no ethnic differences in stroke severity. In logistic regression analyses, among those without formal, paid care, MAs were more likely to have informal caregiving (odds ratio, 1.75 [95% CI, 1.12–2.73]) adjusted for age, National Institutes of Health Stroke Scale, prestroke modified Rankin Scale, and insurance. No ethnic differences in informal care were found among those who had formal care. There were no differences between ethnic groups in which family members provided the informal care. MAs were more likely to require help compared with NHWs for walking (
P
<0.0001), bathing (
P
<0.0001), hygiene (
P
=0.0012), eating (
P
=0.0004), dressing (
P
<0.0001), ambulating (
P
=0.0304), and toileting (
P
=0.0003).

Conclusions:

MAs required more help poststroke than NHWs for assistance with activities of daily living. MAs received more help for activities of daily living through informal, unpaid caregiving than NHWs if they were not also receiving formal, paid care. Efforts to help minority and low-resource populations provide stroke care are needed.
Lumumba, Hammarskjoeld, and the 1960 Congo Crisis: A case of international misunderstanding?
Authors: Blommaert Jan
Published: August 2021

Lumumba, Hammarskjoeld, and The 1960 Congo Crisis. A Case of International Misunderstanding?

A number of influential works on the 1960 Congo Crisis, as well as most theoretical models of intercultural communication, consistently explain conflicts between culturally different participants in terms of features of ethnic communication style, cognition, value systems etc. A general picture emerges in which culture is seen as the cause of conflicts, misunderstandings, or communication breakdown. An analysis of six Letters exchanged between Lumumba and Hammarskjoeld during one of the crucial episodes of the Congo Crisis reveals that ethnic features of communication style are the consequence, rather than the cause of conflicts.
Tijdsconcepten en Tijdsbeleving, een Probleem uit de Interculturele Communicatie. Case-Study: Rwanda
Authors: Cammaer Gerda
Published: August 2021

Conceptions of Time and Time Experience, A Problem in Intercultural Communication. Case-Study: Rwanda.

The confrontation between people from different cultures causes a lot of problems, most of all communication problems. They are too often considered as only language-problems, but the so-called “cultural-shock” is a lot more comprehensive. Reducing any cultural problem to language troubles, means ignoring the non-verbal and other cultural principles that make cultures so rich and different.

The experience of time and the concepts of time are such principles, rooted in culture and traditions. For the members of the culture in question, these time-principles have become so natural that they remain unexperienced or even unconscious, but they might surprise, even irritate, the members of other cultures. The scientific discipline called “chronemics” examines how humans perceive, structure and use time as communication. Every culture has its own conception of time and its own customs for the use of time. In this sense the Western culture is totally different from the Central African culture in Rwanda. This often causes intercultural conflicts when Europeans working in Rwanda are confronted with the different attitudes towards time of the Rwandese people and vice versa.

The purpose of this research is to find an answer to the question whether the intercultural communication between Rwandese people and Europeans (sometimes, often, always) is disturbed because of misunderstandings caused by the differences in their time-codes. This survey contains two parts: first, a literature study on intercultural communication and time as a message system with references to the two cultures in question and second, a field study in Rwanda consisting of 120 questionnaires answered by Europeans and Rwandese people who work together.
La Femme et le Développement au Maghreb. Une Approche Socio-Culturelle
Authors: Hachlouf Brahim
Published: August 2021

Woman and Development in the Maghreb. A Socio-Cultural Approach.

The under-development problem of the Third World can not exclusively be attributed to economic backlogging, political crises or supernatural events. The perseverance of old ancestral values, cultural, social and psychological, still remain obstructions to any social evolution in a country.

The woman’s role in society in these countries, is restricted to house-keeping and the bearing of children. A situation which weighs heavy on their economies. This article will shed light on the essential elements which hinder active woman participation in development of their economies, in particular in the Maghreb-countries. Discussed is their personal status, women's position in education and in the work-force.
Qualitative research as theater: fieldwork in a South African township through the prism of Goffman’s dramaturgical metaphor
Authors: Masquillier Caroline
Published: August 2021

This autoethnographic paper reflects on the qualitative fieldwork I conducted in a township on the outskirts of Cape Town, South Africa. By exploring how a metaphor can assist in autoethnographic reflection, I aim to gain insight into how data can best be collected in deprived informal settlements characterized by high crime rates. This autoethnographic paper draws on the autobiographical materials of the researcher as primary data. This self-reflexive route, which relied on Erving Goffman’s dramaturgical metaphor, helped me to process my various fieldwork experiences in a more systematic manner. Attempting to reconcile my ‘work’ role – a professional, reliable and confidential advisor – with my ‘non-work’ role – my supposed real self – involved emotion management and the tools of the stage outlined by Goffman in order that the fieldwork could be conducted in an atmosphere of trust while maintaining a professional distance.
Ephemeral stream dynamics, land cover changes and climate variability in the marginal grabens of the northern Ethiopian Rift Valley
Authors: Demissie Biadgilgn
Published: August 2021

This study focused on ephemeral streams morphodynamics and their relation with hydro-climatic and bio-physical characteristics in their headwater and graben floors in the marginal grabens along the northern Ethiopian Rift Valley. The Raya graben was taken as a case study area, which is the largest marginal graben in northern Ethiopia. The link between rainfall variability and land cover changes shows that there was a negative correlation between precipitation and deforestation which implies that an increase in precipitation decreases deforestation deterring the peasants from tree cutting. Regarding the relationship between upper catchment characteristics and river morphology, results show that upper catchment area is the most important controlling factor of the length of and the area occupied by the rivers in the graben bottom. A simple hydraulic analysis based on the change of specific discharge as the river flow approaches the bridges demonstrates that the abrupt change in channel width as the river approaches the bridge is the main cause of the thick deposition and, consequently, of the increased frequency of overbank floods upstream of the road bridges in the study area. The results related to channel bank erosion capacity of flash floods show that all the peak discharges were equally important in triggering channel bank erosion. Concomitantly, vegetated channels are much more resistant to channel bank erosion than non-vegetated banks. Land changes in graben bottoms dictate that the changes are not simply related to a distributary river system but that human intervention (e.g., the conversion of bushland and forests into cropland, settlement on alluvium, and avoidance of losing farmland to other land units) and natural vegetation regeneration (e.g., alluvial deposits into shrubland) are also important. Overall, the study suggests that to control the morphodynamics of the ephemeral rivers and their impact on farming activities in the graben bottom, catchment rehabilitation activities need to focus both on the upper catchment and the river channels in the graben bottom.
Epidemiology of tsetse flies and trypanosomes with a case study in Ethiopia
Authors: Abdi Reta Duguma
Published: August 2021

The aim of this study was to quantify the abundance of tsetse flies using traditional traps and using anti-tsetse saliva ELISA test and the trypanosome infection prevalence in the tsetse flies and cattle. An area-wide tsetse fly and cattle trypanosomosis survey was conducted in Ethiopia. Groups of mice and pigs were experimentally exposed to G. m. morsitans bite to develop total saliva and rTsal ELISA tests that are capable to detect and monitor the induced anti-saliva antibodies of tsetse following host exposure to tsetse bite. A meta-analysis was conducted on prevalence of trypanosome infection in tsetse flies in the field or in laboratory-controlled conditions. Published information available since 1950s was reviewed. The findings indicated that tsetse flies and trypanosome infections of cattle are widely distributed in Ethiopia and their abundance is affected by spatial factors such as altitude, river drainage system, local factors at PA level (presence of game reserves and land use/encroachment). There was no significant association between tsetse density and prevalence of trypanosomes in cattle. Total tsetse saliva and recombinant Tsal1 protein coated indirect ELISA are sensitive immunological probes to detect contact with tsetse flies. The new serological test at hand is a sensitive indicator that can differentiate regimens of tsetse fly bites (various degree of exposure of animals) and that can also detect tsetse fly bite after a prolonged period without exposure. The overall prevalence of trypanosome infection in tsetse fly populations was 10.3% and 31.0% for the field survey data and laboratory experiment data, respectively. Both spatial (country) and temporal (year of publication) variation are noticed in trypanosome infection prevalence of field collected tsetse flies. The lack of association between tsetse density and prevalence of trypanosomes in cattle needs further investigation on the role of Tabanus and Stomoxys for mechanical trypanosome transmission. Due to the ongoing interventions, the vector could decline to a low level beyond the fly catching capacity by traps. The current serological ELISA test could be an important surveillance tool with sensitive diagnostic value.
Between rhetoric and reality: the relevance of substantive equality approach to addressing gender inequality in Mozambique
Authors: Durojaye Ebenezer
Published: August 2021

The purpose of this article is to examine the socio-cultur.il challenges that continue to limit women’s enjoyment of their fundamental rights and freedoms in Mozambique. In this regard, this article focuses on three areas of gender inequality- denial of inheritance rights, sexual violence and early/ child marriage-in the country. In addition, the article, using a substantive equality approach, critically examines whether the steps and measures taken by the government of Mozambique to address gender inequality are consistent with its obligations under international human rights law. For the purpose of this analysis, the article focuses on Mozambique’s obligations under the Convention on the Elimination of All forms of Discrimination against Women (CBDAW) and the Protocol to the African Charter on the Rights of Women (African Women’s Protorol). The article concludes by making suggestions on how Mozambique can better safeguard the rights of women and improve their status.
Intra-annual to multi-decadal xylem traits in a tropical moist semi-deciduous forest of Central Africa
Authors: Mil Tom De
Published: August 2021

A witness of a tree’s past conditions is the wood itself. The main research question of this dissertation is how to assess and reveal the driving forces of the patterns of wood traits on pith-to-bark cross-sections in tropical trees. Cambial and leaf phenology was monitored in the Luki Reserve (Mayombe forest, D.R. Congo). Furthermore, X-ray CT densitometry was explored to assess traits in a reliable way, for multiple species. Variability in phenology is observed for T. superba, which requires traits of individual trees to be fixed on a time axis. Furthermore, X-ray CT is a suitable method for assessing traits in a fast way. Cambial activity of understory trees has shown to be species-specific, whilst many trees show zero xylem growth. Finally, 66 years of tree growth was analysed, while trait analysis revealed a median ring count of only 32, thus implying many non-periodical rings. This work presents methodological improvements to measure traits as continuous variables from pith to bark, but also acknowledges that phenology still remains a key aspect in order to fix traits on a time axis.
A new Gonamytta katydid from central Mozambique (Orthoptera: Tettigoniidae: Meconematinae)
Authors: GUTA RICARDO , MACAMO LAURA , NASKRECKI PIOTR
Published: August 2021

A new small predatory katydid Gonamytta deboisselae sp. n. is described from mid-elevation montane forest habitat in central Mozambique; this species is a putative endemic of Mt. Gorongosa. The call of the new species is ultrasonic, with the peak frequency at 38.2 kHz. Anepitacta (A.) scrofina Beier, 1965 is transferred to Gonamytta based on the morphology of the male terminalia.