bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of the German social attitude barriers and facilitators to participation-scales: an analysis according to the Rasch model
Authors: Upegui-Arango Luz Dary , Mainz Verena , Gecht Judith , Mueller Christian-Andreas , Quack Valentin , Heinemann Allen W. , Boecker Maren
Published: May 2022

Background

Social attitudes experienced by people with disabilities can strongly impact upon their health and quality of life. The extent to which social attitude measurement transcends specific cultures is unknown. Thus, the aim of the study was to develop German item banks to assess social attitude barriers and facilitators to participation and compare the construct definition with that developed in the United States.

Methods

The American version of the two item banks assessing social attitudes that act as barriers and facilitators in persons with disabilities was translated into German and culturally adapted. The sample consisted of 410 in- and outpatients treated for spinal diseases at a German University Hospital. The psychometric properties of the resulting 53 items-item pool were evaluated using Rasch analysis. A special focus was placed on the investigation of unidimensionality, local independence, differential item functioning (DIF) and targeting. To evaluate convergent and divergent validity correlations with perceived social support, depression and pain interference were calculated.

Results

Unlike the American version, both the barriers and facilitators item banks had to be divided into two subscales assessing attitudes that individuals with disabilities experience as being directed towards them (individual perception) or attitudes that respondents experience as being directed towards people with disabilities as a social group (societal perception). Four unidimensional scales were constructed. Fit to the Rasch model required item deletion and forming testlets to account for extensive local dependence. There was no evidence of DIF with regard to gender or age. Targeting of the subscales was moderate to good.

Conclusions

Results support a distinction between social attitudes at the individual and societal level, allowing a more specific assessment than is possible when this distinction is ignored.
Visual inspection of root patterns and radiographic estimation of its canal configurations by confirmation using sectioning method. An ex vivo study on maxillary first premolar teeth
Authors: Faraj Bestoon Mohammed , Abdulrahman Mewan Salahaldeen , Faris Tavga Mustafa
Published: May 2022

Background

A thorough understanding of the original root and canal anatomy is a critical technical prerequisite for performing cleaning and shaping treatments. Therefore, this research aimed to characterize maxillary first premolar teeth' root morphology and canal architecture.

Methods

One hundred forty-two extracted human adult maxillary first premolar teeth have been retrieved. The extracted teeth were thoroughly cleaned and irrigated to eliminate any remaining debris or blood. They were then preserved in formalin solution until they were eligible for screening. To begin, a visual examination was employed to ascertain the number of roots and their geometry in each sample. Then, utilizing digital radiography in two plains, mesiodistal and distomesial, to further determine those parameters. Finally, a sectioning technique had been used to have the samples cut mesiodistally into slices to validate the internal root canal architecture and identify the number of root canals and their varieties in accordance with Vertucci's categorization system. The canal layout, the pulp chamber, and the root canals were all highlighted (marked) using a fine tip marker in a permanent orange hue to make the canal features more accessible and accurate to visualize. All of the processes were conducted by two highly qualified dentists. The sample size was estimated statistically using the Sealed Envelope program, and the percentage of each configuration was derived in proportion to the overall sample size in order to establish the percentage of each type in each configuration.

Results

From the 142 teeth examined, 42 (29.57%) had one root, 97 (68.31%) had two roots, and only three premolars (2.12%) had three roots. Concerning canal configurations, 100 teeth (70.43%) had type (IV) canal configuration, followed by 37 teeth (26.05%) had types (V), three teeth (2.12%) had type (VIII), and one tooth (0.70%) for each of type (I) and type (II).

Conclusions

The anatomical pattern of inspected maxillary first premolars are mainly two rooted and predominantly have a type (IV) canal morphology.
Factors affecting academic burnout of nursing students according to clinical practice experience
Authors: Hwang Eunhee , Kim Jeonghyun
Published: May 2022

Background

Academic burnout has a negative effect on learning outcomes of nursing students. Factors affecting academic burnout may differ depending on whether or not they have experience in clinical practice and identifying these differences would be necessary to seek for strategies to lower academic burnout of nursing students. This study aimed to determine the effects of stress, depression, and anxiety on academic burnout according to the clinical practice experience of nursing students.

Methods

Data were collected from 171 female nursing students in South Korea. Self-report questionnaires from 83 participants without clinical practice experience and 88 with clinical practice experience were analyzed using descriptive statistics, χ2-tests, analysis of variance, t-test, Spearman correlation coefficient, and stepwise multiple regression.

Results

Academic burnout was positively correlated to stress (r = .52, p < .001), anxiety (r = .50, p < .001) and depression (r = .44, p < .001). In those students with no clinical practice experience, anxiety and depression explained for academic burnout by 44%, and those students with clinical practice experience, stress and major satisfaction explained for 33% of academic burnout.

Conclusions

Universities and clinical institutions should establish a cooperative system to reduce stress, depression and anxiety and increase major satisfaction.
Translating qualitative data into intervention content using the Theoretical Domains Framework and stakeholder co-design: a worked example from a study of cervical screening attendance in older women
Authors: Bravington Alison , Chen Hong , Dyson Judith , Jones Lesley , Dalgliesh Christopher , Bryan Amée , Patnick Julietta , Macleod Una
Published: May 2022

Background

Previous screening interventions have demonstrated a series of features related to social determinants which have increased uptake in targeted populations, including the assessment of health beliefs and barriers to screening attendance as part of intervention development. Many studies cite the use of theory to identify methods of behaviour change, but fail to describe in detail how theoretical constructs are transformed into intervention content. The aim of this study was to use data from a qualitative exploration of cervical screening in women over 50 in the UK as the basis of intervention co-design with stakeholders using behavioural change frameworks. We describe the identification of behavioural mechanisms from qualitative data, and how these were used to develop content for a service-user leaflet and a video animation for practitioner training. The interventions aimed to encourage sustained commitment to cervical screening among women over 50, and to increase sensitivity to age-related problems in screening among primary care practitioners.

Methods

Secondary coding of a qualitative data set to extract barriers and facilitators of cervical screening attendance. Barrier and facilitator statements were categorised using the Theoretical Domains Framework (TDF) to identify relevant behaviour change techniques (BCTs). Key TDF domains and associated BCTs were presented in stakeholder focus groups to guide the design of intervention content and mode of delivery.

Results

Behavioural determinants relating to attendance clustered under three domains: beliefs about consequences, emotion and social influences, which mapped to three BCTs respectively: (1) persuasive communication/information provision; (2) stress management; (3) role modelling and encouragement. Service-user stakeholders translated these into three pragmatic intervention components: (i) addressing unanswered questions, (ii) problem-solving practitioner challenges and (iii) peer group communication. Based on (ii), practitioner stakeholders developed a call to action in three areas – clinical networking, history-taking, and flexibility in screening processes. APEASE informed modes of delivery (a service-user leaflet and a cartoon animation for practitioners).

Conclusion

The application of the TDF to qualitative data can provide an auditable protocol for the translation of qualitative data into intervention content.
Respiratory support strategy in adults with acute hypoxemic respiratory failure: a systematic review and network meta-analysis
Authors: Okano Hiromu , Sakuraya Masaaki , Masuyama Tomoyuki , Kimata Shunsuke , Hokari Satoshi
Published: May 2022

Introduction

Network meta-analyses (NMAs) of respiratory management strategies for acute hypoxemic respiratory failure (AHRF) have been reported, but no previous study has compared noninvasive ventilation (NIV), high-flow nasal oxygen (HFNO), standard oxygenation therapy (SOT), and invasive mechanical ventilation (IMV) for de novo AHRF. Therefore, we conducted an NMA to assess the effectiveness of these four respiratory strategies in patients with de novo AHRF.

Methods

The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Ichushi databases were searched. Studies including adults aged ≥18 years with AHRF and RCTs that compared two different oxygenation techniques (SOT, NIV, HFNO, or IMV) were selected. A frequentist-based approach with multivariate random-effects meta-analysis was used. The outcomes were mortality and intubation rates.

Results

Among the 14,263 records initially identified, 25 studies (3302 patients) were included. In the analysis of mortality, compared to SOT, NIV (risk ratio [RR], 0.76; 95% confidence interval [CI], 0.61–0.95) reduced mortality; however, IMV (RR, 1.01; 95% CI, 0.57–1.78) and HFNO (RR, 0.89; 95% CI, 0.66–1.20) did not. For assessments of the intubation incidence, compared to SOT, NIV use (RR, 0.63; 95% CI, 0.51–0.79) was associated with a reduction in intubation, but HFNO (RR, 0.82; 95% CI, 0.61–1.11) was not significant.

Conclusions

Our NMA demonstrated that only NIV showed clinical benefits compared with SOT as an initial respiratory strategy for de novo AHRF. Further investigation, especially comparison with HFNO, is warranted.

Trial registration

PROSPERO (registration number: CRD42020213948, 11/11/2020).
The efficacy of chemical topping in field-grown cotton is mediated by drip irrigation amount in irrigated agricultural area
Authors: TIAN Yu , LIAO Baopeng , HAN Huanyong , WANG Fangyong , DU Mingwei , TIAN Xiaoli , LI Zhaohu
Published: May 2022

Background

Cotton production in China is challenged by high labor input including manual topping (MT). Recently, to replace MT in the Xinjiang cotton region of China, mepiquat chloride (MC) was applied once more than the traditional multiple-application; this was designated as chemical topping (CT), but it is unclear whether the amount of irrigation needs to be adjusted to accommodate CT.

Results

The main plots were assigned to three drip irrigation amounts [300 (I1), 480 (I2), and 660 (I3) mm], and the subplots were assigned to the CT treatments [450 (MC1), 750 (MC2), and 1 050 (MC3) mL·hm−2 25% MC] with MT as a control that was performed after early bloom. The optimum drip irrigation amount for CT was explored based on leaf photosynthesis, chlorophyll fluorescence, biomass accumulation, and yield. There were significant influences of drip irrigation, topping treatments and their interaction on chlorophyll fluorescence characteristics, gas exchange parameters and biomass accumulation characteristics as well as yield. The combination of I2 and MC2 (I2MC2) performed best. Compared with I2MT, the net photosynthetic rate (Pn), stomatal conductance (Gs), transpiration rate (Tr), and photochemical quenching coefficient (qP) of I2MC2 significantly increased by 4.0%∼7.2%, 6.8%∼17.1%, 5.2%∼17.6%, and 4.8%∼9.6%, respectively, from the peak flowering to boll opening stages. Moreover, I2MC2 showed fast reproductive organ biomass accumulation and the highest seed cotton yield; the latter was 6.6%∼12.8% higher than that of I2MT. Further analysis revealed that a 25% MC emulsion in water (MCEW) application resulted in yield improvement by increasing Pn, φPSII, and qP to promote biomass accumulation and transport to reproductive organs.

Conclusion

The results showed that the 480 mm drip irrigation combined with 750 mL·hm−2 MC increased the rate of dry matter accumulation in reproductive organs by increasing Pn, φPSII, and qP to improve photosynthetic performance, thus achieving higher yield.
Deciphering the genome of Simplicillium aogashimaense to understand its mechanisms against the wheat powdery mildew fungus Blumeria graminis f. sp. tritici
Authors: Zhu Mo , Duan Xiao , Cai Pengkun , Li Yong-fang , Qiu Zongbo
Published: May 2022

Simplicillium spp. are mycoparasites that exert growth-inhibitory effects on phytopathogenic fungi. However, limited studies have examined the effects of Simplicillium spp. on powdery mildews. In this study, morphological and molecular analyses revealed that S. aogashimaense is a mycoparasite of the wheat powdery mildew fungus, Blumeria graminis f. sp. tritici (Bgt), under field conditions. The inoculation of Bgt colonies with S. aogashimaense significantly impaired Bgt colony formation and conidial distribution and markedly decreased the biomass of Bgt. To examine the interaction between Simplicillium and Bgt, an S. aogashimaense strain that constitutively expresses green fluorescent protein (GFP) was constructed using the Agrobacterium tumefaciens-mediated transformation (ATMT) method. The hyphae of GFP-expressing S. aogashimaense directly penetrated the B. graminis structures. These findings indicate that ATMT can be employed to reveal the biocontrol activities of physiologically and phylogenetically diverse Simplicillium spp. In vitro, S. aogashimaense exudates compromised Bgt conidial germination and appressorial formation. Thus, S. aogashimaense functions as a potential biological control agent by impeding the development of Bgt and can be a viable alternative for controlling the wheat powdery mildew. To gain further insights into the mechanism underlying this mycoparasitism, the genome of S. aogashimaense was sequenced and assembled. S. aogashimaense harbored seven chromosomes comprising 8963 protein-coding genes. Additionally, two putative effector-coding genes (Sao008714 and Sao006491) were identified. The expression levels of Sao008714 and Sao006491 in S. aogashimaense were dramatically upregulated during the mycoparasitic interaction. In addition, 41 gene clusters putatively involved in the production of secondary metabolites, which exhibit insecticidal, antifungal and antibacterial activities, were identified using genome-wide identification, annotation and analysis of secondary metabolite biosynthesis gene clusters. These results suggest that S. aogashimaense parasitizes Bgt and hence, can be considered for phytopathogen management.
Why care about integrated care? Part 3. Weighing sunlight: delivering integration in practice and measuring success
Authors: Tracy Derek K. , Hanson Kara , Underwood Benjamin R. , Shergill Sukhwinder S.
Published: May 2022

The first two articles in this series have shown the direction of travel for health and social care in England, and how the status quo in already stressed systems is not viable. It is difficult to disagree with the principles of ‘integrated care’, yet we currently lack evidenced models on which we might build. There is a need for experiential learning and sharing of experiences. This third article describes in more granularity the experiences, positive and negative, of an early-adopting integrating service in south-east London that incorporated aspects of the local authority and secondary care physical and mental health services. It provides structured guidance on which types of integration one might aim for, managing internal and external relationships, and discussion on evaluating progress.
Timing of Puberty, Pubertal Growth, and Adult Height in Short Children Born Small for Gestational Age Treated With Growth Hormone
Authors: Upners Emmie N , Raket Lars Lau , Petersen Jørgen H , Thankamony Ajay , Roche Edna , Shaikh Guftar , Kirk Jeremy , Hoey Hilary , Ivarsson Sten-A , Söder Olle , Juul Anders , Jensen Rikke Beck
Published: May 2022

Context

Growth hormone (GH) is used to treat short children born small for gestational age (SGA); however, the effects of treatment on pubertal timing and adult height are rarely studied.

Objective

To evaluate adult height and peak height velocity in short GH-treated SGA children.

Methods

Prospective longitudinal multicenter study. Participants were short children born SGA treated with GH therapy (n = 102). Adult height was reported in 47 children. A reference cohort of Danish children was used. Main outcome measures were adult height, peak height velocity, age at peak height, and pubertal onset. Pubertal onset was converted to SD score (SDS) using Danish reference data.

Results

Gain in height SDS from start of treatment until adult height was significant in both girls (0.94 [0.75; 1.53] SDS, P = .02) and boys (1.57 [1.13; 2.15] SDS, P < .001). No difference in adult height between GH dosage groups was observed. Peak height velocity was lower than a reference cohort for girls (6.5 [5.9; 7.6] cm/year vs 7.9 [7.4; 8.5] cm/year, P < .001) and boys (9.5 [8.4; 10.7] cm/year vs 10.1 [9.7; 10.7] cm/year, P = .002), but no difference in age at peak height velocity was seen. Puberty onset was earlier in SGA boys than a reference cohort (1.06 [–0.03; 1.96] SDS vs 0 SDS, P = .002) but not in girls (0.38 [–0.19; 1.05] SDS vs 0 SDS, P = .18).

Conclusion

GH treatment improved adult height. Peak height velocity was reduced, but age at peak height velocity did not differ compared with the reference cohort. SGA boys had an earlier pubertal onset compared with the reference cohort.
Remnant Cholesterol Predicts Long-term Mortality of Patients With Metabolic Dysfunction–associated Fatty Liver Disease
Authors: Huang Hangkai , Guo Yanjun , Liu Zhening , Zeng Yan , Chen Yishu , Xu Chengfu
Published: May 2022

Context

Elevated serum remnant cholesterol independently predicts risks of cardiovascular diseases. However, the association between remnant cholesterol and metabolic dysfunction–associated fatty liver disease (MAFLD) remains unclear.

Objective

This study aimed to explore the association of remnant cholesterol with MAFLD and its long-term mortality.

Methods

We extracted data from the NHANES III, 1988 to1994 and the linked mortality data until December 31, 2015. The association between remnant cholesterol and MAFLD was analyzed by multivariable logistic regression. Cox proportional hazards regression was performed to assess whether elevated remnant cholesterol increased all-cause and cause-specific mortalities in MAFLD patients.

Results

At baseline, 28.6% (1474/5156) of participants had MAFLD. In multivariable logistic regression, the fourth quartile of remnant cholesterol was associated with an increased risk of MAFLD compared with the first quartile (odds ratio [OR]: 1.714; 95% CI, 1.586-1.971; P < .001). In participants with normal levels of triglycerides, low-density lipoprotein and high-density lipoprotein cholesterol, the relationship between remnant cholesterol and MAFLD risk remained significant (OR: 1.346; 95% CI, 1.248-1.761; P < .001). During a median follow-up of 307 months, MAFLD patients with serum remnant cholesterol in the fourth quartile were associated with a higher risk of all-cause mortality (hazard ratio [HR]: 2.183; 95% CI, 1.825-2.407; P < .001), as well as a higher risk of cardiovascular mortality (HR: 2.346; 95% CI, 2.046-2.885; P < .001) and cancer-related mortality (HR: 2.366; 95% CI, 1.864-2.932; P < .001) compared with MAFLD patients in the first quartile.

Conclusion

Remnant cholesterol was independently associated with the risk of MAFLD and predicted all-cause, cardiovascular, and cancer-related mortalities in MAFLD patients.
The Mount Sinai Clinical Pathway for the Diagnosis and Management of Hypercortisolism due to Ectopic ACTH Syndrome
Authors: Alba Eva L , Japp Emily A , Fernandez-Ranvier Gustavo , Badani Ketan , Wilck Eric , Ghesani Munir , Wolf Andrea , Wolin Edward M , Corbett Virginia , Steinmetz David , Skamagas Maria , Levine Alice C
Published: May 2022

Neoplasms that secrete ectopic adrenocorticotropin (ACTH) may cause severe, life-threatening hypercortisolism. These tumors are often difficult to localize and treat, requiring a comprehensive and systematic management plan orchestrated by a multidisciplinary team. The Mount Sinai Adrenal Center hosted an interdisciplinary retreat of experts in adrenal disorders and neuroendocrine tumors (NETs) with the aim of developing a clinical pathway for the management of Cushing syndrome due to ectopic ACTH production. The result was institutional recommendations for the diagnosis, localization, surgical approaches to intrathoracic tumors and bilateral adrenalectomy, and perioperative and postoperative medical management of hypercortisolism and its sequelae. Specific recommendations were made regarding the timing and selection of therapies based on the considerations of our team as well as a review of the current literature. Our clinical pathway can be applied by other institutions directly or serve as a guide for institution-specific management.
A Novel Method for Adult Height Prediction in Children With Idiopathic Short Stature Derived From a German-Dutch Cohort
Authors: Blum Werner F , Ranke Michael B , Keller Eberhard , Keller Alexandra , Barth Sandra , de Bruin Christiaan , Wudy Stefan A , Wit Jan M
Published: May 2022

Context

Prediction of adult height (AH) is important in clinical management of short children. The conventional methods of Bayley-Pinneau (BP) or Roche-Wainer-Thissen (RWT) have limitations.

Objective

We aimed to develop a set of algorithms for AH prediction in patients with idiopathic short stature (ISS) which are specific for combinations of predicting variables.

Methods

Demographic and auxologic data were collected in childhood (1980s) and at AH (1990s). Data were collected by Dutch and German referral centers for pediatric endocrinology. A total of 292 subjects with ISS (219 male, 73 female) were enrolled. The population was randomly split into modeling (n = 235) and validation (n = 57) cohorts. Linear multi-regression analysis was performed with predicted AH (PAH) as response variable and combinations of chronological age (CA), baseline height, parental heights, relative bone age (BA/CA), birth weight, and sex as exploratory variables.

Results

Ten models including different exploratory variables were selected with adjusted R² ranging from 0.84 to 0.78 and prediction errors from 3.16 to 3.68 cm. Applied to the validation cohort, mean residuals (PAH minus observed AH) ranged from −0.29 to −0.82 cm, while the conventional methods showed some overprediction (BP: +0.53 cm; RWT: +1.33 cm; projected AH: +3.81 cm). There was no significant trend of residuals with PAH or any exploratory variables, in contrast to BP and projected AH.

Conclusion

This set of 10 multi-regression algorithms, developed specifically for children with ISS, provides a flexible tool for AH prediction with better accuracy than the conventional methods.
Racial Disparities in the Use of Peripheral Nerve Blocks for Postoperative Analgesia After Total Mastectomy: A Retrospective Cohort Study
Authors: Mazzeffi Michael A. , Keneally Ryan , Teal Christine , Douglas Rundell , Starks Vanessa , Chow Jonathan , Porter Steven B.
Published: May 2022

BACKGROUND:

Peripheral nerve blocks (PNBs) are used to provide postoperative analgesia after total mastectomy. PNBs improve patient satisfaction and decrease postoperative opioid use, nausea, and vomiting. Few studies have examined whether there is racial-ethnic disparity in the use of PNBs for patients having total mastectomy. We hypothesized that non-Hispanic Asian, non-Hispanic Black, non-Hispanic patients of other races, and Hispanic patients would be less likely to receive a PNB for postoperative analgesia compared to non-Hispanic White patients having total mastectomy. Secondarily, we hypothesized that PNBs would be associated with reduced odds of major complications after total mastectomy.

METHODS:

We performed a retrospective cohort study using National Surgical Quality Improvement Program (NSQIP) data from 2015 to 2019. Patients were included if they underwent total mastectomy under general anesthesia. Unadjusted rates of PNB use were compared between race-ethnicity groups. Multivariable logistic regression was performed to determine whether race-ethnicity group was independently associated with receipt of a PNB for postoperative analgesia. Secondarily, we calculated crude and risk-adjusted odds ratios for major complications in patients who received a PNB.

RESULTS:

There were 64,103 patients who underwent total mastectomy and 4704 (7.3%) received a PNB for postoperative analgesia. Patients who received a PNB were younger, more commonly women, were less likely to have diabetes and hypertension, and had less disseminated cancer (all P < .05). In our regression analysis, the odds of receiving a PNB differed significantly by race-ethnicity group (P < .001). Non-Hispanic Asian and non-Hispanic Black patients had reduced odds of receiving a PNB compared to non-Hispanic White patients (odds ratio [OR], 0.41; 95% confidence interval [CI], 0.33–0.49 and OR, 0.37 [0.32–0.44]), respectively. Non-Hispanic patients of other races, including American Indian, Alaskan Native, and Pacific Islander, also had reduced odds of receiving a PNB (OR, 0.73 [95% CI, 0.64–0.84]) compared to non-Hispanic White patients, as did Hispanic patients (OR, 0.62 [0.56–0.69]). Patients who received a PNB did not have reduced odds of major complications after mastectomy (crude OR, 0.83 [0.65–1.08]; P = .17 and adjusted OR, 0.85 [0.65–1.10]; P = .21).

CONCLUSIONS:

Significant disparity exists in the use of PNBs for postoperative analgesia in patients of different race-ethnicity who undergo total mastectomy in the United States. Continued efforts are needed to better understand the causes of disparity and to ensure equitable access to PNBs.
Development, regeneration and tumorigenesis of the urothelium
Authors: Wiessner Gregory B. , Plumber Sakina A. , Xiang Tina , Mendelsohn Cathy L.
Published: May 2022

The urothelium of the bladder functions as a waterproof barrier between tissue and outflowing urine. Largely quiescent during homeostasis, this unique epithelium rapidly regenerates in response to bacterial or chemical injury. The specification of the proper cell types during development and injury repair is crucial for tissue function. This Review surveys the current understanding of urothelial progenitor populations in the contexts of organogenesis, regeneration and tumorigenesis. Furthermore, we discuss pathways and signaling mechanisms involved in urothelial differentiation, and consider the relevance of this knowledge to stem cell biology and tissue regeneration.
Outcomes and toxicity following post-operative hypofractionated radiotherapy to the regional nodes and the breast or the chest wall in locally advanced breast cancer
Authors: Tramacere Francesco , Arcangeli Stefano , Colciago Riccardo Ray , Lucchini Raffaella , Pati Francesca , Portaluri Maurizio
Published: May 2022

Objectives:

We aimed to analyze the impact of a 3-week schedule of HypoFractionated (HF) radiotherapy (RT) after axillary dissection and breast surgery, in terms of safety and efficacy in patients with locally advanced breast cancer (BC).

Methods:

Eligible patients were females with Stage IIA – IIIC BC who underwent axillary dissection and breast surgery, either quadrantectomy or mastectomy. HF RT was delivered in 15 or 16 fractions for a total dose of 40.05 Gy or 42.56 Gy, respectively, to the clavicular nodal region along with the whole breast (HF WBRT) or the chest wall (HF PMRT), according to the type of surgery. Locoregional recurrence (LRR), distant metastases-free survival (DMFS), overall survival (OS) and acute and late treatment-related toxicities were estimated.

Results:

57 patients with a median age of 60 years (32–85) were retrospectively analyzed. 34 (60%) of patients underwent breast conservative surgery in the form of quadrantectomy and 23 (40%) were offered radical mastectomy. All patients underwent hypofractionated regional nodal irradiation (HF RNI). 34 (60%) of them underwent HF WBRT, while 23 (40%) received HF PMRT. At a median follow-up of 80 months (30–113), the 7-year LRR-free survival was 93% (95% CI, 74%–95%). The same features for DMFS and OS were 76% (95% CI, 52%–78%) and 67% (95% CI, 50%–80%), respectively. Only one (2%) patient experienced G3 acute skin toxicity. No grade ≥2 late toxicity was observed.

Conclusion:

Our study shows that HF RNI with HF RT to the whole breast or the chest wall after breast surgery is safe and effective in patients with locally advanced BC. Longer follow-up is needed to strengthen further analyses on late toxicity and clinical outcomes.

Advances in knowledge:

This paper adds to the evidence that post-operative RNI with WBRT or PMRT can be safely and effectively delivered with 3-week HF regimen. Locally advanced BC patients can be offered HF RT to the regional nodes and the breast or the chest wall regardless the type of surgery.
Intramolecular ligation method (iLIME) for pre-miRNA quantification and sequencing
Authors: Le Minh Ngoc , Le Cong Truc , Nguyen Tuan Anh
Published: May 2022

Hairpin-containing pre-miRNAs, produced from pri-miRNAs, are precursors of miRNAs (microRNAs) that play essential roles in gene expression and various human diseases. Current qPCR-based methods used to quantify pre-miRNAs are not effective to discriminate between pre-miRNAs and their parental pri-miRNAs. Here, we developed the intramolecular ligation method (iLIME) to quantify and sequence pre-miRNAs specifically. This method utilizes T4 RNA ligase 1 to convert pre-miRNAs into circularized RNAs, allowing us to design PCR primers to quantify pre-miRNAs, but not their parental pri-miRNAs. In addition, the iLIME also enables us to sequence the ends of pre-miRNAs using next-generation sequencing. Therefore, this method offers a simple and effective way to quantify and sequence pre-miRNAs, so it will be highly beneficial for investigating pre-miRNAs when addressing research questions and medical applications.
Protocol for the development of a core outcome set for evaluating mixed-diagnosis falls prevention interventions for people with Multiple Sclerosis, Parkinson’s Disease and stroke
Authors: O'Malley Nicola , Coote Susan , Clifford Amanda M
Published: May 2022

Background: Given the high incidence of falls and their associated negative effects, the development of effective falls prevention interventions for people with Multiple Sclerosis (MS), Parkinson's Disease (PD) and stroke is a priority. Currently the implementation of condition-specific falls prevention interventions is challenging in the community due to lack of participants and resources. Given the similarities in falls risk factors across stroke, PD and MS, the design of mixed-diagnosis interventions for groups comprising of people with these three neurological conditions may solve these implementation challenges. Having a core outcome set (COS) for evaluating these interventions would enable the comparison and combination of data, thereby facilitating progress in this research area. Therefore, the aim of this research study is to develop a COS for evaluating mixed-diagnosis falls prevention interventions for people with MS, PD and stroke.

Methods: This will be a mixed-methods, international, multi-perspective Delphi consensus study with five stages. Stage one will involve the identification of potential outcomes through a systematic literature search, patient focus groups, and consultation with our stakeholder group. The second stage will be the development of the Delphi survey using the outcomes elicited from stage one. Stage three will be the prioritisation of outcomes using a two-round online Delphi survey involving patients, clinicians, researchers and policy-makers/service-planners. The fourth stage will be to identify and recommend outcome measures and definitions. The final stage will be a consensus meeting with representatives from each stakeholder group to agree upon the final COS.

Discussion: Adoption of this COS in future trials investigating the effectiveness of mixed-diagnosis falls prevention interventions for people with MS, PD and stroke will facilitate the comparison and combination of research findings. This should translate into improved decision-making by service-planners/policy-makers and clinicians regarding the implementation of evidence-based falls prevention interventions into practice.
Contrasting extremism and radicalisation in a syndemic society
Authors: Antonelli Francesco
Published: May 2022

The purpose of this document is to make recommendations on the necessity to transform current P/CVE policies, emphasizing the importance of a more effective involvement of Politics to contrast the spread of extremism and radicalisation in Europe. In fact, in a syndemic and post-Caliphate world, problems and challenges toward political violence are more and more institutional, systemic, and political.

According to the first HORIZON2020 PARTICIPATION PROJECT’s results, the crisis of participation and the crisis of integration are closely linked to current extremism and radicalisation processes; at the same time, fragmentation, interrelation between different kind of extremism and hybridisation, request a new approach that involve, in a more effective way, civil society and political society to contrast extremism, radicalisation and terrorism.
A qualitative study exploring health workers and patient caregivers’ hand hygiene practices in a neonatal unit in Blantyre, Malawi, implications for controlling outbreaks of drug resistant infections
Authors: Mangochi Helen , Tolhurst Rachel , Simpson Victoria , Kawaza Kondwani , Chidziwisano Kondwani , Feasey Nicholas A. , Morse Tracy , MacPherson Eleanor
Published: May 2022

Background: Neonatal sepsis is responsible for a considerable burden of morbidity and mortality in sub-Saharan African countries. Outcomes from neonatal sepsis are worsening due to increasing rates of antimicrobial resistance. Sub-optimal Infection Prevention and Control (IPC) practices of health care workers and caregivers are important drivers of infection transmission. The Chatinkha Neonatal Unit at Queen Elizabeth Central Hospital, Blantyre, Malawi has experienced multiple outbreaks of neonatal sepsis, associated with drug resistant Klebsiella pneumoniae. We aimed to understand the barriers to implementation of optimal IPC focusing on hand hygiene practice.

Methods: We used a qualitative research methodology to meet the study aim. Combining participant observation (PO) over a seven-month period with semi structured interviews (SSI) to provide an in-depth understanding of activities relating to hygiene and IPC existing on the ward.

Results: While most staff and some caregivers, had a good understanding of ideal IPC and understood the importance of good handwashing practices, they faced substantial structural limitations, and scarce resources (both material and human) which made implementation challenging.  For staff, the overwhelming numbers of patients meant the workload was often unmanageable and practicing optimal IPC was challenging.  Caregivers lacked access to basic amenities, including linen and chairs, meaning that it was almost impossible for them to maintain good hand hygiene. Limited access to soap and the erratic water supply for both caregivers and healthcare workers further worsened the situation. Communication challenges between different cadres of staff and with patient caregivers meant that those handling neonates and cleaning the wards were often unaware of outbreaks of drug resistant infection.

Conclusion: For IPC to be improved, interventions need to address the chronic shortages of material resources and create an enabling environment for HCWs and patient caregivers.
Invasive Streptococcus agalactiae ST283 infection after fish consumption in two sisters, Lao PDR
Authors: Luangraj Manophab , Hiestand Jasmin , Rasphone Othila , Chen Swaine L. , Davong Viengmon , Barkham Timothy , Simpson Andrew J.H. , Dance David A.B. , Keoluangkhot Valy
Published: May 2022

Background: Streptococcus agalactiae is a normal commensal of the human gastro-intestinal and female genital tracts. It causes serious disease in neonates and pregnant women, as well as non-pregnant adults. Food-borne outbreaks have also been described. A link between invasive Group B streptococcus (GBS) infection in humans caused by S. agalactiae serotype III-4, sequence type 283 (ST283) and the consumption of raw fresh-water fish was first described in Singapore in 2015.

Case presentation: We report the simultaneous occurrence of acute fever and myalgia in two sisters who were visiting Laos. Both were found to have invasive GBS ST283 infection, confirmed by blood culture. Infection was temporally linked to fish consumption. They responded well to intravenous antibiotics within 48 hours.

Conclusions: Food-borne transmission of Streptococcus agalactiae is an important and under-recognised source of serious human disease throughout Southeast Asia and possibly beyond.
Incentives and Defaults Can Increase COVID-19 Vaccine Intentions and Test Demand
Authors: Serra-Garcia Marta , Szech Nora
Published: May 2022

Willingness to vaccinate and test are critical in the COVID-19 pandemic. We study the effects of two measures to increase the support of vaccination and testing: defaults and monetary compensations. Some organizations, such as restaurants, fire departments, hospitals, or governments in some countries, have used these measures. Yet there is the concern that compensations could erode intrinsic motivation and decrease vaccination intentions. We show that, in the early stages of the pandemic, both approaches, compensations and defaults, significantly increased COVID-19 test demand and vaccine intentions. Compensations for vaccines, however, need to be large enough because low compensations can backfire. We estimate heterogeneous treatment effects to document which groups are more likely to respond to these measures. The results show that defaults and avoidance of small compensations are especially important for individuals who are more skeptical of the vaccine, measured by their trust in the vaccine and their political views. Hence, both measures could be used in a targeted manner to achieve stronger results.

This paper was accepted by Yan Chen, behavioral economics and decision analysis.

Supplemental Material: The online appendix and data are available at https://doi.org/10.1287/mnsc.2022.4405 .
Dynamic PSF-based jitter compensation and quality improvement for push-broom optical images considering terrain relief and the TDI effect
Authors: Liu Shijie , Lin Feng , Tong Xiaohua , Zhang Han , Lin Hong , Xie Huan , Ye Zhen , Zheng Shouzhu
Published: May 2022

Platform attitude jitter is inevitable during a satellite flight. The jitter reduces the quality of push-broom optical images, resulting in geometric deformation and image blur. This paper proposes an approach that offers jitter effect compensation and quality improvement for push-broom optical images based on dynamic point spread function (PSF) estimation and iterative image restoration considering the effect of terrain relief and time delay integration (TDI). First, the attitude jitter is precisely detected and estimated by considering the terrain relief. The jitter information is then used to establish the dynamic PSF of each image line considering the changing jitter values and TDI effect. Finally, based on the constructed PSF, the image is improved by iterative restoration using the optimal-window Richardson–Lucy algorithm. The method is validated by both simulation and real data experiments. In the simulation experiment, we apply jitter with different amplitudes and frequencies to generate the degraded images and then restore the image using the proposed restoration method. The results show that the proposed method can effectively restore images affected by jitter. In addition, real data experiments are carried out with multispectral remote sensing images from the ZY-3 satellite. The results show that in addition to the improvement of the radiometric quality, the geometric quality is also significantly improved in both the across-track and the along-track directions. The experimental results validated that the proposed method outperformed other methods without considering the terrain and TDI effect.
Analysis of the RCF crack detection phenomenon based on induction thermography
Authors: Liang Xiao , Peng Jianping , Zhang Xiang , Guo Jianqiang , Zhang Yu
Published: May 2022

Eddy current pulsed thermography (ECPT) is used to detect rolling contact fatigue (RCF) cracks on the rail. It is observed that some of the cracks disappear in the thermal image with the increase of heating time. Based on the finite element method, with double cracks as the basic unit, three different crack models are established, and the mutual disturbance relationship between the double cracks is discussed based on the eddy current distribution and thermal diffusion process. The simulation and experimental results show that different crack models are affected by thermal diffusion in different heating stages to different degrees, and the time of the crack thermal image disappearance is obtained. According to the above conclusions, the RCF cracks are extracted and classified based on the influence of thermal diffusion. The possibility of rail condition assessment and maintenance based on the disappearance time is explained.
Effects of water salinity on the multi-angular polarimetric properties of light reflected from smooth water surfaces
Authors: Sun Zhongqiu , Wu Di , Lv Yunfeng
Published: May 2022

Salinity is an important environmental factor regulating the aquatic system structure of lakes and other water bodies. Changes in salinity, which can be caused by human activities, can adversely impact the life of water organisms. The refractive index, which can be directly related to water salinity, also controls the polarimetric properties of light reflected from the water surface. In this study, polarimetric measurements of smooth water surfaces with different salinity content were performed at different viewing zenith angles in the wavelength range of 450–1000 nm in the specular reflection directions. The results show that the light reflected from the water surface (defined as reflectance factor) in one measurement direction can be replaced by the reflectance factor derived from polarimetric measurements, and if the polarizer absorptance is considered, the average relative difference is less than 3%. The degree of linear polarization (DOLP) was used to retrieve the refractive indices of water with different salinities based on the Fresnel reflection coefficient. The inverted refractive indices not only have high accuracy (uncertainty from 0.9% to 1.8%) but also have a very strong relationship with the water salinity content. Our study shows the possibility of estimating the variation in water salinity using multi-angular polarimetric measurements.
Terahertz metamaterial biosensor for diagnosis of hepatocellular carcinoma at early stage
Authors: Li Dongxia , Zeng Lizhen , Wang Yuanli , Tang Hong-Wen , Lee Wen Xing , Chen Zhencheng , Zhang Longhui , Zou Yingchang , Xie Duan , Hu Fangrong
Published: May 2022

We propose a method for diagnosis of cirrhosis and hepatocellular carcinoma (HCC) by using a terahertz (THz) metamaterial (MM) biosensor. The biosensor has a resonance frequency at about 0.801 THz and can measure the concentration of alpha-fetoprotein (AFP) in serum. The sensitivity of the sensor is 124 GHz/refractive index unit (RIU), and the quality-factor (Q) is 6.913, respectively. When the surface of the biosensor is covered with healthy serum (

A
F
P

≤

7

n
g

/

m
L

), the maximum resonance frequency shift is 50 GHz. However, when it is covered with serum from patients with cirrhosis and early HCC (

A
F
P

>

7

n
g

/

m
L

), the resonance frequency shift is more than 59 GHz. Positive correlation exists between the frequency shift of the biosensor and serum levels of the AFP in the HCC patients. This study provides a method for quick diagnosis and prediction of cirrhosis and HCC.
Sharp-edge diffraction under Bessel beam illumination: a catastrophe optics perspective
Authors: Borghi Riccardo , Carosella Cristian G.
Published: May 2022

Boundary diffraction wave theory and catastrophe optics have already proved to be a formidable combination in computational optics. In the present paper, a general paraxial theory aimed at dealing paraxial diffraction of Bessel beams by arbitrarily shaped sharp-edge apertures is developed. A key ingredient of our analysis is the

δ

-like nature of the angular spectrum of nondiffracting beams. This allows the diffracted wavefield to be effectively represented through two-dimensional integrals defined onto rectangular domains, whose numerical evaluation is easily achievable via standard Monte Carlo techniques. As a byproduct of the present analysis, a simple explanation of a recently observed property of some “heart-like” apertures to flatten the axial intensity of apodized Bessel beams is also provided.
The function and evolution of child-directed communication
Authors: Schick Johanna , Fryns Caroline , Wegdell Franziska , Laporte Marion , Zuberbühler Klaus , van Schaik Carel P. , Townsend Simon W. , Stoll Sabine
Published: May 2022

Humans communicate with small children in unusual and highly conspicuous ways (child-directed communication (CDC)), which enhance social bonding and facilitate language acquisition. CDC-like inputs are also reported for some vocally learning animals, suggesting similar functions in facilitating communicative competence. However, adult great apes, our closest living relatives, rarely signal to their infants, implicating communication surrounding the infant as the main input for infant great apes and early humans. Given cross-cultural variation in the amount and structure of CDC, we suggest that child-surrounding communication (CSC) provides essential compensatory input when CDC is less prevalent—a paramount topic for future studies.