bluuebunny/crossref_metadata_2025 huggingface dataset:
“We cobble together a storyline of system performance using a diversity of things”: a qualitative study of perspectives on public health performance measurement in Canada
Authors: O’Neill Meghan , De Prophetis Eric , Allin Sara , Pinto Andrew D. , Smith Robert W. , Di Ruggiero Erica , Schwartz Robert , Pawa Jasmine , Ammi Mehdi , Rosella Laura C.
Published: July 2022

Background

There have been longstanding calls for public health systems transformations in many countries, including Canada. Core to these calls has been strengthening performance measurement. While advancements have been made in performance measurement for certain sectors of the health care system (primarily focused on acute and primary health care), effective use of indicators for measuring public health systems performance are lacking. This study describes the current state, anticipated challenges, and future directions in the development and implementation of a public health performance measurement system for Canada.

Methods

We conducted a qualitative study using semi-structured interviews with public health leaders (n = 9) between July and August 2021. Public health leaders included researchers, government staff, and former medical officers of health who were purposively selected due to their expertise and experience with performance measurement with relevance to public health systems in Canada. Thematic analysis included both a deductive approach for themes consistent with the conceptual framework and an inductive approach to allow new themes to emerge from the data.

Results

Conceptual, methodological, contextual, and infrastructure challenges were highlighted by participants in designing a performance measurement system for public health. Specifically, six major themes evolved that encompass 1) the mission and purpose of public health systems, including challenges inherent in measuring the functions and services of public health; 2) the macro context, including the impacts of chronic underinvestment and one-time funding injections on the ability to sustain a measurement system; 3) the organizational structure/governance of public health systems including multiple forms across Canada and underdevelopment of information technology systems; 4) accountability approaches to performance measurement and management; and 5) timing and unobservability in public health indicators. These challenges require dedicated investment, strong leadership, and political will from the federal and provincial/territorial governments.

Conclusion

Unprecedented attention on public health due to the coronavirus disease 2019 pandemic has highlighted opportunities for system improvements, such as addressing the lack of a performance measurement system. This study provides actionable knowledge on conceptual, methodological, contextual, and infrastructure challenges needed to design and build a pan-Canadian performance measurement system for public health.
Microbiota responses to different prebiotics are conserved within individuals and associated with habitual fiber intake
Authors: Holmes Zachary C. , Villa Max M. , Durand Heather K. , Jiang Sharon , Dallow Eric P. , Petrone Brianna L. , Silverman Justin D. , Lin Pao-Hwa , David Lawrence A.
Published: July 2022

Background

Short-chain fatty acids (SCFAs) derived from gut bacteria are associated with protective roles in diseases ranging from obesity to colorectal cancers. Intake of microbially accessible dietary fibers (prebiotics) lead to varying effects on SCFA production in human studies, and gut microbial responses to nutritional interventions vary by individual. It is therefore possible that prebiotic therapies will require customizing to individuals.

Results

Here, we explored prebiotic personalization by conducting a three-way crossover study of three prebiotic treatments in healthy adults. We found that within individuals, metabolic responses were correlated across the three prebiotics. Individual identity, rather than prebiotic choice, was also the major determinant of SCFA response. Across individuals, prebiotic response was inversely related to basal fecal SCFA concentration, which, in turn, was associated with habitual fiber intake. Experimental measures of gut microbial SCFA production for each participant also negatively correlated with fiber consumption, supporting a model in which individuals’ gut microbiota are limited in their overall capacity to produce fecal SCFAs from fiber.

Conclusions

Our findings support developing personalized prebiotic regimens that focus on selecting individuals who stand to benefit, and that such individuals are likely to be deficient in fiber intake.
Blood-based tumour mutation index act as prognostic predictor for immunotherapy and chemotherapy in non-small cell lung cancer patients
Authors: Lu Jun , Wu Jun , Lou Yuqing , Shi Qin , Xu Jun , Zhang Lele , Nie Wei , Qian Jie , Wang Yanan , Zhang Yanwei , Jiao Jing , Zhang Xueyan , Zhang Wei , Wang Huimin , Chu Tianqing , Zhong Hua , Han Baohui
Published: July 2022

Background

Circulating tumour DNA (ctDNA)-based sequencing might provide a simple test for the stratified model of non-small cell lung cancer (NSCLC). Here, we aimed to assess the ctDNA sequencing-based tumour mutation index (TMI) model for screening responders (from non-responders) among NSCLC patients who received monotherapy with docetaxel or atezolizumab.

Methods

We performed a retrospective analysis of the POPLAR (NCT01903993) and OAK (NCT02008227) trials. We identified three biomarkers, blood tumour mutation burden (bTMB), sensitive blood tumour mutation burden (sbTMB) and unfavourable mutation score (UMS), of the ctDNA profiles. After integrating the advantages and disadvantages of the three independent biomarkers, we developed the TMI model and identified NSCLC patients who may benefit from monotherapy with docetaxel or atezolizumab in terms of overall survival (OS).

Results

The TMI model as a stratified biomarker for docetaxel responders provided a median OS duration of 5.55 months longer than non-responders in the OAK cohort, with a significantly decreased hazard ratio (HR). Moreover, atezolizumab responders had a 10.21-month OS advantage over atezolizumab non-responders in the OAK cohort via TMI stratification, and the HR was also decreased significantly. The TMI demonstrated effectiveness for stratifying responders in the POPLAR cohort. Importantly, we found that the TMI model could screen additional responders upon combining the cohorts from the POPLAR and OAK trials after adjustment.

Conclusion

In the present study, we provide a novel TMI model for screening responders (from non-responders) among NSCLC patients who received the 2nd-line monotherapy with docetaxel or atezolizumab. We believe that the biomarker TMI will potentially be effective for the clinical treatment of NSCLC in the future.
Anomalous relaxation from a non-equilibrium steady state: An isothermal analog of the Mpemba effect
Authors: Degünther Julius , Seifert Udo
Published: July 2022

The Mpemba effect denotes an anomalous relaxation phenomenon where a system initially at a hot temperature cools faster than a system that starts at a less elevated temperature. We introduce an isothermal analog of this effect for a system prepared in a non-equilibrium steady state that then relaxes towards equilibrium. Here, the driving strength, which determines the initial non-equilibrium steady state, takes the role of the temperature in the original version. As a paradigm, we consider a particle initially driven by a non-conservative force along a one-dimensional periodic potential. We show that for an asymmetric potential relaxation from a strongly driven initial state is faster than from a more weakly driven one at least for one of the two possible directions of driving. These results are first obtained through perturbation theory in the strength of the potential and then extended to potentials of arbitrary strength through topological arguments.
Sugar-rich larval diet promotes lower adult pathogen load and higher survival after infection in a polyphagous fly
Authors: Dinh Hue , Lundbäck Ida , Kumar Sheemal , Than Anh The , Morimoto Juliano , Ponton Fleur
Published: July 2022

Nutrition is a central factor influencing immunity and resistance to infection, but the extent to which nutrition during development affects adult responses to infections is poorly understood. Our study investigated how the nutritional composition of the larval diet affects the survival, pathogen load and food intake of adult fruit flies, Bactrocera tryoni, after septic bacterial infection. We found a sex-specific effect of larval diet composition on survival post-infection: survival rate was higher and bacterial load was lower for infected females raised on a sugar-rich larval diet than for females raised on a protein-rich larval diet, an effect that was absent in males. Both males and females were heavier when fed a balanced larval diet compared with a protein- or sugar-rich diet, while body lipid reserves were higher for those that had consumed the sugar-rich larval diet compared with other diets. Body protein reserves were lower for flies that had been raised on the sugar-rich larval diet compared with other diets in males, but not females. Both females and males shifted their nutrient intake to ingest a sugar-rich diet when infected compared with sham-infected flies without any effect of the larval diet, suggesting that sugar-rich diets can be beneficial to fight off bacterial infection as shown in previous literature. Overall, our findings show that nutrition during early life can shape individual fitness in adulthood.
Human Trafficking and Regulating Prostitution
Authors: Lee Samuel , Persson Petra
Published: July 2022

Certain markets are illicit because part of the supply is coerced, but little is known about the optimal regulation of such markets. We model a prostitution market with voluntary and coerced prostitutes and ask what regulation can restore the benchmark outcome that would arise under laissez-faire absent coercion. Whereas current policies—decriminalization, criminalization of the buy or sell sides, and licensing—are ineffective against trafficking or harm voluntary suppliers, we show that an alternative policy can restore the benchmark outcome. Our results are relevant to the ongoing debate about decriminalizing prostitution and provide guidance for empirical work on prostitution regulation. (JEL D45, J47, J82, K38, K42)
Διεθνές Συμβατικό Δίκαιο και Οικουμενικό Πατριαρχείο
Authors: Ιατρίδης Χρήστος
Published: July 2022

Η παρούσα διατριβή διαρθρώνεται σε Εισαγωγή, δύο μέρη από έξι κεφάλαια και τελική ενότητα συμπερασμάτων. Στο πρώτο κεφάλαιο γίνεται αναφορά στην ιστορική εξέλιξη του Οικουμενικού Πατριαρχείου από την ίδρυσή του μέχρι και σήμερα. Στο δεύτερο κεφάλαιο γίνεται επισκόπηση της έννοιας του υποκειμένου του δικαίου γενικά και του υποκειμένου Διεθνούς Δικαίου και των οντοτήτων στις οποίες το Διεθνές Δίκαιο απονέμει νομική προσωπικότητα. Στο τρίτο κεφάλαιο γίνεται αναφορά σε σειρά Διεθνών Συνθηκών Ειρήνης από το 18ο μέχρι τον 20ό αιώνα που επέβαλαν στην Οθωμανική Αυτοκρατορία την υποχρέωση σεβασμού της θρησκευτικής ελευθερίας και άλλα οικονομικά και πολιτικά προνόμια των ορθοδόξων πολιτών της που αναγνώριζαν το Οικουμενικό Πατριαρχείο ως το θεσμό που τους εκπροσωπούσε. Στο τέταρτο κεφάλαιο αναλύονται οι προσπάθειες της Τουρκίας για αποδυνάμωση του Οικουμενικού Πατριαρχείου μετά το 1923, όταν δεν έγινε δεκτή η πρότασή της για την απομάκρυνση του Οικουμενικού Πατριαρχείου από την Κωνσταντινούπολη. Στο πέμπτο κεφάλαιο εξετάζεται η σχέση και διασύνδεση όσων προβλέπονταν στην Ευρωπαϊκή Σύμβαση Δικαιωμάτων του Ανθρώπου κυρίως στο ζήτημα προστασίας της περιουσίας και της θρησκευτικής ελευθερίας με το κανονιστικό πλαίσιο της Συνθήκης της Λωζάννης. Τέλος, στο έκτο κεφάλαιο εξετάζεται η σύγχρονη πραγματικότητα ως προς τη θέση του Οικουμενικού Πατριαρχείου στην Τουρκία υπό το φως της Συνθήκης της Λωζάννης και της Ευρωπαϊκής Σύμβασης Δικαιωμάτων του Ανθρώπου.
Χριστιανικό ήθος και κοινωνική πρακτική στο έργο του αγίου Νικοδήμου Αγιορείτη
Authors: Τσιγκαροπούλου Δήμητρα
Published: July 2022

Το έργο του Αγίου Νικόδημου του Αγιορείτη, μπορεί να έχει γίνει επανειλημμένως αντικείμενο της έρευνας, μία πλευρά του όμως, η οποία δεν είχε μελετηθεί, είναι οι κοινωνικές ιδέες που αυτό περιλαμβάνει. Η έρευνα επικεντρώθηκε στην προσωπικότητα του Νικόδημου Αγιορείτη, το βίο του και την προσφορά του έργου του στα κοινωνικά δρώμενα του 18ου αι. Το θέμα το οποίο εξετάσαμε αφορά τις θέσεις και τις απόψεις του αγίου αναφορικά με τα ηθικά και τα κοινωνικά ζητήματα της εποχής του. Παρατηρήθηκε η ανάγκη μιας συνολικής καταγραφής της περί ηθικής διδασκαλίας του αγίου. Να αναδείξει δηλαδή τις θέσεις του αγίου για τα ηθικά και κοινωνικά ζητήματα της εποχής του. Μέσα στα έργα του παρατηρούμε πως ο άγιος Νικόδημος ο Αγιορείτης διατυπώνει τις απόψεις του για τα πάθη, τους λογισμούς και τις αμαρτίες του ανθρώπου. Σύμφωνα με τον άγιο Νικόδημο, ο πόλεμος του ανθρώπου κατά των παθών είναι έμφυτος. Γι΄ αυτό το λόγο λοιπόν θα πρέπει οι άνθρωποι να μεριμνήσουν και να επιδεικνύουν ζήλο, προκειμένου να επιτευχθεί η απομάκρυνση των παθών και να υφίσταται έτσι κοινωνική συνοχή. Ο κοινωνικός αντίκτυπος των απόψεων του αγίου επιβεβαιώνεται, καθώς κάθε αμαρτία που διαπράττεται θεωρείται κοινωνική, εφόσον επηρεάζει την ακεραιότητα των ανθρώπων και έτσι έχει επιρροή στη ζωή τους. Όταν αναφερόμαστε σε αμαρτίες, αυτό αυτομάτως παραπέμπει σε κοινωνικές αμαρτίες, επειδή αυτές οι περιπτώσεις κοινωνικής αμαρτίας είναι ο καρπός, η συσσώρευση και η συγκέντρωση πολλών προσωπικών αμαρτιών, που έχουν άμεση επίδραση στις ευρείες κοινωνικές ομάδες. Ο Νικόδημος παρά την έλλειψη στην εποχή του συστήματος παιδαγωγικής και ψυχολογίας συνέβαλε επίσης στην παιδαγωγική και κοινωνική προσέγγιση του ανθρώπου. Οι σύγχρονες ανάγκες των πιστών μέσα από την πολυσύνθετη ζωή της εποχής μας και των απαιτήσεων που προκύπτουν, καθιστούν επίκαιρη την προσέγγιση του Νικοδήμου, που διερευνά τον άνθρωπο με σκοπό την επανεύρεση της κοινωνικής πληρότητας και ενότητας. Απαντά στην εποχή του προετοιμάζοντας το πεδίο για σήμερα με τη συνεργασία της ψυχολογίας, της παιδαγωγικής, της θεολογίας, της κοινωνιολογίας και ιατρικής, προκειμένου να αποδοθεί ο κοινωνικός αντίκτυπος του έργου του. Προβάλλονται οι ηθικές και κοινωνικές αντιλήψεις του αγίου και μέσω αυτών γίνεται αντιληπτή η στάση που κρατούσε απέναντι στην κοινωνική πραγματικότητα της εποχής του.
E-learning English textbook on the topic "Social diseases"
Authors: Musina O.R. , Timeeva L.V. , Yarunina I.V.
Published: July 2022

"The authors of this e-learning resource have developed a system of exercises aimed at mastering of professional medical vocabulary and developing skills of working with authentic texts on the topic ""Socially significant diseases and problems of modern society "". Each section contains an authentic text that allows students to get aware and to memorize corresponding terminology. The peculiar feature of this e-learning resource is that after each text there is a series of exercises presented to develop skills of working with medical vocabulary. In addition, each section contains a glossary which includes lexical units for the studied topic. The structure of the electronic educational resource allows to fulfill the tasks of mastering medical professional vocabulary and oral speech skills. This e-learning resource consists of 12 sections united by one topic. This e-learning resource offers learners to study both in the classroom and at home to enhance the professional language."
Comunicación corporativa en tiempos de pandemia. Simulación de un evento de prensa online con estudiantes de Periodismo
Authors: Martín Herrera Inmaculada
Published: July 2022

Las restricciones sociales a consecuencia de la pandemia global por coronavirus han propiciado la organización de eventos de prensa virtuales, donde las aplicaciones tecnológicas suplen la imposibilidad del contacto presencial. Estos cambios en los procedimientos de trabajo y en la transmisión de los mensajes obligan a los profesionales del sector a una adaptación y un aprendizaje, que también deben ser revisados en las facultades de Comunicación. En este contexto, el presente trabajo describe y evalúa una experiencia docente basada en la simulación de un evento de prensa online con alumnos del grado en Periodismo. Empleando una doble metodología: la observación participante y un estudio cuantitativo de percepciones, los resultados concluyen que se trata de una práctica inmersiva, basada en proyectos, donde los estudiantes se implican en su propio aprendizaje. Y en este sentido, indican que han mejorado sus competencias en aspectos tales como la redacción de textos periodísticos, la oratoria, la búsqueda de información en internet o el uso de TIC. En el marco de las implicaciones, cabe decir que este proyecto puede servir de inspiración para aquellos docentes que deseen innovar, a través de actividades con proyección real, en la enseñanza de los futuros informadores.
Marketing relacional como estrategia de fidelización de clientes en una industria panadera
Authors: Caja Gutierrez Felix Eduardo
Published: July 2022

Este estudio se realizó con el objetivo de determinar la relación entre el marketing relacional y fidelización de clientes en una industria panadera, tiene un enfoque cuantitativo de alcance descriptivo-correlacional. La muestra corresponde a 80 clientes. Para recolectar los datos se utilizó la técnica de encuesta, aplicando como instrumento un cuestionario que está conformada por 37 preguntas en la escala de Likert. Para comprobar la validez del instrumento se utilizó el método de juicio de expertos en base a cuatro criterios de evaluación como: claridad, congruencia, contexto y dominio del constructo. De los resultados obtenidos tenemos que: los valores del análisis de relación entre el marketing relacional y la fidelización de clientes, indican correlación significativa (p-valor =.000), positiva y débil (rho =,245**), por otro lado, los valores del análisis de relación entre el marketing relacional y la lealtad como comportamiento y la lealtad actitudinal, los cuales indican que existe correlación significativa (p-valor =.013 /.004) positiva y baja (Rho =.275* /.317**). Con respecto a la relación entre el marketing relacional y la lealtad cognitiva indican que existe correlación inversa y no significativa (p-valor =.307 Rho = -.116).
O uso da prática de lembrar na aprendizagem de crianças: revisão sistemática da literatura
Authors: Mendonça Lisandra Tamires , Ekuni Roberta
Published: July 2022

Para melhorar a educação, é necessário utilizar técnicas baseadas em evidências, ou seja, com base no método científico, usar estratégias que são comprovadamente eficazes para aperfeiçoar as práticas educativas. Entre as práticas altamente recomendadas pela ciência da aprendizagem, está a prática de lembrar, que envolve tentar evocar o conteúdo aprendido, fortalecendo assim, os traços de memória. Esse estudo sintetiza as pesquisas desenvolvidas a respeito da prática de lembrar no processo de ensino e aprendizagem de crianças, a partir de uma revisão sistemática baseada no método PRISMA. Para isso, foi realizada uma pesquisa bibliográfica nas bases de dados do portal de periódicos CAPES/MEC, ERIC, Scielo, PubMed, Web of Science e PsycINFO. Foram incluídos em síntese qualitativa 41 artigos. Os estudos convergem para o fato de que há efeito benéfico do uso de prática de lembrar com bebês a partir dos 18 meses de idade, ou seja, essa prática pode auxiliar tanto a aprendizagem de longa duração, quanto facilitar novas aprendizagens em crianças, especialmente quando o feedback é fornecido. Dessa maneira, há necessidade de ampliar as recomendações a educadores para que esse público também seja beneficiado com o uso dessa estratégia.
El rol de las actividades del tiempo libre en la reserva cognitiva en adultos mayores
Authors: Feldberg Carolina , Tartaglini María Florencia , Barreyro Juan Pablo , Hermida Paula Daniela , Bennetti Laureana , Moya García Lydia
Published: July 2022

La participación en actividades de ocio puede prevenir el deterioro cognitivo. El objetivo del presente trabajo es analizar a través de un modelo de ecuaciones estructurales, el peso relativo que tiene la participación en actividades del tiempo libre en cuatro dominios cognitivos: memoria episódica verbal, lenguaje, funciones ejecutivas y funciones atencionales en adultos mayores autoválidos. Para ello, se llevó a cabo un análisis de senderos, utilizando el procedimiento de ecuaciones estructurales (SEM) en 167 participantes mayores (M = 72.34 años, DE = 5.07 años) independientes en actividades de la vida diaria. Todos fueron evaluados con cuestionario de datos sociodemográficos, cuestionario de participación social y una batería neuropsicológica de pruebas de uso frecuente en el ámbito clínico para memoria, lenguaje, funciones atencionales y funciones ejecutivas. Los resultados obtenidos indican que el factor de actividades muestra efectos significativos sobre el factor de funciones ejecutivas (β = .45, p < .001, R2 = .20), también sobre el factor de memoria (β = .38, p < .001, R2 = .14), al igual que con el factor de lenguaje (β = .45, p < .001, R2 = .20) y el factor funciones atencionales (β = .44, p = .03, R2 = .20). Estos resultados concuerdan con los de otros estudios que indican que las actividades de ocio podrían desempeñar un papel diferencial e importante en la construcción de la reserva cognitiva a lo largo del ciclo de vida, conformando un posible factor de protección cognitiva en el proceso de envejecimiento.
Faraday effect in magnetoplasmonic nanostructures with spatial modulation of magnetization
Authors: Borovkova O. , Lutsenko S. , Sylgacheva D. , Kalish A. , Belotelov V.
Published: July 2022

For the first time, to the best of our knowledge, the properties of the Faraday effect are addressed in a magnetoplasmonic nanostructure with nonuniform spatial distribution of the magnetization. It is shown that the coincidence in period and phase between magnetization modulation and the field of the optical mode provides the resonant enhancement of the Faraday effect. This effect is observed for both the surface plasmon polariton and waveguide modes.
Awareness, willingness and barriers to HIV Self-testing (HIVST) among Men who Have Sex with Men (MSM) in Brazil, Mexico, and Peru: A web-based cross-sectional study
Authors: Elorreaga Oliver A. , Torres Thiago S. , Vega-Ramirez E. Hamid , Konda Kelika A. , Hoagland Brenda , Benedetti Marcos , Pimenta Cristina , Diaz-Sosa Dulce , Robles-Garcia Rebeca , Grinsztejn Beatriz , Caceres Carlos F. , Veloso Valdilea G.
Published: July 2022

HIV self-testing (HIVST) is an essential tool within the combined HIV prevention package and has been available in Latin America since 2015. However, HIVST use among key populations remains low. This study describes awareness, willingness, and barriers to HIVST among MSM in Brazil, Mexico, and Peru. A cross-sectional web-based survey was advertised in two geosocial networking apps (Grindr and Hornet) and Facebook in 2018. We included cisgender men ≥18 years old who self-reported HIV-negative status. We used multivariable Poisson regression models to calculate adjusted prevalence ratios (aPR) to assess the factors associated with willingness to use HIVST for each country. A total of 18,916 completed the survey, 59% from Brazil, 30% from Mexico, and 11% from Peru. Overall, 20% of MSM had never tested for HIV. Awareness and willingness to use HIVST were higher in Brazil than in Peru and Mexico (p < .001). Across the countries, the patterns of association of willingness with HIVST barriers were similar. Most participants think post-test counseling is essential and that dealing with a positive result would be difficult (aPR 1.13 to 1.37, range of aPRs across the three countries). Having the knowledge to deal with a positive HIVST resulted in increased willingness to use HIVST (aPR range: 1.11 to 1.22), while a lack of trust in HIVST compared to HIV testing in clinics was inversely associated (aPR range: 0.80 to 0.90). In general, willingness to use HIVST was associated with higher income (aPR range: 1.49 to 1.97), higher education (aPR range: 1.13 to 1.42), and willingness to use PrEP (aPR range: 1.19 to 1.72). Efforts to increase HIVST knowledge and resolve perceived barriers are warranted, especially among MSM with lower income and education from Brazil, Mexico, and Peru. Personalized virtual counseling could be crucial among this population. In addition, those willing to use HIVST are also willing to use PrEP. It indicates that HIVST delivery could be incorporated into PrEP programs within the Brazilian Public Health System and eventually in Mexico and Peru.
Missed opportunities for earlier diagnosis of HIV infection in people living with HIV in Thailand
Authors: Phuphuakrat Angsana , Khamnurak Kanitin , Srichatrapimuk Sirawat , Wangsomboonsiri Wittaya
Published: July 2022

HIV testing is the first step to making people living with HIV (PLHIV) aware of their status. Thailand is among the countries where antiretroviral therapy is initiated in PLHIV at the lowest CD4 cell counts. We aimed to quantify and characterize missed opportunity (MO) for earlier diagnosis of HIV infection in PLHIV in Thailand. The medical records of adults who were newly diagnosed with HIV between 2019 and 2020 at the two tertiary hospitals in Thailand were reviewed. A hospital visit due to an HIV clinical indicator disease but an HIV test was not performed was considered an MO for HIV testing. Of 422 newly diagnosed PLHIV, 60 persons (14.2%) presented with at least one MO, and 20 persons (33.3%) had more than one MO. In PLHIV with MO, the median (interquartile range) time between the first MO event and HIV diagnosis was 33.5 (7–166) days. The three most common clinical manifestations that were missed were skin manifestations (25.0%), unexplained weight loss (15.7%), and unexplained lymphadenopathy (14.3%). Anemia was a factor associated with MO for HIV diagnosis [odds ratio (OR) 2.24, 95% confidence interval (CI) 1.25–4.35; p = 0.018]. HIV screening reduced the risk of MO for HIV diagnosis (OR 0.53 95% CI 0.29–0.95; p = 0.032). In conclusion, MOs for earlier diagnosis of HIV infection occurred in both participating hospitals in Thailand. Skin manifestations were the most common clinical indicator diseases that were missed. HIV testing should be offered for patients with unexplained anemia. Campaigns for HIV screening tests should be promoted.
Pregnant sows immunized with Cryptosporidium parvum significantly reduced infection in newborn piglets challenged with C. parvum but not with C. hominis
Authors: Sheoran Abhineet , Carvalho Alison , Mimbela Ruby Pina , South Adam , Major Samuel , Ginese Melanie , Girouard Donald , Tzipori Saul
Published: July 2022

Background

The piglet is the only model to investigate the immunogenic relationship between Cryptosporidium hominis and C. parvum, the species responsible for diarrhea in humans. Despite being indistinguishable antigenically, and high genetic homology between them, they are only moderately cross protective after an active infection.

Methodology/Principal findings

Here we examined the degree of passive protection conferred to piglets suckling sows immunized during pregnancy with C. parvum. After birth suckling piglets were challenged orally with either C. parvum or C. hominis at age 5 days. Animals challenged with C. parvum had significant reduction of infection rate, while piglets challenged with C. hominis showed no reduction despite high C. parvum serum and colostrum IgG and IgA antibody.

Conclusions/Significance

We add these data to earlier studies where we described that infection derived immunity provides partial cross-protection. Together, it appears that for full protection, vaccines against human cryptosporidiosis must contain antigenic elements derived from both species.
The Streptococcus agalactiae R3 surface protein is encoded by sar5
Authors: Basson Adelle , Olaisen Camilla , Selvik Linn-Karina , Lyng Randi Valsø , Lysvand Hilde , Gidon Alexandre , Aas Christina Gabrielsen , Afset Jan Egil , Dragset Marte Singsås
Published: July 2022

Streptococcus agalactiae (group B streptococcus; GBS) is an important human pathogen causing pneumonia, sepsis and meningitis in neonates, as well as infections in pregnant women, immunocompromised individuals, and the elderly. For the future control of GBS-inflicted disease, GBS surface exposed proteins are particularly relevant as they may act as antigens for vaccine development and/or as serosubtype markers in epidemiological settings. Even so, the genes encoding some of the surface proteins established as serosubtype markers by antibody-based methods, like the R3 surface protein, are still unknown. Here, by examining a Norwegian GBS collection consisting of 140 strains, we find that R3 protein expression correlates with the presence of the gene sar5. By inducible expression of sar5 in an R3-negative bacterial strain we show that the sar5 gene product is specifically recognized by an R3 monoclonal antibody. With this we identify sar5 as the gene encoding the R3 surface protein, a serosubtype marker of hitherto unknown genetic origin.
Biomechanical responses of human lumbar spine and pelvis according to the Roussouly classification
Authors: Wang Wei , Pei Baoqing , Wu Shuqin , Lu Da , He Peiyan , Ma Chenghao , Wu Xueqing
Published: July 2022

Background

Few studies have analyzed the different biomechanical properties of the lumbar with various morphological parameters, which play an important role in injury and degeneration. This study aims to preliminarily investigate biomechanical characteristics of the spine with different sagittal alignment morphotypes by using finite element (FE) simulation and in-vitro testing.

Methods

According to the lumbar-pelvic radiographic parameters of the Chinese population, the parametric FE models (L1-S1-pelvis) of Roussouly’s type (1–4) were validated and developed based on the in-vitro biomechanical testing. A pure moment of 7.5 Nm was applied in the three anatomical planes to simulate the physiological activities of flexion, extension, left-right lateral bending and left-right axial rotation.

Results

The sagittal configuration of four Roussouly’s type models had a strong effect on the biomechanical responses in flexion and extension. The apex of the lumbar lordosis is a critical position where the segment has the lowest range of motion among all the models. In flexion-extension, type 3 and 4 models with a good lordosis shape had a more uniform rotation distribution at each motor function segment, however, type 1 and 2 models with a straighter spine had a larger proportion of rotation at the L5-S1 level. In addition, type 1 and 2 models had higher intradiscal pressures (IDPs) at the L4-5 segment in flexion, while type 4 model had larger matrix and fiber stresses at the L5-S1 segment in extension.

Conclusion

The well-marched lordotic type 3 lumbar had greater stability, however, a straighter spine (type 1 and 2) had poor balance and load-bearing capacity. The hypolordotic type 4 model showed larger annulus fiber stress. Therefore, the sagittal alignment of Roussouly’s type models had different kinetic and biomechanical responses under various loading conditions, leading to different clinical manifestations of the lumbar disease.
Feasibility of conducting a pilot randomized control trial of a psycho-education intervention in patients with a first episode psychosis in Uganda—A study protocol
Authors: Akena Dickens , Semeere Aggrey , Kadama Philippa , Mwesiga Emmanuel K. , Nakku Juliet , Nakasujja Noeline
Published: July 2022

Background

Psychotic disorders contribute to significant morbidity and mortality partly due to the chronicity of the illness and high relapse rates. Delivering psycho-education messages about disease etiology, their signs and symptoms and the benefits of treatment adherence have been shown to improve clinical outcomes among individuals with psychoses. However, little has been done to examine the feasibility and efficacy of this intervention in low resourced settings.

Objective

Our primary objective will be to determine the feasibility of recruiting and retaining patients with a first episode psychosis (FEP) and for the secondary objective, we will determine the preliminary efficacy of psycho-education on illness self-management, stigma, adherence to medications and symptom severity.

Hypothesis

We hypothesize that (i) we will recruit 70% of eligible participants and accrue a sample size of 80 over 20-weeks, retaining 80% of the sample size for 24 weeks, (ii) the intervention will lead to improvement in clinical outcomes (described above).

Methods

We will recruit 80 adult patients who have been diagnosed with a FEP, received antipsychotic medication at Butabika Hospital and reside within 21km from the Hospital. Trained village health team (VHTs) members will deliver 6 psycho-education sessions to 40 participants and their family members (intervention arm). Participants in the control arm (n = 40) will receive routine care. We will document how feasible it will be to recruit and retain participants over 24 weeks and document the preliminary efficacy of the intervention on illness self-management, stigma, adherence to medications and severity of symptoms.

Data analysis

We will document the proportion of participants who consent and get recruited, the proportion of those who will get retained and reasons for drop out. We will conduct an intention to treat analysis comparing the groups at weeks 4, 12, 24 and assess the effect of the intervention on the clinical outcomes (described above). We will use the Bonferroni approach to correct for multiple comparisons.

Trial registration

Clinical trials.gov registration number: NCT 04602585.
Placental vascular remodeling in pregnant women with COVID-19
Authors: Gychka Sergiy G. , Brelidze Tinatin I. , Kuchyn Iurii L. , Savchuk Tetyana V. , Nikolaienko Sofia I. , Zhezhera Volodymyr M. , Chermak Ihor I. , Suzuki Yuichiro J.
Published: July 2022

Severe acute respiratory syndrome coronavirus 2 has been causing the pandemic of coronavirus disease 2019 (COVID-19) that has so far resulted in over 450 million infections and six million deaths. This respiratory virus uses angiotensin-converting enzyme 2 as a receptor to enter host cells and affects various tissues in addition to the lungs. The present study reports that the placental arteries of women who gave birth to live full-term newborns while developing COVID-19 during pregnancy exhibit severe vascular wall thickening and the occlusion of the vascular lumen. A morphometric analysis of the placental arteries stained with hematoxylin and eosin suggests a 2-fold increase in wall thickness and a 5-fold decrease in the lumen area. Placental vascular remodeling was found to occur in all of SARS-CoV-2-positive mothers as defined by RT-PCR. Immunohistochemistry with α-smooth muscle actin and the Kv11.1 channel as well as Masson’s trichrome staining showed that such placental vascular remodeling in COVID-19 is associated with smooth muscle proliferation and fibrosis. Placental vascular remodeling may represent a response mechanism to the clinical problems associated with childbirth in COVID-19 patients.
The influence of metformin transporter gene SLC22A1 and SLC47A1 variants on steady-state pharmacokinetics and glycemic response
Authors: Ningrum Vitarani Dwi Ananda , Sadewa Ahmad Hamim , Ikawati Zullies , Yuliwulandari Rika , Ikhsan M. Robikhul , Fajriyah Rohmatul
Published: July 2022

Interindividual variation is important in the response to metformin as the first-line therapy for type-2 diabetes mellitus (T2DM). Considering that OCT1 and MATE1 transporters determine the metformin pharmacokinetics, this study aimed to investigate the influence of SLC22A1 and SLC47A1 variants on the steady-state pharmacokinetics of metformin and the glycemic response. This research used the prospective-cohort study design for 81 patients with T2DM who received 500 mg metformin twice a day from six primary healthcare centers. SLC22A1 rs628031 A>G (Met408Val) and Met420del genetic variants in OCT1 as well as SLC47A1 rs2289669 G>A genetic variant in MATE1 were examined through the PCR-RFLP method. The bioanalysis of plasma metformin was performed in the validated reversed-phase HPLC-UV detector. The metformin steady-state concentration was measured for the trough concentration (Cssmin) and peak concentration (Cssmax). The pharmacodynamic parameters of metformin use were the fasting blood glucose (FBG) and glycated albumin (GA). Only SLC22A1 Met420del alongside estimated-glomerular filtration rate (eGFR) affected both Cssmax and Cssmin with an extremely weak correlation. Meanwhile, SLC47A1 rs2289669 and FBG were correlated. This study also found that there was no correlation between the three SNPs studied and GA, so only eGFR and Cssmax influenced GA. The average Cssmax in patients with the G allele of SLC22A1 Met408Val, reaching 1.35-fold higher than those with the A allele, requires further studies with regard to metformin safe dose in order to avoid exceeding the recommended therapeutic range.
The proposed hybrid deep learning intrusion prediction IoT (HDLIP-IoT) framework
Authors: Fadel Magdy M. , El-Ghamrawy Sally M. , Ali-Eldin Amr M. T. , Hassan Mohammed K. , El-Desoky Ali I.
Published: July 2022

Throughout the past few years, the Internet of Things (IoT) has grown in popularity because of its ease of use and flexibility. Cyber criminals are interested in IoT because it offers a variety of benefits for users, but it still poses many types of threats. The most common form of attack against IoT is Distributed Denial of Service (DDoS). The growth of preventive processes against DDoS attacks has prompted IoT professionals and security experts to focus on this topic. Due to the increasing prevalence of DDoS attacks, some methods for distinguishing different types of DDoS attacks based on individual network features have become hard to implement. Additionally, monitoring traffic pattern changes and detecting DDoS attacks with accuracy are urgent and necessary. In this paper, using Modified Whale Optimization Algorithm (MWOA) feature extraction and Hybrid Long Short Term Memory (LSTM), shown that DDoS attack detection methods can be developed and tested on various datasets. The MWOA technique, which is used to optimize the weights of the LSTM neural network to reduce prediction errors in the hybrid LSTM algorithm, is used. Additionally, MWOA can optimally extract IP packet features and identify DDoS attacks with the support of MWOA-LSTM model. The proposed MWOA-LSTM framework outperforms standard support vector machines (SVM) and Genetic Algorithm (GA) as well as standard methods for detecting attacks based on precision, recall and accuracy measurements.
Age, corticosteroid treatment and site of mutations affect motor functional changes in young boys with Duchenne Muscular Dystrophy
Authors: Coratti Giorgia , Lenkowicz Jacopo , Norcia Giulia , Lucibello Simona , Ferraroli Elisabetta , d’Amico Adele , Bello Luca , Pegoraro Elena , Messina Sonia , Ricci Federica , Mongini Tiziana , Berardinelli Angela , Masson Riccardo , Previtali Stefano C. , D’angelo Grazia , Magri Francesca , Comi Giacomo P. , Politano Luisa , Passamano Luigia , Vita Gianluca , Sansone Valeria A. , Albamonte Emilio , Panicucci Chiara , Bruno Claudio , Pini Antonella , Bertini Enrico , Patarnello Stefano , Pane Marika , Mercuri Eugenio ,   for the italian DMD study group
Published: July 2022

The aim of this study was to establish the possible effect of age, corticosteroid treatment and brain dystrophin involvement on motor function in young boys affected by Duchenne Muscular Dystrophy who were assessed using the North Star Ambulatory Assessment between the age of 4 and 7 years. The study includes 951 North Star assessments from 226 patients. Patients were subdivided according to age, to the site of mutation and therefore to the involvement of different brain dystrophin isoforms and to corticosteroids duration. There was a difference in the maximum North Star score achieved among patients with different brain dystrophin isoforms (p = 0.007). Patients with the involvement of Dp427, Dp140 and Dp71, had lower maximum NSAA scores when compared to those with involvement of Dp427 and Dp140 or of Dp427 only. The difference in the age when the maximum score was achieved in the different subgroups did not reach statistical significance. Using a linear regression model on all assessments we found that each of the three variables, age, site of mutation and corticosteroid treatment had an influence on the NSAA values and their progression over time. A second analysis, looking at 12-month changes showed that within this time interval the magnitude of changes was related to corticosteroid treatment but not to site of mutation. Our findings suggest that each of the considered variables appear to play a role in the progression of North Star scores in patients between the age of 4 and 7 years and that these should be carefully considered in the trial design of boys in this age range.
Hospitalized patients dying with SARS-CoV-2 infection—An analysis of patient characteristics and management in ICU and general ward of the LEOSS registry
Authors: Raichle Claudia , Borgmann Stefan , Bausewein Claudia , Rieg Siegbert , Jakob Carolin E. M. , Simon Steffen T. , Tometten Lukas , Vehreschild Jörg Janne , Leisse Charlotte , Erber Johanna , Stecher Melanie , Pauli Berenike , Rüthrich Maria Madeleine , Pilgram Lisa , Hanses Frank , Isberner Nora , Hower Martin , Degenhardt Christian , Hertenstein Bernd , Vehreschild Maria J. G. T. , Römmele Christoph , Jung Norma ,   on behalf of the LEOSS Study Group
Published: July 2022

Background

COVID-19 is a severe disease with a high need for intensive care treatment and a high mortality rate in hospitalized patients. The objective of this study was to describe and compare the clinical characteristics and the management of patients dying with SARS-CoV-2 infection in the acute medical and intensive care setting.

Methods

Descriptive analysis of dying patients enrolled in the Lean European Open Survey on SARS-CoV-2 Infected Patients (LEOSS), a non-interventional cohort study, between March 18 and November 18, 2020. Symptoms, comorbidities and management of patients, including palliative care involvement, were compared between general ward and intensive care unit (ICU) by univariate analysis.

Results

580/4310 (13%) SARS-CoV-2 infected patients died. Among 580 patients 67% were treated on ICU and 33% on a general ward. The spectrum of comorbidities and symptoms was broad with more comorbidities (≥ four comorbidities: 52% versus 25%) and a higher age distribution (>65 years: 98% versus 70%) in patients on the general ward. 69% of patients were in an at least complicated phase at diagnosis of the SARS-CoV-2 infection with a higher proportion of patients in a critical phase or dying the day of diagnosis treated on ICU (36% versus 11%). While most patients admitted to ICU came from home (71%), patients treated on the general ward came likewise from home and nursing home (44% respectively) and were more frequently on palliative care before admission (29% versus 7%). A palliative care team was involved in dying patients in 15%. Personal contacts were limited but more often documented in patients treated on ICU (68% versus 47%).

Conclusion

Patients dying with SARS-CoV-2 infection suffer from high symptom burden and often deteriorate early with a demand for ICU treatment. Therefor a demand for palliative care expertise with early involvement seems to exist.
Contactless continuous heart rate monitoring system using ballistocardiography
Authors: Sumali Brian , Mitsukura Yasue , Nishimura Toshihiko
Published: July 2022

Cardiovascular disease is the number one cause of death in the world and is a serious problem. In the case of cardiopulmonary arrest due to myocardial infarction, the survival rate is as low as 13.3% one month after resuscitation, which birthed the need for continuous heart monitoring. In this study, we develop a Ballistocardiogram (BCG) measurement system using a load cell installed on a chair and a heart rate estimation algorithm that is robust to waveform changes, with the aim of constructing a non-contact heart rate acquisition system. The proposed system was evaluated by utilizing data obtained from 13 healthy subjects and 1 subject with abnormal ECG who were simultaneously measured with ECG. The output of the BCG system was confirmed to change with the same period as the ECG data obtained as the correct answer, and the synchronization of the R-peak positions was confirmed for all cases. As a result of comparing the heart rate intervals estimated from BCG and those obtained from ECG, it was confirmed that the same heart rate variability (HRV) features could be obtained even for abnormal ECG subject.
IL-6 is involved in thoracic ossification of the ligamentum flavum
Authors: Huang Ann Yehong , Shu Li , Chen Zhongqiang , Zhang Chi
Published: July 2022

Thoracic ossification of the ligamentum flavum (TOLF) is a heterotopic ossification of spinal ligaments. TOLF is the major cause of thoracic spinal canal stenosis and myelopathy, and its underlying mechanisms are not clear. Bone formation is a complex developmental process involving the differentiation of mesenchymal stem cells to osteoblasts, and regulated by BMP2, RUNX2, Osterix (OSX), etc. In this study, we continue to further characterize properties of TOLF. Our immunohistochemistry experiments showed that expressions of osteoblastic factors such as BMP2 and RUNX2 increased in TOLF. According to flow cytometry analysis the proportion of S phase of cell cycle in primary TOLF cells was 9% higher than the control. Alizarin red staining and ALP staining observations were consistent with immunohistochemistry results. It was also observed that inflammatory cytokine IL-6 level dramatically increased in the culture supernatant of primary TOLF cells. We propose the hypothesis that IL-6 is involved in TOLF. To testify the hypothesis, we examined the effect of IL-6. Our results showed that IL-6 was able to activate expressions of osteoblastic factors such as BMP2, RUNX2, OSX, OCN and ALP, and that expressions of cell proliferation factors cyclin D1 and cyclin C increased in the presence of IL-6. Moreover, IL-6-induced BMP2 expression was inhibited by p38 inhibitor SB203580, indicating that IL-6 regulated the osteogenic BMP2 activation through p38 MAPK pathway. These data suggest that IL-6 is involved in TOLF.
Exploring musical theatre performance synergy: Accessing seven performative processes
Authors: Cuny Jacqui
Published: July 2022

To meet the demands of the ever-evolving musical theatre industry, performers are expected to craft inspiring performances across eight shows a week, seamlessly integrating their triple-threat expertise. Most actors undertake intensive training to achieve the complex skillset required to execute this art form, yet professional success can be elusive. It appears that a key element to building and maintaining a musical theatre career is performance synergy. This phenomenon is described colloquially as stage presence or X-factor. Whilst the literature regarding the field of musical theatre training is wide-ranging, little formal research has been undertaken on the ephemeral subject of performance synergy as it pertains to the work of the musical theatre actor. To address this lacuna in the literature – and to determine whether performance synergy can be described, comprehended, taught or learned – semi-structured interviews were conducted with 42 Australian actors and creative directors active in the musical theatre industry. Collected data captured expert opinions on the elements, constructs and praxis of musical theatre performance synergy. Following a thematic analysis of the data, a framework of seven performative processes was constructed towards a clearer understanding of the practical aspects of this multifaceted phenomenon.
Emergencias de lo poshumano. Desafíos arquitectónicos y pedagógicos desde un margen disciplinar
Authors: Espinosa Enrique
Published: July 2022

Reseña de libro: Emergencias de lo poshumano. Desafíos arquitectónicos y pedagógicos desde un margen disciplinar. Universidad de Alicante. ISBN: 978-84-9717-769-6.