bluuebunny/crossref_metadata_2025 huggingface dataset:
Change in dietary inflammatory index score is associated with control of long-term rheumatoid arthritis disease activity in a Japanese cohort: the TOMORROW study
Authors: Matsumoto Yoshinari , Shivappa Nitin , Sugioka Yuko , Tada Masahiro , Okano Tadashi , Mamoto Kenji , Inui Kentaro , Habu Daiki , Hebert James R. , Koike Tatsuya
Published: April 2021

Background

The dietary inflammatory index (DII®), a quantitative measure of the inflammatory potential of daily food and nutrient intake, and associations between a variety of health outcomes have been reported. However, the association between DII score and disease activity of rheumatoid arthritis (RA) is unclear. Therefore, this study was designed to test whether higher DII score contributes to disease activity and as a corollary, whether reducing DII score helps to achieve or maintain low disease activity or remission in patients with RA.

Methods

We performed a cross-sectional and longitudinal analysis using 6 years of data (from 2011 to 2017) in TOMORROW, a cohort study consisting of 208 RA patients and 205 gender- and age-matched controls started in 2010. Disease activity of RA patients was assessed annually using DAS28-ESR (disease activity score 28 joints and the erythrocyte sedimentation rate) as a composite measure based on arthritic symptoms in 28 joints plus global health assessment and ESR. Dietary data were collected in 2011 and 2017 using the brief-type self-administered diet history questionnaire (BDHQ). Energy-adjusted DII (E-DII™) score was calculated using 26 nutrients derived from the BDHQ. Data were analyzed with two-group comparisons, correlation analysis, and multivariable logistic regression analysis.

Results

One hundred and seventy-seven RA patients and 183 controls, for whom clinical and dietary survey data were available, were analyzed. RA patients had significantly higher E-DII (pro-inflammatory) score compared to controls both in 2011 and 2017 (p < 0.05). In RA patients, E-DII score was not a factor associated with significant change in disease activity. However, anti-inflammatory change in E-DII score was associated maintaining low disease activity (DAS28-ESR ≤ 3.2) or less for 6 years (OR 3.46, 95% CI 0.33–8.98, p = 0.011).

Conclusions

The diets of RA patients had a higher inflammatory potential than controls. Although E-DII score was not a factor associated with significant disease activity change, anti-inflammatory change in E-DII score appeared to be associated with maintaining low disease activity in patients with RA.

Trial registration

UMIN Clinical Trials Registry, UMIN000003876. Registered 7 Aug 2010—retrospectively registered.
Deep learning for detection of radiographic sacroiliitis: achieving expert-level performance
Authors: Bressem Keno K. , Vahldiek Janis L. , Adams Lisa , Niehues Stefan Markus , Haibel Hildrun , Rodriguez Valeria Rios , Torgutalp Murat , Protopopov Mikhail , Proft Fabian , Rademacher Judith , Sieper Joachim , Rudwaleit Martin , Hamm Bernd , Makowski Marcus R. , Hermann Kay-Geert , Poddubnyy Denis
Published: April 2021

Background

Radiographs of the sacroiliac joints are commonly used for the diagnosis and classification of axial spondyloarthritis. The aim of this study was to develop and validate an artificial neural network for the detection of definite radiographic sacroiliitis as a manifestation of axial spondyloarthritis (axSpA).

Methods

Conventional radiographs of the sacroiliac joints obtained in two independent studies of patients with axSpA were used. The first cohort comprised 1553 radiographs and was split into training (n = 1324) and validation (n = 229) sets. The second cohort comprised 458 radiographs and was used as an independent test dataset. All radiographs were assessed in a central reading session, and the final decision on the presence or absence of definite radiographic sacroiliitis was used as a reference. The performance of the neural network was evaluated by calculating areas under the receiver operating characteristic curves (AUCs) as well as sensitivity and specificity. Cohen’s kappa and the absolute agreement were used to assess the agreement between the neural network and the human readers.

Results

The neural network achieved an excellent performance in the detection of definite radiographic sacroiliitis with an AUC of 0.97 and 0.94 for the validation and test datasets, respectively. Sensitivity and specificity for the cut-off weighting both measurements equally were 88% and 95% for the validation and 92% and 81% for the test set. The Cohen’s kappa between the neural network and the reference judgements were 0.79 and 0.72 for the validation and test sets with an absolute agreement of 90% and 88%, respectively.

Conclusion

Deep artificial neural networks enable the accurate detection of definite radiographic sacroiliitis relevant for the diagnosis and classification of axSpA.
A data fusion method in wireless sensor network based on belief structure
Authors: Long Chengfeng , Liu Xingxin , Yang Yakun , Zhang Tao , Tan Siqiao , Fang Kui , Tang Xiaoyong , Yang Gelan
Published: April 2021

Considering the issue with respect to the high data redundancy and high cost of information collection in wireless sensor nodes, this paper proposes a data fusion method based on belief structure to reduce attribution in multi-granulation rough set. By introducing belief structure, attribute reduction is carried out for multi-granulation rough sets. From the view of granular computing, this paper studies the evidential characteristics of incomplete multi-granulation ordered information systems. On this basis, the positive region reduction, belief reduction and plausibility reduction are put forward in incomplete multi-granulation ordered information system and analyze the consistency in the same level and transitivity in different levels. The positive region reduction and belief reduction are equivalent, and the positive region reduction and belief reduction are unnecessary and sufficient conditional plausibility reduction in the same level, if the cover structure order of different levels are the same the corresponding equivalent positive region reduction. The algorithm proposed in this paper not only performs three reductions, but also reduces the time complexity largely. The above study fuses the node data which reduces the amount of data that needs to be transmitted and effectively improves the information processing efficiency.
Can Physical Activity Support Grief Outcomes in Individuals Who Have Been Bereaved? A Systematic Review
Authors: Williams Jane , Shorter Gillian W. , Howlett Neil , Zakrzewski-Fruer Julia , Chater Angel M.
Published: April 2021

Background

In 2018, there were 616,014 registered deaths in the United Kingdom (UK). Grief is a natural consequence. Many mental health concerns, which can be identified as grief outcomes (e.g. anxiety and depression) in those who have experienced a bereavement, can be improved through physical activity. The objective of this review was to identify from the existing literature if physical activity can benefit grief outcomes in individuals who have been bereaved.

Methods

A systematic review of nine databases was performed. Included studies (qualitative and quantitative) explored physical activity to help individuals (of any age) who had experienced a human bereavement (excluding national loss).

Results

From 1299 studies screened, 25 met the inclusion criteria, detailing eight types of bereavement (parental (n = 5), spousal (n = 6), patient (n = 4), pre-natal (n = 3), later life (n = 1), caregiver (n = 1), multiple (n = 4) and non-defined (n = 1). Activities including yoga, running, walking and martial arts were noted as beneficial. Physical activity allowed a sense of freedom, to express emotions, provided a distraction and an escape from grief, whilst enhancing social support.

Conclusion

There is some evidence that physical activity may provide benefit for the physical health and psychological wellbeing of those who have been bereaved, including when the loss has happened at a young age. This review is timely, given the wide-scale national loss of life due to COVID-19 and extends knowledge in this area. More research is needed to explore the benefits of physical activity for those who have been bereaved. In particular, there is a need for well-designed interventions which are tailored to specific activities, populations and grief outcomes.
Nanomedicine perspective in HIV therapy: biosynthesized gold nanoparticles exhibiting enhanced anti-HIV property
Authors: Priya M. R. Kamala , Ashokkumar Manickam , Precilla Lucia K. , Hanna Luke Elizabeth , Iyer Priya R.
Published: April 2021

Background

Globally, HIV/AIDS is a major public health issue. Currently, available antiretroviral therapy (ART) has a number of impediments. The need for long-term usage of antiretroviral drugs is associated with the problem of drug resistance, high cost, and other side effects. Hence, there is a constant urge for the development of novel drugs to combat the disease. The synthesis of nanoparticles is of great interest because of their reported application in diverse fields. In contrast to chemical synthesis, green synthesis is inexpensive and enviro-safe.

Results

Calophyllum inophyllum (CI) is a plant that is known to possess anti-HIV activity. Hence, this plant was exploited for the synthesis of gold nanoparticles (AuNPs) in the present study. Two parts of the plant, namely, the fruit and leaves (CIF and CIL) were used for the synthesis of nanocompounds. The two nanocompounds were tested on HIV-1 isolates at different concentrations and the EC50 values were determined. While CIF-AuNP demonstrated very good anti-HIV activity with an EC50 value of 0.09097 ng/ml, CIL-AuNPs did not show significant anti-HIV activity.

Conclusions

The present study is a novel attempt to produce nanocompounds that incorporate the medicinal properties of certain plants that are known to have anti-HIV activity within nanoparticles, such that the compound possesses the attributes of a nanomaterial alongside the phytoactivity. Our results provide evidence to suggest that the CIF-AuNP can be further explored for in vivo activity. In vitro cytotoxicity of the AuNPs was checked in VERO cell lines using the MTT assay. Cytotoxicity was observed to be minimal at all the tested concentrations.
Validation of a Mortality Composite Score in the Real-World Setting: Overcoming Source-Specific Disparities and Biases
Authors: Lerman Michelle H. , Holmes Benjamin , St Hilaire Daniel , Tran Mary , Rioth Matthew , Subramanian Vinod , Winzeler Alissa M. , Brown Thomas
Published: April 2021

PURPOSE

This study tested whether a composite mortality score could overcome gaps and potential biases in individual real-world mortality data sources. Complete and accurate mortality data are necessary to calculate important outcomes in oncology, including overall survival. However, in the United States, there is not a single complete and broadly applicable mortality data source. It is further likely that available data sources are biased in their coverage of sex, race, age, and socioeconomic status (SES).

METHODS

Six individual real-world data sources were combined to develop a high-quality composite mortality score. The composite score was benchmarked against the gold standard for mortality data, the National Death Index. Subgroup analyses were then conducted to evaluate the completeness and accuracy by sex, race, age, and SES.

RESULTS

The composite mortality score achieved a sensitivity of 94.9% and specificity of 92.8% compared with the National Death Index, with concordance within 1 day of 98.6%. Although some individual data sources show significant coverage gaps related to sex, race, age, and SES, the composite score maintains high sensitivity (84.6%-96.1%) and specificity (77.9%-99.2%) across subgroups.

CONCLUSION

A composite score leveraging multiple scalable sources for mortality in the real-world setting maintained strong sensitivity, specificity, and concordance, including across sex, race, age, and SES subgroups.
Navigating a Path to Equity in Cancer Care: The Role of Patient Navigation
Authors: Dixit Niharika , Rugo Hope , Burke Nancy J.
Published: April 2021

Notable barriers exist in the delivery of equitable care for all patients with cancers. Social determinants of health at distal, intermediate, and proximal levels impact cancer care. Patient navigation is a patient-centered intervention that functions across these overlapping determinants to increase access to cancer services throughout the cancer care continuum. There is a need to standardize patient navigation training while remaining responsive to local contexts of care and a need to implement patient navigation programs with a health equity lens to address cancer care inequities.
Immune-Based Cancer Treatment: Addressing Disparities in Access and Outcomes
Authors: Osarogiagbon Raymond U. , Sineshaw Helmneh M. , Unger Joseph M. , Acuña-Villaorduña Ana , Goel Sanjay
Published: April 2021

Avoidable differences in the care and outcomes of patients with cancer (i.e., cancer care disparities) emerge or worsen with discoveries of new, more effective approaches to cancer diagnosis and treatment. The rapidly expanding use of immunotherapy for many different cancers across the spectrum from late to early stages has, predictably, been followed by emerging evidence of disparities in access to these highly effective but expensive treatments. The danger that these new treatments will further widen preexisting cancer care and outcome disparities requires urgent corrective intervention. Using a multilevel etiologic framework that categorizes the targets of intervention at the individual, provider, health care system, and social policy levels, we discuss options for a comprehensive approach to prevent and, where necessary, eliminate disparities in access to the clinical trials that are defining the optimal use of immunotherapy for cancer, as well as its safe use in routine care among appropriately diverse populations. We make the case that, contrary to the traditional focus on the individual level in descriptive reports of health care disparities, there is sequentially greater leverage at the provider, health care system, and social policy levels to overcome the challenge of cancer care and outcomes disparities, including access to immunotherapy. We also cite examples of effective government-sponsored and policy-level interventions, such as the National Cancer Institute Minority-Underserved Community Oncology Research Program and the Affordable Care Act, that have expanded clinical trial access and access to high-quality cancer care in general.
Understanding Active Surveillance for Prostate Cancer
Authors: Lai Lillian Y. , Shahinian Vahakn B. , Oerline Mary K. , Kaufman Samuel R. , Skolarus Ted A. , Caram Megan E. V. , Hollenbeck Brent K.
Published: April 2021

PURPOSE:

To assess how active surveillance for prostate cancer is apportioned across specialties and how testing patterns and transition to treatment vary by specialty.

METHODS:

We used a 20% national sample of Medicare claims to identify men diagnosed with prostate cancer from 2010 through 2016 initiating surveillance (N = 13,048). Patients were assigned to the physician responsible for the bulk of surveillance care based on billing patterns. Freedom from treatment was assessed by specialty of the responsible physician (urology, radiation oncology, medical oncology, and primary care). Multinomial logistic regression models were used to examine associations between specialty and treatment patterns.

RESULTS:

Urologists were responsible for surveillance in 93.7% of patients in 2010 and 96.2% of patients in 2016 ( P for trend = .01). Testing patterns varied by specialty. For example, patients of medical oncologists had more frequent prostate-specific antigen testing compared with patients of urologists (1.85 v 2.39 tests per year, respectively; P < .01). Three years after diagnosis, a significantly smaller proportion of patients managed by radiation oncologists (64.3%) remained on surveillance compared with patients managed by other physicians (75.8%-79.5%; P < .01). Although radiation was the most common treatment among all men who transitioned to treatment, a disproportionate percentage of patients followed by radiation oncologists (28.9%) ultimately underwent radiation compared with patients followed by other physicians (15.1%-15.4%; P < .01).

CONCLUSION:

Nontrivial percentages of patients on active surveillance are managed by physicians outside of urology. Given the interspecialty variations observed, efforts to strengthen the evidence underlying surveillance pathways and to engage other specialties in guideline development are needed.
Non-equilibrium Berezinskii-Kosterlitz-Thouless transition in driven-dissipative condensates
(a)
Authors: Comaron P. , Carusotto I. , Szymańska M. H. , Proukakis N. P.
Published: April 2021

We study the two-dimensional phase transition of a driven-dissipative system of exciton-polaritons under non-resonant pumping. Stochastic calculations are used to investigate the Berezinskii-Kosterlitz-Thouless–like phase diagram for experimentally realistic parameters, with a special attention to the non-equilibrium features.
Electron-ion inverse bremsstrahlung absorption in magnetized fusion plasma
Authors: Oussama Boultif , Abdenasser Ghezal , Sid Abdelaziz
Published: April 2021

Magneto-inertial fusion (MIF) is an approach for thermonuclear fusion. It consists in applying a strong magnetic field to the inertial-fusion plasma, with the role of the magnetic field being to limit the diffusion of the formed plasma during the impact of an intense laser pulse with a target containing the thermonuclear fuel, as well as the confinement alpha particles produced by the fusion reaction. This allows the reduction of energy loss and improves compression conditions. In this paper we are interested in the study of the electron-ion inverse bremsstrahlung absorption (IBA) of the laser energy in magnetized plasma in the MIF frame. In addition, we apply the derived formula to calculate the absorption in magnetic fusion plasma heated by microwave. We use the Fokker-Planck-Maxwell theory to calculate the IBA explicitly in magnetized plasma. Scaling laws for IBA in MIF plasma and for magnetic confinement plasma are established. The numerical treatment of the model equations shows the influence of the magnetic field and the polarization of the wave on the absorption.
Psychological Distress and Sleep Disturbance Throughout Thyroid Nodule Screening, Diagnosis, and Treatment
Authors: Li Ruicen , Li Genpeng , Wang Yuting , Bao Ting , Lei Yali , Tian Liuyan , Li Zhihui , Zhu Jingqiang , Lei Jianyong , Tang Huairong
Published: April 2021

Context

Many controversies exist regarding screening and treatment of thyroid cancer (TC), especially papillary thyroid microcarcinoma (PTMC).

Objective

The aim of this study was to evaluate patients’ psychological distress and sleep disturbance throughout thyroid nodule (TN) screening, diagnosis, and treatment.

Methods

A total of 2834 participants (1153 participants with TNs) were enrolled during the screening phase, and 1105 individuals with TNs (87 individuals with TC) were enrolled during the diagnosis phase. Of the 87 TC patients, 66 underwent immediate operation (OP), and 21 patients with PTMC opted for active surveillance (AS). Four validated scales were applied to quantify the outcome indicators at prescreening, postscreening, postdiagnosis, and posttreatment.

Results

Higher psychological distress and sleep disturbance were found postscreening than prescreening in subjects with TNs, but no differences in those without nodules. Compared with postscreening, higher scores of psychological distress and sleep disturbance were identified in patients with suspicious TC treated with fine needle aspiration (FNA) or with AS. Lower psychological distress and sleep disturbance were noted for patients with benign nodules than for TC patients. OP for TC, especially PTMC, did not alleviate psychological distress or sleep disturbance compared with the same parameters in patients who underwent AS.

Conclusion

Based on the findings of impaired psychological health and sleep quality, screening for TNs in adults who show no symptoms should be performed with caution. Psychological distress and sleep disturbance should also be taken into consideration when FNA is performed for suspected TC or OP for papillary thyroid cancer, especially PTMC.
Αξιοποίηση των τεχνολογιών πληροφορίας και επικοινωνιών (ΤΠΕ) στην πρωτοβάθμια εκπαίδευση
Authors: Κεχαΐδου Μαρίνα
Published: April 2021

Τα τελευταία χρόνια η ευρεία είσοδος και χρήση των Τεχνολογιών Πληροφορίας και Επικοινωνιών (ΤΠΕ) στην εκπαίδευση έχει οδηγήσει στην υλοποίηση ψηφιακών αποθετηρίων με σκοπό την αποθήκευση και το διαμοιρασμό του εκπαιδευτικού υλικού που δημιουργείται. Η παρούσα διδακτορική διατριβή ασχολείται με το σχεδιασμό και την υλοποίηση του νέου και καινοτόμου Ψηφιακού Αποθετηρίου Μαθησιακών Αντικειμένων (ΜΑ) «Κάστανος», το οποίο απευθύνεται στο χώρο της Πρωτοβάθμιας εκπαίδευσης. Στόχος είναι το αποθετήριο να διαθέτει μια μεγάλη ποικιλία διαφορετικών ΜΑ για τη δημιουργία μιας πλήρους πρότασης διδασκαλίας στον εκπαιδευτικό. Να δίδει, επίσης τη δυνατότητα εύκολης αναζήτησης και εύρεσης του κατάλληλου κάθε φορά ΜΑ μέσω συγκεκριμένης και αυστηρής ταξινόμησης και να παρέχει στον εκπαιδευτικό τη δυνατότητα επεξεργασίας των ΜΑ μέσω εύχρηστων λογισμικών για την προσαρμογή τους στις ανάγκες του εκάστοτε χρήστη. Τέλος, να περιλαμβάνει εκπαιδευτικό υλικό υψηλής παιδαγωγικής και διδακτικής ποιότητας. Η δημιουργία του εκπαιδευτικού υλικού καθώς και ο σχεδιασμός και υλοποίηση του αποθετηρίου «Κάστανος» πραγματοποιήθηκαν από την αρχή και εξ’ ολοκλήρου κατά την εκπόνηση της παρούσας διατριβής. Αυτήν την χρονική στιγμή, το αποθετήριο περιέχει 3.105 ΜΑ και μεταδεδομένα για κάθε ένα από αυτά. Στο πρώτο μέρος, της διατριβής γίνεται βιβλιογραφική επισκόπηση των ΤΠΕ στην εκπαίδευση, των ΜΑ, των μεταδεδομένων και των ψηφιακών αποθετηρίων ΜΑ. Στο δεύτερο μέρος, το οποίο αποτελεί και το εμπειρικό μέρος της διατριβής, διατυπώνονται οι στόχοι και η μεθοδολογία της έρευνας, ενώ στη συνέχεια γίνεται σύντομη αναφορά στη σχεδίαση και υλοποίηση του εκπαιδευτικού υλικού και του αποθετηρίου. Επιπλέον, παρουσιάζονται και αναλύονται ποσοτικά και ποιοτικά τα αποτελέσματα της έρευνας μέσω δύο ξεχωριστών ερωτηματολογίων με σκοπό την αξιολόγηση της επίτευξης των στόχων του αποθετηρίου. Τα ερωτηματολόγια αυτά περιέχουν ερωτήσεις κλειστού τύπου πενταβάθμιας κατηγοριοποίησης τύπου Likert καθώς και ερωτήσεις ανοικτού τύπου. Το πρώτο συμπληρώθηκε από προπτυχιακούς φοιτητές του Παιδαγωγικού Τμήματος Δημοτικής Εκπαίδευσης του Δημοκριτείου Πανεπιστημίου Θράκης, ενώ το δεύτερο από εκπαιδευτικούς της Πρωτοβάθμιας και Δευτεροβάθμιας εκπαίδευσης καθώς και από μέλη Πανεπιστημιακού Διδακτικού Ερευνητικού Προσωπικού (ΔΕΠ). Στο τελευταίο μέρος της διατριβής παρουσιάζονται τα βασικά συμπεράσματα που προέκυψαν και πραγματοποιείται μια συζήτηση, επί του νέου αποθετηρίου και της συμβολής του στη βελτίωση και συνεπικουρία του έργου του σύγχρονου εκπαιδευτικού. Παράλληλα, αναλύονται οι μελλοντικές προοπτικές και επεκτάσεις του αποθετηρίου σχετικά με τον τρόπο που μπορεί να βελτιωθεί, να εξελιχθεί και να συνδράμει στη συλλογική προσπάθεια της περαιτέρω ανάπτυξης των ελληνικών ψηφιακών αποθετηρίων ΜΑ.
Seismic force redistribution in asymmetrical reinforced concrete buildings due to soil-structure interaction
Authors: Ασκούνη Παρασκευή
Published: April 2021

Η παρούσα διατριβή διερευνά την ανακατανομή των εσωτερικών δυνάμεων μεταξύ των κατακόρυφων μελών οπλισμένου σκυροδέματος (Ο/Σ) απλών ασύμμετρων χαμηλών κατασκευών υπό σεισμική φόρτιση λαμβάνοντας υπόψη την δυναμική αλληλεπίδραση εδάφους-κατασκευής (ΔΑΕΚ). Μια σειρά μονώροφων επιπέδων πλαισίων Ο/Σ με ένα, δύο και τέσσερα ανοίγματα, εδραζόμενα επί απαραμόρφωτου ή παραμορφώσιμου εδάφους μέσω θεμελίων με συνδετήριες δοκούς αναλύεται δυναμικά. Η σεισμική φόρτιση προσομοιώνεται με συνθετικά επιταχυνσιογραφήματα συμβατά με το φάσμα σχεδιασμού του Ευρωκώδικα 8. Μονώροφα και τριώροφα 3-Δ κτιρίων Ο/Σ ενός ανοίγματος εδραζόμενα επί απαραμόρφωτου ή παραμορφώσιμου εδάφους μέσω θεμελίων με συνδετήριες δοκούς και γενικής κοιτόστρωσης, αναλύονται δυναμικά χρησιμοποιώντας πραγματικά επιταχυνσιογραφήματα.Η ασυμμετρία στα εξεταζόμενα 2-Δ και 3-Δ κτίρια Ο/Σ επιτυγχάνεται αντικαθιστώντας έναν στύλο από ένα τοίχωμα μεταβλητού πλάτους. Η συμπεριφορά των μελών Ο/Σ θεωρείται ελαστική σύμφωνα με τους ισχύοντες κανονισμούς σχεδιασμού, καθώς και ελαστοπλαστική σύμφωνα με ένα ελαστοπλαστικό μηχανικό μοντέλο ινών. Τόσο οι γραμμικές όσο και οι μη γραμμικές ελαστοπλαστικές αναλύσεις πραγματοποιούνται στο χρονικό πεδίο. Οι γραμμικές αναλύσεις γίνονται λαμβάνοντας υπόψη τη μειωμένη δυσκαμψία των μελών λόγω της ρηγμάτωσης του σκυροδέματος. Οι μη γραμμικές ελαστοπλαστικές αναλύσεις γίνονται με ένα μοντέλο συγκεντρωμένης μέσω μείωση της δυσκαμψίας. Οι μη γραμμικές ποσότητες απόκρισης περιλαμβάνουν όχι μόνο τις δυνάμεις ροπής και διάτμησης των μελών, αλλά και τις γωνιακές παραμορφώσεις ορόφων και διάφορους δείκτες βλάβης σε επίπεδα μέλους και κατασκευής για τέσσερα επίπεδα επιτελεστικότητας. Αδιάστατοι λόγοι των εσωτερικών απόλυτων μέγιστων δυνάμεων και ροπών των κατακόρυφων μελών Ο/Σ εκφράζονται ως προς τις ιδιότητες διατομής τους και συγκρίνονται για τις περιπτώσεις ΔΑΕΚ και απαραμόρφωτου εδάφους τόσο για τις ελαστικές όσο και για τις ελαστοπλαστικές αναλύσεις. Έτσι, προσδιορίζεται και συζητείται η επίδραση της ΔΑΕΚ στη σεισμική απόκριση των κατακόρυφων στοιχείων και ολόκληρης της κατασκευής. Όλες οι αναλύσεις αποδεικνύουν ότι η ΔΑΕΚ επηρεάζει έντονα τη σεισμική απόκριση μελών Ο/Σ και απλών κατασκευών Ο/Σ και η επιρροή της μπορεί να είναι ευεργετική ή επιζήμια σε αντίθεση με τους ισχύοντες κανονισμούς οι οποίοι θεωρούν μόνο τα θετικά αποτελέσματά της.
Recognition and management of neonatal sepsis
Authors: Crocker Luke William , White Ayesha , Heaton Paul Anthony , Horta Débora Pascoal , Paul Siba Prosad
Published: April 2021

Neonatal sepsis results from acute bacterial or viral infection occurring in the first 28 days of life. It causes significant morbidity and mortality, although the outcome can be improved by early recognition and prompt treatment by health professionals. This article describes the most common causes of sepsis, and explains why neonates are particularly vulnerable to infection. It highlights the non-specific way in which an infant with a serious infection may present, indicating the crucial features to elicit during history taking and examination, and emphasising the ‘red-flag’ signs and symptoms that should increase suspicion of a serious illness. The authors have adapted National Institute for Health and Care Excellence guidelines to produce an evidence-based approach to the management of an infant with suspected sepsis, and describe the roles of nurses in ensuring effective treatment and best outcomes for these babies.
Guideline for the management of long tunnelled external ventricular drains in chronic hydrocephalus
Authors: Copley Phillip Correia , Emelifeonwu John , Gallo Pasquale , Sokol Drahoslav , Kandasamy Jothy , Wallace Hamish , Kaliaperumal Chandrasekaran
Published: April 2021

This article reports on the journey of a child with an inoperable hypothalamic-origin pilocytic astrocytoma causing hydrocephalus, which was refractory to treatment with shunts, and required a new approach. With multidisciplinary support, excellent nursing care and parental education, the child's hydrocephalus was managed long term in the community with bilateral long-tunnelled external ventricular drains (LTEVDs). This article describes the patient's journey and highlights the treatment protocols that were created to achieve this feat. Despite the difficulties in initially setting up these protocols, they proved successful and thus the team managing the patient proposed that LTEVDs are a viable treatment option for children with hydrocephalus in the context of inoperable tumours to help maximise quality of life.
Differences in critical thinking skills between nursing students on a fast-track versus traditional 4-year programme
Authors: Aldiabat Khaldoun , Alsrayheen Enam , Aquino-Russell Catherine , Al-Qadire Mohammad , Al Rawajfah Omar , Al Sabei Sulaiman Dawood
Published: April 2021

Background:

The authors were unable to find studies comparing the critical thinking skills of nursing students on advanced standing programmes (ASP) and on traditional 4-year BN programmes in Canada. The ASP is a condensed Bachelor of Nursing (BN) programme, designed for students who already have a university degree or similar qualification.

Aim:

To measure and compare the critical thinking skills of ASP students and traditional 4-year BN students.

Method:

A cross-sectional study using a self-administered questionnaire used to collect data from 100 nursing students at a university in Canada. Data were analysed using descriptive and inferential statistics. All research ethics were taken into consideration.

Findings:

All participants scored highly in their critical thinking skills. However, ASP students scored significantly higher than their counterparts on the 4-year programme (M=21.6 vs M=18.9, F=4.75, P=0.035).

Conclusion:

Higher critical thinking skills among ASP nursing students is a promising sign to expand and support this type of programme as a fast and effective method to cover the shortage in nurses.
The urgent need to improve health professionals' communication skills
Authors: Tingle John
Published: April 2021

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent reports that consider how health professionals communicate with patients
Dense-code free space transmission by local demultiplexing optical states of a composed vortex
Authors: Paroli B. , Siano M. , Potenza M. A. C.
Published: April 2021

We describe an innovative data transmission scheme exploiting optical vortices to multiplex and demultiplex independent data channels in a standard asynchronous laser link. We report extensive results of the proof of concept of the method, successfully used to transmit two parallel ASCII strings, demultiplexed and decoded in the far field of the radiation beam. A phase locked two arms interferometer is proved to be effective even accessing a small portion of the beam only. Results prove the robustness and reliability of the method to perform dense-code free space transmissions over long distances even in presence of wavefront distortions. Applications and the extension to a larger number of parallel channels are discussed.
Micro two-dimensional slit-array for super resolution beyond pixel Nyquist limits in grating spectrometers
Authors: Chi Mingbo , Han Xinxin , Xu Yang , Xing Huaming , Liu Yongshun , Wu Yihui
Published: April 2021

This paper presents a new micro 2-D slit-array device for spectral resolution enhancement in grating spectrometers. The 2-D slit-array is encoded in Hadamard matrix and the device is fabricated based on the micro-electromechanical system (MEMS) technology. By just using this 2-D slit-array to replace the single slit in the conventional grating spectrometer, real-time super spectral resolution detection beyond the pixel Nyquist limit, which is determined by the size of the detector pixel, can be realized. Furthermore, no other configuration of the spectrometer is changed, no movable parts are used, and the spectral range and instrument size remain almost unchanged while the resolution is improved. A series of experimental verifications for the feasibility of this design are included in this work.
Dielectric perturbations: anomalous resonance frequency shifts in optical resonators
Authors: Azeem Farhan , Trainor Luke S. , Devane Patrick A. , Norman Daniel S. , Rueda Alfredo , Lambert Nicholas J. , Kumari Madhuri , Foreman Matthew R. , Schwefel Harald G. L.
Published: April 2021

Small perturbations in the dielectric environment around resonant dielectric structures usually lead to a frequency shift of the resonator modes directly proportional to the polarizability of the perturbation. Here, we report experimental observations of strong frequency shifts that can oppose and even exceed the contribution of the perturbations’ polarizability. We show in particular how the mode frequencies of a lithium niobate whispering-gallery-mode resonator are shifted by planar substrates—of refractive indices ranging from 1.50 to 4.22—contacting the resonator rim. Both blue- and redshifts are observed, as well as an increase in mode linewidth, when substrates are moved into the evanescent field of the whispering gallery mode. We compare the experimental results to a theoretical model by Foreman et al. [J. Opt. Soc. Am. B 33, 2177 (2016)JOBPDE0740-322410.1364/JOSAB.33.002177] and provide an additional intuitive explanation based on the Goos–Hänchen shift for the optical domain, with applications to dielectric structures ranging from meta-surfaces to photonic crystal cavities.
Terahertz optical Hall effect in p-type monolayer hexagonal boron nitride on fused silica substrate
Authors: Bilal Muhammad , Xu Wen , Wen Hua , Cheng Xingjia , Xiao Yiming , Ding Lan
Published: April 2021

We demonstrate for the first time, to the best of our knowledge, that the optical Hall effect (OHE) can be observed in p-type monolayer (ML) hexagonal boron nitride (hBN) on a fused silica substrate by applying linearly polarized terahertz (THz) irradiation. When ML hBN is placed on fused silica, in which the incident pulsed THz field can create local and transient electromagnetic dipoles, proximity-induced interactions can be presented. The Rashba spin–orbit coupling can be enhanced, and the in-plane spin component can be induced, along with the lifting of valley degeneracy. Thus, in the presence of linearly polarized THz radiation, the nonzero transverse optical conductivity (or Hall conductivity) can be observed. We measure the THz transmission through ML hBN/fused silica in the temperature range from 80 to 280 K by using THz time-domain spectroscopy in combination with an optical polarization examination. The Faraday ellipticity and rotation angle, together with the complex longitudinal and transverse conductivities, are obtained. The temperature dependence of these quantities is examined. The results obtained from this work indicate that ML hBN is a valleytronic material, and proximity-induced interactions can lead to the observation of OHE in the absence of an external magnetic field.
Localized tilted fiber Bragg gratings induced by femtosecond laser line-by-line inscription
Authors: Liu Bonan , Yang Kaiming , Liao Changrui , Cai Zhihao , Liu Yifan , Sun Bing , Wang Yiping
Published: April 2021

Localized tilted fiber Bragg gratings (TFBGs) with low insertion loss are reported. A series of second-order TFBGs with tilt angles of 0°, 7°, 14°, and 21° was inscribed line by line directly in a single-mode fiber. For the 7° TFBG, the Bragg resonance was 2.4 dB at 1550 nm, and the maximum cladding-mode resonance reached 24.6 dB with an insertion loss of 0.8 dB, the same level as that for TFBGs fabricated by the phase-mask method. The range in cladding-mode resonance for the TFBGs obtained was wider than 170 nm with an intensity exceeding 20 dB. Combined with microscope images, the formation of these localized TFBGs and their spectral performance are discussed. The effect of an inscription offset along the

y

-axis direction was further investigated. With increasing offset, the intensity of the cladding-mode resonance dropped rapidly. The refractive index response sensitivity of the 7° TFBG was measured at 507.54 nm/RIU.
Symmetric Pearcey Gaussian beams
Authors: Wu You , Zhao Jiajia , Lin Zejia , Huang Haiqi , Xu Chuangjie , Liu Yujun , Chen Kaihui , Fu Xinming , Qiu Huixin , Liu Hongzhan , Wang Guanghui , Yang Xiangbo , Deng Dongmei , Shui Lingling
Published: April 2021

In this Letter, a new, to the best of our knowledge, type of autofocusing and symmetric beam arisen from two quartic spectral phases is introduced in theory and experiment. The symmetric Pearcey Gaussian beam (SPGB), formed with a Gaussian term and two multiplying Pearcey integrals, processes a focusing intensity approximately 1.32 times stronger than the intensity of the symmetric Airy beam. Its four off-axis main lobes split into four bending trajectories symmetrically after focusing. The rectangular intensity distribution and the focal length of the SPGB can be adjusted by two kinds of distribution factors. Additionally, the vortex-guiding property of the beam is demonstrated by embedding an off-axis vortex into the SPGB, which can be applied in particle guiding.
Inhibitory neurons exhibit high controlling ability in the cortical microconnectome
Authors: Kajiwara Motoki , Nomura Ritsuki , Goetze Felix , Kawabata Masanori , Isomura Yoshikazu , Akutsu Tatsuya , Shimono Masanori
Published: April 2021

The brain is a network system in which excitatory and inhibitory neurons keep activity balanced in the highly non-random connectivity pattern of the microconnectome. It is well known that the relative percentage of inhibitory neurons is much smaller than excitatory neurons in the cortex. So, in general, how inhibitory neurons can keep the balance with the surrounding excitatory neurons is an important question. There is much accumulated knowledge about this fundamental question. This study quantitatively evaluated the relatively higher functional contribution of inhibitory neurons in terms of not only properties of individual neurons, such as firing rate, but also in terms of topological mechanisms and controlling ability on other excitatory neurons. We combined simultaneous electrical recording (~2.5 hours) of ~1000 neurons in vitro, and quantitative evaluation of neuronal interactions including excitatory-inhibitory categorization. This study accurately defined recording brain anatomical targets, such as brain regions and cortical layers, by inter-referring MRI and immunostaining recordings. The interaction networks enabled us to quantify topological influence of individual neurons, in terms of controlling ability to other neurons. Especially, the result indicated that highly influential inhibitory neurons show higher controlling ability of other neurons than excitatory neurons, and are relatively often distributed in deeper layers of the cortex. Furthermore, the neurons having high controlling ability are more effectively limited in number than central nodes of k-cores, and these neurons also participate in more clustered motifs. In summary, this study suggested that the high controlling ability of inhibitory neurons is a key mechanism to keep balance with a large number of other excitatory neurons beyond simple higher firing rate. Application of the selection method of limited important neurons would be also applicable for the ability to effectively and selectively stimulate E/I imbalanced disease states.
Leveraging expression from multiple tissues using sparse canonical correlation analysis and aggregate tests improves the power of transcriptome-wide association studies
Authors: Feng Helian , Mancuso Nicholas , Gusev Alexander , Majumdar Arunabha , Major Megan , Pasaniuc Bogdan , Kraft Peter
Published: April 2021

Transcriptome-wide association studies (TWAS) test the association between traits and genetically predicted gene expression levels. The power of a TWAS depends in part on the strength of the correlation between a genetic predictor of gene expression and the causally relevant gene expression values. Consequently, TWAS power can be low when expression quantitative trait locus (eQTL) data used to train the genetic predictors have small sample sizes, or when data from causally relevant tissues are not available. Here, we propose to address these issues by integrating multiple tissues in the TWAS using sparse canonical correlation analysis (sCCA). We show that sCCA-TWAS combined with single-tissue TWAS using an aggregate Cauchy association test (ACAT) outperforms traditional single-tissue TWAS. In empirically motivated simulations, the sCCA+ACAT approach yielded the highest power to detect a gene associated with phenotype, even when expression in the causal tissue was not directly measured, while controlling the Type I error when there is no association between gene expression and phenotype. For example, when gene expression explains 2% of the variability in outcome, and the GWAS sample size is 20,000, the average power difference between the ACAT combined test of sCCA features and single-tissue, versus single-tissue combined with Generalized Berk-Jones (GBJ) method, single-tissue combined with S-MultiXcan, UTMOST, or summarizing cross-tissue expression patterns using Principal Component Analysis (PCA) approaches was 5%, 8%, 5% and 38%, respectively. The gain in power is likely due to sCCA cross-tissue features being more likely to be detectably heritable. When applied to publicly available summary statistics from 10 complex traits, the sCCA+ACAT test was able to increase the number of testable genes and identify on average an additional 400 additional gene-trait associations that single-trait TWAS missed. Our results suggest that aggregating eQTL data across multiple tissues using sCCA can improve the sensitivity of TWAS while controlling for the false positive rate.
PLD3 is a neuronal lysosomal phospholipase D associated with β-amyloid plaques and cognitive function in Alzheimer’s disease
Authors: Nackenoff Alex G. , Hohman Timothy J. , Neuner Sarah M. , Akers Carolyn S. , Weitzel Nicole C. , Shostak Alena , Ferguson Shawn M. , Mobley Bret , Bennett David A. , Schneider Julie A. , Jefferson Angela L. , Kaczorowski Catherine C. , Schrag Matthew S.
Published: April 2021

Phospholipase D3 (PLD3) is a protein of unclear function that structurally resembles other members of the phospholipase D superfamily. A coding variant in this gene confers increased risk for the development of Alzheimer’s disease (AD), although the magnitude of this effect has been controversial. Because of the potential significance of this obscure protein, we undertook a study to observe its distribution in normal human brain and AD-affected brain, determine whether PLD3 is relevant to memory and cognition in sporadic AD, and to evaluate its molecular function. In human neuropathological samples, PLD3 was primarily found within neurons and colocalized with lysosome markers (LAMP2, progranulin, and cathepsins D and B). This colocalization was also present in AD brain with prominent enrichment on lysosomal accumulations within dystrophic neurites surrounding β-amyloid plaques. This pattern of protein distribution was conserved in mouse brain in wild type and the 5xFAD mouse model of cerebral β-amyloidosis. We discovered PLD3 has phospholipase D activity in lysosomes. A coding variant in PLD3 reported to confer AD risk significantly reduced enzymatic activity compared to wild-type PLD3. PLD3 mRNA levels in the human pre-frontal cortex inversely correlated with β-amyloid pathology severity and rate of cognitive decline in 531 participants enrolled in the Religious Orders Study and Rush Memory and Aging Project. PLD3 levels across genetically diverse BXD mouse strains and strains crossed with 5xFAD mice correlated strongly with learning and memory performance in a fear conditioning task. In summary, this study identified a new functional mammalian phospholipase D isoform which is lysosomal and closely associated with both β-amyloid pathology and cognition.
Sex-stratified genome-wide association study of multisite chronic pain in UK Biobank
Authors: Johnston Keira J. A. , Ward Joey , Ray Pradipta R. , Adams Mark J. , McIntosh Andrew M. , Smith Blair H. , Strawbridge Rona J. , Price Theodore J. , Smith Daniel J. , Nicholl Barbara I. , Bailey Mark E. S.
Published: April 2021

Chronic pain is highly prevalent worldwide and imparts a significant socioeconomic and public health burden. Factors influencing susceptibility to, and mechanisms of, chronic pain development, are not fully understood, but sex is thought to play a significant role, and chronic pain is more prevalent in women than in men. To investigate sex differences in chronic pain, we carried out a sex-stratified genome-wide association study of Multisite Chronic Pain (MCP), a derived chronic pain phenotype, in UK Biobank on 178,556 men and 209,093 women, as well as investigating sex-specific genetic correlations with a range of psychiatric, autoimmune and anthropometric phenotypes and the relationship between sex-specific polygenic risk scores for MCP and chronic widespread pain. We also assessed whether MCP-associated genes showed expression pattern enrichment across tissues. A total of 123 SNPs at five independent loci were significantly associated with MCP in men. In women, a total of 286 genome-wide significant SNPs at ten independent loci were discovered. Meta-analysis of sex-stratified GWAS outputs revealed a further 87 independent associated SNPs. Gene-level analyses revealed sex-specific MCP associations, with 31 genes significantly associated in females, 37 genes associated in males, and a single gene,DCC, associated in both sexes. We found evidence for sex-specific pleiotropy and risk for MCP was found to be associated with chronic widespread pain in a sex-differential manner. Male and female MCP were highly genetically correlated, but at an rgof significantly less than 1 (0.92). All 37 male MCP-associated genes and all but one of 31 female MCP-associated genes were found to be expressed in the dorsal root ganglion, and there was a degree of enrichment for expression in sex-specific tissues. Overall, the findings indicate that sex differences in chronic pain exist at the SNP, gene and transcript abundance level, and highlight possible sex-specific pleiotropy for MCP. Results support the proposition of a strong central nervous-system component to chronic pain in both sexes, additionally highlighting a potential role for the DRG and nociception.