bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress response during early sedation with dexmedetomidine compared with usual-care in ventilated critically ill patients
Authors: Moore John P. R. , Shehabi Yahya , Reade Michael C. , Bailey Michael , Fraser John F. , Murray Lauren , Anstey Christopher , Singer Mervyn
Published: November 2022

Background

Sedative agents may variably impact the stress response. Dexmedetomidine is a sympatholytic alpha2-adrenergic agonist mainly used as a second-line sedative agent in mechanically ventilated patients. We hypothesised that early sedation with dexmedetomidine as the primary agent would result in a reduced stress response compared to usual sedatives in critically ill ventilated adults.

Methods

This was a prospective sub-study nested within a multi-centre randomised controlled trial of early sedation with dexmedetomidine versus usual care. The primary outcome was the mean group differences in plasma levels of stress response biomarkers measured over 5 days following randomisation. Other hormonal, biological and physiological parameters were collected. Subgroup analyses were planned for patients with proven or suspected sepsis.

Results

One hundred and three patients were included in the final analysis. Baseline illness severity (APACHE II score), the proportion of patients receiving propofol and the median dose of propofol received were comparable between groups. More of the usual-care patients received midazolam (57.7% vs 33.3%; p = 0.01) and at higher dose (median (95% interquartile range) 0.46 [0.20–0.93] vs 0.14 [0.08–0.38] mg/kg/day; p < 0.01). The geometric mean (95% CI) plasma level of the stress hormones, adrenaline (0.32 [0.26–0.4] vs 0.38 [0.31–0.48]), noradrenaline (4.27 [3.12–5.85] vs 6.2 [4.6–8.5]), adrenocorticotropic hormone (17.1 [15.1–19.5] vs 18.1 [15.9–20.5]) and cortisol (515 [409–648] vs 618 [491–776)] did not differ between dexmedetomidine and usual-care groups, respectively. There were no significant differences in any other assayed biomarkers or physiological parameters Sensitivity analyses showed no effect of age or sepsis.

Conclusions

Early sedation with dexmedetomidine as the primary sedative agent in mechanically ventilated critically ill adults resulted in comparable changes in physiological and blood-borne parameters associated with the stress-response as with usual-care sedation.
Effect of different weekly frequencies of Chen-style Tai Chi in elders with chronic non-specific low back pain: study protocol for a randomised controlled trial
Authors: Wan Ruihan , Shi Jian , Hu Kun , Wang Yafei , Jiang Xue , Yan Wangwang , Cao Mali , Wang Yuling
Published: November 2022

Background

Tai Chi (TC), as one of mild to moderate exercise therapies specifically recommended by clinical practice guideline from the American College of Physician, is a viable option for chronic non-specific low back pain (CNLBP) treatment. Nevertheless, limited studies focused on the effect of different weekly frequencies of TC in elders with CNLBP. This superiority study aims to compare the differences of TC with different weekly frequencies in elders with CNLBP on the premise of proving its effectiveness, and identifying whether mindfulness mediates the effect of TC on treatment outcomes.

Methods

In total, 284 senior citizens with CNLBP will be recruited in this single-centre, randomised, single-blinded (outcome assessors, data managers and the statistician), parallel controlled trial. Participants will be randomly divided into either one of three TC groups (1, 3, or 5 sessions/week, on the basis of weekly health educational lectures) or weekly health educational lectures, sustaining for 12 weeks, followed by 12 weeks of follow-up after the end of intervention. The primary outcome (the changes of LBP intensity at rest) will be measured at baseline before randomisation and immediately after the completion of weeks 4, 8 and 12 of the intervention, and the end of follow-up (week 24) using the visual analogue scale (VAS, 0–10 cm) to put a mark on the VAS scale to show how severities of their average low back pain have been over the past 24 h. Secondary outcomes, including Beck Depression Inventory-II, Pain Catastrophising Scale and Five Facet Mindfulness Questionnaire, Oswestry Disability Index and Short Form-36, will be measured at baseline and immediately after the completion of week 12 of the intervention and end of follow-up. The intention-to-treat and per-protocol principles will be used to analyse outcomes with a setting at α = 0.05 as statistical significance.

Discussion

This comprehensive and detailed protocol will be the first trial to compare the effectiveness of different weekly frequencies of TC in elders with CNLBP. The outcomes may provide valuable data about the choice of the ideal number of sessions to further normalise the application of exercise for clinicians.

Trial registration

Chinese clinical trial registry ChiCTR2200058190. Registered on 1 April 2022.
Hydrophilic gold nanospheres: influence of alendronate, memantine, and tobramycin on morphostructural features
Authors: Eissa Dina M. , Mabrouk Mokhtar M. , Ebeid El Zeiny M. , Abdel Hamid Mohamed A.
Published: November 2022

Turkevich gold nanospheres are the original nanospheres that have been modified over time. Its combination with targeting medications such as alendronate, memantine, and tobramycin will provide additional benefits in targeting specific areas in the bone, brain, and microorganisms, respectively. Hence, The reactivity and stability of nanospheres with various drug concentrations (milli-,micro-, and nano-levels) have been studied. With alendronate, the absorbance spectra of nanospheres at $$\uplambda _{max}$$

λ

max

520 nm were always stable and no redshifts occurred. In contrast, the spectra with memantine and tobramycin were stable at the nano-level and redshifts occurred at the milli- and micro-levels. HRTEM and DLS revealed that the core diameter was relatively stable in all cases, whereas the hydrodynamic diameter and zeta potential varied with varying drug concentrations. Increasing concentration increased hydrodynamic diameter slightly with memantine (from 64.99 to 98.41 nm), dramatically with tobramycin (from 135.3 to 332.16 nm), and almost negligibly with alendronate (from 52.08 to 58.94 nm ). Zeta Potential, conversely, is reduced as concentration increases. Memantine had the greatest reduction in negativity, followed by tobramycin, but alendronate had a slight increase in negativity. Benefits from this research would be in targeted drug delivery, where stability and reactivity of gold nanospheres are critical.
Interspecific foraging association of a nurse shark (Ginglymostoma cirratum) with bottlenose dolphins (Tursiops truncatus)
Authors: White Connor F. , Pratt Harold. L. , Pratt Theo C. , Whitney Nicholas M.
Published: November 2022

Animals sometimes forage in mixed species groups, where an individual of a “follower” species actively trails a foraging individual of another “nuclear” species to benefit from the latter’s foraging strategy. Here, we report on a serendipitous observation of a large, benthic, reef-associated predator, the nurse shark (G. cirratum) following a pod of bottlenose dolphins (T. truncatus) in an apparent attempt to feed on benthic prey disturbed by dolphin foraging. Data from a shark-borne camera, accelerometer, depth, and temperature datalogger package show the nurse shark following the dolphin pod for a period of 15 min and performing multiple, rapid vertical ascents from a depth of 24 m to near the surface following dolphins. The shark performed gliding descents behind dolphins back to the benthos and repeatedly swam through clouds of sand that were produced from dolphin crater feeding behavior. The dolphins appeared to ignore the shark except for three occasions when they struck the shark in the head with their caudal flukes. The shark eventually appeared to locate a benthic prey item as it turned sharply, stopped swimming, and performed what appeared to be suction feeding near the bottom, with clouds of sand rapidly expelled from its gills. This is the first report of rapid vertical ascents and interspecific foraging in a nurse shark.
Evaluation of starting model approaches and effective source wavelet variations for high-frequency ground-penetrating radar full-waveform inversion
Authors: Hoven Dominik , Mester Achim , Vereecken Harry , Klotzsche Anja
Published: November 2022

High-frequency ground-penetrating radar (GPR) full-waveform inversion (FWI) can enhance the characterization of small-scale structures in the subsurface below the decimeter scale. We have investigated the potential and requirements to use FWI for higher-frequency data. Thereby, we focus on the two most important criteria to achieve reliable FWI results: adequate starting models that fulfill the half-wavelength criterion and the accuracy of the effective source wavelet. Therefore, we have defined a realistic reference model, generated synthetic GPR data sets (200, 450, and 700 MHz), and tested different standard ray-based starting model methods and frequency-hopping approaches to derive results close to our reference model. Although standard starting models provide good parameter reconstruction for lower-frequency data, a frequency-hopping approach is required for the 700 MHz data. In addition, we have seen that the reconstruction of the conductivity results is more sensitive to the presence of noise (25 dB) than the permittivity tomograms. The definition of the effective source wavelets is directly linked to the accuracy of the starting models; therefore, we investigate the effect on the FWI results for high-frequency data by varying the source wavelets in terms of starting time and/or amplitude. Considering the multiparameter nature of FWI, we observe that time shifts have a greater influence on the performance of the FWI than amplitude variations. Large time shifts of approximately 0.1 ns for the 700 MHz data may lead to the failure of the inversion, whereas amplitude variations (±5% of the maximum amplitude) affect the quantitative conductivity results only (no effect on permittivity) with an increased root-mean-square error of the data of up to 20%. Using a stochastically perturbed synthetic model, we determine an improved parameter reconstruction for higher frequencies. On the basis of our findings, we develop a workflow to obtain reliable results for high-frequency GPR FWI for future users.
Psychological factors responsible for low adherence to mask-wearing measures during the COVID-19 pandemic
Authors: Kılıç Cengiz , Yıldız M. İrem , Emekli Esra , Gülşen Gülhan , Alp Anıl
Published: November 2022

Background

The COVID-19 pandemic has led to >6 million deaths. Anti-mask movements may decrease the effects of preventive measures. Psychological factors that may be related to anti-mask behaviour are not well researched.

Aims

This study aims to determine the psychological correlates of anti-mask attitudes and behaviour in an online general population sample, focusing on the possible role of claustrophobia.

Method

Data on attitudes and behaviour toward mask-wearing were collected from an online sample of 3709 people. Predictors of both anti-mask attitudes and behaviour were assessed with linear and logistic regression analyses.

Results

Few people (3.3%) were overtly opposed to mask-wearing; mask opposition was more common in men than women. Predictors of negative attitude toward mask-wearing and low adherence to mask-related measures were similar and included male gender, lower education, lower income, being employed, having had COVID-19 and lower COVID-19-related anxiety. Psychopathology measures did not show a prediction, whereas claustrophobia had a significant prediction that was over and above those of other predictors. Avoidance behaviour had similar predictors, except for higher COVID-19-related anxiety.

Conclusions

Although low adherence to mask-wearing during the pandemic was not related to having a mental disorder, it may partly be caused by psychological factors. Those who had a negative attitude also reported lower adherence behaviour, and were characterised by being male, having lower education, being employed and having lower COVID-19-related anxiety; claustrophobia was a strong predictor of attitude. Understanding psychological factors responsible for low adherence may help to decrease morbidity and mortality in future pandemics.
Preclinical Observations of Systemic and Ocular Antidrug Antibody Response to Intravitreally Administered Drugs
Authors: Wessels Uwe , Zadak Markus , Weidmann Anja Manuela , Stuchly Thomas , Stubenrauch Kay-Gunnar
Published: November 2022

Intravitreally administered biotherapeutics can elicit local and systemic immune responses with potentially serious clinical consequences. However, little is known about the mechanisms of ocular antidrug immune response, the incidence of ocular antidrug antibodies (ADAs), and the relationship between ocular and systemic ADA levels. Bioanalytical limitations and poor availability of ocular matrices make studies of ocular immunogenicity particularly challenging. We have recently reported a novel bioanalytical ADA assay and shown its applicability for the ADA detection in ocular matrices. In the present study, we used this assay to analyze a large set of preclinical samples from minipig and cynomolgus monkeys treated with different ocular biotherapeutics. We found a significant association between the incidence of ADAs in plasma and ocular fluids after a single intravitreal administration of the drugs. Importantly, none of the animals with ADA-negative results in plasma had detectable ADAs in ocular fluids and systemic ADA response always preceded the appearance of ocular ADAs. Overall, our results suggest the systemic origin of ocular ADAs and support the use of plasma as a surrogate matrix for the detection of ocular ADA response.

Graphical Abstract
Eukaryotic fertilization and gamete fusion at a glance
Authors: Lu Yonggang , Ikawa Masahito
Published: November 2022

In sexually reproducing organisms, the genetic information is transmitted from one generation to the next via the merger of male and female gametes. Gamete fusion is a two-step process involving membrane recognition and apposition through ligand–receptor interactions and lipid mixing mediated by fusion proteins. HAP2 (also known as GCS1) is a bona fide gamete fusogen in flowering plants and protists. In vertebrates, a multitude of surface proteins have been demonstrated to be pivotal for sperm–egg fusion, yet none of them exhibit typical fusogenic features. In this Cell Science at a Glance article and the accompanying poster, we summarize recent advances in the mechanistic understanding of gamete fusion in eukaryotes, with a particular focus on mammalian species.
The mechanical properties of the mantle muscle of European cuttlefish (Sepia officinalis)
Authors: Gladman Nicholas W. , Askew Graham N.
Published: November 2022

The circular muscles surrounding the mantle cavity of European cuttlefish (Sepia officinalis) generate the mechanical power to compress the cavity, forcing a jet of water out of the funnel, propelling the animal during jet propulsion swimming. During ontogeny, jetting frequency decreases in adults compared with juveniles, and this is expected to be reflected in the contractile properties of the locomotory muscles. To develop greater insight into how the locomotion of these animals is powered during ontogeny, we determined the mechanical properties of bundles of muscle fascicles during isometric, isotonic and cyclic length changes in vitro, at two life stages: juveniles and adults. The twitch kinetics were faster in juveniles than in adults (twitch rise time 257 ms compared with 371 ms; half-twitch relaxation 257 ms compared with 677 ms in juveniles and adults, respectively); however, twitch and tetanic stress, the maximum velocity of shortening and curvature of the force–velocity relationship did not differ. Under cyclic conditions, net power exhibited an inverted U-shaped relationship with cycle frequency in both juveniles and adults; the frequency at which maximum net power was achieved was shifted to lower cycle frequencies with increased maturity, which is consistent with the slower contraction and relaxation kinetics in adults compared with juveniles. The cycle frequency at which peak power was achieved during cyclical contractions in vitro was found to match that seen in vivo in juveniles, suggesting power is being maximised during jet propulsion swimming.
Feasibility of video assessment of operative skills in FCPS vascular surgery
Authors: Bhatti Ahsin , Ahsin Sadia , Mansoor Sumreena
Published: November 2022

Objective: To explore the feasibility of assessment of operative skills of FCPS vascular surgery trainees based on video recordings of the surgical procedures with a view to introduce it in the curriculum.

Methods: This qualitative study was carried out from 9th April 2021 – 15th July 2021 at Shifa Tameer e Millat University, Islamabad, Pakistan. It is a qualitative study based on constructivist grounded theory. Semi structured interviews of 16 participants, including five vascular surgical trainees, six vascular surgical consultants/supervisors/examiners, and five medical educationists were conducted, recorded and transcribed. Open and axial coding method was employed to identify recurring themes.

Results: Six themes could be identified. (1) There was consensus among participants on deficiency in current assessment of surgical skills. (2) Most participants believed that this is a useful method, although four out of 16 participants believed that current methods were sufficient. (3) There was a unanimous opinion that its purpose should be initially formative assessment and later for summative assessment. (4) It was suggested that it is practical with logistic support; it can be made part of trainee’s record to be reviewed later; maybe by independent observers. (5) Participants believed that the logistic issue in term of equipment and trained manpower will be a challenge in implementing this mode of assessment. Other barriers included medicolegal and ethical issue and acceptability by the stake holders. (6) Participants also suggested remedies for the barriers.

Conclusion: Video review of surgical procedures can improve assessment of operative skills of trainees provided it is used as formative tool initially with a need to overcome logistics, medicolegal and cultural barriers.

doi: https://doi.org/10.12669/pjms.39.1.6737

How to cite this: Bhatti AM, Ahsin S, Mansoor S. Feasibility of video assessment of operative skills in FCPS vascular surgery. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6737

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Η ευχαριστιακή θεολογία του Αγίου Ιωάννου Χρυσοστόμου
Authors: Αλεξανδράκης Μιχαήλ-Θεολόγος
Published: November 2022

Στόχος της διατριβής είναι η ανάδειξη του λειτουργικο-ποιμαντικού χαρακτήρα της θεολογίας του Αγίου Ιωάννη του Χρυσοστόμου, ιχνηλατώντας παράλληλα την προέλευσή της από την εμπειρία θέωσης του συγγραφέα. Κατέστη αναγκαίο να σταχυολογηθούν αποσπάσματα από ολόκληρο το χρυσοστομικό έργο, εξαιτίας της διάχυσης της συγκεκριμένης θεματικής σε ποικίλα κείμενα. Ο Χρυσόστομος συναρμόζει στην περί Θείας Ευχαριστίας θεολογία του το στοιχείο της κάθαρσης των πιστών με την εσχατολογική διάσταση της Θείας Κοινωνίας. Μέσα από τον εντοπισμό των προτυπώσεων της Θείας Ευχαριστίας σε συμβάντα και σύμβολα της Παλαιάς Διαθήκης, όπως ο θυόμενος μόσχος ή το πυρ του Προφήτη Ηλία στο Καρμήλιο Όρος, ο Χρυσόστομος επιδιώκει την ανάδειξη θεμελιωδών στοιχείων της θυσίας της Θείας Ευχαριστίας. Διά του βαπτισματικού μυστηρίου ο άνθρωπος καλείται στην εσχατολογική βασιλική τράπεζα, επειδή ακριβώς αποκτά την δυνατότητα των αχράντων μυστηρίων. Ενώ, όμως, ο Χρυσόστομος προτρέπει στην συχνή Θεία Κοινωνία διευκρινίζει ότι το μυστήριο επενεργεί μόνο μέσα από την εν Χριστώ ζωή προάγοντας την ηθικοπνευματική προκοπή. Η ειρήνη, ως χριστοκεντρική πραγματικότητα που αφορά την ψυχή του πιστού, την εκκλησιαστική κοινότητα στην οποία τελείται η θυσία της Θείας Ευχαριστίας, την Εκκλησία εν γένει καθώς και τον σύμπαντα κόσμο, συνάπτεται με τον λειτουργικό και ευχαριστιακό της χαρακτήρα και την οντολογική ταύτιση του αιώνιου ιστορικού με το «ευχαριστιακό» και το «εκκλησιαστικό» σώμα του Κυρίου. Στο κέντρο της ευχαριστιακής σωτηριολογίας παραμένει η σταυροαναστάσιμη διάστασή της.
Ανάπτυξη πεπτιδικών ραδιοφαρμάκων με εφαρμογή στην ογκολογία
Authors: Λυμπέρης Εμμανουήλ
Published: November 2022

Η χαρτογράφηση των πεπτιδικών υποδοχέων που υπερεκφράζονται στην επιφάνεια διαφόρων τύπων καρκινικών κυττάρων έχει αποτελέσει τα τελευταία χρόνια τη βάση για την in vivo μοριακή στόχευση νεοπλασματικών ασθενειών με ραδιοεπισημασμένα πεπτίδια. Το διαρκώς αυξανόμενο ενδιαφέρον αναφορικά με τα ραδιοπεπτίδια αυτά έχει οδηγήσει στο σχεδιασμό αρκετών πεπτιδικών αναλόγων, τα οποία φέροντας το κατάλληλο ραδιονουκλείδιο είναι ικανά να προσφέρουν πολλές δυνατότητες στην εξατομικευμένη διάγνωση και θεραπεία ασθενών.Η παρούσα διατριβή εστιάζει στην ανάπτυξη ραδιοσημασμένων πεπτιδικών GRPR-ανταγωνιστών με διαγνωστικά και θεραπευτικά ραδιονουκλίδια, με βελτιωμένα βιολογικά χαρακτηριστικά, όπως κατάλληλη βιοκινητική και υψηλή μεταβολική σταθερότητα. Πραγματοποιήθηκε σύγκριση της βιολογικής συμπεριφοράς και της φαρμακοκινητικής ενός GRPR-ανταγωνιστή κι ενός αγωνιστή παρόμοιας χημικής δομής. Παράλληλα, έγινε προσπάθεια αύξησης της μεταβολικής σταθερότητας με στοχευμένη δομική τροποποίηση της πεπτιδικής αλληλουχίας ενός GRPR-ανταγωνιστή, ενώ αξιολογήθηκε και η επίδραση διαφορετικών ραδιομετάλλων στη σταθερότητα και τις βιολογικές του ιδιότητες των σχηματιζόμενων ραδιοπεπτιδίων. Αντικείμενο εκτενούς μελέτης αποτέλεσε και ο προσδιορισμός της δράσης του πρωτεολυτικού ενζύμου NEP, η ανάδειξη των σημείων που αποικοδομεί τα ραδιοπεπτιδικά ανάλογα, καθώς και η δυνατότητα αναστολής της δράσης της με στόχο την αύξηση της in vivo μεταβολικής σταθερότητας των ραδιοπεπτιδικών αναλόγων.Στο πλαίσιο αυτό σχεδιάστηκαν και συντέθηκαν δύο νέοι GRPR-ανταγωνιστές, το SB4 και το SB9, ο γνωστός GRPR-ανταγωνιστής SB3, καθώς και τα πιθανά προϊόντα αποικοδόμησης του, μεταβολίτες M1-5. Η σύνθεση τους πραγματοποιήθηκε σύμφωνα με την στρατηγική σύνθεσης σε στερεά φάση με τη μέθοδο προστασίας Fmoc και η ταυτοποίηση τους πραγματοποιήθηκε με RP-HPLC και MALDI-TOF MS.Τα αποτελέσματα των in vitro & in vivo μελετών που πραγματοποιήθηκαν επαλήθευσαν την ανώτερη φαρμακοκινητική και υψηλότερη σταθερότητα για τον GRPR-ανταγωνιστή [111In]SB9 έναντι του αγωνιστή [111In]AMBA, γεγονός που συνάδει με τη γενικότερη αντίληψη ότι οι GRPR-ανταγωνιστές είναι προτιμότεροι από τους αντίστοιχους αγωνιστές για την απεικόνιση και τη θεραπεία καρκινικών όγκων. Επιβεβαιώθηκε ότι η αντικατάσταση της γλυκίνης από D-αλανίνη αποτελεί έναν αποτελεσματικό τρόπο αύξησης της μεταβολικής σταθερότητας, δεδομένου ότι το [111In]SB4 εμφανίστηκε σημαντικά πιο ανθεκτικό από το [111In]SB3 έναντι των πρωτεολυτικών ενζύμων, με αντίκτυπο τη σημαντική μείωση στην ικανότητα δέσμευσης στον GRPR και εν τέλει στην ικανότητα στόχευσης πειραμάτικων όγκων PC-3. Αποδείχθηκε η δυνατότητα για περαιτέρω βελτίωση της φαρμακοκινητική μέσω in situ σταθεροποίησης των ραδιοπεπτιδικών αναλόγων με τη συγχορήγηση PA ως αναστολέα της NEP. Τέλος, ταυτοποιήθηκαν οι θέσεις αποικοδόμησης λόγω της δράσης της NEP για το ραδιοπεπτίδια [111In/177Lu]SB3, μέσω της ταυτοποίησης των αντίστοιχων ραδιομεταβολιτών.
An empirical investigation into product rollover decisions
Authors: Κυριακόπουλος Νικόλαος
Published: November 2022

Η παρούσα διδακτορική διατριβή μελετά την σημαντική επιχειρησιακά, αλλά ανεπαρκώς ερευνημένη διαδικασία αντικατάστασης προϊόντος (product rollover), η οποία αποτελείται από δύο διαδικασίες: α) την εισαγωγή της νέας γενιάς προϊόντος στην αγορά και β) τη σταδιακή ή άμεση κατάργηση της παλαιάς γενιάς από την αγορά. Η εμπειρική διερεύνηση σε δείγμα 179 επιχειρήσεων του Ηνωμένου Βασιλείου προσδιόρισε παράγοντες επηρεασμού και αποτελέσματα των αποφάσεων αντικατάστασης προϊόντος. Οι αποφάσεις που μελετήθηκαν είναι οι αλλαγές στο μείγμα μάρκετινγκ του προϊόντος από την παλαιά γενιά στην νέα (product rollover modifications) και η καινοτομικότητα της αντικατάστασης προϊόντος (product rollover creativity). Οι παράγοντες επηρεασμού που εξετάστηκαν είναι η δυνατότητα της επιχείρησης να αφουγκράζεται την αγορά και το τεχνολογικό γίγνεσθαι (market and technology sensing capabilities), η οργανωσιακή απομάθηση (organizational unlearning) και η διάθεση της επιχείρησης για κανιβαλισμό (willingness to cannibalize). Όσον αφορά τα αποτελέσματα των αποφάσεων που ερευνήθηκαν είναι η απόδοση της αγοράς και η χρηματοοικονομική απόδοση της αντικατάστασης του προϊόντος (product rollover market and financial performance), καθώς και η συνολική απόδοση της αντικατάστασης (product rollover performance). Επίσης, διερευνήθηκε ο ρόλος της ρύθμισης (moderation) των σχέσεων από παράγοντες του εξωτερικού περιβάλλοντος όπως ο δυναμισμός (dynamism), η τεχνολογική αστάθεια (technological turbulence) και η αφθονία της αγοράς (munificence). Τα συμπεράσματα της παρούσας διδακτορικής διατριβής συνεισφέρουν σημαντικά τόσο σε θεωρητικό όσο και σε πρακτικό επίπεδο σε ένα ζήτημα το οποίο απασχολεί τη σημερινή εποχή τόσο τις επιχειρήσεις όσο και τους καταναλωτές.
The cretan conflict 1866-1869
Authors: Κούβαρος Μιχαήλ
Published: November 2022

Η Κρήτη αποτέλεσε ιστορικά μία από τις πιο ταραχώδεις επαρχίες της Οθωμανικής Αυτοκρατορίας. Η παρούσα διδακτορική διατριβή επικεντρώνεται στην εξέγερση του 1866-1869 και την εξετάζει στο ιδεολογικό πλαίσιο όπως αυτό αποτυπώνεται μέσα από τα δημοσιεύματα του ελληνικού και οθωμανικού τύπου της εποχής. Από την παρουσίαση των ευρημάτων γίνεται φανερό ότι τα γεγονότα της Κρήτης όχι μόνο εξελίχθηκαν μέσα σε μία γενικότερη αναζωπύρωση των ιδεολογικών ρευμάτων της εποχής, όπως ο ελληνικός επεκτατικός μεγαλοϊδεατισμός, ο ενωτικός Οθωμανισμός, και ο επιθετικός Πανσλαβισμός αλλά σε κάποιο βαθμό τα όξυναν ακόμα περισσότερο. Ωστόσο, η στάση των κωνσταντινοπολίτικων ελληνόγλωσσων εφημερίδων στο συγκεκριμένο ζήτημα αποκαλύπτει την ύπαρξη ενός νέου ιδεολογικού φαινομένου, του Ελληνο-οθωμανισμού, που εντοπίζεται κυρίως στα μέλη της ανώτερης τάξης του ελληνικού millet. Αποτελεί, ένα υποπροϊόν του Οθωμανισμού, και σχετίζεται με την επιθυμία της ελληνικής αστικής τάξης στην Οθωμανική Αυτοκρατορία να διαφυλάξει τα προνόμια της σε ένα μεταβαλλόμενο περιβάλλον αποστασιοποιημένη παράλληλα από το ιδεολογικό αφήγημα της Μεγάλης Ιδέας. Συμπερασματικά, ο σύγχρονος οθωμανικός και ελληνόγλωσσος τύπος όχι μόνο κατέγραψε το ιστορικό γεγονός της εξέγερσης αλλά αποτέλεσε και σημαντικό μέσο έκφρασης όλων των παραπάνω ιδεολογημάτων που χαρακτήρισαν τις εξελίξεις στην περιοχή κατά τον 2ο μισό του 19ου αιώνα.
Topical issues of the qualification exam for auditors in the Russian Federation
Authors: Kazakova Nataliya
Published: November 2022

The article considers the results of the qualification exam for auditors and potential audit engagement leaders in relation to ongoing legislative changes, events and trends that determine the current needs for improving audit practice. An analysis was made of passing the qualification exam for the right to carry out audit activities in the Russian Federation for the period of its implementation from July 2020 to September 2022 based on international standards and a modular competency-based approach. The established and new approaches implemented by the Unified Certification Commission in order to improve the level of preparation of applicants for the qualification exam are considered, constructive projects are proposed to inform the audit community about the principles and methods for the formation of examination questions and exam tasks.
Non-financial environmental information in public statements of companies
Authors: Eremeeva Ol'ga
Published: November 2022

The article considers the problem of the necessity and sufficiency of non-financial envi-ronmental information in the public accounting of companies. The article substantiates the importance of creating a unified information base of operational, environmental, sta-tistical, and accounting data at the enterprise, using related and recurring data of these types of accounting when forming public reporting. The recommendations of the Bank of Russia on the reflection of environmental information in reporting are analyzed. The requirements of normative documents on environmental reporting were highlighted, a search for environmental reports of enterprises with similar information was carried out. Sources of information used to prepare special environmental and accounting reports are shown. A conclusion is made about the possibility of using the operational accounting data of environmental services to form non-financial environmental information in pub-lic accounting.
Bilateral resorption of mandibular angle in patient with systematic sclerosis - a case report
Authors: Futyma-Gąbka Karolina , Piskórz Magdalena , Różyło-Kalinowska Ingrid
Published: November 2022

Progressive systemic sclerosis (PSS) is chronic autoimmune disease affecting a connective tissue. The symptoms of PSS in orofacial area are: restricted mouth opening, xerostomia, facial asymmetry and problems with oral hygiene. Radiographic images can show specific features like bone resorption, especially in mandibular region or periodontal ligament space widening. The aim of this study was to present the case of 56-year-old woman with characteristic scleroderma-related changes visible on panoramic radiograph. The patient diagnosed with severe systemic sclerosis was referred by dermatologist to general dentist. The woman experienced tightening of facial skin, xerostomia and reduced mouth opening which caused problems with daily oral hygiene and dental treatment. General dentist referred the patient to the Department of Dental and Maxillofacial Radiodiagnostics of Medical University of Lublin for the panoramic X-ray. One of the main findings was bilateral resorption of mandibular angles. Localization of the bone resorption in patients with scleroderma is related to attachements of masticatory muscles. Dentists and general doctors should be aware that some of the maxillofacial manifestations of systematic scleroderma can be visible on panoramic radiographs.
Strategies for Talent’s Digital Competence Development at Higher Vocational Colleges for Digital Transformation
Authors: Zeng Xiuzhen , Li Yaxin
Published: November 2022

Digital transformation has brought unprecedented opportunities and challenges to economic and social development, and the development of talent’s digital competence is of growing importance. Under an ideal situation, digitization, digitalization and digital transformation are three stages of gradual digital development. However, influenced by the difference in social and economic development among regions, higher vocational colleges, as an educational system closest to the labor market, vary by their own strengths and digital competence. From the perspective of game theory and based on the model of the boxed pig game, this paper provides strategies and suggestions for the cultivation of talent’s digital competence in terms of non-cooperative strategy at higher vocational colleges. The supply-demand model of talent’s digital competence cultivation is established to provide further suggestions for the top-down cooperation strategy among higher vocational colleges.
ECG of the month
Authors: Regan Martin
Published: November 2022

In this issue's ECG of the month, Martin Regan presents the case of a 62-year-old man who presented to the emergency department after being kept awake all night with chest pain.
Factors that enhance compliance with the Surgical Safety Checklist
Authors: McNamara Claire , Markey Kathleen , O'Donnell Claire , Murphy Jill , O'Brien Brid
Published: November 2022

Background:

The World Health Organization (WHO) has reported that its Surgical Safety Checklist (SSC) has resulted in significant reductions in morbidity and mortality. Despite its proven success, meaningful compliance with the Surgical Safety Checklist initiative has been low.

Aims:

The authors sought to identify and explore published research on factors that enhance compliance with the SSC within surgical team members.

Methods:

A review of the literature published between January 2017 and January 2021 was undertaken. Six databases were searched, and 1340 studies were screened for eligibility. The 17 studies included were critically appraised using the Crowe Critical Appraisal Tool.

Findings:

Three main themes were identified: training and innovations; process adaptations and team leadership.

Conclusion:

This review of the literature draws attention to the complexities of checklist compliance and identifies the need for training, leadership and adaptation to new safety processes.
The basics of blood and associated disorders
Authors: Ashwell Emily
Published: November 2022

The blood and its components are involved in a wide range of processes to support life, including fighting infection and providing the body's tissues with oxygen and nutrients. If any stage in the development of blood cells is disrupted, for example by genetic abnormalities or a lack of nutrients, disease may result. This article provides an overview of some of the blood's key components, blood cells and their formation and functions, blood groups and some of the problems that can arise from malfunctions. A case study on haemophilia A as a blood disorder is presented to consolidate knowledge.
Insanity as a defence to a criminal charge
Authors: Griffith Richard
Published: November 2022

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the availability of the special verdict and common law insanity defence in cases where a person with a mental disorder faces a criminal charge
A long-overdue resource to tackle racism
Authors: Foster Sam
Published: November 2022

Sam Foster, Chief Nurse, Oxford University Hospitals, discusses ethnic inequalities among patient groups and the NHS workforce and a resource to raise awareness and help combat racism
Research Roundup
Authors: Green Laura
Published: November 2022

Synopses of a selection of recently published research articles of relevance to palliative care
Demystifying plastic production processes
Authors: Chaloupka Alexander
Published: November 2022

Process software developed by German company sensXPERT helps engineers monitor molding processes and materials in real time.
Unsupervised learning with a physics-based autoencoder for estimating the thickness and mixing ratio of pigments
Authors: Shitomi Ryuta , Tsuji Mayuka , Fujimura Yuki , Funatomi Takuya , Mukaigawa Yasuhiro , Morimoto Tetsuro , Oishi Takeshi , Takamatsu Jun , Ikeuchi Katsushi
Published: November 2022

Layered surface objects represented by decorated tomb murals and watercolors are in danger of deterioration and damage. To address these dangers, it is necessary to analyze the pigments’ thickness and mixing ratio and record the current status. This paper proposes an unsupervised autoencoder model for thickness and mixing ratio estimation. The input of our autoencoder is spectral data of layered surface objects. Our autoencoder is unique, to our knowledge, in that the decoder part uses a physical model, the Kubelka–Munk model. Since we use the Kubelka–Munk model for the decoder, latent variables in the middle layer can be interpretable as the pigment thickness and mixing ratio. We conducted a quantitative evaluation using synthetic data and confirmed that our autoencoder provides a highly accurate estimation. We measured an object with layered surface pigments for qualitative evaluation and confirmed that our method is valid in an actual environment. We also present the superiority of our unsupervised autoencoder over supervised learning.
Simultaneous modulation format identification and OSNR monitoring based on optoelectronic reservoir computing
Authors: Han Mengyao , Wang Muguang , Fan Yuchuan , Cai Shiyi , Guo Yuxiao , Zhang Naihan , Schatz Richard , Popov Sergei , Ozolins Oskars , Pang Xiaodan
Published: November 2022

An approach for simultaneous modulation format identification (MFI) and optical signal-to-noise ratio (OSNR) monitoring in digital coherent optical communications is proposed based on optoelectronic reservoir computing (RC) and the signal’s amplitude histograms (AHs) obtained after the adaptive post-equalization. The optoelectronic RC is implemented using a Mach-Zehnder modulator and optoelectronic delay feedback loop. We investigate the performance of the proposed model with the number of symbols, bins of AHs and the hyperparameters of optoelectronic RC. The results show that 100% MFI accuracy can be achieved simultaneously with accurate OSNR estimation for different modulation formats under study. The lowest achievable OSNR estimation mean absolute errors for the dual-polarization (DP)-quadrature phase-shift keying signal, the DP-16-ary quadrature amplitude modulation (16QAM) signal, and the DP-64QAM signal are 0.2 dB, 0.32 dB and 0.53 dB, respectively. The robustness of the proposed scheme is also evaluated when the optoelectronic RC is in presence of additive white Gaussian noises. Then, a proof of concept experiment is demonstrated to further verify our proposed method. The proposed approach offers a potential solution for next-generation intelligent optical performance monitoring in the physical layer.
Design method of imaging optical systems using confocal flat phase elements
Authors: Yang Tong , Gao Lina , Cheng Dewen , Wang Yongtian
Published: November 2022

Imaging systems consisting of flat phase element such as diffractive optical element, holographic optical element, and metasurface have important applications in many fields. However, there is still a lack of generalized and efficient design methods of these systems, especially for systems with nonsymmetric configurations. We proposed a design method of imaging system consisting of flat phase elements based on confocal properties. The description of the generalized phase function for realizing point-to-point stigmatic imaging is derived. Given the focal length or magnification as well as the locations of the elements based on the design requirements, the phase functions can be calculated very fast and stigmatic imaging of the central field is realized. The systems can be taken as good starting points for further optimization, during which the rotationally symmetric or freeform phase terms can be added. Several design examples are demonstrated to validate the feasibility of the method. The proposed method increases design efficiency while decreasing the dependence on existing systems and skills significantly, and can be easily integrated into optical design software.
Gate-tunable bolometer based on strongly coupled graphene mechanical resonators
Authors: Chen Hui , Zhao Zi-Fan , Li Wei-Jie , Cheng Ze-Di , Suo Jiao-Jiao , Li Bo-Lin , Guo Meng-Lin , Fan Bo-Yu , Zhou Qiang , Wang You , Song Hai-Zhi , Niu Xiao-Bin , Li Xiao-Yu , Arutyunov Konstantin Yu. , Guo Guang-Can , Deng Guang-Wei
Published: November 2022

Bolometers based on graphene have demonstrated outstanding performance with high sensitivity and short response time. In situ adjustment of bolometers is very important in various applications, but it is still difficult to implement in many systems. Here we propose a gate-tunable bolometer based on two strongly coupled graphene nanomechanical resonators. Both resonators are exposed to the same light field, and we can measure the properties of one bolometer by directly tracking the resonance frequency shifts, and indirectly measure the other bolometer through mechanical coupling. We find that the sensitivity and the response bandwidth of both bolometers can be independently adjusted by tuning the corresponding gate voltages. Moreover, the properties of the indirectly measured bolometer show a dependence on the coupling between the two resonators, with other parameters being fixed. Our method has the potential to optimize the design of large-scale bolometer arrays, and open new horizons in infrared/terahertz astronomy and communication systems.
Thin-film dynamics unveils interplay between light momentum and fluid mechanics
Authors: Verma Gopal , Yadav Gyanendra , Li Wei
Published: November 2022

We quantitatively measure the nanomechanical dynamics of a water surface excited by the radiation pressure of a Gaussian/annular laser beam of incidence near total internal reflection (TIR). Notably, the radiation pressure near TIR allowed us to induce a pushing force (Abraham’s momentum of light) for a wide annular Gaussian beam excitation of the thin-film regime of water, which, to the best of our knowledge, has never been observed with nanometric precision previously. Our finding suggests that the observation of either/both Abraham’s and Minkowski’s theories can be witnessed by the interplay between optics and fluid mechanics. Furthermore, we demonstrate the first, to the best of our knowledge, simultaneous measurement of Abraham’s and Minkowski’s momenta emerging in a single setup with a single laser shot. Our experimental results are strongly backed by numerical simulations performed with realistic experimental parameters and offer a broad range of light applications in optofluidics and light-actuated micromechanics.
Heat stress illness outcomes and annual indices of outdoor heat at U.S. Army installations
Authors: Lewandowski Stephen A. , Kioumourtzoglou Marianthi-Anna , Shaman Jeffrey L.
Published: November 2022

This study characterized associations between annually scaled thermal indices and annual heat stress illness (HSI) morbidity outcomes, including heat stroke and heat exhaustion, among active-duty soldiers at ten Continental U.S. (CONUS) Army installations from 1991 to 2018. We fit negative binomial models for 3 types of HSI morbidity outcomes and annual indices for temperature, heat index, and wet-bulb globe temperature (WBGT), adjusting for installation-level effects and long-term trends in the negative binomial regression models using block-bootstrap resampling. Ambulatory (out-patient) and reportable event HSI outcomes displayed predominately positive association patterns with the assessed annual indices of heat, whereas hospitalization associations were mostly null. For example, a one-degree Fahrenheit (°F) (or 0.55°C) increase in mean temperature between May and September was associated with a 1.16 (95% confidence interval [CI]: 1.11, 1.29) times greater rate of ambulatory encounters. The annual-scaled rate ratios and their uncertainties may be applied to climate projections for a wide range of thermal indices to estimate future military and civilian HSI burdens and impacts to medical resources.
The changes of electroencephalography in mountaineers on Mount Jade, Taiwan: An observational study
Authors: Chang Kuo-Song , Chiu Yu-Hui , Kao Wei-Fong , Yang Cheryl C. H. , How Chorng-Kuang , Lin Yen-Kuang , Hwang Yuh-Shyan , Chien Ding-Kuo , Huang Ming-Kun , Kuo Terry B. J.
Published: November 2022

Background

The diagnosis of acute mountain sickness, which lacks a reliable and objective diagnostic tool, still depends on the clinical symptoms and signs and remains a major threat and unpredictable disease affecting millions of mountaineers.

Objectives

To record electroencephalography signals with small, convenient, wireless equipment and to test whether electroencephalography parameters, which are more sensitive and reliable markers, could predict the symptoms of acute mountain sickness.

Methods

Twenty-five participants were enrolled and separated into two groups to climb Mount Jade in Taiwan. We collected electrocardiography signals and arterial oxygen saturation data at ground, moderate (2,400 m), and high altitude (3,400 m). A spectral analysis of the electrocardiography was performed to assess the study subjects’ electroencephalography activity at different frequencies (α, β, θ, δ) and the mean power frequency of electrocardiography. The clinical symptoms and Lake Louise Acute Mountain Sickness scores of the subjects were recorded for comparison.

Results

A significant change in the δ power of electroencephalography was recorded in subjects ascending from the ground to a high altitude of 3,400 m in a 4-day itinerary. In addition, between the two groups of subjects with and without acute mountain sickness (Lake Louise Acute Mountain Sickness scores < 3 and ≥ 3), the δ power of electroencephalography at the fronto-parietal 1 and parietal 3 electrodes at moderate altitude as well as the changes of δ power and mean power frequency of electrocardiography over parietal 4 at high altitude showed a significant difference. At moderate altitude, the increasing δ power of electroencephalography at the parietal 4 electrode was related to the headache symptom of acute mountain sickness before ascending to high altitude.

Conclusion

At moderate altitude, the δ power increase of electroencephalography at the P4 electrode could be a predictor of acute mountain sickness symptoms before ascending to high altitude. Thus, electroencephalography had the potential to identify the risk of acute mountain sickness.
The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies
Authors: Bikomeye Jean C. , Balza Joanna S. , Kwarteng Jamila L. , Beyer Andreas M. , Beyer Kirsten M. M.
Published: November 2022

Significance

Globally, cardiovascular disease (CVD) and cancer are leading causes of morbidity and mortality. While having different etiologies, CVD and cancer are linked by multiple shared risk factors, the presence of which exacerbate adverse outcomes for individuals with either disease. For both pathologies, factors such as poverty, lack of physical activity (PA), poor dietary intake, and climate change increase risk of adverse outcomes. Prior research has shown that greenspaces and other nature-based interventions (NBIs) contribute to improved health outcomes and climate change resilience.

Objective

To summarize evidence on the impact of greenspaces or NBIs on cardiovascular health and/or cancer-related outcomes and identify knowledge gaps to inform future research.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and Peer Review of Electronic Search Strategies (PRESS) guidelines, we searched five databases: Web of Science, Scopus, Medline, PsycINFO and GreenFile. Two blinded reviewers used Rayyan AI and a predefined criteria for article inclusion and exclusion. The risk of bias was assessed using a modified version of the Newcastle–Ottawa Scale (NOS). This review is registered with PROSPERO, ID # CRD42021231619.

Results & discussion

Of 2565 articles retrieved, 31 articles met the inclusion criteria, and overall had a low risk of bias. 26 articles studied cardiovascular related outcomes and 5 studied cancer-related outcomes. Interventions were coded into 4 categories: forest bathing, green exercise, gardening, and nature viewing. Outcomes included blood pressure (BP), cancer-related quality of life (QoL) and (more infrequently) biomarkers of CVD risk. Descriptions of findings are presented as well as visual presentations of trends across the findings using RAW graphs. Overall studies included have a low risk of bias; and alluvial chart trends indicated that NBIs may have beneficial effects on CVD and cancer-related outcomes.

Conclusions & implications

(1)Clinical implication:Healthcare providers should consider the promotion of nature-based programs to improve health outcomes.(2)Policy implication: There is a need for investment in equitable greenspaces to improve health outcomes and build climate resilient neighborhoods.(3)Research or academic implication: Research partnerships with community-based organizations for a comprehensive study of benefits associated with NBIs should be encouraged to reduce health disparities and ensure intergenerational health equity. There is a need for investigation of the mechanisms by which NBIs impact CVD and exploration of the role of CVD biological markers of inflammation among cancer survivors.