bluuebunny/crossref_metadata_2025 huggingface dataset:
Immune-related histologic phenotype in pretreatment tumour biopsy predicts the efficacy of neoadjuvant anti-PD-1 treatment in squamous lung cancer
Authors: Yuan Pei , Guo Changyuan , Li Lin , Ling Yun , Guo Lei , Ying Jianming
Published: October 2022

Background

Although neoadjuvant anti-PD-1 immunotherapies have shown good efficacy in non-small cell lung cancer (NSCLC) patients, there is still a lack of effective predictive markers. We aimed to develop a pretreatment histologic scoring system to predict the efficacy of neoadjuvant immunotherapy.

Methods

One hundred forty NSCLC cases were evaluated in this study. Initially, surgical specimens from 31 squamous cell lung cancer patients treated with neoadjuvant anti-PD-1 therapy and their eligible paired pretreatment biopsies were used for pathologic evaluation and developing the pretreatment scoring system, immune-related histologic phenotype assessment criteria (irHPC). Three trained pathologists independently scored the haematoxylin-eosin (HE) slides of the pretreatment tumour biopsies according to irHPC. The follow-up was from 07 March 2018 to 31 December 2021, mainly focusing on disease-free survival (DFS) and overall survival (OS). Second, 109 biopsies of lung squamous cell carcinoma were evaluated to explore the relationship between eosinophils and PD-L1 expression.

Results

Superior 2-year DFS rates and 2-year OS rates were observed in patients who achieved major pathologic response (MPR) (MPR vs. non-MPR: 92.9% vs. 78.6%; 100.0% vs. 93.3%). Whether necrosis was included in the calculation of the per cent of residual viable tumour (%RVT) or not had almost no effect on the consistency of pathologic assessment and the histological response grouping. The interpathologist variability in assessing %RVT with immune-activated phenotype was not statistically significant (P = 0.480). Four immune-related features of pretreatment biopsies were included for calculating the predictive score. The trained pathologist accurately predicted most cases according to irHPC. For interobserver reproducibility using “2 points” as the cutoff, the overall per cent agreement was 77.8%. The reliability between pathologists for a binary tumour evaluation showed “moderate” agreement (κ = 0.54). Patients with scores ≥ 2 points tended to have better 2-year DFS rates and 2-year OS rates than those with scores < 2 points (85.7% vs. 71.4%; 100.0% vs. 87.5%).

Conclusions

The irHPC scoring system reflecting the preexisting immune response could be used to predict pathologic response to neoadjuvant immunotherapy, possibly further predicting the long-term prognosis, but larger trials are needed for verification.
Impact of floods on undernutrition among children under five years of age in low- and middle-income countries: a systematic review
Authors: Agabiirwe Caroline Noel , Dambach Peter , Methula Thabile Constance , Phalkey Revati K
Published: October 2022

Background

Weather and climate-related disasters, including floods, impact undernutrition through multiple pathways, including food security, inadequate child care practices, and water and sanitation. This review aimed to provide systematic evidence of the impact of floods on undernutrition in children under five years of age in Low and Middle-income countries (LMICs).

Methods

We searched PubMed, Web of Science, Embase, MEDLINE, CINAHL and Scopus for peer-reviewed articles. Popline, WHO Library database (WHOLIS), the International Disaster database (EM-DAT), Food and Agriculture Organisation (FAO), UNICEF and Eldis were searched for grey literature articles. Database searches were first conducted in 2016 and updated in 2020. We included English language articles that reported the effect of floods on undernutrition outcomes in children under 5 years of age in LMICs, without limitation to study design and year of publication. The quality of selected studies was assessed using the National Institutes of Health (NIH) tool for Observational Cohort and Cross-Sectional Studies.

Results

Of the 5701 articles identified, 14 met our inclusion criteria. The review noted stunting as the most frequently reported significant form of undernutrition in flood-affected areas. Severe and recurrent floods showed the greatest impact on undernutrition. Due to weak and limited evidence, the study is inconclusive on the most significant forms within the short-term and intermediate periods following floods. On the other hand, stunting was noted as the most frequently reported significant form of undernutrition in the long-term period following floods. There was generally little evidence of the effect of floods on micronutrient deficiencies. Factors associated with child undernutrition in the flood-affected areas included age, gender, diarrhoea, maternal and paternal education, maternal age, household size, land ownership and socioeconomic status. Overall, the quality of the evidence was fairly weak, with the main challenge lying in the inability of the studies to establish causal pathways for the observed effects.

Conclusions

The review suggests clear plans and strategies for preventing and reducing the long-term impact of floods on undernutrition in children under five years. Future research utilising long-term prospective data is indispensable to provide more robust evidence to guide better prevention measures, response decisions and interventions.
Sex-specific changes in triglyceride profiles in liver cirrhosis and hepatitis C virus infection
Authors: Peschel Georg , Grimm Jonathan , Müller Martina , Höring Marcus , Krautbauer Sabrina , Weigand Kilian , Liebisch Gerhard , Buechler Christa
Published: October 2022

Background

Hepatitis C virus (HCV) infection is associated with serum lipid abnormalities, which partly normalize following direct-acting antiviral (DAA) therapy. Here, associations of serum triglycerides (TGs) with viral genotype and markers of liver disease severity were evaluated in patients with chronic HCV. 

Methods

The study included the serum of 177 patients with chronic HCV. TGs were quantified by flow injection analysis Fourier transform mass spectrometry. Laboratory values and noninvasive scores for liver fibrosis assessment were determined. The nonparametric Kruskal‒Wallis test, one-way ANOVA, multiple linear regression and Student’s t test were used as appropriate. P values were adjusted for multiple comparisons.

Results

HCV-infected women had lower serum TGs than men, and thus, a sex-specific analysis was performed. None of the 46 TG species analyzed differed in the serum of female patients with and without liver cirrhosis. In contrast, in the serum of male patients with liver cirrhosis, TGs with 53, 56 and 58 carbon atoms and three to eight double bonds were diminished. These polyunsaturated TGs were also low in males with a high fibrosis-4 score. TGs with 7 or 8 double bonds negatively correlated with the model of end-stage liver disease score in males. In addition, TGs with 49, 51 and 53 carbon atoms were reduced in male patients infected with genotype 3a in comparison to genotype 1a. TGs with 56 carbon atoms were lower in genotype 3a-infected males than in genotype 1b-infected males. TGs did not differ in females by genotype. Genotype 3-related changes disappeared at the end of therapy with DAAs. Overall, the levels of serum TGs did not change during DAA therapy in either sex. Consequently, the serum TGs of males with liver cirrhosis were lower than those of males without cirrhosis at the end of therapy. Such a difference was not apparent in females.

Conclusions

The decline in TGs observed only in male patients with liver cirrhosis and male patients infected with genotype 3 illustrates sex-specific changes in lipid metabolism in chronic HCV.
In-hospital initiation of PCSK9 inhibitor and short-term lipid control in patients with acute myocardial infarction
Authors: Lou Bowen , Liu Hui , Luo Yongbai , Jiang Gulinigaer Tuerhong , Wu Haoyu , Wang Chen , Wu Yue , Zhou Bo , Yuan Zuyi , She Jianqing , Liu Junhui
Published: October 2022

Background

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to improve cardiovascular outcomes when added to conventional statin therapy. This study aims to investigate the efficacy and safety of in-hospital initiation of PCSK9 inhibitors among patients with acute myocardial infarction (AMI) based on real-world experience.

Methods and results

Data were collected from the Biobank of the First Affiliated Hospital of Xi’an Jiaotong University between January 2016 and December 2020. A total of 7556 AMI patients were screened for eligibility. Propensity Score Match (PSM) was employed, and covariates were age, sex, admission blood pressure and lipid profiles.

Eligible participants were (1) propensity-matched 1:2:2 of statin plus evolocumab (dual therapy) vs. statin vs. statin plus ezetimibe. Ninety-five statin plus evolocumab users achieved significantly decreased low density lipoprotein (LDL) levels (0.92 ± 0.62 mmol/L in the 1st month and 1.17 ± 0.73 in the 3rd month) and a promising attainment rate of LDL (79.5% in the 1st month and 80.0% in the 3rd month) compared to the other two groups. (2) Propensity-matched 1:2:2 of statin plus ezetimibe evolocumab (triple therapy) vs. statin vs. statin plus ezetimibe. Similarly, 75 triple medication users achieved significantly decreased LDL levels and a promising attainment rate of LDL compared to the other two groups. In-hospital mortality and readmission rates within 3 months were then analyzed, and a decreased readmission rate was observed with PCSK9i therapy.

Conclusions

Based on the present single-center real-world PSM-adjusted study, PCSK9i has been effective in short-term lipid control among AMI patients. The long-term effectiveness for reducing major cardiovascular events among AMI patients based on real-world experience remains to be explored.

Trial registration

The study was registered at ClinicalTrials.gov, ClinicalTrials.gov ID: NCT05184530

Graphical Abstract
Does living liver donors’ underestimation about surgical outcomes impact on their health-related quality of life after donation?: a descriptive cross-sectional study
Authors: Lee Ye Sol , Koh Chin Kang , Yi Nam-Joon , Suh Kyung-Suk , Lee Kwang-Woong
Published: October 2022

Background

In South Korea, the number of living-donor liver transplantations in 2019 was 1,188. Living liver donors (LLDs) undergo surgery and the postoperative recovery process for altruistic purposes. This study explored LLDs’ unmet expectations about surgical outcomes and examined their impact on the donors’ health-related quality of life (HRQOL).

Methods

This descriptive cross-sectional study utilized a self-reported survey. Data were collected at a university hospital in Seoul, South Korea. Among the 535 LLDs who underwent surgery for donation between January 2011 and March 2021, 124 participated in this study. The Korean version of the 12-item Short Form Health Survey version 2 (SF-12v2) was used to measure the HRQOL of LLDs. Unmet expectations regarding surgical outcomes were measured using four items: pain, length of hospital stay, speed of recovery, and complications. Logistic regression model was applied to determine whether the unmet expectations influence HRQOL in LLDs. Odds ratios with 95% confidence interval were used.

Results

The percentage of the participants who reported that their actual experiences for pain, speed of recovery, hospital stay, and complications were worse than expected were 34.7%, 22.6%, 9.7%, and 7.3%, respectively. Unmet expectations about surgical outcomes were significantly associated with physical and mental HRQOL after controlling for age, sex, education level, income, postoperative complications, recipients’ death, time since donation, and satisfaction with the decision to donate.

Conclusion

LLDs should be supported in obtaining more accurate and realistic information about surgical outcomes to decrease unmet expectations, which may help improve their quality of life.
Does one plus one always equal two? Structural differences between nesfatin-1, -2, and nesfatin-1/2
Authors: Lenda Rafał , Padjasek Michał , Krężel Artur , Ożyhar Andrzej , Bystranowska Dominika
Published: October 2022

Nesfatin-1 and -2 are produced from a reaction in which the N-terminus of human Nucleobindin-2 undergoes proteolytical processing. To date, Nucleobindin-2 and/or nesfatin-1 have only been shown to act as peptide hormones. On the other hand, the purpose of nesfatin-2 remains unknown. Since Nucleobindin-2/nesfatin-1 is thought impact the control of a wide range of physiological processes, including energy homeostasis, neurodegenerative processes and carcinogenesis, its ligands/interactions deserve special studies and attention. However, there are no reports about the molecular properties of the proteolytical products of human Nucleobindin-2 in the literature. Hence, this study aimed to analyze the effect of Zn(II) and Ca(II) on human nesfatin-1, -2, and -1/2 structures. Herein, we report that human nesfatin-1 is a member of the intrinsically disordered protein family, as indicated by circular dichroism and analytical ultracentrifugation experiments. In contrast, we found that the human nesfatin-2 and nesfatin-1/2 structures were globular with intrinsically disordered regions. Under Zn(II) treatment, we observed concentration-dependent structurization and compaction of intrinsically disordered nesfatin-1 and its propensity for oligomerization, as well as destabilization of both nesfatin-2 and nesfatin-1/2. Furthermore, dissociation constants for Zn(II) binding by nesfatin-1, nesfatin-2, and nesfatin-1/2 were also reported. Moreover, structurally distinct nesfatin-1 and -2 seem to be interdependent when linked together, as indicated by the observed molecular properties of nesfatin-1/2, which in turn are not a simple sum of the properties exhibited by the former peptides. Thus, herein, we shed new light on the molecular behavior of human nesfatins, which might help to elucidate the complex function of those peptides.
Significant variation in the performance of DNA methylation predictors across data preprocessing and normalization strategies
Authors: Ori Anil P. S. , Lu Ake T. , Horvath Steve , Ophoff Roel A.
Published: October 2022

Background

DNA methylation (DNAm)-based predictors hold great promise to serve as clinical tools for health interventions and disease management. While these algorithms often have high prediction accuracy, the consistency of their performance remains to be determined. We therefore conduct a systematic evaluation across 101 different DNAm data preprocessing and normalization strategies and assess how each analytical strategy affects the consistency of 41 DNAm-based predictors.

Results

Our analyses are conducted in a large EPIC DNAm array dataset from the Jackson Heart Study (N = 2053) that included 146 pairs of technical replicate samples. By estimating the average absolute agreement between replicate pairs, we show that 32 out of 41 predictors (78%) demonstrate excellent consistency when appropriate data processing and normalization steps are implemented. Across all pairs of predictors, we find a moderate correlation in performance across analytical strategies (mean rho = 0.40, SD = 0.27), highlighting significant heterogeneity in performance across algorithms. Successful or unsuccessful removal of technical variation furthermore significantly impacts downstream phenotypic association analysis, such as all-cause mortality risk associations.

Conclusions

We show that DNAm-based algorithms are sensitive to technical variation. The right choice of data processing strategy is important to achieve reproducible estimates and improve prediction accuracy in downstream phenotypic association analyses. For each of the 41 DNAm predictors, we report its degree of consistency and provide the best performing analytical strategy as a guideline for the research community. As DNAm-based predictors become more and more widely used, our work helps improve their performance and standardize their implementation.
Association between religiosity and orthorexia nervosa with the mediating role of self-esteem among a sample of the Lebanese population – short communication
Authors: Sfeir Michel , Malaeb Diana , Obeid Sahar , Hallit Souheil
Published: October 2022

Background

Orthorexia Nervosa is not yet classified as an eating disorder albeit it can be found in different populations. This condition can be characterized by a preoccupation with the quality of food, accompanied by obsessive thoughts regarding eating behaviors, leading to malnutrition. Previous associations have been reported between high levels of eating disorders and lower levels of self-esteem; where individuals have low self-esteem due to the pressured felt to fit the norms of society in beauty standards. The aim of the present study was to evaluate the relationship between religiosity and orthorexia nervosa via either trait or state self-esteem.

Methods

This study was conducted between September 2021 and February 2022 and included 428 participants from all Lebanese governorates. The Teruel Orthorexia Nervosa scale was used to measure orthorexia nervosa. The following scales state self-esteem and religiosity were used to measure self-esteem.

Results

Sociodemographic characteristics (age, gender, marital status, household crowding index, body mass index and education) were entered in the mediation model as confounding variables. Higher religiosity was significantly associated with higher state self-esteem (Beta = 0.07), while higher state self-esteem was significantly associated with lower identification of those that exhibited ON tendencies or symptoms (Beta= -0.11).

Conclusion

A high state self-esteem was correlated with a lower level of orthorexia nervosa. Higher religiosity was shown to be associated with higher self-esteem, which in turn was associated with a decrease in the scores of orthorexia nervosa.
Researching English language textbooks: A systematic review in the Chinese context (1964–2021)
Authors: Pan Molly Xie , Zhu Yan
Published: October 2022

A new wave of developing English textbooks for compulsory education in China demands for more attention on the integration of textbook research and practice. While increasing research has investigated the design and implementation of English textbooks for Chinese learners, there is a lack of a systematic review on the structural development of this field, leaving prominent research areas, research methods, and enlightening findings unclear. This paper addresses the above issues by systematically reviewing 530 research concerning English textbooks in the Chinese context. As a data-driven study, we applied content analysis and developed a coding scheme, manually annotated all data and cross-checked our annotations. Findings from descriptive statistics and content analysis showed increasing attention on textbooks research from Chinese researchers, inadequate empirical studies, insufficient effort on English textbooks for compulsory education, and three research themes, i.e. textbooks production, textbooks implementation, and textbooks evaluation. Future directions and implications are further discussed.
COVID-19 vaccine acceptance: knowledge and beliefs
Authors: Alkattan Abdullah , Radwan Nashwa , Mahmoud Nagla , Alkhalifah Ahmed , Alshamlan Ammar , Alkamis Abdullah , Alfaifi Amal , Alanazi Wedad , Alfaleh Amjad , Haji Alhan , Alabdulkareem Khaled
Published: October 2022

Backgrounds

Vaccine acceptance varies across countries, generations, and the perceived personality of individuals. Investigating the knowledge, beliefs, and acceptability of COVID-19 vaccines among individuals is vital to ensuring adequate health system capacity and procedures and promoting the uptake of the vaccines.

Results

A cross-sectional study was conducted from August 2021 to January 2022 in Saudi Arabia. The study included 281 residents to estimate their acceptance to receive COVID-19 vaccination. Around 70% of the included participants had a moderate to high COVID-19 vaccine acceptance rate during the data collection period. The risk increases to about two folds among undergraduates [OR 1.846 (1.034–3.296), p value = 0.036)] and increases to four folds among non-employed [OR 3.944 (2.310–6.737), p value = 0.001]. About 78% of participants with high and 44% with low COVID-19 vaccine acceptance (p value = 0.001) believed the vaccines were safe and effective. The belief that COVID-19 disease will be controlled within two years increased the risk for low vaccine acceptance by about two folds [OR 1.730 (1.035–2.891), p value = 0.035]. Good knowledge about COVID-19 vaccination significantly affected the acceptance rate (p value = 0.001).

Conclusions

Several factors affect the intention of individuals to receive vaccines. Therefore, building good knowledge and health literacy through educational intervention programs, especially vaccine safety and effectiveness, is important for successful vaccination campaigns among the general population and ensuring control of the COVID-19 pandemic.
Reticulocyte hemoglobin content: a simple parameter for detection of iron deficiency anemia in children with chronic liver disease
Authors: Nassim Mariam Saad , El Raziky Mona S. , Baiomy Kareem , Abd El Salam Mai
Published: October 2022

Background

Iron deficiency anemia is common among patients with chronic liver disease. Reticulocyte hemoglobin is a marker for iron availability in the bone marrow that is not affected by inflammation.

Objective

The aim of this study is to detect the diagnostic value of reticulocyte hemoglobin (Ret-Hb) in diagnosis of iron deficiency anemia among children with chronic liver disease.

Methods

This is a cross-sectional study that included thirty-three children with chronic liver disease (CLD) and Hb < 11 g/dL, MCV < 77 fl, regularly attending the Pediatric Hepatology Clinic, Cairo University Children Hospitals. Patients underwent full history taking, and full iron profile and reticulocyte Hb were done.

Results

The median age of our patients was 5.9 years with a median age of onset of CLD was 1.6 years. The mean reticulocytic Hb was 25.52 ± 4.53 pg (N: 28–36 pg). Mean serum ferritin was 89 ± 16.55 ng/ml (N: 7–140 ng/ml). There was a statistically positive significant linear correlation between S-ferritin and Ret. Hb, r = +0.433, p = 0.012. ROC curve analysis of reticulocytic Hb, at cutoff ≤ 29.3 pg for diagnosis of iron deficiency anemia in children with CLD, had an AUC of 0.824 with a sensitivity of 92.59% and a specificity of 83.33%, with p = 0.012.

Conclusion

Reticulocyte Hb is a sensitive and specific marker for detection of iron deficiency anemia in CLD patients. Anemia in CLD was mostly iron deficiency anemia.
Full waveform inversion of a Brazilian pre-salt OBN dataset using a concentric circle source geometry
Authors: Fagua Duarte Edwin , da Silva Danyelle , Carvalho Pedro Tiago , de Araújo João Medeiros , Lopez Jorge L
Published: October 2022

We have designed a workflow to apply full-waveform inversion (FWI) to a new type of acquisition recorded on ocean-bottom nodes (OBNs) in the Brazilian presalt area. The data set consists of three large-radius concentric circles of seismic source points recorded on OBN placed within the area of the circles. This geometry provides full azimuth distribution and benefits from long offsets in which the effect of diving waves is strong. These diving waves carry information about the presalt targets of interest. In the FWI workflow, we retrieve the P-wave velocity using the density as a propagation parameter. We test three objective functions: ℓ2-norm, ℓ1-norm, and nonparametric residuals objective function (NPR-FWI), which have different abilities to handle low signal-to-noise ratio data. In our inversion tests, the ℓ1-norm and NPR-FWI retrieve more information about the presalt reservoir than the ℓ1-norm. We find through several inversion experiments that we can recover structures related to the presalt reservoir, demonstrating the potential for this new type of OBN circular source geometry. We also discuss implications for low-cost data acquisition that take advantage of the sparse nature of sources and receivers needed in this survey geometry, including its extension to time-lapse target-oriented reservoir monitoring.
Effect of Dapagliflozin on Cardiac Function and Metabolic and Hormonal Responses to Exercise
Authors: Herring Roselle A , Parsons Iain , Shojaee-Moradie Fariba , Stevenage Mary , Jackson Nicola , Manders Ralph , Umpleby A Margot , Fielding Barbara A , Davies Melanie , Russell-Jones David L
Published: October 2022

Objective

This work aimed to investigate the effect of the SGLT2 inhibitor, dapagliflozin (DAPA), on cardiac function and the metabolic and hormonal response to moderate exercise in people with type 2 diabetes.

Methods

This was a double-blind, placebo-controlled crossover study with a 4-week washout period. Nine participants were randomly assigned to receive either 4 weeks of DAPA or 4 weeks of placebo. After each treatment, they underwent an exercise protocol with 2 consecutive 10-minute stages at a constant load corresponding to 40% and 70% maximal oxygen consumption (VO2max), coupled with hormonal and metabolic analysis. A blinded transthoracic echocardiogram was performed 3 days later.

Results

During the exercise protocol, glucose and lactate were lower (P < .0001 and P < .05, respectively) and β-hydroxybutyrate (BOBH) and growth hormone (GH) were higher (P < .0005 and P = .01) following DAPA treatment compared to placebo. There was a trend for lower insulin with DAPA. Adrenalin, noradrenalin, and glucagon were not different. Following DAPA participants demonstrated an increased mean peak diastolic mitral annular velocity (e’) in comparison to placebo (P = .03). The indexed left atrial volume and right ventricular e” were reduced following DAPA compared with placebo (P = .045 and P = .042, respectively). Arterial stiffness was not different between treatments (DAPA 9.35 ± 0.60 m/s; placebo 9.07 ± 0.72 m/s).

Conclusion

During exercise, GH may be more important than catecholamines in driving the shift from glucose to fatty acid metabolism by SGLT2 inhibitors. The 4-week crossover design showed changes in cardiac function were rapid in onset and reversible.
Sugammadex Versus Neostigmine for Recovery of Respiratory Muscle Strength Measured by Ultrasonography in the Postextubation Period: A Randomized Controlled Trial
Authors: Huang Chanyan , Wang Xuan , Gao Shaowei , Luo Wei , Zhao Xu , Zhou Qian , Huang Wenqi , Xiao Ying
Published: October 2022

BACKGROUND:

Although sugammadex is well known for its use in reducing the incidence of residual neuromuscular blockade, this has not always been translated to improved clinical measures of postoperative respiratory muscle strength. Expiratory muscles play an important role in airway clearance and inspiratory muscle capacity augmentation, yet they have not been well studied. Therefore, we tested the hypothesis on whether sugammadex could enhance expiratory muscle strength recovery more completely than neostigmine in the immediate postextubation period.

METHODS:

Adult patients having microlaryngeal surgery under total intravenous anesthesia were randomized to receive sugammadex or neostigmine. The thickening fraction of internal oblique abdominal muscle (TFIO) and diaphragm excursion, respectively, reflecting expiratory and inspiratory muscle strength, were measured via ultrasonography at 3 time points: before induction (baseline), train-of-four ratio (TOFR) recovery to 0.9, and 30 minutes after postanesthesia care unit (PACU) arrival. The primary outcome was the change in TFIO from baseline to TOFR ≥0.9. The postoperative changes of diaphragm excursion from baseline, incidences of TFIO and diaphragm excursion returning to baseline levels, and the time from TOFR 0.9 to 0.95 and 1 were also measured.

RESULTS:

Among 58 patients, a significant difference in the change in TFIO from baseline to TOFR ≥0.9 between the sugammadex and neostigmine groups was observed: mean ± standard deviation, 9% ± 6% vs 16% ± 9%; difference in means: −6% (95% confidence interval [CI], −10 to −2); and adjusted P =.005 (adjusting for imbalanced variables between 2 groups). Sugammadex resulted in smaller changes in diaphragm excursion from baseline to TOFR ≥0.9 compared with neostigmine: difference in means: −0.83 cm (99.4% CI, −1.39 to −0.28 cm; Bonferroni-corrected P < .001). After 30 minutes in the postanesthesia care unit (PACU),33% of patients reversed with sugammadex versus 14% of those receiving neostigmine reached baseline TFIO levels (99.4% CI, −14 to 52; Bonferroni-corrected P > .999). The incidences of TFIO and diaphragm excursion returning to baseline were relatively low (<40%) in both groups despite TOFR reaching 1. The median time from TOFR of 0.9 to 0.95 and to 1 among patients receiving sugammadex was 7 and 10× faster than those receiving neostigmine (0.3 vs 2 minutes, Bonferroni-corrected P = .003; 0.5 vs 5.3 minutes, Bonferroni-corrected P < .001, respectively).

CONCLUSIONS:

Sugammadex provides a more complete recovery of expiratory muscle strength than neostigmine at TOFR ≥0.9. Our data suggest that the respiratory muscle strength might still be impaired despite TOFR reaching 1.
Manually Controlled, Continuous Infusion of Phenylephrine or Norepinephrine for Maintenance of Blood Pressure and Cardiac Output During Spinal Anesthesia for Cesarean Delivery: A Double-Blinded Randomized Study
Authors: Belin Olivier , Casteres Charlotte , Alouini Souhail , Le Pape Marc , Dupont Abderrahmane , Boulain Thierry
Published: October 2022

BACKGROUND:

To counteract the vasoplegia induced by spinal anesthesia (SA) and maintain blood pressure (BP) during cesarean delivery, phenylephrine is currently recommended, but norepinephrine might offer superior preservation of cardiac output. We aimed to compare the hemodynamic effects of phenylephrine and norepinephrine administered by manually adjusted continuous infusion during elective cesarean delivery.

METHODS:

In this pragmatic, parallel-group, double-blind randomized controlled trial, 124 parturients scheduled for elective cesarean delivery under SA in a tertiary maternity in France, between February 2019 and December 2020, were randomized to receive norepinephrine at a starting rate of 0.05 μg·kg−1·min−1 (n = 62) or phenylephrine at a starting rate of 0.5 μg·kg−1·min−1 (n = 62). In both groups, the vasopressor infusion rate was then manually adjusted to maintain maternal systolic BP above 90% of the baseline value. The primary outcome, the change in cardiac index (CI) measured by thoracic bioreactance from SA to umbilical cord clamping, was analyzed through repeated measures analysis of variance and post hoc t tests. Secondary outcomes included maternal BP and neonatal outcomes.

RESULTS:

In the norepinephrine group, cardiac index was maintained between 90% and 100% of baseline from SA to umbilical cord clamping, whereas it was maintained at significantly lower values (81%–88%) in the phenylephrine group (P = .001). The percentage of elapsed time with a mean maternal BP <65 mm Hg and with systolic BP <80% of the baseline value was higher in the phenylephrine group: 2.9% (7.3) vs 0.5% (1.8) (absolute risk difference [ARD], −2.4%; 95% confidence interval, −4.4 to −0.5; P = .012) and 8.5% (16.6) vs 2.3% (5.2) (ARD, −6.2%; 95% confidence interval, −10.6 to −1.8; P = .006). Excluding parturients with gestational diabetes, severe neonatal hypoglycemia was more common in the phenylephrine group at 19.6% (9/46) vs 4.1% (2/49) (P = .02). The other neonatal outcomes did not differ significantly between the groups.

CONCLUSIONS:

When administered by manually adjusted infusion during SA for cesarean delivery, norepinephrine was associated with a higher CI; both infusions were effective for maintaining BP.
Lost in the Game
Authors: Beller Thomas
Published: October 2022

For players, coaches, writers, and fans, basketball is a science and an art, a religious sacrament, a source of entertainment, and a way of interacting with the world. In Lost in the Game Thomas Beller entwines these threads with his lifetime's experience as a player and journalist, roaming NBA locker rooms and city parks as a basketball flaneur in search of the meaning of the modern game. He captures the magnificence and mastery of today’s most accomplished NBA players while paying homage to the devotion of countless congregants in the global church of pickup basketball. He shares his own stories from the courts, meditating on basketball’s role in city life and its impact on the athlete’s psyche as he moves from youth to middle age. Part journalistic account, part memoir of a slightly talented player whose main gift is being tall, Lost in the Game charts the game’s inexorable gravitational hold on those who love it.
Code
Authors: Geoghegan Bernard Dionysius
Published: October 2022

In Code Bernard Dionysius Geoghegan reconstructs how Progressive Era technocracy as well as crises of industrial democracy and colonialism shaped early accounts of cybernetics and digital media by theorists including Norbert Wiener, Warren Weaver, Margaret Mead, Gregory Bateson, Claude Lévi-Strauss, Roman Jakobson, Jacques Lacan, Roland Barthes, and Luce Irigaray. His analysis casts light on how media-practical research forged common epistemic cause in programs that stretched from 1930s interwar computing at MIT and eugenics to the proliferation of seminars and laboratories in 1960s Paris. This mobilization ushered forth new fields of study such as structural anthropology, family therapy, and literary semiology while forming enduring intellectual affinities between the humanities and informatics. With Code, Geoghegan offers a new history of French theory and the digital humanities as transcontinental and political endeavors linking interwar colonial ethnography in Dutch Bali to French sciences in the throes of Cold War-era decolonization and modernization.
Regulators specifying cell fate activate cell cycle regulator genes to determine cell numbers in ascidian larval tissues
Authors: Kobayashi Kenji , Tokuoka Miki , Sato Hiroaki , Ariyoshi Manami , Kawahara Shiori , Fujiwara Shigeki , Kishimoto Takeo , Satou Yutaka
Published: October 2022

In animal development, most cell types stop dividing before terminal differentiation; thus, cell cycle control is tightly linked to cell differentiation programmes. In ascidian embryos, cell lineages do not vary among individuals, and rounds of the cell cycle are determined according to cell lineages. Notochord and muscle cells stop dividing after eight or nine rounds of cell division depending on their lineages. In the present study, we showed that a Cdk inhibitor, Cdkn1.b, is responsible for stopping cell cycle progression in these lineages. Cdkn1.b is also necessary for epidermal cells to stop dividing. In contrast, mesenchymal and endodermal cells continue to divide even after hatching, and Myc is responsible for maintaining cell cycle progression in these tissues. Expression of Cdkn1.b in notochord and muscle is controlled by transcription factors that specify the developmental fate of notochord and muscle. Likewise, expression of Myc in mesenchyme and endoderm is under control of transcription factors that specify the developmental fate of mesenchyme and endoderm. Thus, cell fate specification and cell cycle control are linked by these transcription factors.
Lis1–dynein drives corona compaction and limits erroneous microtubule attachment at kinetochores
Authors: Mitevska Olivera , Lam Pak Wing , Daly Lydia , Auckland Philip
Published: October 2022

Mitotic cell division requires that kinetochores form microtubule attachments that can segregate chromosomes and control mitotic progression via the spindle assembly checkpoint. During prometaphase, kinetochores shed a domain called the fibrous corona as microtubule attachments form. This shedding is mediated, in part, by the minus-end directed motor dynein, which ‘strips’ cargoes along K-fibre microtubules. Despite its essentiality, little is known about how dynein stripping is regulated and how it responds to attachment maturation. Lis1 (also known as PAFAH1B1) is a conserved dynein regulator that is mutated in the neurodevelopmental disease lissencephaly. Here, we have combined loss-of-function studies, high-resolution imaging and separation-of-function mutants to define how Lis1 contributes to dynein-mediated corona stripping in HeLa cells. Cells depleted of Lis1 fail to disassemble the corona and show a delay in metaphase as a result of persistent checkpoint activation. Furthermore, we find that although kinetochore-tethered Lis1–dynein is required for error-free microtubule attachment, the contribution of Lis1 to corona disassembly can be mediated by a cytoplasmic pool. These findings support the idea that Lis1 drives dynein function at kinetochores to ensure corona disassembly and prevent chromosome mis-segregation.
Σχέσεις των Μεγάλων Κομνηνών της Τραπεζούντας με το μεσαιωνικό κράτος της Ιβηρίας (Γεωργίας) του Καυκάσου (1204-1461)
Authors: Ποζίδου Λίνα
Published: October 2022

Στην παρούσα διατριβή εξετάζονται οι πολυετείς και πολύπλευρες σχέσεις που αναπτύχθηκαν από τις αρχές του 13ου έως και περίπου τα μέσα του 15ου αιώνα μεταξύ της Αυτοκρατορίας της Τραπεζούντας και του βασιλείου της Γεωργίας. Δια μέσου της συγκριτικής ανάλυσης των βυζαντινών, γεωργιανών, αρμενικών και ρωσικών πηγών επιδιώξαμε να αναδείξουμε σημαντικές πτυχές των αδιάλειπτων κοινωνικοπολιτικών αλληλεπιδράσεων μεταξύ των δύο όμορων, ομόθρησκων και ομόδοξων βασιλείων σε ένα συνεχώς διευρυνόμενο μουσουλμανικό κόσμο. Η συμμαχία που επικυρώθηκε στις αρχές του 12ου αιώνα μέσω δυναστικού συνοικεσίου μεταξύ του βυζαντινού αυτοκρατορικού οίκου των Κομνηνών και των Βαγρατιδών, ανανεώθηκε στις αρχές του 13ου αιώνα όταν η βασίλισσα της Γεωργίας Θάμαρ αποφάσισε να συνδράμει στην εκστρατεία των Αλεξίου και Δαβίδ Μεγάλων Κομνηνών. Καθ’ όλη τη διάρκεια της εξεταζόμενης περιόδου, οι δύο συμμαχικοί οίκοι, επιδίωκαν να ανανεώνουν συνεχώς τους συμμαχικούς όρους αξιοποιώντας τον θεσμό των δυναστικών συνοικεσίων. Η κορύφωση στη μεταξύ τους συνεργασία επήλθε μετά την άλωση της προστάτιδας δύναμης όλων των χριστιανικών πληθυσμών της Ανατολής, της Κωνσταντινούπολης. Αν και αποδυναμωμένοι από τον εμφύλιο πόλεμο που είχε ξεσπάσει στο πολύπαθο βασίλειο της Γεωργίας, οι γεωργιανοί οίκοι συστρατεύθηκαν με τους Μεγάλους Κομνηνούς στην τελευταία προσπάθεια περιορισμού του ολοένα αυξανόμενου οθωμανικού επεκτατισμού.
Non-parametric volatility estimation of cryptocurrencies using high frequency data
Authors: Τάντουλα Μαρία
Published: October 2022

Αντικείμενο της παρούσας διδακτορικής διατριβής αποτελεί η μοντελοποίηση και πρόβλεψη του κινδύνου της απόδοσης του κρυπτονομίσματος Bitcoin. Προκειμένου να επιτευχθεί αυτό, προτείνεται μια μη παραμετρική προσέγγιση για την εκτίμηση της μεταβλητότητας και τον περαιτέρω διαχωρισμό της σε συνεχές και ασυνεχές ή αλματώδες μέρος. Ειδικότερα, εστιάζουμε στη χρήση δεδομένων υψηλής συχνότητας για τον υπολογισμό της πραγματοποιθείσας μεταβλητότητας του Bitcoin. Επιπλέον, βασιζόμαστε στο Ετερογενές Αυτοπαλίνδρομο Υπόδειγμα για την πραγματοποιθείσα μεταβλητότητα (HAR-RV), ως καταλληλότερο για τη μοντελοποίηση και πρόβλεψη της μεταβλητότητας στην αγορά κρυπτονομισμάτων. Παράλληλα, διερευνάται η σημασία διαχωρισμού της πραγματοποιθείσας μεταβλητότητας σε συνεχή και ασυνεχή συνιστώσα για τον εντοπισμό και υπολογισμό πρόσθετων μετρικών αλμάτων. Για την εκτίμηση των προβλέψεων βασιζόμαστε σε έναν αλγόριθμο μηχανικής μάθησης και συγκεκριμένα τα Τυχαία Δάση. Συγκεκριμένα, δημιουργούνται υβριδικά υποδείγματα λαμβάνοντας υπόψη τις μεταβλητές του υποδείγματος HAR-RV καθώς και ορισμένες μετρικές αλμάτων που χρησιμοποιούνται ως επεκτάσεις του βασικού υποδείγματος HAR-RV. Στη συνέχεια, εξετάζεται συγκριτικά η προβλεπτική αξία του πλήθους των συναλλαγών στα πλαίσια του δικτύου Bitcoin, για την πρόβλεψη της πραγματοποιθείσας μεταβλητότητας των αποδόσεών του. Επιπλέον, επεκτάσεις του υποδείγματος HAR-RV με την παρουσία αλμάτων, εφαρμόζονται για τη μοντελοποίηση της μεταβλητότητας τριών ακόμη σημαντικών κρυπτονομισμάτων από άποψη κεφαλαιοποίησης αγοράς (Litecoin, Ripple και Ethereum). Σκοπός είναι, να διαπιστωθούν οι συσχετίσεις στην αγορά κρυπτονομισμάτων και να προσδιοριστούν οι αλληλεπιδράσεις μεταξύ τους. Ειδικότερα, μελετάμε τη διασύνδεση και διάχυση της μεταβλητότητας στην αγορά κρυπτονομισμάτων. Στο πλαίσιο της ανάλυσης αυτής, εξετάζεται η σημασία της ετερογένειας και των αλμάτων σε μονομεταβλητό επίπεδο, για την πρόβλεψη της πραγματοποιθείσας μεταβλητότητας των κρυπτονομισμάτων. Επιπρόσθετα, διερευνάται η σημασία των αλμάτων της πραγματοποιθείσας μεταβλητότητας και των συν διακυμάνσεων στη διάχυση της μεταβλητότητας μεταξύ τεσσάρων κρυπτονομισμάτων.
Organization and Management of Intensive Care Unit, correlation of team climate with job satisfaction of the nurses in the ICU
Authors: Diamantopoulou Christina , Platis Charalampos , Lahana Eleni , Stergiannis Pantelis , Intas George
Published: October 2022

Introduction: The correlation between team climate and job satisfaction has been studied by researchers worldwide, but only a handful of them have dealt with the reality of Intensive Care Units (ICU). Team climate can contribute to nurses’ job satisfaction, thus increasing their efficiency and effectiveness. Especially during a pandemic, such as Covid-19, the investigation of team climate and job satisfaction is of great importance.Purpose: The purpose of this study was to investigate the correlation between team climate and job satisfaction of nurses in ICU and among the fear of Covid-19.Methodology: This is a contemporary study. The sample of the study is consisted of nurses and nurses’ assistants of a Greek public hospital ICU and special units. The Anderson & West Team Climate Inventory (TCI), the Paul E. Spector Job Satisfaction and the Fear of COVID-19 Scale were used for data collection. The statistical analysis of the data was done with the statistical program SPSS for Windows (version 21).Results: Out of the 212 nurses, 170 responded to the questionnaire (response rate 80.2%). The team climate was generally described as moderate. Especially, the dimensions of communication-innovation, team goals and the way they work assessed as moderate. Job satisfaction was described as moderate. Relationships with the manager, the nature of the work and communication, characteristics of job satisfaction, were evaluated with a high score, while payment, benefits and promotion were evaluated with low score. The fear of Covid-19 scale had low score, indicating that the feeling of fear was at low levels.Conclusions: The team climate and job satisfaction of ICUs nurses of the hospital was characterized as moderate, while the fear levels due to Covid-19 were low. Furthermore, the team climate was positively correlated with job satisfaction. In contrast, neither team climate nor job satisfaction were associated with fear of Covid-19.
Determination of Fever Management and Rational Drug Use of Mothers with Children Under Six Years Old
Authors: Karakul Atiye , Doğan Pınar
Published: October 2022

Background: Fever is one of the most common problems of childhood, which worries mothers. An insufficient level of knowledge about when and how to intervene in fever causes children to be exposed to inadequate and/or wrong practices and to use unnecessary or improper doses of antipyretics and antibiotics
Aim: In this study, it was aimed to examine the fever management and rational drug use of mothers with children under six years old.
Material and Method: The research is of descriptive type. It was conducted with 276 mothers between January and March 2021.Introductory Information Form, Parental Fever Management Scale (PFMS) and Rational Drug Use Scale (RDUS) were used. The data were analyzed by number and percentage distribution, mean standard deviation, Mann Whitney U and Kruskal-Wallis and correlation test.
Results: It was determined that 25% of the mothers participating in the study were 30 years old and younger. The mean total score for PFMS is 28.71±3.86; RDU scale is 39.28±3.18. There was a statistically significant difference between the mothers taking their children to the doctor to fever, the children being hospitalized due to high fever before, the children having convulsions due to fever, and measuring the fever of the children when they got a fever, and the total score of the parental fever management scale. It was found that there was a statistically significant difference between the education level of the mothers, the place of residence, income level, and the total score of the rational drug use scale and getting information from someone when fever occurred.
Conclusion: Based on the result of this study, It was determined that the mothers had good fever management and had rational knowledge of drug use. In addition, mothers' education level, place of residence, income level and the fact that they receive information from someone during febricity increase the knowledge of rational drug use. Therefore, it can be suggested that education programs for mothers on fever management and rational drug use.
Children's leaders left ‘puzzled’ by calls to remove DCS duty on councils
Authors: Hayes Derren
Published: October 2022

Local authority chief executives' group says the requirement for a director of children's services is stifling innovation in children's services and isolating it from the rest of local government – arguments that don't stack up, say leaders
Fears grow over academy closures
Authors: McCardle Laura
Published: October 2022

Education experts and children's leaders say councils should be the safety net when academy chains fail
The art of learning
Authors: McCardle Laura
Published: October 2022

Laura McCardle meets Nick Hudson, director of early years at Ofsted
Uncertainty remains on outsourcing
Authors: McCardle Laura
Published: October 2022

The decision to allow private firms to run child protection services through non-profit subsidiaries alarms campaigners
Lottery early years fund will develop interventions for vulnerable families
Authors: McCardle Laura
Published: October 2022

A £215m pot is to help five charity-led consortia from Blackpool to Southend-on-Sea to design and deliver over 10 years a range of services for young children that will aim to put in place solid foundations for a successful life
Experts urge action on serious case reviews in wake of stinging report
Authors: Hayes Derren
Published: October 2022

Inaugural report by National Panel of Independent Experts on serious case reviews is highly critical of those commissioning SCRs that offer insufficient analysis on how lessons can be learned from child deaths
Newfound independence
Authors: McCardle Laura
Published: October 2022

Laura McCardle meets Michael Lynas, chief executive of the National Citizen Service
Costing the case for change
Authors: Puffett Neil
Published: October 2022

Neil Puffett talks to Matthew Reed, chief executive of The Children's Society
New minister on message
Authors: McCardle Laura
Published: October 2022

Laura McCardle meets Sam Gyimah, minister for childcare
Education is rehabilitation
Authors: Hayes Derren
Published: October 2022

Derren Hayes meets Jacob Tas, chief executive of Nacro
Commissioner plans spark concern
Authors: McCardle Laura
Published: October 2022

Giving regional tsars more powers to intervene in schools could harm support for vulnerable children, experts warn
Meeting the Children Who Need a Home
Authors: Fursland Eileen
Published: October 2022

Adoption activity days give prospective adopters the chance to meet and interact with children needing new parents. Eileen Fursland attends an event in East Anglia to see how they work
Innovation Fund projects outline ambitious plans for social care
Authors: Puffett Neil
Published: October 2022

As the government boosts to £100m the amount available under the DfE's Children's Social Care Innovation Programme, CYP Now looks at how the first four initiatives to gain funding intend to transform services
Independent voice a must for commissioner Anne Longfield
Authors: McCardle Laura
Published: October 2022

The next children's commissioner for England Anne Longfield must stand up to the government if she is to champion the rights of children and young people and allay concerns over the role's independence
Better school-to-work links urged
Authors: McCardle Laura
Published: October 2022

Making schools accountable for pupils' employment outcomes could transform youth job prospects, experts say