bluuebunny/crossref_metadata_2025 huggingface dataset:
Including Students With Significant Support Needs in the Development of Behavior Support Plans
Authors: Johnson Holly N. , Carpenter Megan E. , Borosh Amanda M. , Folkerts Rebecca
Published: April 2022

Students with significant support needs (SSN) are often at an increased risk of demonstrating challenging behaviors compared with their peers without disabilities. As a result, students engaging in these behaviors typically experience fewer opportunities for inclusive education, strained relationships with educators, and increased likelihood of exposure to intrusive and harmful practices (e.g., restraint and seclusion), thus providing increased support for the use of effective behavioral interventions. Although research has shown that function-based interventions are more effective in addressing challenging behavior and these practices should be implemented for SSN who engage in challenging behavior, unfortunately these supports are often planned without involvement from the student. All students, including those with SSN, should have input in the selection and design of the supports they receive. Therefore, the purpose of this article is to provide educators with strategies for including student voice in the functional behavior assessment process and when developing a behavior support plan for students with SSN. We describe in detail methods for (a) gathering student input during the indirect assessment interview process, (b) administering direct preference assessments, and (c) increasing accessibility of these methods for students with SSN.
Are your Faculty Onboard With Interprofessional Education (IPE)?
Authors: Skrabal Julie A. , Shutts Stacey A. , Morbach Julie K. , Stevens Paul L. , Sittner Barbara J.
Published: April 2022

Objective:

Interprofessional collaboration is crucial in providing high-quality care for patients. Professional organizations and accrediting agencies recognize the importance of interprofessional education (IPE) and have required that it be incorporated into curricula. The purpose of the study was to assess faculty, from various disciplines, attitudes, knowledge, and barriers associated with IPE.

Materials and Methods:

A descriptive correlational research design was used to assess attitudes, knowledge, and barriers associated with IPE among faculty at a Midwestern college of health sciences.

Results:

Findings indicated that faculty lacking IPE knowledge, barriers of time, motivation, and scheduling were factors that influenced IPE. Overall, faculty indicated that they were enthusiastic about participating and willing to learn. Those who attended an intervention, which consisted of an educational presentation and activity, provided statistically significant perceptions about IPE.

Conclusion:

These results indicate that faculty attitudes, knowledge, and barriers influenced incorporation of IPE into curricula.

Key Takeaways

Interprofessional education (IPE) is essential to ensure faculty have the knowledge and tools to successfully implement activities in the classroom and clinical setting. Factors that influence IPE implementation include time, scheduling, knowledge, and motivation. These factors must be addressed for successful incorporation of IPE to occur. Begin IPE incorporation with faculty champions who are more enthusiastic and willing to learn about IPE.
Hypertrophic obstructive cardiomyopathy complicated with acute myocardial infarction and diffuse fibrosis: surgery or not?
Authors: Wang Yunhong , Zhao Xuemei , Zhai Mei , Huang Yan , Zhou Qiong , Zhang Yuhui , Mao Yi , Zhang Jian
Published: April 2022

Background

Hypertrophic cardiomyopathy with extreme hypertrophy, biventricular obstruction and diffuse myocardial fibrosis complicated by myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) is a rare phenotype. Evidence and guideline recommendations are still lacking for a treatment strategy.

Case presentation

Emergency coronary angiography was performed in a 38-year-old man with a 2-year history of nonobstructive hypertrophic cardiomyopathy (HCM) presenting with acute myocardial infarction. The coronary angiogram yielded no stenotic lesions but showed a diffusely dilated left descending artery with slow blood flow. All evidence from biomarker analysis, electrocardiography, echocardiography, and imaging supported the diagnosis of acute myocardial infarction in the left ventricular anterior wall. The echocardiogram demonstrated severe interventricular and apical hypertrophy, severe left ventricular outflow tract obstruction and mild right ventricular outflow tract obstruction. Cardiac magnetic resonance imaging showed a concentric morphological subtype of HCM with diffuse late gadolinium enhancement in the left ventricle. Extended septal myectomy was performed 1 month later, and the patient recovered well.

Conclusions

Hypertrophic obstructive cardiomyopathy with acute myocardial infarction is an indication for coronary angiography. Septal reduction surgery could be performed cautiously in HCM patients with extreme hypertrophy, biventricular obstruction and diffuse myocardial fibrosis complicated by MINOCA to improve the patient’s symptoms.
Evaluating the performance of Bayesian and restricted maximum likelihood estimation for stepped wedge cluster randomized trials with a small number of clusters
Authors: Grantham Kelsey L. , Kasza Jessica , Heritier Stephane , Carlin John B. , Forbes Andrew B.
Published: April 2022

Background

Stepped wedge trials are an appealing and potentially powerful cluster randomized trial design. However, they are frequently implemented with a small number of clusters. Standard analysis methods for these trials such as a linear mixed model with estimation via maximum likelihood or restricted maximum likelihood (REML) rely on asymptotic properties and have been shown to yield inflated type I error when applied to studies with a small number of clusters. Small-sample methods such as the Kenward-Roger approximation in combination with REML can potentially improve estimation of the fixed effects such as the treatment effect. A Bayesian approach may also be promising for such multilevel models but has not yet seen much application in cluster randomized trials.

Methods

We conducted a simulation study comparing the performance of REML with and without a Kenward-Roger approximation to a Bayesian approach using weakly informative prior distributions on the intracluster correlation parameters. We considered a continuous outcome and a range of stepped wedge trial configurations with between 4 and 40 clusters. To assess method performance we calculated bias and mean squared error for the treatment effect and correlation parameters and the coverage of 95% confidence/credible intervals and relative percent error in model-based standard error for the treatment effect.

Results

Both REML with a Kenward-Roger standard error and degrees of freedom correction and the Bayesian method performed similarly well for the estimation of the treatment effect, while intracluster correlation parameter estimates obtained via the Bayesian method were less variable than REML estimates with different relative levels of bias.

Conclusions

The use of REML with a Kenward-Roger approximation may be sufficient for the analysis of stepped wedge cluster randomized trials with a small number of clusters. However, a Bayesian approach with weakly informative prior distributions on the intracluster correlation parameters offers a viable alternative, particularly when there is interest in the probability-based inferences permitted within this paradigm.
Development and evaluation of an online questionnaire to identify women at high and low risk of developing gestational diabetes mellitus
Authors: Di Filippo Daria , Bell Chloe , Chang Melissa Han Yiin , Darling Justine , Henry Amanda , Welsh Alec
Published: April 2022

Background

Established risk factors for Gestational Diabetes Mellitus (GDM) include age, ethnicity, family history of diabetes and previous GDM. Additional significant influences have recently been demonstrated in the literature. The oral glucose tolerance test (OGTT) used for GDM diagnosis has sub-optimal sensitivity and specificity, thus often results in GDM misdiagnoses. Comprehensive screening of risk factors may allow more targeted monitoring and more accurate diagnoses, preventing the devastating consequences of untreated or misdiagnosed GDM. We aimed to develop a comprehensive online questionnaire of GDM risk factors and triangulate it with the OGTT and continuous glucose monitoring (CGM) parameters to better evaluate GDM risk and diagnosis.

Methods

Pregnant women participating in two studies on the use of CGM for GDM were invited to complete the online questionnaire. A risk score, based on published literature, was calculated for each participant response and compared with the OGTT result. A total risk score (TRS) was then calculated as a normalised sum of all risk factors. Triangulation of OGTT, TRS and CGM score of variability (CGMSV) was analysed to expand evaluation of OGTT results.

Results

Fifty one women completed the questionnaire; 29 were identified as ‘high-risk’ for GDM. High-risk ethnic background (p < 0.01), advanced age, a family diabetic history (p < 0.05) were associated with a positive OGTT result. The triangulation analysis (n = 45) revealed six (13%) probable misdiagnoses (both TRS and CGMSV discordant with OGTT), consisting of one probable false positive and five probable false negative by OGTT results.

Conclusions

This study identified pregnant women at high risk of developing GDM based on an extended evaluation of risk factors. Triangulation of TRS, OGTT and CGMSV suggested potential misdiagnoses of the OGTT. Future studies to explore the correlation between TRS, CGMSV and pregnancy outcomes as well as additional GDM pregnancy biomarkers and outcomes to efficiently evaluate OGTT results are needed.
Four cycles of R-CHOP followed by two applications of rituximab based on negative interim PET/CT: an analysis of a prospective trial
Authors: Jin Jia , Ji Dongmei , Xia Zuguang , Xue Kai , Zhang Qunling , Liu Yizhen , Cao Junning , Hong Xiaonan , Gu Juan J. , Guo Ye , Lv Fangfang
Published: April 2022

Background

R-CHOP with or without radiotherapy is the standard treatment for limited-stage diffuse large B-cell lymphoma (DLBCL). To prevent overtreatment, we assessed whether four cycles of CHOP plus six applications of rituximab was adequate with negative interim PET/CT and the role of consolidation radiotherapy specifically for patients with Waldeyer’s ring DLBCL. One hundred and twenty-nine patients with limited-stage DLBCL were enrolled in this open-label, nonrandomized, single-arm, phase 2 clinical trial (NCT01804127).

Methods

All patients were initially treated with 4 cycles of R-CHOP and underwent interim PET/CT. Patients with negative PET/CT (Deauville scores 1–2) received 2 additional cycles of rituximab monotherapy, unless they had any risk factors (primary mediastinal large B-cell lymphoma, extranodal primary or bulky disease). Otherwise, patients received another 2 cycles of R-CHOP. Patients with partial response on interim PET/CT received another 4 cycles of R-CHOP. No radiotherapy was conducted in Waldeyer’s ring DLBCL patients with negative PET/CT. The primary endpoint was 3-year progression-free survival (PFS). Overall survival (OS) in this study was compared with those from a historical study (NCT 00854568159).

Results

One hundred fifteen interim PET/CT scans (89.1%) were negative after 4 cycles of R-CHOP. An elevated lactate dehydrogenase level was significantly associated with positive interim PET/CT (P < 0.05). A trend of inferior outcome was observed in patients with positive interim PET/CT in terms of 3-year PFS (78.6% vs. 91.9%, P = 0.24) and 3-year OS (85.7% vs. 95.6%, P = 0.16). There were no PFS or OS differences found between patients treated with 4R-CHOP+2R and those treated with 6R-CHOP from a historical control study. Patients with Waldeyer’s ring DLBCL and negative interim PET/CT achieved a 3-year PFS of 87.2% and a 3-year OS of 89.7%.

Conclusions

Our results suggested that for interim PET/CT-negative patients without risk factors, the extra 2 cycles of CHOP might be omitted, and radiotherapy might also be omitted in patients with Waldeyer’s ring DLBCL without compromising the efficacy. These results need to be confirmed in a randomized study.

Trial registration

clinicaltrials.gov, NCT 01804127. Date of first registration: 05/03/2013.
Effects of the timing of the initiation of dietary intake on pediatric type 1 diabetes for diabetic ketoacidosis
Authors: Yuan Xuewen , Wang Jieguo , Chen Xiaofeng , Yan Wu , Niu Qing , Tang Ning , Zhang Ming Zhi , Gu Wei , Wang Xu
Published: April 2022

Background

Precision treatment of pediatric diabetic ketoacidosis (DKA) has been the focus of research for decades. Whether the timing of the initiation of dietary intake contributes to DKA correction is ignored.

Methods

We conducted a retrospective study to investigate the effects of the timing of the initiation of dietary intake on DKA correction in Children’s Hospital of Nanjing Medical University, a tertiary children’s hospital, from June 2017 to December 2020. Individual basic characteristic and clinical information of all DKA cases (n = 183) were collected. Multiple linear regression, logistic regression model and random forest (RF) model were used to assess the effect of the timing of the initiation of dietary intake on DKA correction.

Results

The mean age of the children diagnosed with DKA was 6.95 (SD 3.82) years. The median DKA correction time and the timing of the initiation of dietary intake was 41.72 h and 3.13 h, respectively. There were 62.3% (n = 114) patients corrected DKA at the end of the 48-h rehydration therapy. For each hour delay in starting dietary intake, child’s DKA correction was prolonged by 0.5 (95% CI 1.05, 1.11, P < 0.001) hours and the adjusted odds of DKA over 48 h was increased by 8% (OR = 1.08, 95% CI: 1.05, 1.11, P < 0.001) after adjustment for potential confounders. The RF model based on the timing of the initiation of dietary intake and child’s weight and systolic pressure achieved the highest AUC of 0.789.

Conclusion

Pediatricians should pay attention to the effect of the timing of the initiation of dietary intake, a controllable factor, on DKA correction.
The quality of service provision to newborns in the primary healthcare, West Gojjam zone, North-West of Ethiopia: a cross-sectional survey
Authors: Birhanu Bizuhan Gelaw , Mathibe-Neke Johanna Mmabojalwa
Published: April 2022

Background

During 2019, neonatal conditions in Ethiopia accounted for 55% of under-5 deaths, with 33 neonatal deaths occurring for every 1000 live births. More than 80% of all newborns deaths are caused by preventable and treatable conditions with available interventions. In Ethiopia, mortality rates for newborn babies have remained stubbornly high over the decades.

Objective

This research aimed to assess the quality-of-service provision for newborns in the primary healthcare units in the North-West of Ethiopia.

Methods

A cross-sectional survey design was employed. Interviewer-administered questionnaires were administered to 221 health workers and health extension workers, and health facility readiness assessment was done in 142 health facilities including 3 Primary hospitals, 76 Health centres and 63 Health posts from April to July 2017. Data was entered into the EpiData 3.1, exported to SPSS and STATA for analysis. Descriptive and regression multivariate analysis was applied.

Results

Out of the 10 quality of newborn care variables, 8.7 [95%CI: 6.03–11.303], the highest mean was achieved by primary hospitals, followed by urban health centres with a 6.4 mean [95%CI:5.168–7.601]. However, nearly half of the rural health centres were providing quality of newborn care at the mean of 5.7 [95%CI: 5.152–6.18], and below half was provided by health posts, 4.5 [95%CI: 3.867–5.116]. From the seven emergency newborn care signal functions, primary hospitals had a higher mean score, 6.3 [95%CI: 6.007–7.325] and rural health centres had the lowest mean score, 2.3 [95%CI: 2.043–2.623]. The availability of essential equipment is also significantly associated with the quality of neonatal care provision in the health facilities (p < 0.05). Overall, the effectiveness of the neonatal healthcare services has a significant association with the health facility readiness score [95%CI: 0.134–0.768].

Conclusion

The quality of newborn care was high at the higher-level health facilities and lower in the lower-level health facilities such as rural health centres and health posts, where these facilities are an entry point to the health system and are expected to provide the essential newborn care services to the majority of the rural communities. In addition, the provision of emergency newborn care signal functions was critically low in rural health centres where these are referral receiving health facilities from health posts. Thus, rural health centres and health posts should be targeted to improve their readiness to provide the quality of services for newborns as per their expected level of care.
Characteristics, satisfiers, development needs, and barriers to success for early-career academic hospitalists
Authors: Kulkarni Shradha A. , Fang Margaret C. , Glasheen Jeffrey J. , Parekh Vikas , Sharpe Bradley A.
Published: April 2022

Background

Academic hospitalists engage in many non-clinical domains. Success in these domains requires support, mentorship, protected time, and networks. To address these non-clinical competencies, faculty development programs have been implemented.

We aim to describe the demographics, job characteristics, satisfiers, and barriers to success of early-career academic hospitalists who attended the Academic Hospitalist Academic (AHA), a professional development conference from 2009 to 2019.

Methods

Survey responses from attendees were evaluated; statistical analyses and linear regression were performed for numerical responses and qualitative coding was performed for textual responses.

Results

A total of 965 hospitalists attended the AHA from 2009 to 2019. Of those, 812 (84%) completed the survey. The mean age of participants was 34 years and the mean time in hospitalist practice was 3.2 years. Most hospitalists were satisfied with their job, and teaching and clinical care were identified as the best parts of the job. The proportion of female hospitalists increased from 42.2% in 2009 to 60% in 2019 (p = 0.001). No other demographics or job characteristics significantly changed over the years. Lack of time and confidence in individual skills were the most common barriers identified in both bedside teaching and providing feedback, and providing constructive feedback was an additional challenge identified in giving feedback.

Conclusions

Though early-career hospitalists reported high levels of job satisfaction driven by teaching and clinical care, barriers to success include time constraints and confidence. Awareness of these factors of satisfaction and barriers to success can help shape faculty development curricula for early-career hospitalists.
Women’s support for voluntary medical male circumcision in fishing communities on the shores of Lake Victoria, Uganda
Authors: Byaruhanga Aggrey , Mbona Nazarius Tumwesigye , Babirye Suzan , Nalugoda Fred , Kankaka Edward Nelson , Ampaire Lucas , Migisha Richard , Kagaayi Joseph
Published: April 2022

Background

Women’s support can improve uptake of voluntary medical male circumcision (VMMC). We assessed the level of women’s support for VMMC and associated factors in fishing settlements on the shores of Lake Victoria in Uganda, to inform interventions aimed at increasing the uptake of safe male circumcision services in such high-risk populations.

Methods

We conducted a cross-sectional study, employing mixed methods of data collection, at Kasenyi and Kigungu landing sites in April 2018. We included women aged 18–49 years, who had stayed at the landing sites for ≥3 months. We obtained qualitative data using focus group discussions (FGDs), and interviewer-administered semi-structured questionnaires for quantitative data. The tool captured demographic characteristics, community factors including cultural norms and beliefs, women’s experiences, and health facility-related factors. The dependent variable was derived from the response to the question: "Would you encourage your partner/husband to go for VMMC?", and used as a proxy for support of VMMC. We used modified Poisson regression to identify factors associated with women’s support for VMMC. Qualitative data were analysed using thematic content analysis.

Results

We enrolled 313 women with a mean age of 28 (SD±6.8) years. Of the 313 women, 230 (73.5%) supported VMMC. Belief that VMMC increases penile hygiene (Adjusted prevalence ratio [aPR]=1.9; CI: 1.8–3.2), performing VMMC for religious reasons (aPR=1.9; CI: 1.8–2.9), preference for a circumcised man (aPR=1.3; CI: 1.2–1.5), belief that vaginal fluids facilitate wound healing (aPR=1.9; CI: 1.3–2.7), and knowledge about when a man can resume sex (4 weeks) after circumcision (aPR=2.1; CI: 1.8–3.3) were associated with women’s support for VMMC. FGDs revealed that women were not adequately involved in VMMC activities for decision making.

Conclusion

The support for VMMC was high among women in the fishing communities. However, women perceived they were not involved in decision-making for VMMC and had several misconceptions, including a belief that vaginal fluids facilitate wound healing. The Ministry of Health and VMMC implementing partners should devise strategies to increase sensitization and involvement of women in VMMC decision-making without slowing service uptake.
Potential of digitalization within physiotherapy: a comparative survey
Authors: Estel Katharina , Scherer Julian , Dahl Heiko , Wolber Eva , Forsat Noah D. , Back David A.
Published: April 2022

Background

Due to the global digitalization, implementation of digital elements into daily work can support physiotherapists’ work but may also pose some challenges. Only little is known about physiotherapists’ attitude towards digitalization. This study primarily aimed to analyze physiotherapists’ attitude towards digitalization and to what extend digital tools have been implemented into their daily work. In second analysis, participants’ characteristics such as age, working place, gender and mode of survey participation were assessed.

Methods

A 12-main-item survey amongst voluntary course participants of one physiotherapeutic training center was conducted via paper-based as well as online questionnaires between July 2018 and June 2019 including questions on participants’ general as well as particular attitude towards digitalization, the use of (mobile) applications and possible advantages and disadvantages of the ongoing digital transformation. Sub-analysis was performed for age (≤40 years versus > 40 years), gender, mode of participation (paper vs. online) and working place (practice vs. hospital).

Results

Overall, 488 physiotherapists participated in the survey. In comparison of the age groups, younger participants had more concerns about data security (p = 0.042) and insufficient financial remuneration (p < 0.001). Younger participants stated higher satisfaction with data literacy than their counterparts (p = 0.0001). Physiotherapists working in the outpatient sector, rather than in hospitals, expected digitalization to increase more in relevance (p < 0.001). The online respondents (OG) indicated that they had more knowledge about key aspects of the current legal situation regarding digitalization than participants completing the paper-based survey (p = 0.002). 50.4% of the considered digitalization as useful for their job.

Conclusions

The majority of participants saw high potential for digitalization in the physiotherapy sector. Younger physiotherapists seem to be more concerned about data security and insufficient financial remuneration. Physiotherapists in the outpatient sector seem to see more potential in digital transformations. General concerns like missing reimbursement, lack of data security or knowledge on legal frameworks should be addressed in the future. Further studies should focus on identifying specific digital tools which can support physiotherapists.
Media portrayal of ethical and social issues in brain organoid research
Authors: Presley Abigail , Samsa Leigh Ann , Dubljević Veljko
Published: April 2022

Background

Human brain organoids are a valuable research tool for studying brain development, physiology, and pathology. Yet, a host of potential ethical concerns are inherent in their creation. There is a growing group of bioethicists who acknowledge the moral imperative to develop brain organoid technologies and call for caution in this research. Although a relatively new technology, brain organoids and their uses are already being discussed in media literature. Media literature informs the public and policymakers but has the potential for utopian or dystopian distortions. Thus, it is important to understand how this technology is portrayed to the public.

Methods

To investigate how brain organoids are displayed to the public, we conducted a systematic review of media literature indexed in the Nexis Uni database from 2013–2019. News and media source articles passing exclusion criteria (n = 93) were scored to evaluate tone and relevant themes. Themes were validated with a pilot sample before being applied to the dataset. Thematic analysis assessed article tone, reported potential for the technology, and the scientific, social, and ethical contexts surrounding brain organoids research.

Results

Brain organoid publications became more frequent from 2013 to 2019. We observed increases in positively and negatively toned articles, suggesting growing polarization. While many sources discuss realistic applications of brain organoids, others suggest treatment and cures beyond the scope of the current technology. This could work to overhype the technology and disillusion patients and families by offering false hope. In the ethical narrative we observe a preoccupation with issues such as development of artificial consciousness and “humanization” of organoid-animal chimeras. Issues of regulation, ownership, and accuracy of the organoid models are rarely discussed.

Conclusions

Given the power that media have to inform or misinform the public, it is important this literature provides an accurate and balanced reflection of the therapeutic potential and associated ethical issues regarding brain organoid research. Our study suggests increasing polarization, coupled with misplaced and unfounded ethical concern. Given the inhibitory effects of public fear or disillusion on research funding, it is important media literature provides an accurate reflection of brain organoids.
Effects of probiotic supplementation on major cardiovascular-related parameters in patients with type-2 diabetes mellitus: a secondary-data analysis of a randomized double-blind controlled trial
Authors: Ahmadian Fatemeh , Razmpoosh Elham , Ejtahed Hanieh-Sadat , Javadi Maryam , Mirmiran Parvin , Azizi Fereidoun
Published: April 2022

Background

Patients with type-2 diabetes mellitus (T2DM), have a higher risk of future cardiovascular diseases (CVD). Meanwhile, probiotics are shown to positively impact CVD-related parameters. This randomized controlled trial sought to evaluate the effects of probiotic supplementation on fundamental CVD-related parameters including atherogenic index of plasma (AIPs), blood pressure, the Framingham risk score, and antioxidant markers in patients with T2DM.

Methods

Eligible participants were randomly assigned to receive 2 capsules/day of probiotics [each containing 500 mg of L.acidophilus(5 × 1010 CFU/g), L.plantarum(1.5 × 1010 CFU/g), L.fermentum(7 × 109 CFU/g), L.Gasseri(2 × 1010 CFU/g) and 38.5 mg of fructo-oligo-saccharides], or placebo for 6 weeks. Systolic and diastolic blood pressures (SBP and DBP, respectively), mean arterial blood pressure (MAP), atherogenic indices (the ratios of TC/HDL-C, LDL-C/HDL-C, and logTG/HDL-C), the 10-year Framingham CVD risk score, as well as total anti-oxidant capacity (TAC), paraoxonase (PON) and total oxidant status (TOS) were evaluated before and after the study. Final analyses were adjusted based on baseline parameters, and potential covariates including age, sex, PUFA and sodium intakes.

Results

Sixty participants completed the study. Compared with placebo, probiotic supplementation resulted in a significant decrease in SBP[-9.24 mmHg(− 14.5, − 3.9)], DBP[− 3.71 mmHg(− 6.59, − 0.83)], MAP[− 5.55 mmHg(− 8.8, − 2.31)], the Framingham risk categories [medium–low(1.5) vs. 2 (medium)] and logTG/HDL-C ratio [− 0.08 (− 0.14, 0)] (All P < 0.05) at the end of the study. No significant changes were observed in the antioxidant markers.

Conclusion

Overall, probiotic supplementation for 6 weeks led to a significant improvement in major CVD-related parameters in populations with T2DM, suggesting the possible beneficial role of probiotics in lowering the risk of future CVDs associated with diabetes. Nevertheless, more studies are needed to confirm the veracity of these results.

Trial registration: IRCT2013100714925N1 (registered on November, 9th, 2013).
Chemical genetic activation of the cholinergic basal forebrain hippocampal circuit rescues memory loss in Alzheimer’s disease
Authors: Liu Weilin , Li Jianhong , Yang Minguang , Ke Xiaohua , Dai Yaling , Lin Huawei , Wang Sinuo , Chen Lidian , Tao Jing
Published: April 2022

Background

The degeneration of the cholinergic circuit from the basal forebrain to the hippocampus contributes to memory loss in patients suffering from Alzheimer’s disease (AD). However, the internal relationships between the acetylcholine (Ach) cycle and memory decline during the early stages of AD currently remain unknown. Here, we investigate the mechanisms underlying the activation of the cholinergic circuit and its impact on learning and memory using APP/PS1 mice models.

Methods

Novel object recognition and Morris water maze tests were used to measure learning and memory function. Magnetic resonance spectrum (MRS) imaging was applied to longitudinally track changes in neurochemical metabolism in APP/PS1 mice aged 2, 4, 6, and 8 months. The number of neurons and the deposition of Aβ plaques were measured using Nissl, immunohistochemistry, and Thioflavin S staining. We then employed a chemogenetic strategy to selectively activate the cholinergic circuit from the medial septal nucleus (MS) and the vertical limb of the diagonal band nucleus (VDB) on the basal forebrain to the hippocampus. MRS and immunoblotting techniques were used to measure the neurochemical metabolism levels and cholinergic-related proteins, respectively.

Results

We found that the levels of choline (Cho) in the basal forebrain were markedly higher compared to other brain regions and that its decrease along with N-acetyl aspartate (NAA) levels in the hippocampus was accompanied by memory deficits in APP/PS1 mice aged 4, 6, and 8 months. In terms of pathology, we observed that the deposition of Aβ plaques gradually aggravated throughout the cerebral cortex and hippocampus in APP/PS1 mice aged 6 and 8 months, while no Aβ deposition was detected in the basal forebrain. In contrast, the activity of choline acetyltransferase (ChAT) enzyme in the basal forebrain was decreased at 6 months of age and the cholinergic neurons were lost in the basal forebrain at 8 months of age. In addition, the activation of the cholinergic circuit from the MS and VDB to the hippocampus using chemical genetics is able to improve learning and reduce memory impairment in APP/PS1 mice. Similarly, the levels of Cho in the basal forebrain; NAA in the hippocampus, as well as the expression of ChAT and vesicular acetylcholine transporter (vAchT) in the basal forebrain; and muscarinic acetylcholine receptor 2 (CHRM2) in the hippocampus all increased.

Conclusions

These findings demonstrate that the neurochemical Cho and NAA of the cholinergic circuit can be used as biomarkers to enable the early diagnosis of AD. In addition, memory impairment in APP/PS1 mice can be attenuated using chemical genetics-driven Ach cycle activity of the cholinergic circuit.
Radiation Therapy in Older Adults With Cancer: A Critical Modality in Geriatric Oncology
Authors: Amini Arya , Morris Lucinda , Ludmir Ethan B. , Movsas Benjamin , Jagsi Reshma , VanderWalde Noam A.
Published: April 2022

Radiation therapy (RT) is a commonly used modality in the treatment of older adults with cancer, and RT represents an attractive oncologic treatment option, providing a noninvasive local therapy with limited systemic side effects. The Journal of Clinical Oncology ( JCO) recently published a special series on Geriatric Oncology providing a comprehensive overview of multiple treatment modalities available to older adults with cancer. The purpose of this short review is to highlight the importance of RT in the treatment of older adults and encourage multidisciplinary participation in their care.
Benchmarking Survival Outcomes Following Surgical Management of pT3 and pT4 Cutaneous Squamous Cell Carcinoma of the Head and Neck
Authors: Yung Amanda E. , Crouch Gareth , Varey Alexander H. R. , Lo Serigne , Elliott Michael S. , Lee Jenny , Rawson Robert , Gupta Ruta , Hong Angela M. , Clark Jonathan R. , Ch’ng Sydney
Published: April 2022

Background

pT3/4 head and neck cutaneous squamous cell carcinomas (HNcSCCs) are associated with poor outcomes, including local recurrence, metastasis and death. Whilst surgery remains the standard treatment for advanced HNcSCC, novel systemic therapies, such as immunotherapy, are being used earlier in the treatment paradigm. It is imperative that the clinical outcomes of surgery are clearly described so that conventional and emerging treatment modalities can be better integrated and sequenced in the management of pT3/4 HNcSCC.

Methods

Patients with confirmed pT3/4 HNcSCC undergoing curative surgical resection between 2014-2020 were identified retrospectively from a prospectively maintained research database. The primary outcomes of interest were locoregional control (LRC), disease-specific survival (DSS), and overall survival (OS). The secondary outcome was surgical complication rate.

Results

A total of 104 patients (median age 74, range 41–94 years) were included, 90% of which had pT3 tumors; 36.5% received adjuvant radiotherapy. Median follow-up was 24.3 (range 1.0–84.3) months. LRC at 5 years was 62.0%, DSS at 5 years was 83.7%, and OS at 5 years was 71.9%. Median time to recurrence was 8.4 months. LRC was reduced in the presence of margin involvement and previous treatment (radiotherapy/surgery). The major surgical complication rate was 9.6%.

Conclusions

More than 60% of patients treated surgically for pT3/4 head and neck cSCC were alive and free of disease at 5 years posttreatment. High-risk features such as margin involvement and having had previous treatment (radiotherapy/surgery) should be used to guide adjuvant therapy.
Επίδραση της εζετιμίμπης σε συνδυασμό με σιμβαστατίνη στην αγγειακή φλεγμονή σε ασθενείς με οικογενή υπερχοληστερολαιμία και σε ασθενείς με οικογενή συνδυασμένη υπερλιπιδαιμία
Authors: Γαλανάκος Σπυρίδων
Published: April 2022

Εισαγωγή: Η αθηροσκληρωτική νόσος αποτελεί σημαντική αιτία θνητότητας σε ασθενείς με δυσλιπιδαιμία. Ωστόσο, με την χρήση μη επεμβατικών μεθόδων, όπως είναι η ακτινομετρία μικροκυμάτων(ΑΜ) μπορεί να γίνει εκτίμηση της φλεγμονής των αθηρωματικών πλακών των καρωτίδων, έμμεσα, από την ανίχνευση της θερμοκρασίας τους. Τόσο στους ασθενείς με οικογενήυπερχοληστερολαιμία, όσο και στους ασθενείς με οικογενή συνδυασμένη υπερλιπιδαιμία παρατηρήθηκε αυξημένη θερμοκρασία των αθηρωματικών πλακών. Στην παρούσα μελέτη είχαμε σκοπό να διερευνήσουμε τον αντίκτυπο της υπολιπιδαιμικής θεραπείας είτε με σιμβαστατίνη είτε με συνδυασμό σιμβαστατίνης με εζετιμίμπη στις θερμοκρασίες καρωτιδικής αρτηρίας ασθενών με σύνδρομα οικογενούςυπερλιπιδαιμίας (FHS).Σκοπός: Σκοπός της παρούσας μελέτης ήταν η ανίχνευση της φλεγμονής τωνκαρωτίδων με την ακτινομετρία μικροκυμάτων(ΑΜ) σε ασθενείς με οικογενήυπερχοληστερολαιμία και οικογενή συνδυασμένη υπερλιπιδαιμία και η συσχέτισημε τα αντίστοιχα υπερηχογραφικά ευρήματα, καθώς και η επίδραση της εζετιμίμπης σε συνδυασμό με σιμβαστατίνη στην αγγειακή φλεγμονή στις δύο ομάδες ασθενών.Υλικό και Μέθοδος: Διαδοχικοί ασθενείς με διάγνωση είτε οικογενούςετερόζυγηςυπερχοληστερολαιμίας (heFH) ή οικογενούς συνδυαστικής υπερλιπιδαιμίας (FCH) συμπεριλήφθηκαν στη μελέτη. Στους ασθενείς χορηγήθηκαν είτε 40 mgσιμβαστατίνης ή 40 mgσιμβαστατίνης και 10 mgεζετιμίμπης κατά τη διακριτική ευχέρεια του ιατρού. Οι ασθενείς με σύνδρομα οικογενούςυπερλιπιδαιμίας που αρνήθηκαν τη θεραπεία με στατίνη χρησιμοποιήθηκαν σαν ομάδα ελέγχου. Το έσω-μέσο πάχος της κοινής καρωτιδικής αρτηρίας (ccIMT) μετρήθηκε και οι μετρήσεις θερμοκρασίας ΔΤ (μέγιστες-ελάχιστες) διενεργήθηκαν σε κάθε καρωτιδική αρτηρία κατά την αξιολόγηση ακτινομετρίας μικροκυμάτων(ΑΜ). Οι μετρήσεις υπερήχου καρωτίδας, ΑΜ, λιπιδαιμικού προφίλ και C-αντιδρώσας πρωτεΐνης επαναλήφθηκαν στους 6 μήνες.Αποτελέσματα: Συνολικά 115 ασθενείς συμπεριλήφθηκαν στη μελέτη. Από αυτούς, 40 ασθενείς έλαβαν σιμβαστατίνη (19 heFH και 21 FCH), 41 σιμβαστατίνη + εζετιμίμπη (31 heFH και 10 FCH) και 34 (21 heFH και 13 FCH) καθόλου στατίνη. Οι θερμοκρασίες της καρωτιδικής αρτηρίας μειώθηκαν σημαντικά στους 6 μήνες σε ασθενείς με οικογενήυπερχοληστερολαιμία που έλαβαν υπολιπιδαιμική αγωγή(0.83±0.34 έναντι 0.63±0.24 oC, p=0.004 για τη σιμβαστατίνη, 1.00±0.38 έναντι 0.69±0.23 oC, p<0.001 για σιμβαστατίνη + εζετιμίμπη) αλλά δεν καταγράφηκαν αλλαγές στην ομάδα ελέγχου (0.72±0.26 έναντι 0.70±0.26 oC, p=0.86).Συμπεράσματα:Hυπολιπιδαιμική θεραπεία μείωσε τις θερμοκρασίες της καρωτιδικής αρτηρίας σε ασθενείς με σύνδρομα οικογενούςυπερλιπιδαιμίας.
Study of bypassing Microsoft Windows Security using the MITRE CALDERA Framework
Authors: Mohamed Nachaat
Published: April 2022

Background: Microsoft Windows Security is a recently implemented safeguard for the Windows operating systems, including the latest versions of Windows10 and 11. However, there is a major shortcoming in this system to stop Advanced Persistent Threat (APT). These are government-financed groups that are funded to attack other government entities. Following the initial security breach, the hacked Windows device is used to access the rest of the network devices in order to transfer data to external storage (Exfiltration).

Methods: In this work, we have tested the Microsoft Windows Security system using MITRE CALDERA and ATT&CK frameworks and explain how APT groups are able to bypass Windows Security.

Results: In this study we used "54ndc47" agent through GoLang feature in MITRE CALDERA platform to test and bypass Microsoft Windows Security systems (MS Windows 10). Through it, we were able to bypass the Windows Security system and display entire files in the victim's device.

Conclusions: In this paper, we have provided recommendations to Microsoft to improve their Windows Security tool through the use of Artificial intelligence (AI).
Case Report: Malignant melanoma in a patient with Crohn’s disease treated with ustekinumab
Authors: Axiaris Georgios , Ioannou Alexandros , Papoutsaki Marina , Marinos Leonidas , Liontos Michael , Michopoulos Spyridon , Zampeli Evanthia
Published: April 2022

The cornerstone of inflammatory bowel disease (IBD) treatment is immunomodulators. IBD patients are at increased risk of intestinal and extraintestinal malignancy. Ustekinumab is a fully humanized monoclonal anti-IL12/23 antibody with a good safety profile. Malignancies of breast, colon, head and neck, kidney, prostate, thyroid, and non-melanoma skin cancer have been reported among patients who received ustekinumab. We report the case of a 42-year-old Crohn’s patient on long-term treatment with ustekinumab, who developed achromatic malignant melanoma. Crohn’s was diagnosed at the age of 15, with upper and lower gastrointestinal involvement and was initially treated with azathioprine (2mg/kg for 4 years) and infliximab (5mg/kg for 6 weeks). Due to ileal obstruction, the patient underwent stricturoplasty and received adalimumab (40mg every other week) for two years. He then discontinued therapy and a year later underwent right hemicolectomy. Adalimumab was reinstituted (40mg every other week) and the patient remained in clinical remission for two years. His overall exposure to adalimumab was four years. Ustekinumab was initiated due to a relapse and after 3 years, an incident of scalp itching led to the diagnosis metastatic achromatic malignant melanoma bearing BRAF V600E mutation. He received targeted therapy with an initial good response. We aim to point out the risk of dermatologic malignancy in IBD patients on long-term immunosuppression and the lifelong and meticulous evaluation that is required.
Energy efficiency of building systems
Authors: Zhukov Aleksey , Bobrova Ekaterina , Bessonov Igor' , Mednikova Elizaveta
Published: April 2022

The monograph summarizes and systematizes the results of experimental and theoretical studies of thermal insulation systems of building structures, technological facilities, transport facilities, and cold preservation.
The criterion for the effectiveness of system insulation solutions is energy efficiency as a criterion for a comprehensive assessment, including both taking into account the direct reduction of energy costs during the operation of insulation shells, and the costs of installation, maintenance of structures in working condition, evaluation of the operational resistance of materials and durability of system solutions as a whole.
Modern types of thermal insulation materials based on gas-filled plastics, foamed glass, foamed rubber and products based on mineral fibers are considered: stone wool, glass wool and glass fiber, basalt fiber.
It is intended for researchers, specialists in the field of materials science, technologists — developers of new types of thermal insulation materials and constructors, designing products from them, as well as for teachers and university students. It can be useful for a wide range of people interested in construction and energy saving problems.
Helicobacter pylori cytotoxin-associated gene A virulence and its association with the epithelial-mesenchymal transition in gastric cancer
Authors: Dudek Iga , Forma Alicja , Hamerska Justyna , Flieger Michał , Januszewski Jacek , Cywka Tomasz , Kozak Joanna , Baj Jacek
Published: April 2022

Gastric cancer is currently one of the most prevalent malignancies worldwide with a high mortality rate. Helicobacter pylori (H. pylori) infection significantly contributes to the onset and progression of gastric cancer mainly due to the induction of chronic inflammatory responses. The pathogenicity of H. pylori is associated with a vast number of virulence factors among which cytotoxin-associated gene A (CagA) plays a crucial role. We conducted a literature review of PubMed, Web of Science, and Scopus on September 1st, 2021. There were no limits regarding the year and the language of publication. Articles included in this review concerned human and animal studies. The following search string was applied during the search: (gastric cancer) AND (epithelial-mesenchymal transition) AND (Helicobacter pylori) AND (cytotoxin-associated gene A). The final analysis included 135 articles independently reviewed by the authors. H. pylori CagA-positive strains seem to be more virulent compared to the CagA-negative strains. CagA pathogenicity includes the increased secretion of pro-inflammatory cytokines, induction of cancer stem cell-like properties, apoptosis prevention, or overactivation of particular oncogenic pathways. H. pylori might induce epithelial-mesenchymal transition (EMT) via numerous pathways, among which CagA-related pathogenicity is considered to be of high significance. Mechanisms associated with CagA action are involved in the maintenance of chronic H. pylori infection, subsequent EMT induction, and further onset and progression of gastric cancer. Because of a huge number of H. pylori strains with different virulence mechanisms, the clinical outcome of patients is also associated with the particular type of strain that infected a patient.
Scaffolding and sequencing
Authors: Ephgrave Siân
Published: April 2022

This article is the fifth in a series of myth-busters on the topic of planning in the moment. In this piece, I explain how logical sequencing occurs in the practice of planning in the moment.
The problem with Family Hubs
Authors: Amiss Jonny
Published: April 2022

Taking a critical look at the new initiative of Family Hubs, Jonny Amiss shares his concerns, and suggests that we act in solidarity with, rather than on behalf of, struggling parents.
Are practitioners underprepared?
Authors: Mason Gill , Fawkes Lauren , Knight Louise
Published: April 2022

Practitioners are often required to support children to deepen their knowledge and understanding of challenging and complex topics. The war in Ukraine is no different. Below, Kids Planet reflect on whether they think practitioners are appropriately prepared to navigate such sensitive conversations with children.
Art inspired by ‘Junk DNA’
Authors: Marycz Adam
Published: April 2022

In this first edition of the new play experience case study we explore an open-ended art invitation inspired by the wordless story ‘Junk DNA’ by artist Clare Thompson. The story of ‘Junk DNA’ is told entirely through the arrangement of loose parts.
Non-diffracting partially coherent waves with binomial coherence
Authors: Charnotskii Mikhail
Published: April 2022

Comprehensive analysis of non-diffracting optical waves with two-point binomial coherence function (BCF) is presented. This coherence function consists of two terms, each depending on either separation of points or the central point. We establish the necessary and sufficient conditions for nonnegative definiteness of the BCFs. Spectral analysis, including calculations of the eigenvalues and eigenfunctions, for the general BCF case is presented. We consider two simple BCF examples of and analyzed the conditions leading to the maximum irradiance contrast.
Cascade light field disparity estimation network based on unsupervised deep learning
Authors: Liu Bo , Chen Jing , Leng Zhen , Tong Yanfeng , Wang Yongtian
Published: April 2022

Light field disparity estimation is an important task in light field applications. However, how to efficiently utilize the high-dimensional light field data is a very worthy issue to investigate. Besides, existing supervised deep learning based algorithms are limited to scenes with ground truth disparity for training. In this paper, we propose a light field disparity estimation network which adopts a cascade cost volume architecture and can predict disparity maps in a coarse to fine manner by fully exploring the geometry characteristics of sub-aperture images. In addition, we design a combined unsupervised loss to train our network without a ground truth disparity map. Our combined loss consists of occlusion-aware photometric loss and edge-aware smoothness loss which can bring targeted performance improvements in occlusion and textureless regions, respectively. Extensive experiments demonstrate that our approach can achieve better results compared to existing unsupervised disparity estimation method and show better generalizability compared to supervised methods.
Modern Magnetophotonic Materials and their Applications: introduction to special issue
Authors: Belotelov V. I. , Bi L. , Kalashnikova A. , Levy M. , Maccaferri N.
Published: April 2022

Magneto-optics was established almost two centuries ago by M. Faraday, who discovered the influence of magnetic field on light polarization [Diary, 1845]. We would like to present this special issue dedicated to the state-of-art in magnetophotonic materials and their applications.