bluuebunny/crossref_metadata_2025 huggingface dataset:
Facies variability and depositional cyclicity in central Northern Switzerland: insights from new Opalinus Clay drill cores
Authors: Zimmerli Géraldine N. , Wohlwend Stephan , Deplazes Gaudenz , Becker Jens , Wetzel Andreas , Francescangeli Fabio , Foubert Anneleen
Published: September 2024

The Opalinus Clay, a silty to sandy claystone formation, Early to Middle Jurassic (Toarcian and Aalenian) in age, has been selected as the host rock for deep subsurface disposal of radioactive waste in Switzerland. Over the past thirty years, numerous geotechnical, mineralogical, and sedimentological studies have been conducted on the Opalinus Clay within the framework of the Nagra (National Cooperative for the Disposal of Radioactive Waste) deep drilling campaigns and the Mont Terri Project, an international research program dedicated to the study of claystone. The present study aims to unravel the variability of the lateral and vertical facies of the Opalinus Clay in central Northern Switzerland and to place this variability in a regional and basinal context. Analyses of new cores drilled in central Northern Switzerland, including petrographic, mineralogical (X-ray diffraction, multi-mineral interpretation), geochemical (X-ray fluorescence), statistical (non-metric multidimensional scaling analysis), and bedding dip and azimuth data, shed new light on the depositional facies and the spatial and temporal variability of the Opalinus Clay. Petrographic descriptions encompass nine new drill cores using a revised subfacies/facies classification scheme based on texture (colour, grain size, bedding) and composition (mineralogy). Particularly, one new subfacies (SF6) is described and interpreted as mass-wasting deposits. The drill cores are correlated laterally using specific marker horizons. This correlation is achieved by combining thorough facies investigations with lithostratigraphy, biostratigraphy, and chemostratigraphy. Six to seven small coarsening-upward cycles and two long-term coarsening-upward sequences can be interpreted as regressive trends. The observed trends are influenced by the interplay between sediment supply, eustatic sea level change, synsedimentary subsidence, but also the palaeogeographic configuration in an epicontinental sea, provenance and delivery of sediments, current dynamics and climate change. Finally, combined results show that the current dynamics in the Opalinus Clay has been underestimated until now and new depositional models, including the occurrence of drift deposits, are discussed.
Longevity of hybrid immunity against SARS-CoV-2 in adults vaccinated with an adenovirus-based COVID-19 vaccine
Authors: Mvula Memory , Mtonga Fatima , Mandolo Jonathan , Jowati Chisomo , Kalirani Alice , Chigamba Precious , Lisimba Edwin , Mitole Ndaona , Chibwana Marah G. , Jambo Kondwani C.
Published: September 2024

Background

Hybrid immunity provides better protection against COVID-19 than vaccination or prior natural infection alone. It induces high magnitude and broadly cross-reactive neutralising anti-Spike IgG antibodies. However, it is not clear how long these potent antibodies last, especially in the context of adenovirus-based COVID-19 vaccines.

Methods

We conducted a longitudinal cohort study and enrolled 20 adults who had received an adenovirus-based COVID-19 vaccine before a laboratory-confirmed SARS-CoV-2 infection. We followed up the study participants for 390 days post the initial breakthrough infection. We assessed the longevity and cross-reactive breadth of serum antibodies against SARS-CoV-2 variants of concern (VOCs), including Omicron.

Results

The binding anti-Spike IgG antibodies remained within the reported putative levels for at least 360 days and were cross-neutralising against Beta, Gamma, Delta, and Omicron. During the follow up period, a median of one SARS-CoV-2 re-infection event was observed across the cohort, but none resulted in severe COVID-19. Moreover, the re-exposure events were associated with augmented anti-Spike and anti-RBD IgG antibody titres.

Conclusions

This study confirms that hybrid immunity provides durable broadly cross-reactive antibody immunity against SARS-CoV-2 variants of concern for at least a year (360 days), and that it is further augment by SARS-CoV-2 re-exposure.
Patient lived experiences of functioning and disability following lumbar discectomy: a secondary analysis of qualitative data
Authors: Mistry Jai , White Louise , Baraks Karl , Davis Chris , Parikh Pulak , Schabrun Siobhan , Heneghan Nicola , Noblet Tim , Walton David , Rushton Alison
Published: September 2024

Background

Knowledge of patient lived experiences of functioning and disability is limited. This study aims to address the gap in the literature by exploring patient lived experiences of functioning and disability following lumbar discectomy.

Method

A secondary analysis, reported in line with the Standards for Reporting Qualitative Research, was conducted of qualitative data exploring patient journeys following lumbar discectomy surgery (DiscJourn). Adult patients (≥ 16 years) undergoing elective or emergency primary lumbar discectomy were recruited from one National Health Service secondary care centre in the UK. Semi-structured interviews were conducted at 1–3 weeks and 1-year post surgery. Participants who completed both semi-structured interviews were eligible for the secondary analysis. Transcripts from the semi-structured interviews were analysed using interpretative phenomenological analysis (IPA). IPA involved two independent reviewers identifying themes for individual data sets followed by an iterative process involving the wider research team to identify overarching themes that represented the whole date set. Subthemes generated from the IPA were mapped against the International Classification of Functioning, Disability and Health (ICF) framework at the level of chapters, in order to ascertain the ICF’s utility in capturing experiences of functioning and disability. Strategies to enhance trustworthiness of data analysis included blind coding, peer examination and debrief, declaration of pre-conceived beliefs and active reflexivity throughout the study.

Results

Nine participants met the eligibility criteria and their interview transcripts were analysed. Patient lived experiences of functioning and disability were captured by three overarching themes: Immediate impact following surgery, Multiple roads to recovery over 1 year, and Functioning influenced by personal loci of control. Each theme consisted of three subthemes which were subsequently mapped onto the ICF. Three subthemes mapped to the ICF’s body component, 1 to activity and participation and 3 to environment. Two subthemes themes did not map onto the ICF.

Conclusion

Findings provide valuable insights into patient experiences of functioning and disability following lumbar discectomy. Convergence in experiences of functioning and disability were identified immediately following surgery. Divergence in such experiences were identified with regards to the roads to recovery over 1 year and the individuals’ locus of control. Findings build on the body of literature exploring patients functioning and disability following discectomy and make recommendations for future research and clinical practice.
Strong associations between fasting lipids and glucose concentrations and ALT levels strengthened with increasing ALT quantiles
Authors: Liu Wei , Shi Lipu , Yuan Mengmeng , Zhang Yonghui , Li Yalong , Cheng Chaofei , Liu Junping , Yue Han , An Lemei
Published: September 2024

Background

A persistent redox state and excessive reactive species involved in carbohydrate and lipid metabolism lead to oxidative damage in the liver, however, how fasting plasma concentrations of lipids and glucose are associated with fasting blood levels of alanine transaminase (ALT) and aspartate transaminase (AST) remains to be evaluated in large-scale population.

Methods

A cross-sectional study with 182,971 residents aged 18 to 92 years; multidimensional stratified analyses including quantile linear regression analysis and sex stratification were adopted to improve the quality of the evidence.

Results

The associations between the concentrations of non-HDL-C and triglyceride and ALT levels were positive, stronger in males in each quantile of ALT levels and the coefficients expanded with increasing ALT levels at slopes of 3.610 and 5.678 in males and 2.977 and 5.165 in females, respectively. The associations between the HDL-C concentrations and ALT levels were negative, also stronger in males in each quantile and the coefficients expanded with increasing ALT levels at slopes of -7.839 in females and − 5.797 in males. The associations between glucose concentrations and ALT levels were positive, but stronger in females in each quantile and the coefficients expanded with increasing ALT levels at slopes of 1.736 in males and 2.177 in females, respectively. Similar pattern consist of relatively weaker coefficients and slops were observed between concentrations of non-HDL-C, triglyceride and glucose and AST levels. The associations between albumin concentration and concentrations of blood lipids and glucose were relatively steady across all quantiles.

Conclusions

The dose dependent effect between blood concentrations of lipids and glucose and liver function changes suggests that excessive carbohydrate and lipid metabolism may cause subclinical liver damage. Long term sustained primary and secondary inflammatory factors produced in the liver might be transmitted to adjacent organs, such as the heart, kidneys, and lungs, to cause and/or exacerbate pathological changes in these visceral organs.
Comparison of targeted next-generation sequencing and metagenomic next-generation sequencing in the identification of pathogens in pneumonia after congenital heart surgery: a comparative diagnostic accuracy study
Authors: Zheng Yi-Rong , Chen Xiu-Hua , Chen Qiang , Cao Hua
Published: September 2024

Background

This study aimed to compare targeted next-generation sequencing (tNGS) with metagenomic next-generation sequencing (mNGS) for pathogen detection in infants with severe postoperative pneumonia after congenital heart surgery.

Methods

We conducted a retrospective observational study using data from the electronic medical record system of infants who developed severe pneumonia after surgery for congenital heart disease from August 2021 to August 2022. Infants were divided into tNGS and mNGS groups based on the pathogen detection methods. The primary outcome was the efficiency of pathogen detection, and the secondary outcomes were the timeliness and cost of each method.

Results

In the study, 91 infants were included, with tNGS detecting pathogens in 84.6% (77/91) and mNGS in 81.3% (74/91) of cases (P = 0.55). No significant differences were found in sensitivity, specificity, PPA, and NPA between the two methods (P > 0.05). tNGS identified five strains with resistance genes, while mNGS detected one strain. Furthermore, tNGS had a faster detection time (12 vs. 24 h) and lower cost ($150 vs. $500) compared to mNGS.

Conclusion

tNGS offers similar sensitivity to mNGS but with greater efficiency and cost-effectiveness, making it a promising approach for respiratory pathogen detection.
Augmented reality- virtual reality wartime training of reserve prehospital teams: a pilot study
Authors: Kaim Arielle , Milman Efrat , Zehavi Eyal , Harel Amnon , Mazor Inbal , Jaffe Eli , Adini Bruria
Published: September 2024

Background

In the realm of trauma response preparation for prehospital teams, the combination of Augmented Reality (AR) and Virtual Reality (VR) with manikin technologies is growing in importance for creating training scenarios that closely mirror potential real-life situations. The pilot study focused on training of airway management and intubation for trauma incidents, based on a Trauma AR-VR simulator involving reserve paramedics of the National EMS service (Magen David Adom) who had not practiced for up to six years, activated during the Israel-Gaza conflict (October 2023). The trauma simulator merges the physical and virtual realms by utilizing a real manikin and instruments outfitted with sensors. This integration enables a precise one-to-one correspondence between the physical and virtual environments. Considering the importance of enhancing the preparedness of the reserve paramedics to support the prehospital system in Israel, the study aims to ascertain the impact of AR-VR Trauma simulator training on the modification of key perceptual attitudes such as self-efficacy, resilience, knowledge, and competency among reserve paramedics in Israel.

Methods

A quantitative questionnaire was utilized to gauge the influence of AR-VR training on specific psychological and skill-based metrics, including self-efficacy, resilience, medical knowledge, professional competency, confidence in performing intubations, and the perceived quality of the training experience in this pilot study. The methodology entailed administering a pre-training questionnaire, delivering a targeted 30-minute AR-VR training session on airway management techniques, and collecting post-training data through a parallel questionnaire to measure the training’s impact. Fifteen reserve paramedics were trained, with a response rate of 80% (n = 12) in both measurements.

Results

Post-training evaluations indicated a significant uptick in all measured areas, with resilience (3.717±0.611 to 4.008±0.665) and intubation confidence (3.541±0.891 to 3.833±0.608) showing particularly robust gains. The high rating (4.438±0.419 on a scale of 5) of the training quality suggests positive response to the AR-VR integration for the enhancement of medical training,

Conclusions

The application of AR-VR in the training of reserve paramedics demonstrates potential as a key tool for their swift mobilization and efficiency in crisis response. This is particularly valuable for training when quick deployment of personnel is necessary, training resources are diminished, and ‘all hands on deck’ is necessary.
Long-term major events after hospital discharge for out-of-hospital cardiac arrest
Authors: Ortuno Sofia , Bougouin Wulfran , Voicu Sebastian , Paul Marine , Lascarrou Jean-Baptiste , Benghanem Sarah , Dumas Florence , Beganton Frankie , Karam Nicole , Marijon Eloi , Jouven Xavier , Cariou Alain , Aissaoui Nadia
Published: September 2024

Background

Cardiac arrest remains a global health issue with limited data on long-term outcomes, particularly regarding recurrent cardiovascular events in patients surviving out-of-hospital cardiac arrest. (OHCA). We aimed to describe the long-term occurrence of major cardiac event defined by hospital admission for cardiovascular events or death in OHCA hospital survivors, whichever came first. Our secondary objective were to assess separately occurrence of hospital admission and death, and to identify the factors associated with major event occurrence. We hypothesized that patients surviving an OHCA has a protracted increased risk of cardiovascular events, due to both presence of the baseline conditions that lead to OHCA, and to the cardiovascular consequences of OHCA induced acute ischemia-reperfusion.

Methods

Consecutive OHCA patients from three hospitals of Sudden Death Expertise Center (SDEC) Registry, discharged alive from 2011 to 2015 were included. Long-term follow-up data were obtained using national inter-regime health insurance information system (SNIIRAM) database and the national French death registry. The primary endpoint was occurrence of a major event defined by hospital admission for cardiovascular events and death, whichever came first during the follow-up. The starting point of the time-to-event analysis was the date of hospital discharge. The follow-up was censored on the date of the first event. For patients without event, follow-up was censored on the date of December, 29th, 2016.

Results

A total of 306 patients (mean age 57; 77% male) were analyzed and followed over a median follow-up of 3 years for hospital admission for cardiovascular event and 6 years for survival. During this period, 38% patients presented a major event. Hospital admission for cardiovascular events mostly occurred during the first year after the OHCA whereas death occurred more linearly during the all period. A previous history of chronic heart failure and coronary artery disease were independently associated with the occurrence of major event (HR 1.75, 95%CI[1.06-2.88] and HR 1.70, 95%CI[1.11-2.61], respectively), whereas post-resuscitation myocardial dysfunction, cardiogenic shock and cardiologic cause of cardiac arrest did not.

Conclusion

Survivors from OHCA must to be considered at high risk of cardiovascular event occurrence whatever the etiology, mainly during the first year following the cardiac arrest and should require closed monitoring.
Natural 14C abundances and stable isotopes suggest discrete uptake routes for carbon and nitrogen in cold seep animals
Authors: Nomaki Hidetaka , Kojima Shigeaki , Miyairi Yosuke , Yokoyama Yusuke , Chen Chong
Published: September 2024

Cold seeps, where geofluids containing methane and other hydrocarbons originating from the subseafloor seeps through the sediment surface, play important roles in the elemental and energy flux between sediment and seawater. These seep sites often harbor communities of endemic animals supported by chemolithoautotrophic bacteria, either through symbiosis or feeding. Despite these animal communities being intensively studied since their discovery in the 1980’s, the contribution of carbon from seep fluid to symbiotic microbes and subsequently host animals remains unclear. Here, we used natural-abundance radiocarbon to discern carbon sources: the ambient bottom water or the seeping geofluid. The 14C concentrations were measured for vesicomyid clams, a parasitic calamyzine polychaete, and a siboglinid tubeworm species from four different cold seep sites around Japan. We found most vesicomyid clams exhibiting 14C concentrations slightly lower than that of the ambient bottom water, suggesting up to 9% of C for chemolithoautotrophy originates from geofluid DIC. The different extent of fluid contribution across species may be explained by different routes to incorporate DIC and/or different DIC concentrations in the geofluid at each seep site. Stable nitrogen isotopic compositions further suggested N incorporation from geofluids in these clams, where the burrowing depth may be a key factor in determining their δ15N values. The siboglinid tubeworm showed a clear dependency for geofluid DIC, with a contribution of > 40%. Our results demonstrate the effectiveness of 14C analyses for elucidating the nutritional ecology of cold seep animals and their symbionts, as was previously shown for hydrothermal vent ecosystems.
In-person and online mixed method non-randomised studies exploring feasibility and acceptability of HEADS: UP, an adapted Mindfulness-Based Stress Reduction programme for stroke survivors experiencing symptoms of anxiety and depression
Authors: Lawrence Maggie , Davis Bridget , Clark Naomi E. , Booth Jo , Donald Graeme , Dougall Nadine , Grealy Madeleine , Jani Bhautesh , MacDonald Jennifer , Mason Helen , Maxwell Margaret , Parkinson Ben , Pieri Matilde , Wang Xu , Mercer Stewart
Published: September 2024

Background

Depression and anxiety are prevalent after stroke and associated with poor outcomes. We previously co-developed a stroke-specific self-management intervention, HEADS: UP (Helping Ease Anxiety and Depression after Stroke). The two studies reported here aimed to test the feasibility and acceptability of the HEADS: UP course and supporting materials, and research processes ahead of a definitive trial.

Methods

We recruited community-dwelling stroke survivors (SS) ≥ 3 months post-stroke, with symptoms of mood disorder (Hospital Anxiety and Depression Scale ≥ 8). Participants could ‘enrol’ a family member/ ‘other’ to take part with them, if desired. Study 1 tested HEADS: UP delivered in-person, and informed optimisation of research processes and intervention delivery and materials. In a pragmatic response to Covid-related socialising restrictions, HEADS: UP was then adapted for online delivery, tested in Study 2. The primary outcome (both studies) was the feasibility (acceptability, fidelity) of the intervention and of research processes. Quantitative data (including patient-reported outcome measures (PROMs) assessing mood and quality of life) and qualitative data were collected pre-/post-intervention. Descriptive statistics were used to analyse quantitative data; a thematic framework approach was used to analyse qualitative data. Both studies received ethical approval prior to commencement.

Results

Study 1

Feasibility: 13 (59.1%) of 22 potentially eligible stroke survivors consented; aged 66 (median, interquartile range (IQR) 14); male (n = 9; 69%); 28 (IQR 34) months post-stroke. Of these, n = 10 (76.9%) completed PROMS pre-intervention; n = 6 (46.2%) post-intervention.

Acceptability: Nine (69.2%) of the 13 participants attended ≥ 4 core intervention sessions. Aspects of screening and data collection were found to be burdensome.

Study 2

Feasibility: SS n = 9 (41%) of 22 potentially eligible stroke survivors consented; aged 58 years (median; IQR 12); male (n = 4; 44.4%); 23 (IQR 34) months post-stroke. Of these, n = 5 (55.6%) completed PROMS pre-intervention; n = 5 (55.6%) post-intervention.

Acceptability: Five (55.6%) of the 9 participants attended ≥ 4 core sessions. They found online screening and data collection processes straightforward.
Precision medicine for personalized cholecystitis care: integrating molecular diagnostics and biotherapeutics
Authors: Addissouky Tamer A.
Published: September 2024

Background

Acute cholecystitis, inflammation of the gallbladder, can lead to serious complications if not promptly diagnosed and managed. Conventional therapies have limitations, necessitating newer personalized approaches.

Main body of the abstract

This review examines recent advances transforming cholecystitis care. Diagnostically, molecular techniques like next-generation sequencing rapidly identify causative microbes from gallbladder specimens, enabling targeted antimicrobial therapy. Regarding treatment, phage therapy uses viruses to lyse pathogenic bacteria. RNA interference and CRISPR-Cas9 gene editing silence microbial virulence factors. Probiotics competitively exclude pathogens. Robotics and fluorescence imaging refine surgical techniques. Additional emerging modalities include biosensors detecting inflammatory mediators, regenerative gallbladder tissue engineering using stem cells, and artificial intelligence for real-time decision support. However, the optimal integration of novel technologies with current best practices remains unknown. Further research is needed to validate and optimize personalized diagnostics and therapeutics for cholecystitis.

Short conclusions

Advances in next-generation sequencing, CRISPR gene editing, robotics, and other biotechnologies promise to transform the precision and personalized management of cholecystitis when thoughtfully implemented. However, controlled trials are still required to define optimal integration with conventional supportive care and antibiotics.
A 10-point preoperative checklist: selecting patients for outpatient joint replacement surgery
Authors: Chowdhry Madhav , McPherson Edward J.
Published: September 2024

Background

With advancements in perioperative care, joint replacement (JR) surgery is undergoing a transition from opacified in-patient institutions to nimble out-patient Ambulatory Surgical Centers (ASC). The goal of JR in ASC setting is safe patient discharge with subsequent rehabilitation without readmission. Multi-modal preoperative rehabilitation (MMPR) is a novel field of perioperative care, encompassing comprehensive parameters to ensure smooth transition from fitness for surgery to JR in outpatient setting. At present, there are no open-access schemes for selecting patients qualified for JR in the ASC setting. In this article, we propose an evidence-based, 10-point systematic evaluation of patients with target endpoints for MMPR to qualify patients for JR as an outpatient procedure. This checklist is a non-proprietary scheme serving as an initial framework for surgeons exploring surgery in the ASC setting.

Body

We introduce factors for a prehabilitation scheme, called Checklist Outpatient-Joint Replacement (CO-JR) to qualify patients for outpatient JR surgery. These factors have been developed based on an extensive literature review and the significant experience of authors to incorporate variables that drive a successful outpatient JR procedure. The factors include patient education, psychiatric & cognitive ability, medical fitness, musculoskeletal capability, financial ability, transportation access, patient motivation, information technology (IT) capabilities, along with ability to recover independently at home postoperatively. The CO-JR scheme is under the process of validation at multiple institutions. We introduce this as a starting point for collaborative development of an open-access scheme for all surgeons to learn and adapt as needed for their respective global region.

Conclusion

We established a non-proprietary 10-point CO-JR scheme, serving as a framework for surgeons to successfully select patients for JR surgery in the ASC setting. We encourage concomitant validation of this scheme globally. Our goal is to reach an international consensus on an open-access scheme, available for all surgeons to enrol patients for JR in the ASC setting, but modifiable to accommodate regional needs.
Posterior reversible encephalopathy syndrome in a known case of beta-thalassemia major after blood transfusion: a case presentation
Authors: Hanna Diana , Nada Mohamad Gamal , Gohary Mahmoud M.
Published: September 2024

Background

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic condition associated with a distinctive brain imaging pattern which typically occur in some complex clinical conditions. However, the leading offender to this condition remains not clear.

Case presentation

We report a 6-year-old female with β-thalassemia major presenting with generalized tonic–clonic convulsions, repeated attacks of projectile vomiting, blurred vision, and altered conscious level after blood transfusion. The brain magnetic resonance imaging (MRI) FLAIR sequence revealed bilateral and symmetrical subcortical edema displaying high signal intensity. Follow-up MRI 1 month later showed complete resolution of the previously identified findings. The clinical presentation along with neuroimaging pattern as well as the reversible course indicated PRES as the most suitable diagnosis. Although PRES has been previously described in different clinical settings, this is a rare case of PRES recognized after blood transfusion in a child with β-thalassemia major.

Conclusion

Acute neurological symptoms in children with thalassemia should raise high suspicion for PRES, especially after blood transfusion.
Clinical study of Wnt inhibitory factor-1 expression and its association with disease severity in non-segmental vitiligo
Authors: Gohary Yasser Mostafa , Abdelhady Ebtehal Gamal , Sayed Aya Nagy , Rashed Laila Ahmed , Kamel Hanan Abd El Razik
Published: September 2024

Background

Vitiligo is classified as an acquired chronic depigmentation disorder that includes the destruction of epidermal melanocytes. It affects 0.5–1% of the population all over the world. Wnt signaling pathway is vital in melanocytes differentiation and development. WIF-1 is an antagonist of the Wnt signaling pathway; it hinders Wnt from binding its receptors. The present study aims to detect WIF-1 expression in vitiligo skin and if it relates to the disease's severity.

Results

This case–control study included 70 subjects: 35 vitiligo patients and 35 healthy controls. Skin WIF-1 expression was estimated using quantitative real-time PCR. Assessment of the vitiligo disease activity score and vitiligo area severity index score was determined. WIF-1 expression showed significant elevation in the skin of vitiligo patients compared to the healthy control group.

Conclusion

Overexpression of WIF-1 may participate in the pathogenesis of vitiligo; hence, it should be a future therapeutic target.
Harnessing Natural Language Processing to Assess Quality of End-of-Life Care for Children With Cancer
Authors: Lindsay Meghan E. , de Oliveira Sophia , Sciacca Kate , Lindvall Charlotta , Ananth Prasanna J.
Published: September 2024

PURPOSE

Data on end-of-life care (EOLC) quality, assessed through evidence-based quality measures (QMs), are difficult to obtain. Natural language processing (NLP) enables efficient quality measurement and is not yet used for children with serious illness. We sought to validate a pediatric-specific EOLC-QM keyword library and evaluate EOLC-QM attainment among childhood cancer decedents.

METHODS

In a single-center cohort of children with cancer who died between 2014 and 2022, we piloted a rule-based NLP approach to examine the content of clinical notes in the last 6 months of life. We identified documented discussions of five EOLC-QMs: goals of care, limitations to life-sustaining treatments (LLST), hospice, palliative care consultation, and preferred location of death. We assessed performance of NLP methods, compared with gold standard manual chart review. We then used NLP to characterize proportions of decedents with documented EOLC-QM discussions and timing of first documentation relative to death.

RESULTS

Among 101 decedents, nearly half were minorities (Hispanic/Latinx [24%], non-Hispanic Black/African American [20%]), female (48%), or diagnosed with solid tumors (43%). Through iterative refinement, our keyword library achieved robust performance statistics (for all EOLC-QMs, F1 score = 1.0). Most decedents had documented discussions regarding goals of care (83%), LLST (83%), and hospice (74%). Fewer decedents had documented discussions regarding palliative care consultation (49%) or preferred location of death (36%). For all five EOLC-QMs, first documentation occurred, on average, >30 days before death.

CONCLUSION

A high proportion of decedents attained specified EOLC-QMs more than 30 days before death. Our findings indicate that NLP is a feasible approach to measuring quality of care for children with cancer at the end of life and is ripe for multi-center research and quality improvement.
Incidence and Prognostic Values in Human Epidermal Growth Factor Receptor 2-Low Expression Metastatic Breast Cancer in Southeast Asian Population: A 10-Year Retrospective Study
Authors: Dajsakdipon Thanate , Pipatsakulroj Wiriya , Dejthevaporn Thitiya
Published: September 2024

PURPOSE

Breast cancer progression varies across molecular subtypes, and treatment options for human epidermal growth factor receptor 2 (HER2)-low expression tumors are limited compared with those of HER2 overexpression tumors. Comprehensive information regarding the epidemiology and clinical outcomes of metastatic HER2-low expression breast cancer in a Southeast Asian population is lacking.

METHODS

This retrospective cohort study was performed to analyze data from patients with de novo advanced breast cancer, including HER2 expression, tumor stage, and metastatic pattern. Statistical analyses, including chi-square tests and survival analyses, were used to compare HER2-low expression and HER2-negative groups.

RESULTS

Of the 491 patients, 21.2% had HER2-low expression, 30% had HER2 overexpression, and 50% had HER2-negative expression. Among the hormone receptor (HR)–positive patients, 34% had HER2-low expression; in the triple-negative patients, the HER2-low incidence was 20.6%. No significant differences in clinical characteristics between HER2-low and HER2-negative groups were observed, except for more HR-positive patients in the HER2-low group. HER2-low patients had a longer overall survival (OS) than HER2-negative patients (43 v 23 months; hazard ratio, 0.7; P < .001), especially in HR-positive patients. After adjusting for HR status, HER2-low patients maintained improved outcomes. HR-positive HER2-low patients showed nonsignificant OS gains compared with HR-positive HER2-negative patients, regardless of first-line chemotherapy or endocrine therapy.

CONCLUSION

This study revealed the incidence and clinical outcomes of HER2-low expression in de novo advanced breast cancer, suggesting favorable outcomes, particularly in HR-positive breast cancer. These findings may inform personalized treatment strategies. Further research into the mechanisms and implications of HER2-low expression in breast cancer is required.
Five Banners
Authors: Feinstein John
Published: September 2024

On an early morning in 1983, after the worst loss of his career (109-66 against Virginia) and amid the cries of powerful athletics boosters calling for him to be fired, Duke men’s basketball coach Mike Krzyzewski went to breakfast at 2:00 a.m. to vent with friends. Sports journalist and Duke alumnus John Feinstein was at the table. For Coach K, “the night at Denny’s” would mark a turning point in his career and for the team, and eight years later, the Blue Devils would win their first NCAA national championship.

In Five Banners, Feinstein tells the inside history of Coach K’s forty-two-year career at Duke and its five NCAA championships, from the first, against Kansas in 1991, to the most recent, in 2015 against Wisconsin. With unparalleled access to Coach K, the team, and its staff, Feinstein takes readers on a mesmerizing ride into the locker room and onto the court. Full of intimate details, personal memories, and previously untold on- and off-court stories, it is a book that only Feinstein could write.

Feinstein explores a basketball legacy that begins with his days as an undergrad Duke Chronicle reporter covering coaches Bucky Waters and Neill McGeachy (who went 10-16 in one year as head coach), includes the “drought years” of the 1980s and the glory of the teams of the 1990s, and moves into the present day with Jon Scheyer’s succession. Drawing on new interviews, Feinstein highlights the voices of Grant Hill, Nolan Smith, Christian Laettner, Tommy Amaker, and Bobby Hurley, who each bring new insights on the championship years.

Throughout, Feinstein unveils the momentous force of college basketball as a game of intense relationships and intimate conversations. Candid, revelatory, and engrossing, Five Banners is an essential book for all Duke fans and anyone who loves the college game.
Understanding the Importance of Blood-Brain Barrier Alterations in Brain Arteriovenous Malformations and Implications for Treatment: A Dynamic Contrast-Enhanced-MRI–Based Prospective Study
Authors: Mosteiro Alejandra , Pedrosa Leire , Amaro Sergio , Menéndez-Girón Sebastián , Reyes Luis , de Riva Nicolás , Misis Maite , Blasco Jordi , Vert Carla , Dominguez Carlos J. , Enseñat Joaquim , Martín Abraham , Rodriguez-Hernández Ana , Torné Ramon
Published: September 2024

BACKGROUND AND OBJECTIVES:

The major clinical implication of brain arteriovenous malformations (bAVMs) is spontaneous intracranial hemorrhage. There is a growing body of experimental evidence proving that inflammation and blood-brain barrier (BBB) dysfunction are involved in both the clinical course of the disease and the risk of bleeding. However, how bAVM treatment affects perilesional BBB disturbances is yet unclear.

METHODS:

We assessed the permeability changes of the BBB using dynamic contrast-enhanced MRI (DCE-MRI) in a series of bAVMs (n = 35), before and at a mean of 5 (±2) days after treatment. A set of cerebral cavernous malformations (CCMs) (n = 16) was used as a control group for the assessment of the surgical-related collateral changes. The extended Tofts pharmacokinetic model was used to extract permeability (Ktrans) values in the lesional, perilesional, and normal brain tissues.

RESULTS:

In patients with bAVM, the permeability of BBB was higher in the perilesional of bAVM tissue compared with the rest of the brain parenchyma (mean Ktrans 0.145 ± 0.104 vs 0.084 ± 0.035, P = .004). Meanwhile, no significant changes were seen in the perilesional brain of CCM cases (mean Ktrans 0.055 ± 0.056 vs 0.061 ± 0.026, P = .96). A significant decrease in BBB permeability was evident in the perilesional area of bAVM after surgical resection (mean Ktrans 0.145 ± 0.104 vs 0.096 ± 0.059, P = .037). This benefit in BBB permeability reduction after surgery seemed to surpass the relative increase in permeability inherent to the surgical manipulation.

CONCLUSION:

In contrast to CCMs, BBB permeability in patients with bAVM is increased in the perilesional parenchyma, as assessed using DCE-MRI. However, bAVM surgical resection seems to reduce BBB permeability in the perilesional tissue. No evidence of the so-called breakthrough phenomenon was detected in our series. DCE-MRI could become a valuable tool to follow the longitudinal course of BBB damage throughout the natural history and clinical course of bAVMs.
Pathophysiology and Prevention of Ventriculostomy-Related Infections: A Review
Authors: Roujansky Ariane , Diop Sylvain , Pasqueron Jean , Aparicio Maxime , Cook Fabrice , Kallel Hatem , Mounier Roman
Published: September 2024

This qualitative review aims to summarize current knowledge on ventriculostomy-related infection (VRI) pathophysiology and its prevention. VRI generally occurs at day 10, mainly because of Gram-positive cocci, after a cerebrospinal fluid leak. Skin microbiota and biofilm seem to play a major role in VRI pathogenesis. Colonization of external ventricular drain by biofilm is universal and occurs quickly after catheter insertion. However, pathogens from the skin are more often associated with VRI than commensal bacteria. A review of proposed preventive measures shows that none has proven to be fully efficient. Periprocedural and prolonged systemic prophylactic antimicrobials have not shown to prevent VRIs and may promote the emergence of more resistant or pathogenic strains. Antimicrobial and silver-impregnated external ventricular drains, although promising, have not demonstrated preventive effects and may modify bacterial ecology. These results are consistent with the proposed pathophysiology. Finally, we will present a few propositions for future research that may help in improving our knowledge and thus better prevent VRIs. Until then, given the available data, limiting the duration of ventricular drainage may be the most attainable option to prevent VRIs.
Intracellular Ca2+ After Eccentric Muscle Contractions: Key Role for Ryanodine Receptors
Authors: Tabuchi Ayaka , Poole David C. , Kano Yutaka
Published: September 2024

Eccentric contractions (ECC) induce excessive intracellular calcium ion (Ca2+) accumulation and muscle structural damage in localized regions of the muscle fibers. In this investigation, we present the novel hypothesis that the ryanodine receptor (RyR) plays a central role in evoking a Ca2+ dynamics profile that is markedly distinguishable from other muscle adaptive responses.
Ο θεσμός του Μέντορα στην εκπαιδευτική διαδικασία
Authors: Μαρτίνου Σωτηρία
Published: September 2024

Από το σχολικό έτος 2022-23 εισάγεται ο  θεσμός του μέντορα στην Πρωτοβάθμια και τη Δευτεροβάθμια Εκπαίδευση. Σκοπός της  παρούσας εργασίας είναι να παρουσιάσουμε τη μεντορεία και να  αναδείξουμε τη σημαντικότητά της για τους/τις νεοεισερχόμενους/ες εκπαιδευτικούς. Θα γνωρίσουμε τα καθήκοντα και τις αρμοδιότητες των μεντόρων, τη θητεία, τα κριτήρια ορισμού και τον τρόπο επιλογής τους. Στην εργασία μας, θα γίνει εστίαση στις ανάγκες υποστήριξης των νεοεισερχόμενων εκπαιδευτικών  και στα χαρακτηριστικά του  μέντορα και του/της μεντορευόμενου/ης για την επιτυχία του δομημένου  προγράμματος της εκπαιδευτικής καθοδήγησης των νεοεισερχόμενων εκπαιδευτικών. Θα αναδειχθούν, επίσης, τα στάδια της μεντορικής σχέσης, τα οφέλη από τους εμπλεκόμενους στο mentoring και η συμβολή του θεσμού του μέντορα στη διαμόρφωση της διδασκαλίας, ως διαδικασία επαγγελματικής μάθησης και ανάπτυξης των εκπαιδευτικών. Θα αιτιολογηθεί, παράλληλα η αποτελεσματικότητα της μεντορικής διαδικασίας μέσα από την αυτοαξιολόγηση των συμμετεχόντων/ουσών, τη διαμορφωτική και την τελική αξιολόγηση στη μεντορεία.
Ο διαπραγματευτικός ρόλος του Ηγέτη στο Δημόσιο
Authors: Αραβίδου Κυριακή , Τριαντάρη Σωτηρία
Published: September 2024

Ο σκοπός της συγκεκριμένης εργασίας είναι να αναδείξει το μείζον θέμα των εργασιακών συγκρούσεων και το ρόλο του ηγέτη-προϊστάμενου στη διαχείριση τους έτσι ώστε να διασφαλιστεί η ομαλή λειτουργία της κάθε εργασιακής ομάδας στο Δημόσιο Τομέα και ειδικότερα στις Διευθύνσεις Τεχνικών Έργων στις επτά (7) Περιφερειακές Ενότητες και στους 37 Δήμους που συγκροτούν διοικητικά την Περιφέρεια Κεντρικής Μακεδονίας. Διενεργήθηκε ποσοτική έρευνα με τη χρήση ερωτηματολογίων, που εγκρίθηκαν από την Επιτροπή Ηθικής και Δεοντολογίας της Έρευνας του Πανεπιστημίου Δυτικής Μακεδονίας. Η στατιστική ανάλυση πραγματοποιήθηκε στο στατιστικό πρόγραμμα IBM SPSS 24 με τη βοήθεια του λογισμικού Microsoft Office Excel 2016 για το σχεδιασμό γραφημάτων και για την κωδικοποίηση των δεδομένων. Σύμφωνα με τους εργαζόμενους/ες, συγκρούσεις συμβαίνουν στις Δημόσιες υπηρεσίες πολύ συχνά και το 70% πιστεύει ότι δεν αντιμετωπίζονται αποτελεσματικά. Τα αποτελέσματα της έρευνας αναδεικνύουν την ανάγκη μιας διαφορετικής προσέγγισης των συγκρούσεων που θα προκύψει από τη συνεχή εκπαίδευση εργαζομένων και προϊσταμένων
Λέξεις-κλειδιά: Διαχείριση Συγκρούσεων, Δημόσιος Τομέας
Έρευνα των οικονομικών της εκπαίδευσης: Μία πολύπλευρη επισκόπηση (1993-2022)
Authors: Κόκκορης Χρήστος , Κουτσουπιάς Νίκος , Βασιλειάδης Νικόλαος
Published: September 2024

Περίληψη
Η σύνδεση της Εκπαίδευσης και της Οικονομικής Έρευνας έχει αυξηθεί σημαντικά, επιτρέποντας συστηματικές και βιβλιομετρικές αναλύσεις. Είναι ενδιαφέρον ότι δεν έχει γίνει ακόμη βιβλιομετρική έρευνα για την μεταξύ τους σχέση (EdER). Για να καλυφθεί αυτό το κενό, η μελέτη μας χρησιμοποιεί βιβλιομετρικές τεχνικές πραγματοποιώντας μια στατιστική ανασκόπηση 4335 δημοσιευμένων μελετών και να ποσοτικοποιήσει την επίδραση τους στην επιστημονική κοινότητα, εστιάζοντας σε τρεις εξέχουσες πηγές, συγκεκριμένα: Economics of Education, International Journal of Educational Development και Οικονομικά της Εκπαίδευσης. Πραγματοποιήσαμε μια βιβλιομετρική εξέταση, ταυτοχρόνως ποιοτική και ποσοτική, χρησιμοποιώντας δημοσιεύσεις μέσω του ευρετηρίου Scopus από θέματα Οικονομικών που δημοσιεύτηκαν τις προηγούμενες τρεις δεκαετίες, καθώς και το λογισμικό ανάλυσης δεδομένων R-language bibliometrix. Η έρευνα αποκάλυψε ποικιλία αποτελεσμάτων, συμπεριλαμβανομένων πληροφοριών για τους πιο εξέχοντες συγγραφείς και περιοδικά. Διερευνήσαμε, επίσης, τα θέματα και τις τρέχουσες ερευνητικές τάσεις στον τομέα των οικονομικών της εκπαίδευσης, καθώς και την εξέλιξη των ερευνητικών ροών και τάσεων στα πεδία του EDER.
Abstract
The connection of Education and Economic Research has grown significantly, allowing for systematic and bibliometric analyses. Interestingly, no bibliometric research has yet been done on the relationship between them (EdER). To fill this gap, our study uses bibliometric techniques by conducting a statistical review of 4335 published studies and quantifying their impact on the scientific community, focusing on three prominent sources, namely: Economics of Education, International Journal of Educational Development and Economics of Education. We performed a bibliometric review, both qualitative and quantitative, using publications through the Scopus index from Finance topics published in the previous three decades, as well as the R-language bibliometrix data analysis software. The search revealed a variety of results, including information on the most prominent authors and journals. We also explored the topics and current research trends in the field of education economics, as well the evolution of research streams and trends in EDER fields.
Το Πλαίσιο του Θαλάσσιου Χωροταξικού Σχεδιασμού: Μια Μελέτη Περίπτωσης για την Βιωσιμότητα του Βορείου, Νοτίου Αιγαίου & Κρήτης
Authors: Παυλογεωργάτος Γεράσιμος , Κόκκινου Αικατερίνη
Published: September 2024

Περίληψη
Ο θαλάσσιος χωροταξικός σχεδιασμός αποτελεί ένα στρατηγικό ολοκληρωμένο σχέδιο που στοχεύει στην ενσωμάτωση των χρήσεων της θαλάσσιας ζώνης και των παράκτιων δραστηριοτήτων με απώτερο  σκοπό την επίτευξη της βιώσιμης και ισορροπημένη ανάπτυξη. Ο θαλάσσιος χωρικός σχεδιασμός ασχολείται με τον σχεδιασμό, την οργάνωση, τη διαχείριση και τη ‘σύνδεση’ του θαλάσσιου και του παράκτιου χώρου, έτσι ώστε να επιτευχθούν πολλαπλασιαστικές θετικές επιπτώσεις με την αξιοποίηση των πόρων, τη βιώσιμη ισόρροπη ανάπτυξη, τη προστασία του περιβάλλοντος και την κοινωνική συνοχή. Το άρθρο αυτό στοχεύει την καταγραφή, παρουσίαση και ανάλυση του πλαισίου του θαλάσσιου χωροταξικού σχεδιασμού και την συμβολή του στην ισόρροπο αειφόρο βιώσιμη ανάπτυξη. Πιο συγκεκριμένα, οι περιφέρειες που αποτελούν αντικείμενο διαχρονικής και δια-συγκριτικής μελέτης είναι η περιοχή του Αιγαίου και ιδιαίτερα το Βόρειο Αιγαίο, το Νότιο Αιγαίο και η Κρήτη.
Abstract
Maritime spatial planning is a strategic integrated plan that aims to integrate the uses of the marine zone and coastal activities with the ultimate goal of achieving sustainable and balanced development. Maritime spatial planning is concerned with planning, organizing, managing and connecting marine and coastal space, so as to achieve multiplier positive effects through resource utilization, sustainable balanced development, environmental protection and social cohesion. This paper  aims to record, present and analyze the framework of marine spatial planning and its contribution to balanced sustainable development. More specifically, the regions that are the subject of a longitudinal and cross-comparative study are the Aegean region and especially North Aegean, South Aegean and Crete.
Η Μακροοικονομική Διερεύνηση της Διάβρωσης Φορολογικής Βάσης και Μετατόπισης Κερδών: Μία Συστηματική Βιβλιογραφική Ανασκόπηση
Authors: Βασιλάκης Αθανάσιος Γ.
Published: September 2024

Περίληψη
Ο κύριος σκοπός της εργασίας είναι η Συστηματική Βιβλιογραφική Ανασκόπηση (ΣΒΑ) των μακροοικονομικών επιπτώσεων της Διάβρωσης της Φορολογικής Βάσης και της Μετατόπισης Κερδών (Base Erosion and Profit Shifting - BEPS). Η επίτευξη του σκοπού πραγματοποιήθηκε με την αξιοποίηση του πλαισίου PRISMA (Preferred Reporting Items for Systematic Reviews and Meta – Analysis). Τα επιστημονικά άρθρα αντλήθηκαν από πέντε βάσεις δεδομένων (ABI-ProQuest, EBSCO, Google Scholar, Scopus, Web of Science) που δημοσιεύθηκαν από το 2003 έως 2022. Η ΣΒΑ βασίζεται σε 30 επιλεγμένες εργασίες που αντλούνται από 16.700 πηγές (μέγιστος αναφερόμενος αριθμός από Google Scholar). Οι 30 επιλεγμένες εργασίες ανακτήθηκαν από επιστημονικά περιοδικά που είναι καταχωρημένα σε τρεις διαφορετικές ακαδημαϊκές βάσεις δεδομένων [Scopus, Chartered Association of Business Schools (ABS), Web of Science (WoS)]. Η ΣΒΑ ταξινομεί τις εξαρτημένες και ανεξάρτητες μακροοικονομικές επιπτώσεις που προκαλεί η πρακτική των BEPS, όπως η όξυνση της διεθνούς φοροαποφυγής που έχουν δυσμενή αντίκτυπο στην Παγκόσμια και Ευρωπαϊκή Οικονομία.
Abstract
A Systematic Literature Review of the Macro-Economics of Base Erosion and Profit Shifting (BEPS) is the main purpose of this study. This has been achieved by a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) that was conducted using five databases (ABI-ProQuest, EBSCO, Google Scholar, Scopus and Web of Science) published between 2003 and 2022. This review is based on 30 studies out of 16.700 (the larger number from Google Scholar) that were identified. The chosen 30 articles were retrieved as triple listed journals on Scopus, The Chartered Association of Business Schools (ABS) and Web of Science (WoS). Our approach aims to identify the serious dependent, independent and control macroeconomic issues that BEPS causes, such as severe acute international tax avoidance that has a destructive impact on the Global and European economies.