bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of quantitative lung ultrasound instead of CT for monitoring COVID-19 pneumonia in pregnant women: a single-center retrospective study
Authors: Deng Qing , Cao Sheng , Wang Hao , Zhang Yao , Chen Liao , Yang Zhaohui , Peng Zhoufeng , Zhou Qing
Published: March 2021

Background

Computed tomography (CT) is the preferred imaging technique for the evaluation of COVID-19 pneumonia. However, it is not suitable as a monitoring tool for pregnant women because of the risk of ionizing radiation damage to the fetus as well as the possible infection of others. In this study, we explored the value of bedside lung ultrasound (LUS) as an alternative to CT for the detection and monitoring of lung involvement in pregnant women with COVID-19.

Methods

Clinical and LUS data of 39 pregnant women with COVID-19 were retrospectively reviewed. All LUS and CT images were analyzed to summarize the findings and calculate LUS scores and CT scores for each patient. LUS findings were compared with CT, and correlation between LUS scores and CT scores was evaluated.

Results

Among the 39 pregnant women, there were 6 mild-type cases, 29 common-type cases, 4 severe-type cases, and no critical-type cases. The most common LUS findings of COVID-19 pneumonia in pregnant women were various grades of multiple B-lines (84.6%), thickened and irregular pleural lines (71.8%), pleural effusion (61.5%) and small multifocal consolidation limited to the subpleural space (35.9%). The mean LUS score at admission was 0 points in mild-type cases, 10.6 points in common-type cases and 15.3 points in severe-type cases (P < 0.01). The correlation between LUS scores and CT was 0.793. All patients were clinically cured and each underwent an average of three LUS follow-ups during hospitalization. The mean LUS score at discharge was 5.6 points lower than that at admission. The consistency of LUS and chest CT during follow-up was 0.652.

Conclusions

Quantitative LUS scoring can effectively instead of CT for detecting and monitoring of COVID-19 pneumonia in pregnant women and protect fetuses from the risk of ionizing radiation.
Comparison of psychological symptoms between infected and non-infected COVID-19 health care workers
Authors: Mohammadian Khonsari Nami , Shafiee Gita , Zandifar Atefeh , Mohammad Poornami Sahar , Ejtahed Hanieh-Sadat , Asayesh Hamid , Qorbani Mostafa
Published: March 2021

Background

Studies have shown that health care workers (HCWs), as front liners of the coronavirus (COVID-19) pandemic, are at high risk for psychological symptoms, but few studies have compared these symptoms in infected and non-infected HCWs. This study compares psychological symptoms among these two groups.

Methods

In this cross-sectional study, 938 HCWs from various medical fields working in the leading general hospitals of Alborz province, Iran, were selected using a multistage sampling method. The participants had contact with COVID-19 patients. Post-traumatic stress disorder-8 (PTSD-8) is a validated questionnaire that we used to evaluate PTSD symptoms along with its subscales, including intrusion, avoidance, and hypervigilance. Also, the Depression, Anxiety, and Stress Scale-21 questionnaire was used to assess the severity of the aforementioned conditions in HCWs. Multivariate logistic regression was used to compare psychological symptoms in infected and non-infected HCWs.

Results

Among 938 included HCWs, 55 had a history of confirmed COVID-19 infection. Prevalence of stress, anxiety, depression, intrusion, hypervigilance, and avoidance among infected HCWs were significantly higher in comparison to non-infected HCWs. In the multivariate logistic model, history of COVID-19 infection among HCWs was associated with a significantly increased risk of anxiety, depression, stress, intrusion, hyper-vigilance, and avoidance.

Conclusion

The present study showed that the HCWs with COVID-19 infection were at a high risk of displaying psychological symptoms. Therefore, it is also necessary to develop psychological support and interventions for HCWs, especially those who got infected with the virus.
Tendon‐to‐bone healing after repairing full‐thickness rotator cuff tear with a triple‐loaded single‐row method in young patients
Authors: He He-Bei , Wang Tao , Wang Min-Cong , Zhu Hui-Feng , Meng Yue , Pan Cheng-Long , Hu Yong , Chao Xiao-Min , Yang Chun Yang , Wang Min , Ou-Yang Jian Feng
Published: March 2021

Background

Arthroscopic repair is recommended for young patients with full-thickness rotator cuff tears (RCTs), but the healing rates have raised concerns. The Southern California Orthopedic Institute (SCOI) row method has been developed based on greater than 3 decades of experience with excellent clinical outcomes; however, studies with a focus on the younger patient population are limited in number. The current study assessed the short-term clinical outcome and the initial tendon-to-bone healing in a young cohort after repair of a full-thickness RCT using the SCOI row method.

Methods

A retrospective cohort study was performed. Patients < 55 years of age who had a full-thickness RCT and underwent an arthroscopic repair using the SCOI row method were reviewed. Clinical outcomes were assessed at baseline, and 3 and 6 months post-operatively. The visual analog scale (VAS), University of California at Los Angeles (UCLA) scale, and Constant-Murley score were completed to assess pain and function. Active range of motion was also examined, including abduction and flexion of the involved shoulder. A preoperative MRI was obtained to assess the condition of the torn tendon, while 3- and 6-month postoperative MRIs were obtained to assess tendon-to-bone healing. Repeated measurement ANOVA and chi-square tests were used as indicated.

Results

Eighty-nine patients (57 males and 32 females) with a mean age of 44.1 ± 8.6 years who met the criteria were included in the study. Compared with baseline, clinical outcomes were significantly improved 3 and 6 months postoperatively based on improvement in the VAS, UCLA score, and Constant-Murley score, as well as range of motion. Greater improvement was also noted at the 6-month postoperative assessment compared to the 3-month postoperative assessment. Three- and six-month postoperative MRIs demonstrated intact repairs in all shoulders and footprint regeneration, which supported satisfactory tendon-to-bone healing. The mean thickness of regeneration tissue was 7.35 ± 0.76 and 7.75 ± 0.79 mm as measured from the 3- and 6-month MRI (P = 0.002). The total satisfactory rate was 93.3 %.

Conclusions

Arthroscopic primary rotator cuff repair of a full-thickness RCT using the SCOI row method in patients < 55 years of age yields favorable clinical outcomes and early footprint regeneration.
The full spectrum of ethical issues in dementia research: findings of a systematic qualitative review
Authors: Götzelmann Tim G. , Strech Daniel , Kahrass Hannes
Published: March 2021

Background

When including participants with dementia in research, various ethical issues arise. At present, there are only a few existing dementia-specific research guidelines (Committee for Medicinal Products for Human Use in Clinical investigation of medicines for the treatment Alzheimer’s disease (Internet).https://www.ema.europa.eu/en/clinical-investigation-medicines-treatment-alzheimers-disease; Food and Drug Administration, Early Alzheimer’s Disease: Developing Drugs for Treatment Guidance for Industry [Internet].http://www.fda.gov/regulatory-information/search-fda-guidance-documents/alzheimers-disease-developing-drugs-treatment-guidance-industy), necessitating a more systematic and comprehensive approach to this topic to help researchers and stakeholders address dementia-specific ethical issues in research. A systematic literature review provides information on the ethical issues in dementia-related research and might therefore serve as a basis to improve the ethical conduct of this research. This systematic review aims to provide a broad and unbiased overview of ethical issues in dementia research by reviewing, analysing, and coding the latest literature on the topic.

Methods

We conducted a systematic review in PubMed and Google Scholar (publications in English between 2007 and 2020, no restrictions on the type of publication) of literature on research ethics in dementia research. Ethical issues in research were identified by qualitative text analysis and normative analysis.

Results

The literature review retrieved 110 references that together mentioned 105 ethical issues in dementia research. This set of ethical issues was structured into a matrix based on the eight major principles from a pre-existing framework on biomedical ethics (Emanuel et al. An Ethical Framework for Biomedical Research. in The Oxford textbook of clinical research ethics, Oxford University Press, Oxford, 2008). Consequently, subcategories were created and further categorized into dementia stages and study phases.

Conclusions

The systematically derived matrix helps raise awareness and understanding of the complex topic of ethical issues in dementia research. The matrix can be used as a basis for researchers, policy makers and other stakeholders when planning, conducting and monitoring research, making decisions on the legal background of the topic, and creating research practice guidelines.
‘She taught me’: factors consumers find important in nurse practitioner and pharmacist prescriber services
Authors: Officer Tara N. , Cumming Jackie , McBride-Henry Karen
Published: March 2021

Background

Advanced practitioner services, such as those nurse practitioners and pharmacist prescribers provide, are an opportunity to improve health care delivery. In New Zealand, these practitioners remain underutilised, despite research suggesting they offer safe and effective care, and considerable international literature recording patient satisfaction with these roles. This study aimed to explore factors underlying consumer satisfaction with primary health care nurse practitioner and pharmacist prescriber services.

Methods

As part of a larger realist evaluation, 21 individuals receiving advanced practitioner services participated in semi-structured interviews. These interviews were transcribed and coded against context–mechanism–outcome configurations tested and refined throughout the research.

Results

Study findings emphasise the importance of consumer confidence in the provider as a mechanism for establishing advanced practitioner roles. Underlying this confidence is a recognition that these practitioners work in a more accessible manner, engage at the individual’s ‘level’, and operate with passion.

Conclusions

This research offers learnings to re-engineer service delivery within primary health care to make best use of the entire health care team by including consumers in the design and introduction of new roles.
Cost effectiveness of outpatient lumbar discectomy
Authors: Linhares Daniela , Fonseca João A. , Ribeiro da Silva Manuel , Conceição Filipe , Sousa António , Sousa-Pinto Bernardo , Neves Nuno
Published: March 2021

Background

Microdiscectomy is the most commonly performed spine surgery and the first transitioning for outpatient settings. However, this transition was never studied, in what comes to cost-utility assessment. Accordingly, this economic study aims to access the cost-effectiveness of outpatient lumbar microdiscectomy when compared with the inpatient procedure.

Methods

This is a cost utility study, adopting the hospital perspective. Direct medical costs were retrieved from the assessment of 20 patients undergoing outpatient lumbar microdiscectomy and 20 undergoing inpatient lumbar microdiscectomy Quality-adjusted life-years were calculated from Oswestry Disability Index values (ODI). ODI was prospectively assessed in outpatients in pre and 3- and 6-month post-operative evaluations. Inpatient ODI data were estimated from a meta-analysis. A probabilistic sensitivity analysis was performed and incremental cost-effectiveness ratio (ICER) calculated.

Results

Outpatient procedure was cost-saving in all models tested. At 3-month assessment ICER ranged from €135,753 to €345,755/QALY, higher than the predefined threshold of €60,000/QALY gained. At 6-month costs were lower and utilities were higher in outpatient, overpowering the inpatient procedure. Probabilistic sensitivity analysis showed that in 65% to 73% of simulations outpatient was the better option. The savings with outpatient were about 55% of inpatient values, with similar utility scores. No 30-day readmissions were recorded in either group.

Conclusion

This is the first economic study on cost-effectiveness of outpatient lumbar microdiscectomy, showing a significant reduction in costs, with a similar clinical outcome, proving it cost-effective.
Safety analysis of early oral feeding after esophagectomy in patients complicated with diabetes
Authors: Jiang Zhisheng , Luo Jing , Xu Mengqing , Cong Zhuangzhuang , Ji Saiguang , Diao Yifei , Xu Yang , Shen Yi
Published: March 2021

Objective

To evaluate the safety of early oral feeding in patients with type II diabetes after radical resection of esophageal carcinoma.

Methods

The clinical data of 121 patients with type II diabetes who underwent radical resection of esophageal carcinoma in the department of cardiothoracic surgery of Jinling Hospital from January 2016 to December 2018 were retrospectively analyzed. According to the median time (7 days) of the first oral feeding after surgery, the patients were divided into early oral feeding group (EOF, feeding within 7 days after surgery, 67 cases) and late oral feeding group (LOF, feeding after 7 days, 54 cases). Postoperative blood glucose level, incidence of complications, nutritional and immune indexes, inflammatory indexes, normalized T12-SMA (the postoperative/preoperative ratio of vertical spinal muscle cross-sectional area at the 12th thoracic vertebra level) and QLQ-C30 (Quality Of Life Questionnaire) scores were recorded and compared in the two groups.

Results

There was no statistical difference in preoperative nutritional index and postoperative complication rates between the EOF and LOF group (p > 0.05). The postoperative nutritional index (ALB, PA, TRF, Hb) and immune index (IgA, IgG, IgM) of the EOF group were higher than those of the LOF group (p < 0.05), and the inflammatory indicators (CRP, IL-6) of the EOF group were significantly lower than those of the LOF group (p < 0.05). Moreover, postoperative T12-SMA variation and QLQ-C30 scores of the EOF group were higher than those in LOF group (p < 0.05).

Conclusions

Early oral feeding is safe and feasible for patients with type II diabetes after radical resection of esophageal cancer, and it can improve short-term nutritional status and postoperative life quality of the patients.
Elafin promotes tumour metastasis and attenuates the anti-metastatic effects of erlotinib via binding to EGFR in hepatocellular carcinoma
Authors: Wang Chenwei , Liao Yadi , He Wei , Zhang Hong , Zuo Dinglan , Liu Wenwu , Yang Zhiwen , Qiu Jiliang , Yuan Yichuan , Li Kai , Zhang Yuanping , Wang Yongjin , Shi Yunxing , Qiu Yuxiong , Gao Song , Yuan Yunfei , Li Binkui
Published: March 2021

Background

Elafin is a serine protease inhibitor critical for host defence. We previously reported that Elafin was associated with the recurrence of early-stage hepatocellular carcinoma (HCC) after surgery. However, the exact role of Elafin in HCC remains obscure.

Methods

HCC tissue microarrays were used to investigate the correlation between Elafin expression and the prognosis of HCC patients. In vitro migration, invasion and wound healing assays and in vivo lung metastasis models were used to determine the role of Elafin in HCC metastasis. Mass spectrometry, co-immunoprecipitation, western blotting, and immunofluorescence staining assays were performed to uncover the mechanism of Elafin in HCC. Dual-luciferase reporter and chromatin immunoprecipitation assays were employed to observe the transcriptional regulation of Elafin.

Results

Elafin expression was frequently increased in HCC tissues compared to normal tissues, and high Elafin expression in HCC tissues was correlated with aggressive tumour phenotypes and a poor prognosis in HCC patients. Elafin dramatically enhanced the metastasis of HCC cells both in vitro and in vivo by interacting with EGFR and activating EGFR/AKT signalling. Moreover, Elafin attenuated the suppressive effects of erlotinib on HCC metastasis. Besides, Elafin was transcriptionally regulated by Sp1 in HCC cells. Clinically, Elafin expression was positively correlated with Sp1, Vimentin, and EGFR signalling in both our HCC tissue microarrays and TCGA database analysis.

Conclusions

Upregulation of Elafin by Sp1 enhanced HCC metastasis via EGFR/AKT pathway, and overexpression of Elafin attenuated the anti-metastatic effects of erlotinib, suggesting a valuable prognostic biomarker and therapeutic target for HCC.
Iatrogenic injury to long thoracic nerve following thoracotomy for right thoracic scoliosis in Marfan syndrome: a case report
Authors: Safaei Saeid , Mirbolook Ahmadreza , Azimi Parisa , Athari Mirbahador , Hamzehzadeh Farhad , Yazdanian Taravat
Published: March 2021

Background

Patients with Marfan syndrome commonly require spinal deformity surgery. The purpose of this case report is to present a rare thoracotomy complication. We present the management of such a patient.

Case summary

In a known case of Marfan syndrome, an 18-year-old Persian man was admitted to our hospital with scoliosis. The patient underwent radiological examinations, and thoracic scoliosis of 70° was diagnosed. A right thoracotomy for anterior spinal fusion from the sixth rib and posterior spinal fusion were performed successfully. Two months later, he was readmitted because of winging of the right scapula due to serratus anterior palsy. Electromyography and nerve conduction velocity confirmed long thoracic nerve injury. Conservative treatment was provided. Ultimately, the patient recovered completely in the last follow-up visit 6 months after the surgery.

Discussion

This is the first report of ipsilateral winged scapula after thoracotomy. Attention needs to be paid to surgical techniques in patients with Marfan syndrome.
Breeding biology of a relictual Maghreb Magpie (Pica mauritanica) population in Tunisia
Authors: Nefla Aymen , Ouni Ridha , Selmi Slaheddine , Nouira Saïd
Published: March 2021

Background

The Maghreb Magpie (Pica mauritanica) is an endemic North African species. Available knowledge on this species is limited to historic descriptive data with no ecological information provided. Populations continue to dramatically decline in Tunisia, where only one relic population survives. Investigating the breeding biology of this species is essential for conservation purposes. The purpose of this study was to increase our understanding of the Tunisian relic population and provide detailed data on breeding biology over two breeding seasons (2017 and 2018).

Methods

This study occurred on a private farm of 650 ha, located 10 km from Dhorbania village at Kairouan Governorate, in central Tunisia. Active nests were monitored weekly during egg laying period and twice a week during hatching period. The Ivlev’s electivity index was used to assess whether the frequency of use of nesting trees and bushes matched their availability in the study area. We recorded nest measurements and positions, and compared them using Wilcoxon signed-rank test. Variations of breeding parameters as number of eggs laid, hatchlings, and fledglings over years were performed using Mann–WhitneyU-test andχ2tests. We used a Generalized Linear Mixed Model (GLMM) to investigate how egg volume varied with clutch size and laying date.

Results

We investigated clutch size, egg size, hatching and fledging success, and evaluated how these parameters varied according to laying date and nest characteristics. Clutch size averaged 5.00 ± 0.19 but was significantly greater in 2017. Hatching success was 2.78 ± 0.34 eggs hatched per nest and fledging success reached 1.69 ± 0.30 young/nest. Causes of nest failure included the depredation of nestlings by shrikes, cobras and rats (e.g.Lanius meridionalis,Naja hajeandRattus rattus), death of parents by the Black-shouldered Kite (Elanus caeruleus) and nest parasitism by the Great Spotted Cuckoo (Clamator glandarius). Clutch size, brood size and fledgling success were unaffected by laying date, nest volume and nest elevation. Egg volume decreased with laying date but was unaffected by clutch.

Conclusion

Our study provides the first and only detailed data on reproductive parameters of the Maghreb Magpie in its entire geographic range (North Africa). Information gleaned from this study provides valuable information for monitoring and long-term conservation plans of the endangered Tunisian Magpie population. Additionally, our data provide an avenue of large-scale comparative studies of the reproductive ecology of the magpie complex.
Contamination within trials of community-based public health interventions: lessons from the HENRY feasibility study
Authors: Stamp Elizabeth , Schofield Holly , Roberts Victoria Laurina , Burton Wendy , Collinson Michelle , Stevens June , Farrin Amanda , Rutter Harry , Bryant Maria
Published: March 2021

Introduction

Contamination occurs when participants allocated to trial control arms receive elements of the active intervention. Randomisation at cluster level, rather than individual level, may reduce or eliminate contamination, avoiding the dilution of intervention effectiveness that it may cause. However, cluster randomisation can result in selection bias and may not be feasible to deliver. We explored the extent of contamination in a qualitative study nested within a feasibility study of HENRY (Health, Exercise and Nutrition for the Really Young); a UK community-based child obesity prevention programme. We aimed to determine the nature and impact of contamination to inform a larger planned trial and other trials in community based public health settings.

Method

We invited participants to take part in the nested qualitative study who were already involved in the HENRY feasibility study. Semi-structured interviews/focus groups were conducted with children’s centre managers (n=7), children’s centre staff (n=15), and parents (n=29). Data were transcribed and analysed using an integrative approach. First, deductively organised using a framework guided by the topic guide and then organised using inductive thematic analysis.

Results

Potential for contamination between treatment arms was recognised by all stakeholder groups. Staff within the intervention centres presented the greatest risk of contamination, predominantly because they were often asked to work in other children centre’s (including control group centres). ‘Sharing of best practice’ by staff was reported to be a common and desirable phenomenon within community based settings. Parental sharing of HENRY messages was reported inconsistently; though some parents indicated a high degree of knowledge transfer within their immediate circles.

Conclusions

The extent of contamination identified has influenced the design of a future effectiveness trial of HENRY which will be clustered at the centre level (with geographically distinct clusters). The common practice of knowledge sharing amongst community teams means that this clustering approach is also likely to be most suitable for other trials based within these settings. We provide recommendations (e.g. cluster randomisation, training intervention facilitators on implications of contamination) to help reduce the impact of contamination in public health intervention trials with or without clustering, whilst enabling transfer of knowledge where appropriate.

Trial registration

ClinicalTrials.gov Identifier NCT03333733 registered 6th November 2017
Foot-ankle functional outcomes of using the Diabetic Foot Guidance System (SOPeD) for people with diabetic neuropathy: a feasibility study for the single-blind randomized controlled FOotCAre (FOCA) trial I
Authors: Cruvinel Júnior Ronaldo H. , Ferreira Jane S. S. P. , Beteli Raquel I. , Silva Érica Q. , Veríssimo Jady L. , Monteiro Renan L. , Suda Eneida Y. , Sacco Isabel C. N.
Published: March 2021

Background

Diabetic neuropathy dramatically affects musculoskeletal structure and function of the lower limbs by impairing their muscle strength and mobility. Specific muscle strengthening through physiotherapy strategies appears to be promising; however, adherence to physiotherapy treatment is low in people with chronic diseases. Thus, an internet-based foot-ankle exercise program was created as a potential telerehabilitation alternative for people with diabetes to improve their self-monitoring and self-care management. This study assessed the feasibility, safety, acceptability, and changes in foot health and neuropathy symptoms in people with diabetes after 12 weeks of the intervention program with the Sistema de Orientação ao Pé diabético - Diabetic Foot Guidance System (SOPeD).

Methods

Fourteen individuals were recruited and randomized to either the usual care (control group) or usual care plus an internet-based foot-ankle exercise program through SOPeD (intervention group) three times per week for 12 weeks. For feasibility, we assessed contact and recruitment rates per week; program adherence, determined as completing over 70% of the 36 sessions; and participant satisfaction and safety assessed through a questionnaire and scored on a 5-point Likert scale. We assessed changes in neuropathy symptoms and foot health and functionality from baseline to 12 weeks estimating differences or median of differences and 95% confidence intervals in the intervention group.

Results

In 24 weeks, of the 822 patients in the database, 192 were contacted, 65 were assessed for eligibility, and 20 were considered eligible. The recruitment rate was 0.83 participants per week. Fourteen out of the 20 eligible participants agreed to participate, resulting in recruitment success of 70%. Adherence to the program was 66.7%, and there was no dropout. Participants’ median level of satisfaction was 5.0 (IQR: 4.5–5.0) and perceived safety was 5.0 (IQR: 5.0–5.0).

Conclusion

The internet-based foot-ankle exercise program using SOPeD is feasible, satisfactory, and safe. Although this study had moderate adherence and a zero-dropout rate, recruitment needs to be improved in the larger trial.

Trial registration

ClinicalTrials.gov, NCT04011267. Registered on 8 July 2019.
The value of endobronchial cryotherapy in the management of malignant endobronchial obstruction in patients with inoperable NSCLC: a prospective analysis of clinical and survival outcomes
Authors: Rashad Alaa , Badawy Mohamed Shahat , Ali Mohammed Mustafa , Mansour Haggagy , Abdel-Bary Mohamed
Published: March 2021

Background

Malignant endobronchial obstruction (MEBO) is the most debilitating complication in non-small cell lung cancer (NSCLC). The therapeutic role of cryotherapy and its impact on survival has not been well addressed. This is to clarify whether the combination of endobronchial cryotherapy (EBCT) and chemoradiotherapy (CRT) improved symptoms, respiratory functions, performance status, and survival outcomes in inoperable NSCLC with symptomatic MEBO compared to that obtained by CRT alone.

Results

A prospective cohort study included 60 cases presented to Qena University Hospital, Egypt, between December 2016 and May 2019. They were divided into two groups. Group A included 30 patients who were managed with EBCT plus CRT. Group B included 30 patients who were managed with CRT alone. The outcomes assessed were symptoms relief, respiratory function tests (RFT), performance status, and survival outcomes at baseline and 4 weeks of follow-up. Group A patients showed a highly significant improvement in symptoms (cough, dyspnea, and hemoptysis), RFT, 6MWD test, and arterial blood gases, compared to group B. The mean Karnofsky score increased from 57.33±5.67% at baseline to 60.67±6.39% post-EBCT (P=0.036); group A was significantly improved compared to group B (P=0.04). The Kaplan-Meier median survival for all patients was 9.7±0.4 months (95% CI= 8.86–10.54), and group A cases (10.77±0.44 months, 95% CI= 9.9–11.6) was significantly longer than that of group B cases (8.6±0.68 months, 95% CI= 7.3–9.97; T test = 2.631, P=0.011).

Conclusion

The use of EBCT with CRT for the management of MEBO in symptomatic patients with inoperable NSCLC is an efficient and safe procedure. EBCT improves clinical outcomes, RFT, performance status, and median survival.

Trial registration

ClinTrial.Gov registration: NCT04710459 on 4/3/2021.
The role of loneliness in the development of depressive symptoms among partnered dementia caregivers: Evidence from the English Longitudinal Study of Aging
Authors: Saadi J. P. , Carr E. , Fleischmann M. , Murray E. , Head J. , Steptoe A. , Hackett R. A. , Xue B. , Cadar D.
Published: March 2021

Background

Depressive symptoms are highly prevalent among partnered dementia caregivers, but the mechanisms are unclear. This study examined the mediating role of loneliness in the association between dementia and other types of care on subsequent depressive symptoms.

Methods

Prospective data from partnered caregivers were drawn from the English Longitudinal Study of Aging. The sample consisted of 4,672 partnered adults aged 50–70 living in England and Wales, followed up between 2006–2007 and 2014–2015. Caregiving was assessed across waves 3 (2006–2007), 4 (2008–2009), and 5 (2010–2011), loneliness at wave 6 (2012–2013), and subsequent depressive symptoms at wave 7 (2014–15). Multivariable logistic regression models were used to assess the association between caregiving for dementia and depressive symptoms compared to caregiving for other illnesses (e.g., diabetes, coronary heart disease (CHD), cancer, and stroke). Binary mediation analysis was used to estimate the indirect effects of caregiving on depressive symptoms via loneliness.

Results

Care for a partner with dementia was associated with higher odds of depressive symptoms at follow-up compared to those not caring for a partner at all (odds ratio [OR] = 2.6, 95% confidence intervals [CI]: 1.4, 5.1). This association was partially mediated by loneliness (34%). Care for a partner with other conditions was also associated with higher odds of depressive symptoms compared to non-caregiving partners (OR = 1.7, 95% CI: 1.2, 2.5), but there was no evidence of an indirect pathway via loneliness.

Conclusion

Loneliness represents an important contributor to the relationship between dementia caregiving and subsequent depressive symptoms; therefore, interventions to reduce loneliness among partnered dementia caregivers should be considered.
A “metaphorical” nonlinear multimode fiber laser approach to weakly dissipative Bose-Einstein condensates
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Authors: Kalashnikov V. L. , Wabnitz S.
Published: March 2021

We demonstrate the stabilization of two-dimensional nonlinear wave patterns by means of a dissipative confinement potential. Our analytical and numerical analysis, based on the generalized dissipative Gross-Pitaevskii equation, makes use of the close analogy between the dynamics of a Bose-Einstein condensate and that of mode-locked fiber laser, operating in the anomalous dispersion regime. In the last case, the formation of stable two-dimensional patterns corresponds to spatiotemporal mode locking, using dissipation-enhanced mode cleaning. We analyze the main scenarios of pattern destabilization, varying from soliton dissolution to its splitting and spatiotemporal turbulence, and their dependence on graded dissipation.
Quantum degeneracy and phase-space density in superradiant semiconductor heterostructures at room temperature
Authors: Vasil'ev Peter P. , Penty Richard V.
Published: March 2021

We investigate the fulfilment of the quantum degeneracy criterium in bulk GaAs/AlGaAs heterostructures operated under the superradiant emission generation at room temperature. The e-h density has been evaluated by analysing both spontaneous window emission from above the samples and amplified spontaneous emission radiated from their edges. The maximum experimental value of the phase-space density is 1.31 at

. It is supposed that resonant photons with energies at the band gap establish coherence within the e-h ensemble and facilitate the build-up of a macroscopic wave packet from overlapped wave functions of collectively paired electrons and holes. As a result, the photon-mediated “stimulated” condensation of e-h pairs in phase space can take place at room temperature.
On the influence of viscosity on the anisotropic dynamics of cosmological perturbations in the presence of a magnetic field
Authors: Di Gioia F. , Incarbone C. , Montani G.
Published: March 2021

We analyse the influence that viscous effects can induce on the evolution of primordial perturbations to the isotropic universe in the presence of a weak uniform magnetic field. Previous analyses have shown that the presence of the magnetic field induces an intrinsic anisotropy in the perturbations dynamics, essentially because of the anisotropic character of the perturbed magnetic pressure. This anisotropic effect is of order unity in the perturbation amplitude, although it remains small in the linear theory when the density constraints are considered. The aim of this study is to determine the impact of viscosity, surely present in the early universe, on the growth of the perturbation anisotropy. The main merit of this study consists of demonstrating that a tiny overlapping exists in the parameter space to deal simultaneously with anisotropic features due to the magnetic field and the viscous damping of such density fluctuation. Actually, we demonstrate that the viscosity affects the value of the anisotropy, by smoothing the growing rate of the instability only when structure smaller than about 5000 solar masses are concerned. This result allows us to guarantee that the intrinsic anisotropy of the magnetized universe perturbations is not affected by the viscosity due to friction among inhomogeneous layers or compressive-like effects, and therefore, they remain good candidates for being seeds for filament formation across the universe.
Genetic Predisposition to Type 2 Diabetes and Insulin Levels Is Positively Associated With Serum Urate Levels
Authors: Zhu Jiahao , Sun Lingling , Yang Jing , Fan Jiayao , Tse Lap Ah , Li Yingjun
Published: March 2021

Purpose

Previous epidemiological evidence showed that type 2 diabetes (T2D) is related with gout. However, the causality and the direction of this association are still not definitely elucidated. We investigated bidirectional associations of T2D and glycemic traits with serum urate concentrations and gout using a Mendelian randomization approach.

Methods

Summary statistics from the large-scale genomewide association studies conducted for T2D (Ncase = 62 892, Ncontrol = 596 424), fasting glucose (N = 133 010), fasting insulin (N = 133 010), hemoglobin A1c (N = 123 665), homeostasis model assessment of insulin resistance (N = 46 186), urate (N = 110 347), and gout (Ncase = 2115, Ncontrol = 67 259) among participants of European ancestry were analyzed. For each trait of interest, independent genomewide significant (P < 5 × 10−8) single nucleotide polymorphisms were selected as instrumental variables. The inverse-variance weighted method was used for the primary analyses.

Results

Genetic predisposition to higher risk of T2D [beta = 0.042; 95% confidence interval (CI) = 0.016-0.068; P = 0.002] and higher levels of fasting insulin (beta = 0.756; 95% CI = 0.408-1.102; P = 1.96e-05) were significantly associated with increased serum urate concentrations. Moreover, we found suggestively significant evidence supporting a causal role of fasting insulin on risk of developing gout (odds ratio = 3.06; 95% CI = 0.88-10.61; P = 0.078). In the reverse direction analysis, genetic predisposition to both urate and gout were not associated with T2D or any of 4 glycemic traits being investigated.

Conclusions

This study provides supportive evidence on causal associations of T2D and fasting insulin with serum urate concentrations and a suggestive association of fasting insulin with risk of gout. Future research is required to examine the underlying biological mechanisms on such relationships.
How the Trump Administration's Pandemic Health Care Response Failed Racial Health Equity: Case Studies of Structural Racism and a Call for Equity Mindfulness in Federal Health Policy Making
Authors: Rosenbaum Sara , Handley Morgan , Morris Rebecca , Casoni Maria
Published: March 2021

Context: The racial health equity implications of the Trump administration's response to the COVID-19 pandemic.

Methods: We focus on four key health care policy decisions made by the administration in response to the public health emergency: rejecting a special Marketplace enrollment period, failing to use its full powers to enhance state Medicaid emergency options, refusing to suspend the public charge rule, and failing to target provider relief funds to providers serving the uninsured.

Findings: In each case, the administration's policy choices intensified, rather than mitigated, racial health inequality. Its choices had a disproportionate adverse impact on minority populations and patients who are more likely to depend on public programs, be poor, experience pandemic-related job loss, lack insurance, rely on health care safety net providers, and be exposed to public charge sanctions.

Conclusions: Ending structural racism in health care and promoting racial health care equity demands an equity-mindful approach to the pursuit of policies that enhance—rather than undermine—health care accessibility and effectiveness and resources for the poorest communities and the providers that serve them.
INPP5E controls ciliary localization of phospholipids and the odor response in olfactory sensory neurons
Authors: Ukhanov Kirill , Uytingco Cedric , Green Warren , Zhang Lian , Schurmans Stephane , Martens Jeffrey R.
Published: March 2021

The lipid composition of the primary cilia membrane is emerging as a critical regulator of cilia formation, maintenance and function. Here, we show that conditional deletion of the phosphoinositide 5′-phosphatase gene Inpp5e, mutation of which is causative of Joubert syndrome, in terminally developed mouse olfactory sensory neurons (OSNs), leads to a dramatic remodeling of ciliary phospholipids that is accompanied by marked elongation of cilia. Phosphatidylinositol (4,5)-bisphosphate [PI(4,5)P2], which is normally restricted to the proximal segment redistributed to the entire length of cilia in Inpp5e knockout mice with a reduction in phosphatidylinositol (3,4)-bisphosphate [PI(3,4)P2] and elevation of phosphatidylinositol (3,4,5)-trisphosphate [PI(3,4,5)P3] in the dendritic knob. The redistribution of phosphoinositides impaired odor adaptation, resulting in less efficient recovery and altered inactivation kinetics of the odor-evoked electrical response and the odor-induced elevation of cytoplasmic Ca2+. Gene replacement of Inpp5e through adenoviral expression restored the ciliary localization of PI(4,5)P2 and odor response kinetics in OSNs. Our findings support the role of phosphoinositides as a modulator of the odor response and in ciliary biology of native multi-ciliated OSNs.
Not just shades of grey: life is full of colour for the ocellate river stingray (Potamotrygon motoro)
Authors: Schluessel Vera , Rick Ingolf P. , Seifert Friederike Donata , Baumann Christina , Lee Davies Wayne Iwan
Published: March 2021

Previous studies have shown that marine stingrays have the anatomical and physiological basis for colour vision, with cone spectral sensitivity in the blue to green range of the visible spectrum. Behavioural studies on Glaucostegus typus also showed that blue and grey can be perceived and discriminated. The present study is the first to assess visual opsin genetics in the ocellate river stingray (Potamotrygon motoro) and test whether individuals perceive colour in two alternative forced choice experiments. Retinal transcriptome profiling using RNA-Seq and quantification demonstrated the presence of lws and rh2 cone opsin genes and a highly expressed single rod (rh1) opsin gene. Spectral tuning analysis predicted these vitamin A1-based visual photopigments to exhibit spectral absorbance maxima at 461 nm (rh2), 496 nm (rh1) and 555 nm (lws); suggesting the presence of dichromacy in this species. Indeed, P. motoro demonstrates the potential to be equally sensitive to wavelengths from 380 to 600 nm of the visible spectrum. Behavioural results showed that red and green plates, as well as blue and yellow plates, were readily discriminated based on colour; however, brightness differences also played a part in the discrimination of blue and yellow. Red hues of different brightness were distinguished significantly above chance level from one another. In conclusion, the genetic and behavioural results support prior data on marine stingrays. However, this study suggests that freshwater stingrays of the family Potamotrygonidae may have a visual colour system that has ecologically adapted to a riverine habitat.
Between the Contrasts of Children's Bodies: Innocence, Evil and Autonomy
Authors: Arpacı Murat , Düzcan Ebubekir
Published: March 2021

This study reveals how the child's body was categorized in the historical process. Throughout history, discussion sabout the child's body have also affected the definition sabout childhood. The claim that childhood was not considered as a separate category from adulthood in the Middle Ages was based on the perceptions about the child's body (disguise, age, etc.) by historians. The idea that limiting the child's body to a chronological period or the idea that it is the natural reflection of adulthood makes it difficult to grasp the contrary practices of childhood, ranging from innocence to evil. For this reason, the concepts of field, capitaland habitus used by the Pierre Bourdieu are recommended as theoretical tools to analyze children's practices better. In this way, it is aimed to discuss the child's body andchild'sworld from a relational perspective. According to Bourdieu, habitus begins in childhood and childhood is at the center of sociality that structures perception, thoughts and practices. The habitus of childhood is built with the practices of institutions that turn to the body, especially the family and school. Simultaneously with this construction, childhood is established as an autonomous area, and socializes as an active subject.The research suggests that the sociological potential of childhood can be analyzed by Bourdieu's conceptualization of “autonomous space”, acting on the fact that childhood has been interpreted as opposed to innocence to evil throughout history.
Society Defends Itself: The Biopolitical Dilemma, Singularity of Existence, and Social Black Hole in Covid-19
Authors: Gökdağ Kamuran
Published: March 2021

This essay focuses on the existential conflict between society and politics that has once again come to the fore in the sense of biopolitical theory with the Covid-19 outbreak. It attempts to demonstrate where and how the theory of biopolitics is insufficient at understanding the individual, who has reset all relationships under the circumstances of the pandemic, while providing a certain viewpoint based on true and logical facts. The essay considers this insufficiency as a common deficiency of the various types of biopolitical theory and correlates this to a historical deficiency that has lacked a concept of absolute singularity (i.e., singularity of existence) that would precede the compromises and necessities associated with life in identifying socio-political origins. Thus, the article argues the theory of biopolitics to have persisted in this sense within the theories of classical order, particularly the Hobbesian theory of social contract, based on replicated historical deficiency. Therefore, the key issue of the essay is whether a non-relational moment of existence exists for any nature or framework that refutes all the responsibilities, concessions, or regularities attached to it such that it cannot be appropriated. The essay affirms this issue through a theoretical probability and attempts to view the circumstances present in the Covid-19 phase not as the moment itself but as its signals, messages, and indications. This moment is conceptualized as a social black hole. Thus, the essay examines the destructive and constitutive role of the moment in which life sinks into social black holes.
Γλωσσική εκπαίδευση και επίδοση των δίγλωσσων μαθητών στη δευτεροβάθμια εκπαίδευση
Authors: Μπακάλη Ιωάννα
Published: March 2021

Η παρούσα εργασία στοχεύει να ανιχνεύσει και να αποτυπώσει τα προβλήματα που αντιμετωπίζουν οι δίγλωσσοι μαθητές στην επίδοσή τους στα γλωσσικά μαθήματα, και να προχωρήσει σε συγκεκριμένες διδακτικές προτάσεις για τη βελτίωση της παρεχόμενης γλωσσικής εκπαίδευσης όχι μόνο σε δίγλωσσους μαθητές που φοιτούν σε μεικτές τάξεις αλλά και σε ελληνόγλωσσους που εμφανίζουν παρόμοιες δυσκολίες στη μαθησιακή τους πορεία, σε μικρότερα ποσοστά. Τα προβλήματα που αποτυπώνονται καταγράφηκαν σε έρευνα που διενεργήθηκε τον Φεβρουάριο και τον Μάρτιο του 2015 σε 15 Γυμνάσια και Λύκεια στην Αττική. Σε αυτήν πήραν μέρος δίγλωσσοι μαθητές και ελληνόγλωσσοι συμμαθητές τους που αποτέλεσαν την ομάδα ελέγχου καθώς και εκπαιδευτικοί/φιλόλογοι που διδάσκουν σε αυτά τα σχολεία. Η έρευνα αξιοποίησε δύο εργαλεία, την συμπλήρωση ερωτηματολογίων από όλες τις ομάδες, μαθητών και εκπαιδευτικών αλλά και τη συγγραφή κειμένων από τους μαθητές και των δύο ομάδων. Μέσα από τη συμπλήρωση των ερωτηματολογίων αποτυπώνεται η εκτίμησή των δίγλωσσων για την επίδοσή τους αλλά και τα προβλήματα που αντιμετωπίζουν στα γλωσσικά μαθήματα και κυρίως αναδεικνύονται οι στάσεις που αυτοί υιοθετούν στο βαθμό που θεωρούν την υστέρηση στη σχολική πορεία ως προσωπική αδυναμία. Παράλληλα η συμπλήρωση ερωτηματολογίων από τους εκπαιδευτικούς για τον τρόπο που χειρίζονται την πολύγλωσση τάξη τους, επέτρεψε να καταγραφούν οι στάσεις τους απέναντι στη διγλωσσία που δεν την αντιλαμβάνονται ως πλεονέκτημα και απέναντι στον δίγλωσσο μαθητή για τον οποίο δεν θεωρούν ότι μπορεί να βελτιωθεί. Τα ευρήματα από τη συμπλήρωση των ερωτηματολογίων συγκρίνονται με τα ευρήματα από την παραγωγή λόγου των μαθητών, έτσι ώστε οι δύο έρευνες να ενωθούν μέσα από συγκριτική μελέτη και να οδηγήσουν σε ασφαλή συμπεράσματα που ενώνουν την υποκειμενική διάσταση, τις εκτιμήσεις που διατυπώθηκαν στα ερωτηματολόγια με την αντικειμενική αποτύπωση των προβλημάτων στον γραπτό λόγο των μαθητών. Η επιστημονική συμβολή της διατριβής έγκειται στα άφθονα ερευνητικά δεδομένα που προέκυψαν από τον μεγάλο αριθμό συμμετεχόντων στην έρευνα (392 δίγλωσσοι μαθητές και 99 ελληνόγλωσσοι και 79 εκπαιδευτικοί) που προέρχονταν από μεγάλο αριθμό σχολείων (15). Όλα αυτά δίνουν μια πρακτική διάσταση στην έρευνα και τα πορίσματά της, καθώς επιτρέπουν να μελετηθεί η πορεία του δίγλωσσου μαθητή στη δευτεροβάθμια, να αποτυπωθούν τα προβλήματα, που είναι κοινά για δίγλωσσους και ελληνόγλωσσους σε διαφορετικά ποσοστά, και να εκτιμηθεί η αποτελεσματικότητα της γλωσσικής διδασκαλίας σε μια βαθμίδα που δεν αποτελεί συχνά αντικείμενο μελέτης για την πορεία των δίγλωσσων μαθητών.
HACIA UNA NUEVA PEDAGOGÍA EN LA EDUCACIÓN SUPERIOR.
Authors: Hansen Helskog Guro , TORGERSEN GLENN-EGIL
Published: March 2021

In this essay the authors argue the need for a new pedagogy in Higher Education (HE). Our hypothesis is that the predominant focus today is on instrumental systems meant to measure the “quality” of education, subjecting the HE-teacher to goal management and frameworks that limit didactic possibilities. However, acting wisely and solving challenges across professions in an increasingly unpredictable world, requires attitudes, knowledge, skills and understanding that cannot unambiguously be defined in advance. Using a reflective practice and action inquiry research approach, the authors reflect upon experiences and research involving the Dialogos approach to philosophical practice, new research findings in pedagogy for the unforeseen and data from the completion of a PhD course for employees from four faculties in higher education. We argue that higher education should focus on open-ended and creative approaches to teaching that includes philosophical practices and reflective “samhandling” across disciplines. All higher education study programmes should to some extent train students for unforeseen events in life and society.