bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensive temporal analysis of right ventricular function and pulmonary haemodynamics in mechanically ventilated COVID-19 ARDS patients
Authors: Tsolaki Vasiliki , Zakynthinos George E. , Karavidas Nikitas , Vazgiourakis Vasileios , Papanikolaou John , Parisi Kyriaki , Zygoulis Paris , Makris Demosthenes , Zakynthinos Epaminondas
Published: February 2024

Background

Cardiac injury is frequently reported in COVID-19 patients, the right ventricle (RV) is mostly affected. We systematically evaluated the cardiac function and longitudinal changes in severe COVID-19 acute respiratory distress syndrome (ARDS) admitted to the intensive care unit (ICU) and assessed the impact on survival.

Methods

We prospectively performed comprehensive echocardiographic analysis on mechanically ventilated COVID-19 ARDS patients, using 2D/3D echocardiography. We defined left ventricular (LV) systolic dysfunction as ejection fraction (EF) < 40%, or longitudinal strain (LS) > − 18% and right ventricular (RV) dysfunction if two indices among fractional area change (FAC) < 35%, tricuspid annulus systolic plane excursion (TAPSE) < 1.6 cm, RV EF < 44%, RV–LS > − 20% were present. RV afterload was assessed from pulmonary artery systolic pressure (PASP), PASP/Velocity Time Integral in the right ventricular outflow tract (VTIRVOT) and pulmonary acceleration time (PAcT). TAPSE/PASP assessed the right ventriculoarterial coupling (VACR).

Results

Among 176 patients included, RV dysfunction was common (69%) (RV–EF 41.1 ± 1.3%; RV–FAC 36.6 ± 0.9%, TAPSE 20.4 ± 0.4mm, RV–LS:− 14.4 ± 0.4%), usually accompanied by RV dilatation (RVEDA/LVEDA 0.82 ± 0.02). RV afterload was increased in most of the patients (PASP 33 ± 1.1 mmHg, PAcT 65.3 ± 1.5 ms, PASP/VTIRVOT, 2.29 ± 0.1 mmHg/cm). VACR was 0.8 ± 0.06 mm/mmHg. LV–EF < 40% was present in 21/176 (11.9%); mean LV–EF 57.8 ± 1.1%. LV–LS (− 13.3 ± 0.3%) revealed a silent LV impairment in 87.5%. A mild pericardial effusion was present in 70(38%) patients, more frequently in non-survivors (p < 0.05). Survivors presented significant improvements in respiratory physiology during the 10th ICU-day (PaO2/FiO2, 231.2 ± 11.9 vs 120.2 ± 6.7 mmHg; PaCO2, 43.1 ± 1.2 vs 53.9 ± 1.5 mmHg; respiratory system compliance—CRS, 42.6 ± 2.2 vs 27.8 ± 0.9 ml/cmH2O, all p < 0.0001). Moreover, survivors presented significant decreases in RV afterload (PASP: 36.1 ± 2.4 to 20.1 ± 3 mmHg, p < 0.0001, PASP/VTIRVOT: 2.5 ± 1.4 to 1.1 ± 0.7, p < 0.0001 PAcT: 61 ± 2.5 to 84.7 ± 2.4 ms, p < 0.0001), associated with RV systolic function improvement (RVEF: 36.5 ± 2.9% to 46.6 ± 2.1%, p = 0.001 and RV–LS: − 13.6 ± 0.7% to − 16.7 ± 0.8%, p = 0.001). In addition, RV dilation subsided in survivors (RVEDA/LVEDA: 0.8 ± 0.05 to 0.6 ± 0.03, p = 0.001). Day-10 CRS correlated with RV afterload (PASP/VTIRVOT, r: 0.535, p < 0.0001) and systolic function (RV–LS, 0.345, p = 0.001). LV–LS during the 10th ICU-day, while ΔRV–LS and ΔPASP/RVOTVTI were associated with survival.

Conclusions

COVID-19 improvements in RV function, RV afterload and RV–PA coupling at day 10 were associated with respiratory function and survival.
Deep learning-based expressive speech synthesis: a systematic review of approaches, challenges, and resources
Authors: Barakat Huda , Turk Oytun , Demiroglu Cenk
Published: February 2024

Speech synthesis has made significant strides thanks to the transition from machine learning to deep learning models. Contemporary text-to-speech (TTS) models possess the capability to generate speech of exceptionally high quality, closely mimicking human speech. Nevertheless, given the wide array of applications now employing TTS models, mere high-quality speech generation is no longer sufficient. Present-day TTS models must also excel at producing expressive speech that can convey various speaking styles and emotions, akin to human speech. Consequently, researchers have concentrated their efforts on developing more efficient models for expressive speech synthesis in recent years. This paper presents a systematic review of the literature on expressive speech synthesis models published within the last 5 years, with a particular emphasis on approaches based on deep learning. We offer a comprehensive classification scheme for these models and provide concise descriptions of models falling into each category. Additionally, we summarize the principal challenges encountered in this research domain and outline the strategies employed to tackle these challenges as documented in the literature. In the Section 8, we pinpoint some research gaps in this field that necessitate further exploration. Our objective with this work is to give an all-encompassing overview of this hot research area to offer guidance to interested researchers and future endeavors in this field.
Fixed point theorems for generalized $(\alpha , \phi )$-Meir–Keeler type hybrid contractive mappings via simulation function in b-metric spaces
Authors: Abduletif Mamud Mustefa , Koyas Tola Kidane
Published: February 2024

In this paper, we introduce the notion of generalized $(\alpha , \phi )$
(
α
,
ϕ
)
-Meir–Keeler hybrid contractive mappings of type I and II via simulation function and establish fixed point theorems for such mappings in the setting of complete b-metric spaces. Our results extend and generalize many related fixed point results in the existing literature. Finally, we provide an example in support of our main finding.
Emotional labor as emotion regulation investigated with ecological momentary assessment – a scoping review
Authors: Pinkawa Corinna , Dörfel Denise
Published: February 2024

Background

This scoping review’s aim is to provide a comprehensive overview of ecological momentary assessment (EMA)- based research on emotional labor (EL) as emotion regulation (ER). This includes an examination of the theoretical foundation this research builds on, how the hypothesized relationships are investigated using EMA methods as well as the studies’ findings themselves. We built on the work of Grandey and Melloy (J Occup Health Psychol 22:407–22, 2004), who broadly distinguished between the two regulatory strategies of deep acting (DA) and surface acting (SA), embedded in a hierarchical model of emotional labor, as a guiding theory for structuring this review.

Methods

To be included, studies had to use EMA to measure SA or DA, with no restrictions regarding population and date of publication. The electronic databases CINAHL, PsycArticles, PsycINFO, PSYNDEX, Embase, PubMed, and Web of Science were searched. Studies were included if they met the above criteria and were written in English or German. Out of 237 publications, 12 were chosen for this review.

Results

All studies were based on emotional labor theories, with Arlie Hochschild’s theory being the most popular, followed by Alicia Grandey's emotional labor theory and its modifications (Grandey AA. Emotion Regulation in the Workplace: A New Way to Conceptualize Emotional Labor; Grandey AA. When “the show must go on”: Surface acting and deep acting as determinants of emotional exhaustion and peer-rated service delivery. 2003). The methodological quality of the studies varied greatly. The results of the studies indicate that SA is influenced by negative events, trait SA, service innovation and certain emotions, while DA is influenced by positive events and emotional intelligence. Emotional labor benefits the organization, e.g., by improving customer conflict handling, but also causes harm by increasing employee withdrawal behavior. For the employee, emotional labor results in more harm than benefits.

Conclusions

The research area is still in its early stages and the findings are mostly consistent, but the small number of studies needs to be replicated to increase the reliability of the results. The lack of evidence for ertain hypotheses highlights the presence of unresolved relationships that require further exploration. We are only at the beginning of investigating emotional labor using ecological momentary assessment, and conducting more high-quality studies will significantly enhance our comprehension of emotional labor.
Which one? Technology or non-technology-assisted vocabulary learning: a probe into the state of academic buoyancy, creativity, and academic achievement
Authors: Abu Al-majd Omar , Belton Barana
Published: February 2024

Ignoring technology in teaching English language in EFL contexts persuaded the researchers to do this study. In fact, this research looked at how Saudi Arabian EFL learners' academic achievement (AA), creativity, and academic buoyancy (AB) were affected by vocabulary acquisition with and without the use of technology. Fifty intermediate EFL students were chosen based on the convenience sampling method to accomplish this goal, and they were split into two groups: control and experimental. Subsequently, the three questionnaires were given out to evaluate the participants' AB, AA, and creativity before the treatment. Next, utilizing the WhatsApp application to teach new words to the experimental group (EG) and the control group using the conventional technique, the research completed a 16-session treatment. At the end of the course, the post-tests for the AB, AA, and creativity for both groups were administered. The results of this research revealed that on three post-tests, the EG outperformed the control group. In other words, the technology-based treatment helped the EG to develop their AA, AB, and creativity. There are implications for English teachers, students, researchers, and other stakeholders from the current study. The implications of this research can encourage EFL teachers to incorporate technology into their English classes.
Trauma surgical simulation: discussing the replacement of live animals used as human patient simulators
Authors: Swain Cara , Stathakarou Natalia , Alzuguren Pilar , Lemarteleur Vincent , Moffatt Ryan , Karlgren Klas
Published: February 2024

Background

Despite advances in simulator technology, live anaesthetised animals continue to be used as human patient simulators for medical professionals to practice techniques in the management of surgical trauma. This article describes the process of convening a working group of individuals with a professional interest in simulation to discuss the use of live animals and consider if and how they can be replaced in the future.

Main body

A working group was formed of voluntary attendees to a workshop held at the SESAM 2023 conference. Iterative discussions reflecting on the topic were used to produce statements summarising the working group’s opinions. The working group determined that live animals are used as human patient simulators due to the presence of accurate and responsive physiology in the presence of bleeding, realistic tissue tactility and an emotional response experienced by the learner due to interaction with the animal. They were unable to reach a consensus on replacement, determining that there is currently no single model which is able to provide all the learning aspects which a live animal model can provide. Several suggestions were made regarding development of technologies and pedagogical change.

Conclusion

Replacement of live animals in surgical simulation is not straightforward but should be an aspiration, if possible. For the ongoing development of trauma surgical simulation models, it is important to combine the knowledge, skills and perspectives of medical stakeholders and educators, academic researchers and industry experts in producing alternative options to the use of live animal simulators.
Generative AI and re-weaving a pedagogical horizon of social possibility
Authors: Hall Richard
Published: February 2024

This article situates the potential for intellectual work to be renewed through an enriched engagement with the relationship between indigenous protocols and artificial intelligence (AI). It situates this through a dialectical storytelling of the contradictions that emerge from the relationships between humans and capitalist technologies, played out within higher education. It argues that these have ramifications for our conceptions of AI, and its ways of knowing, doing and being within wider ecosystems. In thinking about how technology reinforces social production inside capitalist institutions like universities, the article seeks to refocus our storytelling around mass intellectuality and generative possibilities for transcending alienating social relations. In so doing, the focus shifts to the potential for weaving new protocols, from existing material and historical experiences of technology, which unfold structurally, culturally and practically within communities. At the heart of this lies the question, what does it mean to live? In a world described against polycrisis, is it possible to tell new social science fictions, as departures towards a new mode of higher learning and intellectual work that seeks to negate, abolish and transcend the world as-is?
From use cases to business cases: I-GReta use cases portfolio analysis from innovation management and digital entrepreneurship models perspectives
Authors: Malakhatka Elena , Pitz Manuel , Maghnie Marwa , Mazidi Mohammadreza , Plamanescu Radu , Sumereder Christof , Prüfer Thomas , Wallbaum Holger , Müller Dirk , Monti Antonello
Published: February 2024

This study provides a detailed exploration of how innovation management and digital entrepreneurship models can help transform technical use cases in smart grid contexts into viable business cases, thereby bridging the gap between technical potential and market application in the field of energy informatics. It focuses on the I-GReta project Use Cases (UCs). The study employs methodologies like Use Case Analysis, Portfolio Mapping of Innovation Level, Innovation Readiness Level, and the Tech Solution Business Model Canvas (TSBMC) to analyse and transition from technical use cases to viable business cases. This approach aligns technological solutions with market demands and regulatory frameworks, leveraging digital entrepreneurship models to navigate market challenges and foster energy management, sustainability, and digitalization.
Comparative study to determine the proper sequence of simulation training, pelvic trainer versus virtual reality simulator: a pilot study
Authors: Sherpa Ngima Yangji , Minawi Ahmed El , Askalany Ahmed N , Abdalla Marwa
Published: February 2024

Background

Increased surgical efficacy has led to a remarkable increase in the usage of minimally invasive surgical procedures since their inception. The use of simulation in surgical teaching has grown significantly during the past 10 years. Several laparoscopic simulators have been built. Virtual reality (VR) simulators and box trainers (BTs), often known as pelvic trainers, are the two primary training modalities used in hospitals and clinical training institutes for the development and acquisition of laparoscopic skills. Our study aimed to evaluate the proper sequence of pelvic trainers and VR simulator training to improve laparoscopic gynecological skills.

Methodology

We carried out this pilot study at the Virtual Endoscopic Simulation and Skills Acquisition Laboratory at the Obstetrics and Gynecology Department in the Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Egypt, from February to August 2022. All residents with minimal or without laparoscopic experience (twenty residents) were divided into two groups and classified as (group A versus group B). Group A’s training began with a pelvic trainer, which was tested using a checklist. Later, the group trained on a virtual reality simulator, which tested them using an electronic autoassessment. After training on a virtual reality simulator and passing an electronic autoassessment test, group B moved on to pelvic trainers and had a checklist-based assessment.

Results

We compared pelvic trainer tasks between the training groups, and detected no significant differences in camera navigation, cutting pattern, peg transfer, or running stitches (P values 0.646, 0.341, 0.179, and 0.939 respectively); when we compared VR simulator tasks between the training groups, there were no significant differences in camera navigation, cutting pattern, peg transfer, or running stitches (P values 0.79, 0.3, 0.33, and 0.06, respectively).

Conclusion

There was no difference in training, between residents who started on a pelvic trainer or the VR simulator; therefore, both could be used in laparoscopic training with no preferred order.

Trial registration

The trial was registered at clinicaltrials.gov with the name “Pelvic trainer vs VRS” and the identifier “NCT05255614.” The registration date was January 19, 2022, and the trial was prospectively registered. URL: https://register.clinicaltrials.gov/prs/app/action/ViewOrUnrelease?uid=U0004GED&ts=22&sid=S000BR5D&cx=t6mc14
Impact of prosthesis oversizing on clinical outcomes of transcatheter aortic valve implantation using a self-expandable Evolut R valve
Authors: Elnwagy Mohammed Moustafa , Baraka Mahmoud Mohamed Ali , Hafez Mohamed Saber , Kamal Diaa , El-Sayed Maiy Hamdy , Mostafa Ahmad E.
Published: February 2024

Background

Transcatheter Aortic Valve Implantation (TAVI) has a growing target population after being indicated even in low-surgical-risk patients with severe symptomatic aortic stenosis. However, postoperative outcomes can be compromised due to para-valvular leakage (PVL). A lot of procedural steps have been investigated to decrease this partially avoidable operational hazard. Oversizing is a main technique to decrease the PVL, despite being itself a risky step. Many studies have been conducted to identify the optimum degree of oversizing. However, studies about oversizing by more than 20% are scarce. We aimed to evaluate the safety and efficacy of oversizing equal to or more than 20%.

Results

209 patients who underwent TAVI using the self-expandable valve Evolut R were initially included. 66 patients were excluded because of the baseline conduction disturbance and lack of sufficient data, so 143 patients, 60 females and 83 males, were enrolled in our study as two groups based on the degree of oversizing: Group A included 97 patients with an oversizing index (OI) of less than 20%, and Group B included 46 patients with an OI of 20% or more. We conducted a new technique for more accurate measuring of the OI in the context of the implantation depth, and our patients were categorized using this technique. Our findings have met our primary end point in terms of the safety and efficacy of oversizing by 20% or more. There was no significant difference between both groups in terms of new-onset conduction disturbance (NOCD), with zero cases of annular rupture or coronary encroachment. In terms of efficacy, The incidence of significant PVL (grade 2 or more) in group B was less than in group A (P value 0.007). The ROC curve found that the minimum depth of implantation-derived oversizing (DIDO) to predict no significant PVL was less than 17%.

Conclusion

Prosthesis oversizing by 20% using the self-expandable Evolut R valve is safe and effective, with no significant effect on the conduction system, coronary encroachment, or annular injury, and warrants a greater reduction in the incidence of significant PVL.
Neuroimaging in uncontrolled hyperglycemia: a case series and literature review
Authors: Panneer Serene Balaji , Jain Ayush
Published: February 2024

Background

There are wide-ranging differential diagnoses for the myriad of neurological symptoms associated with non-ketotic hyperglycemia. Similarly, various secondary complications of diabetic ketoacidosis present with nonspecific clinical symptoms. These are inadvertently misdiagnosed as epilepsies and strokes with associated hyperglycemia. Direct association between these nonspecific symptoms and hyperglycemia has been proved by demonstrating their resolution with correction of the latter. This case series portrays the spectrum of few rare neuroimaging findings of uncontrolled hyperglycemia, which helps in proper and prompt diagnoses.

Case presentation

Five diabetic patients with uncontrolled hyperglycemia were observed. Striatal hyperdensity on computed tomography or striatal T1 hyperintensity on magnetic resonance imaging was observed in three patients who presented with movement disorders. The abnormality was bilateral in one case. These observations were consistent with hyperglycemia-induced hemichorea–hemiballismus syndrome. In another patient who had presented with focal seizures, magnetic resonance imaging revealed subcortical T2/FLAIR hypointensity in bilateral occipital regions, which has been described to be characteristic for non-ketotic hyperglycemia-related seizures. Yet another patient who had been treated for diabetic ketoacidosis had developed bilateral lower-limb weakness. In correlation with a background of rapid correction of hyponatremia, magnetic resonance imaging revealed symmetric areas of altered signal intensity in the bilateral perirolandic region showing an open ring pattern of diffusion restriction, suggesting extrapontine myelinolysis.

Conclusions

In all the cases, the clinical differentials were wide. Neuroimaging was mandatory in establishing hyperglycemia as the underlying cause for the movement disorders and seizures. Also, neuroimaging aided in timely identification of extra-pontine myelinolysis, which might have prevented further central pontine involvement in the patient with diabetic ketoacidosis.
Computer aided design of novel antibiotic drug candidate against multidrug resistant strains of Salmonella typhi from pyridine-substituted coumarins
Authors: Ameji Philip John , Uzairu Adamu , Shallangwa Gideon Adamu , Uba Sani
Published: February 2024

Background

The rising cases of resistance to existing antibiotics by Salmonella typhi, has made the development of novel drug candidates a necessity. In this study, a data set of antibacterial pyridine substituted coumarins were subjected to Virtual Screening against SipA effector protein of the bacterium. The compounds were geometry-optimized using Semi-empirical (pm3) method in Spartan 14 software, docked against the active sites of SipA using AutoDock Vina software. The molecule with the best docked score was selected as template and subjected to structural modifications leading to the design of a novel coumarin based drug candidate codenamed Y-1.

Results

The docking of Y-1 against SipA revealed that it binds to the target with ΔG value of − 9.1 kcal/mol. This value is better than − 6.8 kcal/mol obtained for ciprofloxacin used herein for quality assurance. Additionally, quantum mechanical calculations on Y-1 using DFT (B3LYP/6-31G* basis set) shows a wide energy gap of 3.44 eV and ω value of 1.47 eV, indicating its sound kinetic and thermodynamic stabilities. Y-1 was also found to possess good oral bioavailability and positive pharmacokinetic profiles.

Conclusion

This is the first time coumarin derivatives are screened against an effector protein of Salmonella typhi. It is envisaged that the findings of this research will provide an excellent blueprint toward the development of novel antibiotics against Salmonella typhi.
Development of superior chitosan–EDTA microparticles as an adsorbent base for solidifying the self-emulsifying drug delivery systems
Authors: Kumar Mohit , Chawla Pooja A. , Faruk Abdul , Chawla Viney , Thakur Shubham , Jain Subheet Kumar
Published: February 2024

Background

The present study focused on developing a superior adsorbent carrier (microparticles) to solidify the self-emulsifying drug delivery system. The two approaches, solvent evaporation and spray drying, were explored to synthesize the microparticles using chitosan (CH) and EDTA disodium. The 32 full factorial design was applied to optimize the microparticle process produced by both methods.

Results

The various characterization evaluations of the microparticles revealed amide linkages between the CH and EDTA disodium, and XRD results showed that microparticles were amorphous. The SE-CHEM (C2) and SD-CHEM (Y1) optimized microparticles were free-flowing and had percentage yield (%), 96 ± 1.2 and 58 ± 1.1, zeta potential (mV), 9 ± 0.44 and 4 ± 0.13, and particle size (μm), 3 ± 0.57 and 2 ± 0.4, respectively. SEM images showed uneven surfaces with wide void spaces and flaky texture for optimized microparticles Y1 and C2, respectively. The SE-CHEM (C2) had an oil adsorption capacity (OAC %) of 46 ± 0.54 and 60 ± 0.77, and oil desorption capacity (ODC %), 38 ± 0.65 and 56 ± 0.86, for Labrafac and Cremophor RH 40, respectively. The SD-CHEM (Y1) had an oil adsorption capacity (OAC %) of 59 ± 0.71 and 68 ± 0.39, and oil desorption capacity (ODC %), 54 ± 0.11 and 65 ± 0.74, for Labrafac and Cremophor RH 40, respectively. In the surface free energy components analysis, the SE-CHEM (C2) had an enhanced dispersive component [γLW (mJ/m2)] of 32 ± 0.68 and 37 ± 0.47 for Labrafac and Cremophor RH 40, respectively. The SD-CHEM (Y1) had an enhanced dispersive component [γLW (mJ/m2)] of 48 ± 0.7 and 52 ± 0.41 for Labrafac and Cremophor RH 40, respectively. The SE-CHEM (C2) had enhanced dynamic advancing contact angles [θa (°)] of 75 ± 0.19 and 78 ± 0.75 for Labrafac and Cremophor RH 40, respectively. The SD-CHEM (Y1) had enhanced dynamic advancing contact angles [θa (°)] of 74 ± 0.6 and 80 ± 0.21 for Labrafac and Cremophor RH 40, respectively.

Conclusion

All the findings indicate that the microparticles have superior characteristics to serve as the adsorbent base for solid self-emulsifying drug delivery systems.
Do gender disparities in socioeconomic status affect
Teff
productivity? A comparative analysis in Ethiopia
Authors: Gebrehiwot Nahusenay Teamer , Ndinda Catherine
Published: February 2024

Ethiopia is one of Africa’s fastest-growing economies, and the recent political and economic reforms recognize the importance of empowering women and increasing their labour force participation. The Federal Democratic Republic of Ethiopia (FDRE) constitution of 1995 recognized women’s right to equality and provides intervened to enable women to compete and participate in all spheres of life and to exercise their rights on equal grounds with men. Gender empowerment and gender equality are given national priority and positioned at the centre of all policy, legal, and institutional frameworks. Research suggests that women remain overrepresented in lower-skilled jobs, while carrying out the bulk of unpaid care work. Women also face multiple forms of deprivation, gender-based discrimination, lack of access to productive resources, intimate partner violence, lack of education and training, and employment. Persistent inequalities in ownership and control over assets, such as land, houses, and oxen negatively affect their productivity and livelihoods. This paper aims at answering the question “Do gender disparities in socioeconomic status affect
Teff
productivity in Ethiopia?” Using mixed methods, the study conducted a cross-sectional household survey. Purposive sampling was used to select top
Teff
-producing regions, districts
, Kebeles
, key informants and FGD participants while a random sampling method was used to select the survey respondents. Results suggest that, although women were fully engaged in
Teff
production activities, due to a low level of ownership of productive resources such as land, labour, and oxen, there is a statistically significant difference in
Teff
production between female and male-headed households which needs the attention of the government and stakeholders. The paper contributes to understanding how gender-based disparities in socioeconomic status affect
Teff
production.
Clinical Endocrinology—Time for a Reset?
Authors: Lightman Stafford L
Published: February 2024

Measurement of blood levels of circulating hormones has always been the cornerstone of the biochemical diagnosis of endocrine diseases, with the objective of detecting hormone excess or insufficiency. Unfortunately, the dynamic nature of hormone secretion means single-point measurements of many hormones often lack diagnostic validity. Endocrinologists have devised complex dynamic tests as indirect assessments of the functioning of the hormone system under investigation. Recent advances in the measurement of dynamic hormone changes across the day now offer an opportunity to reconsider whether there might be better ways both to diagnose and to monitor the therapy of endocrine conditions.
Effect of Changing Estimated Glomerular Filtration Rate Formula on Sugammadex Use and Pulmonary Complications for African American and non-African American Patients
Authors: Engoren Milo , Heung Michael
Published: February 2024

BACKGROUND:

Sugammadex is associated with fewer postoperative pulmonary complications than is neostigmine reversal of neuromuscular blockade. However, the Food and Drug Administration-approved package insert states that its use is “not recommended” in severe renal impairment, separately defined as creatinine clearance <30 mL/min. Recently, the formula for estimating glomerular filtration rate (GFR) was updated to remove the race variable. Compared to the prior formula, the new consensus equation lowers the estimated GFR for African American patients and raises it for everyone else. We sought to determine how this change could differently impact the use of sugammadex, and thus the rate of pulmonary complications, for both African American and non-African American patients.

METHODS:

We used Monte Carlo simulation models to estimate the difference in pulmonary complications that would be suffered by patients when the change in creatine clearance calculated from the estimated GFR (using the old race-based and new race-neutral Chronic Kidney Disease Epidemiology Collaboration formulas) crossed the 30 mL/min threshold, which would require a change in sugammadex or neostigmine use.

RESULTS:

We found that 0.22% (95% confidence interval 0.14%–0.36%) of African American patients’ creatinine clearance would drop from above to below 30 mL/min making sugammadex not recommended and 0.19% (0.16%–0.22%) of non-African American patients would have creatinine clearance increase to >30 mL/min making sugammadex now recommended. Based on our model, we estimate that African American patients would suffer (count [95% confidence interval]) 3 [0.4–6] more pulmonary complications per 100,000 African American patients who received rocuronium or vecuronium through the change from sugammadex to neostigmine reversal to comply with labeling recommendations. Conversely, the same change in formulas would reduce the number of non-African American patients suffering pulmonary complications by 3 [2–4] per 100,000.

CONCLUSIONS:

The recent change in GFR formulas may potentially be associated with an increase in postoperative pulmonary complications in African American patients and a decrease in postoperative pulmonary complications in non-African American patients through GFR-driven changes in sugammadex use.
Mitochondrial morphology dynamics and ROS regulate apical polarity and differentiation in Drosophila follicle cells
Authors: Uttekar Bhavin , Verma Rahul Kumar , Tomer Darshika , Rikhy Richa
Published: February 2024

Mitochondrial morphology dynamics regulate signaling pathways during epithelial cell formation and differentiation. The mitochondrial fission protein Drp1 affects the appropriate activation of EGFR and Notch signaling-driven differentiation of posterior follicle cells in Drosophila oogenesis. The mechanisms by which Drp1 regulates epithelial polarity during differentiation are not known. In this study, we show that Drp1-depleted follicle cells are constricted in early stages and present in multiple layers at later stages with decreased levels of apical polarity protein aPKC. These defects are suppressed by additional depletion of mitochondrial fusion protein Opa1. Opa1 depletion leads to mitochondrial fragmentation and increased reactive oxygen species (ROS) in follicle cells. We find that increasing ROS by depleting the ROS scavengers, mitochondrial SOD2 and catalase also leads to mitochondrial fragmentation. Further, the loss of Opa1, SOD2 and catalase partially restores the defects in epithelial polarity and aPKC, along with EGFR and Notch signaling in Drp1-depleted follicle cells. Our results show a crucial interaction between mitochondrial morphology, ROS generation and epithelial cell polarity formation during the differentiation of follicle epithelial cells in Drosophila oogenesis.
Multifaceted effects on even-skipped transcriptional dynamics upon Krüppel dosage changes
Authors: Lin Shufan , Lim Bomyi
Published: February 2024

Although fluctuations in transcription factor (TF) dosage are often well tolerated, TF dosage modulation can change the target gene expression dynamics and result in significant non-lethal developmental phenotypes. Using MS2/MCP-mediated quantitative live imaging in early Drosophila embryos, we analyzed how changing levels of the gap gene Krüppel (Kr) affects transcriptional dynamics of the pair-rule gene even-skipped (eve). Halving the Kr dosage leads to a transient posterior expansion of the eve stripe 2 and an anterior shift of stripe 5. Surprisingly, the most significant changes are observed in eve stripes 3 and 4, the enhancers of which do not contain Kr-binding sites. In Kr heterozygous embryos, both stripes 3 and 4 display narrower widths, anteriorly shifted boundaries and reduced mRNA production levels. We show that Kr dosage indirectly affects stripe 3 and 4 dynamics by modulating other gap gene dynamics. We quantitatively correlate moderate body segment phenotypes of Kr heterozygotes with spatiotemporal changes in eve expression. Our results indicate that nonlinear relationships between TF dosage and phenotypes underlie direct TF-DNA and indirect TF-TF interactions.
Η ταυτότητα του περιοδικού Η Λέξη και η συμβολή του στην πνευματική ζωή της μεταπολιτευτικής Ελλάδας
Authors: Βενούτσου Μαριάννα
Published: February 2024

Πεδίο έρευνας της παρούσας διδακτορικής μελέτης αποτελεί το λογοτεχνικό περιοδικό "Η Λέξη", του οποίου η έκδοση ξεκίνησε το 1981. Καθότι η εποχή αυτή τοποθετείται χρονικά επτά έτη μετά την αποκατάσταση της Δημοκρατίας, χαρακτηρίζεται ως εποχή της Μεταπολίτευσης. Και επειδή ένα λογοτεχνικό περιοδικό δεν μπορεί να μελετηθεί ανεξάρτητα από την εποχή κατά την οποία εκδίδεται, στην παρούσα μελέτη επιχειρείται μια συνοπτική εξέταση των πτυχών –πολιτικών, οικονομικών, κοινωνικών, πνευματικών– της μεταπολιτευτικής εποχής, μετά από μια σύντομη αναφορά στην ιστορία του περιοδικού Τύπου. Ακολούθως, περιγράφονται και ερμηνεύονται τα εξωτερικά χαρακτηριστικά της "Λέξης" και γίνεται αναφορά τόσο στους εκδότες και το έργο τους όσο και στους συνεργάτες του περιοδικού. Για να καταστεί σαφής η ταυτότητα του περιοδικού περιγράφονται οι μόνιμες στήλες του και παρουσιάζεται η θεματολογία της καθεμιάς. Στη συνέχεια παρουσιάζονται και μελετώνται τα κείμενα που επιλέγει να δημοσιεύει "Η Λέξη" –ποιητικά, πεζά, θεατρικά έργα, επιστολές, συνεντεύξεις, άρθρα, δοκίμια– προκειμένου να καταδειχθεί η φυσιογνωμία του περιοδικού. Το ίδιο επιχειρείται και για τις μεταφραστικές επιλογές του. Επιπλέον, για να γίνει κατανοητός ο ρόλος του στο πνευματικό πεδίο της μεταπολιτευτικής εποχής κρίθηκε αναγκαίος ο συσχετισμός με άλλα ελληνικά λογοτεχνικά περιοδικά της Μεταπολίτευσης. Παράλληλα, μέσα από τη σύγκριση της "Λέξης" με περιοδικά του αγγλοσαξωνικού χώρου –κάποια από αυτά δημοφιλή και μακρόβια– γίνεται προσπάθεια να βρεθούν διαφορές και κυρίως κοινές συνιστώσες, που αφορούν στις επιλογές τους. Γενικότερα, η έρευνα καταλήγει στο συμπέρασμα πως "Η Λέξη" διαφοροποιείται από τους στόχους προγενέστερων περιοδικών (για παράδειγμα του μεσοπολέμου) και δε χαρακτηρίζεται ούτε από ιδεολογικούς προσανατολισμούς ούτε από επιθυμία προβολής συγκεκριμένων λογοτεχνικών γενεών ή λογοτεχνικών ρευμάτων, αλλά είναι ένα περιοδικό ευρείας λογοτεχνικής θεματικής.
Effectiveness of universal Social-Emotional Learning programs for Japanese higher education students: A meta-analytic review
Authors: Takizawa Yu , Matsumoto Yuki , Ishimoto Yuma
Published: February 2024

Background Japanese higher education institutions are increasingly embracing Social-Emotional Learning (SEL) programs to enhance students' mental health. Nevertheless, there is currently a lack of meta-analyses examining the efficacy of these programs in Japan. Methods A systematic search was conducted on PubMed, PsychINFO, Web of Science, Dissertation Abstracts, CiNii Articles, and J-STAGE. Studies meeting the following criteria were included: (a) published; (b) written in Japanese or English; (c) targeted higher education students; (d) designed to enhance one or more social-emotional skills; (e) included a control group; (f) conducted within a higher education setting; and (g) provided sufficient data for effect size calculation. This meta-analysis aimed to evaluate the effectiveness of universal SEL programs for Japanese higher education students and examine potential moderators. The Evidence Project risk of bias tool was utilized for risk assessment. Results The meta-analysis of 32 studies revealed that universal SEL programs demonstrated a small to medium overall effect (ES = .34) and small to medium effects in enhancing social-emotional skills (ES = .33) and attitudes towards the self and others (ES = .37), addressing conduct problems (ES = .37), and mitigating emotional problems (ES = .41) at post-intervention. Moderator analysis indicated a decrease in the overall effect of SEL programs when they were delivered to larger groups of higher education students. However, the present meta-analysis could not conduct moderator analysis for individual outcome categories, except for emotional problems, due to the limited number of eligible studies. Conclusions Future research should investigate enhanced delivery methods for SEL programs, particularly in larger groups, possibly by integrating digital technologies. As the pool of eligible studies expands, future research should conduct meta-analyses with more extensive moderating analyses.
Effectiveness of occupational therapy interventions on function and satisfaction with occupational performance among adults with conditions of the hand, wrist, and forearm: a protocol for a systematic review
Authors: Sheerin Margo , O' Riordan Cliona , Conneely Mairead , Carey Leonora , Ryan Damien , Galvin Rose , Morrissey Ann-Marie
Published: February 2024

Background Functional hand use post injury is important in enabling a person’s engagement in daily living tasks. Without proper treatment, there may be difficulties in self-care, engaging in job roles, or leisure pursuits. Occupational therapists are key health care practitioners for people with upper limb conditions. This systematic review aims to appraise and summarise current evidence regarding effectiveness of occupational therapy interventions among adults with conditions of the hand, wrist, and forearm. Methods A systematic review of randomised control trials and quasi randomised controlled trials will be completed. MEDLINE OVID, CINAHL, CENTRAL, COCHRANE, PUBMED and EMBASE databases will be systematically searched. Grey literature will be searched for via Google Scholar. Studies will be included if they include provision of occupational therapy to adults with a hand, wrist, or forearm condition when compared to treatment as usual or an alternative treatment option. The primary outcome will be function. Secondary outcomes will include satisfaction with occupational performance, quality of life, pain experience, and participation. The Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Hand Conditions will be used to categorise outcomes. The Cochrane Risk of Bias 2 (RoB 2) tool and the Grading of Recommendations Assessment, Development, and Evaluations (GRADE) framework will be utilised to assess quality. A pooled meta- analysis will be completed using RevMan, depending on the uniformity and availability of data. Results This review aims to synthesise high quality evidence to identify the effectiveness of occupational therapy interventions with patients with a hand, wrist, or forearm condition, categorising outcomes in relation to the ICF Core Set for Hand Conditions. Conclusions By synthesising the evidence there is potential for improved evidence base for clinicians; improved outcomes for patients; as well as potential economic benefit. This study is registered with PROSPERO: CRD42022337070.
Development and evaluation of parallel simulated annealing algorithm for reactor core optimization problems
Authors: Mikouchi-Lopez Jake , Delipei Gregory , Hou Jason
Published: February 2024

Background The optimization of core loading patterns in nuclear reactors is one of the most studied optimization problems in nuclear engineering due to the enormous economical and safety benefits. Various algorithms such as Genetic Algorithms (GA), Simulated Annealing (SA), and Parallel Simulated Annealing (PSA) have been used in the past for such problems. Methods In this work, a PSA algorithm was developed and integrated into the Modularly Implemented Design Assistance Suite (MIDAS), a framework developed at North Carolina State University to solve nuclear engineering problems. The effectiveness of PSA was compared against the GA and SA algorithms available in MIDAS for a Pressurized Water Reactor first cycle core loading pattern optimization problem. Results PSA consistently generates more optimal solutions than SA and GA by having the higher average fitness, and showing less variance in its performance and thus being more robust. This provides confidence in the PSA implementation within MIDAS. The obtained loading pattern positions high reactive fuel in peripheral locations and low reactive fuel towards the centers in a strategy resembling both Out-In-Checkboard and L3P loading patter approaches. Conclusions Future studies will involve applying the PSA algorithm to other optimization studies in larger combinatorial spaces, such as in multi-cycle optimization problems.
Born in Bradford’s Age of Wonder cohort: protocol for adolescent data collection
Authors: Shire Katy A. , Newsham Alex , Rahman Atif , Mason Dan , Ryan David , Lawlor Deborah A. , Opio-Te Gail , Nutting Hannah , West Jane , Pickavance John , Dickerson Josie , Pickett Kate E. , Lennon Laura , Gunning Lydia , Mon-Williams Mark , Smith Sean , Gilbody Simon , Dogra Sufyan , Walsh Theresa , McEachan Rosemary , Wright John
Published: February 2024

Background Adolescence and transition into adulthood are periods shaping life-long mental health, cardiometabolic risk, and inequalities. However, they are poorly studied and understood. By extending and expanding the Born in Bradford (BiB) cohort study through this period using innovative, co-produced approaches to collect and analyse data, we aim to understand better the interplay of factors that influence health and wellbeing, and inform/evaluate interventions to improve them and reduce inequalities. Protocol BiB Age of Wonder (AoW) is a large, whole city cohort that will capture the contemporary lived experience amongst multi-ethnic adolescents progressing into young adulthood. We will collect repeated data from existing BiB participants and their peers (N~30,000 adolescents). The protocol for the first phase of the quantitative methods, involving survey measurements and health assessments in mainstream secondary schools is described here. We describe the co-production behind these methods, and lessons learned from the first year of data collection.
“Kuteteza”: A community-engaged COVID-19 Prevention and Protection Initiative in Southern Malawi
Authors: Mategula Donnie , Ibarz-Pavón Ana , Sakala Melody , Chawani Marlen , Sambakunsi Henry , Phiri Mphatso D. , Ndeketa Latif , Sambo Mwiza , Shonga Wisdom , Sambani Clara , Divala Titus , Vinkhumbo Steve , Nkhoma Dominic , Mataya Robert , Nyangulugu Wongani , Saleh Sepeedeh ,   Kuteteza study group
Published: February 2024

Background The COVID-19 epidemic in Malawi involved almost 90,000 recorded cases and 2,638 deaths. Data suggest that the Malawi epidemic developed largely in urban settings, but the extent of rural spread – exposing older adults in particular – is unclear. This concern led us, to develop the ‘Kuteteza’ partnership project: a community-based Public Health intervention involving the shielding of older adults and additional strategies to mitigate COVID-19 impacts in rural Malawi. We now present the results of a realist project evaluation. Methods Clinicians, Public Health professionals, and researchers collaborated with government and district level staff in two Malawi districts. After engagement with local structures, willing older adults (>60 years) and their communities made arrangements for supported 'shielding'. Masks, handwashing stations, and soap were also provided, and government partnerships allowed additional support for vulnerable groups. Finally, context-responsive community engagement reinforced COVID-19 prevention during peak risk periods. Our realist evaluation included collation of anonymised descriptive data and qualitative structured observations and focus groups – involving community members and volunteers – in each setting. Results The project involved 25 villages. Multi-level stakeholder engagement was pivotal in developing and establishing the work, and strong District Health Office support was integral to implementation. Team members contributed to national meetings, aligning the project with national guidance and stakeholder actions. Established partnerships with relevant ministries resulted in the incorporation of shielding in the Malawi COVID-19 response plan. In Kuteteza villages, handwashing stations and soap were used, and there was awareness of COVID-19 prevention measures. Further experiences and evaluation results are presented, including learning points for future outbreak responses. Conclusions Through effective stakeholder engagement and contribution to national response strategy, the Kuteteza project raised awareness and supported populations at a critical time in the pandemic. These approaches can be incorporated in future epidemic and emergency responses.