bluuebunny/crossref_metadata_2025 huggingface dataset:
Infrared small target detection based on region proposal and CNN classifier
Authors: Fan Mingming , Tian Shaoqing , Liu Kai , Zhao Jiaxin , Li Yunsong
Published: June 2021

Infrared small target detection has been a challenging task due to the weak radiation intensity of targets and the complexity of the background. Traditional methods using hand-designed features are usually effective for specific background and have the problems of low detection rate and high false alarm rate in complex infrared scene. In order to fully exploit the features of infrared image, this paper proposes an infrared small target detection method based on region proposal and convolution neural network. Firstly, the small target intensity is enhanced according to the local intensity characteristics. Then, potential target regions are proposed by corner detection to ensure high detection rate of the method. Finally, the potential target regions are fed into the classifier based on convolutional neural network to eliminate the non-target regions, which can effectively suppress the complex background clutter. Extensive experiments demonstrate that the proposed method can effectively reduce the false alarm rate, and outperform other state-of-the-art methods in terms of subjective visual impression and quantitative evaluation metrics.
Vom Problem mit der Bestimmung des Fallproblems
Authors: Rüegger Cornelia
Published: June 2021

Der Beitrag geht der Frage nach, wie Sozialarbeitende ein Wissen darüber entwickeln, was die Fallproblematik ausmacht und welcher Hilfe es bedarf. Es zeigt sich, dass die Fallkonstitution eine komplexe Herstellungsleistung ist und welche Herausforderungen und Fallstricke damit einhergehen. Dabei sticht die Selektivität bezüglich der verarbeiteten Informationen ebenso hervor wie die Bedeutung organisational vorgegebener Relevanzen.
Laboratory evaluation of caricaceae plant as a locally sourced surfactant for gas hydrate inhibition in a laboratory mini flow loop
Authors: Elechi Virtue Urunwo , Ikiensikimama Sunday Sunday , Ajienka Joseph Atubokiki , Akaranta Onyewuchi Emmanuel , Okon Okon Efiong
Published: June 2021

The oil and gas business is serious business and involves millions of dollars so whatever mitigates flow assurance is taken seriously. One of such things is natural gas hydrates. Hydrates are crystalline solids formed when water under low temperatures and high pressures encapsulated natural gases (C1–C4). They form blockages and impede the flow of gas which can lead to the loss of millions of dollars and at times lead to personnel death. Mitigation of gas hydrates has always been with chemicals especially for areas like deep offshore where accessibility is difficult. The chemicals that are in use currently are generally synthetic, expensive and hazardous to lives and environment hence the need for readily available locally sourced materials that are eco-friendly. This study considers and screens a locally sourced surfactant from the plant family caricaceae’ Extract (CE) as a gas hydrate inhibitor in a locally fabricated 39.4-inch mini flow loop of ½ inch internal diameter (ID) which mimics the offshore environment. Various pressure plots (pressure versus time, initial and final pressure versus time and change in pressure versus time) show that the CE performed better than MEG with percentage volumes of gas left in the system for 0.01–0.05 wt% of the extract having values that ranged from 76.7 to 87.33, while volume left for MEG ranged between 70 and 74.67% (1–5 wt%). The CE performed better in small doses compared to those of MEG, in all weight percentages of study. Furthermore, the inhibition capacities which show the level of performance of the inhibitors was also used as a measure of inhibition for both inhibitors. The CE inhibited systems had values of 69.3, 80.7, 78.07, 79.82, and 83.3%, while that of the MEG inhibited system was 60.53, 55.26, 73.68, 72.81, and 66.67% for the various weight percentages considered. The CE should be developed as gas hydrate inhibitors due to its effectiveness and eco-friendliness.
Assessing the contribution of mobility in the European Union to rubber expansion
Authors: Laroche Perrine C. S. J. , Schulp Catharina J. E. , Kastner Thomas , Verburg Peter H.
Published: June 2021

Nearly three-quarters of global natural rubber production is used to produce tyres, supporting mobility around the globe. The projected increase in mobility could contribute to further expansion of rubber plantations and impact tropical ecosystems. We quantified the use of natural rubber in tyres in the European Union (EU), the corresponding land footprint, and explored drivers of tyre use using country-specific transport statistics and trade registers of rubber goods. Five percent of the world’s natural rubber is consumed in tyres used in the EU, using up to a quarter of the area under rubber plantations in some producing countries. Car use is responsible for 58% of this consumption, due to car-dependent lifestyles that are associated with economic prosperity and spatial planning paradigms. While the EU’s transport policy focuses on reducing dependence on fossil-fuels, cross-cutting policies are needed to address car-dependency and reduce the EU’s land footprint in tropical landscapes without compromising progress towards decarbonisation.
Integrating BPMN and DMN: Modeling and Analysis
Authors: de Leoni Massimiliano , Felli Paolo , Montali Marco
Published: June 2021

The operational backbone of modern organizations is the target of business process management, where business process models are produced to describe how the organization should react to events and coordinate the execution of activities so as to satisfy its business goals. At the same time, operational decisions are made by considering internal and external contextual factors, according to decision models that are typically based on declarative, rule-based specifications that describe how input configurations correspond to output results. The increasing importance and maturity of these two intertwined dimensions, those of processes and decisions, have led to a wide range of data-aware models and associated methodologies, such as BPMN for processes and DMN for operational decisions. While it is important to analyze these two aspects independently, it has been pointed out by several authors that it is also crucial to analyze them in combination. In this paper, we provide a native, formal definition of DBPMN models, namely data-aware and decision-aware processes that build on BPMN and DMN S-FEEL, illustrating their use and giving their formal execution semantics via an encoding into Data Petri nets (DPNs). By exploiting this encoding, we then build on previous work in which we lifted the classical notion of soundness of processes to this richer, data-aware setting, and show how the abstraction and verification techniques that were devised for DPNs can be directly used for DBPMN models. This paves the way towards even richer forms of analysis, beyond that of assessing soundness, that are based on the same technique.
Wirkung visueller und auditiver Hinweise auf die visuelle Aufmerksamkeit und Lernergebnisse beim Einsatz physikalischer Lernvideos
Authors: Watzka Bianca , Hoyer Christoph , Ertl Bernhard , Girwidz Raimund
Published: June 2021

Lernende haben oft Schwierigkeiten, Informationen aus visuellen, dynamischen Lernmedien zu extrahieren. Daher werden diese häufig durch Hinweise ergänzt, welche die visuelle Aufmerksamkeit steuern und den Lernerfolg verbessern können.

Bisher ist offen, wie gut der Lernerfolg beim Lernen mit Videos in Abhängigkeit von der Hinweismodalität vorhergesagt werden kann und welche Rolle dabei die visuelle Aufmerksamkeit spielt. Das Ziel dieser Studie ist, die Hinweismodalität zu variieren, um den Lernerfolg zu beeinflussen und dabei zu untersuchen, wie viel der so erzeugten Varianzen im Lernerfolg durch die visuelle Aufmerksamkeit erklärt werden können.

Dazu wurden zwei Videos von Wirbelstromexperimenten erstellt und mit Hinweisen versehen, die entweder visuell als Kombination aus Textfeldern und Spotlights oder auditiv als gesprochener Text implementiert waren. 40 Lehramtsstudierende wurden zufällig der visuellen oder auditiven Bedingung zugeteilt. Ein Eye-Tracker zeichnete die Blickbewegungen auf. Die Vor- und Nachtestung erfolgte durch Fragebögen, die affektive und kognitive Lernfaktoren erfassten.

Verglichen mit Textfeldern und Spotlights führten gesprochene Hinweise zu einer höheren visuellen Aufmerksamkeit und zu besseren Lernergebnissen. Allerdings förderten Textfelder und Spotlights die Anwendung der Fachsprache besser als gesprochene Hinweise. Bemerkenswert dabei ist, dass die visuelle Aufmerksamkeit bei den Lernergebnissen auf das durch den gesprochenen Hinweis adressierte Experiment und somit auf das Videomaterial bezogen war. Im Gegensatz dazu war beim Erwerb der Fachtermini die visuelle Aufmerksamkeit auf die Textfelder und somit auf die Hinweise ausschlaggebend.

Aus den Ergebnissen lässt sich für die Gestaltung von Demonstrationsvideos ableiten, dass die Hinweismodalität auf die Lernziele abgestimmt werden sollte.
Towards a Circular Economy for African Islands: an Analysis of Existing Baselines and Strategies
Authors: Andriamahefazafy M. , Failler P.
Published: June 2021

In recent years, the concept of circular economy has gained increasing attention from both businesses and governments. The African continent has started to adopt circular economy–related policies at national or regional levels, but it is not yet mainstream. Literature on circular economy has mainly focused on developed countries in the global north with limited attention given to the potential of circular economy for developing countries especially in the context of African islands. In this paper, we fill this gap by providing existing baselines regarding CE for 9 African islands and present their existing strategies that could foster the development of a circular economy. Adopting the Ellen MacArthur Foundation diagram and the ReX framework, we use different components of the combined frameworks to situate the various initiatives. We show that African islands have led an array of initiatives especially in waste management and also in regenerating natural resources. However, various challenges remain, such as the lack of national umbrella frameworks that would ensure circularity across actions. Countries with more favourable socio-economic and political contexts such as Reunion Island or Mauritius implement policies relating to a circular economy. However, these countries and others, such as Maldives or Seychelles, also have a high level of material consumption that requires changes from production to consumption stages. Countries with challenging contexts, such as Madagascar, Guinea-Bissau, Sao Tome and Principe, Comoros and to a lesser extent Cabo Verde, have less dedicated policies but various dispersed activities such as using renewable energy that could contribute to circularity. Extraction of natural resources in these countries remains an important source of growth that requires a systemic change towards circularity. Embracing a circular economy presents various opportunities to African islands especially considering the blue economy agendas adopted in these islands.
A critique of the ‘as–if’ approach to machine ethics
Authors: You Jun Kyung
Published: June 2021

In this paper, I argue that the replication of the effect of ethical decision-making is insufficient for achieving functional morality in artificial moral agents (AMAs). This approach is named the “as–if” approach to machine ethics. I object to this approach on the grounds that the “as if” approach requires one to commit to substantive meta-ethical claims about morality that are at least unwarranted, and perhaps even wrong. To defend this claim, this paper does three things: 1. I explain Heidegger’s Enframing [Gestell] and my notion of “Ready-Ethics,” which, in combination, can hopefully provide a plausible account for the motivation behind the “as if” approach; 2. I go over specific examples of Ethical AI projects to show how the “as if” approach commits these projects to versions of moral generalism and moral naturalism. I then explain the flaws of the views that the “as if” approach necessitates, and suggest that they cannot account for the justificatory process crucial to human moral life. I explain how Habermas’ account of the justificatory process could cast doubt on the picture of morality that the meta-ethical views of the “as if” approach proposes; 3. Finally, I defend the relevance of discussing these topics for the purpose of functional morality in AMAs.
Positioning students for political discussions: Attending to the mode of address
Authors: McAnulty Joseph , Garrett H. James
Published: June 2021

Social studies teachers are often reported as remaining reluctant to engage their students in discussions of contemporary social and political issues. It is therefore critically important to investigate instances of such discussions when they do occur. This paper, part of a larger qualitative study that included six middle and high school classrooms and 24 observed discussions, considers how students are positioned in classroom discussions of social and political issues. By thinking in terms of positions and Ellsworth's (1997) notion of “modes of address”, the authors conceptualize political discussions in terms of the delicate relations between intent and outcome, the social and personal, certainty and surprise. This paper identifies three modes through which students are invited into relation to social and political life via discussions of current topics: task-oriented participants, distanced commentators, and/or as implicated citizens.
Dudo of Saint-Quentin’s Historia Normannorum
Authors: Pohl Benjamin
Published: June 2021

When Dudo of St. Quentin's Historia Normannorum first appeared in or around 1015, written for the then Duke of Normandy, Richard II, Dudo created a text without precedent. By committing the lives and deeds of Richard II's ancestors to written memory for the first time since the foundation of Normandy under the Viking Rollo in 911, Dudo provided the Norman court at Rouen with both an official dynastic historiography and a treasured record of their collective past. The Historia Normannorum was conceived, from the outset, as an idiosyncratic text which purported to be both staunchly traditional and remarkably innovative. This book's analysis of the Historia uses historical and manuscript evidence, alongside literary theory and approaches from memory studies, to provide fresh insights into the text. It shows the Historia to be one of the most influential and important historical narratives of the Middle Ages, perhaps even the earliest surviving example of an illustrated chronicle from the entire Latin West. Benjamin Pohl is a DAAD Postdoctoral Research Fellow at the Faculty of History, University of Cambridge. He is also a Research Associate at Emmanuel College, Cambridge.
Rapid diagnostic testing for antimicrobial stewardship: Utility in Asia Pacific
Authors: Apisarnthanarak Anucha , Kim Hong Bin , Moore Luke , Xiao Yonghong , Singh Sanjeev , Doi Yohei , Kwa Andrea Lay-Hoon , Sri La Sri Ponnampalavanar Sasheela , Cao Qing , Kim Shin-Woo , Lee Hyukmin , Santanirand Pitak
Published: June 2021

Rapid diagnostic testing (RDT) can provide prompt, accurate identification of infectious organisms and be a key component of antimicrobial stewardship (AMS) programs. However, their use is less widespread in Asia Pacific than western countries. Cost can be prohibitive, particularly in less resource-replete settings. A selective approach is required, possibly focusing on the initiation of antimicrobials, for differentiating bacterial versus viral infections and identifying locally relevant tropical diseases. Across Asia Pacific, more data are needed on RDT use within AMS, focusing on the impact on antimicrobial usage, patient morbidity and mortality, and cost effectiveness. Moreover, in the absence of formal guidelines, regional consensus statements to guide clinical practice are warranted. These will provide a regionally relevant definition for RDT; greater consensus on its role in managing infections; advice on implementation and overcoming barriers; and guidance on optimizing human resource capacity. By addressing these issues, the outcomes of AMS programs should improve.
Biofilm accumulation in new flexible gastroscope channels in clinical use
Authors: Primo Mariusa Gomes Borges , Tipple Anaclara Ferreira Veiga , Costa Dayane de Melo , Guadagnin Simone Vieira Toledo , Azevedo Adriana Silva , Leão-Vasconcelos Lara Stefânia Netto de Oliveira , Alfa Michelle , Vickery Karen
Published: June 2021

Objective:

Assess the accumulation of protein and biofilm on the inner surfaces of new flexible gastroscope (FG) channels after 30 and 60 days of patient use and full reprocessing.

Design:

Clinical use study of biofilm accumulation in FG channels.

Setting:

Endoscopy service of a public hospital.

Methods:

First, we tested an FG in clinical use before the implementation of a revised reprocessing protocol (phase 1 baseline; n = 1). After replacement of the channels by new ones and the implementation of the protocol, 3 FGs were tested after 30 days of clinical use (phase 2; n = 3) and 3 FGs were tested after 60 days of clinical use (phase 3; n = 3), and the same FGs were tested in phase 2 and 3. Their biopsy, air, water, and air/water junction channels were removed and subjected to protein testing (n = 21), bacteriological culture (n = 21), and scanning electron microscopy (SEM) (n = 28). Air–water junction channels fragments were subjected to SEM only.

Results:

For the FGs, the average number of uses and reprocessing cycles was 60 times. Extensive biofilm was detected in air, water, and air–water junction channels (n = 18 of 28). All channels (28 of 28) showed residual matter, and structural damage was identified in most of them (20 of 28). Residual protein was detected in the air and water channels of all FG evaluated (phases 1–3), except for 1 air channel from phase 2. Bacteria were recovered from 8 of 21 channels, most air or water channels.

Conclusions:

The short time before damage and biofilm accumulation in the channels was evident and suggests that improving the endoscope design is necessary. Better reprocessing methods and channel maintenance are needed.
Factoids of Assyrian presence in Anatolia: towards a historiography of archaeological interpretation at Kültepe-Kaneš
Authors: Heffron Yağmur
Published: June 2021

This article offers a historiographical examination of how 20th-century ideas of assimilation and cultural purity have shaped our understanding of Bronze Age Anatolia, focusing on the canonical narrative of Assyrian presence at the site of Kültepe-Kaneš. According to this narrative, Old Assyrian merchants who lived and conducted business at Kaneš from the early 20th to the late 18th century BC left no trace in the archaeological record except for cuneiform tablets and cylinder seals, assimilating to local culture to such a degree that Kültepe’s archaeological record is entirely of Anatolian character. The accuracy of this view has met increasing circumspection in recent years. What remains to be articulated is why it remained unchallenged for so long, from its initial formulation in 1948 until the late 2000s, during which time it was widely repeated and reiterated. It is proposed here that the persistence and longevity of what is essentially a misconstrued notion of foreign (in)visibility in Kültepe’s material record can be explained by treating it as a ‘factoid’. The article first historicises the factoid’s formulation and subsequent development. This is followed by a critical evaluation of the evidentiary bases of the factoid to show how disciplinary tendencies to privilege certain categories of evidence over others have created artificial gaps in the data. Ultimately, the article seeks to highlight the epistemological implications of how one of the key sites of Bronze Age Anatolia came to represent a perceived rather than an observed case of indigenous cultural purity.
A new proof of the dimension gap for the Gauss map
Authors: JURGA NATALIA
Published: June 2021

In [4], Kifer, Peres and Weiss showed that the Bernoulli measures for the Gauss map T(x)=1/x mod 1 satisfy a ‘dimension gap’ meaning that for some c > 0, supp dim μp < 1– c, where μp denotes the (pushforward) Bernoulli measure for the countable probability vector p. In this paper we propose a new proof of the dimension gap. By using tools from thermodynamic formalism we show that the problem reduces to obtaining uniform lower bounds on the asymptotic variance of a class of potentials.
Risk factors for death or mechanical ventilation time after bidirectional cavopulmonary anastomosis in a developing country
Authors: Jonas Marina C. , Carmona Fabio , Caneo Luiz F. , Turquetto Aida L. R. , Jatene Marcelo B. , Manso Paulo H.
Published: June 2021

Background:

Glenn procedure is performed for patients with cyanotic CHD and univentricular physiology and has a survival rate above 90%.

Aim:

To evaluate the risk factors associated with a poor outcome after Glenn procedure.

Methods:

The data for this retrospective analysis were collected from a regional Brazilian registry of congenital heart surgeries (ASSIST initiative) from 2014 to 2019. Data from 97 patients who underwent the Glenn procedure were considered. The primary outcomes were prolonged mechanical ventilation (>24 hours post-operatively) or in-hospital death, alone and combined.

Results:

The overall in-hospital mortality was 13.4% (n = 13). Prolonged mechanical ventilation occurred in 52% (n = 51) of the patients. Our analysis found that risk factors for death or prolonged post-operative mechanical ventilation were cardiopulmonary bypass duration and post-operative lactate, whereas weight-for-age z-score and age at surgery were risk factors for prolonged mechanical ventilation. Cardiopulmonary bypass duration increased (adjusted odds ratio: 1.02; 95 % CI: 1.01, 1.03) and age at surgery decreased (adjusted odds ratio: 0.96; 95 % CI: 0.93, 0.99) the odds of the combined outcome.

Conclusions:

Age at surgery, post-operative lactate, and low-weight-for-age z-score are associated with prolonged mechanical ventilation and death following the Glenn procedure.
The role of community participation in primary health care: practices of South African health committees
Authors: Haricharan Hanne Jensen , Stuttaford Maria , London Leslie
Published: June 2021

Background:

Community participation is an essential component in a primary health care (PHC) and a human rights approach to health. In South Africa, community participation in PHC is organised through health committees linked to all clinics.

Aims:

This paper analyses health committees’ roles, their degree of influence in decision-making and factors impacting their participation.

Methods:

Data were collected through a mixed-methods study consisting of a cross-sectional survey, focus groups, interviews and observations. The findings from the survey were analysed using simple descriptive statistics. The qualitative data were analysed using thematic content analysis. Data on health committees’ roles were analysed according to a conceptual framework adapted from the Arnstein ladder of participation to measure the degree of participation.

Findings:

The study found that 55 per cent of clinics in Cape Town were linked to a health committee. The existing health committees faced sustainability and functionality challenges and primarily practised a form of limited participation. Their decision-making influence was curtailed, and they mainly functioned as a voluntary workforce assisting clinics with health promotion talks and day-to-day operational tasks. Several factors impacted health committee participation, including lack of clarity on health committees’ roles, health committee members’ skills, attitudes of facility managers and ward councillors, limited resources and support and lack of recognition.

Conclusions:

To create meaningful participation, health committee roles should be defined in accordance with a PHC and human rights framework. Their primary role should be to function as health governance structures at facility level, but they should also have access to influence policy development. Consideration should be given to their potential involvement in addressing social determinants of health. Effective participation requires an enabling environment, including support, financial resources and training.
Gender Attitudes and Candidate Preferences in the 2016 U.S. Presidential Primary and General Elections
Authors: Long Meri T. , Dawe Ryan , Suhay Elizabeth
Published: June 2021

Scholars increasingly recognize that voters’ attitudes about gender shape their electoral preferences. Yet previous research has not captured important nuances of the relationship between gender attitudes and electoral choice. We argue that the effects of gender attitudes are not unidirectional and interact in complex ways with voters’ perceptions of candidates, depending not only on candidates’ sex but also on their gender-relevant characteristics and values. We draw on an original survey of Americans during the 2016 elections that measured three gender attitudes—hostile sexism, modern sexism, and traditional gender roles—and evaluations of primary and general election candidates. Our study design increases analytical leverage by examining actual and hypothetical candidate matchups. We find that among Democrats, hostile sexists were drawn to Bernie Sanders, but gender traditionalists preferred Hillary Clinton. Our results also suggest that if Sanders had been the Democratic nominee, gender egalitarians would have strongly supported him over Donald Trump, as they did Clinton.
The legacy of Frank H. Knight for the politics of financial governance
Authors: Clarke Chris
Published: June 2021

The politics of financial governance under conditions of uncertainty has re-emerged as a significant issue for scholars of International Political Economy and related fields, not least because of the fallout from the 2007-2008 financial crisis. In this article I assess the legacy of Frank H. Knight's Risk, Uncertainty, and Profit for debates about reconceptualising financial governance and fostering financial stability. I argue Knight's book is productive in assisting understanding of the fallacies of the ‘risk-based’ economic theory tending to underpin financial governance, in particular drawing attention to the limitations of social scientific knowledge that reduce governance capacity and increase uncertainty in financial markets. I further argue, after Knight's deliberately paradoxical approach, that uncertainty in finance might be beyond regulation but at the same time there is still a societal need to attempt to achieve a politics of uncertainty that can cope with ignorance of the future through experimental governmental efforts.
Genetische Risikofaktoren und ihre Auswirkungen auf die neurale Entwicklung bei Autismus-Spektrum-Störungen
Authors: Freitag Christine M. , Chiocchetti Andreas G. , Haslinger Denise , Yousaf Afsheen , Waltes Regina
Published: June 2021

Zusammenfassung. Die Ätiologie der Autismus-Spektrum-Störungen (ASS) ist in genetischen Risikofaktoren sowie der Interaktion von genetischen und biologisch wirksamen Umweltrisikofaktoren begründet. ASS werden aufgrund von Verhaltensmerkmalen, nämlich bleibend eingeschränkter sozialer Kommunikation, sowie durch stereotypes Verhalten, sensorische und Sonderinteressen diagnostiziert. Hinsichtlich des genetischen Hintergrundes besteht eine hohe genetische Heterogenität, d. h., die genetischen Ursachen sind vielfältig und individuell oft sehr unterschiedlich ausgeprägt. Allerdings konvergieren diese Ursachen in bestimmten biologischen Mechanismen und überlappenden biologischen Endstrecken, deren Veränderung sehr wahrscheinlich den autismusspezifischen Verhaltensmerkmalen zugrunde liegt. Die vorliegende, selektive Literaturübersicht summiert die genetischen Befunde und fokusiert sich insbesondere auf Mechanismen und Endstrecken, die aufgrund der neueren Forschung immer besser charakterisiert werden. Der Artikel schließt mit Hinweisen zur klinischen Relevanz der aktuellen Befunde sowie offenen Fragen der translationalen Forschung.
Gute Demenzpflege ist wie…Jazz?
Authors: Vögeli Samuel
Published: June 2021

Was ist zu diesem Thema bekannt?

Improvisation ist ein zentraler Bestandteil professioneller Pflege und setzt ein hohes Maß an Erfahrung bei Pflegenden voraus. Dennoch wird Improvisation häufig geringgeschätzt. Pflege wird deshalb oft mit technischen Berufen verglichen.

Wie wird eine neue Perspektive eingebracht?

Um einem trivialen Technikparadigma in der Pflege gegenzusteuern, empfiehlt es sich, improvisatorische Praktiken – wie etwa den Jazz – zum Vergleich und Maßstab heranzuziehen.

Was sind die Auswirkungen für die Praxis?

In der Aus- und Weiterbildung sowie in der betrieblichen Praxisentwicklung sollten in Zukunft mehr Raum, Zeit und Ressourcen für die Förderung der Improvisationskompetenz der Pflegenden zur Verfügung stehen.
Aufsuchende psychiatrische Pflege
Authors: Sprecher Nicolaj , Richter Dirk , Gurtner Caroline
Published: June 2021

Was ist zu diesem Thema bekannt?

Die aufsuchende psychiatrische Pflege gewinnt zunehmend an Relevanz. Hingegen ist die Entwicklung der aufsuchenden Versorgungsstrukturen in den westlichen Industriestaaten unterschiedlich weit fortgeschritten.

Wie wird eine neue Perspektive eingebracht?

Der Artikel schafft eine Übersicht über die Entwicklung verschiedener Versorgungsangebote, Kompetenzprofile und Organisationsstrukturen in Großbritannien und den USA und zeigt Herausforderungen im deutschsprachigen Raum auf.

Was sind die Auswirkungen für die Praxis?

Aufsuchende psychiatrisch Pflegende sowie Nutzende sollten zunehmend in die Entwicklung und Evaluation von Angebotsstrukturen einbezogen werden.
Flood‐Induced Recharge of Matrix Water in a Vertic Forest Soil
Authors: Morales Savannah R. , Lemon Mary Grace T. , Stewart Ryan D. , Keim Richard F.
Published: June 2021

Vertisols shrink and swell with changes in soil moisture, influencing hydraulic properties. Vertisols are often in floodplains, yet the importance of flooding as a source of soil moisture remains poorly understood. We used blue dye and deuterated water as tracers to determine the role of the macropore network in matrix recharge under artificial flood durations of 3 and 31 days in large soil monoliths extracted from a forested soil. Gravimetric soil moisture content increased by 47% in the first three days, then increased only 3.5% from day 3–31. Post‐flood moisture content was greatest in the organic‐rich, top 10 cm and was lower at 10–75 cm where organic matter was less. Deuterium concentration revealed that soil moisture in the top 10 cm was quickly dominated by artificial flood water, but at depth remained <80% floodwater even after 31 days. Pervasive dye staining of ped surfaces in the top 4 cm indicated connectivity to flood waters but staining at depth was less and highly variable. The isotopic composition of soil water at depth continued to shift toward flood water despite no differences in dye staining between days 3 and 31. Results indicate flooding initially but incompletely recharges matrix water via macropores and suggest the importance of flooding as a source of matrix recharge in vertic floodplain soils may depend more on flood frequency than duration. Isotopic composition of matrix water in vertic soils depends on both advective and diffusional processes, with diffusion becoming more dominant as porosity decreases.
Investigation of measurable residual disease in acute myeloid leukemia by DNA methylation patterns
Authors: Božić Tanja , Kuo Chao-Chung , Hapala Jan , Franzen Julia , Eipel Monika , Platzbecker Uwe , Kirschner Martin , Beier Fabian , Jost Edgar , Thiede Christian , Wagner Wolfgang
Published: June 2021

Assessment of measurable residual disease (MRD) upon treatment of acute myeloid leukemia (AML) remains challenging. It is usually addressed by highly sensitive PCR- or sequencing-based screening of specific mutations, or by multiparametric flow cytometry. However, not all patients have suitable mutations and heterogeneity of surface markers hampers standardization in clinical routine. In this study, we propose an alternative approach to estimate MRD based on AML-associated DNA methylation (DNAm) patterns. We identified four CG dinucleotides (CpGs) that commonly reveal aberrant DNAm in AML and their combination could reliably discern healthy and AML samples. Interestingly, bisulfite amplicon sequencing demonstrated that aberrant DNAm patterns were symmetric on both alleles, indicating that there is epigenetic crosstalk between homologous chromosomes. We trained shallow-learning and deep-learning algorithms to identify anomalous DNAm patterns. The method was then tested on follow-up samples with and without MRD. Notably, even samples that were classified as MRD negative often revealed higher anomaly ratios than healthy controls, which may reflect clonal hematopoiesis. Our results demonstrate that targeted DNAm analysis facilitates reliable discrimination of malignant and healthy samples. However, since healthy samples also comprise few abnormal-classified DNAm reads the approach does not yet reliably discriminate MRD positive and negative samples.
A 3D-printed magnetic digital microfluidic diagnostic platform for rapid colorimetric sensing of carbapenemase-producing Enterobacteriaceae
Authors: Kanitthamniyom Pojchanun , Hon Pei Yun , Zhou Aiwu , Abdad Mohammad Yazid , Leow Zhi Yun , Yazid Nurhidayah Binte Mohamed , Xun Vanessa Lim Wei , Vasoo Shawn , Zhang Yi
Published: June 2021

Carbapenemase-producing Enterobacteriaceae (CPE) are a group of drug-resistant Gram-negative pathogens that are classified as a critical threat by the World Health Organization (WHO). Conventional methods of detecting antibiotic-resistant pathogens do not assess the resistance mechanism and are often time-consuming and laborious. We have developed a magnetic digital microfluidic (MDM) platform, known as MDM Carba, for the identification of CPE by measuring their ability to hydrolyze carbapenem antibiotics. MDM Carba offers the ability to rapidly test CPE and reduce the amount of reagents used compared with conventional phenotypic testing. On the MDM Carba platform, tests are performed in droplets that function as reaction chambers, and fluidic operations are accomplished by manipulating these droplets with magnetic force. The simple droplet-based magnetic fluidic operation allows easy system automation and simplified hands-on operation. Because of the unique “power-free” operation of MDM technology, the MDM Carba platform can also be operated manually, showing great potential for point-of-care testing in resource-limited settings. We tested 27 bacterial isolates on the MDM Carba platform, and the results showed sensitivity and specificity that were comparable to those of the widely used Carba NP test. MDM Carba may shorten the overall turnaround time for CPE identification, thereby enabling more timely clinical decisions for better clinical outcomes. MDM Carba is a technological platform that can be further developed to improve diagnostics for other types of antibiotic resistance with minor modifications.
Genetic-guided pharmacotherapy for venous thromboembolism: a systematic and critical review of economic evaluations
Authors: Lim Ka Keat , Koleva-Kolarova Rositsa , Chowienczyk Philip , Wolfe Charles D. A. , Fox-Rushby Julia
Published: June 2021

Despite the known contributions of genes, genetic-guided pharmacotherapy has not been routinely implemented for venous thromboembolism (VTE). To examine evidence on cost-effectiveness of genetic-guided pharmacotherapy for VTE, we searched six databases, websites of four HTA agencies and citations, with independent double-reviewers in screening, data extraction, and quality rating. The ten eligible studies, all model-based, examined heterogeneous interventions and comparators. Findings varied widely; testing was cost-saving in two base-cases, cost-effective in four, not cost-effective in three, dominated in one. Of 22 model variables that changed decisions about cost-effectiveness, effectiveness/relative effectiveness of the intervention was the most frequent, albeit of poor quality. Studies consistently lacked details on the provision of interventions and comparators as well as on model development and validation. Besides improving the reporting of interventions, comparators, and methodological details, future economic evaluations should examine strategies recommended in guidelines and testing key model variables for decision uncertainty, to advise clinical implementations.
Cancer Grade Model: a multi-gene machine learning-based risk classification for improving prognosis in breast cancer
Authors: Amiri Souri E. , Chenoweth A. , Cheung A. , Karagiannis S. N. , Tsoka S.
Published: June 2021

Background

Prognostic stratification of breast cancers remains a challenge to improve clinical decision making. We employ machine learning on breast cancer transcriptomics from multiple studies to link the expression of specific genes to histological grade and classify tumours into a more or less aggressive prognostic type.

Materials and methods

Microarray data of 5031 untreated breast tumours spanning 33 published datasets and corresponding clinical data were integrated. A machine learning model based on gradient boosted trees was trained on histological grade-1 and grade-3 samples. The resulting predictive model (Cancer Grade Model, CGM) was applied on samples of grade-2 and unknown-grade (3029) for prognostic risk classification.

Results

A 70-gene signature for assessing clinical risk was identified and was shown to be 90% accurate when tested on known histological-grade samples. The predictive framework was validated through survival analysis and showed robust prognostic performance. CGM was cross-referenced with existing genomic tests and demonstrated the competitive predictive power of tumour risk.

Conclusions

CGM is able to classify tumours into better-defined prognostic categories without employing information on tumour size, stage, or subgroups. The model offers means to improve prognosis and support the clinical decision and precision treatments, thereby potentially contributing to preventing underdiagnosis of high-risk tumours and minimising over-treatment of low-risk disease.
TAM kinase signaling is indispensable for proper skeletal muscle regeneration in mice
Authors: Al-Zaeed Nour , Budai Zsófia , Szondy Zsuzsa , Sarang Zsolt
Published: June 2021

Skeletal muscle regeneration following injury results from the proliferation and differentiation of myogenic stem cells, called satellite cells, located beneath the basal lamina of the muscle fibers. Infiltrating macrophages play an essential role in the process partly by clearing the necrotic cell debris, partly by producing cytokines that guide myogenesis. Infiltrating macrophages are at the beginning pro-inflammatory, but phagocytosis of dead cells induces a phenotypic change to become healing macrophages that regulate inflammation, myoblast fusion and growth, fibrosis, vascularization and return to homeostasis. The TAM receptor kinases Mer and Axl are known efferocytosis receptors in macrophages functioning in tolerogenic or inflammatory conditions, respectively. Here we investigated their involvement in the muscle regeneration process by studying the muscle repair following cardiotoxin-induced injury in Mer−/− mice. We found that Axl was the only TAM kinase receptor expressed on the protein level by skeletal muscle and C2C12 myoblast cells, while Mer was the dominant TAM kinase receptor in the CD45+ cells, and its expression significantly increased during repair. Mer ablation did not affect the skeletal muscle weight or structure, but following injury it resulted in a delay in the clearance of necrotic muscle cell debris, in the healing phenotype conversion of macrophages and consequently in a significant delay in the full muscle regeneration. Administration of the TAM kinase inhibitor BMS-777607 to wild type mice mimicked the effect of Mer ablation on the muscle regeneration process, but in addition, it resulted in a long-persisting necrotic area. Finally, in vitro inhibition of TAM kinase signaling in C2C12 myoblasts resulted in decreased viability and in impaired myotube growth. Our work identifies Axl as a survival and growth receptor in the mouse myoblasts, and reveals the contribution of TAM kinase-mediated signaling to the skeletal muscle regeneration both in macrophages and in myoblasts.
Hypoxic TAM-derived exosomal miR-155-5p promotes RCC progression through HuR-dependent IGF1R/AKT/PI3K pathway
Authors: Gu Wenyu , Gong Linjing , Wu Xu , Yao Xudong
Published: June 2021

Hypoxic tumor-associated macrophages (TAMs) are related to poor prognosis of patients with clear cell renal cell carcinoma (ccRCC). Exosomes are small lipid-bilayer vesicles that implicated in tumor progression and metastasis. However, whether hypoxic TAM-derived exosomes affect RCC progression within the hypoxic tumor microenvironment has not been elucidated. GSE analysis identified miR-155-5p was upregulated in RCC. Moreover, we quantified levels of miR-155-5p using RT-qPCR, performed immunohistochemical staining in 79 pairs of primary RCC specimens and related them to clinicopathological parameters. Higher miR-155-5p levels were related to more CD163 + TAM infiltration and elevated HIF-1a expression in our cohort. In the in vitro studies, we initially purified and characterized the exosomes from the supernatant of TAMs subjected to normoxia or hypoxia, and then transfected antagomiR-155-5p or control into these TAMs to produce corresponding exosomes. Gain and loss-of-function studies further investigated the effect of transferred hypoxic exosomal miR-155-5p on the cross-talk between TAMs and RCC cells in xenograft model and in vitro co-culture experiments. The results of RNA immunoprecipitation analyses elucidated that miR-155-5p could directly interact with human antigen R (HuR), thus increasing IGF1R mRNA stability. Mechanistically, hypoxic TAM-Exo transferred miR-155-5p promoted RCC progression partially through activating IGF1R/PI3K/AKT cascades. Taken together, transfer of miR-155-5p from hypoxic TAMs by exosomes to renal cancer cells explains the oncogenic manner, in which M2 macrophages confer the malignant phenotype to RCC cells by enhancing HuR-mediated mRNA stability of IGF1R.
MicroRNA-326 attenuates immune escape and prevents metastasis in lung adenocarcinoma by targeting PD-L1 and B7-H3
Authors: Shao Lijuan , He Qian , Wang Jingbo , He Fei , Lin Shengcheng , Wu Liujing , Gao Yubiao , Ma Wei , Dong Jun , Yang Xiaofei , Li Furong
Published: June 2021

Tumor-infiltrating T cells are highly expressive of inhibitory receptor/immune checkpoint molecules that bind to ligand expressed by tumor cells and antigen-presenting cells, and eventually lead to T cell dysfunction. It is a hot topic to restore T cell function by targeting immune checkpoint. In recent years, immunotherapy of blocking immune checkpoint and its receptor, such as PD-L1/PD-1 targeted therapy, has made effective progress, which brings hope for patients with advanced malignant tumor. However, only a few patients benefit from directly targeting these checkpoints or their receptors by small compounds or antibodies. Since the complexity of the regulation of immune checkpoints in tumor cells, further research is needed to identify the novel endogenous regulators of immune checkpoints which can help for developing effective drug target to improve the effect of immunotherapy. Here, we verified that microRNA-326 (miR-326) repressed the gene expression of immune checkpoint molecules PD-L1 and B7-H3 in lung adenocarcinoma (LUAD). We detected that the expression of miR-326 in LUAD tissue was negatively correlated with PD-L1/B7-H3. The repression of PD-L1 and B7-H3 expression through miR-326 overexpression leads to the modification the cytokine profile of CD8+ T cells and decreased migration capability of tumor cells. Meanwhile, the downregulation of miR-326 promoted tumor cell migration. Moreover, blocking PD-L1 and B7-H3 attenuated the tumor-promoting effect induced by miR-326 inhibitor. In tumor-bearing mice, the infiltration of CD8+ T cells was significantly increased and the expression of TNF-α, and IFN-γ was significantly enhanced which contributed to tumor progression after miR-326 overexpression. Collectively, miR-326 restrained tumor progression by downregulating PD-L1 and B7-H3 expression and increasing T cell cytotoxic function in LUAD. Our findings revealed a novel perspective on the complex regulation of immune checkpoint molecules. A new strategy of using miR-326 in tumor immunotherapy is proposed.
Potential transmission chains of variant B.1.1.7 and co-mutations of SARS-CoV-2
Authors: Zhang Jingsong , Zhang Yang , Kang Jun-Yan , Chen Shuiye , He Yongqun , Han Benhao , Liu Mo-Fang , Lu Lina , Li Li , Yi Zhigang , Chen Luonan
Published: June 2021

The presence of SARS-CoV-2 mutants, including the emerging variant B.1.1.7, has raised great concerns in terms of pathogenesis, transmission, and immune escape. Characterizing SARS-CoV-2 mutations, evolution, and effects on infectivity and pathogenicity is crucial to the design of antibody therapies and surveillance strategies. Here, we analyzed 454,443 SARS-CoV-2 spike genes/proteins and 14,427 whole-genome sequences. We demonstrated that the early variant B.1.1.7 may not have evolved spontaneously in the United Kingdom or within human populations. Our extensive analyses suggested that Canidae, Mustelidae or Felidae, especially the Canidae family (for example, dog) could be a possible host of the direct progenitor of variant B.1.1.7. An alternative hypothesis is that the variant was simply yet to be sampled. Notably, the SARS-CoV-2 whole-genome represents a large number of potential co-mutations. In addition, we used an experimental SARS-CoV-2 reporter replicon system to introduce the dominant co-mutations NSP12_c14408t, 5′UTR_c241t, and NSP3_c3037t into the viral genome, and to monitor the effect of the mutations on viral replication. Our experimental results demonstrated that the co-mutations significantly attenuated the viral replication. The study provides valuable clues for discovering the transmission chains of variant B.1.1.7 and understanding the evolutionary process of SARS-CoV-2.
Shortwave infrared otoscopy for diagnosis of middle ear effusions: a machine-learning-based approach
Authors: Kashani Rustin G. , Młyńczak Marcel C. , Zarabanda David , Solis-Pazmino Paola , Huland David M. , Ahmad Iram N. , Singh Surya P. , Valdez Tulio A.
Published: June 2021

Otitis media, a common disease marked by the presence of fluid within the middle ear space, imparts a significant global health and economic burden. Identifying an effusion through the tympanic membrane is critical to diagnostic success but remains challenging due to the inherent limitations of visible light otoscopy and user interpretation. Here we describe a powerful diagnostic approach to otitis media utilizing advancements in otoscopy and machine learning. We developed an otoscope that visualizes middle ear structures and fluid in the shortwave infrared region, holding several advantages over traditional approaches. Images were captured in vivo and then processed by a novel machine learning based algorithm. The model predicts the presence of effusions with greater accuracy than current techniques, offering specificity and sensitivity over 90%. This platform has the potential to reduce costs and resources associated with otitis media, especially as improvements are made in shortwave imaging and machine learning.
Publisher Correction: Maternal control of visceral asymmetry evolution in Astyanax cavefish
Authors: Ma Li , Ng Mandy , Shi Janet , Gore Aniket V. , Castranova Daniel , Weinstein Brant M. , Jeffery William R.
Published: June 2021

An amendment to this paper has been published and can be accessed via a link at the top of the paper.