bluuebunny/crossref_metadata_2025 huggingface dataset:
The consequences of COVID-19 lockdown for formal and informal resource utilization among home-dwelling people with dementia: results from the prospective PAN.DEM study
Authors: Vislapuu Maarja , Angeles Renira C. , Berge Line I. , Kjerstad Egil , Gedde Marie H. , Husebo Bettina S.
Published: September 2021

Background

COVID-19 isolated home-dwelling people with dementia (PwD) from home care services, respite care, and daytime activities. We aimed to investigate the consequences of these restrictions on informal (family, friends) and formal (homecare staff) resource utilization among co-residing (e.g., spouses) and visiting caregivers (e.g., children).

Methods

105 PwD (≥65 years old) and their caregivers were included in the prospective PANdemic in DEMentia (PAN.DEM) study, which was initiated when the ongoing stepped-wedge, cluster randomized LIVE@Home.Path trial (N = 438) was temporarily halted due to the pandemic. Primary outcome was change in resource utilization assessed by the Resource Utilization in Dementia Care (RUD) instrument in pre- (12 Dec. 2019 to 11 Mar. 2020) and during the lockdown periods (20 April 2020 to 15 May 2020). Degree of cognitive impairment was assessed by Mini-Mental Status Examination (MMSE), and physical functioning and independent living skills by Physical Self-Maintenance Scale and Lawton Instrumental Activities of Daily Living Scale. Associations between informal and formal care utilization, socio-demographics, and clinical variables were assessed by descriptive statistics and Ordinary Least Squares models (OLS).

Results

Mean age for PwD was 81.8 years; 61% were female; 45.6% lived alone, and the mean MMSE score was 20.8 (SD ± 3.7). PwD with co-residents (44%) were younger (78.4 years) than those who were living alone (84.5 years; P < 0.001). During the first 2 months of lockdown, PwD missed on average 20.5 h of formal care in a month (P < 0.001) leading to an approximately 100% increase in informal care, which was particularly pronounced in personal hygiene (6.9 vs. 11.4 days in a month, P < 0.001) and supervision (9.2 vs. 17.6 days in a month; P < 0.001). Visiting caregivers increased by 1.9 days (SD ± 11.5), but co-residing caregivers increased their number of days providing ADL by approximately 7 days per month (β = 6.9; CI, 0.39–13.1, P < 0.05) after adjusting for PwD and caregiver demographics and clinical variables. Decrease in home nursing care was particularly visible for PwD living alone (− 6.1 vs. -1.3 h per month, P = 0.005). Higher cognitive function (β = − 0.64, CI, − 1.26 – 0.02, P = 0.044) was associated with reduction in home nursing service during the lockdown.

Conclusion

The care situation for PwD changed dramatically in the early phase of the COVID-19 pandemic, especially for those living alone who received less support from homecare services and visiting caregivers. For future crises and the forthcoming post-pandemic period, health authorities must plan better and identify and prioritize those in greatest need.

Trial registration

ClinicalTrials.gov; NCT04043364.
Time series decomposition into dyslipidemia prevalence among urban Chinese population: secular and seasonal trends
Authors: Lao Jiahui , Liu Yafei , Yang Yang , Peng Peng , Ma Feifei , Ji Shuang , Chen Yujiao , Tang Fang
Published: September 2021

Background

Previous epidemiological studies have indicated the seasonal variability of serum lipid levels. However, little research has explicitly examined the separate secular and seasonal trends of dyslipidemia. The present study aimed to identify secular and seasonal trends for the prevalence of dyslipidemia and the 4 clinical classifications among the urban Chinese population by time series decomposition.

Methods

A total of 306,335 participants with metabolic-related indicators from January 2011 to December 2017 were recruited based on routine health check-up systems. Multivariate direct standardization was used to eliminate uneven distributions of the age, sex, and BMI of participants over time. Seasonal and trend decomposition using LOESS (STL decomposition) was performed to break dyslipidemia prevalence down into trend component, seasonal component and remainder component.

Results

A total of 21.52 % of participants were diagnosed with dyslipidemia, and significant differences in dyslipidemia and the 4 clinical classifications were observed by sex (P <0.001). The secular trends of dyslipidemia prevalence fluctuated in 2011–2017 with the lowest point in September 2016. The dyslipidemia prevalence from January to March and May to July was higher than the annual average (λ = 1.00, 1.16, 1.06, 1.01, 1.02, 1.03), with the highest point in February. Different seasonal trends were observed among the 4 clinical classifications. Compared to females, a higher point was observed among males in February, which was similar to participants aged < 55 years (vs. ≥ 55 years) and participants with a BMI ≤ 23.9 (vs. BMI > 23.9).

Conclusions

There were significant secular and seasonal features for dyslipidemia prevalence among the urban Chinese population. Different seasonal trends were found in the 4 clinical classifications of dyslipidemia. Precautionary measures should be implemented to control elevated dyslipidemia prevalence in specific seasons, especially in the winter and during traditional holidays.
Image-guided selection of Gd@C-dots as sensitizers to improve radiotherapy of non-small cell lung cancer
Authors: Ma Xiaofen , Lee Chaebin , Zhang Tao , Cai Jinghua , Wang Hui , Jiang Fangchao , Wu Zhanhong , Xie Jin , Jiang Guihua , Li Zibo
Published: September 2021

Background

Recently, gadolinium-intercalated carbon dots (Gd@C-dots) have demonstrated potential advantages over traditional high-Z nanoparticles (HZNPs) as radiosensitizers due to their high stability, minimal metal leakage, and remarkable efficacy.

Results

In this work, two Gd@C-dots formulations were fabricated which bore carboxylic acid (CA-Gd@C-dots) or amino group (pPD-Gd@C-dots), respectively, on the carbon shell. While it is critical to develop innovative nanomateirals for cancer therapy, determining their tumor accumulation and retention is equally important. Therefore, in vivo positron emission tomography (PET) was performed, which found that 64Cu-labeled pPD-Gd@C-dots demonstrated significantly improved tumor retention (up to 48 h post injection) compared with CA-Gd@C-dots. Indeed, cell uptake of 64Cu-pPD-Gd@C-dots reached close to 60% of total dose compared with ~ 5% of 64Cu-CA-Gd@C-dots. pPD-Gd@C-dots was therefore further evaluated as a new radiosensitizer for non-small cell lung cancer treatment. While single dose radiation plus intratumorally injected pPD-Gd@C-dots did lead to improved tumor suppression, the inhibition effect was further improved with two doses of radiation. The persistent retention of pPD-Gd@C-dots in tumor region eliminates the need of reinjecting radiosensitizer for the second radiation.

Conclusions

PET offers a simple and straightforward way to study nanoparticle retention in vivo, and the selected pPD-Gd@C-dots hold great potential as an effective radiosensitizer.

Graphic abstract
Long non-coding RNA NORAD promotes pancreatic cancer stem cell proliferation and self-renewal by blocking microRNA-202-5p-mediated ANP32E inhibition
Authors: Ma Yu-Shui , Yang Xiao-Li , Liu Yu-Shan , Ding Hua , Wu Jian-Jun , Shi Yi , Jia Cheng-You , Lu Gai-Xia , Zhang Dan-Dan , Wang Hui-Min , Wang Pei-Yao , Yu Fei , Lv Zhong-Wei , Wang Gao-Ren , Liu Ji-Bin , Fu Da
Published: September 2021

Background

Cancer stem cells (CSCs) are key regulators in the processes of tumor initiation, progression, and recurrence. The mechanism that maintains their stemness remains enigmatic, although the role of several long noncoding RNAs (lncRNAs) has been highlighted in the pancreatic cancer stem cells (PCSCs). In this study, we first established that PCSCs overexpressing lncRNA NORAD, and then investigated the effects of NORAD on the maintenance of PCSC stemness.

Methods

Expression of lncRNA NORAD, miR-202-5p and ANP32E in PC tissues and cell lines was quantified after RNA isolation. Dual-luciferase reporter assay, RNA pull-down and RIP assays were performed to verify the interactions among NORAD, miR-202-5p and ANP32E. We then carried out gain- and loss-of function of miR-202-5p, ANP32E and NORAD in PANC-1 cell line, followed by measurement of the aldehyde dehydrogenase activity, cell viability, apoptosis, cell cycle distribution, colony formation, self-renewal ability and tumorigenicity of PC cells.

Results

LncRNA NORAD and ANP32E were upregulated in PC tissues and cells, whereas the miR-202-5p level was down-regulated. LncRNA NORAD competitively bound to miR-202-5p, and promoted the expression of the miR-202-5p target gene ANP32E thereby promoting PC cell viability, proliferation, and self-renewal ability in vitro, as well as facilitating tumorigenesis of PCSCs in vivo.

Conclusion

Overall, lncRNA NORAD upregulates ANP32E expression by competitively binding to miR-202-5, which accelerates the proliferation and self-renewal of PCSCs.
Digitally connected work and its consequences for strain – a systematic review
Authors: Zolg Sabrina , Heiden Barbara , Herbig Britta
Published: September 2021

Background

Evolving digitization has an impact not only on the organization of work, but also on the health of employees. Dealing with new technologies, integrating new processes and requirements into work, and restructuring tasks among others are demands that can be stressful and impair health.

Objectives

Our aim was to identify (clusters of) working conditions associated with digitally connected work and to analyze their relations with strain, that is, health and well-being outcomes.

Methods

Between May and October 2019, a search string was used to systematically search six databases (EMBASE, Medline, PSYNDEX, PsycInfo, SocIndex, WISO) for German and English texts according to the PEO scheme. The methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Design.

Results

14 studies were identified. Despite the search string containing latest technologies, we identified mostly studies from the 1980s/90s. To aggregate findings, a categorization of work factors (cognitive demands, social factors, organizational factors, environmental factors) and health factors (motivation/satisfaction, reduced well-being/affective symptoms, physiological parameters/somatic complaints) is introduced. The most frequently identified work factors belong to the category of cognitive demands. For health factors, motivation/satisfaction was identified most often. 475 associations were found in total.

Conclusions

This systematic review provides an overview of work and health factors that have been studied between 1981 and 2019. Recent texts frequently study individualized health factors (e.g., life satisfaction) whereas objective physiological measurement data and objective survey methods such as workplace analysis are not used. This latter approach was predominantly found in the older studies. In order to obtain a comprehensive picture, however, it is worthwhile to use a combination of these subjective and objective approaches for future studies in this field.
Effectiveness of diluted povidone-iodine lavage for preventing periprosthetic joint infection: an updated systematic review and meta-analysis
Authors: Kobayashi Naomi , Kamono Emi , Maeda Kento , Misumi Toshihiro , Yukizawa Yohei , Inaba Yutaka
Published: September 2021

Background

Of the several methods used to prevent surgical site infection (SSI), diluted povidone-iodine (PI) lavage is used widely. However, the clinical utility of PI for preventing periprosthetic joint infection (PJI) remains controversial. The aim of this study was to perform a systematic review and meta-analysis of the utility of dilute PI lavage for preventing PJI in primary and revision surgery.

Methods

This study was conducted in accordance with the PRISMA checklist for systematic reviews and meta-analyses. A comprehensive literature search of PubMed, CINAHL, ClinicalTrials.gov, and Cochrane Library databases was performed. The results are summarized qualitatively and as a meta-analysis of pooled odds ratios with 95% confidence intervals (95% CIs). Heterogeneity of treatment effects among studies was classified as low, moderate, or high, corresponding to I2 values of < 25%, 25–50%, and > 50%. A random effects model was applied in cases of high heterogeneity; otherwise, the fixed effects model was applied. Subgroup analyses were conducted to identify potential sources of heterogeneity.

Results

After the screening and eligibility assessment process, eight studies were finally extracted for analysis. Overall, the results showed that PI had no significant effect on PJI with ununified control group. However, subgroup analysis of studies with a saline control group revealed an odds ratio of 0.33 (95% CI, 0.16–0.71) for the PI group, suggesting a significant effect for preventing PJI.

Conclusion

The systematic review and meta-analysis of the current literature demonstrates that diluted PI lavage is significantly better than saline solution lavage for preventing PJI.

Level of evidence

Level I, Systematic review and meta-analysis.
Modified Nuss operation using introducer-bar complex for pectus excavatum in adults: a retrospective study
Authors: Wang Lei , Liu Juan , Li Yao , Feng Tienan , Cao Beibei , Xiao Haibo , Hu Fengqing , Li Guoqing
Published: September 2021

Background

Shortcoming of traditional Nuss operation on adults is gradually found in the clinical practice. A new kind of introducer-bar complex was introduced. However, there is limited evidence regarding its safety and efficacy. Therefore, a single center, retrospective study was conducted to address this issue.

Methods

Patients with pectus excavatum who underwent surgery between January 2015 and June 2017 were consecutively enrolled in this study. In all, 52 patients underwent the modified procedure using the introducer-bar complex (new procedure group), whereas 48 underwent the traditional anti-Nuss procedure (traditional procedure group). Outcomes analysis of balanced baseline was performed to compare the intraoperative and postoperative short-term outcomes.

Results

All patients in the new procedure group had shorter operation duration (51.54 ± 20.32 vs. 79.45 ± 13.88 min, p = 0.017), postoperative hospitalizations (4.77 ± 1.62 vs. 6.86 ± 2.18 days, p = 0.028), plate removal surgery durations (39.30 ± 8.97 vs. 60.30 ± 10.49 min, p < 0.001), and less blood loss during operation (6.25 ± 4.88 vs. 10.90 ± 5.75 ml, p = 0.003) than patients in the traditional procedure group. There was no significant difference in the length of incision, postoperative Haller index, cost, number of steel bars, postoperative surgical outcome and incidence of complications between the two groups.

Conclusion

Through the main clinical outcome were similar, our results shown that modified procedure may have the shorter operation time, postoperative hospital stay, and operation time for plate removal and less blood loss, which may bring potential clinical benefits to patients.
Comparative evaluation of BMI-1 proto-oncogene expression in normal tissue, adenoma and papillary carcinoma of human thyroid in pathology samples
Authors: Hajian Mohadeseh , Esmaeili Abolghasem , Talebi Ardeshir
Published: September 2021

Objective

Papillary Thyroid carcinoma accounts for more than 60% of adult thyroid carcinomas. Finding a helpful marker is vital to determine the correct treatment approach. The present study was aimed to evaluate the expression of the B cell-specific Moloney murine leukemia virus integration site 1 (BMI-1) gene in papillary carcinoma, adenoma, and adjacent healthy thyroid tissues. Pathology blocks of thyroid tissues at the pathology department of patients who have undergone thyroid surgery between 2015 and 2019 were examined; papillary carcinoma, adenoma, and healthy tissues were selected and sectioned. Total RNA was extracted, and the relative expression level of theBMI-1gene was examined using the Real-Time qPCR method.

Results

In the papillary and adenoma tissues,BMI-1was overexpressed (1.047-fold and 1.042-fold) in comparison to healthy tissues (p < 0.05 for both comparisons). However, no statistically significant differences were observed between adenoma and papillary carcinoma tissues regardingBMI-1gene expression. This study demonstrated a new biomarker for thyroid malignancies and found that the mRNA levels of the BMI-1 gene were higher in tumor tissues compared with healthy tissues. Further studies are needed to evaluate theBMI1gene expression in other thyroid cancers.
Cardiovascular comorbidities of atopic dermatitis: using National Health Insurance data in Korea
Authors: Jung Hye Jung , Lee Dong Heon , Park Mi Youn , Ahn Jiyoung
Published: September 2021

Background

It is well known that atopic dermatitis (AD) is associated with other allergic diseases. Recentely, links to diseases other than allergic disease have also been actively studied. Among them, the results of studies regarding AD comorbidities, especially cardiovascular disease (CVD), have varied from country to country.

Objective

To analyze whether the risk of CVD is different between AD patients and healthy controls using Korean National Health Insurance Data.

Methods

We obtained data from 2005 to 2016 from the Korean National Health Insurance Research Database. Patients with one AD code and two AD-related tests codes were selected as AD patients, and age-and sex-matched controls to the AD patients were selected from among those without AD (1:5). Each group was investigated for accompanying metabolic syndrome (which contains hypertension, type 2 diabetes, and hyperlipidemia) and CVD (angina, myocardial infarction, peripheral vascular disease, and stroke) using ICD 10 codes.

Results

The incidence of metabolic diseases and CVD were significantly different between the AD and control groups. Using multivariable Cox regression, differences were adjusted for sex, age, and other CVD and metabolic diseases. As a result, not only metabolic disease, but also the CVD risk of AD patients was significantly higher than that of the control group. Patients with AD had as significantly higher risk of hyperlipidemia (hazard ratio [HR] = 33.02, p < 0.001), hypertension (HR = 4.86, p < 0.001), and type 2 diabetes (HR = 2.96, p < 0.001). AD patients also had a higher risk of stroke (HR = 10.61, p < 0.001), myocardial infarction (HR = 9.43, p < 0.001), angina (HR = 5.99, p < 0.001), and peripheral vascular disease (HR = 2.46, p < 0.001). Besides hyperlipidemia, there was no difference in risk according to AD severity.

Conclusion

Patients with AD have a greater risk of CVD than those without AD.
Vulvar cancer staging: guidelines of the European Society of Urogenital Radiology (ESUR)
Authors: Nikolić Olivera , Sousa Filipa Alves e , Cunha Teresa Margarida , Nikolić Marijana Basta , Otero-García M. Milagros , Gui Benedetta , Nougaret Stephanie , Leonhardt Henrik ,   On behalf of the ESUR Female Pelvic Imaging Working Group, Nougaret Stephanie , Fournier Laure , Bourgioti Charis , Tsili Athina C. , Otero-Garcia Milagros , Manganaro Lucia , Cunha Teresa Margarida , Kido Aki , Alt Celine , Lucas Rita , Leonhardt Henrik , Gui Benedetta , Forstner Rosemarie , Maciel Cristina , Sala Evis , Bharwani Nishat , Buñesch Laura , Lakhman Yulia , Lopez Carolina , Nikolic Olivera , Nikolić Marijana Basta
Published: September 2021

Objective

The aim of the Female Pelvic Imaging Working Group of the European Society of Urogenital Radiology (ESUR) was to develop imaging staging guidelines for vulvar cancer and to propose standardised MRI protocols and reporting.

Methods

The guidelines recommended from the ESUR in this article resulted from a questionnaire analysis regarding imaging staging of vulvar cancer that was answered by all members of the Female Pelvic Imaging Working Group. Only the answers with an agreement equal to or more than 80% were considered. Additionally, the literature was reviewed to complement and further support our conclusions.

Results

The critical review of the literature and consensus obtained among experts allows for recommendations regarding imaging staging guidelines, patient preparation, MRI protocol, and a structured MRI report.

Conclusions

Standardising image acquisition techniques and MRI interpretation reduces ambiguity and ultimately improves the contribution of radiology to the staging and management of patients with vulvar cancer. Moreover, structured reporting assists with the communication of clinically relevant information to the referring physician.
First case of childhood Takayasu arteritis from Syria: a case report
Authors: Alwattar Wafa , Al khudari Rawan , Naameh Judy , Batha Jia , Almajzoub Raghad , Khalil Basheer
Published: September 2021

Background

Takayasu arteritis is a systemic granulomatous inflammation affecting the large- and medium-sized vessels such as aorta, its main branches, and pulmonary and renal arteries. Childhood Takayasu arteritis is a subtype of Takayasu arteritis that affects the age group ranging from young infants to late adolescents.

Case presentation

We report the first childhood Takayasu arteritis case from Syria, a 12-year-old Syrian girl presenting with nonspecific symptoms and signs plus ischemic clinical features in her left arm. She relapsed twice with different additional symptoms each time.

Conclusions

There is scarcity of reviews and studies on childhood Takayasu arteritis in Arabs. We aim to share our experience to keep childhood Takayasu arteritis in mind as a differential diagnosis in any child presenting with hypertension, absent or reduced peripheral arterial pulse, or blood pressure differences between extremities.
The key role of conjugate fault system in importing earthquakes into the eastern flank of the Red Sea
Authors: Abdelfattah Ali K. , Jallouli Chokri , Fnais Mohamed , Qaysi Saleh , Alzahrani Hassan , Mogren Saad
Published: September 2021

This study aims to synthesize seismic observations with gravity and magnetic data and to suggest a new scenario on the development of the Harrat Lunayyir (HL) tectonic system on the eastern Red Sea coastline, Saudi Arabia. Gravity and aeromagnetic anomalies distinctly mapped the NE and NW trends, while the InSAR data depict a small NW–SE graben and an NW–SE dyke. High-resolution relocations, which are well-consistent with the focal mechanism solutions for events with magnitudes greater than 3.0, admit two distinctly fault styles of different orientations. Thus, leading to the NE and NW fault planes’ reactivation related to the Precambrian basement faults and the Red Sea rift system, respectively. The spatiotemporal distributions of epicenters and focal mechanism solutions suggest a new seismic deformation scenario of the 2009 earthquake seismic activity. The low static frictions of 0.2–0.35 obtained from the stress inversion indicates reactivation of preexisting faults in the respective seismogenic zones. The obtained results give rise to a swarm-like sequence of tectonic implications, two activated fault styles differently oriented, and an NE conjugate fault system inherited in the region, which plays a vital role in transferring the ambient stress regime into the Red Sea’s eastern flank.
A randomised controlled trial of succinylated gelatin (4%) fluid on urinary acute kidney injury biomarkers in cardiac surgical patients
Authors: Smart Lisa , Boyd Corrin , Litton Edward , Pavey Warren , Vlaskovsky Philip , Ali Umar , Mori Trevor , Barden Anne , Ho Kwok Ming
Published: September 2021

Background

Fluid resuscitation is frequently required for cardiac surgical patients admitted to the intensive care unit. The ideal fluid of choice in regard to efficacy and safety remains uncertain. Compared with crystalloid fluid, colloid fluid may result in less positive fluid balance. However, some synthetic colloids are associated with increased risk of acute kidney injury (AKI). This study compared the effects of succinylated gelatin (4%) (GEL) with compound sodium lactate (CSL) on urinary AKI biomarkers in patients after cardiac surgery.

Methods

Cardiac surgical patients who required an intravenous fluid bolus of at least 500 mL postoperatively were randomly allocated to receive GEL or CSL as the resuscitation fluid of choice for the subsequent 24 h. Primary outcomes were serial urinary neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C concentrations measured at baseline, 1 h, 5 h and 24 h after enrolment, with higher concentrations indicating greater kidney injury. Secondary biomarker outcomes included urinary clusterin, α1-microglobulin and F2-isoprostanes concentrations. Differences in change of biomarker concentration between the two groups over time were compared with mixed-effects regression models. Statistical significance was set at P < 0.05.

Results

Forty cardiac surgical patients (n = 20 per group) with similar baseline characteristics were included. There was no significant difference in the median volume of fluid boluses administered over 24 h between the GEL (1250 mL, Q1–Q3 500–1750) and CSL group (1000 mL, Q1–Q3 500–1375) (P = 0.42). There was a significantly greater increase in urinary cystatin C (P < 0.001), clusterin (P < 0.001), α1-microglobulin (P < 0.001) and F2-isoprostanes (P = 0.020) concentrations over time in the GEL group, compared to the CSL group. Change in urinary NGAL concentration (P = 0.68) over time was not significantly different between the groups. The results were not modified by adjustment for either urinary osmolality or EuroSCORE II predicted risk of mortality.

Conclusions

This preliminary randomised controlled trial showed that use of succinylated gelatin (4%) for fluid resuscitation after cardiac surgery was associated with increased biomarker concentrations of renal tubular injury and dysfunction, compared to crystalloid fluid. These results generate concern that use of intravenous gelatin fluid may contribute to clinically relevant postoperative AKI.

Trial registration ANZCTR.org.au, ACTRN12617001461381. Registered on 16th October, 2017, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373619&isReview=true.
Specifically designed magnetic biochar from waste wood for arsenic removal
Authors: Chen Chih-Kuei , Chen Jia-Jia , Nguyen Nhat-Thien , Le Thuy-Trang , Nguyen Nguyen-Cong , Chang Chang-Tang
Published: September 2021

Arsenic is a carcinogenic substance, with many cases of poisoning related to arsenic pollution in groundwater. In Taiwan arsenic in groundwater caused the notorious Blackfoot disease. Methods for arsenic removal from water include precipitation, membrane processes, ion exchange, and adsorption, but these processing technologies suffer from high investment costs and complex operations. The traditional adsorption method cannot be used for arsenic removal due to its high operating costs, difficulties in recovery, and low adsorption capacity. To address these issues, this study designed an adsorption material based on biochar for arsenic removal with higher adsorption properties and easy recovery. Biochar sources are readily available from waste wood as a cheap and environmentally friendly material. The efficiency of As (III) removal is also promoted by FeCl3 and KMnO4. The objectives of this research are to obtain optimum operation conditions by assessing the effects of different iron and manganese contents, different doses, different pH and different initial concentration. The adsorption mechanism between As (III) and biochar was studied by adsorption isotherms and the kinetic model. X-ray diffraction, energy-dispersive X-ray spectroscopy and elemental analyzer analysis results show that modified biochar has major elements of Fe and Mn. There is greater magnetism, 40 emu g− 1, in the modified biochar. The maximum adsorption efficiency of 81% and 0.72 mg g− 1 capacity occurs when the ratio of Mn, Fe and C is 4:1:1. The adsorption capacity is high under higher pH with pristine biochar and 1FeC under lower pH with 1Fe2MnC. The reaction mechanism is divided into four pathways. The first pathway is the attachment of As (III) ions into the pore of biochar via physical adsorption. In the second pathway, biochar can connect with As (III) through hydrogen bonding from the function group -OH in the biochar and the As (III) itself. In the third pathway, they can contact each other by electron force when the biochar surface is filled with a positive charge. In the fourth pathway, the compounds of manganese have strong oxidizability to oxidize As (III) to As(V). The iron ions then act as a bridge connecting the biochar and the As (III), resulting in the formation of new complex compounds.
Rock-physics characterization of chalk by combining acoustic and electromagnetic properties
Authors: Yuan Hemin , Looms Majken C. , Nielsen Lars
Published: September 2021

The characterization of shallow subsurface formations is essential for geologic mapping and interpretation, reservoir characterization, and prospecting related to mining/quarrying. To analyze elastic and electromagnetic (EM) properties, we characterize near-surface chalk formations deposited on a shallow seabed during the Late Cretaceous-Early Paleogene (Maastrichtian-Danian). EM and elastic properties, both of which are related to mineralogy, porosity, and water saturation, are combined to characterize the physical properties of chalk formations. We also perform rock-physics modeling of elastic velocities and permittivity and analyze their relationships. We then use measured ground-penetrating radar and P-wave velocity field data to determine the key model parameters, which are essential for the validity of the models and can be used to evaluate the consolidation degree of the rocks. Based on the models, a scheme is developed to estimate the porosity and water saturation by combining the two rock-physics templates. The predictions are consistent with previous findings. Our templates facilitate fast mapping of near-surface porosity and saturation distributions and represent an efficient and cost-effective method for near-surface hydrologic, environmental, and petrophysical studies. In the current formulation, the method is only applicable to rock type (chalk) comprising a single mineral (pure calcite). It is possible to tailor the formulation to include more than one mineral; however, this will increase the uncertainty of the results.
True-amplitude migration through regularized extended linearized waveform inversion
Authors: Biondi Ettore , Meadows Mark A. , Biondi Biondo
Published: September 2021

The ability to create subsurface images whose amplitudes are proportional to the elastic wavefield variations recorded within seismic data as a function of reflection angle is fundamental for performing accurate amplitude-variation-with-offset (AVO) analysis and inversion. A process that generates such images is commonly referred to as true-amplitude migration. We have determined how the extended subsurface-offset image space is able to preserve the elastic behavior of the primary reflections when these events are acoustically migrated with a reverse time migration approach performed in a least-squares fashion. Using a single-interface model, we determine how the angle-domain image amplitude variations from an extended-offset acoustically migrated image closely follow the theoretical elastic Zoeppritz response even at the critical angle. Furthermore, we develop a subsalt synthetic test in which 1C ocean-bottom-node (OBN) data are used within a regularized linearized waveform inversion procedure. In this test, we highlight the ability of the acoustic extended-angle image domain to preserve the correct elastic amplitude variations of the reflected events from three subsalt sand lenses. Our method allows accurate inversion of elastic-wave data for subsurface parameter variations that are critical for reservoir characterization in oil and gas exploration and production. We determine its performance on an OBN field data set recorded in the Gulf of Mexico in which the AVO response of a potential gas-bearing prospect is correctly retrieved.
Experiences of care for self-harm in the emergency department: comparison of the perspectives of patients, carers and practitioners
Authors: O'Keeffe Sally , Suzuki Mimi , Ryan Mary , Hunter Jennifer , McCabe Rose
Published: September 2021

Background

Each year, 220 000 episodes of self-harm are managed by emergency departments in England, providing support to people at risk of suicide.

Aims

To explore treatment of self-harm in emergency departments, comparing perspectives of patients, carers and practitioners.

Method

Focus groups and semi-structured interviews with 79 people explored experiences of receiving/delivering care. Participants were patients (7 young people, 12 adults), 8 carers, 15 generalist emergency department practitioners and 37 liaison psychiatry practitioners. Data were analysed using framework analysis.

Results

We identified four themes. One was common across stakeholder groups: (a) the wider system is failing people who self-harm: they often only access crisis support as they are frequently excluded from services, leading to unhelpful cycles of attending the emergency department. Carers felt over-relied upon and ill-equipped to keep the person safe. Three themes reflected different perspectives across stakeholders: (b) practitioners feel powerless and become hardened towards patients, with patients feeling judged for seeking help which exacerbates their distress; (c) patients need a human connection to offer hope when life feels hopeless, yet practitioners underestimate the therapeutic potential of interactions; and (d) practitioners are fearful of blame if someone takes their life: formulaic question-and-answer risk assessments help make staff feel safer but patients feel this is not a valid way of assessing risk or addressing their needs.

Conclusions

Emergency department practitioners should seek to build a human connection and validate patients’ distress, which offers hope when life feels hopeless. Patients consider this a therapeutic intervention in its own right. Investment in self-harm treatment is indicated.
Differentiation of Human Induced Pluripotent Stem Cells Into Testosterone-Producing Leydig-like Cells
Authors: Ishida Takaki , Koyanagi-Aoi Michiyo , Yamamiya Daisuke , Onishi Atsushi , Sato Katsuya , Uehara Keiichiro , Fujisawa Masato , Aoi Takashi
Published: September 2021

Late-onset hypogonadism (LOH) syndrome, due to a partial lack of testosterone, decreases the quality of life of older men. Testosterone is mainly secreted by Leydig cells in the testes. Leydig cell transplantation is expected to be a promising alternative to conventional testosterone replacement therapy for LOH syndrome. We herein report a simple and robust protocol for directed differentiation of human induced pluripotent stem cells (hiPSCs) into Leydig-like cells by doxycycline-inducible overexpression of NR5A1 and treatment with a combination of 8-bromoadenosine-3′,5′-cyclic monophosphate (8-Br-cAMP) and forskolin. The differentiated cells expressed the steroidogenic enzyme genes STAR, CYP11A1, CYP17A1, and HSD3B2 and the specific markers of adult Leydig cells HSD17B3, INSL3, and LHCGR. Furthermore, we confirmed the secretion of functional testosterone from the cells into the culture supernatant by a testosterone-sensitive cell proliferation assay. These findings showed that the hiPSCs were able to be differentiated into Leydig-like cells, supporting the expectation that hiPSC-derived Leydig-like cells can be novel tools for treating LOH syndrome.
Elucidation of Detailed Pore Structure of (NH4)4SiW12O40 Sponge Crystal
Authors: Matsuda Kaito , Kobayashi Yuto , Inoue Sayaka , Morita Yusuke , Ishikawa Tomoya , Uyama Takeshi , Shimono Akinori , Ito Takeru , Misono Makoto , Kamiya Yuichi , Inumaru Kei
Published: September 2021

Pore structure of (NH4)4SiW12O40 sponge crystal was successfully elucidated by means of Ar adsorption isotherm analysis combined with molecular probe method and molecular modeling. The pores consist of spherical voids or “cages” with diameter of ca. 12 Å and these are connected by smaller “windows”. These “cages” and “windows” are clearly resolved in the pore size distribution analysis for the first time. Molecular probe method elucidated the diameter of the “windows” is larger than 8.5 Å and smaller than 10.2 Å, being consistent with molecular modeling.
Αρχαιόθεμη νεοελληνική δραματουργία και τεχνικές του θεάτρου εν θεάτρω (19ος-20ος αιώνας)
Authors: Χάλκου Αικατερίνη
Published: September 2021

Στόχος της ανά χείρας διδακτορικής διατριβής «Αρχαιόθεμη νεοελληνική δραματουργία και τεχνικές του θεάτρου εν θεάτρω (19ος - 20ός αιώνας)» είναι η ανίχνευση των σχετικών δραματουργικών μηχανισμών στα έργα του γραμματολογικού είδους της δραματικής ποίησης των νεοελληνικών 19ου και 20ού αιώνων• έργα, στα οποία ο γνωστός, αποθησαυρισμένος, γραπτός –διαφοροποιημένος ή όχι– λόγος της αρχαίας τραγωδίας και κωμωδίας, ή ο νέος, βασισμένος στον αρχαίο μύθο και λόγο, εκείνος του νεότερου δραματουργού, παρεισφρέει μέσα σε μια ήδη υπάρχουσα δραματική δομή και προτίθεται –ή/και επιτυγχάνει– να λάβει τη μορφή σκηνικής παρουσίασης. Αυτός ο παλαιός, σε πρωτότυπο ή μετάφραση, υποκείμενος λόγος ή ένας σύγχρονος λόγος, υπερκείμενος, αρχαιόθεμος ή αρχαιόμυθος, εισέρχονται στη νεότερη δραματουργία με πολλές μορφές: ανάγνωση κειμένου, επωαστικά στάδια θεατρικής παράστασης, παράσταση, παρασκήνια παράστασης, πρόσληψη παράστασης. Παραπέρα, επιλέγεται να ενταχθεί και να μελετηθεί εκείνος ο λόγος ο οποίος εκφέρεται από τα δραματικά πρόσωπα, ιστορικά ή μυθοπλαστικά, που φέρουν καλλιτεχνική ιδιότητα συναφή με το θέατρο, και από τα μεταδραματικά αντίστοιχα, εκείνα που, εκκινώντας από τον αρχαίο μύθο και λόγο, επιστρέφουν στη νεότερη δραματουργία με συνείδηση της θεατρικότητάς τους, της ένταξής τους στον προϊστορικό μύθο και της παλαιάς τους παρουσίας –ή της δυνατότητάς τους να παρίστανται– στα γραμματολογικά είδη και στο θέατρο της αρχαιότητας.
Συμμετοχική διακυβέρνηση και πολιτικά δίκτυα στην Τοπική Αυτοδιοίκηση
Authors: Τολίκα Μαρία
Published: September 2021

Σκοπός της διατριβής είναι η ανάδειξη του πλαισίου της συμμετοχικής διακυβέρνησης στην ελληνική Τοπική Αυτοδιοίκηση. Για την επίτευξη αυτού του στόχου διενεργήθηκε εμπειρική έρευνα σχετική με τη λειτουργία των δημοτικών συμβουλίων, των θεσμοθετημένων συμμετοχικών δομών της Τοπικής Αυτοδιοίκησης και των άτυπων συμμετοχικών δομών προς αντιμετώπιση συγκεκριμένων καίριων ζητημάτων της τοπικής κοινωνίας υπό μορφή πολιτικών δικτύων. Η μελέτη επικεντρώθηκε σε θέματα θεσμικής συγκρότησης, ηγεσίας και νομιμοποίησης. Σε πρώτο επίπεδο επιχειρείται η κριτική προσέγγιση θεωρητικού πλαισίου σχετικά με τη συμμετοχική διακυβέρνηση, την ηγεσία και τη νομιμοποίηση. Σε δεύτερο στάδιο καταβάλλεται προσπάθεια να αναλυθεί η συμμετοχή των δημοτικών συμβούλων εντός των συνεδριάσεων των δημοτικών συμβουλίων και να συνδεθεί με την διαδικασία λήψης αποφάσεων. Σε επόμενο επίπεδο επιχειρείται η σύνδεση της διαδικασίας λήψης πολιτικών αποφάσεων ως διαδικασία συμμετοχής ενεργών πολιτών στις θεσμοθετημένες συμμετοχικές δομές (Δημοτική Επιτροπή Διαβούλευσης και Συμβούλιο Ένταξης Μεταναστών). Εν συνεχεία, επιχειρείται η σύνδεση της διαδικασίας λήψης πολιτικών αποφάσεων ως διαδικασία συμμετοχής ενεργών πολιτών στα άτυπα πολιτικά δίκτυα που σχηματίστηκαν ad hoc προς αντιμετώπιση σύγχρονων προβλημάτων της τοπικής κοινωνίας (π.χ. Κοινωνικό Παντοπωλείο, δομές φιλοξενίας μεταναστών κ.λπ.). Τέλος, επιχειρείται η διερεύνηση του ρόλου της ηγεσίας –πολιτικής, τεχνοκρατικής και κοινωνίας των πολιτών- σε διαδικασίες διαβούλευσης και συμμετοχής που αναφέρθηκαν παραπάνω. Η σύγκριση και συμπληρωματικότητα των ανωτέρω προσεγγίσεων αναδεικνύει τις αδυναμίες και δυσχέρειες αλλά και τα θετικά στοιχεία και πρόσημα της συμμετοχικής διακυβέρνησης στη σύγχρονη ελληνική Τοπική Αυτοδιοίκηση.
Αποτελέσματα της εξάλειψης των Β λεμφοκυττάρων σε ασθενείς με συστηματικό ερυθηματώδη λύκο
Authors: Στάβερη Χρυσάνθη
Published: September 2021

Σκοπός της παρούσας μελέτης ήταν ο προσδιορισμός της αποτελεσματικότητας και της ασφάλειας της θεραπείας με RTX σε ασθενείς με ΣΕΛ και αντοχή στη συμβατική θεραπεία. Συμπεριλάβαμε 34 ασθενείς και αναλύσαμε τα δεδομένα από 38 περιπτώσεις χορήγησης του RTX. Οι περιπτώσεις στις οποίες χορηγήθηκε το RTX περιλάμβαναν νεφρίτιδα λύκου (11 ασθενείς), αρθρίτιδα (7 ασθενείς), νευροψυχιατρικό ΣΕΛ (7 ασθενείς), αγγειΐτιδα (5 ασθενείς), εκδηλώσεις από το δέρμα και τους βλεννογόνους (5 ασθενείς), αιματολογικές διαταραχές (5 ασθενείς), εκδηλώσεις από τους πνεύμονες (4 ασθενείς), καθώς και σε 1 περίπτωση αυτοάνοσης ηπατίτιδας, 1 περίπτωση θρομβωτικής θρομβοπενικής πορφύρας και 1 περίπτωση αιμοφαγοκυτταρικού συνδρόμου. Όλοι οι ασθενείς είχαν πρωτεϊνουρία που κυμαινόταν από 1,000mg/24h έως 11,500 mg/24h [μέσος όρος (Μ.Ο.) ± σταθερή απόκλιση (S.D.) : 3336mg/24h ± 3120mg/24h]. Ένα μήνα μετά τη χορήγηση του RTX παρατηρήσαμε μείωση της λευκωματουρίας (Μ.Ο. ± S.D. : 1693mg/24h ± 1653mg/24h, p = 0.06). Παρόμοια εικόνα καταγράψαμε και στο εξάμηνο μετά το RTX (Μ.Ο. ± S.D. : 1550mg/24h ± 2025mg/24h, p = 0.08). Μετά την πάροδο 12 μηνών η ελάττωση της λευκωματουρίας ήταν στατιστικά σημαντική (Μ.Ο. ± S.D. : 954mg/24h ± 1062mg/24h, p = 0.01). Επίσης, μελετήσαμε τη νεφρική λειτουργία προσδιορίζοντας τις τιμές της κρεατινίνης του ορού πριν την έναρξη της θεραπείας (Μ.Ο. ± S.D. : 1.26mg/dL± 0.67mg/dL), στους 6 μήνες (1.22mg/dL ± 0.82mg/dL) και στον ένα χρόνο (1.26mg/dL ± 0.83mg/dL). Δεν υπήρξαν στατιστικά σημαντικές αλλαγές ( p > 0.05 τόσο στους 6 όσο και στους 12 μήνες). Η θεραπευτική απάντηση για τους ασθενείς με νεφρίτιδα λύκου ήταν περίπου 82%. Σχετικά με τις υπόλοιπες εκδηλώσεις η κλινική ανταπόκριση ήταν 100% για την αρθρίτιδα, την αγγειΐτιδα και τις αιματολογικές διαταραχές, 80% για τις εκδηλώσεις από το δέρμα και τους βλεννογόνους και 75% για αυτές από το πνευμονικό παρέγχυμα. Η διάρκεια παρακολούθησης των ασθενών κυμάνθηκε από 1 έως και 15 έτη. Εξάρσεις σημειώθηκαν σε 10/38 περιπτώσεις και η πρωιμότερη έξαρση σημειώθηκε μέσα σε 6 μήνες σε 4 ασθενείς. Το RTX ήταν γενικά ασφαλές και καλά ανεκτό είτε όταν χορηγήθηκε για πρώτη φορά είτε επαναλαμβανόμενα. Η μείωση της απαιτούμενης ημερήσιας δόσης των χορηγούμενων κορτικοειδών ήταν στατιστικά σημαντική τόσο στους 6 μήνες (p = 0.0002), όσο και στους 12 μήνες (p = 0.0003) μετά τη χορήγηση του RTX.
Ο ρόλος της οικονομικής αποτίμησης των περιβαλλοντικών πόρων στο σχεδιασμό της βιώσιμης τουριστικής ανάπτυξης
Authors: Αποστολίδης Γεώργιος
Published: September 2021

Τις τελευταίες δεκαετίες η αειφορική διαχείριση των περιβαλλοντικών πόρων και η βιώσιμη ανάπτυξη αποτελούν στόχο και στρατηγική παγκόσμιων αλλά και εθνικών νόμων, πολιτικών και κυβερνήσεων. Οι φυσικοί πόροι αποτελούν απόσπασμα της οικονομίας για τις περιφέρειες τόσο στις αναπτυγμένες όσο και στις αναπτυσσόμενες χώρες. Η Ευρωπαϊκή Επιτροπή τις τελευταίες δεκαετίες ανέπτυξε μια σειρά στρατηγικών πλαισίων για τη προστασία και διαχείριση των φυσικών πόρων δημιουργώντας ένα πυλώνα προστασίας για τα κράτη μέλη της. Έτσι λοιπόν, υπάρχει μεγάλη αναγκαιότητα να αποτιμηθούν οικονομικά, αγαθά όπως (περιβαλλοντικά, κοινωνικά, οικοσυστημικά) προκειμένου να υπάρξει διαρκής και σταθερή εξασφάλιση αυτών των αγαθών στο μέλλον. Στην παρούσα Διδακτορική έρευνα ως περιοχή έρευνας επιλέχθηκε Ορεινό Τόξο (Ορεινός Όγκος Βόρα). Η περιοχή του ορεινού όγκου επιλέχθηκε εξαιτίας της ιδιαίτερης περιβαλλοντικής της σημασίας. Συγκεκριμένα, σύμφωνα με το Πρόγραμμα ENVIREG 1995 του Υπουργείου Περιβάλλοντας Χωροταξίας και Δημοσίων Έργων μεγάλες εκτάσεις της περιοχής αυτής προστατεύονται από το δίκτυο Natura 2000, ενώ περιλαμβάνει και άλλες περιοχές προστασίας: π.χ. Καταφύγιο Θηραμάτων. Επιπρόσθετα, έχει ιδιαίτερο επιστημονικό και ερευνητικό ενδιαφέρον διότι αποτελεί έναν Πόλο Εντατικής ανάπτυξης ειδικών εναλλακτικών μορφών τουρισμού (Ορεινός-Ορειβατικός τουρισμός, Υπαίθρου, Πολιτισμικός, Ιαματικός-Θεραπευτικός και Ευεξίας) καθώς διακρίνεται ταυτόχρονα ως Λουτρόπολη και ως περιοχή με εγκαταστάσεις Χιονοδρομικού Κέντρου (Χιονοδρομικός τουρισμός). Ο τουρισμός αποτελεί έναν από τους κύριους πυρήνες ανάπτυξης και εφοδιαστικής αλυσίδας της τοπικής οικονομίας. Έτσι η ευρύτερη περιοχή καθίσταται ως τουριστικό θέρετρο το οποίο μάλιστα σύμφωνα με το Ειδικό Πλαίσιο Χωροταξικού Σχεδιασμού και Αειφόρου Ανάπτυξης για τον Τουρισμό ανήκει στην κατηγορία των πόλων εντατικής ανάπτυξης ειδικών μορφών τουρισμού. Ειδικότερα, η ανάλυση (έρευνες οικονομικής αποτίμησης) επικεντρώθηκε στην περιοχή, των Λουτρών Πόζαρ (Ιαματικός Φυσικός Πόρος) και Χιονοδρομικό Κέντρο Καϊμακτσαλάν. Μέσα από την παρούσα διδακτορική διατριβή για πρώτη φορά στην Ελλάδα α} θα παρουσιαστεί μία πρότυπη διαχειριστική μελέτη αειφορικής διαχείρισης τουρισμού με σκοπό την μελλοντική σύσταση διακυβερνητικών συμβουλίων τουρισμού σε όλη Ελληνική επικράτεια β} οι δημόσιες αλλά και ιδιωτικές υπηρεσίες και εταιρίες αντίστοιχα θα έχουν γνώση για την υφιστάμενη κατάσταση της σχέσης τουρισμού-περιβάλλοντος (εκπόνηση τουριστικής διαχειριστικής μελέτης από δασαρχεία και δήμους ενδεικτικά ανά 10 χρόνια με ενδιάμεσους περιοδικούς πίνακες καταγραφής τουριστικών αξιών ανά 2έτη) γ} θα παραχθεί νέα γνώση η οποία δύναται να αποτελέσει βάση για νέα πληροφορία μελλοντικά με την οικονομική αποτίμηση και τουριστική αξία σε Εθνικό αλλά και μεταγενέστερα Ευρωπαϊκό Επίπεδο. Τα αποτελέσματα της έρευνας αναμένεται να έχουν άμεσο ενδιαφέρον απο φορείς με άμεσο ενδιαφέρον και να αποτελέσουν ένα εφαλτήριο για την αρχή νέων συζητήσεων.
Το Γυμνάσιο της Μ. Ασίας ως θεσμός αθλητισμού και παιδείας κατά τον 1ο αι. π.Χ.
Authors: Καμέας Νικόλαος
Published: September 2021

Σκοπός της παρούσας εργασίας ήταν η παρουσίαση και η ανάλυση του λειτουργικού ρόλου της/των αθλητικής παιδείας/αθλητικών δραστηριοτήτων, της διανοητικής παιδείας, της ηθικής και κοινωνικοπολιτικής αγωγής, αλλά και της στρατιωτικής εκπαίδευσης, στα πλαίσια των θεσμών του Γυμνασίου καθώς και της Εφηβείας στη Μικρά Ασία, κατά τoν 1ο αι. π.Χ. Πρωτογενείς πηγές της έρευνας αποτέλεσαν επιγραφές-κυρίως τιμητικά ψηφίσματα. Το επιγραφικό υλικό αντλήθηκε-βασικά-μέσα από την ηλεκτρονική/ διαδικτυακή πλατφόρμα/βάση επιγραφικών δεδομένων του The Packard Humanities Institute-Project Centers Cornell University & Ohio State University https:// epigraphy. packhum.org., καθώς και από μια σειρά σχετικών συλλογών και έργων (ενδεικτικά Supplementum Epigraphicum Graecum-SEG, κ.ά.). Ακόμη, αξιοποιήθηκαν πληροφορίες από έργα τέχνης, αρχαιολογικές μαρτυρίες, γραμματειακές πηγές, καθώς και από σύγχρονες μελέτες. Αρχικά μελετήθηκαν (79) εβδομήντα εννιά επιγραφές και από αυτές επιλέχθηκαν-με τη μέθοδο της σκόπιμης δειγματοληψίας-(19) δεκαεννιά, από τις παρακάτω πόλεις: Μύλασα, Αφροδισιάδα, Ιασό, Πριήνη, Ερυθρές, Φιλαδέλφεια, Σάρδεις, Απολλωνίδα, Πέργαμον. Μεθοδολογικά, χρησιμοποιήθηκαν-κατά βάσιν και συνδυαστικά-ο περιγραφικός και ο επεξηγηματικός/ερμηνευτικός τύπος ιστορικής έρευνας στη Φυσική Αγωγή, ενώ κατά περίσταση αξιοποιήθηκαν (και) η φιλοσοφική μέθοδος (στη Φυσική Αγωγή), καθώς και ερευνητικές προσεγγίσεις της κοινωνικής ιστορίας και της ιστορίας των εννοιών. Τα αποτελέσματα της έρευνας διακρίθηκαν σε ποσοτικό και ποιοτικό επίπεδο. Σε πρώτο επίπεδο (ποσοτικό) καταγράφηκαν αριθμητικά οι αναφορές που βρέθηκαν στο επιγραφικό υλικό σχετικά με: α) τα διδακτικά/ εκπαιδευτικά αντικείμενα, β) τους αξιωματούχους (Γυμνασίων-Εφηβείας), γ) το αγωνιστικό/ανταγωνιστικό στοιχείο (θεσμική/λειτουργική παρουσία και παιδευτική αξία) και δ) την καλοκαγαθία (παιδευτικό και πολιτειακό-κοινωνικοπολιτικό ιδανικό). Σε δεύτερο επίπεδο αναλύθηκαν τα ποιοτικά χαρακτηριστικά και η σημασιολογική βαρύτητα-το «ειδικό βάρος» των παραπάνω δομικών αξόνων της έρευνας, σε σχέση (και) με το ευρύτερο κοινωνικοπολιτικό πλαίσιο. Συμπερασματικά, μπορεί να ειπωθεί πως ο προσανατολισμός της παιδείας στα Γυμνάσια της Μ.Ασίας τον 1ο αι. π.Χ., φαίνεται να διατηρεί τα βασικά χαρακτηριστικά του αρχαιοελληνικού πρότυπου παίδευσης (ολόπλευρη σωματική, διανοητική και κοινωνικοπολιτική παιδεία, αγώνας, καλοκαγαθία) με κάποιες όμως διαφοροποιήσεις. Η σωματική εκπαίδευση-οι αθλητικές δραστηριότητες και οι στρατιωτικές ασκήσεις-συνυπάρχουν με τη διανοητική παιδεία, καθώς και με την ηθική αγωγή. Παρόλα ταύτα όμως φαίνεται να προκρίνονται-αξιολογικά-έναντι των άλλων η διανοητική παιδεία και η ηθική και κοινωνικοπολιτική αγωγή. Το πρότυπο του φιλομαθούς/πολυμαθούς και ενάρετου νέου που είναι έτοιμος να υπηρετήσει την πατρίδα του-κυρίως-σε πολιτικό/διπλωματικό επίπεδο είναι μάλλον κυρίαρχο.