bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of early versus delayed rehabilitation following total shoulder replacement: A systematic review
Authors: Moffatt Maria , Whelan Gareth , Gill Peter , Mazuquin Bruno , Edwards Peter , Peach Chris , Davies Ronnie , Morgan Marie , Littlewood Chris
Published: November 2021

Objective

To investigate the effectiveness of early versus delayed rehabilitation following total shoulder replacement.

Design

Intervention systematic review with narrative synthesis.

Literature search

MEDLINE, EMBASE, CINAHL, Scopus and the Cochrane Library were searched from inception to the 29th of July 2021.

Study selection criteria

Randomised controlled trials comparing early versus delayed rehabilitation following primary anatomic, primary reverse, or revision total shoulder replacement.

Data synthesis

A revised Cochrane risk of bias assessment tool for randomised controlled trials was used, as well as the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the quality of evidence. A narrative synthesis was undertaken.

Results

Three eligible randomised controlled trials ( n = 230) were included. There was very low-quality evidence of no statistically significant difference ( P > 0.05) in pain, shoulder function, health-related quality of life or lesser tuberosity osteotomy healing at 12 months between early or delayed rehabilitation. There was conflicting and very low-quality evidence of a difference between the effect of early and delayed rehabilitation on shoulder range of movement. There was limited, very low-quality evidence of statistically significantly improved pain and function ( P < 0.05) in the early post-operative period with early rehabilitation following anatomic total shoulder replacement.

Conclusions

No differences were seen in patient-reported or clinician-reported outcomes at 12 months post-surgery between early and delayed rehabilitation following total shoulder replacement. There is very low-quality evidence that early rehabilitation may improve shoulder pain and function in the early post-operative phase following anatomic total shoulder replacement.
An assessment of health information literacy among women in rural Lake Zone, Tanzania
Authors: Kassim Mohamed , Ndumbaro Faraja
Published: November 2021

This article presents the results from a descriptive cross-sectional survey that was conducted to assess the health information literacy skills of women of childbearing age in rural Lake Zone, Tanzania. A total of 349 women were involved in the study. The study found that most rural women in the study area have low levels of health information literacy. The aggregate scores of health information literacy indicate a mean of 42.86% with a normal distribution curve, and estimated close-to-zero skewness (0.172) and kurtosis (−0.297) measures. The causal relationships between health information literacy and women’s socio-demographic factors indicate a positive and statistically significant effect ( p < .01) of women’s level of education, income, ownership of means of communication and access to health facilities on their level of health information literacy. The women’s inadequate ability to access, read, understand, appraise and use health information is a barrier to their acquisition of relevant health information. Enhancing the health information literacy skills of these women is most likely to improve their health outcomes.
Novel poly(arylene ether nitrile) containing pendant aliphtatic ring in the chain: Synthesis and properties
Authors: Luo Shajie , Ren Fajian , Dai Jiangang , Chen Yan , Yang Zhongzhu
Published: November 2021

Two kinds of novel poly(arylene ether nitrile)s (CPDP-DCBN and CHDP-DCBN) containing pendant aliphtatic ring were synthesized by 4,4′-cyclopentane-1,1′-diyldiphenol (CPDP) or 4,4′-cyclohexane-1,1′-diyldiphenol (CHDP) and 2,6-dichlorobenzonitrile (DCBN) in this work. The inherent viscosities of poly(arylene ether nitrile)s (PENs) were in the range of 0.701–0.806 dL g−1. The polymers showed high glass transition temperatures ( T g) of 185.4–196.4°C and weight-loss temperatures ( T5%) of 447.8–454.3°C. The obtained CPDP-DCBN and CHDP-DCBN could be hot pressed into the films, which showed the tensile strengths of 82.6 MPa and 86.8 MPa, respectively. And the storage modulus of CPDP-DCBN and CHDP-DCBN were about 1.0 GPa and 1.5 GPa at 150°C, respectively. Additionally, the PENs could be dissolved in many solutions at room temperature, such as NMP and concentrated H2SO4, indicating that they had good solubility; they can be processed by the solution method. Meanwhile, the optical transmittance of CPDP-DCBN was 78.1% at 450 nm; it has potential to be applied to the heat-resistant optical film.
The Impact of Parenting Styles on Subsequent Parenting Styles in Sons
Authors: Lawall Alexandra R. , Tram Jane M. , Kumar Nandita
Published: November 2021

Research indicates that there is continuity in both maladaptive ( Chen & Kaplan, 2004 ) and positive parenting from one generation to the next. Within the topic of parenting, intergenerational transmission of specific parenting styles, specifically, the intergenerational transmission of authoritarian, permissive, and authoritative parenting styles has received limited attention in the research. In addition, few researchers have examined the impact of parenting styles applied to specific family members. As such, this study examined whether certain types of parenting styles may be passed down from parent to son. Through an online questionnaire, ( N = 28) men indicated, retrospectively, how they were parented and how they raise (or would raise) their children. The results of this study indicate a positive correlation between sons being parented in an authoritarian or permissive manner and subsequent engagement in the same parenting style.
The equivalent resistance model of double-layer embroidered conductive lines on nonwoven fabric
Authors: Zhang Yaya , Hu Jiyong , Yan Xiong , Tu Huating
Published: November 2021

To reveal the engineering relationship among the electrical properties of embroidered conductive lines, the electrical properties and arrangements of conductive yarns, it is necessary to establish their equivalent resistance model. Embroidered conductive lines in textiles are usually fabricated by single-layer (conductive and nonconductive yarn used as upper and lower yarn) or double-layer embroidery technology (conductive yarns used as upper and lower yarn). Several researchers have proposed the simple resistance model for single-layer embroidered conductive line based on geometric structure of single conductive yarn in fabric. However, the double-layer conductive line has the contact resistance periodically interlaced by the upper and lower conductive yarns, and it made its equivalent circuit different from that of single-layer conductive line. In this work, a geometric model was built to describe the trace of conductive yarn in fabric, and in combination with Wheatstone Bridge theory, was applied to establish the equivalent resistance models of double-layer conductive lines with a certain width, consisted of various courses. First, the equivalent resistance model of double-layer conductive lines consisting of single course was proposed to calculate the contact resistance. Then, to obtain the electrical resistance of double-layer conductive lines with a certain width, the equivalent resistance model was extended from single course to multiple courses ([Formula: see text]). Finally, to validate the proposed equivalent resistance model, double-layer conductive lines with different embroidery parameters (stitch length and stitch spacing) on nonwoven fabric were fabricated and evaluated. The experimental results revealed that the proposed model accurately predicted the resistances of double-layer conductive lines.
Para-Sports can Promote Functional Reorganization in the Ipsilateral Primary Motor Cortex of Lower Limbs Amputee
Authors: Nakanishi Tomoya , Mizuguchi Nobuaki , Nakagawa Kento , Nakazawa Kimitaka
Published: November 2021

Background. Drastic functional reorganization was observed in the ipsilateral primary motor cortex (M1) of a Paralympic long jumper with a unilateral below-knee amputation in our previous study. However, it remains unclear whether long-term para-sports are associated with ipsilateral M1 reorganization since only 1 athlete with amputation was investigated. Objective. This study aimed to investigate the relationship between the long-term para-sports and ipsilateral M1 reorganization after lower limb amputation. Methods. Lower limb rhythmic muscle contraction tasks with functional magnetic resonance imaging and T1-weighted structural imaging were performed in 30 lower limb amputees with different para-sports experiences in the chronic phase. Results. Brain activity in the ipsilateral primary motor and somatosensory areas (SM1) as well as the contralateral dorsolateral prefrontal cortex, SM1, and inferior temporal gyrus showed a positive correlation with the years of routine para-sports participation (sports years) during contraction of the amputated knee. Indeed, twelve of the 30 participants who exhibited significant ipsilateral M1 activation during amputated knee contraction had a relatively longer history of para-sports participation. No significant correlation was found in the structural analysis. Conclusions. Long-term para-sports could lead to extensive reorganization at the brain network level, not only bilateral M1 reorganization but also reorganization of the frontal lobe and visual pathways. These results suggest that the interaction of injury-induced and use-dependent cortical plasticity might bring about drastic reorganization in lower limb amputees.
Using robotic toys in early childhood education to support children’s social and emotional competencies
Authors: Kewalramani Sarika , Palaiologou Ioanna , Dardanou Maria , Allen Kelly-Ann , Phillipson Sivanes
Published: November 2021

This Australian study examines whether and how technologies such as Artificially Intelligent (AI) toys in a home-based setting might socially and emotionally support children with diverse needs through play. Building on the concept of ‘emotional capital', and employing a design-based research approach, parents during the COVID-19 lockdown periods in 2020 intentionally used robotic toys to engage their children with additional diverse needs in home-based play experiences. The data from both parents’ and children’s ( n = 5) Zoom interviews, digital observations and children’s drawings demonstrated how children creatively conversed with their AI robots in innovative and empathy-based dialogues that generated happy feelings and a sense of ‘imaginary’ togetherness with their robot during the coding experiences. This study contributes to research by exploring the use of AI robotic toys together with physical and artificial environments and offers a case to build children’s emotional capital in enabling children’s social-emotional literacies.
Cuban Media During the Presidency of Raúl Castro: A Multidimensional Approach to Understanding Patterns of Change and Continuity in Media Systems
Authors: Olivera Pérez Dasniel , De Maio Mariana
Published: November 2021

This paper analyzes the relationship between media and politics in Cuba during the presidency of Raúl Castro (2006–2018). It contributes to the theoretical discussion about the approaches concerning change and continuity in media systems with empirical evidence from interviews with communication and political science experts, and an analysis of non-standardized content in academic, political, legal, and professional documents. The (re)structuring of the media system is explained by the most important political, economic, technological, and cultural events of the period studied: the survival of the Soviet media model, the impact of the U.S. conflict with Cuba on domestic politics, and a (de)territorialized notion of system boundaries. The patterns of change and continuity are discussed through the relationships among the State’s participation in media and the fulfillment of media’s democratic functions, the media policy projection and journalism cultures, and the political articulation of the media and development of the media industry. The articulations among these patterns highlight the relevance of a multidimensional approach as an interpretive dimension of media systems.
Endothelial eNAMPT drives EndMT and preclinical PH: rescue by an eNAMPT‐neutralizing mAb
Authors: Ahmed Mohamed , Zaghloul Nahla , Zimmerman Prisca , Casanova Nancy G. , Sun Xiaoguang , Song Jin H. , Hernon Vivian Reyes , Sammani Saad , Rischard Franz , Rafikova Olga , Rafikov Ruslan , Makino Ayako , Kempf Carrie L. , Camp Sara M. , Wang Jian , Desai Ankit A. , Lussier Yves , Yuan Jason X.‐J. , Garcia Joe G.N.
Published: November 2021

Pharmacologic interventions to halt/reverse the vascular remodeling and right ventricular dysfunction in pulmonary arterial hypertension (PAH) remains an unmet need. We previously demonstrated extracellular nicotinamide phosphoribosyltransferase (eNAMPT) as a DAMP (damage‐associated molecular pattern protein) contributing to PAH pathobiology via TLR4 ligation. We examined the role of endothelial cell (EC)‐specific eNAMPT in experimental PH and an eNAMPT‐neutralizing mAb as a therapeutic strategy to reverse established PH. Hemodynamic/echocardiographic measurements and tissue analyses were performed in Sprague Dawley rats exposed to 10% hypoxia/Sugen (three weeks) followed by return to normoxia and weekly intraperitoneal delivery of the eNAMPT mAb (1 mg/kg). WT C57BL/6J mice and conditional EC‐cNAMPTec−/− mice were exposed to 10% hypoxia (three weeks). Biochemical and RNA sequencing studies were performed on rat PH lung tissues and human PAH PBMCs. Hypoxia/Sugen‐exposed rats exhibited multiple indices of severe PH (right ventricular systolic pressure, Fulton index), including severe vascular remodeling, compared to control rats. PH severity indices and plasma levels of eNAMPT, IL‐6, and TNF‐α were all significantly attenuated by eNAMPT mAb neutralization. Compared to hypoxia‐exposed WT mice, cNAMPTec−/− KO mice exhibited significantly reduced PH severity and evidence of EC to mesenchymal transition (EndMT). Finally, biochemical and RNAseq analyses revealed eNAMPT mAb‐mediated rectification of dysregulated inflammatory signaling pathways (TLR/NF‐κB, MAP kinase, Akt/mTOR) and EndMT in rat PH lung tissues and human PAH PBMCs. These studies underscore EC‐derived eNAMPT as a key contributor to PAH pathobiology and support the eNAMPT/TLR4 inflammatory pathway as a highly druggable therapeutic target to reduce PH severity and reverse PAH.
A Glimpse into the “Black Box”: Which Elements of Consultation in an EBP are Associated with Client Symptom Change and Therapist Fidelity?
Authors: Mallard Swanson Kera , Song Jiyoung , Beristianos Matthew , Aajmain Syed , Lane Jeanine E.M. , Landy Meredith S.H. , Suvak Michael K. , Shields Norman , Monson Candice M. , Stirman Shannon Wiltsey
Published: November 2021

Background: Consultation is an implementation strategy that improves delivery and clinical outcomes for Cognitive Processing Therapy (CPT), an evidence-based practice (EBP) for posttraumatic stress disorder (PTSD). However, little is known about the specific components of consultation that influence the fidelity of treatment delivery or clinical outcomes. Methods: The current study examined whether specific activities performed during CPT consultation meetings were associated with better fidelity to the CPT protocol among 60 newly trained therapists or improved clinical outcomes among 135 clients treated by these therapists. Consultation activities that fall under three broad categories (discussion of the application of CPT to individual cases, review/feedback on fidelity, and technical difficulties) were measured by consultant checklists for each consultation session. Treatment fidelity (adherence to the protocol and competence of delivery) was rated by trained observers for a random sample of therapists’ CPT sessions following consultation. The self-reported PTSD Checklist-IV assessed PTSD symptom change. Results: Multilevel regression analyses indicated that higher therapist consultation attendance predicted a greater decrease in their clients’ PTSD symptoms and that attendance was not associated with observer-rated treatment fidelity. Discussion of the application of specific CPT strategies was the only consultation activity that was significantly associated with greater improvement in PTSD symptoms. Lastly, no consultation activities were significantly associated with treatment fidelity. Conclusions: Our findings suggest that specific consultation strategies such as emphasizing the discussion of the application of specific CPT strategies to individual cases during consultation meetings may be effective in improving the clinical outcomes of CPT.
Hemostatic and thrombotic disorders in the pediatric patient
Authors: O’Brien Sarah H. , Zia Ayesha
Published: November 2021

This review focuses on significant advances in the field of pediatric hemostasis and thrombosis, with a focus on published studies within the past decade. The evaluation and management of patients with excessive bleeding remain cornerstones of consultative hematology. We will describe the development of validated bleeding assessment tools relevant to pediatric practice, laboratory advances in the evaluation of von Willebrand disease, and a shift in clinical practice regarding the interpretation of normal coagulation studies in patients with significant bleeding phenotypes. There have also been critical advances in the management of hemostatic disorders. This review highlights new treatment paradigms in hemophilia and the rise of multidisciplinary medical homes for women living with bleeding disorders. Given the continued increase in the incidence of thrombosis, particularly in the hospital setting, a full call to arms against pediatric venous thromboembolism is now essential. We will describe recently completed clinical trials of direct oral anticoagulants in children and adolescents and ongoing work to elucidate the appropriate duration of therapy for children with provoked thrombosis. Recent work regarding the prevention of pediatric venous thromboembolism is highlighted, including studies of thromboprophylaxis and the development of risk prediction models for hospital-acquired thrombosis. Finally, we review advances in our understanding of thrombotic sequelae and the need for continued refinement of our evaluation tools. Despite the significant advances in pediatric hemostasis and thrombosis over the past decade, many unanswered questions remain for the next generation of investigators.
HLA associations, somatic loss of HLA expression, and clinical outcomes in immune aplastic anemia
Authors: Zaimoku Yoshitaka , Patel Bhavisha A. , Adams Sharon D. , Shalhoub Ruba , Groarke Emma M. , Lee Audrey Ai Chin , Kajigaya Sachiko , Feng Xingmin , Rios Olga Julia , Eager Holly , Alemu Lemlem , Quinones Raffo Diego , Wu Colin O. , Flegel Willy A. , Young Neal S.
Published: November 2021

Immune aplastic anemia (AA) features somatic loss of HLA class I allele expression on bone marrow cells, consistent with a mechanism of escape from T-cell–mediated destruction of hematopoietic stem and progenitor cells. The clinical significance of HLA abnormalities has not been well characterized. We examined the somatic loss of HLA class I alleles and correlated HLA loss and mutation-associated HLA genotypes with clinical presentation and outcomes after immunosuppressive therapy in 544 AA patients. HLA class I allele loss was detected in 92 (22%) of the 412 patients tested, in whom there were 393 somatic HLA gene mutations and 40 instances of loss of heterozygosity. Most frequently affected was HLA-B*14:02, followed by HLA-A*02:01, HLA-B*40:02, HLA-B*08:01, and HLA-B*07:02. HLA-B*14:02, HLA-B*40:02, and HLA-B*07:02 were also overrepresented in AA. High-risk clonal evolution was correlated with HLA loss, HLA-B*14:02 genotype, and older age, which yielded a valid prediction model. In 2 patients, we traced monosomy 7 clonal evolution from preexisting clones harboring somatic mutations in HLA-A*02:01 and HLA-B*40:02. Loss of HLA-B*40:02 correlated with higher blood counts. HLA-B*07:02 and HLA-B*40:01 genotypes and their loss correlated with late-onset of AA. Our results suggest the presence of specific immune mechanisms of molecular pathogenesis with clinical implications. HLA genotyping and screening for HLA loss may be of value in the management of immune AA. This study was registered at clinicaltrials.gov as NCT00001964, NCT00061360, NCT00195624, NCT00260689, NCT00944749, NCT01193283, and NCT01623167.
Mid-pass whole genome sequencing enables biomedical genetic studies of diverse populations
Authors: Emde Anne-Katrin , Phipps-Green Amanda , Cadzow Murray , Gallagher C. Scott , Major Tanya J. , Merriman Marilyn E. , Topless Ruth K. , Takei Riku , Dalbeth Nicola , Murphy Rinki , Stamp Lisa K. , de Zoysa Janak , Wilcox Philip L. , Fox Keolu , Wasik Kaja A. , Merriman Tony R. , Castel Stephane E.
Published: November 2021

Background

Historically, geneticists have relied on genotyping arrays and imputation to study human genetic variation. However, an underrepresentation of diverse populations has resulted in arrays that poorly capture global genetic variation, and a lack of reference panels. This has contributed to deepening global health disparities. Whole genome sequencing (WGS) better captures genetic variation but remains prohibitively expensive. Thus, we explored WGS at “mid-pass” 1-7x coverage.

Results

Here, we developed and benchmarked methods for mid-pass sequencing. When applied to a population without an existing genomic reference panel, 4x mid-pass performed consistently well across ethnicities, with highc recall (98%) and precision (97.5%).

Conclusion

Compared to array data imputed into 1000 Genomes, mid-pass performed better across all metrics and identified novel population-specific variants with potential disease relevance. We hope our work will reduce financial barriers for geneticists from underrepresented populations to characterize their genomes prior to biomedical genetic applications.
COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort
Authors: Jewell Paul D. , Bramham Kate , Galloway James , Post Frank , Norton Sam , Teo James , Fisher Richard , Saha Rohit , Hutchings Sam , Hopkins Phil , Smith Priscilla , Joslin Jennifer , Jayawardene Satish , Mackie Sarah , Mudhaffer Ali , Holloway Amelia , Kibble Henry , Akter Mosammat , Zuckerman Benjamin , Palmer Kieran , Murphy Ciara , Iatropoulou Domniki , Sharpe Claire C. , Lioudaki Eirini
Published: November 2021

Background

Acute kidney injury (AKI) is common among patients hospitalised with COVID-19 and associated with worse prognosis. The aim of this study was to investigate the epidemiology, risk factors and outcomes of AKI in patients with COVID-19 in a large UK tertiary centre.

Methods

We analysed data of consecutive adults admitted with a laboratory-confirmed diagnosis of COVID-19 across two sites of a hospital in London, UK, from 1st January to 13th May 2020.

Results

Of the 1248 inpatients included, 487 (39%) experienced AKI (51% stage 1, 13% stage 2, and 36% stage 3). The weekly AKI incidence rate gradually increased to peak at week 5 (3.12 cases/100 patient-days), before reducing to its nadir (0.83 cases/100 patient-days) at the end the study period (week 10). Among AKI survivors, 84.0% had recovered renal function to pre-admission levels before discharge and none required on-going renal replacement therapy (RRT). Pre-existing renal impairment [odds ratio (OR) 3.05, 95%CI 2.24–4,18;p <  0.0001], and inpatient diuretic use (OR 1.79, 95%CI 1.27–2.53;p <  0.005) were independently associated with a higher risk for AKI. AKI was a strong predictor of 30-day mortality with an increasing risk across AKI stages [adjusted hazard ratio (HR) 1.59 (95%CI 1.19–2.13) for stage 1;p < 0.005, 2.71(95%CI 1.82–4.05);p < 0.001for stage 2 and 2.99 (95%CI 2.17–4.11); p < 0.001for stage 3]. One third of AKI3 survivors (30.7%), had newly established renal impairment at 3 to 6 months.

Conclusions

This large UK cohort demonstrated a high AKI incidence and was associated with increased mortality even at stage 1. Inpatient diuretic use was linked to a higher AKI risk. One third of survivors with AKI3 exhibited newly established renal impairment already at 3–6 months.
Pathological post-obstructive diuresis following obstructive uropathy due to constipation in the post-partum period: a case report
Authors: Rishard Mohamed , Kossinna Thalagala Kossinnage Maheeka , Latiff Mohamed Nazar , De Silva Susantha , Asmath Mohamed Hilmy Mohamed
Published: November 2021

Background

Constipation during pregnancy is not uncommon. Usually, this does not warrant extensive evaluation and settles with minor interventions or lifestyle modifications. Severe fecal impaction in chronically constipated patients can rarely lead to obstructive uropathy. Relief of obstruction can result in a diuretic phase which may be self-limiting or pathological. However, occurrence of pathological post-obstructive diuresis as a result of severe constipation is an extremely rare complication during pregnancy and puerperium which can even be fatal if not promptly diagnosed and adequately monitored and timely intervened. We describe the management of a pathological post-obstructive diuresis which occurred in the immediate postpartum period after treatment of severe constipation and obstructive uropathy.

Case presentation

A woman who had undergone an emergency caesarean section due to deep transverse arrest 1 week ago, presented with fecal impaction and anuria. On relief of urinary obstruction which had developed secondary to fecal impaction, she developed pathological post-obstructive diuresis. Careful and timely monitoring with exact fluid replacement, correction of electrolyte imbalances and multidisciplinary care ensured complete recovery of the patient.

Conclusions

Despite obstructive uropathy being uncommon in obstetric practice, clinicians need to have a high index of suspicion to monitor and promptly manage the potentially life-threatening condition of post-obstructive diuresis in pregnant and puerperal women undergoing urinary tract decompression. Due to unreliability of laboratory cutoff values in pregnancy and puerperium, a more vigilant and multidisciplinary approach with lower threshold for intervention is more prudent in the management of these patients.
A neural network for glomerulus classification based on histological images of kidney biopsy
Authors: Cascarano Giacomo Donato , Debitonto Francesco Saverio , Lemma Ruggero , Brunetti Antonio , Buongiorno Domenico , De Feudis Irio , Guerriero Andrea , Venere Umberto , Matino Silvia , Rocchetti Maria Teresa , Rossini Michele , Pesce Francesco , Gesualdo Loreto , Bevilacqua Vitoantonio
Published: November 2021

Background

Computer-aided diagnosis (CAD) systems based on medical images could support physicians in the decision-making process. During the last decades, researchers have proposed CAD systems in several medical domains achieving promising results.

CAD systems play an important role in digital pathology supporting pathologists in analyzing biopsy slides by means of standardized and objective workflows. In the proposed work, we designed and tested a novel CAD system module based on image processing techniques and machine learning, whose objective was to classify the condition affecting renal corpuscles (glomeruli) between sclerotic and non-sclerotic. Such discrimination is useful for the biopsy slides evaluation performed by pathologists.

Results

We collected 26 digital slides taken from the kidneys of 19 donors with Periodic Acid-Schiff staining. Expert pathologists have conducted the slides preparation, digital acquisition and glomeruli annotations. Before setting the classifiers, we evaluated several feature extraction techniques from the annotated regions. Then, a feature reduction procedure followed by a shallow artificial neural network allowed discriminating between the glomeruli classes.

We evaluated the workflow considering an independent dataset (i.e., processing images not used in the training procedure). Ten independent runs of the training algorithm, and evaluation, allowed achieving MCC and Accuracy of 0.95 (± 0.01) and 0.99 (standard deviation < 0.00), respectively. We also obtained good precision (0.9844 ± 0.0111) and recall (0.9310 ± 0.0153).

Conclusions

Results on the test set confirm that the proposed workflow is consistent and reliable for the investigated domain, and it can support the clinical practice of discriminating the two classes of glomeruli. Analyses on misclassifications show that the involved images are usually affected by staining artefacts or present partial sections due to slice preparation and staining processes. In clinical practice, however, pathologists discard images showing such artefacts.
How staff characteristics influence residential care facility staff’s attitude toward person-centered care and informal care
Authors: Boumans Jogé , van Boekel Leonieke , Kools Nathalie , Scheffelaar Aukelien , Baan Caroline , Luijkx Katrien
Published: November 2021

Background

Staff members, and their attitudes, are crucial for providing person-centered care in residential care facilities for people with dementia. However, the literature on the attitudes of nursing staff regarding person-centered care is limited. The objective of this study is to explore the association between staff characteristics (age, education level, years of work experience and function, i.e., care or welfare) and staff attitudes toward perceived person-centered care provision and including informal caregivers in the caregiving process in residential care facilities.

Methods

A convenience sample of 68 care staff – nurses and nurse assistants - welfare staff members – activity counselors, hostesses, and living room caretakers - of two residential care facilities filled out a questionnaire. Staff attitudes regarding perceived person-centered care were measured with the Person-centered Care Assessment Tool (P-CAT). Staff attitudes regarding informal care provision were measured with the Attitudes Toward Families Checklist (AFC). Multiple linear regression analysis explored the association between variables age, work experience, education, and function (care or welfare).

Results

A higher age of staff was associated with a more negative attitude toward perceived person-centered care and informal care provision. Welfare staff had a more negative attitude toward the inclusion of informal caregivers than care staff. The perceived person-centered care provision of the care and welfare staff was both positive. Work experience and education were not associated with perceived person-centered care provision or informal care provision.

Conclusion

This study is one of the first to provide insight into the association between staff characteristics and their attitude toward their perceived person-centered care provision and informal care provision. A higher age of both the care and welfare staff was associated with a more negative attitude toward their perceived person-centered care and informal care provision. Welfare staff had a less positive attitude toward informal care provision. Additionally, future studies, also observational studies and interview studies, are necessary to collect evidence on the reasons for negative attitudes of older staff members towards PCC and informal care giving, to be able to adequately target these reasons by implementing interventions that eliminate or reduce these negative attitudes.
Safety and effectiveness of switching to Abacavir/Lamivudine plus rilpivirine for maintenance therapy in virologically suppressed HIV-1 individuals in Singapore (SEALS)
Authors: Lim Z. C. , Hoo G. S. , Ang J. H. , Teng C. B. , Ang L. W. , Lee C. C. , Leo Y. S. , Law H. L. , Ng O. T. , Wong C. S.
Published: November 2021

Background

The efficacy and tolerability of an antiretroviral regimen are important considerations for selection of HIV-1 infection maintenance therapy. Abacavir/lamivudine plus rilpivirine (ABC/3TC + RPV) has been shown in international studies to be effective and well-tolerated in virologically suppressed individuals. This study evaluated the effectiveness and safety of switching to ABC/3TC + RPV as maintenance therapy in virologically suppressed HIV-1 infected individuals in Singapore.

Methods

In this retrospective, single-centre study, we included individuals who were prescribed ABC/3TC + RPV, had HIV-1 viral load (VL) < 50 copies/ml immediately pre-switch, and had no documented history of resistance mutations or virologic failure to any of the components. The follow-up period was 48 ± 12 weeks. The primary outcome was the proportion of individuals who maintained virologic suppression of HIV-1 VL < 50 copies/ml at the end of follow-up period based on on-treatment analysis. The secondary outcomes were the resistance profiles associated with virologic failure, changes in immunologic and metabolic parameters, and the safety profile of ABC/3TC + RPV.

Results

A total of 222 individuals were included in the study. The primary outcome was achieved in 197 individuals [88.8%, 95% confidence interval: 83.7–92.4%]. There were 21 individuals (9.5%) who discontinued treatment for non-virologic reasons. The remaining 4 individuals experienced virologic failure, of whom, 3 of these individuals had developed emergent antiretroviral resistance and had HIV-1 VL > 500 copies/ml at the end of the 48 ± 12 weeks follow-up period. The remaining individual experienced sustained low level viremia and subsequently achieved viral suppression without undergoing resistance testing. A total of 49 adverse events were observed in 31 out of 222 individuals (14.0%), which led to 13 individuals discontinuing therapy. Neuropsychiatric adverse events were most commonly observed (53.1%). A statistically significant increase in CD4 was observed (p < 0.01), with a median absolute change of 31 cells/uL (interquartile range: − 31.50 to 140.75). No significant changes in lipid profiles were detected.

Conclusion

ABC/3TC + RPV is a safe and effective switch option for maintenance therapy in virologically suppressed HIV-1 individuals with in Singapore.
Assessment of the learning curve of video-assisted thoracoscopic sympathectomy in a single neurosurgical trainee: a cumulative summation analysis
Authors: Alkosha Hazem M. , Elkiran Yasser M.
Published: November 2021

Background

Video-assisted thoracoscopic sympathectomy (VATS) is a common procedure unusually practiced by neurosurgeons due to lack of training.

Objective

To evaluate the learning curve for VATS in a young neurosurgeon with no previous experience in open sympathectomy techniques or extracranial endoscopic procedures.

Methods

This is a retrospective review and analysis of prospectively collected data in 50 consecutive cases admitted to our facility with the diagnosis of essential palmar and axillary hyperhidrosis operated by a neurosurgical trainee under strict supervision of 2 experienced mentors. After an initial training phase, cumulative sum mation (CUSUM) analysis was used to evaluate the surgical performance of the trainee in terms of operating time, blood loss, hospital stay and failures.

Results

Improvement in operating time was noticed after the first 20 cases with significant affection by changes in OR team. The blood loss was significantly improved after the first 10 cases with less sensitivity to changes in OR team. Hospital stay and failures were steady and within expected values throughout the study.

Conclusion

An average of 20 cases may be enough for a neurosurgeon with basal knowledge to attain technical competence in VATS sympathectomy. Mentored surgical training on VATS sympathectomy is a safe and effective training method with failures within expected limits. The experience of the OR team plays an important role in the rapid improvement and consistency of performance.
The use of GnRH analogs in preserving ovarian function during chemotherapy
Authors: Odeh Omar M. , Awwad Johnny , Khalife Dalia , Ghunaim Suleiman
Published: November 2021

Background

The literature has always been controversial on the use of gonadotropin-releasing hormone agonists in preserving fertility in women of childbearing age after chemotherapy; thereby, in this article, we will be discussing its use in preserving fertility.

Main body of abstract

When it comes to preserving fertility, it is crucial to consider all available options in this topic due to its very sensitive nature, thereby we have found that while a lot of trials favor the use of gonadotropin-releasing hormone agonists, the lack of proper follow-up and long-term trials renders its use highly debatable, and since the longest follow-up trial showed non-significant results, it also opens the floor for debate on whether this short-term benefit is worth adding another drug to the regimen or not.

Short conclusion

As described in this review, while the use of gonadotropin-releasing hormone agonists is beneficial in a lot of studies, the lack of long-term reports still makes its use debatable, thereby more trials should be done.
Reviewing cancer’s biology: an eclectic approach
Authors: Diori Karidio Ibrahim , Sanlier Senay Hamarat
Published: November 2021

Background

Cancer refers to a group of some of the worldwide most diagnosed and deadliest pathophysiological conditions that conquered researchers’ attention for decades and yet begs for more questions for a full comprehension of its complex cellular and molecular pathology.

Main body

The disease conditions are commonly characterized by unrestricted cell proliferation and dysfunctional replicative senescence pathways. In fact, the cell cycle operates under the rigorous control of complex signaling pathways involving cyclins and cyclin-dependent kinases assumed to be specific to each phase of the cycle. At each of these checkpoints, the cell is checked essentially for its DNA integrity. Genetic defects observed in these molecules (i.e., cyclins, cyclin-dependent kinases) are common features of cancer cells. Nevertheless, each cancer is different concerning its molecular and cellular etiology. These could range from the genetic defects mechanisms and/or the environmental conditions favoring epigenetically harbored homeostasis driving tumorigenesis alongside with the intratumoral heterogeneity with respect to the model that the tumor follows.

Conclusions

This review is not meant to be an exhaustive interpretation of carcinogenesis but to summarize some basic features of the molecular etiology of cancer and the intratumoral heterogeneity models that eventually bolster anticancer drug resistance for a more efficient design of drug targeting the pitfalls of the models.
Realization of the key aspects of the right to adequate housing in affordable housing programs in Egypt
Authors: Hafez Nahla Mahmoud , Kamel Rowaida Reda , Elsherif Doaa Mahmoud , Nasreldin Rania Ibrahim
Published: November 2021

The realization of the right to adequate housing is a critical issue that countries seek to achieve through affordable housing projects. However, there is a discrepancy in fulfilling the right to adequate housing between countries, which has surfaced the dilemma of defining adequate housing. In this respect, scanning relevant literature figured out seven key aspects to meet the right to adequate housing. Using a questionnaire launched to experts in the field, they figured out to what extent the seven aspects have been realized in the affordable housing programs in Egypt. The results showed a significant percentage of realization of the seven key aspects of the right to adequate housing. The findings showed an apparent variation in the completion of the seven key aspects, which decision-makers can improve at different scales with the progression of the programs. Future research can build on this direction to consider aspects like accessibility and cultural adequacy of these programs.
Geophysics Bright Spots
Authors: Behura Jyoti
Published: November 2021

Welcome to the latest installment of Geophysics Bright Spots. There are a number of interesting research articles in the latest issue of Geophysics. Here is a list of what piqued the editors' interests.
Analysis on Material Characteristics of Restored Areas with Mortar and Basis of Surface Deterioration on the Stupa of State Preceptor Jigwang from Beopchensaji Temple Site in Wonju, Korea
Authors: Chae Seung A , Cho Ha Jin , Lee Tae Jong
Published: November 2021

The Stupa of State Preceptor Jigwang from Beopcheonsa Temple Site in Wonju (National Treasure) is a representative stupa of the Goryeo Dynasty, with outstanding Buddhist carvings and splendid patterns, clearly indicating its honoree and year of construction. However, it was destroyed by bombing during the Korean War (1950-1953) and repaired and restored with cement and reinforcing bars in 1957. The surface condition of the original stone shows long-term deterioration due to the m ortar used in past restorations. In order to identify the exact causes of deterioration, the m ortar and surface contaminants on the original stone were analyzed. Portlandite, calcite, ettringite, and gypsum from the mortar were identified, and its ongoing deterioration was observed through pH measurements and the neutralization reaction test. Analysis of surface contaminants identified calcite and gypsum, both poorly water-soluble substances, and their growth in volume among rock-forming minerals was observed by microscopy. Based on those results, semi-quantitative analysis of Ca and S contents significantly influencing the formation of salt crystals was conducted using P-XRF to analyze the basis of surface deterioration, and cross-validation was performed by comparing the body stone affected by the mortar and the upper stylobate stone unaffected by the mortar. Results indicate that the elements are directly involved in the surface deterioration of the body stone.
Conservation Treatment on the Bamboo Sunblind from the No. 1 Catchment Site in Baesanseongji, Busan
Authors: Park Ji Hyeon , Park Jung Hae , Lee Kwang Hee , Seo Yeon Ju , Park Jung Wook , Kim Soo Chul
Published: November 2021

In the present study, safe management and value improvement of bamboo sunblind, which is an item of cultural heritage, were performed by adopting stable conservation treatment methods. The bamboo sunblind used in the present study was excavated from No. 1 catchment site in Baesanseongji, Busan. It was determined that the main material used to make the sunblind was bamboo, and herbal plants were used to weave the bamboo using lacquer as an adhesive agent. All contaminants and soil adhered to the sunblind was removed. Thereafter, the sunblind, which was recovered in the form of blocks, was washed separately after fixing it to a temporary plaster frame and to avoid the blocks from breaking during washing. Then, polyethylene glycol (PEG) impregnation was utilized for the reinforcement treatment. Based on the preliminary test results, the shape of the sunblind was fixed using a stainless-steel frame to prevent physical damage that may occur during the drying process. Thereafter, the bamboo sunblind was vacuum freeze-dried. PEG 20% (in ethyl alcohol) was applied as a surface treatment agent for stabilization the sunblind. After the surface treatment, the bamboo sunblind were joined together to fit the maximum width, and the rectangular shape of the sunblind was restored—as best as possible—while filling in the missing parts by maximizing the use of unknown members such as in the disturbed layers below bamboo sunblind surface. The conservation treatment was completed by fixing the bamboo sunblind into the fabricated frame.
Οι πολλαπλές όψεις της θρησκευτικότητας και του ιερού στο έργο της ελληνικής εικαστικής πρωτοπορίας
Authors: Στεργίου Άννα
Published: November 2021

Η διενεργούμενη έρευνα κινείται μεταξύ τέχνης, θεολογίας και ανθρωπολογίας, επιζητώντας νέες νοηματοδοτήσεις και αποτυπώσεις των εννοιών της θρησκευτικότητας, του ιερού και του βέβηλου σε μια απομαγεμένη εποχή. Η καλλιτεχνική πρακτική προσεγγίζεται ως mysterium fascinosum et tremendum, ως αυτού δηλαδή που προκαλεί ταυτόχρονα έλξη και φόβο καθώς αποτυπώνει το αόρατο, το άκτιστο αλλά και το κτιστό (ως βεβηλωμένη κτίση). Το κύριο αντικείμενο του προβληματισμού, περιστρέφεται γύρω από́ την έννοια της «κρυπτοθρησκευτικής συμπεριφοράς» στο εκκοσμικευμένο γίγνεσθαι, η οποία συνεπάγεται ακολούθως την διατύπωση και τον ορισμό της «κρυπτοθρησκευτικής τέχνης» μέσα από παραδείγματα της διεθνούς εικαστικής σκηνής. Δίνεται ιδιαίτερη έμφαση στο έργο σύγχρονων Ελλήνων καλλιτεχνών όπως η Αθηνά Τάχα, ο Νίκος Αλεξίου, η Αιμιλία Παπαφιλίππου, ο Δημήτρης Αληθεινός, ο Μάριος Σπηλιόπουλος, η Μπία Ντάβου, ο Πάνος Χαραλάμπους, ο Στάθης Λογοθέτης, ο Κωστής Τριανταφύλλου. Τα έργα μελετώνται σε συνάρτηση με το ευρύτερο πλαίσιο ιδεών που επικρατούν στην ελληνική και διεθνή κουλτούρα και είτε συνειρμικά μέσα από τον τίτλο, είτε μέσα από την επιλογή υλικού και συμβόλου ή από την επιλογή τόπου δράσης παραπέμπουν στις προειρημένες έννοιες. Μέσα από συγκεκριμένα έργα της ελληνικής πρωτοπορίας θα παρακολουθήσουμε την εξέλιξη της θρησκευτικής αναφοράς των καλλιτεχνών.
Νεολογικά αθησαύριστα στην ΟΔΥΣΕΙΑ του Νίκου Καζαντζάκη
Authors: Μαθιουδάκης Νικόλαος
Published: November 2021

Η παρούσα διατριβή ασχολείται με τις στρατηγικές κατανόησης της ποιητικής γλώσσας της ΟΔΥΣΕΙΑΣ του Καζαντζάκη, προκειμένου να εντοπιστούν, όσο είναι δυνατό, οι μέθοδοι που ακολουθεί ο εκάστοτε αναγνώστης για να αποκωδικοποιήσει τη σημασία άγνωστων λέξεων, διευκολύνοντας κατ’ αυτόν τον τρόπο την κατανόηση του κειμένου, που είναι και ο κύριος σκοπός της διδασκαλίας της λογοτεχνίας. Επιπλέον, σκοπό της παρούσας έρευνας αποτελεί ο εντοπισμός των διαφορετικών παραγόντων, συμπεριλαμβανομένων ενδογλωσσικών, εξωγλωσσικών, ψυχολογικών και κοινωνικών, που μπορεί να επηρεάσουν αυτή τη διαδικασία και να διερευνηθούν πιθανές μέθοδοι για καλύτερη αντιμετώπιση. Εξαιτίας της εγγενούς ασάφειας και υποκειμενικότητας που ενυπάρχουν σε ένα λογοτεχνικό κείμενο, η μελέτη των στρατηγικών ανάγνωσης και κατανόησης αποτελεί πραγματική πρόκληση από γλωσσολογική άποψη, αφού χρήζει ειδικής μελέτης ώστε να αναδειχθούν τα βασικά χαρακτηριστικά και τα ιδιαίτερα γνωρίσματα ενός έργου, όπως η ΟΔΥΣΕΙΑ, που ουσιαστικά απαρτίζουν την ιδιοσυγκρασιακή προσωπική γραφή του Καζαντζάκη, η οποία εντάσσεται στο ευρύτερο θεωρητικό πλαίσιο των ποιητικών γραμματικών. Ιδιαίτερο ενδιαφέρον της ποιητικής γραμματικής του συγγραφέα παρουσιάζει ο εντοπισμός, η καταγραφή και ο προσδιορισμός των ποιητικών νεολογικών αθησαύριστων λέξεων, οι οποίες θα αποτελέσουν ουσιαστικά το γλωσσικό υλικό και το ερευνητικό εργαλείο. Η εμπειρική προσέγγιση της παρούσας εργασίας εξετάζει τη σχέση της ορθότητας και της βεβαιότητας σε φυσικούς ομιλητές (ΦΟ) της ελληνικής γλώσσας που ήταν φοιτητές και φοιτήτριες του πρώτου (Α΄) και του τέταρτου (Δ΄) έτους σπουδών στα τμήματα (ελληνικής) Φιλολογίας των πανεπιστημιακών ιδρυμάτων όλης της Ελλάδας. Τα υποκείμενα κλήθηκαν να μαντέψουν με ακρίβεια τη σημασία ορισμένων άγνωστων λέξεων που είναι ενσωματωμένες στο επικό ποίημα του Καζαντζάκη. Στη συνέχεια, έπρεπε να προσδιορίσουν τον βαθμό βεβαιότητάς τους για την ορθότητα των απαντήσεων τους σε ένα συνεχές [0,1], ουσιαστικά τέμνοντάς το σε οποιοδήποτε σημείο αισθάνονταν ότι δήλωνε τη βεβαιότητά τους τη στιγμή της απάντησης. Το συγκεκριμένο εργαλείο αποτελεί μια πρόταση των Vougiouklis & Kambaki-Vougioukli (2008, 2011), όπου υποστηρίζονται τα πλεονεκτήματα της χρήσης της ράβδου [0,1] έναντι της κλίμακας Likert. Βασική υπόθεση στην παρούσα έρευνα είναι ότι οι επικοινωνιακές στρατηγικές και ειδικότερα, η στρατηγική του ελεύθερου μαντέματος, μέσα από στοιχεία προερχόμενα από διαφορετικές πηγές, μπορούν να ενισχύσουν δραστικά τη διαδικασία της ανάγνωσης και κατανόησης ενός κειμένου, λογοτεχνικού ή μη. Φυσικά, προϋπόθεση είναι οι χρήστες να λάβουν την κατάλληλη εκπαίδευση, προκειμένου να αξιοποιούν οποιαδήποτε πηγή πληροφορίας έχουν στη διάθεσή τους, αφού πρώτα την αναγνωρίσουν, της δώσουν την αρμόζουσα προσοχή και να την επεξεργαστούν, εμπιστευόμενοι το κριτήριό τους, δηλαδή αποκτώντας ανάλογη βεβαιότητα των ικανοτήτων και των δυνατοτήτων τους, ανεπηρέαστοι από κοινωνικές προκαταλήψεις.