bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral presentation assessment and image reading behaviour on brain computed tomography reading in novice clinical learners: an eye-tracking study
Authors: Liu Chi-Hung , Hung June , Chang Chun-Wei , Lin John J. H. , Huang Elaine Shinwei , Wang Shu-Ling , Lee Li-Ang , Hsiao Cheng-Ting , Sung Pi-Shan , Chao Yi-Ping , Chang Yeu-Jhy
Published: October 2022

Background

To study whether oral presentation (OP) assessment could reflect the novice learners’ interpretation skills and reading behaviour on brain computed tomography (CT) reading.

Methods

Eighty fifth-year medical students were recruited, received a 2-hour interactive workshop on how to read brain CT, and were assigned to read two brain CT images before and after instruction. We evaluated their image reading behaviour in terms of overall OP post-test rating, the lesion identification, and competency in systematic image reading after instruction. Students’ reading behaviour in searching for the target lesions were recorded by the eye-tracking technique and were used to validate the accuracy of lesion reports. Statistical analyses, including lag sequential analysis (LSA), linear mixed models, and transition entropy (TE) were conducted to reveal temporal relations and spatial complexity of systematic image reading from the eye movement perspective.

Results

The overall OP ratings [pre-test vs. post-test: 0 vs. 1 in case 1, 0 vs. 1 in case 2, p < 0.001] improved after instruction. Both the scores of systematic OP ratings [0 vs.1 in both cases, p < 0.001] and eye-tracking studies (Case 1: 3.42 ± 0.62 and 3.67 ± 0.37 in TE, p = 0.001; Case 2: 3.42 ± 0.76 and 3.75 ± 0.37 in TE, p = 0.002) showed that the image reading behaviour changed before and after instruction. The results of linear mixed models suggested a significant interaction between instruction and area of interests for case 1 (p < 0.001) and case 2 (p = 0.004). Visual attention to the target lesions in the case 1 assessed by dwell time were 506.50 ± 509.06 and 374.38 ± 464.68 milliseconds before and after instruction (p = 0.02). However, the dwell times in the case 2, the fixation counts and the frequencies of accurate lesion diagnoses in both cases did not change after instruction.

Conclusion

Our results showed OP performance may change concurrently with the medical students’ reading behaviour on brain CT after a structured instruction.
Strengthening vaccination delivery system resilience in the context of protracted humanitarian crisis: a realist-informed systematic review
Authors: Ismail Sharif A. , Lam Sze Tung , Bell Sadie , Fouad Fouad M. , Blanchet Karl , Borghi Josephine
Published: October 2022

Background

Childhood vaccination is among the most effective public health interventions available for the prevention of communicable disease, but coverage in many humanitarian settings is sub-optimal. This systematic review critically evaluated peer-review and grey literature evidence on the effectiveness of system-level interventions for improving vaccination coverage in protracted crises, focusing on how they work, and for whom, to better inform preparedness and response for future crises.

Methods

Realist-informed systematic review of peer-reviewed and grey literature. Keyword-structured searches were performed in MEDLINE, EMBASE and Global Health, CINAHL, the Cochrane Collaboration and WHOLIS, and grey literature searches performed through the websites of UNICEF, the Global Polio Eradication Initiative (GPEI) and Technical Network for Strengthening Immunization Services. Results were independently double-screened for inclusion on title and abstract, and full text. Data were extracted using a pre-developed template, capturing information on the operating contexts in which interventions were implemented, intervention mechanisms, and vaccination-related outcomes. Study quality was assessed using the MMAT tool. Findings were narratively synthesised.

Results

50 studies were included, most describing interventions applied in conflict or near-post conflict settings in sub-Saharan Africa, and complex humanitarian emergencies. Vaccination campaigns were the most commonly addressed adaptive mechanism (n = 17). Almost all campaigns operated using multi-modal approaches combining service delivery through multiple pathways (fixed and roving), health worker recruitment and training and community engagement to address both vaccination supply and demand. Creation of collaterals through service integration showed generally positive evidence of impact on routine vaccination uptake by bringing services closer to target populations and leveraging trust that had already been built with communities. Robust community engagement emerged as a key unifying mechanism for outcome improvement across almost all of the intervention classes, in building awareness and trust among crisis-affected populations. Some potentially transformative mechanisms for strengthening resilience in vaccination delivery were identified, but evidence for these remains limited.

Conclusion

A number of interventions to support adaptations to routine immunisation delivery in the face of protracted crisis are identifiable, as are key unifying mechanisms (multi-level community engagement) apparently irrespective of context, but evidence remains piecemeal. Adapting these approaches for local system resilience-building remains a key challenge.
Medium development and production of carotenoids and exopolysaccharides by the extremophile Rhodothermus marinus DSM16675 in glucose-based defined media
Authors: Mukti Israt Jahan , Sardari Roya R. R. , Kristjansdottir Thordis , Hreggvidsson Gudmundur O. , Karlsson Eva Nordberg
Published: October 2022

Background

The marine thermophilic bacterium Rhodothermus marinus can degrade many polysaccharides which makes it interesting as a future cell factory. Progress using this bacterium has, however, been hampered by limited knowledge on media and conditions for biomass production, often resulting in low cell yields and low productivity, highlighting the need to develop conditions that allow studies of the microbe on molecular level. This study presents development of defined conditions that support growth, combined with evaluation of production of carotenoids and exopolysaccharides (EPSs) by R. marinus strain DSM 16675.

Results

Two defined media were initially prepared: one including a low addition of yeast extract (modified Wolfe’s medium) and one based on specific components (defined medium base, DMB) to which two amino acids (N and Q), were added. Cultivation trials of R. marinus DSM 16675 in shake flasks, resulted in maximum cell densities (OD620 nm) of 2.36 ± 0.057, cell dry weight (CDW) 1.2 ± 0.14 mg/L, total carotenoids 0.59 × 10–3 mg/L, and EPSs 1.72 ± 0.03 mg/L using 2 g/L glucose in DMB. In Wolfe’s medium (supplemented by 0.05 g/L yeast extract and 2.5 g/L glucose), maximum OD620 nm was 2.07 ± 0.05, CDW 1.05 ± 0.07 mg/L, total carotenoids 0.39 × 10–3 mg/L, and EPSs 1.74 ± 0.2 mg/L. Growth trials at 5 g/L glucose in these media either failed or resulted in incomplete substrate utilization. To improve reproducibility and increase substrate utilization, a screening of macroelements (e.g. phosphate) in DMB, was combined with use of trace elements and vitamins of the modified Wolfe’s medium. The resulting defined minimal R. marinus medium, (DRM), allowed reproducible cultivations to a final OD620nm of 6.6 ± 0.05, CDW 2.85 ± 0.07 mg/L, a maximum specific growth rate (µmax) of 0.26 h−1, total carotenoids 0.77 × 10–3 mg/L and EPSs 3.4 ± 0.17 mg/L in cultivations supplemented with up to 5 g/L glucose.

Conclusion

A minimal defined medium (DRM) was designed that resulted in reproducible growth and an almost doubled formation of both total carotenoids and EPSs. Such defined conditions, are necessary for systematic studies of metabolic pathways, to determine the specific requirements for growth and fully characterize metabolite production.
New anti-cancer explorations based on metal ions
Authors: Hu Han , Xu Qi , Mo Zhimin , Hu Xiaoxi , He Qianyuan , Zhang Zhanjie , Xu Zushun
Published: October 2022

Due to the urgent demand for more anti-cancer methods, the new applications of metal ions in cancer have attracted increasing attention. Especially the three kinds of the new mode of cell death, including ferroptosis, calcicoptosis, and cuproptosis, are of great concern. Meanwhile, many metal ions have been found to induce cell death through different approaches, such as interfering with osmotic pressure, triggering biocatalysis, activating immune pathways, and generating the prooxidant effect. Therefore, varieties of new strategies based on the above approaches have been studied and applied for anti-cancer applications. Moreover, many contrast agents based on metal ions have gradually become the core components of the bioimaging technologies, such as MRI, CT, and fluorescence imaging, which exhibit guiding significance for cancer diagnosis. Besides, the new nano-theranostic platforms based on metal ions have experimentally shown efficient response to endogenous and exogenous stimuli, which realizes simultaneous cancer therapy and diagnosis through a more controlled nano-system. However, most metal-based agents have still been in the early stages, and controlled clinical trials are necessary to confirm or not the current expectations. This article will focus on these new explorations based on metal ions, hoping to provide some theoretical support for more anti-cancer ideas.
Human resource needs and costs for HIV pre-exposure prophylaxis provision in nurse-led primary care in Eswatini and opportunities for task sharing﻿
Authors: Kohler Stefan , Dalal Shona , Hettema Anita , Matse Sindy , Bärnighausen Till , Paul Nicolas
Published: October 2022

Background

The global expansion of HIV pre-exposure prophylaxis (PrEP) includes health systems that face a shortage of skilled health care workers (HCWs). We estimated the human resource needs and costs for providing PrEP in nurse-led primary care clinics in Eswatini. Furthermore, we assessed potential cost savings from task sharing between nurses and other HCW cadres.

Methods

We conducted a time-and-motion and costing study in a PrEP demonstration project between August 2017 and January 2019. A form for recording time and performed activities (“motion”) was filled by HCWs of six primary care clinics. To estimate the human resource needs for specific PrEP activities, we allocated recorded times to performed PrEP activities using linear regression with and without adjusting for a workflow interruption, that is, if a client was seen by different HCWs or by the same HCW at different times. We assessed a base case in which a nurse provides all PrEP activities and five task shifting scenarios, of which four include workflow interruptions due to task sharing between different HCW cadres.

Results

On average, PrEP initiation required 29 min (95% CI 25–32) of HCW time and PrEP follow-up 16 min (95% CI 14–18). The HCW time cost $4.55 (uncertainty interval [UI] 1.52–9.69) for PrEP initiation and $2.54 (UI 1.07–4.64) for PrEP follow-up when all activities were performed by a nurse. Time costs were $2.30–4.25 (UI 0.62–9.19) for PrEP initiation and $1.06–2.60 (UI 0.30–5.44) for PrEP follow-up when nurses shared tasks with HCWs from lower cadres. Interruptions of the workflow added, on average, 3.4 min (95% CI 0.69–6.0) to the time HCWs needed for a given number of PrEP activities. The cost of an interrupted workflow was estimated at $0.048–0.87 (UI 0.0098–1.63) depending on whose time need increased.

Conclusions

A global shortage of skilled HCWs could slow the expansion of PrEP. Task shifting to lower-cadre HCW in nurse-led PrEP provision can free up nurse time and reduce the cost of PrEP provision even if interruptions associated with task sharing increase the overall human resource need.
Ankle strategy assistance to improve gait stability using controllers based on in-shoe center of pressure in 2 degree-of-freedom powered ankle–foot orthoses: a clinical study
Authors: Choi Ho Seon , Baek Yoon Su , In Hyunki
Published: October 2022

Background

Although the ankle strategy is important for achieving frontal plane stability during one-leg stance, previously developed powered ankle–foot orthoses (PAFOs) did not involve ankle strategies because of hardware limitations. Weakness of movement in frontal plane is a factor that deteriorates gait stability and increases fall risk so it should not be overlooked in rehabilitation. Therefore, we used PAFO with subtalar joint for frontal plane movement and tried to confirm that the existence of it is important in balancing through clinical experiments.

Methods

We developed a proportional CoP controller to assist ankle strategy or stabilizing moment and enhance eversion to compensate for the tilting moment with 2 dof PAFO. It was true experimental study, and we recruited seven healthy subjects (30 ± 4 years) who did not experience any gait abnormality participated in walking experiments for evaluating the immediate effect of subtalar joint of PAFO on their gait stability. They walked on the treadmill with several cases of controllers for data acquisitions. Indices of gait stability and electromyography for muscle activity were measured and Wilcoxon signed-rank tests were used to identify meaningful changes.

Results

We found that subjects were most stable during walking (in terms of largest Lyapunov exponents, p < 0.008) with the assistance of the PAFO when their electromyographic activity was the most reduced (p < 0.008), although postural sway increased when a proportional CoP controller was used to assist the ankle strategy (p < 0.008). Other indices of gait stability, kinematic variability, showed no difference between the powered and unpowered conditions (p > 0.008). The results of the correlation analysis indicate that the actuator of the PAFO enhanced eversion and preserved the location of the CoP in the medial direction so that gait stability was not negatively affected or improved.

Conclusions

We verified that the developed 2 dof PAFO assists the ankle strategy by compensating for the tilting moment with proportional CoP controller and that wearer can walk in a stable state when the orthosis provides power for reducing muscle activity. This result is meaningful because an ankle strategy should be considered in the development of PAFOs for enhancing or even rehabilitating proprioception.

Trial registration 7001988-202003-HR-833-03
Global prevalence of chronic fatigue syndrome among long COVID-19 patients: A systematic review and meta-analysis
Authors: Salari Nader , Khodayari Yassaman , Hosseinian-Far Amin , Zarei Hosna , Rasoulpoor Shabnam , Akbari Hakimeh , Mohammadi Masoud
Published: October 2022

Background

Chronic fatigue syndrome is a persistent and debilitating disorder. According to several studies, chronic fatigue syndrome has been identified among recovered COVID-19 patients as the most common symptom of long COVID. The aim of this systematic review and meta-analysis study was to obtain the prevalence of chronic fatigue syndrome in long COVID cases.

Methods

In this systematic review and meta-analysis, we analysed reported results of studies that assessed the occurrence of chronic fatigue syndrome among COVID-19 patients four weeks after the onset of symptoms. The study selection was commenced by searching PubMed, Web of Science, Science Direct, Scopus, Embase, and Google scholar using the keywords of Chronic fatigue syndrome, COVID-19, and post-COVID-19 syndrome. The searches were without a lower time limit and until April 2022. Heterogeneity of studies was assessed using the I2 index, and a random effects model was used for analysis. Data analysis was performed within the Comprehensive Meta-Analysis software (version 2).

Results

The pooled prevalence of chronic fatigue syndrome four weeks after the onset of COVID-19 symptoms, in 52 studies with a sample size of 127,117, was 45.2% (95% CI: 34.1-56.9%). Meta-regression analysis in examining the effects of the two factors of sample size, and year of study on the changes in the overall prevalence, showed that with increasing sample size, and year of study, the prevalence of chronic fatigue syndrome among long COVID patients (p < 0.05).

Conclusion

Our results show that the overall prevalence of chronic fatigue syndrome as a long COVID symptom is 45.2%. Chronic fatigue after infection with COVID-19 can negatively affect personal and social lives. Given such significant negative consequences caused by the syndrome, it is recommended that health policymakers allocate funds to reduce the adverse effects of this syndrome, by creating programs to support long COVID patients.
Smartphone-assisted guided self-help cognitive behavioral therapy for young people with distressing voices (SmartVoices): study protocol for a randomized controlled trial
Authors: Cavelti Marialuisa , Kaeser Janko M. , Lerch Stefan , Bauer Stephanie , Moessner Markus , Berger Thomas , Hayward Mark , Kaess Michael
Published: October 2022

Background

The long-standing view that auditory verbal hallucinations (AVH) or hearing voices is a sign of schizophrenia has been challenged by research demonstrating that they lie on a continuum ranging from normal to pathological experience related to distress and need for care. Hearing voices is more prevalent in adolescence than in later life, and hearing voices during adolescence indicates a risk for severe psychopathology, functional impairments, and suicide later in life. While there is increasing evidence for the efficacy of cognitive behavioral therapy for voices (CBTv) in adults with schizophrenia, research on psychological treatments for youth with distressing voices has been scarce. The aim of the current study is to examine the efficacy of CBTv, delivered using smartphone-based Ecological Momentary Assessment Intervention (EMI) in a transdiagnostic sample of youth.

Methods

This is a superiority randomized controlled trial comparing 8 weeks of CBTv-based EMI in addition to treatment as usual (TAU) versus TAU only. TAU covers both no treatment and any form of psychiatric/psychological treatment. In the EMI condition, participants will be prompted twice a day to complete an EMA survey, and receive one intervention proposal per assessment. One-hundred fifty-four youth aged 14–25 years with distressing voices will be recruited from psychiatric clinics, local private practices, internet forums, and advertisements in print and social media. Before and after the intervention phase, participants will undergo a 9-day EMA. Single-blinded assessments will be conducted at baseline (T0) and at 3-month (T1) and 6-month (T2) follow-up. The primary outcome is the distress dimension of the Auditory Hallucinations subscale of the Psychotic Symptom Rating Scales at T1. Secondary outcomes include perceived hostile intention, power, and dominance of voices, passive, aggressive, and assertive relating to voices, and negative core beliefs about the self.

Discussion

Adolescence provides a crucial window of opportunity for early intervention for hearing voices. However, youth are notoriously reluctant help-seekers. This study offers a low-intensity psychological intervention for youth with distressing voices beyond diagnostic boundaries that, using a mobile technology approach, may match the treatment preferences of the generation of “digital natives.”

Trial registration

German Clinical Trials Register DRKS00026243. Registered on 2 September 2021
Temporal associations between leukocytes DNA methylation and blood lipids: a longitudinal study
Authors: Wu Zhiyu , Chen Lu , Hong Xuanming , Si Jiahui , Cao Weihua , Yu Canqing , Huang Tao , Sun Dianjianyi , Liao Chunxiao , Pang Yuanjie , Pang Zengchang , Cong Liming , Wang Hua , Wu Xianping , Liu Yu , Guo Yu , Chen Zhengming , Lv Jun , Gao Wenjing , Li Liming
Published: October 2022

Background

The associations between blood lipids and DNA methylation have been investigated in epigenome-wide association studies mainly among European ancestry populations. Several studies have explored the direction of the association using cross-sectional data, while evidence of longitudinal data is still lacking.

Results

We tested the associations between peripheral blood leukocytes DNA methylation and four lipid measures from Illumina 450 K or EPIC arrays in 1084 participants from the Chinese National Twin Registry and replicated the result in 988 participants from the China Kadoorie Biobank. A total of 23 associations of 19 CpG sites were identified, with 4 CpG sites located in or adjacent to 3 genes (TMEM49, SNX5/SNORD17 and CCDC7) being novel. Among the validated associations, we conducted a cross-lagged analysis to explore the temporal sequence and found temporal associations of methylation levels of 2 CpG sites with triglyceride and 2 CpG sites with high-density lipoprotein-cholesterol (HDL-C) in all twins. In addition, methylation levels of cg11024682 located in SREBF1 at baseline were temporally associated with triglyceride at follow-up in only monozygotic twins. We then performed a mediation analysis with the longitudinal data and the result showed that the association between body mass index and HDL-C was partially mediated by the methylation level of cg06500161 (ABCG1), with a mediation proportion of 10.1%.

Conclusions

Our study indicated that the DNA methylation levels of ABCG1, AKAP1 and SREBF1 may be involved in lipid metabolism and provided evidence for elucidating the regulatory mechanism of lipid homeostasis.
An electric circuit model of the Earth’s polar electrojets and field-aligned currents for the estimation of magnetospheric magnetic field from along-track Swarm magnetic data
Authors: Martinec Zdeněk , Velímský Jakub
Published: October 2022

This study deals with the analysis of Swarm vector magnetic data in order to create a circuit model of electric currents flowing in the Earth’s polar ionosphere and the inner magnetosphere. The model is composed of a system of two-dimensional electric currents representing the magnetic fields of three-dimensional ionospheric polar electrojets (PEJs), the field-aligned currents (FACs), magnetospheric ring currents (MRCs) and magnetospherically induced electric currents inside the Earth (MICs) for each Swarm track. The aim of this paper is to model PEJ and FAC magnetic fields in terms of electric currents on a track-by-track base, subtract those magnetic fields from along-track Swarm magnetic data and estimate the magnetospheric magnetic field (MMF) in discrete time bins. The proposed method is primarily intended to apply to Swarm signals recorded during magnetic storms. The electric circuit model is set up in three steps. After subtracting the main, lithospheric, Sq ionospheric and oceanic tidal magnetic fields from along-track Swarm magnetic signals, the residuals are grouped in 1-h time bins and adjusted by the magnetic field of a two-circular loop model of MRCs and MICs represented by $$3\times 2$$

3
×
2

parameters of the electric circular loops in the magnetosphere and the Earth. The adjustment is carried out for the X and Z magnetic field components only because the Y component contains a large signal due to FACs. In the second step, the modelled MRC–MIC magnetic field is removed from the original residuals and the reduced residuals are adjusted by the magnetic field of a system of two-dimensional electric circuits in the polar ionosphere and FACs. The circuit model is set up according to known geometry of PEJs and FACs. In the final step, the modelled magnetic fields of PEJs and FACs are subtracted from the original residuals and all three magnetic field components are adjusted by the MRC–MIC model, named MMC, in a similar way as in the first step. Reliability of the approach is demonstrated by the scatter plots of model MMC showing a significantly better agreement with Swarm magnetic field residuals than the existing MMFs.

Graphical Abstract
Psychopathology of attention deficit/hyperactivity disorder: from an inflammatory perspective
Authors: Wong Rebecca Shin Yee
Published: October 2022

Background

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattentiveness, hyperactivity and impulsivity, which may affect one’s cognitive and psychosocial functioning. This review gives an overview of ADHD, particularly from an aetiological and clinical perspective. It also critically examines current evidence on the role of inflammation in ADHD and consolidates key findings in this area of research.

Results

The exact cause of ADHD remains unknown, and the aetiology of the disorder is believed to be multifactorial. Numerous genetic and environmental factors have been linked to the development of ADHD. Like many psychiatric disorders, ADHD has been associated with inflammation that occurs locally and peripherally. A growing body of evidence shows that maternal inflammatory status during pregnancy is associated with diagnosis of ADHD in the offspring, whereas oxidative stress, inflammatory biochemical markers and immune-mediated diseases have been observed in individuals with ADHD.

Conclusions

The underlying inflammatory processes and mechanisms in ADHD are not clearly understood. Therefore, further exploration is warranted in future research. This has clinical implications as inflammation may be a potential target in the treatment of ADHD.
De moeda social a criptomoeda: dilemas da emancipação tecnológica do E-Dinheiro
Authors: Sanches Bruno , Faria Luiz , Gonçalves Neto Pedro , Ferreira Marcos
Published: October 2022

E-Dinheiro é uma moeda social que se tornou digital. Nessa trajetória, a Rede Brasileira de Bancos Comunitários, a entidade comunitária gestora do e-Dinheiro, se tornou tecnologicamente dependente da empresa que forneceu e administrava seu software. Depois de muitos anos de luta, a entidade comunitária rompeu com as algemas tecnológicas que a deixaram subjugada à empresa de tecnologia e está diante de novas oportunidades. Uma delas, apresentada por um grupo de pesquisadores, é transformar o e-Dinheiroem uma criptomoeda. Porém, essa oportunidade coloca a entidade diante de novos e antigos dilemas, sobre os quais ela precisa decidir.
Formação de jovens em empreendedorismo rural: adaptando uma tecnologia social para a comunidade LGBTQIA+
Authors: De Souza Ana Clara Aparecida Alves , Pozzebon Marlei , Prado Saldanha Fabio , Alves Aurigele
Published: October 2022

A ADEL é uma instituição sem fins lucrativos fundada em Pentecoste em 2007 com o objetivo de capacitar jovens rurais a desenvolver seus próprios negócios e ficar no território onde nasceram como empreendedores. Uma das metodologias mais conhecidas da ADEL é o PJER, um projeto de formação de jovens empreendedores rurais, uma tecnologia social que já formou e financiou centenas de jovens na região do Semiárido. Em 2019, a ADEL lançou o programa PJER Diversidade, tendo como alvo a comunidade LGBTQIA+. Trata-se de um imenso desafio não somente para os fundadores e gestores da ADEL como também para os participantes e para a comunidade local.
“El arte de transformar”: o caso da D1 no Peru
Authors: Bourdeau Ginchereau Camille , Aguilar Delgado Natalia , Tello-Rozas Sonia
Published: October 2022

O caso descreve a história e a metodologia (ou tecnologia social) da organização D1 criada em 2005 no Peru. Por meio de uma metodologia inclusiva que preconiza o desenvolvimento humano combinado com a excelência técnica e artística, a missão da organização está na inclusão de jovens pela dança. No início dos anos 2020, após uma série de mudanças organizacionais e a expansão de novas atividades comerciais, o componente social perdeu em atratividade para os jovens das periferias, e a organização se questiona como mobilizar as comunidades e como seguir tendo o impacto social que um dia teve.
Editorial
Authors: Dudek Dominika , Sobański Jerzy , Klasa Katarzyna
Published: October 2022

bez streszczenia
Second primary cancer in the brain: a longitudinal case study from childhood into adulthood
Authors: Rahesh Jasmin , Khan Shazma , Siddiqui Arham , Jacob Roy
Published: October 2022

Second cancers occur after the remission of a previous cancer in patients. Due to the increased successful treatment of childhood cancers, these second cancers are more likely to occur for these patients, later in life. Risk factors and causes for these second cancers include predisposing genetic factors, exposure to radiation and chemotherapy from initial cancer treatment, and environmental conditions. The most likely the reason second cancers occur is multifactorial and involves an interaction of both environmental and genetic factors. We present a longitudinal case study following a patient who was treated for an ependymoma at age three and twenty-two years later presenting with symptoms indicative of another cancer, at age 25.
Assessing and addressing COVID-19 vaccine hesitancy in a West Texas Free Clinic through motivational interview-guided intervention
Authors: Nesiama Esere , Vopni Rachel , Fuentes Nayeli , Prabhu Fiona , Bennett Kelly
Published: October 2022

Background
Vaccine hesitancy is a public health issue that threatens successful prevention of vaccine-preventable diseases. The Free Clinic at Lubbock Impact serves rural, West Texas uninsured patients. In recognition of low vaccination rates among this population, an initiative was undertaken to better understand factors contributing to COVID-19 vaccine reluctance and conduct interventions to reduce hesitancy.
Methodology
Patients at the Free Clinic between January 2022 and March 2022 received a voluntary survey regarding their COVID-19 vaccination status, perceived barriers to vaccination, and factors influencing vaccination status with Likert-scale response options. Following the first 3 weeks of data collection, an educational intervention was designed and implemented for unvaccinated participants. The intervention included a motivational interview, pamphlet review, and exit survey to assess future likelihood of vaccination.
Results
 
A total of 161 survey responses were obtained from the initial survey with a total unique patient population of 138. Of the 138 unique patients surveyed, 73 reported as vaccinated and 65 reported as not vaccinated against COVID-19. For hesitancy factors among unvaccinated participants, the mode for the “Extremely Important” hesitancy factor was “Personal Preference”.
 
37 of the 41 unvaccinated participants who received an intervention reported liking the discussion of the COVID-19 vaccine (90.2%), 4 reported they were not interested (9.8%), and 0 reported disliking the intervention. Half of the respondents indicated an increased likelihood of future vaccination.
 
Conclusion
The goal of reducing vaccine hesitancy at The Free Clinic was successful. These findings support the benefits of openness to educational interventions among vulnerable populations.
Left ventricular outflow tract pseudoaneurysms and severe paravalvular aortic regurgitation treated by percutaneous approach in a Marfan syndrome patient
Authors: Paz Dean , Hegeman Timothy , Varli Onur , Cevik Cihan
Published: October 2022

A 66-year-old male with a history of Marfan syndrome and resolved infective endocarditis was found to have shortness of breath after a previous aortic valve replacement in 2010. Several severe paravalvular leaks were seen on imaging, and left ventricular outflow tract pseudoaneurysms were identified as the cause of his symptoms which warranted treatment. Due to this patient’s risk of surgical intervention, a retrograde transaortic approach was used.
Progressive lower extremity weakness as the initial presentation of isolated large thoracic plasmacytoma
Authors: Abdelnabi Mahmoud , Morataya Cristina , Mittal Neha
Published: October 2022

Plasmacytoma is a tumor of monoclonal plasma cells of bone or soft tissue that can occur anywhere in the body without evidence of systemic multiple myeloma. It may present as solitary or multiple masses and is classified as osseous if arising from bone or extraosseous if arising from soft tissue. Osseous plasmacytoma is the most common form of plasmacytoma with predominance in active hematopoietic bones, including vertebrae, femur, pelvis, and ribs. The diagnosis is made with a tissue biopsy. Different imaging modalities allow for tumor localization, and magnetic resonance imaging (MRI) is the gold standard to detect spinal cord compression. Corticosteroids provide analgesia, reduce vasogenic edema, and have anti-myeloma activity which may result in better neurological outcomes in cases of acute spinal cord compression. Corticosteroids should be started promptly once cord compression is suspected. We report a case of progressive lower extremity weakness as the initial presentation of a thoracic plasmacytoma. The patient was started on a high-dose corticosteroid after acute cord compression was suspected. Magnetic resonance imaging confirmed cord compression. T1-T2 corpectomy with C5-T5 posterior spinal fusion for decompression and stabilization was done. He was successfully discharged to an inpatient rehabilitation facility with plans for definitive radiotherapy. Worsening back pain and lower extremity weakness in elderly patients should raise concerns for acute cord compression. Early intervention to relieve compression is crucial to preserve neurological functions.
 
Keywords: plasmacytoma, weakness, steroids, multiple myeloma
Pain problem in patients in palliative home care
Authors: Czernecki Karol , Ślusarska Barbara
Published: October 2022

Aim of the study: The aim of the study is to determine the intensity and nature of pain and treatment methods, as well as to assess the patient's sense of comfort in palliative care in the home environment.
 
Material and methods: Research using the diagnostic survey method, using the PAPI (Paper & Pen Personal Interview) technique, was carried out among patients in palliative care provided by the home care team in March and April 2022. The study included 55 palliative patients under the care of the home palliative care team in the following cities: Warszawa, Kraków, Sosnowiec and the poviats of Stalowa Wola, Tarnobrzeg and Sandomierz.
Results: Of the 55 patients studied, the majority of 50.9% (n = 28) were men. The vast majority of 90.9% (n = 50) of people replied that pain was present, but patients were taking pain medications. Pain in the majority of patients, 65.5% (n = 36), it was felt at any time during the day. On the NRS scale, pain intensity ranging from 4 to 7 points was assessed by 61.8% of patients. Among the symptoms associated with pain, patients indicated the following as very severe: fatigue and weariness (63.6%), drowsiness (41.8%), nervousness (40.0%), depression (38.2%), difficulty concentrating (32.7%), lack of energy, weakness (30.9%), worry (36.4%), apathy (36.4%), dry mouth (34.5%). The average result on the comfort scale in the group of patients is M = 34.50; SD = 5.04. There was a statistically significant correlation between satisfaction with care and the level of perceived comfort (p = 0.014).
Conclusions: In the group of palliative patients treated at home, "pain" is one of their main ailments. Most patients take painkillers to reduce or completely eliminate the pain. However, the symptoms associated with it remain. Patients who strongly indicated satisfaction with care had a significantly higher level of comfort compared to other patients
The potential of naproxen and its derivatives in inhibiting the processes of initiation, promotion and progression of cancerogenesis
Authors: Bednarz Katarzyna , Banaś Patryk , Sobańska Natalia , Banasiak Aleksandra , Teichman Rafał , Kasprowicz Jakub , Pierzchała Jakub Rafał , Abram Kamila , Adamus Justyna , Hyjek Michał
Published: October 2022

Introduction: Naproxen is a non-steroidal anti-inflammatory drug mainly used to treatinflammation, pain, and fever of various etiology. Scientific studies conducted over the lastfive years have shown, that its introduction significantly influenced neoplastic processes inthe in vitro and in vivo studies carried out within cell cultures and animal models.Aim of the study: Our aim was to review the theses, extract and present the influence ofnaproxen and its derivatives in signaling pathways involved in the initiation, promotion andprogression of cancer as well as to indicate potential directions for further research.Methods and materials: We have reviewed the theses in the bibliographic PubMed database,using the keywords: „naproxen”; „naproxen derivatives”; „cancer”; „cancer treatment”„cancer prevention”.Results: In addition to the well-known mechanism of inhibiting COX, there are scientificproofs of the activity of naproxen against other molecules, such as PI3-K(phosphatidylinositol 3-kinase), GSK-3β (glycogen synthase kinase-3β), NFκB (nucleartranscription factor κB), MMP ( metalloproteinases), NO (nitric oxide) involved in neoplasticprocesses.Conclusion: Conclusions drawn from the analysis of specific molecular activities of naproxenand its derivatives against neoplastic processes are promising. However, more preclinicalresearch is needed to confirm the effectiveness, practical applicability and to assess the sideeffects of the therapy, before starting the clinical trials in humans.
Zmiany i perspektywy rozwoju polskiego rynku literatury dla młodzieży
Authors: Marciniak Sylwia
Published: October 2022

Artykuł jest próbą spojrzenia na literaturę dla młodzieży, ale w oderwaniu jej od książek dedykowanych czytelnikowi dziecięcemu. Zwrócono uwagę na samodzielne, integralne cechy różnicujące te dwie kategorie i wynikające z tego rozszerzenie grona odbiorców publikacji przeznaczonych dla młodzieży. Artykuł ma być próbą oceny obecnej kondycję literatury dla młodzieży na polskim rynku wydawniczym. Celem artykułu jest sprawdzenie, czy na przestrzeni ostatnich lat literatura przeznaczona dla młodzieży uległa rozwojowi, czy też obserwowana jest jej stagnacja. Badanie przeprowadzono poprzez analizę zawartości dostępnej literatury przedmiotu, licznych raportów, książkowego środowiska internetowego.
PREDICTING STOCHASTIC LIGHTNING MECHANICAL DAMAGE EFFECTS ON CARBON FIBER REINFORCED POLYMER MATRIX COMPOSITES
Authors: LEE JUHYEONG JUHYEONG , SHAH SYED ZULFIQAR HUSSAIN
Published: October 2022

Three stochastic air blast models are developed with spatially varying elastic properties and failure strengths for predicting lightning mechanical damage to AS4/3506 carbon/epoxy composites subjected to < 100 kA peak currents: (1) the conventional weapon effects program (CWP) model, (2) the coupled eulerianlagrangian (CEL) model, and (3) the smoothed-particle hydrodynamics (SPH) model. This work is an extension of our previous studies [1–4] that used deterministic air blast models for lightning mechanical damage prediction. Stochastic variations in composite material properties were generated using the Box-Muller transformation algorithm with the mean (i.e., room temperature experimental data) and their standard deviations (i.e., 10% of the mean herein as reference). The predicted dynamic responses and corresponding damage initiation prediction for composites under equivalent air blast loading were comparable for the deterministic and stochastic models. Overall, the domains with displacement, von-Mises stress, and damage initiation contours predicted in the stochastic models were somewhat sporadic and asymmetric along the fiber’s local orientation and varied intermittently. This suggests the significance of local property variations in lightning mechanical damage prediction. Thus, stochastic air blast models may provide a more accurate lightning mechanical damage approximation than traditional (deterministic) air blast models. All stochastic models proposed in this work demonstrated satisfactory accuracy compared to the baseline models, but required substantial computational time due to the random material model generation/assignment process, which needs to be optimized in future work.
CONVOLUTIONAL NEURAL NETWORK FOR PREDICTING MECHANICAL BEHAVIOR OF COMPOSITES WITH FIBER WAVINESS
Authors: LIU XIN , COSTA SÉRGIO , LIU BANGDE , TREHAN SARTHAK
Published: October 2022

The fiber waviness is inevitable in non-crimp fabric (NCF) reinforced composites. It is very challenging to accurately and efficiently predict the material behavior with fiber waviness. This work presents a machine learning approach to the prediction of material behavior of NCF composites under a compressive load. The out-of-plane fiber orientations are first extracted from micrographs of NCF laminates. A digital twinning process is followed to create finite element (FE) models with elementwise fiber orientations. Based on the FE models, a physics-based damage model is employed to generate high-fidelity simulation datasets, capturing the kink-band due to the fiber waviness. With the simulation datasets, convolutional neural network (CNN) models are developed to take the images of the fiber orientations and predict the corresponding stiffness, strength, and stress-strain curves of the NCF composites. The results show that the CNN models can capture spatial information of the fiber orientation and efficiently predict the corresponding material behavior with a high accuracy. In addition, the correlations of the fiber orientations and the final material behaviors are investigated based on the developed CNN models.
SUBSTRUCTURE DAMAGE TOLERANCING IN CARBON FIBER COMPOSITES UNDER IMPACT FATIGUE
Authors: MENDOZA ISABELLA , LAMBERSON LESLIE
Published: October 2022

The service life of aircraft structural components often experience sub-catastrophic impact events, such as during launch and landing cycles or blunt impacts from ground service equipment. These occurrences lead to impact fatigue that can result in damage of the carbon fiber-reinforced composite structural components (CFRCs). Due to their stacked lay-up structure, internal damage may not manifest visibly on the surface as it could for a solid isotropic material. Consequently, it is critical to quantify subsurface damage accurately, including the link between impact energy, loading cycles and reduction in elastic stiffness parameters of composite structures for more rigorous service life predictions. A unique identification method to quantify impact fatigue substructure damage in the form of stiffness degradation is considered here. The method leverages deflectometry, a full-field optical method with high sensitivity to surface defects not visible to the naked eye. Coupled with the use of the Virtual Fields Method (VFM), this approach is demonstrated numerically through finite element ABAQUS simulations.
DEEP LEARNING FRAMEWORK FOR WOVEN COMPOSITE DESIGN AND OPTIMIZATION
Authors: FENG HAOTIAN , SUBRAMANIYAN SSABARINATHAN P. , PRABHAKAR PAVANA
Published: October 2022

Woven composites are produced by interlacing warp and weft fibers in a pattern or weave style. By changing the pattern or material, the mechanical properties of woven composites can be significantly changed. However, how a woven composite’s architecture (pattern, material) is related to its mechanical properties is still unclear. Thus, in this paper, we utilize Deep Neural Network to explore the relationship between 2D woven composite architectures and their corresponding mechanical properties. We propose Deep Convolutional Neural Network to predict in-plane modulus from a given weave pattern and material sequence. More importantly, we propose a Physics-Constrained Neural Network to predict woven composite architecture from in-plane modulus, which is an extremely complex problem. The results demonstrate that our proposed Deep Neural Network frameworks can effectively represent the relationships between woven composite architecture and corresponding in-plane modulus with much higher accuracy compared to existing frameworks. We anticipate our proposed frameworks will not only facilitate woven composite analysis and optimization process but also be a starting point to introduce Physics knowledge guided Neural Networks into woven composite analysis.
DAMAGE AND FAILURE ANALYSIS OF ULTRA-HIGH TEMPERATURE CERAMICS (UHTCS) SUBJECTED TO THERMAL SHOCK
Authors: AVALOS EDGAR , CASTELLANOS ALEJANDRA G.
Published: October 2022

In this study, the finite element analysis (FEA) software ABAQUS 2020 and the eXtended Finite Element Method (XFEM) were used to predict the crack initiation and propagation within a UHTC subjected to cold thermal shock from 2000°C to 20°C. Within the XFEM enriched region, the maximum principal stress damage criterion was implemented to capture the crack initiation, and an energy-based damage criterion was used for crack propagation. Two simulations were developed, one for zirconia diboride (ZrB2) and one for hafnium diboride (HfB2). Temperature-dependent thermomechanical and fracture material properties were used for both simulations. A convective heat transfer condition was applied to the models' exposed surface. The multiple crack initiation and propagation were captured by using several XFEM enriched regions. The results for both UHTCs showed that crack initiation began at the exposed surface of the geometry and propagated into the material in a fast and brittle manner. The study found that defining the UHTCs' material temperature-dependent properties for the cold thermal shock models produced faster cracking due to the embrittlement of the materials' elastic properties and the degradation of the fracture properties at high temperatures. The properties of the materials can be seen to degrade as the temperature increases.
FLEXURAL PERFORMANCE OF HYBRID DISCONTINUOUS FIBER COMPOSITES MADE OF REPURPOSED AEROSPACE PREPREG
Authors: NAKAGAWA TROY , KO SEUNGHYUN , HOUSER GUY , YANG JINKYU , SALVIATO MARCO
Published: October 2022

The flexure properties of Discontinuous Fiber Composites (DFCs) made from repurposed aerospace prepreg are investigated. In this study, two platelet sizes with varying length and the same width are used. Three thicknesses are investigated along with hybrid laminates, which combine DFCs and unidirectional (UD) and textile tapes. The study showed that by increasing platelet length, the flexure properties increased by, on average, 37%, but the Coefficient of Variation (CoV) also increased by, on average, 47%. However, as the thickness increased the CoV decreased by, on average, 25% while the flexure properties did not change. By adding continuous fiber plies, the average flexure properties increased by 29-67%. However, there were cases where adding these plies increased the CoV of the modulus. This is due to fiber waviness caused by platelet motion during cure. This was mitigated by a precure routine and using a textile ply between the UD and DFC core. The precured and textile hybrids resulted in a lower CoV of the flexure modulus. On the other hand, the CoV of the flexure strength was always lowered by the addition of continuous fiber plies by 36-67%. A finite element model was developed which could match and predict the flexure modulus of DFC and hybrid specimen. The development of this model is of utmost importance to mitigate the need of extensive physical tests to validate parts made using DFCs. The experiments and computations showcase the excellent tunability of DFCs, and the immense potential this repurposing method has to reduce thermoset prepreg waste.
Wokół konfederacji targowickiej. Adam Chmara, ostatni wojewoda miński, wobec upadku Rzeczypospolitej
Authors: Rolnik Dariusz
Published: October 2022

The present paper is based on research on biography of A. Chmara, the last voivode of Mińsk living in 1720-1805. He represented beliefs characteristic to his times. Chmara assumed that the state should serve citizens, their career and development rather than them defense it, despite the changes in people’s mentality occurred during the reign of the last ruler. The mentioned views had a great impact on Chmara and his attitudes towards the political events he witnessed both as a participant and as an observer. The Voivode of Mińsk, recalled as an example of a new senator created by Stanisław August, seems to be a model for the whole generation of politicians who in spite of the true love for their homeland, were not ready for the sacrifices required by the situation.