bluuebunny/crossref_metadata_2025 huggingface dataset:
The Legitimacy of Sustainability Standards: A Paradox Perspective
Authors: Haack Patrick , Rasche Andreas
Published: October 2021

Sustainability standards have proliferated widely in recent years but their legitimacy remains contested. This paper suggests that sustainability standards need to cope with an important but unexplored paradox to gain legitimacy. While standard setters create low entry barriers and requirements for adopters so that standards can diffuse quickly and achieve a status of cognitive legitimacy, standards also need to ensure that adopters create high levels of impact, thereby acquiring moral legitimacy. While the need for diffusion and impact occurs at the same time, they cannot be achieved simultaneously. We unpack this paradox and show that its salience for standard setters differs depending on (a) the growth trajectory of a standard and (b) the perceived intensity of the demands for diffusion and impact. We outline five response strategies that standard setters can use to tackle the diffusion–impact paradox and illustrate our theoretical considerations through a detailed case study of the UN Global Compact. Our paper advances scholarly understandings on how sustainability standards gain legitimacy and sheds light on the complex and inherently paradoxical nature of legitimacy. We derive implications for the literatures on sustainability standards, legitimacy, and paradox management.
The uncertain commodity of ‘security’: Are private security companies ‘value for money’ for domestic violence services?
Authors: Harkin Diarmaid
Published: October 2021

Reflecting on Loader and White ’s (2018) suggestion that the labour of private security workers is difficult to ‘commodify’, this paper uses original empirical data to show that there are four elements to what private security workers ‘do’ for victims of domestic violence when contracted by domestic violence advocacy services: they provide (a) practical ‘target-hardening’ measures, (b) ‘expert’ advice on security, (c) forms of ‘security therapy’ as workers talk clients through their safety-based anxieties and (d) forms of ‘security theatre’ as workers provide the appearance of providing security despite the efficacy often being unclear or uncertain. Each of these elements have significant risks that can threaten the interests of victims and domestic violence services.
DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD
Authors: Keefer Amy , Vasa Roma A.
Published: October 2021

Background

Anxiety disorders are highly prevalent in children and adolescents with autism spectrum disorder and often emerge before the age of 6 years. Yet, only a few studies have examined anxiety treatment for this group. Preliminary evidence from these studies suggests that utilizing cognitive behavioral therapy (CBT) as well as strategies to target intolerance of uncertainty (IU) and parental accommodation, known mechanistic and maintaining factors of anxiety may improve anxiety and optimize outcomes in this age group.

Main body

To meet this need, we developed an integrated treatment called DINO Strategies for Anxiety and intolerance of Uncertainty Reduction (DINOSAUR), a 12-week group telehealth treatment for 4- to 6-year-old children with ASD. DINOSAUR works with young children and their parents to deliver CBT along with interventions targeting IU and parental accommodation. In this paper, we first discuss the rationale for developing this treatment and then describe a pilot study of its feasibility and preliminary efficacy.

Conclusions

There is a great need to develop anxiety treatments for young children with ASD. We proposed a novel integrated treatment approach that aims to alter the way young children and parents respond to fear, which could potentially improve short- and long-term mental health outcomes for this age group.

Trial registration

ClinicalTrials.govNCT04432077 on June 03, 2020
Is orchiectomy avoidable in testicular tuberculosis mimicking malignancy? A case report
Authors: Kharbach Youssef , Retal Youssef , Khallouk Abdelhak
Published: October 2021

Background

Isolated testicular tuberculosis (TB) is extremely uncommon. It has non-specific presentation; thus, diagnosis is challenging and is often discovered on pathology examination after orchiectomy.

Case presentation

We report herein the case of a 73-year-old male, with no significant medical or family history, who presented with left scrotal swelling, physical examination revealed a left testicular firm mass measuring 3 cm and ultrasound was suggestive of testicular tumor. Left inguinal orchiectomy was performed and the pathologic examination revealed testicular TB. The presentation was typically mimicking a testicular cancer with no evocative evidence of TB; this can lead to a dilemma and highlights the need to consider TB in differential diagnosis of testicular tumor, especially in areas endemic for the disease.

Conclusions

The aim of our presentation is to argue if orchiectomy was avoidable. It also illustrates the probable hematogenous or lymphatic spread of Mtb to the testicle.
Beware of pharyngeal Fusobacterium nucleatum in COVID-19
Authors: Bao Lirong , Zhang Cheng , Lyu Jinglu , Yan Caixia , Cao Ranran , Pan Ming , Li Yan
Published: October 2021

Background

Fusobacterium nucleatum (F. n) is an important opportunistic pathogen causing oral and gastrointestinal disease. Faecalibacterium prausnitzii (F. p) is a next-generation probiotic and could serve as a biomarker of gut eubiosis/dysbiosis to some extent. Alterations in the human oral and gut microbiomes are associated with viral respiratory infection. The aim of this study was to characterise the oral and fecal bacterial biomarker (i.e., F. n and F. p) in COVID-19 patients by qPCR and investigate the pharyngeal microbiome of COVID-19 patients through metagenomic next-generation sequencing (mNGS).

Results

Pharyngeal F. n was significantly increased in COVID-19 patients, and it was higher in male than female patients. Increased abundance of pharyngeal F. n was associated with a higher risk of a positive SARS-CoV-2 test (adjusted OR = 1.32, 95% CI = 1.06 ~ 1.65, P < 0.05). A classifier to distinguish COVID-19 patients from the healthy controls based on the pharyngeal F. n was constructed and achieved an area under the curve (AUC) of 0.843 (95% CI = 0.688 ~ 0.940, P < 0.001). However, the level of fecal F. n and fecal F. p remained unaltered between groups. Besides, mNGS showed that the pharyngeal swabs of COVID-19 patients were dominated by opportunistic pathogens.

Conclusions

Pharyngeal but not fecal F. n was significantly increased in COVID-19 patients, clinicians should pay careful attention to potential coinfection. Pharyngeal F. n may serve as a promising candidate indicator for COVID-19.
Use of health and aged care services in Australia following hospital admission for myocardial infarction, stroke or heart failure
Authors: Hsu Benjumin , Korda Rosemary J. , Lindley Richard I. , Douglas Kirsty A. , Naganathan Vasi , Jorm Louisa R.
Published: October 2021

Background

Cardiovascular diseases (CVD), including myocardial infarction (MI), stroke and heart failure (HF) are the leading cause of death amongst the older population worldwide. The aim of this study is to investigate trajectories of use of health and aged care services after hospital admission for MI, stroke or HF among community-dwelling people not previously receiving aged care services.

Methods

The study population comprised people aged 65+ years from the 45 and Up Study with linked records for hospital stays, aged care services and deaths for the period 2006–14. Among those with an index hospital admission for MI, stroke or HF, we developed Sankey plots to describe and visualize sequences and trajectories of service use (none, re-hospitalization, community care, residential care, death) in the 12 months following discharge. We used Cox proportional hazards models to estimate hazard ratios (HRs), for commencing community care and entering residential care (and the other outcomes) within 3, 6 and 12 months, compared to a matched group without MI, stroke or HF.

Results

Two thousand six hundred thirty-nine, two thousand five hundred and two thousand eight hundred seventy-three people had an index hospitalization for MI, stroke and HF, respectively. Within 3 months of hospital discharge, 16, 32 and 29%, respectively, commenced community care (multivariable-adjusted HRs: 1.26 (95%CI:1.18–1.35), 1.53 (95%CI:1.44–1.64) and 1.39 (95%CI:1.32–1.48)); and 7, 18 and 14%, respectively, entered residential care (HRs: 1.25 (95%CI:1.12–1.41), 2.65 (95%CI:2.42–2.91) and 1.50 (95%CI:1.37–1.65)). Likewise, 26, 15 and 28%, respectively, were rehospitalized within 3 months following discharge (multivariable-adjusted HRs: 4.78 (95%CI:4.31–5.32), 3.26 (95%CI:2.91–3.65) and 4.94 (95%CI:4.47–5.46)).

Conclusions

Older people hospitalized for major CVD may be vulnerable to transition-related risks and have poor health trajectories, thus emphasizing the value of preventing such events and care strategies targeted towards this at-risk group.
Developing a model for estimating infarction onset time based on computed tomography radiomics in patients with acute middle cerebral artery occlusion
Authors: Wen Xuehua , Shu Zhenyu , Li Yumei , Hu Xingfei , Gong Xiangyang
Published: October 2021

Background

Radiomics analysis is a newly emerging quantitative image analysis technique. The aim of this study was to extract a radiomics signature from the computed tomography (CT) imaging to determine the infarction onset time in patients with acute middle cerebral artery occlusion (MCAO).

Methods

A total of 123 patients with acute MCAO in the M1 segment (85 patients in the development cohort and 38 patients in the validation cohort) were enrolled in the present study. Clinicoradiological profiles, including head CT without contrast enhancement and computed tomographic angiography (CTA), were collected. The time from stroke onset (TFS) was classified into two subcategories: ≤ 4.5 h, and > 4.5 h. The middle cerebral artery (MCA) territory on CT images was segmented to extract and score the radiomics features associated with the TFS. In addition, the clinicoradiological factors related to the TFS were identified. Subsequently, a combined model of the radiomics signature and clinicoradiological factors was constructed to distinguish the TFS ≤ 4.5 h. Finally, we evaluated the overall performance of our constructed model in an external validation sample of ischemic stroke patients with acute MCAO in the M1 segment.

Results

The area under the curve (AUC) of the radiomics signature for discriminating the TFS in the development and validation cohorts was 0.770 (95% confidence interval (CI): 0.665–0.875) and 0.792 (95% CI: 0.633–0.950), respectively. The AUC of the combined model comprised of the radiomics signature, age and ASPECTS on CT in the development and validation cohorts was 0.808 (95% CI: 0.701–0.916) and 0.833 (95% CI: 0.702–0.965), respectively. In the external validation cohort, the AUC of the radiomics signature was 0.755 (95% CI: 0.614–0.897), and the AUC of the combined model was 0.820 (95% CI: 0.712–0.928).

Conclusions

The CT-based radiomics signature is a valuable tool for discriminating the TFS in patients with acute MCAO in the M1 segment, which may guide the use of thrombolysis therapy in patients with indeterminate stroke onset time.
Identification of a novel RHO heterozygous nonsense mutation in a Chinese family with autosomal dominant retinitis pigmentosa
Authors: Liu Wei , Guo Ruru , Hao Huijie , Ji Jian
Published: October 2021

Background

To explore the molecular genetic cause of a four-generation autosomal dominant retinitis pigmentosa family in China.

Methods

Targeted region sequencing was performed to detect the potential mutation, and Sanger sequencing was used to validate the mutation. Multiple sequence alignment from different species was performed by CLUSTALW. The structures of wild-type and the mutant RHO were modeled by Swiss-Model Server and shown using a PyMOL Molecular Graphic system.

Results

A novel heterozygous nonsense mutation (c.1015 A > T, p.Lys339Ter, p.K339X) within RHO, which cosegregated with retinitis pigmentosa phenotype was detected in this family. Bioinformatics analysis showed the mutation was located in a highly conserved region, and the mutation was predicted to be pathogenic.

Conclusions

We identified a novel heterozygous nonsense mutation of RHO gene in a Chinese family with retinitis pigmentosa by target region sequencing and our bioinformatics analysis indicated that the mutation is pathogenic. Our results can broaden the spectrum of RHO gene mutation and enrich the phenotype-genotype correlation of retinitis pigmentosa.
Microspheres present comparable efficacy and safety profiles compared with polyvinyl alcohol for bronchial artery embolization treatment in hemoptysis patients
Authors: Fu Zhigang , Li Xun , Cai Fei , Yuan Yinpeng , Zhang Xiaolin , Qin Jingxia , Liang Yonghui
Published: October 2021

Background

The present study aimed to compare the efficacy and safety profiles of microspheres versus (vs.) polyvinyl alcohol (PVA) for bronchial artery embolization (BAE) treatment in patients with hemoptysis.

Methods

Totally, 152 patients with hemoptysis who were about to receive BAE treatment were consecutively enrolled and divided into microspheres group (N = 62) and PVA group (N = 90). Technical success and clinical success were assessed after BAE procedure, and the hemoptysis-recurrence status, survival status and adverse events were recorded during follow-up.

Results

Technical success rates were both 100% in microspheres group and PVA group; clinical success rate (96.8% vs. 100.0%, P = 0.165), 6-month (9.7% vs. 7.8%, P = 0.681) and 1-year (9.7% vs. 8.9%, P = 0.869) hemoptysis recurrence rate, 6-month (4.8% vs. 2.2%, P = 0.374) and 1-year (4.8% vs. 3.3%, P = 0.639) mortality were similar between microspheres group and PVA group. Furthermore, hemoptysis-free survival (P = 0.488) and overall survival (P = 0.321) were of no difference between two groups. In addition, all adverse events were mild, and there was no difference of adverse events between two groups (all P > 0.05). These data were validated by further multivariate regression analysis.

Conclusions

Microspheres present comparable efficacy and safety profiles compared with PVA for the BAE treatment in patients with hemoptysis, providing evidence for embolic agent selection.
Positive feedback between lncRNA FLVCR1-AS1 and KLF10 may inhibit pancreatic cancer progression via the PTEN/AKT pathway
Authors: Lin Jiewei , Zhai Shuyu , Zou Siyi , Xu Zhiwei , Zhang Jun , Jiang Lingxi , Deng Xiaxing , Chen Hao , Peng Chenghong , Zhang Jiaqiang , Shen Baiyong
Published: October 2021

Background

FLVCR1-AS1 is a key regulator of cancer progression. However, the biological functions and underlying molecular mechanisms of pancreatic cancer (PC) remain unknown.

Methods

FLVCR1-AS1 expression levels in 77 PC tissues and matched non-tumor tissues were analyzed by qRT-PCR. Moreover, the role of FLVCR1-AS1 in PC cell proliferation, cell cycle, and migration was verified via functional in vitro and in vivo experiments. Further, the potential competitive endogenous RNA (ceRNA) network between FLVCR1-AS1 and KLF10, as well as FLVCR1-AS1 transcription levels, were investigated.

Results

FLVCR1-AS1 expression was low in both PC tissues and PC cell lines, and FLVCR1-AS1 downregulation was associated with a worse prognosis in patients with PC. Functional experiments demonstrated that FLVCR1-AS1 overexpression significantly suppressed PC cell proliferation, cell cycle, and migration both in vitro and in vivo. Mechanistic investigations revealed that FLVCR1-AS1 acts as a ceRNA to sequester miR-513c-5p or miR-514b-5p from the sponging KLF10 mRNA, thereby relieving their suppressive effects on KLF10 expression. Additionally, FLVCR1-AS1 was shown to be a direct transcriptional target of KLF10.

Conclusions

Our research suggests that FLVCR1-AS1 plays a tumor-suppressive role in PC by inhibiting proliferation, cell cycle, and migration through a positive feedback loop with KLF10, thereby providing a novel therapeutic strategy for PC treatment.
Societal and equity challenges for Brain Health Services. A user manual for Brain Health Services—part 6 of 6
Authors: Milne Richard , Altomare Daniele , Ribaldi Federica , Molinuevo José Luis , Frisoni Giovanni B. , Brayne Carol ,   on behalf of the European Task Force for Brain Health Services
Published: October 2021

Brain Health Services are a novel approach to the personalized prevention of dementia. In this paper, we consider how such services can best reflect their social, cultural, and economic context and, in doing so, deliver fair and equitable access to risk reduction. We present specific areas of challenge associated with the social context for dementia prevention. The first concentrates on how Brain Health Services engage with the “at-risk“ individual, recognizing the range of factors that shape an individual’s risk of dementia and the efficacy of risk reduction measures. The second emphasizes the social context of Brain Health Services themselves and their ability to provide equitable access to risk reduction. We then elaborate proposals for meeting or mitigating these challenges. We suggest that considering these challenges will enable Brain Health Services to address two fundamental questions: the balance between an individualized “high-risk” and population focus for public health prevention and the ability of services to meet ethical standards of justice and health equity.
Individual and collective human intelligence in drug design: evaluating the search strategy
Authors: Cincilla Giovanni , Masoni Simone , Blobel Jascha
Published: October 2021

In recent years, individual and collective human intelligence, defined as the knowledge, skills, reasoning and intuition of individuals and groups, have been used in combination with computer algorithms to solve complex scientific problems. Such approach was successfully used in different research fields such as: structural biology, comparative genomics, macromolecular crystallography and RNA design. Herein we describe an attempt to use a similar approach in small-molecule drug discovery, specifically to drive search strategies of de novo drug design. This is assessed with a case study that consists of a series of public experiments in which participants had to explore the huge chemical space in silico to find predefined compounds by designing molecules and analyzing the score associate with them. Such a process may be seen as an instantaneous surrogate of the classical design-make-test cycles carried out by medicinal chemists during the drug discovery hit to lead phase but not hindered by long synthesis and testing times. We present first findings on (1) assessing human intelligence in chemical space exploration, (2) comparing individual and collective human intelligence performance in this task and (3) contrasting some human and artificial intelligence achievements in de novo drug design.
Decontaminating N95/FFP2 masks for reuse during the COVID-19 epidemic: a systematic review
Authors: Peters Alexandra , Lotfinejad Nasim , Palomo Rafael , Zingg Walter , Parneix Pierre , Ney Hervé , Pittet Didier
Published: October 2021

Background

With the current COVID-19 pandemic, many healthcare facilities have been lacking a steady supply of filtering facepiece respirators. To better address this challenge, the decontamination and reuse of these respirators is a strategy that has been studied by an increasing number of institutions during the COVID-19 pandemic.

Methods

We conducted a systematic literature review in PubMed, PubMed Central, Embase, and Google Scholar. Studies were eligible when (electronically or in print) up to 17 June 2020, and published in English, French, German, or Spanish. The primary outcome was reduction of test viruses or test bacteria by log3 for disinfection and log6 for sterilization. Secondary outcome was physical integrity (fit/filtration/degradation) of the respirators after reprocessing. Materials from the grey literature, including an unpublished study were added to the findings.

Findings

Of 938 retrieved studies, 35 studies were included in the analysis with 70 individual tests conducted. 17 methods of decontamination were found, included the use of liquids (detergent, benzalkonium chloride, hypochlorite, or ethanol), gases (hydrogen peroxide, ozone, peracetic acid or ethylene oxide), heat (either moist with or without pressure or dry heat), or ultra violet radiation (UVA and UVGI); either alone or in combination. Ethylene oxide, gaseous hydrogen peroxide (with or without peracetic acid), peracetic acid dry fogging system, microwave-generated moist heat, and steam seem to be the most promising methods on decontamination efficacy, physical integrity and filtration capacity.

Interpretation

A number of methods can be used for N95/FFP2 mask reprocessing in case of shortage, helping to keep healthcare workers and patients safe. However, the selection of disinfection or sterilization methods must take into account local availability and turnover capacity as well as the manufacturer; meaning that some methods work better on specific models from specific manufacturers.

Systematic registration number

CRD42020193309.
Application of modified Michaelis – Menten equations for determination of enzyme inducing and inhibiting drugs
Authors: Saganuwan Saganuwan Alhaji
Published: October 2021

Background

Pharmacokinetics (PK) is the process of absorption, distribution, metabolism and elimination (ADME) of drugs. Some drugs undergo zero-order kinetics (ethyl alcohol), first order kinetics (piroxicam) and mixed order kinetics (ascorbic acid). Drugs that undergo Michaelis-Menten metabolism are characterized by either increased or decreased metabolism constant (Km) and maximum velocity (Vmax) of enzyme reaction. Hence literatures were searched with a view to translating in vitro-in vivo enzyme kinetics to pharmacokinetic/pharmacodynamic parameters for determination of enzyme inducing and inhibiting drugs, in order to achieve optimal clinical efficacy and safety.

Methods

A narrative review of retrospective secondary data on drugs, their metabolites, Vmax and Km, generated in the laboratory and clinical environments was adopted, using inclusion and exclusion criteria. Key word search strategy was applied, to assess databases of published articles on enzyme inducing and inhibiting drugs, that obey Michaelis-Menten kinetics. In vitro and in vivo kinetic parameters, such as concentration of substrate, rate of endogenous substrate production, cellular metabolic rate, initial velocity of metabolism, intrinsic clearance, percent saturation and unsaturation of the enzyme substrate, were calculated using original and modified formulas. Years and numbers of searched publications, types of equations and their applications were recorded.

Results

A total of fifty-six formulas both established and modified were applied in the present study. Findings have shown that theophylline, voriconazole, phenytoin, thiopental, fluorouracil, thyamine and thymidine are enzyme inducers whereas, mibefradil, metronidazole, isoniazid and puromicin are enzyme inhibitors. They are metabolized and eliminated according to Michaelis-Menten principle. The order could be mixed but may change to zero or first order, depending on drug concentration, frequency and route of drug administration.

Conclusion

Hence, pharmacokinetic-pharmacodynamic translation can be optimally achieved by incorporating, newly modified Michaelis-Menten equations into pharmacokinetic formulas for clinical efficacy and safety of the enzyme inducing and inhibiting therapeutic agents used in laboratory and clinical settings.
Melanin-based structural coloration of birds and its biomimetic applications
Authors: Jeon Deok-Jin , Paik Suejeong , Ji Seungmuk , Yeo Jong-Souk
Published: October 2021

Melanin has been a widely researched pigment by scientists for decades as it is undoubtedly the most ubiquitous and ancient pigment found in nature. Melanin plays very significant roles in structural plumage colors in birds: it has visible light-absorbing capabilities, and nanoscale structures can be formed by self-assembling melanin granules. Herein, we review recent progress on melanin-based structural coloration research. We hope that this review will provide current understanding of melanin’s structural and optical properties, natural coloration mechanisms, and biomimetic methods to implement artificial melanin-based structural colors.
Life-cycle cost analysis of bridges subjected to fatigue damage
Authors: Sacconi Stefano , Ierimonti Laura , Venanzi Ilaria , Ubertini Filippo
Published: October 2021

Life-cycle cost analysis (LCCA) is a decision-making tool particularly useful for the design of bridges as it predicts lifetime expenses and supports the inspections management and the maintenance activities. LCCA allows to consider uncertainties on loads, resistances, degradation and on the numerical modelling and structural response analysis. It also permits to consider different limit states and different types of damage in a unified framework. Among the types of damages that can occur to steel and steel-concrete composite bridges, fatigue is one of the most dangerous ones, as it may lead to sudden and fragile rupture, even at operational traffic levels. In this context, the present paper proposes a framework for LCCA based on the use of the Pacific Earthquake Engineering Research (PEER) equation which is for the first time utilized for fragility and cost analysis of bridges subjected to fatigue, highlighting the possibility of treating the problem of fatigue damage estimation with an approach similar to the one currently adopted for damage induced by other hazards, like earthquake and wind. To this aim, a damage index computed through the Palmgren-Miner’s rule is adopted as engineering demand parameter. The framework is applied to a composite steel-reinforced concrete multi-span roadway bridge by evaluating the fatigue limit state from different traffic load models, i.e. a Technical Code-based model and a model based on results of Weigh in Motion monitoring system. The evolution over time of the probability of failure and the life-cycle costs due to fatigue damage induced by heavy traffic loads are investigated for different probability distributions of the engineering demand parameter and for different fragility models. The comparison between the fatigue failure probabilities and the life-cycle costs obtained with the two traffic models, encourages the adoption of traffic monitoring systems for a correct damage estimation.
Regulation of rose petal dehydration tolerance and senescence by RhNAP transcription factor via the modulation of cytokinin catabolism
Authors: Zou Jing , Lü Peitao , Jiang Liwei , Liu Kun , Zhang Tao , Chen Jin , Yao Yi , Cui Yusen , Gao Junping , Zhang Changqing
Published: October 2021

Petals and leaves share common evolutionary origins but have different phenotypic characteristics, such as the absence of stomata in the petals of most angiosperm species. Plant NAC transcription factor, NAP, is involved in ABA responses and regulates senescence-associated genes, and especially those that affect stomatal movement. However, the regulatory mechanisms and significance of NAP action in senescing astomatous petals is unclear. A major limiting factor is failure of flower opening and accelerated senescence. Our goal is to understand the finely regulatory mechanism of dehydration tolerance and aging in rose flowers. We functionally characterized RhNAP, an AtNAP-like transcription factor gene that is induced by dehydration and aging in astomatous rose petals. Cytokinins (CKs) are known to delay petal senescence and we found that a cytokinin oxidase/dehydrogenase gene 6 (RhCKX6) shares similar expression patterns with RhNAP. Silencing of RhNAP or RhCKX6 expression in rose petals by virus induced gene silencing markedly reduced petal dehydration tolerance and delayed petal senescence. Endogenous CK levels in RhNAP- or RhCKX6-silenced petals were significantly higher than those of the control. Moreover, RhCKX6 expression was reduced in RhNAP-silenced petals. This suggests that the expression of RhCKX6 is regulated by RhNAP. Yeast one-hybrid experiments and electrophoresis mobility shift assays showed that RhNAP binds to the RhCKX6 promoter in heterologous in vivo system and in vitro, respectively. Furthermore, the expression of putative signal transduction and downstream genes of ABA-signaling pathways were also reduced due to the repression of PP2C homolog genes by RhNAP in rose petals. Taken together, our study indicates that the RhNAP/RhCKX6 interaction represents a regulatory step enhancing dehydration tolerance in young rose petals and accelerating senescence in mature petals in a stomata-independent manner.
Joint full-waveform ground-penetrating radar and electrical resistivity inversion applied to field data acquired on the surface
Authors: Domenzain Diego , Bradford John , Mead Jodi
Published: October 2021

We exploit the different but complementary data sensitivities of ground-penetrating radar (GPR) and electrical resistivity (ER) by applying a multiphysics, multiparameter, simultaneous 2.5D joint inversion without invoking petrophysical relationships. Our method joins full-waveform inversion (FWI) GPR with adjoint derived ER sensitivities on the same computational domain. We incorporate a stable source estimation routine into the FWI-GPR. We apply our method in a controlled alluvial aquifer using only surface-acquired data. The site exhibits a shallow groundwater boundary and unconsolidated heterogeneous alluvial deposits. We compare our recovered parameters to individual FWI-GPR and ER results, and we compare them to log measurements of capacitive conductivity and neutron-derived porosity. Our joint inversion provides a more representative depiction of subsurface structures because it incorporates multiple intrinsic parameters, and it is therefore superior to an interpretation based on log data, FWI-GPR, or ER alone.
Exploratory and confirmatory factor analysis of the 12-item Arabic World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a screening tool for Syrian refugees
Authors: Akhtar Aemal , Cuijpers Pim , Morina Naser , Sijbrandij Marit , Bryant Richard
Published: October 2021

Background

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a generic measure of functional impairment and disability but to date no studies have reported its applicability in a population of Syrian refugees.

Aims

The aim of this study was to explore the psychometric properties and factor structure of the Arabic version of the WHODAS 2.0 among a population of Syrian refugees in a Jordanian refugee camp setting. The tool was used as part of a screening procedure for a randomised controlled trial assessing the effectiveness of a low-intensity psychological intervention.

Method

A representative sample of Syrian refugees (n= 650) were screened to assess levels of functional impairment and psychological distress. The screening results were used to explore the internal consistency and dimensionality of the WHODAS 2.0. We assessed level of convergence with the validated Kessler 10-item Psychological Distress Scale (K10), which assesses psychological distress. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to explore the construct validity and factor structure of the WHODAS 2.0.

Results

The mean baseline WHODAS 2.0 score was 20.5 (s.d. = 7.6). The internal consistency was acceptable (Cronbach's alpha 0.74), with all 12-items appearing to be related to the same construct. The WHODAS 2.0 was positively correlated with the K10 (r= 0.57,P <0.001). The results of the EFA identified a three-factor solution accounting for 51% of variation, corresponding with factors related to self-activities, external activities and self-care. CFA results indicated good fit of the three-factor solution.

Conclusions

The results indicated that the WHODAS 2.0 has a three-factor solution and is an acceptable screening tool for use among Syrian refugees.
Αλληλεπίδραση διαχείρισης αγροτικών οικοσυστημάτων και βιοποικιλότητας
Authors: Χρηστάκης Χρήστος
Published: October 2021

Το κιρκινέζι (Falco naumanni Fleisch) είναι ένα μικρό μεταναστευτικό αρπακτικό. Κατά τη διάρκεια της αναπαραγωγικής περιόδου του, ενδιαιτεί στις ανοικτές καλλιεργούμενες περιοχές της Δυτικής Παλαιαρκτικής. Θεωρούνταν ως ένα από τα πιο κοινά ευρωπαϊκά αρπακτικά πουλιά. Στην περιοχή της Θεσσαλίας αναπαράγεται το μεγαλύτερο τμήμα του ελληνικού πληθυσμού του είδους. Το κιρκινέζι υπέστη δραματική πληθυσμιακή μείωση κατά το δεύτερο μισό του 20ού αιώνα. Ως κύριες αιτίες της μείωσης των πληθυσμών του είδους θεωρούνται η μείωση της διαθεσιμότητας των περιοχών φωλεοποίησης και η αύξηση της γεωργικής εντατικοποίησης, η οποία επηρέασε την έκταση ή/και την ποιότητα των ενδιαιτημάτων τροφοληψίας του είδους και τη διαθεσιμότητα τροφής του. Ειδικότερα, αίτια μείωσης του πληθυσμού του κιρκινεζιού στην περιοχή της Θεσσαλίας θεωρούνται οι μεταβολές της γεωργικής γης, με κυριότερη τη σταδιακή αύξηση της αρδευόμενης καλλιέργειας βαμβακιού κατά τις τελευταίες δύο δεκαετίες. Το κιρκινέζι θεωρείται ως κατάλληλο είδος-δείκτης της αγροτικής βιοποικιλότητας και αποτελεί ένα αντιπροσωπευτικό είδος για την αξιολόγηση των περιβαλλοντικών επιπτώσεων της ΚΑΠ (Κοινή Αγροτική Πολιτική) και των εφαρμοζόμενων γεωργικών πρακτικών στα αγροοικοσυστήματα. Σκοπός της παρούσας διατριβής είναι η διερεύνηση των μηχανισμών αλληλεπίδρασης της διαχείρισης του αγροτικού περιβάλλοντος και της βιοποικιλότητας, μελετώντας την τροφική οικολογία του κιρκινεζιού στη Θεσσαλία, ως είδος- δείκτη για την υγεία του αγροοικοσυστήματος. Η εκτίμηση διαθεσιμότητας ορθόπτερων και κολεόπτερων στις κύριες καλλιέργειες της περιοχής έρευνας, ανέδειξε ότι τα αγροτεμάχια ψυχανθών εμφάνισαν την υψηλότερη συνολική αφθονία κολεόπτερων, ενώ τα αγροτεμάχια βαμβακιού την χαμηλότερη. Στην οικογένεια Carabidae ανήκαν τα περισσότερα άτομα, υπερέχοντας από όλες τις υπόλοιπες οικογένειες κολεόπτερων. Αντίστοιχα, η υψηλότερη αφθονία ορθόπτερων μετρήθηκε στα χέρσα/ακαλλιέργητα αγροτεμάχια, ενώ ακολούθησαν οι καλλιέργειες σιτηρών. Η εκτίμηση της σύνθεσης της τροφής του κιρκινεζιού ανέδειξε ως κύριες κατηγορίες λείας του είδους τα ορθόπτερα και τα κολεόπτερα, ενώ τα μυρμήγκια, τα ημίπτερα, τα δερμάπτερα και λιγότερο οι σκολοπένδρες και τα μικρά θηλαστικά ολοκλήρωναν τη διατροφική προτίμηση του κιρκινεζιού κατά την αναπαραγωγική περίοδο. Η γη σε καθεστώς αγρανάπαυσης ή ακαλλιεργησίας, φαίνεται να αποτελεί το ιδανικό ενδιαίτημα τροφοληψίας του είδους στην περιοχή, ενώ και οι καλλιέργειες των ψυχανθών και των σιτηρών, φαίνεται να είναι προτιμώμενες καλλιέργειες-ενδιαιτήματα από το κιρκινέζι. Συνολικά, οι καλλιέργειες σιτηρών, ψυχανθών και τα χέρσα ή ακαλλιέργητα αγροτεμάχια διατηρούν αφθονότερη λεία για το κιρκινέζι και παράλληλα προτιμώνται από το είδος ως ενδιαιτήματα τροφοληψίας. Κατά συνέπεια, αποτελούν προτεινόμενες καλλιεργητικές προτάσεις σε σχέδια διατήρησης του είδους και γενικότερα της βιοποικιλότητας, σε αγροτικά οικοσυστήματα στην περιοχή του θεσσαλικού κάμπου.
Η ακεραιότητα της σύγχρονης αγοράς χρηματοπιστωτικών μέσων
Authors: Γκαβογιάννη Παρθένα-Χριστίνα
Published: October 2021

Το θεσμικό πλαίσιο έναντι των πράξεων κατάχρησης της αγοράς εδράζεται στο ακόλουθο δίπολο της αθέμιτης χρήσης της πληροφορίας στον χώρο της κεφαλαιαγοράς: αφενός, πρόκειται για την αθέμιτη χρήση γνησίων πληροφοριών, ο προνομιακός χαρακτήρας των οποίων πλήττει την επιδιωκόμενη ισότητα των ίσων ευκαιριών μεταξύ των συναλλασσομένων· αφετέρου, πρόκειται για την αθέμιτη δημιουργία και διακίνηση μη γνήσιων πληροφοριών, ο τεχνητός και κατ’ ουσίαν αναληθής χαρακτήρας των οποίων πλήττει την δυνατότητα των συναλλασσομένων να λάβουν τις επενδυτικές τους αποφάσεις, επί τη βάσει αξιόπιστων δεδομένων. Υπό την ανωτέρω προσέγγιση, στο πρώτο κεφάλαιο παρουσιάζονται οι ιστορικές καταβολές του πλαισίου έναντι των πράξεων κατάχρησης της αγοράς, υπό το πρίσμα τόσο της οικονομικής θεωρίας, όσο και της νομικής θεωρίας, στην οποία θεμελιώνονται. Στο δεύτερο κεφάλαιο αναλύεται η συμπεριφορά που συνιστά παράνομη χρήση της προνομιακής πληροφορίας, η οποία χαρακτηρίζεται ως προσβολή της ακεραιότητας της αγοράς με διακριτικό γνώρισμα το παραγωγικό αίτιο της συμπεριφοράς. Στο τρίτο κεφάλαιο αναλύεται η συμπεριφορά που συνιστά χειραγώγηση της αγοράς, η οποία χαρακτηρίζεται ως προσβολή της ακεραιότητας της αγοράς με διακριτικό γνώρισμα το δυνητικό αποτέλεσμα της συμπεριφοράς.
Psychosomatic health and sympathetic nervous adaptation of health professionals and the general population during the second covid-19 wave in Greece. between-group comparisons and regression analysis
Authors: Pilafas Georgios , Lyrakos Georgios
Published: October 2021

Background: Based on previous COVID-19 global literature, the second COVID-19 outbreak in Greece probably created a stressful environment for health professionals and the general population. It is likely that psychosomatic and sympathetic nervous symptoms increased in both groups.Aim: The study tests whether health professionals would present significantly higher levels of psychosomatic and sympathetic nervous symptoms, and whether several biopsychosocial criteria would predict psychosomatic symptoms overall.Material & Methods: 192 participants were recruited though the snowball strategy after the first domestic COVID-19 lockdown in Greece. Participants provided socio-demographic details, while they answered measurements regarding nervous adaptation (DASS-21), psychosomatics (PSSQ-29), resilience (NMRQ), self-efficacy (GSE) and personality (IPIP-50). The researchers performed independent t-tests, one-way ANOVAs, Pearson’s r correlation analysis and a multiple linear regression.Results: Health professionals experienced significantly less psychosomatic and sympathetic nervous symptoms compared to the general population, while none of the socio-demographic variables show between-groups differences. 10 out of 15 biopsychosocial variables were found significantly correlated with psychosomatic symptoms. The predictive model (Adjusted R2= .586) shows ‘stress’ (β= .242, p= .006), ‘anxiety’ (β= .494, p< .001) and ‘emotional stability’ (β= -.160, p= .004) to be significant predictors, excluding ‘gender’, ‘being a health professional’, ‘resilience’, ‘self-efficacy’ and ‘extraversion’.Conclusions: The findings contradict to previous studies regarding psychosomatic and sympathetic nervous symptoms in the COVID-19 era. Additionally, the prediction model is not consistent to the theories regarding resilience and self-efficacy. The present study provides much debate in the relevant fields of research.
Clinical indicators as prognostic factors of multi-trauma patients in the Intensive Care Unit
Authors: Agorogianni Despoina , Michalopoulos Eleni , Prantzou Ariadni , Liaskou Chara , Stamou Angeliki , Kapadochos Theodoros , Tzenalis7 Anastasios
Published: October 2021

Background: In recent years, there has been a growing interest in understanding the role of prognostic factors in patient outcome.Aim: To investigate the role of clinical indicators, and severity-of-disease assessment scales, as prognostic factors in the outcome of multi-trauma patients in the ICU.Material and Method: The sample consisted of 65 ICU multi-trauma patients treated in a hospital in Thessaloniki city, with an average stay of 16.5 days. Clinical indicators such as Glasgow Coma Scale, heart rate, mean arterial pressure, lactic acid, hemoglobin, urine output, as well as APACHE II and SAPS II scales, were recorded on the day of admission to the ICU.Data analysis: Data were analyzed using multiple logistic regression and Mann-Whitney Test. Multiple logistic regression analysis was performed to examine the predictive capacity of specific indicators on patient outcome.Results: The results of the analysis showed that in cases where all clinical indicators changed, then patient outcome may be affected by 79,4% (Relative Risk 3.846, p<0.001). Glasgow Coma Scale (p=0.022) and hemoglobin (p=0.013) were the strongest influencing factors related to patient outcome. Mann-Whitney analysis was used to evaluate the predictive value of Apache II and SAPS II and demonstrated that both systems could significantly predict patient outcome (APACHE II=0.019 and SAPS II=0.013).Conclusion: Hemoglobin and Glasgow Coma Scale values upon multi-trauma patient admission to the ICU appear to be strong prognostic factors of patient outcome.
Effect of Transcranial Direct Current Stimulation associated with aerobic exercise on the autonomic modulation of hemiparetic individuals due to stroke: a study protocol for a double-blind randomized controlled trial
Authors: Zilli Lo Presti Heinz Solange , De Angelis Katia , Heinz Glauber , Viana Ariane , Marciano Consolim-Colombo Fernanda , Calegari Bonfadine Agatha , Rodrigues Nemesio Ruthe , Gabriella Ribolli Bacalhau Claudia , Alves de Oliveira Rafael , Sayuri Miyamura Cristina , Carlos Ferrari Corrêa João , Ishida Corrêa Fernanda
Published: October 2021

Background:Individuals after a stroke have an imbalance in the autonomic nervous system, which increases the risk of death or recurrent episodes of stroke. Transcranial Direct Current Stimulation (tDCS) combined with aerobic exercise has shown an effect on the modulation of this system.

Objective:The Heart Rate Variability (HRV) and the distance traveled on the exercise bike will be assessed to verify the additional impact of tDCS combined with aerobic exercise on individuals with chronic stroke sequelae.

Methods:The 34 adult individuals with diagnoses of chronic stroke will be randomized into two aerobic exercise intervention groups: G1 (with active tDCS) and G2 (with sham tDCS), three times a week, for 12 weeks.

Procedures:tDCS will be implemented during the aerobic exercise with the anodal electrode positioned over the lateral dorsal prefrontal left cortex, and the cathodal electrode over the contralateral supraorbital region, with 2mA, for 20 minutes. Assessments will be carried out pre, immediately after the intervention, and on the 12th, 24th, 36th interventions, and 30 days later.

The HRV data that are pulse interval (PI), square root of the mean of the squares of the differences between adjacent normal RR intervals (rMSSD), absolute high frequency (HF), absolute low frequency (LF), high and low frequency ratio (LF / HF) will be collected using a cardio frequency meter. The analysis of the distance traveled on the exercise bike before and after interventions will be analyzed in meters.

Discussion:The autonomic control via brain networks after a stroke can be altered and can promote an increase in sympathetic tone, and a higher risk of sudden death or relapse of stroke.  It is crucial to demonstrate the effectiveness of available treatments to improve the autonomic function.

Trial registration:The study is registered as aBRAZILIAN CLINICAL TEST RECORD(ReBEC): U1111-1222-4588 on the 2018/10/16
Status of self-esteem in medical students of a college in Kathmandu: A descriptive cross sectional study
Authors: Shrestha Bikal , Yadav Stuti , Dhakal Subodh , Ghimire Pooja , Shrestha Yubika , Singh Rathaure Ela
Published: October 2021

Background: Self-esteem is vital to living a happy, confident and content life. Medical students experience various forms of stress due to academic, financial and social pressures which could affect their levels of self-esteem. This study aims to study the status of self-esteem among undergraduates of a medical college at Tribhuvan University, Nepal.

Methods: After receiving the ethical approval from the Institutional Review Committee (IRC) of NAIHS; we conducted a descriptive cross-sectional study among the first- to fifth-year medical students from December 2020 to April 2021. 190 were selected for the study using a stratified random sampling technique. This study used the Rosenberg self-esteem scale to measure self–esteem of the participants. A Google Forms questionnaire was sent to the participants via email. Then, the data obtained were entered in the Google sheet and later analyzed using SPSS 27. A Chi-square test was used to identify potential differences in self-esteem scores among different variables. A p-value of < 0.05 was considered statistically significant. 

Results: This study included a total of 180 participants, among which, 18.9% (13.19% to 24.61%; at 95% CI) students showed low self -esteem. 74.4% (68.02% to 80.78%; at 95% CI) students had normal self-esteem and 6.7% (3.05% to 10.35%; at 95% CI) students had high self-esteem. The mean self-esteem score was 19.19 (15.01 to 23.37; at 95% CI). Female participants suffered more than males from low self-esteem, and third-year students had the highest percentage of low self-esteem (30.77%).

Conclusion: The majority (74.4%) of medical students had normal self-esteem. However, 18.9% students had low self-esteem, among which, third-year students suffered the most (30.77%). Likewise, females exhibited higher prevalence of low self-esteem compared to males. Interventions to boost the level of self-esteem should be carried out to help medical students become confident and efficient doctors.
Motion and Geometric Feature Analysis for Real-time Automatic Micro-expression Recognition Systems
Authors: Muhammad Buhari Adamu , Ooi Chee-Pun , Baskaran Vishnu Monn , Tan Wooi-Haw
Published: October 2021

The trend of real-time micro-expression recognition systems has increased with recent advancements in human-computer interaction (HCI) in security and healthcare. Several studies in this field contributed towards recognition accuracy, while few studies look into addressing the computation costs. In this paper, two approaches for micro-expression feature extraction are analyzed for real-time automatic micro-expression recognition. Firstly, motion-based approach, which calculates motion of subtle changes from an image sequence and present as features. Then, secondly, a low computational geometric-based feature extraction technique, a very popular method for facial expression recognition in real-time. These approaches were integrated in a developed system together with a facial landmark detection algorithm and a classifier for real-time analysis. Moreover, the recognition performance were evaluated using SMIC, CASME, CAS(ME)2 and SAMM datasets. The results suggest that the optimized Bi-WOOF (leveraging on motion-based features) yields the highest accuracy of 68.5%, while the full-face graph (leveraging on geometric-based features) yields 75.53% on the SAMM dataset. On the other hand, the optimized Bi-WOOF processes sample at 0.36 seconds and full-face graph processes sample at 0.10 seconds with a 640x480 image size. All experiments were performed on an Intel i5-3470 machine.