bluuebunny/crossref_metadata_2025 huggingface dataset:
SARS-CoV-2 antibody seroprevalence in Togo: a national cross-sectional household survey, May–June, 2021
Authors: Konu Yao Rodion , Condé Siaka , Gbeasor-Komlanvi Fifonsi , Sadio Arnold Junior , Tchankoni Martin Kouame , Anani Joel , Bitty-Anderson Alexandra , Mirindi Bisimwa Ruhana , Diallo Fatoumata Binta Tidiane , MIjiyawa Moustapha , Dagnra Anoumou Claver , Ekouevi Didier Koumavi
Published: December 2022

Background

The extent of SARS-CoV-2 circulation in African countries is still unclear. Seroprevalence studies are a common approach to epidemiological surveillance, allowing estimation of the proportion of people who have had contact with the virus. We aimed at estimating the seroprevalence of anti-SARS-CoV-2 antibodies and associated factors in Togo at the national level in 2021 according to age groups, gender, and place of residence (rural or urban).

Methods

From 15 May to 31 June 2021, we conducted a nationally representative cross-sectional serological survey in 12 health districts (two districts per health region) in the > 5 years old population in Togo. The Wantai SARS-CoV-2 total antibody assay S protein receptor-binding domain-based ELISA (Wantai Biological Pharmacy Enterprise Co.; Beijing, China) was used to determine the presence of SARS-CoV-2 total antibodies in plasma. Crude and weighted seroprevalences (weighted by age, sex and place of residence) were calculated and then weighted seroprevalences were adjusted according to sensitivity and specificity of the ELISA test. Finally, logistic regression models were performed in order to describe factors associated.

Results

Of the 7593 participants, the overall weighted and adjusted seroprevalence of total anti-SARS-CoV-2 antibodies was 65.5% (95%CI: 64.3 -66.6). Urban dwellers, young adults (30–49 years) and vaccinated individuals were significantly more likely to be seropositive.

Conclusion

The high seroprevalence we observed is consistent with observations across West Africa. Quantification of the level of immunity in the population is needed to know how close we are to herd immunity. In the meantime, vaccination against the COVID-19 remains necessary.
Whole ureter replacement with Yang–Monti principle: successful treatment of challenging conditions
Authors: Lin Chyau-Wen , Chen Jen-Chieh , Huang William J. , Lin Tzu-Ping
Published: December 2022

Background

No clear consensus has been reached on the reconstruction of long-segment or total ureter discontinuation. Here we present our experience using the Yang–Monti technique in total ureter reconstruction.

Methods

This study was a single-center retrospective study of patients who underwent Yang–Monti ileal whole ureter reconstruction (from the ureteropelvic junction[UPJ] to the ureterovesical junction). Data were collected on patients’ baseline characteristics, stricture etiology, the time interval between insult and surgical repair, pre/postoperative serum creatinine, estimated glomerular filtration rate (eGFR), split renal function, complications during admission and follow-ups, and the indwelling durations of JJ tubes and nephrostomy tubes, if presented.

Results

Seven patients underwent Yang–Monti ileal ureter reconstruction in 2010–2020 at our hospital. One of the patients underwent single-session bilateral ureter repair. Radiation therapy-related fibrosis and degloving injury were the most common etiologies for ureter injury. The median interval between ureter insult and operation was 8 months. The median follow-up was 36.7 months. The average operation time was 11.4 h, and the average blood loss was 273 ml. Postoperatively, no significant differences were found in serum creatinine, eGFR, or split renal function. As for postoperative complications, two patients experienced ileus and were treated conservatively. One patient had UPJ stenosis, which resolved after re-anastomosis surgery 11 months later. Metabolic acidosis or electrolyte imbalance was not reported.

Conclusion

We found that ileal replacement of total ureteral loss using the Yang–Monti principle is effective and durable. This is the largest cohort study conducted with more than 2 years of follow-up.
Online learning for continuous professional development of healthcare workers: an exploratory study on perceptions of healthcare managers in Rwanda
Authors: Byungura Jean Claude , Nyiringango Gerard , Fors Uno , Forsberg Elenita , Tumusiime David K.
Published: December 2022

Background

Due to outbreaks of new diseases, development of new treatment regimens and requirement of evidence-based practice, health professionals continuously need to acquire updated knowledge and skills. This type of learning is known as continuous professional development (CPD). The scarcity of skilled health care professionals in developing countries further increases the need of CPD. Traditionally, face-to-face approach has been preferred as the best mode of CPD. Currently, health professionals have started using online learning for continued professional growth in different parts of the world. Consequently, research studies from different settings are needed to investigate the significance of online learning for CPD. Therefore, the aim of this study was to investigate the importance and challenges attributed to online learning by the managers of health facilities in Rwanda. Moreover, the study aimed to identify the status of infrastructures that could support online CPD, and assess the perceived enhancement and barriers for implementing online CPD.

Methods

The study used a convergence mixed-method design to explore quantitative and qualitative data from 42 health care managers. A descriptive analysis was conducted on quantitative data while qualitative data were thematically analyzed to inform the study findings.

Results

It was revealed that 90.5% of managers, who participated in this study, consider positively the use of online learning for CPD. All managers acknowledged that online learning could improve the knowledge and practice skills of health care professionals. Nevertheless, 52.4% of health institutions who participated in this study currently do not use online for CPD. Participants demonstrated challenges such as the lack of access to digital devices, poor or lack of internet access, poor online learning design, low digital skills of healthcare professionals, lack of time dedicated to online learning, and heavy workload of staff.

Conclusion

These findings indicate then that the managers of health institutions value the importance of online learning for CPD of health professionals. However, online learning should be designed to fit for the purpose and with a high consideration on needs and preferences of healthcare professionals and thereby improve information communication technology infrastructure that support online learning for CPD. Traditional in-person CPD courses are still recommended in health institutions with shortage in resources and technology. Also, the barriers of online CPD delivery such as low internet connectivity and lack of access to digital devices by healthcare professionals need to be co-creatively addressed through the pyramidal structure of the Rwandan health system.
Classification of medicines and materials in hospital inventory management: a multi-criteria analysis
Authors: de Assis Amanda G. , dos Santos Ana Flávia A. , dos Santos Lucas A. , da Costa João F. , Cabral Marco Antonio L. , de Souza Ricardo P.
Published: December 2022

Background

In the hospital environment, to achieve an optimum level of operations and service, it is necessary to develop adequate inventory management system. Stocks can be managed, amongst other ways, through inputs classification, which is generally carried out based on a single criterion, such as monetary value, demand or criticality, which does not fully address the complexity of a hospital’s inventory management system. Thus, the present study proposes a multi-criteria decision support model to help classify the stock of medicines and materials, enabling a more effective inventory management system for hospitals.

Methods

Methodologically, the study followed 3 stages: (1) preliminary phase; (2) modelling and choice phase; and (3) finalization phase. Each stage had a set of specific steps that were followed. The first stage identified the actors of the process, objectives, criteria and alternatives, establishing 5 criteria and 48 alternatives; the second stage was the choice and execution of the multi-criteria decision method to solve the problem. It was decided to use the Flexible and Interactive Tradeoff method for the sorting problematic. Finally, in the third stage, the sensitivity analysis for the developed model and the validation of the results with decision makers were carried out. In the study, 48 medicines and materials were included to validate the proposed model; however, the model could be used for more items.

Results

From the total of 48 medicines and hospital medical materials selected for the study, the classification of 34 of these alternatives to a single class was obtained through modelling and the other 14 alternatives were destined to two possible classes; moreover, the sensitivity analysis performed showed robust results. The items classified in class W should receive special attention by the stock manager; therefore, they should be monitored weekly. Items classified in class B should be monitored biweekly and finally, items classified in class M, should be monitored monthly.

Conclusions

The classification of medicines and materials developed according to the inventory demands allowed more efficient purchasing decisions, optimizing the stock of materials and medicines at the hospital while optimizing the inventory manager’s activities, saving time. Consequently, the proposed model can support the development of other multicriteria models in different hospital scenarios.
The anterior gradient homologue 2 (AGR2) co-localises with the glucose-regulated protein 78 (GRP78) in cancer stem cells, and is critical for the survival and drug resistance of recurrent glioblastoma: in situ and in vitro analyses
Authors: Hussein Deema , Alsereihi Reem , Salwati Abdulla Ahmed A. , Algehani Rinad , Alhowity Alazouf , Al-Hejin Ahmed M. , Schulten Hans-Juergen , Baeesa Saleh , Bangash Mohammed , Alghamdi Fahad , Cross Richard , Al Zughaibi Torki , Saka Mohamad , Chaudhary Adeel , Abuzenadah Adel
Published: December 2022

Background

Glioblastomas (GBs) are characterised as one of the most aggressive primary central nervous system tumours (CNSTs). Single-cell sequencing analysis identified the presence of a highly heterogeneous population of cancer stem cells (CSCs). The proteins anterior gradient homologue 2 (AGR2) and glucose-regulated protein 78 (GRP78) are known to play critical roles in regulating unfolded protein response (UPR) machinery. The UPR machinery influences cell survival, migration, invasion and drug resistance. Hence, we investigated the role of AGR2 in drug-resistant recurrent glioblastoma cells.

Methods

Immunofluorescence, biological assessments and whole exome sequencing analyses were completed under in situ and in vitro conditions. Cells were treated with CNSTs clinical/preclinical drugs taxol, cisplatin, irinotecan, MCK8866, etoposide, and temozolomide, then resistant cells were analysed for the expression of AGR2. AGR2 was repressed using single and double siRNA transfections and combined with either temozolomide or irinotecan.

Results

Genomic and biological characterisations of the AGR2-expressed Jed66_GB and Jed41_GB recurrent glioblastoma tissues and cell lines showed features consistent with glioblastoma. Immunofluorescence data indicated that AGR2 co-localised with the UPR marker GRP78 in both the tissue and their corresponding primary cell lines. AGR2 and GRP78 were highly expressed in glioblastoma CSCs. Following treatment with the aforementioned drugs, all drug-surviving cells showed high expression of AGR2. Prolonged siRNA repression of a particular region in AGR2 exon 2 reduced AGR2 protein expression and led to lower cell densities in both cell lines. Co-treatments using AGR2 exon 2B siRNA in conjunction with temozolomide or irinotecan had partially synergistic effects. The slight reduction of AGR2 expression increased nuclear Caspase-3 activation in both cell lines and caused multinucleation in the Jed66_GB cell line.

Conclusions

AGR2 is highly expressed in UPR-active CSCs and drug-resistant GB cells, and its repression leads to apoptosis, via multiple pathways.
Cerium oxide-based nanozyme suppresses kidney calcium oxalate crystal depositions via reversing hyperoxaluria-induced oxidative stress damage
Authors: Deng Jiwang , Yu Bangxian , Chang Zhenglin , Wu Sicheng , Li Guanlin , Chen Wenzhe , Li Shujue , Duan Xiaolu , Wu Wenqi , Sun Xinyuan , Zeng Guohua , Liu Hongxing
Published: December 2022

Oxidative stress damage to renal epithelial cells is the main pathological factor of calcium oxalate calculi formation. The development of medicine that could alleviate oxidative damage has become the key to the prevention and treatment of urolithiasis. Herein, porous nanorods CeO2 nanoparticles (CNPs) were selected from CeO2 with different morphologies as an antioxidant reagent to suppress kidney calcium oxalate crystal depositions with excellent oxidation resistance due to its larger specific surface area. The reversible transformation from Ce3+ to Ce4+ could catalyze the decomposition of excess free radicals and act as a biological antioxidant enzyme basing on its strong ability to scavenge free radicals. The protection capability of CNPS against oxalate-induced damage and the effect of CNPS on calcium oxalate crystallization were studied. CNPS could effectively reduce reactive oxygen species production, restore mitochondrial membrane potential polarity, recover cell cycle progression, reduce cell death, and inhibit the formation of calcium oxalate crystals on the cell surface in vitro. The results of high-throughput sequencing of mRNA showed that CNPs could protect renal epithelial cells from oxidative stress damage caused by high oxalate by suppressing the expression gene of cell surface adhesion proteins. In addition, CNPS can significantly reduce the pathological damage of renal tubules and inhibit the deposition of calcium oxalate crystals in rat kidneys while having no significant side effect on other organs and physiological indicators in vivo. Our results provide a new strategy for CNPS as a potential for clinical prevention of crystalline kidney injury and crystal deposition.
PhenoTrack3D: an automatic high-throughput phenotyping pipeline to track maize organs over time
Authors: Daviet Benoit , Fernandez Romain , Cabrera-Bosquet Llorenç , Pradal Christophe , Fournier Christian
Published: December 2022

Background

High-throughput phenotyping platforms allow the study of the form and function of a large number of genotypes subjected to different growing conditions (GxE). A number of image acquisition and processing pipelines have been developed to automate this process, for micro-plots in the field and for individual plants in controlled conditions. Capturing shoot development requires extracting from images both the evolution of the 3D plant architecture as a whole, and a temporal tracking of the growth of its organs.

Results

We propose PhenoTrack3D, a new pipeline to extract a 3D + t reconstruction of maize. It allows the study of plant architecture and individual organ development over time during the entire growth cycle. The method tracks the development of each organ from a time-series of plants whose organs have already been segmented in 3D using existing methods, such as Phenomenal [Artzet et al. in BioRxiv 1:805739, 2019] which was chosen in this study. First, a novel stem detection method based on deep-learning is used to locate precisely the point of separation between ligulated and growing leaves. Second, a new and original multiple sequence alignment algorithm has been developed to perform the temporal tracking of ligulated leaves, which have a consistent geometry over time and an unambiguous topological position. Finally, growing leaves are back-tracked with a distance-based approach. This pipeline is validated on a challenging dataset of 60 maize hybrids imaged daily from emergence to maturity in the PhenoArch platform (ca. 250,000 images). Stem tip was precisely detected over time (RMSE < 2.1 cm). 97.7% and 85.3% of ligulated and growing leaves respectively were assigned to the correct rank after tracking, on 30 plants × 43 dates. The pipeline allowed to extract various development and architecture traits at organ level, with good correlation to manual observations overall, on random subsets of 10–355 plants.

Conclusions

We developed a novel phenotyping method based on sequence alignment and deep-learning. It allows to characterise the development of maize architecture at organ level, automatically and at a high-throughput. It has been validated on hundreds of plants during the entire development cycle, showing its applicability on GxE analyses of large maize datasets.
A green and efficient synthetic methodology towards the synthesis of 1-allyl-6-chloro-4-oxo-1,4-dihydroquinoline-3-carboxamide derivatives
Authors: Gill Muhammad Shoaib Ali , Azzman Nursyuhada , Hassan Sharifah Syed , Shah Syed Adnan Ali , Ahemad Nafees
Published: December 2022

Quinolone is a privileged scaffold in medicinal chemistry and 4-Quinolone-3-Carboxamides have been reported to harbor vast therapeutic potential. However, conversion of N-1 substituted 4-Quinolone 3-Carboxylate to its corresponding carbamates is highly restrictive. This motivated us to adopt a much simpler, scalable and efficient methodology for the synthesis of highly pure N-1 substituted 4- Quinolone-3-Carboxamides with excellent yields. Our adopted methodology not only provides a robust pathway for the convenient synthesis of N-1 substituted 4- Quinolone-3-Carboxamides which can then be explored for their therapeutic potential, this may also be adaptable for the derivatization of other such less reactive carboxylate species.
Task offloading in hybrid-decision-based multi-cloud computing network: a cooperative multi-agent deep reinforcement learning
Authors: Chen Juan , Chen Peng , Niu Xianhua , Wu Zongling , Xiong Ling , Shi Canghong
Published: December 2022

Multi-cloud computing is becoming a promising paradigm to provide abundant computation resources for Internet-of-Things (IoT) devices. For a multi-device multi-cloud network, the real-time computing requirements, frequently varied wireless channel gains and changeable network scale, make the system more dynamic. It is critical to satisfy the dynamic nature of network with different constraints of IoT devices in multi-cloud environment. In this paper, we establish a continuous-discrete hybrid decision offloading model, each device should learn to make coordinated actions, including cloud server selection, offloading ratio and local computation capacity. Therefore, both continuous-discrete hybrid decision and coordination among IoT devices are challenging. To this end, we first develop a probabilistic method to relax the discrete action (e.g. cloud server selection) to a continuous set. Then, by leveraging a centralized training and distributed execution strategy, we design a cooperative multi-agent deep reinforcement learning (CMADRL) based framework to minimize the total system cost in terms of the energy consumption of IoT device and the renting charge of cloud servers. Each IoT device acts as an agent, which not only learns efficient decentralized policies, but also relieves IoT devices’ computing pressure. Experimental results demonstrate that the proposed CMADRL could efficiently learn dynamic offloading polices at each IoT device, and significantly outperform the four state-of-the-art DRL based agents and two heuristic algorithms with lower system cost.
No “carry-over” effects of tracking devices on return rate and parameters determining reproductive success in once and repeatedly tagged common swifts (Apus apus), a long-distance migratory bird
Authors: Wellbrock Arndt H. J. , Witte Klaudia
Published: December 2022

Background

To understand life-history strategies in migratory bird species, we should focus on migration behaviour and possible carry-over effects on both population and individual level. Tracking devices are useful tools to directly investigate migration behaviour. With increased use of tracking devices, questions arise towards animal welfare and possible negative effects of logger on birds. Several studies were conducted to address this question in birds that were tagged and tracked for one complete non-breeding season including migration but with mixed results. To detect individual-based decisions regarding migration strategy, we need to track the same individuals several times. So far, there are no studies investigating effects of repeatedly tagging on reproduction and life-history traits in individual migratory birds, especially in small birds.

Methods

We used long-term data of 85 tagged common swifts (Apus apus), a long-distance migratory bird, of a breeding colony in Germany to test whether carrying a geolocator or GPS logger once or repeatedly during non-breeding season affected return rate, apparent survival, and parameters determining reproductive success. Additionally, we checked for individual differences in arrival date and breeding parameters when the same individuals were tagged and when they were not tagged in different years. Further, we calculated the individual repeatability in arrival at the breeding colony and date of egg laying in repeatedly tagged swifts.

Results

Once and repeatedly tagged birds returned to the colony at a similar rate as non-logger birds and arrived earlier than non-logger birds. We found no effect of logger-type on return rate in logger birds. We detected no differences in apparent survival, time lag to clutch initiation, date of clutch initiation, clutch size, number of chicks and fledglings between logger and non-logger birds. We found neither an effect of loggers nor of logger-types on the arrival date and breeding parameter on individual-level. Arrival date was highly repeatable and date of clutch initiation was moderately repeatable within repeatedly tagged individuals.
Inferring the temporal evolution of synaptic weights from dynamic functional connectivity
Authors: Celotto Marco , Lemke Stefan , Panzeri Stefano
Published: December 2022

How to capture the temporal evolution of synaptic weights from measures of dynamic functional connectivity between the activity of different simultaneously recorded neurons is an important and open problem in systems neuroscience. Here, we report methodological progress to address this issue. We first simulated recurrent neural network models of spiking neurons with spike timing-dependent plasticity mechanisms that generate time-varying synaptic and functional coupling. We then used these simulations to test analytical approaches that infer fixed and time-varying properties of synaptic connectivity from directed functional connectivity measures, such as cross-covariance and transfer entropy. We found that, while both cross-covariance and transfer entropy provide robust estimates of which synapses are present in the network and their communication delays, dynamic functional connectivity measured via cross-covariance better captures the evolution of synaptic weights over time. We also established how measures of information transmission delays from static functional connectivity computed over long recording periods (i.e., several hours) can improve shorter time-scale estimates of the temporal evolution of synaptic weights from dynamic functional connectivity. These results provide useful information about how to accurately estimate the temporal variation of synaptic strength from spiking activity measures.
A calcitonin-producing pancreatic neuroendocrine neoplasm treated with distal pancreatectomy a lengthy time after a left trisectionectomy for liver metastases: a case report
Authors: Yamamoto Ryusei , Yamaguchi Ryuzo , Yoshida Katsushi , Ando Masataka , Toyoda Yoshitaka , Tanaka Aya , Kato Kenji
Published: December 2022

Background

Calcitonin-producing pancreatic neuroendocrine neoplasms (PanNENs) are extremely rare. There have been no reports of a patient in whom liver metastases were the presenting finding, and a calcitonin-producing PanNEN was subsequently detected after a lengthy period.

Case presentation

A 53-year-old man had diarrhea for several years. Computed tomography (CT) revealed multiple liver tumors. We performed a left trisectionectomy with a bile duct resection. The histologic examination showed neuroendocrine tumors G1. Immunohistochemistry was positive for calcitonin and the serum calcitonin level was elevated. Neuroendocrine neoplasms of hepatic origin are extremely rare, so a systemic exploration was performed, but no tumor was detected. CT showed a 4-mm calcification in the pancreatic body, but no contrast-enhanced mass was noted. Although the liver tumors were resected, the diarrhea and high serum calcitonin level persisted. Serial examinations were performed for 6 years, but no tumor was identified; however, 6.5 years after the hepatectomy the serum calcitonin level increased. CT showed a 10-mm contrast-enhanced mass in the calcified area of the pancreatic body. A distal pancreatectomy was performed. The histologic examination showed a neuroendocrine tumor G1, which mimicked the liver tumors. Immunohistochemistry was positive for calcitonin. After the distal pancreatectomy, the serum calcitonin level decreased and diarrhea resolved. The calcitonin-producing neuroendocrine neoplasm was considered the pancreatic primary and the hepatic tumors were metastases.

Conclusions

Calcitonin-producing PanNENs may be initially recognized as liver tumors and may become evident after a lengthy period, thus long-term observation is recommended. Aggressive surgeries may contribute to long-term survival.
Investigating the impact of explicit and implicit instruction on the use of interactional metadiscourse markers
Authors: El-Dakhs Dina Abdel Salam , Yahya Noorchaya , Pawlak Miroslaw
Published: December 2022

The current study aimed to compare the influence of explicit versus implicit instruction on EFL learners’ use of interactional metadiscourse markers in their writing. The study also aimed to explore the perceptions of EFL learners on the instruction of these markers in their writing classes. 120 female undergraduates who are Arab EFL learners took part in the investigation. A mixed-methods research design was adopted with an explicit instruction group, an implicit instruction group and a control group. The experimental groups were introduced to a set of interactional metadiscourse markers as per Hyland’s (2005) interaction model in two 70-minute sessions. Additionally, the experimental groups completed two post-experimental questionnaires. The results of analysis of variance showed a positive, albeit very limited, influence for the explicit/implicit teaching with the markers of self-mentions, appeals to shared knowledge, directives and questions. As for the participants’ perception of the instructional intervention, the participants viewed both explicit and implicit instruction as helpful but could not always apply what they had learned due to task demands. The results are discussed in light of the existing literature and the specific context in which the study was implemented. Furthermore, implications for writing pedagogy are proposed.
Co-learner presence and praise alters the effects of learner-generated explanation on learning from video lectures
Authors: Pi Zhongling , Liu Caixia , Meng Qian , Yang Jiumin
Published: December 2022

Learning from video lectures is becoming a prevalent learning activity in formal and informal settings. However, relatively little research has been carried out on the interactions of learning strategies and social environment in learning from video lectures. The present study addresses this gap by examining whether learner-generated explanations and co-learner presence with or without nonverbal praise independently and interactively affected learning from a self-paced video lecture about infectious diseases. University students were randomized into viewing either the video with instructor-generated explanations or the same video but generating explanations themselves. Outcomes were assessed by the quality of explanations, learning performance, mental effort, attention allocation, and behavioral patterns. Between-group comparisons showed that, in the absence of a peer co-learner, learning performance was similar in both the instructor-generated and learner-generated explanation groups. However, in the presence of a peer, learner-generated explanation facilitated learning performance. Furthermore, learner-generated explanation in the presence of a co-learner also reduced learners’ mental effort and primed more behaviors related to self-regulation and monitoring. The results lead to the following strong recommendation for educational practice when using video lectures: if students learn by generating their own explanations in the presence of a co-learner, they will show better learning performance even though the learning is not necessarily more demanding, and will engage in more behaviors related to explanation adjustment and self-regulation.
Coronary angiography using spectral detector dual-energy CT: is it the time to assess myocardial first-pass perfusion?
Authors: D’Angelo Tommaso , Martin Simon , Micari Antonino , Booz Christian , Steyer Alexandra , Blandino Alfredo , Lanzafame Ludovica R. , Koch Vitali , Ascenti Giorgio , Mazziotti Silvio
Published: December 2022

Coronary computed tomography angiography (CCTA) represents a common approach to the diagnostic workup of patients with suspected coronary artery disease. Technological development has recently allowed the integration of conventional CCTA information with spectral data. Spectral CCTA used in clinical routine may allow for improving CCTA diagnostic performance by measuring myocardial iodine distribution as a marker of first-pass perfusion, thus providing additional functional information about coronary artery disease.
Non-motor manifestation of Parkinson's disease: a cross-sectional study in a teaching hospital in Jordan
Authors: Dahbour Said Salah , Al Murr Mohammad J. , Oweis Liyan H. , Al Antary Nada T. , Mohsen Maram , Al Fegi Safa
Published: December 2022

Background

Parkinson's disease (PD) is the most common degenerative movement disorder. It is featured by motor manifestations and up till now the clinical diagnosis is based on them. Since the progress in the symptomatic treatment of PD and the longer survival of patients, non-motor manifestations (NMM) were more recognized and considered to be significant. The importance of NMM is that they reflect the more diffuse pathology of PD and may represent an opportunity of earlier diagnosis and treatment. Here in this cross-sectional study, we try to estimate the frequency of such manifestations in PD patients in the country. Using slightly modified PD non-motor (28 of 30 responses) questionnaire (NMS Quest), we studied the incidence of NMM in 100 PD patients attending one major teaching hospital and compared their occurrence in 130 age- and gender-matched non-PD controls.

Results

Out of 100 PD patients (40% females) mean age 67.4 ± 12 with disease duration of 7.3 ± 5.8, range < 1–33.2 years), and 130 control subjects (48.5% females), mean age 65.0 ± 7.0. PD patients had 8.6 ± 5.3 NMM while controls had 3.4 ± 3.3 NMM, respectively (p < 0.00001 t test). Constipation, urgency, insomnia, sad feeling, panic, light headedness and recent memory impairment were the most prevalent NMM in PD compared to controls, while nocturia, restless legs, encopresis and falling were not different in the two groups. The number of NMM ranged from 0 to 21 in PD patients with 50% having ≥ 8 manifestations. The number of NMM did not correlate with age, gender, or disease duration as defined by the classical motor symptoms. Frequency of 23 of these 28 manifestations differed significantly in PD patients compared to controls.

Conclusions

This study confirms that NMM in Jordanian PD patients are very common as reported in other populations. This signifies the universal prevalence of such NMM reflecting their important impact on their daily life and their relevant contribution to better understanding of this disease.
Assessment of the diagnostic performance of various screening tools for bipolar disorder: a meta-analysis
Authors: Rahim Fakher , Rouhani Kianmehr , Delirrooyfard Ali , Sayyah Mehdi
Published: December 2022

Background

Various studies have shown that about 40–50% of patients with bipolar disorder (BD) are undiagnosed at the time of referral and are often treated as depression. The present meta-analysis was conducted to determine the diagnostic accuracy of psychometric properties of the bipolarity index (BI) in people with BD.

Methods

We systematically searched databases including, Scopus, ISI Web of Sciences (WOS), Pubmed/Medline, Embase, and PsycINFO using standard search terms.

Results

Two hundred and ninety-six records were found through the initial search. Of 679 articles, 25 duplicated studies were found and 70 were omitted due to the irrelevant titles and abstracts. The rest 450 were entered the full-text screening, of which 186 were excluded due to pre-defined inclusion criteria. Ultimately, 15 studies on 6525 patients were included. Our findings showed that the pooled sensitivity of BI in the diagnosis of BD was 0.82 (95%CI: 0.81–0.83, P < 0.0001, I2 = 99%), while the pooled specificity also was 0.73 (95%CI: 0.72–0.74, P = 0.000, I2 = 99%). The BI was significantly more accurate than the other tests with a pooled DOR of 47.2 (95%CI: 12.01–85.52, P = 0.0000, I2 = 99.2%).

Conclusion

BI appears to be a useful screening instrument with suitable psychometric properties to identify BD compared to both the MDQ and the HCL-32. Consequently, patients detected by the BI should be confirmed through diagnostic interviews. Thus, more studies are needed to explore the optimal cut-off values of BI among screened populations during long-term follow-up, since a considerable portion of individuals primarily diagnosed with major depressive disorders could have BD.
Exploring the role of microfinance in women’s empowerment and entrepreneurial development: a qualitative study
Authors: Khursheed Ambreen
Published: December 2022

In developing countries, women’s empowerment is a major concern. Several efforts were made to tackle this issue as the aims of poverty reduction and development cannot be achieved without giving attention to women’s empowerment. Over the past decades, microfinance institutions (MFIs) have appeared as crucial tools not only to address the issue of poverty but also particularly to empower women. Resultantly, a huge number of studies focus on the relationships between MFI and women empowerment. However, in the context of rural areas of Pakistan, the research is limited. Therefore, the objective of this study is to investigate the role of MFI in women’s empowerment in Pakistan so that the research will facilitate MFIs and policymakers in strengthening the link between MFIs and women entrepreneurship. We have used a qualitative methodology, using primary data collected through in-depth interviews and a focus group discussion with six female borrowers of Rural Community Development Programs (RCDP). The empirical results provide valuable insights into the efforts made by RCDP to empower women and combat poverty by encouraging women’s entrepreneurship. Hence, this paper not only examines empowerment, which women are attaining from microfinance but also assists MFIs to know about their significance in developing the economy. The paper is significant for MFI practitioners to develop policies for boosting women’s entrepreneurship and to help their existing women clients with efficient training and supervision.
Reasons for discontinuation of methotrexate in the treatment of rheumatoid arthritis and challenges of methotrexate resumption: a single-center, retrospective study
Authors: Nagafuchi Hiroko , Goto Yutaka , Kiyokawa Tomofumi , Kawahata Kimito
Published: December 2022

Background

Methotrexate (MTX) is an anchor drug used for the treatment of rheumatoid arthritis (RA); hence, understanding the reasons for MTX discontinuation in RA can help improve its treatment. Therefore, this study aimed to investigate the reasons for MTX discontinuation and to identify future challenges in RA treatment regarding the discontinuation and resumption of MTX treatment.

Results

MTX administration was discontinued in 771 patients with RA. The reasons for MTX discontinuation were as follows: (1) infectious diseases (20.0%), (2) malignancy (14.1%), and (3) respiratory problems (10.2%). Some patients did not resume MTX therapy even after the infections were cured. Liver dysfunction (8.0%) did not improve with MTX discontinuation and was often associated with fatty liver disease. In addition to adverse events, MTX discontinuation was due to patient preference (4.3%), planning for pregnancy (5.1%), invalidity (5.7%), remission (5.6%), remission with biologics (4.7%), old age (2.6%), and poor compliance (1.6%).

Conclusions

This study revealed diverse reasons for the discontinuation of MTX; there are cases in which MTX is discontinued but should be considered for resumption. Furthermore, issues such as the indications for MTX discontinuation should still be debated, and multicenter evidence must be collected and examined in future studies.
BRCA-CRisk: A Contralateral Breast Cancer Risk Prediction Model forBRCACarriers
Authors: Sun Jie , Chu Futao , Pan Jiani , Zhang Yaxin , Yao Lu , Chen Jiuan , Hu Li , Zhang Juan , Xu Ye , Wang Xiaojia , Cao Wenming , Xie Yuntao
Published: December 2022

PURPOSE

The absolute cumulative risk of contralateral breast cancer (CBC) for patients with BRCA1/ 2 variants is unknown. The purpose of this study was to develop a CBC risk prediction model for assessing CBC risk for BRCA1/ 2 carriers.

METHODS

The primary cohort of 491 patients with BRCA1/ 2 variants was derived from a large series of unselected patients with breast cancer. A nomogram was established on the basis of the results of a multivariate Cox regression analysis from this cohort. This model, named BRCA-CRisk, was further validated by an independent cohort of 205 patients with BRCA1/ 2 variants. Discrimination and calibration of the model were assessed.

RESULTS

In the primary cohort of 491 patients, 66 developed contralateral breast cancer after a median follow-up of 7.0 years. Four variables were significantly associated with risk of CBC and were incorporated in the establishment of the BRCA-CRisk prediction model: younger age at first breast cancer (with continuous variable, P = .002), positive first-degree family history of breast and/or ovarian cancer (hazard ratio [HR], 1.89; 95% CI, 1.16 to 3.08; P = .011), variant located near the 3′ region of BRCA (HR, 2.01; 95% CI, 1.23 to 3.30; P = .006), and endocrine therapy (HR, 0.54; 95% CI, 0.33 to 0.88; P = .013). The area under the time-dependent curves for the 5- and 10-year cumulative risks of CBC were 0.775 and 0.702, respectively. The model was well validated in the independent cohort of 205 BRCA1/ 2 carriers, with area under the curves of 0.750 and 0.691 for 5 and 10 years, respectively.

CONCLUSION

BRCA-CRisk model provides a useful tool for assessing the absolute cumulative risk of CBC for BRCA1/ 2 carriers and may help carriers and clinicians optimally select risk-reducing strategies on the basis of individual CBC risk.
Plasticity in Na+/K+-ATPase thermal kinetics drives variation in the temperature of cold-induced neural shutdown of adult Drosophila melanogaster
Authors: Andersen Mads Kuhlmann , Robertson R. Meldrum , MacMillan Heath A.
Published: December 2022

Most insects can acclimate to changes in their thermal environment and counteract temperature effects on neuromuscular function. At the critical thermal minimum, a spreading depolarization (SD) event silences central neurons, but the temperature at which this event occurs can be altered through acclimation. SD is triggered by an inability to maintain ion homeostasis in the extracellular space in the brain and is characterized by a rapid surge in extracellular K+ concentration, implicating ion pump and channel function. Here, we focused on the role of the Na+/K+-ATPase specifically in lowering the SD temperature in cold-acclimated Drosophila melanogaster. After first confirming cold acclimation altered SD onset, we investigated the dependency of the SD event on Na+/K+-ATPase activity by injecting the inhibitor ouabain into the head of the flies to induce SD over a range of temperatures. Latency to SD followed the pattern of a thermal performance curve, but cold acclimation resulted in a left-shift of the curve to an extent similar to its effect on the SD temperature. With Na+/K+-ATPase activity assays and immunoblots, we found that cold-acclimated flies have ion pumps that are less sensitive to temperature, but do not differ in their overall abundance in the brain. Combined, these findings suggest a key role for plasticity in Na+/K+-ATPase thermal sensitivity in maintaining central nervous system function in the cold, and more broadly highlight that a single ion pump can be an important determinant of whether insects can respond to their environment to remain active at low temperatures.
Political polarization and economic inequality in the European Union
Authors: Ραλλάτου Διονυσία
Published: December 2022

Την τελευταία πενταετία η πολιτική πόλωση παρουσιάζει συνεχή αυξητική τάση. Υστέρα από μια σύντομη περίοδο όπου υπήρχε διάθεση συναίνεσης και συνεργασίας μεταξύ των πολιτικά αντίθετων παρατάξεων, φαίνεται ότι πλέον περνάμε σε μια φάση όπου κυριαρχεί η επιλογή της στρατηγικής και ρητορικής μίσους προκειμένου να αυξηθεί η προσέλκυση ψηφοφόρων καθώς και να μεγιστοποιηθεί η προσέλευση στις κάλπες. Αυτό σήμερα έχει οδηγήσει σε αυξημένο κατακερματισμό, τόσο εντός των κοινοβουλίων όσο και ανάμεσα στον λαό. Παρά το γεγονός ότι το ζήτημα αυτό έχει μελετηθεί εκτενώς στις Ηνωμένες Πολιτείες, δεν υπάρχουν πολλές μελέτες πάνω στο φαινόμενο αυτό για τις χώρες της Ευρώπαικης Ένωσης, πολλώ δε μάλλον συγκριτικές μελέτες μεταξύ των χωρών εντός αυτής. Στην παρούσα διατριβή, μελετήθηκε η εξέλιξη της πολιτικής πόλωσης σε 10 χώρες της Ευρωπαϊκής Ένωσης κατά την διάρκεια τριάντα ετών, από το 1989 έως και το 2019. Για την υλοποίηση της συγκριτικής αυτής μελέτης χρησιμοποιήθηκε ένας δείκτης ο οποίος λαμβάνει υπόψη του την ετερογένεια μεταξύ των ομάδων καθώς και την ομοιογένεια εντός των ομάδων. Η διαδικασία εκτίμησης του δείκτη πολιτικής πόλωσης εντός κάθε χώρας έχει βασιστεί στον υπολογισμό της εκτίμησης της ιδανικής θέσης (ideal point estimate) των ερωτώμενων αναφορικά με την αυτοτοποθέτησή τους στην πολιτική κλίμακα. Για τον υπολογισμό της ιδανικής θέσης χρησιμοποιήθηκε μια πιθανοθεωρητική μέθοδος αναπροσαρμογής μεγέθους. Χρησιμοποιώντας τα αποτελέσματα αυτά, σε συνδυασμό με τις απαντήσεις για την αντίληψη των ερωτηθέντων περί της θέσεως των κομμάτων των χωρών τους, εκτιμούμε την συνάρτηση πυκνότητας πιθανότητας της κατανομής της κοινής πολιτικής γνώμης. Η εκτίμηση αυτή γίνεται μη παραμετρικά, με τη βοήθεια μιας συνάρτησης πυρήνα της κανονικής κατανομής Gauss. Χρησιμοποιώντας τα αποτελέσματα που προκύπτουνε από την παραπάνω διαδικασία, εκτιμούμε τον δείκτη της πολιτικής πόλωσης. Ο δείκτης βασίζεται στην ιδέα ενός πλαισίου «Ταύτισης – Αποξένωσης» μεταξύ ατόμων της ίδιας ομάδας όσο και των ατόμων μεταξύ των ομάδων. Σύμφωνα με το πλαίσιο αυτό, η πολιτική πόλωση αυξάνεται με την αύξηση της ετερογένειας ανάμεσα στις ομάδες (δηλαδή με την αύξηση της αποξένωσης μεταξύ των ομάδων) καθώς και με την αύξηση της ομοιογένειας εντός των ομάδων (δηλαδή με την αύξηση του αισθήματος ταύτισης μεταξύ των μελών κάθε ομάδας). Επιπλέον, ελέγχεται η εξάρτηση του επιπέδου της πολιτικής πόλωσης από δύο ανεξάρτητες οικονομικές μεταβλητές, και συγκεκριμένα την εισοδηματική ανισότητα και την οικονομική μεγέθυνση. Οι παλινδρομήσεις πραγματοποιούνται χρησιμοποιώντας τη μέθοδο Σταθερών Επιδράσεων καθώς και τη Μέθοδο Τυχαίων Επιδράσεων. Και τα δύο μοντέλα εκτιμώνται και επιτρέποντας για ατομικές επιδράσεις (Individual effects). Όπως ήταν αναμενόμενο, τα αποτελέσματα δείχνουν ότι η πολιτική πόλωση επηρεάζεται θετικά από την εισοδηματική ανισότητα και αρνητικά από την οικονομική μεγέθυνση.
Εφαρμογή αλγορίθμων κυρτής βελτιστοποίησης στην διαχείριση φόρτισης ηλεκτρικών οχημάτων
Authors: Θεοδωρόπουλος Θεόδωρος
Published: December 2022

Ο αυξανόμενος στόλος ηλεκτρικών οχημάτων (ΗΟ) αναμφίβολαθα αποτελέσει ενα επιπλεόν φορτίο για τα σύστηματα διανομής ενέργειας πουθα απαιτήσουν λύσεις για τη διασφάλιση κανονικής λειτουργίας δικτύου καιαπρόσκοπτης φόρτισης ΗΟ. Η δίκαιη κατανομή ισχύος φόρτισης ΗΟ και ηευθυγράμμιση με τους περιορισμούς πτώσης τάσης μπορεί να αποτελέσεισημαντικό ζήτημα. Προς αυτή την κατεύθυνση, η διατριβή μελετά ένα πλαίσιο διαχείρισης φόρτισης που λαμβάνει υπόψη τις ανάγκες οικιακής ενέργειας, τη ζήτηση φόρτισης ΗΟ και τους περιορισμούς πτώσης τάσης σε ακτινικά δίκτυα διανομής. Η προσέγγισή μας χωρίζει το πρόβλημα φόρτισης σε δύο μέρη. Πρώτον, κατανέμεται ισχύς σε ζυγούς της γραμμής διανομής σύμφωνα με τοσταθμισμένο αναλογικό κριτήριο δικαιοσύνης λαμβάνοντας υπ’όψη τη ζήτηση του στόλου των ΗΟ. Δεύτερον, ως αποτέλεσμα μιας διαδικασίας βελτιστοποίησης ελαχίστων τετραγώνων με περιορισμούς,κάθε ΗΟ λαμβάνει μια ανώτατη τιμή ισχύος φόρτισης. Και τα δύο προβλήματα επιλύονται με αλγόριθμους κυρτής βελτιστοποίησης αναφοράς καθώς και αποκατανεμημένους που εισήχθησαν για την επίλυση του προβλήματος για μεγάλους στόλους ΗΟ. Η ανάλυση αποδεικνύει ότι η λύση των κατανεμημένων αλγορίθμων είναι κοντά στην κεντρική λύση αναφοράς. Τα αποτελέσματα της προσομοίωσης φόρτισης ΗΟ υποδεικνύουν μια πιο ισορροπημένη κατανομή ισχύος φόρτισης ΗΟ σε σχέση με προσεγγίσειςγραμμικής και τετραγωνικής στρατηγικής βελτιστοποίησης. Παράλληλα μελετάται και το πρόβλημα διαχείρισης σε περιβάλλον ασύρματης καιδυναμικής (εν κινήσει) φόρτισης με σκοπό την εναρμόνιση της συνολικής ισχύος φόρτισης ενός πλήθους οχημάτων σε ενα επιθυμητό προφίλ.