bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of planned presence of the family at the time of weaning on the length of weaning from mechanical ventilation in patients with brain injury admitted to intensive care units
Authors: Salmani Fatemeh , Moghimian Maryam , Jouzi Mina
Published: November 2022

Background

Weaning the patient from mechanical ventilation (MV) is one of the common treatments in intensive care units (ICU). Among the factors that can complicate the weaning process are psychological problems caused by a lack of family visits.

Objective

This study aimed to evaluate the effect of scheduled visiting on weaning from mechanical ventilation in patients with brain injury admitted to ICUs.

Methods

This quasi-experimental study was performed on 60 patients with brain injury referred to one of the hospitals in Central Province, Iran in 2020. The selection of samples based on inclusion criteria and random allocation to the two groups of intervention and control by permuted block randomization was done. The first-degree relatives of the patients at the time of weaning in the intervention group were present at the patient’s bedside twice a day at 10:00 AM and 3:00 PM for 30–45 min and performed what they had been trained to do. Participants in the control group visited patients from the area outside the patient room. Length of weaning, length of mechanical ventilation, and length of stay in the ICU were recorded and measured using a researcher-conducted checklist. The results were analyzed using descriptive and inferential statistics and chi-square and independent t-tests in SPSS16.

Results

The study results showed that the number of patients weaned from mechanical ventilation in the intervention group was significantly higher than that of the control group (P ≤ 0.05). The mean length of weaning in the intervention and control groups was not statistically significant, but it was clinically significant in the intervention group (P > 0.05). In addition, the length of mechanical ventilation and the length of stay of the intervention group in the ICU were significantly shorter than that of the control group (P ≤ 0.05).

Conclusion

According to the study results, scheduled visiting resulted in faster weaning from mechanical ventilation. As a result, nurse managers are suggested to make arrangements for family members to be present at the patient’s bedside in order for patients to be weaned off the mechanical ventilator more easily.
Balancing adaptability and standardisation: insights from 27 routinely implemented ICHOM standard sets
Authors: Benning Leo , Das-Gupta Zofia , Sousa Fialho Luz , Wissig Stephanie , Tapela Neo , Gaunt Suzanne
Published: November 2022

Background

Healthcare systems around the world experience increasing pressure to control future growth of healthcare expenditures. Among other initiatives, quality and value-based benchmarking has become an important field to inform clinical evaluation and reimbursement questions. The International Consortium for Health Outcomes Measurement (ICHOM) has become one of the driving forces to translate scientific evidence into standardized assessments that are routinely applicable in day-to-day care settings. These aim to provide a benchmarking tool that allows the comparison and competition of health care delivery on the basis of value-based health care principles.

Methods

This work focuses on the consolidation of the ICHOM methodology and presents insights from 27 routinely implemented Standard Sets. The analysis is based on a literature review of the ICHOM literature repository, a process document review and key informant interviews with ICHOM’s outcomes research and development team.

Results

Key findings are that the scope of ICHOM Standard Sets shifted from a more static focus on burden of disease and poorly standardized care pathways to a more dynamic approach that also takes into account questions about the setting of care, feasibility of implementing a benchmarking tool and compatibility of different Standard Sets. Although certain overlaps exist with other initiatives in the field of patient reported outcomes (PRO), their scopes differ significantly and they hence rather complement each other. ICHOM pursues a pragmatic approach to enable the benchmarking and the analysis of healthcare delivery following the principles of value-based healthcare.

Conclusion

The ICHOM Standard Sets complement other initiatives in the field of patient-reported outcomes (PRO) and functional reporting by placing a particular focus on healthcare delivery, while other initiatives primarily focus on evaluation of academic endpoints. Although ICHOM promotes a pragmatic approach towards developing and devising its Standard Sets, the definition of standardized decision making processes emerged as one of the key challenges. Furthermore, the consolidation of core metrics across number of disease areas to enable the parallel implementation of different Standard Sets in the same care setting is an important goal that will enable the widespread implementation of patient-reported outcome measures (PROM).
Perfectionism as a predictor of physician burnout
Authors: Martin Sarah R. , Fortier Michelle A. , Heyming Theodore W. , Ahn Kyle , Nichols Whitney , Golden Charles , Saadat Haleh , Kain Zeev N.
Published: November 2022

Background

Burnout is common among physicians and has detrimental effects on patient care and physician health. Recent editorials call attention to perfectionism in medicine; however, no studies to date have examined the effect of perfectionism on burnout in physicians practicing in the United States. This study examined associations among demographics, perfectionism and personality traits, and burnout among practicing physicians.

Methods

This cross-sectional study included general pediatric and pediatric sub-specialist physicians. Out of the 152 physicians contacted, 69 enrolled (Meanage = 44.16 ± 9.98; 61% female). Emotional exhaustion, depersonalization, and personal accomplishment burnout were assessed via the Maslach Burnout Inventory. Validated instruments were used to measure personality and perfectionism. Data were analyzed using linear regression models.

Results

Across physicians assessed, 42% reported either high emotional exhaustion burnout or depersonalization burnout. High self-critical perfectionism uniquely predicted both high emotional exhaustion burnout (B = 0.55, 95%CI 0.25–0.85) and depersonalization burnout (B = 0.18, 95%CI 0.05–0.31). Low conscientiousness (B = -6.12; 95%CI, -10.95- -1.28) predicted higher emotional exhaustion burnout and low agreeableness (B = -3.20, 95%CI -5.93- -0.46) predicted higher depersonalization burnout.

Conclusions

Perfectionism is understudied among physicians and the current findings suggest that addressing system and individual-level factors that encourage perfectionism is warranted and may reduce risk for physician burnout.
The ecology of medical care in Korea: the association of a regular doctor and medical care utilization
Authors: Lee Jeehye , Choi Yong-jun , Ryu Dong-Hee
Published: November 2022

Backgrounds

There is no registered regular doctor system in Korea, but people voluntarily select regular doctors for medical services. This study aims to study the ecology of medical care in Korea according to the presence and type of a regular doctor.

Methods

This study was conducted using Korean Health Panel survey in 2018. The proportion of people who had health problems and received medical care in various settings was analyzed per 1,000 people according to the following groups: without a regular doctor, having a clinic physician as a regular doctor, and having a hospital physician as a regular doctor. The adjusted odds ratio for usage of medical services was calculated.

Results

Health problems and medical care use increased in the groups in this order: group without a regular doctor, group with a clinic physician as a regular doctor, the group with a hospital physician a regular doctor. Having a hospital physician as a regular doctor was associated with higher odds of inpatient care and emergency room visits, and having a clinic physician as a regular doctor was not associated with odds of inpatient care and emergency room visits when adjusting demographic and health-related variables.

Conclusion

Depending on whether having a regular doctor and a regular doctor’s type, different ecology of medical care was observed. The position and role of a regular doctor in the context of the Korea health care system should be considered from the perspective of primary care.
Abnormal cortical thickness and structural covariance networks in systemic lupus erythematosus patients without major neuropsychiatric manifestations
Authors: Li Shu , Bai Ru , Yang Yifan , Zhao Ruotong , Upreti Bibhuti , Wang Xiangyu , Liu Shuang , Cheng Yuqi , Xu Jian
Published: November 2022

Background

Non-neuropsychiatric systemic lupus erythematosus (non-NPSLE) has been confirmed to have subtle changes in brain structure before the appearance of obvious neuropsychiatric symptoms. Previous literature mainly focuses on brain structure loss in non-NPSLE; however, the results are heterogeneous, and the impact of structural changes on the topological structure of patients’ brain networks remains to be determined. In this study, we combined neuroimaging and network analysis methods to evaluate the changes in cortical thickness and its structural covariance networks (SCNs) in patients with non-NPSLE.

Methods

We compare the cortical thickness of non-NPSLE patients (N=108) and healthy controls (HCs, N=88) using both surface-based morphometry (SBM) and regions of interest (ROI) methods, respectively. After that, we analyzed the correlation between the abnormal cortical thickness results found in the ROI method and a series of clinical features. Finally, we constructed the SCNs of two groups using the regional cortical thickness and analyzed the abnormal SCNs of non-NPSLE.

Results

By SBM method, we found that cortical thickness of 34 clusters in the non-NPSLE group was thinner than that in the HC group. ROI method based on Destrieux atlas showed that cortical thickness of 57 regions in the non-NPSLE group was thinner than that in the HC group and related to the course of disease, autoantibodies, the cumulative amount of immunosuppressive agents, and cognitive psychological scale. In the SCN analysis, the cortical thickness SCNs of the non-NPSLE group did not follow the small-world attribute at a few densities, and the global clustering coefficient appeared to increase. The area under the curve analysis showed that there were significant differences between the two groups in clustering coefficient, degree, betweenness, and local efficiency. There are a total of seven hubs for non-NPSLE, and five hubs in HCs, the two groups do not share a common hub distribution.

Conclusion

Extensive and obvious reduction in cortical thickness and abnormal topological organization of SCNs are observed in non-NPSLE patients. The observed abnormalities may not only be the realization of brain damage caused by the disease, but also the contribution of the compensatory changes within the nervous system.
Blood DNA methylation signatures of lifestyle exposures: tobacco and alcohol consumption
Authors: Chamberlain Jonviea D. , Nusslé Sébastien , Chapatte Laurence , Kinnaer Cassandre , Petrovic Dusan , Pradervand Sylvain , Bochud Murielle , Harris Sarah E. , Corley Janie , Cox Simon R. , Gonseth Nusslé Semira
Published: November 2022

Background

Smoking and alcohol consumption may compromise health by way of epigenetic modifications. Epigenetic signatures of alcohol and tobacco consumption could provide insights into the reversibility of phenotypic changes incurred with differing levels of lifestyle exposures. This study describes and validates two novel epigenetic signatures of tobacco (EpiTob) and alcohol (EpiAlc) consumption and investigates their association with disease outcomes.

Methods

The epigenetic signatures, EpiTob and EpiAlc, were developed using data from the Swiss Kidney Project on Genes in Hypertension (SKIPOGH) (N = 689). Epigenetic and phenotypic data available from the 1921 (N = 550) and 1936 (N = 1091) Lothian Birth Cohort (LBC) studies, and two publicly available datasets on GEO Accession (GSE50660, N = 464; and GSE110043, N = 94) were used to validate the signatures. A multivariable logistic regression model, adjusting for age and sex, was used to assess the association between self-reported tobacco or alcohol consumption and the respective epigenetic signature, as well as to estimate the association between CVD and epigenetic signatures. A Cox proportional hazard model was used to estimate the risk of mortality in association with the EpiTob and EpiAlc signatures.

Results

The EpiTob signature was positively associated with self-reported tobacco consumption for current or never smokers with explained variance ranging from 0.49 (LBC1921) to 0.72 (LBC1936) (pseudo-R2). In the SKIPOGH, LBC1921 and LBC1936 cohorts, the epigenetic signature for alcohol consumption explained limited variance in association with self-reported alcohol status [i.e., non-drinker, moderate drinker, and heavy drinker] (pseudo-R2 = 0.05, 0.03 and 0.03, respectively), although this improved considerably when measuring self-reported alcohol consumption with standardized units consumed per week (SKIPOGH R2 = 0.21; LBC1921 R2 = 0.31; LBC1936 R2 = 0.41). Both signatures were associated with history of CVD in SKIPOGH and LBC1936, but not in LBC1921. The EpiTob signature was associated with increased risk of all-cause and lung-cancer specific mortality in the 1936 and 1921 LBC cohorts.

Conclusions

This study found the EpiTob and EpiAlc signatures to be well-correlated with self-reported exposure status and associated with long-term health outcomes. Epigenetic signatures of lifestyle exposures may reduce measurement issues and biases and could aid in risk stratification for informing early-stage targeted interventions.
The Patient Health Questionnaire (PHQ-9) as a tool to screen for depression in people with multiple sclerosis: a cross-sectional validation study
Authors: Beswick Emily , Quigley Suzanne , Macdonald Pamela , Patrick Sarah , Colville Shuna , Chandran Siddharthan , Connick Peter
Published: November 2022

Background:

Depression has a point prevalence of 25% and lifetime prevalence of 50% in people with multiple sclerosis (pwMS). Due to accessibility and brevity, the 9-item Patient Health Questionnaire (PHQ-9) may be a useful tool in clinical practice for screening and monitoring of depressive symptoms in people with MS (pwMS).

Methods:

The objective of this study was to evaluate the reliability, validity and acceptability of the PHQ-9 as a screening tool for depressive symptoms in pwMS. PwMS completed online questionnaires at 3 time-points over 4-weeks. The PHQ-9, Multiple Sclerosis Impact Scale (MSIS-29), Centre for Disease Control Health-Related Quality of Life Measure (CDC-HQOL-4) and clinical history.

Results:

103 participants completed the PHQ-9 at three time points, 43% were categorised as depressed on at least one response. The PHQ-9 exhibited high internal reliability (Cronbach’s α = 0.89), and test-re-test agreement (ICC 0.89, 95% CI 0.85–0.91). Convergent validity was indicated through positive correlation with the mental health items on the MSIS-29 (r = 0.46 and r = 0.50) and CDC-HQOL-4 (r = 0.79 and r = 0.73) at both assessment points. Positive correlations between the PHQ-9 and the MSIS-29 (r = 0.86 and r = 0.84) and CDC-HQOL-4 (r = 0.55 and r = 0.37) physical symptom sub-scores did not indicate divergent validity. 93% of ratings evaluated the PHQ-9 as “Very” or “Completely” acceptable.

Conclusion:

The PHQ-9 is a reliable and valid measure of depressive symptoms in people with MS. Given its accessibility, ease of administration, and acceptability, we recommend the PHQ-9 as a tool to screen for depressive symptoms in people with MS.
What lessons can African nations learn from the COVID-19 pandemic?
Authors: Akinola Olanrewaju , Olawade David Bamidele , David-Olawade Aanuoluwapo Clement
Published: November 2022

While the impact of the COVID-19 pandemic differed per country, the impact on African nations was comparable. Health, money, the economy, education, and inventions have all been criticised over the years, but the discoveries during the pandemic were stunning. We witnessed a system being devoured by corruption and anti-patriotic citizens seeking their agenda. The commentary discusses the influence of the COVID-19 pandemic on several sectors in African nations, as well as the lessons that may be drawn from it. Furthermore, it recommends methods to avoid a recurrence.
Multiple sexual partnership among adolescent boys and young men in Ghana: analysis of the 2003–2014 Ghana Demographic and Health Survey
Authors: Yeboah Isaac , Okyere Joshua , Dey Nutifafa Eugene Yaw , Mensah Ronald Osei , Agbadi Pascal , Essiaw Mary Naana
Published: November 2022

Background

Multiple sexual partnership (MSP) is a major cause of HIV/AIDS epidemic and unplanned pregnancies in sub-Saharan Africa. We investigate how individual, household, interpersonal, community and structural factors correlate with multiple sexual partnership of adolescent boys and young men in Ghana.

Methods

We pooled secondary data from the 2003, 2008 and 2014 Ghana Demographic and Health Surveys (GDHS). Analytic sample of 1422 males aged 15–24 years who are sexually active and never married were used for the study. The outcome variable for the study was two or more sexual partners in the last 12 months preceding the survey. Five models were fitted using multilevel mixed effects logistic regression to identify predictors of multiple sexual partners. Results were presented using adjusted odds ratios (ORadj) with its corresponding 95% confidence interval.

Results

The pooled data prevalence of multiple sexual partnership was 28.1%, with 18.7%, 30.0% and 33.3% of adolescent boys and young men involved in multiple sexual partnerships in 2003, 2008 and 2014, respectively. Results of the study showed that young men aged 20–24 years [ORadj = 1.39, 95% CI = 1.01–1.91], being from household with richest wealth index [ORadj = 1.76, 95% CI = 1.01–3.06] and those with secondary/higher education [ORadj = 2.94, 95% CI = 1.44–6.06] were more likely to have multiple sexual partners. On the other hand, those who delayed their first sex [ORadj = 0.45, 95% CI = 0.29–0.70] and those currently using modern contraceptive methods [ORadj = 0.37, 95% CI = 0.28–0.50] were less likely to have multiple sexual partners.

Conclusion

The findings provide support for the social ecological argument that sexual health behaviours are influenced by individual, interpersonal, community and contextual characteristics. Future policies and interventions seeking to address the increasing prevalence of multiple sexual partnerships among adolescent boys and young men should take into consideration family planning programmes and sexual education in affluent communities, secondary and higher institutions.
Magnetic resonance imaging features of post-COVID-19 regional and invasive sino-nasal mucormycosis
Authors: Abd El Megid Ahmed Gamil Ibrahim , AbdelHamid Ghada Adel , Abd Elbary Mohamed El-Sayed , Ghonimi Nesma A. M. , Elagrody Ahmed I. , Abd Elhamed Marwa Elsayed
Published: November 2022

Background

Sino-nasal mucormycosis is an opportunistic, invasive fungal disease which has shown a rising trend in the setting of COVID-19. The objective of this study is to document and analyze demographic data, clinical presentation and MR imaging spectra for early detection and management of post-COVID-19 sino-nasal mucormycosis.

Results

Sixty-two cases of sino-nasal mucormycosis were enrolled in this study; their mean age was 50.65 ± 8.25 years, with significant female predominance. Nine patients (14.5%) had active COVID-19 and 53 (85.5%) were recent COVID-19 cases. Sixty patients have not received COVID-19 vaccine. The mean duration from the initial COVID-19 laboratory confirmation to the detection of sino-nasal mucormycosis was 25.7 +/− 4.6 days. Thirty-five patients (56.5%) were kept in the hospital for COVID management and 4 of them received intensive care unit (ICU) treatment. Twenty-seven patients (43.5%) were treated in home isolation. Corticosteroids were administered in 48 cases (77.4%). Twenty-nine patients (46.8%) had been given oxygen for an average time of 11.2 ± 4.15 days. Diabetes was found in 56 cases (90.3%). The most common clinical symptoms were headache, seen in 52 patients (83.87%). The ethmoid sinus was the most common paranasal sinus involved in our study, seen in 47 cases (75.81%). In 36 cases (58%), multiple sinuses were involved. MRI staging according to the extent of regional involvement. Stage 1 seen in 2 cases (3.23%), stage 2 in 13 cases (20.97%), stage 3 in 35 cases (56.45%) and stage 4 in 12 cases (19.35%).

Conclusions

MRI shows a spectrum of findings in sino-nasal mucormycosis. Imaging plays a major role in staging and assessing the extent of involvement and complications. In light of this, mortality and morbidity can be dramatically decreased with adequate evaluation and therapy.
New opioid use and risk of opioid-related adverse events among adults with intellectual and developmental disabilities in Ontario, Canada
Authors: Guan Qi , Men Siyu , Lunsky Yona , Juurlink David N. , Bronskill Susan E. , Wunsch Hannah , Gomes Tara
Published: November 2022

Background

Individuals with intellectual and developmental disability (IDD) can have a high prevalence of pain, which can be managed with prescription opioids. However, the prevalence of substance use disorder is also high in this population, raising concern about opioid-related adverse events.

Aims

To assess the risk of opioid-related adverse events following opioid initiation among adults with versus without IDD.

Method

We conducted a population-based, propensity score matched cohort study on all adults starting prescription opioid therapy in Ontario, Canada, between January 2013 and December 2018. The outcomes of interest were opioid toxicity, new opioid use disorder (OUD) diagnosis and dose escalation (≥90 mg morphine or equivalent) in the year after opioid initiation. We used Cox proportional hazards models to assess the association between IDD diagnosis and each outcome.

Results

The hazards of opioid toxicity and OUD were significantly higher in those with IDD compared with those without IDD in unmatched analyses (opioid toxicity hazard ratio 3.19, 95% CI 2.81–5.18; OUD hazard ratio 2.36, 95% CI 2.10–2.65), whereas the hazard of dose escalation was significantly lower (hazard ratio 0.76, 95% CI 0.66–0.88). Findings were no longer significant in propensity score matched models for opioid toxicity and dose escalation, whereas the hazard of OUD diagnosis was attenuated substantially in those with IDD (hazard ratio 0.79, 95% CI 0.68–0.91).

Conclusions

IDD diagnosis is not a driver of opioid-related harm. The increased risk we observed is likely driven by various risk factors often present in this population.
State Variation in Squamous Cell Carcinoma of the Anus Incidence and Mortality, and Association With HIV/AIDS and Smoking in the United States
Authors: Damgacioglu Haluk , Lin Yueh-Yun , Ortiz Ana Patricia , Wu Chi-Fang , Shahmoradi Zahed , Shyu Shiang Shiuan , Li Ruosha , Nyitray Alan G. , Sigel Keith , Clifford Gary M. , Jay Naomi , Lopez Vivian Colon , Barnell Gregory M. , Chiao Elizabeth Y. , Stier Elizabeth A. , Ortiz-Ortiz Karen J. , Ramos-Cartagena Jeslie M. , Sonawane Kalyani , Deshmukh Ashish A.
Published: November 2022

PURPOSE

Squamous cell carcinoma of the anus (SCCA) incidence and mortality rates are rising in the United States. Understanding state-level incidence and mortality patterns and associations with smoking and AIDS prevalence (key risk factors) could help unravel disparities and provide etiologic clues.

METHODS

Using the US Cancer Statistics and the National Center for Health Statistics data sets, we estimated state-level SCCA incidence and mortality rates. Rate ratios (RRs) were calculated to compare incidence and mortality in 2014-2018 versus 2001-2005. The correlations between SCCA incidence with current smoking (from the Behavioral Risk Factor Surveillance System) and AIDS (from the HIV Surveillance system) prevalence were evaluated using Spearman's rank correlation coefficient.

RESULTS

Nationally, SCCA incidence and mortality rates (per 100,000) increased among men (incidence, 2.29-3.36, mortality, 0.46-0.74) and women (incidence, 3.88-6.30, mortality, 0.65-1.02) age ≥ 50 years, but decreased among men age < 50 years and were stable among similar-aged women. In state-level analysis, a marked increase in incidence (≥ 1.5-fold for men and ≥ two-fold for women) and mortality (≥ two-fold) for persons age ≥ 50 years was largely concentrated in the Midwestern and Southeastern states. State-level SCCA incidence rates in recent years (2014-2018) among men were correlated ( r = 0.47, P < .001) with state-level AIDS prevalence patterns. For women, a correlation was observed between state-level SCCA incidence rates and smoking prevalence ( r = 0.49, P < .001).

CONCLUSION

During 2001-2005 to 2014-2018, SCCA incidence and mortality nearly doubled among men and women age ≥ 50 years living in Midwest and Southeast. State variation in AIDS and smoking patterns may explain variation in SCCA incidence. Improved and targeted prevention is needed to combat the rise in SCCA incidence and mitigate magnifying geographic disparities.

[Media: see text]
Theorizing the Afropolitan Past and Present
Authors: Carrasquillo Rosa , Pappademos Melina , Semley Lorelle
Published: November 2022

The term Afropolitan—evoking the image of mobility, cultural production, and consumerism in Africa and the African diaspora—has enjoyed some salience in popular culture. However, much of the scholarly debate has focused on the elitism associated with the concept. Linked initially to short reflective pieces by Taiye Selasi in 2005 and Achille Mbembe in 2007, Afropolitanism has rarely been analyzed in historical contexts. The contributors engage the concept of the Afropolitan across a broad time and space that spans the fourteenth to twenty-first centuries and locates the Afropolitan in Africa, the Americas, Europe, and Asia. This introduction analyzes their written and photographic essays along three themes: visual culture, narrativity, and intersectionality, recognizing that their work also pushes against and expands on these frameworks. By engaging with the Afropolitan as a historical phenomenon, the issue highlights new methods and theories for analyzing global diasporas—past, present, and future.
Blackness out of Place
Authors: Marcos Patrícia Martins
Published: November 2022

This article explores how historical narratives and aesthetic models configuring Portuguese imperial visuality produced the absented presence of Africa and its diasporas. Despite centuries of interconnected histories of colonial domination and enslavement, but also marronage and resistance, Black subjecthood was reduced in Portugal to a “foreign” presence. These silences ossify a regime of imperial visuality premised on the hegemonic overrepresentation of white masculinity—rendered through depictions of “navigators” as paragons of historical agency. Through the analytic countervisual quilombismo, this essay confronts such elisions by engaging with Achille Mbembe’s Afropolitan call to “produce new images for thought.” Focus on countervisual maroon (quilombismo) methods of refusal and fugitivity reveals the enactment of Black sovereignty and affirms Blackness as being. By affirming Black life and autonomy, diasporic artists, performers, and everyday people interrupt colonial frames, refusing the ethnographic reduction of Blackness to a body and its classificatory markers, thus revealing possibilities for different pasts, presents, and futures.
A Needle in the Desert
Authors: Mediavilla Héctor
Published: November 2022

In his photo essay A Needle in the Desert, photographer Héctor Mediavilla poses the question: “Can fashion be a vector for development in a poor country?” Documenting FIMA (the International Fashion Festival in Africa), his work captures the environment, planning, and staging of the festival, focusing specifically on the relationship between people and place.
Variation in Public Support for Government Action on Unexpected Medical Bills
Authors: McCabe Katherine T.
Published: November 2022

Context: Nearly half of the adults in the United States have received an unexpected medical bill in recent years. While government, provider, and insurance policies related to unexpected medical expenses receive attention in the media, this study focuses on variation in public support.

Methods: The study employs two multifactor survey vignette experiments to detect how different features of common health care scenarios that result in costly medical expenses influence the public's sympathy for the patient, perceived fairness of the medical costs, and demand for government action.

Findings: The results point to out-of-pocket cost, severity of the treatment, and the patient's insurance situation as important for public opinion. The public is significantly more supportive of government action when the costs are high and out of the patient's control; in contrast, respondents are generally less sympathetic toward patients described as uninsured or who seek out more costly providers.

Conclusions: The findings underscore the sensitivity of health care attitudes to framing effects, which may occur when media choose how to cover health care costs. The results also point to a potential mismatch in legislation that narrowly addresses “surprise billing,” with public support for government addressing disproportionate costs across a broader range of scenarios.
Transposon control as a checkpoint for tissue regeneration
Authors: Angileri Krista M. , Bagia Nornubari A. , Feschotte Cedric
Published: November 2022

Tissue regeneration requires precise temporal control of cellular processes such as inflammatory signaling, chromatin remodeling and proliferation. The combination of these processes forms a unique microenvironment permissive to the expression, and potential mobilization of, transposable elements (TEs). Here, we develop the hypothesis that TE activation creates a barrier to tissue repair that must be overcome to achieve successful regeneration. We discuss how uncontrolled TE activity may impede tissue restoration and review mechanisms by which TE activity may be controlled during regeneration. We posit that the diversification and co-evolution of TEs and host control mechanisms may contribute to the wide variation in regenerative competency across tissues and species.
Fine-tuning of mTOR signaling by the UBE4B-KLHL22 E3 ubiquitin ligase cascade in brain development
Authors: Kong Xiangxing , Shu Xin , Wang Jiachuan , Liu Dandan , Ni Yingchun , Zhao Weiqi , Wang Lebo , Gao Zhihua , Chen Jiadong , Yang Bing , Guo Xing , Wang Zhiping
Published: November 2022

Spatiotemporal regulation of the mechanistic target of rapamycin (mTOR) pathway is pivotal for establishment of brain architecture. Dysregulation of mTOR signaling is associated with a variety of neurodevelopmental disorders. Here, we demonstrate that the UBE4B-KLHL22 E3 ubiquitin ligase cascade regulates mTOR activity in neurodevelopment. In a mouse model with UBE4B conditionally deleted in the nervous system, animals display severe growth defects, spontaneous seizures and premature death. Loss of UBE4B in the brains of mutant mice results in depletion of neural precursor cells and impairment of neurogenesis. Mechanistically, UBE4B polyubiquitylates and degrades KLHL22, an E3 ligase previously shown to degrade the GATOR1 component DEPDC5. Deletion of UBE4B causes upregulation of KLHL22 and hyperactivation of mTOR, leading to defective proliferation and differentiation of neural precursor cells. Suppression of KLHL22 expression reverses the elevated activity of mTOR caused by acute local deletion of UBE4B. Prenatal treatment with the mTOR inhibitor rapamycin rescues neurogenesis defects in Ube4b mutant mice. Taken together, these findings demonstrate that UBE4B and KLHL22 are essential for maintenance and differentiation of the precursor pool through fine-tuning of mTOR activity.
Η έκφραση της πρωτεΐνης S100A14 στον καρκίνο του παχέος εντέρου
Authors: Διαμαντοπούλου Αγγέλα
Published: November 2022

Σκοπός: Η πρωτεΐνη S100A14 που δεσμεύει το ασβέστιο εμπλέκεται σε διαδικασίες που σχετίζονται με την ογκογένεση και τον πολλαπλασιασμό του όγκου, όπως ο κυτταρικός πολλαπλασιασμός, η απόπτωση, η κινητικότητα και η διεισδυτικότητα. Στόχος μας ήταν να διερευνήσουμε τον ρόλο της πρωτεΐνης S100A14 στον καρκίνο του παχέος εντέρου. Ασθενείς και Μέθοδοι: Εκατόν επτά ασθενείς (65 άνδρες και 42 γυναίκες) συμπεριλήφθηκαν σε αυτή τη μελέτη. Είχαν διαγνωστεί με καρκίνο του παχέος εντέρου και είχαν υποβληθεί σε πλήρη εκτομή του πρωτοπαθούς όγκου τους. Δείγματα ιστών από αρχειακά μπλοκ των φυσιολογικών και κακοήθων ορθοκολικών ιστών τους χρησιμοποιήθηκαν για την ανοσοϊστοχημική αξιολόγηση της έκφρασης της πρωτεΐνης S100A14. Τα επίπεδα S100A14 αξιολογήθηκαν χρησιμοποιώντας ανάλυση εικόνας και συσχετίστηκαν με διάφορες κλινικοπαθολογικές παραμέτρους και την πρόγνωση. Αποτελέσματα: Η έκφραση της πρωτεΐνης S100A14 μειώθηκε στους κακοήθεις ιστούς σε σύγκριση με τον φυσιολογικό εντερικό βλεννογόνο σε περιπτώσεις όγκων Τ3-Τ4 (p=0,017). Επιπλέον, όσον αφορά τα επίπεδα S100A14 σε κακοήθεις ιστούς, ήταν χαμηλότερα στους όγκους T3-T4 (p=0,001), στη νόσο N2 (p=0,034) και στη νόσο M1 (p=0,019). Τέλος, η πολύ υψηλή παραγωγή S100A14 (>75ο εκατοστημόριο) συσχετίστηκε με βραχύτερη ειδική για τη νόσο επιβίωση (DSS) (HR=3,584, p=0,045) και βραχύτερη επιβίωση ελεύθερη υποτροπής (RFS) (HR=4,527, p=0,007) στην πολυπαραγοντική ανάλυση επιβίωσης. Συμπέρασμα: Η έκφραση του S100A14 είναι μειωμένη στον προχωρημένο καρκίνο του παχέος εντέρου. Ωστόσο, οι περιπτώσεις με πολύ υψηλά επίπεδα S100A14 έχουν χειρότερη επιβίωση.
Ανάλυση και επεξεργασία δεδομένων ακτινοθεραπείας κεφαλής και τραχήλου με τεχνικές ευθυγράμμισης εικόνων και μηχανικής μάθησης
Authors: Ηλιάδου Βασιλική
Published: November 2022

Σε αυτή τη Διδακτορική Διατριβή ο σκοπός ήταν η ανάλυση ιατρικών δεδομένων ακτινοθεραπείας, ασθενών με καρκίνο κεφαλής και τραχήλου, με χρήση τεχνικών ευθυγράμμισης ιατρικών δεδομένων και μεθόδων Μηχανικής Εκμάθησης (Machine Learning). Στόχος ήταν να εντοπιστούν πιθανές σοβαρές ανατομικές μεταβολές κατά την διάρκεια των συνεδριών ακτινοθεραπείας των ασθενών, διότι αυτές μπορεί να οδηγήσουν σε λανθασμένη απόδοση της δόσης στον καρκινικό όγκο καθώς και σε υπερ-ακτινοβόληση των γύρω υγειών ιστών, προκαλώντας ανεπιθύμητες παρενέργειες. Προς αυτή την κατεύθυνση, σε πρώτο στάδιο ευθυγραμμίστηκαν οι εβδομαδιαίες CBCT εικόνες που λαμβάνονται κατά την καθοδηγούμενη από την εικόνα ακτινοθεραπεία ασθενών (IGRT), με την αρχική αξονική σχεδιασμού του πλάνου θεραπείας (planning CT). Η ευθυγράμμιση έγινε σε δύο στάδια, με το πρώτο να αφορά την ευθυγράμμιση με μετασχηματισμούς τύπου affine και το δεύτερο την ευθυγράμμιση με ελαστικούς μετασχηματισμούς. Οι εν λόγω μετασχηματισμοί χρησιμοποιήθηκαν για να μετασχηματιστούν οι αρχικά σχεδιασμένες, από τους κλινικούς ιατρούς, ανατομικές δομές, ώστε να συμπίπτουν με τις ανατομικές δομές του ασθενούς την ημέρα της συνεδρίας ακτινοθεραπείας. Με τον τρόπο αυτό έγινε υπολογισμός του όγκου του καρκίνου και του όγκου των παρωτίδων, καθώς και η ποσοστιαία μεταβολή αυτών μετά το πέρας κάθε εβδομάδας θεραπειών και οι ασθενείς χωρίστηκαν σε αυτούς που είχαν σοβαρές ανατομικές μεταβολές μετά την 3η εβδομάδα θεραπειών και σε αυτούς που δεν εμφάνισαν σοβαρές μεταβολές. Οι δύο κατηγορίες (κλάσεις) ασθενών χρησιμοποιήθηκαν ώστε να κατασκευαστούν προβλεπτικά μοντέλα σχετικά με πιθανή εμφάνιση ανατομικών μεταβολών σε ασθενείς από το τέλος της πρώτης εβδομάδας θεραπειών. Για τον σκοπό αυτό, υπολογίστηκαν για τις ανατομικές δομές του όγκου και των παρωτίδων, χαρακτηριστικά εικόνας από το τέλος της πρώτης εβδομάδας θεραπειών με βάση τα οποία κατασκευάστηκε προβλεπτικό μοντέλο, ικανό να προβλέπει με ακρίβεια εάν ένας ασθενής δύναται να εμφανίσει σοβαρές ανατομικές μεταβολές μετά την 3η εβδομάδα θεραπειών.
Growth kinetics of multiple Acinetobacter baumannii resistotype after meropenem-based antibiotic combination exposure
Authors: Rivani Erizka , Endraswari Pepy Dwi , Widodo Agung Dwi Wahyu
Published: November 2022

Background: Carbapenems are the treatment of choice for multidrug-resistant (MDR) and extensively drug-resistant (XDR) Acinetobacter baumannii infections, but the emergence of carbapenem-resistant A. baumannii (CRAB) has rendered it ineffective in the vast majority of cases. Combination therapy has grown in popularity over the last decade; this study aims to analyze A.baumannii growth kinetics after exposure to meropenem and ampicillin-sulbactam compared with meropenem and amikacin antibiotic combinations in clinically relevant concentrations. 

Methods: This experimental laboratory study was conducted on the A. baumannii ATCC 19606 isolate and three clinical isolates that were intermediate or resistant to tested antibiotics. Meropenem and ampicillin-sulbactam, as well as meropenem and amikacin, were tested at four different concentrations against isolates. Turbidity measurements were taken at predetermined time points of 0, 1, 2, 4, 6, 8, and 24 hours following exposure; bacterial concentration was enumerated using the agar plate method, with the results plotted in a time-kill curve.  

Results: A bactericidal effect was achieved in isolates that were intermediate to ampicillin-sulbactam and resistant to meropenem after the administration of meropenem and ampicillin-sulbactam combination with a concentration of 4 µg/ml and 16/8 µg/ml, respectively. The combination of meropenem and ampicillin-sulbactam demonstrated bacteriostatic activity against isolates that were resistant to both antibiotics. Isolates treated with resistant antibiotics showed an increased growth rate compared to the growth control. 

Conclusion: The combination of meropenem and ampicillin-sulbactam could be a promising combination therapy in treating CRAB infections. The mechanism and degree of antibiotic resistance in the isolates affect the efficacy of antibiotic combinations; further research is needed to corroborate the findings of this study.
Narayana numbers as sums of two base b repdigits
Authors: Ray Prasanta Kumar , Bhoi Kisan , Patel Bijan Kumar
Published: November 2022

In this study, we find all Narayana numbers which are expressible as sums of two base b repdigits. The proof of the main result uses lower bounds for linear forms in logarithms of algebraic numbers and a version of the Baker–Davenport reduction method.
On Pellnomial coefficients and Pell-Catalan numbers
Authors: İpek Ahmet
Published: November 2022

In this paper, we first give the Pascal’s identity for Pellnomial coefficients and then we show that the Pellnomial coefficients are integers. We obtain that the product of r consecutive Pell numbers is divisible by the Pell analog of r!. Also, we introduce the divisibility theorems between Pell numbers and Pellnomial coefficients. Furthermore, we first define Pell–Catalan numbers and then we derive two formulas for presenting Pell–Catalan numbers.
On some properties of CV_{(0)}(X, A)
Authors: PALACIOS LOURDES , Ramos-Martinez Pavel , Signoret Carlos
Published: November 2022

Let X be a completely regular Hausdorff space and V a Nachbin familyon X. For a locally convex algebra A, let CV(0)(X, A) be the algebra ofall weighted vector-valued continuous functions with the topology givenby the uniform seminorms induced by V . In this paper we study someproperties of A that are inherited by CV(0)(X, A). These properties arerelated to the unit element, spectral seminorms and uniformly A-convexproperty
Applications of degenerate q-Euler and q-Changhee polynomials with weight α
Authors: Duran Ömer , Ömür Neşe , Koparal Sibel
Published: November 2022

In this paper, we give new identities involving degenerate q-Euler polynomials with weight α and q-Changhee polynomials of the second kind with weight α, using the Faà di Bruno formula and some identities of the Bell polynomials of the second kind.
Tensor product of partial acts
Authors: Saarse Heleen , Väljako Kristo
Published: November 2022

In this article we define the tensor product of partial acts over a semigroup and prove several properties of this tensor product. We also define the notion of a polite partial biact, which is needed to define partial actions on the tensor product of partial acts. Finally, we prove that a certain tensor functor of partial acts is left adjoint of a certain hom-functor of partial acts.
Film tourism in Poland: potential and perspectives for development
Authors: Stasiak Andrzej
Published: November 2022

Travel has been inspired by films for many years, but only in the early 21st century did it begin to constitute a significant volume. In many places in the world, film tourism has become a true phenomenon. The paper constitutes the first so broad an attempt at determining the state of film tourism in Poland. Based on 15 years of the author’s own research and research by other Polish scholars, an inventory of film heritage (film locations, museums, festivals and other attractions) was taken and – as far as the available data allowed – the characteristics of associated tourist traffic were provided. The research procedure revealed numerous gaps in our knowledge. Hence, apart from other conclusions, a list of problems that, in the years to come, should become a subject of interest among cultural tourism scholars in Poland was included in the summary.
Entre la exclusión y la convivencia multicultural. Panorámica regional de la inmigración en Andalucía.
Authors: Torres Gutiérrez Francisco José
Published: November 2022

En el marco periférico y fronterizo que constituye Andalucía, en un momento histórico en el que las crisis económicas se suceden y superponen (crisis de 2008, actual pandemia del COVID-19…), nos preguntamos acerca de cómo se produce el asentamiento de la población migrante, qué caracteres contienen los territorios y hábitats concretos en que se localiza, y qué limitaciones y oportunidades se pueden reconocer desde el punto de vista de la inclusión social, el encuentro intercultural y la convivencia. En estos sentidos, tratamos de abordar la influencia que pueden tener el mercado en el sector agrícola y sus necesidades de mano de obra barata, así como el modo en que se producen distintos aterrizajes de inmigrantes en barrios periféricos desfavorecidos de las ciudades; en ambos casos, distintos factores parecen conducir a unas relaciones caracterizadas por la pérdida de la cultura del diálogo y por el predominio de un modelo meramente multicultural. En los primeros, ello puede vincularse con el carácter temporal y dimensión productiva de una actividad agraria que demanda, cada vez más, una mano de obra foránea subordinada y marginalizada ante sus intereses, en los segundos toman notoriedad las propias dinámicas segregadoras del espacio urbano.
Vivir para producir. El hábitat colonial en el Andévalo Occidental (Huelva).
Authors: Chapela Cabrera Patricia , Ojeda Rivera Juan Francisco
Published: November 2022

Mediante una lectura hermenéutica de paisajes basada en una metodología propia, se presenta el núcleo minero de La Zarza, situado en el Andévalo Occidental (Huelva), como ejemplo significativo de hábitat colonial. Con subsuelos, suelos y vuelos concedidos a perpetuidad a compañías mineras foráneas, la cercanía y/o el solapamiento de usos entre parcelas productivas y habitacionales nos permite comprender este tipo de paisaje colonial e híbrido, en el que la existencia y evolución del núcleo urbano están supeditadas a la extensión explotable de los filones mineros. El crecimiento de territorios extractivos y productivos determina los emplazamientos sucesivos de los núcleos habitacionales, de manera que sus planos urbanísticos evolucionarán al socaire de los avances sobre ellos de aquellos filones y de las necesidades coyunturales de mano de obra. Tras mostrar las claves físico-naturales, territoriales y perceptivas que justifican este tipo de paradigmática colonización minera y presentar el caso específico de La Zarza-Perrunal, se irá demostrando el carácter colonial y dependiente de estas implantaciones típicas del extractivismo productivista minero a partir de la mencionada lectura paisajística de dicho núcleo urbano, su corta minera y sus ámbitos circundantes.
Un listado inédito de veinticuatros de Sevilla (1494-1590) / An Unpublished List of Veinticuatros from Seville (1494-1590)
Authors: Cartaya Baños Juan
Published: November 2022

Obtenido a partir de un expediente nobiliario para la orden de Santiago, presento en este artículo un listado inédito de veinticuatros sevillanos, que abarca entre los años 1494 y 1590, cerca de un siglo en el que el cabildo hispalense evolucionará de un modo significativo: este listado nos muestra con claridad los diversos estratos que conformaron los grupos de poder en la ciudad, además del cambio social que se produjo en Sevilla tras la creación de la Casa de la Contratación, al acceder un elevado número de ricos mercaderes al consistorio, hasta entonces ocupado por linajes nobles (incluyendo a varios conversos de primera hora) que formaban en él desde la baja Edad Media. Se mencionan grupos familiares notables o significativos, presentes en años sucesivos en el Ayuntamiento, al igual que individuos específicos de interés, y se analiza la conflictividad del propio grupo, enfrentado –por ejemplo– en los años finales del siglo XVI con los fiscales de la Real Chancillería de Granada. Por último, transcribo dicho documento y lo vuelco en un listado posterior que facilita su comprensión.
Negociar la paz y la guerra entre el episcopado y la nobleza: la revuelta contra Rodrigo de Luna, arzobispo de Santiago (1458-1460) / Negotiating Peace and War Between The Episcopate and The Nobility: The Revolt Against Rodrigo De Luna, Archbishop of Santiago (1458-1460).
Authors: González Nieto Diego
Published: November 2022

El objetivo del presente estudio es analizar en detalle los procesos de negociación y pacto mantenidos por Rodrigo de Luna, arzobispo de Santiago, y distintos miembros de la nobleza gallega durante la revuelta contra el prelado que se desarrolló entre los años 1458 y 1460. En el estudio se pondrá de manifiesto la necesidad historiográfica de atender a dichos procesos pactuales en tanto que elementos fundamentales para la propia comprensión del conflicto en curso, y las diversas utilidades que el arzobispo encontró en el desarrollo de pactos y acuerdos tanto para alcanzar la paz con sus rivales como para hacerles frente.