bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of the primary care residents on the productivity of the ambulatory health centres in Portugal: a cross-sectional study
Authors: Reis Ivo , Envia Gonçalo , Santos Paulo
Published: June 2022

Background

The presence of residents in Primary Care health centres may influence their operational results.

Aim

To examine the relationship between the presence of residents and the results of the evaluation in Portuguese Primary Care Health Centres.

Methods

We conduct a cross-sectional study, comparing the results achieved by the mainland Portuguese Primary Care Health Centres measured by the Global Performance Index (Índice de desempenho global – IDG) by the presence of General & Family Medicine residents in training. Analysis took into consideration the distribution by region and typology of the health centres.

Results

We evaluated 906 units, 55.7% involved in the training of General & Family Medicine residence. The presence of residents was associated with higher Global Performance Index values (77.3 vs 57.6; p < 0.001). The higher difference was found in the less developed Personalized Health Care Units and in the region of Lisbon and Tagus Valley.

Conclusion

The presence of residents in training is a contributing factor in the productivity of the Primary Health Care facilities. It may model the asymmetry in the performance of Portuguese Health Centres.
Development of a patient-oriented navigation model for patients with lung cancer and stroke in Germany
Authors: Gödde Kathrin , Fügemann Hella , Desch Anke , Stumm Judith , Schindel Daniel , Rieckmann Nina , Meisel Andreas , Müller-Nordhorn Jacqueline , Goerling Ute , Holmberg Christine
Published: June 2022

Background

The concept of patient navigation was first established in the USA to support vulnerable patient groups in receiving timely and comprehensive access to cancer care. It has recently gained increasing interest in Germany to support patients with chronic diseases in a fragmented healthcare system. The aim of this paper is to present the development of such a model adapted to the German context based on the results of mixed-methods studies investigating the need for and barriers to patient-oriented care.

Methods

In a process adapted from Delphi rounds, we conducted regular structured workshops with investigators of the project to discuss results of their studies and identify content and structure of the model based on the data. Workshop discussions were structured along seven core components of a navigation model including target patient groups, navigator tasks, occupational background and education of navigators, and patient-navigator interaction mode.

Results

Using an approach based on empirical data of current care practices with special focus on patients’ perspectives, we developed a patient-oriented navigation model for patients who have experienced stroke and lung cancer in the German healthcare context. Patients without personal social support were viewed as struggling most with the healthcare system, as well as multimorbid and elderly patients. Navigators should serve as a longer-term contact person with a flexible contact mode and timing based on the individual situation and preferences of patients. Navigator tasks include the provision of administrative and organizational support as well as referral and guidance to available resources and beneficial health programs with special forms of knowledge. Implementation of the navigator should be flexibly located to ensure a reliable outreach to vulnerable patients for first contact in settings like specialized in-patient and out-patient settings, while navigation itself focuses on care coordination in the out-patient setting.

Conclusion

Flexibility of navigator tasks needed to be a core characteristic of a navigation model to be perceived as supportive from patients’ perspectives. In a subsequent feasibility study, an intervention based on the model will be evaluated according to its acceptance, demand, and practicality.
lncRNA MALAT1 promotes HCC metastasis through the peripheral vascular infiltration via miRNA-613: a primary study using contrast ultrasound
Authors: Zhou Dandan , Wang Ying , Hu Haifeng , Liu Huilin , Deng Jiajia , Li Lu , Zheng Chunlei
Published: June 2022

Background

This study aimed to explore the specific pathogenesis of lncRNA MALAT1 promoting the invasion and metastasis of hepatocellular carcinoma (HCC) through peripheral blood vessels by regulating the expression of miRNA-613 molecule.

Methods

The data of 60 HCC metastatic patients and 60 HCC non-metastatic patients detected by the contrast-enhanced ultrasound (CEUS) in the Second Affiliated Hospital of Qiqihar Medical College from January 2020 to June 2021 were collected, as well as postoperatively retained HCC tissues and paired paracancer tissues (5 cm laterally from the edge of the cancer area), to study the changes of microangiogenesis in HCC tissues with CEUS. The correlation between CEUS grading and lncRNA MALAT1 in patients with HCC was analyzed through Pearson correlation analysis, lncRNA MALAT1 and miRNA-613 in HCC tissues of patients with HCC were detected by qRT-PCR, followed by the bioinformatic analysis for the relationship between lncRNA MALAT1 and miRNA-613. The Log-growing human HCC cell strain, HepG2, was selected for experiments. Adenovirus transfection knocked down lncRNA MALAT1 in HCC cells, which was divided into two groups (inhibitor-NC group and lncR-inhibitor group), followed by knocking down miRNA-613 on the basis of knocking down lncRNA MALAT1, which was divided into three groups (inhibitor-NC group, lncR-inhibitor groups, and lncR/miR613-inhibitor group). The expression of miRNA-613 and lncRNA MALAT1 in each group was detected by qRT-PCR. The migration and invasiveness of cells in each group were detected by Transwell assay.

Results

CEUS of HCC and Pearson correlation analysis showed that CEUS grading and lncRNA MALAT1 were positively correlated in patients with HCC. In HCC tissues of patients with HCC, lncRNA MALAT1 expressed high and miRNA-613 expressed low. The results of bioinformatic analysis showed the targeting of lncRNA MALAT1 and miRNA-613. Knocking down lncRNA MALAT1 could increase miRNA-613 expression significantly, and reduce the migration of HCC cells. Inhibiting miRNA-613 based on knocking down lncRNA MALAT1 could increase the survival and migration of HCC cells.

Conclusions

lncRNA MALAT1 can promote HCC metastasis through the peripheral vascular infiltration by inhibiting the level of MiRNA-613, which can, therefore, be used as a potential target for the treatment of HCC.
Does the anatomical region predict blood loss or neurological deficits in embolized renal cancer spine metastases? A single-center experience with 31 patients
Authors: Voelker Anna , Osterhoff Georg , Einhorn Stefanie , Ebel Sebastian , Heyde Christoph-Eckhard , Pieroh Philipp
Published: June 2022

Background

No comparison of a single hypervascular tumor entity in terms of major complications in different spinal regions has been performed. We aimed to evaluate post-embolic and post-operative outcomes in anatomic regions with renal cell carcinoma (RCC) metastases to the spine.

Methods

We retrospectively evaluated data from patients with confirmed, embolized, and surgically treated RCC spine metastases at a single-spine center between 2010 and 2020. Patients were divided into thoracic (TSM) and lumbar (LSM) spine metastasis groups.

Results

Seventeen patients had TSM and 14 had LSM. In all cases, embolization was performed preoperatively. The ΔHb value did not differ between the two groups pre- and postoperatively (p=0.3934). There was no significant difference in intraoperative blood loss between both groups either within 1 day or 2 days after embolization. Neurological deficits occurred in eight patients after embolization or surgery, with no significant difference between TSM (n=5) and LSM (n=3).

Conclusions

Embolization is the standard procedure for the preoperative treatment of hypervascular spinal metastases, possible up to 48 h before surgery, without the risk of higher intraoperative blood loss. Regardless of intraoperative complications, major complications can occur up to several hours after embolization. We recommend surgery the day after embolization to reliably detect neurologic complications from this procedure.
Anthropogenic legacies shaping the present composition of demarcation trees in a temperate upland field landscape in Japan
Authors: Yoshinori Tokuoka , Kenichiro Kimura , Mitsunori Oka
Published: June 2022

Background

Isolated trees are often planted in agricultural landscapes around the world, but their planting background often remains unclear. In this study, we examined the history of demarcation trees in Ibaraki Prefecture in eastern Japan by using land dispute records mainly from the early modern period (from 1600 to 1868), the Rapid Survey Map (RSM) drawn in the late nineteenth century, demarcation tree records from 2011, and interviews of the local residents.

Methods

We reviewed 39 documents on land disputes to examine the temporal and spatial usage of demarcation tree species in the early modern period. The association between the present distribution of 1486 individuals of six demarcation tree species and past land use in the RSM were analyzed with Fisher’s exact test and residual analysis. In addition, we conducted interviews with 48 farmers, most of whom were over 60 years old.

Results

The demarcation plants in vast communal lands and village boundaries in the early modern period were mostly visually prominent tall trees, usually pines. In contrast, smaller trees were planted for demarcation in small-scale areas of forests and farmlands. Although Pourthiaea villosa (Thunb.) DC. Has been planted since the mid-eighteenth century, its planting seems to have accelerated as communal forests were divided mainly in the Meiji period (from 1868 to 1912). The present dominant state of Deutzia crenata Siebold et Zucc. in older farmlands and its ritual use, history of upland field development in the Kanto region, and ancient demarcation use in central Japan indicate its original use may date back to the medieval (from 1185 to 1600) or ancient ritsuryo period (from the seventh century to 1185). Tea (Camellia sinensis (L.) Kuntze) and mulberry (Morus spp.) individuals were considered as early modern or modern crop remnants. Results from the map-based analysis and interviews clarified the recent increase in the use of Euonymus japonicus Thunb. and Celtis sinensis Pers. for demarcation.

Conclusions

Chronologically dynamic anthropogenic legacies have shaped the present agricultural landscape with different demarcation tree species. A better understanding of the dynamic transformation of vegetation under human influence adds to the historical heritage value of the landscape and should motivate its conservation.
Research priorities in emergency general surgery (EGS): a modified Delphi approach
Authors: Vaughan Elizabeth Mary , Pearson Robert , Wohlgemut Jared Mark , Knight Stephen Richard , Spiers Harry , Damaskos Dimitrios , Cornish Julie , Parmar Chetan , Mahawar Kamal , Moug Susan , Baiocchi Gian Luca , Catena Fausto , Tierney Gillian , Wilson Michael Samuel James ,   the Scottish Surgical Research Group, the World Society of Emergency Surgery and the Association of Surgeons of Great Britain & Ireland
Published: June 2022

Background

Emergency general surgery (EGS) patients account for more than one-third of admissions to hospitals in the National Health Service (NHS) in England. The associated mortality of these patients has been quoted as approximately eight times higher than that of elective surgical admissions. This study used a modified Delphi approach to identify research priorities in EGS. The aim was to establish a research agenda using a formal consensus-based approach in an effort to identify questions relevant to EGS that could ultimately guide research to improve outcomes for this cohort.

Methods

Three rounds were conducted using an electronic questionnaire and involved health care professionals, research personnel, patients and their relatives. In the first round, stakeholders were invited to submit clinical research questions that they felt were priorities for future research. In rounds two and three, participants were asked to score individual questions in order of priority using a 5-point Likert scale. Between rounds, an expert panel analysed results before forwarding questions to subsequent rounds.

Results

Ninety-two EGS research questions were proposed in Phase 1. Following the first round of prioritisation, forty-seven questions progressed to the final phase. A final list of seventeen research questions were identified from the final round of prioritisation, categorised as condition-specific questions of high interest within general EGS, emergency colorectal surgery, non-technical and health services research. A broad range of research questions were identified including questions on peri-operative strategies, EGS outcomes in older patients, as well as non-technical and technical influences on EGS outcomes.

Conclusions

Our study provides a consensus delivered framework that should determine the research agenda for future EGS projects. It may also assist setting priorities for research funding and multi-centre collaborative strategies within the academic clinical interest of EGS.
First, do no harm: the proposed definition of “terminal anorexia” is fraught with danger for vulnerable individuals
Authors: Riddle Megan , O’Melia Anne Marie , Bauschka Maryrose
Published: June 2022

A recent article in the Journal of Eating Disorders (10:23, 2022) proposed criteria for “terminal anorexia” with a cited goal of improving access to end-of-life care (Gaudiani et al. in J Eat Disord 10(1):23, 2022). The authors presented three cases in which patients received end-of-life care, including the prescription of medical assistance in dying (MAID), also known as physician-assisted suicide (PAS). The proposed criteria lack the evidence base for adoption and do not acknowledge the compelling evidence that exists surrounding possible prolonged timelines to recovery for some individuals and the nuances of assessing capacity in this population.
Ugliness in architecture in the Australian, American, British and Italian milieus: Subtopia between the 1950s and the 1970s
Authors: Charitonidou Marianna
Published: June 2022

The article examines the reorientations of the appreciation of ugliness within different national contexts in a comparative and relational frame, juxtaposing the Australian, American, British and Italian milieus. It also explores the ways in which the transformation of the urban fabric and the effect of suburbanization were perceived in the aforementioned national contexts. Special attention is paid to the production and dissemination of how the city’s uglification was conceptualized between the 1950s and 1970s. Pivotal for the issues that this article addresses are Ian Nairn’s Outrage: On the Disfigurement of Town and Countryside, Robin Boyd’s The Australian Ugliness, Donald Gazzard’s Australian Outrage: The Decay of a Visual Environment, and the way the phenomenon of urban expansion is treated in these books in comparison with other books from the four national contexts under study, such as Ludovico Quaroni’s La torre di Babele and Reyner Banham’s The New Brutalism: Ethic or Aesthetic?. Particular emphasis is placed on Boyd’s articles in The Architectural Review between 1951 and 1970. At the core of the article is the analysis of the debates around ugliness between the 1950s and 1970s within the British, Italian, American and Australian contexts.
Purification and biofabrication of 5-aminolevulinic acid for photodynamic therapy against pathogens and cancer cells
Authors: Lee Yen-Ju , Yi Ying-Chen , Lin Yu-Chieh , Chen Chao-Chung , Hung Jia-Horung , Lin Jia-Yi , Ng I-Son
Published: June 2022

5-Aminolevulinic acid (5-ALA) is a non-proteinogenic amino acid which has involved in heme metabolism of organisms, and has been widely applied in agriculture, and medical fields nowadays. 5-ALA is used in the elimination of pathogens or cancer cells by photodynamic therapy (PDT) owing to the photosensitizer reaction which releases the reactive oxygen species (ROS). Currently, biofabrication of 5-ALA is regarded as the most efficient and eco-friendly approach, but the complicated ingredient of medium causes the nuisance process of purification, resulting in low recovery and high producing cost. In this study, hydrogen chloride, sodium acetate, and ammonia were examined to maximize the recovery of 5-ALA from ion-exchange chromatography (IEC), thus a 92% recovery in 1 M ammonia at pH 9.5 was obtained. Afterward, the activated carbon was used for decolorization to further remove the pigments from the eluent. Four organic solvents, i.e., diethyl ether, methanol, ethanol, and acetone were compared to extract and form 5-ALA precipitation. The purified 5-ALA was verified to eliminate 74% of A549 human lung cancer and 83% of A375 melanoma skin cancer cell. Moreover, Proteus hauseri, Aeromonas hydrophila, Bacillus cereus, and Staphylococcus aureus were killed via anti-microbial PDT with 1% 5-ALA and reached 100% killing rate at optimal condition. With the addition of 0.05% 5-ALA during the culture, the growth of microalgae Chlorella sorokiniana was improved to against a common aquatic pathogen, A. hydrophila. The broad application of 5-ALA was demonstrated in this study for the first time.

Graphical Abstract
Determination of puberty in gilts: contrast of diagnostic methods
Authors: Vela Antonio , Suárez-Usbeck Andrés , Lafoz Laura , Mitjana Olga , Tejedor María Teresa , Martín Sofía , López Marina , Falceto María Victoria
Published: June 2022

Background

Early onset of a gilt´s puberty is needed for adequate economic performance in farms, because it indicates her reproductive performance and longevity. Therefore, an effective diagnosis is needed. Our purpose was to compare different procedures (external characteristics, blood progesterone analysis and ultrasonography diagnosis) to detect puberty in 70 gilts (Topigs TN70; 240 days old) on farm conditions. Postmortem examination was the standard reference. Multiple logistic regression analysis was used to identify which combination of independent variables (predictors) best predicts the status of gilts.

Results

Puberty (46/70 gilts; 65.71%) was characterized by the presence of follicles larger than 6 mm,corpus albicans, corpus rubrum,andcorpus luteum(postmortem examination). Vaginal length, body condition, backfat, carcass weight and progesterone blood concentration were significantly higher in pubertal than prepubertal gilts (P < 0.05). Two types of ultrasonography equipment (DELTA and W3) were compared and performed by the same senior technician (V1). The results obtained by two technicians with different levels of experience (V1 and V2, a junior technician) using W3 were also compared. Ultrasonography provided better results than other diagnostic techniques, although the effectiveness of the ultrasonography changed with technological improvements and with increased expertise of technicians. The most accurate results were found by V1/DELTA (Nagelkerke´s R2 = 0.846; Sensitivity = 0.956; Specificity = 0.958; Positive predictive value = 0.978; Negative predictive value = 0.920; Area under ROC curve = 0.957). Results using the W3 equipment could be improved when used in conjunction with vaginal length (V1; Nagelkerke´s R2 = 0.834; Sensitivity = 0.933; Specificity = 0.958; Positive predictive value = 0.977; Negative predictive value = 0.885; Area under ROC curve = 0.972) or progesterone concentration (V2; Nagelkerke´s R2 = 0.780; Sensitivity = 0.955; Specificity = 0.826; Positive predictive value = 0.915; Negative predictive value = 0.905; Area under ROC curve = 0.970).

Conclusions

Ultrasonography provided better results than other diagnostic techniques. The effectiveness of the ultrasonography changes with technological improvements and with increased expertise of technicians. Results using the W3 equipment could be improved when used along with vaginal length (V1) or progesterone concentration (V2). Accuracy parameters are a guide to choose puberty diagnosis, but the farms must also evaluate effect on gilts, ease and cost of administration.
Impact of resilience on disease severity and psychiatric comorbidities in patients with fibromyalgia
Authors: Ismail Zahraa Nour Eldine , Hefny Mohamed Ahmed , Hendi Ahmed Elarabi
Published: June 2022

Background

Resilience is the process of adjusting successfully in the face of adversity, trauma, threats, or severe stress, such as serious health problems. It is one of the factors that affect recovery from psychiatric disorders. It was suggested that fibromyalgia patients have low resilience. This study aimed to assess the impact of resilience on disease severity and psychiatric comorbidities in patients with fibromyalgia.

Results

We found that patients with fibromyalgia had a significantly lower resilience and higher prevalence of psychiatric comorbidities than the control group (P < 0.05). Also, fibromyalgia patients with high disease severity had a significantly lower resilience and a higher percentage of psychiatric problems than those with a better disease state (P = 0.0001). Also, there was a significant negative correlation of resilience with disease severity (as assessed by the FIQ score), visual analog scale (VAS) of anxiety, and VAS of depression (P = 0.0001).

Conclusion

Resilience significantly impacts the severity and psychiatric comorbidities in patients with fibromyalgia. So, enhancing and improving resilience must be considered in the management protocols of fibromyalgia patients.
Mise-a-la-masse-based induced-polarization method for heavy-metal pollution leakage monitoring: Methodology and modeling results
Authors: Li Jinghe , He Zhanxiang , Wu Xiangling , Zhang Zhi
Published: June 2022

A new mise-a-la-masse (MALM)-based induced-polarization (IP) method is developed for heavy-metal contamination monitoring, in which the charged source in a nonperfect conductor and contact measurements are leveraged to achieve higher accuracy. The MALM-based source enhances the amplitude of potential anomalies due to the bottlenecks of weak signal and limited measurement environment which commonly occur in traditional IP methods for heavy-metal contamination monitoring. The charged current intensity inside the conductor is calculated using an approximate formula rather than only following a current source applied in conventional MALM method. Then, the numerical modeling is based on the discreted charged sources and staggered tetrahedral meshes under the finite-element framework. An improved resistivity computation algorithm is developed for the MALM-IP measurements. It is concluded that the numerical results for the proposed technique are consistent with the model parameter variations. Moreover, a soil box experiment is consistent with the modeling results and confirms the viability of the proposed MALM-IP method. The verification of this technology also is based on the comparisons of numerical modeling and soil box experiment results with those of traditional IP methods and indicates the superiority of this MALM-IP method for heavy-metal contamination monitoring.
Impaired Sensitivity to Thyroid Hormones Is Associated With Elevated Homocysteine Levels in the Euthyroid Population
Authors: Ding Xiaoyu , Wang Ying , Liu Jia , Wang Guang
Published: June 2022

Context

Homocysteine (Hcy), a known risk factor for cardiovascular disease, has been reported to be linked with thyroid dysfunction. However, the association of thyroid hormones sensitivity with Hcy levels remains unknown.

Objective

We aimed to investigate the relationship between thyroid hormone sensitivity and elevated Hcy levels in the euthyroid population.

Methods

A total of 8957 euthyroid adults were included in this study. Free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH), Hcy levels, and other clinical parameters were measured. Hyperhomocysteinemia (HHcy) was defined as serum Hcy level > 15 μmol/L. Thyroid hormone sensitivity indices were calculated by thyroid feedback quantile-based index (TFQI), Chinese-referenced parametric TFQI (PTFQI), TSH index (TSHI) and thyrotropin thyroxine resistance index (TT4RI).

Results

Subjects with decreased sensitivity to thyroid hormones had higher Hcy levels (P for trend < 0.001). Logistic regression analysis revealed the higher quartiles of TFQI, PTFQI, TSHI, and TT4RI were significantly associated with elevated Hcy levels, and these associations remained significant even after adjustment for multiple risk factors. After adjusting for age, sex, body mass index, dyslipidemia, fatty liver, diabetes, and hypertension, the odds ratio (95% CI) for having HHcy of the TFQI in the highest quartile was 1.393 (1.210, 1.603), the PTFQI in the highest quartile was 1.409 (1.225, 1.621), the TSHI in the highest quartile was 1.372 (1.190, 1.583), and the TT4RI in the highest quartile was 1.315 (1.141, 1.515) (all P < 0.001).

Conclusion

In euthyroid subjects, impaired sensitivity to thyroid hormones was associated with elevated Hcy levels.
Dual-Layer Rotation: A Versatile Therapeutic Mammoplasty Technique
Authors: Joukainen Sarianna , Laaksonen Elina , Vanninen Ritva , Kaarela Outi , Sudah Mazen
Published: June 2022

Background

Multifocal or complex breast lesions are a challenge for breast-conserving surgery, particularly surgery in small breasts or those located in the upper inner quadrant. The dual-layer rotation technique exploits the idea of manipulating the skin and glandular tissue in separate layers to fill the resection cavity via vertical mammoplasty if skin excision is not required, except in the central area.

Methods

The authors performed a retrospective review of consecutive breast cancer patients who underwent DLR mammoplasty between 2017 and 2019 at a single institution. Clinical data, reoperations, surgical complications, delays in adjuvant treatments, and the need for late revisional surgery were evaluated. Aesthetic outcomes were evaluated objectively and subjectively from photographs.

Results

The study included 46 breasts of 40 patients. Tumors were located in the UIQ (30%, 14/46) or in multiple quadrants (22%, 10/46). One third (33%, 13/40) of the patients had a small breast cup size (A–B). Negative margins were primarily achieved in 45 of the 46 breasts. Major complications occurred in three patients, who needed reoperation, and adjuvant therapy was delayed for one of these patients. Late refinement surgery was needed for two patients. The objective and subjective aesthetic outcomes were good or excellent regardless of the tumor position.

Conclusion

As a novel oncoplastic approach, DLR mammoplasty offers a one-step procedure to treat selected breast cancer patients with challenging resection defects due to different breast sizes or lesion locations. The technique preserves the breast’s natural appearance.
Performance measurement of university-industry collaboration in the technology transfer process: A systematic literature review
Authors: Pujotomo Darminto , Helmi Syed Hassan Syed Ahmad , Ma’aram Azanizawati , Sutopo Wahyudi
Published: June 2022

Background

To fostering organizational improvement, the performance must be assessed. In the context of university-industry collaboration (UIC) in the technology transfer process, the performance of also must be assessed. However, the performance covers complex aspects which makes it difficult to be measured. This indicates the need to have a better understanding of the methods used. Therefore, this study presents a systematic literature review on the performance measurement of UIC in the technology transfer process that can give to the researchers an easy and quick overview of the literature about (mainly) the methods used for the performance measurement.

Methods

We used two major scientific databases, i.e., Scopus and Web of Science. We defined four groups of keywords to restrict the search criteria. We only consider articles published in the last decade, during 2010 to November 2021. The search procedure contains four phases following the PRISMA framework: (i) identification, (ii) screening, (iii) eligibility, and (iv) inclusion.

Results

The final screening process resulted in 24 articles that satisfied the criteria for inclusion in this review. The collected articles are categorized according to two classifications. The first is about type of the collaboration, while the second is about the methods used. We investigated three types of collaboration, i.e., at the level of technology transfer office (TTO), the academic (university) spin-offs, and joint-research. There are several methods for assessing performance, ranging from qualitative, quantitative, to mixed methods.

Conclusion

The literature review leads us to the following conclusions. First, most studies are conducted at the TTO level, in which it is anticipated since it is the most common form UIC. Second, the application of data envelopment analysis is still preferable than other method in measuring the performance. This study also provides possible research directions that can facilitate scholars to uncover gaps in the literature.
Emergency care in life-threatening medical situations
Authors: Kernytskyy Roman
Published: June 2022

The health and life of the patient often depend on the timeliness and quality of medical care for various diseases, traumatic injuries, accidents, poisonings, etc. A significant proportion of patients in need of emergency medical care die due to its untimeliness or inadequacy. Cardiopulmonary resuscitation and possession of modern principles of emergency medical care are relevant for doctors of all specialties. Every doctor is obliged to provide emergency medical care to the patient, regardless of the root cause of the terminal condition, in accordance with modern standards and international protocols.
Analysis of football referees injuries - literature review
Authors: Mańko Aleksandra
Published: June 2022

Introduction and purpose: According to the literature, injuries are defined as the result of the action of significant energy, causing dysfunction and anatomical-physiological changes. In the case of football referees, sports injuries occur during physical exertion in the form of matches and training sessions. As a result, various injuries occur, both on the pitch and during arduous training. They often take place as the aftermath of summed micro-injuries. Properly early detection and analysis of these signals helps to heal the damage and to avoid a longer break from activity, which would inevitably result in a serious injury. The aim of this study is to analyze the most common injuries and their risk factors in football referees on the basis of the current literature.

Description of the state of knowledge: 9 research papers from the last twelve years (2009-2021) containing the above-mentioned keywords have been qualified for this review. Based on the above works, it is possible to determine when and how often injuries occur among referees, and what areas of the body are injured. Due to the multifactorial etiology of injuries and heterogeneous diagnostic systems, which would constitute a standardized research tool, it is difficult to say unequivocally what is the greatest cause of an injury.

Conclusions: 1) Injuries among referees at different levels of the game occur more often due to the match load than the training load. 2) Muscle injuries were the most common, but there was no indication of a tendency towards the exact location of the injury, which requires further research.
The Hidden Costs of Securing Innovation: The Manifold Impacts of Compulsory Invention Secrecy
Authors: Gross Daniel P.
Published: June 2022

One of the most commanding powers of the U.S. Patent and Trademark Office (USPTO) is to compel inventions into secrecy, withholding patent rights and prohibiting disclosure, to prevent technology from leaking to foreign competitors. This paper studies the impacts of compulsory secrecy on firm invention and the wider innovation system. In World War II, USPTO issued secrecy orders to more than 11,000 patent applications, which it rescinded en masse at the end of the war. Compulsory secrecy caused implicated firms to shift their patenting away from treated classes, with effects persisting through at least 1960. It also restricted commercialization and impeded follow-on innovation. Yet it appears it was effective at keeping sensitive technology out of public view. The results provide insight into the effectiveness of compulsory secrecy as a regulatory strategy and into the roles, and impacts, of formal intellectual property in the innovation system.

This paper was accepted by Toby Stuart, entrepreneurship and innovation.

Funding: This work was supported by Harvard Business School (Division of Research and Faculty Development) and the National Bureau of Economic Research (Innovation Policy Grant). This material is based upon work supported by the National Science Foundation [Grant 1951470].

Supplemental Material: Data and the online appendices are available at https://doi.org/10.1287/mnsc.2022.4457 .
'Health foodies' como prescriptores saludables, gastronómicos y publicitarios
Authors: Aznar Íñiguez Cristina , Segarra Saavedra Jesús
Published: June 2022

Objetivos: analizar los contenidos publicados por los principales health foodies españoles con el fin de conocer tanto el uso que hacen de Instagram desde el punto de vista gastronómico y publicitario como el grado de compromiso que alcanzan con su audiencia social.
 Metodología: se realiza un análisis de 1.174 contenidos publicados en Instagram por parte de seis health foodies españoles durante quince días. El estudio se lleva a cabo desde tres perspectivas: el compromiso conseguido con su actividad, la presencia de elementos propios de la gastronomía y la inserción de marcas, productos y servicios en los contenidos difundidos.
 Resultados: se detecta que un mayor número de seguidores no implica un mayor grado de compromiso con la audiencia social ni viceversa, que no solo promocionan marcas relacionadas con la alimentación y la gastronomía y que la alimentación vegana y de gusto salado priman por encima de otros estilos alimentarios.
Un nuevo reto para la gestión de los documentos : la gestión de la memoria ciudadana
Authors: Postico Soler Núria
Published: June 2022

El 17 de agosto de 2017 se produjo el atentado en La Rambla de Barcelona. A partir de aquel día los ciudadanos, esporádicamente, generaron muestras de pésame depositando flores, mensajes, velas u objetos a lo largo del paseo. El Ayuntamiento de Barcelona creó una página web que incluía un libro de condolencias electrónico. Asimismo, se dispuso, en el Salón de Ciento de la Casa de la Ciudad, un libro de condolencias, en soporte papel, para todo el mundo que lo quisiera hacer presencialmente. Días después del atentado, un equipo de personas que trabajan en el Ayuntamiento llevó a cabo una actuación en La Rambla. El objetivo era recoger las muestras de pésame, expresiones de luto y solidaridad de la ciudadanía, tratándolas y haciéndolas accesibles a través de las diferentes plataformas digitales, para ponerlas en valor.
Apuntes para una visión crítica de las Bibliotecas Humanas dentro de la función social de la biblioteca pública
Authors: Draper Martínez Sergi
Published: June 2022

La función social de la biblioteca pública es un factor intrínseco a su esencia y a sus valores. La intención de influir positivamente en la sociedad que rodea a la biblioteca ha estado presente, de una forma o de otra, como mínimo desde el origen de la lectura pública moderna, ahora hace unos 150 años, con la idea de acceso a la educación del pueblo y el fomento del espíritu democrático (Faus, 2000). Cuando decimos 'de una forma o de otra', nos referimos al hecho de que el concepto de acción o intervención sociocultural ha ido variando a lo largo de los años, y que el ánimo asistencialista y benéfico inicial ha dado paso, de manera progresiva, a prácticas más participativas y transformadoras. Aun así, a pesar de que esta visión social es comúnmente aceptada en el plano teórico, a las bibliotecas todavía les resulta difícil definir la planificación alrededor de la acción social que llevan a la práctica. En este texto, pondremos en valor la necesidad de definir la acción social en las bibliotecas públicas, tanto desde una vertiente teórica como práctica. Posteriormente, analizaremos las Bibliotecas Humanas como parte de la planificación y programación de servicios y actividades sociales de la biblioteca pública, y, desde una visión crítica, intentaremos averiguar los puntos fuertes y lo que consideramos que son las debilidades. Finalmente, plantearemos toda una serie de reflexiones que hay que tener en cuenta a la hora de articular una programación de actividades de sentido social en la biblioteca, partiendo de esta como espacio accesible, participativo y transformador.
Luces y sombras del aprendizaje-servicio: dificultades y decisiones para poner en marcha los proyectos
Authors: Palape Inés , Sepúlveda Gaby , Bizkarra Maria Teresa , Gamito Rakel
Published: June 2022

Los proyectos de aprendizaje-servicio (ApS) han demostrado tener un enorme potencial formativo. Para que un proyecto de ApS pueda implementarse exitosamente se deben cuidar aquellos detalles que puedan obstaculizar su inicio. El objetivo de este trabajo es identificar y analizar las dificultades e inconvenientes que se presentan en la etapa inicial de un proyecto de ApS y proponer algunas orientaciones que contribuyan a mejorar una implementación exitosa. Han participado dos grupos de 17 y 19 estudiantes en dos asignaturas de la Universidad de Arturo Prat (Chile), en las que se implementó la metodología ApS, dos docentes responsables de las asignaturas y dos entidades receptoras del servicio. La información se ha recogido mediante un cuestionario de expectativas aplicado al alumnado, una entrevista a los socios, los diarios del alumnado y las notas de campo de las docentes. Los resultados indican que es necesario adelantarse a planificar detalladamente las acciones del alumnado, porque se cuenta con un tiempo bastante acotado. Además, para lograr el éxito del proyecto se requiere establecer relaciones de confianza que permitan conocer el contexto y facilitar la colaboración. Es imprescindible que el diagnóstico se realice adecuadamente para dar respuesta a las necesidades reales de la comunidad.
Ejemplar completo
Authors: Revista Iberoamericana de Aprendizaje-Servicio RIDAS
Published: June 2022

Ejemplar completo
67  GHz light-trapping-structure germanium photodetector supporting 240  Gb/s PAM-4 transmission
Authors: Chen Daigao , Zhang Hongguang , Liu Min , Hu Xiao , Zhang Yuguang , Wu Dingyi , Zhou Peiqi , Chang Siyao , Wang Lei , Xiao Xi
Published: June 2022

A light-trapping-structure vertical Ge photodetector (PD) is demonstrated. In the scheme, a 3 μm radius Ge mesa is fabricated to constrain the optical signal in the circular absorption area. Benefiting from the light-trapping structure, the trade-off between bandwidth and responsivity can be relaxed, and high opto-electrical bandwidth and high responsivity are achieved simultaneously. The measured 3 dB bandwidth of the proposed PD is around 67 GHz, and the responsivity is around 1.05 A/W at wavelengths between 1520 and 1560 nm. At 1580 nm, the responsivity is still over 0.78 A/W. A low dark current of 6.4 nA is also achieved at

−
2
  
V

bias voltage. Based on this PD, a clear eye diagram of 100 GBaud four-level pulse amplitude modulation (PAM-4) is obtained. With the aid of digital signal processing, 240 Gb/s PAM-4 signal back-to-back transmission is achieved with a bit error ratio of

1.6
×

10

−
2

. After 1 km and 2 km fiber transmission, the highest bit rates are 230 and 220 Gb/s, respectively.
Impact of the Grain for Green Project on water resources and ecological water stress in the Yanhe River Basin
Authors: Han Yuping , Xia Fan , Huang Huiping , Mu Wenbin , Jia Dongdong
Published: June 2022

The Grain for Green project (GGP), initialized by the Chinese government in 1999, has achieved substantial achievements accompanied by a decrease in surface runoff on the Loess Plateau, but the impacts of large-scale afforestation on regional water resources are uncertain. Hence, the objective of this study was to explore the impact of land use change on generalized water resources and ecological water stress using the blue and green water concepts, taking the Yanhe River Basin as the case study. The Soil and Water Assessment Tool (SWAT) was applied to quantify the green water and blue water, which are defined as generalized water resources. The ecological water requirement of vegetation (forest and grass), agricultural water footprint and virtual water flow are considered regional water requirements. The land use types of 1980 (Scenario I) and 2017 (Scenario II) were entered into the SWAT model while keeping the other parameters constant to isolate the influence of land use changes. The results show that the average annual differences in blue, green and generalized water resources were -72.08 million m3, 24.34 million m3, and -47.74 million m3, respectively, when the simulation results of Scenario II were subtracted from those of Scenario I, which shows that land use change caused by the GGP led to a decrease in blue and generalized water resources and an increase in green water resources. Surface runoff in Scenario I was more than that in Scenario II in all of the years of the study period from 1980–2017, and green water storage in Scenario I was more than that in Scenario II in all of the years of the study period except in 1998; although lateral flow in Scenario I was less than that in Scenario II except in 2000 and 2015, as was groundwater runoff in 1992, 2000 and 2015, and green water flow in 1998. Blue water flow, green water storage and green water flow in Scenario II were less than those in Scenario I in the whole basin, 12.89 percent of the basin and 99.21 percent of the basin, respectively. The total water footprint increased from 1995 to 2010 because the forest water footprint increased significantly in this period, although the agricultural water footprint and grass water footprint decreased. The ecological water stress index values had no obvious temporal change trends in either land use scenario, but the ecological water stress index in Scenario II was greater than that in Scenario I, which illustrates that the GGP led to an increase in ecological water stress from the perspective of generalized water resources.
Cost-effectiveness of Ezetimibe plus statin lipid-lowering therapy: A systematic review and meta-analysis of cost-utility studies
Authors: Sasidharan Akhil , Bagepally Bhavani Shankara , Kumar S. Sajith , Jagadeesh Kayala Venkata , Natarajan Meenakumari
Published: June 2022

In addition to statin therapy, Ezetimibe, a non-statin lipid-modifying agent, is increasingly used to reduce low-density lipoprotein cholesterol and atherosclerotic cardiovascular disease risk. Literature suggests the clinical effectiveness of Ezetimibe plus statin (EPS) therapy; however, primary evidence on its economic effectiveness is inconsistent. Hence, we pooled incremental net benefit to synthesise the cost-effectiveness of EPS therapy. We identified economic evaluation studies reporting outcomes of EPS therapy compared with other lipid-lowering therapeutic agents or placebo by searching PubMed, Embase, Scopus, and Tufts Cost-Effective Analysis registry. Using random-effects meta-analysis, we pooled Incremental Net Benefit (INB) in the US $ with a 95% confidence interval (CI). We used the modified economic evaluations bias checklist and GRADE quality assessment for quality appraisal. The pooled INB from twenty-one eligible studies showed that EPS therapy was significantly cost-effective compared to other lipid-lowering therapeutic agents or placebo. The pooled INB (95% CI) was $4,274 (621 to 7,927), but there was considerable heterogeneity (I2 = 84.21). On subgroup analysis EPS therapy is significantly cost-effective in high-income countries [$4,356 (621 to 8,092)], for primary prevention [$4,814 (2,523 to 7,106)], and for payers’ perspective [$3,255 (571 to 5,939)], and from lifetime horizon [$4,571 (746 to 8,395)]. EPS therapy is cost-effective compared to other lipid-lowering therapeutic agents or placebo in high-income countries and for primary prevention. However, there is a dearth of evidence from lower-middle-income countries and the societal perspective.
Identification of homozygous missense variant in SIX5 gene underlying recessive nonsyndromic hearing impairment
Authors: Kakar Mohib Ullah , Akram Muhammad , Zubair Mehboob Muhammad , Younus Muhammad , Bilal Muhammad , Waqas Ahmed , Nazir Amina , Shafi Muhammad , Umair Muhammad , Ahmad Sajjad , Rafeeq Misbahuddin M.
Published: June 2022

Hearing impairment (HI) is a heterogeneous condition that affects many individuals globally with different age groups. HI is a genetically and phenotypically heterogeneous disorder. Over the last several years, many genes/loci causing rare autosomal recessive and dominant forms of hearing impairments have been identified, involved in various aspects of ear development. In the current study, two affected individuals of a consanguineous family exhibiting autosomal recessive nonsyndromic hearing impairment (AR-NSHI) were clinically and genetically characterized. The single affected individual (IV-2) of the family was subjected to whole-exome sequencing (WES) accompanied by traditional Sanger sequencing. Clinical examinations using air conduction audiograms of both the affected individuals showed profound hearing loss across all frequencies. WES revealed a homozygous missense variant (c.44G>C) in theSIX5gene located on chromosome 19q13.32. We report the first case of autosomal recessive NSHI due to a biallelic missense variant in theSIX5gene. This report further supports the evidence that theSIX5variant might cause profound HI and supports its vital role in auditory function. Identification of novel candidate genes might help in application of future gene therapy strategies that may be implemented for NSHI, such as gene replacement using cDNA, gene silencing using RNA interference, and gene editing using the CRISPR/Cas9 system.