bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers, facilitators, and disparities in retention for adolescents in treatment for substance use disorders: a qualitative study with treatment providers
Authors: Acevedo Andrea , Harvey Nellie , Kamanu Maureen , Tendulkar Shalini , Fleary Sasha
Published: June 2020

Background

Retention in substance use treatment is one of the strongest predictors of improved outcomes among adolescents, making retention an important goal of treatment. We examined treatment providers’ perspectives on barriers and facilitators to treatment retention among adolescents, and their views on contributors to racial/ethnic disparities in retention including ways to address disparities.

Methods

Semi-structured interviews were conducted with 19 providers at state-licensed detoxification, residential, and outpatient facilities serving adolescents for substance use disorders in Massachusetts. Interviews were coded by at least two independent coders.

Results

Providers identified barriers and facilitators at the policy/systems, facility, family, and client levels. Some of the barriers included insurance limits on sessions/length of stay and low reimbursement (policy/systems), staff turnover (facility), low family engagement (family), and low internal motivation (client). Some facilitators mentioned were support from state’s substance use agency (policy/systems), flexibility with meeting location (facility), family participation (family), and high internal motivation and presence of external motivators (client). Barriers that contributed to racial/ethnic disparities included lower socio-economic status, language barriers, and mistrust. Having bilingual/bicultural staff and multi-lingual materials, and facilitating transportation were identified as strategies for reducing disparities in treatment retention.

Conclusions

It is critical that adolescents who access substance use services remain and complete treatment and that there is equity in treatment retention. Provider perspectives in factors associated with retention can inform the development of comprehensive interventions and policies to help improve retention and reduce disparities.
Sex-specific risk factors for early mortality and survival after surgery of acute aortic dissection type a: a retrospective observational study
Authors: Friedrich Christine , Salem Mohamed Ahmed , Puehler Thomas , Hoffmann Grischa , Lutter Georg , Cremer Jochen , Haneya Assad
Published: June 2020

Background

Although gender-related disparities in cardiovascular surgery have been investigated extensively in the past decades, knowledge about the impact of gender on outcomes after surgery for acute aortic dissection type A (AADA) is sparse. This study investigated the impact of gender on early morbidity and mortality and follow-up outcome in patients after surgery for AADA and to analyze gender-related risk factors for 30-day mortality.

Methods

This retrospective study included 368 consecutive patients (male 65.8% vs. female 34.2%) undergoing surgery for AADA between 2001 and 2016 at our department. Survival was estimated by Kaplan-Meier curves. Risk factors for 30-day mortality were assessed by multivariable logistic regression and interaction analysis.

Results

Women were older (70.7 years vs. 60.6 years; p <  0.001) and showed a higher logistic EuroSCORE I (31.0% vs. 19.7%, p <  0.001). In the male group, a higher portion of smokers (27.6% vs. 16.0%, p = 0.015) and intraoperatively, more complex procedures and longer cardiopulmonary bypass (CPB) (171 min vs. 149 min, p = 0.001) and cross-clamping times (94 min vs. 85 min, p = 0.018) occurred. 30-day mortality was 19.0% in the female and 16.5% in the male group (p = 0.545). Predictive for 30-day mortality in both genders was intraoperative blood transfusion, while in the female group chronic obstructive pulmonary disease (COPD), peripheral arterial disease and preoperative intubation were predictive. Preoperative cardiopulmonary resuscitation and duration of CPB time were predictors only in males. Averaged follow-up time was 5.2 years and survival did not differ between genders, even if it was stratified by age over 70 years.

Conclusions

This analysis demonstrated a similar and satisfactory survival in both genders after surgical treatment of AADA. Women and men differed significantly in age, unadjusted and adjusted risk factors and complexity of surgical treatment, but gender itself was no risk factor for mortality. These results suggest that the decision-making for surgical treatment should not depend on gender, but that accounting for sex-specific risk factors rather than common risk factors may help to improve the outcome in both genders.
The unique characteristics of COVID-19 coagulopathy
Authors: Iba Toshiaki , Levy Jerrold H. , Connors Jean Marie , Warkentin Theodore E. , Thachil Jecko , Levi Marcel
Published: June 2020

Thrombotic complications and coagulopathy frequently occur in COVID-19. However, the characteristics of COVID-19-associated coagulopathy (CAC) are distinct from those seen with bacterial sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC), with CAC usually showing increased D-dimer and fibrinogen levels but initially minimal abnormalities in prothrombin time and platelet count. Venous thromboembolism and arterial thrombosis are more frequent in CAC compared to SIC/DIC. Clinical and laboratory features of CAC overlap somewhat with a hemophagocytic syndrome, antiphospholipid syndrome, and thrombotic microangiopathy. We summarize the key characteristics of representative coagulopathies, discussing similarities and differences so as to define the unique character of CAC.
The OPTIMIZE patient- and family-centered, primary care-based deprescribing intervention for older adults with dementia or mild cognitive impairment and multiple chronic conditions: study protocol for a pragmatic cluster randomized controlled trial
Authors: Bayliss E. A. , Shetterly S. M. , Drace M. L. , Norton J. , Green A. R. , Reeve E. , Weffald L. A. , Wright L. , Maciejewski M. L. , Sheehan O. C. , Wolff J. L. , Gleason K. S. , Kraus C. , Maiyani M. , Du Vall M. , Boyd C. M.
Published: June 2020

Background

Most individuals with dementia or mild cognitive impairment (MCI) have multiple chronic conditions (MCC). The combination leads to multiple medications and complex medication regimens and is associated with increased risk for significant treatment burden, adverse drug events, cognitive changes, hospitalization, and mortality. Optimizing medications through deprescribing (the process of reducing or stopping the use of inappropriate medications or medications unlikely to be beneficial) may improve outcomes for MCC patients with dementia or MCI.

Methods

With input from patients, family members, and clinicians, we developed and piloted a patient-centered, pragmatic intervention (OPTIMIZE) to educate and activate patients, family members, and primary care clinicians about deprescribing as part of optimal medication management for older adults with dementia or MCI and MCC. The clinic-based intervention targets patients on 5 or more medications, their family members, and their primary care clinicians using a pragmatic, cluster-randomized design at Kaiser Permanente Colorado. The intervention has two components: a patient/ family component focused on education and activation about the potential value of deprescribing, and a clinician component focused on increasing clinician awareness about options and processes for deprescribing. Primary outcomes are total number of chronic medications and total number of potentially inappropriate medications (PIMs). We estimate that approximately 2400 patients across 9 clinics will receive the intervention. A comparable number of patients from 9 other clinics will serve as wait-list controls. We have > 80% power to detect an average decrease of − 0.70 (< 1 medication). Secondary outcomes include the number of PIM starts, dose reductions for selected PIMs (benzodiazepines, opiates, and antipsychotics), rates of adverse drug events (falls, hemorrhagic events, and hypoglycemic events), ability to perform activities of daily living, and skilled nursing facility, hospital, and emergency department admissions.

Discussion

The OPTIMIZE trial will examine whether a primary care-based, patient- and family-centered intervention educating patients, family members, and clinicians about deprescribing reduces numbers of chronic medications and PIMs for older adults with dementia or MCI and MCC.

Trial registration

NCT03984396. Registered on 13 June 2019
Existence and uniqueness of finite beam deflection on nonlinear non-uniform elastic foundation with arbitrary well-posed boundary condition
Authors: Choi Sung Woo
Published: June 2020

For arbitrary two-point boundary condition, which makes the corresponding linear uniform problem well-posed, we obtain an existence and uniqueness result for the boundary value problem of finite beam deflection resting on arbitrary nonlinear non-uniform elastic foundation. The difference between the desired solution and the corresponding linear uniform one in $L^{\infty}$L∞ sense is bounded explicitly in terms of given inputs of the problem. Our results seamlessly unify linear uniform and nonlinear non-uniform problems and lead to an iteration algorithm for uniformly approximating the desired deflection.
Boundary value conditions for linear differential equations with power degenerations
Authors: Kalybay Aigerim
Published: June 2020

On the interval $[0,1]$[0,1] we consider the nth order linear differential equation, the coefficient of the highest derivative of which is equivalent to the power function $t^{\mu }$tμ when $t\rightarrow 0$t→0. The main aim of the paper is to pose “generalized” Cauchy conditions for the given equation at the point of singularity $t=0$t=0, which would be correct for any $\mu >0$μ>0.
A fractional differential equation model for the COVID-19 transmission by using the Caputo–Fabrizio derivative
Authors: Baleanu Dumitru , Mohammadi Hakimeh , Rezapour Shahram
Published: June 2020

We present a fractional-order model for the COVID-19 transmission with Caputo–Fabrizio derivative. Using the homotopy analysis transform method (HATM), which combines the method of homotopy analysis and Laplace transform, we solve the problem and give approximate solution in convergent series. We prove the existence of a unique solution and the stability of the iteration approach by using fixed point theory. We also present numerical results to simulate virus transmission and compare the results with those of the Caputo derivative.
Laparoscopic-based perivascular renal sympathetic nerve denervation: a feasibility study in a porcine model
Authors: Zhao Linwei , Su Enyong , Yang Xiaohang , Zhu Binbin , Fan Zhiqiang , Wang Xianpei , Qi Datun , Zhu Lijie , Bai Mingfu , Zhang You , Zhao Qiuping , Li Muwei , Gao Chuanyu
Published: June 2020

Background

This study aims to evaluate the effects and safety of laparoscopic-based perivascular renal sympathetic nerve denervation (RDN) in a porcine model fed a high-fat diet.

Method

Thirty-six high-fat diet-fed Bama minipigs were randomly divided into an RDN group (n = 18), in which minipigs received laparoscopic-based perivascular RDN, and a sham group (n = 18). All pigs were fed the high-fat diet after the operation to establish a model of obesity-induced hypertension. Bama pigs in the RDN and sham groups were killed at 3 time points [2 days after RDN (n = 6), day 90 (n = 6) and day 180 (n = 6)].

Result

The systolic blood pressure (SBP) and noradrenaline (NE) concentration in the kidney tissue were significantly lower in the RDN group than in the sham group at 2 days (113.83 ± 3.26 mmHg vs 129.67 ± 3.32 mmHg, P = 0.011, and 112.02 ± 17.34 ng/g vs 268.48 ± 20.61 ng/g, P < 0.001, respectively), 90 days (116.83 ± 3.88 mmHg vs 145.00 ± 4.22 mmHg, P = 0.001, respectively) and 180 days (129.33 ± 2.87 mmHg vs 168.57 ± 2.86 mmHg, P < 0.001, and 152.15 ± 16.61 ng/g vs 318.97 ± 24.84 ng/g, P < 0.001, respectively) after the operation. The diastolic blood pressure (DBP) was significantly lower in the RDN group than in sham group at 90 and 180 days after the operation (72.17 ± 2.7 mmHg vs 81.50 ± 2.22 mmHg, P = 0.037, and 76.83 ± 2.75 mmHg vs 86.33 ± 2.22 mmHg P = 0.021, respectively). Based on the pathological evaluation, the renal sympathetic nerve fascicles were successfully disrupted by radiofrequency energy after laparoscopic-based perivascular RDN, but the intima was intact. Tyrosine hydroxylase (TH) expression was decreased, while the expression of the S100 protein was increased in treated renal arteries after RDN.

Conclusions

Laparoscopic-based perivascular RDN prevented the occurrence and development of hypertension, and thus it may be an efficient and safe method for controlling blood pressure in an experimental model.
Estimating the daily trend in the size of the COVID-19 infected population in Wuhan
Authors: Lin Qiu-Shi , Hu Tao-Jun , Zhou Xiao-Hua
Published: June 2020

Background

The outbreak of coronavirus disease 2019 (COVID-19) has become a pandemic causing global health problem. We provide estimates of the daily trend in the size of the epidemic in Wuhan based on detailed information of 10 940 confirmed cases outside Hubei province.

Methods

In this modelling study, we first estimate the epidemic size in Wuhan from 10 January to 5 April 2020 with a newly proposed model, based on the confirmed cases outside Hubei province that left Wuhan by 23 January 2020 retrieved from official websites of provincial and municipal health commissions. Since some confirmed cases have no information on whether they visited Wuhan before, we adjust for these missing values. We then calculate the reporting rate in Wuhan from 20 January to 5 April 2020. Finally, we estimate the date when the first infected case occurred in Wuhan.

Results

We estimate the number of cases that should be reported in Wuhan by 10 January 2020, as 3229 (95% confidence interval [CI]: 3139–3321) and 51 273 (95% CI: 49 844–52 734) by 5 April 2020. The reporting rate has grown rapidly from 1.5% (95% CI: 1.5–1.6%) on 20 January 2020, to 39.1% (95% CI: 38.0–40.2%) on 11 February 2020, and increased to 71.4% (95% CI: 69.4–73.4%) on 13 February 2020, and reaches 97.6% (95% CI: 94.8–100.3%) on 5 April 2020. The date of first infection is estimated as 30 November 2019.

Conclusions

In the early stage of COVID-19 outbreak, the testing capacity of Wuhan was insufficient. Clinical diagnosis could be a good complement to the method of confirmation at that time. The reporting rate is very close to 100% now and there are very few cases since 17 March 2020, which might suggest that Wuhan is able to accommodate all patients and the epidemic has been controlled.
Sequence analysis and protein interactions of Arabidopsis CIA2 and CIL proteins
Authors: Yang Chun-Yen , Sun Chih-Wen
Published: June 2020

Background

A previous screening of Arabidopsis thaliana for mutants exhibiting dysfunctional chloroplast protein transport identified the chloroplast import apparatus (cia) gene. The cia2 mutant has a pale green phenotype and reduced rate of protein import into chloroplasts, but leaf shape and size are similar to wild-type plants of the same developmental stage. Microarray analysis showed that nuclear CIA2 protein enhances expression of the Toc75, Toc33, CPN10 and cpRPs genes, thereby up-regulating protein import and synthesis efficiency in chloroplasts. CIA2-like (CIL) shares 65% sequence identity to CIA2, suggesting that CIL and CIA2 are homologous proteins in Arabidopsis. Here, we further assess the protein interactions and sequence features of CIA2 and CIL.

Results

Subcellular localizations of truncated CIA2 protein fragments in our onion transient assay demonstrate that CIA2 contains two nuclear localization signals (NLS) located at amino acids (aa) 62-65 and 291-308, whereas CIL has only one NLS at aa 47-50. We screened a yeast two-hybrid (Y2H) Arabidopsis cDNA library to search for putative CIA2-interacting proteins and identified 12 nuclear proteins, including itself, CIL, and flowering-control proteins (such as CO, NF-YB1, NF-YC1, NF-YC9 and ABI3). Additional Y2H experiments demonstrate that CIA2 and CIL mainly interact with flowering-control proteins via their N-termini, but preferentially form homo- or hetero-dimers through their C-termini. Moreover, sequence alignment showed that the N-terminal sequences of CIA2, CIL and NF-YA are highly conserved. Therefore, NF-YA in the NF-Y complex could be substituted by CIA2 or CIL.

Conclusions

We show that Arabidopsis CIA2 and CIL can interact with CO and NF-Y complex, so not only may they contribute to regulate chloroplast function but also to modulate flower development.
Preservice teachers perceptions about the use of blended learning in a science education methods course
Authors: Yılmaz Özkan , Malone Kathy L.
Published: June 2020

The purpose of this quantitative study was to determine the effectiveness of blended learning within the context of a science education methods course for early childhood elementary preservice teachers in Turkey. Elementary teachers historically fear science and avoid using it in their classes. This course was blended to allow the students to experience active science learning during face to face sessions. Student perceptions about their experiences in a blended methods course were collected using a previously validated survey. The data analysis of the post-test only survey research design demonstrated that students’ perceptions were positive towards the use of blended learning within their science education methods course. However, the analysis determined that students felt that certain technical aspects of the blended learning environment hindered their learning.
Cultural competence or deficit-based view? A qualitative approach to understanding middle school students’ experience with culturally framed engineering
Authors: Keratithamkul Khomson , Kim Justine N. , Roehrig Gillian H.
Published: June 2020

Background

Recent policies have given momentum to the science, technology, engineering, and mathematics (STEM) education in the USA and throughout the world. This has resulted in rapid growth in engineering and STEM curricula, many of which incorporate global contexts to frame student experiences; however, little research has been done on the effects of this contextualization. Thus, it is critical to explore the impact of these curricula on student learning and the development of STEM identities, especially those who have historically been marginalized in STEM fields. The purposes of this study are to critically examine how STEM curriculum helps shape students’ perceptions of the underlying cultural context and suggest ways that anti-oppressive education theory can be applied in middle school physical science classrooms. This study draws on classroom observational data and the curriculum text itself to understand how students perceive culture that they do not identify with.

Results

We found that the curriculum provides very limited perspectives of the non-dominant culture in which the learning was situated. Our results also indicate three emerging themes showing students to be demonstrating an elitist viewpoint, having a narrow view of another culture, or being indifferent toward the embedded cultural context in the lessons. As a class, deficit-based views of the people and places presented in the lesson were created rather than the desired culturally competent views. These negative perceptions were imprinted and solidified through limited portrayal of the embedded culture in the curriculum.

Conclusions

This work highlights the importance of curriculum context in students’ learning. Beliefs about the people and places are created through global context presented in the curriculum. Portrayal of these people and places was not representative of the culture; thus, resulting in limited perceptions of the situated contexts. It is crucial that the teachers critically evaluate the curriculum prior to its implementation to make sureOthersare represented appropriately by drawing upon the anti-oppressive education theory. Lastly, we also advocate for the incorporation of global culture in STEM curriculum by having students learn beyond what the written curriculum offers.
Harderian gland of flying and non-flying birds: morphological, histological, and histochemical studies
Authors: Beheiry Rasha R. , Ali Sozan A. , Aref Mohamed , Emam Hassan
Published: June 2020

Background

The aim of the present study is to describe the morphological and histological features of Harderian gland (HG) in long-legged wadding bird (ibis) and different domestic birds (duck, goose, and pigeon). The HG of forty adult male and female from the four avian species constituted the material of the study.

Result

The HG extended from the optic nerve to the rostral part of the eyeball presents two extremities, one posterior and other anterior, from which the excretory duct was arisen. Between two extremities of the gland, middle groove is present in case of duck and geese, while middle isthmus is present in case of ibis. In pigeon, the gland appeared pointed oval in shape. Microscopically, the HG was multilobular; each lobule was composed of secretory acini that were lined by a single layer of columnar epithelium. In all studied birds, a single duct located centrally with an irregular lumen. In goose, there were crypts along the duct while in duck, the central lumen had villi-like folds projected into the central canal of the tubules. In ibis, the irregular lumen was narrow and elongated while in pigeon, the gland had a central cavity that collected the secretion from tubules arranged radially around the cavity; also, the gland mainly contained both acidic and neutral mucopolysaccharides.

Conclusion

This work revealed that the histological structure of HG in the four avian species showed characteristic features and thus explained the relationship between their habits and behavior on the structure of this gland.
Crime and punishment: Pakistan's legal failure to account for mental illness
Authors: Khan Romesa Qaiser , Khan Abdul Moiz
Published: June 2020

The Mental Health Ordinance 2001 was the last comprehensive legislation on mental health policy in Pakistan, replacing the Lunacy Act 1912. Since then, most of the amendments to the act have only delineated the jurisdiction of the provincial governments. Failure to account for mental illness in Pakistan brings with it unique challenges, such as the criminalisation of suicide and exploitation of blasphemy laws. There is a need for organised efforts to promote awareness of mental illness, amend the obsolete legislation in conformity with the scientific evidence, implement mental health policy effectively and deal with sensitive issues that have a strong sociocultural or religious background.
Event-Free Survival, a Prostate-Specific Antigen–Based Composite End Point, Is Not a Surrogate for Overall Survival in Men With Localized Prostate Cancer Treated With Radiation
Authors: Xie Wanling , Regan Meredith M. , Buyse Marc , Halabi Susan , Kantoff Philip W. , Sartor Oliver , Soule Howard , Berry Donald , Clarke Noel , Collette Laurence , D’Amico Anthony , Lourenco Richard De Abreu , Dignam James , Eisenberger Mario , James Nicholas , Fizazi Karim , Gillessen Silke , Loriot Yohann , Mottet Nicolas , Parulekar Wendy , Sandler Howard , Spratt Daniel E. , Sydes Matthew R. , Tombal Bertrand , Williams Scott , Sweeney Christopher J. ,   on behalf of the ICECaP Working Group
Published: June 2020

PURPOSE

Recently, we have shown that metastasis-free survival is a strong surrogate for overall survival (OS) in men with intermediate- and high-risk localized prostate cancer and can accelerate the evaluation of new (neo)adjuvant therapies. Event-free survival (EFS), an earlier prostate-specific antigen (PSA)–based composite end point, may further expedite trial completion.

METHODS

EFS was defined as the time from random assignment to the date of first evidence of disease recurrence, including biochemical failure, local or regional recurrence, distant metastasis, or death from any cause, or was censored at the date of last PSA assessment. Individual patient data from trials within the Intermediate Clinical Endpoints in Cancer of the Prostate–ICECaP–database with evaluable PSA and disease follow-up data were analyzed. We evaluated the surrogacy of EFS for OS using a 2-stage meta-analytic validation model by determining the correlation of EFS with OS (patient level) and the correlation of treatment effects (hazard ratios [HRs]) on both EFS and OS (trial level). A clinically relevant surrogacy was defined a priori as an R2 ≥ 0.7.

RESULTS

Data for 10,350 patients were analyzed from 15 radiation therapy–based trials enrolled from 1987 to 2011 with a median follow-up of 10 years. At the patient level, the correlation of EFS with OS was 0.43 (95% CI, 0.42 to 0.44) as measured by Kendall’s tau from a copula model. At the trial level, the R2 was 0.35 (95% CI, 0.01 to 0.60) from the weighted linear regression of log(HR)-OS on log(HR)-EFS.

CONCLUSION

EFS is a weak surrogate for OS and is not suitable for use as an intermediate clinical end point to substitute for OS to accelerate phase III (neo)adjuvant trials of prostate cancer therapies for primary radiation therapy–based trials.
Diabetic Ketoacidosis in COVID-19: Unique Concerns and Considerations
Authors: Palermo Nadine E , Sadhu Archana R , McDonnell Marie E
Published: June 2020

Context

While individuals with diabetes appear to be at similar risk for SARS-CoV-2 infection to those without diabetes, they are more likely to suffer severe consequences, including death. Diabetic ketoacidosis (DKA) is a common and potentially lethal acute complication of diabetes arising from a relative insulin deficiency, which occurs more often in those with type 1 diabetes and in the setting of moderate to severe illness. Early reports indicate that among patients with pre-existing diabetes, DKA may be a common complication of severe COVID-19 and a poor prognostic sign.

Case Description

This clinical perspective explores the key elements of caring for individuals with DKA during the COVID-19 pandemic through 2 cases. Topics addressed include diagnosis, triage, and the fundamental principles of treatment with a focus on the importance of characterizing DKA severity and medical complexity to determine the best approach.

Conclusions

As discussed, some tenets of DKA management may require flexibility in the setting of COVID-19 due to important public health goals, such as preventing transmission to highest risk individuals, reducing healthcare worker exposure to infected patients, and preserving personal protective equipment. Evidence for alternative treatment strategies is explored, with special attention placed on treatment options that may be more relevant during the pandemic, including use of subcutaneous insulin therapy. Finally, DKA is often a preventable condition. We include evidence-based strategies and guidance designed to empower clinicians and patients to avoid this serious complication when possible.
AMP-activated protein kinase regulates cytoplasmic dynein behavior and contributes to neuronal migration in the developing neocortex
Authors: Naito Yasuki , Asada Naoyuki , Nguyen Minh Dang , Sanada Kamon
Published: June 2020

The microtubule motor cytoplasmic dynein contributes to radial migration of newborn pyramidal neurons in the developing neocortex. Here, we show that AMP-activated protein kinase (AMPK) mediates the nucleus-centrosome coupling, a key process for radial neuronal migration that relies on dynein. Depletion of the catalytic subunit of AMPK in migrating neurons impairs this coupling as well as neuronal migration. AMPK shows overlapping subcellular distribution with cytoplasmic dynein and the two proteins interact with each other. Pharmacological inhibition or activation of AMPK modifies the phosphorylation states of dynein intermediate chain (DIC) and dynein functions. Furthermore, AMPK phosphorylates DIC at Ser81. Expression of a phospho-resistant mutant of DIC retards neuronal migration in a similar way to AMPK depletion. Conversely, expression of the phospho-mimetic mutant of DIC alleviates impaired neuronal migration caused by AMPK depletion. Thus, AMPK-regulated dynein function via Ser81 DIC phosphorylation is crucial for radial neuronal migration.
Bad neighbours: hypoxia and genomic instability in prostate cancer
Authors: Ashton Jack , Bristow Robert
Published: June 2020

Prostate cancer (PCa) is a clinically heterogeneous disease and has poor patient outcome when tumours progress to castration-resistant and metastatic states. Understanding the mechanistic basis for transition to late stage aggressive disease is vital for both assigning patient risk status in the localised setting and also identifying novel treatment strategies to prevent progression. Subregions of intratumoral hypoxia are found in all solid tumours and are associated with many biologic drivers of tumour progression. Crucially, more recent findings show the co-presence of hypoxia and genomic instability can confer a uniquely adverse prognosis in localised PCa patients. In-depth informatic and functional studies suggests a role for hypoxia in co-operating with oncogenic drivers (e.g. loss of PTEN) and suppressing DNA repair capacity to alter clonal evolution due to an aggressive mutator phenotype. More specifically, hypoxic suppression of homologous recombination represents a “contextual lethal“ vulnerability in hypoxic prostate tumours which could extend the application of existing DNA repair targeting agents such as poly-ADP ribose polymerase inhibitors. Further investigation is now required to assess this relationship on the background of existing genomic alterations relevant to PCa, and also characterise the role of hypoxia in driving early metastatic spread. On this basis, PCa patients with hypoxic tumours can be better stratified into risk categories and treated with appropriate therapies to prevent progression.
Marx y Weber: el ethos de la burguesía y los orígenes del capitalismo moderno
Authors: Fonseca Rincón Juan David , Prieto Cortés Juan Sebastián
Published: June 2020

El siguiente artículo busca exponer de manera general y resumida los puntos más relevantes de la explicación acerca del origen del capitalismo en Occidente tanto para Marx como para Weber. A partir de esta exposición se dilucida la conexión entre ambos análisis en lo que concierne a la época en la que se origina el capitalismo y a la mirada fundamentalmente económica que gobierna las explicaciones de ambos autores. Estos, sin embargo, al incorporar elementos políticos y religiosos en sus análisis, problematizan aquellas lecturas reduccionistas que los separan a partir de las posturas materialistas y económicas por parte de Marx, así como las espirituales e ideológicas por parte de Weber. A continuación, se hace un análisis de la relación entre el capitalismo y su forma política correspondiente, es decir, del Estado moderno y del ethos económico de esta forma de Estado, (burgués para Marx, racional-legal para Weber) para dar un comentario acerca de las diferentes posturas políticas de estos autores en lo que concierne a la valoración del capitalismo burgués en Occidente.
Reinforcement with Fading Memories
Authors: Xu Kuang , Yun Se-Young
Published: June 2020

We study the effect of imperfect memory on decision making in the context of a stochastic sequential action-reward problem. An agent chooses a sequence of actions, which generate discrete rewards at different rates. She is allowed to make new choices at rate β, whereas past rewards disappear from her memory at rate μ. We focus on a family of decision rules where the agent makes a new choice by randomly selecting an action with a probability approximately proportional to the amount of past rewards associated with each action in her memory. We provide closed form formulas for the agent’s steady-state choice distribution in the regime where the memory span is large ([Formula: see text]) and show that the agent’s success critically depends on how quickly she updates her choices relative to the speed of memory decay. If [Formula: see text], the agent almost always chooses the best action (that is, the one with the highest reward rate). Conversely, if [Formula: see text], the agent chooses an action with a probability roughly proportional to its reward rate.
Gastrointestinal symptoms of pelvic radiation disease (part 4): professional awareness and specialist support
Authors: Ludlow Helen , Malik Nabihah , Turner Jeff , Green John , Hanna Louise
Published: June 2020

This is the fourth and final article in a series on the gastrointestinal (GI) symptoms of pelvic radiation disease (PRD). Published studies and patient reports suggest that health professionals lack of awareness of PRD. This professional awareness can be improved with third-sector advocacy and provision of simple screening tools, such as Assessment of Late Effects of Radiotherapy-Bowel (ALERT-B). In South Wales, patients with suspected PRD are referred to a PRD specialist nurse in either a gastroenterology clinic or a gynae-oncology follow-up clinic. These two nurse-led clinics demonstrate different ways to identify, assess and manage patients with late GI effects of PRD. Data from these clinics suggest that systematic investigations based on appropriate guidance are effective in identifying these symptoms, many of which can be managed or treated. The rising incidence of PRD and lack of specialist services suggests that the NHS needs to provide more funding to care for patients beyond the end of their cancer treatment.
In sickness and in health: sick pay and employer duty
Authors: Bernstein Adam
Published: June 2020

There has never been a better time to review employer and employee obligations in regards to illness, absence and pay. Adam Bernstein delves into the legalities and outlines each party's rights
The inside story of how one successful residential care home is surviving lockdown
Authors: Ashurst Adrian
Published: June 2020

Sharing best practice is one of the ways in which providers are managing and innovating in the face of the pandemic and its impact. Adrian Ashurst explores one residential care facility's journey during these unprecedented times
How to … develop an in-house COVID-19 training programme for care home staff
Authors: Ashurst Adrian
Published: June 2020

Adrian Ashurst provides some ideas for developing in-house staff training for staff during lockdown, when external trainers are not permitted, in order to effectively care for and support older people through the pandemic
Emergency measures: the Care Quality Commission's emergency support framework
Authors: Frankova* Helena
Published: June 2020

There has been much discussion in mainstream media on the government's response to the impact of COVID-19 in the adult social care sector, but what support has the regulator been providing during the pandemic? Helena Frankova reports
Introducció
Authors: Comalat Maite , Agustí Lluís
Published: June 2020

Ens plau presentar-vos, una vegada més, un nou volum de l’Anuari de Biblioteques, Llibres i Lectura. Aquesta sisena edició ofereix un primer canvi important respecte de les anteriors, la desaparició de l’Observatori de Biblioteques, Llibres i Lectura i la continuació de les seves tasques sota la nova adscripció al Centre de Recerca en Informació, Comunicació i Cultura (CRICC), ens ha portat a un canvi de títol de la publicació, sense que això impliqui grans canvis d’abast temàtic. Així doncs, com a les edicions anteriors, l’Anuari manté com a objectiu recollir les actuacions més rellevants i fer un estat de la qüestió del bienni corresponent, en aquest cas, als anys 2018 i 2019 en els tres àmbits d’especialització: les biblioteques, els llibres i la lectura.  En aquest número, fidels a la voluntat de mantenir una mirada àmplia, recuperem alguns articles que no es van publicar a l’edició anterior: així doncs, podrem llegir allò de més rellevant que ha passat a casa nostra pel que fa a les biblioteques especialitzades i les biblioteques universitàries, amb una anàlisi de les accions i iniciatives que s’hi han dut a terme els darrers quatre anys, 2016-2019.
Nonnull interferometric testing of spherical gratings under Littrow conditions with opposite diffraction orders
Authors: Liu Weijian , Yuan Qun , Wang Ruoyan , Ji Wen , Xue YingZe , Ma Jun , Wang Lingjie , Gao Zhishan
Published: June 2020

Diffracted wavefront measurements are qualitative and comprehensive verifications for the spherical grating that was manufactured to specifications. Direct interferometric testing of the diffracted wavefront is convenient and implemented by tilting the spherical grating at a Littrow angle to obtain autoreflection and then results in a nonnull interferometric testing configuration. The diffracted wavefront of the spherical grating contains not only wavefront errors induced by the manufacturing imperfections but also inherent wavefront contributions from the autoreflection testing setup. The magnitudes of the latter are affected by both the spherical substrate and the groove pattern. Through the analysis of geometric aberrations of spherical gratings, the groove pattern contributions are demonstrated to be contrary for the opposite diffraction orders. A nonnull interferometric testing of spherical gratings is proposed without foreknowledge of the groove pattern, in which the wavefront errors contributed only by the manufacturing imperfections are derived from dual measurements under Littrow conditions with opposite diffraction orders. Simulations are implemented for varied line spacing (VLS) spherical gratings with an F-number slower than 1.5 and groove density varying from 150 to 300 lp/mm, and the residual error less than

0.004

λ

RMS is obtained. The residual misalignment error after conventionally removing defocus and tilt is further analyzed and discussed. A VLS grating in which the NA is 0.13 and groove density is 200 lp/mm is chosen as an experimental sample, and the diffracted wavefront error with 0.018λ RMS is obtained.
Observation of rogue events in non-Markovian light
Authors: Frostig Hadas , Vidal Itamar , Fischer Robert , Herzig Sheinfux Hanan , Silberberg Yaron
Published: June 2020

Efforts to understand the physics of rogue waves have motivated the study of mechanisms that produce rare, extreme events, often through analogous optical setups. As many studies have reported nonlinear generation mechanisms, recent work has explored whether optical rogue events can be produced in linear systems. Here we report the observation of linear rogue events with tunable height, generated from light imprinted with a non-Markovian wavefront. Moreover, if the non-Markovian wavefront is allowed to propagate through a nonlinear medium, extraordinarily long-tailed intensity distributions are produced, which do not conform to the statistics previously observed in optical rogue wave experiments.
Electrical properties and microstructure formation of V/Al-based n-contacts on high Al mole fraction n-AlGaN layers
Authors: Sulmoni Luca , Mehnke Frank , Mogilatenko Anna , Guttmann Martin , Wernicke Tim , Kneissl Michael
Published: June 2020

The electrical and structural properties of V/Al-based n-contacts on

n
‐

Al
x

Ga

1
−
x

N

with an Al mole fraction

x

ranging from

x
=
0.75

to

x
=
0.95

are investigated. Ohmic n-contacts are obtained up to

x
=
0.75

with a contact resistivity of

5.7
×

10

−
4

  
Ω
·

cm
2

whereas for higher Al mole fraction the IV characteristics are rectifying. Transmission electron microscopy reveals a thin crystalline AlN layer formed at the metal/semiconductor interface upon thermal annealing. Compositional analysis confirmed an Al enrichment at the interface. The interfacial nitride-based layer in n-contacts on

n
‐

Al
0.9

Ga
0.1

N

is partly amorphous and heavily contaminated by oxygen. The role and resulting limitations of Al in the metal stack for n-contacts on n-AlGaN with very high Al mole fraction are discussed. Finally, ultraviolet C (UVC) LEDs grown on

n
‐

Al
0.87

Ga
0.13

N

and emitting at 232 nm are fabricated with an operating voltage of 7.3 V and an emission power of 120 μW at 20 mA in cw operation.
À conquista da sabedoria. A pintura de quadratura e o programa iconográfico da Biblioteca Joanina
Authors: Raggi Giuseppina
Published: June 2020

O artigo propõe a releitura do processo de construção e decoração da Biblioteca da Universidade de Coimbra, conhecida como Biblioteca Joanina (1716-1728). O texto reinterpreta o contexto artístico e cultural da primeira metade do reinado de D. João V (1707- acerca de 1728) e o impacto dos projetos do arquiteto italiano Filippo Juvarra para a nova cidade de Lisboa (1719). A construção da Biblioteca Joanina integrou o plano de renovação do conhecimento em todos os campos do saber promovido por D. João V, pela rainha D. Maria Ana de Áustria e pela corte portuguesa. Desta forma, o artigo oferece uma nova interpretação do programa iconográfico, baseado na metáfora militar. A Biblioteca torna-se fortaleza da Sabedoria que o estudante-soldado é chamado a conquistar. No interior, o espaço do conhecimento é dividido em três etapas progressivas: o espaço da adquisição dos novos saberes (Imago Bibliotecae); do conhecimento académico (Universitas) e do enciclopédico (Enciclopedia). Porém, o verdadeiro objetivo final é alcançar a sabedoria do Sabio Cristão, tal como a descreve padre Rafael Bluteau nas suas Prosas Academicas… (1717-1728). Chegando ao fim do seu percurso, depostas as armas aos pés do soberano, o estudante-conquistador espelha-se no retrato de rei D. João V, imagem vivente do Sabio Cristão. O texto aprofunda, também, os seguintes tópicos: 1) as conexões artísticas com a arquitetura italiana e austríaca; 2) as estreitas relações entre a pintura de arquiteturas em perspetiva, realizada nos três tetos da Biblioteca Joanina por António Simões Ribeiro e Vicente Nunes, e a tradição da “quadratura” bolonhesa; 3) a carência de fornecimento de livros para a Biblioteca da Universidade de Coimbra, depois da conclusão do edifício e ao longo da segunda metade do reino de D. João V; 4) a reinterpretação da quadratura dos tetos da Biblioteca Joanina por António Augusto Gonçalves no século XIX; 5) as obras de restauro promovidas pela Direção dos Monumentos Nacionais entre 1931 e 1934 e o envolvimento do pintor Joaquim Lopes, Professor de artes no Porto.
Patrones de distribución de orquídeas en un relicto de bosque altoandino, Cundinamarca-Colombia
Authors: Estupiñan Bravo Luis Hernando , Califa Rodríguez Solmar David
Published: June 2020

Colombia es uno de los países con mayor diversidad de orquídeas, cuenta con un estimado de 4270 especies nativas, de las cuales 199 presentan algún tipo de amenaza. Conocer las características que determinan su distribución es crucial para generar programas que propendan por su conservación. Este estudio buscó conocer la influencia de factores bióticos y abióticos sobre la distribución de orquídeas en un relicto de bosque altoandino en la región de Cundinamarca, Colombia, para tal fin se colectó información de las orquídeas encontradas en nueve transectos de 50 m x 4 m. Los factores ambientales que mayor influencia tuvieron sobre la abundancia y distribución de orquídeas fueron la altitud y el porcentaje de cobertura de musgos, así como las características inherentes a las comunidades de forófitos para el caso de las especies epífitas.
Establecer patrones de distribución de orquídeas permitirá, en el futuro, diseñar programas de conservación de esta flora en particular y del bosque altoandino en general.
Surgical correction of degenerative sagittal imbalance of the lumbar spine
Authors: Baikov E. S. , Peleganchuk A. V. , Sanginov A. J. , Leonova O. N. , Krutko A. V.
Published: June 2020

Objective. To analyze the early clinical and radiological outcomes of lumbar spine fusion in patients with degenerative sagittal imbalance.

Material and Methods. The data of 45 patients who were operated on sequentially using a combination of surgical methods for vertebrogenic pain syndrome and (or) neurological deficit and who had a violation of the sagittal balance of degenerative origin were analyzed. All patients underwent anterior spinal fusion at the L4–L5, L5–S1 levels to correct and restore lower lumbar lordosis. The next stage was decompression through posterior approach, if necessary supplemented by interbody fusion at clinically significant lumbar levels above the L4–L5 segment. In all patients, surgical treatment was completed with screw transpedicular fixation at the levels of interbody fusion.  Demographic, clinical and surgical data, and radiological parameters were evaluated.

Results. The study included data from 6 men and 39 women with an average age of 58.9 ± 7.8 years. Duration of hospital stay was 27.1 ± 7.4 days. The primary surgery was performed in 33 (73.3 %) patients, and the reoperation for pain recurrence after previous surgery at the same lumbar level – in 12 (26.7 %) patients. The duration of surgery was 529.8 ± 117.8 min, the blood loss was 1130.4 ± 560.1 ml. Back and leg pain VAS score decreased after surgery from 6.7 ± 0.9 and 4.7 ± 1.4 to 3.3 ± 0.9 and 0.5 ± 0.6, respectively (p < 0.001). The ideal sagittal type according the Russoly’s classification was restored in 27 (60 %) cases, that below the ideal – in 9 (20 %), and hypercorrection was in 9 (20 %). PT decreased from 26.1° ± 5.7° to 17.4° ± 3.9° (p < 0.001) and SVA – from 6.7 ± 3.5 to 2.7 ± 2.3 cm (p < 0.001). LL increased from 36.3° ± 18.5° to 55.1° ± 11.8° (p < 0.001) and Low LL – from 13.5° ± 9.8° to 37.9° ± 8.2° (p < 0.001). According to GAP, the number of patients with severe and moderate imbalance was reduced (p < 0.001). Surgical complications were observed in 26 (57.7 %) patients.

Conclusion. The multi-stage surgical treatment of patients with degenerative spinal deformities using corrective fusion in the lumbar spine significantly improves parameters of the spinopelvic and global sagittal balances in the early postoperative period.
Is tactical algorithmization possible for infectious lesions of the spine? Literature review
Authors: Mushkin М. A. , Dulaev A. K. , Abukov D. N. , Mushkin A. Yu.
Published: June 2020

Non-specific infectious lesions of the spine present a severe clinical problem due to the high risk of the septic complications and possible mortality. The late diagnosis and subjective treatment options could lead to complicated course of disease, progression of vertebral destruction, development of neurological disorders, as well as multi-resistance of bacteria due to the empiric antibacterial chemotherapy.  The modern algorithms of diagnosis and treatment should be aimed at improving the quality of care for patients with infectious spondylitis. A literature review on the current concept of their assessment, including a step-by-step description of the Vertebral Osteomyelitis Guideline Team (VOGT) strategy, and the classifications of Pola (NCPS) and Homagk (SSC) is presented.
Port of Bitung Development in North Sulawesi and Its Impacts on Loading and Unloading Commodities, 1954-2005
Authors: Hisna Hisna , Susilowati Endang , Supriyono Agustinus
Published: June 2020

This article aims to analyze the development of the Port of Bitung in North Sulawesi and its impacts on loading and unloading commodities in 1954-2005. In 1954, the port of Bitung was designated as an ocean port. Since then, activities at the port such as ship visits and loading and unloading commodities began to run well. The physical development of the Port of Bitung in the form of basic and supporting facilities functioned as supporting activities at the port. The main facilities of Bitung Port consisted of the port area, port ponds, shipping lanes, docks, breakwater, and roads. Meanwhile, the supporting facilities consisted of warehouses, stacking fields, port administration offices, ship guides, parking lots, electricity or generator sets, loading, and unloading equipment. The physical development of Bitung Port had an impact on increasing ship visits, loading and unloading commodities at the port. Loading and unloading commodities in Port of Bitung were in the form of plantation products and the daily needs of the people of Bitung and the surrounding area.