bluuebunny/crossref_metadata_2025 huggingface dataset:
Pre-service Training for Students’ Coping Capacity in the Workplace through Research and Development of an E-store Game-based Education System
Authors: Weng Ting-Sheng
Published: November 2022

The pre-service education systems and research papers about level games, which give automatic answers and instant evaluation, are scarce. The system developed in this study could timely judge whether the answers chosen by students are right or wrong when they try to pass game levels and automatically provide the correct answers. In this study, learning units, such as store management practice, circulation management, and mathematics, were comprehensively designed into an animated game for students to play as new employees before beginning employment. Furthermore, the students were allowed to experience the problems and situations that shop service staff may encounter in the workplace. In this way, the students could increase their knowledge and experience in-store operation and customer relationship management in the workplace in advance. Thereby, the students could give better spontaneous responses after entering the workplace in the future. By using the level game designed by this study, students could also improve their service efficiency and professionalism, including store management and operation, as well as the intuition and insight of estimation and number sense ability. This level game contributes to pre-service education.
Intention with Organizational Commitment as Interverning Variable. Case Study at ‘XYZ’ Life Insurance
Authors: Mufidah Afnan , Anjasari Ariestania , C Jonni C , Rohman Abdul
Published: November 2022

The purpose of this study was to determine and analyze the effect of Transformational Leadership and Organizational Culture on the Turnover Intention of employees in insurance companies through Mediation from Organizational Commitment. The survey uses a sample of 100 of 113 Life Insurance Employees 'XYZ'. This study uses a quantitative approach and the data source is primary data. The data were analyzed with Smart PLS 3 to get the SEM model and the results of the hypothesis. Based on the results of hypothesis testing, shows that Organizational Culture has a significant effect on Organizational Commitment and Turnover Intention and Transformational Leadership has a significant effect on Organizational Commitment and a positive effect on Organizational Culture, but Transformational Leadership has no significant effect on Turnover Intention. Organizational Commitment can mediate between Organizational Culture and Transformational Leadership on Turnover Intention.
Thermoelectric Properties of Cu-added Polycrystalline Bi2O2Se Oxyselenide
Authors: Bae Si-young , Lee Se Woong , Kim Hyun-Sik , Park Okmin , Park Hyunjin , Seo Won-Seon , Kim Sang-il
Published: November 2022

Bi2O2Se oxyselenide has been actively studied as a potentialn-type thermoelectric material because of its intrinsically low thermal conductivity and high Seebeck coefficient (S). However, Bi2O2Se has very low electrical conductivity (σ), resulting in relatively poor thermoelectric performance. Herein, we investigate the effect of Cu addition on the electrical and thermal transport ofn-type polycrystalline Bi2O2Se. A series of CuxBi2O2Se (x = 0, 0.0025, 0.005, and 0.0075) polycrystalline samples were synthesized by a conventional solidstate reaction. Tetragonal Bi2O2Se was successfully synthesized, and its lattice parameters gradually decreased with the addition of Cu. Further, σ decreased and the magnitude of S increased with increasing Cu content, according to the trade-off relationship between these parameters. Consequently, a maximum power factor of 0.106 mW m-1 K-2 was achieved for the sample with x = 0.0025 at 300 K, owing to the increase in the magnitude of S. The Hall carrier concentration decreased exponentially with the addition of Cu, which is mainly attributed to the possible enlargement of the band gap of the Cu-added samples. The lattice thermal conductivity decreased with increasing x, which was attributed to point-defect phonon scattering via Cu addition. Therefore, a maximumzT of 0.222 was obtained at 790 K for the Cu0.0025Bi2O2Se (x = 0.0025) sample, which was approximately 8% higher than that of the pristine Bi2O2Se sample.
Effect of Grain Boundary Morphology on the High Temperature Tensile Properties of Developed Ni-Based Superalloy (LESS)
Authors: Shin Yong Kwan , Kang Byung Il , Youn Jeong IL , Kwon Yong Nam , Kim Young Jig
Published: November 2022

In order to investigate the mechanical properties of the developed wrought γ'-hardened Ni-based superalloy, LESS alloy (Low Eta Sigma Superalloy), and to understand the deformation behavior, tensile tests were carried out from room temperature to 800oC in comparison with IN 740H alloy. Like other superalloys, the tensile properties of the LESS alloy were found to be dependent on temperature. As the temperature rose between room temperature and 700oC, the ultimate tensile strength (UTS) decreased slightly, and then decreased sharply. The yield strength (YS) of the LESS alloy was found to be about 40% higher than that of IN 740H alloy from room temperature to 700oC. On the basis of microstructure observations, the high yield strength of the LESS alloy is thought to result from the dense grain boundary, where the fine carbides (MC, M23C6) and the γ' phase form a continuous film structure, which more effectively suppressed dislocation movements during deformation. It was found that the deformation mode of the LESS alloy changed from γ'- shearing to mixed mode (γ'-shearing + climb) at around 700~800oC. Although the main fracture mode of the LESS alloy was ductile dimple fracture, elongation decreased with temperature due to the local brittle region caused by micro-twins.
Shangri-La on the Popular Front: ‘China’, the Global Left, and Auden and Isherwood’s Journey to a War
Authors: Chan Julia
Published: November 2022

This article examines W. H. Auden and Christopher Isherwood’s co-authored travelogue, Journey to a War (1939), as a product of the interwar global left culture, exemplified by the Popular Front campaign that spanned Europe and Asia (1936–1939). Set out to observe and report on the Sino-Japanese War (1937–1945), a less popular but more exotic alternative to the contemporaneous Spanish Civil War, the two writers found themselves caught in the impossible task of reconciling the ravages of war with images of Shangri-La that mediated Popular Front discourses on wartime China. Nonetheless, Auden and Isherwood’s difficult negotiations with Orientalist discourses also made the text a generative site for translations, exchanges and appropriations. This essay offers an account of the travelogue’s composition and contemporary reception in China, how it became a composite, mobile text.
Bilateral Elbow Dislocation Without Fracture After Minor Trauma in a Healthy Adult Man
Authors: Vural Nafis , Duyan Murat
Published: November 2022

The elbow is the second most frequently dislocated major joint in adults. Elbow dislocation is a common traumatic injury, occurring in approximately 20% of all joint dislocations. Falling onto an outstretched hand is the most prevalent cause of elbow dislocation. Simultaneous bilateral elbow dislocation is a rare presentation, and reports of similar injuries are very limited. A 21-year-old male patient was brought to the emergency department after landing on both hands with flexed elbows from a height of one meter while doing home decoration work. The posterolateral dislocations was detected in both elbows without a fracture on the plain radiographs. The patient's elbows were reduced under procedural sedation analgesia in the emergency department. The patient's splints were removed in the orthopedics outpatient clinic after a 2-week follow-up, and he had no complications. It should be noted that serious bilateral dislocations can occur even in minor traumas like this. Procedural sedation not only prevents the delay of the procedure and the occurrence of complications, especially during the treatment of such multiple dislocations, but also increases patient comfort.
Türk Kültüründeki Yapraklı Panayırları ile Arap Kültüründeki ‘Ukâz Panayırlarının Benzerlikleri
Authors: ÜNALAN Özlem , ÜNALAN İbrahim
Published: November 2022

Yapraklı panayırı, Çankırı’nın Yapraklı İlçesi’nde kurulmuş eski bir panayırdır. Yapraklı panayırı kurulduğu dönemlerde; Anadolu’dan, Mısır, İran ve Suriye gibi ülkelerden gelen ürünlerin ticaretinin yapıldığı önemli bir mekân hâline gelmiştir. Panayırda, eğlenceler, yarışmalar düzenlenmiş ve çeşitli kültürel etkinlikler tertip edilmiştir. Ayrıca yapraklı panayırı âşıkların sanatlarını icra ettikleri merkezlerden biri olmuştur. Önceleri ticari amaçla kurulan bu panayır, daha sonra kültürel alışverişe de sahne olmuş ve âşıklar için edebî bir muhit hâline gelmiştir. Arap halkının sosyal ve kültürel hayatında önemli gelişmeler sağlayan ‘Ukâz panayırında da ticaret, eğlence ve yarışmalar ön plana çıkmıştır. Şiir okuma yarışmaları Arap edebiyatının gelişmesinde etkili olmuştur. Yarışmada beğenilen şiirler, Kâbe’nin duvarına asılmış ve yarışmaları kazananlara çeşitli ödüller verilmiştir.Âşıklık geleneğinde, âşıkların sanatlarını ortaya koydukları Yapraklı panayırı, Arap edebiyatının gelişmesinde büyük rol oynayan ‘Ukâz panayırına benzemektedir. ‘Ukâz’da bir kabilenin şairi müşaare neticesinde kendisine ve kabilesine şöhret sağladığı gibi Yapraklı’da da muammayı çözen ve atışmalarda kendini ispatlayan şairler de aynı şöhreti sağlamıştır. Her iki panayır da gerek kuruldukları mekân ve zaman gerekse kendi edebiyatlarına katkıları bakımından birbirleriyle benzerlikler taşımaktadır. Bu çalışmada Yapraklı ve ‘Ukâz panayırlarının sosyal ve kültürel özellikleri ele alınmış, Türk ve Arap kültüründeki yeri ortaya konulmuştur. Ayrıca Yapraklı ve ‘Ukâz panayırlarının çeşitli açılardan karşılaştırılması yapılarak ortak noktaları tespit edilmiştir.
27 Mayıs 1960 ve 28 Şubat 1997 Tarihleri Arasında Konya Genel Seçim Sonuçları Üzerine Bir Değerlendirme
Authors: UĞRAŞ Özge Seda
Published: November 2022

Çalışmada da 27 Mayıs askeri darbesi ile 28 Şubat postmodern darbe arasındaki Konya genel seçim sonuçları analiz edilecek ve seçim sonuçlarına etki eden sosyolojik, siyasal, sosyo-kültürel ve ekonomik faktörlerin seçmen davranışına olan etkileri tartışılacaktır. Bu iki darbe arasındaki 12 Mart ve 12 Eylül gerçeği ve otuz yılı aşkın sürecin on yıllık periyotlarında bir darbeyle karşılaşılmış olması bu dönemin önemini daha da artırmakta, araştırmacıları teşvik etmektedir. Seçmen tercihlerinde küçük yaşta ailelerinin ve yakın çevrelerinin etkisiyle geliştirilen siyasal sosyalleşme sürecine odaklanarak siyasi yönelim geliştirmesini önceleyen sosyo-psikolojik yaklaşım (Michigan Ekolü) ile sosyal grubun üyesi olma ya da aidiyet hissetmeyle seçmen tercihlerini ilişkilendiren sosyolojik yaklaşım (Columbia Ekolü) esas alınarak bu metodolojik yaklaşımlar doğrultusunda değerlendirme yapılacaktır.
7747 Numaralı Şe’riyye Siciline Göre Malatya’nın Sosyo-Ekonomik Durumu (1878-1882)
Authors: ULUKAYA Gülşen
Published: November 2022

er’iyye Sicilleri, sosyal ve ekonomik tarih belgelerini içeren tereke kayıtları yoluyla Osmanlı Devleti tarihi için önemli kaynak olarak görülmektedir. Bu siciller, Osmanlı tarihinin ana kaynakları arasında bulunmaktadır. Bu sicillerde kadının devlet merkeziyle yaptığı yazışmalar, halkın şikâyet ve dilekleri ile en önemlisi sicillerin ait olduğu mahallin sosyal ve ekonomik hayatı hakkında bilgi veren mahkeme kayıtları elde edilmektedir.

Son yıllarda şehir tarihi ile ilgili çok sayıda çalışma yapılmaktadır. Bu çalışmalarda şehrin sosyal yapısı, sosyal münasebetleri, sosyo-kültürel veya sosyo-ekonomik düzeni gibi konular üzerinden genel durumu incelenmektedir. Bu çalışmada başlıkta ifade edildiği gibi 1878-1882 yılları arasında Malatya’nın sosyo-ekonomisi hakkında değerlendirmeler Şer’iyye Sicillerine göre yapılmıştır. Sosyo-ekonomik başlıklı çalışmalar için bazı temel bilgilere; nüfus, iş-meslek, evlilikler, menkul ve gayrı menkul ile fiyatlar hakkında bazı verilere ihtiyaç duyulmaktadır. Osmanlı şehir tarihi çalışmalarında şer’iyye sicillerinde o mahallin sosyo-ekonomik hayatıyla ilgili mühim bilgiler bulunmaktadır. Hususiyetle sicillerdeki tereke kayıtları malumat bakımından zengin bilgiler sunmaktadır. 7747 numaralı Malatya Şer’iyye Sicili (M. 1878-1882) bu çalışmanın ana kaynağıdır.
DESAIN ARSITEKTUR ENTERPRISE SISTEM PEMERITAHAN BERBASIS ELEKTRONIK BIDANG KESEHATAN
Authors: Laksono Agung
Published: November 2022

Kesehatan menjadi pusat perhatian terutama sejak Covid-19 merebak dan berdampak terhadap berbagai aspek kehidupan masyarakat Indonesia. Layanan Kesehatan diharuskan untuk mampu menyajikan data dan informasi yang cepat dan akurat, sehingga diharapkan strategi penyelesai berbagai tantangan bidang Kesehatan dapat terkendali dan cepat diselesaikan. Transformasi digital menjadi penting karena hanya teknologi informasi yang mampu mendorong pelayanan publik menjadi dapat lebih  cepat, adaptif, akurat dan terintegrasi. Perlu adanya perencanaan transformasi digital yang terstruktur dan menyeluruh dapat memberikan pelayanan prima dan adaptif terhadap harapan masyarakat terhadap layanan kesehatan. Tantangannya, palayanan antar satu puskesmas dan lainnya masih berbeda-beda tergantung dari letak geografis dan fasilitas yang dimiliki.  Selain itu, variasi aplikasi yang dikembangkan oleh pemerintah pusat mencapai hingga 77 variasi apliasi di tingkat puskesmas sehingga berakibat  sulitnya integrasi dan mendukung interoperabilitas antar sistem. Pengembangan teknolog informasi masih bersifat fragmented antar divisi yang berakibat duplikasi entri untuk sistem yang berbeda, data olahan yang redundan, dan sulitnya menjaga konsistensi data.

 

Penelitian ini bermaksud untuk membuat arsitektur enterprise bidang Kesehatan dengan studi kasus pusdatin Kementerian Kesehatan yang berfokus pada layanan Kesehatan di tingkat puskesmas. Puskesmas merupakan garda terbawah layanan Kesehatan (Kemenkes, 2019) dan telah memiliki regulasi sistem informasi puskesmas (Kemenkes, 2021) yang seharusnya dapat mendorong peningkatan optimasasi penggunaan teknologi informasi di tingkat puskesmas yang terintegrasi hingga pusat. Harapannya penelitian ini dapat menyajikan grand design pengelolaan teknologi informasi berbasis industry 4.0 yang efektif dan sesuai dengan regulasi yang berlaku. Penelitian akan berfokus pada pengembangan arsitektur enterprise dengan mempertimbangkan kebijakan Sistem Pemerintahan Berbasis Elektronik (SPBE).

 

Metode perancangan arsitektur dikembangkan menggunakan kerangka kerja TOGAF ADM untuk menganalisis arsitektur sistem. Studi ini  merancang arsitektur pada tingkat kementerian sebagai turunan dari arsitektur induk serta menyelaraskan dengan arsitektur daerah. Analisa didukung dengan mempertimbangkan kesesuaian regulasi SPBE, regulasi Meteri Kesehatan, rencana strategis jangka Menengah, dan peta jalan digital transformasi Kementerian Kesehatan. Hasil analisis akan disajikan dalam gap analysis yang membandingkan kondisi saat ini dan target arsitektur ingin dicapai. Rancangan ini diharapkan dapat memberikan usulan arsitektur enterprise dalam imlementasi Sistem Pemerintahan Berbasis Elektronik pada Kementerian Kesehatan. Selain itu, studi ini juga dapat  menjadi referensi untuk desain arsitektur enterprise dengan metodologi TOGAF ADM dan pengembangan berbasis SPBE.
Numerical analysis of finite difference schemes arising from time-memory partial integro-differential equations
Authors: Fakharany M. , El-Borai Mahmoud M. , Abu Ibrahim M. A.
Published: November 2022

This paper investigates the partial integro-differential equation of memory type numerically. The differential operator is discretized based on θ-finite difference schemes, while the integral operator is approximated using Simpson's rule. The mesh points of an integral part are adapted to coincide with the nodes of the computational domain using the Heaviside function. The stability of the proposed numerical methods is established based on Gerschgoren's theorems. Also, its consistency is investigated to guarantee the numerical solutions' convergence. Several examples are provided to discuss the efficiency of the used finite difference schemes and compare them with previous studies.
An imaging-based RNA interference screen for modulators of the Rab6-mediated Golgi-to-ER pathway in mammalian cells
Authors: Heffernan Linda F. , Suckrau Pia M. , Banerjee Teerna , Mysior Margaritha M. , Simpson Jeremy C.
Published: November 2022

In mammalian cells, membrane traffic pathways play a critical role in connecting the various compartments of the endomembrane system. Each of these pathways is highly regulated, requiring specific machinery to ensure their fidelity. In the early secretory pathway, transport between the endoplasmic reticulum (ER) and Golgi apparatus is largely regulated via cytoplasmic coat protein complexes that play a role in identifying cargo and forming the transport carriers. The secretory pathway is counterbalanced by the retrograde pathway, which is essential for the recycling of molecules from the Golgi back to the ER. It is believed that there are at least two mechanisms to achieve this - one using the cytoplasmic COPI coat complex, and another, poorly characterised pathway, regulated by the small GTPase Rab6. In this work, we describe a systematic RNA interference screen targeting proteins associated with membrane fusion, in order to identify the machinery responsible for the fusion of Golgi-derived Rab6 carriers at the ER. We not only assess the delivery of Rab6 to the ER, but also one of its cargo molecules, the Shiga-like toxin B-chain. These screens reveal that three proteins, VAMP4, STX5, and SCFD1/SLY1, are all important for the fusion of Rab6 carriers at the ER. Live cell imaging experiments also show that the depletion of SCFD1/SLY1 prevents the membrane fusion event, suggesting that this molecule is an essential regulator of this pathway.
Molecular perspectives in hypertrophic heart disease: An epigenetic approach from chromatin modification
Authors: Lizcano Fernando , Bustamante Lizeth
Published: November 2022

Epigenetic changes induced by environmental factors are increasingly relevant in cardiovascular diseases. The most frequent molecular component in cardiac hypertrophy is the reactivation of fetal genes caused by various pathologies, including obesity, arterial hypertension, aortic valve stenosis, and congenital causes. Despite the multiple investigations performed to achieve information about the molecular components of this pathology, its influence on therapeutic strategies is relatively scarce. Recently, new information has been taken about the proteins that modify the expression of fetal genes reactivated in cardiac hypertrophy. These proteins modify the DNA covalently and induce changes in the structure of chromatin. The relationship between histones and DNA has a recognized control in the expression of genes conditioned by the environment and induces epigenetic variations. The epigenetic modifications that regulate pathological cardiac hypertrophy are performed through changes in genomic stability, chromatin architecture, and gene expression. Histone 3 trimethylation at lysine 4, 9, or 27 (H3-K4; -K9; -K27me3) and histone demethylation at lysine 9 and 79 (H3-K9; -K79) are mediators of reprogramming in pathologic hypertrophy. Within the chromatin architecture modifiers, histone demethylases are a group of proteins that have been shown to play an essential role in cardiac cell differentiation and may also be components in the development of cardiac hypertrophy. In the present work, we review the current knowledge about the influence of epigenetic modifications in the expression of genes involved in cardiac hypertrophy and its possible therapeutic approach.
Sex differences in coronary artery bypass grafting-related morbidity and mortality
Authors: Nurkkala Jouko , Kauko Anni , Palmu Joonatan , Aittokallio Jenni , Niiranen Teemu
Published: November 2022

Background

Coronary artery bypass grafting (CABG) is associated with both cardiovascular disease (CVD) and non-CVD traits. In addition, women’s prognosis after coronary events and revascularizations is worse than in men. As the course of CVD in women differs from that of men, we performed a phenome-wide analysis on the sex differences in CABG -related morbidity and mortality.

Materials and methods

We performed an untargeted analysis on the sex differences in predictors and outcomes of CABG. We studied a sample of 176,680 FinnGen participants, including 5,950 individuals who underwent CABG (4,988 men and 962 women) and were followed between 1998 and 2019. Over 1,100 different traits were analyzed for both sexes and the results were adjusted with age, smoking status and BMI. Cox proportional hazards models with sex-trait interactions were used to estimate the associations between (1) traits and incident CABG; and (2) CABG and incident traits.

Results

In women, CABG was more strongly related to greater increases in risk of diseases such as hypertension, Alzheimer’s, aortic aneurysms, gout, and chronic kidney disease compared to risk increases observed in men (all interaction p-values < 0.03). After CABG, men had 2.5-fold (p = 3.1E−15) and women 6.3-fold (p = 9.4E−08) greater risk of cardiac death compared to same-sex individuals who did not undergo CABG (p for interaction 8.2E−4). Moreover, the risk of death in women remained higher even 12 years after CABG, whereas the long-term risk of death in men was not increased, compared to same-sex individuals who did not undergo CABG.

Conclusion

The adverse outcomes after CABG, both quantity and quality, also appear to differ between men and women. In women, CABG is related to greater long-term increases in risk of cardiac death and several other disease states than in men. Consideration should therefore be given to whether women receive adequate long-term post-operative therapy and follow-up as CABG is not associated with equally improved cardiovascular disease prognosis in women than in men.
The atrial secondary tricuspid regurgitation is associated to more favorable outcome than the ventricular phenotype
Authors: Gavazzoni Mara , Heilbron Francesca , Badano Luigi P. , Radu Noela , Cascella Andrea , Tomaselli Michele , Perelli Francesco , Caravita Sergio , Baratto Claudia , Parati Gianfranco , Muraru Denisa
Published: November 2022

Aim

We sought to evaluate the differences in prognosis between the atrial (A-STR) and the ventricular (V-STR) phenotypes of secondary tricuspid regurgitation.

Materials and methods

Consecutive patients with moderate or severe STR referred for echocardiography were enrolled. A-STR and V-STR were defined according to the last ACC/AHA guidelines criteria. The primary endpoint was the composite of all-cause death and heart failure (HF) hospitalizations.

Results

A total of 211 patients were enrolled. The prevalence of A-STR in our cohort was 26%. Patients with A- STR were significantly older and with lower NYHA functional class than V-STR patients. The prevalence of severe STR was similar (28% in A-STR vs. 37% in V-STR, p = 0.291). A-STR patients had smaller tenting height (TH) (10 ± 4 mm vs. 12 ± 7 mm, p = 0.023), larger end-diastolic tricuspid annulus area (9 ± 2 cm2 vs. 7 ± 6 cm2/m2, p = 0.007), smaller right ventricular (RV) end-diastolic volumes (72 ± 27 ml/m2 vs. 92 ± 38 ml/m2; p = 0.001), and better RV longitudinal function (18 ± 7 mm vs. 16 ± 6 mm; p = 0.126 for TAPSE, and −21 ± 5% vs. −18 ± 5%; p = 0.006, for RV free-wall longitudinal strain, RVFWLS) than V-STR patients. Conversely, RV ejection fraction (RVEF, 48 ± 10% vs. 46 ± 11%, p = 0.257) and maximal right atrial volumes (64 ± 38 ml/m2 vs. 55 ± 23 ml/m2, p = 0.327) were similar between the two groups. After a median follow-up of 10 months, patients with V-STR had a 2.7-fold higher risk (HR: 2.7, 95% CI 95% = 1.3–5.7) of experiencing the combined endpoint than A-STR patients. The factors related to outcomes resulted different between the two STR phenotypes: TR-severity (HR: 5.8, CI 95% = 1, 4–25, P = 0.019) in A-STR patients; TR severity (HR 2.9, 95% CI 1.4–6.3, p = 0.005), RVEF (HR: 0.97, 95% CI 0.94–0.99, p = 0.044), and RVFWLS (HR: 0.93, 95% CI 0.85–0.98, p = 0.009) in V-STR.

Conclusion

Almost one-third of patients referred to the echocardiography laboratory for significant STR have A-STR. A-STR patients had a lower incidence of the combined endpoint than V-STR patients. Moreover, while TR severity was the only independent factor associated to outcome in A-STR patients, TR severity and RV function were independently associated with outcome in V-STR patients.
Hypothermia and its role in patients with ST-segment-elevation myocardial infarction and cardiac arrest
Authors: Keller Karsten , Sagoschen Ingo , Schmitt Volker H. , Münzel Thomas , Gori Tommaso , Hobohm Lukas
Published: November 2022

Background

Patients suffering cardiac arrest resulting from ST-segment-elevation myocardial infarction (STEMI) are at very high risk of death. In addition to reperfusion strategies, therapeutic hypothermia is recommended for cardiac arrest patients who remain unconscious after resuscitation. However, data analysis of the impact of therapeutic hypothermia on survival showed inconsistent results. We aimed to investigate the benefits of therapeutic hypothermia in STEMI patients after cardiopulmonary resuscitation (CPR).

Methods

Patients with STEMI who received CPR were identified after nationwide German inpatient data (2005–2019) were screened. These patients were stratified for therapeutic hypothermia. The impact of hypothermia on mortality and adverse in-hospital outcomes was analyzed.

Results

Overall, 133,070 inpatients with STEMI and CPR (53.3% aged ≥70 years; 34% females) were recorded in Germany between 2005 and 2019, of which 12.3% (16,386 patients) underwent therapeutic hypothermia. Females (23.8 vs. 35.4%, p < 0.001) and patients aged ≥70 years (34.9 vs. 55.9%, p < 0.001) were less frequently treated with therapeutic hypothermia. The in-hospital case fatality rate was lower for STEMI with CPR and subsequent therapeutic hypothermia than for treatment without therapeutic hypothermia (53.5 vs. 66.7%, p < 0.001). Therapeutic hypothermia was independently associated with a reduced in-hospital case fatality rate {OR 0.83 [95% confidence interval (CI) 0.80–0.86], p < 0.001}. In addition, therapeutic hypothermia was associated with an increased risk for stroke (OR 1.37 [95% CI 1.25–1.49], p < 0.001), pneumonia (OR 1.75 [95% CI 1.68–1.82], p < 0.001), and acute kidney injury (OR 2.21 [95% CI 2.07–2.35], p < 0.001).

Conclusion

Therapeutic hypothermia is associated with a survival benefit for STEMI patients after cardiac arrest.
The treatment choices of abdominal aortic aneurysm patients in China in the era of value-based healthcare
Authors: Duan Liren , Xin Wei , Li Shenli , Zhao Lin , Xin Shijie
Published: November 2022

Background

Endovascular aneurysm repair (EVAR) is often seen as the first choice treatment for patients with abdominal aortic aneurysm (AAA), particularly high-risk patients, yet the long-term survival rate and improvement in quality of life are still unclear. In order to seek the value of EVAR to the entire healthcare field, we conducted a retrospective study to evaluate whether the improvement EVAR can truly bring to the quality of medical care in the era of value-based healthcare.

Methods

We included AAA patients who underwent surgical treatment in the Department of Vascular Surgery, First Hospital of China Medical University, from January 1, 2004, to December 31, 2019 and evaluated surgery procedure data, short-term and long-term mortality, complications, prognoses, and medical costs.

Results

We analyzed 507 patients with AAA who underwent open repair (n = 232) or EVAR (n = 275) over a 15-year period. The operative time, blood loss, blood transfusion rate, and postoperative length of hospital stay of the EVAR group is significantly lower than which of the open repair group. Meanwhile, neither short-term nor long-term mortality rates shows significant differences between the two groups. On the other hand, the complication rate of the EVAR group was significantly higher than that of the open repair group. Lastly, the total cost of EVAR was significantly higher than that of open repair.

Conclusion

Existing evidence suggests that EVAR improves neither short-term nor long-term survival rate compared with open surgery. In contrast, the complication rate and the reintervention rate in the EVAR group were higher than those in the open surgery group. Moreover, the cost of EVAR and that paid by medical insurance were higher than those for open surgery. For patients with a long-life expectancy, in order to ensure that patients receive appropriate and effective care, surgeons should choose a suitable method that considers both the quality of medical care as well as the expense accordingly.
Machine learning-based identification of SOX10 as an immune regulator of macrophage in gliomas
Authors: Xiao Gelei , Wang Kaiyue , Wang Zeyu , Dai Ziyu , Liang Xisong , Ye Weijie , Luo Peng , Zhang Jian , Liu Zaoqu , Cheng Quan , Peng Renjun
Published: November 2022

Gliomas, originating from the glial cells, are the most lethal type of primary tumors in the central nervous system. Standard treatments like surgery have not significantly improved the prognosis of glioblastoma patients. Recently, immune therapy has become a novel and effective option. As a conserved group of transcriptional regulators, the Sry-type HMG box (SOX) family has been proved to have a correlation with numerous diseases. Based on the large-scale machine learning, we found that the SOX family, with significant immune characteristics and genomic profiles, can be divided into two distinct clusters in gliomas, among which SOX10 was identified as an excellent immune regulator of macrophage in gliomas. The high expression of SOX10 is related to a shorter OS in LGG, HGG, and pan-cancer groups but benefited from the immunotherapy. It turned out in single-cell sequencing that SOX10 is high in neurons, M1 macrophages, and neural stem cells. Also, macrophages are found to be elevated in the SOX10 high-expression group. SOX10 has a positive correlation with macrophage cytokine production and negative regulation of macrophages’ chemotaxis and migration. In conclusion, our study demonstrates the outstanding cluster ability of the SOX family, indicating that SOX10 is an immune regulator of macrophage in gliomas, which can be an effective target for glioma immunotherapy.
Numerical simulations of generation and propagation of internal tides in the Andaman Sea
Authors: Wang W. , Gong Y. , Wang Z. , Yuan C.
Published: November 2022

The generation and propagation of internal tides in the Andaman Sea are investigated using a three-dimensional high-resolution numerical model. Three categories of experiments, including driving the model with four main semidiurnal tides (M2, S2, N2, and K2), four main diurnal tides (K1, O1, P1, and Q1), and eight main tides (M2, S2, N2, K2, K1, O1, P1, and Q1), are designed to examine the effects of barotropic tides. The results show that the semidiurnal internal tides are dominant in the Andaman Sea, and the inclusion of diurnal barotropic tides negligibly modulates this result. That is partly due to the strength of the diurnal barotropic tides is generally one order smaller than that of the semidiurnal barotropic tides in this region. The sensitivity experiments put this on a firmer footing. In terms of the internal tidal energy, the experiments driven by the diurnal barotropic tides are three orders and one order smaller than those driven by the semidiurnal barotropic tides, respectively, during the spring and neap tides. In addition, the experiments result in total barotropic-to-baroclinic energy conversion rates over the Andaman Sea 29.15 GW (driven by the eight tides), 29.24 GW (driven by the four semidiurnal tides), and 0.05 GW (driven by the fourdiurnal tides) in the spring tidal period and 3.08 GW, 2.56 GW, and 0.31 GW in the neap tidal period, respectively. Four potential generation regions of internal tides are found, three of which are in the Andaman and Nicobar Islands and one in the northeastern Andaman Sea.
Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave
Authors: Dai Yu-Ching , Lin Yen-Chia , Ching Lauren L. , Tseng Alanna C. , Qin Yujia , Nerurkar Vivek R. , Wang Wei-Kung
Published: November 2022

Uncontrolled transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the emergence of several variants of concern (VOC). As vaccine-induced neutralizing antibodies against VOC waned over time, breakthrough infections (BTIs) have been reported primarily among healthcare workers or in long-term care facilities. Most BTIs were identified by reverse transcription-polymerase chain reaction (RT-PCR) or antigen test for individuals experiencing symptoms, known as symptomatic BTIs. In this study, we detected seroconversion of anti-nucleocapsid (N) antibody to identify both symptomatic and asymptomatic BTIs in a cohort of COVID-19-naive university employees and students following two or three doses of mRNA vaccines. We reported 4 BTIs among 85 (4.7%) participants caused by the Omicron and Delta VOC during the transition from the Delta to Omicron wave of the pandemic; three were symptomatic and confirmed by RT-PCR test and one asymptomatic. A symptomatic reinfection two and half months after a BTI was found in one participant. Two of three symptomatic BTIs and the reinfection were confirmed by whole genome sequencing. All were supported by a >4-fold increase in neutralizing antibodies against the Delta or Omicron variant. Moreover, we found both symptomatic and asymptomatic BTIs can boost neutralizing antibodies against VOC with variable degrees ranging from 2.5- to 77.4-fold increase in neutralizing antibody titers. As BTIs continue, our findings highlight the application of anti-N antibody test to ongoing studies of immunity induced by spike-based vaccine, and provide new insights into the establishment of herd immunity in the community during the post-vaccination era.
Dynamics of price competition in Italian pharmaceutical off-patent market
Authors: Perna Serena , Cangini Agnese , Marini Roberto , Guerrizio Maria Alessandra , Da Cas Roberto , Traversa Giuseppe , Trotta Francesco
Published: November 2022

Introduction

The aim of the study was to evaluate, in a regulated generics market, the effect of the number of manufacturers of generic drugs on the amplitude of off-patent products price reduction and the price evolution of originators and generics after the patent expiry of pharmaceuticals dispensed by community pharmacies and reimbursed by the Italian National Health Service (INHS).

Methods

The AIFA “transparency list” was utilized to select unbranded and branded off-patent drug dispensed by community pharmacies and reimbursed by the Italian National Health Service between 2012 and 2018. The unbranded drug entry in the transparency list database was considered as a proxy of its patent expiry.

Results

A total of 42 different active ingredients were included in the analysis. The relative price per dose at time t of unbranded and branded drugs, considering as common denominator the price per dose a year before the patent expiry, (t-1) decreased with the increase of unbranded manufacturers. At the time of the patent expiry, the price of unbranded drugs was almost 50% less than that of branded drugs at t-1 and the price of branded drugs started to decrease before the first unbranded entry.

Conclusion

An inverse relation between the number of generic drug entrants and the price of generics and originators was detected. The patent expiry determines a price decline, more concentrated in the first year of patent expiry.
Costs and effects of telerehabilitation in neurological and cardiological diseases: A systematic review
Authors: Del Pino Rocio , Díez-Cirarda Maria , Ustarroz-Aguirre Iker , Gonzalez-Larragan Susana , Caprino Massimo , Busnatu Stefan , Gand Kai , Schlieter Hannes , Gabilondo Iñigo , Gómez-Esteban Juan Carlos
Published: November 2022

Introduction

Telerehabilitation in neurological and cardiological diseases is an alternative rehabilitation that improves the quality of life and health conditions of patients and enhances the accessibility to health care. However, despite the reported benefits of telerehabilitation, it is necessary to study its impact on the healthcare system.

Methods

The systematic review aims to investigate the costs and results of telerehabilitation in neurological and cardiological diseases. MEDLINE and EMBASE databases were searched from 2005 to 2021, for studies that assess the costs and results of telerehabilitation compared to traditional rehabilitation (center-based programs) in neurological and cardiological diseases. A narrative synthesis of results was carried out.

Results

A total of 8 studies (865 participants) of 430 records were included. Three studies were related to the costs and results of telerehabilitation in neurological diseases (specifically in stroke). In total, five studies assessed telerehabilitation in cardiological diseases (chronic heart failure, coronary heart disease, acute coronary syndrome, and cardiovascular diseases). The duration of the telerehabilitation ranged from 6 to 48 weeks. The studies included cost-analysis, cost-benefit, cost-effectiveness, or cost-utility. In total, four studies found significant cost/savings per person between $565.66 and $2,352.00 (p < 0.05). In contrast, most studies found differences in costs and clinical effects between the telerehabilitation performed and the rehabilitation performed at the clinic. Just one study found quality-adjusted life years (QALY) significant differences between groups [Incremental cost-effectiveness ratio (ICER) per QALY ($−21,666.41/QALY).

Discussion

Telerehabilitation is an excellent alternative to traditional center rehabilitation, which increases the accessibility to rehabilitation to more people, either due to the geographical situation of the patients or the limitations of the health systems. Telerehabilitation seems to be as clinical and cost-effective as traditional rehabilitation, even if, generally, telerehabilitation is less costly. More research is needed to evaluate health-related quality of life and cost-effectiveness in other neurological diseases.

Systematic review registration

[https://figshare.com/articles/journal_ contribution/Review_Protocol_Costs_and_effects_of_Telerehabilitation_in_ Neurological_and_Cardiological_Diseases_A_Systematic_Review/19619838], identifier [19619838].
Profile of coronavirus disease enlightened asthma as a protective factor against death: An epidemiology study from Brazil during the pandemic
Authors: Sansone Nathalia Mariana Santos , Valencise Felipe Eduardo , Bredariol Rafael Fumachi , Peixoto Andressa Oliveira , Marson Fernando Augusto Lima
Published: November 2022

Introduction

The possibility that asthma is not a risk factor for the worst outcomes due to coronavirus disease (COVID-19) is encouraged. The increase in Th2 response dominance can downregulate the late phase of hyperinflammation, which is typically the hallmark of more severe respiratory viral infections, alongside lower angiotensin-converting enzyme receptors in patients with asthma due to chronic inflammation. Few studies associated asthma diagnosis and COVID-19 outcomes. In this context, we aimed to associate the asthma phenotype with the clinical signs, disease progression, and outcomes in patients with COVID-19.

Methods

We performed an epidemiologic study using patients’ characteristics from OpenDataSUS to verify the severity of COVID-19 among Brazilian hospitalized patients with and without the asthma phenotype according to the need for intensive care units, intubation, and deaths. We also evaluated the demographic data (sex, age, place of residence, educational level, and race), the profile of clinical signs, and the comorbidities.

Results

Asthma was present in 43,245/1,129,838 (3.8%) patients. Among the patients with asthma, 74.7% who required invasive ventilatory support evolved to death. In contrast, 78.0% of non-asthmatic patients who required invasive ventilatory support died (OR = 0.83; 95% CI = 0.79–0.88). Also, 20.0% of the patients with asthma that required non-invasive ventilatory support evolved to death, while 23.5% of non-asthmatic patients evolved to death (OR = 0.81; 95% CI = 0.79–0.84). Finally, only 11.2% of the patients with asthma who did not require any ventilatory support evolved to death, while 15.8% of non-asthmatic patients evolved to death (OR = 0.67; 95% CI = 0.62–0.72). In our multivariate analysis, one comorbidity and one clinical characteristic stood out as protective factors against death during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients with asthma were less prone to die than other patients (OR = 0.79; 95% CI = 0.73–0.85), just like puerperal patients (OR = 0.74; 95% CI = 0.56–0.97) compared to other patients.

Conclusion

Asthma was a protective factor for death in hospitalized patients with COVID-19 in Brazil. Despite the study’s limitations on patients’ asthma phenotype information and corticosteroid usage, this study brings to light information regarding a prevalent condition that was considered a risk factor for death in COVID-19, being ultimately protective.
Identifying individuals using proteomics: are we there yet?
Authors: Fierro-Monti Ivo , Wright James C. , Choudhary Jyoti S. , Vizcaíno Juan Antonio
Published: November 2022

Multi-omics approaches including proteomics analyses are becoming an integral component of precision medicine. As clinical proteomics studies gain momentum and their sensitivity increases, research on identifying individuals based on their proteomics data is here examined for risks and ethics-related issues. A great deal of work has already been done on this topic for DNA/RNA sequencing data, but it has yet to be widely studied in other omics fields. The current state-of-the-art for the identification of individuals based solely on proteomics data is explained. Protein sequence variation analysis approaches are covered in more detail, including the available analysis workflows and their limitations. We also outline some previous forensic and omics proteomics studies that are relevant for the identification of individuals. Following that, we discuss the risks of patient reidentification using other proteomics data types such as protein expression abundance and post-translational modification (PTM) profiles. In light of the potential identification of individuals through proteomics data, possible legal and ethical implications are becoming increasingly important in the field.
Histology-informed automatic parcellation of white matter tracts in the rat spinal cord
Authors: Nami Harris , Perone Christian S. , Cohen-Adad Julien
Published: November 2022

The white matter is organized into “tracts” or “bundles,” which connect different parts of the central nervous system. Knowing where these tracts are located in each individual is important for understanding the cause of potential sensorial, motor or cognitive deficits and for developing appropriate treatments. Traditionally, tracts are found using tracer injection, which is a difficult, slow and poorly scalable technique. However, axon populations from a given tract exhibit specific characteristics in terms of morphometrics and myelination. Hence, the delineation of tracts could, in principle, be done based on their morphometry. The objective of this study was to generate automatic parcellation of the rat spinal white matter tracts using the manifold information from scanning electron microscopy images of the entire spinal cord. The axon morphometrics (axon density, axon diameter, myelin thickness and g-ratio) were computed pixelwise following automatic axon segmentation using AxonSeg. The parcellation was based on an agglomerative clustering algorithm to group the tracts. Results show that axon morphometrics provide sufficient information to automatically identify some white matter tracts in the spinal cord, however, not all tracts were correctly identified. Future developments of microstructure quantitative MRI even bring hope for a personalized clustering of white matter tracts in each individual patient. The generated atlas and the associated code can be found at https://github.com/neuropoly/tract-clustering.
Event-related brain potential markers of visual and auditory perception: A useful tool for brain computer interface systems
Authors: Proverbio Alice Mado , Tacchini Marta , Jiang Kaijun
Published: November 2022

Objective

A majority of BCI systems, enabling communication with patients with locked-in syndrome, are based on electroencephalogram (EEG) frequency analysis (e.g., linked to motor imagery) or P300 detection. Only recently, the use of event-related brain potentials (ERPs) has received much attention, especially for face or music recognition, but neuro-engineering research into this new approach has not been carried out yet. The aim of this study was to provide a variety of reliable ERP markers of visual and auditory perception for the development of new and more complex mind-reading systems for reconstructing the mental content from brain activity.

Methods

A total of 30 participants were shown 280 color pictures (adult, infant, and animal faces; human bodies; written words; checkerboards; and objects) and 120 auditory files (speech, music, and affective vocalizations). This paradigm did not involve target selection to avoid artifactual waves linked to decision-making and response preparation (e.g., P300 and motor potentials), masking the neural signature of semantic representation. Overall, 12,000 ERP waveforms × 126 electrode channels (1 million 512,000 ERP waveforms) were processed and artifact-rejected.

Results

Clear and distinct category-dependent markers of perceptual and cognitive processing were identified through statistical analyses, some of which were novel to the literature. Results are discussed from the view of current knowledge of ERP functional properties and with respect to machine learning classification methods previously applied to similar data.

Conclusion

The data showed a high level of accuracy (p ≤ 0.01) in the discriminating the perceptual categories eliciting the various electrical potentials by statistical analyses. Therefore, the ERP markers identified in this study could be significant tools for optimizing BCI systems [pattern recognition or artificial intelligence (AI) algorithms] applied to EEG/ERP signals.
Case report: Varicella-zoster virus infection triggering progressive encephalomyelitis with rigidity and myoclonus
Authors: Yuan Jing , Wang Aihua , Hou Yunfeng , Xu Xuxu
Published: November 2022

Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a rare neurological disease of unknown etiology, and most patients with PERM are positive for anti-glycine receptor (GlyR) antibody. In this case study, we report a clinical case of a varicella-zoster virus-infected patient who developed anti-GlyR antibody-positive PERM. He initially suffered from herpes zoster and gradually developed symptoms of impaired brainstem functions including hoarse voice and dysphagia, accompanied by paroxysmal sympathetic hyperactivity. The patient also suffered from severe spasms, which were easily triggered by external stimuli. Glycine receptor antibodies were then found to be positive in serum and cerebrospinal fluid, and the diagnosis of PERM was confirmed. Methylprednisolone and gamma globulin treatments were given, and spasms were improved after treatment. Unfortunately, the patient's family insisted on automatic discharge and the patient passed away several days later.