Focal Areas Research Articles

Pseudosquamous Adenocarcinoma of the Lung: Clinicopathologic and Immunohistochemical Study of 10 Cases.

Pseudosquamous adenocarcinoma of the lung is an unusual morphologic variant of poorly differentiated non-small cell lung carcinoma that superficially resembles a squamous cell carcinoma. We have examined 10 cases of these tumors in 4 women and 6 men, aged 47 to 93 years. The tumors were all peripheral and measured from 1.5 to 5.5cm. All cases were characterized by solid nests of large polygonal tumor cells containing atypical nuclei with abundant cytoplasm and sharp cell borders, adopting a pavement-like architecture that simulated squamous cell carcinoma. Some cases demonstrated intracytoplasmic hyaline inclusions suggestive of keratinization. The nests of tumor cells often showed central comedo-like areas of necrosis. Intercellular bridges were not seen in any of the cases. The tumors often displayed marked clearing of the cytoplasm enhancing their epidermoid appearance. In 4 cases, the solid pseudosquamous areas were seen to merge with a focal lepidic adenocarcinoma component, and in 1 case, abortive microscopic foci of acinar differentiation were also noted within the tumor. One case showed focal sarcomatoid spindle cell areas. The tumor cells were negative for p40 and CK5/6 and labeled with TTF1 or Napsin-A, confirming an adenocarcinoma phenotype. Clinical follow-up information was available in 8 patients; 6 patients died of their tumors between 6 months to 11 years after diagnosis (mean: 3.1y). One patient died of complications related to surgery and one patient with a low-stage tumor died at 27 years from other causes. Solid pattern adenocarcinomas can be confused for squamous cell carcinoma and may require immunohistochemistry to determine their true phenotype.

Neurosurgical and pharmacological management of dystonia

Dystonia characterizes a group of neurological movement disorders characterized by abnormal muscle movements, often with repetitive or sustained contraction resulting in abnormal posturing. Different types of dystonia present based on the affected body regions and play a prominent role in determining the potential efficacy of a given intervention. For most patients afflicted with these disorders, an exact cause is rarely identified, so treatment mainly focuses on symptomatic alleviation. Pharmacological agents, such as oral anticholinergic administration and botulinum toxin injection, play a major role in the initial treatment of patients. In more severe and/or refractory cases, focal areas for neurosurgical intervention are identified and targeted to improve quality of life. Deep brain stimulation (DBS) targets these anatomical locations to minimize dystonia symptoms. Surgical ablation procedures and peripheral denervation surgeries also offer potential treatment to patients who do not respond to DBS. These management options grant providers and patients the ability to weigh the benefits and risks for each individual patient profile. This review article explores these pharmacological and neurosurgical management modalities for dystonia, providing a comprehensive assessment of each of their benefits and shortcomings.

Quality of life in permanent ostomates - what really matters to them?

The impact of a permanent stoma, such as post-abdominoperineal resection (APR), on quality of life (QoL) is well-documented. While stoma-related QoL tools exist, their relationship with stoma satisfaction is unclear. This study aimed to identify which aspects of QoL were most associated with stoma satisfaction. A cross-sectional study of consecutive patients who had an APR for rectal cancer at an Australian tertiary hospital (2012-2021), identified from a prospectively maintained database, was conducted. The Stoma-QoL questionnaire was used. Overall patient satisfaction with stoma function, and whether healthcare advice was sought for stoma dysfunction, were explored. Linear regression assessed the association between individual issues examined in the Stoma-QoL questionnaire and overall patient satisfaction with stoma function. Overall, 64 patients (62.5% male, mean 68.1 years) participated. Stoma-QoL score was associated with stoma satisfaction (P < 0.05). QoL items impacting satisfaction were: needing to know nearest toilet location (P = 0.04), pouch smell concerns (P = 0.008), needing daytime rest (P = 0.02), clothing limitations (P = 0.02), sexual attractiveness concerns (P < 0.05), embarrassment (P < 0.05), difficulty hiding the pouch (P = 0.02), concerns about being burdensome (P = 0.04) and difficulty with interpersonal interaction (P = 0.03). Only 11 (17.2%) patients sought healthcare advice for stoma dysfunction. While stoma-specific QoL is associated with stoma satisfaction, individual QoL aspects impact differently on satisfaction in permanent colostomy patients. These findings may help identify focus areas for peri-operative counselling for clinicians and stomal therapists, highlight the importance of tailored multidisciplinary care in ostomates and suggests that a stoma type-specific Stoma-QoL questionnaire is required.

Focusing Surface Acoustic Waves with a Plasmonic Hypersonic Lens.

Plasmonic nanoantennas have proven to be efficient transducers of electromagnetic to mechanical energy and vice versa. The sudden thermal expansion of these structures after an ultrafast optical pulsed excitation leads to the emission of hypersonic acoustic waves to the supporting substrate, which can be detected by another antenna that acts as a high-sensitivity mechanical probe due to the strong modulation of its optical response. Here, we propose and experimentally demonstrate a nanoscale acoustic lens comprised of 11 gold nanodisks whose collective oscillation at gigahertz frequencies gives rise to an interference pattern that results in a diffraction-limited surface acoustic beam of about 340 nm width, with an amplitude contrast of 60%. Via spatially decoupled pump-probe experiments, we were able to map the radiated acoustic energy in the proximity of the focal area, obtaining a very good agreement with the continuum elastic theory.

Discover Use Linen Back Baby Carriers in Social Science of Ancient Egypt

This article presents a thought-provoking perspective on a possible link between ancient Egyptian design and ergonomics. Remember that this is an ongoing field of research, and new discoveries or interpretations may challenge or refine the presented ideas. Always strive to critically evaluate sources and consider alternative perspectives when exploring historical topics.The Pharaohs of Egypt innovate the science of ergonomics and the design of infant carriers. Definitive proof of photos ancient Egypt, the explicit evidence does of back baby carriers being used in ancient Egypt, even within the royal household. Considering the cultural context, practical advantages, and potential adaptations for royalty, further research holds promise in unlocking this fascinating aspect of childcare in a bygone era.This article is intended for research informational purposes and should be depended of research professional ergonomics medical advice. And this research paper is a starting point and can be further expanded upon by including specific citations, additional research findings, and personalized discussions based on your specific interests and areas of focus.

Building Blocks for an Energy Transition

The present need for an energy transition in the wake of a global climate catastrophe led to the “EU green deal” which requires a transition of the energy system in all countries. This study aimis survey aims to identify strategies within such an energy transition based on global trend analyses and reports on available technologies for implementation. Based on a literature analysis of over 300 pieces (of feasibility studies and technology implementation reports with a focus on Central Europe) and a statistical analysis of the levels of “energy intensity” (E/GDP) covering three decades and all countries worldwide, the diagnosis is made that steady improvements in several dedicated technological focus areas can be made and were made and could still be increased in the future, as required by climate targets. Across several distinct fields of energy economy, the concrete options for such improvements are portrayed: Energy infrastructure, Smart grids, Transmission grid management, Electricity storage, Heat storage, and Industrial waste heat; and linked with the diagnosed long-term trends emerging from the “Global Change Data Base” GCDB, allowing for a sectorial analysis of the so-called energy intensity, which was not yet delivered until now as time series in the literature. The main findings show which economic sectors and clusters of technologies can be most appropriate to achieve climate targets while safeguarding social aspects of sustainability.

Emotional labour in nursing research: A bibliometric analysis.

This study aims to conduct a comprehensive bibliometric analysis to explore the trajectory and thematic developments of emotional labour research in nursing. Utilizing descriptive and bibliometric analysis techniques. The data analysis and graphical presentation were conducted using the Bibliometrix Package in R software. The Web of Science Core Collection (WoSCC) database was searched on October 20, 2023. From 1992 to 2023, 842 authors published relevant articles, yielding 779 author keywords. There has been a general upward trend in the number of articles published over the past 30 years, with an annual growth rate of 11.71%. Keyword co-occurrence cluster analysis revealed the main focus areas of research on emotional labour antecedents and consequences, regulatory modalities, training and education, as well as research methods and application scenarios. Emotional labour significantly influences nursing staff's well-being and patient care outcomes. Effective management and education regarding emotional labour are crucial for enhancing nursing staff performance and patient care quality. Future research should focus on long-term effects, training efficacy, regulatory strategies across clinical settings, and innovative approaches to address current challenges. This study provides valuable insights into the unique trajectory and thematic developments of emotional labour research in nursing. The findings underscore the importance of addressing emotional labour in nursing practice and education to improve patient care outcomes and nursing staff well-being. Adherence to recognized bibliometric reporting methods, following relevant EQUATOR guidelines. This study is based solely on existing literature and did not involve patients or the public in its design, conduct, analysis, interpretation, or preparation.

Environmental stewardship in the oil and gas sector: Current practices and future directions

This paper provides an overview of the current practices and future directions in environmental stewardship within the oil and gas industry, focusing on key areas of concern and strategies for improvement. The oil and gas industry has made significant strides in environmental stewardship in recent years, driven by a combination of regulatory requirements, corporate initiatives, and stakeholder pressure. One of the primary areas of focus has been the reduction of greenhouse gas emissions associated with extraction, refining, and transportation processes. Companies have implemented technologies such as carbon capture and storage to minimize their carbon footprint, alongside investments in renewable energy sources and energy efficiency measures to transition towards cleaner energy alternatives. Furthermore, the industry has placed increasing emphasis on the responsible management of water resources, recognizing the potential environmental impacts of water extraction and usage in oil and gas operations. Strategies for water recycling, reuse, and wastewater treatment have been adopted to mitigate pollution and minimize strain on local ecosystems. Biodiversity conservation has also emerged as a critical aspect of environmental stewardship in the oil and gas sector, with companies undertaking environmental impact assessments and collaborating with conservation organizations to minimize habitat disruption and restore ecosystems affected by their operations. Community engagement and social responsibility are integral components of environmental stewardship, with companies seeking to address the social impacts of their operations through employment opportunities, infrastructure development, and social programs benefiting local communities. However, the industry continues to face challenges and limitations in its efforts to minimize environmental impact. Accidental spills, leaks, and other incidents pose significant ecological risks, highlighting the importance of stringent safety regulations and emergency response protocols. Moreover, the transition to renewable energy presents challenges for traditional oil and gas companies, requiring substantial capital investment and strategic planning. To address these challenges and advance environmental stewardship, several future directions are proposed. These include accelerating the transition to renewable energy, enhancing transparency and accountability in reporting environmental performance, strengthening environmental regulations and enforcement, investing in research and development of innovative technologies, and fostering collaboration among industry stakeholders, governments, NGOs, and local communities. Keywords: Stewardship, Oil, Gas, Sustainability, Climate, Mitigation

Earthquakes Three-Stage Early Warning and Short-Term Prediction

Among the anomalous geophysical phenomena observed preceding earthquakes, specific attention has been given to VLF/LF, ULF (very low frequency/low frequency, ultra-low frequency) electromagnetic (EM) emissions, recorded before earthquakes, because of an interesting correlation between them and seismic activity. Numerous scientific papers have been published on this topic, providing convincing evidence of these processes observed using ground-based and satellite ground-based observations during the preparation for the earthquake. These phenomena are detectable both at laboratory and geological scales. The authors of this paper have used an avalanche-like unstable geological model of fault formation and a model of the generation of electromagnetic emissions detected before the earthquakes to prove the prediction capabilities of VLF/LF EM emissions. The first gives a clear imagination of earthquake preparation in all stages in the focal area from the beginning of the micro-cracks appearing to the final formation of fault. Another one, based on electrodynamics, explains the EM emissions origination process and offers a formula that analytically connects the observed frequency of EM radiation with the linear size of the emitted body (fault). It is worth emphasizing the synthesis and rather harmonious relation of the mentioned models. Based on the above models conducted studies clearly show that the description of a qualitative avalanche-unstable geological model of fault formation using VLF/LF EM radiation data made it possible to quantitatively characterize the full cycle of preparation and occurrence of earthquake process. Namely, in the case of VLF/LF emissions monitoring, the beginning of the “avalanche process” of ruptures is considered the first stage of early warning of an incoming earthquake. The so-called EM emissions “silence” period is assessed as the second stage of early warning. The third early warning or an alarm about an incoming earthquake may be announced immediately at the moment of the first anomaly appearance subsequently the “silence” period. This article offers the method of earthquake three-step early warning and short-term (hourly) prediction.

IMPACT OF GST ON INDIAN BUSINESSES

The Goods and Services Tax (GST) regime in India, implemented in July 2017, represents a transformative overhaul of the country's indirect tax system. This research paper extensively analyzes the multifaceted impact of GST on Indian businesses across various sectors. By harmonizing numerous central and state levies into a unified tax structure, GST aims to simplify compliance, boost economic growth, and cultivate a common national market. The study delves into the intricate aspects of GST, encompassing its objectives, statutory framework, and implementation challenges. It evaluates the profound implications for diverse business entities, ranging from large corporations to micro, small, and medium enterprises (MSMEs). Key areas of focus include supply chain optimization, pricing strategies, working capital management, and transitional complexities. Furthermore, the paper scrutinizes sector-specific ramifications, shedding light on industries experiencing seismic shifts due to GST, such as manufacturing, services, e-commerce, and real estate. It also examines the role of technology in facilitating GST compliance and the digital transformation catalyzed by this tax reform. Through empirical analysis and case studies, the research paper assesses the extent to which GST has achieved its intended objectives, identifying areas of success and ongoing challenges. It provides valuable insights for policymakers, industry stakeholders, and academics, contributing to the discourse on optimizing the GST framework for enhanced economic competitiveness and ease of doing business in India. Keywords: GST, Indian Businesses, Tax Reform, Supply Chain, Compliance, Digital Transformation, Sectoral Impact, Economic Growth, Policy Implications.

Systematic Approach to Evaluate the State of Illinois’ Preparedness for Smart Mobility

Connected, automated, shared, and electric (CASE) technologies are shaping Mobility 4.0—a connected, digitized, multimodal, and autonomous system of systems that is challenging past and existing strategic transportation planning practices at state and local levels. A systematic approach is presented to aid transportation agencies in their planning needs to evaluate preparedness for smart mobility. Guided by a set of online surveys, interviews, and workshops conducted among different stakeholders, this paper identifies strengths and opportunities to leverage the state’s public, private, and academic sector resources to prepare agencies in realizing the potential opportunities of Mobility 4.0 technologies, while avoiding possible pitfalls in the process. Seven smart mobility pillars were identified and ranked through a balanced scorecard analysis in this study for Illinois—namely (in decreasing order of importance), alternative fuels, scaling intelligent transportation systems, connected and automated (CA) freight, farm automation, CA logistics, insurance, and urban mobility. Tactical focus areas were also identified for each pillar and prioritized with suggested leads and stakeholders to champion the CASE directives and opportunities. Near-term actions were also suggested that included establishing a central structure for Illinois’ CASE program, enriching the knowledge base and experience, preparing the transportation infrastructure, partnerships with external stakeholders, and expansion of laws, regulations, and policies that will help administer and grow CASE technology deployment and integration.

Precision agriculture in the United States: A comprehensive meta-review inspiring further research, innovation, and adoption

Precision agriculture has emerged as a dominant force in the United States, with widespread adoption of advanced technologies and decision support systems (DSS) since the 1980s. Key tools such as variable rate application (VRA), autopilot systems, and remote sensing have become integral for U.S. farmers, offering invaluable insights from crop, soil, and weather information to optimize agricultural production while minimizing environmental impact. To synthesize and categorize the extensive research available on precision agriculture, a systematic review protocol has been designed. Our objective is to offer clear and authoritative insights into the nature, scope, and volume of this field. Implementing a rigorous search strategy, we utilized renowned databases such as Scopus® and Web of ScienceTM to gather relevant and significant materiality. The retrieval process involved the use of indexing terms and Boolean operators, with a focus on ’precision agriculture’ and ’precision farming’, striking a balance between specificity and comprehensiveness. To ensure the credibility of our findings, only peer-reviewed papers authored by individuals affiliated with U.S. institutions have been included. Expert reviewers with deep knowledge in the field independently assessed the selected papers, thoroughly evaluating titles, abstracts, keywords, methods, conclusions, and declarations. Consistency and eligibility were paramount in determining which papers met the criteria for inclusion. Any discrepancies or disagreements were resolved through rigorous consensus-building discussions among the reviewers. Through this comprehensive meta-review, we provide a scientific contribution that enhances our understanding of precision agriculture, highlighting focus areas for further research and development (R&D). By synthesizing and categorizing the existing literature, we offer authoritative insights into the research landscape, informing future investigations and fostering innovation. Focusing specifically on the U.S., we shed light on the unique aspects and pioneering advancements in precision agriculture within the country. Ultimately, our findings have the potential to drive progress, contributing to sustainable development, increased productivity, enhanced environmental sustainability, and responsible agricultural practices.

The Convergence of Artificial Intelligence and Blockchain: The State of Play and the Road Ahead

Artificial intelligence (AI) and blockchain technology have emerged as increasingly prevalent and influential elements shaping global trends in Information and Communications Technology (ICT). Namely, the synergistic combination of blockchain and AI introduces beneficial, unique features with the potential to enhance the performance and efficiency of existing ICT systems. However, presently, the confluence of these two disruptive technologies remains in a rather nascent stage, undergoing continuous exploration and study. In this context, the work at hand offers insight regarding the most significant features of the AI and blockchain intersection. Sixteen outstanding, recent articles exploring the combination of AI and blockchain technology have been systematically selected and thoroughly investigated. From them, fourteen key features have been extracted, including data security and privacy, data encryption, data sharing, decentralized intelligent systems, efficiency, automated decision systems, collective decision making, scalability, system security, transparency, sustainability, device cooperation, and mining hardware design. Moreover, drawing upon the related literature stemming from major digital databases, we constructed a timeline of this technological convergence comprising three eras: emerging, convergence, and application. For the convergence era, we categorized the pertinent features into three primary groups: data manipulation, potential applicability to legacy systems, and hardware issues. For the application era, we elaborate on the impact of this technology fusion from the perspective of five distinct focus areas, from Internet of Things applications and cybersecurity, to finance, energy, and smart cities. This multifaceted, but succinct analysis is instrumental in delineating the timeline of AI and blockchain convergence and pinpointing the unique characteristics inherent in their integration. The paper culminates by highlighting the prevailing challenges and unresolved questions in blockchain and AI-based systems, thereby charting potential avenues for future scholarly inquiry.

Quality and Safety in Nursing: Recommendations From a Systematic Review.

As a consistent 24-hour presence in hospitals, nurses play a pivotal role in ensuring the quality and safety (Q&S) of patient care. However, a comprehensive review of evidence-based recommendations to guide nursing interventions that enhance the Q&S of patient care is lacking. Therefore, the purpose of our systematic review was to create evidence-based recommendations for the Q&S component of a nursing professional practice model for military hospitals. To accomplish this, a triservice military nursing team used Covidence software to conduct a systematic review of the literature across five databases. Two hundred forty-nine articles met inclusion criteria. From these articles, we created 94 recommendations for practice and identified eight focus areas from the literature: (1) communication; (2) adverse events; (3) leadership; (4) patient experience; (5) quality improvement; (6) safety culture/committees; (7) staffing/workload/work environment; and (8) technology/electronic health record. These findings provide suggestions for implementing Q&S practices that could be adapted to many healthcare delivery systems.

Autism in girls: ‘Camouflaging,’ social functioning, and diagnostic dilemmas

The subject of autism spectrum disorder (ASD) diagnosis in girls has become an important area of clinical and research focus. For years, the male:female ratio of ASD has been estimated as approximately 4:1, with affected girls historically presenting with a higher likelihood of significant intellectual impairments. Clinicians and researchers have increasingly questioned this ratio, with findings indicating that girls with average or higher intellectual and/or verbal functioning have a different phenotype than males affected with ASD.

Excessive left anterior hippocampal and caudate activation in schizophrenia underlie cognitive underperformance in a virtual navigation task

We used a virtual navigation paradigm in a city environment to assess neuroanatomical correlates of cognitive deficits in schizophrenia spectrum disorders (SSD). We studied a total of N = 36 subjects: 18 with SSD and 18 matched unaffected controls. Participants completed 10 rapid, single-trial navigation tasks within the virtual city while undergoing functional magnetic resonance imaging (fMRI). All trials tested ability to find different targets seen earlier, during the passive viewing of a path around different city blocks. SSD patients had difficulty finding previously-encountered targets, were less likely to find novel shortcuts to targets, and more likely to attempt retracing of the path observed during passive viewing. Based on a priori region-of-interest analyses, SSD participants had hyperactivation of the left hippocampus when passively viewing turns, hyperactivation of the left caudate when finding targets, and hypoactivation of a focal area of the dorsolateral prefrontal cortex when targets were initially shown during passive viewing. We propose that these brain-behaviour relations may bias or reinforce stimulus-response navigation approaches in SSD and underlie impaired performance when allocentric spatial memory is required, such as when forming efficient shortcuts. This pattern may extend to more general cognitive impairments in SSD that could be used to design remediation strategies.

Radiation-induced DNA double-strand breaks in cortisol exposed fibroblasts as quantified with the novel foci-integrated damage complexity score (FIDCS)

Without the protective shielding of Earth’s atmosphere, astronauts face higher doses of ionizing radiation in space, causing serious health concerns. Highly charged and high energy (HZE) particles are particularly effective in causing complex and difficult-to-repair DNA double-strand breaks compared to low linear energy transfer. Additionally, chronic cortisol exposure during spaceflight raises further concerns, although its specific impact on DNA damage and repair remains unknown. This study explorers the effect of different radiation qualities (photons, protons, carbon, and iron ions) on the DNA damage and repair of cortisol-conditioned primary human dermal fibroblasts. Besides, we introduce a new measure, the Foci-Integrated Damage Complexity Score (FIDCS), to assess DNA damage complexity by analyzing focus area and fluorescent intensity. Our results show that the FIDCS captured the DNA damage induced by different radiation qualities better than counting the number of foci, as traditionally done. Besides, using this measure, we were able to identify differences in DNA damage between cortisol-exposed cells and controls. This suggests that, besides measuring the total number of foci, considering the complexity of the DNA damage by means of the FIDCS can provide additional and, in our case, improved information when comparing different radiation qualities.

Investigating the CO2 Geological Sequestration Potential of Extralow-Permeability Reservoirs: Insights from the Es1 Member of the Shahejie Formation in the Dawa Oilfield

Investigating the CO2 Geological Sequestration Potential of Extralow-Permeability Reservoirs: Insights from the Es1 Member of the Shahejie Formation in the Dawa Oilfield

Exploring the dynamics of physician-patient relationships: Factors affecting patient satisfaction and complaints.

This review identifes the factors influencing the relationship between physicians and patients that can lead to patients' dissatisfaction and medical complaints. Utilizing a systemic approach 92 studies were retrieved which included quantitative, qualitative, and mixed method studies. Through a thematic analysis of the literature, we identified three interrelated main themes that can influence the relationship between physicians and patients, patients' satisfaction, and the decision to file a medico-legal complaint. The main themes include patient and physician characteristics; the interpersonal relationship between physicians and patients; and the health care system and policies, with relevant subthemes. These themes are demonstrated in a descriptive model. The review suggests areas of focus for physicians who may wish to increase their awareness around the potential sources of relational problems with their patients. Identifying these issues may assist in improvements in the therapeutic relationship with patients, can reduce their medico-legal risk, and enhance the quality of their clinical practice. The findings can also be utilized to support andragogical principles for medical learners. The article can serve as a structured framework to identify potential problems and gaps to design and test effective interventions to mitigate these potential relational problems between physician-patient.

Australia’s ECEC workforce pipeline: Who and how many are pursuing further qualifications?

AbstractThe significant shortfall of staff in the early childhood education and care (ECEC) workforce identifies an imperative not only to recruit educators but to support ongoing qualifications and career advancement of those within. Indeed, Shaping Our Future, Australia’s workforce strategy for 2022–2031 identifies qualifications and career development as key focus areas. Taking this imperative, we asked Who? and How many? within the Australian workforce are committed to ongoing study? Analysing a national survey (N = 1291), we examine characteristics of those studying (20.5%) intending (52.3%) or wavering about further study (18.7%). Study and study intention were associated with being younger and at early career-stage, identifying a positive message for career growth. Those who were older or working part-time were less certain about ongoing training. Those with long tenure in ECEC had higher rates of studying for non-ECEC qualifications. Implications for qualification pipeline, career pathways and workforce strategy are discussed.