Integral Step Research Articles

Is the PHQ-2 a Good Measure to Inform Providers About Patient Well-Being and Functioning? Data From the Veterans Health and Life Survey.

Health care systems are increasingly focused on assessing patient well-being and functioning. The objective of the current analysis was to evaluate a pragmatic question: to what extent and in what way can the PHQ-2, a routinely collected screening measure, be used to help clinicians and a learning health system understand the well-being and functioning of its beneficiaries? The current analysis focused on 2872 Veterans who completed a large-scale longitudinal survey about health and wellness for whom we were able to link survey responses to PHQ-2 scores recorded in their electronic health records (EHR). Regression analyses examined the cross-sectional and longitudinal associations between PHQ-2 scores recorded in the EHR and measures of well-being (life satisfaction, purpose in life, and social health) and functioning (pain severity and interference, physical and mental health, and perceived stress). Veterans were aged 65 years on average (11% women). PHQ-2 scores were correlated cross-sectionally with all well-being and functioning measures; however, there was minimal variance accounted for. Changes in the PHQ-2 over time were associated with 3 measures: purpose in life (b = -0.19; 95% CI: -0.34, -0.04), mental health functioning (b = -0.29, 95% CI: -0.54, -0.04), and perceived stress (b = 0.13; 95% CI: 0.02, 0.24). The PHQ-2 was minimally associated with patient well-being and functioning, with more work needed on how the PHQ-2 may be used in large health care settings within the context of VA Whole Health. Assessment of well-being is critical as VA's Whole Health transformation continues, and identifying strategies for well-being measurement is an integral next step.

Methodological and Practical Basis for the Formation of a Matrix of Attractiveness of Tourist Sites and Its Role in the Process of Implementing Educational Tourism in the Education System of Higher Education Students

The article develops a methodological and practical basis for assessing the attractiveness of regional tourist sites from the point of view of educational tourism. An assessment methodology was created, including groups of criteria and sub-criteria (6 and 53, respectively), selected based on expert evaluation; a matrix was formed, allowing us to calculate integral indicators step by step, which was tested on the example of 50 objects of five regions of Kazakhstan (Central, Northern, Southern, Western and Eastern). In addition, the article implements hierarchical cluster analysis on three blocks of parameters: the first—indicators characterizing the level of education development in the context of 17 regions and 3 cities of republican significance; the second—indicators reflecting the cultural development of the country’s regions; the third—parameters showing the level of development of tourism activities in the regions of Kazakhstan, which allowed us to obtain three clusters that can be used to develop recommendations for the development of education in the regions of Kazakhstan. As a conceptual complementary component of the system of implementation of educational tourism, an audio guide “Tourist sites of Karaganda” was developed and uploaded on the izi.Travel platform.

Tips and Tricks for Image-Guided Breast Biopsies: Technical Factors for Success.

Image-guided biopsy is an integral step in the diagnosis and management of suspicious image-detected breast or axillary lesions, allowing for accurate diagnosis and, if indicated, treatment planning. Tissue sampling can be performed under guidance of a full spectrum of breast imaging modalities, including stereotactic, tomosynthesis, sonographic, and MRI, each with its own set of advantages and limitations. Procedural planning, which includes consideration of technical, patient, and lesion factors, is vital for diagnostic accuracy and limitation of complications. The purpose of this paper is to review and provide guidance for breast imaging radiologists in selecting the best procedural approach for the individual patient to ensure accurate diagnosis and optimal patient outcomes. Common patient and lesion factors that may affect successful sampling and contribute to postbiopsy complications are reviewed and include obesity, limited patient mobility, patient motion, patients prone to vasovagal reactions, history of anticoagulation, and lesion location, such as proximity to vital structures or breast implant.

Some Bifurcations of Codimensions 1 and 2 in a Discrete Predator–Prey Model with Non-Linear Harvesting

This paper delves into the dynamics of a discrete-time predator–prey system. Initially, it presents the existence and stability conditions of the fixed points. Subsequently, by employing the center manifold theorem and bifurcation theory, the conditions for the occurrence of four types of codimension 1 bifurcations (transcritical bifurcation, fold bifurcation, flip bifurcation, and Neimark–Sacker bifurcation) are examined. Then, through several variable substitutions and the introduction of new parameters, the conditions for the existence of codimension 2 bifurcations (fold–flip bifurcation, 1:2 and 1:4 strong resonances) are derived. Finally, some numerical analyses of two-parameter planes are provided. The two-parameter plane plots showcase interesting dynamical behaviors of the discrete system as the integral step size and other parameters vary. These results unveil much richer dynamics of the discrete-time model in comparison to the continuous model.

The biological integrity of natural poly-species symbiotic bacterial communities for the production of kefir: Basic aspects of the preservation

An integral step in kefir production technology is the use of kefir grains, but in some cases it is necessary to maintain their population at the plant. A convenient method is freezing, but with direct freezing, kefir grains lose activity and some microorganisms die off. The use of substances with cryoprotective properties can help preserve kefir grains under direct freezing conditions. The study has examined three environments that have the potential to protect the symbiosis of kefir grains under subcryoscopic conditions: skim sterile milk, gelatin and a sterile solution of 30 % sucrose, and one environment that is stressful – sterile distilled water. At previous stages of research, it was proven that sharp defrosting aggravates the stress phenomena of the bacterial community, in particular, promotes the death of surface lactococci which leads to dysbacteriosis of the symbiosis. The work used for the first time a periodic scheme for defrosting kefir grains in a protective environment; the methods of visual and organoleptic assessment have been applied, the studies of microbiological and physico-chemical parameters of milk after fermentation of kefir starter with kefir grains have been conducted. Milk changes have been carried out using the technology of cultivating kefir grains with daily passages. It is accepted that if based on a set of indicators kefir grains from the experimental groups within 7 days correlate with the indicators detected for the control group, which was not subjected to freezing, then it is accepted that the kefir grains have completely restored viability. If this does not happen, a conclusion is drawn that the symbiosis has not been restored. As a result of the research, the prospects for using the studied substances as protective media have been proven and the need to construct specialized cryoprotective media for direct freezing of kefir grains in order to create your own kefir culture banks has been substantiated. The approach will reduce the use of bacterial substitutes for kefir like direct fermentation starters.

Spaced training activates Miro/Milton-dependent mitochondrial dynamics in neuronal axons to sustain long-term memory

Neurons have differential and fluctuating energy needs across distinct cellular compartments, shaped by brain electrochemical activity associated with cognition. Invitro studies show that mitochondria transport from soma to axons is key to maintaining neuronal energy homeostasis. Nevertheless, whether the spatial distribution of neuronal mitochondria is dynamically adjusted invivo in an experience-dependent manner remains unknown. In Drosophila, associative long-term memory (LTM) formation is initiated by an early and persistent upregulation of mitochondrial pyruvate flux in the axonal compartment of neurons in the mushroom body (MB). Through behavior experiments, super-resolution analysis of mitochondria morphology in the neuronal soma and invivo mitochondrial fluorescence recovery after photobleaching (FRAP) measurements in the axons, we show that LTM induction, contrary to shorter-lived memories, is sustained by the departure of some mitochondria from MB neuronal soma and increased mitochondrial dynamics in the axonal compartment. Accordingly, impairing mitochondrial dynamics abolished the increased pyruvate consumption, specifically after spaced training and in the MB axonal compartment, thereby preventing LTM formation. Our results thus promote reorganization of the mitochondrial network in neurons as an integral step in elaborating high-order cognitive processes.

Molecular dynamics simulation of the effect of temperature on the conformation of ubiquitin protein.

Ubiquitin, a ubiquitous small protein found in all living organisms, is crucial for tagging proteins earmarked for degradation and holds pivotal importance in biomedicine. Protein functionality is intricately linked to its structure. To comprehend the impact of diverse temperatures on ubiquitin protein structure, our study delved into the energy landscape, hydrogen bonding, and overall structural stability of ubiquitin protein at varying temperatures. Through meticulous analysis of root mean square deviation and root mean square fluctuation, we validated the robustness of the simulation conditions employed. Within our simulated system, the bonding energy and electrostatic potential energy exhibited linear augmentation, while the van der Waals energy demonstrated a linear decline. Additionally, our findings highlighted that the α-Helix secondary structure of the ubiquitin protein gradually transitions toward helix destabilization under high-temperature conditions. The secondary structure of ubiquitin protein experiences distinct changes under varying temperatures. The outcomes of our molecular simulations offer a theoretical framework that enhances our comprehension of how temperature impacts the structural stability of ubiquitin protein. These insights contribute not only to a deeper understanding of iniquity's behavior but also hold broader implications in the realm of biomedicine and beyond. All the MD simulations were performed using the GROMACS software with GROMOS96 force field and SPC for water. The ubiquitin protein was put in the center of a cubic box with a length of 8nm, a setting that allowed > 0.8nm in the minimal distance between the protein surface and the box wall. To remove the possible coordinate collision of the configurations, in the beginning, the steepest descent method was used until the maximum force between atoms was under 100kJ/mol·nm with a 0.01nm step size. Minimization was followed by 30ps of position-restrained MD simulation. The protein was restrained to its initial position, and the solvent was freely equilibrated. The product phase was obtained with the whole system simulated for 10ns without any restraint using an integral time step of 1fs with different temperatures. The cutoff for short-range electronic interaction was set to 1.5nm. The long-range interactions were treated with a particle-mesh Ewald (PME) method with a grid width of 1.2nm.

The Impact of Mental Health on Patient Outcomes in Peripheral Arterial Disease and Critical Limb Threatening Ischemia and Potential Avenues to Treatment

The physical consequences of peripheral arterial disease (PAD) are well established, however, the impact of comorbid mental health disorders such as depression and anxiety are not well understood. The impact of psychological stress is not only associated with worse perioperative morbidity and mortality but also with a physiologic cascade that accelerates plaque formation. Increasing screening to identify and subsequently treat comorbid mental health disorders is an integral next step in improving outcomes in PAD management. Failure to adequately address social and psychological impact on PAD patients will further widen the gap in disparities faced by high risk and disenfranchised populations. Integration of mental health professionals, addiction specialists, and community navigators into multidisciplinary care teams can bolster support for PAD patients and improve outcomes.

Metabolite T1 relaxation times decrease across the adult lifespan.

Relaxation correction is an integral step in quantifying brain metabolite concentrations measured by in vivo magnetic resonance spectroscopy (MRS). While most quantification routines assume constant T1 relaxation across age, it is possible that aging alters T1 relaxation rates, as is seen for T2 relaxation. Here, we investigate the age dependence of metabolite T1 relaxation times at 3 T in both gray- and white-matter-rich voxels using publicly available metabolite and metabolite-nulled (single inversion recovery TI = 600 ms) spectra acquired at 3 T using Point RESolved Spectroscopy (PRESS) localization. Data were acquired from voxels in the posterior cingulate cortex (PCC) and centrum semiovale (CSO) in 102 healthy volunteers across 5 decades of life (aged 20-69 years). All spectra were analyzed in Osprey v.2.4.0. To estimate T1 relaxation times for total N-acetyl aspartate at 2.0 ppm (tNAA2.0) and total creatine at 3.0 ppm (tCr3.0), the ratio of modeled metabolite residual amplitudes in the metabolite-nulled spectrum to the full metabolite signal was calculated using the single-inversion-recovery signal equation. Correlations between T1 and subject age were evaluated. Spearman correlations revealed that estimated T1 relaxation times of tNAA2.0 (rs = -0.27; p < 0.006) and tCr3.0 (rs = -0.40; p < 0.001) decreased significantly with age in white-matter-rich CSO, and less steeply for tNAA2.0 (rs = -0.228; p = 0.005) and (not significantly for) tCr3.0 (rs = -0.13; p = 0.196) in graymatter-rich PCC. The analysis harnessed a large publicly available cross-sectional dataset to test an important hypothesis, that metabolite T1 relaxation times change with age. This preliminary study stresses the importance of further work to measure age-normed metabolite T1 relaxation times for accurate quantification of metabolite levels in studies of aging.

Detection of colinear blocks and synteny and evolutionary analyses based on utilization of MCScanX.

As different taxa evolve, gene order often changes slowly enough that chromosomal 'blocks' with conserved gene orders (synteny) are discernible. The MCScanX toolkit ( https://github.com/wyp1125/MCScanX ) was published in 2012 as freely available software for the detection of such 'colinear blocks' and subsequent synteny and evolutionary analyses based on genome-wide gene location and protein sequence information. Owing to its simplicity and high efficiency for colinear block detection, MCScanX provides a powerful tool for conducting diverse synteny and evolutionary analyses. Moreover, the detection of colinear blocks has been embraced as an integral step for pangenome graph construction. Here, new application trends of MCScanX are explored, striving to better connect this increasingly used tool to other tools and accelerate insight generation from exponentially growing sequence data. We provide a detailed protocol that covers how to install MCScanX on diverse platforms, tune parameters, prepare input files from data from the National Center for Biotechnology Information, run MCScanX and its visualization and evolutionary analysis tools, and connect MCScanX with external tools, including MCScanX-transposed, Circos and SynVisio. This protocol is easily implemented by users with minimal computational background and is adaptable to new data of interest to them. The data and utility programs for this protocol can be obtained from http://bdx-consulting.com/mcscanx-protocol .

Solar Landscapes: A Methodology for the Adaptive Integration of Renewable Energy Production into Cultural Landscapes

The increasing use of solar energy is an integral step toward carbon neutrality. At the same time, outdoor solar farms are significantly altering existing cultural landscapes. This work examines the possibilities of integrating the use of solar energy into these landscapes in such a way that the unique, regional character of places is preserved and enhanced. The research project that was carried out developed a conceptual design approach that takes as its starting point landscape architectural and aesthetic analyses of existing sites in Styria, Austria, the spatial characteristics of the cultural landscapes in which they are embedded, and their suitability for generating solar energy. The comparison of a site’s characteristics with the technical possibilities evaluated from a literature review enables a responsive design practice using solar modules. The result is a method of landscape architectural design that integrates solar energy on the basis of an adaptive site-specific approach as well as a catalogue of sample cases that illustrate how designing with solar modules can honor and add value to existing places while enhancing their ecological, economic, and social functions.

Convergence Analysis of Value Iteration Adaptive Dynamic Programming for Continuous-Time Nonlinear Systems.

This article is concerned with the convergence property and error bounds analysis of value iteration (VI) adaptive dynamic programming for continuous-time (CT) nonlinear systems. The size relationship between the total value function and the single integral step cost is described by assuming a contraction assumption. Then, the convergence property of VI is proved while the initial condition is an arbitrary positive semidefinite function. Moreover, the accumulated effects of approximation errors generated in each iteration are taken into consideration while using approximators to implement the algorithm. Based on the contraction assumption, the error bounds condition is proposed, which ensures the approximated iterative results converge to a neighborhood of the optimum, and the relation between the optimal solution and approximated iterative results is also derived. To make the contraction assumption more concrete, an estimation way is proposed to derive a conservative value of the assumption. Finally, three simulation cases are given to validate the theoretical results.

Nanoflowers of Ternary Cobalt–Copper–Manganese Oxide as an Efficient Electrocatalyst for Oxygen Evolution Reaction

Oxygen evolution reaction (OER) is an integral step in the water‐splitting process. Hence, to promote OER, efficient catalysts are required to lower the energy barriers at the electrode/electrolyte interface. Low‐cost and highly active catalysts are in great demand. Herein, a ternary metal oxide, CoCuMnOx, synthesized by a facile hydrothermal method is reported, which possesses excellent catalytic ability for OER in alkaline electrolytes. The nanoscale morphology of the catalyst with flower‐like nanostructures is instrumental in increasing the electrochemical surface area of the electrode. The presence of multivalent ions and the incorporation of copper greatly enhance the electrochemical properties of the catalysts. The catalysts typically demonstrate an overpotential value of 220 mV for achieving 10 mA cm−2 current density and a Tafel slope of 73 mV dec−1. The catalysts demonstrate good stability with minimal degradation in OER activity even after 20 h of chronopotentiometry test. For practical applications, this low‐cost material holds great potential.

LiverZap: a chemoptogenetic tool for global and locally restricted hepatocyte ablation to study cellular behaviours in liver regeneration.

The liver restores its mass and architecture after injury. Yet, investigating morphogenetic cell behaviours and signals that repair tissue architecture at high spatiotemporal resolution remains challenging. We developed LiverZap, a tuneable chemoptogenetic liver injury model in zebrafish. LiverZap employs the formation of a binary FAP-TAP photosensitiser followed by brief near-infrared illumination inducing hepatocyte-specific death and recapitulating mammalian liver injury types. The tool enables local hepatocyte ablation and extended live imaging capturing regenerative cell behaviours, which is crucial for studying cellular interactions at the interface of healthy and damaged tissue. Applying LiverZap, we show that targeted hepatocyte ablation in a small region of interest is sufficient to trigger local liver progenitor-like cell (LPC)-mediated regeneration, challenging the current understanding of liver regeneration. Surprisingly, the LPC response is also elicited in adjacent uninjured tissue, at up to 100 µm distance to the injury. Moreover, dynamic biliary network rearrangement suggests active cell movements from uninjured tissue in response to substantial hepatocyte loss as an integral step of LPC-mediated liver regeneration. This precisely targetable liver cell ablation tool will enable the discovery of key molecular and morphogenetic regeneration paradigms.

Writing a manuscript for publication in a peer-reviewed scientific journal: Guidance from the European Society of ClinicalPharmacy.

Publishing in reputable peer-reviewed journals is an integral step of the clinical pharmacy research process, allowing for knowledge transfer and advancement in clinical pharmacy practice. Writing a manuscript for publication in a journal requires several careful considerations to ensure that research findings are communicated to the satisfaction of editors and reviewers, and effectively to the readers. This commentary provides a summary of themain points to consider, outlining how to: (1) select a suitable journal, (2) tailor the manuscript for the journal readership, (3) organise the content of the manuscript in line with the journal's guidelines, and (4) manage feedback from the peer review process. This commentary reviews the steps of the writing process, identifies common pitfalls, and proposes ways to overcome them. It aims to assist both novice and established researchers in the field of clinical pharmacy to enhance the quality of writing in a research paper to maximise impact.

The TYPHOON Stellar Population Synthesis Survey. I. The Young Stellar Population of the Great Barred Spiral NGC 1365

We analyze TYPHOON long-slit-absorption line spectra of the starburst barred spiral galaxy NGC 1365 obtained with the Progressive Integral Step Method covering an area of 15 kpc2. Applying a population synthesis technique, we determine the spatial distribution of ages and metallicities of the young and old stellar populations together with star formation rates, reddening, extinction, and the ratio R V of extinction to reddening. We detect a clear indication of inside-out growth of the stellar disk beyond 3 kpc characterized by an outward increasing luminosity fraction of the young stellar population, a decreasing average age, and a history of mass growth, which was finished 2 Gyr later in the outermost disk. The metallicity of the young stellar population is clearly super solar but decreases toward larger galactocentric radii with a gradient of −0.02 dex kpc−1. On the other hand, the metal content of the old population does not show a gradient and stays constant at a level roughly 0.4 dex lower than that of the young population. In the center of NGC 1365, we find a confined region where the metallicity of the young population drops dramatically and becomes lower than that of the old population. We attribute this to the infall of metal-poor gas, and additionally, to interrupted chemical evolution where star formation is stopped by active galactic nuclei and supernova feedback and then after several gigayears resumes with gas ejected by stellar winds from earlier generations of stars. We provide a simple model calculation as support for the latter.

Afet Yönetiminde Zarar Görebilirliği Önleyici Yapılar: Bina Yapısal Elemanlarında Poliüre Kaplama

Numerous disasters occur due to the inability to manage risks arising from natural, technological, and human-induced hazards. As a result of these disasters, the magnification of incurred damages underscores the significance of the concept of risk management, an integral step in disaster management. Consequently, efforts to mitigate the adverse effects of earthquakes and other disasters are progressively increasing. However, endeavors aimed at reducing the damages inflicted by earthquakes and other disasters on structures, particularly earthquakes, are not yet at an adequate level. Presently, the importance of alternative solution models to counteract the forces exerted on structures during disasters like earthquakes is on the rise.In this study, unreinforced concrete blocks were coated with flexible polyurea, a state-of-the-art cladding material extensively used in various fields, at different thicknesses. Three-point bending tests were performed on the coated specimens. The data obtained from these tests were analyzed and evaluated. It was concluded that specimens coated with polyurea exhibited higher strengths compared to uncoated specimens. This study introduces the utilization of polyurea flexible composite material in structural elements as an alternative method within the spectrum of precautions taken to enhance the safety of structures against various disasters, primarily earthquakes.

Optimizing the Composition of the Substrate Enhances the Performance of Peroxidase-like Nanozymes in Colorimetric Assays: A Case Study of Prussian Blue and 3,3'-Diaminobenzidine.

One of the emerging trends in modern analytical and bioanalytical chemistry involves the substitution of enzyme labels (such as horseradish peroxidase) with nanozymes (nanoparticles possessing enzyme-like catalytic activity). Since enzymes and nanozymes typically operate through different catalytic mechanisms, it is expected that optimal reaction conditions will also differ. The optimization of substrates for nanozymes usually focuses on determining the ideal pH and temperature. However, in some cases, even this step is overlooked, and commercial substrate formulations designed for enzymes are utilized. This paper demonstrates that not only the pH but also the composition of the substrate buffer, including the buffer species and additives, significantly impact the analytical signal generated by nanozymes. The presence of enhancers such as imidazole in commercial substrates diminishes the catalytic activity of nanozymes, which is demonstrated herein through the use of 3,3'-diaminobenzidine (DAB) and Prussian Blue as a model chromogenic substrate and nanozyme. Conversely, a simple modification to the substrate buffer greatly enhances the performance of nanozymes. Specifically, in this paper, it is demonstrated that buffers such as citrate, MES, HEPES, and TRIS, containing 1.5-2 M NaCl or NH4Cl, substantially increase DAB oxidation by Prussian Blue and yield a higher signal compared to commercial DAB formulations. The central message of this paper is that the optimization of substrate composition should be an integral step in the development of nanozyme-based assays. Herein, a step-by-step optimization of the DAB substrate composition for Prussian Blue nanozymes is presented. The optimized substrate outperforms commercial formulations in terms of efficiency. The effectiveness of the optimized DAB substrate is affirmed through its application in several commonly used immunostaining techniques, including tissue staining, Western blotting assays of immunoglobulins, and dot blot assays of antibodies against SARS-CoV-2.

“Women with Hearts” and the Americanization of Jewish San Francisco, 1850–1880

For San Francisco’s female Jewish pioneers, learning to organize and operate charitable societies was an integral step in their Americanization, or assimilation into American culture. Charity work taught women leadership skills and, at the same time, accustomed their fathers, husbands, and sons to limited forms of female authority within the community. In the process, leaders of San Francisco’s first female-led Jewish charities transformed themselves as well as their community. In some cases, male support for women’s charitable enterprises marked the spread of American Reform Judaism through San Francisco’s pioneer synagogues. In other instances, questions regarding the proper place of women intensified community members’ adherence to the traditions of their fathers. Even so, by founding and leading charitable associations through the period 1850–1880, “women with hearts” transformed Jewish San Francisco, male and female, foreign- and native-born, helping all to become more fully American. The glory of the San Francisco example is that the sources allow us to watch the process unfold, as the female leaders of benevolent agencies trod paths taking them from Jewish immigrants to Jewish Americans, or from well-intentioned but untrained “ladies bountiful” to what Jacob Marcus Rader called the New Woman, the “Jewish social worker.”

Codimension-Two Bifurcations of a Simplified Discrete-Time SIR Model with Nonlinear Incidence and Recovery Rates

In this paper, a simplified discrete-time SIR model with nonlinear incidence and recovery rates is discussed. Here, using the integral step size and the intervention level as control parameters, we mainly discuss three types of codimension-two bifurcations (fold-flip bifurcation, 1:3 resonance, and 1:4 resonance) of the simplified discrete-time SIR model in detail by bifurcation theory and numerical continuation techniques. Parameter conditions for the occurrence of codimension-two bifurcations are obtained by constructing the corresponding approximate normal form with translation and transformation of several parameters and variables. To further confirm the accuracy of our theoretical analysis, numerical simulations such as phase portraits, bifurcation diagrams, and maximum Lyapunov exponents diagrams are provided. In particular, the coexistence of bistability states is observed by giving local attraction basins diagrams of different fixed points under different integral step sizes. It is possible to more clearly illustrate the model’s complex dynamic behavior by combining theoretical analysis and numerical simulation.